Reasons for Early Menopause

Reasons for Early Menopause

Menopause begins earlier for some people, and Hormone replacement therapy can be helpful if this happens. People who experience the transition early may:

1. have had surgery to remove the uterus, ovaries, or both
2. have some types of cancer
3. have certain genetic or chromosomal factors
4. have certain autoimmune diseases
5. smoke

Sometimes, the transition starts early for no clear reason. Anyone who is scheduled to undergo surgery or another treatment that will affect their reproductive system should ask about the likelihood of experiencing early menopause. A doctor can describe the range of treatments available, should a person need them.

What is Early Menopause?
Early menopause happens when a woman's periods stop before the age of 45. It can happen naturally, or as a side effect of some treatments.
For most women, the menopause starts between the ages of 45 and 55.

Causes of early menopause
 Genetics-If there’s no obvious medical reason for early menopause, the cause is likely genetic. Age at menopause onset is likely inherited. Knowing when your mother started menopause can provide clues about when you’ll start your own. If your mother started menopause early, you’re more likely than average to do the same. However, genes tell only half the story.
 Lifestyle factors- Some lifestyle factors may have an impact on when you begin menopause. Smoking has anti-estrogen effects that can contribute to early menopause.
 Body mass index (BMI) can also factor into early menopause. Estrogen is stored in fat tissue. Women who are very thin have fewer estrogen stores, which can be depleted sooner.
 The ovaries stop working- Early menopause can happen naturally if a woman's ovaries stop making normal levels of certain hormones, particularly the hormone oestrogen. This is sometimes called premature ovarian failure, or primary ovarian insufficiency.

The cause of premature ovarian failure is often unknown, but in some women it may be caused by:
• chromosome abnormalities – such as in women with Turner syndrome
• an autoimmune disease – where the immune system starts attacking body tissues
• certain infections, such as tuberculosis, malaria and mumps – but this is very rare

Premature ovarian failure can sometimes run in families. This might be the case if any of your relatives went through the menopause at a very young age (20s or early 30s).
 Cancer treatments- Radiotherapy and chemotherapy can cause premature ovarian failure. This may be permanent or temporary.

Risk of having an early menopause will depend on:
• Age – girls who have not yet reached puberty can tolerate stronger treatment than older women
• the type of treatment given – different types of chemotherapy may affect the ovaries differently
• where on body any radiotherapy is focused – your risk of developing premature menopause is higher if you have radiotherapy treatment around brain or pelvis

 Surgery to remove the ovaries- Surgically removing both ovaries will also bring on premature or early menopause. For example, the ovaries may need to be removed during a hysterectomy (an operation to remove the womb).
 Autoimmune diseases- Early menopause can be a symptom of an autoimmune disease such as thyroid disease and rheumatoid arthritis.
In autoimmune diseases, the immune system mistakes a part of the body for an invader and attacks it. Inflammation caused by some of these diseases can affect the ovaries. Menopause begins when the ovaries stop working.
 Epilepsy- Epilepsy is a seizure disorder that stems from the brain. Women with epilepsy are more likely to experience premature ovarian failure, which leads to menopause.

What are symptoms of early menopause?
Early menopause can begin as soon as you start having irregular periods or periods that are noticeably longer or shorter than your normal.

Other symptoms of early menopause include:
• heavy bleeding
• spotting
• periods that last longer than a week
• longer amount of time in between periods
In these cases, see your doctor to check for any other issues that might be causing these symptoms.

Other common symptoms of menopause include:
• mood swings
• changes in sexual feelings or desire
• vaginal dryness
• trouble sleeping
• hot flashes
• night sweats
• loss of bladder control
• Urinary urgency (a pressing need to urinate more frequently)
• More urinary tract infections (or symptoms without an infection)
• Difficulty sleeping (insomnia)
• Emotional changes (irritability, mood swings, mild depression, worsening anxiety)
• Dry skin, dry eyes or dry mouth
• Breast tenderness
• Racing heart
• Headaches
• Joint and muscle aches and pains
• Changes in libido (sex drive)
• Difficulty concentrating, memory lapses (often temporary)
• Weight gain
• Hair loss or thinning

How is early menopause diagnosed?
The time leading into menopause is called perimenopause. During this time, you may have irregular periods and other symptoms that come and go.
You’re generally considered to be in menopause if you go 12 months without menstrual bleeding, and you don’t have another medical condition to explain your symptoms.
Tests aren’t usually needed to diagnose menopause. Most women can self-diagnose menopause based on their symptoms. But if you think you’re experiencing early menopause, you may want to see your doctor to be sure.

