Minimally Invasive & Robotic Laparoscopic Gynae Surgery
jameslee.gyne@gmail.com
What Is Menopause or Midlife Crisis?
The menopause is the time in life when a women stops having periods. The periods
stop because the ovaries stop producing the normal amounts
of estrogen and progesterone hormones. Across most ethnic
population, the menopause occurs around fifty-one years
old. For many people, the menopause is uneventful and
they do not suffer adverse symptoms. Nevertheless, some
of you will experience a series of different symptoms
at the time of the menopause that initiate you to seek
help and treatment.Menopausal Symptoms & Complaints
In Caucasian women, hot flushes and night sweats are very common and characteristic of the menopause. But local Asian women do not complain much of these, possibly due to climatic adjustment. Instead, Asian women tend to speak of non-specific joint aches and body aches that become progressively disturbing. You may have disrupted or poor quality sleep, that eventually contributes to tiredness and chronic exhaustion; mood swings and irritability, poor concentration, reduced short-term memory, and in few of you, episodic heart palpitations and panic attacks. With time, some of you will deep into depression. In addition, you will notice body changes like drying and itching of skin, thinning of hair and cracking of nails, and the vaginal skin also become thin and dry. Women often describe a decrease in libido (sex drive) as well.A few years into the menopause, you may notice changes in your urinary habits. The pelvic floor becomes weaker and the pelvic organs may begin to slide downward, giving rise to uncomfortable sensation. Osteoporosis is the commonest long term complication of the menopause. As the amount of estrogen decreases, increasing amount of calcium dissolves out of the cortical bone. This process of accelerated bone loss is osteoporosis, and it continues to the end of life. As you age, the “soften” bone becomes prone to fracture. Severe osteoporosis of the spine leads to loss of vertical height and the back becomes hunched. When your long bones are severely osteoporotic, you may have hip or wrist fractures with minimal trauma. For many years, it is known that estrogen is cardio-protective; which is the reason why there are less coronary heart disease and strokes in women before the age of the menopause. When the menopause sets in, your risk for coronary heart disease increases significantly.
Diagnosing Menopause
Diagnosing menopause when you are in the late forties is straight forward. However, when it happens in the mid thirties, then certain blood investigations have to be organized. Other causes of period cessation have to be excluded.
Hormone Replacement Therapy -
Is It Advisable?
When estrogen level declines with the menopause, supplementing it with extraneous
hormones is a appropriate concept. HRT has been a very
popular through the eighties and nineties. Many women
have benefited from the replacement treatment. Yet,
at the turn of the Millennium, several large plunged
HRT into disrepute. The bad press has continued to turn
women away from HRT. The clinical effect of the estrogen
replacement at the menopause is about fifty to hundred
times less potent that the estrogen effect in the combine
oral contraceptive pill. As a result, the side effect
profile of HRT is far less, especially with venous thromboembolism.
What is true is that HRT is used in women in their fifties
and sixties, as compared to the younger women with the
pill.Is It Advisable?
If you suffer from the symptoms of going through “the change”, and they are making your life unbearably miserable, the use of estrogen replacement is the most apt treatment. No other medication or plant products measure up to it. Your quality of life improves soon after and you will be in a better position to engage the mid-life. Hormone replacement is also prescribed, albeit less frequently nowadays, to prevent the long term effect of the menopause. This is especially important if you belong to the high risk group who are prone to osteoporosis, coronary heart disease and strokes.
It is wisdom to say that anything and everything when used in excess has undesirable
outcomes. There is no medication that does not come
with a host of potential complications. The science
of medicine determines what possible effect can arise
and what is the risk involved. The art of medicine applies
the data in each individual to use it appropriately
in order to minimize the risk. We are in the position
to advice, but we cannot make the decision for you.
Unfortunately everyone is concern about side effects,
and the bad media publicity does not make it easier
to have an informed understanding.
Side Effects of Hormone Replacement Therapy
There is evidence since the 1970s that prolonged use of combined estrogen and
progestogen replacement therapy increases the risk of
breast cancer by a small amount, estimated at 2 per
10000 per year (after 5 years of use) above the baseline
risk. This increase is nullified when estrogen is used
on its own. The risk is not high, and it is certainly
advisable to have regular breast surveillance if you
are using hormone replacement. There is no evidence
to suggest that HRT increases the risk of cervical or
ovarian cancer. In fact, users of HRT are found to have
reduced risk for colorectal cancer.
Among those women who is unfit to use hormonal preparation, severe vaginal dryness may be effectively cured by vagial laser therapy, such as the Monalisa Touch.
38 Irrawaddy Road #05-21/22
Mt Elizabeth Novena Specialist Centre
Singapore 329563
Tuesday: 9am-4pm
Wednesday: 9am-2pm
Friday: 9am-2pm
681 Punggol Drive #03-11
Oasis Terraces (LRT Stn)
Singapore 820681
Monday: 9am-2pm,
4pm-7pm
Thursday: 9pm-2pm,
4pm-7pm
Saturday: 9am-2pm
We are CLOSED on
SUNDAYS &
PUBLIC HOLIDAYS
Please call for
appointment at
+65 62585530
| Pregnancy Care| Gynecologic Conditions| Pelvic Floor Disorders| My Blog| MyComments |
| Copyright © JLG 2010 |