It’s a pause, not a full stop : The Tribune India

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It’s a pause, not a full stop

If you are woman in your mid-forties, and if you are having irregular periods for some time now; the sexual drive has waned; vaginal dryness is making sex uncomfortable; hot flashes and mood swings are becoming frequent; you are having trouble sleeping and you are fatigued easily — all these changes maybe signs of that you are approaching menopause.

It’s a pause, not a full stop


Dr Tripat Chaudhary 

If you are woman in your mid-forties, and if you are having irregular periods for some time now; the sexual drive has waned; vaginal dryness is making sex uncomfortable; hot flashes and mood swings are becoming frequent; you are having trouble sleeping and you are fatigued easily — all these changes maybe signs of that you are approaching menopause. Coupled with life’s other challenges, these symptoms may sometimes trigger a panic situation in one’s mind and be mistaken for having a midlife crisis.  

These two events should, however, never be confused with each other . 

Midlife crisis vs menopause

A midlife crisis can be understood as having a feeling of anxiety and worry, lack of self-confidence and insecurities that a person may experience, usually in his/her late forties or early fifties. Apart from reviewing their professional  success, most women also tend to evaluate their relationships, their identity, and specially the loss of youth and prime.

Characterised by changing eating habits and sleep patterns, coupled with feelings of helplessness, pessimism and hopelessness, this particular time is confusing for many. It is sometimes assumed that menopause may have a contributory factor to this transitory phase, but both things are pretty different.

 A midlife crisis is more of a psychological condition and it largely depends upon the individual when he or she feels affected by it. Some people may be affected by it as early as in late thirties and events like death of parents, partner or someone close can be a trigger.

Menopause, on the other hand, is a natural occurring phase in a woman’s life like childhood, puberty, adolescence, youth and old age. It is a biological stage for menstruation, which began in puberty, to end and is accompanied by dropping estrogen and progesterone levels. When a woman has not menstruated for one year at a stretch it is called menopause.

 The hormonal changes manifest in various ways through mood swings and hot flashes. Because of the transformation of female body and the feeling of loss of fertility, a woman may be feeling down and upset. However, women don’t suffer clinical depression due to menopause. It may have less or no significant influence on midlife crisis. 

Dealing with change

Menopause for every woman is unique. Some have a difficult peri-menopausal phase while others make a smooth move directly to menopause. Other than the discussed symptoms, a woman may show signs of memory problems, difficulty in concentrating, increased urination due to urinary incontinence, etc. Other complications due to dipping hormones can lead to lower metabolic function, osteoporosis, thinning vaginal walls and an overactive bladder. Studies have indicated that the risk of breast, cervical and uterine cancers increases with increasing age. Therefore, regular medical check-ups are highly advised. Women are also at a higher risk of cardiovascular diseases after menopause. With proper medical guidance and some healthy lifestyle habits, this difficult phase in a woman’s life can be managed easily.  

— The writer is director, obstetrics and gynaecology, Fortis LaFemme, New Delhi


Coping with it

  • Accept it as a natural event. The pregnancy related worries are no longer there. Women are known to feel free and explore newer avenues while engaging in hobbies which they always wanted to pursue.
  • Intimacy may increase. Some women say that they have enjoyed intimacy during menopause more due to miniscule chances of getting pregnant
  • Be cautious with hormone replacement therapy (HRT). It is considered one of the ways to manage menopause. However, studies are not conclusive about the long-term and short-term efficacy. The objectives, which the therapy is supposed to achieve, are to help women minimise the risks of cardiovascular diseases, osteoporosis and other complications by regulating the hormone levels in the body. In the short term, it is used in cases where a woman is affected by menopause at an early age or if the woman has undergone a surgery. However, at present, it is still being assessed that whether the benefits outweigh the risks, as it increases the chance of breast and uterine cancer. According to a Women's Health Initiative study it increases the risk of stroke and heart diseases
  • Peri-menopause begins a few years before menopause starts and is characterised by some of the key menopausal features such as fluctuating hormone levels, mood swings, etc. Regular check-ups, continuing with contraceptives while having sex, exercising, having a calcium-rich diet, limiting alcohol and smoking are some of the precautions one should take.
  • Immediately consult doctor if you have irregular bleeding during peri-menopause ,it may be an early sign of cancer. No periods for a year are a clear sign of menopause. If you bleed after that consult a gynaecologist immediately.

Ways to manage

Lifestyle changes and home remedies can help in reducing severity of menopausal symptoms:

  • Wear comfortable clothes and keep yourself cool. Layered loose clothing and maintaining comfortable room temperature helps in managing hot flashes.
  • Increase physical activity and manage body weight. Exercising helps you lose heat, reduce body weight, increase energy, improve blood flow to organs, improve mood, and get good sleep at nights. Managing diet to reduce calorie intake helps the cause further.
  • Consume nutrient-rich diet. It is important that women eat a diet rich in calcium, omega-3 fats, magnesium and vitamin D. Take supplements as prescribed by your doctor.
  • Limit tobacco and alcohol consumption. Smoking or exposure to it and heavy drinking worsens the symptoms of menopause and can contribute towards other complications.
  • Take medical and psychological consultation as appropriate. If menopause is becoming distressing, it is advisable to go for psychological consultation. 
  • For sleep-related issues as well, one should consult doctors and not go for self-medication.

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