Among the most common cancers in the world, breast cancer has been a global health concern for decades now. As per the World Health Organization, 2.3 million women were diagnosed with breast cancer and 670,000 deaths globally in 2022. To raise awareness about this deadly disease and promote early detection and prevention, October is observed as Breast Cancer Awareness Month around the globe. While there are a range of risk factors from genetics to lifestyle, one prominent factor that can influence breast cancer risk and has often been overlooked is the timing of menopause. To delve deeper into how hormonal changes during menopause can impact breast health and proactive measures women can undertake, we contacted Dr. Poonam Patil, consultant in medical oncology at Manipal Hospital (Old Airport Road), and Dr. Geeta Kadayaprath, senior consultant in breast surgery at Apollo Cancer Centre (New Delhi). Below, the medical experts answer pressing questions about breast health. How do hormonal changes during menopause affect breast health? Patil: Menopause signifies the end of a woman's reproductive years, characterised by a reduction in estrogen and progesterone production by the ovaries. Estrogen is crucial for the development and maintenance of breast tissue, and its reduction during menopause can lead to various changes in the breasts. Breast tissue is made of glandular and fatty tissue, and as estrogen reduces, glands start shrinking, the breast becomes less dense and fattier. This transition may lead to sagging in the breasts and size may change. The decrease in hormone levels can make breast tissue less resilient and more prone to various changes. Are there specific risk factors for breast cancer during menopause? Patil: Yes, several risk factors for breast cancer become particularly relevant during menopause. Age: The risk of developing breast cancer increases with age, with the majority of cases diagnosed in women over 50. However, in the last few years, there has been a shift in age groups and even younger women are diagnosed with breast cancer. Family history: A family history of breast cancer is a risk factor, regardless of menopausal status, especially if close relatives were diagnosed with breast or ovarian cancer at an early age. Genetic mutations: Women with mutations in the BRCA1 or BRCA2 genes have a higher risk of breast and ovarian cancer. Hormonal factors: Long-term exposure to estrogen, such as those who started menstruating early or went through late menopause, is a risk factor. Body weight: Postmenopausal obesity is associated with higher estrogen levels due to fat tissue's ability to produce estrogen, increasing breast cancer risk. Lifestyle choices: Factors like alcohol consumption, smoking, and lack of physical activity can also contribute to increased risk. What are the key hormonal changes that occur during menopause and how do they impact breast tissue? Patil: During menopause, there occurs a significant drop in estrogen and progesterone levels because of the non-functioning of the ovaries. Estrogen plays a critical role in the growth and maintenance of breast tissue, and bone health, and its decline leads to the following effects: Loss of glandular tissue: The glandular components of the breast shrink, leading to an increase in fatty tissue. The breast size also may reduce and may sag. Altered breast density: As glandular tissue diminishes, breast density decreases. Increased fatty tissue: With the reduction of estrogen, there may be an increase in fat deposition in the breasts, which can alter their texture and appearance. Also Read: ‘I was always exhausted’: Things about menopause that no one prepares you for What are some common misconceptions about breast cancer during menopause? Kadayaprath: During menopause and otherwise, women believe that painless lumps are not a concern. On the contrary, a new lump which is painless and is of recent origin, should be investigated. With menopause, the probability of developing breast cancer goes up. About 75-80% of breast cancers happen in women over the age of 50. Any change in the breasts should not be ignored. Other than a painless lump, spontaneous bloody or clear nipple discharge, dimpling of the skin, orange peel appearance of the skin and nipple retraction could all indicate breast cancer. Menopausal women and even younger women should not ignore any of these symptoms if these are of recent origin. What are the early signs and symptoms of breast cancer in menopausal women? Patil: Early detection of breast cancer is crucial for effective treatment. Breast cancer is curable if detected early. Women should be vigilant for specific signs and symptoms, including: Lump or mass: The most common symptom is often a painless lump or mass in the breast or underarm area. Changes in breast size or shape: Any noticeable change in the size or shape of the breast requires an evaluation. Skin changes: Dimpling, puckering, or changes in skin texture (e.g., redness or scaling) should be evaluated. Nipple changes: Spontaneous blood-stained discharge or changes in the appearance of the nipple can be concerning. Persistent pain: While breast pain is common, persistent pain in one breast or localized to a specific area warrants investigation. What role does hormone replacement therapy (HRT) play in breast cancer risk? Patil: Hormone Replacement Therapy (HRT) is often prescribed to alleviate menopausal symptoms by replenishing estrogen mainly. However, HRT has been linked to an increased risk of breast cancer, especially with some preparations. The impact of HRT on breast cancer risk varies based on individual factors, including family history and personal medical history. It is essential for women considering HRT to discuss the potential risks and benefits with their doctor, especially concerning breast cancer risk. What are the most effective methods for early detection of breast cancer in menopausal women? Patil: Regular screening for breast cancer is crucial for all women, particularly those who are postmenopausal. Breast self-exams: Breast self-exams can help women become familiar with their breast tissue and detect any unusual changes early. Mammograms: Women aged 40 or older should have mammograms annually, along with an