Menopausal complaints

What is the menopause?

The final menstrual period in a woman's life is called the menopause. The perimenopause ('the change') is 'that time of life' between when menstrual periods become more irregular until one year after the menopause. In layman's terms, the perimenopause is often simply referred to as the menopause. The postmenopause is the period beginning one year after the last menstruation.

 

What are the complaints associated with the menopause?

Typically, the hormonal changes during the perimenopause result in: irregular menstrual periods, and possibly more, or even less, bleeding than previously; vasomotor symptoms such as hot flushes (short, sudden and intense heat sensations, usually in the face, neck and chest, sometimes followed by perspiration), sweating (particularly at night); vaginal dryness, dyspareunia (pain during intercourse). These complaints may lead to others. Sweating at night, for example, may result in sleep disorders and therefore fatigue.


People with intellectual disabilities sometimes find it impossible to communicate these symptoms. The people around them may then notice only a change in behaviour.

 

How common are menopause complaints in the general population?

The age at which half of Dutch women reach the menopause is on average between 50 and 51 years (usually between 40 and 60 years). Women who smoke reach the menopause earlier on average.


Menopause symptoms, and particularly vasomotor complaints, affect 60% of women. Only a small proportion seek medical help. Morbidity records indicate that the incidence rate for menopause symptoms in general practice is approximately 17 per 1000 women annually. The prevalence of vasomotor complaints is highest during the perimenopause. The menstrual cycle changes occur (by definition) during the perimenopause. The complaints due to urogenital atrophy (dryness and soreness in the urinary tract and vagina) mainly increase during the postmenopausal period (in 15-30% depending on age). 444

 

How common are menopause complaints in people with intellectual disabilities?

It is not known how often women with intellectual disabilities have menopause symptoms. An interview with 15 women with intellectual disabilities showed that they knew and understood little about the menopause. This means that they will tend not to report menopause symptoms. A number of women said that they were in any case happy that they no longer menstruated. 445


Furthermore, people involved are not always alert to menopause symptoms or they may not pay particular attention to them. 609

 

It has been suggested that women with intellectual disabilities are more likely to reach the menopause earlier. 445 , 446 , 447
Studies in this area have focused on Down syndrome 448 , 449 , 450 , 451 and the fragile-X syndrome 452 , 453 , 454 in particular.


The average age of the menopause in women with Down syndrome was found to be 44 to 46 years. 449 , 450
The age at which women with Down syndrome reach the menopause is related to the age at which they develop dementia and die (earlier menopause is associated with a higher risk of earlier dementia and mortality). 610

0.27% to 3% General population
Not known for people with intellectual disabilities

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Rodriguez-Revenga L, Madrigal I, Badenas C, Xunclà M, Jiménez L, Milà M. Premature ovarian failure and fragile X female premutation carriers: no evidence for a skewed X-chromosome inactivation pattern. Menopause. 2009 Sep-Oct;16(5):944-9

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Seltzer GB, Schupf N, Wu HS. A prospective study of menopause in women with Down’s syndrome. J Intellect Disabil Res. 2001 Feb;45(Pt 1):1-7.

Seltzer GB, Schupf N, Wu HS. A prospective study of menopause in women with Down’s syndrome. J Intellect Disabil Res. 2001 Feb;45(Pt 1):1-7.

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378

Cosgrave MP, Tyrrell J, McCarron M, Gill M, Lawlor BA. Age at onset of dementia and age of menopause in women with Down’s syndrome. J Intellect Disabil Res. 1999 Dec;43 ( Pt 6):461-5.

Cosgrave MP, Tyrrell J, McCarron M, Gill M, Lawlor BA. Age at onset of dementia and age of menopause in women with Down’s syndrome. J Intellect Disabil Res. 1999 Dec;43 ( Pt 6):461-5.

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Coppus AM, Evenhuis HM, Verberne GJ, Visser FE, Eikelenboom P, van Gool WA, Janssens AC, van Duijn CM. Early age at menopause is associated with increased risk of dementia and mortality in women with Down syndrome. J Alzheimers Dis. 2010;19(2):545-50.

Coppus AM, Evenhuis HM, Verberne GJ, Visser FE, Eikelenboom P, van Gool WA, Janssens AC, van Duijn CM. Early age at menopause is associated with increased risk of dementia and mortality in women with Down syndrome. J Alzheimers Dis. 2010;19(2):545-50.