Menopause is a time for lifestyle changes
Menopause is defined by the World Health Organisation (WHO) as the
permanent cessation of menstruation (periods) due to loss of ovarian
function. Diagnosis is made 12 months after the last period. It is also
known as the climacteric or the ‘change of life’. The average age of
menopause is 51 but it can occur any time from 44-55. If the ovaries are
removed surgically or damaged by chemotherapy or radiotherapy, menopause
will occur early. The perimenopause is a time of decreasing ovarian
function that may last up to 10 years before the last period.
Once the ovaries stop functioning, there is a dramatic drop in the
levels of the hormones oestrogen and progesterone. Oestrogen deficiency is
the main cause of symptoms such as hot flushes and night sweats, vaginal
dryness and irritation and urinary problems. Other symptoms associated
with menopause include sleep problems, sexual difficulties, mood swings
and depression, joint aches and pains, memory and concentration problems,
headaches, palpitations and dry eyes. While many women have some hot
flushes, only about 10% have frequent, severe episodes. Longer-term
effects of the menopause include increased heart disease risk and
osteoporosis (loss of bone mineral density).
Hormone replacement therapy (HRT) involves taking small doses of
oestrogen with or without progesterone. These can be taken as tablets,
transdermal skin patches or implants.
Oestrogen is also available as a vaginal cream or pessary. Concerns were
raised when recent studies showed increased risk of breast cancer with HRT.
Current understanding is that when used early in the menopause, for up to 5
years, there is very little risk for most women. Benefits of HRT include
the relief of hot flushes, vaginal and urinary symptoms, joint pain and
insomnia. It also increases bone mineral density and reduces the risk of
fractures. On the other hand, HRT is associated with an increased risk of
venous thromboembolism (VTE), which can cause clots in the legs and lungs.
The risk of gallbladder disease and some cancers including breast, ovary
and lung may increase a little with HRT.
Ultimately, the decision as to whether or not to use HRT is made on an
individual basis after discussing your particular risk factors and
symptoms with your doctor. There are other non-hormonal medications
available for some menopausal symptoms. While many women choose to use
herbal preparations to help with symptoms, there is currently no
scientific evidence for their effectiveness and a lack of information
about their long-term safety.
Lifestyle choices are perhaps more important than ever in this group of
women. Maintaining a healthy weight, a heart-healthy diet, sufficient
calcium and vitamin D, 30 minutes of exercise a day, stopping smoking,
limiting alcohol, caffeine and spicy foods are all excellent ways of
reducing symptoms and lowering the risks of heart disease and
osteoporosis. Adopting healthy habits at this stage will help ensure a
long and happy future for the next 1/3 of your life.
Fat comes in many forms
Fat tends to get bad publicity. Many people eat too much of it. It comes
in several forms, not all of which are bad. Fat is a concentrated source of
energy and carries the fat-soluble vitamins A, D, E and K.
The word ‘fat’, when used by nutrition experts, is a collective term for
fat and oil. Oil is a liquid form of fat. Fat consists of several types of
fatty acids. Depending on its chemical composition a fatty acid may be
saturated, mono-unsaturated, or poly-unsaturated.
Monounsaturated and polyunsaturated fats are usually liquid at room
temperature and are regarded as ‘good’ fats. They have many benefits such
as lowering blood cholesterol (which can reduce the risk of heart
disease), maintaining good eyesight, strong bones, healthy skin and brain
function.
Monounsaturated fats are found in avocados, peanuts, almonds, seeds,
vegetable oils such as olive, peanut and canola and in margarine spreads
based on these oils.
The best known polyunsaturated fats are omega-3 - found in fish, canola,
soybeans, lean meat, and eggs; and omega-6 - found in plant foods such as
seeds, walnuts, vegetable oils such as sunflower, safflower, soybean and
in some margarine spreads.
Saturated fats are usually solid at room temperature and are often
regarded as ‘bad’ because they raise blood cholesterol. The three main
sources of these fats are:
Animal fats – Full fat dairy products - butter, cheese and cream - and
the surface fat of meat.
Tropical oils - coconut and palm oil,
Trans fats. These are unsaturated fats that behave like saturated fats.
Small amounts naturally occur in animal foods.
