Menopause is the time when a woman is no longer able to bear children. It is marked by the end of her menstrual periods. Menopause can occur at any age, but it is most common at the age of 50 and above. Menopause is a natural biological occurrence, but it can have physical and emotional symptoms that may last for months or even years and which, in some cases, may affect a woman’s ability to function and carry out normal activities. It can also have a negative impact on her relationships, professional life and sense of well-being.

The Three Stages of Menopause

Menopause does not happen overnight. It is a gradual process that takes years and it can be divided into three distinct stages.

• Perimenopause (Menopause Transition): This often starts to occur between 8 to 10 years before actual menopause as the ovaries begin to produce less of the hormone estrogen. In the early stages, there may be no significant symptoms and the menstrual cycles and ability to become pregnant may not be significantly impacted. In the last year or two of this stage, while the menstrual cycles continue, the symptoms of menopause begin to appear.
• Menopause: This is the stage when the menstrual periods completely stop. The ovaries no longer release eggs and the production of estrogen also ends. Because the menstrual cycle may be disrupted temporarily due to various physiological and psychological reasons, a doctor will normally diagnose menopause when menstrual periods are absent for 12 consecutive months.
• Post-Menopause: Once a woman has not had her menstrual periods for a full year and no other reasons have been found for this, she has entered the post-menopause phase. During this phase, menopausal symptoms such as hot flashes may decrease, but in some cases, the symptoms may continue for some years. Because of the lower levels of estrogen, there is an elevated risk of heart disease and osteoporosis.

The Symptoms of Menopause

There are many symptoms associated with the onset of menopause. Among the common ones are:

1. Hot flashes – a sudden sensation of warmth spreading over the body.
2. Cold flashes – the reverse of hot flashes.
3. Irregular periods.
4. Periods that may be lighter or heavier than usual.
5. Night sweats – waking from sleep covered with perspiration.
6. An increased frequency of urination and at times, the sudden onset of the desire to urinate.
7. Vaginal dryness that makes sexual intercourse uncomfortable.
8. Dryness of the eyes, mouth and skin.
9. Insomnia.
10. Premenstrual syndrome (PMS) becomes worse.
11. Breast tenderness.

Other symptoms include:

1. Bouts of heart palpitations.
2. Joint and muscle pain.
3. Headaches.
4. Change in the sex drive (libido).
5. Memory loss or difficulty in concentration.
6. Hair loss.
7. Weight gain.

Some women may have few or even no symptoms, while others may experience some or most of them in varying degrees of intensity.

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Diagnosing Menopause

In most cases, the overt symptoms of menopause are enough to confirm the onset of the condition. However, because irregular periods, hot flashes and other symptoms of menopause may have other causes, it is best to have the onset of menopause confirmed by a doctor. If there are any doubts, a blood test or other tests may be ordered to confirm the diagnosis.

Treating Menopause

Menopause is not a disease or sickness that requires medical treatment. However, this natural occurrence may cause symptoms and conditions that could affect quality of life and well-being. When the impact goes beyond the physical effects and impacts relationships and social and personal life, a doctor may prescribe various treatments to alleviate the symptoms. These may include:

• Hormone Therapy: Doses of estrogen may be prescribed to alleviate the impact of the body stopping its natural production of this hormone.
• Vaginal Estrogen: The direct application of an estrogen cream to the vagina can alleviate the problems of vaginal dryness and could also help with relieving the pain of urination.
• Antidepressants: If menopausal-related depression is severe, antidepressants may be prescribed to bring mental equilibrium.
• Other Specific Medications: Depending on the nature of each case, specific medications may be prescribed to control symptoms.
• Medications to Treat or Prevent Osteoporosis: Because osteoporosis is such a common post-menopausal problem, vitamin D and other supplements and medications for the condition may be prescribed.

In addition, there are various lifestyle and home remedies available. It is advisable to discuss these with a doctor before starting them.

1. Keeping a record of when hot or cold flashes start will help pinpoint triggers so that they can be avoided. Specific foods, activities or social situations are common triggers.
2. Using over-the-counter vaginal lubricants will help reduce discomfort.
3. Getting enough sleep will strengthen the body’s energy to counter the symptoms.
4. Meditation and relaxation techniques can help alleviate the stress and discomfort that come with menopause.
5. Exercises that strengthen the pelvic floor will relieve the problems of urinary incontinence.
6. Eating a healthy and balanced diet will help boost immunity levels and increase the body’s ability to mitigate the symptoms of menopause.
7. Tobacco use (in any form), alcohol consumption and recreational drug use will weaken the metabolic system and may make the symptoms of menopause worse and hence should be avoided.

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Also Read: Vaginal Discharge - When Should You See A Doctor

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Although menopause is a natural process, the symptoms can often be severe and the effects of these could lead to other physical or mental problems. If a woman has been having regular gynecological checkups at a multispecialty hospital where the most modern examination, diagnostic and treatment options are available, along with the best gynecologists, her doctors will be able to anticipate the onset of menopause and will help her prepare for the changes that will come. If there is a doubt about the symptoms being those of menopause, it is best to go to the same type of multispecialty hospital to have access to the best doctors and medical technology to confirm the diagnosis and plan the course of treatment to minimize discomfort and side-effects.

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