Menopause

Synonyms

• climacteric
• Climacterium
• Climacter
• Climax

English: climacteric

definition

The menopause describes the natural transition of a woman from full sexual maturity, the reproductive age, to the hormonal rest of the ovaries (ovaries), which determines the beginning of old age (senium).
The decrease in the hormonal activity of the ovaries becomes noticeable through the last menstrual period that takes place, which is known as menopause. This usually occurs at the age of 52 and is determined retrospectively after a year without bleeding.

The period before menopause with mostly irregular bleeding is referred to as Premenopausethat follow menopause as post menopause.
Due to the increasing decrease in hormone production by the ovaries, discomfort can occur throughout the menopause. They take on average Menopause for 10 years and take place between the 45th and 55th year of the woman's life.

root cause

Menopause is caused by changes in the organs of the ovaries, which result in a decrease in the number of egg cells and the hardening of vessels (Sclerotherapy) that contribute to the nutrition of the ovaries.

Of the birth a girl takes on the number of ova within the ovaries.
Already at the time of puberty of the initial two million egg cells, just an eighth of them is left.
This number of egg cells continues to decrease with increasing age of the woman, so that by around 52 years there are no more egg cells and therefore the Menopause (menopause) entry.
For this reason, the weight of the ovaries decreases progressively with the 4th decade of a woman's life. Bleeding that occurs after menopause should therefore always be examined by a doctor so that its cause can be clarified, which is often to be found in the continuing hormonal fluctuations.

At the beginning of Menopause (Climacteric) there is a decreased hormone production in the second half of the female monthly cycle, medically the luteal phase. Because of this hormonal change which the sex hormone progesterone concern, gradually decreases a woman's ability to conceive and thus the creation of a pregnancy from.

As a result, the Ovulationwhat is known as anovulation. Nevertheless, the menstrual period continues initially, the cause of which is the rejection of the top layer of the uterus (Stratum functionalale) is.
In the period before menopause, in particular, there are frequent intermenstrual bleeding and irregular cycles, the reason being the gradually declining function of the ovaries.

Due to the altered progesterone production in the second half of the female cycle, the muscle layer of the uterus (Endometrium) not constructed and converted as usual. This can lead to enlargements of the uterus come when the number of cells increases (hyperplasia).

In the further course of the Menopause and as the ovarian dysfunction increases, so does hormone production in the first half of the cycle. Another female sex hormone is affected. It will estrogen called and decreases in quantity also more and more in the course of the menopause. It should be emphasized, however, that the production of estrogens is not completely stopped. A preliminary stage of estrogens can still be formed, especially in the peripheral area of ​​the ovaries, and then converted in some fat cells with the help of appropriate substances.

Hormones are also produced in parts of the brain that stimulate the ovaries and stimulate them to produce hormones for female sex hormones. your name is FSH (foliclestimulating Hormon) and LH (luteinizing Hormon). With the onset of menopause, FSH and LH are not inhibited by the free sex hormones, as is usually the case, but instead increase in their quantity. This increase in FSH and LH can be seen in the blood of the woman and is a definite manifestation in menopause.
The increase in hormones after the menopause declines a little again around the age of 65, but it always remains higher than before the menopause.

Age

The age at which a woman enters menopause varies. Menopause usually begins between the ages of 40 and 50, and in some cases later. Only with surgical removal of the ovaries does the menopause begin immediately.

Signs of menopause

The onset of menopause can be noticeable through various signs. The most important sign is increasingly irregular menstrual periods. In addition, hot flashes, heavy sweating without a special trigger, sleep disorders, irritable mood and exhaustion can occur. It can also lead to a depressed mood, nervousness, dryness in the genital area and weight gain. At the beginning of menopause, menstrual periods are often shorter than before and the intervals between two periods of bleeding increase. In some women, however, the bleeding may get heavier at first. At some point there is a complete absence of the menstrual period.

