Menopause

Menopause can bring about various signs and symptoms. As you approach menopause, you may experience the following:

• Vaginal dryness
• Mood changes
• Sleep problems
• Night sweats
• Decrease in metabolism
• Weight gain
• Loss of breast fullness
• Thinning of hair
• Dry skin
• Difficulty concentrating
• Increased irritability
• Mild depression
• Joint aches
• Decreased libido or sex drive
• Increased heart rate
• Loss of bladder control
• Urinary tract infections

Women who are transitioning to menopause (perimenopause) may also experience the following symptoms:

• Irregular periods
• Skipping periods
• Periods that are heavier or lighter
• Breast tenderness
• Worsening of premenstrual syndrome (PMS)

Not all women experience these symptoms; some may experience more than one. Women affected by urinary changes, a racing heart, or new medical problems should consult a doctor to rule out other possibilities.

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Your reproductive cycle starts from puberty and ends near the age of 40-50. Various complex methods and hormones control the process. The hypothalamus, a brain structure near the pituitary gland, produces certain chemicals that release essential sex hormones called estrogen and progesterone. These hormones stimulate the release of eggs from the ovary. If the egg fails to fertilize, the thickened lining of the uterus is shed through the vagina in the form of periods. As women age, their reproductive cycle starts to slow down and eventually stops. When your body starts nearing menopause, the ovaries begin producing less estrogen. This decline in hormone levels leads to changes in the pattern of your menstrual cycle, which may become irregular or experience changes in flow. With these hormonal changes, your body also undergoes physical changes as it adapts to the new hormone levels. The symptoms that women experience during this transitional phase of menopause are part of the body’s attempt to adjust. For women undergoing natural menopause, the process occurs in three stages.

Perimenopause

This can start ten years before the onset of menopause. This is the time when your ovaries gradually begin producing less estrogen. Women in their 40s generally experience menopause, but some may begin experiencing it in their 30s. The period of perimenopause lasts until menopause, when the ovaries completely stop producing eggs. Before that, fluctuating hormone levels cause various symptoms in women. Each woman experiences perimenopause differently due to hormonal fluctuations. Increased levels of progesterone and estrogen during anovulatory cycles (absence of menstrual cycle) may lead to:

• Endometrial cancer or hyperplasia (thickening of the uterine lining)
• Uterine polyps (growths attached to the inner wall of the uterus)
• Leiomyoma (also known as fibroids)

Menopause

Menopause is the stage when your ovaries stop producing eggs and most of their estrogen. It is diagnosed when a woman has gone 12 months without any occurrence of periods. Conditions that can cause premature menopause include:

• Primary ovarian insufficiency: This may result from the failure of ovaries to produce normal levels of reproductive hormones, stemming from genetic factors or autoimmune disease. For these women, hormone therapy is typically recommended until the natural age of menopause.
• Induced menopause: This can occur if the ovaries are removed for medical reasons, such as uterine cancer or endometriosis.
• Cancer therapies: Chemotherapy and radiation therapy can induce menopause if they damage the ovaries. Symptoms such as hot flashes may be experienced during or shortly after treatment. The cessation of menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures need to be taken. Radiation therapy affects ovarian function only if directed at the ovaries. Radiation to other body parts, such as breast tissue or the head and neck, does not cause premature menopause.

Postmenopause

After going through menopause, you will be in the post-menopause phase for the rest of your life. Since the body has nearly stopped producing estrogen, postmenopausal women are at an increased risk of various health conditions such as:

• Heart diseases
• Osteoporosis (weakening of bones)
• Urinary tract infections

Many women may also experience relief from the symptoms they were undergoing during the perimenopause phase. Hot flashes may ease after some time, but some women continue experiencing these symptoms for ten more years or longer. Every woman’s risk and experience post-menopause is different. It is essential to learn more about the potential risks and consult your doctor for guidance.

