The hormones estrogen and progesterone are made by the ovaries. These hormones control menstruation and ovulation. If the released egg is not fertilized, the egg and the uterine lining will shed as period or menstruation. Menopause occurs between ages 45 and 55, when the ovaries stop releasing eggs .

Some women experience premature menopause before the age of 40 and this may be due to surgery in which the ovaries are removed, cancer or Primary Ovarian Insufficiency, a condition where the ovaries produce insufficient amount of estrogen. Signs of Primary Ovarian Insufficiency are similar to the symptoms of menopause. Causes of Primary Ovarian Insufficiency are numerous, however, some causes are unknown.



Premenopause is the stage before the symptoms of menopause begin. The main stages of menopause are:


  • PERIMENOPAUSE - This is the time leading to menopause. It commences when a woman is in her 40s and may last for many years. Estrogen production declines and the ovaries slowly stop working with lesser egg production. Symptoms of perimenopause include irregular period, hot flashes, night sweats, weight gain, memory issues, sleep disturbance and vaginal dryness.
  • MENOPAUSE -This is the end of a woman’s cycle and fertility. Usually, it naturally starts at age 51. A woman is said to have reached menopause when the body stops producing the hormone that causes menstrual period and have gone continuously without  menstruation  for 12 consecutive months (a year). The ovaries stop working and do not release eggs.
  • POST MENOPAUSE - It is the time after the cessation of menses, where a woman has been without her period for 12 months and this continues for the rest of her life. At this stage, menopausal symptoms get milder for most women. Depression, insomnia, weight gain, thinning and loss of hair, dry skin, low libido, hot flashes and night sweat are all symptoms that a woman might experience at this stage. Some may also be at risk of osteoporosis and heart disease.


Other symptoms of menopause include difficulty concentrating, low mood, anxiety, headaches, palpitations, joint stiffness, body aches and pains, change in body odour, reduced muscle mass, recurrent UTIs (Urinary Tract Infections), fatigue, irritability, increased risk of osteoporosis, incontinence, bloating, nausea and digestive problems, tingling sensations, dry and itchy skin, dizziness, brittle nails, bleeding gums and sore breasts.



Symptoms can be mild for some women and may fade away without treatment. There are different treatments for different menopausal  symptoms. These can be grouped into Non-hormonal and Hormonal treatments.


Non-hormonal treatment – This includes diet and lifestyle modification and over-the-counter therapies. Understanding what triggers hot flashes will help when using non-hormonal treatment. Hot flash triggers may be different for different women. Eating of spicy and sugary foods, consuming caffeinated beverages, exercising in very hot temperatures, consuming alcoholic beverages, stress, smoking, hot weather, wearing of tight clothing and more are triggers of hot flashes. 


Some Diet and Lifestyle Changes for menopause

  • Avoid consuming substances which trigger hot flashes to minimizes the number and severity.
  • Consume a balanced meal rich in phytoestrogen (plant estrogen). This should be the first step to take before the use of supplements. Rich sources of plant estrogens include soybeans, chickpeas and lentils. Note that plant estrogens are less effective when compared to human estrogen.
  • Incorporate probiotics and prebiotics in the diet to help with weight management thereby preventing obesity.
  • Drink enough water. This has numerous benefits. 8 glasses of water is sufficient for most adults.
  • Regular exercise will help with mood changes, insomnia, pains, memory and cognitive problems, weight gain etc.
  • Dress lightly and in layers to help manage hot flashes.
  • Practice relaxation to ease symptoms.


Hormonal therapy – Hormone Replacement Therapy (HRT) is the treatment in which natural hormones are replaced with artificial ones. It is effective and safe for many women if appropriately used and can help relieve most menopausal symptoms. It also helps prevent osteoporosis which is common after menopause. There are however some health risks associated with hormone therapy treatment  which includes blood clot and stroke.


Some women are unsuitable candidates for hormonal therapy. Such women include those who have had recent treatment for breast cancer, women  above 60, women with heart disease, those with high triglyceride levels and high cholesterol, woman with liver disease and family history of gallbladder disease,  women with history of stroke and blood clots and women who intend to become pregnant.


DOSAGE – Hormone replacement therapy are available in various forms including tablets, gels to rub on the skin and implants. It is advisable that a very low dose that works for the shortest time be taken or used. Consult with a doctor before taking hormonal therapy treatment. Other medications like blood pressure medications, antidepressants and antiseizure drugs may be used by those who do not want to use hormone therapy treatment, however, doctor’s consultation is important.


SUPPLEMENTS:  The use of supplements may relieve symptoms. Such supplements include Estro support, Black Cohosh, soy, red clover and provitalize. Calcium and vitamin D supplements may be combined with diet to prevent osteoporosis which may develop due to  lack of estrogen after menopause. It should however be noted that some supplements, especially herbal supplements, prevent other medications from working effectively. Consult a doctor before taking supplements for menopause support.

Mrs. Christiana Mere



1 comment

  • Very educative ,thanks Mrs.Mere

    Marion Sesay

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