Menopause

 

This is a time in a woman’s life, usually between 45 to 55 years, when the ovaries stop producing eggs and menstrual period end. Menopause is considered to have set in, when a woman has no periods for a year.

There are several ways in which this happens. In some women, the periods start reducing in quantity of blood flow and longer cycles. In others there may be excessive bleeding, shorter cycles etc.

Due to decreased levels of estrogen, women have symptoms such as, hot flushes, night sweats, mood swings, sleep problems and vaginal dryness.

Normally, women do not have any need for treatment but sometimes, symptoms can interfere with quality of life and women seek treatment.

What is Peri-menopause?

This is a transition phase when periods start to change and can last upto 4 years. During this phase, women may have less bleeding or heavy bleeding. Periods may be irregular, shorter or longer cycles are experienced.

Symptoms of Menopause

  • Periods more or less often than usual
  • Lesser quantity of bleeding during periods
  • Miss one or more menstrual periods
  • Hot flashes which starts with a sudden feeling of heat in the upper chest and face and spreads throughout the body, lasting a few minutes. Sometimes, this is accompanied by sweating, followed by shivering and chills. It can occur once or twice a day and sometimes every hour. Triggers for hot flashes are spicy food, caffeine, alcohol or tobacco
  • Night sweats are hot flashes which occur at night. This prevents women from getting a restful slumber and leads to irritability, lack of concentration and mood swings.
  • Vaginal dryness occurs due to decreased levels of estrogen before and during menopause. This leads to pain during sex or urination
  • Mood swing and depression are common.
  • Hair fall and more hair on face
  • Susceptibility to urinary tract infections and increased urinary frequency

Complications of Menopause

  • Increased risk of osteoporosis
  • Increased risk of coronary heart disease
  • Increased risk of cancers, especially breast cancer
  • Urinary incontinence, especially stress incontinence
  • Obesity/ overweight

Treatment

Exercise: prevents weight gain, strengthens bones, improves mood and reduces cancer risks

Menopausal hormone therapy or hormone replacement therapy: estrogen is a safe, low risk option for hot flashes and can be given for upto 5 years. It is not recommended for women with a high risk of breast cancer, heart diseases and stroke. In menopause due to hysterectomy (removal of the uterus) only estrogen may suffice. In others, estrogen -progestin (a progesterone derivative) may be given. In addition to helping with hot flashes, hormones also help with vaginal dryness, and mood swings. In those with only vaginal dryness, an estrogen cream will suffice

Benefits of Hormone Replacement Therapy

  • Effectively manages symptoms
  • Prevents osteoporosis
  • Lowers colorectal cancers

Risks of Hormone Replacement Therapy

  • Raises breast, uterine and ovarian cancer risk
  • Raises the risk of coronary heart disease
  • Raises the risk of stroke

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