Even More Than Just Hot Flushes…

Even More Than Just Hot Flushes…

More than 90 percent of women were never taught about menopause at school, and more than 60 percent did not feel informed at all about menopause. So, let school commence and let's learn more about menopause. It is about a lot more than just hot flushes. 

Menopause is like a fingerprint, no two are ever the same. There are over thirty-four recognised symptoms and on average women experience eight of those, meaning every woman’s experience is nuanced and different. Almost a third of women aged between 50 and 64 find the symptoms of the menopause so debilitating that they consider reducing/ reduce their working hours or changing their working pattern completely.

So what are the full list of symptoms?

We've covered the biggies in the preceding article, More than Hot Flushes, which can be read here. 

Perimenopause, the transitional phase leading up to menopause, is marked by hormonal fluctuations that can give rise to various symptoms, including the exacerbation of premenstrual syndrome (PMS) for some women. Often referred to as "perimenopausal PMS," this intensification can manifest as more pronounced emotional and physical symptoms in the weeks leading up to menstruation. Hormonal changes, particularly the irregularity in oestrogen and progesterone levels, contribute to the heightened sensitivity of the reproductive system during perimenopause. 

This can result in mood swings, irritability, bloating, breast tenderness, and other classic PMS symptoms becoming more pronounced and disruptive to daily life.

The intensification of PMS during perimenopause can vary from woman to woman, with some experiencing only subtle changes, while others may find their symptoms significantly magnified.

In additon to breast tenderness, breast size can also change at this time. Fluctuations in breast size during menopause can be attributed to various factors. The hormonal shifts that define this life stage, including a decrease in oestrogen and progesterone, influence the composition of breast tissue. These changes often result in a reduction in the glandular tissue of the breasts, which can lead to a decrease in breast size. Additionally, as women age, the supportive ligaments of the breasts may lose elasticity, causing a shift in breast positioning and potentially contributing to perceived size changes. Variations in body weight and fat distribution can also impact breast size during menopause. It's essential to wear appropriately fitting bras and maintain regular breast health check-ups, as breast changes during this time are not uncommon and may affect comfort and appearance.

Genitourinary Syndrome of Menopause (GSM), another consequence of hormonal changes, that we spoke of a lot in our previous article, can contribute to discomfort in the urinary tract and cause an increase in UTIs. Additionally, some menopausal women experience increased urinary frequency and urgency, which can lead to urge incontinence. 

This can also create general bladder weakness, a common concern during menopause, which often arises from the hormonal shifts of menopause. The decline in oestrogen levels can lead to weakened pelvic floor muscles and bladder support tissues, resulting in urinary symptoms. Stress urinary incontinence, characterised by leakage during activities like coughing or sneezing, is a frequent manifestation. 

While these symptoms can be distressing, various strategies, including pelvic floor exercises, lifestyle modifications, and, in some cases, hormone therapy or medication, can help manage and improve bladder health during menopause.

Bloating may arise as a symptom during menopause due to a combination of factors. Hormonal fluctuations, especially the decline in oestrogen levels, can disrupt the body's fluid processing and retention mechanisms, potentially resulting in fluid retention and bloating. Furthermore, these hormonal shifts can affect the digestive system, leading to changes in digestion and the possibility of experiencing gas and discomfort. The metabolic slowdown that often accompanies menopause can make weight gain more likely, further contributing to the sensation of bloating. Additionally, alterations in lifestyle, such as decreased physical activity and adjustments in diet, can influence digestive patterns and contribute to the perception of bloating in menopausal women.

The perceptibility of body odour tends to increase in menopausal women due to a confluence of factors. Hormonal fluctuations, particularly the decline in oestrogen, can bring about alterations in both the production and composition of sweat. These changes in sweat create an environment more conducive to the proliferation of odour-producing bacteria. Furthermore, as women age and undergo menopause, the slowing of metabolism can impact the breakdown of specific compounds in sweat, potentially intensifying the odour. Lifestyle elements, such as heightened stress or modifications in diet, also play a role in influencing body odour during this life stage. Managing body odour and enhancing overall comfort during menopause can be achieved through practices like staying hydrated, maintaining good hygiene, and opting for breathable fabrics.

Respiratory challenges may arise during menopause due to a complex interplay of factors. Hormonal shifts, especially the decrease in oestrogen, can induce alterations in lung function and airway elasticity. These changes might pose challenges for certain menopausal individuals, making deep breaths more difficult or causing a sense of breathlessness. Additionally, hormonal fluctuations can influence the autonomic nervous system, which plays a role in regulating breathing. Menopausal symptoms like hot flashes and night sweats, disrupting sleep and causing fatigue, can further impact respiratory function. Adopting a healthy lifestyle, encompassing regular exercise and stress management, proves beneficial in alleviating these breathing issues during menopause. It's crucial to consult with a healthcare provider to rule out any underlying medical conditions that might contribute to respiratory difficulties.

