Menopause is a condition that marks the end of the menstrual cycle. It is a normal phenomenon that women experience with age. Menopause affects the bone health adversely. Bone health is directly tied to oestrogen, the hormone responsible for reproductive cycles, pain sensitivity. As a woman moves out of her fertile years there is an internal change in the reproductive system and the consequences can be seen and felt all over the body, including the bones.

The years just preceding menopause, with their hormonal fluctuations can set the stage for later health issues like bone weakening. As the oestrogen level drops, the bone density starts to decline which continues for a long period of time. The bone loss can become significant during perimenopause (the decades making up to menopause) and will speed up in the first few years of menopause.

The oestrogen level directly affects the process known as bone remodelling; the constant breakdown and the remodelling of the bone in the skeleton. With less oestrogen in the body cells called osteoclasts are able to absorb bone at a faster rate than osteoblasts (bone-building cells) are able to regenerate new bone. Thus the bone remodelling equation is no longer equal and the bone density continues to decline.

The osteoporosis risk after menopause is a serious one, yet so many women refuse to pay it much attention. Perhaps it s because the bone damage isn t visible, or that bone loss continues so gradually for so many years. While the bone loss cannot be completely halted, there is plenty that can be done to slow it down. Here are some ways to take care of your bone health before or after menopause.

Stay active: Adopting an active lifestyle after menopause helps in protecting the bones. It's recommended that adults between 19 to 64 years of age should do moderate to intense activity. This could include activities such as cycling or brisk walking. Sitting for long hours should be avoided. Weight-bearing exercises and resistance exercises are particularly important for improving bone strength and helping to prevent osteoporosis.
A balanced healthy diet: A healthy, balanced diet that includes calcium and vitamin D will help maintain healthy bones after the menopause. Good sources of calcium include green, leafy vegetables (but not spinach), nuts, seeds, dried fruit, tinned fish with the bones in, and dairy products like milk, yoghurt and cheese. Good food sources of vitamin D include oily fish, eggs, and fat spreads or breakfast cereals
Hormone replacement therapy: HRT can be an effective treatment for common menopausal symptoms like night sweats, sleep disturbance and achy joints. It works by replacing oestrogen, which naturally begins to lower post menopause. HRT can also help to maintain bone density and reduce the risk of osteoporosis.

Bone Health - Know How It Is Affected Post Menopause!

Pregnancy is definitely a new and beautiful phase in a woman s life. During this time, the woman s body goes through multiple changes during the nine months and post-delivery, extra care is needed for the body to get back to its pre-pregnancy state. The following are some tips to care for your post-partum body immediately after delivery and through the first six weeks after childbirth.

Perineal soreness: The area between the vagina and the anus stretches a lot during labour and can be sore for quite a while. In some women, this area may even be cut to enable easy passing of the baby (episiotomy). This would be more painful and can be managed with topical creams, ice packs, Kegel exercises and warm baths.
Uterine shrinkage: The uterus enlarges to accommodate the developing baby shrinks back to its original stage after delivery. This causes severe cramps, especially during the first six weeks and if required, pain medications can be taken for the cramps.
Breast fullness: The breasts fill with milk after birth to enable feeding, and the woman feels engorged. This is relieved with feeding, but if the baby is not on mother s milk, warm soaks on the breasts and a supportive bra can help. It will stop once the breasts stop making milk.
Constipation: This is common post pregnancy, and so foods rich in fibre should be consumed. Lots of vegetables, fruits and whole grains should be included in the diet. If required, stool softeners can be used.
Body swelling: In preparation for the delivery, the hands and feet swell due to fluid accumulation. This naturally subsides over the first week to 10 days. Lying on the left side and keeping the feet elevated can help.
Urination problem: Experiencing a burning sensation or pain while urinating and inability to start or stop a stream of urine are common urination problems, especially immediately after childbirth, which will subside in a couple of weeks. Drinking lots of water, Kegel exercises and warm baths are helpful measures that can be undertaken.
Fatigue: Taking care of the newborn can leave you drained. Get adjusted to the baby s routine and try to sleep with your baby. Get friends and family to help you take care of your child so that you don t feel the entire strain.
Emotional health: Changes in the hormone levels again affects your emotional health, so try and stay positive. Post-partum depression is very common in women, as they feel overwhelmed with caring for the newborn.
It is important to realise that while pregnancy is an important phase, it is a natural process. The body will adapt to these short-lived changes and allow you to bond with your baby by staying close to your child, responding to its needs, spending time together, and taking care of your newborn.

