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Menopause and associated complications

<div><span style="font-family: helvetica;"><img src="/nairobi/PublishingImages/cervical%20cancer%20body.jpg" alt="" style="margin: 5px;"/> </span></div><div><p style="line-height: normal; margin-bottom: 0pt;"><span style="color: #434343; font-family: helvetica; font-size: 10.5pt;">
</span> </p><p><span style="font-family: helvetica;">Menopause is the cessation of menstrual bleeding which
occurs on average at 50 years. It signals the end of reproductive life in a
woman. At menopause, a woman’s ovaries stop making eggs and produce less
hormones. This period is preceded by the perimenopause which is typically
characterized by irregular menstrual cycles over a few years.</span></p><p><span style="font-family: helvetica;">Some women experience symptoms such as hot flashes, night
sweats, disturbed sleep patterns and a low sexual drive &amp; vaginal dryness.</span></p><p><span style="font-family: helvetica;">Due to very low hormones, women may be predisposed to
complications such as weak and brittle bones, heart problems and memory and
learning disabilities. These complications are rare.</span></p><p><strong style="font-family: helvetica;">Heart Disease</strong></p><p><span style="font-family: helvetica;">Post-menopausal women are more likely than men to have a heart
attack. This is due to the decline in estrogens produced by the ovaries.</span></p><p><span style="font-family: helvetica;">Adopting a healthy lifestyle by eating a heart-healthy diet
filled with whole grains, fruits, and vegetables, will provide a strong defense
against heart problems. Smoking cessation and reduction in alcohol intake is
strongly recommended.</span></p><p><strong style="font-family: helvetica;">Osteoporosis</strong></p><p><span style="font-family: helvetica;">This is where bones become weak and brittle such that a fall
or even mild stress such as bending over or coughing can cause a fracture.
Commonly, fractures occur in the hip, wrist or spine. Bone is living tissue
that is constantly broken down and replaced a process regulated by adequate
oestrogen levels which is lacking in menopause. Osteoporosis occurs when there
is decline of estrogen in creation of new bone doesn&#39;t keep up with the loss of
old bone.</span></p><p><strong style="font-family: helvetica;">Sexual function and
vaginal atrophy</strong></p><p><span style="font-family: helvetica;">Vaginal dryness from decreased moisture production and loss
of elasticity can cause discomfort and slight bleeding during sexual
intercourse. Also, decreased sensation may reduce your desire for sexual
activity (libido).</span></p><p><span style="font-family: helvetica;">Water-based vaginal moisturizers and lubricants may help. If
a vaginal lubricant isn&#39;t enough, many women benefit from the use of local
vaginal estrogen treatment, available as a vaginal cream, tablet or ring.</span></p><p><span style="font-family: helvetica;"> <strong>Urinary incontinence</strong></span></p><p><span style="font-family: helvetica;">This is much more common in older than younger women.
Although not entirely due to low hormone levels, a lack of oestrogen may worsen
bladder symptoms. Testing for a urinary infection and thorough assessment by
doctors is recommended. You may be offered vaginal oestrogen preparations in
some instances to help with the symptoms, especially when recurrent.</span></p><p><span style="font-family: helvetica;">In other instances, strengthening pelvic floor muscles with
Kegel exercises may help relieve symptoms of incontinence. Hormone therapy may
also be an effective treatment option for menopausal urinary tract and vaginal
changes which can result in urinary incontinence.</span></p><p><span style="font-family: helvetica;"><strong>​Sleep problems</strong>
</span></p><p><span style="font-family: helvetica;">After menopause, hot flashes and night sweats may keep you
up at night causing a feeling of exhaustion and fatigue. Regular exercise, a
healthy lifestyle and taking hormone replacement may alleviate this.</span></p><p><strong style="font-family: helvetica;">Mood and certain emotional changes</strong></p><p><span style="font-family: helvetica;">Changes around midlife can be overwhelming and predispose to
mood and emotional problems. Oestrogen production also helps to support certain
types of brain functioning, such as cognition and a decrease may cause some
women to have occasional episodes of forgetfulness, or “fuzzy-brain,” which may
lead to frustration, negatively affecting mood. Mindfulness, exercise and a
healthy lifestyle are usually helpful. Occasionally, your doctor may prescribe
medications for this.</span></p><p><span style="font-family: helvetica;">Whereas symptoms for the menopause may be debilitating, they
are fortunately temporary and long-term complications may be prevented by
appropriate medical advice.</span></p><p><span style="font-family: helvetica;"><em><strong>​By Dr Charles Muteshi, Consultant Fertility Specialist at
Aga Khan University Hospital</strong></em>

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