It is natural for every woman to go through menopause. However, some women may experience premature menopause, which means that their menstrual cycle stops earlier than the expected mean age. Premature menopause occurs when a woman is 40, while early menopause occurs at the age of 45. You are at an increased risk of developing early menopause if you:

• Had surgery to remove the ovaries
• Are a chronic smoker
• Underwent surgery to remove the uterus (hysterectomy)
• Have side effects of chemotherapy or radiation
• Have a family history of early menopause
• Have certain medical conditions such as rheumatoid arthritis, inflammatory bowel disease, epilepsy, thyroid disorders, HIV/AIDS, or chromosomal abnormalities
• Have certain infections such as mumps

The tests that are essential for diagnosing menopause are:

1. Physical exam
   Before visiting your doctor, track your symptoms and note their frequency and severity, along with your last period and any irregularities in your cycle. Discuss any medications or supplements you might be taking. Usually, the described symptoms are sufficient evidence for the diagnosis of menopause.
2. Vaginal swab
   Your healthcare provider may direct you to take a vaginal swab to test your vaginal pH. The vaginal pH is around 4.5 during your reproductive years and can rise to a pH balance of 6 during menopause. Reduced estrogen during menopause affects a woman’s vaginal pH.
3. Follicle-stimulating hormone (FSH) test
   Your doctor may order a blood test to check the levels of FSH along with estrogen. During menopause, FSH levels tend to increase while estrogen levels decrease. FSH stimulates the maturation of eggs and the production of estradiol, a form of estrogen that regulates the menstrual cycle and protects the female reproductive system. When FSH levels are consistently elevated to 30 mIU/mL or higher, and a woman hasn't had periods for over 12 months, it is generally diagnosed as menopause. However, a single FSH test with elevated results does not necessarily indicate menopause; multiple subsequent tests are needed to confirm the diagnosis. Additionally, FSH tests can detect signs of pituitary disorders since the anterior pituitary gland releases FSH.
4. Thyroid-stimulating hormone (TSH) test
   Your doctor may order a TSH test, as the symptoms of hypothyroidism often resemble those of menopause. Hypothyroidism is a condition in which the thyroid gland produces less than the average amount of thyroid hormone. The TSH test also indicates how much T4 hormone is being produced. A high TSH level means that the thyroid gland is making excessive T4 due to insufficient T4 in the body, indicating hypothyroidism. The result of this test will help your doctor rule out the possibility of hypothyroidism.
5. PicoAMH Elisa diagnostic test
   This recent test evaluates whether you have reached menopause or are likely to reach it. It measures the levels of anti-Müllerian hormone (AMH) in the blood, a protein hormone released during pregnancy. The test alone is not sufficient for diagnosing menopause and can be used in conjunction with bone mineral density tests and hormonal tests. Additionally, your doctor may order other tests, such as a lipid profile and tests for liver and kidney functions, as women experience changes in their lipid profile during menopause that can assist in the final diagnosis.
6. Inhibin A and inhibin B
   The decline in inhibin A and inhibin B may also be useful for assessing reproductive aging. Studies have shown that the disappearance of these hormones is an important indicator of the approaching menopause.

Menopause is a natural biological process of a woman’s body in response to age. There is no method of preventing menopause, and it should be accepted as a part of your body’s natural cycle. You can prevent the onset of early menopause by making lifestyle modifications such as:

• Having balanced meals
• Avoiding smoking
• Exercising daily
• Reducing weight

If you have a family history or a relevant medical history that can cause early menopause, talk to your doctor about the same.

Menopause doesn't require any treatment. However, there are certain medications and therapies available to relieve and manage the signs and symptoms of menopause. Your doctor will also assist you with treatment modalities to prevent the development of any chronic medical conditions resulting from menopause.

