Definition and Overview
Menopause marks the period when a woman ends her menstrual cycle and her capability to reproduce. It happens in stages starting with perimenopause, which is the transition period when the ovaries, which produces estrogen and the egg cells, begin to slow down. Perimenopause ends and menopause begins when the woman has not had a menstrual period in the last 12 months.
Women who are in the middle of either perimenopause or menopause are encouraged to consult a medical professional particularly if they're experiencing symptoms. While some of these are mild and can easily be disregarded, others can be severely painful and can affect the quality of life. Women who have undergone surgical menopause will also benefit from a consultation since they are likely to experience menopausal symptoms following their operation. Medical professionals, such as obstetricians and gynaecologists (OB-GYN), generally evaluate the symptoms and recommend treatments and therapies to manage them.
Who Should Undergo and Expected Results
A menopause consultation is recommended for women who are in the perimenopausal stage particularly those who experience the following:
Worse premenstrual syndrome (PMS) – This is linked to migraines, pimples and unusual cravings before the menstrual cycle starts. These symptoms may get worse as menopause looms.
Irregular periods – When the levels of estrogen drop, the body experiences irregular periods – either a longer cycle with minimal bleeding or a shorter cycle with heavy bleeding.
Vaginal dryness – This symptoms is due to hormonal changes
Discomfort during sex – With vaginal dryness, sex can bring discomfort or pain
Urine leakage – As the muscles of the vagina and the uterus become thinner, simple things such as coughing or sneezing can cause the sudden expulsion of urine at inopportune moments
The consultation is also for women who enter the menopause stage. This is a gradual process and not all women understand what they’re going through when it happens. This can begin in women as early as in their 30’s or as late in their 60’s. For women who have irregular periods, it can be difficult to track if their monthly period is slowing down or not. The only constant that women can look out for is when menopausal symptoms, like the following, start to manifest:
Hot flashes – Women experience a flush of radiating warmth in the face and neck area for brief episodes. These are called hot flashes that last between 30 seconds and a couple of minutes.
Night sweats – Hot flashes are sometimes accompanied by night sweats, which is described as intense heat at night that causes severe perspiration.
Vaginal dryness and itching – These are caused by the reduction of estrogen production, leading to less moisture in the vagina making it thinner and less elastic.
Lower sex drive – From hormonal changes to vaginal dryness, a woman’s sex drive may decrease during menopause
Painful sex – A less lubricated vagina can lead to pain or discomfort during sexual intercourse.
Trouble sleeping – Some women experience difficulty in sleeping, either due to night sweats or because the symptoms during the day extend during the night.
There are instances when the symptoms of menopause occur immediately as a result of an oophorectomy (surgical removal of the ovaries) or a hysterectomy (surgical removal of the uterus). These two procedures cause the cessation of menstruation and this leads to the onset of menopause. Scheduling a consultation after such surgical procedures may be beneficial in preparation for the effects of menopause.
Not all women will experience the same type of symptoms. Some may be lucky enough to have manageable hot flashes. Others may have an extensive array of symptoms that can severely affect the quality of their life. There is also a possibility that symptoms will worsen over time. The purpose of a menopause consultation is to develop a treatment and management plan to effectively handle these symptoms.
How Does the Procedure Work
A menopause consultation may be conducted by an OB-GYN or a healthcare provider who specialises in menopause treatment and management. The consultation begins by collecting information about the woman’s history, paying particular attention to her monthly periods, menopausal symptoms and contraception usage. Further examination can determine the severity of the symptoms being experienced, other medical problems that may be causing the same symptoms and other risk factors such as the presence of heart disease and osteoporosis.
Some physical examination procedures such as breast and pelvic examination and cervical and mammography screening may be performed. These exams are preventive measures in relation to the possibility of developing certain diseases and cancers.
The doctor, when all the information has been gathered, will proceed by creating a personalised treatment program, taking into consideration the severity of the symptoms, the patient’s risk of developing certain medical conditions and her unique circumstances. The treatment program may include medications, hormone replacement therapies, alternative therapies, diet and nutrition plans and lifestyle changes.
Possible Complications and Risks
A menopause consultation rarely has any complications or risks. If the woman discloses everything that she’s experiencing, even though it may seem embarrassing, a proper treatment can be formulated to effectively address the symptoms and manage the condition.
Lobo R. Menopause and care of the mature woman. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 14.
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG Committee Opinion No. 420, November 2008: hormone therapy and heart disease. Obstet Gynecol. 2008;112:1189-1192.