ultrasound of the breast or an MRI of breasts in some situations. Clinical breast exams: Regular check-ups with a doctor can help identify changes that might not be evident during self-exams. Screening is vital because early-stage breast cancer often presents with minimal or no symptoms. Regular mammograms and clinical evaluations significantly increase the chances of early detection, leading to more effective treatment and better outcomes. Also Read: Breast Cancer Awareness Month: Fear of test results delays breast cancer diagnoses, say Mumbai doctors How can women maintain a healthy lifestyle to reduce their risk of breast cancer during and after menopause? Kadayaprath: To reduce the risk of breast cancer, one must focus on lifestyle changes. The most important changes one can incorporate in one’s lifestyle are regular and moderate-intensity exercises and inculcating healthy food habits. Moderate-intensity exercise, means about 3.5 hours of exercise during the week. It is also essential to keep one’s body weight in check as it is now quite well-known that obesity is associated with a higher risk of cancer. For nutritional needs, it is important to seek the services of a trained nutritionist to advise according to the body type and the specific needs of the individual. While one should include more coloured fruits and vegetables in their diet, one must also pay attention to the source of the food on the plate. How can women with a family history of breast cancer manage their risk during menopause? Kadayaprath: If there is a strong family history of breast cancer, and one of the first-degree (mother, sister, daughter) relatives with breast cancer has had a genetic test done and found to have a mutation (an error in the gene), then the lady in question should undergo genetic counselling and testing. Family history alone contributes to about 5 to 10 per cent of all breast cancer cases. The history of significance is when one of the first-degree relatives has got breast cancer and is of a certain subtype called triple-negative breast cancer or ovarian cancer or there is a first-degree relative with cancer in both breasts. Or, if there is a male relative with breast cancer and so forth. Even with a high-risk family history, one should focus on lifestyle changes and seek a consultation with a genetic counsellor to ascertain the risk of developing breast cancer.
21 October,2024 09:55 AM IST | Mumbai | Maitrai AgarwalKarwa Chauth is considered an important Indian festival which involves a day-long fast, traditionally observed by married women. Now also observed by some men to support their partners, the fast is broken only after the moon rises. It usually lasts for 12-15 hours, with people not eating or drinking anything during this period. While Karwa Chauth fasting is a traditional practice and is usually considered food for detoxification, if not done right, it can pose several complications, especially for people with existing health conditions. A drop in blood sugar levels is one such issue. Dr. Ankita Tiwari, Consultant - Diabetes & Endocrinology, Manipal Hospital Bhubaneshwar, informs, “When you fast, the body does not get its regular food source of glucose i.e., no carbs to digest which can result in lowering blood sugar. This natural response will not create an issue when one is not a diabetic, but people with conditions like diabetes, especially those on medication can likely develop a risk of hypoglycemia (which simply means low blood sugar).” The hormonal changes that occur in the body while fasting also impact blood sugar levels. “It is a known fact that fasting influences insulin and glucagon – both hormones that help regulate blood sugar. For some people, any shift in meal patterns can disrupt their usual blood sugar control management,” she adds. Tips to maintain blood sugar levels while fasting It is extremely important to assess your health before keeping the fast. “Those individuals living with diabetes who wish to incorporate fasting must align their plans with their diabetologist or nutritionist/dietician so that they can prepare in advance,” suggests Dr. Tiwari. Jinal Patel, Dietitian, Zynova Shalby Hospital Mumbai, says, “If you are diabetic and want to fast then you should try consulting a doctor before you start. Your doctor may assess your health and blood sugar levels and suggest recommendations accordingly.” Experts share the following tips: Stay hydrated Drink an adequate amount of water during non-fasting duration. Dehydration can affect blood sugar levels. Check blood sugar level Monitor the blood sugar before fasting and after fasting so that if there are any fluctuations, necessary steps can be taken to bring blood sugar under control. Eat balanced food before and after fasting What you eat before and after the fast makes a huge difference when it comes to Karwa Chauth fasting. “Remember to eat a balanced meal. Your plate should have carbohydrates, proteins, fruits, food high in fibre content and healthy fats before you start the fast (commonly known as Sargi in Hindi) and after finishing your fast. Fibre-rich foods including whole grains, millet, and legumes, help regulate blood sugar levels by slowing down the process of digestion and absorption,” informs Dr. Tiwari. Patel says, “Opt for healthy and fulfilling options like whole grains, vegetables, fruits and lentils to maintain your sugar levels.” “If you start to feel uneasy or your blood sugar levels start to fluctuate then do not hesitate to break your fast. Always listen to your body and avoid doing things that can affect your overall health,” she adds. Post-fast nutrition While blood sugar levels can drop while fasting, they can also increase if excessive carbohydrates are consumed after breaking the fast. “Long periods between meals can cause stress on the body. When one resorts to consuming excessive amounts of carbohydrate foods immediately after breaking a fast, it may lead to high blood sugar levels,” says Dr. Tiwari. To prevent this, one must cut out sugar-intense foods and beverages that can spike blood glucose quickly. Dr. Tiwari suggests the following foods that one can opt for: 1. Protein-packed foods including legumes (lentils, chickpeas, black beans), quinoa, tofu, tempeh, dahi or curd (without any added sweetener), paneer, nuts and seeds, edamame, seitan and protein-rich whole grains like amaranth and buckwheat are some of the options. They can help balance blood sugar and keep you satisfied longer. 