2. DEFINITION OF MENOPAUSE
Menopause is the permanent cessation of ovarian follicular
function.
It is diagnosed retrospectively after a period of 12 months of
amenorrhea
This signals the end of a woman’s fertility
3. RELATED TERMS
Premenopause refers to the phase of normal reproductive life
of a woman, it extends from her first to her last regular
menstrual period
Perimenopause refers to the transitional phase preceding
actual menopause by about 2 to 8 years, characterized by
signs and symptoms due to declining ovarian follicular activity
Post menopause is the time after the complete cessation of
menstruation until the end of life
4. AGE OF MENOPAUSE
Age at which a woman will reach menopause is
variable and depends on a number of factors
5. FACTORS AFFECTING AGE OF MENOPAUSE
Hereditary Factors:
Menopause has a strong
genetic link. The age at which
a woman’s mother reached
menopause is a good predictor
of her approximate age of
menopause
Smoking: Women who
smoke are likely to
experience menopause
earlier than nonsmokers
Ethnicity: Women from
certain ethnic groups have
menopause earlier than
others ; while average age of
menopause for Caucasian
women is 51 years, the
same is 46 years for Indian
women
Chemotherapy/
Ovarian Surgery: Can
accelerate the onset of
Menopause by
damaging the normal
ovarian tissue
6. HORMONAL CHANGES DURING PERIMENOPAUSE
Estrogen levels generally decline but may fluctuate
unpredictably, even increase at times causing “estrogen
dominance”
Progesterone levels typically decline
Testosterone levels show decline
FSH levels vary markedly during the perimenopause . High
FSH(>30 IU/l) levels may be helpful in confirming the
menopause in later stages
LH levels rise in response to low levels of estrogen
7. ESTROGEN LEVELS DURING PERIMENOPAUSE
Peri Menopause
Age
45
Menopause
Post Menopause
Estrogen Levels
Pre Menopause
35
Symptom Experience
~51
Less
Strong
9. SIGNS AND SYMPTOMS OF PERIMENOPAUSE
Physical symptoms
Emotional symptoms
Hot flashes
Irritability
Night sweats
Fatigue
Irregular menses
Reduced attention span
Loss of libido
Difficult concentration
Vaginal dryness/itching
Mood swings
Fatigue
Sadness
Headaches
Depression
Thinning of hair
Sleep difficulty
Memory loss/lapse
Weight gain
Urinary incontinence
Dizzy spells
10. SIGNS AND SYMPTOMS OF PERIMENOPAUSE
Physical symptoms
Sensation of electric shock like
pains
Palpitations/irregular heartbeat
Breast pain/loss of fullness
Joint/muscle pain
Flatulence/bloating/poor digestion
Dryness/itching of skin
Backache/stress fractures due to
osteoporosis
Receding gums
Increased risk of
hypertension/cardiovascular
disease
Emotional symptoms
Anxiety
Panic attacks
11. GENERAL MANAGEMENT
Maintain a healthy lifestyle
Promote healthy eating habits ,diet should contain healthy ,low fat, fresh foods,
dairy products, dark green vegetables, fish, eggs in order to maintain optimal
levels of Calcium and Vitamin D
Regular exercise goes a long way in staying physically fit by maintaining ideal
weight and promotes general wellbeing besides reducing the risk of osteoporosis
and symptoms like hot flashes
Moderate physical exercise of 30 minutes everyday helps to combat the increased
risk of developing cardiovascular disease
Pelvic floor exercises can reduce urinary incontinence
Create a cool and comfortable environment at home and at work to minimize the
discomfort due to hot flashes
Regular health checkup to monitor Blood Pressure, levels of Blood Sugar, Lipids,
mammogram, Pap Smear, and Bone Densitometry should be done
Quit smoking
Seek help when symptoms are persistent or more distressing. Do not assume all
symptoms to be due to menopause.
Suitable contraceptive should be used until actual menopause is reached
12. POST MENOPAUSAL BLEEDING
Any vaginal bleed more than 12 months after last period is
called post menopausal bleeding
It should not be ignored as a feature of perimenopausal
syndrome
Immediate medical advice should be sought to rule out other
causes such as Endometrial Carcinoma
14. HOMOEOPATHIC MANAGEMENT
Despite its benefits, HRT is known to have some adverse effects. It is
known to increase the risk of
Breast cancer
Ovarian cancer
Endometrial cancer
Heart disease
Stroke
In contrast, Homoeopathy offers a wide range of safe and effective
remedies to treat symptoms of perimenopausal syndrome.