1. Hormone therapy
   Doctors recommend taking estrogen hormone as it effectively manages menopausal hot flashes. A hot flash is a sudden feeling of warmth over the upper body, particularly intense over the face and neck. To relieve your symptoms, your doctor may provide you with a low dosage of estrogen for a limited time, determined by your family history and personal medical history. In some cases, your doctor may also prescribe progestin alongside estrogen. Benefits of hormone therapy include improvement in menopausal symptoms, increased bone mineral density, and decreased fracture risk. Long-term use of hormones can increase the risk of endometrial cancer, pulmonary embolism, deep vein thrombosis, breast cancer, or gallbladder disease. However, taking these medications for a limited time has proven beneficial for women experiencing menopausal symptoms. It is essential to discuss your medical and family history, along with the risks and benefits of hormonal therapy, with your doctor.
2. Vaginal estrogen
   It is common for women to experience increased vaginal dryness during perimenopause and postmenopause. To relieve this, estrogen hormone can be administered directly into the vagina through a vaginal cream, tablet, or ring. Vaginal estrogen modalities work by releasing low amounts of estrogen directly into the vagina, which is absorbed by the vaginal walls. This helps relieve vaginal dryness and manage discomfort associated with intercourse and urinary problems.
3. Antidepressants
   Certain medications from the class of selective serotonin reuptake inhibitors (SSRIs) can relieve menopausal hot flashes. A low-dose antidepressant is helpful for women seeking ways to manage their hot flashes, particularly those who cannot take estrogen due to allergies or other health reasons. Women suffering from mood disorders related to menopause may also be prescribed low dosages of antidepressants. Paroxetine, a selective serotonin reuptake inhibitor (SSRI), works by increasing serotonin levels, a chemical messenger in the brain, improving mood and physical symptoms of depression while also relieving symptoms of panic and obsessive disorders.
4. Anti-seizure medications
   Gabapentin is an anti-seizure drug used to treat seizures and has shown promising results in managing menopausal hot flashes in women who cannot use estrogen therapy. It is also beneficial for women experiencing hot flashes at night.
5. Clonidine
   This drug is an adrenergic agonist and has been found to significantly reduce the frequency of hot flashes. It is widely used as a non-hormonal treatment for hot flashes in breast cancer patients as well. Your doctor will monitor the effectiveness of the drug for two to four weeks; if there is no significant reduction in hot flashes, the drug usage will be reviewed.
6. Vitamin D supplements
   The decline in estrogen levels after menopause can affect bone density in women. Depending on your needs, you may require treatment to prevent or treat osteoporosis. Several medications can improve osteoporosis and reduce fracture risk. Many women are also prescribed Vitamin D supplements to strengthen bone density.

If you have started noticing signs and symptoms of menopause, note down your symptoms and record your menstrual cycle along with its irregularities. Your doctor will be able to provide a diagnosis based on these observations.

If you have been experiencing hot flashes, talk to your doctor about medications that can help you manage these symptoms. In the case of hormonal pills, ensure you take your medications on time. Do not take the medications for longer than the recommended duration without your doctor's advice. You can keep your pills in a marked case to ensure that you do not skip taking them regularly.

Here are a few simple tips to manage the symptoms of menopause naturally:

• Maintain a healthy diet rich in fruits, vegetables, and whole grains.
• Engage in regular physical activity to improve mood and reduce symptoms.
• Practice relaxation techniques such as yoga or meditation.
• Stay hydrated and avoid excessive caffeine and alcohol.
• Consider herbal supplements after consulting with your healthcare provider.

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The decline in estrogen hormone increases the risk for women developing various health complications. However, estrogen is not solely responsible for these diseases; age and other factors also contribute to their development.

• Heart Diseases: The risk of developing heart conditions increases after menopause. Postmenopausal women are more likely to have a heart attack than men. The steep decline in estrogen levels post-menopause increases the risk of having irregular heartbeats (palpitations). If a woman experiences heart palpitations, it is important to consult a doctor to determine the best course of action.
• Osteoporosis: The decline in estrogen levels puts postmenopausal women at an increased risk of developing osteoporosis. Estrogen plays a vital role in supporting the production of new osteoblasts, which are responsible for creating bone. After menopause, osteoblasts do not receive an adequate amount of estrogen, leading to a failure in regenerating new bone structures. Consequently, osteoclasts, which absorb bone, overpower the rate of bone regeneration, resulting in weakened bones. Osteoporosis can lead to an increased rate of fractures in the hips and spine. Having a fracture at an older age is serious, as recovery takes longer. Click To Know More!
• Urinary Problems: Urinary incontinence occurs when women experience an involuntary release of urine. It is common in aging and postmenopausal women. The reduced estrogen level causes the thinning of the lining of the urethra (the tube that connects the bladder to the body's exterior) and the vaginal wall, leading to urinary leakage, often during sudden movements such as sneezing or laughing.
• Sexual Problems: Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Additionally, decreased sensation may reduce the desire for sexual activity (libido). Water-based vaginal moisturizers and lubricants may help. If a vaginal lubricant is insufficient, many women benefit from local vaginal estrogen treatment, available as a vaginal cream, tablet, or ring.
• Weight Gain: Many women experience weight gain after reaching menopause. This is influenced by aging and the effects of menopause. With increasing age, it becomes harder to maintain muscle mass, and the decrease in muscle mass further reduces metabolism, making weight gain easier. Women often gain weight around the abdominal region after menopause, which increases the risk of heart diseases.
• Visual Disturbances: Estrogen provides elasticity to the corneas of the eyes. During menopause and perimenopause, reduced estrogen levels cause the corneas to stiffen, affecting how light travels into the eyes and potentially leading to blurred vision. Dry eyes may also occur during menopause, with symptoms including itchiness, a burning sensation, eye pain, dryness, mucus discharge, and a sensation of a foreign body in the eye. Wearing contact lenses may also become uncomfortable.
• Central Nervous System Problems: Alzheimer's disease is more common in women after menopause. It is possible that estrogen plays a role in protecting the brain from damage associated with Alzheimer's.

