Menopause Treatment in Delhi, India

Menopause is the time in a woman’s life when she no longer has monthly periods. It marks the end of her ability to have children. Often referred to as the "change of life," menopause usually occurs around the age of 50, but it can happen anywhere between the ages of 40 and 58. During this stage, the ovaries stop releasing eggs, and levels of important hormones like estrogen and progesterone begin to drop. 

Note - In some cases, menopause can happen before 40, which can occur naturally or due to medical treatments like chemotherapy or surgery.

Before reaching menopause, women go through a phase called perimenopause. During this time, the ovaries start to produce fewer eggs, and periods may become irregular. The most noticeable changes occur because of a drop in estrogen levels, which leads to many of the symptoms women experience. Menopause is officially reached when a woman has not had a period for 12 consecutive months.

Menopause occurs as a natural part of ageing when the ovaries gradually reduce the production of reproductive hormones. The primary causes of menopause include:

Ageing

Menopause is a natural part of the ageing process and typically occurs between the ages of 45 and 55. During this time, the ovaries gradually reduce their production of oestrogen and progesterone, the hormones responsible for regulating the menstrual cycle and fertility. This hormonal shift marks the end of a woman’s reproductive years.

Surgical Removal of Ovaries (Oophorectomy)

When the ovaries are surgically removed, menopause occurs immediately. This is known as surgical menopause and can cause more severe symptoms due to the sudden and complete drop in hormone levels. Women who undergo this procedure may require hormone replacement therapy (HRT) to manage symptoms and maintain long-term health.

Cancer Treatments

Certain cancer treatments, such as chemotherapy and pelvic radiation, can damage the ovaries and result in premature menopause. The extent of the impact depends on the type, dose, and duration of treatment. Women undergoing these therapies may benefit from proactive discussions with their doctors about preserving hormonal balance.

Primary Ovarian Insufficiency (POI)

Primary ovarian insufficiency occurs when the ovaries stop functioning before the age of 40. This condition may be caused by genetic factors, autoimmune diseases, or environmental exposures. Women with POI often experience irregular periods or infertility and may require medical intervention to manage their symptoms and protect bone and heart health.

Lifestyle Factors

Certain lifestyle choices can influence the timing of menopause. Smoking, for example, is known to lower oestrogen levels and can lead to an earlier onset of menopause. Chronic stress, poor dietary habits, and excessive alcohol consumption can also disrupt hormonal balance, further impacting the timing and severity of menopause symptoms.

While menopause is a natural biological process, certain factors can influence its timing and severity. Understanding these risk factors can help women prepare for this transition and manage its effects more effectively.

Genetics

A family history of early menopause may increase the likelihood of experiencing menopause at a younger age. Genetic predisposition often determines the timing of menopause and the severity of associated symptoms.

Smoking

Smoking is a significant risk factor for early menopause, as it accelerates the decline in oestrogen levels. Women who smoke are more likely to experience menopause several years earlier than non-smokers.

Chemotherapy and Radiation

Cancer treatments, such as chemotherapy and radiation, can damage ovarian function and lead to premature menopause. The risk depends on the intensity and duration of treatment.

Autoimmune Diseases

Conditions such as rheumatoid arthritis or thyroid disorders can trigger an immune response that damages the ovaries, increasing the risk of early menopause.

Medical Conditions and Surgeries

Certain medical conditions, like primary ovarian insufficiency or endometriosis, and procedures such as hysterectomy (with or without removal of ovaries), can elevate the risk of early menopause.

Lifestyle Factors

Poor nutrition, excessive alcohol consumption, and chronic stress can disrupt hormonal balance and contribute to an earlier onset of menopause.

The symptoms of menopause vary widely among women, ranging from mild to severe. These changes are primarily due to fluctuating hormone levels and can affect both physical and emotional well-being.

Irregular Periods

One of the earliest signs of menopause is irregular menstrual cycles. Periods may become lighter, heavier, or occur less frequently before eventually stopping.

