Mens Health Blog. Medical Blog

About a quarter of women starting on HRT experience a small weight gain (up to 3 kg) during the first cycle and for a few months after. A smaller proportion put on considerable weight, part of which seems to be due to fluid retention. Some other women gain weight because of increased muscle mass — because they have discovered exercise in midlife. In older women who already have trouble moving freely, further weight can present problems because it makes regular activity more difficult.

Heather was sixty-eight when her doctor suggested she go onto HRT because of a personal and family history of heart disease. (She had already had coronary bypass surgery and her mother had died of a heart attack.) Heather’s weight shot up after starting on a twice-weekly oestrogen patch and daily progestogen tablets. The doctor reduced the dose of the patch but her weight increase continued, amounting to 13 kg over a ten-month period. In consultation with her doctor she embarked on a program of exercise and dieting aimed at getting her weight down and benefiting her heart. At the time of writing she was trying to decide whether HRT was worth the trouble. ‘I’m looking at the information and making up my mind whether to continue with HRT,’ Heather said.

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Comments (0) Apr 20 2009

women CONSIDER HRT for many different reasons, the most common being to relieve symptoms associated with the menopause. In addition, women at risk of fractures due to osteoporosis, or likely to develop heart and blood vessel disease, may have HRT recommended to them by their medical practitioners. The same advice is increasingly given to women with existing osteoporosis, or those with a diagnosed heart or blood vessel condition, the rationale being that HRT may prevent these problems getting any worse.

HRT and menopausal symptom control

Hot flushes and sweating often prompt menopausal women to seek medical assistance. Other common reasons for consultations include psychological symptoms like loss of concentration and ‘feeling blue’, general tiredness, irritability, vaginal dryness and pain with intercourse, loss of libido, urinary frequency and persistent urinary discomfort.

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Comments (0) Apr 20 2009

Research shows that when the ovaries stop releasing eggs at the menopause, and the lining of the uterus no longer changes in preparation for a possible pregnancy, most women continue to make measurable and useful amounts of active sex hormones. The major source of oestrogen is chemical conversions that take place in fat tissue, hence the amount of body fat has a good bit to do with oestrogen levels in postmenopausal women. The brain and the adrenal glands (two small organs near the kidneys) also continue to produce hormones that control the reproductive system at this stage of your life. Like body weight, your genetic make-up is an important factor in the output of these hormones.

Overall, we produce relatively smaller amounts of oestro-gens, progesterone and androgens (a class of hormones that includes testosterone) after menopause than before it, and the balance of the various hormones changes. Testosterone, for example, becomes a more dominant hormone, even though less is produced after menopause than beforehand. The altered hormone balance explains some of the rapid and not-so-rapid changes to the body associated with menopause.

These hormones act on chemical structures called hormone receptors in many parts of the body. Their influence extends to the ovaries, fallopian tubes, uterus, cervix, vagina, vulva, skin, heart, blood vessels, liver, joints, bone, breasts, brain and urethra (the passage from the bladder to the outside). Various forms of oestrogen affect tissues such as the vaginal lining and the blood vessels in quite different ways. For each of us, changes in our hormone balance will be different, and consequently the effects will vary from woman to woman. Thus the increased prominence of testosterone after menopause may cause an increase in facial hair, altered libido (interest in sex), and a change in the distribution of body fat that is quite apparent to some women but goes almost unnoticed by others.

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Comments (0) Apr 20 2009

Bowel function varies a great deal from one person to another, making it difficult to say exactly what diarrhoea is. For most people, one bowel movement a day seems to be the norm, but some people only go once every three or four days, while others go twice a day or more. An important question here is whether ‘average’ is the same thing as ‘normal and healthy’. One survey of 301 apparently healthy adults found that almost a third of them reported bowel symptoms of some sort (diarrhoea, constipation etc), although most had not consulted a doctor for their problem. This study can be interpreted in two ways. It either shows that everyone’s bowel function is different and there is no such thing as a normal pattern – or it shows that a large percentage of the population are suffering from minor bowel complaints. We would lean towards the latter view, and suggest that some of those people, at least, are sensitive to the food they eat.

In general, a healthy bowel pattern feels healthy, whether you go three times a day or twice a week. There is a regularity to the pattern – it is not erratic. The stools are fairly firm and well-formed and there is no particular urgency, nor any great difficulty in going. There is no sense of malaise or pain, either before or afterwards, and the movement feels complete – not as if you still have some faeces left to pass. In diarrhoea, soft, loose or semi-liquid stools are passed several times a day; there is usually a sense of urgency and, usually, some feeling of malaise. Diarrhoea is basically a means of ridding the body of toxins, harmful bacteria or other unwanted substances – it is a healthy reaction to infection, and should only be considered a problem when it serves no useful purpose. However, acute diarrhoea can lead to dehydration because so much water is lost, and this can be dangerous.

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Comments (0) Apr 20 2009