Menopause is a time much feared by most women. But there’s no need to be afraid.

Although women undergo multiple body changes in their lifetime, the hormonal changes occurring after cessation of the menses can be truly vexatious. Termed menopause, many women dread this partly because it signals the onset of ageing. But menopause is simply a transition between two major phases of a women’s life; not a disorder.

How it happens

If one year passes without menstrual periods, menopause is confirmed to have occurred. The transition phase after the last menstrual cycle may last for years. During this time many women experience various symptoms due to hormonal changes. Bone density often diminishes and blood cholesterol levels may rise.

In most women, menopause occurs around the age of 50. In some cases, it can set in before 40. Premature Menopause is more likely to occur in women who smoke, have never been pregnant or live at high altitudes. In cases where none of these reasons apply, the doctor may advise a check-up to rule out other problems. For most women, menopause normally occurs between 45 and 55 years. If menopause occurs after 55, it is considered to be late menopause.

Menopausal symptoms vary in intensity from woman to woman. With the onset of menopause, the ovaries dramatically reduce production of oestrogen — the main sex hormone in women, which is essential for the menstrual cycle — and progesterone. Although oestrogen occurs in both males and females, it is present in higher levels among women. Since it affects many parts of the body its loss is thought to cause many menopause symptoms. During menopause, production of testosterone, the ‘male’ hormone involved in libido or sexual drive, also decreases. As a result, women’s sexual responses may also change. But this could also be due to vaginal dryness and the thinning of vaginal walls, which may make sex uncomfortable. This can be remedied through adequate lubrication.

Treatment options

Since many symptoms are associated with lower oestrogen levels, oestrogen replacement could reduce some symptoms. Since hormone replacement therapy carries the risk of vaginal bleeding and is linked with higher risk of breast cancer, stroke and heart disease, it should only be considered under expert medical supervision.

Treatment could also include lifestyle changes. Dietary changes involve avoiding caffeine, alcohol and spicy foods. For those susceptible to heart diseases, a low-fat, low-cholesterol diet is advised. Foods or supplements with calcium and vitamin D also help. Eating soy foods is also good, since soy contains oestrogen. Plenty of exercise is recommended; especially Kegel exercises, which strengthen the pelvic and vaginal muscles. Strength and resistance training strengthens the bones.

If women follow these guidelines, the menopause years will bring minimum discomfort and maximum well-being.

Common symptoms

Hot flashes, mood swings, sleep disturbances, anxiety and headaches.

Rapid bone loss causing osteoporosis and increasing bone fracture risks.

Urinary incontinence and burning during urination. Changes in the bladder and urethra may cause higher frequency and urgency of urination, including increased risk of urinary tract infection after menopause.

Pain during sex and changes in vaginal discharge.

Changes in breast shape.

Increase in cholesterol levels heightening heart-disease risk; irregular heartbeats and weight gain.

Pubic muscles can lose tone, and the vagina, uterus or urinary bladder could prolapse causing stress incontinence.

Changes in levels of normal microorganisms in the vagina may increase the risk of vaginal yeast infections.