Climacteric and menopause - the difficulties they bring along

Learn the basic facts about medical problems commonly brought about by climacteric and menopause and how they can be treated!

Menopause and climacteric

Menopause is the last (natural) occurence of period which is calculated retrospectively, a year after a woman’s last bleeding. An era of 5 up to 10 years around menopause is commonly referred to as climacteric. The difficulties that mark this era in a woman's life occur due to lack of female sex hormones: ovaries as the active hormone glands run dry over the course of years and the levels of sex hormones such as estrogen and progesterone gradually fall.

Short- and long-term medical problems

The early or short-term difficulties that most women experience are hot flushes, night sweats, vertigos, headaches, tiredness and insomnia, irritability, moodiness and even depression, lack of concentration and forgetfulness. Experts in the field have come to an assessment that up to 80 per cent women experience the unpleasant hot flushes and night sweats as they enter the climacteric. Middle and long-term symptoms occur from 2 to 5 years after menopause: the vagina becomes extremely sensitive, itchy and painful, especially during intercourse, susceptibility to inflammation and infection, for example vaginal candidiasis, and urinary tract infections (which result in painful and very frequent urinating) increases. These difficulties have a medical umbrella term - urogenital atrophy – and will be further discussed in the second part of this article. 

Vaginal changes

Being a part of the inner genital area, the vagina contains estrogen receptors. Before menopause, its natural acidic pH values provide a perfect environment for cell glycogen turning into lactic acid which protects the vagina against inflammations and over-reproduction of bacteria that cause unpleasant smelly discharge. The abundance of the hormone estrogen provides for the approprite wetness and emotionally satisfying reactions to physical stimuli. With the level of estrogen dropping in the menopause, the acidic environment in the vagina changes and apart from harmless lactobacilli, many harmful bacteria, especially streptococci and stafilococci can multiply. These may account for the greenish vaginal discharge, accompanied by feeling poorly and other problems mentioned above.

Hormone replacement therapy

Women with climacteric difficulties are advised to visit their gynaecologist as soon as possible: the sooner the treatment starts, the more successful it will be. Nowadays, hormonal treatments and therapies are considered to be completely safe, without any side-effects and relatively successful as well. As a hormone replacement therapy, your gynaecologist will prescribe you the lowest effective dose to make the menopause easier to cope with. Hormone therapy usually means taking pills, except for women whose blood pressure is too high – their medication is usually prescribed in the form of plasters.  

What's the examination like?

Before your gynaecologist chooses the appropriate therapy, s/he will check your weight and blood pressure, exclude chronical ilnesses such as high blood pressure, diabetes, high level of lipids in blood, immune system diseases or liver problems. The check-up also includes a vaginal smear test, a manual internal examination and ultrasound. In this way, your gynaecologist will be able to exclude different gynaecological ilnesses, such as mioma, endometriosis, abnormal bleeding from the womb, cancer or  pregnancy, which inhibit the start of hormone replacement therapy. S/he will probably also feel your breasts and instruct you to self-examine them carefully and regularly, plus recommend you take a mamograph examination every two years. After the procedure the risks, will be assessed and the doctor will decide whether hormone replacement therapy is appropriate in your case. Another check- up will follow after a few months to ensure that the therapy is going well and that your menopause difficulties are overcome or at least diminished. Once you enter the climacterium, you should visit your gynaecologist regularly at least once a year.