2. Complex carbohydrates such as millet, brown rice, quinoa or whole wheat chapati that are digested slower than simple carbohydrates. 3. Healthy fats such as nuts, seeds or avocado because fat helps with staying full and curbing blood sugar levels. 4. High-fibre vegetables, especially no-starchy options like leafy greens, spinach (palak), fenugreek leaves (methi), mustard greens (sarson), broccoli, bottle gourd (lauki), bitter gourd (karela), cucumbers (kheera), radishes (mooli) and drumsticks, are very low in calories and fibrous. One should not opt for heavy meal options since consuming large portions after fasting or before fasting, can affect metabolism. “Eat in small portion size. This can help avoid overeating and ensure to have balanced meals,” suggests Patel. “Avoid eating foods that are oily, spicy and processed like pakoda, noodles, chips, fries, samosa, cutlet, chat, kachori, bhel puri, and pav bhaji. Go for light food options like khichdi, soups, salads, sprouts, porridge and raita,” she concludes. Also Read: A guide to festive nutrition
20 October,2024 08:48 PM IST | Mumbai | Raaina JainCancer patients are nearly five times more likely to experience bankruptcy, as financial fallout can follow patients with cancer and their families in the form of lower credit scores and other forms of monetary challenges years after a cancer diagnosis. For patients with bladder, liver, lung, and colorectal cancers, the impact on credit scores was larger compared with other types of cancers, said researchers at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston in the US. “These are the first studies to provide numerical evidence of financial toxicity among cancer survivors. Previous data on this topic largely relies on subjective survey reviews,” said Benjamin C James, chief of general surgery at Beth Israel Deaconess Medical Center and associate professor of surgery at Harvard Medical School. The first study included 99,175 people who had a cancer diagnosis from 2010 through 2019 and 188,875 non-cancer patients to serve as a control. Researchers matched patient registry data with Experian credit bureau data to evaluate objective financial markers of financial toxicity. Patients with cancer had higher rates in total debt collections, medical collections, and bankruptcies. Cancer patients are nearly 5 times more likely to experience bankruptcy. The cancer patients also had average credit scores nearly 80 points lower. The second study used a sample of 7,227 patients with colorectal cancer and identified a number of factors that correlated with lower credit scores. The study also found that declines in credit scores are larger for people with bladder, liver, lung, and colorectal cancers, and persist for up to 9.5 years after diagnosis. However, Dr James noted that the researchers did not directly correlate cancer prognosis with financial toxicity, but that some more aggressive cancers actually have less financial toxicity than cancers with a good prognosis. “There are certain factors that are associated with worse financial toxicity, including being under the age of 62, identifying as Black or Hispanic, not being married, having an area deprivation index below the median, not owning a home, and having an income below a median of $52,000 a year,” Dr James noted. The studies followed up on findings from the 2015 North American Thyroid Cancer Survivorship Study, which showed that 50 per cent of thyroid cancer survivors encountered financial toxicity due to their diagnosis. “Further research is needed, but I think financial security should be a priority in cancer care,” said the authors. Also Read: Mid-Day Explains | 'Your health needs a safety net': Mumbai experts urge 8-10 lakh savings for major illnesses like Cancer and heart disease This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
20 October,2024 01:48 PM IST | Mumbai | IANSListening to music may help patients recover from surgery through a lower heart rate, reduced anxiety levels, less opioid use and lower pain, according to researchers. A reduction in cortisol levels when listening to music may play a role in easing patients’ recovery, according to a meta-analysis presented at the American College of Surgeons (ACS) Clinical Congress 2024 in San Fransisco. “When patients wake up after surgery, sometimes they feel really scared and don’t know where they are,” said Eldo Frezza, professor of surgery at California Northstate University College of Medicine. “Music can help ease the transition from the waking up stage to a return to normalcy and may help reduce stress around that transition.” Dr Frezza and study co-authors noted that unlike some more active therapies such as meditation or Pilates which require considerable concentration or movement, listening to music is a more passive experience and can be incorporated by patients without much cost or effort almost immediately after surgery. To reach this conclusion, the team analysed existing studies on music and its role in helping people recover from surgery, narrowing a list of 3,736 studies to 35 research papers. In their analysis, the researchers found that the simple act of listening to music after surgery, whether with headphones or through a speaker, had noticeable effects on patients during their recovery period: Patients who listened to music had a statistically significant reduction in pain the day after surgery. Across all studies, patient self-reported anxiety levels were reduced by about 2.5 points, or 3 per cent. Patients who listened to music used less than half of the amount of morphine compared to those who did not listen to music on the first day after surgery, the research noted. They also experienced a reduced heart rate (around 4.5 fewer beats per minute) compared with patients who did not listen to music. “Although we can’t specifically say they’re in less pain, the studies revealed that patients perceive they are in less pain, and we think that is just as important,” said Shehzaib Raees, first author of the study. Also Read: Standards for safe listening must to save youngsters from hearing loss: Experts This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
