By María Teresa Arboleda Grajales, El País Reporter
Between the ages of 45 and 52, the vast majority of women experience various physical and emotional symptoms as a result of the menopause.
Menopause causes hot flashes, but also anxiety, depression and even heart disease. | Foto: Getty Images
Martha Cecilia Torres, for example, remembers that, when her menstrual period ended, she began to have frequent bleeding.
“Then they began the heat, like hot flashes that went up to my face; Sometimes my head hurt and sometimes I felt depressed, wanting to cry,” says this Cali housewife.
Why does it occur?
-Menopause transition: it can occur from 40 to 45 years of age.
In hormonal management, it must be kept in mind that a woman who has a uterus or womb must receive both hormones: estrogen and progesterone. Those without a uterus should only receive estrogen. | Foto: Pexels
-Menopause: Loss of the menstrual cycle for one year naturally. It goes from 45 years to 52 years.
-Postmenopause: ranges from 52 years of age and older.
Menopause “occurs because as the years go by the ovary ages and the production of hormones decreases, the main one being estrogen. This is called hypoestrogenism. Other hormones, such as progesterone and testosterone, are also reduced, and this decrease produces various symptoms,” explains the obstetrician-gynecologist at the Imbanaco Clinic, María Cecilia Arturo Rojas.
Main changes
“The estrogen hormone has receptors throughout our body, we pretend that it is our body’s gasoline,” explains the doctor, mentioning that among the most common symptoms are vasomotor symptoms, known as hot flashes, in 70%. ”.
Then there are alterations in sleep and mood, which can manifest themselves in anxiety, depression and irascibility.
Alterations in cognition (brain fog) may occur, as well as urological symptoms, dryness in all mucous membranes, skin, eyes, vulva and vagina, thus altering sexual relations due to pain, which is known as dyspareunia.
At this stage there is also usually a greater possibility of urinary infections. Likewise, the density or strength of the bones is lost, generating the risk of fractures, while the metabolism that leads to weight gain is decreased.
It should be noted that these manifestations appear as we age and the loss of hormones increases.
In this regard, Dr. Claudia Otálora, a gynecologist attached to Colsanitas, states: “Menopause implies that the production of hormones stops, which causes physical changes such as sagging breasts, wrinkles and changes in the distribution of body fat.
The doctor also specifies that there are cases in which menopause comes prematurely (before the age of 40) or early (before the age of 45). This can occur for several reasons:
-Castration: patients with malignant pathologies in the ovaries or who have had them removed.
-Germ cell destroying agents: women who have been treated with chemotherapy.
-Ovarian failure: it happens when the ovaries have fewer eggs, which causes them to wear out in less time and cause menopause.
Why is it important to learn about these changes?
Every October 18 marks World Menopause Day, a stage about which many women still do not have enough information, and when it arrives, they are afraid, anxious or frustrated.
Hence the importance of “being very well informed, because knowing the symptoms you can take actions according to each patient,” explains Dr. Arturo Rojas.
Adjustments to be made
Among the aspects that must be considered to prevent health from deteriorating are, for example, the type of nutrition, physical exercise, whether hormones are required or not, and “also knowing that it will be a stage of more or less 30 years to necessarily take care of ourselves,” highlights the Imbanaco Clinic professional.
And he adds that, “by knowing the stage of life we are in, we will be able to understand much better what we are exposed to and thus provide management to avoid pathologies that may appear over the years. Among them, cardiovascular diseases, such as myocardial infarction, the leading cause of death in women in menopause.
He emphasizes that osteoporosis can also be prevented, a silent disease that could lead to severe fractures and prostration; Likewise, genitourinary syndrome can be avoided, that is, changes due to dryness in the vagina, vulva and bladder, which cause pain, bleeding and infections.
Another important point derived from the knowledge of this common stage in the vast majority of women is the possibility of avoiding mood conditions, such as depression and anxiety, that alter daily functions due to fatigue.
According to Dr. Otálora, it is also recommended to attend annual medical check-ups to follow up on procedures such as mammography, cytology and vaginal ultrasound, and thus receive the best possible support during the climacteric.
New lifestyles
The gynecologist emphasizes the need to make lifestyle changes, such as having regular physical activity (walking, yoga, tai chi); include foods rich in calcium and avoid spicy products, alcohol and caffeine to reduce hot flashes.
Likewise, it suggests integrating foods with phytoestrogens such as soy, tofu and flax seeds to relieve symptoms.
“During menopause, the decrease in estrogen levels leaves the bones less protected, hence vitamin D plays a fundamental role in several body systems,” says gynecologist Alfonso Correa.
In addition to the above, women should not feel ashamed to talk about the topic and ideally they should encourage communication with their family and social support group or network.
Abbott professionals also highlight the importance of establishing friendly and empathetic work environments for those women who experience this condition.
The purpose, in any case, is to maintain a good quality of life, and not fear this stage.
One of the effects is weight gain, because, in many cases, it can go unnoticed, since it usually coincides with menopause. | Foto: Getty Images
How to mitigate changes
If menopause causes a hormonal deficiency, should all women take hormones? To this question, the answer is no.
The obstetrician-gynecologist María Celilia Arturo clarifies that treatments are divided into hormonal and non-hormonal according to each patient.
There are women who are in a group that cannot receive them due to having alterations or pathologies, such as: those who have suffered thrombosis, or are obese, smokers or those who have estrogen-dependent cancers: endometrium, breast and some ovarian.
“Each woman should have her own way of receiving guidance and whether she requires hormonal replacement, which will depend on her clinical history and the consultation with her treating gynecologist to define the dose, the route of administration, whether it is oral or transdermal; alone, with estrogen or estrogen plus progesterone or another combination,” the doctor says.
As for non-hormonal treatments, these consist of substances that help reduce vasomotor symptoms in a slower and weaker way. Among them are serotonin reuptake inhibitors, which are antidepressants.
What all women must comply with is routine exercise of at least 150 minutes per week, as well as maintaining healthy and adequate nutrition to avoid overweight and major alterations in blood sugar and cholesterol.
Monitoring your nutritional status will surely lead to adding some vitamins and trace elements necessary to further prevent cell oxidation, such as vitamins C, D, B complex, zinc and magnesium, which will be defined with the professional who accompanies you in this natural process. of life.
Generally, interdisciplinary management is warranted that may involve professionals such as gynecologist, psychiatrist, internist, urologist, nutritionist and others, depending on the case of each patient.
Take care of heart health
One of the key factors in the increase in heart pathologies among women is menopause, because during this period, levels of estrogen, a protective hormone of the cardiovascular system, decrease significantly.
“The drop in estrogen levels has a direct impact on a woman’s arterial health, which explains why heart disease is more prevalent after menopause,” explains Dr. Giovanni de la Cruz, Head of the Cardiology Unit. Cardiovascular Diagnosis at the Clínica del Country, in Bogotá.
You have to pay attention to the symptoms, since women usually present different cardiovascular signs than men. Instead of typical chest pain, they often experience fatigue, shortness of breath, and nausea.
The climacteric comprises the third part of our life. Approximately between 30 and 40 years we will be in this stage and we deserve to have an excellent quality of life. We are responsible for living it fully.”
Maria Cecilia Arturo Rojas, Gynecologist and obstetrician at the Imbanaco Clinic.