They can be very distressing and lead to disturbed sleep. This then causes fatigue irritability and a whole range of psychosomatic symptoms.

Vaginal dryness is also a common problem; this can lead to dry and painful sex and sometimes-vaginal infections due to change in vaginal pH and flora.

Urinary frequency and urgency also occur due to similar reasons and can lead to embarrassing moments.

Hormone deprivation also has long-term implications. It causes bone loss and eventually leads to osteoporosis. The alterations in the lipid profile can lead to increase in the risk of cardiovascular disease.

At the time of perimenopause it is advisable that one should evaluate one’s own health. The aim here is to improve ones quality of life. The other objectives are to identify the risks factors and silent diseases if any.

It is the time that one would address the alterable risk factors such as diet, smoking, alcohol, etc. A complete health check up includes detailed history and examination followed by screening tests.

Screening test routinely advised by the gynecologists would include Complete Hemogram, Sugars Levels, Liver, Renal And Lipid Profile, thyroid function tests, Pap smear test and urine test.

The radiological tests include Ultrasound of the abdomen and pelvis, Mammography and dexa scanning.

After a complete assessment the doctor will advice life style modifications, drugs (prescription and non-prescription) and sometimes even alternative medicine methods.
Estrogen and Progesterone replacement therapy needs special mention as the last decade has seen a lot of research and a shift in attitude due to the scientific evidence that has emerged from the research. Estrogen alone or Estrogen Progesterone replacement both are still useful for the management of the menopausal symptoms. They are prescribed in the lowest possible dose and for the shortest possible duration in women who do not have any contraindication.
They are not prescribed for primary or secondary prevention and treatment of chronic diseases such as osteoporosis and cardiovascular diseases.

Phytoestrogens are popular but the evidence regarding their efficacy and safety is not yet conclusive. Therefore they have to be taken with caution.

Fore more information on management of menopause please feel free to contact Dr Sangeeta