Live Your Best Life AFTER Menopause

The inclination for sex also increases because the messiness of periods, the need for contraception and the fear of pregnancy are over, the nest is empty and her partner retired, with all the time in the world at their disposal to indulge in such activities, which makes them enjoy it all the more!

“A lot of women resent that their reproductive career is cut short by middle age, while men can reproduce till the end of their lives.

“‘Good riddance!’ I say. Imagine having to worry about contraception and unwanted pregnancies at that age!

“After imposing upon the women the overwhelming responsibility of carrying forward the human race.”

That’s a very sound commonsensical view from Dr Amrinder Bajaj, a senior gynaecologist at the Fortis Memorial Research Institute, Gurugram.

In Live Your Best Life: Understanding MENOPAUSE for a Wiser, Happier and Healthier YOU, Dr Bajaj, who trained at the All India Institute of Medical Sciences, New Delhi, unpacks the much dreaded life stage of menopause and lays out the pros and cons. It’s mostly all about pros.

In the following excerpt from the book she answers a few of the troubling questions that go through many a pre-menopausal heads. Read on.

All sorts of problems begin with menopause?

Partly true. Menopause does make a woman prone to heart disease, fractures and senile dementia, but so does age. Men too suffer from similar ailments, though the decrease in hormone levels does add up for women. One can minimise these and even delay them indefinitely by maintaining a healthy lifestyle and a positive attitude.

Menopause brings many symptoms along with it?

Partly true, for there is a wide spectrum of symptoms associated with menopause. But some women have such a smooth transition from the reproductive to the menopausal phase, with not a single symptom, that makes them wonder what all the fuss was about.

Others could suffer anything ranging from hot flashes and cold sweats to genito-urinary symptoms and weak bones prone to fractures, but there is no need to be pessimistic about it, for they can be managed with medical assistance.

The end of menstruation signals the end of sexual life?

False… We have seen that some women become (more sexually driven) and hairier after menopause, for testosterone (a small amount of male hormones in the blood responsible for libido) gets the upper hand after the levels of female hormones decrease, thereby increasing sex drive.

The inclination for sex also increases because the messiness of periods, the need for contraception and the fear of pregnancy are over, the nest is empty and her partner retired, with all the time in the world at their disposal to indulge in such activities, which makes them enjoy it all the more!

There are others who are willing but cannot enjoy sex because of the dryness which causes soreness and pain. Once they start using water-based lubricants or oestrogen-based creams locally, they are as good as new.

But a lot depends on the woman’s health, the health of her partner and her relationship with him, besides any sexual issues that have been carried forward. These have nothing to do with menopause.

A busy life with chronic fatigue, low moods and sleep disturbances take a toll on the sex life of a person of either sex at any age, more so at this age, contributing to a decrease in the desire for sex.

Tackling the root cause, for example, by a good night’s rest or a short holiday with your partner, can work wonders in replenishing sexual vigour.

You do not need contraception after you stop your periods?

False. Why? Because you do not know that you have attained menopause till a year after the last period.

Many women have erratic, delayed cycles in later years and do ovulate occasionally, which can lead to unwanted pregnancies. It is always a good idea to use contraceptives till two years after the last period. Those who have had an intrauterine contraceptive device inserted should not be in a hurry to get rid of it.

Others can use barrier methods like condoms, especially with a new or with multiple partners, for sexually transmitted diseases, including HIV, are on the rise in people over fifty. As for contraceptive pills, they are not for postmenopausal women.

You put on weight after menopause?

True to a certain extent: The older you get, the more difficult it is to maintain optimal weight, especially around menopause. Due to hormonal changes, you tend to gain more weight around your abdomen than around your hips and thighs.

A lot depends upon your lifestyle and genetic factors. If there is a family tendency to gain weight in middle age, you are likely to do the same. Also, with age, one tends to lose muscle mass due to slowing down of metabolism, while fat increases.