Hot Flashes and Night Sweats

Hot flashes, sudden feelings of heat often accompanied by sweating, are a hallmark symptom of menopause. Night sweats can disrupt sleep and impact daily functioning.

Vaginal Dryness

Lower oestrogen levels can lead to reduced lubrication, causing discomfort or pain during intercourse and increasing the risk of infections.

Mood Swings

Hormonal fluctuations can result in mood changes, including irritability, anxiety, and depression. These emotional shifts may vary in intensity and duration.

Sleep Disturbances

Many women experience difficulty falling or staying asleep during menopause. Insomnia is often linked to hot flashes or increased stress.

Weight Gain and Metabolism Changes

Hormonal changes during menopause can slow metabolism, leading to weight gain, especially around the abdomen.

Bone and Joint Pain

Decreasing oestrogen levels can weaken bones and contribute to joint pain or stiffness, increasing the risk of osteoporosis.

Cognitive Changes

Some women report memory lapses, difficulty concentrating, or "brain fog" during menopause, which may be linked to hormonal changes.

By recognising these symptoms early, women can seek timely medical advice and adopt lifestyle changes to manage them effectively.

Diagnosing menopause involves understanding a woman’s symptoms and medical history. While menopause is often confirmed based on the absence of menstruation for 12 consecutive months, healthcare professionals may use additional methods to rule out other conditions or confirm hormonal changes.

Medical History and Symptom Assessment

Doctors typically begin with a thorough review of medical history, focusing on symptoms such as irregular periods, hot flashes, and sleep disturbances. Understanding the patient’s family history can also provide insights into the timing of menopause.

Blood Tests

Blood tests may be recommended to measure hormone levels. Key tests include:

• Follicle-Stimulating Hormone (FSH): Elevated levels of FSH indicate reduced ovarian function.
• Oestrogen Levels: Lower oestrogen levels are a hallmark of menopause.
• Thyroid Function Tests: These help rule out thyroid disorders, which can mimic menopause symptoms.

Physical Examination

A general physical exam may be conducted to check for signs like vaginal dryness or bone density issues. If necessary, a pelvic exam may also be performed to assess reproductive health.

Bone Density Tests

Since menopause increases the risk of osteoporosis, a bone density test (DEXA scan) may be recommended to evaluate bone health and detect early signs of bone loss.

Additional Tests

If symptoms are unusual or severe, additional diagnostic tests, such as pelvic ultrasounds, may be used to rule out other conditions like fibroids or ovarian issues.

Treatment for menopause focuses on alleviating symptoms and improving quality of life. While menopause is a natural phase of life, certain medical interventions and lifestyle changes can help manage its physical and emotional challenges effectively.

Hormone Replacement Therapy (HRT)

HRT is one of the most effective treatments for relieving symptoms such as hot flashes, night sweats, and vaginal dryness. By supplementing oestrogen and progesterone levels, HRT helps restore hormonal balance. However, it may not be suitable for everyone and requires careful monitoring.

Non-Hormonal Medications

Non-hormonal treatments, including antidepressants and certain blood pressure medications, can help manage symptoms like mood swings, hot flashes, and sleep disturbances for women who cannot undergo HRT.

Lifestyle Modifications

Simple lifestyle changes can significantly reduce menopause-related discomfort:

• Balanced Diet: Consuming foods rich in calcium, vitamin D, and phytoestrogens supports bone health and hormonal balance.
• Regular Exercise: Physical activity helps improve mood, maintain a healthy weight, and strengthen bones.
• Stress Management: Techniques such as yoga, meditation, and mindfulness can ease anxiety and promote relaxation.

Vaginal Oestrogen Therapy

For women experiencing vaginal dryness or discomfort during intercourse, local oestrogen therapy in the form of creams or rings can provide targeted relief with minimal systemic effects.

Complementary Therapies

Many women benefit from natural remedies such as herbal supplements, acupuncture, and aromatherapy. It’s important to consult a healthcare provider before starting any alternative treatments.

