Menopause describes the natural transition of a woman from full sexual maturity, the reproductive age, to the hormonal rest of the ovaries, which determines the onset of senile age.
Noticeable is the decrease in the hormonal activity of the ovaries due to the last menstruation (menstruation), which is called menopause. This usually occurs at the age of 52 years and is determined retrospectively after a bleeding-free year.
The period before menopause with mostly irregular bleeding is known as premenopause, which is postmenopausal after menopause.
The increasing decrease in ovarian hormone production can cause discomfort throughout the menopause. On average, menopause lasts 10 years and takes place between the 45th and 55th of the woman's life.
Menopause has its origin in organ abnormalities of the ovaries, which are reflected in a decrease in oocytes and the hardening of the vessels ( sclerosis ), which contribute to the nutrition of the ovaries.
From the birth of a girl, the number of eggs within the ovaries decreases.
Already at the time of puberty of the initially two million egg cells just one-eighth of it left.
This number of oocytes continues to decrease with increasing age of the woman, so that at about 52 years, there are no more eggs and therefore the menopause (menopause) occurs.
For this reason, the weight of the ovaries decreases with the 4th decade of life of a woman increasingly. Bleeding after menopause should therefore always be examined by a doctor so that its cause can be clarified, which is often found in the ongoing hormonal fluctuations.
At the beginning of the menopause (climacteric) there is a decrease in hormone production in the second half of the female monthly cycle, medically the luteal phase . Due to this hormonal change, which affect the sex hormone progesterone, gradually decreases the conception ability (conception) of a woman and thus the emergence of a pregnancy.
As a result, it is increasingly common for the absence of ovulation, which is called anovulation. Nevertheless, menstrual bleeding, the cause of which is the rejection of the uppermost layer of the uterus ( stratum functionale ), persists .
Especially in the period before the menopause, there are often inter-bleedings and irregularly lasting cycles, the reason for which is the gradually diminishing function of the ovaries.
Due to altered progesterone production in the second half of the female cycle, the muscular layer of the uterus ( endometrium ) is not built and converted as usual. This can sometimes lead to enlargements of the uterus, as the number of cells increases (hyperplasia).
In the further course of the menopause and with increasing functional weakness of the ovaries also reduces the hormone production in the first half of the cycle. This affects another female sex hormone. It is called estrogen and decreases in quantity over the course of menopause more and more. It should be emphasized, however, that the production of estrogens is not completely stopped. A precursor of the estrogens can still be formed in particular in the margins of the ovaries and then converted into some fat cells with the help of appropriate substances.
Also in parts of the brain, hormones are produced that stimulate the ovaries and stimulate them to produce hormones for female sex hormones. They are called FSH (folate stimulating hormone) and LH (luteinizing hormone). With the onset of menopause, FSH and LH are not inhibited as usual by the free sex hormones, but are increasing in their amount more and more. This increase in FSH and LH can be measured well in the woman's blood and is a clear manifestation during menopause.
The hormone gain goes back after the menopause about 65 years of age back a little, but always remains higher compared to the time before menopause.
The age when a woman enters the menopause is different. Most menopause starts between the 40th and 50th year of life, in some cases later. Only with an operative removal of the ovaries there is an immediate onset of menopause.
The onset of menopause can be manifested by various signs. The most important signs are increasingly irregular menstrual bleeding. In addition, hot flashes, heavy sweating without special triggers, sleep disorders, irritable mood and exhaustion. It can also lead to a depressed mood, nervousness, dryness in the genital area and weight gain. The menstrual period is often shorter at the beginning of the menopause than before and the intervals between two hemorrhages increase. In some women, however, the bleeding initially synonymous stronger. Eventually it comes to the complete absence of menstrual bleeding.
In addition, some women notice unusual weight gain and fat redistribution that is more like a man's fat distribution (because of the steady decline in estrogen levels, the male sex hormone gains influence). In most cases, the abdomen and breasts become larger, whereas the butt becomes flatter. Meals that were previously unobtainable without weight gain are now too much due to the body's declining energy needs during menopause.
Another commonly described symptom of menopause is tenderness or chest pain, which is also caused by falling estrogen levels. Not a few women complain at this time in addition to a beginning bladder weakness, which is caused less by the hormonal effects of menopause, but rather by the, through several pregnancies and births, weakened pelvic floor muscles.
The main symptoms of menopause are diverse and individually very different in their strength. Most women initially complain of increasing menstrual cycle changes: the bleeding becomes stronger and longer-lasting, and the intervals between each bleeding increase until the period is completely absent.
Other common symptoms of menopause include sudden, unexpected flushes, excessive sweating, and sweating, especially around the face, neck, and torso. These can lead to unpleasant everyday situations during the day and have a strong impact on a regulated and energizing sleep at night.
These problems of getting in and going to sleep often occur in menopausal women and have not to be underestimated effects on their physical condition. The resulting symptoms of fatigue and reduced performance can cause symptoms such as excessive irritability, dissatisfaction or strong mood swings, which in turn affect sleep patterns. This vicious circle puts so much strain on some women that their mood can even shift towards depression. In this case, it is advisable to seek professional psychological advice.
