What is menopause?

Menopause is a natural stage in every woman’s life. It occurs when a woman stops having her monthly period and marks the end of her reproductive phase.

Every woman is born with a fixed number of eggs in her ovaries, which get depleted with each periodic monthly cycle. When all the eggs get exhausted, she enters a phase called menopause, which means “halting of the menstrual cycle”.

This process usually begins three to four years before periods actually stop. She feels hot flushes and experiences delayed cycles at intervals of two to six months. This phase is known as “pre-menopause”.

Periods usually cease when a woman is in her late 40s to early 50s. However, some women may have it earlier than their 40s, which is called “premature menopause”. This can be harmful to the woman and she requires additional supplements of external hormones to prevent heart and bone problems.

At times, if she continues to have periods even after 50 years of age — a phenomenon known as “late menopause” — she should undergo an assessment by a gynaecologist to check if there is any abnormality, such as fibroids, cancer of the uterus, or other pathology.

A woman may enter menopause suddenly when she undergoes the surgical removal of ovaries or chemotherapy for cancer, which is known as “surgical menopause”. Nowadays ovaries are not removed before 45 years during hysterectomy (removal of the uterus).

What are the symptoms associated with menopause?

Once the ovaries stop functioning, it has a deleterious effect on women at the heart and bone level. Each woman’s experience of menopause is different or unique. Some experience few or no symptoms, while others may suffer significant discomfort. Hormones secreted by the ovaries decrease, and symptoms occur.

The immediate symptoms are:

Hot flushes: Sudden sensation of heat in the body from chest to head, which is followed by sweating and shivering. These may last for a few months to 12 months.

Night sweats: Hot flushes that occur during sleep.

Insomnia: Difficulty in sleeping because of night sweats.

Vaginal dryness: Often the vagina becomes drier than normal due to the lack of vaginal secretions.

Mood swings: She may experience anxiety, irritation, and feel low.

Decreased sex drive: Because of decreased secretions, sex drive declines.

Stress incontinence (urine leak): Owing to loss of muscle tissue and thinning of tissues, there is involuntary loss of urine on coughing, laughing, or bending. Again, the urinary passage becomes more vulnerable to urinary infections.

Palpitations (increased heart beat): This is usually felt by many women. The heart beats rapidly.

What if menopause is left untreated?

The long-term effects of menopause, if left untreated, include:

Osteoporosis or brittle bones.

Coronary heart disease, caused by clogging of veins and arteries due to deposition of fat.

Prolapse of uterus: Uterine hernia.

How can women cope with menopause?

Symptoms of menopause can be effectively reduced by lifestyle modifications such as:

Deep breathing.

Doing exercise — walking, swimming, and jogging.

Taking vitamin E supplements.

Consuming soya foods, milk products, and sprouts.

Avoiding coffee and alcohol.

Keeping the bedroom cool and airy.

Showering before retiring to bed, or reading a book, or listening to music.

Practising yoga as a stress-buster.

Using water-based vaginal moisturisers for dry vagina.

Preventing osteoporosis by taking foods rich in calcium, such as low-fat food, green leafy vegetables, almonds, soya milk.

Daily exercises.

Avoiding high-fat, high-cholesterol diet to prevent heart diseases.

Avoiding smoking.

Annual check-ups by a gynaecologist.

Taking hormonal supplements in the case of premature and early menopause.

Using local hormonal creams, which are helpful for urinary leaks and frequent urinary infections.

What will happen if such lifestyle modifications are not carried out?

If these are not followed, a woman may suffer from:

Frequent bladder problems.

Leaky bladder.

Degenerative disease of brain: Alzheimer’s disease.

Vision deterioration — clouding of the lens.

Rapid weight gain.

Painful joints, osteoporosis and osteoarthritis.

Wrinkled skin and ageing.

What are the conditions and symptoms about which women should be aware so as to lead healthy lives?

Just a little awareness, regular check-ups by the gynaecologist, and lifestyle changes are all that are needed for a healthy postmenopausal life. These are enough to tide over menopausal symptoms or side effects and symptoms, and help women lead healthy lives.

There are certain conditions which a woman may face after her periods have stopped. The commonest conditions are:

Cancer of the cervix or cancer of the mouth of the uterus: This usually affects women after menopause and takes the form of vaginal bleeding or white discharge, or bleeding on contact with partner, or foul-smelling discharge.

A yearly liquid pap smear can detect it in the precancerous stage as it takes more than 18 years to develop. Early cancer of cervix is totally curable.

Ovarian cancer: The ovary may turn cancerous after periods have stopped in many women. It may produce a wide variety of symptoms such as heaviness of the lower abdomen, gastric symptoms like acidity and gaseous distension, the urge to pass urine at short intervals or inability to pass urine, loss of appetite, and difficulties in breathing.

Cancer of the ovary is a silent killer. To detect it early, one must undergo annual somography. Any woman who has a relative with breast cancer should have regular check-ups from 30 years of age onwards to ensure early detection.

Breast cancer: This also affects this age group. One must carry out self-examination of the breasts every month to ensure early detection.

Uterine prolapse: This is the sagging of the uterus. The uterus herniates down and remains outside the body. It should be surgically removed.

Nowadays, all surgical treatment can be carried out through microsurgery.