Menopause symptoms, their management and hormone therapy

Hot flushes are one of the most common menopausal or perimenopausal symptom, experienced by almost 75% of women. Hot flush refers to a sudden hot or feverish feeling that is experienced for a few days after menopause. The symptom may subside within 2 days of menopause but it also has a chance of continuing until years later. This symptom not only affects the quality of life, daily activities and work efficiency, but also has an impact on sleep, most often causing sleep disturbances. Around menopause, women often tend to wake up during the night due to night sweats from these flushes.

Hot flushes are one of the primary reasons that women seek hormonal therapy after menopause but they can be managed by other treatment interventions like oral contraceptives and selective serotonin reuptake inhibitors, which will be prescribed to you by your doctor while you are transitioning to menopause. Vitamin E supplements may also be prescribed. Other than this, weight management or reduction along with cessation of smoking and alcohol habits will likely help with your symptoms.  

(Read more: How to quit alcohol)

Vaginal dryness is another common menopause symptom, which is a great matter of concern as it affects sexual activity. This occurs due to the loss of collagen and adipose tissue in the region of the vulva. Due to a decrease in the thickness of the superficial layer of vagina, there is also a reduction in vaginal secretions, causing its dryness. Dryness of the vagina may be a common cause of pain during coitus and loss of libido among postmenopausal women. However, the precise cause of sexual dysfunction during menopause is not yet known.

While hormonal replacement therapies are effective in the management of a dry vagina, topical estrogen application is a much more convenient way to manage this condition. Other than this, use of lubricants while having sexual intercourse can be helpful in the management of dyspareunia (painful sex).

(Read more: How to improve libido)

With a decrease in vaginal secretions around menopause, there is also a change in the vaginal pH. As the normal vaginal pH of 4.5 is disturbed, there is an increased likelihood of vaginal infections due to a disturbance in the acidic environment, which was hostile to the growth of microorganisms. Overgrowth and colonisation of these bacteria is what is responsible for the occurrence of vaginal infections around menopause.

Vaginal infections can be prevented by taking good care of your vaginal health and by the practice of safe sex. It is also important that you do not touch your vagina with unclean hands and avoid the practice of vaginal douching. Douching can irritate the already thin and sensitive vaginal lining post-menopause.

During menopause, genitourinary atrophy will be seen in addition to vaginal atrophy. This leads to an increased risk of urinary tract infection, which will present with symptoms like frequent urination or painful micturition. Frequent urination is anyway a common symptom during menopause.

(Read more: Vaginal pain causes)

Osteoporosis refers to a disease marked by a reduction in the bone mass density, causing bone pain and brittle bones. These bones have a higher tendency to fracture. It has been found that postmenopausal women have a greater risk of developing osteoporosis due to a reduction in the levels of the hormone oestrogen, which helps to protect the bone structure. As this happens, backache, pain on exertion, frequent fractures and the development of a hunchback are the symptoms.

While hormone therapy is effective in the management of osteoporosis, it can also be managed with the help of simple lifestyle changes like cessation of smoking, an increase in physical activity along with the intake of a balanced diet. Women around menopause must also begin taking calcium and vitamin D supplements as directed by their physician.

Insomnia refers to a reduction in the quality or quantity of sleep or both. Insomnia along with other sleep disturbances like repeated awakening and night sweats are common in postmenopausal women due to the hormonal changes experienced during this period. An average of 25 minutes of sleep has been estimated to be compromised in women around menopause.

While this can be managed with the help of pharmacological interventions, poor sleep in perimenopausal women can also be dealt with the help of simple remedies. Sleep meditation, relaxation and intake of a relaxing tea right before bed can be helpful. An increase in physical activity and exercise can also help regulate the sleep cycle in postmenopausal women.

Quite obviously the ever-changing hormones during menopause will have an effect on your mood. The number of physical changes you experience during this phase and the stigma around menopause may add on to your concerns. This is experienced differently by different women. While some women may have no effects at all, others may actually go into a state of depression. Some studies also suggested that a reduction in cognition may occur around menopause, so, it is imperative that you take care of your mental health. If you are facing any mental health issues, it is important that you talk to your doctor. It is also imperative that you understand that menopause is a normal body mechanism and not a disease that you have to deal with. Acceptance of this phase will help you in managing your symptoms better.