Menopause

In most women the menopause begins in their mid 40s. Hormone production gradually diminishes – firstly progesterone (corpus luteum hormone) and later oestrogen.
The duration and intensity of the menopause can be very varied. About one third of women experience serious physical and emotional problems, a further third experience moderate to mild symptoms and the other third no difficulties whatsoever. Typical symptoms of the menopause are: hot flushes, outbreaks of sweating, sleep disorders, fatigue, depressed moods, palpitations, dryness in the vagina, pain in the muscles and joints, urinary incontinence and obesity.
Progesterone and oestrogen have an extensive developmental and protective function in the body; long-term hormone deficiency, as occurs during and after the menopause, can therefore have many detrimental effects: the tension of the muscles diminishes, osteoporosis and arthritis advance more rapidly, the risk of arteriosclerosis, stroke and high blood pressure increases, late-onset diabetes can develop and there is a risk of dementia.

Diagnosis and treatment

Treatment is always preceded by thorough screening of the hormone levels. It is also important to consider the patient's personal situation and document the family history for the purpose of early identification and prevention of possible therapeutic risks. Only then can the hormone doses be individually adjusted.
Until recently, too high a quantity of oestrogen – given in tablet form – was generally prescribed with hormone therapy for menopausal symptoms. In addition, synthetic progestogens were prescribed. This resulted in too many side effects, e.g. biliary disorders or thrombosis, and a slight increase in certain cancers – breast cancer in particular. Today it is known that this was the wrong way to administer therapy. However, to put this into perspective it must be added that obesity and alcohol consumption increase the risk of cancer much more considerably than the administration of the wrong oestrogens at too high a level.
Diminishing hormones do need to be replaced in order to restore the natural balance between oestrogens and progesterone. The way in which oestrogen is administered is extremely important. If oestrogen is absorbed as a gel through the skin, it can be adjusted on a very individual level. Also, it is not absorbed by the digestive tract and thus the possibility of biliary disorders is ruled out. The second most important point is the administration of natural progesterone. Large studies of hormone therapy have demonstrated that the addition of a synthetic gestagen (progestogen) can considerably increase the risk of breast cancer. This has not been reported with natural progesterone. In addition, natural progesterone has mood-enhancing, tranquilising and sleep-promoting effects. Moreover, it has a mild effect in terms of removing water and lowering the blood pressure, and does not carry a risk of thrombosis. A large study was able to demonstrate that the intake of transdermal oestrogen and natural progesterone did not increase the risk of cancer.

How to help yourself

Regular physical exercise is important. This helps to stimulate the metabolism and circulation, slow the transformation processes in the organism and prevent obesity. Moreover, a balanced diet consisting of plenty of fresh vegetables and lean meat and fish, as well as low-fat milk products, is very important. Try to drink plenty of water and unsweetened tea. Nicotine and excess alcohol should be avoided.