Menopause is that time in a woman’s life when periods stop permanently. This is a retrospective diagnosis and a woman is said to have reached menopause if she has not had any vaginal bleeding, including spotting, for a full year after her last period. If her mother or an elderly woman at home is going through this stage of life, she should inform them about effective ways to manage menopause.
The average age of menopause in India is 47 years, compared to the West, where it is 51 years. However, in recent times, women in India are also going through menopause at a later stage, around their fifties.
For many women, the absence of periods is a great relief, especially if they have been suffering from heavy and painful periods. Along with this, however, come the not-so-pleasant symptoms.
What are the symptoms of menopause?
Menopausal symptoms can start suddenly and be very noticeable, or they can be transient and mild. They can start about 6 years before menopause and continue for several years after menopause.
The symptoms are:
1. Irregular menstrual periods.
2. Heavy or light periods
3. Hot flashes: feeling hot and sweaty even in cold temperatures
4. Weight gain and swelling
5. Mood swings, insomnia and depression
6. Vaginal dryness and loss of libido
7. Frequent urination, higher incidence of urinary infection, urinary incontinence
8. Loss of balance and increased frequency of falls
The other changes include loss of bone density, leading to brittle bones and an increased risk of fractures, especially hip fractures. During this period, the risk of heart attacks and strokes also increases due to decreased levels of the hormone estrogen.
What can be done to manage menopause?
The goals of menopausal management are:
* Hot flash relief
* Reduce the risk of diseases
* Improve Life Quality
What is hormone replacement therapy and how does it help?
This is the most widely used pharmacological treatment for the treatment of menopause. It can help relieve menopausal symptoms such as hot flashes, night sweats, mood swings, vaginal dryness, reduced sex drive, and help prevent osteoporosis.
Types of hormone replacement therapy (HRT)
Hormone replacement therapy includes the hormones estrogen and progesterone. Estrogen can be used only if the woman has had a hysterectomy. Estrogen and progesterone are used in combination if the uterus is intact. Estrogen therapy (with or without progesterone) is the best treatment for hot flashes and night sweats. It also helps relieve vaginal dryness and protects against bone loss. These medications are available in the form of tablets, gels, patches, implants, and vaginal inserts such as cream, ring.
Side Effects of Hormone Replacement Therapy for Women Reaching Menopause
* Breast tenderness
* Vaginal bleeding – monthly or irregular
* Abdominal pain
What are the risks of Hormone Replacement Therapy?
The benefits of this therapy generally outweigh the risks for most women. The risks are usually very small and depend on the type of therapy, the length of therapy, and individual health risks.
1. Breast cancer
There is little or no change in breast cancer risk if you take estrogen-only HRT. Combined HRT may be associated with a small increased risk of breast cancer. The increased risk is related to the duration of HRT and decreases after stopping it. Due to the risk of breast cancer, regular breast cancer screening is especially important if you are taking HRT.
2. Blood clots
Evidence shows that: there is no increased risk of blood clots with HRT patches or gels; however, taking HRT tablets may increase your risk of blood clots, but this risk is still small.
3. Heart disease and stroke
HRT does not significantly increase the risk of heart disease and stroke if started before the age of 60. In fact, you can lower your risk. Taking HRT tablets is associated with a small increased risk of stroke, but the risk of stroke for women under the age of 60 is generally very low, so the overall risk is still small.
Who should avoid Hormone Replacement Therapy?
Women with a history of:
* Breast cancer/ovarian cancer/uterine cancer
* blood clots
* Heart attack, stroke, or increased risk of vascular disease
* liver disease
* Untreated high blood pressure
Is tibolone good for menopause control?
This is similar to combined HRT. It is suitable for women who have had their last period for more than a year. The risks of tibolone are similar to those of HRT.
Non-hormonal drugs like “Selective Estrogen Receptor Modulators” (SERMS) act like estrogens in some parts of the body and anti-estrogens in others. They are very helpful in improving bone density and can reduce the risk of fractures. However, they do not relieve hot flashes. Newer SERMs are available that help reduce hot flashes and night sweats.
Alternative medications, such as plant estrogens, include isoflavones and lignans. These are found in soybeans, lentils, chickpeas and other legumes. However, it remains to be shown whether they help relieve menopausal symptoms. Similarly, bioidentical hormones, black cohosh, yoga, acupuncture, and hypnosis are recommended for symptom control, but their efficacy is not medically proven.
Lifestyle Changes Women Should Make to Manage Menopause
You can choose to make these lifestyle changes during menopause:
* Dress in cottons.
* Have a glass of cold water and find a cooler place to go.
* Avoid hot drinks, caffeine, stress, spicy food, alcohol, hot rooms, and hot weather.
* Eat a balanced diet and drink at least 2.5-3 liters of water per day * Include calcium and vitamin D supplements in your diet
* Exercise regularly
* Sleep at least 8 hours
* Reduce your stress levels
* Practice relaxation techniques
* Avoid smoking
the last words
Menopause is a natural transition in a woman’s life and cannot be avoided. Whether it’s a blessing or a ruin, she’s here to stay. The good news is that the symptoms associated with menopause are temporary. There are medications and lifestyle changes that can help you cope with the symptoms of menopause and ease this transition period.