Problems in the menopause

The most marked symptoms of the menopause often occur before periods end completely. They are linked to the hormonal changes that occur during this time of transition, but are also due to ageing.

These problems occur in an unpredictable manner and fluctuate greatly from one month to another. Their intensity also varies from one woman to another: some only notice the cessation of menstruation, whereas others (about 20% to 30% of women) have moderate to severe symptoms.

A changing body, a thickening waistline due to the shifting distribution of fat, and skin becoming drier may be felt as a loss of femininity. The menopause represents the loss of fertility, which may create difficult feelings for those who have not had children.

Psychological and medical support can ease this transition. Reducing hot flushes and sweating helps to restore undisturbed sleep and tone, while hormone replacement therapy can provide relief. We strive to offer you the best care.

• Hot flushes and night sweats

  A feeling of intense heat, sweating and palpitations may last for a few seconds to several minutes. They are often first noticed in the abdomen or chest before rising within a few seconds to the neck and face. Their frequency and intensity vary greatly from one woman to another. Hot flushes are the main reason why women decide to see a doctor. If they occur at night, they can significantly reduce sleep quality and lead to tiredness.

• Mood disorders

  Other symptoms of the menopause include mood disorders, poor concentration, loss of energy and bouts of anxiety.

  It is important to emphasise that the menopause does not automatically lead to episodes of depression. This stage also presents the opportunity to be liberated from certain constraints such as that of contraception.

• Bodily changes

  The lack of oestrogens leads to a change in the production of collagen and elastin, and causes a decrease in the quality of the skin, hair and nails, which become dryer, fragile and more easily split. Hormonal problems may induce episodes of acne, hair loss or excessive hairiness, as well as osteoporosis (reduction of bone density).

• Weight gain

  The slowing of metabolism in a menopausal woman may cause some weight gain.

  Physical exercise and not smoking improve the health and longevity of women. Assessing weight problems is a priority matter in the management of menopause so that patients can be offered treatments which improve their quality of life and reduce the risk of complications.

• Urinary incontinence

  The involuntary loss of urine can occur at various ages but is most frequent in menopausal women.

  Some medicines act on the hyperactivity of the bladder muscle. Hormone treatment may prove useful if there is oestrogen deficiency, and antibiotics will be prescribed if the problem originates from urinary infection. Surgical intervention will be considered if perineal weakness is responsible for the leaks. Perineal re-education is often indicated.

• Contraception, sexuality and bladder problems

  A decrease of mucus production in the vagina and bladder may be linked to cessation of oestrogen secretion by the ovaries. The consequence is a tendency to urinary tract infections as well as vaginal dryness. Combined with reduced libido, this can cause a lowering of the quality of sexual life. However, it is not uncommon for pregnancy to occur after 40 years of age.

• Irregular periods and premenstrual syndromes

  Irregular periods are a frequent feature linked to reduction of the hormonal function of the ovaries.

  After several examinations and tests, the treatment will be matched to your symptoms. It may include modifications of lifestyle and diet, or even treatment with medicines.

• Premature menopause

  Menopause occurring before the age of 40 years requires special management