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Eating Right During Menopause!

Dt. Manpreet Kalra 90% (41 ratings)
MSc - Food and Applied Nutrition, Post Graduate in Diabetes Education
Dietitian/Nutritionist, Ludhiana
Eating Right During Menopause!

Menopause is a phase when the estrogen in the body starts to diminish. Every woman has to face this "change of life" at the time of her last period. On average, women reach menopause at age 51, but it can happen earlier or later. Menopausal symptoms vary with every woman. Common symptoms include hot flashes, night sweats, weight gain around the middle, sleep disturbances and mood changes. However, some women go through menopause with no real symptoms.

What causes menopause? Hormones. As women age, your ovaries produce less estrogen and progesterone, two of the main hormones for reproduction. As estrogen levels go down, one of the first signs of "menopausal transition" is irregular periods in which bleeding is unusually heavy or light; the time between periods also may become longer.

While the symptoms and the risk factors of menopause cannot be negated in totality, good nutrition can ease certain condition for the body. A variety of food along consisting of enough iron and calcium is of prime importance during this phase. Here is a basic guideline of the dietary her healthy practices one should follow:

  1. Enough calcium intake: A daily serving of three to four dairy-based products can pay rich dividends in the endeavor of acquiring calcium for the body. Other calcium-rich food sources include fish such as salmon and sardine, legumes and broccoli. The aim should be to intake a minimum of 1200 mg of calcium daily.
  2. Iron is a must: Three servings of iron-rich diet is a necessity for the body. Some iron-rich food sources include red meat, nuts, grain products, green vegetables, red meat, poultry etc. Acquiring 8 MG of iron daily is a must for every woman going through the phase of menopause.
  3. Fiber is a key dietary component: The intake of fiber-rich food is a necessity during menopause. Some fiber-rich food includes bread, fresh fruits, pasta, cereals etc. A daily intake of 21 gms of fiber content is essential for the body to function properly.
  4. Gamma Linolenic Acid: This is a form of fatty acid that is extremely crucial to regulate the balance of hormone and maintain health during menopause. Good sources of Gamma Linolenic Acid or GLA are vegetable oils originated from hemp seed, primrose, blackcurrant etc. Intake of these oils along with curry or salad should do the trick.
  5. Intake of Magnesium: The human skeleton is comprised of 60 percent of magnesium. Over 300 enzymes require magnesium for a various catalytic reaction of the body. Needless to mention that intake of magnesium is crucial for a woman going through menopause. Some good sources of magnesium include halibut fish, leafy vegetables, grains, seeds etc.
  6. Intake of Phytoestrogens: Soy isoflavones are rich in phytoestrogens. Good source of the same include soya milk, soya beans, tofu etc. Soy protein is extremely beneficial due to their support function of HDL. It can even influence positive heart function. Studies have found that phytoestrogens can successfully limit the flow of free radicals in the body and block the signs of aging.
  7. Antioxidants Vitamins: Vitamins, especially A, C, and E are known to be mighty effective in maintaining good menopause health. Food items such as kale, butter, turkey, pork are a great source of vitamin A. Rose hips, lemon, strawberries, sprouts are good sources of vitamin C. Vitamin E can be found in certain food items such as avocado, spinach, hazelnuts, sunflower, milk, asparagus, whole grain etc.
1293 people found this helpful

5 Things You Would Experience After Menopause

Dr. Usha. M. Kumar 90% (35 ratings)
Diploma in Advance Endoscopy, Royal College of Obstetricians and Gynaecologists (MRCOG), MS, MBBS
Gynaecologist, Delhi
5 Things You Would Experience After Menopause

Menopause is the loss of a woman's natural ability to conceive as she approaches the age of 50. The levels of the female sex hormones estrogen and progesterone begin to drop disrupting the ovulation and menstruation cycles. There are also associated symptoms of menopause, such as weigh gain, low sex drive and hot flashes. You can also take the package for Living Healthy - Woman.

