There are three important hormonal milestones in any woman’s life cycle:
Puberty and pregnancy are instrumental in defining womanhood. These hormonal events are responsible for continuation of mankind and make women biologically distinct and superior to their male counterparts. This positive hormonal balance continues till age of 45 to 55 years and comes to an end at, what we call, menopause.
Why this discussion about Menopause?
Menopause is an important milestone in any woman’s health cycle. Female hormones viz. estrogens and progesterone are responsible for maintaining cyclical menstrual bleeding and thus fertility in women. These hormones, especially estrogen, have been shown to have a tremendous positive impact on health of other organs like bones, heart and brain. At menopause, secretion of these hormones gets halted. This predisposes the women towards poor health outcome in form of disruption in sex life, osteoporosis (weak bones), heart problems and also increased risk of dementia (decreased thinking power).
How do you identify impending menopause?
Menopause happens usually between 45 and 55 years, but, the average age of menopause is 51 years. In general, you can expect to have menopause at approximately same age as your mother or sister had., Changing hormonal milieu can lead to some of the symptoms of menopause even years before you stop having menstrual periods. The most common symptoms are irregular periods, hot flashes, night sweats, mood changes, sleep problems, and vaginal dryness.
Can we discuss Hot-Flashes in little detail?
Hot flashes are experienced as a feeling of intense heat with sweating and rapid heartbeat, and may typically last from two to thirty minutes, ending with chills and shiver. The sensation of heat usually begins in the face or chest and it can spread throughout the whole body. Hot flashes may be associated with a feeling of anxiety or heart palpitations during the hot flash. The hot-flashes may happen few times each week or every few minutes throughout the day. Hot flashes are often more frequent and more intense during hot weather or in an overheated room. When hot flashes happen during sleep, they are called night sweats.
Does every woman with menopause needs treatment?
Menopause is a normal physiological event in any woman’s life. In view of positive impact of female hormones on all body function, there had been a great enthusiasm towards treating every woman with these hormones in past. But, recent studies have suggested that benefit of this treatment is not uniform and great and may even harm woman. But, this does not mean that a woman with menopausal symptoms have to suffer. We have safe and established treatments to alleviate these symptoms and thus improving quality of life during menopausal transition. Even hormonal replacement for short term periods has been shown to be safe. But, individualization of treatment is of paramount importance in management.
Apart from symptomatic management, what are the health issues requiring specific attention?
Heart and Bones.
Osteoporosis is one issue, importance of which cannot be overemphasized. Every woman should get a DXA scan (bone density test) done ten years post menopause and get it evaluated by their hormone specialist (Endocrinologist). As diabetes is becoming more prevalent in our society, heart problems in post-menopausal age are becoming more and more common. So getting your blood sugars and cholesterol tested would be good idea. Another health issue which should not be overlooked is depression and anxiety.
All these little things can help you to continue your life as before.
Happy Menopause to you.
Author: Dr. Rajiv Singla
A leading endocrinologist and diabetologist from New Delhi. An alumnus of University College of Medical Sciences, Dr. Singla completed his MD (Medicine) from Maulana Azad Medical College (MAMC). He went on to pursue DM (Endocrinology & Diabetes) from reputed AIIMS, Delhi.