Pausing to give thanks, I was given the joy Of birthing our beautiful children Pausing to give thanks, for my infinite emotions Occasionally high on occasion low Typically moderate and colourful now and again Pausing to give thanks, my life still holds excitement and promise Now that I have paused I give thanks.

Women are one of the most wonderful creations created by God. She goes through different phases in her life. She is born as a girl, who gradually evolves and matures in to a pretty lady.

She plays various roles. She is a daughter to her father, wife to her husband, mother to her children. These roles never end, they continue throughout her life. She ages with them, but never complains. She goes through various highs and lows. During a certain age there comes a pause indicating the end of something very imperative, what is it, let us have a look…..

The pause is none other than MENOPAUSE which is part of a gradual and natural process in which the ovaries produce less and less of the female hormones, estrogen and progesterone, and menstrual periods gradually disappear, indicating the end of her reproductive life. The process of menopause does not occur overnight, but rather is a silent process. There is no way to predict when an individual woman will have menopause or begin having symptoms suggestive of menopause. The age of menopause is not related to age of menarche (onset of menses) or age at last pregnancy. It is also not related to the number of pregnancies, lactation, use of oral pill, socio-economic condition, race, height or weight. However, cigarette smoking and severe malnutrition may cause early menopause. Most women reach menopause between the ages of 45 and 55, average being 50 years. As a rough “rule of thumb,” women tend to undergo menopause at an age similar to that of their mothers. Each woman experiences menopause differently.

Few changes occur in the menstrual pattern before menopause. It may include any one of the following patterns –

– By CINDY STEVENS

– Sudden stoppage of menstruation (which is rare)

– Gradual decrease in both amount and duration. It may be spotting or delayed and ultimately lead to cessation.

– Menstrual periods (menses) may occur more frequently (meaning the cycle shortens in duration), or they may get farther and farther apart (meaning the cycle lengthens in duration) before stopping.

There is no “normal” pattern of bleeding before menopause occurs, and patterns vary from woman to woman. Changing hormone levels can cause a variety of symptoms that may last from a few months to a few years or longer. There is no set length of time it takes for a woman to complete the menopausal transition. A woman can have irregular periods for years prior to undergoing menopause. It is important to remember that all women who develop irregular menses should be evaluated by her doctor to confirm that the irregular menses are as a result of menopausal transition and not as a sign of another medical condition.

It is however important to remember that each woman’s experience is highly individual. Some women may experience few or no symptoms of menopause except for stoppage/ cessation of menstruation, while others experience multiple physical and psychological symptoms. The extent and severity of symptoms varies significantly among women. It is also important to remember that symptoms may come and go over an extended time period for some women. This, too, is highly individual. Let us quickly brief through the important menopausal symptoms –

– Hot Flushes and Night Sweats – Hot flushes are common amongst women undergoing menopause. A hot flush is a feeling of warmth that spreads over the body and is often most pronounced in the head and chest. A hot flush is often followed by profuse perspiration. Hot flushes usually last from 30 seconds to several minutes. Although the exact cause of hot flushes is not fully understood, hot flushes are likely due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen (hormone secreted by the ovaries responsible for menstruation) levels. Sometimes hot flushes are accompanied by night sweats (episodes of drenching sweats at nighttime). This may lead to awakening and difficulty in falling asleep again, resulting in unrefreshing sleep and daytime tiredness.

– Vaginal Symptoms – Vaginal symptoms occur as a result of the lining tissues of the vagina becoming thinner, drier, and less elastic as estrogen levels fall. Symptoms may include vaginal dryness, bleeding due to minimal trauma, itching, or irritation and/or pain with sexual intercourse (dyspareunia). The vaginal changes also lead to an increased risk of vaginal infections.

– Urinary Symptoms – The lining of the urethra also undergoes changes similar to the tissues of the vagina, and becomes drier, thinner, and less elastic with declining estrogen levels. This can lead to an increased risk of urinary tract infection, feeling the need to urinate more frequently, or leakage of urine (urinary incontinence). The incontinence can result from a strong, sudden urge to urinate or may occur during straining when coughing, laughing, or lifting heavy objects.

– Skin and Hair Symptoms – Thinning of hair, loss of elasticity and wrinkling of the skin occurs as a result of the declining estrogen levels.