Here are 5 other problems you may experience after menopause:

  1. Increased level of cholesterol: The human body comprises two types of cholesterol primarily: High Density Lipoprotein (HDL) and Low Density Lipoprotein (LDL). The former is known as "good cholesterol". Estrogen helps to keep your HDL high and LDL low. After menopause, the levels of LDL or "bad cholesterol" naturally go up even if HDL levels remain unaltered. Regular physical exercise can prevent the rise in the levels of LDL.
  2. Dry skinEstrogen is responsible for controlling the production of oil in your body. As estrogen levels fall, the oil secretion falls too. This leads to dry and scaly skin, especially skin of the face and arms. You can use moisturizers and creams to prevent flaking of the skin.
  3. Hair fallThis is also a result of dry skin. The skin of the scalp dries up and cannot provide nourishment to the hair. This causes hair fall. The variability in the levels of the hormones also causes deficiency of certain proteins that are essential for the nails and hair. Use mild herbal shampoos to deal with the problem. Chemical treatment procedures often do more harm than good.
  4. Unsocial tendencies: The irregularities in the production of the female hormones have an impact on your emotional and social behavior. You may want to spend more and more time by yourself instead of socializing with friends and relatives. These are not symptoms of depression or any other psychological condition. It is simply an emotional transference period.
  5. DrowsinessWhile insomnia is one of the most symptoms of menopause, the situation somewhat reverses after some time. Menopause causes changes in the body weight, hormone cycles and metabolism. All of these, in turn, affect your energy levels. You feel extremely sleepy during the day, especially in the afternoon. However, sleeping during the day can cause sleeping problems at night. So, do not take a nap for more than half an hour during the day.

If you wish to discuss about any specific problem, you can consult a specilized gynaecologist and ask a free question.

2644 people found this helpful

How Hormone Replacement Therapy Can Help In Menopause?

MBBS, DGO
Gynaecologist, Ghaziabad
How Hormone Replacement Therapy Can Help In Menopause?

In the course of their life, women have to go through a lot of changes and challenges that make them wiser and better at handling the circumstances that they faced. Women go through physical as well as emotional changes when they reach puberty. Also, after the menstrual cycle begins the lady has to struggle through different pre-menstrual symptoms each month. It is because of the menstrual cycle that women are able to conceive and give birth to life, which means that it can be safely said that the source of all human life is owed to the menstrual cycle of women.

It is however, seen that when the menstrual cycle comes to an end in the form of menopause and the uterus takes a retirement, the women going through menopause end up experiencing difficult times and health issues. A lot of women complain of severe mood swings, depression, increased fatigue, hot flashes, dryness in the vaginal region and even problems like osteoporosis in a lot of cases. While these may sound like deadly challenges and a lot of women may lead unhealthy lives by accepting the changes, it should be realized that the problem is treatable.

Hormone replacement therapy:
When the menstrual cycle works regularly, it ensures that the level of hormones in the body are regularised and the body does not face discomfort, but when menopause strikes the body stops making the important hormones and throws the system out of order. In order to make sure that the body remains healthy and the problems related to menopause are kept at bay, it may be important to replenish the body with the hormones and this is how the hormone replacement therapy works.

HRT or hormone replacement therapy is found to be a common medication and type of treatment in the modern times, but this does not mean that the patients may be safe by getting their treatment from just any doctor. It is particularly essential to make sure that the best gynaecologist in the field is chosen and the therapy is started only with the right expertise. The administering of the hormones may be a tricky treatment and if the patient is not in the right hands, they may fall prey to problems such as inadequate or excessive hormones, which may in turn be a source of more health issues.

Choosing your expert:
Running a simple search on the internet about how the treatment for hormone replacement should be taken and the doctors who specialize in the course of treatment may lead you to a number of reliable names. With the help of the search and a thorough study about the background and experience of the specialists so that you are able to put yourself in safe and able hands only.

2509 people found this helpful

Menopause - Know Complications Associated With It!

Dr. Jayanti Kamat 89% (556 ratings)
MBBS, MD - Obstetrics & Gynaecology, Advanced Infertility
Gynaecologist, Mumbai
Menopause - Know Complications Associated With It!

Menopause is the loss of a woman's natural ability to conceive as she approaches the age of 50. The levels of the female sex hormones estrogen and progesterone begin to drop disrupting the ovulation and menstruation cycles. There are also associated symptoms of menopause such as weight gain, low sex drive and hot flashes. Here are 5 other problems you may experience after menopause:

1. Increased level of cholesterol
The human body comprises two types of cholesterol primarily: High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL). The former is known as "good cholesterol". Estrogen helps to keep your HDL high and LDL low. After menopause, the levels of LDL or "bad cholesterol" naturally go up even if HDL levels remain unaltered. Regular physical exercise can prevent the rise in the levels of LDL.

2. Dry skin
Estrogen is responsible for controlling the production of oil in your body. As estrogen levels fall, the oil secretion falls too. This leads to dry and scaly skin, especially the skin of the face and arms. You can use moisturizers and creams to prevent flaking of the skin.