20 October,2024 01:32 PM IST | Mumbai | IANSOver 1 billion young people are at the risk of hearing loss globally due to unsafe listening habits, and it is important for policymakers and regulators to develop global standards not only for device manufacturers but also for users and services, experts have stressed. At a workshop organised during the ‘ITU-WTSA 2024’ in the national capital, Nidhi Khare, Secretary, Department of Consumer Affairs, said there should be training for tracking sound exposure, on the lines of tracking other health parameters like calorie intake and footsteps. "In our culture, there's a festival called ‘Mauni Amavasya’, in which one is supposed to keep quiet and fast. Perhaps, relishing the sound of silence. I think that is extremely therapeutic and we must realise that together, we can create a difference for not only India, but for the world at large,” said Khare. The joint ITU-WHO workshop on safe listening addressed the urgent global public health crisis of hearing loss, and the dangers posed by unsafe listening practices. In response to this growing public health problem, the WHO launched the ‘Make Listening Safe’ initiative in 2015, with the aim of preventing hearing loss through hearing conservation. P Payden, Deputy Head, WHO country Office, India, said that the cascading consequences of hearing loss translates into millions facing communication challenges, diminished quality of life, and potential impact on professional development/education. “Besides, noise-induced hearing loss in children can impair language acquisition, leading to learning disabilities and increased anxiety. Untreated hearing loss can lead to isolation, depression, and cognitive decline,” she mentioned. The global ITU standard for safe listening devices and systems provides a framework for incorporating features into personal audio devices, such as acoustic symmetry which monitors a sound allowance for a given period. “The WHO is committed to promoting safe listening practices through research. Dissemination of evidence-based guidance and collaborating with stakeholders to create safe listening. Hearing loss is irreversible, but it's preventable,” said Payden. Also Read: Wearing earphones for prolonged periods may damage your hearing; here's how This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
20 October,2024 12:08 PM IST | Mumbai | IANSMenopausal women who regularly swim in cold water report significant improvements to their physical and mental symptoms such as anxiety, hot flushes, finds a new study. The research, published in the journal Post Reproductive Health, surveyed 1,114 women, 785 of which were going through the menopause, to examine the effects of cold water swimming on their health and wellbeing. Led by researchers from the University College London (UCL), the findings showed that menopausal women experienced a significant improvement in anxiety (as reported by 46.9 per cent of the women), mood swings (34.5 per cent), low mood (31.1 per cent) and hot flushes (30.3 per cent) as a result of cold water swimming. In addition, a majority of women (63.3 per cent) swam specifically to relieve their symptoms. “Cold water has previously been found to improve mood and reduce stress in outdoor swimmers, and ice baths have long been used to aid athletes’ muscle repair and recovery,” said senior author Professor Joyce Harper from UCL’s EGA Institute for Women’s Health. “Our study supports these claims, meanwhile the anecdotal evidence also highlights how the activity can be used by women to alleviate physical symptoms, such as hot flushes, aches and pains. “More research still needs to be done into the frequency, duration, temperature and exposure needed to elicit a reduction in symptoms. However, we hope our findings may provide an alternative solution for women struggling with menopause and encourage more women to take part in sports,” Harper added. Alongside aiding menopausal symptoms, the women said their main motivations for cold water swimming were being outside, improving mental health and exercising. “The majority of women swim to relieve symptoms such as anxiety, mood swings and hot flushes. They felt that their symptoms were helped by the physical and mental effects of the cold water, which was more pronounced when it was colder,” Harper said. “Those that swam for longer had more pronounced effects. The great thing about cold water swimming is it gets people exercising in nature, and often with friends, which can build a great community.” The researchers also wanted to investigate whether cold water swimming improved women’s menstrual symptoms. Of the 711 women who experienced menstrual symptoms, nearly half said that cold water swimming improved their anxiety (46.7 per cent), and over a third said that it helped their mood swings (37.7 per cent) and irritability (37.6 per cent). Yet despite the benefits of cold water swimming, the researchers were also keen to highlight that the sport comes with certain risks. “Caution must be taken when cold water swimming, as participants could put themselves at risk of hypothermia, cold water shock, cardiac rhythm disturbances or even drowning,” Harper explained. “Depending on where they are swimming, water quality standards may also vary. And, sadly, this can increase the likelihood of gastroenteritis and other infections.” This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
18 October,2024 11:28 AM IST | London | IANS
