Midlife: A time of change and reflection — SA Menopause Society

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To mark World Menopause Day on the 18th October 2019, the South African Menopause Society writes:

It is estimated that by 2030 1.2bn women will either be menopausal or postmenopausal, yet social attitudes towards women in menopause is often negative and, in an increasingly ageist society, linked to the “cultural taboo” of ageing. Menopause, which is marked by the end of menstrual periods occurs when a woman’s ovaries run out of functioning eggs, resulting in a loss of the reproductive hormones, oestrogen and progesterone.

Symptoms, like hot flushes, night sweats, pain during intercourse, a loss of libido, weight gain and anxiety are all thought to be caused by the loss of oestrogen.

Dr Trudy Smith, president of the SA Menopause Society believes that many women suffer in silence and are unaware of the assistance available to them to manage these symptoms. “The transition from reproductive years to menopause can be difficult and confusing for women. It is not necessary to compound this with unpleasant symptoms which leave you feeling uncomfortable”, she said.

The transition into menopause can last for years and although each woman’s journey is unique, almost all women will experience irregular periods leading up to menopause (perimenopause). Skipping a period or having periods closer together are both common during perimenopause. Smith cautions, however, that pregnancy is still possible during this time.

Menopause is reached after six consecutive months without a period. Smith believes that the menopause journey provides an opportunity for women to take stock of their health and lifestyle and make the changes necessary that will benefit their future wellbeing. “While keeping up with regular doctor check-ups for preventative healthcare and screening is important, modifying your lifestyle, getting enough exercise, ensuring bone health and taking care of your sexual health are just as crucial”, she says.

Smith says that there is rapid loss of bone density during the first few years after menopause leading to weakened bones and a higher risk of fractures. She adds that weight bearing exercise; eating foods high in calcium; getting enough Vitamin D; taking a supplement; and, hormone therapy are all treatments that can help in the prevention of osteoporosis.

Smith explains that, while many women feel more confident during their midlife and less stressed about getting pregnant, the loss of oestrogen can lead to vaginal dryness, which may make intercourse uncomfortable or painful. “For many women, menopause can be a time for a closer and more intimate time with a partner, but menopausal symptoms may get in the way of enjoyable sexual intercourse. A lubricant or vaginal oestrogen may be all that is necessary to ensure a more comfortable experience”, she says. Smith adds that a loss of libido during menopause is also common and says that, while there are treatments that can help the causes of a decreased sex drive during menopause, a focus on intimacy and communication can often help.

The most important thing for women to know about this time of their lives is that it is not necessary to suffer the symptoms in silence and that assistance and support is available”, she concludes.

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