The menstrual cycle is a complex happening in a woman's body, the task of which is to prepare the body for becoming pregnant. At a certain age in a woman's life, the body is no longer capable of natural fertilization and bearing offspring. In this case, the hormonal system stops the menstrual cycle.
According to the World Health Organization (WHO), menopause is the period between the 45th and 60th year of a woman's life that begins approximately one year before menopause and is associated with specific clinical manifestations.
The definition and introduction of this term was first used at an international medical congress in France in 1976.
Menopause is also known as climacteric.
What happens in the body in menopause?
The female cycle is regulated by a number of hormones that are controlled by the central nervous system in the brain.
The root cause of these changes in a woman's body is a change in hormone levels: a decrease in the production of progesterone and estrogen.
Conversely, an increase in hypothalamic and pituitary hormones.
As a consequence of hormonal changes, there is a depletion of follicles in the ovarian reproductive system. This process is called follicular atresia.
The menstrual cycle does not stop overnight. It is a process in which menstrual cycles may gradually lengthen, anovulatory cycles or metrorrhagia may occur, and finally the menstrual cycle will stop altogether.
The last menstrual bleeding is called menopause. However, popularly, menopause is synonymous with the period of changes in a woman's body associated with the end of menstruation.
In addition to hormonal changes, there is a slight atrophy of the uterus, vagina, ligaments and pelvic floor muscles.
Soft structures lose their original elasticity and weaken. The Ph level becomes neutral to alkaline, while the level of lactobacilli gradually decreases.
Noticeable changes are also external, such as weight change, change in the deposition of subcutaneous fat, skin pigmentation, increased skin dryness and others.
The onset of menopause is determined by a number of factors that are largely uncontrollable.
These include menarche (the onset of the first menstrual period - the later it occurs, the later menopause can be assumed), the duration of menstrual cycles (the longer, the later the onset of menopause can be assumed), human race, and older age.
Influencing factors include the number of births (the more, the later the onset of menopause can be predicted), lifestyle (alcohol and smoking can influence earlier onset of menopause), and psychosocial factors (relationships, stress, environment).
The climacteric is divided into 4 time periods:
Premenopause: A period lasting 1 year with regular menstruation before the onset of hormone decline.
Menopause: Period of cessation and disappearance of the menstrual cycle.
This is the last physiological menstruation.
Perimenopause: The period of the last menstrual bleeding and the period after it, where there is a significant fluctuation in hormones.
Possible is the presence of weaker irregular menstrual bleeding.
Postmenopause: The period of 1 year after menopause, characterized by low levels of the female hormone estrogen.
At what age do women experience menopause?
Usually, this is the period between the ages of 45 and 60 years of age. For some, it occurs earlier.
Women face a lot of difficulties during this period. They are united by the name...
It tends to affect about 70% to 80% of menopausal women.
It lasts on average 2 years and is characterized by specific clinical symptoms of both physical and psychological nature. However, there are ways in which the course of menopausal syndrome can be significantly alleviated.
What are the earliest symptoms of menopause/climacterium?
Sudden hot flashes, hot flushes and increased night sweats affect up to 70% of menopausal women.
The thermal mechanism probably results from a temporary disturbance or change in thermoregulation controlled in the hypothalamus, which also influences changes in skin temperature, blood flow, blood pressure and heart rate.
The duration of hot flashes is individual. Mostly it is a sudden 3-5 minutes, but it can last up to an hour.
With age, the sleep cycle also changes physiologically. Falling asleep and waking up usually shift to earlier hours.
There may be increased fatigue, drowsiness, but also problems falling asleep.
Some studies point to reduced levels of the sleep hormone melatonin during menopause. Taking melatonin in the form of dietary supplements positively affects sleep and its quality.
One of the most common symptoms of menopause is a disturbance of the psyche. Anxiety, depression, nervousness, impaired attention and memory, and rapid mood changes.
Receptors for estrogens are located in certain parts of the brain that are responsible for the state of the psyche.
Estrogen levels also correlate with dopamine and serotonin levels, which are related to our current mood and inner feeling.
Changes in skin characteristics
The change in hormones also affects the largest organ of the body (skin). Hormonal aging can manifest itself in the formation of wrinkles, increased dryness and atrophy (sagging) of the skin.
There is a decrease in collagen production, a decrease in hair follicles, a slowing of nail growth, and a loss of melanocytes, which can lead to a change in skin pigmentation.
Urinary incontinence is an uncontrollable leakage of urine that affects approximately 50% of women. The most at risk group is women in older age and during menopause.
As a result of a decrease in estrogen, the musculature of the bladder, lower urinary tract and pelvic floor atrophy. By weakening the muscle sphincters, reflex closure may not occur with increased physical activity, coughing or sneezing.
Decrease in libido
The female genital tract undergoes a slight change in the form of atrophy. Flaccidity, loss of elasticity, shortening of soft fibres or dryness of the vagina with lack of lubrication. The psychological factor plays an important role.
A drop in sex hormone levels can cause a decrease in libido, sex drive, and a dampening of the experience of sexuality.
Progression of bone tissue micro-architecture disorder and bone loss: osteoporosis. This is one of the common symptoms of menopause.
Some studies have shown that approximately 80% of women with femoral fractures are menopausal.
Thinning bones mean a greater risk of fractures, especially in the femoral neck, vertebrae of the spine and in the carpal bones.
Prevention by a doctor and regular replenishment of necessary vitamins and minerals are necessary. In particular, the supply of calcium and vitamin D.
