Menopause -- things you need to know

Menopause is a natural process every woman goes through at a certain age. And while it may not be so bad for some, many find this to be a very difficult time. 70 per cent women complain of hot flushes and night sweats which are the most common symptoms. Other more troubling complaints are depression, tiredness, lack of energy and in the long term increased risk of bone and heart disease.
Why does menopause occur?
At a certain age, there is a change in the balance of the female hormone, estrogen. The reduction in estrogen means your ovaries will no longer release an egg (ovum) each month. This means you can no longer get pregnant and you will no longer have your periods. While that can be a relief for some, the drop in estrogen also causes a spectrum of minor to major symptoms which have already been mentioned.   
What you may be experiencing when you hit menopause
The initial stage of menopause which is known as the perimenopausal stage, is when your periods may become heavier or lighter, they will also become irregular. You may miss your periods a few months until they eventually stop.
Other symptoms which gradually appear include hot flushes and night sweats, loss of sexual desire, vaginal dryness and discomfort, palpitations and headaches. Many women also report depression, anxiety, tiredness and difficulty in sleeping.
The most common and unspoken problem associated with menopause is a feeling of impending doom. Most women start believing their lives are over. And this terrible feeling is what causes depression, anxiety and sleeplessness.
Menopause and bone health
Estrogen helps in maintaining bone strength by preventing death of certain bone cells which are responsible for bone growth and development. When these cells die off, especially in older individuals, the bones gradually get weaker and are more prone to fractures. One in three women develops osteoporosis after menopause. This is why it is essential that women who have crossed menopause start taking calcium and vitamin D supplements.
Fractures around the wrist, hip or spine are common in women and can be excruciatingly painful. That is why it is important to load up on milk products like yoghurt, spinach and small bony fish especially after menopause. And don't skip your supplements unless your doctor suggests otherwise.
Menopause and heart disease
Estrogen has been proved to reduce the risk of heart disease in women. And once the level of estrogen reduces after menopause, women become more likely to develop heart attacks and strokes. As a result, it becomes essential for women to start exercise and change their food habits once menopause has started. Cut down on cholesterol and saturated fats. Estrogen prevents heart disease by reducing the levels of cholesterol in the body. A lot of women can also benefit from hormone replacement therapy.
What is HRT?
Hormone Replacement Therapy (HRT) is given to women in order to ease the symptoms of menopause. Apart from HRT, there are also other treatment options that may be recommended like tibolone, clonidine, vaginal lubricants and antidepressants. HRT relieves the more common symptoms of menopause like vaginal discomfort, hot flushes and urine infections. Long term treatment has also shown a reduced risk of osteoporosis (so lesser chance of breaking a bone in your 50s) and in some cases less chance of heart attacks.
There are some problems associated with HRT however, the hormone-containing variety may cause all the side-effects of birth control pills like weight gain, bloating, nausea and mood changes. Other varieties like Clonidine is associated with depression, meanwhile Tibolone has a slight risk of causing breast and uterine cancer.
While the risk of cancer is still there, HRT is recommended to some women because of the increased sense of well-being, lesser incidence of broken bones (which can be severely debilitating) and heart attacks in patients given these drugs. They are especially important to those women who have had their ovaries removed during hysterectomy, especially at ages less than 50.
Primrose oil is an herbal supplement prescribed instead of HRT quite widely these days. If taken once daily primrose oil is a well tolerated herbal aid which can relieve breast pain and osteoporosis (in conjunction with calcium) if taken for the long term. Symptoms of menopause may show some improvement in 2 to 3 months.
Things to remember:
A woman's average life-expectancy is increasing and many women are living beyond their 70s and 80s. So don't think menopause is the end of life, this is just the halfway point. Remember, you have another 30 to 40 years or maybe more to live and enjoy.
A loss of libido is normal but don't let that affect your love life. Use lubricants to tackle discomfort during sex. A healthy love life is very important for a healthy marriage which in turn is essential for happiness in the later years.
Regular exercise will reduce the risk of any disease, you will even be able to counter the risks of HRT with a 30 minute jog/walk daily.
Calcium supplements are very important! Don't forget to take them.
If you have had an unhealthy diet in the past, change your food habits. Cut down your rice portions to once daily. Oatmeal is a wonderful heart-healthy breakfast option. Try to have wholegrain bread (or wholemeal flour) and not the white variety. Have at least 5 portions of fruits and vegetables a day. Have sea fish at least twice a week. Try to start depending on daal, beans, eggs and low fat milk for your protein needs, reduce your dependence on animal meats. Remember the healthier you eat, the longer you'll live.
 

By Dr Naomi Mirza, Medical Expert, maya.com.bd