"I haven't been feeling well lately." "I've become easily irritated over small things. Is it because I'm getting older?"
Many women are probably confused by the changes in their mind and body that occur when they turn 40. These unexplained discomforts may be a sign that menopause is beginning.
Menopause is a natural life change that all women experience, and understanding it properly can help you cope with the changes more comfortably.
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What is menopause and at what age does it start?
Menopause is the gradual loss of ovarian activity and the permanent cessation of menstruation. When it is confirmed that menstruation has ceased for one year since the last menstruation, menopause is diagnosed retroactively one year prior. Menopause refers to the period before and after menopause, specifically the approximately 10 years that include the five years before menopause and the five years after menopause.
The average age of menopause for Japanese women is around 50, so menopause generally occurs between the ages of 45 and 55.
During menopause, the secretion of the female hormone estrogen, which has protected women's health for many years, drops sharply as ovarian function declines, causing a major disruption to hormone balance. Changes in hormone balance can cause a variety of mental and physical disorders.
Source: Japan Society of Obstetrics and Gynecology | Menopausal Disorders
Source: Japan Society of Women's Medicine | For those considering hormone replacement therapy: "To gain a correct understanding of hormone replacement therapy - From the Hormone Replacement Therapy Guidelines"
Source: "Ministry of Health, Labour and Welfare Project" "Healthcare Lab, Women's Health Promotion Office" supervised by the Department of Obstetrics and Gynecology, University of Tokyo and the National Center for Child Health and Development | What are menopausal disorders?
Early symptoms of menopause and a checklist
The first symptom of menopause is irregular menstrual cycles. Check for typical symptoms and see a doctor if any of them concern you.
Early symptoms of menopause
The first thing that often appears is an irregular menstrual cycle. Around the age of 40, the cycle begins to become irregular or shorter, and tends to become even more irregular around the age of 50.
The organs affected by the female hormone estrogen are not only the uterus and ovaries, but also the brain, blood vessels, bones, skin, etc. Therefore, various physical and mental symptoms appear during menopause when estrogen levels decrease.
Menopause Checklist
Take a look back at your recent health condition and see if any of these symptoms apply to you. These are typical signs of menopause.
- My face is hot
- Sweat easily
- Your face, hands and feet get cold easily
- Shortness of breath and palpitations
- Difficulty falling asleep or having shallow sleep
- Easily angered and easily annoyed
- I sometimes worry or feel depressed
- Frequent headaches, dizziness, and nausea
- Get tired easily
- Stiff shoulders, back pain, and pain in the arms and legs
If you have any symptoms that concern you, visit an obstetrician-gynecologist.
Source: J-stage | Menopausal symptoms
Source: "Ministry of Health, Labor and Welfare Project" supervised by the Department of Obstetrics and Gynecology at the University of Tokyo and the National Center for Child Health and Development, "Women's Health Promotion Office Healthcare Lab" | Menopausal Symptom Check
Treatment of menopausal symptoms
If menopausal symptoms become so severe that they interfere with your daily life, you may be experiencing a condition called menopausal disorder, which is a medical condition that requires treatment. Medical institutions offer a variety of options to alleviate symptoms, including medication and counseling.
drug therapy
The mainstay of treatment is drug therapy. Hormonal vaginal tablets are effective for vaginal dryness and pain during intercourse, and depending on the symptoms, hormones may be used in combination with Chinese herbal medicine, or autonomic nervous system regulators, sleeping pills, or psychotropic drugs may be used.
Hormone replacement therapy (HRT)
Hormone replacement therapy (HRT) is an effective treatment that compensates for the decline in estrogen, which is the root cause of menopausal symptoms. HRT usually involves administering a combination of two hormones, estrogen and progesterone (estrogen-progesterone combination therapy).
HRT is a treatment that is particularly effective for the typical menopausal symptoms of hot flashes. It also has many benefits for protecting your future health, such as preventing osteoporosis, which weakens bones, and heart and vascular diseases.
If your uterus has been removed surgically, you do not need progesterone. There are various forms of medication (oral, patch, topical) and administration methods, so consult with your doctor to choose the most appropriate one based on your lifestyle and symptoms.
herbal medicine
Traditional Chinese medicine regards the mind and body as one and aims to achieve a holistic balance. Kampo medicines are prescribed according to each individual's constitution, known as "Sho," and are characterized by their gentle action on both the mind and body.
The three main prescriptions that are often used for menopausal symptoms are "Tokishakuyakusan," "Kamishoyosan," and "Keishibukuryogan."
The most common is Tokishakuyakusan, which is prescribed to weak people who are prone to cold and fatigue. For those who are even weaker and have mental symptoms such as anxiety and insomnia, Kamishoyosan is used, and for those who are relatively physically strong and have hot flashes or resistance and tenderness in the lower abdomen, Keishibukuryogan is used. Kampo medicine is said to have beneficial effects on both the mind and body.
psychotropic drugs
Psychotropic drugs (antidepressants, anti-anxiety drugs, etc.) are used when mental symptoms such as depression, anxiety, insomnia, and irritability are particularly severe. Antidepressants such as SSRIs (selective serotonin reuptake inhibitors) in particular alleviate symptoms by acting on serotonin, which is involved in stabilizing mood.
Serotonin is also involved in regulating body temperature, so it is expected to be effective in alleviating hot flashes. Side effects such as nausea and constipation may occur in 10-20% of people.
Counseling and Psychotherapy
Menopausal symptoms are also greatly influenced by psychological and social factors such as personality traits and stress at home or work. For this reason, improvement with drug therapy alone may be difficult, and counseling may be effective.
Having a specialist listen to you and positively acknowledge your feelings often makes you feel better.
Cognitive behavioral therapy, which helps people become aware of their perceptions and behavioral habits and change their way of thinking to make them feel more comfortable, is said to be effective not only for mental symptoms but also for physical symptoms such as insomnia, hot flashes, and night sweats.
Source: J-stage | Menopausal symptoms
Source: Japan Society of Obstetrics and Gynecology | Menopausal Disorders
Source: "Ministry of Health, Labour and Welfare Project" "Healthcare Lab, Women's Health Promotion Office" supervised by the Department of Obstetrics and Gynecology, University of Tokyo and the National Center for Child Health and Development | What are menopausal disorders?
summary
Menopause is a natural life stage that all women go through. You may be confused by the various changes in your mind and body, but it is not an unusual worry.
By properly understanding how it works and making good use of medical treatments such as hormone replacement therapy and herbal medicine when you are struggling, you can spend menopause more comfortably and positively. If you ever feel like "maybe this is the case," don't put up with it; feel free to consult a gynecologist.