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Menopause is the biological term for the stopping of the menstrual or period cycle. It begins when a woman does not experience her periods for 1 complete year.
Menopause occurs when the ovaries do not produce enough estrogen and progesterone for the menstrual cycle to continue. This reduced production of estrogen and progesterone can also cause other changes in a woman’s body.
With the advancement in the medical field, average life expectancy has improved, and most women can now foresee spending at least one-third of their lives in menopause. Notably, the menopausal transition and the years lived in the postmenopausal state carry with them problems associated with both quality of life and disease prevention and management. (1)
Almost 3.1% of Indian women have signs of menopause between 29 and 34 years of age, according to a recent study. It was observed that about 1.5% of women below the age of 40 years were in menopause, consistent with the 1–2% range reported internationally, and the number went up to 8% in the case of women who are aged between 35 and 39 years. (2)
Women from all around the globe usually reach menopause between 45 and 55 years of age, with an average age of around 51 years. (3) One of the causative factors can be premature ovarian failure (POF), which is a disease where the ovaries stop working usually before the age of 40. The cause of POF often is undetermined in the maximum cases, but changing dietary habits and work culture with inflated stress levels are some of the reasons. (4)
The most common symptoms of menopause include:
- Hot flashes
- Mood swings
- Difficulty in falling asleep
- Gaining weight
- Dryness of the vagina
- Depression – Healthcare professionals may directly examine for depression, anxiety, and sexual functioning or may decide to hand out a straightforward questionnaire to evaluate psychosocial issues.
- Loss of libido
It is important to have knowledge of menopause to prepare your body and yourself mentally for the challenges that are to come with it. (5)
Read on to know more about menopause.
When Does Menopause Occur?
Menopause can occur anytime once a woman reaches 45. It can also be as late as 55 years of age or above. The average age for menopause has been found to be 51. (6)
The age of menopause is linked with genetics and other factors such as: (7)
- Use of oral contraceptives
- Hormonal changes
- Unhealthy lifestyle interventions
- Insufficient nutritional intake
- Irregular weight management or obesity
Be Prepared for Early Menopause
Although the average age of menopause is 52 years, most women experience menopause after the age of 45.
There are also people who may experience menopause very early, that is, even before they reach 40. This can be due to their genetic makeup or medical issues such as thyroid or lupus. Chemotherapy and any other kind of radiation exposure have also been linked with early menopause.
Moreover, some women have to get their ovaries removed due to medical problems; these women can expect to experience early menopause. Habitual smoking can also accelerate your menopause. (7)
Factors that can cause menopause to occur much earlier include: (7)
- Smoking – It can hasten the onset of menopause by about 2 years.
- Medical conditions
- Decreased production of estrogen and progesterone
- Issues with the ovaries
Introduction to Perimenopause
Perimenopause is the period right before the beginning of menopause.
Menopause is when you have not had your period for one year or 12 months consecutively, but before this stage, there is a period of reduced production of estrogen and progesterone, which causes problems with your menstrual cycles.
Your menses may start becoming irregular and you may experience changes in your body. This is termed perimenopause.
Although the menstrual cycle may be disrupted, it still does not stop unlike in menopause. The symptoms of perimenopause include: (8)
- Breast tenderness
- Increased heart rate
- Sweating at night
- Difficulty falling asleep
- Mood swings
Introduction to Hot Flashes
Menopause brings about a lot of symptoms and bodily changes, but the most commonly noted symptom of menopause is hot flashes. More than half of the women going through menopause will experience hot flashes.
As the name suggests, a hot flash occurs when your body temperature rises and causes you to sweat a lot. This also comes with feeling dizzy and having palpitations.
Hot flashes are most commonly seen at night but can occur at any time during the day. Because of this, you can have trouble sleeping at night and may develop insomnia.
Hot flashes persist for a long duration after menopause. The best way to deal with hot flashes is to limit your consumption of alcohol and caffeine. Also, avoid eating spicy foods. Try to stay in a place where you have a fan or proper air conditioning to stay cool. (9)
Menopause and Its Effects on Bone Health
Estrogen is an important hormone for your bone health. Once a woman experiences menopause, the level of estrogen production drops, which can drastically affect the calcium in the bones.
Therefore, after reaching menopause, a woman can expect lower bone density, which can further lead to osteoporosis. This increases the risk of fractures in women who have undergone menopause.
Bone loss seems to be very high during the first few years of menopause, causing the body weight to drop as bone mass density is also reduced.
Other factors that contribute to bone health issues in menopausal women include insufficient dietary intake of calcium and their age.
It is important that your bones remain healthy even after menopause. So, make sure that you eat foods rich in calcium such as green vegetables and dairy products. Taking supplements after consulting a doctor is also helpful to increase calcium absorption and maintain bone health. (10)
Menopause and Heart Issues
It has been noted that menopause also causes an increase in the risk of heart problems. This is because of the reduced production of estrogen in the body, which makes menopausal women more prone to heart issues.
