Indian women
invariably feature at the bottom of global health and wellness
surveys. But that's not all. A recent survey now shows that they are
at a phenomenally high risk of suffering from "premature menopause"
with many experiencing this biological transition even before
they've hit the third decade of their lives!
A pan-India survey, conducted recently by the Bangalore-based
Institute for Social and Economic Change (ISEC), highlights the
alarming new phenomenon of premature menopause amongst Indian women.
This is increasingly becoming a source of consternation amongst the
medical community.
The data for the study
- based on the 1998-99 National Family Health Survey - drew samples
from 100,000 women in the age band of 15-50 years, across 26 states.
The study revealed that Indian women fare abysmally with regard to
their menopausal health. While the percentage of young menopausal
women was the highest in Andhra Pradesh at 31.4 per cent, Bihar
(21.7 per cent) and Karnataka (20.2 per cent) were no better. Kerala
(11.6 per cent) was a tad better while West Bengal (12.8 per cent)
and Rajasthan (13.1 per cent) were just a rung lower. Overall, the
percentage of women hit by premature menopause is marginally lower
in urban areas (16.1 per cent) as against rural (18.3 per cent).
According to T.S. Syamala of ISEC, who conducted the pan-India
research, the proportion of premature menopausal Indian women
plummets remarkably with a corresponding increase in education. This
establishes the fact that women from the lower economic strata are
more vulnerable to premature menopause than their more privileged
counterparts. Also, a higher number of illiterate women experience
premature menopause as against those who are educated. Among the
illiterate women, a substantive 20 per cent suffer from premature
menopause as against 11.1 per cent of women who hold at least a
graduate degree.
The findings of the ISEC survey, which were tabled in the Parliament
recently, also highlight that on an average nearly four per cent of
Indian women are already menopausal between the ages of 29-34 years,
one of the lowest thresholds for menopause in the world. The natural
age for menopausal onset is between 45 to 55 years with a mean age
of 51 years, worldwide. Interestingly, women who marry and have
children late have less reason to worry as they experience a delayed
onset of menopause.
Apart from being an important socio-economic pointer, doctors feel
the survey has confirmed their worst fears - that women's health is
simply not a priority in our country. "The changing dynamics of the
Indian family, the increased stress upon women to be financially
independent and the whittling down of the familial support structure
have all put tremendous physical, emotional and mental strain on our
women," observes Dr. Vidhi Chowdhury, obstetrician and gynaecologist,
Spring Meadows Hospital, New Delhi. "These pressures, coupled with
the lack of proper nutrition and education about health play havoc
with female hormones, resulting in a skewed menstrual pattern."
But what exactly is a 'skewed' menstrual pattern and how does it
impact a woman's mental and physical health? "Menopause," elaborates
Chowdhury, "is the strongest biological transitory phase in a
woman's life accompanied by volatile physical changes. The ovaries
stop producing eggs, menstrual activity ceases and the body
decreases the production of the female hormones (estrogen and
progesterone) which play a catalytic role in conditioning the body
for uniquely female functions such as pregnancy and child-bearing."
By stimulating skeletal growth, estrogen and progesterone help
maintain healthy bones, protect the heart and veins by upping the
body's 'good cholesterol' (HDL or high-density lipoprotein) and
lowering 'bad cholesterol' (LDL or low-density lipoprotein). But
with the onset of menopause, and the subsequent dip in the levels of
these hormones, a woman's overall health, including her libido, gets
impacted. The plummeting estrogen levels trigger increased blood
flow to the face, neck, chest and back thereby resulting in the
famed 'hot flushes'. Mood swings, decreased libido and vaginal
dryness are also caused by this hormone dip.
"The thinning of the vaginal wall tissues leads to vaginal dryness,"
adds Chowdhury. "In some cases, many physiological changes during
menopause may go undetected. For instance, osteoporosis (loss of
calcium in bones causing bone fragility) is often not diagnosed till
a bone fracture actually occurs. So it is advisable for menopausal
women to be in regular touch with their doctors."
In fact, most doctors advocate that menopausal health demands a
well-defined holistic approach. "Menopause should not be
misconstrued as a disease," exhorts Dr Girish Vaishnav, Head,
Department of Internal Medicine, Fortis Hospital, Noida. "After all,
it is a naturally occurring biological phenomenon whose transitory
effects can be offset by proper medical and nutritional care."
Diet can, in fact, play a crucial role in combating the emotional,
physical and mental stress of menopausal and pre-menopausal years. A
high-fibre, low fat and low-carb diet incorporating herbs, minerals
and vitamins in one's daily diet can work wonders. Advises Dr.
Anupama Shastri, consultant dietician, Max Medicare, "One should
eliminate tea, coffee, alcohol, caffeine, spicy foods and smoking
during this period. This automatically eliminates food cravings
often experienced by women during this period. Also, one ought to
keep one's weight under check as being overweight augments these
symptoms. Including soya, Vitamin E and herbal supplements in one's
diet also helps."
The correct diet, according to dieticians, also helps eliminate
quintessentially menopausal symptoms like depression, irritability,
dizziness, hair loss and changes in body temperature, better known
as hot and cold flushes. Sleep disturbances, trouble falling asleep,
or if awakened, going back to sleep can also be minimised by the
correct diet.
Focusing on lean proteins such as fish and chicken is a good idea,
recommends Shastri. "A menopausal nutrition plan usually includes
lots of vegetables, fruits, fibre and whole grains," he says. Eating
five small meals per day rather than three huge ones is recommended
as this helps keep blood sugar levels from fluctuating.
April 8,
2007
By arrangement with
WFS
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