Dr Shobha Teterwal
Dr Lekhika Singh
Menopause is a subject which is not commonly discussed in our nation. It actually needs more social and health attention because women during menopause experience many hormonal changes that affect their behavior and mood patterns. During menopause, a woman hardly realizes that her moods are fluctuating because of the menopause and often feels depressed about her behavior, even her family fails to recognize what is wrong with their superwoman.
Keywords : Menopause , hormones , diet , behavior , oestrogen , progesterone ,homoeopathy
Menopause is permanent cessation or stoppage of menstruation (periods) at the end of reproductive life of a woman between the age 45 – 50 years. It is difficult phase of a women’s life where she does all her work but her body and mind undergoes so many changes because of changes in the hormonal level ,which we all need to know and understand. Sometimes a woman who is not very educated or who is not related to medical field fails to understand what is wrong with her mood why is she behaving in certain impulsive manner ,dull manner or in a completely strange way than usual.
When menopause sets before the age of 40 then it is called premature menopause. Smoking may induce premature menopause.
When menopause occur after the age of 55 then it’s called delayed menopause. It can be a result of good nutrition and good health or in women who have utrine fibroids or in those women who have high risk of endometrial cancer.
Relation: menopausal age is not related to menarche (onset of menstrual cycle/periods), religion, race, number of pregnancies, lactation or taking oral contraceptives. It has relation with smoking and genetic disposition.
Climacteric: We often hear this term. Climacteric is actually a phase when ovary decreases it’s activity and may begin 2-3 years before menopause and may continue 2-5 years after menopause.
Why menopause occurs?
During climacteric, ovarian activity declines. Initially, ovulation fails, no progesterone is secreted by the ovary, estrogen activity is reduced and lining of the uterus undergo atrophy which leads to amenorrhea (stoppage of menses).
What are the symptoms of menopause?
Shorter cycles of menstruation, irregular bleeding, hot flushes, night sweating, sleep disturbances, vaginal dryness, dyspareunia, urgency to urinate, dysuria can also be present.
How menopause is diagnosed?
Cessation of menstruation for 12 months.
- Average age- 50 years
- Appearance of the menopausal symptoms like hot flushes and night sweat.
- General examination includes blood pressure recording, palpation of the breasts, weight, hirsutism (facial hair growth).
- Pelvic examination include pap smear.
- Blood sugar, lipid profile, ECG.
- Mammography, pelvic ultrasound.
- Bone density study.
- Oestrogen level, FSH level may be checked.
What are the later consequences of menopause?
Menopausal women who go through chronic oestrogen deficiency are prone to: bone problems – arthritis, osteoporosis and fracture.
Heart related problems like ischemic heart disease , myocardial infraction and atherosclerosis, stroke. osteoarthritis, fibrositis and backache may be age related.
Other problems may include skin changes, pigmentation, ano-colonic cancer and tooth decay
How to manage menopause ?
This is the most important part to learn about menopause.
Counseling: women often develops pregnancy and cancer phobia, here women should go to the gynecologist and she will do the thorough checkup and investigation and tell you how to manage this phobia.
The advices on the contraceptive is mandatory. Until menopause is completely established periods has stopped for 12 months, the couple is adviced to use barrier method. Hormonal pills are not that safe because of risk of thromboembolism. And woman can also share her mental state with her doctor so that she can be guided for the hormonal challenges of mood swings and depression. It is suggested that women should take their husband or children also for some part of the counseling because when you suffer, your family suffer too, and of course they can help and understand you better in your difficult days of menopause.
Exercises like weight bearing and yoga and meditation and a little social work or something that you enjoy doing can help in self management of menopause and will boost your confidence.
HRT (hormone replacement therapy) is the common therapy given to manage symptoms of menopause but it has numerous side effects if not taken in minimal required doses.
Women can also go to the safer therapies to manage menopause like homoeopathy, ayurveda, unani
In homoeopathy there are many medicine that can work wonderfully for the management of menopause like graphitis, lachesis, natmur etc.
- Graphitis : suited to women who are inclined to obesity, with all the symptoms of menopause ,women suffer from habitual constipation ,history of delayed menstruation is present..woman is indecisive .music makes her weep. she is timid. Cautious. Thinks of death all the time.
- Lachesis mutus :palpitation, flashes of heat, menses too short and feeble .pains all relieved by the flow.left ovary very painful and swollen. breast inflamtion can be present. coccyx and sacrum pain ,especially on rising from sitting position.
- Natrum mur: vaginal dryness is present, acrid leucorrhoea, prolapsus uteri with cutting in urethra, bearing down pains worse in the morning.menses irregular and profuse. symptoms worse in warm room, feels better by having irregular meals ,pressure against back
But no medicine should be taken without the proper prescription of physician.
Diet: Diet is important to support your immune system and to manage the menopausal symptoms and to prevent the late consequences of menopause .
So just include these in your diet :
- Calcium ( min. 1.2 g )
Sources : milk, curd, cheese, chia seeds, sesame seeds
- Vitamin A
Sources: orange and yellow vegetables and fruits like mango, carrots, apples, pumpkin, sweet potatoes
- vitamin C
Sources: orange, kiwi, lemon, guava, grape fruit, broccoli, cauliflower, capsicum, papaya
- Vitamin D ( about 400mg)
Sources: sunlight, fatty fish, soya milk, orange juice, beaf liver, cheese, egg yolks, salmon
Boericke W. Boericke’s new manual of homoeopathic materia medica with repertory.3rd revised and augmented edition based on ninth edition. B.Jain Publishers, New Delhi. 2020
Padubidri VG ,Daftary N Shirish howkins & Bourne Shaw’s textbook of gynaecology 14th edition
Allen H.C. Allen’s keynotes Rearranged and classified with leading remedies of material medica and bowel nosodes 10th edition
Dr. Shobha Teterwal
H.O.D. (Dept.ofPaed., SKHMC&RC)
MD Part II (Dept.of Paed., SKHMC&RC)