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All About Menopause

What is menopause?

Menopause refers to the period when a woman loses her ability to conceive, as there is a permanent ending of menstruation. It generally occurs between 45 to 55 years of age. It can be a natural cessation or artificial — when a woman gets her ovaries surgically removed – this is called bilateral oophorectomy.

For women undergoing natural menopause, the process is described in 3 stages: perimenopause, menopause and post-menopause. Menopause is said to occur when a woman has not had any periods for a year.

Why does menopause happen?

As a woman approaches her late 30s or 40s, the quality of eggs produced by the ovaries tends to deteriorate, and finally stop. When it stops, a woman’s periods or menses become irregular and cease. This is because the inner lining of the uterus, which prepares for the fertilised egg to implant itself becomes redundant. It is this lining that comes out during a woman’s period when pregnancy does not occur.

As the ovaries stop producing eggs, the hormones that it secretes, namely oestrogen and progesterone also decrease. These hormonal changes are responsible for most menopausal symptoms like hot flashes, irritability and disrupted sleep.

What is Perimenopause?

Perimenopause is the first stage of natural menopause. It refers to the rime period when a woman’s body shifts from regular menstruation/ovulatory cycles to a permanent cessation of menstruation and ovulation (infertility). It is also called as menopausal transition.

It usually occurs in the fourth decade of a woman’s life but may begin as early as late thirties. When a woman goes through a year without having had a period she has reached menopause and the perimenopausal period is over.

This stage is characterized by changes in the menstrual cycle, vaginal dryness, mood disturbances and sleep problems among others.

Symptoms of Menopause

Listed below are the typical symptoms of menopause.

  • Hot flashes: You feel a burning sensation rising from your chest to your face and find beads of perspiration trickling down your face. You are experiencing hot flashes which last for a few minutes and then disappear.
  • Night sweats and insomnia: Sometimes you wake up at night and find yourself sweating mildly or profusely. You may also have problems falling asleep and find yourself awake for hours when earlier insomnia was never a problem.
  • Irregular periods: In some women, the periods have scanty flow before ceasing completely. In others, there may be heavy bleeding and the duration of periods may increase.
  • Emotional changes: These are very commonly seen. You may find yourself becoming moody, irritable, fatigued and restless. Sometimes, depression may also occur in the menopausal period
  • Urinary incontinence: The wonderful female hormone oestrogen also helps maintain the tone of the urethra (the tube connecting the bladder to the outside opening). When oestrogen is in short supply during menopause, symptoms of incontinence like dribbling of urine occur. A woman may not be able to exercise control while coughing or sneezing and this may cause urine to leak out posing an embarrassment.
  • Loss of libido: Due to lack of oestrogen, vaginal dryness occurs and as a result sexual intercourse may become painful. Hence a woman may try to avoid having sex. Also due to the other changes in her body she might be stressed and this causes the temporary loss of libido.
  • Vaginal infections: During and after menopause a woman is more prone to vaginal infections due to removal of the protective effect of hormones.
  • Headaches: In women prone to getting them, headaches can occur more frequently during this phase. They may also occur as a result of anxiety and stress.
  • Forgetfulness: Forgetfulness has been documented in some women and may be the result of hormonal changes.
  • Joint aches and pains: This may be due to the lack of calcium in the diet, impending osteoporosis and lack of exercise.
  • Change in body shape: After menopause, women tend to accumulate more fat around the abdomen and breasts may lose their fullness.
  • Palpitations: Palpitations means the awareness of one’s heartbeat. It may occur along with anxiety and during extreme mood swings.

The symptoms of menopause vary from woman to woman. Menopause is a biological phenomenon, and some women sail through it smoothly while for others, they are turbulent times.

How is menopause diagnosed?

It’s worth talking with your doctor if you are experiencing disabling or troublesome menopause symptoms, or you are experiencing menopause symptoms at 45 years of age or younger.

To check if you are experiencing menopause, your doctor may ask you to get a blood test that checks your follicle stimulating hormone (FSH) level. FSH is a hormone produced by pituitary gland, which is located at the base of our brain.

For many women, this blood test is not required. If you or a loved ones are having the symptoms of menopause and the periods have been irregular, see your doctor. Your physician will be able to diagnose menopause after a conversation with you.

A new US FDA (Food and Drug Administration) approved blood test, called PicoAMH Elisa diagnostic test is being used to help determine whether a woman entered menopause or is on the verge of entering menopause. This test can be helpful to women showing symptoms of perimenopause, which can also lead to adverse health impacts.

Other commonly used blood tests to confirm menopause include:

  • Blood lipid profile
  • Thyroid function tests
  • Kidney function tests
  • Liver function tests
  • Testosterone, prolactin, progesterone, chorionic gonadotropin (hCG) and estradiol tests

Duration of Menopause

The length of menopause could be for a few months or as long as five years. In induced menopause (due to the removal of the uterus – hysterectomy or chemotherapy or radiation of ovaries in case of ovarian cancer) menopause occurs more abruptly and the symptoms are said to be more severe.

If you are in the age bracket of 45-55 years and have skipped a period make sure to check if you are pregnant. It is easy to attribute some pregnancy symptoms to menopause.

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