Musings of a Menopausal Woman

 

 By Namrata Kohli 

I was chatting with a gynecologist, and she told me that the most neglected aspect of a woman is her health and how extra careful women ought to be esp during menopause, but they never consult unless a calamity happens. I told her that as a woman in my forties, I plead guilty of the same crime until there is a storm (read health-tsunami of sorts). But I looked at this opportunity to explore more on this intriguing subject plus educate others and myself. 

But first what's not menopause. "Don’t confuse heavy bleeding with menopause or 15–20-day cycle ever with menopause," Delhi based gynecologist Dr Sunita Nagpal tells me- "In fact, quite on the contrary, the number of days of the cycle tends to decrease and the gap between the two cycles tends to increase during menopause. But when there is excessive bleeding, there could be certain underlying pathology that needs to be investigated. "

So what is menopause exactly? Like our skin ages and has wrinkles, our hair ages and has greying; likewise, our ovaries tend to age and end up producing lesser hormone and that is perimenopause – the first stage of menopause. To put it medically, menopause is defined as the point when a woman has not had a menstrual period for 12 consecutive months, and it is typically accompanied by a decline in the production of reproductive hormones, primarily estrogen and progesterone. It usually occurs between the ages of 45 and 55, with the average age being around 51 years. It happens in three phases starting with Perimenopause, the transition period leading up to menopause, where hormonal fluctuations begin and symptoms such as irregular periods, hot flashes, and mood swings may start. Then comes Menopause, the point at which menstruation stops completely and finally Post menopause, the years following menopause, during which the body adjusts to lower hormone levels. In a nutshell, menopause is a natural biological process marking the end of a woman’s reproductive years.

Gynecologists plead – Women should just come and say hello to us in their mid-forties. This is the age when certain diseases tend to come up such as AUB or abnormal uterine bleeding which is hormone related. And it's definitely time to get several tests – starting from Mammogram for early detection of breast cancer, Pap Smear test for early detection of cervical cancer to DEXA scan. Perimenopausal changes can affect bone density. A DEXA scan or bone density scan is particularly important if you have risk factors for osteoporosis or a family history of bone loss. 

But what happens in reality. Says Dr Sunita-“No one turns up. Indian women put their health on the lowest priority – for lack of (own) money or time. Those who are not earning feel guilty of ‘wasting money’ on screening tests while those who are earning, feel guilty of ‘wasting time’ - they would rather plan a holiday rather than go for preventive healthcare screening.” Any role of the family? Of course. Lots of support and understanding from the family is required at this stage - for the woman tends to become irritable, can have mood swings. At times, she may not feel like working. Her body requires certain special supplements and dietary changes too. And since the hormone is decreasing, you have to take care of your bones, body weight – and do any and many forms of fitness exercises- be it yoga, walk, pilates. Many a times, women hate themselves for they have bloating - a deposit of abdominal fat and may not get into old jeans. 

Aging is seldom a feel-good factor esp in a society obsessed with looks and appearances, it can be a daunting task for women to keep pace with the many changes her mind and body are experiencing. and since the hormone is decreasing, there are several changes. Brain fog is common - A50-year-old woman shares how she would lose count of the number of times she was losing her car in the parking lot; until she received her first hormone fix. Another one says - "Is the car seat on fire? "Nope, it's just me, feeling like I will spontaneously combust at any moment." Yet another one shares how she was being extremely forgetful and scatterbrained– “I remember being at a stoplight and dreading the light turning green, because I literally did not know which way to turn. I could not remember why I was going to town." 

This is not you, this is your hormones. Menopause is a normal phase of aging. But what is not normal is that you allow hormones to run riot over you and your life. Many times, we as women get overwhelmed with the number of physical changes the body is undergoing. women are unprepared, unaware of its symptoms like hot flashes, mood swings, and health risks such as osteoporosis or heart disease. To worsen the situation this phase often coincides with the going away of children “empty nest syndrome” or losing a loved one. 

At such times, family and friends come into the picture and provide much needed encouragement and support.  The famous play The Vagina Monologues touched upon this once stigmatized topic of menopause. By fostering openness, The Vagina Monologues encouraged women to discuss and embrace changes that come with aging. The monologues challenged conventional norms about beauty and sexuality by celebrating the authenticity of women’s experiences. Menopause often comes with a shift in self-perception, and the play’s themes help redefine attractiveness and sexuality beyond youth, focusing instead on confidence, wisdom, and authenticity and taking aging as an integral part of life. 

Finally, menopause is the ultimate liberation from periods. You can actually plan your holidays without worrying about dates. A chance to transform life's transition into triumph- no more monthly meetings with cramps, PMS, and a never-ending supply management crisis.