Sakaal Times
13 May 2011

It’s a dreaded word for most women. But menopause requires to be demystified and understood. Namita Shibad provides some essential notes

Menopause. The word technically means an end to a woman’s reproduction capabilities. And a lot more physically. So your baby making days are over. Estrogen production stops, making your bones brittle. That also makes your heart as prone to heart attacks as a male who has less of the same harmone. It gives you those hot flashes. And…. the list goes on. Of course, all this is bound to depress you.

But what all the fall–outs of menopause fail to address is the fact that it’s like having a disability. Well, almost. Disability, because the precursor to the final menopause is what doctors call the perimenopause.

Fancy name, but most treacherous, as many women in their forties will agree. Says Leena Giri, who turned 50 last year and is still in the throes of perimenopause, "The problem is that as you get closer to the end of your periods, the cycle goes haywire. You can never be sure when they will come or when they will end. And if you are working, it becomes such a bane."

Says a woman in her forties who is too embarrassed to give out her name, "I’ve had to face so much embarrassment on account of my periods. When they come it’s like a deluge.... I’ve had to use as many as 14 sanitary napkins in my waking hours. This kind of bleeding has got me in several painfully embarrassing situations. During my periods I largely sit on plastic sheets on sofas and have a permanent mackintosh on my bed."

What makes it worse for menopausal women is the fact that it is not a disease like a flu or a dysentery. The shame attached to periods is another issue women have to deal with. Says Kalpana Thapar, "What can you say to your male boss, I can’t come to office because I have my periods?"

So most women carry the burden of concealing the fact that they’re menstruating, and badly enough to become house bound. Rama Kapur, who runs a catering service says, "I think we women should simply state our condition. Why hide something that’s so normal and natural? If men get to hear a women confidently state the real cause of their monthly problem, maybe the apparent shame attached to it will slowly disappear."

This story is fairly common to most women. Says Dr Manjiri Kulkarni, a practising obstetrician and gynecologist, "Menopause and its precursor, perimenopause behaves differently in different women. Technically it is supposed to peter off, get spaced out and then end. But then about half of the women will have difficulty in this phase of their lives. They have heavy bleeding, their periods may come closer and closer, sometimes even twice in a month and this has a different fall out. Excessive bleeding will make a woman anemic. Treatment will depend on the pathology of the uterus, whether there are fibroids or malignancy."

Medicine offers some help. Says Kulkarni, "We can, depending on the case, put women on a hormone treatment. At times, surgical intervention can help reduce the problems. But what is more important is that women undergo regular check ups. Women must ensure that they have regular gynaec check ups as this is the time when one can be prone to a lot of health problems in any case."

Apart from the physical fall out, women have a lot to deal with menopause emotionally. Says Dr Suparna Telang, psychiatrist and sexual medicine counselor, "The hormonal changes may have a role to play in depression. But that happens only if the reduction of estrogen is very rapid. We must remember that the body does not completely stop producing estrogen. In my opinion, the anticipation of depression is far greater than it actually is seen."

Telang points out that the other much–believed myth is that menopause means the end of sexual activity for the woman. "But this is not true. If a woman is in a loving relationship, has had good time and memories with her spouse or partner, she is perfectly capable of a normal sexual function. Her desire for sex is more dependent on the relationship she shares with her spouse than the level of estrogen in the body.

It was also believed that estrogen was essential for lubrication. But the truth is that if a woman is not emotionally ready, is stressed or is in a bad relationship, she will not lubricate. In fact, sex after menopause is often better in some women because the fear of getting pregnant is not there."

This great battle is definitely not unconquerable. Says Bianca Talwar, whose menopause was without much ado.

"I am and have been a regular practitioner of yoga. As a result my menopause was without too much of a problem. I did get those hot flashes and mild headaches, but most of them were manageable. But this was for just one and a half years. Not anything I could not deal with."

Combat menopause
Remember your body has for a long time been used to greater levels of hormones than it did in the past. That loss will show up in many ways. But if you follow these tips you increase your chances of having a happy menopause.

Improve your diet. Include milk if you’ve been missing it. Calcium and iron rich foods will help. And so will an all round good diet

Your body will not have the help of your friendly estrogen centre that helps absorb calcium and direct it to the bones. So include a calcium tablet, at least a 1000 mg a day.

Exercise. Any form of exercise helps increase endorphins, the feel good hormone, which will help you battle to blues.

If you are obese, lose weight. This is the time your body gets prone to hypertension and diabetes. Yoga and meditation will help.