Menopause is a physiological process where woman stops having menstrual cycles due to permanent cessation of primary functions of the ovaries. Menopause is a transitional phase in woman’s life and an end of fertile phase. This transition is not abrupt, it occurs over a period of years. This occurs during the age between 40 and 50.
This transition from reproductive to non-reductive is due to complex series of hormonal changes in the female body. At the time of birth every female has about 1 to 3 million eggs in the ovaries and they are lost gradually in the process of menstrual cycles throughout a woman’s life. At the time of menopause eggs decline and woman may have about 10,000 eggs. Most of these eggs die in the process of atresia [degeneration and resorption of eggs]. These changes lead to permanent cessation of ovary functions subsequently leading to hormonal changes. The depletion in the eggs cause increased levels in the Follicular Stimulating Hormone [FSH] and Luteinizing Hormone [LH] and decrease in estrogen levels. The decrease in estrogen levels is the cause for the menopausal symptoms.
SIGNS AND SYMPTOMS-
Hot Flushes- Hot flushes are one of the most common symptoms of menopause, where 75% of women experience. Hot flushes are feeling of warmth inside the body which spread all over the body. They may last for 30 seconds to few minutes. Hot flushes are often associated with palpitations, insomnia, flushed skin and sweating. Women experience hot flushes for 2 to 3 ears in some cases up to 5 years during their menopausal phase.
Weight Gain- Most of the women experience weight gain during menopause due to hormonal changes and aging.
Changes in Reproductive System- Decreased estrogen levels affect the vaginal lining causing dryness and painful sexual intercourse. Finally leads to vaginal atrophy. Decreased libido is experienced in most of the women. Shape of the breasts change due to atrophy, women may experience other symptoms like breast tenderness and swelling. Urogenital atrophy causes urinary incontinence. Most of the women experience irregular menstrual cycles. Usually cycles are erratic and unpredictable. Flow may be excessive or scanty, followed by spotting. Further in the process woman may skip cycles for few months. And these skipped cycles are followed by a heavy bleeding cycle.
Psychological- Depression associated with anxiety. Irritability, mood swings memory loss, lack of concentration are the common symptoms.
Skeletal System- Back pain, joint pain and myalgia. Bone loss due to low calcium levels in the serum due to decreased estrogen levels. This bone loss leads to osteoporosis which increases the risk of fracture.
Circulatory System- The LDL cholesterol levels go up during menopausal phase due to hormonal changes. This increased LDL cholesterol causes atherosclerosis leading to ischemic heart diseases.
Management- Menopause is a natural process of life therefore doesn’t have standard line of treatment. Depending upon the signs and symptoms palliative line of treatment helps the women to overcome menopausal phase. All women in menopausal phase should consult their healthcare practitioner once in a year.