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Menopause What is Menopause?
Symptoms: The symptoms of menopause are varied and can be broadly classified as: Psychological: 1. Anxiety and depression Somatic: 1. Headaches
For Hot Flushes it is better to avoid synthetic fibres with high necks. It is important to drink lots of water. Vitamin E supplements can also help. In case of Night Sweats avoid wearing nylon night dresses, and keep the temperature in your bedroom low. Keep sponges with a bowl of water near your bed. For Vaginal and Urinary Complaints it is better to use loose cotton underwear and avoid perfumed bath additives. For Muscle and Joint Pain regular exercise helps to strengthen muscles and makes you more agile. There are several who may suffer from facial and/or skin symptoms, like dryness, wrinkling and itching, etc, keeping the skin moisturised by using lotions and moisturising soaps will help. It is advisable to use regular sun protection. In case of sexual difficulty, which may be experienced in the form of less lubrication, use of vaginal lubricants help. Avoid douches and powders since they irritate the vagina. It will help if you spend longer time on foreplay prior to coitus. Insomnia can be one of symptoms of menopause. It helps to take a shower before going to bed. Reading a good book or listening to music can also help. Breasts should be regularly examined, at least once a month. Mammography should be done preferably one in three years. It is important to measure your weight, and size of waist and hips regularly since more weight around your waist increases the risk of heart disease. Regular exercise along with low fat nutritious diet will help keep your weight in check. Many suffer more from psychological symptoms. You can discuss your feelings with your partner. Joining a self-help group where you have active discussions on the symptoms you're suffering from is also helpful. Medical disorders related to Menopause: The fall in the level of oestrogen combined with natural aging increases the susceptibility of a woman to various illnesses.
a) Osteoporosis Osteoporosis: This is the most important health hazard for women who pass menopause. It is a silent disease characterized by thin weak bones. It may not have symptoms but it can lead to broken bones (fracture). It is estimated that 40% of women above the age of 50 are at a risk of developing an osteoporotic fracture during their lifetime. It is estimated that 1 in every 3 women in India over the age of 60 suffer a fracture due to osteoporosis. Bone mass reaches its peak around the age of 30 and thereafter begins to decline at a steady rate. Estrogen helps to absorb calcium from the blood into the bones and thus decreased Estrogen causes reduced bone density. For women with severe osteoporosis even a knock or a jolt is enough to cause a fracture. Osteoporosis can be prevented by regular bone densitometry to detect changes of osteoporosis earlier. Calcium-rich foods and calcium supplement after the age of 35 years will help. In cases of known osteoporosis regular physiotherapy and certain medicines like Calcium supplements, Vitamin D3, Raloxiphene and Tibolone should be taken after consulting your gynaecologist. HRT is the recommended choice of treatment for severe osteoporosis. Heart attacks and Strokes: Oestrogen has a cardio-protective effect and thus decrease in E2 level makes a woman more susceptible to heart attacks and strokes. Persons who are at a high risk of heart attacks and strokes are persons with high B.P., obesity, sedentary life style, smoking and stress. Regular exercise and avoiding high risk factor will help reduce them. Urogenital Ageing: Due to fall in the estrogen level the urogenital system thins, wears down and becomes prone to infections. This may cause dry itchy vagina, frequent urination and/or cystitis - which means pain during urination. The treatment for this is drinking plenty of oral fluids, use of lubricating jelly. For cases especially those of incontinence - pelvic floor exercises like Kegels exercises are extremely useful. Breast Cancer: This is the most common type of cancer in women and the leading cause of death in women between the ages of 35-50 years. Those women who have a family history of breast cancer, early onset of menstruation and late menopause, pregnancy at a later age and obesity with diet-rich fat are persons who are at a high risk for breast cancer. These persons must undergo annual mammography to detect it, so consult your doctor immediately for prompt treatment.
Since it is well known that most symptoms of menopause are caused due to decrease in hormone levels, external replacement of these hormones is the answer. HRT can be given in the form of: 1. Estrogen only These pills can be taken once a day for at least 3 weeks, every month. The decision of which pill to use is based on each woman's individual characteristics. For women, who have not undergone hysterectomy or removal of the uterus, progesterone is also given as it protects the uterus from the effects of excessive estrogen. HRT is recommended for a period of 2-3 years after which it can be stopped. In a large study undertaken by the Women Health Initiative (WHI), a comparative study was done to compare estrogen and progesterone and with estrogen only, in menopausal women. The study was conducted on 10,000 women taking Ethinylestradio (EE) + Medroxy Progesterone Acetate (MPA) for 5 years. There was an increase in the number of cases of breast cancer (9-10) 10,000 women and stroke (8-9) while there was a decrease in the number of cases of colorectal cancer (6-7 cases) and fractures (5-6 cases). Selective drugs can be given for various symptoms like: a) Hot flushes and mood swings - Estrogen and Progesterone Thus HRT is a freely available choice for all women suffering from symptoms of menopause. It is thus essential for these women to discuss the various drugs available, do a regular follow up, weigh the pros and cons, with their gynaecologist and thus enable themselves to lead a happier life. Other Therapies:
Nandita Palshetker Published on 31st October, 2002
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Complete cessation of the menstrual period is called menopause. The average age of menopause is 45-50 years. For many women, menopause can be a psychological, emotional and intellectual turning point in their lives but it does not have to mean a decline. As the function of the ovaries decline there are fluctuations in the levels of Estrogen and Progesterone which begin to decline, and this change can take months to years. Most of the symptoms are felt due to
withdrawal of Estrogen. It signifies the end of a woman's reproductive age.
Many women experience few or no symptoms while some are completely incapacitated by them. There are several simple measures you can take to relieve yourself of these symptoms.
The major disorders are:
Hormone Replacement Therapy
(HRT):
Recently plant-derived estrogens have been found to work in the body like a weak form of estrogen itself. They are found in cereals, vegetables, legumes or beans and some herbs. These are found to have a positive effect on the brain, bone and the cardiovascular system. At the same time these do not have excessive stimulatory action on the breast and uterus and thus protect from breast and uterine cancer. They are also beneficial in hot flushes, lowering cholesterol, improving skin and bone health.
