Home   |  Issues  |  The Daily Star Home | Volume 3, Issue 30, Tuesday March 7, 2006



Health Wise

Wake-up call for 40-plus women

Recently, at a party, I overheard a woman pouring out her frustrations to her girlfriends, "I'm in my 40s and feel like I'm going crazy. Granted, with two school-aged children and working full-time, I am under a great deal of stress. The last six months I've had a few irregular menstrual cycles where I'm two weeks late for my period, and my once-mild PMS symptoms are going haywire. I'm having severe mood swings…I feel my level of concentration diminishing…forgetting things I shouldn't be forgetting…and I feel tired all the time! Oh..it can't be all due to stress-can it!?"

There were sympathetic murmurs all around but one woman, in her mid 50s and quite robust looking, firmly spoke up, 'Sounds like the onset of menopause. I'd advice you to consult your gynae for a full diagnosis...after all you are in your 40s…it's best to be aware of all the health issues.' She had the right idea there awareness is the first step towards prevention.

Let's first explore the concept of menopause. Often called the 'change of life', menopause signals the end of a woman's ability to have children. Menopause is complete when menstrual periods have ceased for one continuous year. The transitional period of time before menstruation completely stops is called perimenopause. Symptoms result from the changing levels of estrogen and progesterone in the body, caused by the declining function of the ovaries, and may trigger symptoms similar to premenstrual syndrome (PMS). At other times, the estrogen levels may decrease, triggering hot flashes or night sweats. This fluctuation of estrogen levels may be interspersed with normal menstrual cycles during perimenopause. Research studies show no two women experience perimenopause the same way, having varying patterns of hormonal fluctuations. Many women think they're too young to be going through perimenopause, but, while perimenopause generally starts between one and six years before menopause, it can actually start up to 10 years before. With the average age of menopause being 51 years of age, the starting age for perimenopause could be as young as 41 years old.

Menopause also results in associated ailments.
There's osteoporosis, wherein bone density and structure are progressively lost, weakening the bones and making them more susceptible to fractures. Estrogen deficiency is one significant cause of accelerated osteoporosis in women during and after menopause. A physician can help determine your risk of developing osteoporosis by taking your personal and family medical history, and by performing a bone density test.

Another related disease is urinary incontinence (UI) or the loss of urine control. Incontinence isn't an inevitable result of aging, but is increasingly common as women age and it's a great idea to consult an urologist, a physician who specializes in diseases of the pelvic floor and urinary system.

It's also a myth that heart disease is 'a man's disease'. Check out these statistics. At menopause, a woman's heart disease risk starts to increase significantly one in 12 women aged 45 to 64 has heart disease while one in four women over the age of 65 has heart disease. Beginning at age 50, more women than men have an elevated cholesterol level and women are more likely than men to die within a few weeks of a heart attack. About 35 percent of women who have had a heart attack will have another within six years. Women having Type 1 diabetes or hypertension are at even a higher risk.

You should also be aware of common cancers that most often affect women like uterine and breast cancer. Cancer of the uterus, or the womb, usually occurs around the time perimenopause begins. The occasional reappearance of bleeding should not be considered a part of perimenopause. It should always be checked by a physician. And ignoring the possibility that we may develop breast cancer or avoiding the processes to detect cancer, can be dangerous. The fact remains all women are at risk for breast cancer. Early detection of problems provides the greatest possibility of successful treatment, which is why it's crucial to follow the 3-step Plan for Preventive Care, outlined below:

Step 1. Breast Self-Examination (BSE) should be practiced by women from their 20s and continued throughout their life. BSE should be done regularly at the same time every month. Regular BSE teaches you to know how your breasts normally feel so that you can more readily detect any change. Changes may include:
♦ development of a lump
♦ discharge other than breast milk
♦ swelling of the breast
♦ skin irritation or dimpling
♦ nipple abnormalities (i.e., pain, redness, scaliness, turning inward)

If you notice any of them, see your physician asap.
Step 2. Clinical Breast Examination by a physician or nurse trained to evaluate breast problems every three years is recommended for women between the ages of 20 and 39, and every year for those above 40.

Step 3. Mammography, a low-dose x-ray of the breasts, finds cancer or other problems before a lump becomes large enough to be felt, as well as assist in the diagnosis of other breast problems. However, a biopsy is required to confirm the presence of cancer. Women in their 40s and older should begin having a screening mammogram every one to two years or even every year, as per their physicians' recommendations.

The imperative perspective? One can stay youthful and active in the face of all these problems through simple lifestyle strategies. For hot flashes, avoid possible dietary triggers, such as spicy foods, alcohol, and caffeine. Add tofu, soymilk, and other soy products to your diet. Exercise and stress-reduction techniques, such as yoga, may improve mood swings and sleeplessness. Simple Kegel exercises (squeezing and releasing the muscles that control urine flow) can help with UI. For vaginal dryness try using natural moisturizers, such as vitamin E oil, sesame oil, and olive oil. What about heart health and protection against osteoporosis? Well, in addition to lifestyle strategies, such as a healthy diet, regular weight-bearing exercises, not smoking, supplementary calcium, vitamin D, and other medications can help you manage beautifully.

But do remember one vital point. The symptoms of almost all the medical conditions mentioned thus far may resemble other conditions or medical problems so always consult a physician for diagnosis and hence, accurate treatment.

Also, if you're considering hormone replacement therapy (HRT) or estrogen replacement therapy (ERT) to treat perimenopausal/menopausal symptoms or for heart disease protection, remember that there's still a great deal of controversy regarding these methods, so the decision to start should be made only after you and your physician have evaluated the risk versus benefit ratio based on your family medical history, current health problems, and current clinical evaluation.

Your final motto? Show the world that life begins at 40!

By Simin Saifuddin

Pop Up

While stocks last, grab your share of “fresh veggies” from the kitchen markets. Eating and living healthy should be everyone's top priority, especially in Bangladesh, where the numbers of new diseases affecting people are constantly on the rise.


home | Issues | The Daily Star Home

2006 The Daily Star