Of concern from a health point of view are the trans fats made from
unsaturated vegetable fats. These are chemically altered (hydrogenated) to
be solid or semi solid at room temperature. Heating polyunsaturated oils,
as in deep-frying, may also cause hydrogenation.
Tropical oils and trans fats are used extensively in commercially
prepared foods like pastries, biscuits, chips, confectionary, salad
dressing and takeaway foods.
All fats are high in energy (calories) and produce weight gain when
eaten in excess. Dietary guidelines recommend that we should eat a low-fat
diet, in particular one low in saturated fat. One to two tablespoons of
mono- and poly-unsaturated fats each day, used in cooking and at the
table, are sufficient for a healthy diet.
Words such as ‘lite’ on bottles of oil refer to the flavour and colour,
not the calorie or fat content.
Good Health on the Menu
This salad can be prepared quickly and contains many of the good
fats.
Nutty Green Salad
(serves 4)
1-cup baby spinach leaves,
1-cup rocket
1 bunch broccolini, lightly cooked
2 tabs chopped walnuts/pecans
Dressing:
1-2 tabs walnut or olive oil
2 tsp lemon juice or balsamic vinegar
1 clove garlic, crushed
Place dressing ingredients in a jar. Put on lid and shake. Wash and dry
salad leaves. Combine salad ingredients and lightly toss with the
dressing.
Myth and Fact
Myth
If I have had too many late nights I can catch up on sleep with an early
night.
Fact
If this works for you, you are one of the lucky ones! Most people need
regular sleep patterns and the body’s internal clock for sleep can be
disrupted by changes to routine. After a few late nights, the body clock
may reset. Going to bed early will not necessarily guarantee getting to
sleep early.
Good sleep patterns include:
Regular bedtimes.
A winding down period from activity and screens, including TV.
Keeping sleeping area as dark as possible.
Avoiding heavy meals and/or alcohol before bed.
Relaxation techniques or practices before sleep.
If you find yourself lying in bed trying to sleep and becoming
frustrated or worried about not sleeping, try getting up and doing some
calming activity like yoga or meditation for an hour or so before
returning to bed. Writing thoughts in a journal may also help. Sleep
cycles come in waves every 90 minutes or so and if you have missed one,
you need to wait for the next.
Did you Know?
Bedbugs were eradicated from most developed countries after World War II
using the pesticide DDT. Increased international travel may have hastened
the spread of bedbugs, which are now becoming an increasing problem. They
are more common in places with high occupancy rates like hotels, military
barracks, apartment complexes and dormitories.
Bedbugs are small wingless insects, about ½ cm long with flat, oval
bodies. They are nocturnal and feed mainly on humans, biting to obtain
blood. Bites are often seen in neat rows rather than random patterns,
preferentially on the face, neck, arms and hands. The bites can become
very red and irritated, though bedbugs do not tend to spread infections
and are not considered dangerous. Bites can be treated with calamine
lotion or soothing creams. See your doctor if there is a severe
reaction.
During the day, bedbugs retreat to crevices, mattresses and accessible
suitcases (best to place suitcases on a table or dresser, not the floor).
They can survive many months between feeds but are vulnerable to extremes
of temperature and can be killed by freezing, steaming or in a hot washer
or clothes dryer. Normal insect repellants do not deter them. Surface
insecticides must be registered to control bedbugs.
Signs you may see in an infestation include dark specs of excrement,
blood smears on the sheets, light brown shed skins and sometimes the bugs
themselves when they are active. Check with your local council or a pest
control company for further advice.
Community Service Announcement
Mothering in Illness
An appeal to Australian women for their stories
Despite the fact that many women work outside of the home, they still
assume the majority of responsibility for childcare.
This means that it can be devastating for a women to suffer a major
illness that impacts upon her ability to care for her children.
My name is Tammy Vallido, and I am a researcher from the University of
Western Sydney. I am interested in interviewing women face to face, via
telephone or email exchange, who have at some time in their lives had
difficulty mothering due to an illness.
I am interested in how the illness affected your mothering, how this
affected you, and your relationship with your child. It is hoped the
results from this study will contribute to better health care for women
with maternal responsibilities.
I can be contacted on 0435044715, 02 4620 3355 or email:
t.vallido@uws.edu.au
This study has full ethics approval from the University of Western
Sydney Ethics Committee (HREC number H7473), and all information will be
treated confidentially.
