Staying “Well”, Post-Menopause

This series of articles started on a positive note about the change of attitude towards women’s health and well-being, with greater awareness of the unique health problems faced by women, and better treatment and understanding of these problems.

The life of a woman can be split into three distinct phases; reproductive, midlife, and post-menopausal, according to Dr Rihab Awad, consultant obstetrician/gynecologist at the American Hospital Dubai. In previous issues of Connector, we identified health problems women face, both physical and psychological, at the reproductive stage and throughout midlife, and we now focus on the post-menopausal stage.

The post-menopausal stage is the phase where a woman’s body slows down; from 60 years old she is preparing herself for retirement, and her body is not prone to the rapid physical changes she may have experienced in her earlier life. However, it is a time when a woman needs to be looking after herself to help prevent illness in old age. She will also be developing different activities to keep her mind and body active and replace her working life, and to improve her general health and wellbeing.

Whilst the general pace is slower in this phase of her life, a woman still has plenty of major life events happening at this age, and these can affect her psychological state, and in turn her health and wellbeing. The biggest change for these women is retirement- it is a huge adjustment to everyday life and routine, which also affects her social activities; added to this is the fear of the unknown that is associated with old age.

Good Habits Should Die Hard
By the time she reaches 60 years old, a ‘well woman’ should have healthy habits ingrained into her daily life, but with retirement threatening to disrupt daily routine, it is important to ensure that these habits continue through old age.

As a woman progresses through into old age her body will gradually change, and she will become more vulnerable to a variety of different medical conditions that she has not been susceptible to before. This means that these women need to carefully consider their lifestyles and habits as they grow older, and to educate themselves so that they are aware of the potential medical problems associated with ageing, as this will allow them to be more proactive in preventing these problems from occurring.

Exercise remains important, generally a woman’s physical activity levels decrease with age as her energy levels decrease, but it is important that she tries to keep exercising regularly. It is still recommended that she aim for twenty minutes of physical activity, three times a week, though the form of exercise should change to something gentler. Walking and swimming are particularly good forms of exercise for those post-menopause, and retirement brings more time for this kind of activity.

Diet is a key factor in keeping the body healthy and functioning well; calorie intake should be kept low, while vitamin and mineral intake should be high to help prevent illness. Folic acid is a particularly important mineral for women post-menopause as it helps to prevent heart disease. Studies have also shown that people over 60 who regularly consume the RDA (recommended daily amount) of folic acid significantly reduce the risk of developing Alzheimer’s Disease. Folic acid can be found in broccoli, asparagus, peas, beans, whole grains, lettuce, and orange juice, as well as pasta and rice. Calcium intake should also to be kept high to reduce the chances of developing osteoporosis.

Checks For Health
All through a woman’s life she should take some responsibility for her health, through her lifestyle choices and self education as well as through regular self-examination, of the breasts for example.

Women over the age of 60 should continue to have an annual check-up with their doctor, which focuses on preventing illness in old age, and the early treatment of any medical problems that develop. Regular check-ups can help avoid/treat early; diabetes, osteoporosis, high cholesterol leading to atherosclerosis, and cancer. These check-ups are also equally important to help a woman develop different activities and interests, with the aim of improving general health and wellbeing.

If a woman is aware of her body and is routinely examining herself, she may notice abnormalities, which lead her to consult a doctor outside of the normal routine check-ups. Abnormalities can include; a lump in the breast, palpitations or recurrent dizziness, any sign of urinary or genital infection, any symptom of diabetes, any bone or joint pain, and any post-menopausal bleeding, and in these instances a doctor should be consulted immediately.

Screening- Stay Healthy
There are several different tests and screenings that the American Hospital Dubai recommends for all women over the age of 40:

• Monthly breast self-examination, regular height, weight and BMI monitoring, as well as regular eye tests (which become more and more important with age).
• An annual pap smear, which takes a smear of cells from the cervix and can detect abnormal cervical cells, which can lead to cervical cancer.
• CBC (Complete Blood Count) blood screening, which can detect dehydration, blood loss or anemia, or blood abnormalities, infections, and allergies.
• Lipid profile, which is blood screening to check the body fat, represented in cholesterol and Triglycerides, which are indicators of heart disease.
• Urinalysis, which is urine screening to check overall kidney function, and detect urinary tract infections, diabetes, or any other kidney disease.
• A bilateral breast mammogram, which is an x-ray picture of the breast that is used to detect tumors. For women over 50 this is recommended every 12 months.
• A pulmonary function test, which measures how well the lungs take in air, the volume of air the lungs hold, and how well the lungs exhale air. The test diagnoses for lung diseases- asthma, bronchitis, and shortness of breath.
• Occult blood-faeces screening, which can detect cancer in the bowel. The earlier the cancer is detected, the better the chances are of a cure
• Bone density DXA scan, which determines whether a woman has osteoporosis or is at risk of developing it, and is recommended for all women over the age of 50.

In addition to these screenings, the American Hospital Dubai recommends two extra screenings for women over the age of 60:
• The ElectroCardioGram with short rhym test (ECG), which is a test to measure the electrical activity of the heart to determine whether a person has heart disease, or any abnormal heart beat.
• Flexible Sigmoidoscopy, which is an internal exam of the rectum and distal colon to detect colorectal cancer.

These screenings, combined with regular medical attention will enable the early treatment of any illnesses that develop. A woman should also maintain a healthy lifestyle, and take some responsibility for her health, and this will help ensure that she remains a healthy ‘Well Woman’ into her old age.