Early menopause on the rise, say experts

October 2016:

As World Menopause Day was observed globally on October 18, the focus this year is on — take action at menopause to prevent health problems in later life. Doctors say that a large number of women fail to take adequate precaution while they are undergoing menopause and end up suffering with chronic diseases as they age. And with the age of menopause coming down, it is even more imperative that women take utmost care.

What is menopause?

Consultant gynaecologist Dr Mamta Shriyan says that menopause is a transition phase from the reproductive to the non-reproductive phase in a woman's life. "It is also described as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity."

Adds gynaecologist and obstetrician Dr Bandita Sinha, "Ovaries gradually reduce their function, which causes hormonal imbalance, resulting in waxing and waning ovarian function along with physiological changes. Psychological changes also take place. Once a woman hasn't had her period for a year, we tell them that they are experiencing menopause."

Symptoms

Menopause is associated with the stopping of monthly periods along with other symptoms. These include:

Vasomotor symptoms like hot flushes, cold sweats and night sweats. Hot flushes occur as an abrupt onset of warmth, associated with redness and sweating lasting for a few seconds to several minutes.

Urogenital symptoms due to genitourinary atrophy leading to vaginal dryness, irritation, painful intercourse, recurrent urinary tract infections and sexual dysfunction like loss of sexual desire.

Somatic symptoms like back pain, stiff or painful joints, and body pain.

Other symptoms include mood disorders and depression.

Average age of menopause among Indian women

Says Dr Sinha, "Many women undergo early menopause. Sometimes women undergo menopausal changes at 35 or even before that age. Once you are not getting your menses and are above 40 to 45, it is advisable to go to a doctor for a check-up. If everything is normal and hormones are not in the menopausal range, we tell them not to worry. Many a times it so happens that women stop experiencing menses and assume it is because of advancing age but later get diagnosed with ovarian cancer."

Adds Dr Shriyan, "The average age of menopause in India is 46 to 48 years. This is lower than Caucasians, who undergo menopause at 51. Factors affecting the timing are familial factors, tobacco consumption and lifestyle. Menopause is advanced by up to four years in women, who have undergone a hysterectomy."

Early menopause on the rise

It is vital to get a medical check-up when you reach 40. "Sometimes, women may even undergo menopause at the age of 25 or 30, which is known as premature ovarian failure. These are women, who have a genetic history. Menopause often makes a woman overly conscious about her looks. She starts disliking her appearance and her behavior may show extreme level of physiological upset. Those around her should help alleviate her fears instead of aggravating them."

Adds Dr. Shriyan, "The age of 40 is used frequently as an arbitrary limit below which menopause is said to be premature. The incidence of premature menopause is gradually increasing due to a rising number of hysterectomies, intensive assisted reproductive technology and the improved survival of children with cancer (ovarian failure after chemotherapy or radiotherapy)."

How important are lifestyle modifications?

Eating foods rich in estrogen like soybean, soya milk, celery, parsley, beetroot, apples, broccoli, cauliflower, carrots, cucumbers, mushrooms, brussel sprouts, cherries, olives, pears, plums, tomatoes, oats, etc help in reducing hot flushes, apart from improving your skin tone and hair.

Once menopause sets in, women start losing their bone composition very fast. While women are in the reproductive stage, hormones protect the body from such bone loss. But once this protection is lowered (after menopause), bone loss is faster. Calcium-rich foods will help keep bones in good health and delay osteoporosis. A balanced diet will also help keep the digestive system running smoothly and keep indigestion and constipation at bay. Include plenty of fresh fruits and vegetables in your diet and make sure you exercise, practice yoga and meditation for mental and physical well-being. Drinking plenty of water and vitamin supplements also help.

Overall lifestyle modifications have a major role to play in menopausal health. They not only help control changes that are happening due to reducing hormone levels but also help maintain good health so that age-related diseases like cardiac disease, osteoporosis, osteoarthritis, depression can be kept at bay," explains Dr Sinha.

"If the symptoms of menopause become unbearable, approach your gynaecologist for Hormone Replacement Therapy (HRT). Walking and swimming are two of the most commonly recommended forms of exercises for menopausal women. Weight bearing exercises can reduce the risk of osteoporotic fractures by increasing bone strength and improving muscle strength and balance," ends Dr Shriyan. Times of India