Pause and effect: Dealing with menopause

Menopause is inevitable: accept it, prepare for it, and carry on happily

Woman experiencing menopause symptoms

Menopause happens when the ovaries begin to stop functioning and a woman stops having her monthly period. The ovaries also stop producing oestrogen and progesterone, the female sex hormones.

Menopause can occur any time from age 40 to 59 and is a gradual process that can take several years to complete. You’re not really through it until you haven’t had a period for 12 months. Low oestrogen levels during this phase may cause many menopausal symptoms and lead to long-term changes in a woman’s overall health. Here we discuss some of the major ones.

Emotional symptoms of menopause

Menopause not only brings many changes in the body, but also plays havoc with a woman’s emotions. The emotional problems may arise in the period just preceding menopause, and subside when you are 1 to 2 years into the postmenopausal period.

Some of the main emotional symptoms experienced by majority of menopausal women are:

1. Anxiety

The physiological changes that a woman experiences during menopause are the biggest source of her anxieties. The irony here is that if a woman doesn’t know about the problems to expect during this period, she gets anxious about the unfamiliar things happening to her. If she is aware of the health risks and discomforts, she gets anxious that something terrible might happen to her during or after her menopause.

2. Depression

Most women experience depression during this time, which may manifest as sadness, suicidal thoughts, lack of motivation, lack of interest in sex, poor self-image, fatigue, difficulty in concentrating, changed appetite or insomnia. The feelings of ‘sexlessness’ and ‘shapelessness’ are the biggest cause of depression.

3. Irritability

A jeopardised social and sexual life can be very distressing for some women. Feelings of being misunderstood by the husband and children also fuel resentment. Mood swings: Many women find themselves oscillating between depression; they wonder if they have gone crazy. One day they feel extremely sad and useless and the next day they feel raring to go. This kind of behaviour not only confuses the sufferer but also those around.

4. Embarrassment

Hot flashes, urine incontinence, poor sexual performance or skin itching often cause embarrassment. In fact, the mere mention of going through menopause may be very embarrassing, as it may make one feel ‘the odd one out in the family’.

Other changes at this point in life include: fear of ageing, children leaving home for studies or jobs, change in family structure with children’s marriages and/or change in job structure or retirement. All these lead to bouts of emotional turmoil. Many times any pre-existing emotional difficulty, poor coping strategies and other real problems can multiply the chances of menopausal disturbances.

Changes in physiology

Here are the physiological symptoms of menopause:

Changes in periods

Irregular periods, skipping periods, heavier or lighter than usual periods is disturbing for many women during this time.

Hot flashes

Many women experience a sudden feeling of warmth that spreads over the upper body. Other symptoms which may accompany a hot flash include palpitations, weakness, fatigue, faintness and vertigo. Sometimes hot flashes are severe enough to look like a heart attack.

Changes in vagina

With the drop in oestrogen, the vaginal lining becomes thinner, drier and less elastic, and over time, the vagina shrinks. These changes make the vagina more vulnerable to injury during intercourse and to local bacterial infection.

Urinary incontinence

Bladder irritability and poor bladder control is seen in more than 60 per cent women in this phase. They always feel the urge to urinate even though the bladder is not so full.


Some women experience a prickling, itching sensation on the skin. It has also been called ‘crawling’ skin because it feel s as though tiny insects are marching along your body. There is extreme dryness on skin, eyes and mouth.


Sleep deprivation is a common problem faced by women during this phase. A profound sleep disturbance may result in poor memory or poor concentration and may also cause a woman to cry easily and feel mentally and physically exhausted.

Weight gain

A small problem for others but a big problem for the woman who is rapidly gaining weight. The hormonal imbalance may cause big gains in weight and inches, thus resulting into losing body shape.

Long-term health risks

Some of the long-term health risks that menopause threatens to bring are osteoporosis, coronary artery disease, genitourinary atrophy, colon cancer and Alzheimer’s disease.

Dealing with menopause

The following tips with help you cope with the symptoms of menopause and help you move on with your life.

1. Train yourself

Research the internet, read books and magazine articles about menopause and menopausal reactions. Many women find that simply identifying the fact that they are in a bad mood or feeling irritable helps them get through it with less friction. Some women call a ‘time out’ when they are feeling out-of-sorts and delay discussion of serious issues for another time.

2. Look for a pattern

Maintain a chart of the symptoms present, to give you an idea about a pattern that the menopausal periods could be having. This reduces the strangeness of the situation and provides control.

3. Seek emotional support

Nurture your social and personal relationships. Join online communities for support. Talk about your emotions and feelings. Ask for guidance and understanding from your children and husband. Encourage them to read up on menopause as well. If they know more about menopause, they will be more compassionate about your problems.

4. Indulge yourself

Try something as simple as the latest haircut/massage to elevate your mood.

5. Get creative

Do not sit idle, do anything that gives you creative satisfaction—painting, cooking, gardening.

6. Become health conscious

Join a health club or try a self-calming skill such as yoga, meditation, or rhythmic breathing. Have a balanced diet and try to keep fit. Consult your doctor for any supplements you may need to take. Avoid consuming alcohol and tobacco and control your tea/coffee intake. Do Kegel’s exercises [exercises that contract and relax the muscles that form part of the pelvic floor] for urine incontinence and toning the vaginal muscles.

7. Get sex-savvy

Talk to your husband/partner about the vaginal discomforts you are experiencing. Try mutually-satisfying and gentler sexual techniques to handle this problem. An active sexual life can help maintain vaginal health, as well as have a positive impact on your married life.

8. Get medical help

If you’re having uncontrollable emotional problems, talk to your doctor. You may be advised hormone replacement therapy [HRT] to relieve menopausal symptoms. However, HRT is not for everyone. You may also be prescribed sleep-aids, anti-anxiety or anti-depressants and/or psychotherapy.

Soothing words

Menopause is a fact of life—it neither changes nor diminishes a woman, in fact makes her stronger. Even though the symptoms accompanying menopause can be irritating, they don’t in any way take away from her. It can be comforting for women undergoing unpredictable mood swings to realise that there’s something to look forward to a little further down the road. Confidence, patience, self-assurance and a sense of humour will help.

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Aanchal Agrawal
Aanchal Agrawal is a mother, a psychotherapist, and a special educator. She is a gold medallist in psychology from Benaras Hindu University. She is interested in removing taboos regarding mental illness and aims to spread awareness about child development.


  1. Everything you say is so true….anxiety, sleep issues and those horrible night sweats. Thank goodness for my Cool-jams Pjs and the meditation tapes that help me sleep.


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