Menopause is the cessation of menstruation and it is a natural process. A woman is said to have attained menopause when she is amenorrheic for 12 months. Menopausal age averages between 50 – 55 years. This age is also affected by genetic factors. If a woman attains menopause before the age of 40, she is said to have premature ovarian failure. Menopause is a physiological signifying failing of ovulation and falling in the endogenous estrogen level.
Common menopausal symptoms include hot flushes, sleeplessness, mood changes, impaired libido, and lower genital tract symptoms including vaginal dryness + dysuria. These symptoms may start before the cessation of menstruation that is in the perimenopausal period. Estrogen support is required for many purposes including cerebral function, bone homeostasis, cardiovascular function, and various effect on skin and breast.
Treatment focuses on symptomatic relief. Management depends on the age of the patient. In young females with premature menopause, hormone replacement therapy is absolutely needed and should be continued until menopausal age. In elderly patients, simple measures like exercise, intake of vitamins, and minerals can be tried. If these simple measures have failed, medication may be required which includes hormonal and non-hormonal medicines that have hormone-like actions. Patients selected for hormone replacement therapy should have basic health checkup which includes cardiology evaluation, breast checkup, and evaluation of osteoporosis. Hormone replacement therapy is an effective treatment for many post-menopausal issues. The lowest effective dose for the shortest possible time must be selected.
Dr. Annamma Abraham, MBBS, MD
Senior Consultant, Obstetrics & Gynaecology