3. Hair fall
This is also a result of dry skin. The skin of the scalp dries up and cannot provide nourishment to the hair. This causes hair to fall. The variability in the levels of the hormones also causes the deficiency of certain proteins that are essential for the nails and hair. Use mild herbal shampoos to deal with the problem. Chemical treatment procedures often do more harm than good.

4. Unsocial tendencies
The irregularities in the production of female hormones have an impact on your emotional and social behavior. You may want to spend more and more time by yourself instead of socializing with friends and relatives. These are not symptoms of depression or any other psychological condition. It is simply an emotional transference period.

5. Drowsiness
While insomnia is one of the most symptoms of menopause, the situation somewhat reverses after some time. Menopause causes changes in the body weight, hormone cycles and metabolism. All of these, in turn, affect your energy levels. You feel extremely sleepy during the day, especially in the afternoon. However, sleeping during the day can cause sleeping problems at night. So, do not take a nap for more than half an hour during the day.
 

4403 people found this helpful

Nutritional Concerns During Menopause!

Dr. Anjana Agarwal 90% (241 ratings)
MSc - Food and Applied Nutrition, Ph.D, Aroma Therapist
Dietitian/Nutritionist, Ghaziabad
Nutritional Concerns During Menopause!

Menopause is a phase when the estrogen in the body starts to diminish. Every woman has to face this "change of life" at the time of her last period. On average, women reach menopause at age 51, but it can happen earlier or later. Menopausal symptoms vary with every woman. Common symptoms include hot flashes, night sweats, weight gain around the middle, sleep disturbances and mood changes. However, some women go through menopause with no real symptoms.

What causes menopause? Hormones. As women age, your ovaries produce less estrogen and progesterone, two of the main hormones for reproduction. As estrogen levels go down, one of the first signs of "menopausal transition" is irregular periods in which bleeding is unusually heavy or light; the time between periods also may become longer.

While the symptoms and the risk factors of menopause cannot be negated in totality, good nutrition can ease certain condition for the body. A variety of food along consisting of enough iron and calcium is of prime importance during this phase. Here is a basic guideline of the dietary her healthy practices one should follow:

  1. Enough calcium intake: A daily serving of three to four dairy based products can pay rich dividends in the endeavor of acquiring calcium for the body. Other calcium-rich food sources include fish such as salmon and sardine, legumes and broccoli. The aim should be to intake a minimum of 1200 mg of calcium daily.
  2. Iron is a must: Three servings of iron-rich diet is a necessity for the body. Some iron rich food sources include red meat, nuts, grain products, green vegetables, red meat, poultry etc. Acquiring 8 MG of iron daily is a must for every woman going through the phase of menopause.
  3. Fiber is a key dietary component: The intake of fiber rich food is a necessity during menopause. Some fiber-rich food includes bread, fresh fruits, pasta, cereals etc. A daily intake of 21 gms of fiber content is essential for the body to function properly.
  4. Gamma Linolenic Acid: This is a form of fatty acid that is extremely crucial to regulate the balance of hormone and maintain health during menopause. Good sources of Gamma Linolenic Acid or GLA are vegetable oils originated from hemp seed, primrose, blackcurrant etc. Intake of these oils along with curry or salad should do the trick.
  5. Intake of Magnesium: The human skeleton is comprised of 60 percent of magnesium. Over 300 enzymes require magnesium for a various catalytic reaction of the body. Needless to mention that intake of magnesium is crucial for a woman going through menopause. Some good sources of magnesium include halibut fish, leafy vegetables, grains, seeds etc.
  6. Intake of Phytoestrogens: Soy isoflavones are rich in phytoestrogens. Good source of the same include soya milk, soya beans, tofu etc. Soy protein is extremely beneficial due to their support function of HDL. It can even influence positive heart function. Studies have found that phytoestrogens can successfully limit the flow of free radicals in the body and block the signs of aging.
  7. Antioxidants Vitamins: Vitamins, especially A, C, and E are known to be mighty effective in maintaining good menopause health. Food items such as kale, butter, turkey, pork are a great source of vitamin A. Rose hips, lemon, strawberries, sprouts are good sources of vitamin C. Vitamin E can be found in certain food items such as avocado, spinach, hazelnuts, sunflower, milk, asparagus, whole grain etc. If you wish to discuss about any specific problem, you can consult a Dietitian/Nutritionist.
3235 people found this helpful

Menopause - Can Hormone Replacement Therapy Help?

MD - Obstetrics & Gynaecology, MBBS
Gynaecologist, Hyderabad
Menopause - Can Hormone Replacement Therapy Help?

