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Menopause is a term used to describe the time when a woman has stopped having periods for twelve months. This typically occurs around the age of 50 years. If it occurs before the age of 40 years, it is known as premature menopause. Menopause represents the time when the egg numbers have declined significantly, with a lack of egg development in the ovaries resulting in a decline in oestrogen levels. This marks the end of a woman’s reproductive lifespan and may be accompanied by many symptoms that affect the quality of life, such as disruptive sleep, hot flushes, night sweats, fatigue, mood swings, loss of libido and general drive for life.
Many of these symptoms occur prior to the menopause, and this period leading up to the menopause is known as the perimenopause. Perimenopause may occur as early as the late thirties in some women and therefore these symptoms can often be disruptive to a woman’s life for many years. Perimenopause is also the time when women experience an increase in premenstrual symptoms such as breast tenderness, migraines, mood swings, as well as a change in their menstrual cycle length, with some women having more frequent periods, whilst others have less frequent periods. The hormonal changes that occur in the perimenopause are also what makes women more likely to develop heavy, irregular periods, fibroids, ovarian cysts, endometrial polyps, as well as both benign and cancerous breast disease.
Optimisation of the hormonal status in women in the perimenopause and the menopause helps to reduce the incidence of bothersome symptoms, improve the quality of life and vitality, as well as to reduce the likelihood of developing gynaecological or other medical conditions that may require more invasive treatment. Hormonal optimisation may include improving lifestyle factors and the diet to support detoxification pathways for hormones and hormone activity.
A detailed consultation and physical examination by our specialists will help determine what intervention would be best for each individual patient. A detailed blood and urine test often identify a patient who may benefit from hormone replacement as well as identifies patients who need special attention whilst on hormone replacement to monitor for side effects.
Targeted supplementation and bioidentical hormones may also be considered. Patients receive close follow-up to ensure that they are responding well to therapy since patients have an often-varied response to hormone manipulation or replacement. Follow-up tests may be performed to ensure that hormone levels are optimal. The whole patient is taken into consideration as menopause is not a separate entity in a woman’s health.