Feared by many women, menopause is still surrounded by fears, both due to the body’s natural transformations and the impacts it can have on health and quality of life. More than the end of the reproductive cycle, this period marks a phase of hormonal changes that can trigger physical and emotional symptoms and require greater care for the body.

“Climacteric symptoms include menstrual irregularity, hot flashes, night sweats, vaginal dryness, mood changes and insomnia”, explains gynecologist Dr. Nélio Veiga Junior, master and doctor in Tocogynecology from the Faculty of Medical Sciences of the State University of Campinas (FCM/UNICAMP). Anxiety, depression, loss of libido, sleep and concentration disorders are also some of the problems, adds Dr. Patricia Magier, a gynecologist graduated from the Universidade Federal Fluminense (UFF).

The doctor explains that the symptoms linked to menopause do not only appear when it is established. They can appear years before, during the so-called perimenopause, a phase marked by intense hormonal fluctuations, and, in many cases, persist for a long period even after this transition.

“However, other complications are potentially more serious than these. There are medical issues involved and an increased risk of disease, so it is not advisable to ignore treatment during this period. Postmenopausal women may experience cardiovascular problems, decreased bone resistance, weight gain, urinary incontinence and increased fat mass”, warns the gynecologist.

Below, experts explain medical complications related to untreated menopause. Check it out!

1. Cardiovascular diseases

In menopausal women, cardiovascular risk increases, attributed to the combined effects of vasoconstriction and unfavorable changes in the lipid profile. “Both stroke and coronary artery disease increase 2 to 3 times more than in premenopausal women. Hormone replacement therapy is indicated to prevent cardiovascular risk”, explains Dr. Patricia Magier.

Hormonal changes during menopause also increase the risk of cardiovascular disease. “Estrogen is associated with maintaining vessel elasticity, reducing ‘bad’ cholesterol (LDL) and production of ‘good’ cholesterol. So, with the reduction in the levels of this hormone during menopause, there is a greater accumulation of cholesterol plaques, an increase in blood pressure and, consequently, an increased risk of cardiovascular diseases. Hormone therapy can help overcome this situation”, highlights Dr. Igor Padovesi, menopause specialist certified by the North American Menopause Society (NAMS) and member of the International Menopause Society (IMS).

2. Osteoporosis and joint problems

Bone strength decreases significantly after menopause due to estrogen deficiency, which begins around age 40. “At this time, 0.3% to 0.5% of bones are lost each year, increasing tenfold over the next 5 to 7 years. With the drop in estrogen, there is greater reabsorption and less bone production. In addition to hormone replacement therapy, we recommend exercise, smoking cessation and calcium supplementation”, highlights Dr. Patrícia Magier.

During menopause, women are also at greater risk of suffering from joint problems. “As hormone production changes during menopause and estrogen levels decrease, joints become more inflamed, which causes pain in areas such as hands, knees and shoulders and favors the emergence of conditions such as arthritis and arthrosis”, explains Dr. Marcos Cortelazo, orthopedist specializing in knee and sports traumatology.

The doctor also states that the risk of injuries to the knee joint is greater due to the natural anatomy of women. “In general, women have a wider pelvis (gynecoid), tend to have valgus knees (arched inwards) and have a greater quadriceps angle. These factors cause biomechanical and alignment changes, especially in the lower limbs, thus increasing women’s susceptibility to suffering from conditions such as patellar chondromalacia, characterized by the softening of the patellar cartilage”, he says.

3. Urinary incontinence

A urinary loss Without a woman’s conscious desire, it can cause great physical, social and psychological discomfort, mainly due to the fact that it is an unpredictable situation and can occur at any time and in any place, according to Dr. Ana Paula Fabricio, gynecologist, with the title of Specialist in Gynecology and Obstetrics (TEGO).

“Therefore, it is very important to alert your doctor about the problem so that he can determine specific treatment protocols for the condition, which can be caused by factors such as menopausal transition, menopause, excessive physical exercise, aging and previous natural births”, he advises.

Treatment for urinary continence may vary depending on the patient. “There are a series of effective therapeutic options for the problem, including muscle strengthening, pelvic physiotherapy, electrical stimulation, use of topical vaginal hormones, local turgidity and even surgery in more serious cases”, highlights Dr. Ana Paula Fabricio.

In addition to the physical impacts, the hormonal changes of menopause can also directly interfere with intimate life and relationships. Dr. Patrícia Magier highlights that urovaginal dryness can make sexual intercourse painful, which contributes to a decrease in libido and intensifies the drop in sexual desire already caused by hormonal changes. According to her, the impacts of this situation on the relationship could end up fueling a continuous cycle of difficulties.

4. Burnout and professional separation

According to Dr. Igor Padovesi, the effects of menopause go beyond health and also impact professional life. Some reports indicate that the hormonal changes This period has contributed to an increase in the number of women leaving the job market, which raises discussions about how companies can offer more support to their employees.

Although there are advances in valuing motherhood and the female presence in leadership positions, menopause is still little discussed in the corporate environment, especially in spaces mostly occupied by men, who often do not understand the particularities of this phase. “The risk is that, instead of evolving, we create a new stigma that devalues ​​precisely the most experienced women, in leadership positions or in a phase of great professional contribution”, explains Dr. Ana Paula Fabricio.

Menopause symptoms directly impact women at work. “Hot flashes, urgency and urinary incontinence, poor sleep, headaches and migraines, bad mood, irritability, anxiety or panic attacks, with loss of concentration and memory, are symptoms that affect women in the professional environment”, highlights Dr. Patrícia Magier.

When these changes are not understood by managers or colleagues, there is a risk of misinterpretations. “A lack of understanding of the reasons for deteriorating performance or the need for breaks or time off during this period can lead to discriminatory actions against women, which can increase pressure on them and cause even greater emotional problems that will require time off”, warns the doctor.

Hormone replacement as a form of treatment

According to gynecologist Dr. Nélio Veiga Junior, during menopause, treatment always involves the work of a multidisciplinary team. “Always start with lifestyle changes: regular physical activity, a balanced diet, watching your weight, avoiding smoking, alcohol and caffeine, introducing techniques to reduce stress (yoga, meditation and relaxation techniques). Multivitamin supplementation (calcium and vitamin D, which work to prevent osteoporosis) also help”, he says.

Hormone replacement therapy also stands out as an important alternative. Studies have already shown that the treatment can improve the quality of life of women with intense climatic symptoms, in addition to reducing hot flashes and episodes of night sweats, contributing to a more restful sleep.

Dr. Patricia Magier explains that hormone replacement therapy is important during this period and aims not only to minimize the disturbances caused by menopause symptoms, but also to avoid long-term complications. “In addition to treating hormonal changes in menopausal women, it is also important to encourage increased physical activity, the consumption of a balanced diet and the modification of any harmful lifestyle habits”, he concludes.

By Maria Paula Amoroso