Your doctor can order hormone tests to help determine whether your symptoms are due to perimenopause or another condition. These are the most common hormones to check:
• Anti-Mullerian hormone (AMH). The PicoAMH Elisa testTrusted Source uses this hormone to help determine whether you’re approaching menopause or have already reached your last menstrual cycle.
• Estrogen. Your doctor may check your levels of estrogen, also called estradiol. In menopause, estrogen levels decrease.
• Follicle-stimulating hormone (FSH). If your FSH levels are consistently above 30 mIU/mL, and you haven’t menstruated for a year, it’s likely that you’ve reached menopause. However, a single elevated FSH test can’t confirm menopause on its own.
• Thyroid-stimulating hormone (TSH). Your doctor may check your levels of TSH to confirm diagnosis. If you have an underactive thyroid (hypothyroidism), you’ll have TSH levels that are too high. Symptoms of the condition are similar to the symptoms of menopause.

How is early menopause treated or managed?
• Early menopause generally doesn’t require treatment. However, there are treatment options available to help manage the symptoms of menopause or conditions related to it. They can help you deal with changes in your body or lifestyle more easily.
• Premature menopause, however, is often treated since it occurs at such an early age. This helps support your body with the hormones that would normally be made until you reach the age of natural menopause.
• The most common treatment includes hormone replacement therapy (HRT). Systemic hormone therapy can prevent many common menopausal symptoms. Or you may take vaginal hormone products, usually in low doses, to help with vaginal symptoms.
• HRT does have risks though. It can increase your chances of heart disease, stroke, or breast cancer.
• Talk to your doctor about the risks and benefits to your individual care before starting HRT. Lower doses of hormones may decrease your risk.

Complications of early menopause
Infertility is often the most obvious concern when you start menopause 10 or more years early. Yet, there are other health concerns.
A steady stream of estrogen to your tissues has many uses. Estrogen increases “good” HDL cholesterol and decreases “bad” LDL cholesterol. It also relaxes blood vessels and prevents bones from thinning.

Losing estrogen earlier than normal can increase your risk of:
• heart disease
• osteoporosis
• depression
• dementia
• premature death
• Various neurological diseases (including an increased risk of dementia).
• Sexual dysfunction
• Heart disease
• Mood disorders

Easing the transition to early menopause
A genetic test may one day determine a person’s likelihood of early menopause. For now, though, only time will tell when you’ll start your transition.
See your doctor for regular checkups, and be proactive about your reproductive health. Doing so can help your doctor ease the symptoms or decrease your risk factors for early menopause.
Seeing a therapist can also help you cope with any pain or anxiety you may feel during menopause.
Fertility and your options

If you’re interested in having children, you still have a few options for growing your family. These include:
• adoption
• receiving an egg donation
• having a surrogate carry your child
A fertility specialist may also suggest procedures that can help you have children. Talk to your doctor about the options available to you for becoming a mother. Its risks and successes can be affected by many factors, including your age and overall health.

Menopause

Menopause begins 12 months after a person’s last period. On average, this occurs at the age of 52 in the United States. After menopause, it is no longer possible to become pregnant without medical assistance. Everyone experiences menopause differently, but hot flashes, mood changes, and other symptoms are common.

A trusted journal published in 2015 suggests that in more than half of females, vasomotor symptoms, such as hot flashes:

1. last for more than 7 years
2. start before the final monthly period
3. continue for an average of 4.5 years after menstruation ends

During this time, HRT can help manage the symptoms.

What is hormone replacement therapy?

Due to hectic lifestyle, women face Early Menopause. We tried to find Reasons for Early Menopause and Solutions either. It replaces hormones that are at a lower level as you approach the menopause.

Hormone therapy (HT) involves the administration of synthetic estrogen and progestogen to replace a woman's depleting hormone levels and thus alleviate menopausal symptoms. However, HT has been linked to various risks; debate regarding its risk-benefit ratio continues.

Though both can have symptomatic benefits, progestogen is specifically added to estrogen regimens when the uterus is still present. Unopposed estrogen therapy promotes endometrial thickening and can increase the risk of cancer, while progestogen reduces this risk. Androgens like testosterone are sometimes used as well. HRT is available through a variety of different routes.

