Menopause

Menopause Q & A

Q1. What is menopause?

Menopause is referred to as that phase of life when there is permanent cessation of your menstrual cycles and you don’t get your periods for 12 consecutive months. After menopause, you cannot get pregnant naturally. It is a natural process that occurs due to depletion of eggs in the ovaries as a result of aging.

Q2. What age does menopause start?

Menopause generally occurs between the age of 45 and 55 years. In about one percent of females, it begins before they reach the age of 40 years. This is known as primary ovarian insufficiency or premature menopause. In about five percent of females, menopause occurs between the age of 40 and 45 years. This is called early menopause.

Q3. What are the symptoms and signs of menopause?

Menopause symptoms in every female are unique. They are generally more severe in intensity when menopause happens over a short duration of time or suddenly.

The common pre menopause symptoms or early menopause symptoms are:

• Less frequent menses
• Lighter or heavier menses than normal
• Vasomotor symptoms such as hot flashes, flushing and night sweats

Some other common menopause symptoms include:

• Insomnia
• Dryness of the vagina
• Chills
• Sleep problems such as insomnia
• Mood changes
• Dryness of skin, eyes, and mouth
• Thinning or loss of hair
• Slowed metabolism and menopause weight gain
• Depression
• Anxiety
• Reduced breast fullness
• Memory problems
• Difficulty in concentration
• Reduced sex drive or libido
• Headaches
• Increased urination
• Racing heart
• Tender or sore breasts
• Increased urinary tract infections
• Stiff or painful joints
• Decreased muscle mass
• Increased growth of hair on other regions of the body including the face, chest, upper back, and neck

Q4. What are the causes of menopause?

Menopause usually occurs as your ovaries produce a reduced quantity of reproductive hormones due to aging. In response to reduced levels of reproductive hormones including estrogen and progesterone, several signs of early menopause are produced in your body during your late 30s. When you reach your 40s, your menses become irregular until they stop by the age of 51 year as your ovaries stop the production of eggs.

In certain females, menopause is induced by removing the ovaries surgically or by an injury. Some of the common ways in which menopause may be induced are:

• Surgical removal of both the ovaries also known as bilateral oophorectomy
• Pelvic radiation
• Ovarian ablation, in which the function of the ovaries is stopped by hormone therapy, radiotherapy or surgery in females who have estrogen receptor (ER) positive tumors
• Pelvic injuries, which severely destroy or damage the ovaries

Q5. How do doctors diagnose menopause?

You should talk to your physician if you are suffering from disabling or troublesome symptoms and signs of menopause, particularly if your age is 45 years or less.

A new blood test referred to as the PicoAMH Elisa diagnostic test has been approved recently by the Food and Drug Administration (FDA). This test helps in determining whether a female is in early menopause state or has entered menopause. This test is especially helpful for females who show signs of early menopause as it may have a negative effect on their health. Early menopause can make you more prone to develop heart disease, osteoporosis, and bone fracture, vaginal changes and reduced libido, mood changes and cognitive changes.

Your doctor may also recommend blood tests to measure levels of certain hormones including FSH and estradiol. Consistently elevated levels of FSH (30 mIU/mL or higher) in association with no menses for 12 consecutive months is generally a confirmation of menopause.

Depending on your health history and symptoms, your doctor may also recommend additional tests to rule out any other medical condition that may be causing your symptoms. Additional tests that are used to help in the diagnosis of menopause are:

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

Q6. What is menopause treatment?

You may require treatment in case your menopause symptoms and signs are severe or they affect your life quality. Hormone therapy is an effective form of menopause treatment in females below the age of 60 years or within ten years of the onset of menopause. It helps in reducing the following symptoms of menopause:

• Night Sweats
• Hot flashes
• Flushing
• Osteoporosis
• Vaginal atrophy

Additional menopause medication sometimes used to treat other symptoms includes:

• Minoxidil five percent topically once a day for hair loss and thinning
• Antidandruff shampoos for hair loss
• Eflornithine hydrochloride cream topically for unwanted growth of hair
• Selective serotonin reuptake inhibitors (SSRIs) for anxiety, depression and hot flashes
• Nonhormonal vaginal lubricants and moisturizers
• Vaginal lubricants containing low-dose estrogen in the form of a ring, cream or tablet
• Sleep medicines for insomnia
• Prophylactic antibiotics for UTIs
• Ospemifene for dryness of vagina and pain during sex
• Denosumab, raloxifene, calcitonin or teriparatide for post menopause symptoms of osteoporosis

Q7. What are the home remedies and alternative treatments for menopause relief?

You can reduce mild to moderate menopause symptoms and signs naturally by using alternative treatments, home remedies, and lifestyle changes.

• Dress in loose and layered clothing to help manage hot flashes. Keep the temperature of the bedroom cool to reduce night sweats.
• Reduce your calorie intake by about 400-600 calories daily. This can help in managing your weight. You should do moderate intensity exercise for 25-30 minutes regularly. Learn about menopause diet-include a wide variety of vegetables, fruits and whole grains in your diet and avoid oils, sugars, and saturated fats.
• Take magnesium, vitamin D and calcium supplements as they help in reducing your risk of osteoporosis.
• Practice relaxation techniques including meditation, breathing exercises and yoga.
• Quit smoking if you are a smoker and limit your intake of alcoholic beverages.
• Certain natural supplements have been found to relieve menopause symptoms. These are soy, isoflavone, vitamin E, flax seed and melatonin.

Q8. What are the complications or side effects of menopause?

After menopause, you are more prone to develop certain medical diseases. Some of these are cardiovascular disease, osteoporosis, urinary incontinence, loss of sexual function and weight gain.