Menopausal Symptoms

Symptoms

Menopausal symptoms are very individual and vary from woman to woman. The most common possible disorders include:

Longer-term risks in postmenopause:

Causes

Natural menopause in women begins around the age of 40 and can last for several years. They are often announced by changes in the menstrual cycle. During menopause, the production of estrogens in the ovary gradually stops altogether and ovulation ceases. The consequences are the end of monthly bleeding, infertility, and the typical menopausal symptoms. Finally, menopause is the time of the last menstrual period, which is on average around the age of 50. It can only be determined in retrospect. Estrogen deficiency is also possible before menopause and can be caused by medications, chemotherapy, radiation therapy and surgery.

Diagnosis

The diagnosis is made in medical treatment. Thyroid dysfunction should be ruled out because it causes similar symptoms. Other possible differential diagnoses include pregnancy, hyperprolactinemia, and anemia.

Nonpharmacologic treatment

  • Healthy lifestyle: exercise, sufficient physical activity, diet rich in vegetables and low in fat, do not smoke and avoid too much alcohol. Reconsider and adapt one’s own lifestyle.
  • When hot flashes avoid heat and cool if necessary.
  • Maintain sexual activity
  • Good sleep hygiene
  • The appearance of the skin changes during menopause, the skin becomes drier and should therefore be treated regularly with skin care products.
  • To find inner balance, maintaining social contacts and relaxation exercises are helpful.

Drug treatment

Estrogens:

  • Such as estradiol and estriol are used orally, transdermally, and topically for the treatment of menopausal symptoms and have been shown to be effective. They are also approved for osteoporosis prophylaxis. However, longer-term systemic treatment carries a slightly increased risk of cancer and cardiovascular disease, so the risk-benefit ratio must be weighed individually before treatment. Estrogens are also combined with progestins, such as cyproterone acetate, dydrogesterone and norethisterone acetate, and related substances such as tibolone are available.

Osteoporosis drugs:

Antidepressants:

  • Especially venlafaxine and einge SSRI are effective against flushes, but somewhat weaker than estrogens. They additionally help with co-existing mental disorders. Their use is limited by the possible adverse effects.

Cimicifuga (black cohosh):

  • Is widely used in phytotherapy and is approved in many countries for this indication. Medicines are available that need to be taken only once daily. Possible adverse effects include digestive problems and very rarely liver damage. If yellowing of the skin or other symptoms suggestive of liver damage occur, the remedies should be discontinued. According to rational phytotherapy, standardized extracts are preferred.

Monk’s pepper: Monk’s pepper is recommended mainly for the symptoms of the initial phase.St. John’s wort can be tried for depressive moods, hawthorn to treat palpitations. Rhapontic rhubarb:

  • Extracts from the roots of rhapontic rhubarb are approved for the treatment of menopausal symptoms. The tablets are usually taken once daily with a meal. Possible adverse effects include hypersensitivity reactions.

Sleep aids:

Many other herbal medicines, such as red clover, cardiac stimulants, phytoestrogens, soy, antioxidants, and wild yam, are used, but some are highly controversial in the scientific literature.