World MENOPAUSE Day


18th October

  • Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining (a.k.a. the menses). Menopause typically (but not always) occurs in women in midlife, during their late 40s or early 50s, and signals the end of the fertile phase of a woman’s life.
  • The transition from reproductive to non-reproductive is the result of a major reduction in female hormonal production by the ovaries. This transition is normally not sudden or abrupt, tends to occur over a period of years, and is a natural consequence of aging. However, for some of women, the accompanying signs and effects that can occur during the menopause transition years can significantly disrupt their daily activities and t heir sense of well-being. In addition, women who have some sort of functional disorder affecting the reproductive system (i.e. endometriosis, polycystic ovary syndrome, cancer of the reproductive organs) can go into menopause at a younger age than the normal timeframe; the functional disorders often significantly speed up the menopausal process and create more significant health problems, both physical and emotional, for the affected woman.
  • The word “menopause” literally means the “end of monthly cycles” from the Greek word pausis (cessation) and the roo t men- (month), because the word “menopause” was created to describe this change in human females, where the end of fertility is traditionally indicated by the permanent stopping of monthly menstruation or menses. However, menopause also exists in some other animals, many of which do not have monthly menstruation[1]; in this case, the term is synonymous with “end of fertility”.
  • The date of menopause in human females is formally medically defined as the time of the last menstrual period (or menst rual flow of any amount, however small), in those women who have not had a hysterectomy. Women who have their uterus removed but retain their ovaries do not immediately go into menopause, even though their periods cease. Adult women who have their ovaries removed however, go immediately into surgical menopause, no matter how young they are.
  • Menopause is an unavoidable change that every woman will experience, assuming she reaches middle age and beyond. It is helpful if women are able to learn what to expect and what options are available to assist the transition, if that becomes necessary. Menopause has a wide starting range, but can usually be expected in the age range of 42–58 (Bucher, et al. 1930). An early menopause can be related to cigarette smoking, higher body mass index, racial/ethnic factors, financial strain, illnesses, chemotherapy, radiation and the surgical removal of the uterus and/or both ovaries (Bucher, et al. 1930).
  • Menopause can be officially declared (in an adult woman who is not pregnant, is not lactating, and who has an intact uterus) when there has been amenorrhea (absence of any menstruation) for one complete year. However, there are many signs and effects that lead up to this point, many of which may extend well beyond it too. These include: irregular menses, vasomotor instability (hot flashes and night sweats), atrophy of genitourinary tissue, increased stress, breast tenderness, vaginal dryness, forgetfulness, mood changes, and in certain cases osteoporosis and/ or heart disease (Bucher, et al., 1931). These effects are related to the hormonal changes a woman’s body is going through, and they affect each woman to a different extent. The only sign or effect that all women universally have in common is that by the end of the menopause transition every woman will have a complete cessation of menses. [wikipedia]
  • At the other end of life, at ages forty five to fifty, the ovarian cycles of a woman become more irregular and finally cease, a process known as menopause. Once again, the reasons for menopause are not at all well understood. Work in rats suggest that the ovaries are not at fault: if ovaries from older rats are transplanted into younger rats, they resume a normal function. Many people suspect that changes in the hypothalamus are again to blame, but what exactly happens is still unclear.
  • Regardless of the cause of menopause, the loss of ovarian hormones in older women has a disruptive, and even perhaps unhealthy, influence upon the remainder of life. Physicians have increasingly supported the administration of small doses of estrogen to replace the missing estrogen in older women, and have found that this combats the loss of minerals in bones with age and reduces the risk of heart disease. [source]
  • Thus, the use of sex hormones can improve both the quality and quantity of life in older women.

WHAT IS MENOPAUSE?

  • Menopause is the last drop of blood a woman sheds. A woman can be peri-menopausal (around menopause) or post-menopausal (after menopause) but she can never be menopausal, according to this definition.
  • To most women, however, the years between the first suspicion of change and the final menses constitute the menopausal years, and we are menopausal throughout that time. This decade of transition is compared by some to non-stop PMS, by others to an extended pregnancy. I see it as a second puberty.
  • Menopause is puberty prime, and the change from a familiar, known self to new and unknown self is the same: amazing, difficult, rewarding, exasperating, and momentous.
  • “Do not become alarmed when you experience yourself in totally new ways,” sighs Grandmother Growth tenderly. “You are changing, getting ready to be initiated into the third stage of your life. Are you ready for the ride of your life?” – Susun Weed, Menopausal Years the Wise Woman Way, Woodstock: Ash Tree, 2002

