A woman is menopausal when she no longer has monthly periods for 1 year. It is not a disease but a natural event where a woman's fertility comes to an end. It almost always takes place between the ages of 45 and 55.

A biological process takes place before and after menopause, divided into two phases.

Perimenopause begins when ovarian function decreases and menstrual periods become more irregular.
Postmenopause starts a year after menopause and is the period when the body adapts to the hormonal changes. It lasts an average of four years.

Preventing pregnancy

If you want to avoid pregnancy with certainty, contraceptives remain necessary. Although the chances of pregnancy in women over 50 are very low.

Usually, contraception already taken is further recommended until the age of 52.

Reduced hormone production during the menopausal years can cause discomfort. It cannot be predicted to what extent they will occur. Some women have a lot of symptoms, others hardly or not at all.

Typical menopause symptoms

Irregular and altered menstrual periods (e.g. more or less blood loss, longer or shorter menstrual periods).
(Nighttime) perspiration attacks.
Hot flashes: short, sudden and intense heat flashes, usually in the face, neck and chest and often accompanied by palpitations.
Vaginal dryness and pain during intercourse.
In addition, the following complaints may also occur:
- muscle and joint complaints;
- fatigue;
- irritability;
- gloomy feelings;
- insomnia;
- moodswings;
- brainfog.

There is often a domino effect, with one complaint triggering another. For instance, nocturnal perspiration attacks can lead to insomnia, which triggers fatigue, causing gloomy feelings to surface.

Not always due to menopause

Some symptoms may not be simply attributed to menopause.

Fatigue, irritability and gloomy feelings are usually caused by other conditions that are common during this period:
- intensified care for (in-law) parents;
- the loss of parents or partner:
- children leaving home;
- coping with childlessness rearing its head again.
Hot flashes and/or excessive perspiration can also be due to:
- excessive thyroid function;
- excessive alcohol consumption;
- the use of antidepressants or vasodilators.
Irregular blood loss can signal perimenopause but also various abnormalities.

Therefore, before attributing bothersome symptoms to menopause, a doctor will first rule out all other causes.

Healthy living

Healthy living helps against menopause symptoms. The two most important pillars are a healthy diet and sufficient exercise (at least thirty minutes a day).

A positive attitude, viewing the transition as the start of a new phase of life full of challenges, also leads to fewer symptoms.

Reducing hot flashes

Some simple measures can reduce the risk of hot flashes.

Wear cotton clothes instead of synthetic ones.
Avoid hot rooms.
Limit consumption of alcohol, highly spiced foods, coffee and tea.
Lower the bedroom temperature and do not use a synthetic down bed.
Do more physical exercise.

Preventing painful intercourse

If during intercourse the vagina does not become sufficiently moist, a lubricant can help. You can buy lubricant from the drugstore or pharmacy without a prescription. If this does not work, there are other remedies, some hormone-based that can help.

Benefits of natural products not proven

Hops, soy, flaxseed, sunflower seeds, ginseng and other natural products are often touted against menopause symptoms because their effect is said to be similar to that of oestrogens. However, their effectiveness has not been sufficiently proven. Some products even have side effects when taken in concentrated form (tablets).

Transitional symptoms usually go away on their own and rarely require medical treatment. From a purely medical point of view, menopause complaints should not be treated.

However, those who experience the symptoms as bothersome should visit their GP-gynaecologist. And in the situations below, a doctor's visit is indeed necessary:

Menstruation is more intense and accompanied by loss of blood clots.
Menstruations last longer than seven days or at least two to three days longer than usual.
The interval between two periods is shorter than 21 days.
Intermittent bleeding occurs (spotting).
There is bleeding after sexual intercourse.
Quality of life is compromised.

Hormonal drugs

If discomfort limits daily functioning, temporary medicines such as hormones may possibly be considered. However, these hormonal replacement drugs also have drawbacks that you should discuss with the doctor. While they may reduce heat flare-ups and night sweats, they involve a slight increase in breast cancer risk and increase the risk of blood clots.

Taking hormones does maintain or improve bone strength. There is also less risk of heart attack and less risk of skin ageing, vaginal dryness, ‘a sagging uterus’, urine leakage, functioning of liver enzymes, ...

Complaints aside, there is ample evidence in the recent medical community that taking hormonal replacement in early menopause gives protection later in life towards dementia, heart attack, osteoporosis, skin ageing, vaginal dryness, urine leakage, liver function.

Sleeping pills and sedatives

Sleeping pills and sedatives are not recommended. They may temporarily improve symptoms but do not remedy the cause and also have drawbacks.

Necessary tests

Mammography, bone densitometry and lab with review of hormones and a general review of liver and kidney function.

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