A 2024 study in Scientific Reports shows that in India the estimated prevalence of premature menopause is 2.2 per cent and early menopause is 16.2 per cent. 

Perimenopause signifies the start of a woman's journey towards menopause, a natural phase during which the body gradually transitions from regular menstrual cycles to the cessation of menstruation and fertility. Some women experience menopause earlier than usual due to ovarian insufficiency, lifestyle factors, or hormonal imbalances.
Commonly referred to as the menopausal transition, this period typically commences in a woman's 40s, but it can onset as early as the late 30s. Menopause is when a person's periods stop for 12 months in a row. Before that, they may have irregular periods and hormone changes during perimenopause.

 

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5 Questions on Perimenopause

It is natural for people with a uterus to get lots of questions and confusion when hitting perimenopause. To clarify some of the commonly asked doubts, we collated information from reputed Apollo obstetrician-gynaecologists to answer them all.

1. Can menopause cause anxiety, depression, or panic attacks?
Dr. Rituparna Ghosh, psychologist at Apollo Hospitals, Navi Mumbai, in a YouTube video, shares her inputs on how mental health can be affected due to menopause. As menopause sets in, most  women do feel anxious and stressed. There are two main reasons for this: first, during this time, there is a change in the level of reproductive hormones that itself leads to generalised stress and anxiety. Psychologically, many women are not able to accept the fact that they will no longer be able to conceive a child. In other words, there is a perception that ‘my symbol of femininity is going away’, and because of that many women go through this tremendous mental distress.

 

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2. When to start hormone therapy?
Dr. Rooma Sinha, a Senior Consultant Gynaecologist, Laparoscopic & Robotic Surgeon at Apollo Hospitals Jubilee Hills in Hyderabad in a YouTube video suggests hormone replacement therapy for women who experience early menopause or perimenopause. By the late 30s or 40s, you’re already in perimenopause and still have 5-6 years to supplement them else, it will have long-term effects of hormonal imbalance. Another reason to give hormone therapy is to treat the symptoms and support bone health in females in some cases. 

 

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3. Does perimenopause affect sex life?
Dr. Raghavender Kosgi, a top-notch urologist and andrologist at Apollo Hospitals in Jubilee Hills, Hyderabad, has more than 18 years of experience. In his enlightening YouTube video, he explains sexual health for older women, shedding light on menopause and the challenges that come with it. Menopause can bring about hormonal changes that lead to vaginal dryness, causing discomfort or pain during sex. This can lead to avoiding intimacy due to fear of pain. To address these symptoms, consider using vaginal moisturisers and lubricants. If these are not sufficient, it's a good idea to consult with your ob-gyn about other options, such as topical or oral medications.

 

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4. What are the primary signs of perimenopause?
Dr. Rooma Sinha, a Senior Consultant Gynaecologist, Laparoscopic & Robotic Surgeon at Apollo Hospitals Jubilee Hills in Hyderabad in a YouTube video speaks about some apparent signs of perimenopause:

• Irregular periods
• Vaginal dryness
• Hot flashes
• Chills
• Night sweats
• Sleep problems
• Mood changes
• Weight gain and slowed metabolism
• Thinning hair
• Dry skin
• Loss of breast fullness

 

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5. Is it important to get pap tests and mammograms done after menopause?
It’s usually advised to keep doing Pap tests until you’re 65, unless you have certain risks for cervical cancer, like HIV. Even if you've had a hysterectomy, you might still need to get screened.
For mammograms, most women who aren’t at high risk for breast cancer can stop at age 75. In both cases, it’s important to talk with your ob-gyn, share your health details, and decide together how often you need these screenings based on what’s best for you.

Regular health screenings, like Pap tests and mammograms, are important for staying on top of your well-being as you age. While general guidelines suggest stopping certain tests at specific ages, personal risk factors and preferences should always guide these decisions. Having open conversations with your ob-gyn about your health history and wishes will help you make informed choices on when to continue or stop screening. Ultimately, it’s about finding the right plan that keeps you feeling confident and cared for.

 

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