Menopause

The time in the life of women when periods stops, and they no longer get pregnant naturally is called menopause. It is part of natural ageing. Menopause usually occurs at 45 to 55 years of age. It is a natural process and appears as ovaries age and produces less estrogen. The main reason is a decline in estrogen levels. You may have menopause suddenly. In some women, periods become less frequent for a few months or years and then stop. In medical terms, menopause is when you have had no periods for 12 successive months or a year.

Symptoms of Menopause

Following are some of the symptoms of menopause:

• Alterations in menstrual periods: This would probably be the first sign of menopause. The women undergoing menopause may not have regular periods. The periods may either be longer or shorter. Further, the bleeding may also be abnormal, i.e., it may either be less or more. Although these changes are normal during menopause, you must consult a doctor if you experience heavy bleeding, spotting, a very small gap between the periods, and an extended period of bleeding.
• Bladder incontinence: One of the symptoms of menopause is bladder incontinence. However, it may also be due to various causes, such as urinary tract infections. The patient may experience urinary leakage or extreme urge for urination during laughing or exercising. It is necessary to consult the doctor.
• Problem sleeping: Getting good sleep is sometimes difficult for menopausal women. The sleep can be disrupted by anxiety, night sweats, or increased need to urinate. It is one of the symptoms of menopause and can lead to fatigue, lack of energy, and weakness.
• Hot flashes: The sudden feeling of warmth that spreads all over is known as hot flashes. It occurs due to a change in estrogen level. The intensity and frequency of hot flashes differ in different people. It may include sweating, a red flushed face, and a chilled feeling after the heat. It usually lasts from 30 to 40 seconds.
• Mood alterations: Anxiety, depression, low mood, and irritability are common during menopause. It is caused by hormonal change and sleep disturbances. Women may also have feelings of sadness and tiredness during menopause.
• Pain during intercourse: Women may have pain during sex. It is due to vaginal dryness, itching, and discomfort, which are common symptoms of menopause.
• Feeling the overall change in the body: Many physical changes are seen during menopause, such as weight gain, breast reduction, fat build-up at the abdomen, change in hair colour and volume.
• Other symptoms: The other symptoms of menopause are change in sex drive, headache, muscles and joint pain, dry skin, eyes and mouth, and difficulty focusing.

Causes

The primary cause of menopause is the change in the level of reproductive hormones. As the woman gets older, the level of certain hormones decreases. Reduction in estrogen production alters the menstrual cycle. The cycle becomes inconsistent and finally stops. The other causes of menopause are damage to the ovary, removal of the ovaries, and cysts and tumours in the ovary.

Risk Factors

The risk factors which increase the chances of early menopause are:

• Surgeries such as vaginal, uterine, or ovarian surgeries
• Chemotherapy and radiation ( used during treatment of cancer)
• Smoking
• Chromosome defects leading to premature menopause (such as Turner syndrome)
• Autoimmune diseases such as rheumatoid arthritis
• Epilepsy
• Thyroid disease ( leading to less production of hormones)

What are the stages of menopause?

The three stages of menopause are:

Perimenopause: This stage starts a few years before menopause. It is when ovaries start making less estrogen. It lasts till menopause (till ovaries stop releasing eggs).

Menopause: In this stage, the ovaries stop releasing an egg and making most of the estrogen. Menopause is when it’s been a year since you had a period.

Postmenopause: In this stage, you may experience hot flashes to ease but health-related risks due to loss of estrogen may increase. These are the years after menopause.

What are the symptoms of pre-menopause?

The common symptoms of pre-menopause are:

• Periods lighter or heavier than normal
• Irregular periods
• Hot flashes
• Fatigue and tiredness
• Less sex drive
• Discomfort during sex
• Pain and discomfort in the vagina
• Frequent mood swings and depression
• Urinary incontinence (need to urinate more frequently)
• Sleep problems