Home Health & Food Women more prone to fracture after menopause, should avoid high heel shoes –Gynaecologist

Women more prone to fracture after menopause, should avoid high heel shoes –Gynaecologist

by James Davies

Emmanuel Ojo

A professor of Obstetrics and Gynaecology at the University of Ilorin, Adegboyega Fawole, discusses menopause and its management with EMMANUEL OJO

what is menopause?

Menopause is the cessation of menstrual flow for at least six months in a woman who has previously been menstruating or in a woman who has a longer cycle of more than 28 days but has missed her period for over three times.

When is the normal onset of menopause in women?

Usually it occurs between the ages of 45 and 55. Many women, more often, come with some complaints and the usual one is the irregularity of the menstrual cycle. The menstruation bleeding may also be little. This goes on and on until it completely stops.

Can menopause start prematurely or before age 45?

Yes. Premature menopause is when menstruation ceases before age 40. This is abnormal and many times it is associated with family history, which means it runs in the family.

Secondly, it could come from a chromosomal problem, stemming from the way the person is genetically engineered.

Premature menopause can also be due to some diseases. For example, if there’s a health challenge leading to the removal of the ovaries, the woman in question will go into menopause.

Are there bodily changes that come with the onset of menopause?

Menopause is associated with the withdrawal of some hormones in the female body, basically estrogen and progesterone. The more dominant one is oestrogen, which gives the woman her looks, her smoothness, and her curves. When menopause comes, oestrogen level is very much reduced and that’s the cause of all these major bodily changes. The breasts become flaccid and every part of the body experiences certain changes.

Sometimes, the woman can have some unexplained blisters with itches. The itching could be terrible in the private parts, i.e. vulva area, and this requires treatment. Then, this oestrogen that is withdrawn affects the bones in the long run. The bones that were strong before get thinner on the inside and that makes them weak. So, they are prone to fracture, especially the hip bone. Oestrogen also confers some level of protection against heart attack; with its withdrawal, women are open to the risk of heart attack, a little more than every other person. Ordinarily, men are usually more prone to heart attack than women, but a woman in menopause is at the same risk level as a man.

The body also shows signs of ageing, such as the wrinkling of the skin – the skin won’t be as luxuriant as it was and it will look a little dry and all that. Then, there may be some sort of hair loss from the scalp, especially at the sides; the hairlines start receding like that of men and then, the woman may experience some sort of mood swing, becoming a little more irritable or quieter.

The other sign that is more characteristic is what is called heat flushes. It is a situation where the woman experiences sudden intense heat from head to toe. And it doesn’t matter whether she’s sitting under a fan or an air conditioner. This sudden sensation of heat can last for between just a few seconds and two to three minutes. But the heat is so intense that sweat breaks out. This is called heat flushes and it can be very disturbing for some women. This and other signs previously mentioned may begin about five years before full menopause.

What are the triggers for menopause in the female body?

The cause of menopause is like a thermostat. Women, in their anatomical make-up, have ovaries and these ovaries are programmed to start ovulating, then menstruating at a particular age, usually between ages 10 and 13. It actually varies. We found out that menstruation starts earlier in girls on good nutrition.

At the same time, these ovaries are also programmed to stop functioning or ovulating at a particular age, which is between age 45 and 55 years. That is what is called the ovarian period and it is a natural phenomenon.

Does menopause affect the sexual drive in women?

Sexual drive in menopause has been found to be ambivalent. For some women, entering menopause brings some relief, psychologically, from the anxiety or risk of getting pregnant after intercourse. That freedom may result in increased libido or urge for sex in such women.

On the other hand, some women, especially in our environment, see menopause as a time to take a break or stop having sexual intercourse because menopause comes with suppressed libido for them and, in some cases pain, because they get dry faster or they do not even get wet at all or enough during sexual intercourse.

The two extremes, explained above, may co-exist or interchange in a woman.

How can women deal with the negative psychological effects of menopause?

For some, there could be psychological upset about the changes in their body and looks. And many times, when they are at home, their partners don’t understand that these changes are occurring, which makes it complicated, hence, they have a bigger complex. This may result in the woman withdrawing from people or they may even begin to go out more frequently, particularly to have fresh air and feel good. But it has been found that the more they mix with people in the environment, the better for them. They need psychotherapy, counselling and understanding from the immediate family, extended family and friends.

A lot more than that, they may need to see a consultant in behaviours or a behavioural scientist – a clinical psychologist first, then a behavioural scientist later. As I said, menopause may come with a lot of psychological draining.

Secondly, they need some substances to help them look good and stay healthy. They need certain creams for their body and, most times, when intercourse becomes difficult, they need to use appropriate cream as a lubricant for intercourse to be successful and satisfying. They also need to be careful with what they are wearing. Menopause is not a time to be wearing high-heel shoes anymore because a single slip may result in a bad fracture. Rather, they are encouraged to wear comfortable flat shoes or slippers. They don’t have much to prove anymore to anybody.

They may need to have hormone replacement therapy to replenish their oestrogen level. This is available in form of creams or tablets but must be used under the supervision of a gynaecologist, because excessive use of these products can have adverse effects on the womb and breasts. For instance, too much oestrogen can lead to breast lumps and the lumps may become not just painless and simple lumps, but complex lumps which may result to cancer.

When the bones are having issues, they are given things, such as calcium, and Vitamin D, that help to harden and make the bones stronger. Of course, a number of our elderly people use vitamins and supplements.

Menopause also coincides with the time the body experiences some advancing age-related illnesses. There are such issues as high blood pressure, for example. Menopause is a reality that comes with age for every woman; the best approach is to be prepared for the changes that it brings. The ones that one cannot cope with, one should ask for help from family members, friends, groups, community and so on. If one must seek professional help, it has to be from a professional in that field.

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