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Menopause

What is Menopause?

Menopause is the time in your life when your ovaries stop producing estrogen and your monthly period ceases. This time also typically marks the end of your reproductive years. On average menopause happens around the age of 51*, but it can vary from person to person. A diagnosis of menopause can only be made after the fact, or after you have gone 1 year without menstruating.

The Symptoms of Menopause

What happens as you get older, approach menopause, or experience these changes? Some of the most common symptoms of hormone deficiency or fluctuation include the following:

• Hot flashes and night sweats: A sensation of warmth and flushing spreading throughout the body. This may cause sweating, which is often followed by chills. These are a common cause of sleep disturbances during perimenopause.
• Change in your periods: Years before you actually stop having your period, the menstrual bleeding may become irregular, meaning you skip months, your period comes more frequently, or your flow is heavier than usual.
• Insomnia and/or other sleep disturbances: There are a variety of factors of why women suffer from increased insomnia with menopause. Hot flashes, irregular hormone levels, increased trips to the bathroom, stress, and anxiety can all lead to sleep disturbance.
• Mood changes: As your hormone levels change or fluctuate you may feel like you have chronic PMS or even the post-partum blues. Symptoms include irritability, sadness, emotional outbursts, anxiety and/or depression.
• Vaginal dryness: As your estrogen levels decline, the vaginal tissue begins to lose its ability to stay moist. This can lead to itchiness, soreness and pain during intercourse.
• Urinary symptoms: As your estrogen levels decline, the muscles controlling urination begin losing tone. This can lead to incontinence symptoms such as a more frequent urge to urinate or urine leakage.
• Decreased sex drive: Decreased libido is thought to be due to lowered levels of estrogen, progesterone, and testosterone present in your body during menopause.
• Fatigue and decreased ability to concentrate: Dealing with insomnia, hot flashes, and lowered energy levels can cause fatigue.

The varied symptoms of menopause demonstrate the important role that our sex hormones play beyond just preparing the body for pregnancy. The hormone receptors for estrogen and progesterone are found in organs throughout your body, which helps explain many of the changes you may experience after menopause in bone density, your skin may become less elastic and you may gain weight or the weight you have may shift location.

The symptoms mentioned above often get a great deal of attention. Less talked about, however, are the effects that menopause can have on the pelvic floor and the urinary tract. Although urinary incontinence can and does occur at any age, many women notice that symptoms begin or seem to worsen around this time in their lives.

In fact, about one-quarter of menopausal women feel this way, and the answer why is not surprising: The vaginal and urinary tissues are incredibly sensitive to decreases or deficiency in estrogen. Estrogen helps maintain the tone and strength of the pelvic floor muscles and ligaments, and helps keep the vaginal and urethral tissues moist. In order for the urethra to close completely (which prevents urine leakage), there must be a certain degree of elasticity and moisture. As estrogen levels decrease during menopause, many women experience an increase in stress incontinence, the urge to go to the bathroom, or urge incontinence. The loss of estrogen can also affect the urethral tissues in the same way, leading to symptoms such as frequent urination, increased urgency, urinary tract infections, or bladder leakage.

Helpful Links:

Visit the Red Hot Mamas at www.redhotmamas.org.

Special thanks to:
Dr. Melinda Ring, Medical Director of the Center for Integrative Medicine at Northwestern Memorial Hospital and Assistant Professor in the Department of Medicine at Northwestern University's Feinberg School of Medicine for her contributions.

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