Estrogen is required to keep the walls of the arteries flexible so that they are able to regulate their size to accommodate the flow of blood by contracting or relaxing accordingly. Therefore, it becomes even more important to make sure that your heart is in good health after undergoing menopause.
Keep a close watch on your weight, eat a healthy balanced diet, and implement regular physical activity to avoid any heart complications. (11)
The diagnosis of menopause can generally be made with an evaluation of age-relevant symptoms and careful physical assessment. Normally, symptoms such as irregular menstrual cycles, hot flashes, and vaginal dryness are sufficient for an experienced gynecologist to make a diagnosis.
Nonetheless, periodic testing such as FSH (follicle-stimulating hormone) or estradiol levels can be conducted to record ovarian failure. However, FSH levels may be normal in those in menopause.
In much younger women with comparable symptoms, evaluation should still include FSH measurement. If ovarian failure happens before the age of 40, it is usually pathological. (12)
When formulating a diagnosis for menopause, it is suggested that chromosomal irregularities (a disorder characterized by a morphological or numerical alteration in single or multiple chromosomes, sex chromosomes, or both), illnesses, autoimmune disorders, galactosemia (galactose in the blood), cigarette smoking, or iatrogenic causes such as radiation or chemotherapy are taken into account.
Most-Asked Questions About Menopause
Will having a hysterectomy cause menopause?
Hysterectomy is the removal of the uterus. Because of this, the woman would be unable to get pregnant and also will not experience periods.
But this does not mean that the ovaries are also removed, which is why the production of estrogen is not hindered and the woman may not experience menopausal symptoms immediately. (13)
If a woman has to remove both ovaries during a hysterectomy, then she might reach menopause right away.
How can I keep my bones healthy after menopause?
Keeping your bones healthy after menopause is extremely important because of the increased bone loss after menopause due to the lower production of estrogen. To keep your bones healthy after menopause, you should: (10)
- Do weight-bearing exercises such as walking or jogging.
- Eat foods rich in calcium and vitamin D.
- Quit smoking.
- Take calcium and vitamin D supplement, if necessary.
Do women experience sexual problems during menopause?
Many women experience sexual problems after hitting menopause. These problems may include:
- Decrease libido
- Issues with having an orgasm
- Pain during sex
If a person experiences any of these problems, they should contact their doctor and look for possible management options. (14)
How do I deal with dryness of the vagina after reaching menopause?
Vaginal dryness is a very common symptom of menopause. What you can do is use lubricants that are plant-based such as olive oil or coconut oil before having sex to be more comfortable and avoid pain.
There are also over-the-counter moisturizers available for the vagina. If the vagina experiences extreme dryness, you can go to the doctor for possible treatment options. (15)
What to do if you have trouble sleeping after menopause?
The majority of women experience trouble sleeping after hitting menopause, which can cause insomnia. Here are some tips you can follow to ensure a good night’s sleep: (16)
- Implement regular physical activity.
- Quit smoking.
- Avoid eating large meals at night.
- Keep your bedroom dark and quiet.
- Don’t nap during the day.
- Seek therapy – Cognitive behavioral therapy (CBT) for sleeplessness is effective in lessening insomnia and improving the quality of sleep. (17) CBT can be provided via different strategies, including face-to-face and digitally-delivered therapy. Retain a consistent sleep routine, which means going to bed and waking up at the same time daily. Plan your day accordingly, if needed.
- Create a nighttime routine – Formulate a relaxing sleep routine before you get a shuteye. This could comprise habits such as taking a shower, dimming the lights, and reading a book before sleeping.
- Be patient with yourself – Women are often very hard on themselves. Be delicate with yourself because it is tough to operate at full capacity when you’re exhausted. It can be useful to leave reminders to take a break. If you are incapable of nodding off even in your bedroom, being restless, staring at the ceiling for hours, counting stars, or caught in negative ideas, try to come out of this vicious cycle of insomnia by waking up and going to another room. Stay there for 10 minutes, go through a book, and then come back to your bedroom to sleep.
- Manage stress – Last but not least, a stress-free day is essential for a good night’s sleep.
What is hormone therapy for menopause?
Hormonal therapy is hormone replacement with estrogen and progesterone. If a woman has her uterus, then she need not have progesterone therapy. Women are prescribed these hormones to relieve the symptoms of menopause.
Hormone therapy should only be considered after talking to a professional and seeking the required medical advice. (18)
Who should avoid hormone therapy?
The following people should not consider hormone therapy: (18)
- Those who are pregnant
- Those with vaginal breeding
- Those fighting breast cancer or uterine cancer
- Those who have heart problems
- Those with liver disease
- Women who have blood clots
Although menopause comes with a lot of issues and stresses, you have to remember that it is a natural part of a woman’s life. It is not something to worry about. With the necessary steps, it can be managed nicely.
Stay in touch with your gynecologist and get regular checkups to deal with any menopause-related health issues effectively.