The menopause, sometimes known as the “change of life,” occurs when levels of the female hormones oestrogen and progesterone fall and your ovaries stop producing eggs. Menstruation ends and you are no longer able to conceive.

Perimenopause is the months and years prior to menopause. For some women the perimenopause period may be short, only a year or two. For others it may be as long as seven to ten years. Some women in their late thirties and early forties may begin to show symptoms. Menopause is defined one year after menstrual periods have ended.

Sign and symptoms  • Hot flashes, flushes, or power surges—sense of warmth that starts suddenly, usually over your face, neck, and chest. • Related to fluctuations in estrogen, occurs only during perimenopause when estrogen levels are decreasing. • Fluctuating estrogen levels may cause an imbalance in the hypothalamus. The body is tricked into thinking it is too hot. To cool itself blood is rushed to the surface of the skin, therefore resulting in a flushed appearance. • Night sweats—when hot flashes interfere with sleep• Vaginal dryness, itching, and irritation. • Thinning of the vaginal lining may cause painful intercourse. • Urinary tract infections, need to urinate frequently, burning on urination, itching in the urethra area. • Urinary incontinence if the uterus and bladder slip lower into the pelvis. • Osteoporosis—or bone density loss occurs when estrogen diminishes to a low level. The most rapid bone loss occurs during the first ten years of menopause. • Heart rate rises after menopause. Estrogen helped to dilate the arteries. Menopausal women are at greater risk of heart attacks. • Skin changes with an increase in wrinkles. The decreasing estrogen levels makes the skin more elastic.

Major depression in menopause Women who experience a major depression in the postpartum period may be at greater risk of experiencing a depression in menopause. if a woman’s body is sensitive to hormonal shifts in the past, it may be sensitive to shifts in the future. however, not all women who experience a major depression in the postpartum period will experience a major depression during peri-menopause or menopause. Women who experience major depression during menopause can be successfully treated with anti-depressants alone, or in conjunction with hormone replacement therapy.

Self care • Vitamin E may alleviate hot flashes. • Eat foods rich in natural estrogens—yams, lentils, oat bran, tofu, and soy milk. • get plenty of relaxation and sleep—the brain regulates its biochemistry during sleep. • Take time for yourself. Read, keep a journal, and take a class you have always wanted. • Exercise regularly to reduce your stress and to help regulate your sleep cycle (eg walking, swimming).• Prevent osteoporosis. • Eat calcium rich foods.

Menopause and hormone replacementOnly consider hormone replacement therapy (HRT) after looking at your psychological and physical risks, your personal history, and your family history. HRT is a treatment used to replace the female hormones that a woman’s body is no longer producing because of the menopause. The menopause, sometimes known as the “change of life,” occurs when levels of the female hormones oestrogen and progesterone fall and your ovaries stop producing eggs. Menstruation (your periods) ends and you are no longer able to conceive (become pregnant).

Oestrogen and progesterone have very important roles in a woman’s body. When levels fall, this causes a wide range of physical and emotional symptoms. HRT can restore these hormone levels and enable the body to function normally again. HRT has been extensively studied and a great deal of information is known about the benefits and the risks. The main and most obvious benefit of HRT is that it has proved very successful in controlling the symptoms of the menopause.