Menopause
The perimenopause period paves way to the menopausal period which is closely followed by post menopause period. Post menopause is usually defined as more than twelve months or more without periods, in someone with intact normal ovaries or immediately following surgery, if ovaries have been removed as Currie (2006) records. Since it is a period that is usually characterized by a lot of changes, most women dread it and there are a lot of misconceptions about the same. In view of the fact that it is a key phase in the development cycle of a woman, it is important to study it more comprehensively. This essay shall discuss the issue of menopause in all aspects, biological, psychological, sociological, cultural and in any other perspective that can help in understanding the issue better.
The reproductive system of a woman is usually controlled by hormone estrogen which in turn controls ovulation. High levels of hormone estrogen stimulate the releasing of the luteinising hormone by the pituitary glands, which in turn enhances the release of the egg, a process known as ovulation. The numbers of eggs released continue to decrease as age progresses. There is a gradual decrease of release of eggs during puberty and continues to decrease up to the age forty, after which the decreased level of estrogen leads to as rapid decrease of the same. During this period, there are occasional menstrual periods which characterize peri menopause phase. The irregular periods which are experienced during the perimenopause result from irregular shedding of the womb. During the initial stages, the ovaries are not usually very stable such that the cycle may be normal for some months and abnormal in others. Slowly, the number of irregular menstrual cycles increases up to a time when no follicles develop, the level of estrogen and progesterone become very low and the lining of the womb is actually not stimulated at all. At this point the periods stop and the level of the follicle stimulating hormone remain high (Currie 2006).
The three stages are characterized by different symptoms which are usually experienced by about 70-80 of women (Currie 2006). Despite the fact that these symptoms are also influenced by diet, lifestyle and exercise, majority are believed to result from change in hormonal levels. Women experience these symptoms differently depending with their different styles. Women, who do not smoke, eat a healthy diet, exercise regularly, and dont take alcohol experience less severe menopause symptoms. Therefore, this affirms that there are other factors that influence these symptoms apart from low levels of estrogen and progesterone.
The very early symptom that most of the women experience is the change in the menstrual periods. They become irregular such that they can be shorter or even last longer. The flow may also increase or it can be reduced. However, the change of the periods is usually a normal change but incase the abnormal changes are noticed, medical assistance ought to be sought. The change in periods usually paves way for other physical and psychological changes. It would be important to look at some of these changes more extensively so as to understand better all issues related to menopause.
Physical symptoms are inclusive but not limited to night sweats, hot flushes, insomnia, headaches, breast tenderness, joint aches and palpitations. Of all these, hot flushes which are also known as vasomotor symptoms affect quite a considerable number of women. Since they occur occasionally, they do not cause much distress expect to some few women. However, to some women, the same symptom can lead to distress which affects their work and sleep. On average, some women are affected by hot flushes for about two years but in some abnormal circumstances they have been known to last for about fifteen years. While experiencing the flush, the upper part of the body feels hot, the skin turns red and sweating may occur. It is quite disturbing but it does not last for long, for it takes about two to three minutes (Currie 2006).
Most women do not actually understand much about the hot flushes and it can be quite disturbing at that particular time. For instance, National Institute of Aging (2008), reports that in one cool day, Ellen and Sue were watching their teenage boys playing soccer when one of them by the name Ellen, experienced a hot flush and started to sweat. When Sue became concerned, Ellen explained that it was a hot flush and she was accustomed to it for she was already experiencing it more often, during the day and at night. She went on to explain to her friend that initially she did not know what it was, until her doctor explained that it was a menopause symptom. Sue only laughed and said that she remembers such although she does not experience them any more. The story of Ellen and Sue clearly illustrate that hot flushes affect women during the perimenopause stage and do not actually last forever. Sue told her friend that though she used to experience them, she had already stopped experiencing such. Yet another story derived from Hamiliton (2004) explains a womans experience during menopause.
After Christine turned fifty she started to feel emotional such that she would cry at very small things and also lose temper very easily. Despite the fact that she knew she was at menopausal age, she was expecting hot flushes, night sweats and change in periods. Since she was still passing through some problems like difficult court cases, she thought the emotional problems were as a result of stress. Her beloved Husband Neil also thought stress was as all that was making her to be emotional. She often felt guilty of how she was treating her husband but she could not have helped it. She started to put on weight but she still thought it was due to stress. Her symptoms continued for a whole year, and for that time she was still in ignorance. Even though at times she thought it was menopause she was too busy to think about it and still felt embarrassed to speak about it since in her community, menopause was considered to be a taboo.
