INTERVIEW:  How To Manage Menopause

Many women experience variety of symptoms as a result of the hormonal changes associated with the transition to menopause. Around the time of menopause, women often lose bone density and their blood cholesterol levels may worsen, increasing their risk of heart disease.

However, Dr DANIEL UMOREN in an interview with THE WHISTLER recently in Abuja gave insights on how women can manage and live a healthy life in the menopause stage. Excerpts:

What Is Menopause? What Is The Average Age Of Menopause?

UMOREN: Menopause refers to the seizing of a woman’s menstruation for at least 12 months.

The age range for menopause is between 45-55years but the median age is 51. If it occurs before 45 it is regarded as a primary ovarian failure because the ovary at this age should keep producing estrogen.

Estrogen is the primary female sex hormone responsible for the development and regulation of the female reproductive system.

However, this is the age adopted by a lot of physicians, gynaecologist and obstetrician association including Nigeria.

Does Every Woman Go Through Menopause? What Causes Menopause?

UMOREN: Yes, every woman experiences Menopause and the precipitating factors are;

Physiological cause: like ageing, the older you get the lesser your ovary produces estrogen leading to an accuracy reduction at which your ovaries function.

At the time of birth, most females have about 1 to 3 million eggs, which are gradually lost throughout a woman’s life. By the time of a girl’s first menstrual period, she has an average of about 400,000 eggs, and by the time of menopause, a woman may have fewer than 10,000 eggs.

A small percentage of these eggs are lost through normal ovulation (the monthly cycle), while most eggs die off through a process called atresia (the degeneration of those ovarian follicles which do not ovulate during the menstrual cycle)

Normally follicle stimulating hormone(FSH) is the substance responsible for the growth of ovarian follicles (eggs) during the first half of a woman’s menstrual cycle.  So as menopause approaches, the remaining eggs become more resistant to FSH, and the ovaries drastically reduce their production of estrogen.

Just to deviate, we have a lot of congenital abnormalities (birth problems) like co-joined twins, and down syndrome, often times occur in older women, so when you start getting to 45 the probability that the eggs you produce will be very viable is low and the ovaries begin to malfunction.

Surgical causes:  there is an operation called bilateral oophorectomy (removal of ovaries) so when you have ovarian cancer or Hysterectomy (the removal of the uterus) then the ovary has to be removed.

Also, it can be seen in people that have other cancers in their abdomen and are placed on radiation; the radiation may then affect the ovaries and then shut it down completely. Chemotherapy and primary ovarian disease may also lead to menopause in women.

What Is Primary Ovarian Disease?

UMOREN: This is an autoimmune disease (the body fights against itself).

There is something called antigen and antibody. Usually, when people get sick the body fights the antigen(the agent causing the illness ) while the body produces an antibody that helps to fight it but sometimes the body becomes an antigen and then fights against itself till it is destroyed completely.

Is There A Link Between Menopause And Food

UMOREN: Menopause has nothing to do with what we eat, physiologically apart from the factors I have mentioned there is no other scientifically proven case to link diet to menopause.

Can Menopause Be Delayed?

UMOREN: Menopause is going to happen. It cannot be delayed but can be prevented through hormonal replacement treatment.

If you get to see a physician regularly, he or she will measure the estrogen level and follicle stimulating hormone level and then would be able to tell which of the hormones is high or low thus predicting when you are close to menopause.

So when he notices that you are close to this stage he starts replacing the hormones so you don’t even get  the symptoms and signs of menopause because till your ovaries finally shut down at menopause the physician will keep replacing it, but to clear the public menopause cannot be delayed, it can only be prevented.

What Safe Option Is There For Child Bearing For Women That Marry Late?

UMOREN: For ladies that may marry late they have to work hand in hand with their obstetrician and gynecologist, because the doctor after running series of test can accredit her for conception, so he says I think it’s the right time for you to meet with your husband even if you are close to menopause he can induce menstruation because when she is in the Premenopausal (PM) stage her menstruation begins to fluctuate.

If she has gotten to menopause but her uterus is still viable, the doctor can via hormonal replacement therapy get an egg from her, fertilise it outside through Vitro fertilization and then put it back, watch the child grow and finally deliver the child in a section.

All of this options must be prescribed by her personal doctor (obstetrician or gynaecologist) because the options differ for different women.

There are some women that are in the PM stage, so her doctor can watch her, tell her this week you can get something if you intensify your meeting with your husband, while others who have clocked menopause would be advised to undergo an implantation. This is quite expensive because the child has to be monitored for any congenital problem.

 Signs And Symptoms Of Menopause?

UMOREN: Hot flashes: Hot flashes are the most common symptom of menopause. Hot flash symptoms vary among women. Commonly, a hot flash is a feeling of warmth that spreads over the body, lasting from around 30 seconds to a few minutes. Flushed (reddened) skin, palpitations (feeling a strong heartbeat), and sweating often accompany hot flashes. It usually lasts 2 to 12years.

Urinary problem: the pelvic wall is supported by estrogen so once it is redrawn at menopause she starts to experience a burning during urination.

Vaginal changes: Because estrogen affects the vaginal lining, premenopausal women may also have pain during intercourse and may note a change in vaginal discharge. This can also introduce an emotional trauma or mood swing if her husband does not understand.

Bone mass: Rapid bone loss is common during the premenopausal years because estrogen is one of the reasons why a woman’s bone is strong so immediately it is redrawn, the bones begin to suffer because its density is reduced leading to arthritis, osteoporosis (condition that increases the risk of bone fractures) and a whole lot of bone related issues, which can increase the risk of death.

Weight gain: A three-year study of healthy women nearing menopause found an average gain of five pounds during the three years. Hormonal changes and ageing are both possible factors in this weight gain.

How Can An Average Nigerian Manage These Symptoms

UMOREN: There are simple things to be done for example the hot flashes can be treated with certain drugs but you can also treat it by initiating rest, and staying in cool environments.

Kegels exercise (consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor) can help to resolve the urinary problem because it will help to straighten the wall of the pelvic floor.

Women are usually advised to use lubricant to get their vaginas wet in order to ease sexual intercourse as well as keep happy with her husband.

Finally, for the bone pains, exercise will go a long way to help, also eating lots of fruits and vegetables containing minerals, calcium and vitamin D. But if you have enough money you can go for vitamin D supplement.