Ms. Bolanle is a 53-year-old businesswoman who has recently grown more temperamental and short-tempered. One moment she might seem cheerful, but without warning, she could abruptly turn emotional and begin crying for seemingly no reason at all. Additionally, she finds herself feeling fatigued much quicker than before and struggling with sleep issues. Concerned about her health, she visited a medical facility whereupon the physician meticulously gathered her medical background, performed a thorough physical assessment, and ordered several diagnostic tests. Afterward, he alleviated her worries by informing her that there wasn’t anything specifically medically amiss; instead, these signs were indicative of menopausal changes. Ms. Bolanle found this explanation confusing, leading to further discussion between them.
Ms. Bolanle: Thank you, Doctor. However, could you explain more clearly? I’ve only had vague notions about menopause before, so I’m not quite clear on what it entails.
Doctor: Alright, allow me to begin by explaining this. There are certain chemicals responsible for regulating how our brains operate and influencing our emotions—whether we feel joyous or melancholic, or derive pleasure from experiences. These substances play a crucial role in our everyday well-being. Essentially, they act as messengers delivering commands that govern both the physical and biochemical processes within our bodies.
Secondly, hormones serve as particular instances of such chemical messengers. In the female body, there are distinct hormone varieties known as estrogen and progesterone, responsible for regulating menstruation and fertility in women. These hormones are produced by a woman’s ovaries and can influence her emotional state. Consequently, many females might observe during puberty onwards that leading up to their menstrual cycle, they occasionally become moody, irritable, and undergo various other shifts in temperament known collectively as premenstrual syndrome (PMS).
Finally, these hormones manage the menstrual cycle from puberty until around middle age when menstruation becomes irregular and ultimately ceases in their 40s and 50s due to a gradual decrease in estrogen production. Consequently, menopause is identified once a woman within this age bracket hasn’t had her period for about 12 consecutive months. The phase known as perimenopause refers to the 5-10 year span preceding complete menopause during which estrogen levels start to slowly decline.
Ms. Bolanle: So, how does all of this clarify what I’ve been experiencing recently?
Doctor: Excellent, recall that I mentioned I would begin with an overview of the general changes in a woman’s body due to chemicals like hormones. Can you recall the names of these hormones?
Ms. Bolanle: Certainly, I recall: estrogen and progesterone decrease until their levels drop significantly, leading to the cessation of menstruation. Once menstruation ceases completely for about one year, menopause is considered to have taken place.
Doctor: Great. The following step involves recognizing how fluctuations in estrogen levels and other substances influence both our brains and bodies through various mechanisms. This can manifest as i) physical symptoms like sensations of inner warmth (hot flushes), fatigue, disrupted sleep patterns, nighttime perspiration, and memory lapses; ii) emotional symptoms encompassing shifts in temperament marked by bouts of weepiness, episodes of melancholy, short-temperedness, challenges with focus, and diminished drive.
Therefore, it is evident that all the symptoms you reported during your initial visit fall under both physical and emotional indications associated with menopause.
Ms. Bolanle said, “Thank you, Doctor, but my close friend Ms. Taiwo, who is 55 years old, isn’t experiencing these issues. She went through menopause around five years back and she’s doing great. So why am I different?”
Doctor: Menopause typically presents with subtle and hardly detectable signs for most women. Each individual’s journey through menopause is distinctively personal. Medical attention usually isn’t necessary until the symptoms start interfering considerably with daily life. In fact, numerous women find relief simply from understanding their experiences, feeling at ease without requiring any clinical help.
Ms. Bolanle: Thank you very much for all these clarifications. I’m feeling much better informed now. Is there any additional information I ought to be aware of?
Doctor: It’s good to know that you feel more at ease now. Remember, this stage of life frequently involves numerous significant transitions that can be quite taxing. Kids growing up and moving out, aging parents requiring care or passing away, potential marital strife or divorce, money troubles, anxieties regarding retirement—all these factors compound the stress associated with menopause.
Ms. Bolanle: So, what am I supposed to do next?
Doctor: Simple steps can make a difference. This involves consistent physical activity, maintaining overall bodily well-being and addressing any medical issues, along with sufficient rest and sleep. If your symptoms prove particularly bothersome, consulting a gynecologist might be necessary; they could recommend hormone replacement therapy. For severe emotional signs like anxiety and depression, antidepressants and psychological counseling may also be needed.
Ms. Bolanle: Thank you very much, Doctor. I’m feeling much better now.
Doctor: You’re quite welcome.
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