In the course of their life, women have to go through a lot of changes and challenges that make them wiser and better at handling the circumstances that they faced. Women go through physical as well as emotional changes when they reach puberty. Also, after the menstrual cycle begins the lady has to struggle through different pre-menstrual symptoms each month. It is because of the menstrual cycle that women are able to conceive and give birth to life, which means that it can be safely said that the source of all human life is owed to the menstrual cycle of women.

It is however, seen that when the menstrual cycle comes to an end in the form of menopause and the uterus takes a retirement, the women going through menopause end up experiencing difficult times and health issues. A lot of women complain of severe mood swings, depression, increased fatigue, hot flashes, dryness in the vaginal region and even problems like osteoporosis in a lot of cases. While these may sound like deadly challenges and a lot of women may lead unhealthy lives by accepting the changes, it should be realized that the problem is treatable.

Hormone replacement therapy:
When the menstrual cycle works regularly, it ensures that the level of hormones in the body are regularised and the body does not face discomfort, but when menopause strikes the body stops making the important hormones and throws the system out of order. In order to make sure that the body remains healthy and the problems related to menopause are kept at bay, it may be important to replenish the body with the hormones and this is how the hormone replacement therapy works.

HRT or hormone replacement therapy is found to be a common medication and type of treatment in the modern times, but this does not mean that the patients may be safe by getting their treatment from just any doctor. It is particularly essential to make sure that the best gynaecologist in the field is chosen and the therapy is started only with the right expertise. The administering of the hormones may be a tricky treatment and if the patient is not in the right hands, they may fall prey to problems such as inadequate or excessive hormones, which may in turn be a source of more health issues.

Choosing your expert:
Running a simple search on the internet about how the treatment for hormone replacement should be taken and the doctors who specialize in the course of treatment may lead you to a number of reliable names. With the help of the search and a thorough study about the background and experience of the specialists so that you are able to put yourself in safe and able hands only. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

3865 people found this helpful

Obesity - How It Affects The Human Brain?

M.Phil in Clinical Psychology, Ph.D. Psychology
Psychologist, Hubli-Dharwad
Obesity - How It Affects The Human Brain?

Obesity is the new-age lifestyle disease with multiple ramifications. While its effects on the physical aspects are very evident, the damage it does to the brain are more severe, though not obvious. Read on to know some harmful effects of obesity on the emotional well-being.

  1. Leads to binge eating: There is a certain pleasure in eating sugary and fatty food, and this is lost with depression. Therefore, to get that emotional satisfaction, people tend to eat more chocolates, cookies, milkshakes, and other weight-accumulating food items, which further add to obesity. Greater the weight gained by a person, lesser the response or happiness from such food products.
  2. Increases impulsivity: The area of the brain known as orbitofrontal cortex, which is in charge of controlling impulsivity, shrinks in obese people. This results in people eating more impulsively.
  3. Affects immunity: Obesity is a major cause of inflammation, leading to damage in certain parts of the brain. This impairs the immune system, making the affected person more prone to infections and tissue damage. This leads to increased chances of diabetes, heart disease, stroke, sleeping disorders, eating disorders, etc. The chemical known as C-reactive protein increases as seen on MRIs in obese people, and which is usually seen in patients with chronically increased inflammation.
  4. Effects on memory: As the BMI increases, there is a decrease in scores of memory tests. This effect is more obvious in women after menopause. With increased fat accumulation, more hormones are released, which affects the memory. Increased inflammation also affects cognition and memory.
  5. Increased risk of dementia: With more belly fat accumulating, there is extra stress on the body to burn the visceral fat. This reduces brain size and causes certain hormones to release, which further affects the body’s ability to remember things. It has been proven that people with smaller brain size are at greater risk for developing dementia.
  6. Weight loss stress adding to more stress: When obesity sets in and the BMI goes up, there is an added pressure to lose weight, which further ups the stress levels. During these dieting days, the brain is constantly alert and finds ways to eat more. This also leads to excess eating. Moreover, there are indications that there could be genetic changes during this phase, which may leave a permanent mark in the person’s composition.
  7. Depression: When a person is not happy with their reflection in the mirror, the chances of feeling good and happy are very less. In this age, where aesthetics plays a major morale booster, an obese image staring back does not help at all.

So, if you have a risk of obesity, watch out. It is not just how you look, but how you feel is also altered. If you wish to discuss about any specific problem, you can consult a Psychologist.

2753 people found this helpful

Diet And Menopause!

Dr. Shivani Ingle 87% (62 ratings)
MSc Food Nutrition and Dietetics
Dietitian/Nutritionist, Mumbai
Diet And Menopause!

