Menopause is the term used to indicate the end of the period of possible sexual reproduction, as evidenced by the cessation of menstrual periods. This is absolutely normal and occurs between 45 to 55 years. Menopause does not decrease women's physical capacity, sexual vigour and enjoyment of life. Menopause brings certain freedoms to female life. For example no longer they have to worry about the monthly bleeding and about birth control. Even then during this period women undergo a lot of emotional stress. Ovaries stop producing oestrogen and this leads to oestrogen deficiency. This hormonal imbalance may cause short-term symptoms and long term health risks.

Some women experience severe symptoms and others experience nil or limited symptoms or view it as a positive life enhancing process. 50% to 60% of women seek medical help for the short-term symptoms due to oestrogen deficiency associated with menopause. The same strange feeling may occur if the ovaries are removed by surgery due to any cause.

Oestrogen deficiency is associated with many long-term changes in the body. Before menopause the oestrogen in the body helps to protect from the diseases. After menopause when oestrogen level fall this protection is lost. For example incidence of heart attack before menopause is much lower compared to their male counterpart where as after menopause incidence slowly increases and after few decades incidence is more among the female. Some of the changes associated with menopause are

1. cardiovascular disease
2. osteoporosis
3. Alzheimer's disease
4. age related muscular degeneration
5. changes in cholesterol level

Hormone replacement therapy

Hormone replacement therapy (H R T) can counter act many of the unpleasant symptoms of menopause and reduce the risk of the diseases. Oestrogen replacement therapy can alleviate the short-term symptoms of oestrogen deficiency and can also provide protection against some of the long-term health risks associated with oestrogen deficiency. Studies have shown that women who use oestrogen replacement reduce their risk of cardiovascular disease by at least one half compared to women who do not use oestrogen replacement, decreases the level of LDL cholesterol (bad) and increase level of HDL cholesterol (good). This can help to protect from atherosclerosis. Oestrogen replacement also increases the bone density even in women with established osteoporosis.

Oestrogen or hormonal replacement therapy (ERT) OR (HRT) increase the risk of breast cancer and does not suit all women. If women with uterus are treated with oestrogen alone have an increased risk of endometrial cancer. When progesterone is added to the therapy the risk is reduced. However a regular gynaecological check up and every 3 years "pap" smear test (for early detection of cancer) to be done. Periodic breast examination and mammogram is required for early detection of breast cancer.

1. Oral tablets
2. Transdermal patches
3. Vaginal creams/ gels
4. Vaginal inserts.
5. Ingestion's

Diet to be Followed

Keeping to a healthy diet can do wonders for over all vitality and this in turn helps to give you greater resilience against any problems during the menopause. Hot flushes may be reduced by taking vitamin E rich foods like wheat germ, nuts, eggs and olive oil. Vitamin A, D, calcium, phosphorous and magnesium can help to prevent osteoporosis.

Fish, drumstick leaves, ragi and dairy products are excellent source of calcium. Avoid eating raw bran, which inhibits calcium absorption and cut down on tea, coffee which promote the excretion of calcium.

Many women put on weight and increase the blood cholesterol level. To control body weight and blood cholesterol select low fat dairy foods and cut down on saturated fats like butter, cheese, and ghee.

Research has found that substances from plants called phytoestrogens might help to reduce the severity of hot flushes and other symptoms of the menopause. Phytoestrogens, which mimic human oestrogen, are found mainly in soybeans and alfalfa sprouts. Soya bean flour can be mixed with wheat flour for making rotis. Other soya products are soymilk, tofu, and soy sauce. Carrot and beet root juice is found very use full in menopausal disorders. Oats, corn, barley, brown rice, whole wheat are also excellent sources of phytoestrogens. Regular exercise is essential during this period.

1. Spicy foods like pickles
2. Coffee, tea
3. Chocolate
4. Alcoholic drinks
5. Refined products.

This period is to be viewed as a normal stage in a lady's life. How ever the members of the family must realise that during this stage in the life of a women needs lot of attention, care and understanding to make the day to day life tension free.