Prof. (Dr.) Subhas Ch. Biswas

Menopause

Menopause is defined as occurring 12 months after your last menstrual period and marks the end of menstrual cycles. Menopause can happen in your 40s or 50s, but the average age is 51.

Menopause is a natural biological process. Although it also ends fertility, you can stay healthy, vital and sexual. Some women feel relieved because they no longer need to worry about pregnancy.

Even so, the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or — for some women — trigger anxiety or feelings of sadness and loss.

Don't hesitate to seek treatment for symptoms that bother you. Many effective treatments are available, from lifestyle adjustments to hormone therapy.

Causes:

Estrogen regulates menstruation, while progesterone is more involved with preparing the body for pregnancy.

When the ovaries start producing less of these two hormones, perimenopause will begin. In fact, by the time a woman is in her late 30s the ovaries start producing less progesterone and estrogen. A woman's fertility starts to decline a long time before she may notice any menopausal or perimenopausal symptoms.



As time passes and the ovaries produce less estrogen and progesterone, the ovaries eventually shut down completely, and the woman no longer has any more menstrual periods. The vast majority of females experience a gradual change in menstrual activity, while some go on normally until they stop suddenly.

Some women may experience premature menopause - their ovaries fail earlier than they are supposed to (before the age of 45). Although rare, ovarian failure can occur at any age. Premature menopause may be caused by a number of factors, including:

• Enzyme deficiencies
• Down's syndrome
• Turner's syndrome
• Addison's disease
• Hypothyroidism
• Removal of the ovaries (bilateral oophorectomy surgery)
• Radiotherapy to the pelvic area
• Chemotherapy
• Hysterectomy surgery (the uterus - womb - is surgically removed)

Symptoms

Experts say that technically, menopause is confirmed when a woman has not had a menstrual period for 1 year. However, the symptoms and signs of menopause generally appear well before that 1-year period is over. They may include:

1) Irregular periods
This is usually the first symptom; menstrual pattern changes. Some women may experience a period every 2-3 weeks, while others will not have one for months at a time.




2) Lower Fertility
During the perimenopausal stage of a woman's life, her estrogen levels will drop significantly, lowering her chances of becoming pregnant.


3) Vaginal Dryness
This may be accompanied by itching and/or discomfort. It tends to happen during the perimenopause. Some women may experience dyspareunia (pain during sex). The term "vaginal atrophy" refers to an inflammation of the vagina as a result of the thinning and shrinking of the tissues, as well as decreased lubrication, caused by a lack of estrogen.


4) Hot Flashes
A sudden feeling of heat in the upper body. It may start in the face, neck, or chest, it then spreads upwards or downwards (depending on where it started). The skin may redden and become patchy, and the woman typically starts to sweat. The heart rate may suddenly increase (tachycardia), or it might become irregular or stronger than usual (palpitations). Hot flashes generally occur during the first year after a woman's final period.


5) Night Sweats
If the hot flashes happen in bed, they are called night sweats. Most women say their hot flashes do not last more than a few minutes.




6) Disturbed Sleep
Sleeping problems are generally caused by night sweats, but not always. Sleep disturbance may be caused by insomnia or anxiety. Difficulty falling asleep and staying asleep increase as women go through menopause.


7) Urinary Problems
Women tend to be more susceptible to urinary tract infections, such as cystitis. Urinary frequency may increase as well.


8) Moodiness
Moodiness often goes hand-in-hand with sleep disturbance. Experts say that most mood changes are triggered by poor sleep.




9) Problems Focusing and Learning
Some women may also have short-term memory problems, as well as finding it hard to concentrate on something for long.


10) Other symptoms of menopause can include:
• More fat building up in the abdomen
• Hair loss (thinning hair)
• Loss of breast size