Before it happens to us...
Will I have severe hot flashes if I have always had painful periods? There is no link between period pain and hot flashes. The two symptoms respond to different mechanisms. The first is often explained by strong contractions of the uterus or endometriosis. The puffs are linked to a disruption of temperature control. It is therefore not because you suffer during your period that your puffs will be bothersome. However, nothing can predict their intensity. Regarding their appearance, a study in the journal Menopause identified certain genetic variations common to women prone to hot flashes.
Will I suffer the same fate as my sister, who went through a particularly difficult menopause? To each his own menopause, one might say. Especially since tolerance towards climacteric disorders (hot flashes, mood swings, etc.) is partly linked to the history of each woman, to her relationship with her body, her sexuality and her aging. The same symptom will not have the same repercussions depending on its acceptance and the way each person approaches this new phase. Some will live it more serenely, others will be more active in seeking solutions...
Will I go through menopause at the same age as my mother? The hereditary factor is indisputable, but others can be taken into account, such as smoking, which can bring the cessation of menstruation forward by one or two years, or chemotherapy. On the other hand, the age of the first period, the number of pregnancies or the taking of a contraceptive pill have no influence.
Can I delay the onset of my menopause? No, it is impossible to delay this deadline, largely genetically programmed. And there's really no medical benefit to going into menopause late.
At premenopause
Are hot flashes visible? Not necessarily, even if one has the impression of being red as a tomato! However, if drops bead on the face or between the breasts, you can discreetly go to the toilet to cool off. Breathing slowly through your nose, making your belly puff out when you feel a puff coming, can help make it go away more quickly.
How do I know where I am since I no longer have periods under a hormonal IUD? It is indeed difficult to notice cycle fluctuations since your IUD contains progestins which suppress bleeding. On the other hand, some signs can give you a hint: hot flashes and/or night sweats, mood swings. Intermittent bleeding or tenderness in the breasts may occur. Here is a benchmark that can help you find your way around: on average, the first symptoms mentioned above appear three to four years before the final cessation of menstruation. Then, it takes a year to reach the stage of menopause proper.
Why are my breasts swollen? This is one of the signs of pre-menstrual syndrome that can reappear, and even worsen. The breasts are more tense and painful, due to the drop in progesterone secretion. Other possible symptoms: swelling of the face and legs, abdominal bloating, greater fatigue...
Can I do without contraception? Despite a plummeting fertility after 45 years (about 2% risk of being pregnant), a surprise pregnancy is still possible as long as menopause is not "officially" declared. It is therefore better to keep contraception until the final cessation of menstruation. Beyond 50 years, however, we can discuss his interest with his gynecologist. Caution, however, in case of a new partner. Wearing a condom remains necessary to be protected from sexually transmitted infections, the risk of which is present at any age.
To avoid hot flashes, can I take the pill instead of the hormonal IUD? It all depends on which pill it is. If, like the IUD, it contains only progestogen hormones, this will not change anything. The so-called combined estrogen-progestogen pill (estrogen + progestogen), on the other hand, effectively suppresses climacteric symptoms and menstruation continues to occur each month – “false” periods. However, it is not because one does not wish to feel the beginnings of menopause that one must necessarily adopt this method of contraception.
Should I be worried about a drop in my libido? Not necessarily. You may very well want to make love more than before. It's related to male hormones, including testosterone, that women continue to secrete. In addition, stopping the rules can also be liberating and increase the desire for your partner. In any case, the quality of previous sex life plays a big role. Of course, desiring and feeling desirable also depends on self-image. If you feel bad about yourself because of a few extra pounds, if intercourse is painful because of a dehydrated vaginal mucosa, it does not make you want to get closer to your spouse. Especially since the excitement and lubrication rise more slowly than before. It is then necessary to reinstall a virtuous circle: reclaiming one's body and using local lubricating treatments to reconnect with fulfilling sexuality.
