Understanding Menopause: Symptoms, Causes And Treatment Options

Menopause is defined as having no menstruation for 12 consecutive months. It is a normal part of aging and is associated with a decrease in the production of hormones like estrogen and progesterone.

All about menopause (Representational Image)

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New Delhi: Menopause is a natural biological process that marks the end of a woman's reproductive years. It typically occurs between the ages of 45 and 55, with the average age being around 51. Menopause is defined as having no menstrual periods for 12 consecutive months. This transition is a normal part of aging and is associated with a decrease in the production of hormones like estrogen and progesterone by the ovaries.

Symptoms Of Menopause:

Dr Swathi Gogineni, MS, DNB, FMAS, DMAS, Fellowship in infertility, Consultant Obstetrician and Gynaecologist and infertility specialist at Apollo Clinic, Manikonda shared the symptoms of menopause:

• Irregular Periods: As women approach menopause, their menstrual cycles may become irregular, with changes in cycle length and flow.
• Hot Flashes and Night Sweats: Hot flashes are sudden sensations of heat that spread over the body, often accompanied by flushing and sweating. They can also occur at night, leading to night sweats and disrupted sleep.
• Vaginal Changes: Decreased estrogen levels can lead to thinning and drying of the vaginal walls, causing discomfort, pain during intercourse, and an increased risk of urinary tract infections.
• Sleep Disturbances: Hormonal changes and night sweats can lead to sleep disruptions, causing fatigue and irritability.
• Mood Changes: Fluctuations in hormones can contribute to mood swings, irritability, anxiety, and even depression.
• Weight Gain: Hormonal changes can sometimes lead to weight gain, particularly around the abdomen.
• Bone Health: Estrogen helps maintain bone density, so its decrease during menopause can increase the risk of osteoporosis.
• Cognitive Changes: Some women report memory problems and difficulty concentrating during menopause, although the exact link is still being studied.

Phases Of Menopause:

Menopause occurs in 2 phases as suggested by Dr. Madhulika Singh, Consultant Obstetrician & Gynaecologist, Ankura Hospital, Pune.

Perimenopause -This phase usually begins several years before menopause when your ovaries slowly make less estrogen. In the last 1-2 years of this stage, estrogen level falls faster.

Menopause - This is when it’s been a year since you had a period, and your ovaries have stopped releasing eggs and making most of their estrogen.

Causes of Menopause:

The primary cause of menopause is the natural aging process, which leads to a decline in the function of the ovaries and a decrease in hormone production.

But, Dr. Veena Aggarwal who is a Trustee at Heart Care Foundation of India, CMD and Group Editor-in-chief, IJCP Group of Publications and Medtalks said, "Emerging research suggests that other factors such as genetic predisposition, lifestyle, use of oral contraceptives, clinical conditions like obesity and hypertension, and environmental elements can also lead to the early or delayed onset of menopause."

"According to the clinical statistics, early menopause (menopause before 45) occurs in about 5% of women, while premature menopause (menopause before 40) happens in about 1% of people assigned female at birth (AFAB). It’s rare to experience menopause in the 20s, which occurs in about 0.1% of people AFAB," she further added.

She also said that as per studies, women with a family history of early or late menopause may experience a similar trend. It is believed that in about 50% of women, genetic factors play a role in determining the age of onset of menopause. Lifestyle choices such as smoking, alcohol abuse, and heavy physical activity contribute to alterations in menopause timing, causing earlier onset. On the contrary, frequent sexual activity, number of pregnancies and healthy dietary habits with higher intake of B6 and zinc are associated with a higher age of natural menopause.

"Additionally, environmental factors, including exposure to certain chemicals and pollutants, are also potential influencers of menopause onset. Substances like endocrine disruptors, commonly found in plastics and pesticides, have been scrutinized for their potential impact on hormonal balance, which could, in turn, affect the timing of menopause," she further added.

Treatment Options:

Dr Swathi Gogineni shared the probable treatment options of symptomsduring menopause"

• Hormone Replacement Therapy (HRT): Estrogen therapy can help alleviate hot flashes, night sweats, and vaginal dryness. However, HRT is not suitable for everyone and comes with potential risks, including an increased risk of blood clots and certain types of cancer.
• Non-Hormonal Medications: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can help manage hot flashes and mood changes.
• Lifestyle Changes: Regular exercise, a healthy diet rich in calcium and vitamin D, and avoiding smoking and excessive alcohol consumption can help manage symptoms and maintain overall health.
• Vaginal Moisturizers and Lubricants: These products can help alleviate vaginal dryness and discomfort during intercourse.
• Bone Health: Calcium and vitamin D supplements, along with weight-bearing exercises, can help maintain bone density.
• Counseling and Support: For mood changes and emotional challenges, counseling and support groups can be beneficial."

Dietary Requirements For Women Undergoing Menopause:

Menopause marks a significant transition in a woman's life, with a cascade of hormonal changes that can influence various aspects of health. It is crucial to navigate the nutritional needs during this transitional phase. During menopause, women often experience a range of physical and emotional symptoms due to hormonal fluctuations. These symptoms can be managed effectively with a holistic approach towards diet and lifestyle. Here are a some dietary requirements suggested by Dietician Garima Goyal:

• Amla, or Indian gooseberry, holds potential benefits for menopausal women. Eating an amla every day can help in alleviating symptoms like hot flashes. This effect can be attributed to the presence of phytoestrogens in amla. Amla also helps during menopause to keep your lipid profile under control.
• While many minerals are important during menopause, magnesium can help in boosting your energy metabolism and ensure muscle performance. You can include magnesium-rich food sources such as dark chocolate, green leafy vegetables, nuts, and seeds.
• During pre-menopause, where there is irregular menstruation and heavy bleeding it is helpful to add more nourishing foods like fruits and vegetables to the diet. Iron-rich foods such as green leafy vegetables, organ meat, raisins, pulses (consumed with a tablespoon of lemon juice or any vitamin C sources), sesame seed balls, and dried apricots can help maintain your hemoglobin levels.
• Owing to the hormonal changes, there is an increased risk of bone deterioration. For this, it is important to consume foods that are good sources of 'bone minerals and vitamins' such as vitamin D, vitamin K, and calcium. You should include foods like Dairy products- milk, cheese, paneer, Green leafy vegetables, eggs, tomato, onion, cabbage, cauliflower, and adequate sun exposure.
• The utilization of red clover to alleviate menopausal symptoms has emerged relatively recently. Much like soy products, the majority of studies indicate only modest efficacy in reducing hot flashes. Like soy, red clover has also been proposed as a potential preventive measure for osteoporosis, improvement of lipid profiles, and even cognitive function.
• Talking about supplements, it is important to take any medications only under the guidance of a clinical dietitian or your physician. Supplements like vitamin D, calcium, vitamin C, B vitamins, and isoflavones can help in alleviating the symptoms.

A balanced diet rich in nutrients such as calcium, vitamin D, omega-3 fatty acids, and antioxidants can offer holistic support by improving bone health, managing hormonal fluctuations, and mitigating oxidative stress.