"You will not get rid of hot flashes" and other unresolved taboos of menopause

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The rule comes to girls' life at about 12 years old. From then on, if it is regular and health is going well, it will be presented once every month; with pains, mood swings and migraines more or less intense depending on the person. This bleeding will be repeated every 28 days of his life until he reaches 51 years on average. This means that, during the fertile period, the rule will arrive about 400 times, something that makes it completely understandable that its absence, when menopause arrives, means a whole liberation, although it is not for everyone.

For many women, stop releasing eggs is the beginning of a complicated time of physical and psychological changes that worsen their quality of life. No one can deny that the symptoms are important: hot flashes, osteoporosis, vaginal discomfort, joint pain, anxiety, depression ... But is everything that is said about menopause true?
Hot flushes: neither all suffer nor all are equal

"It always happens to me at the most inopportune moment, when I am in a work meeting. It lasts only a few seconds, although sometimes I feel it as minutes. I feel hot, palpitations and sweats in the upper thorax, neck and head, accompanied by a redness that makes me look like a light bulb [laughs] When it arrives, I can do nothing but relieve myself, giving me air with what I first catch, taking off my jacket and, yes, always apologizing. all if it is a man in front of me, although I am ashamed to say it, I usually lie and I always blame it on a drop in tension. " It is the experience of Mayte (55 years), but not that of all women.

According to José Luis Neyro, gynecologist at Cruces de Bizkaia University Hospital and spokesperson for @SaludSinBulos, "20% of women who go through their menopause without hardly knowing. They are the most fortunate. Of the remaining 80%, half have a symptomatology light, with some discomfort, perhaps some suffocation, but without it leading them to lose quality of life. " The serious problem is for the rest: almost 4 out of 10 suffer from what is known as climacteric syndrome, which is a very variable set of symptoms. "It groups the hot flashes and the alterations of the control center of the changes of body temperature, the arthralgias (which are characterized by joint pain), insomnia, which is often accompanied by an uncomfortable sweating, dizziness, palpitations that both overwhelmed, emotional instability with a tendency to cry and depression for no apparent reason, susceptibility, loss of concentration ... ", explains Neyro.

Among women who do suffer hot flashes, not all experience them with the same intensity. Leire Andraca, representative of the Women's Health Group of the Spanish Society of Family and Community Pharmacy (SEFC), explains that "the duration of each hot flash can be very variable from one woman to another, and can last from a few seconds to several minutes, its periodicity is also different, from less than once a day to several hot flashes every hour, although the progression is usually descending as time goes by. " On average, women suffer between 6 months and 2 years. It is not yet known what causes some women to experience them with more force than others, but some scientists point out race and geographical origin as risk factors, having started with premenopausal symptoms very early, the stress that is perceived when having them and going through a depression.
Sexual desire does decline, but it does not die

"It's funny because in my house (I was the only daughter in a family with 4 siblings) they never advanced the arrival of my period, so when it arrived I thought I was going to bleed, something bad was happening to me. A friend reassured me, but I still hid it from my mother for months. Forty years later, menopause arrives and something similar has happened to me. No one had told me anything! It is true that the sexual frequency with my partner was not the same as when we were younger, but sex has become so painful that in the end I have chosen to stop looking for it. I don't feel like it. " María Luisa (58 years old) reports something quite common in women with menopause: vaginal dryness.

When cessation of ovarian function ceases and estrogen levels decrease, atrophy of the female genital tract occurs, causing vaginal dryness. In turn, this favors infections and dyspareunia or painful intercourse, Andraca explains. Gynecologist José Luis Neyro points out that "vaginal dryness is something that practically no one gets rid of, but it is also fair to point out that it is not related nor is it directly causing loss of desire, which, especially in women, is multifactorial. " But if libido does decline and, in addition, women experience difficulties for penetration, even pain, it is understandable that many women park their sexual activity.

The good news is that vaginal dryness is treated by intimate gels to hydrate the area, lubricants that facilitate penetration, pelvic gymnastics exercises, sexual therapy to revitalize life as a couple, practice more emotional sex or understand that sexual satisfaction does not It comes only through intercourse ... However, do women consult this problem with the specialist? The answer is no. "The gynecologists can confirm that it is we who, during the gynecological examination, observing the deteriorated and dry vagina, initiate an interrogation around this symptomatology, which seriously conditions the quality of life of the woman. Here emotional, cultural or even religious factors enter that make many women consider it normal for their vagina to dry out and, therefore, to decide not to continue having sex, "says the expert.
It does not make you fat, although it changes the metabolism and redistributes the fat

"I must be a weirdo because menopause has made me lose weight. When I turned 50 I began to take more care of my diet, I stopped drinking alcohol, not even a drink, and I started exercising. I had not started with the first symptoms, but when a few years later I began to have them, I had already established my routine and, far from gaining weight, right now I can say that I have neither the rule nor the 10 kilos of more that I had left over, ”says María José (59 years old ). The claim that menopause fattens is a myth. What there are are changes in metabolism due to the hormonal readjustment that occurs. With this metabolic change "come the variations in body composition and the increase and redistribution of fat, which tends to move from the buttocks to the waist and abdominal area. If the woman does not take care of her diet and increases physical activity in this period, most likely you will gain weight for all these reasons, "says Leire Andraca.

That is, that menopause, rather than fattening, redistributes body fat in the female body. "The increase in the umbilical perimeter suffered by women from the moment of the loss of estrogen is evident. While still having the thighs or hips that each one has had until that moment, what most women notice is they start to 'gut', and that accumulation of abdominal fat is what is really dangerous, due to the increase in cardiovascular risk (88 centimeters is the maximum limit without risk), "says gynecologist José Luis Neyro.
Cardiovascular risk and bone mass: there is no hoax here

"The legs". Carmen (72 years old) is adamant when asked if she remembers the side effects of her menopause. "I have been without a rule for almost the same years I was with her - she exaggerates - but I can only say that all these problems that I have in my bones started then. They have already operated on one knee and I am on the waiting list for the other. I'm scared to go out walking in case I fall. " José Luis Neyro, who is also a researcher in the field of osteoporosis, explains that "bone mass, that capital of minerals that give resistance to bones and that women are increasing thanks to their hormones up to 25 or 28 years, also it depends on estrogen. From menopause, with the decrease in these hormones, bone mass is lost with figures between 2 and up to 5% every year during the first years. Bone fractures, then, are the consequence logic of that disease, although many go unnoticed or do not relate them to osteoporosis. " Estrogens are, in general, a great defense for many health risks for women throughout their fertile life.

Another negative effect of not segregating them is that cardiovascular risk is increased: cholesterol increases and lipid profile worsens (coronary risk), blood pressure tends to increase gradually and abdominal fat deposition begins. "But although it is true that estrogens are cardioprotective hormones - and therefore a woman in the reproductive phase, on equal terms, has a lower risk of suffering a cardiovascular disease than man - and that in menopause that protection is gradually lost, also It should be noted that it seems that in postmenopausal women the increase in cardiovascular risk is linked more to the increased prevalence of risk factors that usually appear with age such as diabetes, obesity, hypertension, hypercholesterolemia ... ", clarifies Leire Andraca.