A 51- year- old banker, who wants to stay anonymous, recalls how she started experiencing hot flashes while shopping for her older daughter’s wedding. In the wedding rush, she didn’t understand what was happening and why. She chose to ignore it; the wedding was, after all, just two weeks away, and there was no time to pause and think. She remembers being highly emotionally charged all through those weeks. “I was crying for no reason at times, and the next moment, I was yelling at someone for a very silly thing.” It was only after a while she realised that those had been symptoms of menopause and admitted to feeling relieved that there was an explanation for her mood swings.
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A lot of women might be able to relate to her account, but not everyone is even aware of the complexities of this life change. Often, it gets dismissed as just another female problem that causes mood swings, leading women to ignore the physical and emotional implications of it. The truth is that lack of timely management and a prevalent lack of awareness about its symptoms and signs leads to an increased risk of women being prone to both poorer physical and mental health.
For starters, the hormonal impact that menopause has on a woman is colossal leading to the woman experiencing low mood, anxiety, fatigue, mood changes, anger and irritability, and self-esteem issues. Additionally, menopause in women often coincides with a time when one’s life undergoes significant other changes: children leaving the nest, sudden weight gain and financial concerns, among a host of other issues. “Women may have to balance a work life and domestic responsibilities along with managing their menopause symptoms, which can increase stress levels and low mood,” explains Tanu Choksi, a psychologist & counsellor based in Mumbai. According to her, depression and anxiety are common during menopause, and so are irritability and crying spells. She warns that anyone who experiences a low mood for two weeks or longer should see a doctor.
Another issue that often pops up is memory issues, which, in turn, makes the symptoms of anxiety worse. “Cognitive complaints in menopause are common and are associated with anxiety in many women as they fear that these changes may later lead to dementia,” says Dr Ashwini Bhalerao Gandhi, a consultant gynaecologist at P D Hinduja Hospital & MRC, Mahim, Mumbai, adding that memory issues at menopause should not be confused with dementia, which is rare before 64 years of age.
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According to her, the significant physical and mental changes that menopause can cause have different effects on different women. For instance, some women are relieved that their fertile period is over and hence the tension of becoming pregnant is also over, while others completely start losing interest in sex. In general, Asian women report fewer hot flushes but more aches and pains, insomnia and mood changes, she says. Women typically gain abdominal fat and may lose muscle mass in early menopause. Over time, other symptoms like wrinkling of the skin and frontal balding are seen due to a reduction in the collagen content of the skin. Issues like osteoporosis and osteoarthritis are long-term consequences of oestrogen deficiency, she adds. “Some women face problems with memory loss and difficulty in concentration. There may be difficulty in initiating and maintaining sleep,” says Gandhi, who believes that lifestyle modifications and adopting sleep hygiene measures should be recommended as the first line of treatment. In addition to lifestyle interventions, there are also hormonal therapies. Swathi Kulkarni, the co-Founder & CEO of Elda Health, a mid-life and menopausal care platform for women, adds that, while both help improves the quality of menopausal women’s lives, lack of awareness often leaves many women in the dark.
So how can you support someone going through menopause? “Start by asking how she is feeling, and check in with her regularly,” she says. “Having a support system can make the woman feel better,” Choksi states. And yes, the need to destigmatise menopause is also a key factor in offering support to women undergoing it, points out Kulkarni. “ From couples and family education to corporate workshops, awareness initiatives would go a long way in making our women’s lives better,” she says.
Three steps to raising awareness about menopause
This is a key step in increasing awareness. Many people shy away from talking about the changes women’s bodies go through in a lifetime, from menstruation to pregnancy, perimenopause and menopause. Open, informed conversations help to a large extent.
Research and education
Reading, researching and updating yourself can help in understanding symptoms- mental and physical--can aid in supporting women even further.
Creating a support system
Menopause doesn’t happen in a vacuum, and family and friends can help in alleviating some stress.
(Inputs by Tanu Choksi)
Divya Naik is a Mumbai-based psychotherapist