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Menopause is the permanent end of menstruation. It's a
turning point, not a disease, but it can have a big impact on a
woman's well-being. Although menopause can bring physical
discomfort from hot f lashes, night sweats, and other
symptoms, it can also be the start of a new and rewarding
phase of a woman's life -- and a golden opportunity to guard
against major health risks like heart disease and
Age is the leading cause of menopause. It's the end of a
woman's childbearing years, brought on by the ovaries
gradually slowing down. Certain surgeries and medical
treatment can induce menopause. Those include surgical
removal of the ovaries (bilateral oophorectomy),
chemotherapy, and pelvic radiation therapy. Having a
hysterectomy (surgical removal of the uterus) without
removing the ovaries does not lead to menopause,
although you will not have periods anymore.
On average, women are 51 at natural menopause, notes the
National Institute on Aging. But menopause can start
earlier or later. A few women start menopause as young as
40, and a very small percentage as late as 60. Women who
smoke tend to go through menopause a few years earlier
than nonsmokers. There is no proven way to predict
menopause age. It's only after a woman has missed her
periods for 12 straight months, without other obvious
causes, that menopause can be confirmed.
Natural menopause happens gradually. The ovaries don't
abruptly stop working, they slow down. The transition to
menopause is called perimenopause. Menopause is a
milestone -- it's the day that marks 12 months in a row
since a woman's last period. During perimenopause, it's
still possible to get pregnant -- a woman's childbearing
years are winding down, and although her periods may
become more unpredictable, her ovaries are still working
and she still may ovulate, though not always monthly.
Menopause isn't a one-size-fits-all event. It affects
each woman differently. Some women reach natural
menopause with little to no trouble. Others have
severe symptoms. And when menopause starts
suddenly as a result of surgery, chemotherapy, or
radiation, the adjustment can be tough. Here is a look
at menopausal symptoms that many women have,
though the intensity can vary.
As menopause approaches, a woman's menstrual
periods will likely change. But those changes can vary
from woman to woman -- periods may get shorter or
longer, heavier or lighter, with more or less time
between periods. Such changes are normal, but the
National Institute on Aging recommends seeing a
doctor if your periods come very close together, if you
have heavy bleeding or spotting, or if your periods last
more than a week.
Hot flashes (or hot flushes) are common around
menopause. A hot flash is a brief feeling of heat that
may make the face and neck flushed and cause
temporary red blotches to appear on the chest, back,
and arms. Sweating and chills may follow. Hot flashes
vary in intensity and typically last between 30 seconds
and 10 minutes. Dressing in light layers, using a fan,
getting regular exercise, avoiding spicy foods and heat,
and managing stress may help you deal with hot
Nighttime hot flashes can hamper sleep and cause
night sweats. Try these sleep tips:
Use a fan in your bedroom.
Avoid heavy bedding.
Choose light cottons or sheer materials for your
Keep a damp cloth nearby to cool yourself quickly if
you wake up feeling hot and sweaty.
Keep pets out of your bedroom. They can give off heat.
Talk to your doctor if your sleep problems don't stop or
bother you.
Less estrogen can lead to vaginal dryness, which may
make intercourse uncomfortable or painful. Try using
a water-soluble lubricant. Your desire may go up or
down, but many things besides menopause --
including stress, medications, depression, poor sleep,
and relationship problems -- affect sex drive. Talk to
your doctor if you have sex problems -- don't settle for
a so-so sex life. And remember, sexually transmitted
diseases (STDs) don't end with menopause. "Safer" sex
still counts.
If menopause symptoms are a problem, talk with your doctor.
He or she can help you weigh the pros and cons of
menopausal hormone therapy, also known as hormone
replacement therapy. Other treatments include low-dose
birth control pills if you're perimenopausal; antidepressants,
blood pressure drugs, or other medications to help with hot
flashes; and vaginal estrogen cream. Your doctor may also
have lifestyle tips about adjusting your diet, exercise, sleep,
and stress management.
Hormone replacement therapy can ease menopausal
symptoms. Various prescription products are available
to treat hot flashes and vaginal symptoms. The FDA
recommends taking the lowest dose that helps, and
only for the shortest time because studies have linked
long-term use of hormone replacement therapy to a
greater risk of heart attacks, strokes, blood clots, and
breast cancer.
"Bioidentical hormone therapy" for menopausal symptoms
can refer to certain FDA-approved prescription drugs. Or it
can refer to custom-compounded hormones derived from
plants prepared at compounding pharmacies to match each
patient. Some doctors claim that compounded bioidentical
hormones are safer, but the FDA isn't convinced. The FDA's
advice -- take the lowest dose for the shortest time -- applies
to bioidentical hormone therapy. Custom-compounded
bioidentical hormones aren't FDA approved.
Interested in trying alternative or complementary
treatments for menopause symptoms? According to
the National Institutes of Health, there hasn't been a
lot of well-designed research on this topic, so the
research isn't firm enough to draw conclusions about
treatments such as black cohosh, dong quai, red clover
(shown here), and soy. Talk it over with your doctor,
and tell him about any supplements you take so he can
check on drug interactions.
With menopause comes a greater chance of heart disease
(which is the No. 1 cause of death for U.S. women) and
osteoporosis (thinning bones, seen here). Loss of estrogen
may play a role in heart disease after menopause, but
hormone replacement therapy is not recommended to
reduce the risk of heart disease or stroke. Of course, heart
and bone health is important throughout a woman's life,
but menopause means it's really time to step up and get
serious about it if you haven't already.
Living a healthy lifestyle is important throughout a woman's
life. And it's not too late to start at menopause. Get a checkup
that includes measuring your blood pressure, cholesterol,
and blood sugar and make appointments for routine
screenings such as mammograms. Menopause is also a great
time to upgrade your diet, physical activity, and stress
management skills -- your doctor can give you pointers as you
work together to plan for a healthy menopause.
One of the smartest things a woman can do as she
transitions to menopause and afterward is to get
regular physical activity. That includes aerobic exercise
for her heart and weight-bearing exercise for her bones
-- both of which may help ward off weight gain and
provide a mood boost. Even if a woman hasn't been
very active in her younger years, it's never too late to
start. Menopause is a new beginning, and the perfect
time to weave more activity into your life.
Western culture has long been obsessed with youth.
But today's postmenopausal women are making the
most of -- and even celebrating -- their new phase of
life. Instead of looking back mournfully, Christiane
Northrup, MD, recommends using it as a time to
redefine yourself with positive thoughts, love yourself,
explore what brings you pleasure, and revive (not
retire) your sex life.
S. R. Davis, C. Castelo-Branco, P. Chedraui, M. A.
Lumsden, R. E. Nappi, D. Shah,