Risk of cardiovascular disease
In postmenopausal women, there may also be changes in the cardiovascular system due to estrogen deficiency.
Blood systolic and diastolic pressure, glycemia and cholesterol may be elevated. This also increases the risk of stroke, coronary heart disease or diabetes (Diabetes Mellitus).
Estrogen replacement in the treatment of cardiovascular disease does not meet medical expectations. Therefore, the best prevention is a healthy lifestyle in terms of smoking and alcohol prohibition, weight adjustment and sufficient compensatory exercise.
Medical history - a description of the difficulties experienced by the woman
Densitometric screening for osteoporosis
Laboratory blood tests, but not necessarily (FSH level rise and estrogen drop, and thyroid hormones)
How does menopause progress?
It usually has 4 stages, i.e. premenopause, menopause, perimenopause and postmenopause. A more detailed description of the phases is given in the section on causes.
Is it possible to get pregnant at menopause?
Climacterium or manopause is the period when the function of the ovaries is extinguished: egg production.
Already in perimenopause (the year before the last menstrual period/menopause), the chances of getting pregnant are very low. In menopause, almost zero.
It is important to remember that pregnancy at an older age increases the health risks for both the baby and the mother (gestational diabetes, high blood pressure, increased blood clotting, haemorrhoids, varicose veins and others).
However, the woman's uterus is still able to receive embryos.
Theoretically, the method of artificial insemination is possible, but pregnancy over the age of 40 is strongly discouraged by doctors due to the possible risks.
It is therefore necessary to consult each case individually with a gynecologist.
Prevention and elimination of menopausal symptoms
Wondering how to alleviate menopausal problems? Maybe 3 basic steps will help you.
1. Taking vitamin D and calcium
Vitamin D is mainly found in foods such as salmon, tuna, cheese, eggs, mushrooms, peas and nuts. During the menopause, with the risk of osteoporosis, a significant decrease in the level of this vitamin has been shown.
One of the most important functions of vitamin D in the human body is to support bone health and the immune system.
To prevent osteoporosis, it is important to achieve as much bone mass as possible at a young age and to slow down its gradual loss in the following years.
Calcium is an important mineral widely represented in the human body. Calcium is mainly contained in the bones and teeth of the human body. It helps to regulate the contractility of the heart muscle and the function of nerves and muscles.
Bone deterioration, muscle cramps, heart palpitations, anxiety, depression and sleep disturbances can occur when it is deficient.
Many studies confirm that calcium supplementation has a beneficial effect on menopausal syndrome and improved bone density.
2. Sufficient protein intake
It is a known fact that we need a regular supply of calcium and vitamin D for healthy bones.
Less well known is the fact that sufficient protein intake is also necessary for healthy bones and the prevention of osteoporosis.
Older people in many cases have insufficient protein intake in their diet, which can adversely affect the skeletal system and bone density.
Proteins, technically called proteins, are natural macro-nutrients found in our bodies. They are the basic building blocks of the human body.
Proteins are involved in all the processes that take place in the body at both the cellular and extracellular level.
The drop in estrogen during menopause can cause muscle loss and thinning of the bones. It is therefore recommended that the diet consumed should contain plenty of good quality protein.
Examples of food sources are fish, eggs, legumes, nuts or good quality meat.
3. Movement lifestyle
Regular physical activity of a recreational and compensatory nature is important.
Eliminate muscle and movement imbalances, strengthen weakened muscles and, on the contrary, relax overloaded muscles.
Exercises aimed at strengthening the sitting area and the muscles of the hip joint are highly recommended. Individually tailored training aimed at strengthening the muscles is suitable as a prevention against musculoskeletal atrophy.
It is advisable to avoid risky and impact sports. On the contrary, a treadmill, yoga, swimming, pilates, walking and Nordic walking are recommended.
Regular exercise not only improves overall physical condition and fitness, but also increases mental resilience and mental stability.
Movement also boosts the body's defences, strengthens the immune system, aids digestion and, last but not least, improves mood.
We recommend: better hormonal activity and vitality of women during menopause
In the menopausal period, the harmony of the body's response to the action of sex hormones increasingly breaks down. Estrogen depletion impairs thermoregulation and the function of neurotransmitters, especially serotonin. This results in hot flashes, night sweats, sleep disturbances, vaginal atrophy, painful musculoskeletal manifestations, bone loss and increased risk of cancer. The ability to perform activities effectively (memory, thinking, attention, problem-solving ability) declines.
The complex of active ingredients selectively activates estrogen receptors β, improves serotonergic signaling and enhances the effect of progesterone. As a result, the emotional and neurological manifestations of aging and menopause are alleviated. GOOD MOOD + MENOPAUSE is an effective prevention of cancerous changes in the breasts, ovaries and other tissues, heart attack, stroke and osteoporosis.
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I completed my bachelor's degree in physiotherapy at the Faculty of Biomedical Engineering of the Czech Technical University in Prague. I continued and completed my master's degree in physiotherapy at the Faculty of Health Engineering of TnUAD. I am currently pursuing my PhD rigorosis at the Slovak University of Health Sciences in Bratislava. During my studies I worked as a physiotherapist in the rehabilitation clinic of Vamed Mediterra in Prague and then as a physiotherapist at the Regional Hospital in Liberec in the Department of Neurology. During my employment I was part of the medical team in the Covid19 department. I am mostly interested in human musculoskeletal system, rehabilitation, physiotherapy in gynaecology and natural medicine. My hobbies include exercising, running, writing and managing social media.