At Max Hospitals, we offer a comprehensive approach to menopause management. Our multidisciplinary team of gynaecologists, endocrinologists, and wellness experts work together to provide personalised care, ensuring that every woman receives the right support during this transition.

While menopause is a natural stage of life, it can lead to various health complications if not managed properly. Here are some of the most common complications of menopause.

Osteoporosis

Reduced oestrogen levels during menopause accelerate bone loss, increasing the risk of fractures. Bones become weak and brittle, particularly in the hips, spine, and wrists. Regular bone density tests and calcium-rich diets can help mitigate this risk.

Cardiovascular Disease

Menopause increases the likelihood of heart-related issues due to hormonal changes that impact cholesterol levels and blood vessel elasticity. Adopting a heart-healthy lifestyle, including exercise and a balanced diet, is crucial during this phase.

Weight Gain

Hormonal fluctuations can lead to changes in metabolism, causing weight gain, particularly around the abdomen. This can further increase the risk of diabetes and other metabolic disorders.

Urinary Incontinence

Weakened pelvic muscles and thinning of the urethral lining may lead to bladder control issues, including urinary incontinence. Pelvic floor exercises and targeted therapies can help manage this condition.

Emotional Well-being

The hormonal changes associated with menopause can result in anxiety, depression, and mood swings. If left unaddressed, these issues may negatively impact mental health and quality of life.

Sexual Health Issues

Vaginal dryness, discomfort during intercourse, and decreased libido are common complications that can strain intimate relationships. Treatments such as vaginal oestrogen therapy or counselling can help address these challenges.

While menopause itself cannot be prevented, its onset and severity of symptoms can often be influenced by lifestyle choices and proactive health measures. By prioritising self-care and early interventions, women can reduce the risks of complications and enjoy a smoother transition.

Maintain a Healthy Lifestyle

A balanced diet rich in calcium, vitamin D, and antioxidants supports bone health and reduces the risk of osteoporosis. Regular exercise helps maintain a healthy weight, improves mood, and strengthens bones and muscles.

Manage Stress

Chronic stress can exacerbate menopause symptoms. Incorporating relaxation techniques such as yoga, meditation, and deep breathing into daily routines can promote hormonal balance and emotional well-being.

Avoid Smoking and Limit Alcohol

Smoking accelerates the decline of oestrogen levels, potentially leading to an earlier onset of menopause. Limiting alcohol consumption can also help reduce the risk of hot flashes and other menopause-related symptoms.

Prioritise Regular Health Check-ups

Routine health screenings, including bone density scans and cardiovascular evaluations, help in the early detection and management of menopause-related complications.

Explore Hormonal and Non-Hormonal Therapies

Under the guidance of a healthcare professional, therapies such as HRT or non-hormonal medications can help manage symptoms and improve quality of life.

How long does menopause typically last?

Menopause itself is defined as the cessation of menstrual periods for 12 consecutive months. The perimenopausal phase, which leads up to menopause, can last anywhere from a few months to several years. After menopause, some women may experience symptoms like hot flashes and night sweats for 1–5 years, but they can persist for longer in some cases.

Can menopause affect my mental health?

Yes, hormonal changes during menopause can lead to mood swings, anxiety, irritability, and depression. These emotional symptoms are common and can be influenced by factors such as sleep disturbances, hot flashes, and changes in self-esteem. It's important to seek support from healthcare professionals if you're struggling with your mental health.

What are the best ways to cope with menopause-related mood swings?

Regular exercise, stress management techniques such as yoga or meditation, and maintaining a healthy diet can help manage mood swings. Additionally, speaking to a therapist or counsellor may be beneficial for addressing emotional challenges. In some cases, medication may be recommended to help stabilise mood.

Is it possible to experience menopause earlier than expected?