Read more on the topic: Signs of menopause

In addition, some women notice unusual weight gain and a redistribution of fat that is more similar to the distribution of fat in a man (the male sex hormone gains influence due to the continuous decrease in estrogen levels). In most cases, the abdomen and breasts will be larger while the bottom will be flatter. Meals that could previously be eaten without noticeable weight gain are now too much due to the body's lower energy requirements during menopause.

Another frequently described symptom of menopause is a feeling of tightness or pain in the chest, which is also caused by falling estrogen levels. Quite a few women also complain of the onset of bladder weakness during this time, which, however, is less caused by the hormonal effects of menopause, but rather by the pelvic floor muscles weakened by multiple pregnancies and births.

Read more on this topic at:

• Menopause symptoms
• excessive sweating during menopause
• Palpitations during menopause

Menopause symptoms

The main symptoms of Menopause are diverse and individually very different in their strength. Most women complain right at the beginning increasing menstrual cycle changes: The bleeding will be stronger and longer persistent and the intervals between the individual bleeds increase until the period finally stops completely.

More common ones Menopause symptoms are sudden, unexpected hot flashes, excessive sweating and Sweats especially in the face, neck and upper body area. These can lead to unpleasant situations in everyday life during the day and have a strong impact on regular and energizing sleep at night.
This Problems falling and staying asleep often occur in women going through menopause and have an impact on their physical well-being that should not be underestimated. The resulting Signs of exhaustion and Reduced performance can cause symptoms such as excessive irritability, dissatisfaction or strong mood swings, which in turn have an influence on sleep behavior. This vicious circle burdens some women so much that their basic mood can even change towards depression. In this case, it is advisable to seek professional psychological advice.

Another common symptom of menopause is one disturbing drought of the mucous membranes (especially in the area of ​​the vagina as Vaginal dryness), which can cause problems during intercourse. The resulting restriction of intimacy with the partner can even lead to relationship conflicts. Openness and discussions about worries, fears and physical stress are essential during menopause for a stable relationship in which the partners give each other support.

Weight gain

Round 60% of women in menopause complain of unwanted weight gain despite unchanged eating habits. Of the Po becomes flatter, the Waist wider and The chest and stomach grow larger. The fat distribution is increasingly similar to that of a man, who is affected by the falling estrogen level and the resulting increasing influence of the male sex hormone testosterone (a woman has female and male sex hormones as well as many other hormones in her body; if the concentration of a hormone drops, there is one Effect enhancement of the other) is due.

The increasing proportion of fat in the abdomen also increases the risk of diabetes mellitus, Lipid metabolic diseases, High blood pressure and others Cardiovascular diseasestherefore weight gain should not proceed unimpeded. To get an overview of whether your own weight gain is actually a problem, you can use your own body mass index (BMI) determine. Here you divide the weight in kilograms by the square of your own height in meters. A result under 19 means that a Underweight present (so you weigh too little for your height). Between 19 and 24.9 one speaks of normal body weight, whereas values ​​between 25 and 29.9 are already overweight indicate. However, the values ​​should over 30 be, one speaks of one severe obesity.

The weight gain that occurs during menopause is caused by an age-related decline in the basal metabolic rate, i.e. of the daily energy requirement (Calorie requirement) decreases. This is partly due to the decreasing muscle mass to explain, because in the muscles the energy turnover takes place and if there are fewer muscles, only less energy can be used. The excess energy is stored in the form of adipose tissue. If a woman going through menopause eats the same large portions with meals as usual, this can already be too much due to the significantly slower metabolism. In this case you should think carefully about whether the size of the portion is actually necessary to be full.

Another factor influencing weight gain during menopause is the decreasing level of exercise. This means that fewer calories are consumed and the fat stores increase in volume. However, if you want to prevent this, it is recommended regular exercise to drive and thus support muscle building. In addition, a woman should eat a balanced diet, especially during her menopause lots of whole grains, fruits, vegetable fats, low fat meats, fish and dairy products to take in. This not only reduces weight gain, but also reduces the risk of osteoporosis (Bone loss) decreased. However, there is one small advantage of weight gain: adipose tissue produces estrogen. In this way, the fat tissue can at least partially compensate for the falling estrogen level. The classic symptoms of estrogen withdrawal such as hot flashes, sleep disorders, dry mucous membranes, incipient osteoporosis etc. are noticeably reduced.

sweat

Sweating is a typical symptom of menopause that many women suffer from. All of a sudden, hot flashes occur without a specific trigger. This can be very uncomfortable, especially in public, as some women are actually wet with sweat within a few moments. If the symptoms are very severe, treatment of the symptoms can be considered.

