On the cusp

Dr Deepmala elaborates on the six symptoms that suggest a woman is in her perimenopause stage

Menopause is an inevitable phase of a woman’s life. Whether a woman is aware or not, her ovaries get empty with time. Various signals are given to women in the form of changes in the menstrual cycle, physical and emotional changes. Hence, it is very important for every woman to know that they can plan and take care of that stage of their life well in advance. There are a couple of other symptoms that women should be aware of and seek the help of a gynaecologist.

Changes of menopause are not only restricted to reproductive life or sexual health, but it also has a widespread effect on other vital systems of our body. Perimenopause means “around menopause” when a woman’s body prepares for menopause. Usually, the perimenopausal symptoms can be experienced in the mid-40s. It may also happen that women may not experience this stage at all and can directly experience menopause. Changes of menopause are not only restricted to reproductive life or sexual health, but it also has a widespread effect on other vital systems of our body.

Irregular and heavy bleeding: This happens mainly due to infrequent ovulation leading to an estrogen and progesterone imbalance, out of which severe anaemia can start affecting other vital organs, like the liver, and heart. If you have prolonged bleeding for more than seven days, have menstrual clots, the vaginal cup gets filled every 1-2 hours, or have to change your sanitary pad frequently, you must consult a gynaecologist.

Hot flushes: Night sweats occur when you are awakened in the early hours of the morning. Deep breathing exercises can be helpful. You should also aim to avoid causes like hot weather, hot beverages, and spicy foods. As a natural source of estrogen, try black cohosh or add soy to your diet.

Vaginal dryness: Itchiness or soreness is caused by vaginal dryness due to estrogen deficiency. It causes recurrent urinary tract infections. Maintain proper personal hygiene, take plenty of oral fluids, and consult a gynaecologist if the problem persists.

Mood swings: A feeling that one is getting old, is depressed and irritable, has a tendency to cry, faces lack of sleep, and shows a lack of interest in sexual life are signs of one going through bouts of anxiety. Accepting each phase of life beautifully is essential.

Sleep problems: Hot flushes, mood swings, anxiety, are reasons for sleep disturbance. Night sweats will wreak havoc on your sleep. Adequate hydration plenty of fruits, salad, dry fruits, yoga, and meditation may be helpful. If it persists, you need to consult a gynaecologist.

Muskulo-skeletal issues: Estrogen plays an important role in bone metabolism. Inadequate calcium intake, Vitamin D deficiency, lack of exercise, an abnormal posture while sleeping, walking and sitting causes more back pain. Leg cramps, skin thinning, and easy bruising tendencies are seen.

An estrogen deficiency puts women at higher risk of hypertension, stroke and cholesterol change. Regular health check-ups after 40 years is very important.

We must welcome and accept changes in life. Transitions can have little asynchrony which can be managed better if we have proper guidance from a doctor.

It will be a good practice to undergo a health check-up during the perimenopause and menopausal age to get assured about the normal changes of life and early diagnosis and treatment of the grave ones. Menopause is a biological process. Let us enjoy this phase with good health and happiness.

Maturing with grace and health should be our life mantra.

(The author is a consultant obstetrician & gynaecologist.)