If you continue to eat as before but do not increase your physical activity, you will gain weight. You can reverse it by inculcating healthful eating habits and leading an active lifestyle.

Lack of sleep may be a contributory factor, for people who sleep less tend to snack more. Besides making you look ungainly, increased fat around your middle predisposes you to diabetes, heart and lung problems and certain cancers like that of the breast, colon and endometrial cavity.

Though postmenopausal weight gain is not shed easily, the formula remains the same — eat less and work out more.

Physical activity should include aerobic exercise, like walking for 150 minutes a week, and strength training at least twice a week. The latter increases muscle mass, which helps your body burn more calories.

Also, decrease your calorie intake by about 200 once you cross fifty years of age, but do not decrease the nutritional value of your food.

Replace processed food and sugars, beverages with empty calories, red meat and dairy fats with a diet rich in fruits, vegetables, legumes, nuts, soy and whole grains.

Limit the intake of alcohol.

These changes have to be permanently incorporated into your lifestyle. Any slackness on your part will undo the good you have so painstakingly achieved and you will have to start all over again.

Sleep problems have nothing to do with menopause?

False. They do — big time. As many as 60 per cent of postmenopausal women have difficulty in initiating or maintaining sleep.

Hot flashes could be one reason; others could be mood disorders or insomnia.

To improve the quality of sleep, include some sort of exercise in your daily regimen, and meditate.

Avoid caffeine, which can take up to eight hours to be completely eliminated from the body.

Try to sleep and wake up at the same time every day.

Avoid watching late-night TV shows.

Read or listen to light music before going to bed.

A warm bath and a warm glass of milk may help.

Keep your bedroom cool and comfortable, and wear loose cotton clothes to bed.

Hormone replacement therapy is dangerous?

Partly true. Temporary use of low-dose hormone replacements is safe for the majority of women, but it has to be taken under strict medical supervision. They are particularly useful in treating hot flashes and genitor urinary symptoms like vaginal dryness.

On the other hand, there are women who think all females should be put on HRT after menopause to maintain their youth and prevent its deleterious effect. This is a false notion and could be positively dangerous in women who have a personal or family history of breast or endometrial cancers. It is also contraindicated in women with a tendency for intravascular clotting.

If your periods have begun early in life, they will end early too?

False. In fact, it is the other way around in many cases. They may finish late, though most women will attain menopause between forty-five and fifty-five years of age.

Those who have early menopause for whatever reason should visit a gynaecologist as she may need HRT till the actual age of menopause is reached to prevent the side effects of hormonal withdrawal manifesting at an early age.

Menopausal symptoms are only physical?

False. You can get symptoms which are both physical and emotional. You could have mood swings, irritability and become generally disgruntled with life for no reason.

You will have to put in extra effort to overcome these by going out and meeting friends, doing regular exercise and eating a balanced, nutritious diet. If you are unable to do it on your own, there is no shame in seeking medical help.

Lifestyle changes to adopt pre- and post-menopause:

  • Quit smoking, active or passive
  • Avoid caffeine, alcohol and spicy foods
  • Follow a healthy, nutritious diet
  • Increase intake of fruits, vegetables and soya
  • Calcium and vitamin D supplements
  • Antioxidants and vitamins
  • Maintain a healthy body weight
  • Keep BP, sugar, cholesterol in check
  • Dress lightly and in layers
  • Regular exercise — at least thrice a week
  • Yoga and meditation
  • Do Kegel’s exercises to prevent leakage of urine
  • Remain sexually active — use water-based lubricants or hormonal cream if required
  • Go for yearly preventive health check-ups
  • Do whatever you are passionate about — religion, painting, writing or even gossiping with friends.

Excerpted from Live Your Best Life: Understanding MENOPAUSE for a Wiser, Happier and Healthier YOU by Dr Amrinder Bajaj, with the kind permission of the publishers, Penguin Random House India.

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