HOW LONG DO MENOPAUSAL PROBLEMS LAST AND THE PLACE OF HORMONE MEASUREMENTS

Apr
21
2009

HOW LONG DO MENOPAUSAL PROBLEMS LAST AND THE PLACE OF HORMONE MEASUREMENTS

Studies of large groups of women in Western countries indicate that about 70 per cent experience menopausal problems they regard as moderately distressing. A further 10 per cent of women describe their symptoms as severe, and 20 per cent get through the menopause with barely any disturbance.

In some women the signs of menopause last a few months, in others for two or three years. About a third of women are still experiencing distressing problems five years after their last period, and about a fifth have disturbances including hot flushes for a total often years. In general, you will be relieved to know, the severity of symptoms decreases with time.

The place of hormone measurements

Even before your menstrual periods become noticeably irregular, there are subtle changes going on in your ovaries. Studies involving the monitoring of women’s sex hormones over many years show that there are small shifts in hormone levels for about ten years before the last menstrual bleed. This contrasts with the view held by many women that menopause is a relatively sudden life change.

Denise, for example, regarded menopause as a swift transition, since she was keenly aware of changes for only a little more than a year. ‘I was shocked when my always-predictable menstrual cycle went haywire. Instead of five days, I was bleeding for eight days and my cycle got longer. Then things went back to near-normal for a while, before I had bleeding and spotting for nearly two weeks and another long cycle. This sort of irregularity continued for about fifteen months, including a month when I had nineteen days of bleeding and spotting with just two days relief in the middle. I have a theory that this irregular bleeding helps women adjust to menopause in a positive way. I mean, when I looked back and could see that menopause had occurred, I was truly relieved that my body had become predictable once again.’

By the time symptoms are obvious, sex hormone levels can be fluxing significantly from day to day. Interpretations of hormone measurements at this time are notoriously misleading, which is why most doctors prefer to rely on symptoms as the most useful guide to the stage of menopause. In a world where we rely on tests in so many areas, this may seem unsatisfactory. But the fact is that despite sophisticated hormone measuring systems, there is still no test to show that menopause is occurring or to predict just when the last menstrual bleed will take place.

There are some situations in which hormone tests can be very helpful indicators of what is happening to the reproductive system. These include the following:

after a woman’s own hormone production has stabilised and her menopause is confirmed;

in women who have had a hysterectomy or an artificial

menopause and are experiencing distressing symptoms; and in women who have been given sex hormones in the form of implants.

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