What is Hormone Replacement Therapy?

Menopause marks the end of a woman’s reproductive years and the transition out of fertility. It is a natural process that every woman goes through as she ages. 

However, hormonal changes during menopause can bring uncomfortable symptoms and changes that significantly impact the quality of life. 

Understanding what causes menopause, how long it lasts, and the best ways to manage symptoms can help women navigate this life stage with more ease and confidence.

What is Menopause?

Menopause occurs when a woman has not had a menstrual period for 12 consecutive months. It indicates the ovaries have stopped releasing eggs and producing reproductive hormones like estrogen and progesterone. 

Menopause is diagnosed retrospectively once a woman has missed her period for a full year. 

The average age of menopause is 51, but it can happen between ages 45 to 55. Menopause before age 45 is considered premature menopause.

How Long Does Menopause Last?

Menopause itself only lasts a single day. However, the menopausal transition, known as perimenopause, typically begins several years before menopause and lasts around 4-6 years for most women. During this transition, hormone levels fluctuate and eventually decline, causing the symptoms associated with menopause like hot flashes, menstrual changes, and vaginal dryness. After menopause has occurred, women enter postmenopause which lasts for the rest of their lives. Treatment and close monitoring by a doctor may be needed during the menopausal transition and beyond.

The Role of a Private Menopause Clinic

Seeing a menopause specialist at a private menopause clinic can help provide relief from troublesome symptoms that significantly impact the quality of life. A menopause specialist has advanced training in hormones, menopause, and medical management options available. They will do a thorough assessment, diagnose the stage of menopause, evaluate risks like bone loss or heart disease, and recommend a customized treatment plan based on individual needs and health risks. Options may include therapy at a hormone replacement clinic, medications, lifestyle changes, or alternative therapies.

What Causes Menopause?

Menopause is a natural ageing process that occurs as a woman’s ovaries age and produce fewer eggs. Several factors influence when menopause occurs:

•Ovarian ageing: A woman is born with all her eggs, and they age over time. By the 40s and 50s, most eggs have died or aged, causing the ovaries to stop functioning.

•Declining egg supply: Women are born with 1-2 million eggs, but only 300-400 eggs are released during their lifetime through ovulation. The rest of the eggs die or absorb into the body. By the late 30s, over 90% of eggs are gone.

•Family history: Women who experience menopause before the age of 45 tend to have mothers or sisters who went through early menopause as well. Genetics plays a role in the age at menopause occurs for some women.

•Certain surgeries or health conditions: Removal of the ovaries or damage from treatments like chemotherapy or radiation therapy cause acute menopause with suddenly declining hormone levels. Some autoimmune or endocrine disorders may also trigger early menopause.

•Smoking: Long-term smoking accelerates ovarian ageing and follicle loss, which leads to on average 1-2 years earlier menopause than non-smokers. Quitting smoking can help delay the onset of menopause, even when quitting later in life.

Menopause Diagnosis

In addition to missed periods for 12 months, menopause is typically diagnosed using two blood tests to check hormone levels:

•Follicle stimulating hormone (FSH) test: FSH levels rise as the ovaries fail, so a high FSH indicates menopause. FSH levels higher than 30-40 miU/mL are consistent with menopause for most labs.

•Estradiol test: The main estrogen produced by the ovaries, estradiol, declines significantly at menopause. Very low estradiol levels, typically less than 30 pg/mL confirm depleted ovarian function.

In some women, an ultrasound may also be done to check the ovaries for signs they have stopped releasing eggs, such as low follicle count or ovarian volume. A formal diagnosis of menopause opens up treatment options to help relieve symptoms and reduce health risks that come with long-term estrogen loss.

Menopause Treatments

The goals of menopause treatment include relieving troublesome symptoms like hot flashes and vaginal dryness, reducing risks of osteoporosis and heart disease from lack of estrogen, and improving quality of life. The main options for managing menopause include:

  1. Hormone replacement therapy (HRT): Estrogen therapy helps relieve symptoms by replacing depleted hormones. Estrogen is available as pills, skin patches, gels, injections, and vaginal creams. Progestin may be needed for women with a uterus to reduce the risk of endometrial cancer. HRT does carry some risks like blood clots or stroke, so women with certain health conditions may not be able to take it.
  2. Medications: For women unable or unwilling to take hormones, certain medications like antidepressants, Gabapentin, or clonidine may provide relief from hot flashes and night sweats. Vaginal estrogen or moisturizers can help with vaginal dryness.
  3. Vitamins and supplements: Some supplements like evening primrose oil, omega-3 fatty acids, and flax seeds may help balance hormones and relieve symptoms. Always talk to your doctor before taking supplements to avoid interference with any other medications.
  4. Lifestyle changes: Simple lifestyle changes can significantly help with symptom relief and overall wellness during and after menopause. These include:

Mind-body therapies for menopause

•Exercise regularly. Aerobic and strength training exercises help release endorphins to improve mood and sleep, build bone density, and prevent weight gain.

•Practice relaxation techniques. Yoga, meditation, mindfulness and deep breathing help reduce stress and anxiety, improve sleep, and decrease the severity/frequency of hot flashes.

• Limit alcohol/caffeine/spicy foods. These substances can trigger or worsen symptoms like hot flashes and sleep problems in some women.

•Stay hydrated and dress in layers. Keeping hydrated and wearing breathable clothing help regulate body temperature changes from menopause to minimize the severity of hot flashes.

•Stop smoking. Smoking accelerates the ageing of the ovaries and increases risks associated with menopause like osteoporosis, heart disease, and earlier death. Quitting improves the quality of life and longevity.

Menopause is an inevitability for all women, but with the right resources and support from her healthcare team, symptoms can be managed and risks reduced so that women can thrive in the postmenopausal years. Speaking with your doctor about any concerns you have regarding menopause is the first step towards the lifestyle adjustments and treatments available to help you navigate this transition with confidence and grace.