Symptoms you may be searching for
If any of these brought you here, you are in the right place.
- hot flashes
- body heat at 45
- night sweats
- periods stopped, is it normal
- irregular periods after 40
- joint pain after menopause
- vaginal dryness
- frequent urine or urine leaking
- mood swings and poor sleep
- bleeding after menopause
See a doctor soon
Any bleeding after menopause, meaning spotting or bleeding once you have gone 12 months without a period, needs prompt evaluation. It is often a thin lining or a polyp, but cancer of the lining of the uterus must be ruled out with a scan and, if needed, a biopsy. The same applies to a new lump in the breast. Call or WhatsApp the clinic for a same-day appointment.
What is menopause, and what is perimenopause?
Menopause is confirmed only in hindsight, after 12 months without a period. The years before it are perimenopause. Oestrogen falls unevenly. Periods change first: closer together or further apart, lighter or heavier. The same uneven hormones cause sudden waves of heat in the face and chest (hot flashes), body heat at 45 that no fan settles, night sweats, broken sleep, irritability, low mood and forgetfulness.
After menopause, low oestrogen works slowly on other tissues. The vagina becomes dry and thin, so intercourse can hurt. The bladder lining thins, so urine infections and urgency increase. Bones lose calcium faster, the heart loses the protection oestrogen gave it, and morning joint stiffness is common for a few years.
When you should see a doctor
Menopause itself does not need a doctor. These do:
- Hot flashes, night sweats or poor sleep that disturb your work or family life.
- Very heavy periods after 40, or periods that come more often than every three weeks.
- Any bleeding or spotting after 12 months without a period. Even once.
- Vaginal dryness, burning, or pain during intercourse.
- Urine leaking, passing urine often, or repeated urine infections.
- Joint or back pain, or a fracture from a small fall (possible osteoporosis).
- Periods stopping before 40.
Many women from Velachery, Nanganallur and Keelkattalai come to RV Clinic Madipakkam simply to ask whether what they feel is menopause. That is a good reason to come.
How it is diagnosed at RV Clinic
Menopause is diagnosed from your history, not a blood test. Dr. Ragavi asks about your last period, the pattern over two years, your symptoms, sleep, and any bleeding between periods.
The examination is short: blood pressure, weight, a breast check, and a pelvic examination in the separate examination room with the lady attender present. A Pap smear is taken if due; see gynaecological cancer screening and care in Chennai.
Blood sugar (HbA1c), thyroid (TSH), cholesterol and vitamin D are checked, because problems here copy menopause symptoms. A pelvic scan (transvaginal ultrasound) is done for heavy or irregular bleeding, and always for bleeding after menopause; a thick lining leads to a biopsy or hysteroscopy. A bone density scan (DEXA) is advised at 65, or earlier if you have risk factors.
A note on scans
Sex determination of the foetus is not done at RV Clinic, and no scan report here will state it. It is a punishable offence under the PCPNDT Act, 1994.
Treatment options
Treatment starts with what troubles you most. Many women need no medicine at all.
Lifestyle measures
Cut down on coffee, alcohol and very spicy food if they set off flashes. Exercise for 30 minutes most days; it helps sleep, mood, weight and bones together. Stop smoking. Eat calcium-rich food (milk, curd, ragi, sesame, greens) and get some sunlight for vitamin D.
Non-hormonal medicines
Certain low-dose antidepressant-class tablets, gabapentin and clonidine reduce hot flashes and improve sleep for women who cannot or do not want to take hormones. Calcium and vitamin D supplements are given when needed. If DEXA shows osteoporosis, bone-strengthening tablets are started.
Menopausal hormone therapy (MHT, also called HRT)
This replaces the oestrogen your ovaries have stopped making, with progesterone added if you still have a uterus. It is the most effective treatment for flashes and dryness, and it protects bones. It suits healthy women under 60, or within ten years of menopause, whose symptoms affect their life. It is usually not given after breast cancer, a blood clot, a stroke, unexplained vaginal bleeding or active liver disease. It is started at the lowest dose that works and reviewed every year. Women with premature menopause are advised to continue it until about 50.
Local oestrogen cream
For dryness, pain during intercourse and repeated urine infections, a little oestrogen cream or a pessary in the vagina works well. Very little is absorbed, so it suits most women who cannot take tablets.
Heavy bleeding in perimenopause is treated with progesterone tablets or a hormonal IUD; a hysterectomy (uterus removal) is discussed only when fibroids or a thick lining do not respond. For urine leaking and prolapse, see urine leakage and prolapse treatment in Chennai.
Where treatment happens
Consultation, examination, scans and follow-up happen at RV Clinic Madipakkam or RV Clinic Thalambur, whichever is closer to you. Menopause care rarely needs an operation. If a hysteroscopy, biopsy or hysterectomy is needed, it is done by Dr. Ragavi herself at Unittas Multispeciality Hospital, which is 21 km from the Madipakkam clinic and 5 km from the Thalambur clinic. RV Clinic is an outpatient clinic. No operation is done at either clinic address. Thalambur, off OMR, has evening hours.
What to expect at your appointment
- Book by call or WhatsApp and say it is for menopause symptoms. Bring recent period dates, old reports and your tablets.
- A full history first: periods, symptoms, sleep, mood, bladder and intercourse.
- Blood pressure, weight, a breast check and a pelvic examination, with the lady attender present.
- Blood tests and a scan only if they will change the plan.
- You leave with a written plan and a review date, usually after three months.
Frequently asked questions
My periods stopped at 45. Is that normal?
Yes. Menopause between 45 and 50 is the usual range in India. What matters is that there is no bleeding afterwards and that your symptoms are manageable.
Is hormone therapy safe?
For healthy women under 60 with troublesome symptoms, the benefits usually outweigh the small risks. Breast cancer and clot risk rise a little with longer use, so it is reviewed every year. Women with breast cancer, clots, stroke or unexplained bleeding should not take it.
Period nindru oru varusham aachu, ippo thirumba bleeding varudhu. Idhu normal-a?
Illai. Bleeding after 12 months without periods is never treated as normal, even spotting. Usually it is a thin lining or a polyp, but the lining must be checked with a scan and sometimes a biopsy. Book a same-day appointment.
Udambu romba soodu-a irukku, 45 vayasu. Menopause thaan-a?
Very likely, if your periods have started changing too. Thyroid problems and diabetes cause similar symptoms, so a few blood tests are checked before treatment starts.
Do I need a DEXA scan?
Not routinely. It is advised at 65, or earlier if you had early menopause, are very thin, take steroids, or a parent broke a hip. It is done at a diagnostic centre.
Can I still get pregnant during perimenopause?
Yes, until you have gone 12 months without a period (two years if under 50). Keep using contraception until then; see contraception and family planning advice.
Book a consultation
Hot flashes, dryness, bleeding after your periods stopped, or a question about hormone therapy: call or WhatsApp RV Clinic for a menopause consultation. Most patients get an appointment the same day.