Perhaps the most telltale sign of menopause is the onset of hot flushes. You may feel hot and flustered even though everyone else is cool, calm and collected – and complaining bitterly when you open windows and turn off the heat. Hot flushes occur when the body’s thermo regulating part of the brain, the hypothalamus, does not function at all when it is deprived of estrogen. One minute, you may be cold and shivering; the next minute you may feel like an inferno, with an uncontrollable desire to pull off all your clothes and bedding.
Nearly 80 percent of menopausal women are troubled by hot flushes and in 70 percent of this group, the flushes will occur, on average, over a period of 5 years. This manifestation varies in severity and may be associated with heart palpitations, dizziness and strange crawling or itching sensations under the skin.
Another symptom of estrogen deficiency in menopause is an increase in bodily aches and pains. Headaches may be more severe or frequent, joints may ache, the back and neck may ache and one may begin to suffer from various rheumatic aches and pains.
The vaginal tissues are very sensitive to the effect of estrogen deficiency. More than 50 percent of menopausal women are troubled by vaginal dryness and failure to achieve adequate lubrication during sexual intercourse. This causes discomfort or pain during sex and, in severe cases, may result in some bleeding from the fragile mucous membrane lining the vagina. Without the strengthening effect of estrogen, the vagina may be more susceptible to infection by yeast and bacteria, which may result in vaginal discharge, itching and burning.
The tissues of the bladder are sensitive to estrogen deficiency during menopause as well. Some menopausal women complain of a frequent and urgent desire to pass urine, a reduced ability the passage of urine (urge or stress incontinence), a reduced bladder capacity and become more prone to bladder infection. Fortunately, these symptoms can be overcome by a combination of pelvic floor exercises, hormone replacement therapy and nutritional measures.
Both the superficial and the deeper layers of the skin on our faces and bodies are sensitive to estrogen. Without estrogen, the skin becomes thinner and more fragile, more prone to developing discolorations and broken capillaries and less capable of retaining moisture. The skin is more susceptible to dehydration and irritation and collagen depletion results in a more rapid appearance of wrinkles.
Another manifestation of menopause is difficulty going to sleep or early morning awakenings. The problem may be associated with, or made worse by, the occurrence of hot flushes during night. Studies have shown that taking estrogen increases the proportion of sleep time spent in the dreaming phase. Many women find that taking estrogen improves memory and decreases irritability. This may be due, in part, to estrogen’s beneficial effect on sleep.
Mental and emotional changes are common at the time of menopause. The most common complaints are depression and anxiety. Personality change may occur, with rapidly changing moods, irritability, loss of confidence and panic attacks occurring in women who had none of these problems before menopause. Some women say that they feel numb and can no longer muster any passion. If this occurs on a physical level, a woman may experience a total loss of libido and, in extreme cases, she may become completely unresponsive sexually.
Your mental attitude is a power factor in coloring your personal experience of menopause. Estrogen deficiency does not affect all women in a negative way. Indeed, some women sail through menopause with no emotional problems. Some women find that the cessation of hormonal highs and lows associated with monthly menstrual cycles makes their menopause a time of tranquility and composure.