The emergence of Burning Mouth Syndrome (BMS) as a challenging symptom during menopause is intricately linked to a multifaceted set of factors. While the precise cause remains elusive, various elements contribute to this condition. Hormonal fluctuations, especially the reduction in oestrogen levels, can affect the oral mucosa and nerve function, potentially causing a burning or discomfort sensation in the mouth. Furthermore, emotional stress and anxiety commonly associated with menopause can worsen BMS. Alterations in taste perception, dry mouth, and the use of specific medications during this life stage may also contribute to the onset or intensification of the condition. Addressing and managing Burning Mouth Syndrome during menopause involves essential steps such as maintaining proper hydration, adopting a balanced diet, practising stress management, and seeking guidance from a healthcare provider.

As oestrogen levels decrease, changes in taste and smell perception may occur. This hormonal shift can impact taste buds and olfactory receptors, resulting in a diminished ability to detect and enjoy certain flavours and aromas. Additionally, the natural ageing process can contribute to alterations in taste and smell, as sensory receptors may naturally become less sensitive over time.

Research indicates that more than one in four (28 percent) post-menopausal women are likely to experience tooth loss within five years. The decline in oestrogen levels during menopause can affect gum health, leading to reduced blood flow to the gums, making them more vulnerable to inflammation and irritation. As oestrogen levels drop, the entire body, including the mouth, becomes drier, creating an environment where bacteria can cause tooth decay, bleeding, or receding gums. Hormonal shifts can modify the body's immune response, potentially increasing the risk of gum disease and discomfort. Age-related changes, such as decreased saliva production and weakened gum tissue, can also contribute to gum sensitivity. Osteoporosis, which affects the jaw, may initially manifest as the recession of the gum line, exposing more of the tooth and increasing the potential for tooth decay.

Dry mouth and eyes during menopause result from a blend of hormonal changes and the natural ageing process. The decline in oestrogen levels in menopause affects saliva and tear production, leading to dryness in the mouth and eyes. Hormonal fluctuations can impact the distribution of body fluids, potentially reducing moisture in mucous membranes, such as those in the mouth and eyes. Additionally, the gradual ageing process contributes to a natural decline in saliva and tear production, accentuating these symptoms in menopausal women. Lifestyle factors, such as increased consumption of caffeine or alcohol and certain medications, can worsen these symptoms. To alleviate dry mouth and eyes during menopause, it's essential to stay well-hydrated, use eye drops, and maintain good oral hygiene.

Heart palpitations during menopause can be attributed to hormonal fluctuations and the physiological changes that accompany this life stage. The decline in oestrogen levels can impact the autonomic nervous system, responsible for regulating heart rate and rhythm, potentially causing irregularities in heartbeats that manifest as palpitations. The heightened body response to stress and anxiety during menopause can also contribute to palpitations. Additionally, common menopausal symptoms like hot flashes and night sweats may lead to an increased heart rate, further exacerbating palpitations. Lifestyle factors, such as diet and exercise, play a role in heart health during menopause. It is crucial to discuss palpitations with a healthcare provider to rule out any underlying heart conditions and determine the most appropriate management strategies.

Nails, composed of the hard protein keratin, undergo changes during perimenopause and menopause due to declining oestrogen levels, which weaken keratin and reduce nail resilience. Lower oestrogen levels contribute to hair feeling brittle and the scalp becoming dry, while decreasing progesterone levels affect hair growth. Oestrogen, in addition to its role in hair and nail health, plays a crucial role in regulating water retention, making dehydration more likely. Consequently, this can lead to flaky nails, as well as changes in skin and hair. The hormonal shifts during this phase can impact various aspects of our physical well-being.

Skin brightness and elasticity can really suffer during menopause. Oestrogen plays a crucial role in maintaining skin health. It enhances the production of glycosaminoglycans, which contribute to skin hydration, and stimulates sebum production, preventing excessive dryness. Oestrogen also aids in increasing water retention, ensuring the skin remains supple, and fortifies the protective barrier of the stratum corneum, the outermost layer of the skin. However, as women transition through menopause and experience a significant decline in oestrogen levels, these beneficial effects diminish, often leading to dry and dull skin. Knowing this, you can change your skin care regime, introduce different types of products and inject more moisture and vitamins into your regime.

In addition to dryness, menopausal changes in hormone levels contribute to the degradation of elastin, a protein crucial for skin elasticity. The microvasculature diminishes, and the epidermis thins, resulting in noticeable changes in skin texture. Moreover, the decline in oestrogen leads to a reduction in axillary and pubic hair. Some women report experiencing pruritus, characterised by itching sensations, while others describe a peculiar feeling of ants crawling on their skin, a phenomenon known as formication. These diverse effects underscore the intricate relationship between hormonal changes and skin physiology during the menopausal transition.

Sarcopenia refers to the age-related loss of muscle mass, strength, and function. While it is not exclusive to menopause, hormonal changes during this life stage can contribute to its development. The science of sarcopenia in menopause involves understanding the impact of hormonal fluctuations, particularly the decline in oestrogen, on muscle health.