Another common symptom of menopause is a disturbing dryness of the mucous membranes ( especially in the vagina as vaginal dryness), which can cause problems with sexual intercourse. The resulting restriction of intimacy with the partner can even lead to conflicting relationships. Openness and talking about worries, fears and physical stress during menopause are essential for a stable relationship in which the partners support each other.
Around 60% of menopausal women complain of an unwanted weight gain despite unchanged eating habits. The butt becomes flatter, the waist wider and chest and stomach are larger. The fat distribution is increasingly similar to that of a male, which is due to the declining estrogen levels and the resulting increase in the male sex hormone testosterone (a woman has female and male sex hormones and many other hormones in her body, decreases the concentration of a hormone, it comes to a Effect amplification of the other) is due.
The increased fat content of the abdomen also increases the risk of diabetes mellitus, lipid metabolism disorders, hypertension and other cardiovascular diseases, which is why weight gain should not progress unhindered. To gain an overview of whether your own weight gain is actually a problem, you can determine your own body mass index ( BMI ). Here you divide the weight in kilograms by the square of your own height in meters. A score below 19 means that you are underweight (so you do not weigh enough for your height). Between 19 and 24.9 is called normal body weight, whereas values between 25 and 29.9 already indicate an overweight. If the values are over 30, one speaks of a strong overweight.
The weight gain occurring during the menopause arises due to an age-related declining basal metabolic rate, ie the daily energy requirement (calorie requirement) decreases. Among other things, this is explained by the decreasing muscle mass, because in the muscles, the energy turnover and if less muscle, only less energy can be consumed. The excess energy is stored in the form of fatty tissue. If a woman during menopause consumes just as large portions at meal times as usual, this may already be too much due to the significantly slower metabolism. In this case, you should think carefully about whether the size of the serving is actually needed to get full.
Another factor influencing weight gain during menopause is the decreasing level of exercise. As a result, fewer calories are consumed and fat stores increase in volume. However, if you want to prevent it, it is advisable to do sports regularly and thus support muscle building. In addition, a woman should eat well, especially during her menopause, and consume many whole grains, fruits, vegetable fats, low-fat meats, fish and dairy products. This not only reduces weight gain but also reduces the risk of osteoporosis ( bone loss). However, weight gain does offer a small advantage: fatty tissue produces estrogen. In this way, the fatty tissue can at least partially compensate for the falling estrogen level. The classic estrogen withdrawal symptoms such as hot flashes, sleep disorders, dry mucous membranes, incipient osteoporosis, etc. are significantly reduced.
Sweating is a typical symptom of menopause, which affects a great many women. All of a sudden there are hot flashes without a special trigger. This can be very uncomfortable, especially in public, because some women are actually sweaty in a few moments. For very severe complaints, treatment of the symptoms can be considered.
Pain on the ovaries is not a typical symptom of menopause. In case of persistent complaints, therefore, a medical examination is recommended. Ovarian pain during the menopause can hide harmless causes, but also various diseases. For example, the pain can be caused by ovarian cysts or ovarian inflammation. At an advanced age, the incidence of ovarian cancer is also increasing, so that it is urgently recommended for complaints in this area.
There is no clear test of whether the menopause has begun. However, there are physical signs that may indicate menopause. Above all, the menopause can be recognized by the fact that the menstrual period is getting more and more irregular. In addition, the woman should pay attention to other typical symptoms, such as hot flashes. In summary, all signs together may indicate the menopause. A visit to a gynecologist can help to classify the symptoms if in doubt.
During the menopause, there is a change in the hormone balance. The body's own production of female hormones decreases. This is noticeable by various complaints. Accordingly, it is possible to perform hormone replacement therapy during menopause. The lack of female hormones is thereby compensated and the typical menopausal symptoms can be largely prevented.
In most cases, no further examinations are necessary for the diagnosis of menopause, since the symptoms of estrogen deficiency at the corresponding age of the woman can be used to make a clear diagnosis of menopause.
During the course of the procedure, a vaginal cytological examination is recommended in which cells are removed from the vagina (vagina) in a smear and subsequently evaluated under the microscope.
This study provides information on whether the body is still producing enough estrogen, as this is not completely absent even after menopause. If the menopause ( climacteric praecox ) stops prematurely, a hormone examination can take place to secure the diagnosis. But such is not necessary in principle.
A woman enters menopause when the function of her ovaries ceases and she no longer has eggs to produce ovulation. This time is individually different for each woman and depends on many different factors. Both genetic and environmental factors play a role in the timing of the definitive onset of menopause. Most women between the age of 40-50 come to the menopause, with some women, they come later. Even before the final absence of the menstrual period begin hormonal changes in the body of the woman. The beginning of these changes is difficult to determine. By definition, the "true" menopause is achieved only when the ovarian function has completely dried up. Women who have had their ovaries surgically removed experience an immediate onset of menopause with correspondingly radical symptoms of hormonal deficiency.
