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Lifestyle Approaches

Lifestyle Approaches. Piyusha Atapattu MBBS, MD, FRCP ( Edin ), MSc Senior lecturer, Physiology Faculty of Medicine University of Colombo. SLMA/ MENOSOC. Menopause.

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Lifestyle Approaches

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  1. Lifestyle Approaches PiyushaAtapattu MBBS, MD, FRCP (Edin), MSc Senior lecturer, Physiology Faculty of Medicine University of Colombo SLMA/ MENOSOC

  2. Menopause “Ovarian failure due to loss of ovarian follicular function accompanied by oestrogen deficiency resulting in permanent cessation of menstruation and loss of reproductive function.” • The median age for menopause is 51 yrs (39 –59 yrs) • The average woman is postmenopausal for 1/3rd of her life! SLMA/ MENOSOC

  3. SLMA/ MENOSOC

  4. What are the problems associated with menopause? • Vasomotor symptoms • Gynaecological problems • Psychological disturbances • Osteoporosis • Visceral Obesity, Metabolic Syndrome, CVD • Increased incidence of malignancy SLMA/ MENOSOC

  5. Remember….. • CHD • most common cause of death in women • Approximately 1/2 develop CHD, 1/3rd die from it • Early mortality following MI is higher and long-term prognosis is worse in women than in men • Osteoporosis • 1/2 of all postmenopausal women will have an osteoporotic fracture during their lifetime SLMA/ MENOSOC

  6. How do we prevent/ manage these problems? • Lifestyle approaches • Screening for DM, hyperlipidaemia • Screening for cancer –breast, cervical, bowel • Counseling • Pharmacotherapy • Surgery SLMA/ MENOSOC

  7. Lifestyle approaches in menopause - evidence • Studies have shown that lifestyle intervention approach, with modest dietary restrictions and increased leisure physical activity, was effective for weight loss and/or weight maintenance and CVD risk factor reduction that typically occur as a woman transitions through menopause. (WHLP, WOMAN) SLMA/ MENOSOC

  8. What are the Lifestyle approaches that would help? • Diet and nutrition • Exercise • Weight control • Psychological aspects • Reducing the impact of symptoms • Other -smoking/ alcohol SLMA/ MENOSOC

  9. Diet • Individualized, affordable, practical, sustainable SLMA/ MENOSOC

  10. Dos and Don’ts SLMA/ MENOSOC

  11. Regular Exercise - benefits • Necessary to remain active, healthy and independent • Reduces BP and the CVD risk • Increases energy levels, muscle strength and bone density • Weight-bearing exercise reduce risk of developing osteoporotic fractures • Helps weight loss • Reduce stress, anxiety, depression, and improves sleep • May reduce hot flushes SLMA/ MENOSOC

  12. Regular Exercise • Types - Low/ Moderate / High intensity • Greatest health benefits when sedentary persons begin moderate-intensity exercise • Even low intensity exercise have significant impact on health • Walking or light jogging for 1 hr daily will produce significant loss of visceral fat • Any Exercise –better than No Exercise!!! SLMA/ MENOSOC

  13. Exercise prescription • Individualized, achievable, practical, sustainable • When recommended frequency increases actual participation decreases • Break up the exercise • Gradual increase in intensity and frequency • 30-40 min/ d on 3-5 days of the week SLMA/ MENOSOC

  14. Weight reduction • Improves all aspects of metabolic syndrom, all-cause and CVD mortality • Aim - Weight reduction – 10% of basal weight in 6-12 months • Even though NO weight loss, exercise and dietary changes • Lower BP • Improve lipids • Improve insulin resistance • Protect from osteoporosis • Improve general wellbeing • Make women feel good and look good!! SLMA/ MENOSOC

  15. Psychological aspects • Regular mental stimulation to maintain cognitive ability • Social activity and learning new skills improve mental function • Concentration improved with crosswords, puzzles, quizzes • Counseling , relaxation or stress reduction techniques may help to deal with life events causing anxiety and improve coping strategies SLMA/ MENOSOC

  16. Reducing the impact of symptoms • Hot flushes • Avoid triggers- spicy foods, caffeine, alcohol, smoking • Wearing cotton dresses and using light-weight cotton bedding may help • Use fans, ice cold drinks…. • Regular exercise • Vaginal symptoms may be relieved by regular use of vaginal moisturisers, or non-systemic oestrogen SLMA/ MENOSOC

  17. Other aspects • Education • Strong need for educating women • Many women ignorant of menopause • May become confused and anxious, fearing that something abnormal is happening • Other • Smoking cessation • Alcohol reduction

  18. Screening • Malignancies • NCDs –CVD and CVD risk factors • BMI and waist circumference, HT, Lipids, FBS • Osteoporosis • BMD after 65 years

  19. Plus points of menopause and after…. • Postmenopausal period has much to offer • Free from many responsibilities • No menstruation or pregnancy • ‘Still young’ and ‘healthy’ • Financially stable • Capable/ respected/ powerful SLMA/ MENOSOC

  20. Power Women Of Asia SLMA/ MENOSOC

  21. Summary • The average woman is postmenopausal for 1/3rd of her life • There are many problems associated with menopause (CVD, osteoporosis, vasomotor symptoms, gynaecological problems, psychosocial problems, malignancies..) • Lifestyle approaches may help considerably in alleviating problems • Weight reduction, healthy diet, physical activity, psychological help and education are the important lifestyle approaches • Cultivating a positive attitude towards menopause contributes to healthy living for menopausal women SLMA/ MENOSOC

  22. Let women have a good life after menopause!! SLMA/ MENOSOC

  23. References • Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women:2007 Update. Circulation. 2007, 115:1481-1501: • Menopause: lifestyle and therapeutic approaches RCN guidance for nurses, midwives and health visitors (RCN 2010) • Nied RJ and Franklin B. Promoting and Prescribing Exercise for the Elderly. Am Fam Physician. 2002;65(3):419-427. • Pettee K K, Storti K L, Conroy M B, Ainsworth B E. A Lifestyle Approach for Primary Cardiovascular Disease Prevention in Perimenopausal to Early Postmenopausal Women. AMERICAN JOURNAL OF LIFESTYLE MEDICINE. 2008;2:421-431 • Kuller L H, Simkin-Silverman L R, Wing R R, Meilahn E Nand Ives D G. Women’s Healthy Lifestyle Project: A Randomized Clinical Trial : Results at 54 months. 2001, 103:32-37 Circulation • Kuller LH, Pettee Gabriel KK, Kinzel LS, Underwood DA, Conroy MB, Chang Y, Mackey RH, Edmundowicz D, Tyrrell KS, Buhari AM, Kriska AM. The Women on the Move Through Activity and Nutrition (WOMAN) Study: Final 48-Month Results. Obesity (Silver Spring) 2011 Apr 14. [Epub ahead of print] • Rao S S, Singh M, Parkar M, Sugumaran R. Health Maintenance for Postmenopausal Women. American Family Physician. 2008;78(5): 583-591. SLMA/ MENOSOC

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