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Menopausal zone: Can exercise be a substitute for hormonal treatment? Living with lupus Health Notes
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Menopausal zone: Can exercise be a substitute for hormonal treatment? Sapna, 50, known for her beauty and youth, broke down in tears over the changed look of ‘Bebeji’ with 8 kg weight gain after going through menopause. When the gynaecologist told her that it was due to getting older, falling hormones, slowing metabolism and lack of activity, she didn’t seem to believe. The truth is that women’s bodies do change as they enter middle age and go through menopause, but weight gain isn’t inevitable. ‘Well, exercise has an important role to regain your wellness and shape, it may prove as good as taking hormonal replacement therapy (HRT) without the risk of side-effects,’ replied the doctor. Many experts believe that it is the reduction in physical activity, along with a decreased metabolism, not attenuated by resistance training, that causes those extra pounds rather than something physiologically related to menopause. The low level of estrogen is the reason why fat tends to shift from the typical hip and thigh distribution to the tummy, where it becomes potentially more of a health threat because this area is more ‘active’ and, therefore, secretes more fatty acids into the bloodstream, putting the liver under stress. Which is why exercise is even more crucial at this stage in life. What happens during menopause Beginning around 40, hormone production in the ovaries starts to slow down. What many women don’t like about this process are the symptoms and problems that come with these shifting hormones such as hot flashes, depression, stress and anxiety, sleep disorders, irritability, frail bones or osteoporosis, cardiovascular disease and weight gain. Besides menopause, other factors include lack of exercise, reduced muscle mass and metabolism decline, overeating and genetic make-up. The good news is that a regular programme of physical activity can help manage most of the uncomfortable symptoms of menopause as well as the related health concerns such as heart disease and osteoporosis. The benefit may nearly equal HRT. Benefits of exercise Reduced stress: Menopause can often lead to depression, anxiety and stress. Exercise is proven to help reduce stress and improve your mood. Weight loss: Exercise can help create a calorie deficit which is what you want when it comes to losing body fat. Reduction of hot flashes: Some research has found that exercise increases estrogen levels, which can decrease the severity of hot flashes. Increased bone mass: Strength training and impact activities (like walking or running) can help strengthen the bones and prevent osteoporosis. Reduced risk of high blood pressure, heart attacks and strokes: Pelvic muscle exercises increase support to the urethral sphincter and bladder muscle and prevent and treat involuntary loss of urine. The key is to start slowly and do things you enjoy such as walking, cycling, vigorous yard work, swimming, cardio exercises, group fitness programmes or yoga exercises. Appropriate stretching exercises should be performed before and after each aerobic and resistance session to improve and maintain flexibility. Exercise safely 1. Warm up and cool down before and after the exercise 2. Drink plenty of water. 3. Be more vigilant about exercising in extreme heat or cold as we get more prone to dehydration and heatstroke as we age while very cold weather causes the blood vessels to constrict, putting extra strain on the heart. 4. Wear thin cotton clothing and not thick jeans to reduce the risk of triggering a hot flush. 5. Be vigilant about stretching — don’t overdo it to increase flexibility suddenly. 6. Allow yourself longer to recover between sessions. 7. Ensure that you get at least 1,000 mg of calcium per day and, may be, some micronutrients. The writer is a senior gynaecologist based in Chandigarh. drkumar232@hotmail.com |
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Living with lupus Systemic lupus erythematosus (SLE) is also commonly known as lupus. The signs and symptoms of lupus can be commonly seen in many other diseases. It is also called “the great imitator”. Lupus is an autoimmune disease affecting nearly 5 million people throughout the world. Lupus affects mostly women of child-bearing age, yet no age or race is immune. What causes lupus? The immune system is the body’s defence system against germs — viruses and bacteria. In lupus, as in other autoimmune conditions, the immune system is aberrant. The immune system mounts an attack against one’s own organ system just like it would attack germs. This results in inflammation (swelling) of the affected organ, organ dysfunction and, if not treated in time, irreversible damage to the organ. The exact cause for this aberrancy in the immune system remains a dilemma. There is some genetic predisposition. A child whose parents are affected has more chances of having lupus. However, in most others, the family history of lupus is absent. Factors that can trigger lupus in some include ultraviolet rays from the sun, drugs like sulfonamides, anti-tubercular, anti-epileptics, etc, infection and stress. Therefore, the question what causes lupus remains partially unanswered presently. Symptoms Lupus is considered a disease with thousand faces because of its protean manifestations which depends upon the organ involved — skin, joints, muscles and nerves, kidneys, lungs, heart, brain, eyes, liver and/or blood. These organs can be affected simultaneously or sequentially either individually or in combination. It is also a disease of remissions and relapses which means symptoms come and go. More serious life threatening complications can occur with the involvement of major organ systems:
