Change is a recurring motif in life’s rich tapestry. The process of ageing in humans brings with it a plethora of changes that are definitive for every stage of growth, some of the changes manifest physically as humans age and these include decrease in fatty tissue, the skin thins and becomes less elastic and more fragile, a drier skin due to low production of natural oils, wrinkles and many other changes in appearance. However, one major change that comes with age in most females, and whose onset is less subtle is Menopause.

Menopause is that time in most women’s lives when monthly periods seize and child bearing stops. It is said to occur mostly between 49 and 52 years of age. The depletion of ovarian reserve causes an increase in circulating hormones; Follicle stimulating hormones (FSH) and luteinizing hormone (LH), this is because there are fewer oocytes and follicles responding to these hormones.

Cause

Menopause is a natural change but its occurrence can be influenced by certain factors that cause its early occurrence in some women, these factors include the surgical removal of ovaries, smoking of tobacco and certain types of chemotherapy.

Signs and symptoms

There are many scenarios that factor in the broader definition of menopause considering that there are noticeable effects that occur in the several years leading to the actual menopause, menopause is usually confirmed by the absence of periods for twelve months. In the several years before menopause, women experience many effects such as hot flashes associated with sweating and reddening of the skin, trouble sleeping, irregular periods and vaginal dryness.

The signs and symptoms of menopause that usually go on until the post menopause phase are vaginal dryness and painful intercourse. The other physical symptoms of menopause include joint soreness, stiffness, back pain, breast enlargement, breast pain, weight gain, urinary incontinence, urinary urgency, heavy night sweats, lack of energy, heart palpitations, headache, dizziness and dry itchy skin. The mood and memory effects of menopause include inability to concentrate, anxiety, poor memory, depressive mood, irritability, mood swings and less interest in sexual activity.

The long term effects of menopause include risk of atherosclerosis, osteoporosis.

It should however be noted that the severity of symptoms varies greatly among different individuals.

Diagnosis may involve use of the menopause rating scale, and the Greene climacteric scale questionnaire

Management

Menopause is a natural phase of life and is therefore not considered as a disorder, and therefore it doesn’t automatically warrant any kind of medication. Medication may only be required or deemed appropriate in instances where the effects of the sharp fall in hormone levels are able to interfere with normal life by creating overwhelming discomfort. Therapy may involve Hormone replacement therapy, Selective Serotonin Reuptake Inhibitors (SSRIs) which provide some relief from vasomotor symptoms. 

In some instances, though with a lack of evidence, alternative medicine has been utilized to help with alleviating post-menopausal symptoms. These have included black cohosh and soy isoflavones.

 

Some research appears to show that melatonin supplementation in perimenopausal women can improve thyroid function and gonadotropin levels and as well restore fertility and menstruation and preventing depression associated menopause.

Menopause in popular culture

Societal perception of the condition has presented a marked influence on response to menopause, some societies have embraced menopause as a transition or a symbol of age while others have viewed it negatively as a health condition. The subjective perception to menopause has been seen to vary widely among different ethnic groups and social economic statuses. For example, research has shown that most women in the western world view menopause more negatively than their Asian counterparts who have understood it as freedom from risk of pregnancy and a sense of liberation.

There have been many suggestions on the evolutionary development and benefits of menopause in comparison to other species, mostly to help provide reasons as to why females can outlive their ability to reproduce, a characteristic that only a few other animals (four) share.