Everything You Should Know About Menopause

Menopause refers to the time when a woman’s menstrual cycle stops altogether. During this phase, your ovaries stop releasing eggs which usually occurs in your late 40s or early 50s.

But menopause also may occur earlier in some women. This article shares everything you need to know about menopause.

What is Menopause?

When a woman does not menstruate continuously for 12 months after her last period, she is said to have entered the stage of menopause. Since the ovaries stop releasing eggs, the woman can no longer conceive naturally.

Females aged 45-55 undergo menopause naturally. The average age at menopause for women in India is 46.6 years. It isn’t a disorder or disease, so most women don’t require any treatment.

However, you may require treatment if:

• You experience signs of early menopause and plan on becoming pregnant
• You experience severe menopause symptoms such as stiff joints, increased urination, painful intercourse, hot flashes, or vaginal dryness

Menopause symptoms

Before a woman stops menstruating completely, she undergoes certain changes in her hormonal levels, particularly progesterone  and estrogen levels. During this time, she may experience symptoms such as hot flashes and trouble sleeping at night.

This phase is known as perimenopause or menopausal transition, and it may last anywhere between seven to 14 years. The duration depends upon genetics, age, ethnicity, and lifestyle factors such as smoking.

Listed below are the common signs of menopause:

• Hot flashes: They are a sudden feeling of heat that starts in the chest, moves up the neck and face, and sometimes causes sweating. Hot flashes can last for thirty seconds or more and can happen as often as every hour.
• Vaginal atrophy: It is a condition that occurs when the tissues in the vagina become thin and dry and can happen after menopause when the estrogen levels in the body decrease. It can cause women to have painful intercourse and also leads to urinary incontinence (intense, sudden urge to urinate).
• Trouble sleeping: If you experience heavy night sweats, you may wake too early or have trouble falling asleep at all. The lack of sleep, in turn, contributes to increased stress, irritability, anxiety, or depression.
• Cardiac symptoms: Fast heart rhythm, cardiac palpitations, and dizziness are some cardiac symptoms of menopause.

Research confirms that the most common menopause symptoms are:

• hot flashes (40%)
• insomnia (16%)
• vaginal dryness (13%)
• mood disorders (12%)

Other menopause symptoms include memory problems, urinary tract infections (UTIs), reduced bone mass, hair thinning, and increased hair growth on other body parts such as the upper back, chest, face, and neck.

Menopause causes

Menopause is a natural process that every women has to go through as they get older.

However, some women may experience premature menopause due to a variety of reasons, including:

• Premature ovarian failure

Due to unknown reasons, your ovaries may stop releasing eggs prematurely. When this occurs before the age of 40, it’s termed as a premature ovarian failure.

Worldwide, this condition affects 0.1% of women below 30 years of age and 1% of women below 40 years of age. Also known as premature ovarian insufficiency (POI), it’s a major cause of infertility in women under 40.

• Induced menopause

Certain medical procedures like chemotherapy or radiation can damage your ovaries. This may lead to induced menopause. Apart from that, surgical removal of one or both of your ovaries (oophorectomy) can cause abrupt menopause.

This procedure is used for treating large ovarian cysts, benign tumours, chronic pelvic pain, and pelvic inflammatory disease. The hysterectomy procedure (removal of the uterus) also leads to the cessation of menstruation.

Certain autoimmune disorders such as lupus and Graves’ disease cause premature menopause as well.

According to research, 3.7% of women in India report premature menopause. Nearly 1.7% of them have surgically induced menopause, while 2% have undergone natural premature menopause.

Menopause diagnosis

The only way to get a confirmation is to get a formal diagnosis. Before you consult a doctor, try tracking your periods. The uneven pattern will serve as an additional clue for your doctor.

A gynaecologist may recommend tests to determine the levels of:

• Follicle-stimulating hormone (FSH): When you approach menopause, the FSH goes up.
• Estradiol: The level of Estradiol tells how much estrogen is being produced by your ovaries. During menopause, the Estradiol decreases in level.
• Thyroid hormones: Problems with the thyroid gland cause symptoms that mimic menopause.

The lack of menstruation for 12 consecutive months can further confirm your diagnosis.

Menopause treatment

Since menopause is a natural phenomenon in most women, most symptoms will fade over time. However, if menopause symptoms are reducing your quality of life, you may want to consider treatment options.

Some of them may include:

• Sleep medications for insomnia
• Estrogen-based lubricants and moisturisers for vaginal atrophy (also known as topical hormone therapy)
• Certain medications for hair loss and hair thinning
• Medications and vitamin D supplements for postmenopausal osteoporosis (weak and brittle bones).
• Antibiotics for UTIs
• Medications for depression, anxiety
• Hormone replacement therapy (HRT) for hot flashes
• Lifestyle changes such as smoking cessation and reduced alcohol intake

It’s important to note that you must never self-medicate under any circumstances. Your doctor will chart a suitable treatment plan based on your diagnosis.

Bleeding after menopause

Some women experience bleeding after menopause, and it can be a sign of a more serious health issue. Postmenopausal bleeding occurs after a year since the last period.

It can be a symptom of uterine cancer, polyps (noncancerous growth), or vaginal dryness.

Bleeding after menopause requires medical attention and suitable treatment.

Can you get pregnant post menopause?

Since your ovaries cannot release eggs after menopause, you cannot become pregnant naturally. However, that shouldn’t stop you from becoming a parent. Even though your eggs have a biological clock, your reproductive system continues to function.

A combination of donor egg and In vitro fertilisation (IVF) method can help you become pregnant. The donor egg is infused with your partner’s sperm artificially, after which the embryo is transferred into your uterus.

The IVF technique could help you become a parent if you froze your eggs earlier in life. However, the pregnancy won’t likely be without minor or major complications. You may have a caesarean birth, premature birth, high blood pressure, gestational diabetes, etc.

Doctors will closely monitor your pregnancy. If the risk is too high, you can consider surrogacy.

To determine the best course of action for your family, consult a fertility expert.

Conclusion

A few women experience premature menopause due to autoimmune disorders, premature ovarian insufficiency, hysterectomy, radiation, oophorectomy, or chemotherapy. It’s a prominent cause of infertility in women under 40.

The treatment plan for this usually involves the management of symptoms using medications and lifestyle changes. If you plan on becoming a parent, you have two options: IVF and donor egg or IVF and frozen egg methods.

To get the best diagnosis and treatment for menopause and infertility, visit Birla Fertility & IVF or book an appointment with Dr. Sugata Mishra

FAQs :

1. What happens during menopause?

It is a time when your body stops producing estrogen and progesterone. This can leave you feeling fatigued, moody, and hot flashes.

2. What are the three stages of menopause?

Women undergo three stages of menopause: perimenopause, menopause, and postmenopause.

3. What are the first signs of menopause?

The first signs of menopause include sore breasts, trouble sleeping, vaginal dryness, missed or irregular periods, and mood changes.