Post-Partum - How To Take Care of Your Body?

Endometriosis is a painful condition where the endometrium tissue lining the walls of the uterus, grows as implants outside the womb of the patient. This can lead to a number of painful conditions and is often considered as a common cause behind severe pelvic pain, as far as women are concerned. Here is all you need to know about endometriosis and pelvic pain.

 Painful menstruation: depending on the stage of the condition, the implants could remain on the surface or go deeper into the ovaries which may cause acute and severe problem during ovulation as well as the menstrual cycles. This is one of the symptoms that one must not ignore. If you are having painful cramps that affect the pelvic area and the abdomen, and if these cramps last throughout the duration of the cycle, then there are strong chances that you are experiencing the pain that comes with endometriosis. 
 Pain during and after intercourse: while there are many reasons why women may face pain during intercourse, it may be noted that vaginal and pelvic pain that come during and after intercourse could point towards the presence of endometriosis, which is causing irritation and discomfort due to the implants. 
 Bowel movements and urination: usually, pelvic pain may trickle down to and also get activated by the bowels when there is a motion as well as urination. This is a common problem that can cause pain, which spreads throughout the region if the patient is suffering from endometriosis. 
 Bloating and other symptoms: when the abdomen and nearby regions face bloating due to the implants and their painful spread, the pelvic region as a whole bears the brunt in terms of severe pelvic pain. The bloating and other symptoms like loose motions and constipation can also create pain in the abdomen and pelvic region on a persistence basis. Sharp pains may also shoot up and down the lower back due to such symptoms which should not be ignored if they do not abate within a few days. 
 Misdiagnosis: many times, the bloating and pelvic pain may be linked with pelvic inflammatory disease, which causes pain in the muscles and joints. But if you are having pain in the abdomen as well as problems during your menstrual cycle, then it may be helpful to have the tests for endometriosis done as well. 

In order to diagnose the condition, the doctor must ensure that proper imaging tests like mri and ct scans as well as an ultrasound with lab tests based on blood samples have been conducted. The pelvic pain that comes with this condition can be treated with the help of pain relievers like ibuprofen and aspirin.

Could Your Pelvic Pain be Endometriosis?

Dealing with Dysmenorrhoea (Painful Periods)

Dysmenorrhoea is a medical condition where a woman has extremely painful periods. While menstruation is normal, it is very painful. This is caused by disorders like fibroids, pelvic inflammatory disease, adenomyosis, endometrial polyps, use of intrauterine contraceptive device or endometriosis. Many women assume that pain is normal and must be tolerated.

Few ways to deal with dysmenorrhoea are:

1. It’s Ok To Take Pain Relievers: To relieve the pain, simple analgesics like paracetamol and aspirin can be taken.

2. Anti-inflammatory Drugs Can Taken: Non-steroidal anti-inflammatory drugs are also prescribed to deal with dysmenorrhoea and most women are known to feel relief from the pain.

3. Fish Oils Capsules: Fish oil capsules which contain Omega 3 fatty Acids are also a good option to use when troubled with severe menstrual pain.

4. Prefer Light Diet: A few minor dietary changes can also help. Eating low fat vegetarian food especially on the days of the periods can prove to be helpful.

5. Avoid Sedentary Lifestyle: It is said that exercise can reduce the pain of dysmenorrhoea. Sedentary lifestyle is not good for the uterus region and it is advisable to indulge in regular exercises.

6. Use Heat Therapy: Heat therapy is a common and effective way to deal with dysmenorrhoea. Keeping a hot water bag on the region of the pain is known to soothe the pain and help relax the muscles.  

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Why Do Some Girls Have Extremely Painful Periods?