For Priyanka (name changed), a Mumbai-based retired government employee, the period of her mid-40s was daunting. Apart from hot flashes, constant exhaustion and cranky mood, she also faced physical complications after menopause, a phase she reached at the age of 45. Coping with work, home and family became difficult. “Around menopause, there was a time when I had heavy bleeding, which lasted for the entire month. I had to get a D&C procedure done. During that time, I also got typhoid and malaria, which led to a massive weight loss,” she shares. The definition of menopause seems fairly simple – a phase when a woman’s menstrual cycle ends and she is no longer able to reproduce. However, this nine-letter word holds implications and complications that far exceed the scope of this definition. World Menopause Day is marked on October 18 every year to raise awareness about the condition and various support options available to help navigate the challenges, not limited to physical complications. Women also have to battle mental and emotional difficulties during this period. After 53-year-old Veena (name changed) reached menopause at the age of 48, she started experiencing things she didn’t before. “Since menopause, I start sweating easily which is often accompanied by a sense of unease and anxiousness. Additionally, I have frequent mood swings. I have also observed that after menopause, I get emotionally hurt even by little or insignificant things,” she reveals. Another often-ignored aspect of menopause is the effect it has on one’s intimate relationships and sex life. As the taboo around menopause slowly starts fading, and conversations start seeing the light of day, mid-day.com speaks to medical experts who highlight what people need to know about menopause and life after it. When does one reach menopause? “When one does not have periods consistently for 12 months, menopause is considered final,” informs Dr Nirmala Chandrashekar, Sr. Consultant Obstetrics and Gynecology, Gleneagles BGS Hospital, Bangalore. However, before reaching there, women may also start experiencing irregular periods. This phase is called perimenopause, which comes with its own set of challenges. Physical changes and complications during menopause As one reaches menopause, several physical changes might occur in the body. A major one is the reduction in skin elasticity, says Dr. Chandrashekhar. “As skin elasticity decreases, wrinkles start appearing,” she states. Menopause also has an impact on other organs of the body, which can either give birth to new health complications or worsen existing ones. Dr. Chandrashekhar informs: The ovaries and uterus atrophy after menopause. Reduced estrogen levels may also lead to vaginal dryness. Bones tend to weaken, which might cause susceptibility to fractures. The heart may also get affected, increasing the risk of coronary artery disease or cardiovascular complications. There are chances that vision might also get affected. Urinary infections and other problems are also common after menopause. Mental and emotional challenges after menopause While physical challenges are often talked about, most women are not prepared for the mental and emotional changes that accompany menopause. This phase can cause various neurological changes, according to Dr. Chandrashekhar. “This can cause various mental health issues and also lead to episodes of migraine,” she explains. She continues, “Anxiety episodes are common in women after menopause. They often experience hot flashes i.e., they start sweating profusely, which may be accompanied by panic or anxiety.” Relationship counsellor Ruchi Ruuh believes that menopause is a significant transition that can bring about complex mental and emotional challenges. “The decline of essential hormones leads to mood fluctuations, increased irritability and even heightened anxiety or depression,” she states. “Women may find themselves feeling overwhelmed by changes in their sense of identity and body. They may struggle with a sense of loss of fertility and youth that can create a negative outlook towards their own body. Additionally, cognitive changes such as memory retention or difficulty concentrating can be unsettling. Each woman’s experience is unique and while some may breeze through this phase, some may experience it more severely,” she adds. Intimacy and sex after menopause These physical and emotional challenges can also impact intimacy. Ruuh explains, “The reduction in estrogen can lead to vaginal dryness, thinning tissues and discomfort during sex, which can decrease sexual desire. Emotional intimacy can also be impacted—hormonal fluctuations may cause mood swings, emotional distancing or even a dip in self-esteem, making it harder to feel connected or confident around their partner.” Challenges in both physical and emotional intimacy can impact sex after menopause. According to Dr. Rajan Bhonsle, Hon Professor & HOD, Department of Sexual Medicine, KEM Hospital & G.S. Medical College, one’s sex life can change for the better or worse. “I have seen two things happening. One is that the sex life gets better due to many factors. There’s no fear of pregnancy anymore. By the time menopause occurs, couples are quite well-experienced in terms of each other’s preferences in sex. At this point, their children are also usually well-settled and living their own lives, so there are no privacy obstacles. So, I have seen many couples saying that this is the best time of their lives,” Dr. Bhonsle informs. He continues, “There are other people who believe that their sex life is over just because the woman has reached menopause. Women might also have self-esteem issues, feeling things like they don’t look as attractive anymore. The partner may also comment on her saying things like ‘I don’t get aroused by you anymore’ or ‘you’ve put on too much weight after menopause’. These are things that negatively impact the sex life.” Physical changes in the body may also cause complications in sex. Dr. Bhonsle explains, “Due to lack of oxygen, the vagina can start remaining dry. There’s also a thinning of the vaginal lining which makes it prone to abrasions and injuries, if there’s no proper lubrication. So, many people complain about pain while having sex, or remaining dry.” While physical issues can be treated with medications prescribed by qualified experts, psychological or relationship issues pose a risk to healthy sex life. How to navigate menopausal challenges Priyanka navigated this difficult phase of life by taking leaves from work, resting and focusing on her health. She also engaged in yoga and meditation which significantly helped her symptoms. Every woman’s journey with menopause is different, posing diverse challenges. However, experts suggest some important ways to navigate these. Dr. Chandrashekar believes regular health check-ups are significant. “Through regular scans, bone density can be tested and necessary steps can be