Menopause is a clinical diagnosis in healthy women over 45 years who have not had a period for at least 12 months and are not using hormonal contraception, or who do not have a uterus and have menopausal symptoms.
For vasomotor symptoms, offer hormone replacement therapy (HRT) after discussing the short term and longer term benefits and risks ; prescribe oestrogen and progestogen to women with a uterus, and oestrogen alone to women without a uterus.
Thousands of women are said to be affected. The average age of menopause in the India 48 years. But if it occurs before the age of 40, it is termed as premature menopause.
One of the reasons of premature menopause is the increased survival of childhood and other cancers. Cancer survivors have a higher risk of premature menopause due to the effects of chemotherapy and radiotherapy. Smoking also contributes to increased risk for premature ovarian failure.
The most prominent symptom is absent or irregular periods. A woman may not get her natural period or not get a period after she stops using the birth control pill. Some women experience shorter cycles or spotting before or after periods, followed by gradually decreasing flow and finally no flow. Some women experience hot flashes, mood swings, irritability, loss of interest in sex and vaginal dryness. Others experience difficulty in conceiving or poor response to fertility drugs as the first sign of failing ovaries. These symptoms would soon be followed by changes in the menstrual cycle as mentioned above. The diagnosis is made by a blood test – serum FSH level. As the ovary produces less oestrogen, the level of FSH in blood rises. So, high FSH is an indicator of premature menopause.
Hormone replacement therapy HRT is the most effective treatment for the relief of vasomotor symptoms although other options, including non-pharmacological ones, are available.