- Women's Health
'I STARTED MENOPAUSE IN MY EARLY FOURTIES
I NEEDED A HYSTERECTOMY BUT COULDN'T HAVE ONE
By the time I had hit my 40's I was really in a bad way. I was practically flooding all the time and I felt scared to go out. I didn't know whether or not my ileostomy was going to leak, I was going to have a big bleeding from the vagina, or both at the same time. That had happened to me a couple of times already. I was almost to the point of crying everytime I was asked how I was. I didn't want to tell them the truth because it sounded like I never had anything else to talk about. Then one night, I woke up drenched in blood, I had huge clots inside me. My husband drove me to A&E at our Private Hospital, where I was admitted. My haemoglobin had dropped to 6.3 because of the blood loss and they said that unless I got some blood into me I was at risk of having a cardiac arrest. My husband said I was the same colour as the sheets, which were white by the way.
The blood finally went up and I had six bags of packed cells and some other things as well. When the Specialist came to see me, I told him how I felt and he said that he had also been talking with some other doctors and agreed something needed to be done but a hysterectomy was not the way to go. He said the risk of dying was too high. He wanted me to see some other doctors, and see if they were prepared to take the chance.
The problem was that due to the fact that by this time I had endured many operations on my abdomen for gut obstructions, the risk to my health and to dying on the operating table was too high. I could not believe it. It had gone from needing something done to stop this menorrhagia (heavy periods) to lifethreatening surgery and now they were saying even that was out of the question.
I was sent therefore to see not one, not two but four Gynaecological Oncologists. Not one of them was prepared to do a hysterectomy, the operation I required. The reason of course being, that it was far to risky because of the condition of my abdomen. The truth was they, the Specialists, were all too worried that I would die on the operating table and did not want to take the risk of that happening. You can imagine how that made me feel, exactly right. My anomaly for this was "I felt like a person in a glass box that had a sign on it saying "DO NOT OPEN THIS BOX UNLESS IT IS AN EMERGENCY, AND THINK LONG AND HARD AGAIN BEFORE YOU DO". I mean here I was bleeding at both ends, anaemic, in pain, and they couldn't or wouldn't do even a small version would have been better than nothing.
What they did next is like a compromise called an Endometrial Ablation.
UNDERSTANDING YOUR MENOPAUSE
Most of us know that menopause is literally the cessation of your menses, (the end of your menstrual cycles).
Prior to this occurring many women, this happened to a friend of mine, experience "menopause like" symptoms well before the actual "last period" as our bodies undergo various hormonal changes and fluctuations in the lead up to the menopause. This is often referred to as the "climacteric" or change of life"
We are born with approximately 2 million egg follicles. By the time we reach puberty there are about 750,000 and by the age of around 45, only 10,000 may be left. The rest may have disintegrated over the years. Menopause occurs when your store of eggs run dry.
Menopause can be divided into three distinct stages:
1. (1.a) THE PRE-MENOPAUSE AND (1.b) PERI-MENOPAUSE
1.a. This indicates the beginning of changes that are now occurring with your hormones. Pre-menopausal symptoms can occur for a woman as early as the age of thirty years but tend to occur more commonly around the mid to late 40's. They may include hot flushes, sweats, emotional swings,etc. I am sure that you are familiar with these symptoms if you have been in this stage, or going through it now.
1.b The peri-menopause is the next stage following the pre-menopause. During peri-menopause your ovaries begin to decline and your periods will become irregular. The changes in your cycle may be very subtle or very dramatic. i.e. you may notice a slightly lighter flow, or slightly heavier flow. The duration of your cycle may be shorter or slightly longer. You may go from a 28 day cycle to a 33 day cycle, followed by a 31 day cycle.
Alternatively the changes may be more dramatic, you may skip a period completely, or cease having periods for several months at a time then recomence your periods two weekly or monthly. You may experience the heaviest periods of your entire reproductive life or alternatively your menstrual flow may be significantly lighter. Regardless this is a time when you notice changes to your cycle whether they be subtle or dramatic.
Generally speaking the symptoms during the Peri-menopause will be more severe than those experienced during the Pre-menopause and normally occur around the mid 40's but can occur as early as the late 30's early 40's and for other women may occur as late as the mid 50's.
Most women experience what is termed a "natural menopause", which occurs gradually. Many women begin noticing changes in their menstrual cycle and/or mood years before they actually have their final period. It is not uncommon for a woman to experience irregular cycles with associated symptoms sometimes up to 5-10 years prior to a complete cessation of their menses. For other women their periods suddenly stop one month and never menstruate again.
SYMPTOMS OF PERI MENOPAUSE
When you are going through Peri-menopause you will generally feel the result of low levels of progesterone, potentially coupled with estrogen dominant symptoms and symptoms associated with low levels of testosterone. Estrogen levels during this stage can be quite erratic hence your symptoms may be reflected by this.
