Menopause is the last menstrual period and symbolizes the permanent end of menstruation. It is diagnosed retrospectively after 12 months. The first symptom may be a shortening or increasing interval between menstrual periods due to changing hormone levels. If the time from the start of one period to the start of the next is shorter than three weeks or longer than six weeks, this may be one of the first symptoms. Other symptoms include physical, psychological and sexual problems, such as

• Hot flushes
• Night sweats
• Insomnia
• Palpitations
• Headache
• Joint and muscle pains
• Irritability and mood changes
• Anxiety and panic attacks
• Attention disorder
• Memory impairment
• Sexual aversion
• Discomfort during
• Intercourse (due to vaginal dryness)

Depending on estrogen levels, later symptoms are related to the bladder and vagina and may manifest as decreased frequency of urination, inability to urinate comfortably, increased urinary tract infections, urinary incontinence and vaginal dryness, burning and itching. Skin becomes drier, thinner and prone to bruising; hair becomes thin and dry. The appearance of unwanted hair on the face can be explained by a decrease in estrogen levels.

Since most women experience mild to moderate menopausal symptoms, they do not need treatment and can manage the symptoms themselves. This is because medication is only started if the symptoms are severe enough to affect a woman’s daily life.

• Medication consists of the following:
• Hormone replacement therapy
• Vaginal lubrication