Beyond hot flushes: Women seek answers for menopause distress

Bengaluru: Many women say their menopausal symptoms are routinely dismissed as unavoidable hormonal changes, leaving them without proper medical guidance or treatment. From hot flushes and irritability to severe anxiety and osteoporosis, the symptoms can significantly disrupt life. But many struggle to find physicians who do not dismiss their concerns as "just another symptom of menopause".Nalini (name changed), 50, has spent the past year dealing with severe physical and psychological distress, believed to be linked to menopause. She describes persistent heaviness in the head, a burning sensation throughout the body, and intense anxiety, including a recurring fear about her survival. The symptoms have significantly affected her daily functioning and sense of well-being. Despite visiting multiple doctors, she has received varying diagnoses but no proper treatment plan. Her symptoms are so debilitating she cannot stay alone at home and has to depend on family members for support. For 52-year-old Manasa, the problems have been different but equally disruptive. She has experienced hot flushes for over six months, along with rapid weight gain. "As a working woman, having hot flushes started becoming a major inconvenience in my day. When I consulted a gynaecologist, I expected some advice about how to manage these symptoms. Unfortunately, the doctor dismissed my problems, saying they are menopausal symptoms and nothing can be done."Women commonly report anxiety, depression, hot flushes, mood swings and irritability, weight gain, joint pain, frozen shoulder, and brain fog, but many are referred from one specialty to another without ultimately receiving any meaningful treatment. This often leaves them to manage the symptoms on their own. Limited treatment options & awarenessWhen TOI discussed these issues with doctors, they acknowledged that menopause is misunderstood, by both patients and many in the medical community. Dr Tanya SP, consultant, obstetrics & gynaecology, Kinder Women's Hospital and Fertility Centre, said: "While symptoms like night sweats, anxiety, libido changes, and vaginal discharge are common, there is limited treatment available. Hormone replacement therapy (HRT) is administered in severe cases, but it has drawbacks such as endometrial or breast carcinoma. For vasomotor symptoms like vaginal dryness, we prescribe local oestrogen application, and for osteoporosis we prescribe Vitamin D."However, some doctors say menopause needs to be looked at objectively to provide better treatment. "The whole concept of menopause being the reason for multiple traumatic symptoms was there for quite some time. Previously, women also neglected these symptoms and did not present to doctors. But now, awareness has increased. However, many doctors are not aware of the range of symptoms, which leads to dismissal," said Dr Madhva Prasad, associate professor, OBG, St John's Hospital."In busy clinical practices, doctors do not look at menopause objectively. There is a scoring system and well-established questionnaires which can help with better identification and treatment of the multiple symptoms of menopause," he said, adding, "A short course of HRT with minimal dosage can help women without serious side-effects." (With inputs from Akilandeshwari J)