Updated Tuesday,4July2023-00:19

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Suddenly, a hot flash comes, but please don't notice it at work.

Sleepless night and eight-hour workday ahead from, say, seven in the morning. Shower, some rouge and going.

Menopause, that process that half of the population has gone through or will go through, is still a subject that is talked about in whispers. Behind a fan, if anything. Because even among women who have already turned 40 is the elephant in the middle of the room: "Menopause? I don't, I'm still young."

Surely you remember Drew Barrymore, the blonde girl with two pigtails from 'E.T.'. Well, that girl is already 48 years old and 'came out of the closet' perimenopausal (the phase before menopause, which by definition is the right time 12 months after the last period) recently.

It was at his workplace. In his case, he was not in a routine budget meeting or attending to a client, but live before thousands of viewers on his television show. He was interviewing Jennifer Aniston and Adam Sandler, stopped for a moment, took off his jacket and blurted out: "I think it has given me my first hot flash and it is documented."

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According to the INE, in Spain there are exactly 13,406,564 women between the ages of 40, the age at which the first symptoms of perimenopause can begin, and 84 years, more or less the life expectancy that women have in our country. 13,406,564 reasons to speak loudly about the matter because, according to all the experts interviewed for this special, there is still a lot of ignorance.

Not only among the women themselves and the population in general, also among the doctors who attend them in consultation and in theory answer their doubts about the symptoms and changes of this new vital stage. A kind of second puberty because of the dance of hormones that occurs [in this graph you can see all the changes].

"Of course there is modesty. Fertility still frames women a lot, there are as Lorca vestiges, of 'Yerma'. It seems that if you can't have children you're no longer a woman or attractive," says Clotilde Vázquez, head of Endocrinology and Nutrition at the Jiménez Díaz Foundation in Madrid and author of the books Klimaterio: historias de mujeres y hormonas (Letrame) and Con hormones y a lo loco (Ed. Vergara).


"There are treatments that can help not to lose quality of life"

  • Writing: CRISTINA G. LUCIO
  • Writing: GRACIA PABLOS

"There are treatments that can help not to lose quality of life"

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  • Writing: GRACIA PABLOS

This is how menopause changes a woman's body

The diagnosis to improve the situation of this doctor, an expert in menopause, is clear. Without forgetting to call attention to the administration to stop looking the other way on how the climacteric is addressed in public health: "Nothing happens, the doctor assesses what is happening and a correct transition is made. Neither intellectual nor sexual life, nor physical appearance necessarily have to change if one is taking reasonable steps and accompanied. This is the important thing." But, he adds from the experience of his consultation, "public health has to take charge of this situation. I appeal for that step, because it will be a great help for women."

Antonio Cano is Professor of Obstetrics and Gynecology at the University of Valencia and coordinator of the women's health group of the Incliva Research Institute, belonging to the Clinical Hospital of Valencia. He has participated in the study of fezolinetant, the first effective drug against hot flashes recently approved by the US FDA (Food and Drug Administration) and which is expected to be given the green light shortly by the EMA (the European Medicines Agency) and which, therefore, can be sold in Spain.

Cano was also president of the European Menopause Society (2019-2022), the first Spaniard in this position. We detail their curriculum to highlight this assessment in bold and fluorescent: "Women are not only half of the population, they are also half of the working population, the intellectual, the management and menopause must be attended to in the appropriate way. It has to sink in." He mentions that a good number of gynecologists are not trained and that there are many health centers in which they are not treated: "Menopause is only treated in a lesson in medical school."

Sandra is 52 years old. She says she felt sad, didn't sleep well, gained weight and got sudden heat: "The worst of all is that you don't understand anything." Patricia is 60 years old and has been with symptoms for 10 years: "They go and come back stronger." Rosa is only 36 but she had early menopause for no medical reason: "There is not enough information from health professionals." The case of Sonia, 35, was a tumor: "I would like to feel normal again."

The four responded to a survey that we launched on the Instagram account of EL MUNDO and their testimonies, collected by our Social Media colleague Josita García de la Herrán, show that there is still a taboo about menopause and lack of knowledge:

"He didn't recognize me"


Sandra, hormone replacement therapy

Two years ago Sandra's life changed radically. She gained weight, did not sleep well, spent long periods in deep sadness and sex life with her partner became almost non-existent. She didn't recognize herself and she didn't understand what was going on.

It was started with natural treatments, but they did not work. Desperate, she decided to go to the gynecologist to start hormone therapy. Now, we can say that she was Sandra again, the usual one: "I have friends who do not dare with therapy because of the risks. I, on the other hand, am one of those who think that today we are here and tomorrow we are not, so whatever I am, I want to be well."

