Let's talk about menopause

News for those who think menopause is about night sweats; there's more going on below the surface than you can tell

Every time we talk about menopause, there's the litany of discomforts - hot flashes, night sweats, insomnia, headaches, mood swings, depression and vaginal dryness. That's just the party on the surface; there's a mutiny boiling underneath.

Menopause is a transition period when the ovaries stop producing eggs, the body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether. This normally occurs between the ages of 45 and 55. A gradual decrease of estrogen allows the body to adjust to the hormonal changes, and because of the fall in these hormone levels, changes occur in the reproductive system.

Gyneacological endoscopic and pelvic oncosurgeon Dr Uddhav Raj tells you five things you didn't know about menopause


1. You can roar in bed

During menopause, the vaginal walls become less elastic and thinner. The vagina also becomes shorter and it secretes less lubrication. The outside genital tissue also thins, which is called atrophy of the labia. All this may lead to poor response to sexual stimulation. However, there is no need to give in. Drink lots of water to ensure enough fluid to regulate proper functioning of the tissue. Also, weekly internal application of vaginal estrogen cream is recommended, but only under medical supervision. As Raj says, "Menopause is not a limiting experience; if approached properly, it can be a liberating one."



2. Nature calls often

Most menopausal women suffer from incontinence and need to urinate frequently. Normally, the urge to pass urine occurs only when there is 150 ml liquid stored in the bladder, but menopausal women may even get the feeling when there is only 60 ml. In an emotional state, they may even leak without realising. Raj says, "Muscles of the vagina and the pelvic region become weak. This problem, however, can be treated medically."

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3. You can get pregnant

Though you stop producing eggs during menopause, you can still get pregnant through in-vitro fertilization with a donor egg. If you plan to have a child later on, you can even have your eggs frozen for later use. During the permenopause stage, when the periods become irregular, there is a slim chance of natural pregnancy. However, in both cases of prenancy, the success rate is very low.


4. Guests arrive early

Sometimes the symptoms of menopause start three to 10 years in advance. This is known as perimenopause. You may no longer sleep as well, feel mentally sluggish, have trouble concentrating and even experience short term memory loss. These may arise slowly, or come at once and differ from woman to woman. Smokers go through these changes earlier and they also tend to be more intense.



5. You can eat estrogen

Hormone Therapy is not harmful and is not required for every patient. Doctors recommend this treatment to only those who show severe symptoms of menopause. Soybean, which has phyto-estrogen and isoflavones estrogen molecules, is a natural as well as viable option for external hormonal support. Switch to soy flour chapatis to help make up for the lack of estrogen in the body.

When you come to your mid 40s, here are a few tests you should undergo

• In some women, menstrual flow comes to a sudden halt. Blood and urine tests can be used to measure changes in hormone levels that may signal when a woman is close to menopause or is already undergoing menopause.
• If you have had six consecutive months with no periods and suddenly spot vaginal bleeding or spotting begins again (even if it is a very small amount), visit your doctor immediately and do as told.
• Having regular pelvic exams, and Pap smears (once a year after the age of 35; and every six months after 40) to detect if there is a risk of cervical cancer.