Some risk factors and symptoms linked with aging and menopause can't be changed. But good nutrition can help prevents or ease certain conditions that may develop during and after menopause.

Basic dietary guidelines for menopause-

During menopause, eat a variety of foods to get all the nutrients you need. Since women's diets are often low in iron and calcium, follow these guidelines:

1. Get enough calcium. Eat and drink two to four servings of dairy products and calcium-rich foods a day. Calcium is found in dairy products, fish with bones (such as sardines and canned salmon), broccoli, and legumes. Aim to get 1, 200 milligrams per day.

2. Pump up your iron. Eat at least three servings of iron-rich foods a day. Iron is found in lean red meat, poultry, fish, eggs, leafy green vegetables, nuts, and enriched grain products. The recommended dietary allowance for iron in older women is 8 milligrams a day.

3. Get enough fiber. Help yourself to foods high in fiber, such as whole-grain bread, cereals, pasta, rice, fresh fruits, and vegetables. Most adult women should get about 21 grams of fiber a day.

4. Eat fruits and vegetables. Have at least 1 1/2 cups of fruit and 2 cups of vegetables each day.

5. Read labels. Use the package label information to help yourself make the best choices for a healthy lifestyle.

6. Drink plenty of water. As a general rule, drink eight glasses of water every day. That fulfills the daily requirement for most healthy adults.

7. Maintain a healthy weight. If you're overweight, cut down on portion sizes and eat fewer foods that are high in fat. Don't skip meals, though. A registered dietitian or your doctor can help you figure out your ideal body weight.

8. Cut back on high-fat foods. Fat should provide 25% to 35% or less of your total daily calories. Also, limit saturated fat to less than 7% of your total daily calories. Saturated fat raises cholesterol and boosts your risk for heart disease. It's found in fatty meats, whole milk, ice cream, and cheese. Limit cholesterol to 300 milligrams or less per day. And watch out for trans fats, found in vegetable oils, many baked goods, and some margarine. Trans fat also raises cholesterol and increases your risk of heart disease.

9. Use sugar and salt in moderation. Too much sodium in the diet is linked to high blood pressure. Also, go easy on smoked, salt-cured, and charbroiled foods -- these foods have high levels of nitrates, which have been linked to cancer.

10. Limit alcohol to one or fewer drinks a day.

  • Foods to help menopause symptoms-

Plant-based foods that have isoflavones (plant estrogens) work in the body like a weak form of estrogen. For this reason, soy may help relieve menopause symptoms, although research results are unclear. Some may help lower cholesterol levels and have been suggested to relieve hot flashes and night sweats. Isoflavones can be found in foods such as tofu and soy milk.

  • Avoid foods during menopause-

If you're having hot flashes during menopause, you may find it helps to avoid certain" trigger" foods and drinks, like spicy foods, caffeine, and alcohol.

  • Supplements after menopause​-

Because there is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis, the following supplements, combined with a healthy diet, may help prevent the onset of this condition:

  • Calcium. If you think you need to take a supplement to get enough calcium, check with your doctor first. A 2012 study suggests that taking calcium supplements may raise the risk for heart attacks in some people -- but the study showed that increasing calcium in the diet through food sources didn't seem to raise the risk.
     
  • Vitamin d. Your body uses vitamin D to absorb calcium. People ages 51 to 70 should get 600 IU each day. Those over 70 should get 800 IU daily. More than 4,000 IU of vitamin d each day is not recommended, because it may harm the kidneys and weaken bones.
1 person found this helpful

Menopause- How to tackle it

Dr. Sujoy Dasgupta 90% (11529 ratings)
MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG, MRCOG (London, UK)
Gynaecologist, Kolkata
Menopause- How to tackle it
Today 18th October is WORLD MENOPAUSE DAY....
Aging is an inevitable phenomenon in our lives. Often our parents or grand-parents say “we are aged now, so it’s just a matter of few years”. But is it really so? French author Jules Renard said “It`s not how old you are, it`s how you are old”. Scientific studies has shown that “we can expect to become old”. There are mainly two reasons for it. One is our life style changes, leading to faster aging of the general population. The second thing is profound improvement in medical care that made it possible to conquer death even at the age of 80 years.In 1000 BC, the life expectancy was only 18 years. By 100 BC, the time of Julius Caesar, it had reached 25 years. In 2005, it was 80 years for women and 75 years for men. And today, you can expect to reach 82 years if you are a male and 85 years if you are a female. Men and women population need to be addressed differently from social, economic and biological points of view. Half of men at 85 and above live with their wives, but only 10% of elderly women live with their husbands. Aging is nothing but a sign of maturity. There are three signs of maturity in each sex. Two of them are common in both men and women; graying of hair and cataract in eye. The third one is unique to each sex. In men, it’s increased size of prostate gland (prostatism) and in female, it’s menopause.

