Menopause Overview

Introduction

In most cases, menopause is a natural part of the ageing process that occurs at around 51 years of age. 1,2 However, some people experience early menopause or severe symptoms of menopause, which can have an important impact on their quality of life. 1,2 In this article, we examine these topics in greater detail and discuss lifestyle habits that can prevent the development of early or severe menopause. 

What is menopause?

Menopause, in most cases, is part of the normal ageing process that occurs when the ovaries stop releasing eggs and lower the production of reproductive hormones, namely oestrogen and progesterone. However, it can also be caused by diseases, treatments, or surgical procedures. In all cases, menopause often causes symptoms, such as hot flashes and mood swings, that can significantly impact people’s well-being, which is one of the reasons why the condition should be properly managed with a healthcare team and treated when necessary. 1,2 

Symptoms

Oestrogen and progesterone are important hormones with different functions in the body. Therefore, the hormonal changes that happen during menopause are often accompanied by several signs and symptoms, including: 1,2,3

  • Hot flashes: feelings of hot or cold in the face, neck, and chest that appear suddenly, usually last up to 10 minutes, can cause the face and neck to become flushed, and can be accompanied by dizziness.
  • Vaginal dryness: can cause pain or discomfort during sex.
  • Night sweats: these can be intense enough to wake people during the night and/or impair their sleep quality. 
  • Sleep problems: these include difficulties falling asleep, staying asleep, or waking up too early, which can be caused or worsened by night sweats.
  • Mood swings: these include feeling more irritable, sad, or anxious; and
  • Other body changes: weight gain, slower metabolism, dry skin, thin hair, reduced libido, and pain in the joints or muscles. 

All these symptoms can significantly impair people’s quality of life. However, fortunately, there are many types of treatment available, so if you are experiencing any of these issues, consult with your general practitioner or gynaecologist. 

Cause

In most cases, menopause is caused by a decline in reproductive hormone levels, which happens as a regular part of ageing. However, it can also be caused by diseases, treatments, or surgical procedures, such as primary ovarian deficiency, chemotherapy, radiotherapy, and oophorectomy (a surgery in which the ovaries are removed). 

Risk factors of early menopause and severe symptoms

When menopause occurs between the ages of 40 and 45, it is named early menopause. The condition can be caused by surgical procedures, health conditions, or treatments, such as: 4

These causes are often beyond people’s control and therefore cannot be prevented. However, some factors that increase the risk of early menopause are under people’s control and can be prevented, such as smoking, nutrition, and health status.2,4,5 Similarly, some risk factors for severe menopausal symptoms can be influenced by lifestyle habits, such as smoking, body mass index, and nutrition. 6,7

You can reduce your risk of early menopause or severe menopausal symptoms by making a few changes to your lifestyle.

The following lifestyle factors have the most significant impact on your risk of early or severe menopause. We will also look at what you can do to reduce your risk from today. 

Nutrition

Keeping a healthy diet is an essential part of maintaining a healthy body mass index, which diminishes the risk of developing severe menopausal symptoms. 6,7 Moreover, certain dietary practices, such as avoiding the consumption of caffeine and spicy food, and eating food rich in oestrogens, may ease menopause symptoms. 1-3

Physical activity

Besides being beneficial for general health, including bone health, practising physical activities regularly can ease symptoms of menopause, such as alleviating sleeping problems like insomnia, and reducing mood swings. 1-3

Obesity

Maintaining a healthy body mass index minimizes the risk of developing severe menopausal symptoms. Therefore, avoiding obese weight levels is an important way to reduce the risk of developing the condition. 6,7

Alcohol

The increased consumption of alcohol is associated with a higher risk of early occurrence of menopausal symptoms. 8 Therefore, reducing or stopping the consumption of alcohol is a potential way to prevent such events. 

Hydration

At older ages, the human body becomes more susceptible to dehydration. This susceptibility is exacerbated by the hormonal changes that occur during menopause. Additionally, people can lose more water when suffering from hot flashes and night sweats. 9 Therefore, keeping hydrated is especially important during menopause, and it can also ease some of the menopause symptoms, such as dizziness and tiredness. 

Sleep

Even though sleep is not reported as a risk factor for early or severe menopause, many people going through menopause experience sleeping problems, including difficulties falling asleep, staying asleep, or waking up too early. 10 This can significantly impair their quality of life, which is why such sleeping disturbances should be discussed with a healthcare professional. 

