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The opinion of your gynecologist

dr. Sali Rafik


dr. Sali Rafik, Gynecologist

Menopause is a delicate period of a woman’s life that affects the whole body. Very often women are embarrassed to talk about this period and try to ignore the symptoms without seeking help from a specialist.

What is menopause and what causes it?
The word menopause comes from ancient Greek and means the final cessation of monthly uterine bleeding. The transition to menopause or perimenopause is associated with profound reproductive and hormonal changes that have an overall impact on the body.
The processes occurring in the female body during menopause are caused by the loss of ovarian function and lack of hormonal production. This can be a natural process or as a result of surgical removal of the ovaries, as well as radiation and chemotherapy.
These hormonal changes are well known and combined with a number of concomitant symptoms. Menopause can be premature and physiological. Premature menopause is defined as the onset of menopause 40 years ago. The average age for physiological onset of menopause in Bulgaria is about 51 years.

What are the stages of menopause?
A woman’s reproductive health undergoes many changes throughout her life. From the first menstruation, during the reproductive years, and all the way to menopause, menopause includes the following three phases: premenopause, menopause and postmenopause. Premenopause includes the pre-menopausal period in which ovarian activity decreases. This phase can last from 4 to 10 years. Menopause covers the period since the last menstrual period and a period of 12 months in which it does not occur. We call the postmenopausal period after 1 year of non-menstruation.

What are the symptoms of menopause?
Most women will experience some symptoms related to this delicate period of their lives. The duration and severity of these symptoms can vary widely. Symptoms usually begin several months or years before the final cessation of menstruation, known as perimenopause, and may continue for some time thereafter. On average, most symptoms last for about 4 years from the last menstrual period. However, about 1 in 10 women experience them by the age of 12. The symptoms of carpet mites are different, varied and different in duration. The changes in this phase have an impact on the whole woman’s body, as well as on all organs and systems. In general, they can be short-lived, such as hot flashes, night sweats, headaches, tension and long-term, such as osteoporosis and cardiovascular changes.

In general, they are divided into 4 major groups:
Menstrual disorders – of the most varied nature, due to impaired ovulation and changes in the secretion of sex hormones: frequent menstruation; heavy menstruation; non-cyclic bleeding; lack of menstruation or more sparse menstruation.
Neurovegetative and neuropsychiatric complaints – hot flashes; night sweats; insomnia; nervousness; depression; crying; feeling of inferiority; decreased libido, etc.
Atrophic changes – atrophy of the skin and physical aging; atrophy of the vagina, vulva, bladder and duct and, as a consequence, painful to impossible sexual intercourse; small bowel movements; frequent infections.
Metabolic changes – expressed in adverse changes in blood lipids and the development of atherosclerosis, and hence increased cardiovascular and cerebrovascular risk / heart attack and stroke /. Metabolic abnormalities include the development of osteoporosis. This is a very serious disease, which manifests itself in the destruction of bone structure / 2-4% of bone mass is lost annually /, the appearance of bone pain, increased risk of fractures.

How to cope?
There are a number of methods and tools that have a beneficial effect on the body.
They can be alternative methods and lifestyle changes, as well as medication to affect symptoms. Healthy eating and increased physical activity have a positive effect on overall tone, regulate metabolism, prevent the accumulation of excess fat and overweight, which is characteristic of menopause.
To avoid hot flashes, it is recommended to reduce the consumption of alcohol, coffee and black tea, sleep in cool rooms and reduce stress.
At the heart of menopausal symptoms is age-related hypoestrogenemia or decreased production of female sex hormones, mainly estrogen and progesterone. Therefore, in order for the symptoms to be effective, exogenous estrogen or estrogen and progesterone, so-called hormone replacement therapy (HRT), must be obtained. Before starting treatment with HRT, each woman should consult a specialist, because therapy with this type of drug carries a number of risks and must be strictly individual to each patient.

There are alternative methods of hormonal therapy, such as phytoestrogens and herbal therapies. Phytoestrogens affect vasomotor symptoms and improve a woman’s mental state. Some patients have absolute contraindications to hormone therapy, while others refuse hormone therapy. In this group of women, prescribing a non-hormonal product or herbal extracts can have a positive overall effect and improve neurovegetative and neuropsychological symptoms.

You can trust FemiBalance – which naturally modulates the hormonal balance in the body. Supports normal mental function, normal functioning of the nervous system and helps reduce the feeling of fatigue and tiredness, as well as improves the overall appearance and women’s health. FemiBalans contains soy isoflavones, which have an estrogen-like effect and are the main substitutes for exogenous estrogen, successfully dealing with night sweats, hot flashes, and irritability.
Read more about FemiBalans here.

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