Fortunately or unfortunately, she developed some health problems that forced her to go to hospital to have a blood test. It was after the test that the doctor noticed that her estrogen levels were down and diagnosed menopause. She felt relieved, after knowing that her problems resulted from hormonal changes. To relieve the symptoms, she used to exercise daily, take a healthy diet as well as calcium tablets to reduce chances of developing osteoporosis. Having gone through that period successfully she felt that she would not opt to go for hormonal replacement therapy.
Although in most cases the symptoms are synonymous some of the symptoms discussed below may not affect all women as highlighted in the Christines story. Insomnia is yet another symptom that affects most women and can be worsened by the hot flushes. Nearly all women usually complain of lack of sleep such that they stay for too long without getting sleep or they wake up too early. The situation worsens when they are woken up by the hot flashes and getting back to sleep again becomes a problem. There are still other symptoms like the joint aches which can be taken to be symptoms of other diseases but they are still perimenopause symptoms. Most of the women in this stage usually complain of joint aches around the neck, wrist and the shoulders. Weight gain is also a common symptom of menopause because most women in this stage have recorded an increase in weight.
Although most of these physical symptoms result from decreased level of estrogen, breast tenderness is usually caused by high levels of estrogen which occur when the level of the same fluctuates. The same problem is also caused by weight gain and fluid retention. Whichever the case, there are many physical symptoms which can be associated with perimenopause but the problem in categorizing the symptoms usually arises because adequate research has not been conducted in this area .
The hormonal symptoms also result to psychological changes whether directly or indirectly. Currie (2006) records that most women experience mood swings, anxiety, forgetfulness and irritability. Some of these symptoms may be closely related to the sleep disturbances and other life events that are more prevalent at this particular stage, like worries about children, relatives, lack of enough finances to cater for the family problems among others. Since women usually have a lot of cares, the symptoms some times become unbearable, though with enough family and medical support they are usually able to cope with all the symptoms.
The low estrogen levels lead to dryness of the vaginal which causes a lot of discomfort during sexual intercourse. As a result, most of the women lose interest in sex. Some of the menopause symptoms like insomnia and hot flushes can also contribute greatly to sex problems as well as other problems that women may be going through at this stage. All these early symptoms may last for a period of few months and in some instances, they may last for a period of between two to five years. As discussed earlier, there is deficiency in research necessary to confirm how these symptoms are related to hormonal changes.
After menopause, there are still other symptoms that follow almost immediately and are usually referred to as post menopausal symptoms. These symptoms are usually due to effects of a reduced level of estrogen on the vagina and the bladder. They include leakage of urine, vaginal discomfort, burning and itching, discomfort usually experienced during intercourse and while passing urine, and vaginal discharge. Most of such symptoms are the same in almost all women, although the severity may vary from one woman to another due to different lifestyles. Other symptoms that may be as a result of menopause include hair thinning or extra hair, depression, memory loss and skin problems.
Most of these menopause problems are quite disturbing and some women usually seek medical attention so as to reduce the severity of the same. Some doctors prescribe birth control pills to women with heavy and irregular periods and it actually helps to alleviate the problem. In addition, birth pills help to reduce the severity of the hot flushes. There are a lot of other interventions that can help control the severity of the menopausal problem but since the main cause is hormonal imbalances most women go for the hormone replacement therapy (National Institute on Aging, 2008).
Hormone replacement therapy is a treatment that involves use of hormones so as to treat certain medical conditions and more so menopausal problems that affect women. Hormones that are used in this mode of treatment are usually synthetic for they are manufactured in a laboratory. However, once inside the body these hormones act alike natural hormones and that is the reason as to why they have been used to treat problems that emanate from hormonal imbalances. The therapy which was developed in 1960s requires women to take small doses of hormone estrogen and progesterone. Since then, the therapy has been very popular especially in the United States until recently, when some concerns were raised that the therapy may actually pose some health risks to the users (Callahan 1993).
In view of the fact that the hormones act just like the natural hormones once in the body as highlighted earlier, women are very much fond of this therapy since it helps them to continue functioning normally even though the levels of estrogen and progesterone are usually low at this stage. The therapy has also been known to protect women from other diseases like osteoporosis since their cause is closely related to low levels of estrogen in the body. Nonetheless, every medicine has got some side effects. After the continued use of the hormonal replacement therapy, Women Health Initiative was set up so as to study the most probable side effects of the hormone replacement therapy. Although this study was stopped after it was realized that the HRT risks are more than the benefits that can be realized from the same, it was set up to study the health of women who had gone though the therapy as measure to prevent the onset of the menopausal symptoms. The same study found out that continued use of the HRT led to the increased risk of breast cancer heart attack, blood clots and some strokes. Compared to women who did not use the therapy, the risk of these conditions was found to be 8 more in women who had used the hormone replacement therapy for a period that exceeded five months (American Academy of Family Physicians 2008).
