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During the natural course of events, a women's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. In some cases, for various reasons including medical, the ovaries stop functioning earlier, and this is medically termed early or premature menopause. Menopause that occurs before 40 years of age is termed premature menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women. If it occurs between 45 to 50 years, it is termed early menopause.
Effects: Estrogen and progesterone have a lot of beneficial effects on a women's body. Reduction in their levels leads to some of the below changes:
- Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
- Irregular cycles before complete cessation of the menstrual cycles.
- General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
- There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
- For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
- Osteoporosis - Bones lose their density and get weak and are more prone to fracture.
- Cardiovascular health - Post menopause, women are more prone to heart attacks and stroke. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
- Accelerated ageing - Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.
There is also a good news, that after menopause women are at lesser risk of cancer, especially breast and ovarian. It is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it, especially if associated with infertility or chemotherapy for cancer.
Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness. It is easier said than done, but one of the key ways to handle premature menopause is an open discussion. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
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While sexual problems are common among colorectal cancer patients, they are not necessarily caused by surgical treatment, Dutch researchers report. The patients may already have sexual issues before surgery.
Noting that there was not much information available on colorectal cancer patients? sexual function and quality of sexual life before surgery, the researchers aimed to describe these aspects for both patients and their partners. They also wanted to use standardized sexual health assessments and compare the scores of those patients and partners to mean norm scores.
To do this, they recruited 136 patients who had been diagnosed with colorectal cancer, but had not yet undergone surgical treatment. One hundred six of the patients? partners were also involved.
To measure sexual function and quality of life, the researchers used several questionnaires.
Male patients and male partners completed the International Index of Erectile Function (IIEF), which assesses erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.
All of the women were given the Female Sexual Function Index (FSFI), which is used to evaluate arousal, lubrication, orgasmic function, sexual desire, sexual pain, and intercourse satisfaction.
Participants with partners completed the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), which addresses the quality of sexual life. They were also given the Maudsley Marital Questionnaire (MMQ), which examines relationship issues.
Finally, all participants completed an adapted version of the Self-Administered Comorbidity Questionnaire, which provides data on any comorbidities.
Mean norm scores were provided in the manuals of each questionnaire.
The researchers found that when compared to mean norm scores, both male and female colorectal patients had lower scores on the sexual functioning and quality of sexual life domains on the given assessments. Female patients had lower sexual functioning and lower quality of sexual life than male patients. The partners also had lower scores in these areas when compared to mean norm scores. Male partners had lower scores than male patients.
The lower scores could be explained by stress, as there were not many differences between the scores of colon cancer patients and those with rectal cancer. Past research has shown high levels of stress in cancer patients and a link between psychological issues (such as stress, anxiety, and depression) and sexual dysfunction.
In spite of the lower scores, however, the participants? scores on relationship functioning were comparable to the corresponding mean norm scores, suggesting that the sexual issues did not seem to damage relationships.
The findings could help healthcare providers consider the sexual needs of colorectal cancer patients. ?More information provision and/or psychosexual guidance may be needed preoperatively in order to give license to couples to discuss sexual problems and to search for adequate professional support during any point in treatment, especially as the majority of patients do not take the initiative to discuss the treatment options for possible sexual dysfunction,? the authors wrote.