Menopause stage in women's life is characterized by a consecutive lack of menstrual periods for a duration of not less than 12 months from the date of their last period. Also referred to as climacteric, menopause isboth physiological and a biological process that causes a decline in sexual activity and fertility (Greer, 2018). This cessation of menstruation flow is of two types which best marks the transition stage of a woman's life. These two types include natural and premature menopause. Natural menopause is globally considered to occur at about 50 years but this may be affected by the level of socio-economic terms which prolongs the age. On the other hand, premature or early menopause occurs when ovaries can not produce hormones and menstruation flow stops at an earlier age. This is common due to medical condition such as a surgical operation and can also occur naturally. It takes somestages in women's menopause during the transition period when reproductive hormones like progesterone, estrogen, and testosterone stop to function. The perimenopause and premenopause maylast for ten and five years respectively with the latter marking the transition stage to menopause. This period is characterized by fluctuations in the level of reproductive hormones which leads to irregular, heavy, or high menstrual flows. In this stage, there is the preparedness of women to menopause since several symptoms due to decreased production of estrogen start to appear. Some of these symptoms include hot flushes, vagina dryness, dryness and skin thinning, intercourse challenges amongst others. Psychological impacts and symptoms of menopause may include irritations, anxieties, and abrupt changes in mood.
Menopause is a natural process for elderly women regardless of their cultural background. The misconceptions of menopause as a natural phenomenon are based on ethnicity, cultural, and racial factors. According to Makuwa, Rikhotso, and Mulaudzi(2015), women have different menopausal experiences owing to the uniqueness of the perceptions. Some black women view menopause as a transition to permanent infertility and relief from monthly periods. In Zulu culture, women at menopause are regarded as clean people who can go to cows yards and crop fields without making the cattle sick and damaging crops. Most African women refuse hormone replacement therapies because they believe menopause occurs naturally as a result of supernatural power (Makuwa, Rikhotso& Mulaudzi, 2015). Other cultures view menopause as a disease-causing process that occurs as a result of menstruation cessation, poison in the body system of women, or illness. The U.S culture medicalizes menopause, a major biological transition in women. Medicalizing means that they perceive menopause as a condition that requires medical attention. Specifically, the menopausal physical changes are viewed as maladies that require cosmetic and medical intervention. Medical practitioners, drug manufacturing firms, and healthcare researchers define menopause as a hormone deficiency disease that occurs as a result of ovarian failure (Pérez& Newman, 2017). This perception paints a picture of menopause as a condition that can be risky if not treated. The view makes postmenopausal women seek medical attention on a natural process.
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Women have different experiences of menopause. The symptoms can be severe when the process occurs within a short period. Some common symptoms that manifest early are irregular menstruation, lighter or heavier menstruation than normal, flushing night sweats, and hot flashes (Huizen, 2019).Other signs include vaginal dryness, insomnia, depression, weight gain, difficulty in concentrating, anxiety, reduced sex drive, memory loss issues, increased urination, dry eyes, mouth and skin, headaches, urinary tract infections, racing heart, tender or sore breasts, stiff joints, less full breasts, reduced bone mass, reduced muscle mass, hair loss, high hair growth in areas like the upper back, chest, neck, and the face.
Hormone replacement therapy is helpful in relieving menopausal vasomotor symptoms like night sweats and hot flushes, genitourinary symptoms like urinary frequency and vaginal dryness, and psychological symptoms like irritability and mood swings (Lobo, 2017). The HRT helps a great deal in enhancing the quality of life. It is also used in the prevention and treatment of a long-term menopausal condition known as osteoporosis. Moreover, HRT helps in reversing and preventing bone turnover and bone loss by minimizing bone resorption. Other benefits of taking hormone therapy include decreased tooth loss, reduced risk of diabetes and colon cancer, relief of joint pains, and reduced mortality rate. Although HRT is effective in improving the quality of life for women in menopause, it is not without risks. It places women that still have uterus at risk of endometrial cancer especially if estrogen is not administered alongside progesterone. It also increases the chances of gallstone issues, stroke, blood clots, and dementia. Dementia can occur if the woman started HRT after being in menopause for about ten years.
Other management strategies for menopause are vaginal estrogen, low-dose antidepressants, and Gabapentin. Vaginal estrogen involves administering estrogen directly through the vagina with a ring, tablet, or cream. This treatment helps in relieving vaginal dryness, urinary symptoms, and discomfort during sexual intercourse. However, it can cause bloating, breast tenderness, mood changes, vomiting, nausea, breast lumps among other negative symptoms (Pérez& Newman, 2017). Low- dose antidepressants may reduce hot flashes and other mood disorders. The antidepressants may lead to side effects like nervousness, restlessness, nausea, insomnia, sexual issues, and dry mouth. Gabapentin helps in treating hot flushes and seizures associated with menopause. This treatment is especially suitable for women who cannot use estrogen therapy. The risks of gabapentin may include dizziness, drowsiness, and somnolence.
References
Greer, G. (2018). The change: Women, ageing and the menopause. Bloomsbury Publishing.
Huizen, J. (2019, January 17). Everything You Should Know About Menopause. Retrieved from https://www.healthline.com/health/menopause
Lobo, R. A. (2017). Hormone-replacement therapy: current thinking. Nature Reviews Endocrinology, 13(4), 220-231.
Makuwa, G. N., Rikhotso, S. R., & Mulaudzi, F. M. (2015). The perceptions of African women regarding natural menopause in Mamelodi, Tshwane district. curationis, 38(2), 1-7.
Pérez, M. Z., & Newman, A. (2017, February 9). The Medicalization of Menopause. Retrieved from https://www.ourbodiesourselves.org/book-excerpts/health-article/medicalization-of-menopause/