Men also have some kind of menopause. However, unlike women, these do not necessarily occur in the form of symptoms in every man. Also, this so-called andropause is not clearly defined in men, as in the course of life gradually leads to a decline in hormonal production in men and thus no specific date for menopause can be defined. However, when symptoms occur they are similar to the symptoms of a menopausal woman and usually occur between the45 and 45 years. and 65 years of age. In general, the term "menopause" is controversial for men as such.
Just a few years ago, women with menopausal symptoms were generously treated with hormone replacement therapy. In this case, the female sex hormones are supplied by medication. However, after several studies have pointed to the side effects of such a therapy, especially a long-term therapy, there was a rethinking of the forms of therapy. Today, increasingly active herbal ingredients find application in the treatment of menopausal symptoms. Increased exercise and targeted calcium-rich diet (eg by dairy products such as cheese) is also an improvement of the symptoms around the menopause reached around. Thus, the symptoms of menopause without hormone replacement therapy usually reduce after one to two years, so that the woman no longer feels impaired.
In addition, the individually differently pronounced symptoms can usually be treated individually individually. The skin changes already described lead to a loss of elasticity, strength and moisture of the tissue. Therefore, just a sufficient sun protection on the skin is particularly important in order not to burden the tissue increasingly. Likewise, moisturizers or greasy skin creams can help with skin dryness. The pain of intercourse caused by dry mucous membranes of the vagina can be effectively treated with lubricating cream or locally applied estrogens and avoided.
Strong bleeding irregularities around the menopause sometimes necessitate surgical removal of the uterus ( hysterectomy ).
Psychologically or psychotropic drugs can help with individually pronounced psychological changes.
Hormone replacement therapy is only used for medical reasons such as massive menopausal symptoms, premature onset of menopause before the age of 43, severe changes in the external genitalia, premature surgical removal of the ovaries ( ovariectomy ) or premature loss of function.
The hormone therapy is always adapted to the individual complaints, so that the choice of the appropriate drug on the nature, the strength and the time of occurrence depend.
Basically, the hormones administered are all estrogen - combined preparations. These consist of one part each of the hormone group of the estrogen and another from the progesterone group (this group of hormones are also called progestagens). The administered hormones are either naturally derived sex hormones or artificially produced. There are different forms of administration of the hormones. So they can be taken in the form of tablets over the mouth, on the skin as a patch or as a cream on the vagina (vagina) but can also be injected through the skin.
Hormone replacement therapy is indicated by previous blood clots ( thrombembolism ), breast cancer and uterine cancer (breast and carcinoma of the breast) as well as severe liver damage.
The duration of therapy is determined individually for each woman, but in about half of all treated women it is about one year and should not take longer than two years due to the side effects.
Possible side effects of such a therapy are described as nausea, weight gain and fluid retention ( edema ) but also stomach and headache and tension pain in the chest are possible.
As menopause is a naturally occurring period in a woman's life and contributes to her aging and maturing process, it is not possible to circumvent the menopause or to prevent it with the help of medication. Positive effects of reducing and experiencing menopausal symptoms include physical activity, a healthy, balanced diet and a healthy sleep.
There is the possibility to alleviate menopausal symptoms by medication or to bring it to an end. Because the menopausal symptoms are caused by the changing hormone levels, therapeutic female hormones can be used to fight the symptoms. However, this so-called hormone replacement therapy in medicine is discussed very controversially, as among the increased occurrence of certain diseases was observed. For example, from various cancer and cardiovascular diseases. Increasingly, homeopathic and naturopathic remedies for menopausal symptoms are used, which can also mitigate the symptoms. For example, preparations from chasteberry, yarrow and black cohosh are often taken during menopause in order to combat unpleasant symptoms such as hot flashes.
The duration of menopause varies from woman to woman. In most cases, at the age of 45, they express themselves for the first time in the form of cycle changes and end only at the age of 65-70 years in the form of the disappearance of the last remaining symptoms. This 20-25-year phase of a woman's body is divided into different, but smoothly merging sections: premenopause, perimenopause with menopause and postmenopause .
The symptoms can last up to 15 years. In some women, however, the menopause is much shorter and already after three years or less over. How long a single woman will suffer from menopausal symptoms is therefore difficult to predict. In general, it could be observed that the symptoms tend to persist the sooner they occur in the woman. Menopausal women often suffer from menopausal symptoms for longer than other menopausal women.
During premenopause, the body slowly prepares to stop bleeding. The ovaries now work slower, ie only a few ovulations occur and the estrogen production is reduced. At this point, first cycle changes are noticeable. The bleeding becomes stronger and longer, but also increasingly irregular, until it finally stops after menopause (the menopause is the last bleeding). This period around menopause is also summarized as perimenopause.
In the next step, the body must now create a new balance, because the estrogen and gestagen production is almost stopped. The duration until a new balance is found is also very different. However, in order to get a rough idea of the period of your own menopause, it is possible to find out more about the rough parameters of the mother's menopause. Most likely, the period of their menopause will be very similar to their own.