Managing menopause

Dr Aruna Tantia, Director, GPT Healthcare (Consultant Gynaecologist & Gynae Endoscopic Surgeon- ILS Hospitals) gives a rundown on the symptoms of menospause, its effects and ways to cope with it

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 fixed number of eggs in her ovaries which get depleted with each periodic monthly cycle. When all the eggs get exhausted, she enters into a phase called menopause – means ‘halting of menstrual cycle.’

The process usually begins three to four years before actual stoppage of periods. She feels hot flushes and has delayed cycles at two to six month interval. This phase is called as pre-menopause. Cessation of periods usually occur to a woman between late 40s and early 50s. However, some women may have it earlier than 40s, when it is called premature menopause. This can be harmful to her and she requires additional suppliment of external hormone to prevent heart and bone problems.

At times if she continues to have periods even after 50 years of age (late menopause), she should be assessed by a gynaecologist for any abnormality like fibroid; cancer of uterus or other pathology. A woman may enter menopause suddenly when she undergoes surgical removal of ovaries or chemotherapy for cancer, known as surgical menopause. Ovaries nowadays is not removed before 45 years during hysterectomy (hys=uterus, rectomy=removal).

Once the ovaries stop functioning, it has a delirious effect on women at the heart and bone level. Each woman’s experience with menopause is different or unique. Some experiences few or no symptoms while others may suffer significant discomfort. The decrease in hormone secreted by the ovaries often is attributed to the symptoms produced.

Immediate symptoms

• < Hot flushes: Sudden sensation of heat in the body from chest to head and is followed by sweating and shivering. These may be lasting for few months to 12 months.
• < Night sweats: Hot flushes occurring during sleep.
• < Insomnia: This is difficulty in sleeping due to night sweats.
• < Vaginal dryness: Often the vagina goes drier than normal due to lack of vaginal secretions.
• < Mood swings: One may experience anxiety, irritation, low down feeling.
• < Decreased sex drive: Due to decreased secretions, the sex drive decreases.
• < Stress incontinence (urine leak): Due to loss of muscle tissue and thinning up of tissues, there is involuntary loss of urine on coughing, laughing or bending. Also the urinary passage becomes more vulnerable to urinary infections.
• < Palpitations (Increased heart beat): This is usually felt by many women. The heart beats rapidly.

Long-term effects of menopause untreated

• < Osteoporosis or brittle bones
• < Coronary heart disease: Due to clogging of veins and artery by fat deposition.
• < Prolapse of uterus: Uterine hernia

Coping with menopause

Menopause symptoms can be effectively reduced by lifestyle modifications like:

• < Deep breathing
• < Exercise – Walking, swimming and jogging
• < Vit-E supplements
• < Soya food, milk products, spouts
• < Avoid coffee, alcohol
• < Keep bedroom cool and airy
• < Shower before retiring to bed or read a book, listen music
• < Practice yoga as a stress buster
• < Use vaginal water-based moisturiser for dry vagina
• < Prevent osteoporosis by taking food rich in calcium, like – low fat food, green leafy vegetable, almonds, soya milk
• < Do exercise daily
• < Avoid high fat cholesterol diet to prevent heart disease
• < Avoid smoking

Besides these one should also go for

• < Well-woman check-up yearly with a gynaecologist
• < Hormonal supplement in premature and early menopause
• < Local hormonal creams are helpful for urinary leak and frequent urine infections

All these are enough to tide over menopausal symptoms or its side effects to help one lead a healthy life. Not following these measures may cause:

• < Frequent bladder problem
• < Leaky bladder
• < Degenerative disease of the brain – Alzhiemer’s disease
• < Vision deterioration – clouding of lens
• < Rapid weight gain
• < Painful joints, osteoporosis and osteoarthritis
• < Wrinkled skin – ageing

There are certain conditions which a woman may face after her periods have stopped. One should be aware of these conditions and the symptoms so as to reach the doctor early.

The most common symptoms are Cancer cervix or cancer of mouth of uterus: This usually affects women after menopause and presents in 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 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 menstruation have stopped in many. It may produce a wide variety of symptoms like heaviness in the lower abdomen, gastric symptoms like acidity, gaseous distention, desire to pass urine at short intervals or inability to pass urine, loss of appetite, difficulty in breathing. Ovary cancer is a silent killer. To detect it early one must undergo yearly ultra-sonography. People with relatives who have had breast cancer should have regular check ups to detect it early from 30 years of age.

Breast cancer: It also affects this age group. One must do self examination of breast every month to detect it early.

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

Nowadays, all surgical treatment can be done by micro-surgery. So just a little awareness, regular check up and change in lifestyle is all you need for a healthy postmenopausal life.

After all life begins at 40! Start enjoying.