The aim of this review was to summarize the literature

regarding the impact of the menopause transition on
body weight and body composition.
We conducted a search of the literature using Medline
(Ovid, 1946present) and PubMed (19662012) for
English-language studies that included the following
search terms: menopause, midlife, hormone therapy
or estrogen combined with obesity, body weight or
body composition.
Whereas weight gain per se cannot be attributed to the
menopause transition, the change in the hormonal
milieu at menopause is associated with an increase in
total body fat and an increase in abdominal fat.
Weight excess at midlife is not only associated with a
heightened risk of cardiovascular and metabolic
disease, but also impacts adversely on health-related
quality of life and sexual function.
Animal and human studies indicate that this tendency
towards central abdominal fat accumulation is
ameliorated by estrogen therapy. Studies mostly
indicate a reduction in overall fat mass with estrogen
and estrogenprogestin therapy, improved insulin
sensitivity and a lower rate of development of type 2
The hormonal changes across the perimenopause
substantially contribute to increased abdominal
obesity which leads to additional physical and
psychological morbidity. There is strong evidence that
estrogen therapy may partly prevent this menopause-
related change in body composition and the associated
metabolic sequelae. However, further studies are
required to identify the women most likely to gain
metabolic benefit from menopausal hormone therapy
in order to develop evidence-based clinical

1. Department of Community Medicine, KVG Medical
College, Sullia, Dakshina Kannada, Karnataka, India.
2. Department of Community Medicine, Kannur Medical
College, Kerala, India.
3. Department of Anatomy, KVG Medical College, Sullia,
Dakshina Kannada, Karnataka, India.
To find the prevalence of menopausal symptoms and
perceptions regarding menopause among menopausal
women of Kerala.
The study was conducted among 106
postmenopausal women staying
more than 6 months
A community based cross-sectional house to house
survey was conducted at Anjarakandy a field practice
area under Kannur Medical College, Anjarakandy.
The study was conducted among 106 postmenopausal
women staying more than 6 months at Anjarakandy
with the help of pretested questionnaire administered
by a trained social worker from January to October 2013.
Before that a pilot study was conducted and required
sample size of 100 was calculated. Random sampling of
houses was done.
Data was coded, entered, and analyzed
using SPSS 15. Chi-square test,
proportions, and percentages were used.
The mean age of attaining menopause was 48.26 years. Prevalence of
symptoms among ladies were emotional problems (crying spells,
depression, irritability) 90.7%, headache 72.9%, lethargy 65.4%, dysuria
58.9%, forgetfulness 57%, musculoskeletal problems (joint pain, muscle
pain) 53.3%, sexual problems (decreased libido, dyspareunia) 31.8%,
genital problems (itching, vaginal dryness) 9.3%, and changes in voice
8.4%. Only 22.4% of women knew the correct cause of menopause.
Thus study stated that all the ladies
were suffering from one or more
number of menopausal symptoms.
Ladies should be made aware of
these symptoms, their causes and
treatment respectively.