World Menopause Day, observed annually on October 18th, is a globally recognized event established in 2009 by the International Menopause Society and World Health Organization (WHO).
This annual celebration is part of Menopause Awareness Month, dedicated to shattering stigmas and enhancing women's well-being through education on menopause symptoms and support options.
Each year, a specific theme is highlighted. For 2024, the focus is on “Menopause Hormone Therapy,” also known as “Hormone Replacement Therapy” (HRT).
What is Menopause?
Menopause, a natural biological transition of aging, signifies the conclusion of a woman's reproductive phase. It occurs when ovarian egg release ceases, typically diagnosed 12 months after the final menstrual period. The transitional phase preceding menopause is perimenopause.
The menopausal transition initiates between 45-55 years of age, with a median duration of seven years, although individual experiences may vary from 7-14 years.
Menopause, the permanent end of menstruation, unfolds in three stages when occurring naturally, without medical or surgical influence.
Peri-menopause (Menopause Transition): 8-10 years before menopause, estrogen levels decline, starting in your 40s. Symptoms include irregular periods, hot flashes, and mood swings.
Menopause: Diagnosed after 12 consecutive period-free months. Ovaries stop releasing eggs, and estrogen production significantly decreases. This stage marks the official end of menstruation.
Post-menopause: The lifelong stage following menopause. Symptoms may linger, and individuals are at increased risk for osteoporosis and heart disease due to low estrogen.
MedBound Times reached out to Dr Shweta Shah, Gynaecologist and Laparoscopic Surgeon for her insights on Menopause.
Dr Shweta Shah says that some common menopause myths patients believe are:
Menopause starts at 50.
All women experience severe symptoms.
Menopause means a pause in sexual life.
Weight gain is inevitable.
Hormone Replacement Therapy (HRT) is dangerous.
You can't get pregnant during menopause.
Menopause leads to depression.
These myths can be busted by counseling the women by giving them the right understanding and knowledge about this phase of life and explaining to them about the hormonal interplay that causes all these issues through podcasts, webinars and articles. Encouraging women to talk and communicate openly about menopause with friends, family and health care providers using media and social media platforms. Encouraging women to get regular health checkups and screenings and explaining treatment options beyond HRT.Dr Shweta Shah, Gynaecologist and Laparoscopic Surgeon, Cloudnine Group of Hospitals, Mumbai
Signs and Symptoms:
Navigating Menopause: Common Symptoms
Hot flashes (vasomotor symptoms)
Night sweats/cold flashes
Vaginal atrophy
Urinary urgency (frequent need to pee)
Emotional shifts (irritability, mood swings, depression)
Xerosis (Dry skin/eyes/mouth)
Worsened premenstrual syndrome (PMS)
Some women may also experience:
Headaches
Arthralgias (Joint/muscle aches)
Libido alterations
Weight gain
Hair loss/thinning
Statistics:
The global female population is experiencing a significant shift:
Annual menopause transition: approximately 25 million.
1990 estimates: 467 million post-menopausal women (mean age 60).
In 2021, women 50+ accounted for 26% of all women and girls, up from 22% in 2011.
The UN estimates 985 million women were 50+ in 2020, rising to 1.65 billion by 2050.
By 2025, 1.1 billion women will be postmenopausal worldwide.
By 2030, the menopausal/postmenopausal population will reach 1.2 billion, with 47 million new entrants annually.
Premature and Early Menopause:
Menopause timing varies significantly among women.
Premature menopause, also known as Premature Ovarian Insufficiency (POI), occurs before 40 and affects 1% of women under this age and 0.1% of women under 30.
Early menopause refers to menopause before the age of 45, affecting approximately 5% of the population.
This differs from average menopause, where ovaries stop functioning at the expected age.
Notably, Premature or Early menopause can be triggered by various factors, including medical treatments such as chemotherapy and pelvic radiation for cancer, surgical procedures like hysterectomy (removal of the uterus), removal of the ovaries, family history and sometimes may result from chromosomal abnormalities and autoimmune disorders that damage ovarian tissue. In many cases, however, the underlying cause may remain unknown.
