Andrea is 52. She’s excited to be starting a new phase of her life as her children leave home and she has more time for her other interests. She’s looking forward to travelling and taking a computer class.
But recent health changes have been getting in the way of her plans. Andrea has been having irregular periods for the past few months, besides hot flashes and trouble sleeping. The hot flashes, which cause her body and face to heat up quickly and uncomfortably, are waking her up several times a night. She feels tired and irritable from the lack of sleep.
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What Andrea is experiencing is “menopausal transition”, a normal part of ageing. It is not a disease or disorder. After the menopausal transition, many women feel relieved they no longer have to worry about painful periods, cramps, or getting pregnant. Some women don’t have any trouble with menopausal symptoms. For others, the menopausal transition can bring hot flashes, trouble sleeping, moodiness and irritability, pain during sex, or depression.
What is menopause? The ovaries make the hormones estrogen and progesterone, which control a woman’s period (menstruation) and the release of eggs (ovulation). Menopause happens when the ovaries no longer release an egg every month and menstruation stops. Menopause is a regular part of ageing when it happens after the age of 40. It is the time in a woman’s life when menstrual periods permanently stop; it is also called the “change of life”. More precisely, it is defined as the time when there have been no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified. The average time when a woman stops menstruating ranges from 48 to 55 years.
Can a woman get pregnant after menopause? After menopause, a woman no longer produces eggs and thus cannot become pregnant naturally. But although eggs succumb to this biological clock, pregnancy is still possible using a donor egg.
How does one test for menopause? Your doctor may order a blood test to check your levels of follicle-stimulating hormone (FSH) and estrogen. During menopause, your FSH levels increase and your estrogen levels decrease.
Can a woman experience orgasm after menopause? Satisfying sex depends on several things: presence of desire, arousal, absence of pain, and an ability to reach orgasm. After menopause, the libido declines, and changes in our bodies can make it difficult to get aroused, painful to have intercourse, and impossible to climax.
Can you get pregnant after menopause with no period? You haven’t officially reached menopause until you’ve gone a whole year without a period. Once you’re postmenopausal, your hormone levels have changed enough that your ovaries won’t release any more eggs. You can no longer get pregnant naturally.
Can a woman have babies at 50? Pregnancy over age 50 has, over recent years, become possible for more women, and more easily achieved for many, due to recent advances in assisted reproductive technology, in particular, egg donation.
Just like in Goa we attribute everything to “pinth” (biliousness), it is customary to attribute erroneously even psychological symptoms to menopause and many women for lack of diagnosis fail to get the right treatment.
One of the most complex health care decisions facing women is whether to use HT (hormonal treatment). Once prescribed primarily to relieve vasomotor symptoms, HT has been promoted as a strategy to forestall various disorders after menopause, including osteoporosis and cardiovascular disease. The widespread use occurred despite the paucity of conclusive data. Today, doctors are more cautious and balance the benefits and risks in a particular case, before prescribing HT.
But midlife is not just a period where women have hot flashes and experience other menopausal symptoms. It’s a time when their cardiovascular disease risk is increasing as we see significant changes in multiple clinical measures of their physical health. Women going through menopause are at a greater risk of heart disease.
The research team from the University of Pittsburgh in the US, used a subset of data from the SWAN (Study of Women’s Health Across the Nation) Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time.
Ultimately, 339 women were included in this study, 36 per cent black and the rest white, which was published in the journal, “Arteriosclerosis, Thrombosis, and Vascular Biology”. The study focused on how arterial stiffness changes as women transition through menopause. Arterial stiffness refers to the elasticity of arteries and is measured by looking at how fast blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood and damages the heart, kidneys and other organs. This study follows several others that also link the menopausal transition to the accumulation of heart fat, changes in cholesterol, inflammation and coronary artery calcification, among other heart disease risk factors.
The authors speculate that the hormonal changes accompanying menopause might play a role by increasing inflammation and affecting vascular fat deposition. This study tells us that there’s every reason why post-menopausal women ought to keep themselves fit and prime notwithstanding that it requires time, effort, and self-discipline. Hard work pays off.
(Dr Francisco Colaço is a pioneer of Echocardiography in Goa)
