- Category: Health ( Health )
- Published on Tuesday, 13 December 2011 15:14
All women experience menopause. It is a natural part of life, although many people make it sound like a time to fear or ignore. Although this phase does mark a variety of changes in the female body and its overall health, it does not have to be considered a negative experience. In its most basic definition, menopause is the final menstrual period and is usually confirmed when a woman has missed her period for 12 consecutive months (if not attributed to other causes). The significant change in the reproductive system is the reduced functioning of the ovaries due to aging, which in turn leads to lower levels of estrogen and other hormones. It is the permanent end of fertility, and pregnancy is no longer possible. Most women begin this "change of life" between the ages of 45-55.
The transition from child-bearing years through menopause and beyond involves a number of physical changes, most of which are very normal and are often temporary. One of the most widely-noted is the experience of hot flashes, when the body suddenly feels overheated for no reason. Other physical changes occurring during this time of life may involve signs and symptoms of illnesses that began to develop during midlife, such as sleep disorders, diabetes and thyroid irregularities. These conditions can either be brought on by the combination of changing hormone levels with the effects of aging and genetic makeup, or may be the consequence of a history of unhealthy habits, lifestyle choices, or ongoing stresses on the body.
Each woman's experience of menopause is completely unique, although family history can often provide a general outline of what that experience may be. One woman's path of physical change may reflect those of her mother, grandmother, etc., at least to some extent. Although knowing about the physical alterations amongst the women in one's family, it is also extremely important to look at one's expectations and ideas regarding this new passage of life. Each culture and ethnic group in the world has a very different idea of what menopause means in the path of womanhood, from extremely negative to glowingly positive. Depending on one's perspective, it can either be seen as a terrible and limiting barrier, or a celebration of the maturing body and mind. It is extremely important that,whatever one's cultural background dictates, every woman should be educated about the changes happening in her own body and make decisions that continually support her physical and emotional health. Experiencing change can often be challenging, but the support and understanding of loved, ones, as well as patience with oneself, is crucial.
For some women, menopause brings little change beyond the stopping of menstrual periods. Many may feel this is a time of liberation, when concerns about the troublesome symptoms of their monthly cycle may cease, and unexpected pregnancy is longer even possible. For others, they may go through a variety of symptoms, which, besides hot flashes, can also include insomnia, mood disturbances (i.e., depression, anxiety), heart palpitations, night sweats, vaginal dryness and decreased sex drive. Thankfully, the topic of menopause is no longer considered as shameful and inappropriate, and many more women and health care providers are discussing this natural part of life more openly. There are now so many advanced ways to treat symptoms and allow a woman to move through this phase with greater comfort, relief and even enhanced quality of life. It does not have to be viewed as a sign of aging and limiting value in a society that holds youth and fertility as an ideal. Women in the middle part of life are more commonly seen as possessing greater confidence, wisdom and a new energy in their approach to life. Moving past the time of child-bearing can open the realm of possibility to new interests, hobbies and a freedom from the physical conditions of their younger years.
Physical indicators of the onset of menopause may start many years before, sometimes as early as around 35. This transition is called perimenopause. It can last up to 6 years or more and usually ends one year after a woman's very last menstrual period. Perimenopause begins when ovarian hormones like estrogen begin to gradually decline, although they can occasionally increase erratically. Monthly cycles may become irregular, hot flashes might be experienced, mood swings can become common, and a loss or thinning of hair (including eyelashes and eyebrows) sometimes indicate the state of perimenopause. Conceiving a child during this time is still possible, but the chances are typically very low. If pregnancy is not a goal, some form of contraception is necessary until menopause is confirmed by a medical professional.
A common approach to dealing more effectively with the sometimes difficult symptoms of menopause is taking prescription medication, most often hormone therapy (HT). Estrogen therapy (ET) involves treating symptoms with a dose of synthetic estrogen in an effort to balance out the decreased levels of naturally-occurring estrogen in the body. It does not completely replace the estrogen lost, as it only provides a fraction of the hormone that the body once was able to produce. EPT, or estrogen plus progestogen therapy is another option. According to The North American Menopause Society, "estrogen is the hormone in this duo that provides the most symptom relief.” Progestogen is added to protect the uterus from unnecessary estrogen stimulation.
