If your immediate associations with the subject of menopause are a bad period, terrible symptoms, and risky treatments, it’s time to reconsider. Experts show that this is just another natural phase of women’s lives, that treatments have evolved and, in addition to acting against symptoms, guarantee quality of life after age 40.
Andréia Gomes Duraofrom RFI
“The most widespread idea about menopause is negative. She is thought of as a fatality, as if the sky were falling on the woman’s head. That’s not it. Menopause is a natural phenomenon. In the same way that there is puberty, and a woman will have her period, at another point in her life she will stop menstruating. It is a completely natural phenomenon, but it can have unpleasant effects”, highlights Dr Abdoulaye Diop, an obstetrician gynecologist at the Bellevue Clinic in Dakar, Senegal.
One of the first clarifications that the specialist suggests is to distinguish menopause – the definitive interruption of menstrual cycles – from pre-menopause, a transition period that marks the end of a woman’s reproductive life, when the best-known symptoms appear, such as loss of libido, memory loss, vaginal dryness, migraines, sleep disturbance, weight gain, discouragement and bone fragility.
“Menopause itself is not a problem. Menopause means, after age 40, going more than 12 months without menstruating. What causes the problem is the pre-menopause period, the so-called perimenopause. This happens from 12 to 24 months before menopause and is the time when there are many unpleasant symptoms for the woman”, explains Diop.
But if this transition period can represent unpleasant symptoms for some women, menopause can be synonymous with a better quality of life for others. The end of menstrual cycles also puts an end to all the problems associated with them, such as cramps and headaches.
“Menopause is good news, for example, for women who have endometriosis. Because the mechanisms of endometriosis are closely linked to the menstrual cycle. And during menopause there is no menstrual cycle, so most of the lesions, endometriosis pains, will disappear”, recalls the doctor.
Some questions regarding this phase of women’s lives, unfortunately, still remain unanswered. Science still doesn’t explain why some women have more severe symptoms than others, or why some have so-called early menopause, before or well before age 40, or late, much after 50.
The doctor adds that no relationship is found between the beginning and the end of menstrual cycles – a woman who starts menstruating early will not necessarily enter menopause early – and that there would also be no genetic or heredity evidence in cases of early or late menopause. Just as the sexual lifestyle would not influence in this context either.
But not having explanations does not prevent some situations from having a solution. And, once again, those who think that treatments for menopause are applied only to combat symptoms are wrong. Gynecologist Lorena Motta, a partner at Clínica Barufaldi, in Ribeirão Preto, São Paulo, is emphatic, and sees hormone replacement as an important ally for a great improvement in the quality of life of women over 40 years of age.
The doctor admits that doubts about hormone replacement treatments still figure in the female imagination, including some patients she receives in her office. They wonder about the risk of cancer or why they should take hormone replacement if some women don’t do it during menopause.
“Hormone is Life”
The gynecologist emphasizes that, in addition to fighting the symptoms of menopause, which can be extremely unpleasant, hormone replacement can also mean prevention against many health problems that arise at this stage, such as osteoporosis. “Life expectancy is increasing more and more, and the ideal is that we maintain the quality of life with longevity and, for that, we talk about replacement. Hormone is life”, emphasizes the doctor.
The specialist explains that many of the myths surrounding hormonal treatments are due to studies that are already considered obsolete, some dating back to 2002. And that the best antidote to misinformation is the guidance of a gynecologist and the performance of tests that attest to the real health status of these women, to access the most appropriate treatment for each of them.
“There are some types of hormone replacement for that. There is one where the doctor prescribes it and we buy it at the pharmacy and it is the same for everyone, whether for that woman who is extremely healthy or not, but there is also hormone replacement that is called bioidentical or isomolecular, which is a replacement of hormones more similar to the molecular structure of the woman’s body. With this, we managed to replace the three hormones [progesterona, testosterona e estradiol] with better benefits and fewer side effects”, defends the gynecologist.
She explains that, unlike oral hormone replacement, available in pharmacies, the isomolecular method can be found in topical presentation, in gel for application on the skin, or in two types of implants, the absorbable, with an effect of 6 to 8 months, or one that lasts for one year but needs to be removed.
Treatments aside, experts are unanimous in stating that the essential during menopause is the follow-up of the patient by her gynecologist, in addition to a healthy lifestyle, guaranteed by a balanced diet and regular physical activities.
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