taken to improve it such as calcium supplements. Additionally, check-ups are essential to rule out issues of the ovaries, uterus or risk of cervical cancer,” she says. Physical challenges while having sex can also be navigated with proper medical processes, as Dr. Bhonsle informs. “If the couple is passionate, has had a healthy relationship and sex life, physical issues can be navigated without affecting sex,” he states. To navigate intimacy, Ruuh suggests, “Instead of seeing physical and emotional changes as an end of intimacy, it can be an opportunity to rediscover new forms of closeness with cuddling and exploring non-penetrative forms of sex.” She suggests the following tips: Discuss the changes you're experiencing, both physically and emotionally, with your partner. Being open about discomfort or shifting desires can prevent feelings of rejection for both partners. If emotional distress or physical discomfort becomes overwhelming, seeking help from a therapist or healthcare provider can be a game-changer. Having a supportive group of friends can also make this phase less daunting by talking about the journey and experiences. Physical touch and closeness can evolve to include more massages, cuddling or intimate conversations rather than solely on sex. The use of sexual aids such as toys, lubricants, etc., can help couples enjoy moments of intimacy together. Prioritising your well-being through regular exercise, mindfulness and self-compassion can boost your mood and reduce anxiety. Instead of seeing menopause as an end, embrace it as an opportunity to redefine your relationship with yourself and your partner. Disclaimer: This does not replace professional medical advice. Consult a qualified medical expert for personalised guidance. Also Read: Why contraceptives are still essential after 40 until menopause is confirmed
18 October,2024 10:44 AM IST | Mumbai | Raaina JainContraception is often considered a priority during the early reproductive years, but many women overlook its importance after the age of 40. Fertility decreases with age, but pregnancy is still possible, and unplanned pregnancies can carry significant health risks for both mother and child. On World Contraception Day, Dr. Asha Dalal, Director, Obstetrics and Gynaecology, Sir H.N. Reliance Foundation Hospital, Mumbai, highlights why women should continue using contraception until they are certain they have reached menopause. Women can get pregnant even in their 40s While the increase in age is linked to decrease in fertility among women, the chances of pregnancy do not vanish entirely. “As women age, their fertility naturally declines due to the depletion of viable eggs and changes in hormonal balance. By the time a woman reaches her 40s, the chances of conceiving decrease significantly. However, the likelihood of pregnancy, though reduced, does not entirely vanish. Some women continue to ovulate until menopause, making pregnancy a possibility even in their late 40s,” clarifies Dr. Dalal. “The period leading up to menopause, known as perimenopause, is marked by irregular menstrual cycles and fluctuations in hormone levels, but ovulation may still occur sporadically. Since ovulation can be unpredictable, women may unknowingly be at risk of pregnancy, even if their periods have become irregular or less frequent,” she adds. Health risks of pregnancy after 40 While there have been several instances of women successfully navigating pregnancy after the age of 40, there are many health risks associated with it. Dr. Dalal states the following risks: Women over 40 are more likely to experience complications such as gestational diabetes, preeclampsia and hypertension. There is also a higher risk of chromosomal abnormalities in the baby, such as Down Syndrome. The rates of miscarriage and still birth are higher in older women, as are the chances of requiring a cesarean section due to complications during delivery. Additionally, she states, “Unplanned pregnancies at this age can be emotionally, physically and financially taxing, especially when health concerns are at the forefront.” When to stop contraception? Given the health risks associated with unplanned pregnancies, contraception methods should be used until menopause is confirmed. However, determining this can prove to be challenging. “Menopause is confirmed when a woman has gone 12 consecutive months without a menstrual period. However, during perimenopause, menstrual cycles can be erratic, and women may go several months without a period, only to menstruate again. This unpredictability makes it difficult to determine when ovulation has truly ceased,” explains Dr. Dalal. “One year without a period or in some cases, hormone tests may be used to assess whether a woman has entered menopause. These tests are not always definitive due to hormonal fluctuations during perimenopause,” she adds. Also Read: ‘I couldn’t even talk to my friends about it’: Why women in their 40s are now talking about Perimenopause Contraceptive options for women over 40 There are various contraceptive options that can be considered, keeping the age factor in mind. “If you are not having sex often, you may not want a daily hormonal pill or long-term contraceptive,” says Dr. Dalal. She reveals the following options: Non-hormonal methods like condoms, copper IUDs and sterilisation are viable choices for those concerned about hormone use. Hormonal methods, such as birth control pills, hormone-releasing IUDs or implants can also be considered, though they may not be suitable for women with certain health conditions, like a history of blood clots or breast cancer. Additionally, she mentions, “For some women, hormone-based contraception offers the additional benefit of managing perimenopausal symptoms, such as hot flashes, heavy periods and mood swings. However, the choice of contraception should always be personalised based on a woman’s overall health, lifestyle and reproductive goals.” Consulting a healthcare provider can help women choose the safest and most appropriate contraceptive method. Additionally, contraception should be a shared responsibility among men and women. Disclaimer: This information does not replace professional medical advice. Consult a qualified expert for personalised guidance.