Mental health

Mental health issues are not described as risk factors for the development of early or severe menopause. However, mental health symptoms occur often during menopause, including mood swings, low mood, anxiety, depression, and memory or concentration issues. 11 Many forms of treatments are available. Thus, if you are experiencing such issues, contact your healthcare team. 

Wellness

In general, keeping your emotional health balanced is necessary for your physical health. Therefore, self-care is vital for overall good health. For people going through menopause, practising self-care and minding their mental health is essential to go through the menopause period as smoothly as possible. 

Summary

In most cases, menopause is a normal part of the ageing process in which the levels of reproductive hormones decrease, which often causes symptoms such as hot flashes, night sweats, and vaginal dryness. However, some people experience early menopause or severe menopausal symptoms. In this context, certain health and lifestyle factors increase the risk of developing early or severe menopause, including smoking, nutritional habits, and a higher body mass index. 

Additionally, healthy lifestyle habits, such as regular physical activity, keeping hydrated, and reducing the consumption of alcohol can ease menopause symptoms. Thus, there are many lifestyle changes that you can make to decrease your risk of early or severe menopause and ease menopause symptoms. Consult with your general practitioner or gynaecologist if you have any doubts, as they are the ones who can best evaluate what treatment plan best suits you.

References

  1. Avis NE, Crawford SL, Green R. Vasomotor Symptoms Across the Menopause Transition: Differences Among Women. Obstet Gynecol Clin North Am. 2018 Dec;45(4):629-640. https://doi.org/10.1016/j.ogc.2018.07.005 
  2. Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019 Oct 1;55(10):668. https://doi.org/10.3390/medicina55100668 
  3. Minkin MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstet Gynecol Clin North Am. 2019 Sep;46(3):501-514.  https://doi.org/10.1016/j.ogc.2019.04.008 
  4. Giri R, Vincent AJ. Prevalence and Risk Factors of Premature Ovarian Insufficiency/Early Menopause. Semin Reprod Med. 2020 Sep;38(4-05):237-246. https://doi.org/10.1055/s-0040-1722317 
  5. Purdue-Smithe AC, Whitcomb BW, Szegda KL, Boutot ME, Manson JE, Hankinson SE, et al. Vitamin D and calcium intake and risk of early menopause. Am J Clin Nutr. 2017;105(6):1493-1501. https://doi.org/10.3945/ajcn.116.145607 
  6. Pérez JA, Garcia FC, Palacios S, Pérez M. Epidemiology of risk factors and symptoms associated with menopause in Spanish women. Maturitas. 2009 Jan 20;62(1):30-6. https://doi.org/10.1016/j.maturitas.2008.10.003 
  7. Wang L, Zhang R, Yang Y, Sun X, Zhang B, Zhu H, et al. Severity and factors of menopausal symptoms in middle-aged women in Gansu Province of China: a cross-sectional study. BMC Womens Health. 2021 Dec 8;21(1):405.  https://doi.org/10.1186/s12905-021-01531-x
  8. Kwon R, Chang Y, Kim Y, Cho Y, Choi HR, Lim GY, et al. Alcohol Consumption Patterns and Risk of Early-Onset Vasomotor Symptoms in Premenopausal Women. Nutrients. 2022 May 29;14(11):2276. https://doi.org/10.3390/nu14112276
  9. Stachenfeld NS. Hormonal changes during menopause and the impact on fluid regulation. Reprod Sci. 2014 May;21(5):555-61. https://doi.org/10.1177/1933719113518992
  10. Baker FC, Lampio L, Saaresranta T, Polo-Kantola P. Sleep and Sleep Disorders in the Menopausal Transition. Sleep Med Clin. 2018 Sep;13(3):443-456.  https://doi.org/10.1016/j.jsmc.2018.04.011
  11. Hogervorst E, Craig J, O'Donnell E. Cognition and mental health in menopause: A review. Best Pract Res Clin Obstet Gynaecol. 2022 May;81:69-84. https://doi.org/10.1016/j.bpobgyn.2021.10.009 

Juliana Lima Constantino

Medical Doctor and Master Student in Epidemiology, University of Groningen, Netherlands

Juliana completed her studies in Medicine in Brazil in 2019, during which she studied a year abroad in The Netherlands at Vrije Universiteit Amsterdam and took a Medical Elective in England at Oxford University.

After graduating, she worked as a general practitioner and as an emergency doctor in the frontline against COVID-19 in Brazil. In 2021, she moved to the Netherlands to do her Master in Epidemiology.

She is currently working on her Master Thesis in the Global Health Department, with a focus on maternal and child health. She is passionate about medical writing as it serve as a way of spreading trustworthy knowledge to everyone.

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