Menopause is not a disease! It must be approached interdisciplinary and separated from possible ailments

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Statistics show that more than half of Romanian women are in menopause, but a quarter of Romanian women have never been to a gynecologist.

Menopause, although it is a normal physiological state, is a subject that is not talked about very much. Many women who have reached this period of life do not talk to the doctor about the symptoms they have, and others do not follow the recommended treatments. Specialists say that if it is a normal menopause, women have nothing to fear. If there are associated pathologies, then they must be treated. Also, changes at the physical level may require various types of therapy: for example, some women need hormone therapy, for others phytotherapy helps.

“A big problem is that women don’t talk about what hurts them. We need to help them tell us that they don’t feel well. There are some medical myths, some of them inspired by studies that were carried out many years ago, and I mean first of all the approach to sensitive topics, such as hormone replacement treatment, which does not always have to be, but in many situations, must be. Women in this age group constitute an extremely important social segment and from this point of view it is worth developing programs that help them live better”, says Dr. Iosif Niculescudoctor with over 30 years of experience in gynecology.

Three quarters of menopausal women have hot flashes and migraines

More than half of women say that menopause is an unpleasant state, and over 60% declare that they have problems in their professional life. Menopause symptoms are of several types:

  • 75% of women experience vasomotor symptoms: migraines and hot flashes, which can take severe forms, reaching 18 episodes a day, affecting their ability to lead a normal life

  • 60% of women have urogenital symptoms: urethral atrophy, vaginal atrophy, sexual dysfunctions

  • 45% of women have psychogenic symptoms: anger, anxiety, depression, sleep and concentration disorders

  • Only 10% of women have no symptoms at all

What investigations should a menopausal woman do?

First of all, the consultation will be gynecological, senological and endocrinological, and after this it will be determined whether the woman needs additional investigations, such as:

  • cardiological examination, including doppler examination of peripheral vessels

  • ultrasounds of the breast, transvaginal, thyroid, psychological assessment

  • testing diabetes and nutritional diseases

  • uro-gynecological examination

  • thrombophilia tests, hormone dosages, cholesterol

Menopause means the decrease in estrogen production in the body. The effect of the low level is manifested by the lack of menstruation, by atrophy in the entire sphere of the genital apparatus, where hormones regulate the blood flow and secretions, by affecting the resistance of the bones, by deregulating the good cholesterol-bad cholesterol balance, and by decreasing the collagen level. Also, when women no longer have estrogen, cardiovascular diseases have exactly the same incidence and mortality rate as in men. The incidence of cerebral vascular accidents is higher after menopause, the decrease in muscle mass and, last but not least, the appearance of various tumors in close connection with the role of hormones in general. The approach must be interdisciplinary in complicated cases, to solve the health problems of the menopausal woman and to improve the quality of life.

“Menopause is not scary, it is a becoming, if you want, it is even a fulfillment. I think that where, indeed, the physical loses something of its potential, there is a very great gain on the spiritual, mental, I would even say intellectual side. Regular menopause should not be seen as a problem, it is simply another stage of life. Of course yes, when problems arise, just like during adulthood, like during puberty, etc. we enter pathology and then it must be treated. We propose, through the multidisciplinary approach, to try to separate the pathological from the normal and to make women understand that they have nothing to be afraid of. We need to do more popularization, so that the world understands exactly that nothing irreparable happens during menopause”, says Prof. Dr. Nicoale Poianafounding member of the Romanian Menopause Society and founder of the MediPlus clinic, focused on women’s care.

Lifestyle is extremely important during menopause

First of all, it is necessary for women to treat the conditions they discover during the medical control for menopause and to follow the indications of doctors related to hormone therapy or other alternative therapies. But a very important aspect, which is discussed as little, say the doctors, is the fact that, once entering this period, women must make a series of changes in their lifestyle: to quit smoking, have a healthy diet and pay attention to body weight, do not consume alcohol in excess (more than one unit per day). “Regarding therapeutic conduct, menopause should not be treated just because it is menopause, I want to emphasize. We are not advocates of hormone replacement therapy here, we try to have a balanced attitude and explain once again to our patients that it is very important to have a correct lifestyle: not to smoke, not to gain weight, not to consume alcohol. Of course, it is also important to have a sufficient intake of calcium and vitamin D, speaking of the impact on the bones. In well-selected cases, but especially in the case of patients with early menopause, it is clear that hormone replacement plays a beneficial role. At the moment there is talk of other ways of administration than the classic ones, transdermal and transvaginal seems to be much less dangerous than swallowing pills. Patients must be informed, especially since there are alternatives, prepared from phyto-estrogens, as well as new molecules, which act on target and many others. There are conditions discovered at the initial visit related to menopause and we want to help women to treat these things first and only then talk about menopause”, he adds Dr. Niculescu.