Coping with Mother Nature: Menopause

Gynaecologists shed light on the transition towards menopause and how to manage symptoms best.

People joke about a mid-life crisis in men, but for women, it takes a physical form. In Pakistan though, the management of menopause is not always clearly understood. We spoke to some experts to gain an understanding.

Mood swings

Hormone shifts can affect mood and behaviour during the transition. You can be:

• Uncharacteristically nervous

• Forgetful (memory loss)

• Experience sudden anxiety, worries over minor events

• Fall into depression

• Have hot flashes (typically experienced as a feeling of intense heat with sweating and rapid heartbeat)

• Gain weight (both during the transition and after menopause because metabolism slows down in the female body)

Management and care:

• Get some sunlight, at least once a day. Sunlight helps naturally produce Vitamin D which helps the gastrointestinal tract (the stomach and the intestine) to absorb calcium to help your bones

• During the transitional period, women may need to eat less and exercise more — just to maintain their current weight

• Eat healthy — it is important to use grains, vegetables, fruits and beans that are low in sodium and high in calcium. Replace white bread with brown bread and introduce whole wheat to your diet

• Cutting your sodium intake to less than 2 grams per day has been shown to improve bone health. Be mindful when buying regular or fat-free cheeses because they are typically high in sodium

• Avoid smoking — it is harmful for the bones as well as the lungs

Hit 40

Medical examinations and tests are important for women once they reach their 40s, according to Dr Shama Nawaz, an obstetrician and gynaecologist at Al-Zahra hospital, UAE. These steps are also a good check-list for post-menopausal care.

• Keep a check on your cholesterol levels. Due to estrogen withdrawal, women are at a higher risk of heart disease, most importantly the coronary heart disease

• Get the DXA or DEXA (dual X-ray absorptiometry) to check bone density and the risk of osteoporosis

• Get a mammogram, especially if breast cancer has been in family history. Risk of breast cancer is also higher post-menopause

• A cervical smear and a pelvic scan are also recommended to rule out the possibility of any complications



Bone tired

• Both, during and after the transitional period towards menopause, women should take good care of their bones to avoid the possibility of fractures, especially in the neck of the femur, which is the long bone of the thigh

• The risk of osteoporosis (a bone disease featuring abnormally rapid bone loss, aggravated by calcium wasters) increases post-menopause

• Caffeine intake of greater than 300mg per day (about two cups) accelerates bone loss

• Long-term smokers have 10% weaker bones and 90% higher risk of fractures

SOURCE: DR SUMBUL SOHAIL, GENERAL SECRETARY OF THE PAKISTAN MENOPAUSE SOCIETY

Published in The Express Tribune, Sunday Magazine, October 20^th, 2013.