Menopause, which is otherwise known as ‘climacteric’, marks the end of reproductive ability in women. It is the time in a woman’s life when she stops ovulation and menstruation permanently. At menopause, a woman can no longer conceive and it is a stage that every woman will attain. However, because it comes with some disturbing symptoms, a foreknowledge is required for women to cope better.
While the age for Menopause varies, the average age is believed to be 51 years. However, it could be earlier or later than this. The period when menopause begins to set in is termed ‘perimenopause’ which is marked with irregularities in the menstrual flow. These irregularities may make it scanty, shorter or missed.

What Happens in Menopause
Study has shown that a woman has an average of 300,000 eggs and as she grows older they reduce drastically in number. By the age of 40, only 3% of the eggs remain. The ovary functions to release eggs and also produce sex hormone (oestrogen and progesterone). As the eggs reduce, hormone production also decline resulting in irregularities in the menstrual period. This usually starts at late 30’s or early 40’s and is referred to as perimenopause. While the ovary releases eggs in some months, nothing is released in the other months and this determines whether the woman will menstruate or not. These irregularities continue until the woman misses her period for up to 12 months when she is said to have experienced menopause. At this point, the ovaries become less active and oestrogen release drops and continues to drop even shortly after menopause.

What to Expect
Menopause comes with few body changes which could be quite disturbing. These changes occur in the skin, vagina, bone and other parts of the body. Menopause also causes symptoms such as excessive sweating and others which are collectively referred to as “Hot Flush”. These changes are believed to be due to decreased oestrogen level. General symptoms of menopause include the following:
• Vagina Changes: Due to low oestrogen, the vagina wall becomes thin and dry making it itchy and prone to infections. Sex also becomes painful because of this.
• Skin Changes: Low oestrogen level results in low collagen which keeps the skin firm and elastic. Therefore the skin becomes dry, itchy and wrinkled.
• Urinary Symptom: The urethra undergoes changes similar to that of the vagina causing a feeling of sudden urge to urinate, involuntary voiding when coughing, laughing and increased susceptibility to urinary tract infection.
• Hot Flush and Excessive Sweating: The woman experiences internal heat causing excessive sweating usually in the night.
• Decreased Bone Density: Low oestrogen level affect the bone by making it more brittle and prone to osteoporosis.
• Psychological Symptoms: Due to the overall body changes, the woman may become anxious and irritable. Some women may even experience atypical depression.

Management of Menopause
Management of menopause is directed towards relieving symptoms and promoting comfort. These include:
• Hormone replacement therapy.
• Vitamin and mineral supplement: calcium and vitamin D.
• Use of lubricants in the vagina.
• Psychological support.

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