From a very early age, the flood of hormones completely changes a woman’s life. When the menstrual cycle begins, a series of changes appear in the body and change the entire lifestyle.
Menstruation is the shedding of the inner walls of the uterus, and it happens when there is no fertilization of eggs. It’s like the body’s preparation for pregnancy, and when it doesn’t, the endometrium — the uterine membrane — sheds.
This natural phenomenon usually begins in adolescence, being marked by menarche – as a woman’s first menstruation is called. The closing process occurs, on average, between 45 and 55 years old, when the body begins to show some signs, oscillations in the menstrual period. This time is called perimenopause. The closing milestone, in the last menstruation, called menopause.
However, some women experience this period early, characterized before age 40.
THE CNNLuciano de Melo Pompei, president of the National Committee Specialized in Climacteric of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), said that the scientific community uses the term premature ovarian failure, popularly known as ‘early menopause’.
According to Mauricio Abrão, coordinator of Gynecology at BP – A Beneficência Portuguesa de São Paulo, early menopause can happen due to a variety of phenomena. “They range from a personal predisposition, genetic predisposition, or in the case of some diseases it is common for this to happen”, he told the CNN.
A review by the Nilton Lins University, which evaluated women with early menopause in Brazil, showed that about 1% of women have premature ovarian failure in the country.
Abram explains that it is common for menopause to be early in patients who have endometriosis. “Or also when the patient has surgery on the ovary, if the ovaries were removed, or if a cyst was removed”, he comments.
That’s exactly what happened to Maria Tereza Silva, who was diagnosed with premature menopause at age 32.
“I discovered menopause early when I started taking endometriosis medication. I had no blood flow (menstruation) for a period and I started to feel the symptoms of menopause”, said Maria Tereza in an interview with CNN.
Early menopause associated with depression
Hormonal changes not only affect a woman’s body, but also her mind. With the low production of estrogen, a female hormone, linked to the various functions and characteristics of women, changes in mood, mood and even the emergence of depression are common symptoms in the phase of premature menopause.
In an analysis of 14 studies that looked at nearly 68,000 women, researchers at the National and Kapodistrian University of Athens, Greece showed those who entered menopause from the age of 50 had a reduced risk of postmenopausal depression compared with with women who had premature ovarian failure.
The study showed that for every two years it takes menopause to occur, the risk of depression decreases by 2%.
“Longer exposure to estrogens, expressed as older age at menopause and longer reproductive period, is associated with a lower risk of depression in adulthood,” the scientists wrote.
“Depression is directly linked to menopause, because estrogen, which is the hormone that decreases in menopause, ends up being responsible for stimulating the increase of some endorphins such as serotonin (known as the happiness hormone). And with the decrease in estrogen, there is a decrease in this type of neurotransmitter”, explains Abrão.
Maria Tereza says that, during the period she was following up for endometriosis and going through the early menopause phase, she was diagnosed with depression and panic syndrome.
“When I got the diagnosis it was difficult, because I had to start a follow-up, take medication and it messed with my mind a lot. It’s very complicated, because sometimes we tell people and they don’t believe it, they think it’s fresh and that it has nothing to do with it. But only those who pass know,” she says.
The Athens scientists wrote that “identifying women at increased risk of depression due to early menopause who could benefit from psychiatric intervention or estrogen-based therapies may be useful in the clinical setting.”
Hormonal changes and the functioning of the mind
Pompei says the drop in estrogen has a number of consequences for a woman’s life.
“From short-term manifestations, such as hot flashes, emotional changes, lack of lability, more depressive mood, mood changes, this is because hormones interfere with the production and amount of brain neurotransmitters”, he explains.
Ana Lucia Pandini, professor at Universidade Presbiteriana Mackenzie in the area of Analytical Psychology, told CNN that with all these changes, women can end up experiencing sensations ranging from loss of self-esteem to the need to feel more like a woman.
“If there is no understanding on the part of the woman, for physical reasons, for understanding that the body is going through a change, for a hormonal situation, she can develop depressive symptoms”, he said.
Maria Tereza says that she began to experience these sensations at the age of 36. She had to have a surgery called a total hysterectomy, when the uterus and ovaries are removed.
“This got in the way of my routine a lot because people said that with the removal of the uterus, I would lose my libido, so I started putting it in my head and it made me very sick”, said Maria Tereza.
She says she felt very alone. “I lacked attention and understanding from my husband. I thought little, I wanted much more.”
Pandini points out that, in these situations, the best way is to understand everything that involves the uterus, menstruation, which are related to symbols that refer to femininity, but that menopause, even early, is a natural process of the body.
“A woman, when she goes through this period, whether it’s the removal of the uterus, menstruation, when something changes in her routine, starts to have a fantasy of feeling less of a woman. She needs to reframe that symbol and rescue a psychic force, an emotional force,” she says.
Maria Tereza needed to undergo therapy with a psychiatrist and psychologist to deal with the situation. “I had a lot of self-esteem issues, so I started going to therapy weekly to deal with everything that was going on, especially with the removal of the uterus, it felt like I had taken a wall of who I am.”
Carmita Abdo, psychiatrist, professor at the USP School of Medicine, president of the Brazilian Association of Studies in Medicine and Sexual Health, told CNN that this happens very often, but that there is a situation in which the woman should be prepared. “That would not be the natural course of life. Many women refer not menstruating to something not positive, as if she has lost a competence.”
Early menopause and sexual function
Abdo says that it is natural that in the period of low estrogen production, the woman loses the will to maintain relations.
“The first consequence of the lack of estrogen, on the physical plane, is the dryness of the vagina. And with that, not lubricating, she will have discomfort in sexual intercourse. Little by little, as this situation is uncomfortable, the woman loses interest in the act, and loses her desire”, she explains.
Maria Tereza said that she went through this process. “This situation was very bad for my relationship, it was very bad for my partner. I went almost 70 days without having sex. I didn’t feel like it and I was very afraid.
Abdo says that in these cases, there needs to be understanding and conversation.
“As the woman continues with her sexual function preserved, she doesn’t change her hair, she doesn’t age, she doesn’t get weaker in terms of bones, the partner doesn’t observe major changes externally, he can’t see the woman’s psyche because she was emotionally shaken,” he says. .
The way out, according to Abram, is hormonal therapy. “The best way to deal with it is to have accurate medical follow-up, to make correct diagnoses,” he said.
Tereza says that, due to early menopause, she needed to use drugs called ‘hormone replacers’ — therapies that helped her after a period.
Abdo points out that the way is dialogue. “If the partner is very interested, wants to keep sex at the same frequency as in previous times, he needs to know that the woman’s organism is different, and both need to redo an agreement on the rhythm and intensity of the relationship”, he comments.
The psychiatrist also points out that menopause should be relieved of the ‘blame’ of loss of libido. “Taking care of health in general, physical and emotional, is essential for sex to be preserved.”
For psychologist and sexologist Jussania Oliveira, changing this scenario requires “the basics of any physical and mental health: physical exercises, leisure activities, balanced diet, identification of new hobbies or work activities and, without a doubt, therapy”, she said. .
Source: CNN Brasil