Dr Shweta Shah points that menopause significantly impacts bone health due to the decline in estrogen levels, which plays a crucial role in maintaining bone density. Maintaining bone health during and after menopause can involve lifestyle changes, such as adequate calcium and vitamin D intake, regular weight-bearing exercise and in some cases, medical treatments like HRT or medications specifically designed to protect bone density.
Treatment for Menopause:
Managing menopause symptoms involves various treatment options, primarily categorized into three types.
Hormone Therapy (HT): Suitable for women experiencing natural menopause (after 45), involving supplemental hormones to alleviate symptoms.
Hormone Replacement Therapy (HRT): Specifically designed for women experiencing premature menopause (before 40), replacing hormones to address symptoms.
Nonhormonal Treatments: Alternative options for managing menopause symptoms without hormone supplementation.
Menopause Hormone Therapy (MHT):
During menopause, significant hormonal changes occur, leading to decreased estrogen and progesterone production. Hormone therapy supplements these lost hormones, alleviating symptoms like hot flashes and vaginal dryness, while also preventing osteoporosis. Two primary types of hormone therapy exist:
Estrogen Therapy (ET): Low-dose estrogen, prescribed by a healthcare provider, available in various forms (patch, pill, cream, vaginal ring, gel, or spray). However, ET cannot be used alone for individuals with a uterus.
Estrogen Progestogen Therapy (EPT)/Combination Therapy: Combines estrogen and progesterone (natural or synthetic) doses, suitable for individuals with a uterus.
While hormone therapy can alleviate menopause symptoms, it's essential to acknowledge potential risks. Consult your healthcare provider to discuss benefits and risks, considering your unique health history, age, medical conditions, and other factors.
This year's theme focuses on Menopause Hormone Therapy (MHT), chosen by the International Menopause Society (IMS), which aims to address ongoing controversies surrounding MHT prescriptions and promote optimal women's healthcare practices through evidence-based treatment options, ensuring informed decision-making.
Summary:
World Menopause Awareness Day is an annual global initiative that shines a spotlight on menopause and its associated health concerns. This dedicated day seeks to:
Break the silence surrounding menopause.
Provide education and support for women and men.
Foster understanding of physical and emotional changes.
Promote women's health and well-being.
Empower women to take proactive health management steps during midlife.
References:
Menopause Friendly. “World Menopause Day 2024.” Menopause Friendly. Accessed October 11, 2024. https://menopausefriendly.co.uk/world-menopause-day-2024/.
National Institute on Aging. “What Is Menopause?” National Institute on Aging. Accessed October 11, 2024. https://www.nia.nih.gov/health/menopause/what-menopause.
Cleveland Clinic. “Menopause.” Cleveland Clinic. Accessed October 11, 2024. https://my.clevelandclinic.org/health/diseases/21841-menopause.
Meno Martha. “Postmenopause Statistics.” Meno Martha. Accessed October 11, 2024. https://menomartha.com/health-topic/postmenopause-statistics/.
Perrin, A. “Understanding Menopause Symptoms.” ScienceDirect. Accessed October 11, 2024. https://www.sciencedirect.com/science/article/pii/037851229500968X.
NHS Inform. “Early and Premature Menopause.” NHS Inform. Accessed October 11, 2024. https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/early-and-premature-menopause/.
Yale Medicine. “Early and Premature Menopause.” Yale Medicine. Accessed October 11, 2024. https://www.yalemedicine.org/news/early-and-premature-menopause.
World Health Organization. “Menopause.” World Health Organization. Accessed October 11, 2024. https://www.who.int/news-room/fact-sheets/detail/menopause.
Awareness Days. “World Menopause Awareness Day 2024.” Awareness Days. Accessed October 11, 2024. https://www.awarenessdays.com/awareness-days-calendar/world-menopause-awareness-day-2024/.
International Menopause Society. “World Menopause Day.” International Menopause Society. Accessed October 11, 2024. https://www.imsociety.org/education/world-menopause-day/?v=13b5bfe96f3e.
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