Don’t suffer in silence!

If you’re a woman in her 40’s and you intermittently miss a period or two, you may worry that it’s a sign of pregnancy, but it could very well be perimenopause. Perimenopause is characterised by the gradual reduction in oestrogen production by the ovaries, which can lead to uncomfortable symptoms in some women. Fatigue, sleep problems, bloating, mood changes, and weight gain are typical of this phase, explains senior gynaecologist and obstetrician Dr Laxmi Kiran.

1. What are the symptoms of perimenopause?
Most women complain of fatigue, sleep problems and weight gain. Many of them suffer from severe mood swings, depression, anxiety, and in some cases, their confidence levels drop.

2. Is it common for women to mistake perimenopause for pregnancy?
Intermittently missing a period often leads to this misconception. Women do carry out pregnancy tests, and then ultrasound and other tests to check if they’re suffering from any disease. Awareness about the perimenopause stage is very limited. If women know about it, they can avoid the unnecessary anguish. This phase of life can be managed safely and effectively with lifestyle changes and supportive treatment if required. Treatment is only recommended for certain women after evaluation.

3. What is the difference between perimenopause, pre-menopause and menopause?
Pre-menopause is a stage characterised by a small decline in oestrogen levels. A woman usually has regular periods with reduced bleeding. She may also start having an irregular cycle with no menopausal symptoms.

The perimenopause stage is characterised by a sharp decline in oestrogen levels. An irregular menstrual cycle may be accompanied by symptoms such as prolonged and heavy periods, hot flushes, night sweats, vaginal dryness, itching, sleep disturbances, fatigue, mood changes such as depression or anxiety, reduced libido, breast tenderness, and increased PMS. Women may still be able to conceive naturally.

Menopause is the complete cessation of periods for at least one year due to the cessation of ovarian activity that occurs as a part of the ageing process between the age of 45 and 55 years. After this, a woman can no longer conceive naturally. The symptoms of menopause may be as simple as hot flushes, night sweats and mood swings or as severe as fractures due to osteoporosis, memory lapses, panic attacks, depression, high cholesterol leading to cardiovascular disease, headaches, joint pains, and urine incontinence.

4. Are Indian women and their families prepared to deal with these stages in their lives?
Studies show that the average Indian woman experiences menopause between the age of 46 and 52 years. But poor nutrition, lack of exercise, obesity, associated hypertension, diabetes, and the prolonged use of fertility treatments can lead to the early onset of menopause. Indian women tend to ignore their health needs and prioritise the needs of the family, this results in the delayed diagnosis of health conditions and poor response to treatment.

5. How should women deal with the different stages of menopause?
In most women, the symptoms are mild and tolerable. Some things that they can do to lessen the severity are:
1) Consumer calcium and vitamin D supplements.
2) Maintain a good lifestyle, a healthy diet, and exercise regularly.

6. Who requires hormonal therapy?
Hormone replacement therapy is recommended for women who experience debilitating symptoms. Certain symptoms such as depression and anxiety attacks can be managed with cognitive behaviour therapy.

Vaginal dryness, itching, recurrent urinary infections and continence troubles can be treated with simple lubricants or vaginal oestrogen creams.

7. What are the home remedies that women can opt for?
Some simple things that women can do are:

• Maintain a healthy, balanced diet.
• Expose themselves to the sun for some time to have enough vitamin D.
• Exercise regularly; this can be in the form of yoga, breathing exercises, aerobic exercises, walking, or jogging.
• Consume food supplements containing soy or flax seeds, which produce phyto-oestrogens.
• Consume vitamin D, E, and calcium supplements.
• Have regular consultations with a doctor to watch for signs of hypertension, diabetes, high cholesterol, and cardiovascular diseases
• Check for cervical, breast and ovarian cancers.
• Have bone mineral density checked to assess the risk of osteoporosis and fracture.