The trend towards later maternity is strongest among women with better educational qualifications, as they increasingly postpone child rearing to pursue their careers.
On the whole, babies are more likely to be planned and wanted by women in their thirties. There is evidence that older women express greater satisfaction and feel they are ready to have a child because they have been fulfilled in their lives before that time. The notion of sacrifice is more often talked about in younger mothers. Older mothers may want to spend more time with their children."

Most of the degenerative changes, pre menopausal problems and metabolic diseases, thyroid dysfunction, cancers of breast and genital organs and deteriorating vision start from mid thirties, let us say around 35 years only. For preventive and optimal healthcare, we have to start early from the mid thirties, while later comes curative and palliative stage. The most common problem faced by the females over age 35 is menopause. Lets learn what to expect and ways to stay strong and healthy in the years around menopause.

Menopause

Menopause is a natural process that occurs as a woman’s ovaries stop producing eggs and the production of female hormones (estrogen and progesterone) declines. Menopause can also occur if a woman’s ovaries are damaged by certain diseases or cancer treatments, or if they are surgically removed. Menopause usually happens gradually between the ages of 45 - 55. The average age that women reach menopause is 51 years although it can occur as early as age 40 to as late as the early 60s. Women now have a life expectancy of more than 80 years. Currently, women can expect to live some 30 or 40 years of their life in the postmenopausal state.

Menopause does not occur suddenly. A period called perimenopause usually begins a few years before the last menstrual cycle. There are two stages in the transition:

1) Early Stage. Pre menopause can begin in some women in their 30s, but most often it starts in women ages 40 - 44. It is marked by changes in menstrual flow and in the length of the cycle. There may be sudden surges in estrogen.

2) Late Stage. The late stages of pre menopause usually occur when a woman is in her late 40s or early 50s. In the late stages of the menopausal transition, women begin missing the periods until they finally stop. About 6 months before menopause, estrogen levels drop significantly. The fall in estrogen triggers the typical symptoms of vaginal dryness and hot flashes (which can last from half a year to more than 5 years after onset of menopause).

Menopause is considered to have occurred after a woman has gone a full 12 months without a period. Menopause marks the end of menstruation and a women’s fertility.
Menopause is not a disease. However, many conditions are associated with estrogen depletion, including heart disease, osteoporosis, and other complications. Fortunately, effective treatments are available for these conditions.

Many women experience some physical and emotional symptoms during menopause, caused by hormonal imbalance. Typically, a woman will begin to experience menopause symptoms around her mid-40's as her body's reproductive capability comes to the end. This prolonged stage of gradually falling and fluctuating hormone levels is called per menopause, which can last upwards of two years before a woman's final period. For most women, symptoms end at menopause; however, some women will experience symptoms into postmenopausal life. The first symptom is usually a change in the pattern of your monthly periods. The start of the menopause is known as the pre menopausal stage. During this time, you may have light or heavy periods.The frequency of your periods may also be affected. You may have a period every two-three weeks, or you may not have one for months at a time. Other prominent symptoms of the transition to menopause include:

1) Hot flashes and night sweats . Women often feel hot flashes as an intense build-up in body heat, followed by sweating and chills. Some women report accompanying anxiety as the sensation builds. In most cases, hot flashes last for 3 - 5 years, although they may linger in some women for years after menopause. Women who have surgical removal of both ovaries, and who do not receive hormone replacement therapy, may have more severe hot flashes than women who enter menopause naturally.

2) Heart pounding or racing can occur, with or without hot flashes.

3) Difficulty sleeping . Insomnia is common during perimenopause. It may be caused by the hot flashes, or it may be an independent symptom of hormonal changes.

4) Mood changes . Mood changes are most likely to be a combination of sleeplessness, hormonal swings, and psychological factors as a woman undergoes this intense passage in her life. Once a woman has reached a menopausal state, however, depression is no more common than before, and women with a history of premenstrual depression often have significant mood improvement.

5) Sexuality . Sexual responsiveness tends to decline in most women after menopause, although other aspects of sexual function, including interest, frequency, and vaginal dryness vary. It is useful to remember that most symptoms of menopause eventually go away.

6) Forgetfulness . This appears to be one of the few symptoms that are common across most cultural and ethnic groups.

7) Urinary symptoms. During the menopause, you are more likely to experience recurrent lower urinary tract infections, such as cystitis. You may also feel an urgent and frequent need to pass urine.

8) vaginal dryness and pain, itching or discomfort during sex.

