World Menopause Day – October 18

Doctors report various changes in women's health Which woman doesn't pay attention when she starts to feel hot flashes and night sweats around the age of 45? These are some of the symptoms of the menopause transition period. Menopause is the term given to a woman's last menstruation and signifies the end of her reproductive period. According to endocrinologist Gisele Lorenzoni, it is the period when a woman's egg supply is depleted. "Menopause, resulting from the loss of ovarian follicular activity without another pathological or physiological cause, typically occurs between the ages of 45 and 56," explains the doctor. During this menopause transition period, approximately 50% to 75% of women experience hot flashes, night sweats, or both (vasomotor symptoms), and more than 50% experience genitourinary symptoms (Genitourinary Syndrome of Menopause - GSM). "At this stage, it is very important to start looking for a professional to assess the need and feasibility of hormone replacement therapy," says the endocrinologist. According to sleep medicine specialist and president of the Brazilian Sleep Association (Regional ES), Jessica Polese, women have worse sleep than men for various reasons. "I see many women who suffer from sleep issues for various social reasons, such as having a triple workload (working outside, taking care of children, and managing the household), in addition to attention to their spouse, and also biological reasons due to climacteric and menopause," she highlights. "In menopause, women experience changes that can affect sleep, such as hot flashes, excessive sweating, body aches, mood swings and anxiety, breast tenderness, which can indeed cause sleep disturbances," emphasizes the doctor. With menopause, the slowdown of metabolism and the tendency towards a sedentary lifestyle often lead to weight gain and a consequent increase in abdominal fat. According to the Sleep Institute, an increase of 1 cm in abdominal circumference leads to a 5% increase in the risk of obstructive sleep apnea. "This weight gain is detrimental to sleep quality," warns Jessica. Hormonal changes during this phase can also directly impact skin health and appearance. Dermatologist Karina Mazzini explains that it is common for women at this stage to experience increased sagging, dryness, and even the appearance of more pronounced wrinkles. "This happens because the reduction in estrogen levels decreases collagen production, which is one of the main factors responsible for the elasticity and firmness of our skin," reports Karina. According to the dermatologist, at this time, in addition to intensifying daily care, it is important to invest in collagen bio-stimulation procedures to restore skin quality and beauty. "It is always good to have follow-up with a dermatologist, so they can recommend the best products and treatments for women to navigate this new phase well." In addition to sweating and hot flashes, there are physical and emotional transformations caused by the cessation of female hormones from the ovaries. According to Gisele, one of the effective treatments approved by the Food And Drug Administration (FDA) in the United States is oral and transdermal estrogen preparations with or without progestogen. "Before we recommend treatment, we will research the patient's entire history to provide an appropriate prophylaxis that does not cause side effects," she says. The doctor explains that another option is treatment with estradiol, which may be less likely to cause the risk of venous thromboembolism compared to oral estrogen," she states. Dentist Marlei Bonella says that many changes can occur in women's oral health. The gums may become red, the mouth dry, and taste altered. Additionally, osteoporosis, common during this period, can alter bone density in the jaw and lead, if untreated, to tooth loss. "Xerostomia - the sensation of dry mouth caused by the drop in estrogen - can also occur. Another point is menopausal stomatitis, which causes the gums to become pale, dry, or very red, and may even bleed," she says. "Care in nutrition is important, and consuming milk, cheese, yogurt, sardines, salmon, kale, broccoli, spinach, enriched with calcium, and seeking a multidisciplinary treatment that integrates the Periodontist, Gynecologist, and Endocrinologist is essential," she emphasizes.