Treatment During the last few decades significant progress has been made in the treatment of lupus. The general idea that lupus is always fatal is not true anymore. If the patients follow the advice of their rheumatologists, the outlook for lupus patients is much better today with most of them leading a normal life. However, some people will have serious or life-threatening complications. At present though there is no cure for lupus, there are effective treatments for keeping it under check. The type of drugs and the duration of the treatment depend on the organ system involvement and also the severity of the disease. Due to the complete absence of authenticated published data in scientific medical literature, the British Society of Rheumatology and American College of Rheumatology do not recommend alternative systems of medicine for treating lupus. Challenging for life Having lupus can make life very challenging. There would always be some good and some bad days. The following are very useful tips for people to cope up with lupus in everyday life: a. Diet and nutrition: There is no special diet for lupus patients despite the advertisements on the internet and in print. In general, unless a specific diet is recommended, one should eat a healthy nutritious and well-balanced diet while at the same time ensuring adequate intake of calcium and vitamins D to prevent osteoporosis (weak bones). b. Exercise, fatigue and photo-sensitivity: Just like everyone else, people with lupus need to exercise regularly. Activities such as walking, swimming, bicycling and aerobics are recommended. Fatigue is very common and at times very debilitating. Disease activity, pain, medicines, other concomitant conditions (anaemia, kidney failure) contribute to fatigue. Regular stretching and aerobics exercises interspersed with periods of intermittent good rest will help in fighting it. c. Infection and vaccinations: Individuals with lupus are more susceptible to infection per se because of lupus itself and the medications, both of which impair the immune system. Fever in lupus could be due to lupus itself or infection, and the best way is to consult your rheumatologist. People with lupus should avoid contact with anyone having fever, diarrhoea or overt infections. It is also advisable to have influenza vaccine annually and pneumonia vaccine every five yearly. d. Smoking and alcohol: People with lupus should quit smoking as the chances of infection, blockade of arteries supplying blood to various organs (including heart, brain, skin) and osteoporosis are increased manifold in comparison with people without lupus. Occasional alcohol use is usually not a problem for people with lupus, but is best avoided as it can potentiate the side-effects of drugs or disease itself like osteoporosis (weak bones). e. Depression: Since lupus is a chronic disease, it is natural to feel unhappy, frustrated, angry, or sad or feeling of guilt (why me?). Two common feelings associated with clinical depression are hopelessness and helplessness. A combination of psychotherapy, medications, aerobic exercises, developing a hobby, improving your sleep habits and reconnecting with family members, friends and colleagues could be very helpful. Lupus is a disease of uncertainties with periods of flares and remissions with different organs being affected at different points of time in an unpredictable manner. There are no cures at this point of time, but sincerely following the advice of your rheumatologist and adhering to the advice will surely help most to keep lupus in check and to lead a normal life. The writer is senior consultant (rheumatology) at Arthritis Care, Panchkula, and Fortis Hospital, Mohali. E mail: arthritiscare.in@gmail.com |
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Health Notes WASHINGTON: Women with moderate to severe depression and stress symptoms were less likely to use contraception consistently — that is, use it each time they had sex — compared to women with mild or no symptoms, a new study has found. Women with depression or stress were also more likely to say they did not use contraception at all in the past week compared to women with less severe symptoms. The findings are concerning because, although preventing unplanned pregnancies is important for all women, it may be especially important for women with mental health issues, said study researcher Kelli Stidham Hall. — ANI
How to beat insomnia for good
MELBOURNE: Poor sleep, which can make a misery for those who suffer from it, can be overcome by following a simple set of tips, experts have claimed. Evidence shows that insomniacs report low energy levels, mood swings, less productivity at work, relationship difficulties, and persistent poor sleep can even increase the risk of developing conditions including diabetes, depression, high blood pressure and strokes. According to Research at the University of British Columbia, every hour of sleep lost at night may cost us one IQ point the following day, and it is often a long-term issue — a quarter of people with insomnia have suffered from it for more than 10 years. To deal with their sleep problems without pills, most people focus first on what Colin Espie, professor of clinical psychology and Director of the University of Glasgow Sleep Centre, calls “sleep hygiene” — our pre-bed routine, and the physical environment in which we try to sleep. —
ANI
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Despite the huge emotive significance that menopause has in our society — the turning of the corner, the slippery slope towards old age, the passing of femininity — put simply, the menopause is the signal of the end of reproductive potential. ‘Can I fight out this ugly change with protruding tummy and regain my figure?’ enquired Sapna.