Menopause is unavoidable in a woman’s life. In simplest term, it is the cessation of menstruation permanently at the end of reproductive life. The ovaries stop secreting female sex hormones- mainly estrogen and progesterone. In medical terminology, menstruation should be absent for 12 consecutive cycles to define it as menopause. Though menopause is the stoppage of reproductive function, it has profound effect in almost every organ of the body. Despite our socio-economic improvement, the age of menopause remains relatively the same; average 51 years with range of 45 to 55 years. However, there are some causes that may cause early menopause. If it occurs before 40 years, it’s called premature menopause. This needs medical consultation because it is caused by some serious diseases like genetic causes (may have family history of premature menopause- in elder sisters and mother), smoking, autoimmune disorders (body makes destructive substances against itself) etc. Sometimes premature menopause is the side-effect of some treatments like drugs (especially anti-cancer drugs), radiation and removal of ovaries by surgery. On the other hand, if menstruation continues to occur after 55 years, it’s called delayed menopause. It also deserves consultation with gynaecologists, as it is often caused by diabetes, some tumours and even some cancers. So, if menopause occurs too early or too late, it should never be ignored.

But if menopause occurs in time, do the women should consult gynaecologists? Well. You can find the answers from this article. Most of the women have some common problems after menopause; they become irritable or depressed and sometimes very much emotional and moody. Even suicidal tendency is not uncommon. Often they complain of sudden sensation of excessive warmth, the hot sensation, as if there is something burning on the head, the ears or other parts of the body. This is called “hot flush”, which is often associated with excessive sweating at night, palpitation and anxiety. This happens due to absence of estrogen hormone. These problems can be solved by hormonal drugs. Even non-hormonal drugs also work well. So, timely treatment can give them good quality of life and you don’t have to say “my mother has become intolerable these days”.

Frequently our mothers and grand-mothers complain of having back-pain or pain in the bones. This is due to osteoporosis; the destruction of components of bones and joints. They often get fracture with minor trauma. Again, this is due to deficiency of estrogen and also inadequate calcium intake. So, the treatment of this problem is exercise (at least 30 minutes per day), avoidance of smoking and the drugs that inhibits bone formation and adequate calcium and vitamin D intake. Hormone therapy is also effective and there are many non-hormonal drugs that can prevent destruction of bone. Thus timely medical consultation may stop our mothers saying “I cannot go outside for pain in my knees”.

Cardiovascular disease is the leading cause of death in elderly. Before the age of 40 years, males are more likely to die, than females, due to heart attacks. After 40, the sex difference is lost. This is because of absence of estrogen in women after menopause that alters the composition of fat (especially cholesterol) in blood. Cholesterol get deposited in the wall of blood vessels. Such problems can be avoided by dietary control, control of high blood pressure and diabetes and regular medical checkup.

The worst problemof the menopause is faced by the urinary and reproductive systems, i.e., the private parts of the body. In medical terminology, this is called “pelvic atrophy”. Our women remain very silent of it; most of them do not consult doctors for such problems. There is feeling of increased frequency of urination (women has go to the toilets frequently), burning sensation during urination and sometimes inability to hold the urine until they can reach the toilet or leakage of urine during coughing and sneezing (medically called “urinary incontinence”). The incontinence is not only a medical problem but also a social and hygienic embarrassment, for which many women avoid participation in social activities and even do not want to go outside. Sexuality is a thing that is often ignored both by the elderly people as well as the doctors. Menopause does not mean end of the conjugal life. Often the women may feel decreased libido (the desire) because of low hormone levels. And again there is difficulty in keeping intimacy for problems in the concerned area (due to decreased blood supply), again due to deficiency of estrogens. This may even lead to damage to the private parts and bleeding, while leading the conjugal life. For this, the couples should not suffer silently. There are many treatments that can avoid such urinary and sexual problems. Sometimes, simple counselling and some special exercises may prove to be adequate. Otherwise hormonal drugs (estrogens) can be used. And for this purpose, even we don’t need to take the hormones orally or by injection; simple local use of some creams or jellies help a lot. You will be surprised to know that testosterone may also help some women, because testosterone is not only found in male but is also an important female hormone. Those who want to avoid hormones, can try other non-hormonal agents. Even pregnancy is possible after menopause. There have been many examples of conception, either naturally or by test-tube baby (in vitro fertilization), after menopause. The recent socio-economic trend of delaying the age of marriage and child-birth is making this issue of pregnancy after menopause very much relevant.

