WHO defines menopause as a cessation of menstrual periods after the age of 40 years; periods must stop for at least 12 months. In India, 130 million women are living beyond the age of menopause and the mean age of menopause is 46.2 years compared to 51 years in their western counterparts.
Why is menopause such a big deal? Or is it?
Menopause comes with problems like hot flashes, irritability, depression, anxiety, insomnia, weight gain and some genitourinary problems. Repeated urine infections, vaginal dryness, a lack of interest in sex and painful sex due to dryness are some of these.
“Long term effects of menopause due to low estrogen hormones are osteoporosis (weak bones) leading to fractures, cardiac arrest and Alzheimer’s disease,” says Dr Shelly Singh, Senior Consultant, Obstetrics and Gynaecology, Rosewalk Healthcare and Fortis La Femme.
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In the past, women were conditioned to regard these symptoms as inevitable, however debilitating; to endure them as part of the normal aging process. But now empowered women, with better life expectancy, living hectic and fruitful lives look for solutions to take care of these issues? Why endure? Why not cure?
What are the options for curing post-menopausal symptoms?
“Hormone replacement therapy, non-hormone therapy, vaginal creams and lubricants, nutritional agents, calcium, vitamin D and lifestyle changes like regular exercise, healthy eating and weight check,” adds Dr Singh.
Is Hormone Replacement Therapy any good? Doesn’t it cause strokes, heart attacks, breast cancers and weight gain?
“These are questions often asked of us. HRT took off in the 1960’s as the magical cure for menopausal symptoms. However, there was a study conducted in the US called the Women’s Health Initiative (WHI). Women in the age group of 50-70 years, some well past 10 years into menopause with only one type of hormone therapy were enrolled in a study whose results were published in 2002. The results showed improvements in osteoporosis and colon cancer but a definite increase in the risks of heart disease, strokes and breast cancer,” adds Dr Singh.
This was widely publicised by the media too and HRT went into disrepute. Clinicians stopped prescribing the same and women were understandably panic stricken to even use them for short durations. This fear has persisted even till date, denying post menopausal women from addressing so many problems related to the climacteric.
What is the current knowledge and research on HRT?
With newer forms of estrogen and progesterone available with lesser side effects and more trials conducted, HRT has been found to be safe in women who are less than 60 years of age and less than 10 years into menopause. “There’s a definite reduction in hot flashes, vaginal dryness, osteoporosis, heart disease and cognitive decline. There’s improvement in sex drive and more fruitful relationships. However not one size fits everyone! Each woman must be evaluated, history reviewed, contraindications ruled out and treatment customised. Some women may not be good candidates for HRT,” believes Dr Singh.
However, for women fit to receive them, an informed choice will definitely help them live an enriched, empowered, longer and healthier lives.
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