Sonia, early menopause due to tumor

Sonia was diagnosed with a tumor in her rectum at just 32 years old. Their children were 6 and 3. She started with a treatment that quickly cut her period and after two weeks she started with the symptoms of menopause: insomnia, mood swings, weight gain...

After the removal of the tumor began with hormone therapy, however, the nightmare is not over for Sonia. Everything remains the same: "I would like to feel normal again."

Patricia, 10 years old with symptoms

Patricia has been living a martyrdom for 10 years. That's how long she's been suffering from menopause symptoms. It has them in cycles. Sometimes stronger, sometimes softer, but they don't stop. A real sinvivir.

Desperate, she set out to find the treatment that would put an end to these episodes. But no luck. The natural ones barely had an effect and other medicines that are on the market are not covered by Social Security: "You have to take them six months in a row and I have no money for that."

Pink, menopause for no apparent reason

Rosa had been told about postpartum, but not menopause. She had her son and started developing all the symptoms. The doctors blamed it on the recovery process of childbirth, but the months passed and the symptoms continued.

Already desperate, Rosa decided to start with tests. I was menopausal and there was no medical reason. She felt fear, disappointment for her own body, felt that she had failed herself: "You never expect to go through this 15 years before it's time."

"We must demystify menopause as something negative, as if it is the decline of women," says Elena Iracheta, clinical psychologist and sexologist at the Women's Unit of the Ruber International Hospital in Madrid. "As long as one is active there will be no problem. It is a new stage. The worst thing is to go against it and say 'I refuse'. Menopause doesn't mean you're old. It's just reaching a mature age," adds this psychologist about habitual feelings.

Hormonal changes can mainly cause physical symptoms, but also psychological ones, sometimes as a consequence of the former. How not to fall asleep well because of the agitation produced by the drop in estrogen and what that means for day to day. "There may be anxiety, especially if you have already been an anxious person, but above all insomnia produced precisely by hot flashes, which also has its consequences at the psychological level," explains Elena Iracheta.


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  • Writing: CRISTINA G. LUCIO

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  • Writing: CRISTINA G. LUCIO

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"There are more chances of depression if you have already had an episode in your life, but if it is not true that you may feel some irritability and less patience, but it is something transitory, it will not stay," he recalls for those who begin to experience it. The truth is that in this age group the consumption of antidepressants increases, as can be seen in this graph, prepared by Gabriela Galarza:

Another symptom that some women suffer is mental fog, feeling somewhat dazed and that the head seems to go slower than usual. Don't let the simplest word come up in an ordinary conversation. Any solution to this? "There is no better way than to stay active," prescribes this psychologist. "In addition to increasing physical exercise, especially strength because you lose muscle mass, read, get informed, study ... As long as you keep learning every day, your brain won't have any problems." [Three Experts' Tips on Nutrition, Training, and Brain Gymnastics]

When then would it be necessary to go to a mental health specialist? Because the data indicate that this age coincides with the increase in the consumption of antidepressants among women in our country. "When it already interferes in your life, you see that you do not rest, that you can not with your day to day and you have depressive symptoms. When you can neither get out of bed nor do your job, and you have a terrible bad mood. But that's during menopause and at any other time in life. Do not forget that menopause often coincides with the 'empty nest syndrome', with children having left home or no longer need so much. The 'I don't care anymore'. Now is the time for you to take care of yourself."

Raquel Marín is a neuroscientist and professor of Physiology at the University of La Laguna. She is the author of the books 'Get your brain in shape', 'Give life to your brain' and 'Feed sleep for a healthy brain', all published by Roca Editorial. In addition, his latest research is the project 'Alzheimer's in female', focused on the brain of women, less studied than that of men due to the complications posed by hormonal oscillations, which increase the budgets of experiments. They have to use mice in different phases, which is not the case with their male counterparts.

"Post-traumatic stress – the one with the worst consequences – is more frequent in women and the sequelae are more serious. There are studies that show, still with experimental animals, that post-traumatic stress is one of the risks of Alzheimer's, especially in women. Because men and women have different ways of managing stress," says this researcher, who proposes several mental exercises in this other report of the special to keep our brain in shape.

In menopause, "we must listen to ourselves and promote self-esteem, understand that we are more prone to stress as a result of a tendency to perfectionism." In addition, he advises "promoting a healthy social life, because people in solitude get sick, and that begins, he insists, with self-esteem": "Many women have the feeling that they are not important or sexy because they are no longer useful from a reproductive point of view and that generates an important 'bajona'. But, what the hell, what you have to think is that there is still half a life to live."

13,406,564 people among a population of 48 million and with half of life ahead. Well, they seem like two good reasons to talk more and better about menopause.

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