Should menopause be the beginning of the end of your life as a woman?
For most women, menopause is that critical and painful period of transition, when changes in the ovarian function triggers a host of psycho-social problems and physical problems such as climacteric syndrome, osteoporosis, and urogenital issues, diminishing their quality of life.
Climacteric syndrome - a series of symptoms like hot flushes, irritability, chronic fatigue, body aches, insomnia or dryness of the skin - which develops in the peri-menopausal years (years immediately before menopause) due to the lowered production of estrogen, can create physical discomfort and depression in women.
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About a decade ago, hormone replacement therapy (HRT) or replacing the depleting levels of estrogen and progesterone hormones, was thought to be the answer to women’s eternal femininity.
Critical trials But the use of HRT became controversial after clinical trials such as the Women’s Health Initiative (2002) and Million Women Study (2003) brought up evidence that women on HRT were at high risk of developing breast cancer.
But with several international bodies working in the area of menopause and women’s health re-analysing these clinical trials, hormone therapy (HT) is once again in the limelight.
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New recommendations suggest that appropriate use of HT, with individualised dosage and duration, can be beneficial to women during menopause.
“With the life expectancy of women going up, a woman now spends about one-third of her life in the post-menopausal period and improving her quality of life is very important. Latest guidelines say that a woman should not be denied HT if she needs it. HT is safe for healthy women less than 60 years, in the immediate post-menopausal years, for managing the climacteric syndrome. The dosage and regimen should be individualised and assessed annually,” says Sheila Balakrishnan, Professor of Gynaecology, SAT Hospital.
The guiding principle is to use the lowest possible dose for the minimum duration necessary for the management of symptoms.
The average age of menopause for Indian women is 51.5 years. But a significant number of women have been experiencing early menopause at 40 years or less. For them, HT can be safely given till they cross the normal menopausal age.
“A proper, nutritious diet, a good exercise regimen, and adequate dietary supplements of minerals, calcium and Vitamin D is very important for women for maintaining the quality of life and for fighting osteoporosis, especially in the peri and post-menopausal years,” Dr. Sheila says.