Health - A Time for Renewal
by Jamuna Rangachari
Menopause is a natural stage in the life of a woman. With the right care and attitude it could be a deeply fulfilling period of revitalization.
I met Ms Chaturvedi in a conference and found her to be confident, articulate and attractive. Being the only ladies in the group, we had lunch and a long chat and promised to keep in touch, but as it happens ever so often, didn't do so, busy with our respective lives. When I met her after a gap of a year, I was really surprised to see that she had become nervous, edgy and incoherent. I didn't ask her if something was amiss, but was truly concerned. Perhaps she sensed it.
Suddenly, she held my hand tight and broke down, her emotions bursting forth in a volley. "I am 48 and I think my menopause is going to happen anytime. I can feel it. I just realized life has passed me by." I let her speak and just listened for a while.
It wasn't that she was desperately interested in marriage, but was not closed to it either. At the back of her mind, she thought it might happen someday. She did not want to have children. Her work kept her busy and she had long since decided that motherhood was not for her. She had a number of friends, both male and female, and in the cosmopolitan and open culture of Mumbai, socializing was not an issue. Her family let her be, so that again was not a problem.
It was purely the thought of menopause that was disturbing her so much. As she put it, she felt "life had passed her by". And she is not the only one. Many women do feel that life has really come to an end when they reach this stage. This is unwarranted, because with today's life expectancy levels, a menopausal woman has just about reached mid-life.
As in most things, ignorance is at the root of this irrational attitude. Ignorance of the experiencer and that of others around her. Just as an ignorant young girl is terrified of her first period, most women don't really understand what menopause is and therefore, don't know how to deal with it.
According to Dr Rekha Khandelwal of Vardaan hospital, Delhi, many problems, which are actually due to natural aging, lack of physical fitness and improper diet, are attributed to 'menopause'. Therefore, it seems to be a bigger problem that it actually is.
What is Menopause?
What exactly is menopause? The word comes from the Greek mens, meaning monthly, and pausis, meaning cessation. Unlike a woman's first menstruation, which starts on a single day, the changes leading up to menopause happen over several years.
Menopause commonly happens any time between the ages of 42 and 56, when a woman's ovaries no longer produce the hormones, estrogen, progesterone and testosterone. For all practical purposes, the only real change is that a woman can no longer conceive.
The clearest signs of the start of menopause are irregular periods (when periods come closer together or further apart), and when blood flow becomes lighter or heavier. Technically, when a woman has not had a period for a full year, one can say she has begun her menopause.
Just like different women experience different levels of pain and symptoms during their period, there are many possible signs of menopause and each woman feels them differently. Most women have few menopausal symptoms while some women have many moderate or severe symptoms.
Hot flashes, a sudden feeling of heat in the upper part, or all of the body, occur in many women. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Flashes can be as mild as a light blush or severe enough to wake you from a sound sleep (called night sweats). Most flashes last between 30 seconds and five minutes. Other than this, there could be weight loss or gain, vaginal dryness, fatigue, dry eyes, itchy skin and urinary tract infections.
Fortunately, all these are temporary and do pass away. Most doctors today have fully understood that it is best to allow nature to play its role. For instance, most doctors now avoid Hormone Replacement Therapy, a prevalent practice earlier, as its risks far outweigh its benefits.
Homeopathic doctor and consultant to Escorts, Dr Rachna Chopra, uses homoeopathy to treat each patient based on her individual needs, aiming to bring back the balance of body, mind and spirit. Dr Tuli, consultant physician at Apollo Indraprastha hospital, integrates knowledge from various medicinal practices and helps a woman balance her life through a wholesome diet, fitness routine and positive affirmations. He does not subscribe to the commonly held belief that osteoporosis is an inevitable companion of menopause, pointing to other animals on this planet who never experience deterioration of their bones, tuned in as they are to their natural
surroundings and needs.
The Games the Mind Plays
More than physical symptoms, psychological factors play havoc on most women. Low mood, irritability, sleep disturbances, anger outbursts, and a feeling of helplessness and/or hopelessness are common, says Dr. Sanjay Chugh, a leading psychiatrist in Delhi.
