In general, menopause usually occurs between 45 and 55 years, mean age approximately 50 years. In Spain, according to data from a recent survey, the average age of menopause is 48 years. The age of menopause may be influenced by several factors. The gene is of undeniable importance, since it has been observed that women tend to have menopause at about the same age as their mothers.

What signs and symptoms occur during menopause?

Symptoms directly related to menopause, as a result of declining estrogen is flushing and sweating (vasomotor symptoms), and atrophy of the genital and urinary. Other symptoms that have been associated with this period of life of women is urinary incontinence, repeated urinary tract infections, depression, insomnia, memory loss, decreased sexual desire, muscle aches, among others, although most of them there is no direct relationship with menopause, and thus depend on other factors for each woman.

There is great variability in the frequency, intensity and manner in which symptoms occur in postmenopausal women.

• Vasomotor symptoms. Hot flashes, generally known as hot flashes or flushes, are the most common symptom of menopause. Affecting some 60-80% of women, especially in the first 2 years of menopause and can last until about 5 years later. They are characterized by a sudden reddening of the face, neck and chest, with increased temperature and sweating. The duration and frequency of hot flashes varies greatly from one female to another.
• Although it has been related to menopause, a variety of psychological symptoms such as depression, affective disorders, decreased sexual desire or loss of memory, reality has shown that due to other causes.
• Cardiovascular disease. Female hormones have been shown to have a protective effect on the cardiovascular system, which disappears with menopause, which increases the risk of hypertension and stroke, among others.
• Osteoporosis. After menopause there is an accelerated loss of bone density, which translates into an increased risk of osteoporosis and hence fractures risk.

Recommendations and Treatment

The use of female sex hormones is still one of the most commonly used treatment options and has generated more discussion on any of the risks and side effects they produce.

The estrogen hormone therapy, with or without progestin, is effective for controlling vasomotor symptoms, reducing the frequency and intensity of hot flashes. Estrogen, alone or associated with progestin’s, have proven effective in the treatment of vaginal symptoms, being greater efficiency and at less risk and side effects, if used as vaginal creams, suppositories, ovules or rings.

In the treatment of urinary incontinence, the first step is to carry out exercises to strengthen pelvic muscles, in addition to study and treat if necessary, other associated problems, such as the existence of urinary infection. Hormone therapy in urinary incontinence is controversial at this time.

Given the importance of the risks and side effects associated with hormonal therapy, requires detailed medical study, blood tests and pelvic control breast and uterus, and monitoring for the duration of maintenance treatment.

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