October 18 is the World Menopause Day. And while menopause is a biological phenomenon, that happens to almost every menstruator - why does it warrant its own day? Why does it need its own conversation? What significance does it have in one’s life - let us have a glance at it.

Menopause is generally defined as a cessation of monthly periods for more than 12 months without an outside or physiological reason. So basically - the monthly periods stop, thus putting an end to the reproductive functions and fertility. The ovarian ovulation cycles also stop, which is another cause to the occurrence of menopause. Therefore, the stopping of these monthly cycles also mean a lack of the typical hormone responses of estrogen and progesterone - which is what requires our attention.

Picture this: when an individual with XX chromosomes is born, they are born with an ovarian reserve of about 1 to 2 million oocytes (which mature to eggs later during puberty), and as the individual matures and enters puberty - most of these oocytes get wasted away and we are left with about 250,000 - 300,000 oocytes; and these are enough for one’s reproductive life. Only a fraction of these mature into mature eggs ready for fertilization - about 400. And the rest degenerate. Menopause occurs when this ovarian reserve of oocytes deplete.

Depletion of these ovarian reserve of eggs causes a downgrade of estrogen and progesterone hormones - bringing the fertility of the individual to a screeching halt. In a menstruating individual there are monthly pulses of estrogen (in form of estradiol), progesterone, and even testosterone. With menopause, these pulses decline and the lack of circulating estrogen in the body (though there is a small amount still in the blood generated from the fat cells) - is what brings about all the negative side effects. 

And what are these side effects? Let us have a look:

1. Hot flashes, and night sweats because the body’s temperature control system dysfunctions.
2. Mood and memory might be affected with higher occurrence of insomnia, depression, anxiety and mood swings.
3. A lot of non-specific symptoms like fatigue, pain in the joints, aches, and weight gain.
4. Vagina may experience dryness and itching, which may lead to bleeding and pain during sex.
5. Estrogen protects and preserves our heart health, so the lack of circulating estrogen may result in poor cardiovascular health and higher risk of heart attacks.
6. One’s bone density may decrease yearly with menopause, thus these individuals are at high risk of bone-wasting, and fractures.

So the real question is: How do we help these people? Mothers, sisters, aunts, teachers, Mothers-in-Law - and so many others around us that are probably going through all this - and we had no idea!

Menopause isn’t an end to anything, in fact it is another facet of an individual’s life with different challenges and specifications to expect the best outcome. Therefore, it is very important to address the problems one faces during this time and give them optimum healthcare.

1. Make sure to have regular doctor visits and discuss any and all problems with your physician to ensure good treatment.
2. Have a diet with calcium, phosphates, vitamins and minerals - cut out the processed sugars for optimum health!
3. Exercise regularly - whatever floats your boat - some jogging, or walking, or swimming, or pick up a sport.
4. Take the help of loved ones, depend on them, and communicate your needs and wants.

Although menopause is uncomfortable and often stigmatized and untalked of, it is our responsibility to offer care and support to these individuals and also ensure good healthcare so this transition occurs smoothly and seamlessly, and to aid these individuals in their transition into this new phase of life.