Thursday, July 06, 2006

Menopause and Climacteric

This is a phase in women’s life when there is final cessation of menstruation which is known as menopause. This is the period when the women changes from the reproductive life to one of senescence. This happens due to cessation of ovarian follicular function. It is a natural physiological process.

Menopause occurs due to exhaustion of eggs from ovarian follicles and the resultant hormonal changes that happen. (Estrogen deprivation)

Changes that take place in Climacteric or Menopause and Post menopausal age
There is progressive atrophy of genital organs with more deposition of the fibrous tissue in them. The ovaries become small with furrowed surface. The ovarian vessels become sclerosed.There is also shrinkage in the fallopian tubes. The uterus becomes small which occurs due to shrinkage of the muscles .Cervix atrophies and the cervical secretion becomes scanty thick, and later disappears. The lining of the vagina atrophies with loss of rugosity.The vagina contracts with shallowness of the fornicis.Vulva also atrophies with narrowing of the introitus.The cellular tissues of the pelvis become lax.

Changes that take place in the secondary sex characteristics

Breasts: They show gradual atrophy of the glandular tissue which results in flabbiness. They tend to become pendulous due the fat deposition around them.

Pubic and axillary hair becomes sparse.

Physically the body weight decreases after 65 years of age. The skin develops wrinkles, becomes less elastic. There is subcutaneous fat deposition in the hip and the thighs. There can be changes in the spinal column due to osteoporosis. Due to the hormonal changes that take place women tend to suffer from osteoporosis.

During menopause some changes in the digestive system are seen. This can cause indigestion, constipation, hypochlorhydria (decreased secretion of acids).

Psychosexual: the urge for sex is increased at menopause, the person tends to be more sensitive and emotional upsets are common. As an aging process the urge for sex wanes after 60 years of age.


The timing of menopause

The age at which menopause occurs varies widely from 40 years of age to 55 years with the mean age being 47years.The other factors that influence menopause is the genetic makeup,race and climate. Menopause is earlier in women who stay in the tropics as compared to the women who stay in the colder countries.

If the menopause occurs before the age of 35 it is considered early and if it sets in after the age of 55 years it is considered late.

Early menopause can occur due to ovarian failure, oophorectomy or irradiation. Where as delayed menopause is due to some pelvic pathology like a uterine fibroid or in association with diseases like diabetes mellitus.

Clinical feature of Menopause and climacteric
Menstrual Symptoms

The flow during menstruation becomes scanty progressively which is followed by their cessation.

Menses occur after prolonged intervals and finally ceases.

Sudden cessation of the menses. Any excessive bleeding or irregular bleeding is not due to menopause as it is commonly believed by the lay person. This can be due to some pelvic pathology.

Most women do not experience other symptoms they adapt nicely to these changes that take place in the body during menopause. Few women have mild symptoms of weight gain, pain in the joints, and increase in the sexual desire with gradual loss for the same.

SignsIn normal women the following signs occur during menopause and thereafter.

Genital signs
Vulva: There is gradual narrowing of the vaginal introitus.There is progressive atrophy of the vulva and the hair becomes scanty.

Vagina: there is thinning of the mucus membrane and loss of rugae. It becomes narrow with tenting of the vaginal vault.

Cervix: Portio vaginalis atrophies and gets flushed with vaginal vault.

Uterus: it becomes small and hard

Adnexae: Ovaries become small and impalpable.

Diagnosis: the clinical features plus the atrophic vaginal smear and elevated plasma FSH levels are considered in diagnosing menopause.


Treatment
Homeopathic medicines

Psychotherapy
The women going through the phase has to be explained and reassured that it is a natural phase that happens in a women’s life .Adequate rest, exercise and regular evacuation of bowels are suggested.
Article written by,
Dr.Santosh Joshi
Homeopathic consultant
Email me on : tosh116@gmail.com for more details and consultation



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