MENOPAUSE – CHANGE AND CHALLENGE
It happens to every woman, sooner or later. Parenthood you can choose or not. With menopause there is no choice. It happens to women who are nurses, secretaries, politicians, news readers, nuns, teachers, doctors, sales assistants and senior executives, to women who are unemployed and to retirees. It happens to women with young children – the menopause mums who are still breast-feeding when their periods stop – to women who have no children, to women working in the home and from home, to those accustomed to a low-stress existence and to those who have consistently demanded the highest mental and physical performance of themselves. Some wish it would happen quickly so that they can throw away their contraceptives and menstruation paraphernalia. Others regret the sometimes sudden, and perhaps also premature, end to their fertile years.
We’ve talked about the experience of menopause to countless women, the majority of whom have experienced some signs of change in their body chemistry – hot flushes, headaches, depression, mood swings, sleeplessness. Some are less concerned about these difficulties than about future health problems caused by a possible inherited high risk of heart disease or cancer. Still others have broken a bone soon after menopause and show early signs of reduced bone density (osteoporosis). The questions they ask vary accordingly. Will HRT settle my symptoms? Will it reduce or increase my risk of future disease? Can it stop my existing medical problems getting worse?
We are the first to admit that the women with whom we have discussed the menopause and HRT do not necessarily represent all women. We certainly do not want to stereotype menopause in an excessively negative way. But it is believed that about three out of four women in countries like Australia experience some physical signs associated with menopause, even though only one in four feels she needs medical help to deal with them. Maybe women who don’t seek medical advice consider their symptoms to be unimportant, maybe they have not been told about the kinds of help available, or perhaps they are coping perfectly well regardless.
As your GP will tell you, you can be sure menopause has occurred only when you have had no menstrual bleed for twelve months. Three or so months without a period are not enough: about one in five women near menopause menstruates again after that.
Raise the issue of menopause at any gathering of women, and it is clear that the term has come to mean more than just the end of monthly bleeds. Menopause has become shorthand for the many changes occurring during the transition from regular periods to no periods at all. It is a quick way of summing up hormones in flux, children leaving home or returning, ailing parents needing help, changing relationships with partners, and altered responsibilities in the workplace. An alternative catch-all term for this time of midlife change is the perimenopause.
The last menstrual period for most Australian women occurs between the ages of forty-eight and fifty-three (and can happen quite normally five or so years earlier or later than this). It is less tied to age, however, than at any time in human history due to developments in surgery and cancer treatment. These medical procedures can result in a woman having an artificial menopause (that is, one caused by removal of or damage to the ovaries) from the age of puberty onwards.
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