Most women experience some difficulties adjusting to the physical and emotional changes of menopause. The good news is in most cases the changes are mild and manageable. it’s a normal event in the life of an older woman, but as with other transitions in life like puberty and the onset of menstruation, menopause throws up challenges. Taken literally, ‘menopause’ means the last or final menstrual period, but in everyday speak it means the time around the last period, which typically happens between the late 40s and early 50s. The average age is 51 years. Around this time, menstruation stops and starts – it’s usually considered to be menopause if there’s been no vaginal bleeding for 12 months. in a very small number of cases (less than one per cent) it happens before the age of 40. MenopauseWhat happens in menopause is there’s a gradual failure, over a few years, of the normal monthly cycle of hormones that govern ovulation and the menstrual period. The ovaries run out of functional eggs so ovulation stops and the sex hormones oestrogen and progesterone are no longer produced – though low levels of the male-type hormones, androgens, continue to be produced. With the lack of oestrogen to stimulate the uterus, the periods come to an end. Signs of ‘the change The lowering of sex hormones in the body causes a range of changes.  Hot flushes and night sweats. These are sensations of heat that last between 30 seconds and five minutes, felt in the face, chest, neck, or over the whole body, sometimes with sweating, nausea, and flushing of the skin. When they happen at night they’re called night sweats.  Genital changes. The vaginal tissue becomes thin, less elastic and drier; natural lubrication diminishes and sex may become uncomfortable and orgasm less intense. The pH of the vagina alters and it becomes more prone to bacterial infections. The labia and clitoris may decrease in size because they lose some of their fatty tissue. Irregular periods. Over a period of years leading up to menopause, hormone levels can fluctuate wildly, causing erratic, irregular periods, some lighter, and some much heavier than normal.  Urinary problems. Similar changes in the bladder and urethra make urinary tract infections more likely. There may be painful and frequent urination, and a sensation of needing to urinate even when the bladder is empty. The muscles of the pelvic floor become weaker, so stress incontinence (leaking of urine with exertion) is more likely.  Skin and hair thinning. Skin becomes thinner and less elastic and lines may appear. menopauseSkin may feel drier than it was before.  Sleep disturbances. insomnia is more common – so is waking at night with night sweats.  Weight changes. As a woman ages, her metabolism tends to slow, and she becomes more sedentary (as do men) and so tends to put on weight. She may lose weight from the hip and thigh area and put it on around the abdomen.  Mood changes. Some women become depressed, anxious, irritable, and forgetful. The mood changes are partly hormonal. But they may also be related to a sense of loss of fertility and diminished womanhood. Those women who have been deeply involved with family may feel a sense of emptiness and a loss of purpose, especially if, around the same time, children leave home. Although nowadays many women experience the revolving door syndrome where children who have left the home, return.

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