Menopause

Menopause is the permanent end of menstruation and fertility, defined as occuring 12 months after your last menstruation period.

Peri-menopause:
- By the age of 40 years, women already have changes in their bone density and, at the age of 44 they can experience menstrual changes.
- Peri-menopause can start 2-10 years before the last period.
Bloodtest:
- Elevated FSH levels (60-100 mlU/L)
- LH levels (> 50 mlU/L)
- Estradial (< 50pg/ml)
- Ovulation cycles and menstruation become less regular.

PERIMENOPAUSE IS A NORMAL PROCESS, NOT A DISEASE!
The better the shape you are in (physically, nutritionally, mentally, metabolically, spiritually and situationally) going into menopause, the more enjoyable the journey!!!

"Menopause is not a natural condition, it is an endocrine disorder and should be treated medically with the same seriousness we treat other endocrine disorder." (Mucclough 1996).

Hormone replacement therapy is recommended almost exclusively for younger postmenopausal women, particularly those who have had early onset menopause.

Lower doses of HT are becoming more common. Transdermal preparations of hormones may be at lower risk for blood clots than using oral HT.

PELVIC HEALTH & MENOPAUSE:

1. Urogenital complaints: Oestrogen deficiency after menopause cause atrophic changes to the urogenital tract and is associated with urinary symptoms.

• Urinary incontinence
• Lower urinary tract symptoms

1. Decreased sexual desire, sexual function and orgasm
2. Administration of testosterone has been shown to result in significant improvement.

• Increase testosterone without pharmaceuticals by eating food rich in Zinc:
• Seafood such as oysters and crab
• Meats such as lean beef and poultry
• Dairy products including yogurt and cheese
• Nuts and beans, such as chickpeas, cashews and almonds
• Urogenital atrophy, vaginal dryness, dyspareunia
• Causing burning sensation and irritation in the genital area and also an urgent need to urinate, painful urination and recurrent urinary tract infections.
• The musculoskeletal structures of the lumbopelvic area intimately affect the pelvic floor muscle and may cause pain with sexual activity. Intra- articular hip disorders such as femoroacetabular impingement are common in women and hip evaluation is important.

1. Bowel dysfunction

• Peri- and post-menopausal women have a high prevalence or altered bowel function and IBS like gastro intestinal complaints.
• Treatment:
• Diet rich in grains, legumes, fruit and vegetables, beans, potatoes, brown rice are major sources of energy for epithelial cells in the colon.
• Vitamin C and Zinc may both help heal epithelial wounds in the colon

1. Faecal incontinence.

• Regardless the type of delivery, anal incontinence occurs in a surprisingly large number of middle aged women. Faecal incontinence appears to be more prevalent in menopausal women.
• Parity and labor are risk factors and not the mode of delivery.
• Menopausal hormonal therapy is associated with the increased risk of faecal incontinence in women after menopause. The risk of FI increased with longer duration of MHT and decreased with time since discontinuation.
• Anal penetrative intercourse is a risk factor for faecal incontinence

1. Bone health:

• Bone health is not just old ladies' business! Osteoporosis can occur without a known cause or be attributed to another secondary condition, such as hyperthyroidism, coeliac disease, medication or menopause.
• Osteoporosis can have a systemic effect on:
• Breathing
• Cardiac function
• Digestion
• Mobility
• Pain
• Continence
• Mental Heath
• Treatment
• Calcium supplements
• Bisphosphonates
• Movement
• Low load, high repetitive resistance training increases bone mineral density.
• Strengthening exercise may lead to increase in mineral density of the bones
• High intensity resistance and impact training improves bone mineral density
• Vitamin D and sunshine
• Endocrine balance
• Optimal diet
• Effective stress management and great digestion