15. HOMOEOPATHIC MEDICINES AND CLINICAL TIPS
Acid Phos.- mental debility, nervous exhaustion, weakness, tearing bone
pains, hair loss, menses irregular or too early
Amyl nitrosum- Sensation of blood surging to face and head followed by
sweating. Sensation as if blood would burst through skin with heat and
redness. Throbbing in head and throughout body. Feeling of anxiety.
Palpitations. Feels cold and clammy after flushing has died down. Peculiar
derangement of mind, nervous repetition of words
Bellis per- chronic fatigue and persistent tiredness
Calc ars- suited to obese, fleshy women, palpitation from slightest emotion
and exertion, suffocative attacks, anaemic and sensitive to cold
Calcarea carb- fatigue,chilliness,muscular weakness
Chamomilla- Irritable, ill humoured, quarrelsome
Cimicifuga- Fainting spells, flushing, headache,Inframammary pains,
nervousness, panic, pain in uterus, sinking sensation in stomach, great
depression ,dreams of impending evil, tries to injure herself, incessant talking.
Electric shock like pains, muscular pains, tinnitus, irregular menses, insomnia,
fainting spells
16. USEFUL HOMOEOPATHIC MEDICINES AND CLINICAL
TIPS
Glonoine- Headache instead of menses, delayed menses, pulsating
and throbbing type of pain all over the body, headache from heat,
sunlight, gaslight & electric light and lying down, uncovering head,
loathing of work with extreme weakness. Extreme irritability from
slightest opposition. Sensation of rush of blood to the head
Graphites- suited to obese women , sensitive to cold, dryness of skin,
constipation, menses delayed, aversion to intercourse, profuse thin
leucorrhea, burning sensation on vertex
Helonias- profound debility,vaginal,uterine sensitivity
Jaborandi- profuse perspiration, increased salivation, hair loss
Lachesis- sadness, aversion to work and company, talkativeness,
cannot tolerate tight clothing, hot flashes, , intolerance of heat ,
palpitation, headaches, dizziness, fainting spells, aggravation of
symptoms during or after sleep, menses are too short and scanty,
symptoms are better after menses
Manganum aceticum- hot flashes, cannot tolerate cold weather,
menses deranged, too early and scanty in anaemic women
17. USEFUL HOMOEOPATHIC MEDICINES AND CLINICAL
TIPS
Murex- nervous, weak ,run down women, sadness, anxiety, dread,
nymphomania
Pilocarpus- Intense sweating, hot flushes, sometimes accompanied by
nausea and excessive salivation. Excessive perspiration from all parts of the
body followed by chilliness, and sweating over face, ears and neck
Psorinum- offensive discharges especially sweat and leucorrhoea, severe
backache, debility, over sensitiveness to cold
Sangunaria. c- hot flashes, burning sensation in cheeks and chest, offensive
leucorrhoea, right sided priodical headache, better by sleep and lying on right
side, burning in the vertex, painful breasts, sensation of heat in palms and
soles
Senecio. A- insomnia, prolapse uterus
Sepia- Frequent flushes and then shivery, irritable, indifferent, depressed,
weepy, wants affection but rejects it, poor libido, nausea ,weakness,
indifferent to work and family, painful intercourse
18. USEFUL HOMOEOPATHIC MEDICINES AND CLINICAL
TIPS
Sulphur- Menses too late, short, scanty. Pruritus vulvae, burning sensation in
vagina, leucorrhoea burning and excoriating. Easy flushing with red face and
lips
Tabacum- : Severe vertigo with marked pallor, sensation of icy coldness,
much sweating, feels better by uncovering the abdomen
Trillium pendulum- tinnitus, fainting spells, dizziness, backache
Yohimbinum- insomnia
19. CONTRIBUTORS;
DR ASHOK SHARMA ,CMO
DR PAWAN GOEL, CMO
DR ANJALI MIGLANI, SMO
DR PRADIP KUMAR ROY, SMO
DR PARMESHWAR BISWAL, MO
DR ANUBHA SIKKA, MO
DR SUNITA SINGH, MO
COMPILED BY:
DR DEEPTI CHAWLA ,CMO
DTE. OF AYUSH GNCT DELHI
