MENOPAUSE- ALAS!! IT ENDS, BUT IS IT THAT EASY?

Lila is a 46yrs old woman living in Mumbai, India. She has both sons away from home for their higher education and now she wants to give time for her hobbies and interests, also she is looking forward to spending some quality with her husband.

But the last few months have been very irritating and depressing for her. She has irregular periods, and when she has periods those are very painful with either heavy or no blood flow. Along with this she also has frequent mood swings with anxiety, irritation, anger. Due to such irritable behavior, there have been clashes between the spouses. All of this leads her to feel depressed, questions her self-image, and also makes her feel lonely.

 What is menopause?

“Leaders bleed, period.”
― Silvia Young

A woman’s body is one of those creations that have to go through various changes across the lifespan. Right from menarche during puberty, to pregnancy during adulthood, and finally menopause. The above-mentioned example illustrates the common behavior of women in their menopausal stage.

Menopause is a natural biological process. Menopause is the time that marks the end of your menstrual cycle. It’s diagnosed when a woman doesn’t have periods for 12months. Menopause mainly occurs in women between age 40 to 55, this average can change from region to region.

Menopause is a transitional phase that includes many physical changes and emotional/psychological imbalances that mainly occur due to hormonal imbalance. But for when does it start and for how long, we will see next.

 How long does it last?

Most women start experiencing menopausal symptoms a couple of years before their last period. For some women, menopause might be sudden, for others, these symptoms occur just a few months before their last period.

But it is important to know that before the actual menopause, there is a sort of preparatory phase. In this phase hormone level change to prepare the body for menopause which is known as ‘Perimenopause’.

Menopause usually starts in the early ’40s for many women, but there are individual differences in Perimenopause and menopause. Some women enter Perimenopause followed by menopause while others might skip the first stage and directly enter menopause. Some factors such as genetics, lifestyle, and culture are responsible for this phase.

 How do I know that this is Menopause?

 

There are some physical and psychological changes that mark menopause, it includes-

• Physical Symptoms –

• Lack of Sleep
• Vaginal Dryness
• Weight Gain
• Reduced Sexual Desires
• Tender/Sore breasts
• Loss of Hair
• Hot Flashes
• Reduced Bone-mass(osteoporosis)

• Psychological Symptoms –

• Depression
• Anxiety
• Memory problems
• Irritability
• Loneliness
• Frequent mood swings

These are the changes that occur among women in the menopausal phase which affect their daily life at the personal, family, and even societal level. Along with this, there are also some difficulties that can occur as a result of menopause.

Complications due to menopause –

Similar to the changes during menopause, there are some changes that occur post-menopause. These changes are the most severe physical side-effects of reduced hormone level, which include –

•  Heart & Blood Vessels (Cardiovascular diseases) –

During the phase of menopause, there is a decline in the estrogens level which increases the risk of cardiovascular diseases. This is because estrogens act as a guard for controlling blood pressure.

• Osteoporosis –

During the first few years of the menopausal phase, there is a loss of bone density. The saturation of calcium starts to reduce due to which there is a high risk of osteoporosis. Osteoporosis is a medical condition where bones become brittle and weak, which increases the risk of fractures and breaking of bones. This is a very common condition among women during and after menopause.

• Urinary Incontinence –

Similar to the vagina, the urethra loses elasticity causing frequent and strong drives to urinate. But in actuality, there is no or less urine discharge. This could be followed by an involuntary loss of urine or loss of urine when coughing, laughing, or lifting.

• Sexual Dysfunction –

As mentioned earlier, during menopause the moisture in the vagina decreases. Due to the reduced lubrication and elasticity, the vagina becomes dry. This can lead to discomfort and slight bleeding during sexual intercourse. Also, there are reduced sexual desires during this phase.

Reasons behind menopause – 

Every bodily change is associated with a certain reason; similarly, menopause also occurs due to some reason, which includes –

•  Menopause as mentioned earlier is a natural process occurring during a particular stage in every woman’s life. This process is associated with various changes in the hormone level, leading to reduced functioning of sexual organs.
• Every woman’s body releases reproductive hormones such as estrogens, progesterone, and follicle-stimulating hormone. These hormones are responsible for various reproductive processes such as periods, conception, releasing of the egg cell, menopause, etc.
• These hormones also help women by protecting them from various medical conditions such as heart diseases, stress management, etc.
• The production of these hormones is high in early life but reduces gradually due to which the body of a woman has to go through many changes which also includes cessation of periods. This phase is known as menopause.
• In this phase along with reduced hormone level, egg cells are also released irregularly till finally the release is stopped leading to the cessation of the menstrual cycle. This also marks the end of the natural reproductive phase of a woman’s body.

Is Medication necessary in this phase?  

• Medication is not necessary for many women because they are able to handle these changes. But it is better than every woman entering their 40’s should consult a gynecologist and get a check-up done. Also, women of this age who have started with irregular menstruation should consult a doctor. So the later possibility of having a health issue is reduced because during the phase of menopause as a result of hormonal changes there can be deficiencies of various vitamins and minerals.
• Medication other than supplements is not necessary for all except the ones who have severe symptoms that make it unable to for them to carry out their daily task. Also, if there is a previous history of some reproductive medical condition then it is better to be consulted.

Home remedies and Lifestyle Changes – 

More than medication women need love, care, support, and some lifestyle changes as mentioned below-

• Keep cool & stay comfortable- 

Hot flashes, anxiety, irritation are some of the common changes that occur during this phase. Handling these changes is not easy so it is important for women to adjust to these changes and try to feel comfortable and also try being calm and cool when having hot flashes, irritated or angry. Meditation and regular practice of managing emotions could be key for good life.

• Exercising and managing weight-

Regular exercise and meditation act helpful in managing these changes. Also, the weight gain during this phase is natural but if not controlled can increase future complications hence it is suggested to exercise.

• Communicating your needs-

Women experience a lot of physical and psychological changes during this phase. Hence, it is important that women clearly communicate with their family and friends their state of mind so as to give them insight into your situation and avoid interpersonal conflicts.

• Supplementary diet-

As mentioned earlier due to hormonal changes there are chances of vitamin and mineral deficiency which can be fulfilled by having nutritious diet.

• Manage Sleep-

Sleep disturbances are common for both gender during their late adulthood but it is important to work consciously for having a sound sleep. Music, reading, walk, talk, or any other activity that can calm the mind and body could be helpful here.

• Avoid smoking and drinking-

There is a lot of physical and psychological stress that there could be indulgence in smoking or drinking but it is important to avoid it because this can have worse effects on the body during this phase.

A note on menopause and Mental Health – 

Menopause is a very significant phase of a woman’s life where there is a lot of inner struggle and support from the family could just help soothe this phase.

It is the responsibility of every family member that women during this phase are provided with emotional support, given the freedom to explore and understand themselves. Family plays an important role to maintain the mental health of women in this phase because there is a lot of emotional disturbance in her mind but if the family is unable to understand and adjust to this and on the contrary discards her issues it can create a deep impact on her mental health.

“Menopause is the phase where the nurturer has to be nurtured”.

https://www.nia.nih.gov/health/what-menopausehttps://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397#:~:text=Menopause%20is%20the%20time%20that,is%20a%20natural%20biological%20process. https://www.healthline.com/health/menopause#complications https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051232/#:~:text=Average%20age%20of%20menopause%20of,married%20status%2C%20and%20parity%20status.