In our journey to understand women's health, we previously discussed the complexities of irregular menstruation (refer to "Irregular Menstruation" in our past articles). As women approach their mid-30s, perimenopause marks a pivotal transition towards the end of reproductive years, often heralded by changes in menstrual patterns.
Understanding Irregular Menstruation in Perimenopause
During perimenopause, estrogen fluctuations lead to changes in the uterine lining, affecting menstrual cycles. Women may experience varying cycle lengths, with periods that can be irregular, heavier, or lighter.
Ignoring these changes isn't advisable; instead, understanding their causes, including hormone levels and pregnancy status, is crucial.
Menorrhagia: When Menstruation Becomes a Concern
Unlike menstruation, perimenopause does not follow a regular schedule. Sometimes the flow is reduced to just 2 days and then reappears after several months. At other times, it can last continuously for weeks. This phenomenon is known as Menorrhagia. This condition can lead to complications like anemia and may require medical intervention, such as temporary measures to stop the flow.
Oral Contraceptives: A Dual-Purpose Solution
To manage irregular menstruation, doctors often prescribe oral contraceptives containing estradiol and progestin. These pills help regulate periods, ease perimenopausal symptoms, and act as contraception. They are effective in modulating menstrual flow, reducing hot flashes, and preventing bone loss, making them a suitable option for women eligible for hormone therapy.
The Health Risks of Irregular Menstruation
A report has shown that women who consistently report having irregular menstrual cycles experience higher premature mortality rates before the age of 65. Long menstrual cycles have been associated with an increased risk of cardiovascular disease, coronary heart disease, cancer, mental health problems, and various common chronic conditions.
While there are other methods available to control bleeding, if alternative treatments yield little or no improvement, the medical practitioner may check for fibroids. In such cases, a hysterectomy may be necessary to save the lives of some women. Fibroids are non-cancerous tumors that grow in the uterus, causing heavy bleeding, anemia, pelvic pain, and bladder pressure..
Hysterectomy: A Critical Intervention
Hysterectomy, the surgical removal of the uterus, becomes necessary in cases of life-threatening abnormal bleeding. This procedure ends menstruation and the ability to conceive. Depending on the individual's condition, the surgery might involve removing the cervix, fallopian tubes, and ovaries, and is performed under general anesthesia. This is a procedure that can be done at any age!
Hysterectomy is also inevitable for women suffering from uterine prolapse or cancer. Depending on the condition, the hysterectomy may involve surgically removing the cervix, as well as surrounding organs and tissues such as the fallopian tubes and ovaries. Some procedures involve laparoscopic or robotic surgery, wherein long, thin instruments are passed through small incisions in the abdomen.
The Emotional Aftermath of Hysterectomy
Whether a woman opts for a hysterectomy by choice or as a life-saving procedure, the days leading up to the surgery and the post-surgery period can be extremely emotional and confusing.
Negative Impact: Realizing that she will never be able to get pregnant after the surgery, especially if the ovaries are removed and menstruation ceases without a uterus, can be emotional and distressing for a woman.
This may lead to feelings of loss and emptiness. Some women may experience extreme depression, feeling insulted and hurt by the loss of body parts that they feel define their femininity.
Others may feel profoundly sad to end their reproductive journey. These feelings can significantly impact a woman's mental wellness. If the sadness and sense of loss interfere with the ability to enjoy a normal life, seeking help from a counselor may be necessary.
Positive Impact: Conversely, women who have endured extreme abdominal pain and severe bleeding often feel a sense of relief from their symptoms post-hysterectomy.
The absence of chronic pain associated with uterine issues can improve their quality of life, leading to a sense of liberation. Other aspects of life may return to their pre-surgery state or even improve.
While libido and sexual drive may temporarily dip after surgery, the overall sexual life typically remains normal, and many women continue to enjoy a high libido.
Menopause Symptoms Post-Hysterectomy
If a hysterectomy occurs during perimenopause, women may experience menopausal symptoms like hot flashes and mood changes. Regular exercise and a healthy diet can help manage these symptoms.
Natural Remedies for Perimenopause Symptoms
Post-surgery, women may turn to natural sources like phytoestrogens found in soy products and fermented foods. These can help stabilize estrogen levels and alleviate perimenopause symptoms. Topical soy products have also shown benefits in improving vaginal health.
Studies have indicated that isoflavones, a primary group of phytoestrogens, are prevalent in soy supplements and products such as tofu, soymilk, and soy flour. Fermented foods like kimchi and kombucha are also rich in antioxidants and phytonutrients, similar to those found in kale, spinach, flaxseeds, berries, wine, grains, and nuts.
These natural alternatives are known to alleviate symptoms such as hot flashes and vaginal dryness commonly associated with perimenopause. Additionally, the topical application of soy-based products has been shown to improve vaginal health, particularly in alleviating discomfort during intercourse.
This article is for informational purposes and should not replace medical advice. Always consult a healthcare professional for specific health concerns.