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The Menopause

The cessation of monthly periods is known as the menopause or 'change of life'. The climacteric, as it is called in medical terms, rarely occurs abruptly: the menstrual cycle first becomes irregular and eventually stops altogether. The menopause can occur at any age between thirty.five and sixty-five, but the average age is around fifty. Although fertility is greatly reduced by this time, it should not be assumed that pregnancy is impossible until periods have ceased for at least a year. Any symptoms accompanying the menopause result from the decline in the levels of oestro­gen and progesterone, but many women have no symptoms.

Symptoms

There are two main symptoms of the menopause, one or both of which may be experienced. These are: hot flushes and night sweats; and vaginal dryness resulting from diminishing secretions, which can make sexual intercourse difficult. Palpitations are also sometimes experienced. Hot flushes are usually the most distressing problem, since they can occur at any time, leaving the skin bright pink and hot, which may be embarrassing and disturb sleep. They are also often associated with headaches and tiredness. Mood changes such as irritability and depression are common at this time, and these may also be caused by hormonal changes. As with PMT, however, it is important to distinguish these from depression caused by unhappy life events and stresses. Unfortunately the menopause occurs at a time when children may be leaving home and retirement from work is approaching, and these stresses may make menopausal changes even more distressing.

Symptoms of the menopause may persist for a few months or for several years, but if they are severe, treatment is available. Hormone-replacement therapy or HRT is usually very effective and free of side-effects, and the doses of hormones (oestrogen and progesterone) now given are so low as to be safe if taken correctly and under medical supervision to avoid overgroWth of the lining of the uterus.

Sexual responsiveness is not usually affected by the menopause, and women can be as sexually active and gain as much pleasure from sex after their periods stop as before. In fact, it has been said that twenty per cent of women have increased sexual desire after the menopause.

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