According to a recent Gallup Poll, 80 percent of menopausal, post menopausal or surgically menopausal women reported having some symptoms of menopause.
Among the women who had symptoms, the most common were:
72%
50%
49%
31%
Symptoms, brought on, in varying degrees by the reduction in the ovaries' production of estrogen and progesterone affect many areas of our bodies.
Many tissues and organs, including the vagina, uterus, bladder, breasts, bones, heart, blood vessels, brain, skin, and hair, are responsive to estrogen. Consequently, as estrogen levels fall, a variety of symptoms may be experienced.
Some women have no symptoms other than the cessation of the period. About 15% have severe symptoms. Most women fall in between and experience one, some, or all of the common signs.
Hot Flashes are the most common and the earliest symptom of Perimenopause. The lower estrogen level can cause blood vessels to expand rapidly, making the skin temperature rise.
A hot flash begins as a feeling of warmth deep within the chest that seems to flow upward and outward. An actual increase in the skin temperature can cause flushing of the neck and face. Red blotches may also appear on the chest, neck, and arms.
The increased skin temperature may only bring a feeling of warmth, or, it may cause sweating. The moisture evaporating from the skin may bring chills. Some women feel weak and faint.
When hot flashes occur at night with enough severity to wake you up from a sound sleep, they are called Night Sweats . Drenched in sweat, with soaking night clothes and sheets, night sweats are quickly followed by chills as air cools the wet skin. It isn't unusual to have trouble falling asleep or to wake up in the middle of the night for no apparent reason and not be able to get back to sleep.
While some flashes can continue for 30 minutes, most last just a few minutes.
The number and frequency of hot flashes varies with every woman. Some have only a few flashes a day while others have one and hour. The occurrence of hot flashes can last from one to seven years.
While there are no "cures" per se, there are remedies and options that can reduce the incidence of hot flashes and night sweats.
Sleeplessness/insomnia/fatigue
Nearly 40 percent of mid-life women say they have insomnia - double the percentage from premenopausal days. Most often, insomnia or sleeplessness is a consequence of nighttime hot flashes which interrupt REM sleep. Estrogen deprivation may also increase wakefulness without any loss of temperature control.
Fatigue and low energy are another domino effect of hot flashes and poor sleep Irritability, nervousness, memory lapses, and difficulties concentrating may also occur. While mood swings and depression may be linked to hormonal changes, they are most likely due to the effects of insomnia and sleep deprivation. Recent studies have shown that when mid-life men are subjected to sleep interruption, they exhibit the same signs of stress as mid-life women, becoming irritable, short-tempered, moody and tired.
Poor Memory and Loss of Concentration
Delayed reactions, a slowdown in knowledge retrieval, trouble remembering simple things, and vague unfocused feelings have been attributed to menopause. Short-term memory is more often affected than long-term memory.
Poor concentration during menopause can be partially attributed to lack of sleep due to night sweats, however, women who have undergone a sudden, medically-induced menopause, report alarming degrees of forgetfulness. The more sudden the estrogen deprivation, the greater the symptoms.
Women who receive Hormone Replacement Therapy (HRT) report that concentration and memory improve almost immediately. Homeopathic/herbal remedies like Ginseng are also reported to improve memory function.
With the onset of perimenopause, menstrual cycles become irregular. The menstrual flow may become lighter or heavier--or both - and your cycles may become less and less predictable - sometimes shorter, sometimes longer, and sometimes missed altogether.
Overall your periods should gradually become lighter, shorter and further apart. Intermittent light spotting and bleeding are not uncommon. If you experience prolonged or irregular heavy bleeding, consult your doctor.
Declining estrogen levels causes the tissue of the vagina and urethra (the opening to the bladder) to become thinner, drier, and less elastic. The first symptom is a reduction of vaginal fluid secretions. This dryness is due to diminished blood flow to the vaginal walls, fewer cells lining the walls, less mucus produced by the cervix, and less fluid in general.
Decreased lubrication and dryness will develop early in perimenopause with the reduction in estrogen levels. Physical changes to the vagina won't occur overnight, and will be less severe in sexually active women. The vaginal walls , in a process called atrophy, become thinner, less elastic and pale. The stretchy wrinkles that provided the amazing expansion required for child birth smooth out and disappear. Without the usual moisture, the vagina fails to lubricate properly during sexual arousal and intercourse. The thin, less flexible surface can be easily injured by sexual intercourse, especially if it is infrequent.
With the loss of estrogen, the vaginal pH changes from a normally acidic low to a higher, more alkaline pH. This less acidic environment discourages the growth of important protective organisms, lactobacillus which acts as a bacterial guard against abnormal bacteria and yeasts. In the absence of lactobacillus, these "bad guys" overgrow and can cause discharge, irritation, and give rise to increased urinary tract infections.
The bladder, like the vagina, suffers from estrogen depravation. It too loses elasticity, support and some degree of function. Urinary problems can appear in the early stages of menopause.
Among the most frequently noted is stress incontinence - the involuntary urine loss that occurs when coughing, sneezing, or laughing - which occurs in 56% of perimenopausal women. The decline in estrogen levels reduces the strength and tone of urethra and sphincter muscles that control urine flow.
Another complaint is frequency. The good news is that the "urge to go" rises only minimally after menopause, rising from a 28 percent prevalence during perimenopause to a 33 percent incidence six years after menopause.
Fifty percent of premenopausal (not peri) women complain of some degree of urinary urgency. This number remains fairly constant in menopause. It isn't clear that this is estrogen-related.
Bladder infections can cause a combination of symptoms - urgency, frequency, and burning on urination. Changes in the vaginal pH and thinning of the vaginal mucus increase the bladder infection rate during menopause.
Estrogen depletion leads to loss of skin moisture and suppleness which contributes to sagging, bagging, and wrinkling. Collagen, which is responsible for skin resilience and tone, is at its peak quantity between ages 20 and 40.
Sun damage and smoking can decrease the formation of collagen and, after 40, there is an age related collagen loss. The age-related loss accelerates significantly after menopause, giving rise to dry, flaky "alligator" skin and wrinkles.
The skin is a reflection of our bones. If we have a tendency to lose collagen in our skin, the same will occur in our bones. Pale, fine-skinned white women, especially if they are thin, who suffer significant skin loss changes in menopause are undergoing similar bone loss with the development of osteoporosis.
Collagen maintenance doesn't come in the form of creams, facials, or plastic surgery. Hormone replacement therapy (HRT) alone increases collagen production after menopause.
For some women, freedom from birth control and freedom from worries regarding unwanted pregnancy releases long-held inhibitions. Sex becomes freer, more spontaneous, more enjoyable.
For others, physical changes including reduced lubrication, thinning of the vaginal walls, and reduced levels of hormones, reduces sexual desire or interest. Reduced frequency of intercourse can result in further thinning of the vagina and in reduced elasticity - which may ultimately lead to pain during intercourse - which further reduces sexual desire. To avoid or reduce the incidence of these problems, try some of the many lubrication products on the market and find one that works for you and your partner. If you have pain during intercourse, visit your doctor. Consider HRT as an option.
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© 1998 Prairie Public Broadcasting, Inc.