Womens Health Week: Menopause

What is it?
The term ‘menopause’ refers to the last time a woman gets her period. You are considered postmenopausal when for 12 consecutive months you have had no period.
Perimenopause is the time leading up to menopause.

This period usually occurs between 45-55 years of age, with the average onset being age 50. It is during this period that women experience the classic signs and symptoms often referred to as ‘the big change’. Menopause is considered early when it occurs between the ages of 40-45. Some women experience menopausal symptoms 5-10 years before their final menstrual period.

What are the symptoms of peri and post menopause?
Symptoms can include:
● Irregular periods
● Cycles can be shorter or longer
● Changes in flow
● Sore breasts
● Hot flushes
● Night sweats
● Bodily aches and pains
● Dry skin
● Vaginal dryness
● Loss of libido
● Painful sex
● Urinary frequency
● Weight changes
● Sleeping difficulties
● Facial hair growth
● Thinning of pubic and body hair
● Hormonal changes
● Low levels of oestrogen are associated with low levels of serotonin which is an important chemical that regulates mood, emotions, and sleep.
● The combination of hormonal changes and sleeping difficulties can bring about

other symptoms such as:
○ Mood changes
○ Anxiety
○ Irritability

○ Forgetfulness
○ Trouble concentrating or making decisions
○ Depression

While some women aren’t too bothered by the symptoms, others find them very challenging. Research suggests 60% of women will have mild symptoms for 4-8 years, 20% of women will be severely affected with symptoms continuing into their 60s and later, and
some women will have no symptoms at all.

The symptoms of menopause can have a significant impact on one’s quality of life so understanding how to manage the physical, mental, and emotional changes is important.

How do I manage these symptoms?
Knowing the signs and symptoms associated with menopause is useful. If you are prepared for what can happen, you have a better shot of managing it. So reading this blog is a great start! This one may seem obvious, but live a healthy lifestyle. This includes not smoking, eating a varied and balanced diet, exercising regularly, and incorporating mindfulness, relaxation and ‘me time’ into your week.

To manage hot flushes, simple tricks include carrying a fan, dressing in layers so you can strip off when needed, always having a cold drink bottle and or face spray handy, and avoiding caffeine, spicy foods and alcohol.

For psychological symptoms such as depression, anxiety, irritability and mood swings, a session with a psychologist can be helpful. They can provide you with strategies on how to cope with these emotions. It is important to recognise it is perfectly normal to feel
emotional during this time and help is available.

For symptoms such as back pain and bodily aches and pains, exercise is a useful tool. Gentle activities like walking, swimming, cycling, and pilates are great ways to support your musculoskeletal system. If the problem persists, seeing one of our physiotherapists, osteopaths, or massage therapists is also an option. Exercise has the added benefit of supporting bone health which is crucial because after menopause the body produces less oestrogen which affects bone mass and can lead to osteoporosis.

This is ideally avoided as weak bones can lead to unwanted fractures. It is estimated women lose up to 10% of bone mass in the first 5 years of menopause, therefore it is important to counter this with regular weight-bearing exercise. Further, consuming adequate calcium and getting enough vitamin D (from sun exposure) are additional ways to fight against osteoporosis.

For more information on ideal calcium intake read here:
https://healthybonesaustralia.org.au/your-bone-health/calcium/ and for more information on vitamin D read here: https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health/.

Weight gain during and after menopause is associated with lifestyle factors (diet, exercise, sleep), aging, and the hormonal changes of menopause. Menopause is associated with increased body fat.

Women often find most of their weight gain is around their trunk.
Between the ages of 45-55, women gain, on average, half a kilo per year and studies are still determining if midlife weight gain is due to ageing or menopause. Regardless of the cause, managing weight gain requires eating well and exercising regularly. Hormone replacement therapy (HRT) is something you should consider and discuss with your GP.

It has been demonstrated to reduce symptoms of menopause, however in some cases it can increase your risk of other health complications such as thromboembolism and breast cancer. Your doctor should review your HRT annually to ensure its effectiveness and evaluate the risks and benefits. Doctors can also prescribe other drugs such as antidepressants (which can help reduce hot flushes), gabapentin, and clonidine.

You can read about non-hormonal medical interventions for menopause here:
https://www.menopause.org.au/hp/information-sheets/nonhormonal-treatments-for- menopausal-symptoms

What’s the take home message?
While menopause presents challenges physically, mentally, and emotionally, it can be a milestone in a woman’s life that encourages her to ‘take stock’ and reset some goals. Menopause can be seen as a new beginning for your health and wellbeing – a point from which you can make adjustments to enjoy a healthy lifestyle and remain well in your mature years.

If you need more information on this topic or some guidance, come in and see one of our Physiotherapists here at 13th Beach Health Services. In addition we offer individual and group pilates that are suitable for women at all stages of pregnancy.

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References:
https://www.healthywomen.org/your-health/menopause-aging-well/10-things-men-need-know-menopause/2-the-big-change-is-a-big-deal
https://www.sciencedirect.com/science/article/abs/pii/S0378512208003691
https://www.menopause.org.au/hp/information-sheets/what-is-menopause
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-osteoporosis

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