Read more on the topic: Menopause symptoms

Pain in the ovaries

Ovarian pain is not a typical symptom of menopause. If the symptoms persist, a medical clarification is therefore recommended. Ovarian pain during menopause can hide harmless causes, but also various diseases. For example, the pain can be caused by ovarian cysts or an ovarian inflammation. In addition, the incidence of ovarian cancer increases with advanced age, so that clarification is urgently recommended if there are complaints in this area.

Read more on the topic; Pain in the ovaries

test

There is no clear test of whether menopause has started. However, there are physical signs that can indicate menopause. Above all, menopause can be recognized by the fact that the menstrual period is increasingly irregular. In addition, the woman should pay attention to other typical symptoms, such as hot flashes. Taken together, all the signs can point to menopause. If in doubt, a visit to a gynecologist can help to classify the symptoms.

Hormones

During the menopause there is a change in the hormonal balance. The body's own production of female hormones decreases. This is noticeable through various complaints.Accordingly, it is possible to carry out hormone replacement therapy during menopause. The lack of female hormones is compensated for and the typical menopausal symptoms can largely be prevented.

diagnosis

Mostly are used to diagnose the Menopause No further examinations are necessary, as the appearance of the symptoms of an estrogen deficiency at the appropriate age of the woman can make a clear diagnosis of menopause.
In the course of this, a vaginal cytological examination is recommended, in which cells from the Vagina (sheath) taken in a smear and then assessed under the microscope.
This examination provides information about whether the body is still producing enough estrogen, as this is not completely absent even after the menopause. Should the menopause (Climacteric praecox), a hormone test can take place to confirm the diagnosis. In principle, this is not necessary at first.

When does a woman go through menopause?

A woman goes into menopause when the function of her ovaries dries up and she therefore no longer has any eggs to ovulate. This point in time is different for each woman and depends on many different factors. Both genetic and environmental factors play a role in the timing of the final onset of menopause. Most women go through menopause between 40-50 years of age, with some women it only occurs later. Even before the final no menstrual period, hormonal changes begin in the woman's body. The beginning of these changes is difficult to determine. By definition, however, the “real” menopause is only reached when the ovarian function has completely dried up. Women who have to have their ovaries removed surgically experience an immediate onset of menopause with the correspondingly radical onset of symptoms of hormonal deficiency.

Read more on the topic: Signs of menopause

Does menopause also affect men?

There is also a type of menopause in men. However, unlike women, these do not necessarily appear in the form of symptoms in every man. This so-called andropause in men is also not clearly defined, since in men there is a gradual decrease in hormonal production in the course of life and therefore no specific time for menopause can be defined. If symptoms do occur, however, they are similar to symptoms of a woman during the menopause and usually occur between the ages of 45 and 65. In general, the term “menopause” is controversial as such for men.

therapy

A few years ago, women with menopausal symptoms were treated generously with hormone replacement therapy. In this case, the female sex hormones are supplied by medication. However, after several studies pointed out the side effects of such a therapy, especially long-term therapy, there was a rethinking of the forms of therapy. So nowadays, herbal active ingredients are increasingly being used in the therapy of climacteric complaints. Increased physical activity and a targeted diet rich in calcium (e.g. through dairy products such as cheese) can improve symptoms, especially around menopause. Without hormone replacement therapy, the symptoms of menopause usually decrease after one to two years, so that the woman no longer feels impaired.

