Sunday, July 3, 2016
Singapore - Coping well with menopause
Q I am 49 and travel frequently for work. I do not go for regular health screening except for my annual Pap smear with my gynaecologist, and my last mammogram was done two years ago.
Generally, I feel healthy and rarely fall ill, although of late I feel a bit more tired and seem to take longer to recover from extended business trips.
I have put on some weight over the last few years, but I also try to watch what I eat and attempt to exercise at least twice a week.
I would like to find out how to better prepare my body for the onset of menopause and other ailments related to ageing. What supplements should I take to ensure that I look and feel healthy as I age?
A Menopause is the last stage of a gradual natural process which leads to menstruation stopping permanently and the end of a women's reproductive period.
The transition period before menopause is called perimenopause, when the body starts producing less oestrogen.
During this period, women may experience some changes emotionally and physically. Some women experience extremely uncomfortable changes while others hardly notice any difference in their bodies or moods.
Symptoms of menopause include irregular menses, weight gain, loss of muscle strength, tiredness, body aches and stiffness, thinning hair, drier skin, more wrinkles and also mood swings. Some may experience headaches and palpitations.
There is also rapid loss of bone in the first three to five years after menopause. Hence, this may lead to osteoporosis and an increasing risk of fractures.
Decline in oestrogen levels in older women after menopause leads to higher low-density lipoprotein cholesterol levels, contributing to a higher risk of heart disease. As the metabolic rate decreases with age, menopausal women find that they put on weight despite consuming the same amount of energy. Weight gain increases risk of high blood pressure, diabetes and heart disease. Hence to cope with menopause, you should:
Have a healthy, well-balanced diet to combat weight gain.
Reduce sugar and fat intake, and increase your intake of whole grains and brown rice. Fermented beans and soya products like bean curd are high in phytoestrogens and may reduce menopausal symptoms.
Ensure adequate calcium and vitamin D intake to prevent osteoporosis.
An adult aged 50 and above will need 1,000mg of elemental calcium and between 400 and 1,000IU of vitamin D daily. Most women do not have enough vitamin D. It will be good to do a blood test to check for your level of vitamin D.
Lead an active lifestyle.
Do a regular combination of cardio, weight-bearing and balancing exercises. Ageing is often hastened by physical inactivity.
Post-menopausal women who exercise regularly are about half as likely to develop diabetes compared to their sedentary counterparts. Gentle exercises that promote mobility, flexibility and relaxation also decrease stiffness and soreness of muscles.
Have enough rest and sleep.
If you have hot flushes which disturb your sleep, wear cool clothing and reduce the intake of alcohol, coffee or spicy food.
You should also do a health check to exclude hypothyroidism as you complain of weight gain and tiredness as well.
All perimenopausal and menopausal women should have a check-up which includes breast-cancer screening, Pap smear, screening for risk of heart disease, diabetes, cholesterol, hypertension and bone-density changes as early detection and treatment will improve quality of life in later years. In cases where symptoms of menopause are bothersome and severe, hormone replacement therapy may be prescribed.
But, most of the time, lifestyle changes and understanding the process of menopause will help one to manage the symptoms well. Most women do not need treatment for menopause and many women continue to live active and interesting lives after menopause.
Dr Lau Pik Onn
Resident physician at the Thomson Well Women Clinic