Why is my bleeding heavy with my copper IUD? This is not exceptional in premenopause, where bleeding becomes unpredictable. They may be absent for some months, or last more than five days, with clots... In this case, changing the IUD may be a solution. Instead of a copper intrauterine device, the gynecologist can place a device delivering doses of progesterone, of the Mirena type, acting at the level of the uterus and preventing its wall from vascularizing in an anarchic manner. After several cycles, menstruation disappears or causes very little bleeding. However, we must wonder if these heavy periods are not due to a uterine fibroid, a benign tumor common between 40 and 50 years.
Is there a test to know if I am menopausal? Menopause is confirmed after one year without periods. There is therefore no need for a hormonal balance sheet to know where we are. In addition, measuring estrogens can be misleading because, during premenopause, their level is very fluctuating. Some gynecologists offer a progesterone test around the age of 50, after menstruation has stopped, to find out if menopause is effective or not. We take progesterone orally for ten days, and if, when the treatment is stopped, the rules are back, it means that we are not yet menopausal.
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How long will I have to put up with these night sweats and other mood swings? Hot flashes and night sweats last, according to the American observational study Swan (Study of Women's Health Across the Nation), on average seven years after the cessation of menstruation. But it is not uncommon to see women complaining about it, to varying degrees, even ten years after their first appearance. Mood and sleep disorders fade more or less quickly depending on the experience of each woman. On the other hand, when the menopause has set in, vaginal dryness and urinary disorders (leaks, repeated infections, etc.), which are directly linked to estrogen deficiency, tend to worsen over the years. Don't hesitate to raise the subject with your gynecologist – too many women are still reluctant to do so – because there are solutions that permanently improve intimate comfort.
I sometimes wake up soaked, why? These night sweats originate from a disturbance of the temperature regulation center, located in a region of the hypothalamus. He no longer understands why the ovaries do not react when he asks them to produce estrogen. Disturbed, it then begins to function in an anarchic manner, resulting in heat strokes – the rhythm and intensity of which vary from one woman to another – that the body has trouble managing.
Are hormones responsible for my low morale? In part, but they do not explain everything... Estrogens have a stimulating effect and promote the production by the brain of serotonin, the hormone of well-being. The decrease in their secretion therefore puts the nerves in a ball. The production of progesterone drops, too, and there, it is sleep that suffers. As it has a calming effect, its disappearance tends to reduce resistance to stress. These effects sometimes collide with a changing professional or family life. When the children leave the nest, when we are afraid of growing old, it is not surprising to feel depressed. And there, it is not the fault of the hormones!
At menopause
I don't understand why I've put on a belly even though I'm eating less... Female hormones don't act directly on weight gain, but the silhouette changes with a new distribution of adipose tissue, which accumulates on the stomach. Physiologically, the body also burns fat less easily from the age of fifty – as muscle mass tends to melt, it consumes fewer calories. Eating better by making sure to reduce, among other things, your sugar intake is beneficial, as is moving more to reduce muscle wasting.
How to explain that my breasts have melted? The breasts are very sensitive to sex hormones. The drop in estrogen causes a decrease in breast density: the breasts become more supple, but also softer. Under the combined effect of sagging skin, they tend to “sink”, and the nipple to be less bulging, especially if the pregnancies had “flattened” them a little. On the other hand, if you have gained weight, the fatty mass is located more in the breasts, which can make you take a bra size.
Is menopause also responsible for my blackouts? Some studies show that women who take hormone treatment for menopause have better maintenance of cognitive functions. But no direct link between estrogen deficiency and memory problems could really be demonstrated.
Where do my recurrent cystitis come from? At menopause, the bladder fights less well against germs (estrogens stimulated its defenses), leaving the door open to repeated cystitis linked to the proliferation of the bacterium Escherichia coli. In addition, estrogen deficiency leads to a fragility of the urethral wall, which becomes thinner. It is thus irritated more easily, which can cause discomfort, small burns during urination, without the presence of germs. These so-called clear urine cystitis therefore cause the same symptoms as cystitis of infectious origin.
