The Impacts of Menopause

Menopause is a normal and natural process as women get older and their menstrual cycle stops. It is often referred to as the ‘change of life’. Onset is typically around the age of 50, and ranges from 45-55 yrs. Physiologically, the ovaries stop producing estrogen, which is the female hormone, that marks the end of childbearing years and can result in a number of physical and psychological problems. As the production of estrogen stops, the body reacts by shutting down the reproductive organs and the women who have been through menopause can no longer have children. The body does need time to adapt to these changes and there are many common symptoms while this happens. The most common symptoms are hot flushes, heart palpitations, disrupted sleep, lack of energy, loss of libido and weight gain. These symptoms should be considered somewhat normal and part of the transition process that the body goes through, but they do vary in severity with some women having minimal symptoms and other having quite severe symptoms that need treatment. The consequences of these symptoms is a possible increased risk for coronary heart disease, but studies have reached different conclusions. There is an increase in the type of cholesterol that can increase the risk for a number of problems and an elevated levels of fibrinogen which is a risk factor for heart disease. Osteoporosis is a common consequence.

In the foot and lower limb the decreased estrogen levels during menopause can lead to an increased risk of musculoskeletal injury with bone and muscle wasting. There is an increase in the stiffness of the tendons in the body. The postmenopausal osteoporosis increases risk for fractures and stress fractures in the feet, especially if there are higher levels of activity. There can also be issues with the balance that can increase the risk for falls and result in trauma and fractures. The weight gain that occurs during menopause can lead to increased loads on foot and several studies have reported a higher incidence of poorer foot health following menopause.

Psychologically during menopause there is an increased prevalence of depression, anxiety, irritability, mood swings and lack of concentration. The menopausal symptoms generally last around 6-12 months in most women, although some women can experience all or some of the symptoms for as long as 5 years. When the symptoms are problematic a common approach is hormone replacement therapy. This can be quite helpful in reducing the increased risk for osteoporosis that postmenopausal women have and decrease the other symptoms, especially the hot flushes. There is a risk with being on hormonal replacement therapy with a slightly increased risk for heart disease, stroke, blood clots and breast cancer. The risk is increased if the replacement therapy is started later, if the dose needed is higher and the prevalence of other risk factors for the complications. The decision to go on hormone replacement therapy is going to have to be a decision made in consultation with a health professional and weighing up the different risks in the individual.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.