Dr. Monali Shah


Medically, Menopause means permanent cessation of menstruation at the end of the reproductive period, for 12 consecutive months without any identifiable pathology.
It is the point of time when the last menstruation occurs due to loss of ovarian follicular activity.
The age of menopause ideally ranges between 45-55yrs, the average being 50 yrs.

What changes would you notice when you are in or around a menopausal age?
  1. Hot flushes with night sweats, the low oestrogen level is a prerequisite. 
  2. Dyspareunia.
  3. Minimal traumas causing vaginal bleeding,dyspareunia,vaginal infections,dryness,pruritus,leucorrhoea.
  4. Decreased sexual desire.
  5. Thining of skin with loss of elasticity, wrinkles start becoming prominent.
  6. Loss of body hair and slightly balding.
  7. Anxiety, headache, insomnia, dysphagia and depression
  8. Dementia and Alzheimer’s disease.
  9. Increased osteoporosis runs a high risk for bone fracture.
  10. Increased risk for cardiovascular diseases.
  11. Frequent urge for urination and stress urinary incontinence.
Cessation of menstruation for 12 consecutive months without identifiable pathology with hot flushes and night sweats.
Vaginal cytology revealing maturation index of at least 10/85/5(features of low oestrogen).
Serum oestradiol <20pg/ml
Spontaneous menopause is unavoidable however menopause induced by surgery or radiation can be to some extent avoided or delayed.
Counselling is the main aim of treatment. Every woman of this age group should be adequately explained about the psychological events. This helps remove anxiety, depression and insomnia. 
Treatment may be hormonal as well as non-hormonal.
Non-hormonal treatment includes –
  • Nutritious diet
  • Supplementary calcium(daily 1-1.5 gm would reduce risk of bone fracture)
  • Exercise(specifically targetting pelvic floor exercises)
  • Meditation 
Cessation of smoking and alcohol. 
Hormonal treatment includes –
HRT (Hormone Replacement Therapy) is advised to relieve menopausal symptoms, prevents osteoporosis and maintain quality of life in post-menopausal years.



Dr Monali Shah. ( BHMS and Dietician )

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