However, there are risks associated with using hormone therapy. These risks depend on the type of hormone therapy, the dose, how long the medication is taken and your individual health risks. For best results, hormone therapy should be tailored to each person and reevaluated every so often to be sure the benefits still outweigh the risks.

hormone replacement therapy

Benefits of Hormone replacement therapy

The main benefit of HRT is that it can help relieve most of the menopausal symptoms, such as:

• Hot flashes
• Night sweats
• Mood swings
• Vaginal dryness
• Reduced sex drive

Many of these symptoms pass after a few years, but they can be unpleasant and taking HRT can offer relief for many women. It can also help prevent weakening of the bones (osteoporosis), which is more common after the menopause.

Perimenopause
Levels of estrogen and progesterone start to fall when most females are in their 40s, but menstruation will continue for some time. Periods may become less regular, and hot flashes and other menopause symptoms may start to appear during this time. While menstruation continues, it is possible to become pregnant, although the chances reduce with time. Perimenopause, or the lead-up to menopause, usually lasts for around 7 years, but it can occur for up to 14 years, according to the National Institute on Aging.

Who can undergo Hormone replacement therapy?

Most women can have HRT if they're having symptoms associated with the menopause. But HRT may not be suitable if you:

• Have a history of breast cancer, ovarian cancer or womb cancer
• Have a history of blood clots
• Have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
• Have liver disease
• Are pregnant – it's still possible to get pregnant while taking HRT, so you should use contraception until 2 years after your last period if you're under 50, or for 1 year after the age of 50

In these circumstances, alternatives to HRT may be recommended instead.

Types of Hormone replacement therapy

There are many different types of Hormone replacement therapy and finding the right 1 for you can be difficult. There are different:

• HRT hormones – most women take a combination of the hormones- estrogen and progestogen, although women who do not have a womb can take estrogen on its own

• Ways of taking HRT – including tablets, skin patches, gels and vaginal creams, pessaries or rings

• HRT treatment plans – Hormone replacement therapy medicine may be taken without stopping, or used in cycles where you take estrogen without stopping but only take progestogen every few weeks

A General Practitioner can give you advice to help you choose which type is best for you. You may need to try more than 1 type before you find 1 that works best.

Side effects of HRT

As with any medicine, HRT can cause side effects. But these will usually pass within 3 months of starting treatment. Common side effects include:

• Breast tenderness
• Headaches
• Feeling sick
• Indigestion
• Abdominal (tummy) pain
• Vaginal bleeding

In the largest clinical trial to date, hormone replacement therapy that consisted of an estrogen-progestin pill (Prempro) increased the risk of certain serious conditions, including:

1. Heart disease
2. Stroke
3. Blood clots
4. Breast cancer

Subsequent studies have suggested that these risks vary depending on:

Age: Women who begin hormone therapy at age 60 or older or more than 10 years from the onset of menopause are at greater risk of the above conditions. But if hormone therapy is started before the age of 60 or within 10 years of menopause, the benefits appear to outweigh the risks.

Type of hormone therapy: The risks of hormone therapy vary depending on whether estrogen is given alone or with progestin, and on the dose and type of estrogen.

Health history: Your family history and your personal medical history and risk of cancer, heart disease, stroke, blood clots, liver disease and osteoporosis are important factors in determining whether hormone replacement therapy is appropriate for you.
All of these risks should be considered by you and your doctor when deciding whether hormone therapy might be an option for you.

hormone replacement treatment

How to stop HRT?

There's no limit on how long you can take HRT, but talk to a General Practitioner about how long they recommend you take the treatment. Most women stop taking it once their menopausal symptoms pass, which is usually after a few years. Women who take HRT for more than 1 year have a higher risk of breast cancer than women who never use HRT. The risk is linked to all types of HRT except vaginal estrogen.

The increased risk of breast cancer falls after you stop taking HRT, but some increased risk remains for more than 10 years compared to women who have never used HRT. When you decide to stop, you can choose to do so suddenly or gradually.

Gradually decreasing your HRT dose is usually recommended because it's less likely to cause your symptoms to come back in the short term. Contact a GP if you have symptoms that persist for several months after you stop HRT, or if you have particularly severe symptoms. You may need to start HRT again.

