Dr. Maninder Ahuja
MHT and Mid life
Genital organs of woman consists of Uterus, Two ovaries and Tubes, Cervix and Vagina.
Ovaries have fixed number of eggs and they are about 7-8 million even when woman as a fetus is in mothers womb at 24 weeks of pregnancy. When she is born number of eggs comes down to about 3-4 million and when she starts menstruating then about 3-4 lacs. When these follicles are less than 500 woman gets her menopause
Before menopause the ovaries (usually) release an egg each month, which then triggers the normal cascade of hormone changes that result in regular periods and cyclical changes.
As the ovaries ‘fail’, they begin to release their eggs erratically, which in turn causes erratic or irregular hormone levels. Periods become irregular and we enter a stage of ‘hormonal chaos’ where hormone levels are unpredictable and ‘all over the place’. This is why you may have symptoms such as hot flushes (when the ovary has not released an egg for a while and hormone levels drop) and then suddenly the hot flushes disappear (because your ovary spontaneously released an egg and gave you a ‘dose of hormones’ naturally). This ‘spontaneous release of an egg’ is why you need to use contraception for at least 12 months from your last natural period. This period of time, called the ‘menopausal transition’, can take up to 4–5 years.
Very rarely do the ovaries ‘switch off’ overnight (unless they are removed surgically). Eventually, the ovaries fail completely, no eggs are released and hormone levels drop to postmenopausal levels.
How your body reacts to these low hormone levels is different for every woman. Some women (around 20%) will have no symptoms; another 20% will have severe, disabling symptoms; and most (60%) fall in the middle. Similarly, the types of symptoms experienced will vary between women – some get hot flushes, some get mood symptoms, others may have a dry vagina; some have all symptoms!
Your symptoms will also depend on whatever else is going on in your life at the time, such as whether you are stressed or have other medical or psychosocial conditions that are impacting on your menopause symptoms.
It is like putting everything – hormones, relationships, genetics, work, stressors, general health and lifestyle into a big pot and stirring it around and you come out as you are. Therefore, ‘fixing your hormones’ will only be a part of your overall health management plan.
Please see your doctor
When you start having menopausal problems like hot flushes –that means you suddenly have a feeling of heat and followed by sweating, or irregular periods or mood and sleep disturbances or dry and itchy vagina, sexual problems, body aches. This is part of your life where you have to spend more than one-third of your life So please, have regular check-ups and keep your self healthy. Aim of All of us and tag line of Indian Menopause Society is fit at forty, strong at sixty and independent at eighty