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What happens to a woman's body when she enters menopause
It is a natural process of aging, which usually occurs in the 45 to 55 age group, but which can also be caused by surgery to remove the ovaries or the uterus (hysterectomy).
In the United Kingdom, the average age of menopause is 51 years; in Brazil , one of the most complete studies on the subject, published in 2010 by the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (FMUSP), calculated an average age of 48.1 years.
So, what is behind these changes?
Menopause is caused by a reduction in the production of hormones, specifically estrogen.
It is crucial for the entire reproductive cycle - the development and release of an egg from the ovaries each month, and the process of thickening the lining of the uterus to receive the fertilized egg.
Over the years, the body gradually stops producing estrogen. But this does not happen overnight: it can take years for this hormone to reach low levels.
In this process, egg storage declines, gradually affecting the occurrence of ovulation, menstruation and pregnancy.
What is the impact of these hormonal changes?
The brain, skin, muscles and emotions are affected by the drop in estrogen levels; hot flashes, night sweats, sleep problems, anxiety, moodiness and loss of interest in sex are common.
Bladder problems and vaginal dryness are also normal during this period.
And many women experience these symptoms long before menstruation actually stops - a period called perimenopause.
When estrogen production stops completely, there is a long-term effect on bones and the heart. Bones can weaken, increasing the risk of fractures, and women can become more vulnerable to heart disease and stroke.
That is why some women receive so-called hormone replacement therapy, or HRT, which raises estrogen levels and helps relieve symptoms.
But not all women experience these symptoms. They can also vary in severity and duration - from a few months to several years.
What causes hot flashes?
Lack of estrogen. It is also involved in controlling body temperature in the brain.
When this hormone is lacking, the "thermostat" is unstable and the brain thinks the body is overheating - when it is not.
Does estrogen affect mood as well?
Yes, it can happen.
The hormone interacts with chemicals in brain receptors that control mood. At low levels, it can cause anxiety and moodiness.
The lack of estrogen can also affect the skin, causing it to become dry or giving the sensation as if insects are crawling under the skin.
Are there other hormones involved in menopause?
Yes, progesterone and testosterone - but they don't have the same impact as low estrogen levels.
Progesterone helps prepare the body for pregnancy each month, and decreases when menstruation stops.
Testosterone, which women produce at low levels, has been linked to sexual desire and energy levels. It declines from the age of 30, and only a small number of women need it at high levels.
How do you know if you are going through this process?
It is possible to have a blood test to measure the levels of a hormone called FSH (follicle-stimulating hormone) - but the results may not be very accurate, especially at age around 45.
Experts say the hormone levels go up and down all the time, even over the course of a day, so there is always a risk that the test will be inaccurate.
The best way to make this diagnosis is to talk to a general practitioner or a nursing professional about your menstrual pattern and any symptoms you are experiencing.
It is good to know which symptoms to watch for - feeling irritable or feeling "low" weighs as much as the heat and night sweats.
Changes in menstruation, such as when it becomes more intense or irregular, are one of the first signs of approaching menopause.
But you will only be sure that you have reached menopause when you have not had a period for a year.
And then?
The levels of estrogen in the body do not recover after menopause.
With the increase in life expectancy, women are living more than a third of their lives with estrogen deficiency.
But there is no reason to be intimidated, says gynecologist Heather Currie, a menopause specialist and former president of the British Menopause Society.
"Women continue to work later in life, they still look incredible. The image of menopause is changing."
His advice: "If you are affected, visit a doctor and get information".
"Women should know what symptoms to watch for."
She says there is a lot of support and information to help women deal with the physical and emotional changes that menopause brings.
Today, hormone replacement therapy is seen as the most effective treatment available for menopausal symptoms.
It can cause side effects, and there have been uncertainties about its long-term safety.
But there is evidence that "the benefits of HRT outweigh the risks," says Currie.
Talking to other women going through menopause and sharing reports of the same symptoms is also a real help, she adds.
And menopause is another good reason for women to lead a healthy lifestyle, such as:
- having a balanced diet, low in fat and high in calcium to strengthen bones and protect the heart;
- exercise regularly, reducing anxiety and stress;
- stop smoking, preventing heart disease and hot flashes;
- do not drink too much, also reducing hot flashes.


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