Contraindications of HRT

The following are absolute and relative contraindications to HRT:

Absolute contraindications:

• Undiagnosed vaginal bleeding
• Severe liver disease
• Pregnancy
• Severe coronary artery disease
• Aggressive breast, uterine or ovarian cancer

Relative contraindications:

• Migraine headaches
• History of breast cancer
• History of ovarian cancer
• Venous thrombosis
• History of uterine fibroids
• Atypical ductal hyperplasia of the breast
• Active gallbladder disease (cholangitis, cholecystitis)
• Well-differentiated and early endometrial cancer - once treatment for the malignancy is complete, is no longer an absolute contraindication.

Alternatives to HRT

If you're unable to take HRT or decide not to, you may want to consider alternative ways of controlling your menopausal symptoms. Alternatives to HRT include:

• Lifestyle measures: such as exercising regularly, eating a healthy diet, cutting down on coffee, alcohol and spicy foods, and stopping smoking

• Tibolone: a medicine that's similar to combined HRT (estrogen and progestogen), but may not be as effective and is only suitable for women who had their last period more than 1 year ago

• Antidepressants:some antidepressants can help with hot flushes and night sweats, although they can also cause unpleasant side effects such as agitation and dizziness

• Clonidine: a non-hormonal medicine that may help reduce hot flushes and night sweats in some women, although any benefits are likely to be small

Several remedies (such as bioidentical hormones) are claimed to help with menopausal symptoms, but these are not recommended because it's not clear how safe and effective they are. Bioidentical hormones are not the same as body identical hormones. Body identical hormones, or micronized progesterone, can be prescribed to treat menopausal symptoms.




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हार्मोन रिप्लेसमेंट थेरेपी क्या है?

हार्मोन रिप्लेसमेंट थेरेपी (एचआरटी), जिसे रजोनिवृत्ति हार्मोन थेरेपी या पोस्टमेनोपॉज़ल हार्मोन थेरेपी के रूप में भी जाना जाता है, हार्मोन थेरेपी का एक रूप है जो महिला रजोनिवृत्तिसे जुड़े लक्षणों के इलाज के लिए उपयोग किया जाता है। यह हार्मोन की जगह है कि एक निचले स्तर पर है के रूप में आप रजोनिवृत्ति दृष्टिकोण ।

हार्मोन थेरेपी (एचटी) में एक महिला के घटते हार्मोन के स्तर को बदलने और इस प्रकार रजोनिवृत्ति के लक्षणों को कम करने के लिए सिंथेटिक एस्ट्रोजन और प्रोजेस्टोजन का प्रशासन शामिल है। हालांकि, एचटी को विभिन्न जोखिमों से जोड़ा गया है; इसके जोखिम-लाभ अनुपात के बारे में बहस जारी है ।

हार्मोन रिप्लेसमेंट थेरेपी

हालांकि दोनों रोगसूचक लाभ हो सकता है, प्रोजेस्टोजन विशेष रूप से एस्ट्रोजन आहार के लिए जोड़ा जाता है जब गर्भाशय अभी भी मौजूद है । अनविरोधी एस्ट्रोजन थेरेपी एंडोमेट्रियल गाढ़ा होने को बढ़ावा देती है और कैंसर के खतरे को बढ़ा सकती है, जबकि प्रोजेस्टोजेन इस जोखिम को कम करता है। टेस्टोस्टेरोन जैसे एंड्रोजन का उपयोग कभी-कभी भी किया जाता है। एचआरटी विभिन्न मार्गोंके माध्यम से उपलब्ध है।

एचआरटी के लाभ

एचआरटी का मुख्य लाभ यह है कि यह रजोनिवृत्तिके अधिकांश लक्षणों को दूर करने में मदद कर सकताहै, जैसे:

• गर्म फ्लश
• रात पसीना
• मिजाज
• योनि सूखापन
• कम सेक्स ड्राइव

इनमें से कई लक्षण कुछ वर्षों के बाद गुजरते हैं, लेकिन वे अप्रिय हो सकते हैं और एचआरटी लेना कई महिलाओं के लिए राहत प्रदान कर सकता है। यह हड्डियों (ऑस्टियोपोरोसिस)को कमजोर होने से रोकने में भी मदद करसकता है, जो रजोनिवृत्ति के बाद अधिक आम है।

एचआरटी से कौन गुजर सकता है?

