Indian Write-Ups

Menopause is a natural physiological event, which is considered to have occurred after a one-year absence of Menstrual periods. Associated with a gradual decrease in the ovarian function the Menses taper off over a period of 2-5 years between the ages of 48 to 55.

During the perimenopausal period women have irregular menses with variations in the menstrual intervals, and quantity of menstrual flow. The intervals become longer and the flow scanty.

A significant proportion of women, do not experience any adverse effects during this period – in fact they feel freer because they do not have to worry about the discomforts of periods and unwanted pregnancy.

About 50% of women however describe the menopause as an unpleasant experience, the symptoms being both physical and psychological.

Physical symptoms associated with the menopause

Prominent physical symptoms that occur are night sweats and hot flashes. The woman gets up at night suddenly sweating profusely – to the extent that her bedding gets soaked.

Hot flashes are a sudden perception of heat accompanied by sweating and colour change in the face and upper part of the body, lasting from a few minutes to a maximum of about thirty minutes.

The exact cause of these symptoms is not fully understood, but they are probably due to bouts of secretion of leutenising hormone (LH), combined with oestrogen depletion.

Hot flashes start in the perimenopausal period and gradually fade away over a period of two to three years.

Sequential loss of oestrogen function leads to atrophic changes in the mucosal surfaces resulting in vaginitis, pruritis, dysparunea and ultimately vaginal stenosis.

Oestrogen depletion also leads to changes in calcium and lipid metabolism, which result in medical problems associated with osteoporosis and arteriosclerosis.

Osteoporosis causes decreased density of bones, makes postmenopausal women more susceptible to fractures.

Arteriosclerotic changes make the women more prone to hypertension, cardiovascular disease and cerebrovascular disease. After the age of 50, the incidence of the above conditions in men and women become equal as the protective influence of oestrogen on the blood vessels is lost.

Physical symptoms do not cause psychological symptoms, but certainly contribute to perpetuating these symptoms.