Menopause

The meaning of the word menopause in women is the permanent stopping of menstruation.

The female hormone namely estrogen produced by the ovaries is responsible for the cyclical menstrual bleeding in women. Menopause starts because of a decline of ovarian function due to age, surgery, or any ovarian disease and so the estrogen produced by the ovaries is no longer available in a woman s body leading to all menopausal symptoms.

The word menopause in women implies a lot of relief for some while it is one of the most dreaded things one can have in her life. Because for some, cyclical menstrual bleeding signifies youthfulness and feminity. Apart from that menopause may be accompanied by not only hormonal and body changes but also stressors like caring for or death of elderly parents; empty nest syndrome when children leave home or the birth of grandchildren which displaces you to the category of senior people..

Menopause

Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.

If a woman is aged over 45 years and has not had a period for at least 12 months, or has menopausal symptoms like hot flashes, mood swings etc;  this is adequate information to diagnose menopause and perimenopause respectively. Blood tests like FSH are used when menopause is suspected prematurely or before 40 years. Sonography may confirm small uterus and ovaries.

Average menopause age is between 49 to 52 yrs.

Usually your menopause age is  determined by the age at which your mother or sisters or maternal grandmother attained menopause.

Menopause age varies in different regions like:

44 years in India and Philippines

51 years in the United States

52 years in the United kingdom

50 years in Ireland

In rare cases, a woman’s ovaries stop working at a very early age of less than 40. This is known as premature ovarian failure  leading to premature menopause and  it affects 1 to 2% of women .

What are the four stages of menopause?

What Are the Stages?

  • Pre-Menopause Stage: During this menopause stage, You will have regular menstrual cycle, is in her prime childbearing years and has no noticeable symptoms of menopause.
  • Perimenopause: Your cycles will become irregular, but they haven’t stopped. Most women hit this stage around age 47. 
  • Menopause: This is when you’ll have your final menstrual period.
  • Post-Menopause: This begins when you hit the year mark from your final period.

Menopause is a natural process. Menopause Treatment depends on  its severity The aim of menopause treatment is to focus on symptomatic relief.

Vaginal dryness :

It is treated with topical lubricants or oestrogen.

Lack of lubrication is a common problem during and after perimenopause. Vaginal moisturizers and lubricants can help women with overall dryness especially aggravating during sexual intercourse..

Low-dose vaginal estrogen products such as estrogen creams  are used to help vaginal thinning and dryness problems also known as vaginal atrophy    . The advantage of local estrogen application is that it minimally increases the levels of estrogen in the blood stream.

Hot flushes

Medications can reduce the severity and frequency of hot flushes.

   Lifestyle measures such as

drinking cold liquids,

avoiding hot flashes triggers such as hot drinks, spicy foods, etc;

staying in cool rooms,

using fans,

removing excess clothing,

and., may partially help

  • Osteoporosis or brittle bones : It can be minimized by smoking cessation, adequate calcium and vitamin D intake and regular weight-bearing exercise.
  • Oral hormone therapy  or HRT( hormone replacement therapy )may be used in special situations.
  • Psychological counseling or support groups can sometimes be helpful to handle sad and depressed feelings women may be having as they pass through what can be for some a very challenging transition time.
  • Latest advances in menopause treatment:
    • Stem cell therapy which uses your own bone marrow cells which can be transplanted into the ovary in order to regenerate its cells and functioning. But it will still take time and further studies to determine how safe and effective stem cell treatment is for restoration of ovarian functioning.

1. Connecting with support systems

It is important you talk to other women who are also undergoing menopause so that you can receive empathy and feel more relieved. By joining support groups you open the doors for your emotions to come out thus not only discussing your views with other women but also gaining knowledge about how they feel which might give you the answers to questions you may not be even aware of.

2. Preventing vaginal discomfort

Vaginal discomfort can arise out of dryness. This can be prevented by using an over-the-counter lubricant which can either be water-based or silicone-based. Your gynecologist may prescribe you a cream containing estrogen which will reduce dryness symptoms.

3. Prescription-based medicines

There are many medicines that when prescribed by your gynecologist can help to manage your menopause symptoms well such as estrogen treatment which contains estrogen in the form of a pill/cream/gel form. Anti-depressants like sertraline, fluoxetine, or venlafaxine which belong to SSRIs and SNRIs may be used judiciously by your doctor to manage mood swings and even hot flashes. Another medicine called gabapentin has also been shown to improve hot flashes.

4. Exercise 

You can start exercising daily with moderate activity. This helps in

  • More Energy
  • Feeling Fresh
  • Promoting Overall Health

Exercising also helps you prevent lifestyle diseases like hypertension, and diabetes and keep your body active throughout the day. Kegel exercises that strengthen your pelvic floor muscles can definitely help to deal with some forms of urinary incontinence.

5. Sleep 

It is recommended at least 8 hours of sleep daily. If you are suffering from insomnia then talk to your doctor for treatment who may prescribe you melatonin supplements for better and sound sleep.

6. Diet 

Things you should eat You can include foods that have phytoestrogens (isoflavones) in them such foods include soybeans, chickpeas, lentils, grains, beans, fruits, and vegetables. You can try the herb sage which is proven to show estrogen-like effects due to the compounds in it showing estrogen-mimicking activity. Eating high-quality protein will help reduce muscle mass loss and also reduce risk of fractured hips, protein can be obtained from legumes, dairy products, eggs, and meat. Eating fruits and vegetables provide you with anti-oxidants and minerals, vitamins as well as fiber. Seeds like flax seeds, chia seeds, hemp seeds, and fish like tuna, salmon, and mackerel provide you with healthy fats that are omega-3 fatty acids. Dairy products like cheese, milk, and curd give you Vitamin D and Vitamin K along with magnesium. Things you should avoid to eat Avoid spicy foods, foods that are loaded with high salt like processed foods which increase the risk of developing hypertension, and also foods that contain high sugar which can cause elevated levels of blood sugar thus leading towards insulin resistance, etc. Avoid excessive intake of caffeinated drinks.

7. Relaxation methods 

These include deep breathing, paced breathing, guided imagery, massages, and progressive muscle relaxation can also help with menopause.

8. Alcohol and smoking

These two habits only do to make your symptoms more aggressive thus increasing your discomfort and pain. Alcohol can promote dehydration which can also lead to dry skin. Put a brake on them at once, smoking even secondhand is not good at all and it also increases your risk of cancer.