SYMPTOMS OF A LACK PROGESTERONE
I experienced some rather debilitating symptoms .When I had this was mainly Mood swings, depression, anxiety feeling emotional or I was more vulnerable than usual, sore breasts (ouch ouch, not a good one), not flashes (feeling like I had a fever a lot of the time) sweats, feeling tired, insomnia (this has been a big problem for me, it has been ongoing) weight gain, forgetfulness, lack of concentration, reduction of my capacity to deal with any stress related situations, aching in my muscles (not sure whether mine was this or from MSA) and joints, irritability, reduction of sex drive, lack of energy, fibrocystic breasts (I have experienced this before, it is not very pleasant, I had a lot of pain with mine).You can have problems with your periods, even get fibroids (benign tumours in the uterus) endometriosis, low metabolism, cravings (particularly for sweet things, something I have had) hard to get up in the mornings
SYMPTOMS OF DOMINANCE OF ESTROGEN
Here are some of the symptoms you may experience with this problem. I didn't get all of these and may get some and not others, but I will give them all of to you here just in case:
Headache/ maybe Migrains, recurrent vaginal yeast infections(this came to be one of my biggest problems and is ongoing) breast swelling and tenderness is a common symptom, depression, nausea and vomiting another symptom that can be very bothersome, Bloating, Leg cramps ( a big problem for me) yellow tinge to your skin, excessive vaginal bleeding (this can be a very problematic symptom) possible weight gain, cravings again for sweets. Even though this does sound nice, but don't get carried away and make yourself sick..
SYMPTOMS OF LOW TESTOSTERONE
I have not as yet had the symptoms you would experience if this was the case. However, here are some of the symptoms here just in case someone does. You could experience Loss of Sex drive, decreased sexual response,Decreased sensitivity of the erogenous zones, decreased sense of wellbeing as well as your energy and ambition, depression, loss of or thinning of your pubic hair
Well, here we are. Menopause is the very last period and is officially classified as such once you have completely stopped your periods for a full 12 months. N.B. (just be aware, that until this ocurs there is still a slight risk of pregnancy) and we don't want that now do we?. The average age they say to go through menopause is supposed to be around fifty-one years, give or take about five years or so
However, some of us ladies don't feel the full impact of the symptoms of menopause until after this 12th month period, which could indicate a dramatic drop in the circulating estrogen, leading to the more common symptoms associated with menopause such as the hot flushes, night sweats,dryness of the skin and dryhness of the vaginal tissue.
The symptoms you experience can last on average between 4-6 years. In saying this though I would also like to say that some women have the good luck of breezing through their menopause with just a few or not any symptoms at all. Where as others unfortunately, when you include the pre and peri-menopausal stages, may experience symptoms for up to twenty years.
SYMPTOMS OF MENOPAUSE
The sympsoms of Menopause include many of the symptoms associated with the peri-menopause, coupled with symptoms of a lack of oestrogen.
SYMPTOMS OF LACK OF ESTROGEN
When there is a lack of estrogen in the body you will esperience such symptoms as hot flushes, night sweats, crawling or itching sensations under your skin, drying of and possible loss of your hair, ageing skin, mental fuzziness, urinary frequency, vaginal and/ or bladder infections, incontinence, recurrent urinary tract infections, difficulty sleeping, lack of self esteem and osteoporosis.
Progesterone is generally the primary female hormone to decline during the pre/peri-menopausal stage whilst estrogen can remain stable or even increase. This ultimately creates an "imbalance" between the two hormones, wherein this state of low progesterone to estrogen ratio iscommonly referred to as "estrogen dominance". Testosterone levels may also start to decline well before the last menstrual cycle.
Estrogen production during the peri-menopausal stage can become erratic with surges of inapproriately highlevels alternating with irregular low levels. This helps to explain periods of hot flushes and night sweats coupled with estrogen dominant symptoms (high ratio of estrogen to progesterone) such as breast tenderness, headaches, fluid retention and cravings,. In many cases women can successfully manage these symptoms effectively with the support and balancing effects of natural progesterone alone. Ideally both hormones work best in balance and harmony with each other.
As Progesterone is an important hormone involved with building bone, bone loss is accelerated during the first five years after a woman enters her menopause. Therefore it is important to adopt healthy lifestyle factors to further prevent your risk of Osteoporosis. These include regular weight-bearing exercises such as walking or jogging, ensuring a healthy diet with an adequate supply of calcium, avoiding foods and substances that compromise bone health, such as smoking or drinking soft drinks that contain substances known to strip calcium from the bones.
3. POST MENOPAUSE
During this period, both your Estrogen and Progesterone levels are still low but the body has learned to cope with these lower levels and most the symptoms will disappear. I read that there is still some concern however about getting osteoporosis so weight bearing exercises and a good diet should be looked and try to be maintained. Unfortunately, another two horrible symptoms, which I am sad to say, I have battled with both of these, which is vaginal dryness and loss of libido. You may even need ongoing attention if this gets too much for you.
One thing to remember if that Menopause affects each and every one of us in a different way and you may experience different symptoms at different stages of your menopause. We are all unique and your symptoms of menopause, though still similar to your friends and other women, are specific and individual to you.
Other considerations that may affect the severity of your symptoms include lifestyle factors such as your diet, nutrition, exercise, other medications you may be taking, other health problems, which I have loads of,your stress levels, and relationship issues.
A FINAL WORD ABOUT MENOPAUSE
Menopause is not a disease,illness or deficiency but it is rather a natural progression as a woman enters a whole new era in her life. A woman's hormonal life can be divided into two very distinct phases.
In the initial phase, a women's body produces higher volumes of hormones primarily giving her the potential to create new life and bear children. In the second phase, or latter part of her life she will no longer require this high volume of hormone, as she will no longer be producing children.
Each of us needs to look at our own personal view on menopause and realize that menopause is not the beginning of the end....but rather a whole new beginning ...no longer will you have the worry of putting up with a monthly bleed or be concened about falling pregnant. Wouldn't that be wonderful?
This new phase of your lives gives you the opportunity to reflect on life's experiences, to acknowledge your accomplishments and consolidate, knowledge, wisdom and experience gained as you moved forward in this new realm of being .