She lies awake at night. The next morning, she struggles to concentrate at work, snaps at loved ones over things that never bothered her before, or wonders why her own body suddenly feels unfamiliar.For some women, menopause arrives quietly; for others, it brings a wave of physical and emotional changes that can leave them exhausted, anxious and searching for answers.And often, the hardest part is not just dealing with the symptoms, but getting someone to take them seriously.Menopause is a natural biological transition, but the symptoms can be disruptive enough to affect everyday life. While some women dismiss them as stress or ageing, others find their concerns brushed aside or are unsure where to turn for help. Despite growing conversations around women’s health, gaps in awareness, medical guidance and access to appropriate treatment continue to shape their experiences.A quantitative descriptive survey involving 150 women from urban areas assessed the impact of menopausal symptoms on quality of life. The study, published in the Indian Journal of Preventive & Social Medicine, was authored by Somibala Thokchom and David Ratna Paul Talagathoti.Participants aged 40 to 55 years completed the 11-item Menopause Rating Scale (MRS) to assess their symptoms and a modified 32-item Menopause-Specific Quality of Life Questionnaire (MENQOL) to evaluate how menopause affected their daily lives.The study found that 58.7% of participants were aged 40–45 years, while 75.3% had already experienced menopause. Overall, 92% reported moderate to severe symptoms, 4.7% experienced mild symptoms and 3.3% reported very severe symptoms. Nearly all participants (99.3%) reported changes in their daily routines.
Menopause can bring a range of physical, emotional and urogenital symptoms, affecting women’s sleep, mood and everyday lives.
Although the findings cannot be generalised to all Indian women, given the small, urban sample, they highlight the potential impact of menopause on everyday life.The question is not simply how women experience menopause, but why so many may struggle to recognise their symptoms, seek medical advice or access appropriate care.
When menopause symptoms are dismissed as ‘just ageing’
Many women continue to experience menopause symptoms without seeking medical help, often assuming that fatigue, anxiety, disturbed sleep and mood changes are an inevitable part of ageing.Doctors say this can delay assessment and treatment, particularly when women prioritise family and work responsibilities over their own health.“Menopause is a natural condition, but that does not necessarily imply that symptoms cannot be treated,” said Dr Mitul Gupta, senior consultant, obstetrics and gynaecology, Cocoon Hospital, Jaipur.Dr Gupta cautioned against attributing symptoms to ageing without proper examination. Fatigue, irritability and poor concentration can also occur with conditions such as thyroid disorders, anaemia, sleep disorders and anxiety, making a detailed medical assessment important.Maya, a Uttar Pradesh native who now lives in Delhi, said, “I started experiencing menopause when I was 51. I did face difficulties, but back then, we didn’t really talk about these things at home. I used to feel hesitant.”“I thought it was just a normal part of aging, and no one in my family really knew what I was going through. Even today, many families are unaware of what women experience during menopause, and often, women end up dealing with it on their own,” she adds.Menopause care extends beyond irregular periods and hot flashes. Hormonal changes can affect sleep, mood and sexual health, while the menopausal transition is also an important time to discuss longer-term health concerns, including bone health.
Treatment options for menopause range from hormone therapy and non-hormonal medicines to lifestyle changes
A systematic review titled Menopause Symptoms Experienced by Women in India, examined 23 studies reporting symptoms among menopausal women in India. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included eligibility criteria, a literature search, screening and data extraction.The review found that somatic symptoms were the most frequently reported category, with an average of 73.66% across the studies. Joint and muscular pain and fatigue were the most commonly reported complaints, followed by hot flashes.Psychological symptoms were reported in an average of 63.03% of women in the studies assessing this category. Eighteen studies reported psychosomatic symptoms, while five did not report psychological symptoms.Urogenital symptoms were reported in 13 studies, with an average prevalence of 51.40%. Ten studies did not report symptoms in this category. Although urogenital symptoms were the least frequently reported, the review noted that women who experienced them reported greater symptom intensity.The findings highlight the range of symptoms associated with menopause and the importance of recognising them rather than dismissing them as an unavoidable consequence of ageing. The percentages are averages reported across the reviewed studies and should not be interpreted as prevalence estimates for all Indian women.