Hormone therapy is widely regarded as a safe and effective way to deal with the discomforts of menopause, although it remains a sometimes controversial topic. There are hundreds of clinical studies and bodies of research demonstrating the beneficial treatment of hot flashes, bone loss, sleep disturbances, and sexual discomfort. Improved sleep, intimate relations and quality of life are often the result of carefully monitored HT at a dosage suitable to the individual woman. Yet, there can be risk involved. Most medical professional recommend taking HT in the lowest dosage possible, for the shortest period of time while still remaining effective. It is long-term use of hormone therapy that has resulted in concerns about the development of certain types of cancer, stroke or blood clots. In 2002, the Women's Health Initiative's studies led to the US Food & Drug Administration's requirement that all estrogen-containing prescription medications display a warning on their packaging and information materials regarding the potential health risks. Some researchers feel that artificially increasing the levels of certain hormones in the bo dy can cause abnormalities resulting in development of illness and disease. Women experiencing the beginning stages of menopause should speak with their doctor about the many factors involved in taking HT and decide if it is right for them. Family history, menstrual patterns, and other individual issues can help a woman determine whether her body is suited to this form of treatment.
Most importantly, any woman taking the journey through menopause should always strive to be patient and kind with herself. Her body and mind are going through new and sometimes unsettling changes; having the encouragement of others in her life will help her transition to a new chapter that can be blessed with greater freedom to enjoy herself and the world in a different and very positive way. Exercise, a balanced diet, refraining from too much caffeine or alcohol, and taking time to relax, meditate or pray will bring balance and overall mid-life health to her body, mind and spirit.
- Category: Health ( Health )
- Published on Tuesday, 13 December 2011 14:57
Raising a toddler can be both challenging and rewarding. Individual differences such as temperament, family, and environment all influence your toddler’s behavior. When facing problematic behavior, take a moment to consider what your toddler is trying to communicate. Consider areas where you can support your toddler’s regulation. Routine is important so be consistent with sleep and meal times. Everyone has disruptions in their routines, but children who are more regulated can handle disruptions better. Also, remember you are modeling behaviors, so how you deal with your emotions will influence how your child does.
It can be difficult to put ourselves in our toddler’s mind to understand what is driving their problematic behavior. Your toddler has the intellectual limitation that she believes that everything happening in her world is the result of something she has done. She may misunderstand concepts as death, divorce, or illness, thinking that she played some role. Also, reasoning with your toddler is often difficult because the world is more black or white and there is no differentiation between reality and fantasy. Choose simple, straight-forward words. Don’t give choices when you have a desired behavior, such as, “Do you want to go to bed?” Instead make the positive statement, “It is time to go to bed,” and provide an enjoyable transition. When there are choices, keep it simple to two options.
A common problematic behavior is temper tantrums. Usually beginning in the second year, temper tantrums may worsen during the twos and threes, and taper thereafter. Toddlers have strong emotions and may share them with crying, yelling, and throwing themselves down. As toddlers learn more words to communicate, temper tantrums usually fade. Toddlers need to learn to express their emotions, so do not punish a child for having a temper tantrum. Model calm behavior but let your toddler know that you understand that he is upset. You may try to distract your child or use age-appropriate discipline. While it is all right to ignore minor displays of anger, aggression or excessive screaming must be addressed in a firm and consistent manner. Your toddler should be removed and given clear direction, such as “No hitting.” Do not give in to your child just to stop a tantrum! This teaches your child that temper tantrums get her what she wants. Remember consistency in routine and rules. Set the rules and stick with them. When rules change, it is harder for children to understand expectations.
For concerns about your toddler’s behavior, make an appointment with your pediatrician. Your pediatrician is the best person to give objective advice and can suggest resources and behavioral modification techniques. Feel free to discuss any individual family or cultural differences which may influence your child’s behaviors. Your pediatrician may consider sending your child to a specialist for further evaluation and treatment. For more information visit the American Academy of Pediatrics website www.healthychildren.org. Recommended reading/DVD, available at most libraries, is Dr. Harvey Karp’s The Best Toddler on the Block.
Dr. AbdulCader is a pediatrician specializing in the assessment and treatment of children affected by prenatal substance exposure, abuse, neglect, and drug-endangered environments. She co-founded the UMMA Clinic as a student at UCLA.