Menopause is not considered a health condition, because it is normal. Somewhere in their teens, women start menstruating. Every month a woman's body prepares a home for a fertilized egg, and if there is no fertilized egg, the home is broken down, and the tissue and blood is discarded during menstruation, and then the whole cycle starts again. I will be talking more about menstruation in a later post, but lets talk about menopause now.
Women are born with about two million eggs, of which only 300000 remain at puberty and thereafter about a 1000 are lost in every menstrual cycle. When only a 1000 odd eggs are left menstruation stops. This marks the end of a woman's fertility and is called menopause.
The transition in to menopause is usually somewhat gradual. The years leading up to it are called perimenopause. Perimenopause typically starts in a woman's thirties or forties. During this period, estrogen levels start to fall. Perimenopause on average lasts for 4 years but its term varies widely ranging from a few months to a decade.
Perimenopause lasts right up until menopause. In the last couple of years of perimenopause, estrogen levels fall dramatically and one may start experiencing the symptoms of menopause.
Symptoms of menopause
Menopause is diagnosed when a post puberty woman has gone through 12 months without a menstrual period. The symptoms of menopause begin towards the end of perimenopause, and most of them continue past menopause for an average of four years but could continue on for a lot longer.
vaginal dryness, irritation or itching
worsening of acne
loss of bone density
low sex drive
Wow! I got tired just typing that list. Now imagine going through it. The only saving grace is, that not all women experience all the symptoms and degrees of severity too vary. So I sincerely hope we are all spared a significant fraction of the symptoms at least.
If menopause is reached before the age of 40, it is called premature or early menopause. Some of the risk factors of early menopause include chemotherapy, family history of early menopause, autoimmune diseases like lupus, hypothyroidism or Grave's disease. According to this article early menopause in India is on the rise, although it does not give specific numbers to support the claim. The reason it states, is increased survival rate among people with childhood cancers and smoking. Chemotherapy and radiotherapy increases the risk of premature menopause, and smoking contributes to ovarian failure.
The ovaries are also sometimes removed during a hysterectomy, which is an operation performed to remove the uterus in case of a medical problem like thickening of the uterus, endometriosis, uterine fibroids, uterine prolapse, chronic pelvic pain, etc. In such a case early menopause sets in. If only the uterus is removed, and not the ovaries, then menopause may not occur.
Though menopause is inevitable, its symptoms can be treated if they are significantly affecting quality of life. Hormone replacement therapy (HRT) can help with symptoms like hot flashes and night sweats. This link also suggests medicines that help with some of the other symptoms.
Treatments for early menopause also include HRT as well as menopausal hormone therapy. Early menopause cannot be reversed, but treatment can help slow it down and manage the symptoms.
In spite of the long list of symptoms of menopause and the intense discomfort they cause, menopause is rarely discussed. Since it is natural and not considered a health condition, the discomfort is not taken seriously, even though women have to endure these symptoms for several years. Women who find the courage to broach the subject, find that people are often dismissive.
The Padman movie has made it more acceptable to talk about menstruation. So now how about we start talking openly about menopause too?
Menopause is not all bad news, and some people are opening up about it, at least in the west. Few people want to think of post menopausal women having sex, but it is the first time women can have sex without having worrying about pregnancy, though note that sexually transmitted diseases are still a risk of unprotected sex. And menopause does not necessarily imply a decrease in sex drive, in fact it can go up too. Here is an informative article, that discusses sex after menopause and this article reasons that sex can actually be better after menopause.