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Transitioning to Menopause: understanding the different changes

Menopause is a biological milestone that is common to women between the ages of 45 and 55. Characterised by hormonal changes, menopause marks the end of the fertile phase of a woman’s life.

While it is neither a disease nor a disorder, the transition to menopause can pose significant difficulties for most women. As a study published by the NCBI (National Center for Biotechnology Information) notes, approximately 1.5 million women undergo the menopausal transition each year.

This often involves troublesome symptoms such as vaginal dryness, vasomotor symptoms, insomnia, decreased libido, joint pain, and fatigue.

But the effects of menopause on the body are not limited to these symptoms. Women may experience concomitant behavioural, psychological and social changes as well.

However, even today, there is a lack of candid and open discussions on menopause-related changes. Most women, therefore, cannot understand what they are going through or make sense of their feelings and emotions.

If you are at the cusp of the menopausal transition, here are 10 important changes that you need to be aware of.

What is Menopause?

Menopause refers to the natural decline in a woman’s reproductive hormones and the cessation of ovulation and menstruation.

Retrospectively, this is defined after 12 months or 1 year of amenorrhea (the absence of periods) has been observed. These changes, however, do not occur all at once.

The transition into menopause or ‘Perimenopause’ can surface years before menopause, even 8 to 10 years before. During this transition phase, women may experience several symptoms such as hot flashes, night sweats, mood changes and vaginal dryness which are similar to menopause itself.

Most of these symptoms are highly individual and may progress at a different pace for each woman.

10 changes that you may experience during Menopause

1) Hot flashes

Hot flashes are one of the most common symptoms of perimenopause and menopause. Hot flashes may last for a few or several years and are increasingly linked to low levels of estrogen.

Women who experience a hot flash may suffer from sudden feelings of intense warmth, typically over the face, neck, and torso. They may also develop red blotches and break into heavy sweats.

2) Mood swings

Emotional upheavals and mood swings is another typical symptom related to menopause. Women of menopausal age tend to experience rapid changes in mood due to a plunge in their levels of estrogen.

Estrogen can influence the interactions of serotonin and norepinephrine (feel-good hormones) on mood and cognition.

3) Anxiety and depression

Anxiety and depression are common but often overlooked symptoms of menopause. These feelings of irritability, anxiety, worry, and sadness tend to surface due to changing hormone levels.

4) Changes in the immune system

The immune system may become weakened during menopause due to depleting hormone levels. As a result, women may become more susceptible to developing autoimmune diseases, allergies, and colds.

Menopausal women should try to boost their immunity by eating a nutrient-rich diet, managing stress levels, getting adequate sleep and consuming sufficient amounts of vitamins and minerals, especially vitamin C, zinc and vitamins A, D, and E.

5) Bone loss

An NCBI study documents that women lose about half their trabecular bone and 30% of their cortical bone throughout their lifetime. About half of this bone loss is said to occur during the initial 10 years after menopause.

Bone loss reportedly accelerates substantially during late perimenopause and early postmenopausal years.

Thus, menopausal women should eat foods that are rich in the following essential minerals and vitamins:

  • Calcium
  • Vitamin C
  • Omega-3 fats
  • Vitamin D
  • Vitamin K
  • Magnesium

Apart from this, the DEXA (Dual Energy X-ray Absorptiometry) scan can also help determine if you have a low bone density or if you are at a high risk of experiencing fractures.

6) Low sex drive

Women naturally experience a lowered libido or sex drive as they go through menopause. This typically happens as a consequence of declining female hormones, namely estrogen and progesterone.

Symptoms such as vaginal tightness, pain during sex and vaginal dryness also frequently accompany the loss of libido or reduced sex drive.

7) Insomnia

According to the National Sleep Foundation, as much as 61% of menopausal women report symptoms of insomnia. Hormonal fluctuations during menopause lead to changes in the natural circadian rhythm, causing disrupted sleep.

Other factors, such as a weak bladder, night sweats, joint pain, and anxiety, may contribute to insomnia as well. For this reason, women are frequently advised to do regular aerobic exercise and eliminate coffee, alcohol and other hot flush triggers before bed.

8) Ageing skin

Menopause can rapidly advance the ageing of the skin. A scientific study confirms this by pointing out that Type I and III skin collagen decreases by at least 30% in the first five years after menopause.

The body cannot keep up with the production of collagen because the estrogen levels in the body begin to decline.

9) Brain fog

Brain fog is another troublesome concern that many menopausal women face. Brain fog is characterised by forgetfulness and a lapse in focus or concentration. The brain has many estrogen receptors, so when it is robbed of this hormone, it cannot function as well as it used to.

10) Sudden weight gain

Weight gain is another common frustration that women experience during menopause. The inevitable loss of estrogen and progesterone can result in sudden weight gain.

Age-related factors such as loss of lean muscle, increased stress, and sleep deprivation can also come into play.

Concluding thoughts

If you are approaching the onset of a menopausal transition, the first thing you need to do is prepare yourself for major physical and emotional changes. To cope with symptoms of menopause such as night sweats, sleeplessness, and low sex drive, talk with our doctors at the CK Birla Hospital.

Fortunately, women can seek safe treatment options for most of their menopausal symptoms with the thoughtful use of estrogen or Hormone Replacement Therapy (HRT). For patients who are uncomfortable with hormonal therapies, there are alternative treatments as well.

Author: Dr Astha Dayal
Dr. Astha Dayal is an esteemed obstetrician and gynaecologist in Gurgaon. She cleared her MRCOG certification in London, UK, and is a member of the Federation of Obstetric and Gynecological Societies of India. She has over 16 years of experience in the medical and surgical management of women’s health with an emphasis on high-risk pregnancies as well as advanced laparoscopy.