Q. How does menopause occur in women?  
A.Menopause occurs when the function of the ovaries stops permanently. This results in a loss of hormones, which used to act on the uterine wall leading to a permanent stoppage of menstruation.

Q. What is the age when menopause should occur? 
A. In Indian women, menopause occurs around the age of 48 years.       However, it is not unusual to have cyclical periods in the early fifties. In   1% of women, premature menopause is seen before the age of forty.

Q. What are the ways in which menopause can take place?
A. Menopause may occur naturally with age, following the surgical removal of the ovaries or post radiation therapy as a part of cancer treatment.

Q. What short-term problems can arise after menopause?
A. Hot flashes, irritability, mood swings, depression, sleep disturbances, vaginal dryness, decreased libido, painful intercourse, incontinence of urine, frequent passing of urine etc.

Q. What long-term problems can arise after menopause?
A. Long-term problems of menopause are closely associated with problems, which occur due to old age. These include thinning of the bones (osteoporosis) and an increased predisposition to fractures. Cardiovascular   diseases and strokes increase after menopause.

Q. Do menopausal women need treatment?
A. Many short term problems of menopause seriously adverse the quality of life in women thus necessitating treatment. Urinary tract infections and atrophic vaginitis also need appropriate treatment. Osteoporosis, the silent killer, if not treated early may present later in life with a hip fracture.

Q. How can symptomatic menopausal women benefit from non-medical measures?
A. It is not necessary to treat every menopausal woman with medicines. The use of hormones would generally be reserved for symptomatic women. For most others meditation, yoga, light exercises, nutritious diet, avoiding spices and caffeine could be useful in controlling mild symptoms.

Q. What is HRT and how does it fit in menopause?
A. Most of the symptoms of menopause are attributed to the low level of the ovarian hormone – estrogen. HRT or hormone replacement therapy essentially means replacing the deficient hormones to alleviate the symptoms. There is an analogy to the thyroid gland where in cases of deficiency, thyroid hormone is substituted.

Q. What are the side effects of Hormone Therapy?
A. Hormone therapy is an excellent and effective treatment for menopausal symptoms. However, it should always be administered under supervision of a doctor. Side effects include a slightly higher risk of breast cancer, blood clots in the body, strokes and heart disease especially after prolonged (>5 years) unsupervised use.

Q. How is premature menopause managed?
A. Premature menopause is the cessation of menstruation before the age of forty. Due to early deficiency of estrogen the risk of osteoporosis is high. Early replacement of hormones and regular calcium intake is necessary.