Menopause is a natural process that begins at the average age of 50 years. “Menopause marks the end of the menstrual cycle. It happens when the ovaries stop producing eggs and releasing hormones. Menopause is said to have occurred when there has been no menstruation for one year. It is also called the change,” said Dr Vaishali Joshi, senior obstetrician and gynaecologist, Kokilaben Ambani Hospital, Mumbai.
There are three stages of menopause
Peri-menopause – Perimenopause means “around menopause”. It is the menopausal transition, or the time leading up to your last period. It can start 5-10 years before menopause
Menopause- When a woman has gone 12 months in a row without a period, it is diagnosed as menopause.
Post-menopause – This is the duration that starts one year after the last menstrual period
Natural aging – This is due to a decline in ovarian function and ovarian hormones
Forced menopause – This can happen when ovaries are removed surgically or get damaged after chemo or radiotherapy treatments.
Premature menopause – It may result from the failure of ovaries to produce normal levels of hormones (primary ovarian insufficiency), which can be due to defective genes or autoimmune diseases. It can happen in one per cent of women.
Hot flushes, night sweats, vaginal dryness, low mood and/anxiety/irritability, joint and muscle pain, loss of interest in having sex, period irregularities, and weight gain
“Every woman experiences these symptoms in varying severity, starting usually 4-5 years before menopause and have different ways to cope with them. There is no reliable way of predicting how long menopausal symptoms will continue. For many women they resolve within three years,” explained Dr Joshi.
If a woman has symptoms of menopause and is over 45 years of age, then treatment options are offered based on symptoms.
In premature menopause, one may need to check for high levels of FSH or Follicle-stimulating hormone, as it is helpful to differentiate between menopause and other causes of prolonged skipping of periods. The best time to measure FSH is on day 2 or 3 of menstruation if the woman is still cycling.
One can still get pregnant till one reaches post-menopause. So it’s important to continue using contraception like condoms during sex to avoid unplanned pregnancies and practice safe sex.
Every woman who undergoes menopause doesn’t need treatment. When the peri or menopausal symptoms affect the quality of life because of sleeplessness or osteoporosis, irritability, mood changes, or affect sex life due to lack of libido, women should seek medical help. It’s important for the woman and her family to understand these natural processes and acknowledge them. Having this insight into their problem can help them come to terms with the symptoms and reassure them that these are temporary issues and they can cope with them better.