What?

    Menopause is defined as the time of cessation of ovarian function resulting in permanent amenorrhoea. It takes 12 months of amenorrhoea to confirm that menopause has set in. The process of menopause does not occur overnight, but rather is a gradual process. This so-called perimenopausal transition period is a different experience for each woman. Menopause is the time in a woman's life when the function of the ovaries ceases and she can no longer become pregnant.


How?

    Menopause occurs due to a complex series of hormonal changes. Associated with the menopause is a decline in the number of functioning eggs within the ovaries. At the time of birth, most females have about 1 to 3 million eggs, which are gradually lost throughout a woman's life.. By the time of menopause, a woman may have fewer than 10,000 eggs. Normally, FSH, or follicle-stimulating hormone (a reproductive hormone), is the substance responsible for the growth of ovarian follicles (eggs) during the first half of a woman's menstrual cycle. As menopause approaches, the remaining eggs become more resistant to FSH, and the ovaries dramatically reduce their production of estrogens. Estrogens also protect the bone. Therefore, a woman can develop osteoporosis (thinning of bone) later in life when her ovaries do not produce adequate estrogens. At the time of menopause, the ovaries also decrease their production of testosterone-a hormone involved in libido, or sexual drive.


At what age does a woman typically reach menopause?

    Menopause normally occurs between the ages of 45 to 50. It is not uncommon to see a women menstruate even beyond the age of 50. This may be related to good nutrition and better health. But late menopause is also common in ladies who have uterine fibroids and endometrial cancer. Menopausal age is not related to menarche, number of pregnancies, intake of oral contraceptive pills, etc but related to smoking which induces smoking.


Menopausal Symptoms:

    The most common and noticeable symptoms are hot flushes and sweating in 85% of women. Hot flushes are more seen during night so that it can reduce the sleep which leads to mental depression in most ladies. With passage of time the frequency and severity of hot flushes diminishes over a period of 1 or 3 years.
    Oestrogen deficiency can cause dysuria, with or without infection, urge and stress incontinence.
    Irregular vaginal bleeding may occur during menopause. Some women have minimal problems with abnormal bleeding during perimenopause whereas others have unpredictable, excessive bleeding.
    Vaginal dryness, itching, or irritation and/or pain with sexual intercourse (dyspareunia). The vaginal changes also lead to an increased risk of vaginal infections.
    The density of the bone (bone mineral density) normally begins to decrease in women during the fourth decade of life which leading to osteoporosis.
    Women in perimenopause often report a variety of thinking (cognitive) and/or emotional symptoms, including fatigue, memory problems, irritability, and rapid changes in mood due to hormonal variations.


General Management:

    The clinician should adopt a holistic approach towards management of health problems of menopausal women. A woman, who happens to undergo a strong perimenopause with a large number of different effects, may become confused and anxious, fearing that something abnormal is happening to her. There is a strong need for more information and more education on this subject. The women often develops pregnancy and cancer phobia. With thorough examination and investigations only we can convince them. Diet is the other main factor. Diet should include at least 1.2 g of calcium, vit A, C, and Vit E. Eat more fruits and vegetables, eat calcium rich foods including milk, broccoli, green leafy vegetables etc. Avoid high fat and high sugar rich foods. Weight bearing exercises (walking) prevent or delay osteoporosis. Yoga, meditation, social work can reduce mental stress.


Homoeopathic treatment:

Homeopaths treat the menopausal symptoms by constitutional treatment. This is the process by which a homeopathic physician selects and administers a woman's own constitutional remedy based on the totality of her symptoms and her physical, mental and emotional state. This strengthens the body’s vital defences and restores a healthy balance and sense of well-being. Homeopathy is the safest treatment before, during, and after menopause because it stimulates the natural hormonal balance without the use of harmful drugs. Most of the major homeopathic remedies may be used for the symptoms of menopause. Consult a homeopathic physician to determine appropriate remedy for you as each case is different.

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