What is Menopause and at what time it occurs?
Menopause in women is that period of time when permanent cessation of menstruation occurs following the loss of ovarian activity. The average age of menopasue is 50 years, ranging from 45-55 years. Early menopause (<45 years) occurs in smokers, at high altitudes, in women with genetic predisposition i.e. mothers and daughters experience menopause at same age.

What are post menopausal problems?
Women may experience problems after menopause due to reduction in the level of sex hormones. The main problems are:

 
• Hot flushes and night sweats.  
• Psychological symptoms - anxiety, tension, mood changes and irritability.  
• Sleep disturbances and early morning waking.  
• Atrophic changes in skin, reproductive organs.  
• Other prolonged health problems like osteoporsis / weakness of bones and fracture and heart problems (hypertension, heart attacks and stroke).  
• Joint & bone pains.

What are hot flushes and why do they occur?
Hot flushes occur due to vasomotor instability. There is sudden onset of reddening of the skin over head and neck preceeded by an aura and there is feeling of pressure before flushes. They occur for short duration and there’s a sensation of heat for 3-5 minutes followed sometimes by profuse perspiration. It normally lasts for 1 year in 80%of women but may continue forever in 10% women. They are more at night and during stress.

What happens due to atrophic changes in the body?
Atrophic changes in reproductive tract lead to dyspareunia (pain/burning during coitus), pruritus (Itching / irritation / soreness of vulva and vagina).
Changes in the urinary tract include urgency and frequency of urine, painful urination and infections.
Changes in the skin include dry and loose skin and increased feeling of cold due to decrease in subcutaneous fat.

What can be done to cure these post menopausal problems?
HRT (Hormone replacement therapy) can be given for the relief of menopausal symptoms by replacing the hormone (estrogen), which decreases at onset of menopause and leads to various symptoms.

Do all women have to take HRT?
No, all women need not take HRT as many women are asymptomatic, this may be due to production of some hormones but for long terms problems like osteoporosis and heart problems, HRT can be started as a precautionary measure in asymptomatic women.

Does exercise and nutrition have a role in modifying post menopausal problems?
Yes, maintaining good level of activity and taking a balanced diet is very important. Dietary supplements like Calcium are very important in preventing osteoporosis. Similarly, doing regular exercises helps in preventing bone loss, and special exercises like pelvic floor exercises help in modifying problems like urinary incontinence.