Facing a difficult period?

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One of the most difficult phases of a woman's life is often the

time when the hormones are declining, resulting in a sluggish monthly

period or the Menopause. This usually occurs at around 51 years of age

though there are wide variations. Menopause is the permanent natural

stoppage of the monthly periods. It is derived from the Greek word

& quot;Meno & quot; - month and & quot;pausis & quot; - pause. Menopause is caused by

aging of

the ovaries which are the main producer of female hormones. The

reduction of these hormones affects every aspect of a woman's body and

life. The age at which natural menopause occurs is between 45- 55

years. Dr Rishma Dhillon Pai, consultant gynaecologist, Jaslok and

Lilavati Hospital offers tips to cope with menopause.Number gameIn

India, approximately 84 million women are above the age of 45 years and

are experiencing the unpleasant and sometimes disabling symptoms of

menopause. There are about 30 million women in India having

osteoporosis.Symptoms of menopauseMenopause

is inevitable and going into it well prepared is half the battle won.

There is no exact age for menopause-if your mother got her menopause

early-you may too. Sometimes women get normal periods even till the age

of 54 or 55. One may glide into menopause without any symptoms except

the stoppage of periods or one may experience any or all of the host of

symptoms such as:• Irregular scanty or heavy menses • Mood changes• Anxiety and

depression• Sleeplessness• Irritability and forgetfulness• Anger and

resentment• Weight gain• Changes in skin• Hair loss• Vaginal dryness• Loss of

control of urine • Hot flushes where the patient is sweating even when sitting

under a fan.Menopause can cause• Cancer of the cervix • Weakening

of the bones after menopause or osteoporosis is the most important

offshoot. The earlier the menopause, either natural or due to removal

of the ovaries surgically, the greater is the risk of osteoporosis.

Also it is more severe in thin women, smokers, women with sedentary

lifestyle etc• After menopause, women are more prone to ischemic heart diseases,

Alzheimer's disease and strokes.Coping with menopauseCancer screeningThe

important issues in this age group are cancer screening especially

cancer of the cervix by a PAP smear, breast cancer check with

examination and mammography and sonography. Make sure the womb (uterus)

and ovaries are normal. Once the menses stop for one year, the woman

should never have bleeding again and if she does she should meet a

gynaecologist immediately.OsteoporosisOne

of the most important problems in menopause is osteoporosis or thinning

and weakening of the bones, which sometimes the patient is not even

aware of till a minor injury results in a fracture especially of the

hip joint, wrist or the spine. This can be diagnosed only by bone

densitometry (DEXA) or CT scan. A bone density test will reveal the

condition of the bones and if normal, only calcium and exercise is

sufficient. If these reports are regularly normal, there is no need to

worry. Often calcium alone is not sufficient for weak bones and hence

medicines which can be given daily, once a week or once a month can be

given to improve the bone strength. However these medicines do not

benefit any other symptoms of menopause.Hot flushesHot

flushes do not cause any damage and if mild can be neglected. Only if

severe, do they need to be treated. Lifestyle changes such as drinking

cold liquids, staying in cool rooms, avoiding hot flash triggers such

as hot drinks and spicy foods may help reduce hot flushes. Adding some

vitamin E may help the skin and hair.Hormone replacement therapyIt

involves giving back to the woman the hormones which she had in her

body prior to menopause. This is a combination of estrogen and

progesterone or only estrogen if the womb (uterus) has been removed.

There are new low dose hormones now available which relieve many of the

symptoms of menopause and help improve the bones’ weakness. However,

there are some risks associated with use of HRT which are more in obese

women, smokers and those with family history of breast cancer. There

has been a slight increase in incidence of strokes and breast cancer in

patients on long term estrogen and progesterone therapy.Drugs and

medicationDesigner

drugs are newer drugs for the management of symptoms which work

differently in different body parts so as to give maximal benefit and

minimal side effects.Alternative medicineThere

are many alternative drugs to HRT which are available today. These

contain 'phyto -estrogens' or plant estrogens in natural form and low

dose. This helps in relief of symptoms with minimal side effects.Healthy dietA

diet rich in soya  along with an active life and exercise, help improve the

symptoms of menopause.Vaginal DrynessFor vaginal dryness, estrogen creams and

gels can be used for a short period or lubricating jelly can be used.

 

 

 

 

 

 

 

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