THE end of a woman’s fertility life is referred to as menopause during which conception has zero chances. This usually occurs on average at age 51 due to the aging process where there is a natural absence of menstruation for 12 consecutive months.

There are some medical treatments that may induce menopause such as a Total Abdominal Hysterectomy (TAH), chemotherapy and radiation to the ovaries.

Primary ovarian insufficiency, which is a rare genetic condition, is another cause for very early menopause (as early as 15 to 44) which is distinguished by irregular periods with only a 5 to10 percent chance of pregnancy. Some girl babies inherit this at birth whilst some girls may become victims of primary ovarian insufficiency due to an auto immune disease.

Apart from the absence of the period, the following signs and symptoms of menopause are hot flashes (sudden onset of bodily heat), night sweats, vaginal dryness, urinary urgency and urinary incontinence, insomnia, irritability, mood swings, depression, breast tenderness, dry skin, dry eyes, dry mouth, irregular periods and worsening of premenstrual syndrome.

Other symptoms are a racing heart, headaches, muscle and joint pains, hair loss or thinning, weight gain, temporary memory lapses, difficulty concentrating and changes in sex drive.

The intensity of symptoms varies by individual and can be experienced for a period of five to 10 years. However, it is comforting to know that symptoms wane over time.
Menopause has three stages; transitioning into, during and after, which are referred to as perimenopause, menopause and post menopause respectively. Pregnancy is possible during perimenopause which can begin around age 40 but after which estrogen levels begin to decline. Unlike perimenopause where eggs are still being released, no eggs are released during menopause. Menopause can happen as late as 59 years.

The Centre for Disease Control published a key finding from a 2017 National health interview in the United States that may indicate the major contributing factor to heart problems in this category of women. It was found that 56 per cent of perimenopausal women and 40 percent of postmenopausal women sleep less than seven hours during a 24-hour period.

However, the postmenopausal category was found to have a harder time falling asleep and complaining of not feeling rested for at least four days per week.
It has been established that post-menopausal women are not only at a higher risk of heart disease but also osteoporosis since estrogen affects both cholesterol and calcium levels.

It is important to highlight that vaginal bleeding after menopause is a red flag and suggest a visit to your gynaecologist soonest.

Menopause treatment depends on the individual. Treatment may be hormonal or non-hormonal. Over the years it was well established that there are some risks associated with the hormonal replacement therapy (HRT) option such as endometrial cancer (if uterus is still intact), stroke, deep vein thrombosis and gall stones.

The doctor usually weighs the benefits against the risks. So, for the few young women who suffer from primary ovarian insufficiency, HRT will be initiated early to protect the heart, brain and bones and will only be discontinued around menopausal age.

Non-hormonal treatment includes diet, exercise (including Kegel exercises if necessary), lubricants, a support buddy or group, adequate rest, de-stressing and prescription medications. Fruits, vegetables, legumes (beans, peas and lentils) and grains are recommended. Weight loss can address hot flashes so eat less calories and move more since metabolism retardation is highest at this time.

Similarly, aging men like women are not spared from changes in their bodies. About 10 to 25 percent of men may experience a drop in testosterone levels at this stage in their life from mid-life or age 50 and older, which is referred to “male menopause” or andropause. This decline is not sudden, as in menopause, but is very slow over time.

The testosterone hormone, not only present in men, is responsible for muscle mass, physical and mental energy, an emotional response to a situation (fight or flight) and sex drive.

Some physical changes, which may be seen in men are an increase of body fat, gynaecomastia (development of breasts) and loss of body hair. Some men may not be aware of this andropause phase since they have no indications.

However, other signs and symptoms of andropause are lowered self-confidence, decreased motivation, depression, mood swings, poor concentration, decrease bone density, erectile dysfunction and infertility.

In January 2022, the University of Alberta indicated that new guidelines have been published to help pharmacists support the numerous underdiagnosed men who are experiencing late-onset hypogonadism, referred to as andropause.

A professor in the faculty of Pharmacy and Pharmaceutical Sciences believed that most of the symptoms experienced by older men such as trouble sleeping, depressed mood and erectile difficulties are misunderstood for stress.

It is known that from as early as the late 20s, testosterone levels begin to drop. So, when the cases are presented, the physician may not consider ruling out andropause and so those persons fall through the cracks. However, it is believed that such patients are more interactive with pharmacists who are positioned to offer help by referring to them to a physician, having screened the patient via interview.

In February 2023, Pharmacy Today, a publication by the American Pharmacy Association, focused on new approaches to treating menopause. Significant effort to detangle the aged-old controversy of HRT was propagated where it was considered that the WHI (Women’s Health Initiative) had framed this narrative since 1991.

According to NAMS (North American Menopause Society), most of the fearful side effects which discouraged persons from seeking HRT treatment was due to the late onset of initiating treatment, after age 60.

It was believed that at this stage heart disease, stroke and breast cancer were already developed due to aging and lifestyle. Newer classes of drugs are being processed since innovative approaches are unfolding about menopausal conditions such as hot flashes.

For further discussion, contact the pharmacist of Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.