Menopause advice: caring for patients
Aisling Earley highlights the issues surrounding menopause that may affect patients and the oral manifestations of this natural biological process.
In today’s society, women face a lot of prejudice. We spend our entire lives trying to embody an image that is socially acceptable, which leads us down the path of hiding our flaws from the outside world. We see it in magazines, on social media and even as we walk down the street.
Unfortunately, important topics of conversation are therefore considered taboo or inappropriate to speak openly about. That is why I found great strength in writing about menopause for this project.
I felt a great deal of empathy as I delved into the harsh reality of this new chapter in many women’s lives. Look around myself, I could understand the difficulties this natural phase can often come with.
I believe it to be a vital conversation among our friends, family and, most importantly, in our dental surgeries. So, if one woman sitting in that chair could feel seen, it would be enough.
Symptoms of menopause
In Ireland, according to a 2023 census, more than 650,000 women are in the menopausal age bracket (45-64 years). An amazing 418,000 of those women are in employment.
When we take a look at the symptoms of menopause, this is a significant number of patients who may need our expert help or opinions on how it can affect our oral cavity and treatment options available to them.
Common symptoms of menopause include:
- Hot flushes
- Night sweats
- Fatigue
- Lack of energy
- Low mood
- Anxiety
- Problems with memory
- Concentration difficulties
- Vaginal dryness/discomfort
- Reduced libido
- Heart palpitations
- Headaches
- Weight gain
- Loss of muscle
- Joint pain.
Read that again. This long list of common symptoms clearly denotes that there are even more. When we realise the impact lowered oestrogen and progesterone have on our bodies, we can only imagine the manifestations that could present in the oral cavity.
Stages
To understand this natural process a little better, we need to be aware of the different stages:
- Pre-menopause
- Perimenopause
- Menopause.
Pre-menopause (meaning before/early onset menopause) is the timeline before perimenopause or menopause. It usually starts before 40 years of age.
Perimenopause (meaning around menopause) is used to describe the time just before menopause, between the ages of 40 and 55 years, when symptoms of menopause may be experienced but menstruation has not yet ceased. This can occur for up to seven years before menopause begins.
Menopause is defined as 12 consecutive months without menstruating, indicating you are no longer ovulating.
Outside these age categories, menopause may still occur. Ovarian removal (oophorectomy), chemotherapy, radiation therapy and hormone endocrine therapies for breast cancer can all have an effect on the ovarian activity and may cause early onset menopause.
Getting a menopause test in your 40s and 50s can indicate that you are experiencing this decline in sex hormones.
Although menopause doesn’t cause ovarian cancer, the chances of developing it as you get older increases. Similarly, it is found that starting menopause after the age of 55 can increase the risk of breast cancer and endometrial cancer.
Therefore, it is essential to always advise your patients who are peri-menopausal or menopausal to stay up to date with their screening tests.
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