Menopause - Bladder- Flushes-Migraines-Post Menopause Bleeding ..Useful Info..

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Menopause signals a change in women's health needs. To address these changing needs, a woman needs to first understand the facts. Technically, menopause marks the time when the level of estrogen produced by a woman's body gradually declines. The symptoms of estrogen loss may include hot flashes, insomnia, fatigue, difficulty concentrating, urinary incontinence, and vaginal dryness.

Over time, the loss of estrogen in the body can also lead to an increased risk of diseases such as osteoporosis.

Supplements for this must be concidered ..

During menopause, the body makes less of the female hormones, estrogen and progesterone.

Some women may experience troublesome symptoms such as hot flashes (a sudden flush or warmth, often followed by sweating) and sleep problems at this time. Sometimes, women have other physical problems such as vaginal dryness.

While many women have little or no trouble with menopause, others have moderate to severe discomfort.

Here are some of the most common health topics relating to menopause.

Signs and symptoms of natural menopause

*Hot flashes: why they happen?

*Bladder health during menopause

*Migraines and menopause

*Postmenopausal Bleeding

*Blood tests to check hormone status

Signs and symptoms of natural menopause

As a woman’s body prepares for menopause, there is a gradual change in her menstrual cycles over several years.

This is called peri-menopause and it means “around the time” of menopause. Menstrual cycles may become longer, even heavier, with occasional missed periods, and fewer days of flow or lighter flow.

Women often experience flushing spells or hot flashes, night sweats, during this period. The degree to which these flashes make a woman uncomfortable is unique to the individual. Some women have intense experiences, while others have minimal physical discomfort. 

Other signs and symptoms of natural menopause include: vaginal dryness, night sweats, thinning bones, decreases in the level of heart-protecting high-density lipoprotein (HDL) cholesterol, and rises in the level of harmful low-density lipoprotein (LDL) cholesterol.

Along with hot flashes, there may be some sleep disturbances.

Changes in sleep patterns can be very disconcerting and challenging to one’s emotional health.

When sleep is significantly interrupted, women may experience increased “blues” or anxious feelings.

Similar to adolescence, pregnancy and the postpartum period when the body is adapting to changing levels of hormones, it affects our emotions.

Emotions are an expression of how we are experiencing the environment – changes in our hormones, change how we feel.

This stage of life, like all the others, has its challenges and opportunities.

For many women, mid-life is the first time they’re able to focus attention on their health, career, hobbies, home, recreation and romance.

While there is great reward, mid-life may also be the time when you are caring for elderly parents and family members or when your children are leaving home.

These are new stresses and new experiences and you need to prepare yourself.

Hot flashes: why they happen?

Hot flashes, the most common of menopausal symptoms, are sudden feelings of heat that spread over the body, often accompanied by a flushed face and sweating.

A Hot Flash is the way our bodies naturally cool down, during menopause .

During a hot flash, which typically lasts from 1 to 5 minutes, the heart beats faster and blood vessels dilate causing a flush. Women may also sweat or suffer a wave of anxiety, body perspiration may smell stronger, become excessive, also underarm perspiration may become bothersome, when in stressful situations and increased anxiety. 

In the not-too-distant past, a woman was told that hot flashes were "all in her head.” We now know that these uncomfortable waves of heat are the body’s response to declining estrogen.

What is still uncertain is why hot flashes last only a few months for some women, and persist for years or never occur at all for others. Some women may experience night sweats, a drenching sweat that can often disrupt sleep. While these symptoms are disruptive, they’re usually temporary. Treatments are available to help alleviate these symptoms.

Bladder health during menopause

Women going through menopause can experience a number of physical changes, some of which can contribute to irritation of the bladder or bladder control problems.

Among these changes are:

weakening of the pelvic floor muscles, which makes it difficult to prevent urine leaks caused by coughing, sneezing or lifting heavy objects

thinning of the lining of the bladder and urethra, which can lead to more frequent trips to the bathroom (frequency) or unusually urgent needs to urinate (urgency) ( overactive bladder ) .

decreased responsiveness of the bladder and urethra to nerves and hormones, which can make it difficult to control the urge to urinate.

These changes are present in all women going through menopause and are responsible for many of the bladder control problems and urine leaks that some middle-aged and older women experience.

If you have had multiple pregnancies or difficulties with bladder control in the past, you are more likely to experience bladder control problems during or after menopause.

If you are having bladder control problems as you go through menopause, there are a number of treatments available to help. These therapies include prescription medicines and pelvic floor muscle exercises such as Kegels.

Even if you think that your bladder control problems are due to menopausal changes, you should discuss them with your physician or clinician. A medical evaluation will determine if these changes are being caused by another condition, such as an infection, heart problems, medicines, or nerve damage due to diabetes or stroke.

It is important to take care of yourself and stay in control with sensible diet habits (limit your caffeine intake and eat plenty of fiber) and by retraining your bladder to hold more urine (for example, try to train yourself to only go to the bathroom once every three hours).

Urinary tract changes

As estrogen levels decline during midlife, several body systems are affected including the urinary system.

The lining of the bladder responds to lower estrogen levels by becoming thinner and more easily irritated. This means that some women will experience problems with bladder infections or other urinary symptoms. 

During menopause, there is an increased chance of vaginal and urinary tract infections. ( Bacterial Vaginosis & Yeast Infections) If symptoms such as painful or overly frequent urination occur, consult with your physician or clinician. Infections are easily treated with antibiotics, but tend to come back in certain individuals.

