Menopause, or a short history of being stood on our heads

By applying tailor-made solutions, it is possible to effectively treat the symptoms of the menopause. In order to do so, it is essential for the treating physician to have an exact picture of your condition and individual risks.

Menopause, or a short history of being stood on our heads

I believe I was 47 years old when the first signs presented themselves. In the beginning, I was unusually sensitive in the days before the start of my period, and I cried about anything. This progressed into a kind of tense irritability and impatience. By the time I was 50, any kind of minor or major stress led to the onset of my period. There were times when I menstruated three times in a week. I basically had to live with panty liners on a permanent basis. If you're not living with an affectionate, patient husband at a time like that, there is no question you would lose all intimacy in your life. And by the time you come to your senses, your self-confidence has gone to pieces. Not to mention dealing with the stresses of everyday life.

My female friends greeted my complaints by shouting "Welcome to the club!". They then proceeded to list how they had woken up bathed in sweat in the middle of the night, had horrible hot flushes, seen unwanted extra kilos accumulate in just a few months and experienced nervous breakdowns. They were visibly relieved that they were not alone on the certain path to becoming a bitter old dragon! These were all decidedly grim conversations, especially as no one could offer and solutions that would definitely work. I felt like I had to go and see my gynecologist, Dr Gyula Csermely at RMC.

Phytoestrogen (a naturally occurring plant substance) didn't work. After a biopsy, given that in the past I hadn't dealt well with a hormone-releasing spiral that regulates bleeding disorders, I have a womb, I don't smoke and based on the results of earlier screenings that indicated I wouldn't be running any extreme risks, I received systemic hormone replacement. It helped me get through the difficulties. In my case, the right circumstances meant I was able to receive the medicine, though I still had to stop after two years to avoid harmful complications (e.g. liver problems). However, neither the bleeding or outbursts returned, and just like my mum I was able to wave goodbye to periods forever at 53 years of age. At least so far, I hope it's for ever!

In a women's magazine I read that though it affects half of the world's population, the menopause is still a taboo. Approximately one million Hungarian women suffer from it to a smaller or greater extent. There is also an official World Menopause Day, 18 October. The magazine article recommends that we should consciously prepare for it. Experts say that 'the change' can bring countless new possibilities provided we don't approach it in a negative way.  I’ve had to face the fact that though we can fully and rapidly come to terms with our concerns, it’s still hard to get a recipe for how to live all of this in a positive way.

I spoke to Dr Nóra Gullai, the lead physician of gynecology at RMC, about the precise meaning of the term menopause.

Nóra Gullai: The menopause is defined as when a woman doesn't menstruate for at least 12 months. Perimenopause is the state of transition, while the premenopause refers to the preceding state when you may experience uncomfortable, often unbearable symptoms.

Eszter Kallós: Nóri, you are both a woman and a doctor. How do you see your peers in this frankly rubbish situation?

NG: The picture is very diverse. Some people come to us after years of suffering, others simply have absolutely no information about the process, and some haven't yet experienced symptoms, but ask us to treat the situation in advance with hormone replacement because they want to escape the scary-sounding consequences – they genuinely want to stop time. Because let's face it, the onset of menopause is a moment of reckoning for any woman. As we age, menopausal symptoms such as hot flushes, sleep disturbances, irritability and dryness of the urinary tract can occur, our skin tissue loses its tone, our hair starts thinning... This is a difficult time, full of self-esteem issues that go beyond the physical symptoms.  The good news is that there are solutions available to relieve symptoms. The bad news is that although estrogen has a beneficial effect on the skin in several ways, little data is available on the overall aesthetic outcome and such claims alone cannot currently be an indication for hormone replacement. But if you want to know more about the effects of menopause and hormones given as a treatment on the whole body, talk to Timi Baló, my endocrinologist colleague, with whom we put together the RMC menopause package.

EK: Yes, that's the one. Do you really have to go through so many tests now to find a solution?

NG: Our goal in developing the menopause package was to get a complete picture of the current state of the patient’s body and the expected health risks that would allow for a perfectly personalized treatment. The menopause is not just a gynecology issue. For example, the lower risk of cardiovascular issues for women disappears after menopause, urinary tract problems can become more frequent, bones may become more fragile, and so on. So it is good to be consciously preparing for menopause in such a way that, knowing the condition of your body and your risks, we can create personalized treatment, while you should also be aware of the potentially totally new eating and lifestyle habits that will help you live your life with the least amount of upheaval possible to ensure you can continue to accept yourself as you are. We consider this approach, which goes beyond gynecological procedures, to be a modern, professional and truly patient-centered solution.

EK: Yes, I completely agree with this, based on my own experience. You genuinely can avoid years of physical and mental torture with a truly tailor-made and effective treatment program. Is it a coincidence, by the way, that the schedule for menopause on my mother's side is accurate to the year?

NG: It's true that there is a family pattern for when the menopause occurs. This is particularly important if you have a family history of early onset menopause. In that case, it is worth drawing the attention of girls in your family to the fact that they are also more likely to experience the menopause earlier than the average, especially as this may be an important factor in terms of family planning.

EK: And this is unquestionably a taboo topic: is a decrease in libido a cast-iron guarantee in this stage of our life cycle?

NG: It can happen, but the true answer is more complicated. The state of your relationship, sexual habits and emotional life contribute (or take away) from your libido just as much as the menopause. Supporting tools – from a medical point of view – are available, it's best talk to Timi Baló.

EK: I will.


Eszter Kallós