अधिकांश महिलाओं को एचआरटी हो सकता है अगर वे रजोनिवृत्ति के साथ जुड़े लक्षण हो रहे हैं । लेकिन एचआरटी उपयुक्त नहीं हो सकता है यदि आप:

• स्तनकैंसर, अंडाशय के कैंसर या गर्भ के कैंसर का इतिहास है
• रक्त के थक्के का इतिहास है
• अनुपचारित उच्च रक्तचाप है - एचआरटी शुरू करने से पहले आपके रक्तचाप को नियंत्रित करने की आवश्यकता होगी
• जिगर की बीमारी है
• गर्भवती हैं - एचआरटी लेते समय गर्भवती होना अभी भी संभव है, इसलिए आपको अपनी अंतिम अवधि के 2 साल बाद तक गर्भनिरोधक का उपयोग करना चाहिए यदि आप 50 से कम उम्र में हैं, या 50 की उम्र के बाद 1 वर्ष के लिए

इन परिस्थितियों में, इसके बजाय एचआरटी के विकल्पों की सिफारिश की जा सकती है।

एचआरटी के प्रकार

एचआरटी के कई अलग-अलग प्रकार हैं और आपके लिए सही 1 ढूंढना मुश्किल हो सकता है। अलग-अलग हैं:

• एचआरटी हार्मोन - ज्यादातर महिलाएं हार्मोन का संयोजन लेती हैं- एस्ट्रोजन और प्रोजेस्टोजन, हालांकि जिन महिलाओं के गर्भ में गर्भ नहीं होता है, वे अपने दम पर एस्ट्रोजन ले सकती हैं

• एचआरटी लेने के तरीके - टैबलेट, त्वचा पैच, जैल और योनि क्रीम, पेसरी या छल्ले सहित

• एचआरटी उपचार योजनाएं - एचआरटी दवा को बिना रुके लिया जा सकता है, या चक्र में उपयोग किया जा सकता है जहां आप बिना रुके एस्ट्रोजन लेते हैं लेकिन केवल हर कुछ हफ्तों में प्रोजेस्टोजन लेते हैं

एक जीपी आपको यह चुनने में मदद करने के लिए सलाह दे सकता है कि कौन सा प्रकार आपके लिए सबसे अच्छा है। सबसे अच्छा काम करने वाले 1 को खोजने से पहले आपको 1 प्रकार से अधिक की कोशिश करने की आवश्यकता हो सकती है।

एचआरटी के साइड इफेक्ट्स

किसी भी दवा के साथ के रूप में, एचआरटी साइड इफेक्ट पैदा कर सकता है। लेकिन ये आमतौर पर उपचार शुरू करने के 3 महीने के भीतर पारित हो जाएगा। सामान्य दुष्प्रभावों में शामिल हैं:

• स्तन कोमलता
• सिर दर्द
• बीमार महसूस करना
• अपच
• पेट (पेट) दर्द
• योनि रक्तस्राव

हार्मोन रिप्लेसमेंट उपचार

एचआरटी को कैसे रोकें?

एचआरटी कितनी देर तक ले जा सकते हैं, इसकी कोई सीमा नहीं है, लेकिन एक जीपी से बात करें कि वे आपको उपचार लेने की सलाह कितनी देर तक करते हैं। ज्यादातर महिलाएं अपने रजोनिवृत्ति के लक्षणों के गुजरने के बाद इसे लेना बंद कर देती हैं, जो आमतौर पर कुछ वर्षों के बाद होती है। जो महिलाएं 1 साल से ज्यादा समय तक एचआरटी लेती हैं, उनमें कभी एचआरटी का इस्तेमाल नहीं करने वाली महिलाओं की तुलना में ब्रेस्ट कैंसर का खतरा ज्यादा होता है। यह जोखिम योनि एस्ट्रोजन को छोड़कर सभी प्रकार के एचआरटी से जुड़ा हुआ है।

एचआरटी लेना बंद करने के बाद ब्रेस्ट कैंसर का बढ़ा खतरा, लेकिन कुछ बढ़ा खतरा उन महिलाओं की तुलना में 10 साल से ज्यादा समय तक रहता है जिन्होंने कभी एचआरटी का इस्तेमाल नहीं किया है । जब आप रोकने का फैसला करते हैं, तो आप ऐसा अचानक या धीरे-धीरे करने के लिए चुन सकते हैं।

