MENOPAUSE - मेनोपॉज के लक्षण और इलाज — Symptoms And Treatment Of Menopause In Hindi

Symptoms And Treatment Of Menopause 

DEFINITION :-

Permanent cessation of menstruation, is known as menopause.

Age of menopause is usually 45-50 years.

PHYSIOLOGICAL CHANGES DURING MENOPAUSE :-

• Decreased level of serum oestradial.

• Increased FSH level.

• Decreased inhibin level.

• Increased LH level.

• The ovaries become less reproductive to FSH and LH.

• Ovulation becomes irregular and finally stops.

• Increased risk of cardiovascular diseases due to increased cholesterol level.

• Loss of bone mass 

• Atrophy of genital organs.

SIGN AND SYMPTOMS -

Menstrual disturbances i.e. sudden cessation or decreased amount of blood loss or increased duration between two periods.

• Shrinkage of breasts.

• Vaginal dryness.

• Painful sexual intercourse (Dyspareunia).

• Headache.

• Irritability

• Mood changes.

• Night sweating Disturbed sleep

• Loss of pubic and axillary hair

• Increased risk of fracture due to decreased bone mass

• Increased risk of heart problems due to increased level of cholesterol.

• Atrophy of sex organs.

HEALTH EDUCATION AND COUNSELLING :-

• During post menopausal period, the woman may be tense and anxious due to bodily changes. So reassure her and provide psychological support. Explain the woman that these changes and symptoms are normal. After some time these will be disappeared.
• Encourage the woman for taking Hormone Replacement Therapy (HRT) regularly as per doctor's prescription.
• Encourage the woman for light exercise daily.
• During post menopausal period, risk of fracture increases due to decreased bone mass so advise the woman for taking extra precautions while carrying out various activities.
• During post menopausal period, risk of cardiovascular disease also increases so advice the woman for low fat and low salty diet.
• Advice the woman for regular check-up. If any abnormal symptom arises, she should contact to the doctor.

HORMONE REPLACEMENT THERAPY :-

• It is abbreviated as HRT.
• Hormone Replacement Therapy is used in the post menopausal women for the treatment of menopause associated common symptoms.
• As in HRT, principal hormone is oestrogen so it is also known as Oestrogen Replacement Therapy. If uterus is intact, progestins are also added.

Drugs used in HRT :- 

Common oestrogens are

• Conjugated oestrogen
• Micronised oestradiol

Common progestins are

• Medroxyprogesterone acetate 
• Micronised progesterone

Contraindications of HRT :-

• Liver diseases.
• Heart diseases.
• Cancers such as breast cancer, uterine cancer, endometrial cancer etc. 
• Undiagnosed bleeding from reproductive tract.

SIDE EFFECTS :-

• Breast swelling or tenderness
• Mood changes
• Vaginal bleeding
• Headache etc.

SURGICAL MENOPAUSE :- 

            Menopause occuring after a surgical procedure is known as surgical menopause. It occurs after bilateral ooporectomy. Surgical removal of both the ovaries is known as bilateral ooporectomy.

        HRT is prescribed to the woman after surgical menopause for the treatment of associated symptoms.

        In case of oophorectomy+ hysterectomy. only oestrogen replacement therapy is given. If only oophorectomy has been done then combined therapy ( oestrogen + progesterone ) is given.

• Oophorectomy = surgical removal of ovary
•  Hysterectomy = surgical removal of uterus

BY :- A. KUMAR