Menopause is a phase in a woman's life when ovarian function declines. This culminates in the periods stopping completely and is said to be established when the woman has no periods for 12 months continuously.
When do women attain menopause?
The average age at menopause is 52 and is slightly lower in the Indian subcontinent at 48 years of age. Women who go through the menopause before the age of 40, will need hormone replacement therapy to protect their future health and women who are still bleeding over the age of 54 need medical attention to rule out pathology such as cancers.
What are the common symptoms during Menopause?
Most women experience vasomotor symptoms - hot flushes and night sweats, which can be quite uncomfortable and quite easily treated. These symptoms can sometimes start before the actual menopause itself.
Urogenital symptoms such as vaginal dryness, discomfort, Urinary urgency and incontinence are very common.
Women find other symptoms such as Loss of drive, Low mood,
Loss of libido and increased weight gain very distressing too.
What are the long-term effects of menopause?
Estrogen commonly protects the bones and the heart. Due to a lack of this hormone, this protective effect is lost and women are therefore prone to Heart disease and weak bones.
It is a common misconception that menopause causes cancer but it is not wholly the case and the major risk factor that is associated with increased incidence of cancer during this period is age rather than the lack of hormones.
Do all women need Hormone replacement (HRT) during this period?
No - all women who go through menopause do not need HRT. If they have significant symptoms like those mentioned above, if their ovaries are removed surgically at a young age and if they undergo premature menopause before the age of 40, then HRT is indicated
Does HRT cause cancer?
Diligent use of HRT does not cause cancer. Long-term improper use without strict medical supervision can increase the risk of breast and uterine cancers.
Is occasional bleeding during this period common?
No - once women have had no bleeding for a minimum of 6 months, any bleeding, be it even spotting, needs an assessment and is suspicious of cancer. Commonly an examination and Ultrasound scan is required as soon as possible to find the reason for this bleeding.
Can women stop having Pap smears and mammograms after they go through the menopause?
Definitely not - one needs to continue having these screening tests to enable early detection of any changes in the breast and cervix that can become cancer.
What precautions or lifestyle changes does one need to implement during menopause?
Maintain an ideal body weight and avoid weight gain.
Watch your diet and Exercise regularly.
Keep a close check for lifestyle diseases such as Hypertension and Diabetes.
Have regular medical checks and maintain optimum health.
Manage stress efficiently.
Article by Dr. Vaishnavy, MD, MRCOG, DFSRH
Consultant Gynaecologist and Uro-gynaecologist
Kauvery Hospital, Chennai