While open conversations surrounding menstruation have been growing, there several aspects of menstruation that have still been left behind. Young girls find out about menstruation usually around the time of their menarche (first period). They are taught about how to cover up and behave during the time but they are never told that menstruation is not actually a lifelong thing!
Commonly starting at around 45-50 years of age, the end of a woman’s menstrual period is known as menopause. The age of menopause differs from woman to woman but the mean age is around 51 years. Not having significant conversations about menopause has resulted in women being caught off guard when they start to see the symptoms. While menopause can bring about a whole host of problems, in the fast-paced world we live in today, women have been known to experience symptoms of menopause at a much earlier age.
“While it did not happen overnight, my life came tumbling almost instantly”, writes the author of this article who reached menopause at a very early age of just twenty-nine. The author describes the experience as filled with anxiety, mood swings and depression. She experienced hot flashes and racing heartbeats regularly which made life extremely difficult for her.
Her medication resulted in weight gain and breast pain. “What I felt more was the burden of being barren,” she writes describing the societal pressures of being a mother. Lack of knowledge surrounding premature menopause resulted in the author’s symptoms going unnoticed for a long time.
What is Premature Menopause?
When a menstruator undergoes irregular/absent menstrual cycles before their 40s, it is known as premature menopause. One of the main causes of which is Premature Ovarian Failure (POF) – A condition in which the ovaries do not function properly. According to the American Pregnancy Association, approximately 1 in 1000 women between the ages of 15-29 and 1 in 100 women between 30-39 experience POF.
In India, data from NFHS-3 (National Family and Health Survey) shows that by age 40-41, 19% of women have already reached menopause. By age 48-49, ⅔ of all women surveyed are in menopause. Among all states, Andhra Pradesh has the highest reported level of menopause. The data also suggests that menopause occurs earlier in rural areas as compared to urban areas.
NFHS-4 was released in 2017 but contained little to no data on menopause. This clearly shows the lack of importance given to menopause.
Common Causes And Symptoms
According to a research paper published by the Journal of Mid-Life Health:
- Smoking has an antiestrogenic effect which can possibly accelerate menopause by 1.5-2 years.
- Low level of sun exposure can result in premature menopause.
- Severe weight loss and excessive exercise have an impact on reducing estrogen levels while malnutrition or restricted calorie intake during childhood reduces reproductive lifespan.
- Other causes can be thyroid diseases, mumps, hyperparathyroidism and Addison’s disease.
- Survivors of cancer are also at high risk of premature menopause as radiation and chemotherapy can impact oestrogen levels in the body.
The symptoms of POF are quite similar to that experienced during natural menopause. The most obvious symptom is irregular/absent 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,” says Gynecologist, Dr Suman Bijlani in an interview.
Hot flashes, crying spells, loss of interest in sex, sleeplessness, mood swings and irritability are all common symptoms that accompany menopause.
Changing Lifestyle
The best way to prevent early menopause is to be educated about the causes and ensure that you take proper care of your health and body. “The cause of POF goes undetermined in the majority of the cases, but changing food habits, work culture with increased stress are some of the reasons,” says Dr Shobha Gupta, Medical Director at Mother’s Lap IVF Centre, in an interview with The Hindu.
Our way of life has changed drastically in the last 200 years. Environmental changes like pollution, increased globalisation which forces the body to acclimate to different climatic conditions and fast-paced stressful lives have all contributed to the growing risk of early menopause. While genetics may play a small role in determining when a woman reaches menopause, lifestyle choices like drinking and smoking also have an impact.
The best way to avoid POF is to maintain a healthy lifestyle. These infographics by the Indian Menopause Society provide important insight on how to maintain a healthy menopause diet. The research article mentioned previously calls for menopausal clinics and health awareness campaigns especially in countries like India where the age of menopause is 2-3 years earlier than other developed nations. It is necessary to bring about education and awareness. A holistic syllabus must be developed for sex education that covers reproduction from menarche to menopause.
Menopause is an important part of a woman’s growth and journey but it comes at a heavy price. It takes a severe toll physically as well as mentally. It is important for us to hold open conversations not just about menarche but also about menopause so that women are more comfortable asking for support during such trying times.
The author is a part of the current batch of the #PeriodParGyan Writer’s Training Program.