Dr. Nina Mansukhani is a leading Obstetrician and Gynaecologist from Pune. She has been practicing medicine for the last 15 years and has her own clinic called Touch of Life and is associated with Jehangir Hospital Pune as well. Menopause is one of her subjects of interest.
HappyAging met Dr. Nina and talked about Menopause and gynaecological issues with Women Post 40s:
Menopause and Changes
Dr. Nina says that age is never a cut off for Menopause. The changes in women’s bodies actually begin in the perimenopause state which can start in the 40s itself. The changes are due to a sudden shift in the hormones. These changes include visible weight gain, slowdown in the body, changes in skin and hair plus mental changes. Along with this, urine incontinence, vaginal dryness, loss of libido and bone weakness are other aspects of perimenopause.
Awareness on gynaecological health
Dr. Nina says that the awareness about menopause is increasing in women and they are getting open to discussing issues with their gynaecologists. They approach their doctors regarding issues of libido, hot flashes and loss of bladder control more openly now.
Implications of pregnancies in late 30s and 40s
Dr. Nina says that more and more women are choosing pregnancies in their late 30s and early 40s. After 35 and 40, conceiving naturally may be an issue due to lesser number of eggs produced by the ovaries. In that case, women have to resolve to IVF and stimulating ovaries, which may have complications later. It also puts you at risk for diabetes and hypertension in older stages.
Lifestyle changes for women after 40
Dr. Nina says women need lifestyle changes after 40 because their metabolic rate slows down. They may be gaining weight with the same amount of food. It is important to walk at least 30 minutes a day five days a week. It can keep hypertension, thyroid and diabetes at bay. She suggests not to cheat on your diet every day, but maybe once a week. She also asks women to take health check-up packages and go for regular check-ups since prevention is always better than cure.
Important screening tests for women
Dr. Nina Mansukhani also talks about various tests women should do in every decade of their lives.
She suggests that women in their 20s should do a normal heamogram test along with routine sonography for PCOD and a diabetes check only if there is a family history.
In your 30s, get your Vitamin D and B12 checked, along with a routine sonography. Also get your thyroid, sugar levels and heamogram checked as this is the child-bearing age.
In your 40s, get a lipid profile done along with heamogram. Thyroid and sugar levels check-ups are a must too but you need to add annual mammograms in your list, especially if there is a history of cancer in the family. You can also add ECG testing and breast sonography to the list.
In your 50s, the above tests remain the same but women need to also get checked for bone mineral density.
Talking about post-menopausal osteoporosis, Dr. Nina calls it a silent epidemic. She adds that estrogen protects the body against fractures as it absorbs calcium in the bones, but after menopause there is no estrogen production making your prone to osteoporosis. The bone mass rapidly starts declining and it makes it even more imperative to start calcium supplements from your 40s onwards. She suggests doing strength training and walks to keep osteoporosis away.
Sex in older women
Dr. Nina says that sex in older women remains a taboo subject till date in our country. With Hormone therapy into the picture, women can use them to treat sexual issues after menopause. She also insists on doctors providing enough comfort and privacy to the patient for them to open up to them. She also suggests counseling to discuss sexual issues in older age.
Hormone Replacement Therapy
Talking about Hormone Replacement Therapy (HRT), Dr. Nina feels there is still a misconception about it. People don’t know that when used correctly, there are lots of benefits of HRT. She prescribes her patients with a combination of estrogen and progesterone for a short period to treat menopause.
About Geriatric Gynaecology and its importance, Dr. Nina says that since life expectancy has increased, we have a higher number of people in the geriatric group. She says that geriatric medicine is an important field of medicine to ensure that the quality of life of patients is good. It deserves as much importance as the other medicine based subjects.