Cancer is the second leading cause of death in elderly, after heart attack. Lung cancer is increasing day by day in women and even non-smokers can also have lung cancers. Discharge of blood with cough or vomiting, long-standing cough, chest pain and weight loss needs consultation with chest physician. Breast cancer is a major cause of death in women. This can be avoided by monthly self-breast examination and consultation; if any abnormal swelling or discharge is found. Colo-rectal cancer (cancer of lower part of our digestive tract), recently showed increased incidence in all the age groups. So, if there is any bleeding with stool or passage of black coloured stool, it should never be ignored. Ovarian cancer is showing increased incidences all over the world. Despite significant improvement in cancer management, ovarian cancer is a nightmare of the gynaecologists. Often, even after best possible treatment, patients of ovarian cancer don’t survive beyond one year of diagnosis. So, if you have any problems in digestion, abdominal discomfort, pain and swelling, please don’t just go to medicine shop to take antacids; instead go to your doctor. Post-menopausal bleeding is a medical term, used to describe the condition where there is bleeding through vagina, after menopause. Even if the bleeding is only one drop, it should never be ignored. Though, most causes of such bleeding are not worrisome (due to drugs and ‘’pelvic atrophy”- as mentioned earlier), some cancers may present in this way. Cancer of endometrium (the inner lining of uterus) almost always present with post-menopausal bleeding. Cancer of cervix (the mouth of uterus) is the commonest cancer of reproductive system in our country, which is totally preventable by timely diagnosis by screening (even before actual cancer occurs) and timely HPV vaccination.

“What cannot be cured, must be endured”. We cannot cure the menopause, nor can we avoid it. But definitely we can give our older generation a better quality of life. The first step is obviously making them aware of the menopause and its aftermaths. Second issue is regular health checkup by physicians and gynaecologists, even if they feel no problems as such. But the most important issue is managing their problems. As mentioned above, life-style modifications (like diet, exercise) and non-hormonal drugs play important role. But if we consider the basic problem is menopause, it’s simply deficiency of secretion of female sex hormones from the ovaries. So, if we can artificially introduce those hormones in women, menopausal symptoms can be reduced. This led to emergence of a treatment modality, called HRT (Hormone Replacement Therapy).

Clearly, as discussed earlier, HRT is required in women complaining of menopausal symptoms like “hot flush”, urinary and sexual problems, osteoporosis, and mood depression and also for young women having premature menopause. HRT does not only help to improve these problems, but also has some added advantage like preventing excessive weight gain, problems in oral cavity, eyes and ears and even colorectal cancer. Majority of the women report feeling better and having improved quality of life (social, personal, biological and conjugal) after start of HRT. There are multiple ways to give HRT to a woman. Those include injections (one in 1-3 month), oral tablets, local creams or jellies, skin patches etc. And the drugs include estrogen only, estrogen plus progesterone, tibolone etc.

Now the million-dollar question is, “is HRT absolutely safe?” The answer is difficult to give in one word. After the publication of the reports of the WHI (Women’s Health Initiative) and the MWS (Million Women Study), there have been a great hue and cry regarding safety of HRT. Those study found out many serious side effects of HRT and concluded that HRT should not be used in all the menopausal women. However, subsequently, many flaws of those studies were found out and subsequent review of the WHI study proved that HRT has few side effects. Thrombosis (increased tendency of blood to form clots) is a known side effect of hormonal drugs, but the problem occurs only to those who are at risk of thrombosis due to other causes (like obesity). Breast cancer is definitely a risk factor but the risk is small. So, the women need to continue self-breast examination and yearly checkup by their consultants. Blood fat concentration (cholesterol) may be altered, which needs regular lipid profile checkup. And finally there is increased risk of heart attacks and stroke. But possibility of heart attack is there only if HRT is started in very elderly women (after 60 years) and those who are already have some risks (obesity, smokers, and hypertensive). Even, timely initiation of HRT (before 60 years) can protect the heart and brain against stroke.

