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Embracing Change: Menopause and the Path to Healthy Longevity

Menopause is associated with accelerated aging and an increased risk of osteoporosis, heart disease, dementia, depression, and cancer. While women live an average of 4 years longer than men, they experience a lower quality of life compared to men of the same age.


In addition, up to 70% of women experience menopause-associated symptoms, of which there are over 30, and in some women, the symptoms significantly impact their quality of life and well-being. It is a misconception that a woman has to suffer through these symptoms. There are many options for effective medical treatments that can be individualised. Additionally, the negative connotations of aging, societal pressures that value women only for their reproductive ability, fear and denial due to misinformation and misconceptions about menopause continue to perpetuate. Asian women are also less likely to seek treatment for their symptoms and it is a myth that they do not suffer from menopause symptoms. Studies in Asia include a very diverse and heterogeneous group with different rates of prevalence of symptoms. Body aches and joint pains affect 80% of women and over 60% report sleeplessness, irritability and loss of sexual function.



Women comprise half the world's population, yet only 41% of medical research report findings specific to women. This percentage is lower at around 30% in women above age 65. Yet this age group represent a large proportion of real-world drug and treatment recipients. It is well known that there are biological sex differences in drug metabolism result in a greater number of adverse reactions occurring in women. Diseases such as heart disease, dementia and depression are greater among older women, yet over 50% of research in these conditions is performed in men. Scientists are developing better guidelines on inclusive and sex-disaggregated research guidelines and including the menstrual cycle as a vital sign, just like you would have your blood pressure, heart rate and weight recorded.


There are simple things you can do now as you progress past your reproductive life cycle and add life to the years beyond.



Having relevant information on hand can help you and your health provider discuss the best approach for you.


1, Track menstrual cycles: one of the earliest signs of menopause is a change in any or all of the following. The length of the menstrual cycle (may become shorter or longer), the number of days of bleeding (may increase or decrease) and the amount of menstrual flow (may become lighter or heavier).

2. See your provider for a menopause symptom questionnaire as there are over 30 symptoms. Some are more obvious such as vasomotor symptoms (hot flashes, night sweats and difficulty dissipating heat) and bladder or dryness of the genitalia (also known as genitourinary syndrome of menopause). There are less obvious symptoms such as depression, memory problems, lack of concentration, headaches and palpitations which require further evaluation to exclude other causes.

3. Lab testing is usually not needed to diagnose menopause but if you have a family history of diabetes, heart disease, cancer and unusual symptoms, you may need to undergo some testing to rule out some conditions and to identify health risks. This may also be a time to discuss early cancer screening (breast cancer, colon cancer etc.) and assess risk for osteoporosis and sarcopenia. Another tip is the measure your waist-to-height ratio as a screening tool for visceral adiposity. The size of your waist divided by your height in the same metric should be no more than 0.5. A number greater than 0.5 may indicate an early health risk, is simple to calculate and has good predictive value.

4. Discuss both medical and lifestyle treatment options based on your own personal health status, risk and goals.

5. Look for lifestyle information regarding exercise and nutrition that are specifically studied and reported to be effective for women since there are sex differences in muscle, fat and energy metabolism changes as women age. Research in the last 20 years indicates that strength training, polarised training and focus on sufficient protein intake may need to be a priority during the menopause transition.

6. Speak to your partner or close family to engage them in receiving evidence-based information about symptoms, health risks and management options. 50% of women report that their menopause symptoms have impacted their home life and 38% of partners feel helpless.



It is time to change the tone around menopause and the mindset about women as they transition into post-menopause. Women do not need to limit themselves by societal pressures to maintain only a fertile reproductive ideal. We do not impose the same on men when their gonadal volume is reduced to 30% with age, as it is accepted as part of normal aging. With the increasing life expectancy and an increasing global burden of lifestyle-related chronic diseases, our efforts are better directed towards improving resources towards early prevention and a better quality of life.


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For more information on evidence-based medical and lifestyle strategies individualised to you for healthy longevity you can contact us via Email or WhatsApp


References:

  1. Baber RJ. East is east and West is west: perspectives on the menopause in Asia and The West. Climacteric. 2014 Feb;17(1):23-8. doi: 10.3109/13697137.2013.830607. Epub 2013 Oct 1. PMID: 23931652.

  2. Daitch V, Turjeman A, Poran I, Tau N, Ayalon-Dangur I, Nashashibi J, Yahav D, Paul M, Leibovici L. Underrepresentation of women in randomized controlled trials: a systematic review and meta-analysis. Trials. 2022 Dec 21;23(1):1038. doi: 10.1186/s13063-022-07004-2. PMID: 36539814; PMCID: PMC9768985.

  3. https://www.womens-health-concern.org/wp-content/uploads/2020/09/BMS-NationalSurvey-SEPT2020.jpg

  4. https://www.womens-health-concern.org/wp-content/uploads/2020/09/BMS-Infographic-A-womans-relationship-with-the-menopause-SEPT2020.jpg

  5. Ashwell M, Gibson S. Waist-to-height ratio as an indicator of 'early health risk': simpler and more predictive than using a 'matrix' based on BMI and waist circumference. BMJ Open. 2016 Mar 14;6(3):e010159. doi: 10.1136/bmjopen-2015-010159. PMID: 26975935; PMCID: PMC4800150.

  6. Gunes S, Hekim GN, Arslan MA, Asci R. Effects of aging on the male reproductive system. J Assist Reprod Genet. 2016 Apr;33(4):441-54. doi: 10.1007/s10815-016-0663-y. Epub 2016 Feb 11. PMID: 26867640; PMCID: PMC4818633.



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