For all the conversations around menstrual health and hygiene that are slowly breaking past the taboos into public awareness, there is another women’s health concern that is still largely labouring in obscurity and a lack of information – menopause. Experienced by women in their middle ages, menopause is a period of life that for them is extremely difficult, often painful and uncomfortable, and most importantly, unavoidable.
Women aged 45-50 years will go through a few years of perimenopause, which lasts about 4-6 years, and is the period before menopause hits, after which the monthly menstrual cycle comes to an end for women. It is a trial by fire for most, to get past the phase of menopause and into a lifestyle where the monthly menstrual cycle is no longer a concern. Overall, menopause is a natural biological process, but the body’s reduced hormone levels influence physical, emotional, and reproductive health, say doctors, causing a difference in quality of life, accompanying health issues, lowered immunity and more.
What does it feel like?
Although symptoms vary widely among women, some experience extreme symptoms while others go through mild ones, says Dr Manjari Chatterjee, consultant, obstetrician and gynaecologist, Calcutta Medical Research Institute, Kolkata. “Hot flashes, night sweats, sleep disturbances, mood swings, joint pains, vaginal dryness, and irregular periods,” she lists out.
Dr Namrata Gupta, senior consultant, obstetrics and gynaecology, CK Birla Hospitals, Jaipur, explains further, “The hot flashes and night sweats appear as sudden feelings of heat in the face, neck, or chest often followed by sweating and chills, and can range from mild warmth a few times a week to multiple times daily.”
Hormonal fluctuations result in increased irritability and mood swings, progressing often to clinical depression as well. Dr Gupta adds that memory and concentration capacity might be compromised in menopausal women, as well as bone and joint pains, and cardiovascular issues or palpitations. Dr Gupta further shares that while most women experience these symptoms for 4-6 years, around 20-25% of women experience severe ones affecting quality of life. “In some, symptoms may persist for 10 years or more, especially hot flashes and mood swings. And these vague mood and pain patterns affect physical health and quality of performance in daily work in a few patients and may need medical attention and treatment,” she adds.
What really happens?
Dr N Sapna Lulla, lead consultant, obstetrics and gynaecology, Aster CMI Hospital, Bengaluru, explains the process of menopause, and what really happens inside the body. During menopause, estrogen and progesterone radically decrease in the body, and this hormonal shift causes the ovaries to stop releasing eggs, leading to the end of menstrual periods, she says.
“Bones may become weaker, increasing the risk of osteoporosis, while the heart may be less protected, raising the risk of heart disease,” explains Dr Lulla, adding that vaginal tissues can become thinner and drier, causing discomfort. Metabolism may slow down, leading to weight gain, and hair or skin changes.
Dr Chatterjee says that while extreme symptoms of menopause can significantly impact the quality of life of a woman, severe ones can interfere with sleep, concentration, sexual health, and emotional wellbeing. “However, with awareness, support, and the right treatment, women can transition smoothly through this phase and continue leading active, fulfilling lives,” she says. Doctors share that for some a combination of medications and consistent lifestyle changes may be required to alleviate the symptoms of menopause.
“To manage menopausal symptoms like heavy bleeding, cramping, hot flashes, and mood changes, a combination of lifestyle changes and medications is often most effective,” says Dr Chatterjee. She says, “Avoiding triggers like caffeine, alcohol, and smoking can also improve symptoms. Medications, including hormone replacement therapy (HRT) or non-hormonal options, may be recommended for more severe symptoms like heavy bleeding, intense hot flashes, or cramps.” “Pain relievers or supplements like calcium and vitamin D can support bone health. The choice of treatment depends on the woman’s health, symptom severity, and personal preferences, and should be guided by a healthcare professional,” adds Dr Chatterjee.
Dr Gupta advises that the menopausal woman’s diet should include vitamin D and calcium, regular health training exercises can help with bone strength and mood, correcting sleep hygiene, and reducing smoking and alcohol consumption are lifestyle changes that can act as preventative measures for extreme menopausal symptoms. “Menopausal transition or perimenopausal can last for several years — seven years on average,” says Dr Kanti Sahu, obstetrician and gynaecologist at
Apollo Medical Center, Marathahalli, Bengaluru. “On an average, 2% of women suffer from menopausal problems.” Some women may experience it for only a few years, while others may have symptoms for over a decade. The length of the period depends on several factors, like genetics, overall health, and lifestyle habits.
Universal, but stigmatised
Dr Lulla says that in her experience with patients, several suffer complications during menopause but their symptoms depend on age, lifestyle, and medical history. “Roughly, in a typical clinic, a doctor might see about three to five women each week who report significant menopausal symptoms like hot flashes, sleep problems, mood swings, or heavy bleeding. Some of these women also show early signs of related health issues such as osteoporosis, high blood pressure,
or cholesterol changes,” she said.
“In my experience, I see 4-5 women each week seeking help for menopause-related concerns – ranging from hot flashes and mood swings to bone and cardiac issues,” says Dr Chatterjee from CMRI Kolkata, adding, “The numbers are rising as awareness grows, and more women seek timely medical advice.”
Dr Gupta offers a wider scope, saying that hot flashes are experienced by 50-75% menopausal women across the board; 40-60% experience mood swings, sleep disturbances and fatigue; urogenital symptoms experienced by 30-50%; and osteoporosis in about 30% of menopausal women overall. In her personal experience at the clinic, “Four to five such women per week may present with menopausal complaints. Many women with mild symptoms do not seek medical care, so actual prevalence can be estimated much higher.”
She goes on to say that unfortunately menstruation and menopause are both still stigmatised in society. “Menopause in particular is considered a topic too private or associated with ageing and loss of fertility. Women may feel invisible or undervalued in society once they reach this stage,” she says. To combat this stigma that is resulting in isolation, depression, and lack of awareness, Dr Gupta of CMRI Kolkata suggests education on the topic from an early age, media and public campaigns, policy measures, and awareness programmes to change societal bias.
Dr Chatterjee provides a more positive outlook to the menopausal period for women. She says, “Many women see menopause as a sign of ageing or loss of femininity, which leads to silence and neglect. It’s important to understand that menopause is a biological milestone, not an end – but a new beginning.” “Women must take charge of their own health: regular check-ups, exercise, self-care, and open conversations are essential,” she adds.
Dr Lulla elaborates on the misgivings of this societal stigma. “This stigma can lead to misinformation, delayed medical care, and unnecessary shame. To address this, education and awareness are key,” she says, adding: “Healthcare providers should encourage women to ask questions and seek help without embarrassment. Support groups, workshops, and online platforms can also help women share experiences and advice.”
Watch out for
- Hot flashes
- Night sweats
- Sleep disturbances
- Mood swings
- Vaginal dryness
- Brain fog
- Bone and joint pain
- Weight gain and metabolic changes
- Palpitations or cardiovascular issues
How to feel better
- Maintain hormonal balance naturally
- Protect heart health
- Schedule regular health screenings
- Avoid hormonal or herbal self medication
- Get personalised medical guidance
- Ensure calcium, Vitamin D intake
- Regular weight exercises
