I’ve waited a long time to be fashionable but at 51 I’ve finally nailed it! As a menopausal woman, I am officially on trend……zeitgeisty……..cool (ok- maybe not cool). After generations of hushed silence, menopause is headlining everywhere. For too long considered the ugly sister to puberty’s Cinderella, things are changing and it’s long overdue. Far from being the end of womanhood, it’s the start of a new chapter in our lives and there’s actually cause to celebrate, writes Dr Julia Sen.
So what is menopause?
Menopause literally means the last period but in contrast to the first (menarche) a woman is unlikely to know if a period will be her last. A more useful term is perimenopause as the process can take a decade or more from start to finish, beginning in the early 40’s or even late 30’s. Oestrogen levels enter a phase of fluctuating decline, For some, though there may be a surge before their ovaries give up the ghost, resulting in a little spike of friskiness!
Once the levels ultimately drop we feel it in many ways. Every organ in a woman’s body is affected by lack of oestrogen and menopause is increasingly being considered a deficiency disease.
What delights does menopause have in store?
Cessation of periods and hot flushes are the obvious ones but the effects can be surprisingly diverse and include, weight gain with more central fat distribution, bone thinning (osteoporosis) muscle loss (sarcopenia), dryness and thinning of skin, feelings of anxiety, depression, difficulty concentrating, sleep disturbance and loss of libido.
You may have never really considered the purpose of labia but they provide protective cushioning when seated. Deflation due to age and hormonal insufficiency, leaves the delicate structures underneath exposed and susceptible to abrasion. This combined with reduced natural secretions can result in discomfort and itching. Sexual spontaneity may become difficult if a “lubing up” ritual has to be performed before comfortable intercourse is possible and for mums in particular, pelvic floor muscle laxity can result in “Oops” moments and having to work out where the nearest loos are prior to any excursion.
So why not just replace the oestrogen?
Unfortunately a scientific publication 20 years ago suggested that HRT might be more harmful than beneficial but recent evidence suggests that the opposite is true for the majority of healthy women, all things considered. Sadly many women still struggle through this difficult transition without hormonal support, believing that this to be the safer option.
What comprises HRT and how do I take it?
Oestrogen alone can be used post hysterectomy or in the presence of a progesterone-secreting intrauterine device (e.g. Mirena coil). Otherwise progesterone must also be taken so as not to increase the risk of endometrial (womb lining) cancer. This may mean continued periods. Testosterone may be added for symptoms of reduced libido.
Patches, gels, implants and pessaries are available and may be safer than tablets in some cases.
Is there technology that can help intimate ageing symptoms?
Excitingly, yes. Radio frequency energy, used for decades in general surgical procedures has now been adapted for exactly this purpose as the Forma-V device by InMode. Administered using a lubricated hand piece, a feeling of pleasant warmth is experienced as it is gently rotated repeatedly from the cervix downwards stimulating collagen production, tightening the vaginal walls and increasing glandular lubrication and bladder control. Each treatment takes around 30 minutes and there’s no downtime. Three treatments, approximately 1 month apart are recommended with a top-up treatment annually. This is great news for women whose symptoms are not severe enough to warrant surgery or those who prefer to try alternative options. The results can be life-changing, although as with any treatment it’s not effective for everyone.
A new you!
Far from being the end, menopause heralds new beginnings and opportunities. Years of juggling family and career has often meant putting ourselves last. It’s a time to reflect on what’s important in our lives going forwards, perhaps focusing on professional goals, enjoying hobbies or simply taking better care of ourselves. With our mature status comes self-knowledge, letting go of the insecurities of youth leaving us free to enjoy what we have achieved and look forward to the next exciting chapter…