Women undergo many physical, and hormonal changes, one of which is menopause. Menopause is a natural phenomenon that results in decreased ovarian hormonal secretion.¹ The mean age for menopause is 51 years.¹ Two factors take place because, before the permanent cessation of menstruation, perimenopause is the beginning of the postmenopausal period. Early perimenopause occurs when the neurohormonal system begins to disrupt ovulation, which includes an irregular menstrual cycle.² During perimenopause, the concentration of follicle-stimulating hormone (FSH), gonadotropins, and estrogen increases.² The rise of FSH results in a decline in the inhibin B (INH-B) which is a dimeric protein that reflects the fall in the ovarian follicle. Change in menopause includes central neuroendocrine.³ Symptoms include dysfunctional bleeding from the uterus which is termed postmenstrual transitions and around 75% of women suffer from vasomotor symptoms.^{3, 4} Menopause can also be artificially done, by removing the uterus via surgery due to complications, such as ovary cancer. These are the main female hormones, that play an important part in the female reproductive system. Symptoms that address females near menopause are-

• Hot flashes- these are sensations of warmth, skin flushing, and perspiration, these flashes vary, and they can be frequent in some females or occasionally.² Hot flashes usually start during perimenopause, studies have reported that about 58% of females develop hot flashes before their final period of menopause²
• Urinary incontinence- this phenomenon takes place during postmenopausal, in the urinary tract female sense some irritation, this happens due to thinning of the urethral mucosa and decreased level of androgenic receptors⁽²⁾. Studies reported about a 45% decrease in urinary incontinence²
• Reduced sexual function- research says that, due to vaginal atrophy, the vagina can lead to dryness, which can cause dyspareunia, resulting in reduced arousal during sex²
• Stress and depression- stress and depression get triggered by the consumption of alcohol. These factors are common in elderly women at the end of their reproductive stage and get affected due to trauma or emotional damage, altogether affecting menopause⁵

Other than symptoms other risk factors affect and trigger menopause, one of which is Alcohol.

Consumption of alcohol affects females adversely. A study states that alcohol partially affects menopause.⁶ With the increase in age, older people suffer from physical pain, stress, and many more things that lead to the consumption of alcohol for relief. Due to this, there can be adverse effects and it is termed alcohol use disorder (AUD).⁵ A study states that consumption of alcohol is more after menopause.⁵ More consumption of alcohol leads to an increase in the level of blood ethanol, which is higher in females than males, females also have different enzymatic processes compared to males, this happens because females have a lower level of alcohol dehydrogenase.⁵ The interaction of alcohol dehydrogenase with female sex hormones like FSH, leads to pre-systematic metabolism, physical body structure like lean body, and obesity are related to age, therefore in post-menstruation, females are more prone to get affected by AUD.⁵ Early menopause is noticed within the females that consume alcohol, researchers have observed oligomenorrhea, and amenorrhea among females.⁷ Moderate consumption of alcohol during this period can lead to osteoporosis, which is the weakening of the bone.⁵ During menopause, when ovaries stop producing estrogen, the rate of bone loss increases, by 3-7% every year, stating that alcohol causes bone deficiencies at an early age, and damages cartilage cells, which can be harmful in the future.⁸

Summary

Menopause occurs naturally during a certain period depending on the age (45-55). There are several stages for menopause pre-menstruation and post-menstruation which depend upon the health of the female. Menopause is controlled by the hormones (FSH, estrogen) that are produced via endocrine. Several risk factors affect the cycle of menopause like consumption of alcohol, tobacco, stress, and many more which are discussed above and lead to disturbance in the natural menopause. Consumption of alcohol causes severe bone problems, like osteoporosis in females premenstrual and post-menstrual, this can lead to weak bone density and future problems. As we say, prevention is better than cure, alcohol consumption should be prohibited as it not only damages our health but also destroys our families, and our loved ones. We must care about our people and avoid things that are harmful to us.