Menopause

This is the period in a woman's life when her reproductive capacity is coming to an end. At this time she may develop many physical and psychological changes due to the alteration of the pattern of the sex hormones ( especially the reduction of estrogen). Menstruation which has occurred since she attained menarche now gradually stops. The average age of menopause is around the age of 45 to 55 years, but it may range from the late thirties to the early fifties. The menopause is defined as 6 months or more secondary amenorrhea of a woman aged 45 years or more. Menopause can be divided in to 2 categories, that is natural menopause and surgical menopause. Surgical menopause occurs when patient’s both ovaries removed surgically or patients who underwent hysterectomy.

The hormonal changes affect not only the reproductive system but also the entire body and mind. Most women adjust themselves to these changes without much discomfort. They may experience a few distressing symptoms for a short time, but these do not disrupt their normal pattern of life. A few, perhaps about 10% experience serious difficulties.

The symptoms of menopause, if and when they do occur, are similar to those of premenstrual tension. A woman who is in perimenopausal age will experience physical symptoms such as hot flushes which is a burning sensation spreads from trunk to face lasting for few seconds, giddiness (dizziness), trembling,tingling or numbness of hands and feet, loss of appetite, constipation, loss of weight, joint pains, palpitations, and dark circles around the eyes, dryness of the skin and the mucous membranes especially in the vagina (making intercourse difficult or painful), reduced sex desire, tiredness, night sweats, insomnia and increased urinary frequency. She may also experience several psychological symptoms such as mood swings, anxiety, loss of short term memory, lack of concentration, lack of self confidence and depression. The patient will experience few or more such symptoms in different degrees and it is variable from person to person.

It should be stressed that the symptoms described above can be caused by other physical and emotional disorders, so it is best to allow the doctor to make the decision. It should be emphasized that many women are free of most of these distressing symptoms. It should be happily noted that menopause is only a temporary phase in the journey of life -the discomforts may last for a few years, but they will pass off. The period after menopause can be brighter, ‘happier, and more healthy; often a more balanced personality emerges, and a more productive period of life starts. Most of the symptoms of menopause, which are due to falling levels of sex hormones at this age, can now be treated satisfactorily with hormones (hormone replacement therapy-HRT). But it must be remembered that in such treatment, the drug dosage and duration of treatment should be subject to supervision by a doctor. Recently, fears have been expressed of an increasing incidence (occurrence) of cancer of the womb, breasts and ovaries in women receiving hormones (estrogen), the incidence being related to dose and duration. Fortunately this problem has now been overcome by using a combination of hormones (low dose estrogen and progesterone).