What is menopause?
Menopause is a transitional phase. During these years, a woman undergoes a transition to the infertile stage, marking a major turning point in her life. The medical term “climacteric”, which derives from the Latin term for “critical epoch”, is also used when talking about menopause. Menopause is triggered by the decreasing production of the hormones progesterone and oestrogen. The changes in the hormone balance are accompanied by a range of symptoms in around two-thirds of women, whereas the remaining third experience virtually no changes.
What happens during the menopause?
Menopause marks the end of a woman’s reproductive years. The reproductive years begin during puberty with the onset of the menstrual cycle and end when a woman menstruates for the last time. This end of menstruation is referred to as menopause (Greek men: month, pausis: end) and occurs on average at the age of 52. It is possible to determine that it has occurred if, for example, it has been about 12 months since a woman has had her period.
The hormones oestrogen and progesterone play a key role in the menstrual cycle. Oestrogen stimulates the formation of new uterine lining after the old lining has been shed during a woman’s previous period. Levels peak shortly before ovulation. After a woman ovulates, her body produces progesterone, which helps the egg to attach to the uterus in the event of fertilization. If fertilization does not occur, progesterone levels drop and the uterine lining is shed again at the beginning of the next cycle.
During menopause, the egg cells start to mature irregularly until the ovaries stop producing them altogether. With the onset of menopause, there is also a considerable drop in progesterone levels. Likewise, oestrogen levels drop after a woman menstruates for the last time. Menopause can be divided into three phases with fluid transitions.
During pre-menopause, progesterone levels begin to drop. As a result, a woman’s menstrual cycles change as well, becoming more irregular or stopping altogether.
Perimenopause refers to the phase two years before and after a woman’s very last period. This phase is characterised by a drop in production in the ovaries. Ovulation occurs less frequently until it eventually stops altogether. Progesterone levels drop steadily. After a woman menstruates for the last time, oestrogen levels drop significantly as well.
During post-menopause, hormone production continues to drop until stopping completely at around the age of 65.
What symptoms occur during menopause?
There is a range of more or less common symptoms that occur during menopause. All of them fall under the rubric of climacteric symptoms which vary in severity and type. The symptoms can be categorised in different menopausal phases. Here, too, the boundaries are fluid.
During the first phase of menopause, the production of the hormone progesterone drops because ovulation is irregular or has ceased. This can cause a woman’s cycle to become irregular, so that she experiences a heavier or lighter flow.
During perimenopause, the progressive drop in hormone concentrations can cause a variety of symptoms, which sometimes have a major impact on a woman’s health and well-being.
- Hot flushes and sweating
A woman may at times experience uncontrollable hot flushes during the day or at night. These are usually accompanied by sweating, increased heart rate and facial flushing. In extreme cases, they can make it very hard to sleep through the night.
- Sleep disorders
Sleep disorders interfere with a person’s performance and are therefore very debilitating. They can occur as a result of, or along with, other symptoms, such as hot flushes, episodes of depression or nervousness. They can also exacerbate these problems.
Menopause can also have a negative psychological impact. Typical symptoms include mood swings, irritability and nervousness. Extreme cases may result in depression that requires the help of a doctor.
In certain situations, dizziness may occur without any clear trigger, and the person may have the false sense that they or things around them are moving.
- Heart palpitations
Sudden jumps in heart beat can become noticeable. These palpitations often make a person uneasy, but they do not generally pose any risk.
During menopause, hormonal changes can lead to a decrease in sexual desire. In addition to this, the mucous membranes become thinner and dryer, potentially causing sex to become unpleasant or even painful.
- Other symptoms
Other symptoms may include bladder weakness and urinary tract infections, loss of hair on the head as well as growth of facial hair. There can be metabolic changes and secondary conditions, such as osteoporosis (bone atrophy). Calorie consumption drops with increasing age: often resulting in weight gain, unless dietary changes are made.
During post-menopause, which lasts for six to eight years, most of these symptoms go away completely. Osteoporosis developing during menopause may continue, however.
Who is affected by menopausal symptoms?
On average, two-thirds of women suffer from menopausal symptoms. These are most intense during perimenopause and go away during post-menopause. Perimenopause begins around two years before and ends two years after menopause. Menopause usually occurs between the ages of 45 and 55 – on average at 52. The term “early menopause” is used when it occurs between the ages of 40 and 50. Menopause is considered premature when it occurs between the ages of 35 and 40. Smoking and being underweight increase the likelihood of this, whereas regular alcohol consumption can delay a woman’s final menstruation.
How are menopausal symptoms treated?
Herbal remedies made with black cohosh or “fairy candle” (Cimicifuga racemosa) have a long history in the treatment of menopausal symptoms. This North American medicinal plant was given its common name because it resembles a candle when in bloom.
It offers a reliable remedy for symptoms such as hot flushes, sweating and mood swings. Treatment with black cohosh is especially recommended for treating mild to moderate symptoms and is an effective alternative to menopausal hormone replacement therapy (HRT).
Monk’s pepper (Vitex agnus castus) helps regulate the body’s hormone balance and can help to stabilize menstrual fluctuations. It is mainly used during pre-menopause if a woman is experiencing irregular monthly cycles. It helps relieve menopausal symptoms before menstruation and has a balancing effect on the cycle.
Products made with monk’s pepper can be purchased from your pharmacist or chemist.
Soya and red clover
In Switzerland, products made from soya and red clover are not registered as pharmaceuticals, but rather as dietary supplements. In brochures and in presentations, these supplements are often offered as effective, natural alternatives for treating menopausal symptoms. The isoflavones found in both plants have an oestrogen-like effect. The effectiveness for treating menopausal symptoms has not yet been clearly proven in clinical trials.
The use of phytoestrogens in breast cancer patients is a controversial topic and is considered risky, as studies have shown that phytoestrogens can promote cell growth.
Hormone replacement therapy
Hormone replacement therapy (HRT) involves giving additional hormones to compensate for the body’s decrease in its own hormone production.
The primary benefits of HRT include their rapid effect on unpleasant menopausal symptoms. A large US women’s health study (Women’s Health Initiative) showed, however, that HRT slightly increases the risk of developing breast cancer.
The Swiss Menopause Society (Schweizerische Menopausengesellschaft) therefore recommends that a doctor carry out a detailed, individual risk–benefit assessment and adjust the therapy each year, as hormone levels can change relatively quickly. Today, HRT is primarily indicated for the treatment of very acute symptoms resulting from a sharp drop in hormone levels.
Performing a self-test can help to determine whether your symptoms are related to menopause.
Take two minutes to answer the questions from our self-test questionnaire to assess potential symptoms and their severity.
Take the menopause self-test (German)
Tips for menopause
Hormonal changes are a normal part of the natural aging process and cannot be avoided. There are various ways to prevent or reduce the effects, however. These mainly involve taking into consideration what your body needs.
A diet rich in vitamin D and calcium improves a person’s overall well-being and reduces the likelihood of osteoporosis. If you experience hot flushes, you should also avoid hot and spicy foods.
Drinking two to three litres of fluid daily helps to keep the skin from drying out. You should also apply creams especially suited to your needs.
Exercise stimulates the formation of new bone mass and has a positive effect on the bones. In addition, it also burns more energy to counteract weight gain.
Relaxation exercises such as yoga, breathing therapy and the Jacobsen muscle relaxation technique can help boost energy levels. Potentially stressful situations should also be avoided whenever possible to help minimise the risk of sleep disorders or greater irritability, among other things.
Taking walks in the fresh air and in pleasant surroundings is an easy way to complement a healthy lifestyle – and lift your spirits and boost the immune system.