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Menopause Part 1
What is menopause?
Translated literally from Greek, Meno means menstruation and Pausis means cessation.
Officially, menopause is achieved after 12 months without a period and is the signal from Mother Nature that you can’t have any more babies.
A woman’s reproductive life can be divided into three phases:
1) Pre-menopausal: This is the time when you have regular menstrual cycles
2) Menopausal transition (also known as peri menopause): during this time, the ovaries are beginning to produce less oestrogen and your periods start to change in frequency and can become erratic, unpredictable and heavier. As this phase progresses periods will come at longer intervals. Regular checkups with your GP over these later years can be beneficial as they can provide solutions if symptoms become bothersome.
3) Post menopause: This stage commences 12 months after your last menstrual period
Why do we go through menopause?
Menopause is our body’s way of preventing us from having more children. It occurs because our bodies stop producing the hormones needed to become pregnant and carry a baby.
There are two major female hormones, oestrogen and progesterone and these are mainly produced by the ovaries. Production of these hormones start seriously at puberty, triggering periods and productions stops at menopause.
Role of these hormones:
1) Oestrogen enables the release of other hormones to help ripen and produce an egg (follicle). It also contributes to all our characteristics that make us female (e.g. hair pattern, breast development etc.)
2) Progesterone is the pregnancy hormone. It is made by the ovaries after ovulation (when the egg is released). It gets the lining of the uterus ready to receive the fertilised egg. We stop making progesterone if we are not pregnant and this leads to the shedding of the uterine lining (a period) and the cycle beings all over again every month. If we are pregnant the level of progesterone remains high and there is a fall after the baby is born. This is the signal to start producing breast milk.
The average age for menopause in Australia is 52 but timing is very individual. Family members may have a similar menopausal age, but this is not guaranteed. Early menopause is defined as that before the age of 45.
Causes of early menopause:
• Genetics – maybe all the women in your family have a tendency to stop producing oestrogen early
• Environmental factors – poor nutrition and hydration can affect the balance of hormones in your body
• Chemically induced – some types of cancers need female hormones to survive. To treat these diseases drugs are given to stop production of female hormones resulting in menopause.
• Surgical menopause – This will happen if you have your uterus removed and/or the ovaries, which are the organs that produce oestrogen. If the ovaries are still present oestrogen will still be produced and menopausal symptoms may not appear until oestrogen production stops
Signs and Symptoms
1. Periods stopping: obviously this is something that happens to everyone
2. Mood changes: This is not directly as a result of menopause, but it thought to be due to life changes around this time. Mood change are most likely during menopausal transition, which is also when other symptoms peak. Some women experience depressed mood, feelings of worthlessness, anxiety, crying, fatigue and loss of motivation
3. Hot flushes: These cause your body to suddenly feel hot all over or experience a sensation of rising heat. You may look hot or just feel very hot and perspire. These usually start during the menopausal transition and peak after menopause. They can occasionally be accompanied by palpitations (heart racing), dizziness, nausea, headaches and fainting. Some women find they are aggravated by hot weather, hot drinks, alcohol, and particularly, stressful situations. Often these are more frequent at night which can disrupt your sleep which causes fatigue and mood swings
4. Changes in tissues around the vagina, bladder and bowel: The muscles and other parks within the vagina, bladder, and bowel need oestrogen to be healthy and strong. At menopause the ovaries no longer produce oestrogen resulting in weakness which can result in leakage of urine or bowel content or feeling of heaviness in the vagina. The area can also become dry which can make sex uncomfortable. Uncomfortable sex, poor sleep and lack of oestrogen can also all contribute to a decrease in libido at this time.
5. Muscle and Joint aches and pains: This is the most common complaint of menopause. Oestrogen enriches all our connective tissue (tendons, muscles nerves and blood vessels), making them healthy and strong. After menopause we tend to notice aches and pains in our joints more than before even without arthritis.
But what are the long term consequences of no oestrogen in our system?
Weight gain is very common during and after menopause. Due to the changes in your hormones your body finds it harder to lose weight. As your hormones change, your muscles can become smaller and your metabolism slows. Your body is more likely to carry fat around your tummy which can lead to problems with bloody pressure, cholesterol, blood sugar, and heart disease. Healthy diet and exercise during this time can assist you to lose weight or prevent weight gain.
