MENOPAUSE A change in lifestyle

Physical activity is now established as an important component of a healthy lifestyle while inactivity is widely regarded as one of the most significant and prevalent risk factors for a number of medical conditions. However, does activity have a role to play in the reduction of the effects of ‘normal’ phases of life such as menopause? This article examines how exercise can help with the symptoms of the menopause.

By Sarah Bolitho

WHAT EXACTLY IS MENOPAUSE? The menopause is one of several stages in female reproductive life and has four phases which are: l Pre-menopause: includes the period of reproductive life up to the last menstrual period l Peri-menopause: the period leading up to menopause and one year after, usually two to six years in length l Menopause: cessation of menstruation, considered to have occurred one year after the last menstrual period l Post-menopause: the period after menopause.

Menopause signals the end of egg production (ovulation) in women and occurs as a result of progressively lowered levels of the hormone oestrogen. Onset can be sudden or over a number of years (peri-menopause) and menopause is considered to have occurred one year after the last menstrual period. The normal age range for menopause in the UK is between 45 and 55 years, with an average age in the UK of 52 years.

BOX 1: MAIN CHARACTERISTICS OF MENOPAUSE Vasomotor

Emotional

l Menstrual changes including abnormal bleeding or spotting

l Hot flushes l Night sweats l Weight fluctuation l Dizziness l Skin problems (dryness/sensations of crawling or itching)

l Loss of confidence l Irritability l Nervousness or anxiety l Depression l Reduced libido l Insomnia l Fatigue, tiredness or exhaustion l Problems with memory and staying focused

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The main characteristics of menopause are listed in Box 1 and while most of these are self-limiting, decreasing naturally with or without medication, they can last for between two and five years and for some women continue for longer and/or cause significant discomfort.

Premature menopause, before 35 or 40 years, can occur due to natural causes or be brought on by surgery or other factors and will result in similar symptoms that are likely to be more severe. Premature or induced menopause also carries higher risk factors for a range of conditions including osteoporosis, heart disease and depression.

MAJOR PHYSIOLOGICAL EFFECTS OF THE TRANSITION INTO MENOPAUSE Metabolism

As menopause nears, fat deposits on women’s bodies appear to change. Fat tends to accumulate more around the waist instead of more evenly throughout the body. This can change a woman’s metabolic profile and contribute to an increased risk of metabolic syndrome and cardiovascular

Urogenital

n Vaginal atrophy (dryness, itching, discomfort)

n Urinary tract infections n Frequent desire to pass urine n Discomfort during sexual intercourse n Stress incontinence

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