18 October,2024 10:24 AM IST | Mumbai | mid-day online correspondentMenopause is a natural process that women usually experience in their late 40’s. In menopause, women do not experience periods or menstrual cycles for more than 12-14 months. This hormonal shift causes a physical and psychological impact on a woman’s health and body. It is essential to make certain lifestyle modifications to improve heart health and overall well-being. Dr Nitin Gupte, Gynaecologist, Apollo Spectra Pune lists down important measures for menopausal women for a healthy life Engage in physical activities: Women are advised to engage in light physical activities to maintain their mobility throughout the day. This can be achieved by doing yoga, light cardio, swimming, cycling, or breathing exercises to keep your heart health in control. They can gradually start by going for morning walks, as morning walks not only refresh mood but also help maintain heart health during menopause. Exercising regularly can help lower your blood pressure and improve blood flow which in turn can keep various heart problems such as heart attacks at bay. Eat well-balanced meals: It is important to eat nutritious food while going through the transition of menopause. A well-balanced diet helps maintain your heart health and overall well-being. Fresh fruits and vegetables, proteins, and omega-3 fatty acids are vital for your heart. Nuts like walnuts, pistachios, and almonds are good sources of omega-3 fatty acids which help regulate irregular heartbeat and prevent the risk of stroke. Also Read: It's ‘that time’ of the month: Is India ready to have a menstrual leave policy? Follow a structured sleep schedule: Difficulty in maintaining a sleep schedule can increase your risk of heart-related issues like stroke or hypertension. Hence, get at least seven to eight hours of quality sleep. Fulfilling your body’s sleep requirement has great health benefits such as helping refresh your mood, maintaining a stronger immune system, clearer thinking, and lower risk of cardiovascular diseases. Manage stress: Menopause can cause psychological and physiological changes in the body which may increase your stress levels. Stress can have a serious impact on your heart and overall well-being. It is important to maintain and adopt stress-relieving techniques like deep breathing exercises, yoga, meditation, or engaging in hobbies that calm you. Managing stress helps prevent high blood pressure and strengthen your heart muscles. Maintain your weight: Focus on eating well-balanced meals, avoid binge eating, practice portion control, and eat at odd hours to avoid weight gain that is associated with a higher risk of cardiovascular disease. Regular health check-ups: Regular health check-ups provide you with valuable insights necessary to monitor your overall health, especially your heart health. Consult doctors or experts to discuss any health-related concerns, symptoms, or unusual changes that occur during menopause. Regular check-ups and cardiac screening aid in the early detection of heart problems and ensure timely intervention. Also Read: Death by suicide after 1st period: Why menstruation education is importantDisclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.
18 October,2024 10:19 AM IST | Mumbai | mid-day online correspondentMenopause is a condition experienced by women from the age 40 to 55 where their menstrual cycles stop for at least 12 months. In certain cases, if a menstrual cycle stops before the age of 45 then it can be classified as premature menopause. Almost 5 to 10 per cent of women in the world are prone to experience premature menopause. This can be caused due to various reasons such as genetics, certain lifestyle factors, and especially due to the correlation between cigarette smoking. According to the studies, women who smoke cigarettes are at higher risk of developing premature menopause than others and the lifespan of these women decreases over time with premature menopause. Dr Kiran Coelho, head of the obstetric and gynaecologist department, Lilavati Hospital shares key insights. Besides estrogen deficiency can cause long-term effects such as osteoporosis (thinning of the bones), chances of developing cardiovascular diseases like stroke and heart attack, experiencing stubborn joint pain, and risk of getting affected with cognitive disorders like dementia, Alzheimer's disease, and Parkinson's disease increases with premature menopause. The fertility rate decreases tremendously in women with premature menopause making it essential to plan pregnancy to avoid any further complications. In case of low fertility, it gets difficult to conceive. Which leaves no option other than choosing assisted reproductive technology like IVF and IUI. The symptoms experienced during menopause: Low estrogen formation in the ovariesHot flashesIrritationSudden weight gain mostly around the abdominal areaThinning of the hair and hair lossThe skin becomes sensitive and dryConstant mood swingsVaginal dryness which can discomfort and itchingBreast tenderness Sweating excessively during the nightIrregular periodsThe fertility rate decreases even before the preterm menopause. How does cigarette smoking cause premature menopause? It is crucial to understand that the toxins released during smoking are toxic and can be adversely harmful to the ovaries. These toxins eventually decrease the number of eggs available and interfere with the hormones that help regulate the reproductive system. As a result, women who smoke often experience menopause earlier than those who do not. The risk of developing premature menopause increases depending on certain factors like how early a woman starts smoking, how many cigarettes she smokes per day, and for how long she has been smoking. The more and longer a woman chooses to smoke, the higher the risk. However, the good news is if the woman quits smoking early, she can reduce and even reverse the harmful effects on ovaries, which results in experiencing menopause at a typical age like 45 rather than prematurely. Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.
