Healthy after 40
40 is an important milestone in a woman’s life. She can look forward to more time for herself and a productive few decades ahead of her. Yet this is often the time when a woman encounters a lot of health problems such as heavy or irregular menses, prolapse of the womb, leakage of urine on coughing, tumours such as fibroids and cancers such as those of the cervix (mouth of the womb), uterus (womb), ovary and breast. Medical problems such as diabetes and hypertension often begin at this age.
Care at this stage can pick up a lot of serious problems of the future. A regular blood test especially for sugar, cholesterol, thyroid, and kidney functions will pick up specific problems.
An annual gynaecological examination and consultation can give a lot of information on how to deal with common problems. A PAP Smear can be taken at the same time. This is a simple test to diagnose cancer of the mouth of uterus and should be done regularly from the time a woman is sexually active.
Once a month breast self-examination helps pick up breast cancer, which is the commonest cancer amongst women in Mumbai. However by the time the tumour is felt by the hand it is already quite large and spread.Hence a yearly mammography should be done, which can pick up even very early cancer.
Cancer of the uterus & ovary are very silent . A patient starts getting symptoms when the cancer has reached a very late stage.Hence an yearly sonography would be the right thing to do.
Bones tend to start becoming weak and fragile few years before menopause. Exercise and good diet with plenty of calcium will prevent this from happening. Addition to ones diet of soya products and lots of fruits and vegetables will help reduce menopausal symptoms. Early diagnosis of all conditions ensures complete and efficient treatment.
It is important to not neglect any symptoms such as abnormal bleeding, vaginal discharge, abdominal bloating and discomfort, breast lump, bone pains etc. If you feel completely healthy too, an annual health check up is recommended. A woman is the backbone of the family - you owe it to yourself and to your family to take care of your health.
Routine checkups can find health problems early. For many health problems, early treatment can help prevent more grave problems. The value of checkups and how often you have them depends mainly on your age and gender. Your own health history and family health history also play a role.
The cancer screening summaries are based on various levels of published scientific evidence and collective clinical experience. The highest level of evidence is taken as mortality reduction in controlled, randomized clinical trials. The results of clinical studies, case-control studies, cohort studies, and other information are also considered in formulating the summaries. In addition, the incidence of cancer, stage distribution, treatment, and mortality rates are considered. The summaries are subject to modification as new evidence becomes available.
physicians use radiography, or x-rays, to view and evaluate bone fractures and other injuries of the musculoskeletal system. However, a plain x-ray test is not the best way to assess bone density. To detect osteoporosis accurately, doctors use an enhanced form of x-ray technology called dual-energy x-ray absorptiometry (DXA or DEXA). DEXA bone densitometry is today's established standard for measuring bone mineral density (BMD). DEXA is a quick, painless procedure for measuring bone loss. Measurement of the lower spine and hips are most often done. More portable devices that measure the wrist, fingers or heel are sometimes used for screening, including some that use ultrasound waves rather than x-rays.
Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms..
Q.1. I am 53 years old and have been menopausal since 3 years. I have suddenly started having little vaginal bleeding again. Can this be anything serious? Do I need a check up? Hansaben
Ans: Once the periods have stopped for one year then menopause is established. After that you should never have vaginal bleeding again, not even spotting. You need to be immediately checked up by a gynaecologist who will do an internal examination and a PAP smear to rule out cancer of the cervix (mouth of the uterus). You should also undergo a sonography to look for swelling of the uterine lining which may indicate endometrial hyperplasia or cancer or an ovarian tumour, all of which may cause vaginal bleeding.
Q.2. I am 44 years old and have noticed some changes in my menstrual cycle. My sister stopped having periods when she was 42, and my mother stopped when she was 45. My periods have been getting delayed and are now coming every 40-50 days. Otherwise they are normal. Is this unusual? Should I be taking hormones? Prajakta
Ans: The age at which menopause i.e. stoppage of the periods occurs is usually around 50 years. However this is different in families and is often genetic. Few years prior to stoppage of menses they tend to become irregular, either frequent or delayed and may reduce or increase in quantity. However bleeding every 40-50 days is definitely abnormal and should be investigated with pelvic examination, hormone study and sonography, since there may be other problems such as hormonal disturbances, cysts or tumours causing such symptoms. Do not neglect this problem but see a gynecologist soon. Hormonal therapy without proper investigations is definitely not to be taken.
Q.3. I have achieved menopause 2 years ago. I am now 48 yrs. I am suffering from severe hot flushes, vaginal dryness and depression. Should I take hormone replacement therapy? I am otherwise in good health. Chanchal
Ans: You have achieved menopause quite early and must take care so that you don’t develop osteoporosis, which is the weakness of the bones which happens after menopause. Exercise regularly and take calcium supplements. Alternative therapy with yoga, phytoestrogens etc (soya products) can help. Hormone replacement therapy (HRT) will give you good relief from these symptoms, however before taking HRT, you must do all your routine tests and cancer screening including PAP smear, sonography and mammography. There are many new medicines for menopausal problems and you must talk to your gyanaecologist about it.