Oestrogen plays a role in muscle protein synthesis, and its reduction during menopause may contribute to the acceleration of muscle loss. Additionally, lower oestrogen levels are associated with an increase in inflammatory markers, which can further exacerbate muscle wasting. The decline in muscle mass and strength during menopause can lead to various health issues, including a higher risk of falls, fractures, and overall reduced physical function.

To mitigate sarcopenia during menopause, interventions often include regular exercise, especially resistance training, to promote muscle growth and maintenance. Adequate protein intake is also crucial for supporting muscle health. Hormone replacement therapy (HRT), which involves supplementing oestrogen, has been explored as a potential intervention to mitigate the impact of hormonal changes on muscle mass during menopause, but it comes with its own set of considerations and risks, so its use is determined on an individual basis in consultation with healthcare providers. Understanding the science behind sarcopenia in menopause is vital for developing effective strategies to promote healthy ageing and maintain muscle function in women as they go through this life stage.

Osteoporosis is a systemic skeletal disorder characterised by diminished bone density and the deterioration of bone microarchitecture, leading to increased bone fragility and a heightened susceptibility to fractures. Oestrogen, a hormone crucial for maintaining bone health, plays a pivotal role in preventing bone loss and regulating excessive osteoclastic resorption, potentially aiding in the restoration of lost bone mass. As women enter the postmenopausal stage and experience a significant decline in oestrogen levels, the risk of osteoporosis becomes substantially elevated. Statistics reveal that approximately one in three women over the age of 50 may experience fractures due to weakened bone strength, particularly in areas prone to minimal trauma.

These fractures, often occurring in the hip, spine, and wrist, are a serious health concern, ranking as the fourth leading cause of chronic ailments and associated morbidity. The aftermath of fractures, especially hip fractures, can be severe, with shockingly high mortality rates, reaching up to 25% within the first year following such an incident. Understanding the impact of hormonal changes, particularly the decline in estrogen, on bone health is essential in developing preventive measures and effective interventions to mitigate the risk of osteoporosis and its associated complications in postmenopausal women.

The decline in oestrogen levels during menopause, compounded by the inherent ageing process, leads to metabolic changes that significantly increase the risk of cardiovascular disease (CVD), a leading cause of mortality in women. This elevated risk is linked to several interconnected factors, including the accumulation of visceral fat, unfavourable modifications in lipid profiles, and changes in blood vessels. Additionally, diminished endothelial function, heightened insulin resistance, elevated blood pressure, and the activation of the renin-angiotensin pathway contribute collectively to the development of atherosclerosis, a key driver of cardiovascular events.

The intricate interplay of these metabolic shifts underscores the multifaceted impact of hormonal changes during menopause on cardiovascular health. Understanding these mechanisms is crucial for implementing preventive strategies and personalised interventions to mitigate the heightened risk of cardiovascular disease in postmenopausal women, promoting overall heart health during this critical life stage.

Menopausal acne is a prevalent concern affecting a significant portion of women in their forties and fifties, with around 25% encountering skin issues during this transitional phase. The primary culprit behind menopausal acne lies in hormonal changes reminiscent of puberty. As oestrogen levels decline, androgens, a type of male hormone, maintain consistency, excessively stimulating oil glands and obstructing hair follicles. This hormonal imbalance becomes conducive to the development of acne, a challenge that persists even for those utilising hormone replacement therapy (HRT) to supplement oestrogen. HRT introduces progestin into the body, further disrupting the skin's equilibrium and contributing to the persistence of acne issues.

Menopausal acne presents distinctive patterns, typically manifesting on the lower cheeks and along the jawline, in contrast to the acne experienced during adolescence. Intriguingly, some women who enjoyed clear skin in their youth may grapple with blemishes in adulthood during menopause. Dermatologists note a rising trend in acne cases among older women, observing instances of breakouts for the first time as individuals enter middle age. This complex interplay of hormonal shifts during menopause underscores the need for nuanced skincare strategies and targeted dermatological interventions to address the unique challenges faced by women in this life stage.

Menopause electric shock sensations, often referred to as "menopausal zaps" or "menopausal electric shocks," are a distinctive symptom experienced by some women during the menopausal transition. These sensations are characterised by sudden, brief jolts or shocks that women describe as feeling like electric currents passing through various parts of their bodies. These sensations can be unpredictable and may occur in different areas, such as the head, face, neck, or extremities. While the exact cause of these electric shock sensations is not fully understood, hormonal fluctuations, particularly the decline in oestrogen levels, are believed to play a role. Oestrogen has known effects on the nervous system, and its reduction during menopause may contribute to changes in nerve function, potentially leading to these unique sensations.

The impact of menopausal electric shock sensations can vary from mild discomfort to more intense jolts that can be disruptive to daily life. Some women may experience these sensations sporadically, while others may have them more frequently. The phenomenon is considered a part of the broader spectrum of menopausal symptoms, and managing these electric shock sensations often involves addressing overall menopausal symptoms through lifestyle changes, stress management, and, in some cases, medical interventions. Consulting with a healthcare provider can help determine an individualised approach to managing menopausal symptoms, including electric shock sensations, to enhance the overall well-being of women navigating through this life stage.


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