Early treatment best for children’s eating disorders
Eating disorders such as anorexia nervosa and bulimia usually occur in
adolescents and occasionally in adults. They affect mainly girls and are
difficult to treat effectively. Only half will recover within 5 years.
Recently, increasing numbers of children have been affected by early
onset eating disorders (EOED) - defined as food avoidance plus weight loss
(or failure to gain weight in a growth period) without other obvious cause.
Some are as young as 5 years and a quarter of reported cases appear in
boys. The illness is often quite severe with many needing to be in
hospital. The main health effects are low blood pressure, heart problems
and hypothermia (inability to maintain body temperature).
Fortunately, it appears that intensive family therapy treatment may
provide a greatly improved outcome, with most recovering after 5 years in
one major study. The key may be in early recognition and specialised
treatment. See your doctor if you have any concerns about your child’s
behaviour, growth or weight.
Health Reminder!
The cervix – neck of the womb – is a site where cancer can develop. A
simple test, the Pap smear, will detect the pre-cancer stage of this
disease. A small operation can then prevent this potentially fatal
condition developing. Women who have been sexually active should have this
test at regular intervals.
Survival of the fitter
People often think that taking some exercise is a nice thing to do - an
optional extra for health. The thing is, that’s not true. Exercise is a
powerful factor in how well you are, including your likelihood of getting
most diseases and how long you live. It’s optional if you don’t mind
living less well for fewer years. A large study recently confirmed the
link between being fit and having a longer life.
Over 15,000 men, either with or without cardiovascular disease, had
their health tracked for just over seven years. The men’s fitness levels
were measured in METs (metabolic equivalents), where one MET is the energy
used when just sitting around. Walking has a MET score of three or four,
while vigorous activity has a MET of seven or more.
For every one MET increase in fitness, the risk of dying during those
seven years decreased by 13 percent. Those with the greatest exercise
capacity had a 70 percent lower mortality than the unfit, after taking
into account age, body weight and heart disease risk factors.
The really good news is that exercise is not ‘all or nothing’ - so even
though more will always equal better, even a small increase in activity
can do wonders over the long term. And just a reminder about what we’re
aiming for here - it’s 45 minutes to an hour of moderate activity (if it
feels moderate it is) on most days of the week. Include some muscle
strengthening exercises like push-ups, dips and sit-ups and once the
exercise feels easier, step it up a level.
Wounds need special care
Wounds can be either acute – such as a laceration, burn or surgical
wound; or chronic – such as an ulcer or pressure sore. Healing of wounds
usually occurs in 3 phases.
The inflammatory phase occurs in the first 3 days. This is where the
body responds to injury by shutting down blood vessels and sending immune
cells to fight infection and clear up dead cells. At this time the area
becomes red, swollen and painful.
The proliferative phase can last up to 3 weeks. This is the healing
phase where the body produces new blood vessels and skin cells to cover
the wound. By 10 days, acute wounds are generally healed enough to remove
stitches or clips. In chronic wounds this phase can be prolonged.
The maturation phase continues up to a year. This is the phase where
scar tissue is formed and completes the healing process.
General principles of wound care include:
• Keep it clean. Tap water is usually sufficient to clean a wound as
long as it is drinking quality water. Dressings protect from anything that
might introduce infection.
• Use an appropriate dressing. This will depend on the type of wound.
Dressings also keep the wound area moist to aid healing.
• Maintain good nutrition. Healing requires plenty of proteins, vitamins
and minerals – especially Vitamins C, A, E and zinc. Extra fluids may also
be needed.
• Stop smoking. Smoking slows the wound healing process.
• Exercise. Within the constraints of the wound, exercise will improve
circulation and aid healing.
• Medications. Check with your doctor as some medications may affect
healing. Keep diabetes and other chronic conditions well controlled.
• Infection. See your doctor promptly if your wound becomes more
painful, bleeds or discharges pus or fluid or if you develop a fever.
• After healing. Take care with newly healed skin. Avoid sun exposure
and moisturise the skin.
Wounds vary greatly and your doctor will assess each situation and
advise appropriate management. This could include ongoing attention by a
trained nurse or at a specialised clinic.
