Menopause guide

January 8, 2019 01:00 AM Dr Aruna Uprety


In Nepal we do not have government or private initiatives to discuss about health issues of women after menopause 

A few years ago, menopause was not even discussed among women in Nepal. The general assumption was that there was nothing to discuss about it. Women’s health was associated with pregnancy, contraception and reproductive health. Even health workers had limited knowledge about menopause. 

Time has changed. Women are living longer than their mothers and grandmothers used to. The average life expectancy of a Nepali woman is 70 years old. Assuming most women have menopause at around 45-50 years, they live much longer than their grandmothers and mothers. Menopause is therefore a great concern for a large number of people.  

Menopause is a normal natural process. Few adolescent girls feel discomfort during menstruation and among them, only a few need medical treatment. Similarly, a few women feel some discomfort about menopause, and among them even fewer need medical treatment. But proper care must be taken earlier to avoid health problems later on. 

In Nepal we do not have government or private initiatives to discuss about health issues of women after menopause.  So when I received the book Our Bodies, Ourselves published by non-profit organization called ‘Our Bodies Ourselves’ as a gift by my friend in United States a few years ago, I was surprised. “Such a big book on menopause?” I exclaimed. I wondered what could be written about menopause in such a big volume. I thought maybe in the US, it is an issue but not in Nepal. But once I went through the book, I found out how wrong I was. I was happy that I was able to learn about the mental and physical health issues associated with menopause. I also realized that issues associated with menopause may exist among Nepali women, but we do not talk about it openly. 

Valuable information 

Information provided in this book is useful for those women who are still between 25-30 years as it teaches how to take care of our health from early age so that you can lead a healthy life after menopause, which occurs generally between 48 and 50.  During menopause some women may not have any discomfort but others may experience palpitation, dizziness, night sweats, hot flashes headaches, and irritability. But there is no way to predict who will not have those discomforts. We learn from this book that women who live a healthy lifestyle by eating healthy food and do regular exercise experience less symptoms during menopause than those who lead an unhealthy life style. 

Menopause is period of changes and for some women it can be highly stressful. This book stresses that women must help themselves accepting the experience rather than rejecting it or denying it. Menopause occurs to all women, including those who are prepared for it as well as those who are not. Changes that occur with age and after menopause are skin changes, wrinkles, skin spots, etc. If a woman who feels that her physical look is extremely important, she may feel depressed with those changes. This book suggests that we must strive to lead a healthy life and not put much emphasis on appearances.

Lessons to learn  

Our body changes with age, and everyone starts losing bone mass after age of 35. Bone loss in women increases after menopause. Here you will find suggestions on what can be done to minimize this process, including exercise and consuming enough calcium and vitamin D through food and sun exposure.

The book discusses why a woman must eat whole grains, green leafy vegetables, lentils, and season fruits and why it should start from the early age. She must avoid junk foods, carbonated drinks, sugars, processed foods, and fatty foods. 

For optimum health during menopause and after, woman should also avoid smoking because smoking interferes with the way bones absorb calcium and is responsible for weak bones. Lessons learnt from this book made me think that we all have to go through this period in our life so all of us should know about menopause and what should be done to be healthy not only physically but also mentally. 

The book contains interviews of many women who have shared their own experiences on menopause.  After reading this book I also realized that menopause is taken as a “disease” by some health workers in the US too, but the authors reject “the medicalization of women’s natural life transitions, its evenhanded consideration of all treatment options, whether “conventional” or “alternative” and its focus on understanding individual women’s health in social and political context.”

Now in Nepal some of the health workers have started to give hormone therapy for women after menopause. This book gives evidence on why hormone therapy is unnecessary and how it has many negative impacts on woman’s bodies.  

Emphasizing that menopause is a natural process and that most women have a relatively easy time with the transition, this book gives message that the hormonal changes of the menopause affect every woman differently, each woman needs to work out how best to manage these changes. While every woman is unique, attention to diet and lifestyle is important since the effects of the menopause and estrogen deficiency can be helped by adopting as healthy a lifestyle as possible. 

This book also combines trustworthy medical information based on the best available evidence and thoughtful analysis of the social, cultural, and political forces affecting our health. After reading it I realized that a book on menopause should be written in Nepali language too so that young and adult women can benefit by reading it. 

The author writes on nutrition and health issues 


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