Nirmala Gynehealth (Dr. Sharin Barse-Dicon)

Understanding Menopause

Menopause is the permanent cessation of menstrual periods for 12 consecutive months due to ovarian follicular depletion.

Average age : Around 51 years (range 45–55).

Perimenopause : The transition period leading up to menopause, often 4–8 years, with irregular cycles and hormonal fluctuations.

Symptoms

Vasomotor : Hot flashes, night sweats
Genitourinary : Vaginal dryness, urinary urgency
Sleep disturbances : Insomnia or fragmented sleep
Mood changes : Anxiety, irritability, depression
Cognitive issues : Memory lapses, concentration problems
Long-term risks : Osteoporosis, cardiovascular disease, urogenital atrophy

General Principles of Menopause Management

Lifestyle modifications (first-line for mild symptoms):

Regular exercise (weight-bearing for bone health)
Balanced diet (calcium, vitamin D, heart-healthy fats)
Smoking cessation & limit alcohol
Sleep hygiene and stress reduction

Non-hormonal pharmacologic options:

SSRIs/SNRIs (for hot flashes, mood)
Gabapentin or clonidine (vasomotor symptoms)
Vaginal moisturizers and lubricants for genitourinary symptoms
Bisphosphonates or selective estrogen receptor modulators (SERMs) for bone health

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