In addition, the individually different symptoms can usually be adequately treated individually. The skin changes already described lead to a loss of elasticity, strength and moisture in the tissue. That is why it is particularly important to have sufficient sun protection on the skin so that the tissue does not become increasingly stressful. Moisturizing creams or oily skin creams can also help with dry skin. The pain during sexual intercourse caused by dry mucous membranes of the vagina can be effectively treated and avoided with lubricating cream or locally applied estrogens.
Heavy bleeding irregularities around the menopause occasionally require surgical removal of the uterus (hysterectomy) necessary.
Psychotherapy or psychotropic drugs can help if the psychological changes are particularly pronounced.
Hormone replacement therapy is only used if there is a medical need, such as massive menopausal symptoms, early onset of menopause before the age of 43, severe changes in the external genitals and early surgical removal of the ovaries (Ovariectomy) or their early loss of function.
The hormone therapy is always adapted to the individual complaints, so that the choice of the appropriate drug depends on the type, strength and time of occurrence.

Basically, the administered hormones are all estrogen combination preparations. These consist of one part each from the hormone group of estrogen and another part from the progesterone group (this group of hormones is also called gestagens). The hormones administered are either naturally obtained sex hormones or have been produced artificially. The hormones are administered in different ways. They can be taken in the form of tablets through the mouth, through the skin as a plaster or as a cream through the vagina (vagina), but they can also be injected through the skin.
Earlier blood clots speak against hormone therapy (Thromboembolism), Breast cancer and uterine cancer (breast and body cancer) as well as severe liver damage.
The duration of therapy is determined individually for each woman, but for half of all women treated it is about one year and should not be longer than two years due to the side effects.
Symptoms such as nausea, weight gain and water retention are described as possible side effects of such therapy (Edema) but also stomach and headaches as well as tension pains in the chest are possible.

Since menopause is a naturally occurring part of a woman's life and contributes to her aging and maturation process, it is not possible to bypass menopause or prevent it with the help of medication. Physical activity, a healthy balanced diet and a healthy sleep have a positive effect on reducing and experiencing symptoms during menopause.

Read more about the treatment of menopausal symptoms at: Medication for menopause or Hormone replacement therapy in menopause

Medication

There is the possibility of alleviating menopausal symptoms with medication or of bringing them to bear completely. Since the symptoms of menopause are caused by changing hormone levels, female hormones can be used therapeutically to combat the symptoms. However, this so-called hormone replacement therapy is very controversial in medicine, as the increased occurrence of certain diseases has been observed. For example, from various cancer and cardiovascular diseases. Homeopathic and naturopathic remedies for menopausal symptoms are also increasingly being used, which can also alleviate the symptoms. For example, preparations made from monk's pepper, yarrow and black cohosh are often taken during menopause to combat unpleasant symptoms such as hot flashes.

Read more on the topic: Homeopathy for menopause or Hormone replacement therapy in menopause

Duration

The duration of menopause varies from woman to woman. In most cases, they manifest themselves for the first time at around 45 years of age in the form of cycle changes and only end at the age of 65-70 in the form of the resolution of the last remaining symptoms. This 20-25 year long phase of a woman's body is divided into different but smoothly merging sections: Premenopause, Perimenopause With menopause and Post menopause.

The symptoms can last up to 15 years. For some women, however, menopause is significantly shorter and over in three years or less. It is therefore difficult to predict how long an individual woman will suffer from menopausal symptoms. In general, it could be observed that the symptoms tend to last longer the earlier they appear in the woman. Women who enter menopause early often suffer longer from menopausal symptoms than other women who started menopause later.

During premenopause, the body slowly prepares to stop bleeding. The ovaries now work more slowly, i.e. only a few ovulations take place and the production of estrogen is reduced. At this point, the first cycle changes become noticeable. The bleeding becomes stronger and longer, but also increasingly irregular until it finally stops completely after menopause (menopause is the last bleeding). This period around menopause is also summarized as perimenopause.

Also read the article: The menopause.

In the next step, the body now has to create a new equilibrium, because the estrogen and gestagen production has almost ceased. The time it takes to find a new balance also varies greatly from person to person. In order to get an approximate overview of the period of one's own menopause, however, it is possible to find out more about the rough key data of the mother's menopause. In all likelihood, your menopause will be very similar to your own.