Every woman has to experience menopause. During this phase, there are many psychological and physical changes. Some women tend to experience symptoms like hot flashes that can affect their quality of life. However, in some, it is a smooth sailing experience with no outward symptoms.
Menopause is defined as permanent cessation of menstruation. For example, if a woman doesn’t have periods for 12 months at a stretch, she is said to be in menopause. Usually, menopause occurs between 45 – 55 years of age. However, the cases of premature menopause (before 40 years of age) are rising in India.
What are the symptoms of menopause?
Every woman undergoes a phases known as perimenopause (also known as menopause transition) years before hitting menopause. It usually starts in the 40s but can event start in the 30s in some women. It is marked by a drop in the hormone estrogen. Over time, the ovaries tend to gradually decrease the production of estrogen and finally stop releasing eggs, when you hit menopause. Here are some of the common signs and symptoms of menopause.
1. Irregular periods: The changes in menstruation such as irregular periods with heavy or light blood flow or spotting in between periods, can be a sign of menopause. Also, periods which lasts longer or shorter than your regular menstrual cycle could indicate perimenopause. However, if you have spotting after a year of no periods (amenorrhea), then do consult your gynecologist to rule out cancer.
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2. Hot flashes: This is one of the key symptoms of menopause. A hot flash is a sudden sensation of heat all over the body. It can also make your face and neck turn red and make you feel sweaty. The exact mechanism of hot flashes is not understood but is believed to be regulated by the brain which dilates the blood vessels causing more blood to flow through the skin and leading the body to cool off.
The intensity of hot flashes can range from moderate to severe, keeping you awake the whole night. Usually, hot flashes last for an average of three minutes. Some women may experience this symptom for a year or two after their final period.
3. Vaginal dryness: Menopause causes a decreased production of estrogen and progesterone. These hormones are known to play a key role in lubricating the vaginal walls. Lack of these hormones during menopause causes vaginal dryness. This also leads to a burning sensation and itchiness in the vagina. Moreover, it can also lead to pain during sex.
4. Insomnia: It is known that the quality of sleep tends to deteriorate with age and menopause tend to make things worse. This could be attributed to the hormonal changes that happen during menopause and aging. Also, night sweats can make a woman stay awake the whole night which can also lead to difficulty in sleeping and insomnia. In such a case, it is wise to consult a doctor to know about the possible treatment options to deal with insomnia during menopause.
5. Bladder problems: It is seen that women who hit menopause tend to lose control over the bladder. This is because, with age and menopause, the tissues present in the vagina and urethra lose elasticity. It also causes the weakening of the pelvic muscles, increasing your risk of urinary incontinence.
Menopause also puts you at high risk of urinary tract infection (UTI) due to low levels of estrogen and changes in the urinary tract. If you suffer from recurrent UTI or feel an urge to urinate more often, then do consult a doctor.
6. Mood swings: Most women tend to feel irritable and moody around the time of menopause. Although the exact cause of mood swings during menopause is not clear, it could be due to the sudden imbalance in the hormones.
Several studies have shown an increased risk of women suffering from depressed mood during menopause and a 3 fold risk for developing a major depressive episode during this stage.
The other factors such as stressful life, lack of sleep, higher body mass index (BMI) and smoking can increase the risk further.
7. Decreased libido: It is common for women to lose interest in sex during menopause. This is because numerous changes in the body caused due to low levels of hormones can lead to delayed orgasm and lack of sex drive. Also, vaginal dryness during menopause can make sexual intercourse more painful, lowering sex drive.
It could also be due to a condition known as vaginal atrophy, which is characterized by thinning and inflammation of the vaginal walls. This causes pain during sex and thus, lead to decreased sex drive in women. Talk to your doctor for tips and treatment to deal with it.
The symptoms of menopause are mainly due to lowered production of the hormones, estrogen, and progesterone, by the ovaries. Moreover, the symptoms may vary from one woman to another so you need to discuss your specific concerns with your gynecologist.
(The article is reviewed by Dr. Nupur Gupta, Gynecologist, Delhi)
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References:
1. Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their Management. Endocrinol Metab Clin North Am. 2015 Sep;44(3):497-515.
2. Dalal PK, Agarwal M. Postmenopausal syndrome. Indian J Psychiatry. 2015 Jul;57(Suppl 2):S222-32.
3. Grant MD, Marbella A, Wang AT, et al. Menopausal Symptoms: Comparative Effectiveness of Therapies [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. (Comparative Effectiveness Reviews, No. 147.) Introduction.