Yes, these are the few features that occurs after 45 years of age in a women in India. In western countries, that may be from 49 years onwards. First and foremost, normal and regular cycle is hampered. But there may be occasion of spotting. It means there may be slight bleeding at any time, irrespective of the day of cycle. This spotting may be caused by vaginal atrophy, benign sore, etc. Other general signs and symptoms are back pain, breast pain, hot flashes, urinary urgency, headache, heart palpitation, dizziness, itchy skin, weight gain, psychological disturbances like anxiety, poor memory, depression, irritability, mood swings, less interest in sexual activity.
In long term, hyperlipidemia occurs, leading to several cardiovascular diseases.
But Why all these occurs?
Starting from the first, when a girl child is born, she is blessed with 400,000 to 1 million eggs or ova. Till the girl child reaches her puberty, the number of immature ova decreases and remains only 50,000 during the start of puberty. After that, menstruation starts. In every month almost, 3-4 eggs get ready to be in the frontline for meeting with the male counter part. But only one can really get ready and comes out (ovulation) and wait for the male counter part. A girl child do not marry up to her 25 – 30 years. So, there is no male counterpart. When period or menstruation occurs, the egg that was waiting for the male counter part, get expelled from the body. In this way, when this girl will reach her 45 years of age, there will be hardly any egg which can get ready and so there is no way, menstruation can occur and thus, menstruation stops. This also caused by decrease in female hormones (estradiol and progesterone). Due to the decrease of hormones, there are so many signs and symptoms seen during menopause.
So, menopause will occur normally and the mentioned features are normally seen. But although they are normal, these feature sometimes becomes unbearable. In a very simple logic, all these symptoms occur due to lack of estrogen. So, providing estrogen will solve most of the problem but at the same time, it is to be considered that estrogen should get stop after menopause, that is what the nature tells us. For example, we know every child should study. But if this study become mental strain for the child, he or she may be advised to be refrain from study for few days but must not stop studying at all. In similar way, if the symptoms becomes unbearable, estrogen cream (vaginal cream for relieving dryness of vagina) or estrogen oral medicines can be prescribed but not for rest of the life. It has to be accepted the nature does not want any woman to have estrogen the whole life. So, if the symptoms are well tackled, then, estrogen treatment should be withdrawn.
If bone pain increases moderately, Vitamin D can be taken more in food or Vitamin D tablets. In addition, drugs like bisposphate may taken under the advise of a doctor. It will decrease the chance of bone fracture. Regular exercise and lifestyle modifications are also advised during menopause.
About The Author
Dr. Dipan Samanta, MBBS, Associate Member (Royal College Of Obstetrics and Gynaecology, UK), Founder Owner (MedBlog18.com) and Consultant Physician at HealthCareMagic.com and Lybrate.com