Thus HRT is found to have very minimum side-effects and that too at the expense of so many benefits. There are very few women who should not use HRT; those having thrombosis, heart disease or liver disease at present and very high blood fat level (high triglyceride). If the woman has any mass in the breast or post-menopausal bleeding, then HRT should be used only when the diagnosis of the mass or the bleeding is certain. To be on the safe side, before start of HRT, details examination by the consultant doctor is required. This includes checkup of blood pressure, heart, breast, liver and the pelvic organs. The best time to start HRT is as early as after menopause. For premature menopause, the women are relatively younger (before 40, even before 30). So, they should start HRT soon after consultation with doctors, if HRT is suitable for them. For women with natural menopause, HRT should be started before 60 years. Annual visit to the doctor is necessary to detect any side effects and to find whether HRT is needed further or not. HRT need not be continued lifelong. Most of the women can stop it after 5 years. Very few women have to continue it beyond 10 years. Actually, after 2-3 years of HRT, most of the menopausal problems subside and women do not require to continue HRT. However, before stoppage, doctor consultation is required.

In a nutshell, elderly people deserve special care. But that does not mean they should always be in the bed. They should continue their day to day activities. They have the full right to enjoy their life by themselves. What we can do is be supportive to boost up their confidence and self-esteem. That needs social as well as medical attention. Regular touch with physician and gynaecologist cannot be overemphasized. Most of the symptoms can be taken care by life style modifications and drugs. HRT should be used as necessary. HRT is very safe and cost-effective modality. “Not everyone grows to be old, but everyone has been younger than he is now”.
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Menopause - Know More About It!

Dt. Mitali Gupta 87% (85 ratings)
Dietitian/Nutritionist, Jammu

During menopause, eat a variety of foods to get all the nutrients you need. Since women's diets are often low in iron and calcium, follow these guidelines:
Get enough calcium. Eat and drink two to four servings of dairy products and calcium-rich foods a day. Calcium is found in dairy products, fish with bones (such as sardines and canned salmon), broccoli, and legumes. Aim to get 1, 200 milligrams per day.
Pump up your iron. Eat at least three servings of iron-richest foods a day. Iron is found in lean red meat, poultry, fish, eggs, leafy green vegetables, nuts, and enriched grain products. The recommended dietary allowance for iron in older women is 8 milligrams a day.
Get enough fiber. Help yourself to foods high in fiber, such as whole-grain breads, cereals, pasta, rice, fresh fruits, and vegetables. 

1. Eat fruits and vegetables. Have at least 1 1/2 cups of fruit and 2 cups of vegetables each day.
2. Read labels. Use the package label information to help yourself make the best choices for a healthy lifestyle.
3. Drink plenty of water. As a general rule, drink eight glasses of water every day. That fulfills the daily requirement for most healthy adults.
4. Maintain a healthy weight. If you're overweight, cut down on portion sizes and eat fewer foods that are high in fat. Don't skip meals, though. A dietitian or your doctor can help you figure out your ideal body weight.
5. Cut back on high-fat foods. Fat should provide 25% to 35% or less of your total daily calories. Also, limit saturated fat to less than 7% of your total daily calories. Saturated fat raises cholesterol and boosts your risk for heart disease. It's found in fatty meats, whole milk, ice cream, and cheese. Limit cholesterol to 300 milligrams or less per day. And watch out for trans fats, found in vegetable oils, many baked goods, and some margarine. Trans fat also raises cholesterol and increases your risk for heart disease.
6. Use sugar and salt in moderation. Too much sodium in the diet is linked to high blood pressure. Also, go easy on smoked, salt-cured, and charbroiled foods -- these foods have high levels of nitrates, which have been linked to cancer.
7. Limit alcohol to one or fewer drinks a day.

8. supplements for menopause symptoms

  • Foods to help menopause symptoms
  • Plant-based foods that have isoflavones (plant estrogens) work in the body like a weak form of estrogen. For this reason, soy may help relieve menopause symptoms, although research results are unclear. Some may help lower cholesterol levels and have been suggested to relieve hot flashes and night sweats. Isoflavones can be found in foods such as tofu and soy milk.
  • Avoid foods during menopause?
  • If you're having hot flashes during menopause, you may find it helps to avoid certain" trigger" foods and drinks, like spicy foods, caffeine, and alcohol.


9. Supplements after menopause
Because there is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis, the following supplements, combined with a healthy diet, may help prevent the onset of this condition:
* Calcium. If you think you need to take a supplement to get enough calcium, check with your doctor first. A 2012 study suggests that taking calcium supplements may raise the risk for heart attacks in some people -- but the study showed that increasing calcium in the diet through food sources didn't seem to raise the risk.
* vitamin d. Your body uses vitamin d to absorb calcium. People ages 51 to 70 should get 600 iu each day. Those over 70 should get 800 iu daily. More than 4, 000 iu of vitamin d each day is not recommended, because it may harm the kidneys and weaken bones.
 

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