Clinical Features:

  • (1) Menstrual — the three classical ways in which the periods cease are — (a) sudden cessation, (b) gradual diminution in the amount of loss with each regular period until they disappear, (c) gradual increase in the spacing of the periods until they cease for an interval of 6 months.
  • (2) Not flushes & sweats—it may be of mild degree, in some cases there are severe flushes followed by profuse sweats.
  • (3) Psychological—some women are emotionally disturbed and they feel anxious, fearful or irritable. Also some may suffer from insomnia, headache, melancholia or mania etc.
  • (4) Some women may suffer from obesity, raised cholesterol, brittleness of hair, dryness of skin, lassitude, osteoarthritis, fibrosis, backache etc.
  • (5) Genital tract — (a) Vulva — progressive atrophy with scanty hair with narrowing of the vaginal introitus, (b) Vagina— becomes narrow with ‘tenting’ of vagina vault, thinning of mucous membrane and loss of rugae (c) Cervix — portio vaginalis atrophies and gets flushed with vaginal vault, (d) Uterus — body is felt small and hard. (e) Ovaries — Becomes atrophies with gradual decrease in estrogen production.
  • Diagnosis: Confirmed by atrophic vaginal smear and elevated urinary gonadotrophin assay.
  • Differential Diagnosis: Amenorrhea and depressed gonadal function may result from severe metabolic and psychic disorders such as adenohypophysial or adrenocortical insufficiency, anorexia nervosa and myxaedema.
  • Prognosis: The prognosis for an uncomplicated, only mildly disturbing menopause and climacteric is excellent for the well-adjusted, informed woman. Neurotic patients, for whom medication is contra-indicated, may have to endure considerable distress before they ‘settle down’ to a relatively more agreeable old age.
  • Management: (1) the patient should be re-assured that menopause does not mean the end of sexual life and family happiness, also explain to her the exact physiological state in simple language. (2) Improvement of health by balanced diet, adequate rest & sleep, regular evacuation of bowel. (3) For any emotional upset, sedative like tablet Phenobarbitone, tranquilizers etc. may be given but it should be reduced gradually and then withdrawn completely.
  • Prevention of Senile Atrophic Changes: Early and adequate steroid sex hormone therapy will usually reduce the extent of mucosal, muscular, fascial, osseous and frequently, vascular degenerative changes. But, there is controversy of opinions regarding safety of this drug therapy.

Menopause in Ayurveda
Ayurveda says that menopause is not a disease, but a natural transition in women that occurs at the age of 45-55 years. In Ayurveda, the transition is often associated with the process of aging in women. Since aging is a ‘Vata’ predominant stage of life, the symptoms of menopause experienced by some women are often similar to the symptoms, when the Vata dosha rises and upsets the normal balance of the body. Typically, there are three types of menopause – vata dominated menopause, pitta dominated menopause and kapha dominated menopause. [source]

Ayurveda Management

Menopause syndrome is best managed with Kumari (Aleo vera) and Papaya (Carica papaya) compounds. Even these Herbs are consumed directly as they are common edible vegetables. Kumari Asava is taken 3 tsf after food as prophylaxis.

Mahatiktaka Grita internally and Chandanabala Lakshadi taila externally for Abhyanga (massage) is indicated in Menopause syndrome. to relieve the fatigue and irritation, itching – Khandakadyavalehya is the best. Treatments vary according to the constitution and the symptoms presented.

THE STORY OF MENOPAUSE

  • The onerous physical/emotional changes that accompany puberty and menopause are strongly influenced–both positively and negatively–by cultural, familial, and personal beliefs.
  • If we expect our new self to be more powerful, more exciting, more interesting than our old self, we willingly undergo discomfort, pain, sleeplessness, emotional variability, and a host of annoyances and distresses. In America today, this may be the case when we experience puberty, pregnancy, birth, and lactation. [WOMEN’S HEALTH ARTICLES]
  • If we expect our new self to be a weaker, less interesting, grayed-out version of our older self, we will naturally resist changing and find the normal abnormalities of change intolerable. This is often the case when American women encounter menopause.
  • “The joy of menopause is the world’s best-kept secret. Like venturing through the gateway to enter an ancient temple, in order to claim that joy a woman must be willing to pass beyond the monsters who guard its gate. As you stand at the brink of it, it can appear that only darkness, danger and decay lie beyond. [But] … as thousands of women from all cultures throughout history have whispered to each other, it is the most exciting passage a woman ever makes.”

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