The doctor’s dilemma: recognising symptoms, choosing treatment
Menopause symptoms can vary considerably from one woman to another, making individual assessment essential before deciding on treatment.Hormone replacement therapy (HRT) can help women experiencing troublesome symptoms, including hot flashes and night sweats, but it is not suitable for everyone. Decisions about treatment must take into account an individual’s symptoms, medical history, age, time since menopause and potential risks.“HRT is neither universally dangerous nor suitable for everyone. The right treatment is the one that is carefully chosen according to your individual needs, with proper medical guidance and regular follow-up,” said Dr Bharti Soy, consultant, obstetrics and gynaecology, Fortis O.P. Jindal Hospital & Research Centre.Doctors emphasise that consultations should cover the potential benefits and risks of hormone therapy, as well as non-hormonal alternatives where appropriate. Women should be able to discuss their concerns and make informed decisions with their healthcare providers.Symptoms should not automatically be attributed to menopause, as other medical conditions may require separate investigation and treatment. A thorough consultation can help distinguish between menopause-related changes and other possible causes, allowing care to be tailored to the individual’s needs.
Is India’s healthcare system prepared for menopause?
Awareness alone may not be enough if women cannot access appropriate and affordable care. Gaps in menopause-specific knowledge, counselling and healthcare access can leave women without adequate guidance on managing their symptoms.The challenge is not limited to the availability of gynaecologists, but also whether consultations address menopause-related concerns beyond menstrual changes. Symptoms affecting sleep, mood, sexual wellbeing and bone health may require a broader discussion of a woman’s physical and emotional health.
Treatments available in India
“Women need a complete evaluation not a consultation for the issues related to menstruation,” said Dr Priyanka Sharma, senior consultant, obstetrics and gynaecology, Cocoon Hospital, Chandigarh.Barriers such as the cost of travel, time away from work, lack of awareness and limited access to healthcare facilities can make seeking care more difficult. Strengthening primary-level assessment, training healthcare workers and establishing referral pathways could help women receive appropriate support.Education in local languages and more affordable treatment options are also important to ensure that women can understand their symptoms, discuss available choices and access care when needed.Making menopause a routine part of women’s healthcare could help shift the focus from simply enduring symptoms to identifying and managing them appropriately.
How social stigma plays a role
Medical care is only part of the picture. Family attitudes and social expectations can influence whether women feel comfortable discussing menopause or seeking help.“In many Indian households, menopause is still not discussed openly because of social stigma, lack of awareness, and the belief that it is simply a natural process. As a result, many women suffer silently rather than seeking medical help,” said Dr Bharti Soy.When symptoms such as disturbed sleep, irritability or discomfort are dismissed as inevitable consequences of growing older, women may begin to question whether their concerns deserve medical attention.
Dr Soy talks to TOI
“If relatives tell her that discomfort, irritability or sleep problems are simply part of growing older, she may question whether her concerns deserve medical attention,” said Dr Swati Sinha, senior consultant, obstetrics and gynaecology, Rosewalk by Rainbow Hospitals.Families can help by making menopause a subject that can be discussed without embarrassment or judgement. Listening without dismissing symptoms, offering practical support and encouraging medical consultations when problems affect daily life can make the transition easier to navigate.
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Partners, children and other family members need not have all the answers. Understanding that menopause affects women differently, and that help is available when symptoms become disruptive, is an important first step.Menopause may be a natural stage of life, but that does not mean women should have to endure its more difficult symptoms without support. Better awareness, informed medical consultations, accessible treatment and understanding families can help ensure that women are heard and their concerns taken seriously.
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