Havent all of us at some point wished that our menstrual periods would just stop so we would be rid of the period pain and the mood swings that come as part and parcel of it? But what if it actually happens? Is it normal to have your periods completely stop at or before 40 years of age? Is it a blessing in disguise? Is it something to be glad about and feel there is no need to get medical help?

The answer is a resounding NO to all the questions.

The female hormones that are produced by the ovaries namely Estrogen and Progesterone are essential for the overall well-being of a woman. They are the reason why we are different from men. With the age of natural menopause nearing, the ovary gradually stops functioning and produces less of these female hormones. The natural age of menopause, for Indian women, is 47 years when compared to 51 years, for western women. It is these hormones that protect our heart and bones, and also prevent heart attacks, fractures and osteoporosis. They are also the very reason why we hear less about women succumbing to heart attacks compared to men. Basically, they keep us healthy and safe.

When the menopause occurs at or before 40 due to improper functioning of the ovaries, we call it POI-premature ovarian insufficiency, in medical terms. There is a sudden fall in these hormones and women experience hot flushes, night sweats (vasomotor symptoms), mood swings, bone pains, sexual problems (pain during coitus, vaginal dryness), genitourinary problems (frequent urinary infections) and also becomeprone to heart attacks. Some women may not experience any of these, and only their periods gradually decrease over a few months and then stop completely.


Consultant Obstetrician and Gynecologist

Birthright by Rainbow Hospitals, Visakhapatnam

Irrespective of how it presents, these women need to be assessed by a gynecologist. They also need a diagnosis of POI confirmed with blood tests and ultrasound, the cause evaluated, and they should be treated based on their symptoms and, if need be, given replacement of these female hormones(HRT) till the natural age of menopause. All the scientific evidence till date supports the use of HRT in these young women who experience menopause early, and it also advises that the process is more beneficial when started early. Fertility in these women is almost nil, and women, who experience POI and have not conceived yet, definitely need medical help.

The most common cause of early menopause is surgical. Hence, I urge women, who are advised hysterectomy (removal of uterus) for various reasons, to interact with their gynecologist and make an informed decision about whether to get their ovaries removed or not along with the uterus. And women, who undergo removal of ovaries before the natural age of menopause, should be given HRT to protect their heart and bones and general well- being. Studies show that women, who do not take HRT when indicated, have more chances of death compared to women who are treated with HRT.

Your health is your responsibility too. 40 is not old anymore. Its the new 20. So follow these 10 rules for longevity and an improved quality of life.

1. Be physically active - 30 minutes of weight bearing exercises daily.

2. Get exposure to sunlight often helps maintain Vitamin D in the body.

3. Eat balanced diet- eat food rich in calcium.

4. Get good sleep- 8-10 hrs of uninterrupted sleep.

5. Annual physical exams- Breast, Pap smear, Thyroid, cardiac evaluation, Diabetes, High BP.

6. Visit your gynecologist for any sexual or urinary problems.

7. Maintain work-life balance.

8. Prioritise your mental health.

9. Invest in your hobbies.

10. Restrict or avoid smoking and alcohol intake.

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