• Diet
  Include a variety of fruits and vegetables in your diet. Increase your intake of fiber and whole grains. Consider taking calcium and Vitamin D supplements to meet your daily requirements.
• Exercise regularly
  With an increased risk of developing cardiac problems and gaining weight, maintaining an active lifestyle is essential. After menopause, women's metabolism often slows down, increasing the likelihood of weight gain. Aim to walk for at least an hour each day. Additionally, Kegel exercises can strengthen the pelvic floor and help reduce urinary incontinence.
• Talk to a therapist
  Speak with a therapist or doctor about any mood changes or irritability you may experience after menopause. Many women show signs of depression, anxiety, and isolation during this time. Communicate your feelings to family and loved ones to express your needs.
• Practice relaxation techniques
  To manage stress and cope with mood changes, practice relaxation techniques such as light yoga or meditation. Yoga offers proven health benefits that can help manage weight and control stress levels.
• Manage sleep issues
  If you're experiencing sleep issues, consider natural sleeping aids like chamomile tea before bedtime. If problems persist, consult your doctor to identify the cause and seek treatment.
• Natural supplements
  Certain natural supplements may help manage menopause symptoms, including soy, Vitamin E, isoflavones, melatonin, and flax seeds.
• Cognitive Behaviour Therapy (CBT)
  CBT is a non-medical approach beneficial for various menopause-related issues such as anxiety, stress, depression, hot flashes, night sweats, sleep disturbances, and fatigue. It helps individuals develop practical strategies for managing problems and provides new coping mechanisms.
• Hypnotherapy
  Hypnotherapy has been shown to reduce the frequency and intensity of hot flashes and can assist with mild depression and anxiety. Techniques such as focusing on cooling imagery and using a flash control dial have proven effective in managing hot flashes.

Menopause is a natural cessation of a woman's fertile cycle. It brings a lot of physical and emotional changes to the body. Several women find it hard to adapt to these changes and feel confused about the sudden alterations in personality and physical appearance. However, menopause can be managed by implementing certain lifestyle modifications and medications. It is important to be aware of the complications that arise after menopause and take timely action to prevent them.

1. Maintain a healthy weight

A decrease in the level of estrogen increases your rate of weight gain and leads to a decline in the basal metabolic rate. This results in weight gain, especially around the abdominal region. To prevent this, it is important to stay physically active and eat healthily. You can restrict your calorie intake by 400 to 600 calories to compensate for your body burning fewer calories. Losing weight is not an easy task. Get help from our weight loss product range to kick start your journey. Tap to buy!

2. Quit smoking and limit your alcohol intake

Quitting smoking is an essential step towards leading a healthy life after menopause. Smoking increases your risk of developing heart disease, stroke, and osteoporosis. It also increases the frequency of hot flashes after menopause.

3. Get enough sleep

Avoid drinking caffeinated beverages that can make it harder for you to fall asleep. Exercise during the day instead of at night to ensure proper sleep. If you experience hot flashes during sleep, talk to your doctor about finding ways to manage them.

4. Cool your hot flashes

Dress in cool layers and keep yourself hydrated. Drink a glass of cool water or move to a cooler room. Try to pinpoint the triggers behind your hot flashes. These triggers may include beverages, caffeine, alcohol, or heat. You can even check out our range of feminine hygiene and care products. Browse here!