How can I explain that my sensations during intercourse have diminished? This comes from the relaxation of the perineum, a set of muscles located between the pubic symphysis and the coccyx. This particularly innervated area is mobilized during sexual intercourse and orgasm. At menopause, the perineum distends due to lack of estrogen, but also aging and vaginal deliveries. And it shows under the duvet. This relaxation also has repercussions on the bladder, and even on the anus, which lose tone. Urinary leakage can therefore appear during physical activity, when sneezing or carrying heavy loads. A few drops at first... which may turn into incontinence over time. Various methods (functional vaginal electrostimulation, bodybuilding, etc.) are possible to reinvigorate the perineum, regain its sensations and control of its bladder. Talk to your doctor who will certainly prescribe sessions with a physiotherapist.
Why do I get acne breakouts when I expected my skin to get drier? In most cases, the skin tends to dry out. This is due to age, but also to the stopping of the functioning of the ovaries, which cease their production of female hormones (estrogens in particular). But sometimes, testosterone – which continues to be present, because if it is made by the ovaries, it is also made by the adrenal glands – can activate the skin receptors. This can lead to greater secretion of sebum, and promote the appearance of imperfections on the surface of the skin.
And these hairs that grow on my chin, is it temporary? Not really... Hair changes under the effect of hormonal changes: it's another hit of testosterone! We owe him certain more masculine manifestations, such as hair on the chin and at the level of the mustache, or even hair loss. On the other hand, the hairiness of the legs, armpits and eyebrows becomes rare, especially if you used to wax these areas regularly.
Does the consumption of dairy products protect me from the risk of osteoporosis? The sufficient intake of calcium, in the form of dairy products but also by the consumption of mineral waters, seeds and oilseeds, can slow down bone loss, which accelerates with menopause. Without forgetting that it is necessary to cover its needs in vitamin D to fix the calcium on the bone. But this is not always enough, because the risk of osteoporosis is also genetic. It is therefore necessary to inquire about the medical history of his family and to monitor bone loss by a bone densitometry examination if there has been a history of personal or family fractures (wrist, femoral neck).
When she is early
In 1% of women, the symptoms of menopause appear before the age of 40. This is called premature ovarian failure. For 10 to 15% of them, we find a genetic predisposition. But in most cases, the triggering factor remains an enigma. They must receive a THM (hormonal treatment of the menopause) until the age of 50, in order to compensate for the hormonal decline and to prevent cardiovascular diseases as well as osteoporosis.
There is tiredness and tiredness
The impression of having less enthusiasm since the menopause? When you're woken up two or three times in the night by night sweats, you don't necessarily start your days in great shape. Daytime hot flashes, once passed, can also leave the mark of deep weariness. Sometimes joint and muscle pain is added... which is exhausting in the long run. But be careful not to put everything on the back of hormones. It happens that fatigue is correlated with a drop in morale linked, for example, to problems in the couple, or even to the fear of aging. A state of fatigue that prevents you from carrying out daily tasks or that takes away the desire to undertake must, in any case, lead to consultation.
Time for the health check
The onset of menopause should be an opportunity to take stock of cardiovascular and bone risk factors. This assessment can be carried out with his gynecologist, his attending physician or in a specific menopause center within two years after the definitive cessation of menstruation. A questionnaire and a series of examinations are then carried out: blood test, bone densitometry, weight control, gynecological assessment...
The later the better?
It is not because the menopause is late that it will be better lived, or the reverse. Age does not affect symptoms. The difference is felt at the level of the consequences linked to the impregnation with estrogens. The longer it is, the more the arteries and the skeleton are protected against atheroma plaques and osteoporosis respectively. The skin and mucous membranes will also remain better hydrated. On the other hand, "a menopause that occurs after the age of 55 increases the risk of breast and endometrial cancer by 1.2 to 1.4 times", informs Professor Gompel. This requires special vigilance.
>Also discover: Intimate hygiene: 10 products that will do good for the balance of your flora!
