‘If you prepare yourself … menopause can be manageable’, says gynaecologist

‘Women are often so caught up in everyday life that we overlook caring for ourselves. If you have been under prioritising your health and are entering menopause, think of this as a time to reflect, reset and pour energy back into your own well-being.”

So says Dr Taheera Hassim, an obstetrician and gynaecologist practising at Netcare Sunninghill Hospital, noting that menopause is a natural phase that needs to be supported by healthy habits, which can only stand to benefit women as they grow older.

“Menopause signals the end of menstruation and the reproductive years. “This normally occurs between the ages of 45 and 55, though it can be experienced by women in their 30s or even in their 60s.

Women who have not had their period for 12 consecutive months are generally considered to be in menopause, which is when the ovaries stop producing the hormones oestrogen and progesterone,” says Hassim.

Hot flushes, loss of libido “The effects of changing hormonal levels in the body are not insignificant and women should be aware of accompanying symptoms, such as hot flushes; disturbed sleep; general fatigue; loss of libido; vaginal dryness; irritability and mood swings; slower metabolism leading to weight gain; thinning hair; dry skin; and loss of breast fullness, among others.

Many women are anxious about this experience and it is important to approach it with self-compassion and an awareness of your mental health, as it is a big life change.

“There are also a number of steps you can take and constructive behaviours to introduce into your daily life, that will support you through the process and assist in lowering your risk of developing certain conditions after menopause.”

Hassim says if you think you may be going into menopause, start with a visit to your doctor. “A blood test may be taken to check your levels of certain hormones and your doctor may want to talk to you about ruling out the possibility of pregnancy, which can sometimes be mistaken for menopause in later years.”

Hassim says there are certain treatments available to relieve severe symptoms and manage any associated conditions, which vary from woman to woman and which require a personalised approach.

“From this time of life onwards it is important for a woman’s health to be carefully monitored, especially for certain conditions that postmenopausal women are at greater risk of developing.

“Practice preventative care by regularly going for important health screenings, including a bone density test; mammogram and breast ultrasound; pap smear; pelvic exam; colonoscopy ; cholesterol and blood sugar screening; and a thyroid test,” she says.

Many women mistakenly believe cardiovascular disease tends to be a male health issue but this is far from the truth, says Hassim.

“The risk of heart disease escalates with age and studies have found that the rate of heart attacks increases for women 10 years after menopause. It is believed the drop in oestrogen production influences the flexibility and health of blood vessels.

Balanced diet “Eating a balanced diet and maintaining a healthy body weight are two of the most important things a woman can do for herself from a young age.

This drop in oestrogen can also lead to the development of osteoporosis, a condition in which bone density starts to decrease, making bones more brittle and susceptible to injury.

“Postmenopausal women are at greater risk of developing osteoporosis than any other group.” She says alcohol consumption has a negative impact on calcium production, which can heighten this risk and worsen existing osteoporosis.

“Smoking and poor diet are other contributing factors.” Hassim adds that simply paying more attention to making healthy choices can help women through the period after menopause.

“Starting an exercise programme, if you are not already on one, and eating healthier food can make a big difference. “A little weight loss can be remarkably effective – a loss of just a few kilos can reduce blood pressure and stabilise metabolic syndrome, which will make you feel much fitter and able to cope.”

She advises all women over 65 to go for a bone density test, as early diagnosis of osteoporosis is treatable with medication that stops the progression of the disease and can, in some cases, reverse some of the bone loss that occurred prior to diagnosis.

One worrying aspect of menopause for many women is sex. “During menopause, sexual function may be impacted due to physical and emotional changes brought on by decreasing oestrogen levels.

This can include… more frequent urinary tract infections, thinning vaginal tissue and decreased lubrication, among others,” she notes.

“You can expect these changes to alter the experience of sex in a number of ways. Keep your doctor informed about this so they can advise you on how to bring joy and pleasure back into your sex life, if it is being impacted.

Strengthening your pelvic floor with Kegel exercise is an excellent way to maintain pelvic health as you age. “It is also very important to talk to your partner about what you are going through, so that they can better understand and support you during this time – not only in terms of your sexual relationship but overall.

“By being proactive and preparing yourself physically and mentally for the changes you will experience, menopause can be very manageable. Putting your health first can only benefit you, now and in the long run.”

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