Menopause is the state when the monthly period of a woman stops. This usually happens between 50 to 55 years of age. Regular periods do cause some or more inconvenience to women. Leg cramps, abdominal pain, malaise, weakness are some of the major issues faced by women. Regular monthly blood loss is a risk factor for anaemia. Due to these problems, many women feel relieved when menses stop, thinking that these problems are over. But unfortunately, after menopause, many women develop other health issues. The glow of the face is reduced after menopause, due to a declining level of the feminising hormone oestrogen. Wrinkles start appearing, due to the loss of elasticity of the skin. Bags start appearing below eyes or pre-existing bags become more prominent. Women start to develop masculinising features like facial hair, beard, hoarseness of voice, which is very disturbing. Vaginal lubrication becomes less, resulting in dryness. This manifests as discomfort, itching, and painful sexual intercourse. Therefore, the affected woman may lose interest in sexual activity. Changes in bladder and vaginal tissues, due to lower oestrogen levels, increase vulnerability to develop recurrent urinary tract infection. These changes occur in more or less quantity, but do occur. These physical changes tend to cause depression and anxiety. Some effects of the changing hormone levels in menopause may linger after menopause. Hence, a woman can suffer from hot flushes, unexplained depression, sleep disturbances, etc., for a long time after menopause, as during the perimenopause phase. Oestrogen has a cardio protective action in the body. After menopause, this protective action is lost. This increases the vulnerability of women to hypertension and heart problems like heart failure, heart attack. In fact, after menopause, they become more vulnerable to cardiovascular problems than men. Central obesity, which occurs commonly in middle years, increases susceptibility to develop diabetes mellitus. Declining oestrogen levels increase vulnerability to osteoporosis, i.e. softening of the bones. Due to this, they become more vulnerable to joint pain, fracture of the bones, even with a minor injury. If fracture occurs, healing takes time. The demand for calcium and iron is increased during menopause, which, if not fulfilled, causes anaemia and enhanced osteoporosis, after menopause. Anaemia causes weakness and body aches. The health issues which occur after menopause become troublesome. Awareness about them can help a woman to be careful about them and take measures for their prevention. If known prior, she will be mentally prepared for the changes in her body. A healthy lifestyle, regular physical activity, adequate physical and mental relaxation, helps in keeping away from hypertension, diabetes, and heart problems. Diet should be balanced, containing necessary nutrients and healthy fruits like apples, berries, grapes, peaches, plums, and grains like barley, oats, wheat germ, nuts, and seeds like almonds, flax seeds, sesame, sunflower seeds, and natural plant derived drinks like tea, coffee, red wine, etc., are natural oestrogen containing products. They help in supplementing low oestrogen levels and prevent the resultant health issues. Regular physical activity helps to strengthen muscles and joints and keeps the body weight within normal range. It also refreshes the mind and body. Adequate sleep is helpful for adequate physical relaxation. Alcohol and tobacco should be avoided as they can cause multiple short- and long-term health issues. Prayers, meditation, reading good literature, creative hobbies, meeting friends and family members, are activities beneficial for mental relaxation. Supplements of iron and calcium help to prevent anaemia and calcium deficiency, which can occur after menopause. Oestrogen replacement therapy is useful for minimising the ill effects of oestrogen deficiency. However, it should be taken along with the assessment for risks associated with high oestrogen levels. Common ones being, increased tendency for clot formation, increasing risk for heart attacks and stroke, increased risk of uterine cancer, breast cancer, and gall bladder disease, in some people. Menopause and life after that is not optional, hence, all living women have to face it. Taking due precaution can turn it into a comfortable phase of life. Dr Rachna Pande is a specialist in internal medicine.
