Life at and after menopause
PROF DR HAMIDA BEGUM
As one third of womens life passes after menopause and it is the most productive part of life, so women at their menopause deserve best counselling as well as treatment if needed.
Just as a carefree toddler at age 11-14 reaches adolescence with physical, mental psychological changes because of hormones sprouting inside her body, similarly at age 45-50 body behaves some retrogressive changes. So, menopause is that period of womens life when she stops menstruations and at the same time some physical, mental and psychological changes occurs in her body mind. Exact age of menopause varies due to geographical variation, stature of her body and life style she is leading from 49-51 with average of 51.2 years.
Why all these happen
Oestrogens and Progesterone are the two female sex hormones secreted from female sex gonads (Ovaries) from age 11-14(onset of puberty) to age 45-50 after that they gradually give up their functions (period of Climacteric) followed by complete stoppage of menstruation (Menopause).
So, without assistance of these hormones the whole body including her reproductive organs undergo changes which has some physical, mental psychological manifestations.
Physical changes
She gradually gains weight, skin becomes rough, thick wrinkles (looses its elasticity texture) also sometimes she loses appetite. Some suffer from typical symptoms of Hot flash or palpitations (sudden warming up of body with sweating or cold shivering specially over face, chest), problems of having sex (atrophic vaginitis -genital organs shows atrophy), arthralgia (Joint pain), Increased frequency of micturition, all these can make her a bit agitated.
Mental changes
She becomes easily irritated, tensed, stressed without any provocations,depressed or distracted mind along with various mood swings. Some also can have headache constipation.
Psychological changes
Some women think that stoppage of menses means life finished, feminity ends they willloss their husbands love affections superadded false belief that this is the time that every organ will develop cancer (Cancerophobia) makes their life a little bitmiserable. They develop insomnia (trouble sleeping ), heart problems, high Blood pressure, diabetes, atherosclerotic changes, bones becomes fragile(Osteoporosis) history of fractures on minor trauma.
How to manage
Most important part to manage this group of women is
reassurace by proper counselling.
There are gradual steps to make them understand Menopause is just one kind of change of events of life but not end of life.
Three steps to follow
1st step
Education about simple minute things like take adequate exercise (aerobics can help),avoid consumption of too hot drinks (tea, coffee) or avoid hot shower specially those suffer from hot flash rather drink plenty of water, fresh fruits, vegetables, vitamin E and or D, calcium, small fishes with bones all these can ease their life to a greater extent. At the same time avoid too much oily and fried food.
2nd step
If not relieved then may need some sedatives/tranquillizer for sleep problems, some B blockers can give promising results. Those who have DM or high BP or thyroid problems needs control by proper medications.
3rd step
When problems are so intense so as to interfere her life she might need some HRT(hormone replacement therapy) under instructions of a qualified health care personal as all those some side effects, contraindications . So she needs proper follow up.
Those Uterus present: low dose oestrogen with last 10 days supplements by progestogens. Those with uterus operated only with oestrogens in oral, local cream or patch form.
Those with bone weakness or osteoporosis can be benefitted by SERM (selective oestrogen receptor modulators).
As one third of womens life passes after menopause and it is the most productive part of life, so women at their menopause deserve best counselling as well as treatment if needed.
The writer is clinical
professor
Widad University College
Kuantan, Pahang
Malaysia
