What is Menopause?
Symptoms related to menopause begin many years prior to the actual menopause. The cause for the menopause and related symptoms is the decline in the levels of the female hormone oestrogen, produced by the ovary which in turn is under the control of the pituitary gland of the brain. However the adrenal glands situated on top of the kidneys continue to produce the hormones albeit in smaller quantities and the woman could continue to have a normal sexual life. If a woman has had no periods for full one year, she is deemed to have attained her menopause. The post menopausal period lasts for the rest of the life. Smoking can lead to an early onset of menopause. If a woman undergoes surgery for removal of the uterus along with the ovaries, menopause automatically starts since both the substrate i.e. the uterus and the source of the hormone, the ovary, are removed.
There are many symptoms that could be associated with menopause and some can be quite distressful needing immediate attention and treatment. Hot flushes are common at the time of menopause. A hot flush is a sudden feeling of heat usually in the upper part of the body i.e. the face and the neck. It may be followed by heavy sweating and shivering. The flush lasts for 30 seconds to 10 minutes. There may be a problem in falling asleep or going back to sleep after waking up in the night. The woman may also experience night sweats. There may be mood changes and she may feel irritable at times. There may be memory problems also. The genital area may get drier and sexual intercourse could be painful. There may be incontinence of urine with recurrent infections. The woman may complain of aching of joints and muscles.
Osteoporosis and Heart disease are the two major conditions that may develop after menopause. The hormone oestrogen helps control bone loss in women and the reduction in oestrogen levels at menopause causes more bone loss than could be replaced, resulting in the condition called osteoporosis, when the bones become weak and fragile, with a high risk of fracture. Calcium supplementation of 1000 mg per day is strongly recommended. Women are more likely to develop heart disease due to the removal of the protective effect of oestrogen. Advancing age could also be a contributory factor. The blood pressure and lipid levels need to be checked regularly and medication taken if indicated. The weight needs to be controlled since menopause could induce a weight gain. If symptoms like hot flushes, night sweats, vaginal dryness and recurrent urinary tract infections are troubling and causing distress, hormone replacement therapy (HRT) would help control the symptoms. However, the lowest dose that works and for the shortest time should be used.
Certain precautions may be taken to help cope with the problems that may arise due to menopause. The woman should eat a healthy diet low in fat, high in fibre with plenty of fruits and vegetables. Smoking should be avoided. Calcium & Vitamin D Supplements must be taken regularly since dietary intake may be unpredictable. The body weight should be kept at the recommended level. It would help the bones if weight bearing exercises like walking, dancing etc are undertaken for at least three days a week. It is important to be physically active and engage in activities that help lead a fruitful life!
Written By: Dr. Pilli Samuel Rajkumar, MD (Hyderabad, India)
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Edited by: Rajesh Bihani ( Find me on Google+ )