Menopause is natural biological process defined as occurring 12 months after your last menstrual period and marks the end of menstrual cycles. Menopause can happen in your 40s or 50s. The average age for menopause in Indian women is 48 years. Some women can experience menopause before their 40s, and the condition is known as premature menopause.
During menopause the production of the oestrogen and progesterone hormones by the ovaries to regulate the menstrual cycle start to decrease. Eventually, the ovaries stop producing eggs. This results in changes in the woman’s menstrual pattern and brings an end to her periods.
Symptoms
The period leading up to menopause is called perimenopause – during this time you may experience irregular periods, dryness of the vagina, sagging of the breasts, dry skin, thinning hair, slow metabolism, weight gain, hot flashes, night sweats, problems with sleeping, and mood changes. Not all women experience symptoms of menopause and may experience it to varying degrees.
Causes
Menopause is a natural process that takes place in every woman’s life as they reach their 40s or 50’s. There are some factors that can induce menopause at an early age. These include the following:
Cancer treatment: Chemotherapy (treatment with chemical agents) and radiotherapy (treatment by exposure to radiation) can cause menopause symptoms, and a temporary or permanent stop to menstruation.
Failure of ovaries: The ovaries may start producing less than normal amounts of reproductive hormones as a result of autoimmune diseases or genetic factors. This is known as primary ovarian insufficiency, and can lead to premature menopause.
Surgeries: Surgeries such as total hysterectomy (removal of uterus) and bilateral oophorectomy (removal of both ovaries) will immediately stop menstruation.
Complications
With the onset of menopause, the risk of certain medical conditions increases. Your risk for heart and blood vessel (cardiovascular) diseases increases with the decrease in oestrogen production. Heart disease is the leading cause of death in women as well as in men, so it is important to get regular check-ups and follow a healthy diet and lifestyle.
Your bone density may decrease, making them brittle and leading to a condition known as osteoporosis. This can make you more prone to fractures.
Your vaginal and urethral tissues will begin to lose their elasticity, and you may experience the sudden urge to urinate, or may lose control over your bladder (urge incontinence or stress incontinence). You may also become more prone to urinary tract infections.
The loss of moisture and elasticity of your vagina can cause discomfort during intercourse, and can affect your sexual desire (libido).
As the rate of your metabolism slows down, many women experience weight gain during the menopausal transition and after menopause.
When to see the Doctor
Starting at perimenopause, it is advisable to schedule regular visits with your doctor for preventive health care and any medical concerns. Preventive health care can include recommended screenings at menopause, such as a colonoscopy, mammography, lipid screening, thyroid testing if suggested by your history, and breast and pelvic exams.
Always seek medical advice if you have bleeding from your vagina after menopause.
Treatment
While menopause as such is not a disease and does not require treatment, some women may require treatment to control certain symptoms or complications, or to prevent or manage chronic conditions that may occur with aging. Treatments include:
Hormone replacement therapy: Depending on your personal and family medical history, your doctor may recommend treatment with hormones including oestrogen and/or progestin for relief from symptoms like hot flashes and loss of bone density. Hormone therapy may also help prevent cardiovascular problems if started within five years of your last period.
Vagina oestrogen: Small doses of oestrogen in the form of cream, pills, or rings can help you manage vaginal dryness, urinary symptoms and discomfort during intercourse.
Antidepressants: Low-dose antidepressants can help you manage hot flashes when hormone replacement therapy is not advisable for you, and will also help improve your mood.
Osteoporosis medication: Depending on your needs, your doctor may also prescribe medications to reduce your bone loss and risk for fractures.
Besides these treatments, it is advisable for women to take active care of their health – focusing on reducing stress, eating healthy, staying active with regular exercise and getting adequate sleep.