Menopause is a natural phenomenon and women can go through it without much trouble if they can only learn to be positive about it and be ready to cope with all the eventualities of the same. If only they can become more relaxed during this period and have supportive family members the period can easily pass without much havoc. Some problems like insomnia can be addressed by ensuring that the conditions necessary to enhance sleep are put in place so as to avoid the sleep disturbances. Some studies have revealed that reduced use of drugs like alcohol and beverages that contain nicotine and caffeine can contribute greatly in reliving the problems associated with menopause (Currie 2006).
Different cultures regard the issue of menopause differently and that affects the women who are in that particular stage. For instance the medical culture portrays women in menopause as people who are hormone deficiency and in need of medication (Fecteau 2002). Further studies illustrate that the same contribute to the negative view of menopause as people view these women as people in need of hormones so as to treat their ailments. As a result of this, women usually go for the hormonal replacement therapy so as to treat menopause symptoms. However, other cultures view the issue of menopause differently, in a more positive way like some modern western societies. In some cultures like in the African American societies, the issue of menopause is viewed to as a relief, more so economically, as it marks the end of the pregnancies. Since the African American women have more exposure to the family counselors and family groups where they learn more about the realities of menopause, they view the issue in a more positive and neutral way compared to women in other cultures. Menopause symptoms still vary from one culture to another such that in some instances, some symptoms are not mentioned like in Japan, sweats are never mentioned though it is difficult to know whether they actually have them or it is only that they do not talk about them.
Although there are a lot of negative aspects of menopause some positive aspects about the same have also been reported. Most people view it as a phase that leads to increased sense of freedom from fear of pregnancy, childcare responsibilities, menstruation and freedom for a woman to concentrate on personal needs and goals. However, the positive aspect of increased sense of freedom is only reported in those cultures where women independence is highly recognized. The increased sense of freedom especially from pregnancy and menstruation improves women sexual life. Therefore, even though menopause symptoms affect the sexual life of women negatively, sexual confidence can still improve with age but this is usually dependent on the attitude attached to the menopause.
Apart from cultural, biological, and social factors that affect menopause, psychological factors also affect the menopause either negatively or positively. Women having problems in their relationships are bound to experience more problems in menopause than those who are in healthy and less problematic relationships. Similarly, women with a high self esteem have also been reported to experience less problematic symptoms compared to women with a low self esteem. On the other hand, menopause also affects women psychologically because it is a phase that involves change of a woman perceived role in life as a child bearer and the same lead to a low self esteem.
Menopause, though a stage that signifies the cessation of menstruation in women has a lot of issues related to it. A lot of changes take place during, before and after menopause. During the perimenopause a lot is experienced like the changes in periods. After menopause, more changes still take place especially because low levels of estrogen have some effects on the bladder and vagina. However, even though majority of these changes are synonymous in most women, the severity is not the same due to different attitudes and perceptions. Different cultures have different views about the same and therefore have got different intervention methods. Some go to an extent of using herbal medicine so as to relive the severity of the symptoms. In the medical culture, the hormonal replacement therapy is used and it is effective although some risks are involved. Psychological factors also affect the issue of menopause such that women suffering from psychological disturbances are more affected compared to others with no such disturbances. The various interviews that have been conducted show that since there are a lot of misconceptions about the issue of menopause, women need to be taught concerning the reality of the same and through that, they can be empowered to wait and face menopause in a more positive manner.
A Check List for Menopause Symptoms
Menopause symptoms
Peri Menopause
Hot flashes, night sweats and cold flashes
Bone loss
Weight gain
Insomnia
Dry skin and hair loss
Mood changes, Irritability
Vaginal dryness
Heart palpitations
Inability to hold urine
Sudden bouts and bloats
Difficulty in concentrating and confusion
Loss or decreased sexual desire
Respiratory problems
Allergies and Sinus problems
Internal Shaking and tremors
Menopause
Stopping of menstrual period
Post menopause symptoms
Facial hair growth
Osteoporosis and reduced bone density
Vaginal discharge
Hot flashes
Vaginal bleeding
Slowing down of mental processes
Skin wrinkles
High blood pressure
Stress incontinence
Vaginal dryness
Gum problems and increased bleeding
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