With changing times the nature and effects of virus and bacteria are also changing and due to this, one of the biggest risks of unprotected sex is catching a sexually transmitted disease or STD. An STD can be contacted by any form of intercourse including oral, vaginal and anal sex. STDs are serious diseases that should not be ignored and require treatment and medication. Some common STDs are:
1. Chlamydia
2. Hepatitis B
3. Genital Herpes
4. Syphilis and
5. Gonorrhea 

The only way to protect yourself from an STD is to abstain from unprotected sex and always use a condom. Sometimes STD infections have no symptoms and can remain dormant for years, hence it is essential to get yourself regularly treated for STDs if you have more than one sexual partner. On the other hand some STDs have visible symptoms such as:

Skin rash
A rash in the genital area is most often a sign of STDs. This can be in the form of bumps, sores or warts. It may or may not be accompanied by itchiness. A rash caused by a STD usually results in redness and inflammation. Herpes sores may subside within a week or so but just because the rash is gone does not mean the infection has been treated. Hence even if the rash disappears before your doctor's visit, ensure you mention it. 

Painful urination
A burning sensation or pain while urinating is a symptom for a number of STDs. There may also be a change in the colour of urine. Some STDs associated with painful urination as Chlamydia, gonorrhea and trichomoniasis. However, this may also be triggered by kidney stones or a urinary tract infection. 

Painful intercourse
Pain during intercourse is one of the most overlooked symptoms of a sexually transmitted disease. While a little pain may be normal, any sudden increase in pain or new type of pain should not be ignored. This should be kept in mind especially when having intercourse with a new partner or if there is a change in sexual habits. When it comes to men's sexual health, pain at the time of ejaculation can be a symptom of a STD.

Abnormal discharge
Abnormal discharge from the vagina or penis can be a symptom of a number of infections not all of which are STDs. Strangely coloured and odorous vaginal discharge can be a symptom of yeast infections or a Sexually transmitted disease like trichomoniasis or gonorrhea. Bleeding in between periods can also be a symptom of a STD.  Abnormal discharge from the penis can be a sign of Chlamydia, gonorrhea or trichomoniasis.

Learn the Signs and Symptoms of STDs

The menopause can take three very different routes for women. There are those who sail through it with very few symptoms or problems and don't even notice that their ovaries have stopped producing the hormone. Then there are those for whom it is a matter of a few hot flushes and a couple of night sweats, doesn't last long and not really a bother. This usually marks a relief from the periods. But for some it is abject misery accompanied with crippling fatigue, absolute exhaustion, hot flushes, vaginal drying, mood swings along with low desire or lack of sexual feelings. These symptoms might persist for more than 7 years.
Hormone Replacement Therapy (HRT) is considered to be an effective treatment for menopausal symptoms. The other problems linked with menopause can also be influenced by HRT in a positive manner.

HRT is indicated in:
1. Treatment of symptoms of menopause and the risk benefit ratio is apt for the women and they have been informed about the same
2. For women who are around 51 years and are reaching menopause even though they are asymptomatic
3. In women who are at the risk of osteoporotic fractures and are under 60 years and the non-estrogen treatments cannot be given
4. HRT is not recommended in women who are above 60 years

Benefits of HRT:
The benefits of HRT usually are more than the risk if done in a woman who is under 60 years of age. 
These include:
1. Improvement in quality of life by relieving muscle pains and improving sleep
2. The mood swings are controlled and low moods are usually alleviated by HRT. Low moods usually arise due to menopause.
3. It reduces the vasomotor symptoms, usually within four months of the treatment with maximum benefit in three months
4. HRT improves the urogenital symptoms by lowering the vaginal dryness, vaginal atrophy, urinary frequency and symptoms. 
5. HRT reduces the risk of osteoporosis. HRT is believed to preserve the bone mass density of the skeletal sites thus reducing the chances of vertebral and nonvertebral fractures.
6. HRT also reduces the risk of colorectal cancer and cardiovascular diseases

Risks of HRT
The main risks of HRT are stroke, endometrial and breast cancer, thromboembolic disease, pulmonary embolism and gallbladder disease. Though other risks are:
1. It increases the risk of ischemic stroke
2. There is a small risk associated with breast cancer and the risk increases more, if the woman is underweight or overweight, alcohol user, smoker and stops HRT suddenly
3. Estrogen only HRTs can increase the risk of endometrial cancer. If cyclical progestogen is used for 10 days for 28 cycles then the risk is eliminated.

The Efficacy of Hormone Therapy in Early Menopause

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