Even the physical symptoms are much more pronounced when the woman is psychologically disturbed. Dr Bhavna Barmi, clinical psychologist, Escorts Heart Institute and Research Center, Delhi, finds that low self-esteem, particularly when there is a loss or gain in weight, often results in sexual dysfunction.
In reality, concerns about menopause signaling the end of a fulfilling life, have absolutely no validity.
A telling indication is the marked difference in the experiences of menopause in different cultures. Gail Sheehey in her book, The Silent Passage: Menopause, says that menopause is accompanied by many physical symptoms in youth-oriented cultures where it is considered virtually a disease, whereas fewer unpleasant symptoms are reported in cultures that revere age. It is even welcomed in some cultures where a woman enjoys more freedom after the childbearing years have passed. This is still largely true of India. My maid told me one find day she was really happy that she didn't have to bother about 'dates' anymore. That's all it meant to her. She had been regular at work for the past several months, which meant that this was not a big issue with her. It is only the urban woman, so removed from the natural cycles of life, who finds it an occasion for distress, anxiety and fear.
Simple Steps to Good Health
The World Health Organization defines health as "a state of physical, mental and social well-being, and not necessarily the absence of disease or infirmity".
The key word is "well-being" and some simple steps could easily ensure this.
Diet should consist of wholesome, natural food with roughage and calcium from vegetable sources. Mallika Bhanot, a naturopath and yoga practitioner, says that out of the three body constituents (vata, pita and kapha) vata increases during this phase and therefore a vata-suppressing diet that includes "madhur, amla and lavana" (sweet, salt and sour) rasas, is to be adopted. Milk products are not recommended, as they are not easily digestible. As constipation is a common symptom, roughage such as cabbage, methi and palak should be consumed regularly. To keep body heat in check, cold or lukewarm food products and cooling herbs like mint and coriander are a great help. Mint can also be ground and the paste applied for body ache (typically observed in calf muscles). Another pain reliever for body aches is geranium oil, which is also to be combined with a base oil such as almond or olive oil.
It is also very essential to strictly follow a regimen of fitness and an exercise routine. "A fit and healthy woman," says Dr Khandelwal, " should be able to tide over this period in her life without any medication," citing herself as an example.
As the definition says, mental and social well-being is equally important. Talk to positive people who have been through it and keep your loved ones in the picture.
Meditation is unanimously recommended - doctors, psychologists and most importantly, women who have coped well, vouch for its effectiveness. Dr Avinash R Murthi, reiki master and academician, says reiki helped her tremendously when she was undergoing menopause. Transferring energy to the six head points - eyes, ears, temple, back of head, back of eye and throat and to the solar plexus, she was tremendously at ease and sailed through this phase effortlessly. Mrs Shakun Goel, Managing Trustee, Pranic Healing Centre, Delhi, was going through a general transition in life at this time, as her children had just left home. Still, she had no problems as she constantly
practiced self-healing, using pranic healing techniques. Shanmukhi Mudra, which involves redirecting the awareness inside by closing one's outer doors of perception is very effective in stemming mental depression, says Mallika. "Also try Soham meditation, which focuses attention on the breath, and suppresses irritability and restlessness," she says.
Isn't all the above a general guideline for healthy living? Of course it is. Didn't we say menopause is just a natural process in life? Undoubtedly, it is an important milestone and, like all milestones, is an opportunity. It is advisable to treat this milestone positively. In fact, Sheehey, in her research, has found many women, more joyful, peaceful, energetic and plunging into new careers while coming through this 'silent passage'.
"God, give me the serenity to accept the things I cannot change, the courage to change the things I can and wisdom to know the difference, " says my favorite prayer.
I pray that my friend Ms Chaturvedi, and others like her, have the serenity to accept that the body is experiencing a natural stage in its growth, the courage to take the right steps to deal with it, and the wisdom to realize that life has not passed them by but is just taking one of its many turns, which could well lead to renewed vigour and vitality.