Our skin gets thinner and drier and less elastic and means it is more likely to be injured. You may notice it is more likely to get injured. You may notice more character lines and sun spots on your face and hands, but these tissue changes can also affect breasts and you vagina, around the vuval area and around your uterus and ovaries. Changes in the vaginal wall can lead to dryness, irritation, vaginal infections and sometimes painful intercourse.
Cardio System (heart and lungs)
Prior to menopause oestrogen protects us from heart disease. After our bodies stop producing oestrogen, women are more likely to have increased blood pressure, high cholesterol, diabetes, and increased risk of heart disease. It is very important to maintain a healthy lifestyle, manage any risk factors you may have (e.g high cholesterol) and exercise regularly
Reduced Bone Density
As we age, our bones gradually reduce in density. This process is sped up dramatically with the loss of oestrogen at menopause. If bone density reduces too much, osteoporosis can result
Joint and Muscle Pain
Oestrogen makes our connective tissue stronger so it’s absence often results in common conditions among post menopausal women such as Lateral hip pain (gluteus medius tendinopathy or trochanteric bursistis), achilles tendinopathy or plantar fasciitis (pain in sole of foot or heel). If you suffer form any of these please seek advice from your Physio - we can certainly help you get rid of them.
Women’s health Physios have extra training in dealing with issues that effect women as we age. We are compassionate, knowledgable and often in a position to help.
So if it’s painful intercourse, heel pain or incontinence that’s the issue for you - we are able to offer you solutions.
April 16, 2018 0 Comments
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Whilst menopause comes with many (not so pleasant) symptoms, the great news is that you can help manage many of them with exercise.
Exercise has many benefits post menopause including maintaining and improving:
• Muscle strength
• Bone density
• Joint flexibility
• Mood and general wellbeing
There are many different types of exercise so you should choose something that you enjoy, fits in with your lifestyle and helps manage your individual symptoms.
Types of exercise:
Aerobic exercise: This type of exercise works your heart and lungs, and is also important to prevent or manage heart disease, high blood pressure, high cholesterol and high blood sugar. This is any exercise that gets you huffing and puffing including activities such as cycling, swimming, tennis and gardening. It is important to avoid high impact activities such as running and jumping to protect your joints and pelvic floor as these are weaker post menopause.
Flexibility: Stretching and gentle respective movements increase the length of your muscles, resulting in improvement in your range of joint movement. Yoga is a great form of exercise to achieve this.
Resistance/Strength Training: This exercise uses weights, exercise bands, or body weight to help strengthen your bones and muscles whilst also improving your balance and coordination.
Functional Training (Clinical Pilates): Training your pelvic floor muscles to contract and relax as needed assists you to regain or prevent incontinence and prevent prolapse symptoms. This functional training is best done with an individualised exercise program that is designed to suit your individual needs. These exercises also enhance any strength training program and assist in flexibility or balance.
At SquareOne we use Clinical Pilates equipment to rehabilitate the function of pelvic floor muscles and deep abdominals, so that they automatically work during everyday activities. Clinical Pilates combines with a specific home exercise program will assist in achieving optimal function more quickly.
What can a Women’s Health Physiotherapist do for you menopausal symptoms?
A Women’s Health Physiotherapist can assess you individually and tailor an exercise program to address any particular issues and goals that you may have.
At Mosman Women's Health, our physiotherapists have extra training in managing older women and in particular exercise prescription for the different needs of the menopausal woman.
International guidelines all concur with the view that walking, jogging, cycling and swimming (at moderate intensity), muscle strengthening exercises (including pelvic floor exercises), water based exercise, and pregnancy-specific exercise classes are both safe and beneficial for pregnant women.
If you have never been physically active – it’s also suggested that now would be a great time to start.
We interviewed Lauren earlier this year about her experience at the Commonwealth Games in the Gold Coast while juggling the new role of being a first time Mum.
What benefit do I get?
Here at SquareOne, our Philosophy is to not only fix your injury but send you away stronger, fitter and more resilient – in other words, less likely to injure yourself again.
Our Pilates programs help deliver our evidence based exercise programs to those who are in pain, those rehabilitating or those just wanting to move and exercise more.
When taking our clients through their programs we not only have what exercise you are going to do next front in mind we are thinking of a multitude of different things. Our knowledge of anatomy, pain science, biomechanics, load management, pathology and rehabilitation allows us to consider many different facets in developing your program.