To help prevent these infections, urinate before and after intercourse, be sure your bladder is not full for long periods of time, drink plenty of fluids, and keep your genital area clean. Douching is not thought to be effective in preventing vaginal and urinary infections.

Migraines and Menopause

The prevalence of migraine is 2-3 times higher in women than in men. The character of the headaches also differs between the sexes. Women tend to report higher levels of pain, longer duration of headaches, and more associated symptoms, such as nausea and vomiting. Visual symptoms are also less common in women.

There is a long recognized association between ovarian hormones and migraine. Over half the women who experience migraine report an association between their headaches and their menstrual cycle. The frequency and severity of migraine is increased commonly with the use of oral contraceptive pills and during menopause.

Because migraine is affected by hormonal fluctuation, estrogen use during the premenstrual period is sometimes helpful. However, ironically, estrogen may also trigger migraines. Women should discuss with their physicians the use of estrogen such as oral contraceptives and hormonal therapy for migraines.

Stress often triggers migraines, so women who are habitual sufferers should learn relaxation and stress management techniques. These are especially helpful in aborting headaches when warning signs are felt. Massage as well as relaxation exercises of the neck, shoulder, and jaw muscles may all be helpful. Rest in a dark room with cool compresses can prevent the headache. Foods such as alcohol, aged cheeses, chocolate, fermented or marinated foods, MSG, artificial sweeteners such as aspartame, and caffeine all may trigger headaches; diet should be monitored to reduce or eliminate intake of these. Nicotine may cause migraine — yet another good reason to give up smoking!

In summary, each woman's migraine pain, her triggers, and her "headache calendar" (when headaches tend to occur) are unique. Treatments are also unique for each case. To properly plan treatment, individual triggers, lifestyle issues, stress levels, eating habits, and willingness to accept drug therapy, must be considered.

Women with moderate migraines may need prescription drugs for relief. These could include agents that affect neurotransmitters (the chemicals that are the messengers in the brain) such as sumatriptan and various antidepressants. Other drugs might include agents that dilate (widen) the blood vessels in the brain. In some cases, painkillers are prescribed.

Postmenopausal bleeding

Postmenopausal bleeding is characterized by any vaginal bleeding after you have become menopausal, generally defined as having been without a period for 1 or more years.   This is not uncommon, occurring in 30% of post menopausal women, however no matter how light the bleeding is, you should always see a gynecologist if you develop any postmenopausal bleeding. 

The most common cause of postmenopausal bleeding is that the lining of the uterus or vagina may be inflamed, causing sloughing, and superficial ulcerations that lead to bleeding.  Other benign causes include the presence of a cervical polyp, or overgrowths in the lining of the uterus.  There is always a risk of cancer in the cervix or lining of the uterus, which is why it is so important not to delay seeing a gynecologist if you develop postmenopausal bleeding.

Evaluations of postmenopausal bleeding include an examination and often an ultrasound.  Additional testing may include a biopsy of the endometrial lining, a hysteroscopy to take a close look at the uterus and D&C.

Treatment for postmenopausal bleeding will be based on findings from the evaluation and often times includes topical hormone replacement, D&C or in few instances, even hysterectomy.

Blood tests to check hormone status

A blood test is sometimes done to check hormone status in perimenopausal women. This test measures the level of follicle stimulating hormone (FSH.) The problem with interpreting this test, in women approaching midlife, is that one measurement doesn’t provide enough information.

Perimenopause is a time of hormone fluctuation. You may find that your periods are irregular or changed in amount of flow or duration compared to earlier years. Some menstrual cycles are anovulatory (without ovulation). These changes in hormone levels may actually vary significantly from one week to the next. So if a blood test shows a normal FSH, it doesn’t mean that that it was normal 5 days earlier, or that it will be normal 5 days later.

To accurately predict how the levels of FSH correlate to a woman’s peri- menopausal status, in early perimenopause this result often comes back as normal as the hormones are too erractic to test in early perimenopause.

One signal that the midlife change is complete is when FSH levels are above 40 mIU per milliliter on two separate occasions, measured 1 week apart.


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  • Posted

    Wonderful post, so much needed support to help others Thanks so much. Luv to you xx 
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  • Posted

    Useful and informative as usual jay. Thanks
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  • Posted

    Thank you this is comprehensive, we do need more support in the community, professionals trained to offer support and counselling to ladies going through this extremely challenging time of life.  This should include courses for groups to attend with professionals to provide strategies of coping, psychological support.  There is an increased need for well informed GPs ready to offer all the medical options from evidence based well researched holistic to orthodox treatments.  We need to raise the profile and support levels!
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  • Posted

    Such wonderful information - it is appreciated more than you know

    I am 72, have been on tamoxifen since June 2016 and it has been a nightmare - hot flashes, freezing cold chills, can't sleep - I went for a Pap smear and my cervix is closed up - they did an ultra sound and the lining of my uterus has thickened quite a bit - gyn went in to open me at his office and no luck - left me with terrible pain - now I am having a d and c under anesthesia to try to open me up and get a biopsy - I quit the tamoxifen and am seeing the oncologist tomorrow to discuss this - I am up all night peeing and if I don't get up a hot flas starts - it is just a horrible thing to be going thru at my age - I am thinking I will be better off to have a complete hysterectomy 

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