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Late menopausal age calls for caution

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Sakaal Times
24 October 2010
By Vasumita S Adarsh

Late menopausal age calls for caution
While World Menopause Day was observed on October 18, several programmes to create awareness were organised in the city during the week that followed. Fertility expert and gynecologist Dr Pankaj Kulkarni spoke to Vasumita S Adarsh on the various dilemmas that modern-day women face during their transition to menopause.

Dr Pankaj Kulkarni completed his MBBS from BJ Medical College, Pune, in 1988 and obtained a Diploma in Gynaecology and Obstetrics from the Bombay Hospital in 1991. He is a Fellow in Urogynecology, Australia, and a Fellow in Artificial Reproductive Techniques (ART), Belgium. He has been practicing in Pune since 1993 at his own Sakhi Clinic on FC Road . He also works with a number of hospitals in the city like Gupte Hospital, IVF Pune and Galaxy Care Hospital.

What are the significant trends regarding menopause that you have noticed among women today?
The longevity of Indian woman has increased. More and more women cross their seventies and eighties. In India, owing to lifestyle changes and other factors, women today are facing the problem of delayed menopause resulting in more estrogen secretion in the body. Where women were earlier reaching menopause by the age of 43-44, today they are reaching it by the age of 46-47. This is good in certain respects, but can be dangerous too if regular check ups are not done, as excess estrogen with low levels of progesterone can lead to health troubles like cancer of the uterus, etc. While awareness on these issue is increasing, it needs to improve further especially in rural areas.

How does lifestyle affect menopause in women? What changes are required to be adopted to counter these problems?
One of the basic requirements is to go back to our traditional food and methods of eating. The problem today, with rapid Westernisation, is a lifestyle that is hugely sedentary for most women, especially those working in offices. Besides this, smoking along with consumption of alcohol is on the rise. Consuming aerated drinks, pizzas, and excess partying has all led to current problems relating to menopause. Earlier, a woman's transition into menopause was smooth, owing to traditional family life, a diet rich in fibre and psychological preparedness to accept menopause.

What are the major risk factors that women reaching menopause face ?
Stress, heart-related problems along with diabetes, Osteopenia (considered as a pre-stage to Osteoporosis), breast-related problems and psychological issues are increasing among menopausal women. In fact, they require special counselling to prepare for this stage, as on one hand hormonal decline is causing health problems, and on the other hand, they may have to deal with the empty nest syndrome, as children usually leave home for studies or career.

What precautions should women take to avoid post menopausal problems? How should they prepare themselves ?
Exercise is most important as they help prevent sagging of breasts, increase the strength of bones and improve overall physical and mental health. A traditional diet that is low on sugar and provides more iron and calcium is important to maintain bone strength. Routine medical examinations, which must include regular check-up with one's gynaecologist, a PAP smear test, breast examination, bone mineral density check-up and heart check-ups are important to spot any problems before hand. Another important necessity is that women regularly do self check-ups on their breasts like looking for change in the shape of the breasts, retraction of nipples, or feeling for lumps.

What are hospitals in the city doing ? How are they helping to create awareness ? What more needs to be done?
Most hospitals in the city are conducting various awareness camps and free check-up camps to make couples aware of the issue connected with menopause. Sadly though, the turn-out in such camps is very low. Even when free camps are being conducted, people don't turn up thinking it must be for the poor, or only for those with some problem. The mentality that you must go to a doctor only after you detect a problem, needs to change.

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