Menopause is a transitional phase in a woman’s life. Starting with perimenopause, when a woman’s body slows down the production of estrogen and progesterone with significant changes in the menstrual pattern, menopause technically begins when a woman has not had her period for 12 months. It is a part of the normal ageing process that every woman has to undergo at some point in her life.
A pan India survey conducted by IMS identified 46.2 years as the average age of natural menopause in India, which is about 5 years earlier than in the Western world. One estimate suggests that 130 million Indian women were expected to live beyond menopause by 2015. Based on current life expectancy and an average age of menopause, Indian women are expected to live approximately 24 years beyond menopause.
Menopause triggers drastic changes in a woman's body such as hot flushes and sweating (65per cent), sleep disturbance (45 per cent), vaginal dryness and atrophy (45 per cent), painful intercourse (20 per cent), urinary incontinence (30-40 per cent), joint and back pain (45-60 per cent), mood swings (60 per cent), forgetfulness/poor concentration (40 per cent), depression and anxiety (20-60 per cent). These, in turn, lead to reduced Quality of Life (QoL).In some women, natural menopause occurs earlier. Early menopause extends the years lived with lowered quality of life, while also posing a relatively higher risk of heart disease. Lifestyle choices such as smoking and drinking, auto-immune diseases such as thyroid and exposure to radiation or chemotherapy can often cause early menopause.
In addition to causing physical distress, menopause can adversely impact all aspects of life. Not only does it have an impact on emotional well-being, but it is also observed that 45 per cent of working women struggles at work due to reduced productivity, 33 per cent of menopausal women feels that their social life takes a back seat and 51 per cent feel they are unable to enjoy their conjugal life.
Women with early menopause are twice as likely to suffer from coronary heart disease and are also at higher risk of developing type 2 diabetes, than those with later onset of menopause. According to Dr Meeta Singh, Consultant Gynecologist & Ex-IMS President, Tanvir Hospital, Hyderabad “Early menopausal women need comprehensive care for early diagnosis of cardiovascular diseases, diabetes and osteoporosis. And regardless of the age of onset, about 81 per cent of post-menopausal women have a low bone mineral density (BMD) due to falling estrogen hormones leading to increased osteoporosis and fracture risk.”
During the menopausal phase, it is important for a woman to be candid with her doctor about symptoms and discuss the best treatment options to improve quality of life. Dr Singh elaborates, “Though women are opening up in today’s India, they may still hesitate to discuss private topics and symptoms such as depression, vaginal dryness or difficulty having intercourse. Moreover, many women still do not prioritise their own health, often putting their distress on the backburner and suffering silently. Open and honest conversations with healthcare providers on menopause, its symptoms and the best treatment options are essential.” In consultation with their doctor, women can then choose dietary changes, exercise regimens and therapy that is best suited to their menopausal symptoms, medical history, and personal preferences, thus ensuring a smooth transition into the post-menopause phase.
Currently, treatment options include both non-hormonal therapy and menopause hormonal therapy (MHT). Though the former is more commonly prescribed throughout India as it has higher patient acceptance, science shows that MHT has multiple benefits, including alleviation of symptoms such as hot flashes, sleep disturbance, mood swings, and painful intercourse. MHT also helps reduce the risk of osteoporosis and CVDs, especially in women with early menopause. According to Dr Singh, “Women can keep the symptoms of menopause at bay by supplementing their estrogen and progesterone levels. Menopause Hormone Therapy (MHT) started in consultation with a qualified doctor at the right time, with the right dosage and for the right duration can help menopausal women enjoy a better quality of life and live healthily.”
Though menopause is a personal experience, a woman does not have to cope with it on her own. Healthcare professionals can help in management to enhance the quality of life. The need of the hour is to educate both women and their families on the importance of holistic management of menopause, so they can stay healthy and feel good at any stage of life.
