Menopause

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

o Peri-menopause

o By the age of 40 years women have alreadyy changes in their bone density and at the age of 44 they can experience menstraul changes.

o It can be 2-10 years before their last period

o Bloodtest:

 Elevated FSH levels (60-100 mlU/L)

 LH levels > 50 mlU/L

 Estradial< 50pg/ml

o Ovulation cycles and menstraution become less regular.

PERIMENOPAUSE IS A NORMAL PROCESS, NOT A DISEASE!

The better shape you are – physically, nutritionally, mentally, metabolically, spiritually and situationally - going into menopause, the more enjoyable the journey!!!

HORMONES:

Hormones are a regulatory substance produced in an organism and transported in tissue fluids such as blood to stimulate specific cells or tissues into action.

1. Oestrogen

o Oestrogen is produced by the ovaries, liver adrenal gland, the breast and fat cells. During pregnancy by the placenta.

o Low oestrogen

 Hot flashes

 Night sweats

 Vaginal dryness, thinning, irritation, decreased respons

 Incontinnece, bladder infections

 Mood swings (mostly irritaion and depression)

 Mental fuzziness  Headache, migraines

2. Progesterone

o Produced by the ovaries, brain and peripheral nerves and also made from choleserol.

o Low progesterone

 Pre-menstrual headache

 Irregular or excessively heavy periods

 Anxiety and nervousness

 Itchy twitchy legs

 Heart palpitations, coronary artery spasm

 Depression

 Fibromyalgia

3. Testosterone and DHEA

o Made in the ovaries from cholestrtol

o In the adrenals from DHEA

o Low testosterone:

 Loss of sex drive fatigue

 Decreased muscle mass

 Decrease bone density

 Depression

 Achy joints

 Decrease in muscle tone in blsdder and pelvis urinary yincontinnce

 Dulling and brittleness of scalp hair

 Skin dryness

 Atrophy of genital tissue

4. Cortisol

5. Thyroid Controls your metabolism and regulates body temperature

6. Adrenaline

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 dose 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.

o Urinary incontinence

o Lower urinary tract symptoms

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

o Increase in testosterone without pharmaceuticals.

o 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 chick peas, cashews and almonds

o 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.

o 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.

3. Bowel dysfunction

o Peri- and post-menopausal women have a high prevalence or altered bowel function and IBS like gastro intestinal complaints.

o Treatment:

 Food rich grains, legumes, fruit and vegetables, beans potatoes, brown rice are mayor sources of energy for epithelial cells in the colon

 Vitamin C and Zinc may both help heal epithelial wounds in the colon

o Faecal incontinence.

o 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. o Parity and labor are risk factors and not the mode of delivery.

o 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.

o Anal penetrative intercourse is a risk factor for faecal incontinence

4. 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.

o Osteoporosis can have a systemic effect on:

 Breathing

 Cardiac function

 Digestion

 Mobility

 Pain

 Continence

 Mental Heath

o 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