All The Answers To Your Questions About Menopause

Unknown, taboo and feared. Menopause is a key stage in every woman's life. We all have questions that we need answers to, especially when it comes to the perimenopause duration, symptoms, treatments… so keep reading, as we got two doctors answering every single question you might have in mind.

Menopause is characterized by the end of the activity of the ovaries, and in particular the permanent cessation of periods and fertility. For some, it marks the hour of liberation and emancipation, while it’s the beginning of the end for others. However, menopause remains a taboo. A recent survey conducted by the Kantar Institute for MGEN and the Women's Foundation, shows that one in two women do not discuss the subject with her spouse. For women (menopausal or not) and men whose partner is affected or is about to be, menopause refers to health constraints: hot flashes (84%), weight gain (63 %), being old (36%), losing your libido (36%), feeling depressed (33%)… So what is really menopause? Two doctors will answer.

The Arrival of Menopause

51 years old is the average age at which menopause occurs. In rare cases, 1 to 2% of women, it appears before the age of 40, we then speak of "premature ovarian failure (PID)", explains Geneviève Plu-Bureau, gynecologist and head of the medical gynecology unit at Cochin - Port Royal Hospital. This is characterized by a drop or even a cessation of fertility, and an interruption of periods or irregularities in cycles.

Surgical or medical treatments, such as chemotherapy or radiation therapy, can accelerate the onset of menopause by affecting the ovarian reserve. “Hereditary factors can also play, adds the doctor. Women affected by autoimmune diseases such as type 1 diabetes or genetic abnormalities may also be concerned”. Smoking can speed up the onset of menopause for a year or two. In other rare cases, some women may go through menopause after age 55.

The Symptoms

"Some do not feel or slightly feel the symptoms", comments Florence Trémollières, professor of gynecology at the Toulouse University Hospital and director of the only university menopause center in France.

"The most common are hot flashes and night sweats which lead to sleep disturbances" she says. These can impact mood and cause irritability.

Some may also be affected "by joint pain, chilliness, genitourinary syndrome (vaginal dryness, decreased libido, pain during intercourse, urinary disorders), adds gynecologist Geneviève Plu-Bureau. The reason? "Lower to absence or secretion of two sex hormones (estrogen and progesterone) by the ovaries, and no more production of the estradiol molecule, which is essential for women's health", informs Florence Trémollières. The duration of symptoms is extremely variable among women. Some live them between 3 to 5 years, others for ten years or more.

Estradiol deficiency can lead to long-term illness in women who are predisposed to it. The most common of these are osteoporosis (bone loss that causes an increased risk of fractures), and cardiovascular disease.

What about the famous weight gain? Menopause does not necessarily make you fat, "but it is true that it causes an accumulation of fat in the belly", specifies Geneviève Plu-Bureau. A balanced diet and the practice of a regular sport activity can remedy this.

The perimenopause

It’s the period that precedes menopause and can last "between 4 to 5 years, or 7 to 8 years ", specifies Florence Trémollières. The cycles are irregular; the production of hormones fluctuates. You can suffer from hot flashes, trouble sleeping or vaginal dryness. When too many hormones are produced, “the breasts can also be painful, bleeding profuse. You can be irritable or gain weight” adds the doctor. It is considered that the period is over and that we enter menopause, after 12 consecutive months without periods.

How to Relieve Symptoms

Against hot flashes, "the only effective solution is hormonal treatment (hormone replacement therapy). It completely eliminates them, also improves the comfort of sexual life and maintains bone capital over the longer term” indicates gynecologist Geneviève Plu-Bureau. Without forgetting that lubricant, in particular based on hyaluronic acid, can also remedy vaginal dryness.

As soon as certain effects of menopause impact daily life, you can consult your doctor or gynecologist for possible treatment. Each year, the doctor reassesses the doses of the treatment, and particularly after 5 years of use. Beyond this period, the doctor will decide whether to continue or stop it according to the patient’s wishes.

To limit hot flashes, it is better to avoid “coffee in the evening, alcohol and spicy foods. We also recommend wearing light, loose clothing, not to put on several layers and to lower the thermostat in your room,” adds the doctor.

The benefits of so-called "gentle" or "alternative" methods are not scientifically proven yet, they have in practice helped some women. "For other disorders, hypnosis works well, but also acupuncture, yoga, meditation, etc." indicates Geneviève Plu-Bureau.