Your health with Pharmacist Advice

Women's Health - Menopause

DEFINITION

Menopause means "stopping menstruation", signifying the end of a woman's reproductive life. Menopause generally occurs between the ages of 45 and 55 years(1). Some women may experience uncomfortable or unpleasant symptoms as part of their Menopause.

DESCRIPTION

Three terms are used to describe the different types of Menopause.

  • Premature Menopause: When the last period occurs before the age of 40. This may be due to hereditary factors, smoking, exposure to radiation or chemotherapy. An interruption in the blood supply to the ovaries, as may occur during certain surgical procedures, may be associated with premature Menopause.
  • Artificial Menopause: Often the result of medical intervention, for example if a woman has her ovaries surgically removed, or if there is radiation to her pelvis. Artificial Menopause may be deliberately induced. Certain drugs can cause a menopausal state that is reversible if the medication is stopped.
  • Natural Menopause: is Menopause caused by advancing age. Most women experience 'natural' Menopause. As women age, hormone levels change. Onset of Menopause is a gradual process as oestrogen and progesterone levels decline (with fluctuations in a number of other hormones)(2). At Menopause, oestrogen and progesterone production has stopped.


After Menopause, oestrogen is still produced, but in a far less active form (called oestrone). Conversion of certain sex hormones to oestrone occurs in the kidneys, liver and fat cells. For this reason, very thin women may experience more severe menopausal symptoms(3).

SIGNS AND SYMPTOMS

Symptoms of Menopause vary in type and severity. Onset may be gradual or sudden. The most common menopausal symptom is hot flushes. Other symptoms include insomnia, mood changes, vaginal dryness, palpitations, muscle and joint pain and night sweats. The risk of developing osteoporosis is increased after Menopause(4). Fluctuations in the menstrual cycle are often the earliest sign of approaching Menopause. There may be changes in the frequency or volume of menstruation. If any of the following occur, contact your Doctor:(5) bleeding which occurs one year after the last menstrual period, bleeding after sex, persistently heavy periods, mid-cycle bleeding or bleeding between periods or pain, if never experienced before.

HEALTH MANAGEMENT

Always consult your Doctor for diagnosis and advice. In no way is this information intended to replace the advice of a medical practitioner. Treatment options range from positive lifestyle changes, adoption of healthy eating habits, counselling and psychological support and hormone replacement therapies. Non-drug plant oestrogen therapies are also currently available. Discuss possible treatment approaches with your health professional.

  • Perform a breast self examination monthly. Have a mammogramevery 2 years, or as recommended by your medical practitioner.
  • Have an internal gynaecological examination yearly and a Pap smear at least every second year, or as recommended by a medical practitioner.
  • Do weight bearing exercise regularly (30 minutes every second day) to help maintain bone strength.
  • Maintain bodyweight in the middle to upper level of ideal weight.
  • Have a cholesterol check.

PHARMACIST

Ask your Pharmacist for advice.

  1. Follow the Diet Hints.
  2. If you need help reaching an ideal weight ask your Pharmacist for advice. See the diets on this Healthpoint.
  3. If you have queries about your medication ask your Pharmacist.
  4. Ask your Pharmacist about cholesterol checks and bone density tests.
  5. Ask your Pharmacist for products which may help relieve the symptoms of hot flushes and vaginal dryness.
  6. Consider some nutritional supplements if dietary intake is inadequate.

DIET HINTS

  • Menopause causes symptoms that are related to decreased levels of oestrogen in the body. Soybeans are a rich dietary source of phytoestrogens (plant oestrogens). Soybeans contain particularly high levels of the phytoestrogen known as isoflavone, which is able to bind to Oestrogen receptors and mimic some of oOestrogen's actions in the body(6). Diets rich in phytoOestrogens have been found to alleviate hot flushes caused by Menopause(7). There is also evidence that Soybean products can increase the bone mineral density (which is an indicator of bone strength) in post-menopausal women(8). The isoflavones in soybeans possess anti-cancer properties. Soy consumption among Asian women is associated with decreased rates of breast and uterine cancer, which is likely to be a result of the cancer-preventing properties of isoflavones(9).
  • Caffeine may block the absorption of calcium and other minerals. Coffee, spicy foods and alcohol may aggravate hot flushes(10).
  • A vegetarian diet consisting mainly of whole grains, seeds and nuts, vegetables and fruits may help to minimise menopausal symptoms(11).
  • Essential fatty acids found in cold pressed oils and fish may help relieve some menopausal symptoms(12). Cold-pressed nut and seed oils are sources of vitamin E. Vitamin E has been used to help control hot flushes(13).
  • Eating calcium-rich foods during Menopause is important because calcium absorption is decreased. Dairy foods, fortified soy products, canned fish with bones and green leafy vegetables are good sources of calcium.

VITAMINS/MINERALS/HERBS

Nutritional supplements may be of use if dietary intake is inadequate.

  • Vitamin Dand calcium may prevent bone density decreases associated with osteoporosis after menopause(14)
  • Black cohosh (Cimicifuga racemosa) may be an effective herb for menopausal symptoms, particularly in relieving hot flushes and vaginal dryness.(15) (16)
  • Tribulus and withania(17) are androgen promoting herbs which may help to support adrenal gland function and promote ovarian androgen synthesis. Tribulus may provide symptomatic relief for hot flushes, night sweats, depression and insomnia(18).
  • Magnesium may assist with improving and maintaining bone integrity. Research demonstrates that supplemental magnesium can increase bone density in many women and prevent bone loss in others(19).
  • Evening Primrose Oil may help relieve symptoms of hot flushed and skin dryness(20).
  • Phytoestrogenic supplements such as soy-based supplements, red clover and linseed may be of benefit.
  • St. John's Wort (Hypericum performatum) may relieve anxiety, depression and irritability(21).