We all know about periods. But there are some other topics related to periods, such as menopause, perimenopause, or postmenopause, about whom we are hardly aware. Menopause is the time when a woman's menstrual cycle ends. Mostly it is seen in women between 45 and 55 years of age. However, it can also come early or can be late too. Firstly, it starts with irregularity in periods, and then gradually it stops. 

Today we have a special guest on the panel with whom we are going to conduct a discussion- "Menopause – Breaking the taboo" 

Joining the panel is:

Dr.Kumar Kamble is an expert Psychiatrist, De-addiction Specialist, Sexologist, Speaker, Mental and Sexual Health Educator. He is also associated with the Umang Clinic. He has worked with King Edward Memorial Hospital in the Deaddiction center for 4 years as a Medical Office Coordinator. 

Dr. Neelima Mantri is an Obstetrician, Gynecologist, and Laparoscopic Surgeon. She is one of the best Gynecologist-Obstetrician in Mumbai.  She is certified in FMAS and FACS.  She has handled many complicated cases like infertility, hysterectomy, ectopic pregnancy, polycystic ovarian syndrome, tubal ligation, and sterilization. 

Premature Ovarian Insufficiency 

Dr. Neelima informs, “Premature ovarian failure is a medical condition wherein a woman reaches her menopause before the age of 40. This is due to the lack of proper functioning of ovaries. Ovaries are responsible for egg and hormone production. These incidences are rare like 1 in 1000. Premature menopause can be an extremely difficult time for a younger woman with difficult physical and emotional changes. Premature menopause can be a result of removal of uterus or dysfunction of ovaries with the use of chemo drugs or radiation therapy. Premature ovarian failure is due to inefficient ovaries. Ovaries can become inefficient because of 

any genetic disease turner’s syndrome smoking environmental factors like living in a chemically hazardous zone unknowingly ingestion of pesticides

All these lead to weakening ovaries. Family history also plays a role."

Sexual problems during menopause

Dr. Kumar tells, “Sex is not only for reproduction. Moreover, it is a function of our body. The onset of menopause is not the end of sexual life. You can continue your sexual life post-menopause also. Menopause brings a lot of changes in the sexual genital parts of females. There can be vaginal dryness. Natural lubricants produced by glands keep the vagina moist. This gets reduced in menopause leading to painful intercourse. There are many ways to lubricate dry vagina – lubricants and vaginal moisturizers.”

Dr. Neelima adds, “A woman gets mentally and physically affected by menopause. Low levels of estrogen during the menopause period decrease the desire to have sex in females. They experience loss of libido. They stop getting pleasure or orgasm from it. They start avoiding sex thinking of painful intercourse caused by vaginal dryness.”

Hormonal and Non-hormonal therapy

Dr. Neelima mentions, “In hormonal therapy, we fulfill the requirement of estrogen hormone. For this medicines and gels are used. Jellies and patches are used to prevent vaginal dryness. This hormonal therapy has some disadvantages also. If you are on hormonal therapy, follow regular check-ups of your breast and uterus for any type of cancer. Generally, hormonal therapy is best used during the transition period.

The non-hormonal therapy includes dietary changes and herbal tablets. Their side effects are less. Other treatment includes anti-depressant medicines for mood swings, to elevate mood. Lifestyle modifications are also useful to some extent.”

Dr. Neelima speaks, “Osteoporosis is one of the major consequences of menopause in which bones become weaker which increases the risk of fractures. For this hormone therapy with vitamin D and other medicines are used. Vitamin deficiency has been observed in women of all ages. Sunbath is a good source of vitamin D; however, it is not cultured in India. For the maintenance of vitamin D in the body, there are protein powders available that are fortified with vitamin D. But patients having deficiency of vitamin D will not get benefitted with only this, they will have to take extra medicines to fulfill the body requirement.”

Health risk associated with menopause

Dr. Neelima emphasizes, “Estrogen hormone is a boon to the female body. This hormone prevents the chances of heart attack and osteoporosis. But as the woman reaches her menopause, there is an increased risk of heart diseases, osteoporosis, stroke, and painful intercourse. Skin tone gets poorer with the menopausal period resulting in urinary incontinence.

Mental problems associated with menopause

Dr. Kumar says, "During the menopausal period, sleep disturbances are very common. To overcome this, you can do a basic thing, fix your sleeping pattern. You can fix your time of getting up. This will help in creating a fixed sleeping pattern. 

The period before menopause, pre-menopause lasts for years and during this phase, they become depressed, sad, emotionally disturbed. Loss of desire in their sexual activity is observed. We advise them to keep a simple basic lifestyle, eat a well-balanced diet, and keep hydrating themselves.

A woman should be vocal about her problems, she should seek the help of her family members in doing day-to-day activities and they should also lend a supporting hand.

She can consult the doctor for some medicinal advice if the problem is not getting solved by lifestyle modification.”

Dr. Neelima expresses, “Females are generally unaware of their pre-menopause period, they only complain of symptoms related to mood swings that give us an idea of their problems. Medicines and counseling play a vital role here. Sometimes counseling with a psychiatrist is advisable to overcome the depression phase.”

(Edited by Renu Gupta)