Whatever your age, it’s possible to maintain optimum health by adopting a sensible lifestyle, a nutritious diet, a suitable exercise regimen, and listening to your body. Dr Rishma Dhillon Pai shows you how
At the beginning of the New Year most of us made resolutions to stay fit and active all through the year, but three months down the line, quite a few of us are wringing our hands in despair. Staying fit requires commitment and discipline. Good health means soundness of both the mind and the body. Also, each age group has different issues to deal with. Here’s a blueprint to living healthy every day of your life.
IN YOUR 20s/30s
This reproductive age group may face gynaecological problems such as menstrual issues. These may be heavy or irregular menses, painful periods, severe pre-menstrual syndrome (PMS), etc. There may be difficulties in becoming pregnant or dealing with unplanned pregnancies. Miscarriage or pregnancy related problems are also common.
What you must do
- Have regular gynaecological examinations. They can prevent and treat many of these problems.
- Undergo a sonography, which is an excellent test to diagnose common problems like fibroids, endometriosis or polycystic ovaries. Your treatment will depend on the diagnosis.
How to get relief
- For PMS, which causes bloating, breast pain, mood changes, etc., reduce the intake of salt, refined flour and caffeine.
- Increase the intake of vitamin E and evening primrose oil supplements.
- In severe cases, use hormonal pills like ethinyl oestradiol with drospirenone.
- Undergo Pap smear tests.
Preventive measures
- Vaccinate yourself against rubella (German measles that causes sore throat and red spots all over the body).
- Under your doctor’s supervision, take the new HPV vaccine during adolescence or as a young adult. It prevents cancer of cervix.
- Update your knowledge of contraception and use it wisely to prevent unwanted pregnancies and complications arising from MTPs (medically terminated pregnancies).
- Opt for early antenatal registration during pregnancy.
- Start taking folic acid before pregnancy.
- Follow up regularly to take care of most pregnancy problems.
Tackle your cosmetic problems
Cosmetic problems such as acne, hirsutism (excess facial hair), and hair loss are common causes of worry. These often result from hormonal problems such as polycystic ovaries. They can be treated with specific medications.
- Design a good diet with lots of fresh fruits and vegetables.
- Drink enough water.
- Cleanse and moisturise your face regularly to keep acne at bay. It may be necessary to apply ointments and take antibiotics or hormones occasionally.
- Add vitamins such as vitamin E, folic acid, iron, B-complex in your diet.
- Include evening primrose oil, which helps reduce hair fall.
Keep the extra weight at bay
Obesity is another common problem. Assess excessive weight gain or loss with hormone tests such as thyroid levels, insulin and sugar levels. Drug treatment of these can control weight issues in many women. A balanced diet with exercise on a regular basis will definitely control weight in normal women.
IN YOUR 40s
This is the peri-menopausal age and it comes with a different set of problems. The commonest problem is menstrual disturbances. Heavy and irregular menstruation is common. This may be due to fibroids or hormonal problems or even cancers. It is important not to neglect a single symptom, especially inter-menstrual bleeding, which could be a sign of cervical cancer.
Guard against cervical cancer: In case you have any of the above symptoms, get a PAP smear test or a biopsy of the cervix done immediately. You should also get a good pelvic sonography done. Often, an internal (vaginal) sonography gives a clear view of the womb (uterus) and ovaries. It helps pick up uterine or ovarian tumours, swellings or even cancers.
Go for regular check-ups: Some cancers such as ovarian cancer have non-specific symptoms like bloating of the stomach, gas, acidity, etc. The patient continues to take antacids without realising the seriousness of the problem. Hence, it’s important to have regular health check-ups, which can pick up early cancers.
Prevent breast cancer: Breast cancer is one of the commonest cancers in women over 40. Every woman, after 40, must have regular mammographies. If there is a family history of breast cancer, then mammographies should start even earlier.
Tackle excessive bleeding: The doctor may prescribe tablets to tackle heavy menses, due to hormonal problems. Alternatively, you may be advised to insert a hormone intrauterine device which is a temporary method. The procedure takes only five minutes. A uterine balloon ablation, a 10-minute procedure, is a permanent cure for heavy bleeding. Women, who have completed their families, can opt for it.
Check for fibroids: It is advisable to remove a womb distorted by fibroids, etc. Nowadays, this is often done by keyhole or laparoscopic surgery.
Get rid of incontinence: Many women suffer from inability to control urine or involuntary leakage of urine upon coughing or sneezing. This can be embarrassing. You can treat stress urinary incontinence (SUI) with a 15-minute vaginal surgery.
Increase your libido: Many women complain of reduced sex drive or libido or vaginal dryness. These can be improved by positive reinforcement, reassurance and, sometimes, hormonal medication.
Take care of your bones: Some women, in this age group, suffer from problems like arthritis. This could be immunological or a part of the ageing process, and it requires specific diagnosis and treatment.
important: Do your annual cancer screening without fail. Take calcium supplements along with a good balanced diet. Exercise regularly to reduce the chance of osteoporosis (bone weakness).
IN YOUR 50s
The average age of menopause is 51 years. The typical symptoms many women experience are hot flushes, vaginal dryness, mood changes, irritability, anxiety, sleeplessness, loss of sexual desire, etc. Many of these can be reduced by dietary changes with the addition of soya foods, calcium, natural products like tofu, black cohosh, etc. Exercise and yoga also help. Local application of vaginal oestrogen gel reduces vaginal dryness and urinary symptoms. In some women, doctors may use hormone replacement therapy (HRT). The latest drugs, administered in low doses, cause minimal side effects and give excellent symptom relief. However, there is no role of HRT for prevention of symptoms; it’s restricted to the treatment.
Seek relief from dryness: It’s common to have vaginal dryness and pain during intercourse. Vaginal application of oestrogen cream gives good relief in this situation.
Treat incontinence: Get relief from SUI or involuntary urine leak with medicines or a minor surgery.
Get investigated: For any episodes of bleeding, after menopause, for one year. It could be a sign
of cancer.
Undergo other tests: A sonography and a PAP smear test are absolutely necessary. Often, endometrial biopsy with or without a hysteroscopy (putting a thin telescope inside the womb) may be necessary.
Strengthen your bones: Osteoporosis or weakness of bones is very common in the menopausal age group. Though calcium supplementation helps, it cannot treat osteoporosis. Treatment may involve addition of special drugs such as Vitamin D, calcitrol, alendronate, risidronate, etc. Taken once a week or once a month, they help increase bone density.
Conduct breast examination: Do a mammography every year.
Prevent heart disease: At this age, women are at high risk for heart disease. Have regular checks for cholesterol, ECG, stress tests, etc. Also, check regularly for diabetes and hypertension (high BP). Start medication, if required.
Arrest weight gain: As the woman grows older, her metabolic rate slows down and she starts gaining weight. Be very careful about your diet. Exercise more often to maintain your weight and keep your bones strong.
Have supplements: The problems of wrinkling, loss of skin elasticity, etc. are significant. Good supplementation with vitamin, exercise and a healthy diet help. However, in some cases, cosmetic surgery or procedures such as Botox injections, face lifts, etc. work well.
There are problems that occur at every phase of a woman’s life. However, a healthy lifestyle with a balanced diet, exercise and regular health check-ups will go a long way in keeping a woman fit all 365
days a year.
(The writer is a consultant gynaecologist at Jaslok & Lilavati Hospitals, Mumbai)
