Menopause, also known as the climacteric, is the time in most women's lives when menstrual
periods stop permanently, and she is no longer able to have children. Menopause typically occurs
between 45 and 55 years of age. Medical professionals often define menopause as having occurred
when a woman has not had any vaginal bleeding for a year. It may also be defined by a decrease in
hormone production by the ovaries. In those who have had surgery to remove the uterus but still
have ovaries, menopause may be viewed to have occurred at the time of the surgery or when
hormone levels fall. Following the removal of the uterus, symptoms typically occur earlier at the
average of 45 years of age.
Stages of Menopause:
Natural menopause is not brought on by any type of medical or surgical treatment. The process is
gradual and has three stages:
- Perimenopause - This typically begins several years before menopause, when the ovaries gradually make less estrogen. It lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of perimenopause, the drop in estrogen quickens. At this stage, many women have menopause symptoms.
- Menopause - This is the point when it's been a year since a woman last had her last
menstrual period. At this stage, the ovaries have stopped releasing eggs and making most of their estrogen.
- Postmenopause- These are the years after menopause. During this stage, menopausal
symptoms such as hot flashes ease for most women. But health risks related to the loss of estrogen rise as the woman ages.
Symptoms of Menopause:
Most women approaching menopause will have hot flashes, a sudden feeling of warmth that
spreads over the upper body, often with blushing and some sweating. The severity of hot
flashes varies from mild in most women to severe in others.
Other common symptoms around the time of menopause include:
- Irregular or skipped periods
- Mood swings
- Racing heart
- Joint and muscle aches and pains
- Changes in libido (sex drive)
- Vaginal dryness
- Bladder control problems
Not all women get all of these symptoms.
Other signs of menopause are classified as Immediate (Decline in fertility & menstrual irregularities, Vasomotor, Psychological, Urinary, Local), Intermediate (Genital, Skin & Hair, Musculoskeletal, Sexual disturbances, Ocular, Weight Gain) and Late symptoms (Osteoporosis, Cardiovascular).
Osteoporosis is a disease where decreased bone strength increases the risk of a broken bone. It is the most common reason for a broken bone among people who are old. Bones that commonly break include the back bones, the bones of the forearm, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. Chronic pain and a decreased ability to carry out normal activities may occur following a broken bone.
Risk factors of Osteoporosis:
Unomodifiable factors - Female sex, premature menopause, late menarche, short stature, slender build, ethnic origin, nulliparity, family history of osteoporosis, fair skin.
Potentially modifiable factors - Smoking, Physical inactivity, Low dietary calcium, Low Vitamin D, Alcohol intake, Caffeine intake, Estrogen deficiency, Hyperthyroidism, Hyperparathyroidism, Hyperadrenalism, Anticoagulant therapy, Glucocorticoid use.
- Annual gynac visit
- Annual health check ups like CBC, Urea, Creatinine, Blood Sugar, Lipid Profile, TSH, Pap Smear screening (Every 3 years for woman in the age group of 21-65),
- Mammogram - recommended every year starting the age of 40. USPFTF recommends once in every 2 years for 50-74 years of age.
Post menopause women need 1000-1200 mg of elemental calcium and 800-1000 IU of Vitamin D. Resistance and strength training are factors that help fight osteoporosis.