“It's paradoxical that the idea of living a long life appeals to everyone, but the idea of getting old doesn't appeal to anyone.”
Life expectancy in humans has increased over last few decades. But reproductive system ages faster than other systems of the body. Due to delay in completion of education and proper settlement into a career or due to the wait for the correct partner, many women face obstacles in getting pregnant due to changes observed in the reproductive system as a consequence of age.1 Later women get surprised as they begin to develop menopause related symptoms which include hot flashes, while still feeling healthy and young. In order to understand changes in the female body it is essential to first grasp the knowledge of the different stages the reproductive system goes through. Ageing in women is associated with many changes in Hypothalamo-Pituitary-Ovarian axis in her lifetime. Menopause is one of the important milestones in the process of ageing. It occurs mainly due to oocyte depletion.
Menopause is diagnosed when a woman experiences no menstrual period for more than one year after last normal menstrual period. In India, the mean age for which menopause was observed to be 45, however it may range from 40 to 51 years of age.2
Women are born with fixed number of follicles in ovary which produce female sex hormones. With age, the most affected organ is ovary which is evident by reduction in both quality and quantity of oocyte. Various studies involving genetics based on candidate gene and genome wide association, have concluded that there are several interesting loci of small genetic variation which might determine development of fetal follicle pool as well as it’s wastage over time. Further research involving the ageing mechanisms of ovaries might ultimately find the tools required for prediction of menopause and manipulation required in the initial stages of folliculogenesis for contraception, fertility and extension of menopause.3 Apart from acute symptoms of hot flashes, mood changes, long term sequel like osteoporosis, cardiovascular disease and vulvovaginal atrophy significantly affect the quality of life of women when they pass through the phases of climacteric and menopause. Women should be encouraged for considering the perimenopausal period of transition as an opportunity in order to re-evaluate their lifestyle which will ultimately result in reduction of their risk of ill health in the later stage of life.4
Because humans have an increased life expectancy which is much longer than what was seen in the earlier days, a substantial amount of a woman's life is now spent post menopause — as much as a one third.5
Hence, one of the important aspects of geriatric health issues related women’s health need to assessed for their association with menopause.6
The recent evidence suggests that there is significant association between nutritional factors and ovarian reserve and timing of menopause. However, the evidence is weak at present and can be strengthened by encouraging more research in this area.
As health care providers reassurance and counselling that menopause is opportunity to review their health and lifestyle and simple measures like keeping mind relaxed with hobbies indulging in little more exercise, eating a little less, consume less alcohol or smoke less and if needed hormone replacement therapy will make this phase of their life happy and easy.3, 4, 5 Apart from that women should be counselled and encouraged to promote lifestyle changes related to healthy food and exercise, limiting fat and cholesterol intake, maiaintaining caloric balance, consuming whole grains, fruits, vegetables, water. They should also ensure adequate vitamin and mineral intake, especially calcium and vitamin D. They must Engage in regular physical activity
Any individual’s physical condition is driven by lifestyle choices, exercise, nutrition, stress management, Genetics. Exercise-cardio-walking, jogging, biking, and swimming, strength training help in prevention of bone health.
Yoga meditation, dancing, cross trainer can help in maintaining mental peace and balance.
Women experiencing the menopause should consider this transitional period as an opportune moment to re-evaluate their lifestyle, which will go some way in reducing their risk of ill health in later life. This is according to a report published by the International Menopause Society, which noted that women are more vulnerable to certain conditions and diseases like heart disease, osteoporosis and cancer, after experiencing the menopause.
At the end motto for aging women should be
“Fit at forty, Strong at sixty and independent at eighty”.
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