Tackling Menopause Symptoms: A Comprehensive Approach
Menopause is a common phenomenon for 1.5 million women yearly, causing symptoms such as, vaginal dryness, decreased libido, insomnia, fatigue, and joint pain. This transition of late menopause accelerates the prevalence of symptoms like hot flashes, adverse mood, vaginal dryness, and sleep complaints. Depression and cognitive impairment can also trouble women during this stage. [1]
Three symptoms were identified as strongly associated with menopause: vasomotor symptoms, vaginal dryness/dyspareunia, and difficulty sleeping/insomnia. [1]
- Vasomotor symptoms, comprising of hot flushes or night sweats, are common in menopausal women. These symptoms are caused due to estrogen withdrawal., which include sudden heat sensations, chills, anxiety, sleep disturbances, and palpitations. They are more prevalent during the late perimenopausal transition. [2]
- Estrogen fluctuations during menopause may cause urogenital tissue sensitivity and distressing symptoms like vaginal dryness and dyspareunia, affecting a significant percentage of women. The decline of estrogen levels causes urinary incontinence (UI), thereby affecting the urethra and bladder. Menopausal hormone therapy (MHT) is effective for treating vaginal atrophy and dryness. However, MHT does not benefit UI and may even worsen symptoms. Hormonal therapyis one of the long-term treatment for urogenital atrophy, while the OTC medications may offer relief for milder symptoms. [1]
- Sleep disturbances are widespread among menopausal women, Decline in sleep quality during menopause is attributed to menopause-related symptoms such as hot flashes and depressive symptoms. Menopausal women with insomnia often experience both self-reported and physiological hot flashes, contributing to sleep disturbances. Obstructive sleep apnea, one of the common symptom in postmenopausal women, can aggravate sleep disruption and upsurge the risk of cognitive failure. [3]
- Women in the peri-menopausal stage often experience a decline in memory and concentration. Cognitive performance diminishes during this stage, especially with learning and verbal memory. Nevertheless, all these symptoms are exclusive only during the perimenopausal period. [3]
Reference:
[1] Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal Symptoms and Their Management. Endocrinology and Metabolism Clinics of North America, 44(3), 497–515. https://doi.org/10.1016/j.ecl.2015.05.001
[2] Kaunitz, A. M., & Manson, J. E. (2015). Management of Menopausal Symptoms. Obstetrics & Gynecology, 126(4), 859–876. https://doi.org/10.1097/aog.0000000000001058
[3] Monteleone, P., Mascagni, G., Giannini, A., Genazzani, A. R., & Simoncini, T. (2018). Symptoms of menopause — global prevalence, physiology and implications. Nature Reviews Endocrinology, 14(4), 199–215