CONDITIONS

PERIMENOPAUSE AND MENOPAUSE

What is menopause?

In a women’s late 40’s or early 50’s, perimenopause may begin. Periods that are less frequent, hot flashes and night sweats are all signs of the beginning of menopause which is the end of menstruation. At this point the ovaries no longer produce high amounts of oestrogen and progesterone and may cause uncomfortable side effects due to the change in hormones.

What are the symptoms?

Women who have begun menopause will experience one or more of the following symptoms:

  • Hot flashes
  • Vaginal dryness
  • Mood swings
  • Weight gain
  • Discomfort during intercourse or reduced sex drive
  • Headaches
  • Breast tenderness
  • Reduced breast size
  • Hair thinning or problems with hair growth
  • Insomnia
  • Depression and anxiety related to these changes
  • Increased hair growth in other areas of the body such as the face, neck, chest, and upper back

What are the treatment options?

Menopause is the natural ceasing of ovulation and sub-sequentially, menstruation. Medications may be able to counteract specific symptoms such as vaginal dryness, hair thinning, breast tenderness and insomnia. While Dr Makhubo may be able to suggest ways to reduce uncomfortable symptoms associated with lower levels of oestrogen and progesterone or suggest hormone therapy. Hormone replacement therapy (HRT), otherwise known as menopausal hormone therapy (MHT) is a treatment option for the side effects that occur due to lowered female hormones being produced. By restoring the balance and replacing the hormones that are no longer being produced, Dr Makhubo is able to make menopause more tolerable.

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Is post-menopausal bleeding normal?

Menopause is characterised by one year of no menstrual periods. Vaginal bleeding or even spotting after menopause is not normal, thus if this occurs you should see Dr Makhubo to rule out any serious conditions. Vaginal bleeding after menopause isn’t always serious, but it is best to have you gynaecologist test for abnormalities. The following may be the cause of abnormal bleeding:

  • Thinning of the vaginal tissue (vaginal atrophy)
  • Thickening of the endometrial lining (Endometrial hyperplasia)
  • Pelvic trauma
  • Infection of the endometrial lining
  • Polyps or fibroids
  • Sexually transmitted disease or infection
  • Medications which cause the blood to thin
  • Uterine or cervical cancer

How is it diagnosed?

In order to determine what the cause of the vaginal bleeding or spotting may be, Dr Makhubo may use the following diagnostic procedures:

  • An ultrasound of the vagina to view the thickness of the endometrial lining.
  • A sample of the endometrial tissue may be taken during an endometrial biopsy to test for abnormalities.
  • Hysteroscopy may be done to view the inside of the uterus using a hysteroscope which is a thin tube with a camera at the end.
  • The cervix may be dilated by Dr Makhubo in order to take a sample of the uterus lining during a procedure called dilation and curettage (D&C).

What is the treatment for postmenopausal bleeding?

Depending on the cause of abnormal uterine bleeding, the following treatments may be considered:

  • Progesterone or oestrogen therapy
  • Hormone therapy
  • Antibiotics or antivirals
  • Implantation of an intrauterine device
  • Removal of polyps through a hysteroscopy or dilation and curettage (D&C)
  • Hysterectomy to remove the uterus and in some cases the ovaries and fallopian tubes.

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