18 October,2024 10:17 AM IST | Mumbai | mid-day online correspondentIn a medical achievement, a 42-year-old homemaker from Mumbai, underwent a successful weight loss surgery at a city hospital, subsequently leading to the resolution of other health issues including asthma, obstructive sleep apnea and diabetes. Nafisa Khan (name changed) lost over 40 kg in six months, bringing her weight down from 130 kg to 90 kg. She had struggled with her weight for years, especially after her pregnancies. Despite numerous attempts at various diets, she consistently regained any weight she lost. The patient developed high blood pressure in her twenties, and five years ago, she was diagnosed with diabetes. By the age of 38, her worsening health had led to heart disease. By the time she crossed 125 kg weight, lying down flat became impossible; she had to sit up all night to catch her breath and even walking short distances left her breathless. Simple activities like breathing, walking and staying awake turned into daunting challenges, which prompted her to seek urgent medical intervention. Dr. Aparna Govil Bhasker, a bariatric and laparoscopic surgeon at Saifee, Namaha, and Apollo hospitals, who performed the surgery, stated, “When Nafisa came to us, she weighed 130 kg with a BMI of 63.8 kg/m². She was suffering from severe obstructive sleep apnea along with various other health issues. During our consultation, she actually dozed off, which alerted us to the dangerously high levels of carbon dioxide in her blood. (In individuals with obesity, excess weight can lead to the accumulation of fatty tissue around the neck and throat, which increases the likelihood of airway obstruction during sleep. This obstruction causes repeated pauses in breathing, leading to fragmented sleep and reduced oxygen levels in the blood.)” She further informed, “She could barely walk, as even taking two or three steps left her extremely breathless. In addition to obesity and obstructive sleep apnea, she was also dealing with diabetes, high blood pressure and heart disease. Four years prior, she had experienced kidney-related complications as well. Obesity had wreaked havoc on her body and severely impacted her health. Left untreated, her condition could have been life-threatening and what struck me the most was that she was just 42 years old; she had a long life ahead of her.” The surgery was performed after all necessary investigations, and she was medically optimised with the support of various specialists, including an endocrinologist and a cardiologist. Nutritionist Shamika Girkar implemented a low-calorie, high-protein diet for approximately three weeks, which helped Nafisa lose 6 to 8 kg before surgery and improved her metabolic parameters. Nafisa then underwent gastric bypass surgery, which is a minimally invasive procedure conducted through small incisions in the abdomen. Performed under general anaesthesia, the surgery typically lasts between 60 to 120 minutes. Patients are encouraged to start walking within 4 to 6 hours post-surgery and can be discharged from the hospital within 36 to 48 hours. “My life became limited to my home as my weight increased. I struggled to stand or walk without assistance, and for four years, I suffered from sleep apnea and asthma, which left me wheezing and coughing. This had a profound impact on my overall quality of life. Finding clothes that fit was a constant challenge, and I often spent my days lying in bed. As a result, I felt frustrated, anxious, stressed, isolated, ashamed, guilty and embarrassed. There were times when catching my breath felt impossible. Thankfully, I sought help. Now, at 90 kg, I'm feeling much better and am dedicated to continuing my weight loss journey with a proper diet and exercise plan as advised by Dr. Bhasker,” said Nafisa. Bariatric surgery typically results in a total body weight loss of about 30 to 40 per cent and is recognised as one of the most effective methods for weight loss in patients with clinically severe obesity. Dr. Bhasker noted, “Obesity and bariatric surgery are often surrounded by stigma, with many perceiving it as a shortcut. However, that couldn’t be further from the truth. In cases like this, bariatric surgery can truly be life-saving. It’s important to recognise that the journey toward better health starts with bariatric surgery; it is merely the first step. Patients need to have regular follow-ups, maintain consistent nutrient supplementation, and adhere to a healthy diet and lifestyle.” Also Read: Mumbai: 58-year-old Army man with ankle pain successfully undergoes ankle arthroscopy for damaged cartilage
17 October,2024 10:14 PM IST | Mumbai | mid-day online correspondentADVERTISEMENT