Yes, early menopause can occur before the age of 40, known as premature menopause. This may be due to factors like genetics, certain medical treatments (such as chemotherapy), or autoimmune diseases. Women who experience early menopause may face different challenges and should consult with a healthcare provider for tailored guidance.

How does menopause impact my sexual health?

Menopause can lead to vaginal dryness, reduced libido, and discomfort during sex due to lower oestrogen levels. These changes are temporary and can often be managed with treatments like vaginal moisturisers, lubricants, or oestrogen therapy. Communication with a partner and seeking advice from a healthcare provider can also help address sexual health concerns.

Can I continue to work out during menopause?

Yes, exercise is highly recommended during menopause. Regular physical activity helps maintain a healthy weight, improves mood, reduces the risk of osteoporosis, and alleviates some menopause symptoms. Activities like walking, swimming, yoga, and strength training are particularly beneficial.

How does menopause affect my sleep?

Menopause can lead to sleep disturbances, including difficulty falling asleep, staying asleep, or experiencing night sweats. Hot flashes during the night can be particularly disruptive. Maintaining a cool and quiet sleep environment, practicing relaxation techniques before bed, and avoiding caffeine and alcohol can improve sleep quality.

Are there any lifestyle changes that can improve menopause symptoms?

Yes, adopting a healthy lifestyle can significantly ease menopause symptoms. Eating a balanced diet rich in calcium, vitamin D, and phytoestrogens, staying physically active, managing stress, and getting adequate sleep all play important roles in improving symptoms. Limiting alcohol, smoking, and caffeine can also help.

Can menopause cause hair loss or thinning?

Yes, hormonal changes during menopause can lead to hair thinning and hair loss. This is mainly due to a decrease in oestrogen levels, which affects the hair growth cycle. Using gentle hair care products, avoiding heat styling, and maintaining a balanced diet can help promote healthy hair. In some cases, treatments like topical minoxidil or hormone therapy may be considered.

Is it safe to take hormone therapy after menopause?

Hormone therapy (HT) can be a safe and effective option for managing menopause symptoms, but it depends on individual health factors. It’s important to discuss the potential risks and benefits with a healthcare provider, especially if there is a history of certain conditions like breast cancer, heart disease, or blood clots. Regular follow-ups are essential for monitoring health during HT.

Can menopause affect my memory or concentration?

Yes, many women experience difficulty with memory, focus, and concentration during menopause. This is sometimes referred to as “brain fog.” Hormonal fluctuations, sleep disruptions, and stress may contribute to these cognitive changes. Staying mentally active, getting enough rest, and managing stress can help improve cognitive function during menopause.

How can I maintain a healthy weight during menopause?

As metabolism slows down during menopause, maintaining a healthy weight can become more challenging. A balanced diet, regular exercise, and strength training are key to managing weight. Reducing intake of processed foods, sugars, and refined carbs can also help control weight gain associated with hormonal changes.

Will I still need to see my gynaecologist after menopause?

Yes, it’s important to continue seeing a gynaecologist after menopause for regular health check-ups, including screenings for conditions like osteoporosis, cardiovascular disease, and cervical cancer. Your gynaecologist can also help manage any ongoing symptoms or complications related to menopause.

What is the role of vitamin D during menopause?

Vitamin D is crucial for bone health, and menopause increases the risk of osteoporosis due to reduced oestrogen levels. Ensuring adequate intake of vitamin D through diet, supplements, and sunlight exposure is essential for maintaining bone strength and preventing fractures.

How do I know if I am going through perimenopause or menopause

Perimenopause refers to the transition phase leading up to menopause and is characterised by irregular periods, changes in menstrual flow, and early menopause symptoms. Menopause is confirmed when you’ve gone without a period for 12 consecutive months. Your doctor can help determine whether you’re in perimenopause or have reached menopause based on your symptoms and medical history.

Reviewed By Dr. Anuradha Kapur, Principal Director & Head of Unit, Obstetrics And Gynaecology, Robotic Surgery, Gynaecologic Laparoscopy on 12 March 2025.