Healthy Lifestyle

WOMEN used to start preparing for menopause in their late 40s. That made sense, since the normal age to reach menopause was between 45 and 55. In Singapore, the average age is 51 years.

But, said Mrs Dincy Lim, president of the Woman to Woman Menopause Support Group, the support group has seen more women these days with menopausal symptoms at a younger age, even 43 years.

One reason for this, said Dr Chua Yang, a consultant obstetrician and gynaecologist and director of A Clinic for Women, might be that “now women are more aware of menopause, its symptoms and associated discomforts than their counterparts one or two generations ago, who might have been more prone to living through their
menstrual irregularities”.

THE LAST PERIOD
Menopause is defined as the last menstrual period. It occurs when the ovaries run out of follicles and fail to produce enough female hormones. As the hormones dwindle, the body undergoes an adjustment period. In
many women, these adjustments manifest as menopausal symptoms.

According to a menopause survey commissioned by Bionutra, with support from the Woman to Woman Menopause Support Group, 300 women aged between 40 and 55 listed tiredness, hot flushes and forgetfulness
as the top three symptoms. Other indications were night sweats, body, joint and muscle aches, and insomnia.

Local studies, said Dr Chua, indicate that only about 20 per cent of women experience moderate to severe symptoms during the transition period to menopause, while the majority only experience mild or insignificant symptoms.

But, she cautioned, women also sometimes assume any menstrual irregularities in the late 40s must be due to impending menopause. As a result, they fail to seek medical attention for their symptoms.

“Women should realise this is also the high-risk age group for many of the female cancers, so menstrual abnormalities should always be investigated,” she said.

PREMATURE MENOPAUSE
Menopause is by definition premature if the woman is under 40 years of age. Typically, about 5 per cent of women reach menopause prematurely.

It could be because of genetics, chemotherapy or radiation therapy, or autoimmune diseases. Or it could be surgically induced, for example, when the ovaries are diseased and need to be removed.

In the case of colon cancer patient Mrs Lucy Goh, menopause came as early as 37 years. “This was a result of undergoing chemotherapy and radiation therapy to treat my cancer,” she said.

Women such as Mrs Goh, who menopause prematurely, have fairly different needs from those who naturally reach menopause, said Dr Chua. They also have significantly higher risk of health problems such as osteoporosis.

Menopausal symptoms such as hot flushes also tend to occur abruptly and severely in such instances,
making the symptoms more difficult to cope with.

EARLY DIAGNOSIS
When there are no obvious triggering factors such as surgery or chemotherapy, it may not be obvious to the women or indeed to their doctors that they are in fact undergoing premature ovarian failure.

It is important to diagnose these women early to help them effectively manage their symptoms and long-term health.

In Mrs Goh’s case, she said the symptoms are under control because she has taken the necessary steps to manage them.

“I frequently shower to keep myself cool, and I read to control my mood changes,” she said.

The bottom line, say both doctors and support groups, is that suffering menopausal symptoms on your own is not necessary.

Often, support groups can offer emotional support and medical attention helps them to cope better with menopause.

What is Breast Cancer?

Breast cancer is the growth of a malignant tumour composed of abnormal cells within the breast tissue. This growth spreads and destroys the normal breast cells. If this growth is not controlled, it will disseminate throughout the body and can be life threatening. Breast cancer is the most common form of cancer among Singaporean women.

What are some of the risk factors for breast cancer?

• Age - 77% are over the age of 50.
• Family history - especially among first-degree relatives.
• Personal history of breast cancer.
• Reproductive history - among women who delay pregnancy or who never have children.

Currently, there are many studies being conducted to see if lifestyle choices have an effect on the development of breast cancer. For example, studies suggest that the rate of breast cancer in Asian women increase dramatically if these women adopt a Western lifestyle and diet.

At present, there appears to be an increased risk of breast cancer in women who:

• Are inactive.
• Smoke.
• Consume more than 1 alcoholic drink per day.
• Consume a high-fat diet.

Worldwide, one out of every eight women will be diagnosed with breast cancer during her lifetime.

What are the warning signs of symptoms of breast cancer?

Warning signs may include:

• A painless lump in the breast or armpit is the most common sign. However, it’s important to remember that 8 out of 10 breast lumps are not cancerous.
• Swollen thickened breast skin.
• Nipple discharge.

More advanced cancer signs include:

• Dimpling of the breast skin.
• An inverted or crusty nipple.
• Swelling or redness of the breast skin.
• A contour change of the breast or nipple.

How are lumps found

Three types of screenings for breast cancer are recommended by health care professionals. The first type of screening is a monthly breast self-exam, starting at the age of 20. Most cancers appear as a single hard lump, and these can be detected easily by these monthly examinations. A nurse can show you you how to perform the breast screening exam. If a lump is found, it is vital that you see your physician immediately!

Complementing breast self-exam is an examination by a doctor (second type of screening). Breast physical exams conducted by the physician should be done every three years when a woman is aged 20 - 40, and every year after a woman has reached 40 years of age. 10% of cancers are found by clinical exam only.

Mammograms (third type of screening) are recommended every two years when a woman is aged 40 -49, and annually when a woman is older than 50. Mammograms are low-dose X-rays of the breast. Mammograms can detect breast tumours two years before they are large enough to be felt by a breast exam. It is important to remember, however, that mammograms miss up to 15% of the cancer, so manual exams are still important.

What can a woman do to reduce her risk for breast cancer?

• Conduct regular breast self-exams.
• Reduce the number of chest x-rays received, especially at a young age.
• Cut down on high-fat foods.
• Maintain a healthy weight.
• Get regular brisk exercise.
• Restrict alcohol intake.
• Do not smoke.