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Menopause is the point when your periods have stopped for 12 months in a row and your ovaries no longer release eggs. It is a natural stage of life, not an illness. Most women reach it between ages 45 and 55, and symptoms such as hot flushes and poor sleep can be eased in many ways.
This guide explains the symptoms, what is known about timing in India, lifestyle steps that help, how hormone replacement therapy (HRT) is viewed, and when to see a doctor.
What is menopause?
The World Health Organization (WHO) describes menopause as the end of a woman’s reproductive years, following a fall in the hormone oestrogen. It is confirmed after 12 consecutive months without a period when there is no other obvious cause. The years of change before that are called perimenopause, which can last several years. Read our guide to perimenopause signs in your 40s for that stage.
Menopause before age 40 is called premature menopause. It can be linked to chromosome conditions, autoimmune disease, surgery that removes both ovaries, or treatments such as chemotherapy or radiation, and sometimes no cause is found.
When does menopause happen in India?
WHO says most women reach menopause between 45 and 55, and timing cannot be predicted for an individual. Indian studies often report a slightly younger average. A national survey analysis published in the Indian Journal of Medical Research found that about 1.5% of women reported natural menopause before age 40. Among women aged 40 to 44, 20.2% were already in natural menopause, and among those aged 45 to 49 it was 49.1%. The authors also quote earlier Indian studies with average ages between about 42 and 49 years.
Because studies differ in method, treat these numbers as a rough picture, and ask your doctor what is normal for you.
Common symptoms
The NHS lists many possible symptoms. Women vary widely, and some have very few:
- Changes in periods, which become irregular and eventually stop
- Hot flushes and night sweats
- Sleep problems
- Low mood, anxiety, poor memory or “brain fog”
- Vaginal dryness, itching or painful sex
- Urinary symptoms and leakage of urine
- Palpitations
- Aches in muscles and joints
- Thinning hair and dry, itchy skin
- Weight gain around the stomach, and reduced sex drive
WHO adds that symptoms may last for years in some women and affect daily life. Falling oestrogen also has longer-term effects on bones, the heart and pelvic support, covered below.
Lifestyle steps that help
The NHS suggests these self-care steps:
- Hot flushes: wear light clothes, keep the bedroom cool, use a fan or cold drink, and limit triggers such as spicy food, caffeine, hot drinks, smoking and alcohol
- Sleep: keep a regular routine and rest when you can; talking therapy (CBT) can help with sleep, mood and flushes
- Mood: regular exercise, relaxation, yoga or meditation, and talking with friends going through the same change
- Bones: weight-bearing exercise such as walking or dancing, plus strength exercises, and calcium-rich foods
- Vaginal dryness: pharmacy moisturisers and water-based lubricants; ask a doctor about prescribed options if these are not enough
Tip: keep a simple diary of your periods and symptoms for a few weeks. It makes the doctor’s visit far more useful.
HRT: an overview to discuss with your doctor
Hormone replacement therapy replaces the hormones that fall at menopause. The NHS says its benefits usually outweigh the risks for women under 60 who have symptoms and are not at high risk of breast cancer or blood clots. It relieves hot flushes, night sweats, sleep problems, low mood and vaginal dryness, and helps protect bones.
There are risks to weigh:
- Combined HRT slightly raises breast cancer risk, estimated by the NHS at about 5 extra cases per 1,000 women after 5 years of use; the risk falls after stopping
- HRT tablets raise the risk of blood clots and stroke slightly, while patches, gels and sprays do not appear to
- Women with a history of breast cancer are usually advised not to take it
- HRT is not contraception, so you may still need protection from pregnancy until a doctor says it is safe
The NHS also notes that low-dose vaginal oestrogen does not appear to raise breast cancer or clot risks and is considered safe for long-term use. Types, doses and how long to use HRT depend on your age, health and wishes, so your doctor will decide with you. Guidelines vary between countries.
When to be cautious: do not buy hormone products, herbal “menopause cures” or supplements on your own. Tell your doctor about anything you take, so your doctor can check that they are suitable for you.
Long-term health after menopause
WHO explains that lower oestrogen can increase bone loss, raising the risk of osteoporosis and fractures, and that the heart protection women have before menopause fades. Pelvic support can also weaken, raising the chance of prolapse. Regular exercise, a balanced diet, no smoking, limited alcohol and routine check-ups matter more than ever. See our guide to osteoporosis and bone health in women, and our overview of regular gynecological checkups.
Myths and facts
Myth: menopause means the end of a woman’s health and vitality
Fact: WHO notes a 60-year-old woman can expect around 21 more years of life, so looking after your health at this stage pays off.
Myth: you cannot get pregnant once periods become irregular
Fact: pregnancy is still possible during perimenopause. WHO advises contraception until 12 months without a period.
When to see a doctor
Book a visit if symptoms disturb your sleep, work, mood or relationships. The NHS also advises seeing a doctor if:
- You still have periods but the bleeding is heavier than before
- You have had no period for 12 months or more and then have any vaginal bleeding, even spotting or pink or brown discharge, which always needs checking
- You have palpitations
- You are on HRT and still have irregular or heavy bleeding after 6 months
- Your periods stop before age 45, because early treatment protects bones and health
Very heavy bleeding or fainting needs urgent care; see our emergency page. For routine concerns, our gynecologist in Kadapa page explains how we support women’s health.
Talk to a doctor
If menopause symptoms are affecting your life, you do not have to cope alone. You can book an appointment or call +91 944 103 0587. This article is for general awareness and is not a substitute for a doctor's advice.
References
This article was written in our own words from the following public health sources.
Educational content
Please note. This article is for general awareness and is not a substitute for a doctor’s advice, diagnosis or treatment. If you are worried about your health, or in an emergency, call +91 944 103 0587 or visit the hospital.