9) Joint stiffness .

10) Skin, Hair and Other Tissue Changes. With the increase in the age, you will experience changes in your skin and hair. Loss of fatty tissue and collagen will make your skin drier and thinner and will affect the elasticity and lubrication of the skin near your vagina and urinary tract. Reduced estrogen production may contribute to hair loss or cause your hair to feel brittle and dry.

Women from different countries and states have different menopausal symptoms. Menopause is not a disease. However, many conditions are associated with estrogen depletion, including heart disease, osteoporosis, and other complications. Fortunately, effective treatments are available for these conditions. After the menopause it is common for the following complications to appear.

Cardiovascular disease - a drop in estrogen levels often goes hand-in-hand with an increased risk of cardiovascular disease. Women who experience early menopause are almost twice as likely as the general population to have a heart attack, stroke, or other cardiovascular disease later in life. In order to reduce the risk of developing cardiovascular disease a woman should quit smoking, try to keep her cholesterol, blood sugar, and blood pressure within normal, healthy levels, do plenty of regular exercise, sleep at least 7 hours each night, and eat a well-balanced healthy diet.

Osteoporosis - Bone density may be lost at a fast rate for the first few years after menopause because estrogen plays a role in building new bone. The risk of fractures to the hip, wrist, and spine are especially pronounced in postmenopausal women.

Urinary incontinence - the menopause causes the tissues of the vagina and urethra to lose their elasticity, which can result in frequent, sudden, strong urges to urinate, followed by urge incontinence (involuntary loss of urine). Stress incontinence may also become a problem - urinating involuntarily after coughing, sneezing, laughing, lifting something, or suddenly jerking the body.

Urinary Tract Infections - Because of vaginal drying, women are at increased risk for recurrent urinary tract infections after menopause.

Low libido - this is probably linked to disturbed sleep, depression symptoms, and night sweats.

Overweight/obesity - during the menopausal transition women are much more susceptible to weight gain because metabolism slows. Experts say women may need to consume about 200 to 400 fewer calories each day just to prevent weight gain - or burn of that number of calories each day with extra exercise. The chances of becoming obese rises significantly after the menopause.

Breast cancer - women are at a higher risk of breast cancer after the menopause. Regular exercise and check ups after menopause significantly reduces breast cancer risk.

Skin and Hair Changes - Estrogen loss can contribute to slackness and dryness in the skin and wrinkles. Many women experience thinning of their hair and some have temporary hair loss.

Lifestyle Changes Changing and improving lifestyle is the basic factor in preventing 50% of ageing and metabolic diseases. Making lifestyle changes may help ease the discomfort of menopause symptoms. Simple changes in lifestyle and diet can help control menopausal symptoms such as hot flashes. Avoid hot flash triggers like spicy foods, hot beverages, caffeine, and alcohol. Dress in layers so that clothes can be removed when a hot flash occurs. For vaginal dryness, moisturizers, and non-estrogen lubricants are available. Quit smoking, get enough sleep, and make a conscious effort to eat healthily and exercise more to keep symptoms of menopause under wrap and keep yourself fit and healthy. One of the keys to enjoying menopause is to try to keep up a happy and healthy lifestyle. The right diet, open communication with your partner, and stress relief are examples of ways to make life the most easy in menopause.

How long will the phases of menopause lasts in women is completely individual. Most women experience the majority of their symptoms over a 2-year period of time’, but that will just annoy those women who find themselves still up to the eyeballs in hot flushes after 5 years. The average age when menopause is on is around 52 years old, but many women start in their 40s and some not until their late 50s, so really you just have to see what happens for you.

The ultimate aim is to give healthy lives in later age, to compressor illness in to short period of time, to reduce morbidity and disability of ageing women passing more than one third of their life in the menopausal age.

Rupal Hospital for Women is a premiere leader in women's healthcare since 45 long years. The doctors are committed to providing women with the highest quality and most advanced healthcare throughout all stages of their lives, from adolescence through menopause. Rupal clinic for women is providing special care to women around 35 years, Premenopausal, Menopausal and post menopausal ageing women. Dr. Malti Shah senior Gynecologist and obstetrician, qualified for Menopause Practice gives her services to the clinic. Rupal Hospital Menopause Clinic offers care for women with concerns about the menopause, including women with early menopause or menopause caused by surgery or illness. Rupal Hospital understands and meets all the health needs of a woman and fosters the understanding of how advanced health care can improve the lives of women and their families.

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