"The climacteric period," which includes premenopause, menopause, and postmenopause, "should not be considered a limitation; on the contrary, it is a growth; jumping from one stage to another is completely normal and natural; nor should it be stormy," said Zarela Chinolla Arellano, professor at UNAM's Postgraduate Division.
Just as menarche indicates the first period in a woman and, with it, the beginning of the reproductive phase, climacteric establishes the transition from a reproductive to non-reproductive life. The age of onset can range from 40 to 45 years old, but this is considered an early form.
Menopause, whose age of onset is almost always from 48 to 52 years of age, is a period of fullness and growth in the life cycle; "it is the perfect time for women to prepare themselves to enter old age; it is not a process that causes us harm, but a natural stage that has to happen; it is like going from primary to secondary school," according to the specialist in gynecology and obstetrics.
Menopause occurs at a time when most women are fulfilled as mothers or professionals; chronologically, they are still young and have a lot to do since life expectancy is, on average, 75 years.
It is characterized by the absence of the menstrual period for 12 consecutive months, and the ovaries stop producing estrogen and progesterone. Aside from causing hormonal issues, it may also cause changes in glucose metabolism, hepatic dysfunction, and osteoporosis.
The particular symptoms are hot flashes, night sweats, changes in libido and mood, insomnia, vaginal, hair, and skin dryness, as well as joint pain and urinary infections, among others. They vary from person to person, as they could be more intense or, on the contrary, mild.
Managing Menopause: An Overview of Hormone Replacement Therapy and Medical Care
Hormone replacement therapy (estrogens) in this process will depend on the symptoms of each one of them; the main indication is when several signs are registered, mainly vasomotor; that is to say, intense hot flashes, particularly while sleeping, which, although a transitory manifestation, are annoying. There are risk factors that may be favored by hormone replacement therapy. Therefore, the patient should be evaluated.
Hormone replacement therapy is not given to women who have had breast cancer in the past and have reached menopause. Some do not follow the treatment because they are afraid of getting this type of cancer.
For patients with liver failure problems, cirrhosis, or any condition that causes the liver not to function 100 percent, this therapy and any medication such as painkillers or antibiotics cannot be prescribed because they would not metabolize them would be harmful.
Medical care during the climacteric period is based on avoiding any problems, mainly metabolic: high cholesterol and triglycerides, insulin resistance, diabetes, or cardiovascular disorders such as hypertension. People who have had these kinds of health problems for years are not good candidates for hormone replacement therapy, but they should still see their doctor regularly.
Those who go through perimenopause (the time before menopause) in good health and get follow-up care that helps them manage their diet, check their lipid and metabolic profiles, and do a thyroid checkup because a lot of women's thyroid function goes down, benefit from this kind of treatment.
Although they develop on their own due to age-related hormonal changes, metabolic and cardiac diseases, as well as osteoporosis, develop due to aging. If the right precautions aren't taken, climatic or menopausal conditions could make some of them worse or lead to risk factors, especially decalcification.
She recommended going to the gynecologist every year for tests such as Pap smears, whether or not you have a sexual life, whether or not you have had children, or even "if my uterus or womb was removed, or if there is a history of human papillomavirus." After the age of 40, colposcopy should be done if needed along with a mammogram every year.
"If you stop having periods because of menopause, you should get an ultrasound to check the general health of your ovaries. This is because, after menopause, we can find ovarian cancer, which is often mistaken for colitis or inflammation."
During menopause, it is advisable to maintain a diet low in saturated fats, reduce the consumption of carbohydrates, and, most importantly, do cardiovascular exercise and muscular strength training to support our organism and lose weight. "At this stage, women no longer metabolize in the same way because, finally, there is a cellular aging process that is inevitable," she concluded.