– Psychological Changes – There may be increased frequency of anxiety, headache, change in the sleeping pattern, irritability and depression. Mood swings and inability to concentrate may also be seen in few women.

– Other Physical Changes – Weight gain is often seen in many women during menopause. Changes in the body fat distribution, with body fat being deposited more in the waist and abdominal area than in the hips and thighs. Since the body continues to produce small levels of the male hormone testosterone, few women may experience some hair growth on the chin, upper lip, chest, or abdomen.

Every woman goes through a different experience. Nothing can be done about the passage of years, but a great deal can be done throughout a woman’s life to prevent and treat the diseases that keep her from being in the best possible health. There are some ailments which are commonly seen in women after menopause. Along with menopause the function of the ovaries cease which are mainly associated with the female hormone productions estrogen and progesterone. These hormones are mainly responsible for menstruation and pregnancy. Other than these, they help in building strong bones, protect against heart diseases, protect the brain and help keep the reproductive organs healthy. These hormones are partly produced by the ovaries and partly by the adrenal glands present in the body. The productions of these hormones by the ovaries decrease with menopause. Due to which women become more prone to certain ailments at menopause. The two most common conditions associated are Osteoporosis and Heart diseases, which is described below –

1. Osteoporosis (porous bones) – it is a condition which leads to weakness in the bones, increasing the risk of sudden and unexpected fractures. Osteoporosis results in an increase loss of bone mass and strength. Many times, osteoporosis is not discovered until weakened bones cause painful fractures most commonly seen in the back or hips. Unfortunately, once you have a broken bone due to osteoporosis, you are at high risk of having another and these fractures can be debilitating. Lack of estrogen which is usually seen in women during and after menopause is directly linked to osteoporosis. Estrogen is the hormone that helps in formation and maintenance of strong and healthy bones. As its level decreases the bones lose their protection and eventually result in weak and porous bones due to loss of the bone mass in the absence of this hormone. Osteoporosis is often called the “silent disease” because initially bone loss occurs without symptoms. Women over the age of 50 have the greatest risk of developing osteoporosis. In fact, women are four times more likely than men to develop osteoporosis. Women’s lighter, thinner bones and longer life spans account for some of the reasons why they are at a higher risk for osteoporosis. Other important risk factors include hereditary, family history and certain medications like steroids (when taken for a long span of time).

2. Heart diseases – many of us think that only men suffer from heart diseases and not women. But it is not so. Women too suffer from heart diseases and in fact are at higher risk when they attain the menopausal age due to decline in the hormonal levels especially estrogen which is responsible for protecting the heart. Other risk factors for heart diseases in women include diabetes, hypertention, obesity, smoking, strong family history of heart diseases, sedentary lifestyle, low levels of HDL (High density lipoproteins) which is also called the ‘good cholesterol’ and high levels of LDL (Low density lipoproteins) which is also called the ‘bad cholesterol’. A healthy lifestyle goes a long way in preventing heart diseases in women. Incorporating the following tips into your everyday life may help you reduce the risk of heart disease during and after menopause –

Regular exercise – take a brisk walk for at least 5 out of 7 days in a week for 30 minutes. It helps improve the pumping action of the heart, keeping it healthy. Yoga and swimming too can be done which is beneficial to the heart.

Try to maintain a healthy body weight- activity of the heart has a direct proportion to an individual’s body weight. Increase in the body weight above the ideal weight demands an increased pressure on the heart and on its function’s which in the longer run gradually makes the heart weak, giving rise to various cardiac diseases.

Well balanced diet – it goes a long way in preventing and controlling many cardiac diseases. One should follow a well-balanced nutritious diet, which is low in saturated fat. Consume plenty of fruits and vegetables rich in fiber. Avoid deep fried items which contain a high amount of trans fat which is detrimental to the heart.

Avoid or quit smoking – since it has a very hazardous effect on the heart as well as the lungs. The risk of heart diseases in smokers is much more than in non-smokers.
Remember menopause is just a transitional period, a normal part of aging in women and a very important phase of every woman’s life. Nothing can be done to stop menopause or aging, but one can definitely change their approach of looking towards it.

“The more you praise and celebrate your life, the more there is in life to celebrate.”