The treating physician at first has to assess the current health and risks in future before starting treatment for menopause. Different class of women from different geographical areas and dietary habits experience diverse symptoms during perimenopause and after menopause. Basing on the severity of the condition, required clinical examination, laboratory tests and radiological investigation, screening tests have to be performed. The women should be advised healthy lifestyle practices.
There are different methodologies and approaches to managing menopause, including a simple lifestyle modification, disciplined diet, moderate exercise, naturopathy, yoga and dhyana. One has to eat a healthy diet, maintain a healthy weight, should have enough sleep, those who have a habit of smoking and alcohol should quit them. Wear convenient clothing that suits the body. Research has shown that spicy foods, coffee, tea, hot drinks, and stressful situations trigger symptoms of menopause such as hot flashes, irritation, and feeling of suffocation, therefore those who suffer from the said symptoms should avoid spicy foods etc. It is further advised to observe which foods are stimulating the symptoms that should be remembered or noted and try to avoid. Since the latest research has proved there is a great association between diet and menopause problems.
A 2023 study showed that women who followed a Mediterranean diet experienced a 22 percent lower risk of developing central obesity compared to those on a standard Western diet. The Mediterranean diet is a style of eating that emphasizes plant-based foods and olive oil, and is based on the traditional eating habits of people in countries around the Mediterranean Sea such as European and West Asian etc. Few examples of Mediterranean diet meals include: Salmon with mango salsa, Cod with lentils, Lean, roasted chicken over cannellini beans, Chickpea and spinach pancakes, and Black bean burger on a whole-grain bun served with roasted beets.
Kegal exercises otherwise called pelvic floor exercises can greatly help with some types of urinary incontinence that some individuals are complaining. Kegel exercises are a series of pelvic floor muscle contractions and relaxations that can help improve bladder control and strengthen weakened pelvic floor muscles. They are a first-line treatment for urinary incontinence, which is the involuntary loss of urine.
Hormone therapy for menopausal issues has to be judiciously used. Before going for this therapy where usually, hormones such as estrogen, progesterone, or tibolone are prescribed so it is important to discuss the risks and benefits of different treatments with the consultant. A doctor may prescribe hormones for vaginal dryness. It is best to use a water-soluble vaginal lubricant during intercourse or vaginal moisturizers. Some prefer to use vaginal estrogen creams.
SSRIs stand for selective serotonin reuptake inhibitors, which are a type of antidepressant medication that can help with hot flashes. Management of menopause, the newer research that is emerging ‘linking dietary changes and lifestyle’ which can significantly reduce symptoms of menopause and its complications, sex problems, and imitating neuropsychiatric issues also to be treated as per the cause.
Menopausal hormone therapy is the most effective treatment for menopausal symptoms. It can be offered to symptomatic patients with no contraindications following an individualized discussion about the risk of harm versus benefit.
Menopausal hormone therapy is recommended for women with premature ovarian insufficiency (menopause occurring before 40 years of age) regardless of symptoms unless contraindicated. No hormonal medications may improve symptoms for women who have contraindications to, or do not wish to take menopausal hormone therapy.
Management for menopausal symptoms:
According to the Australian Prescriber, the reputed medical journal, the overall management of menopausal symptoms includes an assessment of the patient’s:
General health condition, current symptoms and concern, risks of cardiovascular disease and osteoporosis need for screening and preventive activities.
During perimenopause, a menstrual bleeding history should be documented, noting any abnormal bleeding that requires investigation, before considering systemic menopausal hormone therapy. Depending on individual symptoms, management may include non-pharmacological and pharmacological (including hormonal and non-hormonal) therapies.
Women with premature ovarian insufficiency require comprehensive assessment and management. Menopausal hormone therapy (MHT) is recommended regardless of symptoms (unless contraindicated) until the usual age of menopause, to reduce the risks of osteoporosis and cardiovascular disease. Osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of broken bones (fractures).
MHT is the most effective treatment for menopausal symptoms. It can be offered to symptomatic patients with no contraindications following individualized discussions about risk of harm versus benefits and other therapies available.
Other established benefits of MHT include improved quality of life, and prevention of osteoporosis and, potentially, cardiovascular disease. Estrogen therapy is suitable for the management of osteoporosis or low bone density in women younger than 60 years of age.
Non-pharmacological therapies:
Lifestyle modifications such as exercise, weight loss and reducing alcohol consumption may be helpful for some women. These measures may not reduce the severity of symptoms but may make them more manageable and improve overall well-being. Cognitive behavioral therapy can reduce the impact of vasomotor symptoms and alleviate sleep disturbance. Cognitive behavioral therapy (CBT) is a talking therapy that can help to manage the problems by changing the way of thinking and behavior.
Hormone therapy:
Menopausal hormone therapy (MHT) is indicated for treatment of menopausal symptoms. It is highly effective for alleviating vasomotor symptoms and may improve sleep disturbance, mood changes, cognitive concerns and musculoskeletal symptoms.