धीरे-धीरे अपनी एचआरटी खुराक को कम करने की सिफारिश की जाती है क्योंकि अल्पावधि में आपके लक्षणों के वापस आने की संभावना कम होती है। यदि आपके पास ऐसे लक्षण हैं जो एचआरटी बंद करने के बाद कई महीनों तक बने रहते हैं, या यदि आपके पास विशेष रूप से गंभीर लक्षण हैं। आपको फिर से एचआरटी शुरू करने की आवश्यकता हो सकती है।

एचआरटी के मतभेद

निम्नलिखित एचआरटी के लिए पूर्ण और सापेक्ष मतभेद हैं:

पूर्णमतभेद:

• अनिदान योनि रक्तस्राव
• जिगर की गंभीर बीमारी
• गर्भावस्था
• गंभीर कोरोनरी धमनी रोग
• आक्रामक स्तन, गर्भाशय या अंडाशय का कैंसर

सापेक्षमतभेद:

• माइग्रेन सिर दर्द
• स्तन कैंसर का इतिहास
• अंडाशय के कैंसर का इतिहास
• वेनस थ्रोम्बोसिस
• गर्भाशय फाइब्रॉएड का इतिहास
• स्तन के असामान्य डक्टल हाइपरप्लासिया
• सक्रिय पित्ताशय की थैली रोग(कोलंगाइटिस, कोलेसिस्टिटिस)
• अच्छी तरह से विभेदित और प्रारंभिक एंडोमेट्रियल कैंसर - एक बार द्रोह के लिए उपचार पूरा हो गया है, अब एक पूर्ण मतभेद नहीं है।

एचआरटी के लिए विकल्प

यदि आप एचआरटी लेने में असमर्थ हैं या नहीं करने का निर्णय ले सकते हैं, तो आप अपने रजोनिवृत्ति लक्षणों को नियंत्रित करने के वैकल्पिक तरीकों पर विचार करना चाह सकते हैं। एचआरटी के विकल्प में शामिल हैं:

• जीवनशैली के उपाय। जैसे नियमित रूप से व्यायाम करना, स्वस्थ आहारखाना, कॉफी, शराब और मसालेदार खाद्य पदार्थों कोकाटना, और धूम्रपान रोकना

• टिबोलोन - एक दवा जो संयुक्त एचआरटी (एस्ट्रोजन और प्रोजेस्टोजेन) के समान है, लेकिन प्रभावी नहीं हो सकती है और केवल उन महिलाओं के लिए उपयुक्त है जिनकी अंतिम अवधि 1 साल पहले से अधिक थी

• अवसादरोधी दवाएं - कुछ अवसादरोधी दवाएं गर्म फ्लश और रात के पसीने के साथ मदद कर सकती हैं, हालांकि वे आंदोलन और चक्कर आने जैसे अप्रिय दुष्प्रभाव भी पैदा कर सकते हैं

• क्लोनिडीन - एक गैर हार्मोनल दवा जो कुछ महिलाओं में गर्म फ्लश और रात के पसीने को कम करने में मदद कर सकती है, हालांकि कोई भी लाभ छोटे होने की संभावना है

कई उपचार (जैसे बायोसमान हार्मोन) रजोनिवृत्ति के लक्षणों में मदद करने का दावा किया जाता है, लेकिन इनकी सिफारिश नहीं की जाती है क्योंकि यह स्पष्ट नहीं है कि वे कितने सुरक्षित और प्रभावी हैं। बायोसिडेंटिकल हार्मोन शरीर के समान हार्मोन के समान नहीं होते हैं। रजोनिवृत्ति के लक्षणों के इलाज के लिए शरीर के समान हार्मोन, या माइक्रोनाइज्ड प्रोजेस्टेरोन निर्धारित किए जा सकते हैं।




उपर ब्लॉग में बताई गई उपलब्धिया Neugracia के साथ उपलब्ध हैं
सभी महिलाएं अपने जीवन में रजोनिवृत्ति से गुजरती हैं, यह बोलने, एकजुट होने और जागरूकता पैदा करने का समय है, यह सुनिश्चित करते हुए कि वे जानते हैं कि वे इसमें अकेले नहीं हैं। अपनी रजोनिवृत्ति की कहानी साझा करें और अन्य महिलाओं को साहस दें कि उनका जीवन भी कभी नहीं रुकेगा। Nutralogicx: Neugracia