Menopause is a phase in a woman's life, typically occurring in her 40s or 50s, characterized by the decline of reproductive hormones. It marks the end of the menstrual cycle. Menopause is confirmed after 12 consecutive months without a menstrual period. While it is a natural part of aging, menopause can be physically and mentally challenging for many women.

Premenopause: Premenopause is broadly defined as the entire woman's life before menopause. During this phase, a woman will have regular periods, can bear children, and sex hormones like oestrogen and progesterone retain a steady balance.

• No menopausal symptoms
• Still have periods

Premenopause: A period of a woman's life characterized by the physiological changes associated with the end of reproductive capacity and terminating with the completion of menopause, also called climacteric.

• This means "around or near menopause."
• Symptoms of hormonal changes
• Can still become pregnant
• Usually lasts about four years

Menopause: It is the end of menstruation. The age of menopause ranges between 45-55 years, the average being 50 years.

• No period for 12 consecutive months
• Ovaries stop producing eggs
• The average age is 51.

Postmenopause: It is defined formally as the time after which a woman has experienced 12 consecutive months of amenorrhea without a period.

• Over one year since the last period

• Age is the leading cause of menopause, which is brought on by the slowing function of the ovaries. As women reach their 40s, fertility declines, leading to menopause, a natural process in a woman’s life.
• Certain surgeries and medical treatments can induce menopause
• Surgical removal of the ovaries (bilateral oophorectomy)
• Chemotherapy
• Pelvic radiation therapy

The most common sign of menopause is hot flashes. Hot flashes are sudden feelings of warmth that spread over the upper body, often accompanied by blushing, a racing heart, and sweating.

In addition to hot flashes, other physical symptoms include:

• Mood swings
• Vaginal dryness
• Depression
• Incontinence
• Change in sex drive
• The risk of cardiovascular diseases and osteoporosis increases.

Emotional symptoms include:

• Loss of energy
• Lack of motivation
• Difficulty concentrating
• Anxiety, depression, mood changes, and tension
• Aggressiveness and irritability
• Crankiness

• Some have mild symptoms; others find that their sleep, daily life, and well-being are severely affected.
• Menopause symptoms eventually subside when hormone levels even out
• Postmenopause changes are typical signs of low oestrogen and typically continue over time.

A doctor might recommend tests based on symptoms, including:

• Blood Test: To check FSH hormone levels. Serum FSH and LH >40 IU/ml mean appearance of Menopause.
• Appearance of menopausal symptoms
• Hormone Test: Serum oestradiol<20pg/ml. The estradiol test evaluates the menopause stage as estradiol levels decrease.
• Additional Tests: These may include thyroid function tests, blood lipid profiles, liver function tests, and kidney function tests.

• Holistic approach
• Lifestyle opportunities
• Reducing modifiable risk factors
• Providing Information and Advice
• Other prescription drugs
• Complementary and Alternative Therapies
• CBT
• Vaginal Oestrogens
• HRT

• Relief of menopausal symptoms
• Prevention of osteoporosis
• To maintain quality of life in menopausal years, HRT should be prescribed to a particular group of women.
• Premature ovarian failure
• Gonadal dysgenesis
• Surgical or radiation menopause

Yes, during menopause, there is a sudden drop in estrogen levels in the body. This leads to bone mineral loss, which can cause bones to weaken. This condition is called osteoporosis.

Frequent awakenings suggest that insomnia is secondary to vasomotor symptoms

More common in women with surgical menopause

However, waking episodes may occur in the absence of hot flashes.

The feelings that a woman holds about herself and her social relationships, as well as the symptoms she experiences, can be defined by the culture in which she lives. Women vary in their subjective experiences of symptoms. Not all of a woman's perceived changes in the body are reflected in the mirror; some are derived from her perception of herself based on other expectations that vary and are adjusted to actual experience.

Stay in touch with your doctor, as menopause symptoms can sometimes worsen. If you experience unexpected vaginal bleeding after 12 months of no periods, it could indicate other medical conditions. Always share your concerns with your healthcare provider.

While menopause is a natural transition, the symptoms can be disruptive if left unaddressed. From hot flashes to mood changes, support and proper care can make a meaningful difference. Dr. Sangeeta Dubey offers individualized treatment plans to help you navigate menopause with confidence.