25

Jul2016

All you needed to know about Menopause

Menopause marks the end of the menstrual cycles in a woman. A woman is said to have attained menopause when it has been 12 months since the last menstrual period.Let us first look at the positives of this change before we move on to the medical details!

No more monthly messy periods!

No more nagging pains, cramps and dullness around the lower tummy and back!

Freedom from the napkin rashes and chaffing!

No more fear of pregnancy! After years, your man can chill and spill!!

Symptoms of menopause

Hot Flushes- Transient periods of feeling intensely warm and flushed in the upper arms and face which may be followed by profuse sweating. Hot flushes can disturb sleep and cause fatigue and irritability with negative impact on routine daily efficiency.

Mood changes with high anxiety and depressive symptoms more so in women who have a low baseline anxiety levels.

Menstrual migraines and breast tenderness

Vague muscle and joint pains

Palpitations and disturbed sleep

Symptoms like vaginal dryness, soreness, itchy vulva, recurrent burning urination and loss of bladder control comes many years later.

The two most affected body parts after menopause are bones and heart.

BONES:
Bones become thinner with menopause.
The bone resorption rate is higher i.e. the rate of bone loss is higher than the rate of bone replacement. Initially the Bone Mineral density becomes low – a condition called Osteopenia. Later on the bones become thin, weak and break off easily- a condition called osteoporosis.
Osteoporosis can be prevented.
Sports and Home Physical activity is significantly shown to have beneficial effects on Bone Mineral density.

HEART
The risk of an ischemic heart disease equals to that of a man after menopause which is usually half of that of men before menopause.There is increased intimal thickness, elastin fragmentation, and increased collagen content of the arterial wall and higher risk of Myocardial infarction (heart Attack

Tackling Menopausal issues:

Hot Flushes
• Layered clothing can maintain core temperature and reduce hot flushes.
• Avoiding spicy diet, excess caffeine and alcohol can be beneficial.
• Physical activity and paced breathing may be of additional help.
• Estrogens even in doses as low as 0.03 mg/day is found to be extremely effective if pharmacological intervention is needed.
• Newer antidepressants/ SSRI s are also beneficial.

Sexual Function
• Counseling and assurance with explanation of the natural course of events; sometimes a professional counselor is very helpful in helping the couple cope.
• Intravaginal estrogen creams to regenerate blood supply.Intravaginal DHEA holds promise in future. IVDHEA can reduce vaginal dryness like the hormonal creams without causing undesirable side effects.

Urinary symptoms and vaginal Dryness
• Over the counter vaginal Lubricants and moisturizers
• Topical estrogen cream under strict medical guidance for regeneration of the tissues

What can you do?

Long term prevention of heart disease after menopause
In light of the findings of recently reported clinical trials, most organizations with guidelines on Menopausal hormone therapy (MHT) have revised their recommendations. The American College of Obstetrics and Gynecologists, the North American Menopause Society, and the American Heart Association recommend against the use of MHT for primary or secondary prevention of cardiovascular disease because cardiovascular disease is a more common cause of morbidity and mortality for women than are osteoporosis and cancer combined.

Efforts to identify patients at risk and recommendations on lifestyle modifications, diet, and other pharmacotherapy (i.e., beta blockers, aspirin, angiotensin-converting enzyme [ACE] inhibitors, statins) are more beneficial and probably less harmful than MHT for long-term treatment.

Long term prevention of osteoporosis and fracture
Calcium supplementation of 1200mg/day
Daily Vit D of 600IU
Weight bearing exercises

Medications are needed for those with a high risk of fracture like
Tall thin woman
Suffered fracture earlier
Parents with fractured hip
Current smokers
Glucocorticoid users
Suffering from Rheumatoid arthritis
Suffering from Secondary osteoporosis
Those who consume 3 or more units of alchohol daily

Be aware, take preventive measures and stay healthy!

  • Written byDr Sudeshna Ray

    Dr. Sudeshna Ray (MD, MRCOG- London) is a Consultant Gynecologist & Obstetrician visiting Jaslok, Saifee and Breach Candy hospitals, Mumbai, India. She specializes in critical pregnancy care, Pelvic Laparoscopy and Robotic gynecological procedures. She believes in enhancing awareness on various aspects of women’s health and preventive care through social media, print and other platforms. Her passion makes her travel and talk to various corporates, schools, and colleges around the country. She is involved in various social and charitable activities as well.

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