How to deal with menopause

Menopause is defined as when there has been no menstrual periods for 12 consecutive months and no other cause can be found to explain it.

In the time leading up to menopause, a woman might find that her menstrual cycle starts changing and becomes more irregular - this is referred to as the “peri-menopause” phase.

Also referred to as the “change of life”, menopause was a topic previously avoided by many, however there has been increased awareness of the phenomenon in recent years.


Clinical Features

The average age of menopause is 51 years but can occur as early as the mid 30s to as late as the 60s.

There is no laboratory test to establish when a woman will reach menopause but there is a tendency for women to experience it at a similar age to that of their mothers.

The most common symptoms are hot flashes and night sweats. A hot flash is a sensation of intense warmth that spreads over the body - mostly the chest and head. It is frequently accompanied by sweating and can last from a few seconds to several minutes.

Other symptoms can include vaginal dryness/ irritation, fatigue, irritability and change in mood. Physical changes are also sometimes experienced such as weight gain, skin changes (such as worsening of adult acne), and increased hair growth involving the upper lip, chin, chest and abdomen.

Most of these symptoms are related to a reduction of hormones such as oestradiol and FSH in the body.

The abnormal hair growth is due to a small amount of testosterone that the body continues to produce.



Apart from the physical discomfort, menopause is associated with an increased risk of osteoporosis - a condition where the bone density is reduced and thus increasing the risk of bone fracture.  Menopause has also been linked to an raised risk of cardiovascular disease.


Menopause is a normal phase in a woman’s life and is NOT a disease, however, there are treatment options to relieve the unwanted symptoms.


l Hormone

replacement therapy (HRT)

HRT consisting of oestrogen either alone or in combination with progesterone can help control the symptoms but has also been linked to increased risk of heart attacks, stroke and certain types of cancers. It is recommended that the decision to take HRT be based on a shared decision between the patient and her attending doctor. If HRT has to be used, it should be used at the lowest dosage for the shortest period of time - and only if the benefits of the treatment outweigh the risks.

l Vaginal lubricants

Vaginal lubricants can assist with dryness and irritation of the vagina.


l Phyto-oestrogensj12

These are plant derived oestrogens that are less potent than the natural oestrogens found in the body. They are found in soy beans, chick peas and lentils. The efficacy of these agents are minimal compared to HRT.


l Lifestyle modifications

Modifications towards a healthy lifestyle are essential. A regular exercise regimen can help prevent cardiovascuar disease and osteoporosis. A balanced diet and refraining from smoking can prevent heart disease and also improve menopausal symptoms.



In conclusion, although menopause is a challenging stage in a woman’s life, it can be overcome with a positive attitude and healthy lifestyle modifications. Therapy options do exist and need to be shared decision between a woman and her treating health care provider.(Source Lenmed

The author is SPECIALIST PHYSICIAN AND RHEUMATOLOGIST MBChB, FCP (SA), Cert Rheumatology (SA), MMED Medicine Certificate in Rheumatology

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