Dr.Souvik Banerjee, MD.

 

Menopause - Overview

Menopause, by definition, is the final menstrual period. It is a universal and irreversible part of the overall aging process, as it involves a woman’s reproductive system. The time before menopause is called the menopausal transition, or perimenopause. This period is also termed as climacteric. The menopausal transition or perimenopause typically starts a year before menopause. As a woman goes through the transition to menopause, her ovaries are less likely to release eggs.

Typically, menopause occurs between ages 45 and 55. Menopause is diagnosed after 12 months of stoppage of menses (amenorrhea). Hormonal changes and clinical symptoms occur over a period of time till actual menopause and continue after menopause for variable durations. During perimenopause, women’s ovaries start to produce less of the hormones oestrogens and progesterone.

Menopause is not a disease, and it can be considered as a positive emotional and physical transition. Technically, menopause occurs with the final menstrual period and involves only one day. The hot flushes, mood swings and other symptoms associated with menopause occur during perimenopause, the transitional years before and continue after the actual menopause. By the time a woman stops menstruating, many of the symptoms associated with menopause have been experienced for several years.

Women after menopause are at a greater risk of heart disease and osteoporosis. It usually takes about 6 to 12 months or longer for no menstrual bleeding (amenorrhea) before a woman can be certain that she has experienced menopause. Menopause usually occurs naturally, but can be induced by certain types of surgery (e.g. a hysterectomy called surgical menopause), chemotherapy and pelvic radiation therapy. Symptoms associated with menopause can be reduced by diet and lifestyle changes. Hot flushes are the most common symptom associated with menopause. One must make sure to take adequate amount of calcium in their diet and do regular exercise.

CAUSES:

1. Genetic

2. Life style factor

3. Body mass index

4. Auto immuno disease

5. Epilepsy

6. Natural decline of reproductive hormones

7. Hysterectomy

8. Chemotherapy and radiotherapy

9. Primary ovarian insufficiency

Menopause - Symptoms

The symptoms of menopause are at times very disturbing. Symptoms have a wide range because of the many effects that these hormones have on the female body.

Changes in the menstrual cycle: The woman’s menstrual period may be irregular. She may either bleed more or it may reduce. Duration of the periods may be long or short. If she is not pregnant, a missed period could indicate the onset of menopause.

Hot flushes: Many women experience hot flushes as a main symptom of menopause. Hot flushes are a sudden feeling of heat either in the upper portion of your body or all over. Your face and neck might turn red, and you may feel sweaty or flushed. The intensity is different for person to person. It generally lasts from 30 seconds to 10 minutes.
Most women experience hot flushes for a year or two after their final menstrual period. Some will have them for longer, but they reduce in severity over time.

Vaginal dryness and pain during intercourse: Women can experience vaginal dryness during the menopausal stage. Signs can include itching around the vulva as well as stinging or burning. Vaginal dryness can make intercourse painful and may cause them to lightly bleed or feel like they need to urinate frequently.

Insomnia or problems sleeping: During menopause, it might be hard for her to fall asleep or get sleep for long hours.

Frequent urination or urinary incontinence: The woman’s bladder control reduces, and she may feel a constant need to urinate even when the bladder is not full or experience painful urination. This is because during menopause, the tissues in the vagina and urethra lose their elasticity and the inner surface becomes thin.

Urinary tract infections: During menopause she may be prone to urinary tract infections. If she feels a persistent urge to urinate or a burning sensation while urinating she must consult a doctor.

Decreased libido: She may feel less interested in sex during menopause due to the physiological changes brought upon by reduced oestrogen. These changes could range from delayed clitoral reaction time, slow or absent orgasmic response to vaginal dryness.

Depression and mood swings: She may experience irritability, depression and mood swings, often experiencing extreme highs to severe lows in a short period of time.

Skin: During menopause the skin tends to become dry and thin. It also affects the elasticity and lubrication of the skin near the vagina and urinary tract.

Hair: Hair loss is one of the more common symptoms of menopause. Most women experience hair loss for a few years before and after menopause. This is due to the reducing oestrogen levels which cause hair loss and hair thinning and also make the hair feel brittle and dry.

Complications

After menopause, the risk of certain medical conditions increases such as:

Heart and blood vessel (cardiovascular) disease: When the oestrogen levels decline, there is an increased risk of heart disease. Heart disease is the leading cause of death in women as well as in men. So it is important to get regular exercise, eat a healthy diet and maintain a normal weight. Our doctors advise on how to protect the heart, that is how to reduce the cholesterol and blood pressure levels if they are too high.

Osteoporosis: This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, the woman may lose bone density at a rapid rate, increasing the risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their hips, wrists and spine.

Weight gain: Many women gain weight during the menopausal transition and after menopause because the metabolism slow down. They may need to eat less and exercise more, just to maintain their current weight.

Menopause - Treatment

In a study conducted in 8 countries, over 438 patients with an average age of 55, homeopathic medicines were prescribed to all patients; Lachesis mutus, Belladonna, Sepia officinalis, Sulphur and Sanguinaria canadensis were the most prescribed.

This observational study revealed a significant reduction in the frequency of hot flushes by day and night and a significant reduction in the daily discomfort they caused. Nearly 90% of the women reported disappearance or lessening of their symptoms, with these changes mostly taking place within 15 days of starting the homeopathic treatment. The results of this observational study suggest that homeopathic treatment for hot flushes in menopausal women is effective.