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Menopause: The Great Ending of The Menstrual Cycle

Menopause: The Great Ending of The Menstrual Cycle

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The menstrual cycle – the epitome of the reproductive cycle, which gives birth to life and plays a significant role in the transition from girlhood to womanhood, is considered nature’s phenomenon, gifted to women (minus the agonising PMS symptoms, of course). And after decades and decades of operating the same painful cycle every month, a woman’s menstrual cycle decides to retire into solitude in the mature years of her life.. (great news, right?!) 

But do you know what really happens in this ending stage of a woman’s menstrual cycle? 

This week’s blog unravels the grand (or rather, long-served) ending of this extraordinary cycle: ‘Menopause’. Keep reading as we explain each stage of menopause and how you can prepare for it.

What is menopause?

As the word suggests, menopause involves the permanent pause of a woman’s menstrual cycle. It is the period that indicates the end of a woman’s menstrual cycle, where usually, if a woman has gone 12 months without her menstrual period, she is said to be having her ‘menopause’.

When does menopause occur in a woman’s life?

It usually occurs between the ages 40 and 50.

The female sex hormones - partners in crime

Before we dive in deeper, it’s important to know the two main female sex hormones- oestrogen and progesterone. Oestrogen is responsible for the development of secondary sexual characteristics in a young woman and functions such as menstruation, ovulation and pregnancy. Similarly, progesterone also plays an equally significant role in the menstrual cycle, ovulation and pregnancy. They are indeed two hormones tirelessly working hand in hand in a woman’s body!

The stages of menopause

stages of menopause
  1. Perimenopause

This is the first stage that leads up to menopause. Perimenopause is the period in which a woman’s body makes the transition from having an active menstrual cycle to menopause (menopausal transition). Several changes in hormonal levels occur. In this stage, oestrogen levels begin to rise and fall unproportionately. Furthermore, menstrual cycles may either increase or decrease, causing irregular periods. Women may also have menstrual cycles despite ovaries not releasing an egg (ovulation). During this stage, it is possible for symptoms related to menopause, like hot flashes, vaginal dryness, etc., to be present.

  1. Menopause

Menopause occurs when the female body stops producing the hormones that cause menstrual cycles. These hormones include oestrogen, progesterone, luteinizing hormone and follicle-stimulating hormone. A woman would then not get her period for 12 months consecutively.

       3. Post-menopause

This is the final stage of menopause in which a woman hasn’t experienced her period for over 12 months. The body produces significantly fewer amounts of hormones (oestrogen and progesterone), and women will no longer experience a monthly period nor can get pregnant for the rest of their lives. During this stage, the symptoms of menopause may linger around; however, they are less intense.

Symptoms of perimenopause and menopause

  • Irregular periods

Due to hormonal changes in the perimenopause stage, the duration of time between periods may become longer or shorter. Also, period flows may range from light to heavy, while missing periods are common.

  • Hot flashes and sleep problems

A hot flash is the sudden feeling of warmth in the upper body. These intense feelings spread over the face, neck and chest areas and skin may redden, causing sweating as well. Often, hot flashes may happen at night, causing inconvenience during sleep.

  • Decreased fertility

During the menopausal period, a woman’s ovulation starts to become irregular. This decreases the ability to conceive. Although, it’s important to note that it’s still possible for a woman going through perimenopause to get pregnant, therefore if you are a woman suspecting that you are going through perimenopause and still have your periods regularly, it is advisable to use birth control until you haven’t got your period for more than 12 months.

  • Mood changes

A woman may undergo several mood swings, irritability and an increased risk of depression during the perimenopausal period.

  • Changes in sexual function/libido

As a woman’s testosterone and estrogen levels drop, it becomes more difficult for her to get aroused, and this causes issues with libido and sexual drive.

symptoms of menopause

Other symptoms

  • Loss of bone – Calcium deficiency in bones
  • Vaginal and bladder problems
  • Increased hair growth on areas such as the face, chest, neck

Not having it with menopause? Fret no more, we give you healthy tips to make this period in your life easier below!

Lifestyle changes for better management of menopause

managing menopause

Menopause is a natural process that all women experience once their reproductive cycles reach maturity, and it may be an uncomfortable experience for most women. However, here are some methods in which the symptoms of menopause can be controlled better to reduce its discomfort.

  1. Consume foods rich in vitamin D and calcium

Vitamin D and calcium have proved to improve bone health. As a woman undergoes menopause, hormonal changes result in the weakening of bones, increasing the risk of osteoporosis. Foods like yoghurt, milk, fish and eggs are good sources of these nutrients.

  1. Maintain a moderate/healthy weight

During the menopause period, hormonal changes, aging and lifestyle causes weight gain. This would increase the risk of cholesterol and diabetes.

  1. Exercise regularly

Exercise and work out sessions have been proven to improve sleep and mental health of menopausal women. Therefore, regular exercise may subside the sleep issues menopausal women undergo.

  1. Ensure a consistent intake of a protein-rich diet

Proteins help reduce muscle loss and increase overall body strength in women experiencing menopause.

  1. Consume foods abundant in phytoestrogens such as soya beans, tofu, flaxseeds

Phytoestrogens are a source of dietary oestrogen from naturally occurring plant compounds that have the same function as oestrogen in human bodies. Thus, phytoestrogens may play a vital role in hormonal balance during menopause and reduce symptoms like hot flashes.

When to see a doctor

It is advisable to meet with a gynaecologist if you experience

  • Vaginal bleeding after not having a period for 12 months
  • Recurring or chronic urinary tract infections (UTIs)
  • Bleeding after sex
  • Abdominal pain

These signs may indicate more serious underlying medical conditions that need to be diagnosed to begin early treatment. Every woman’s menopausal period is unique and different to one another. If you are experiencing difficulty managing your uncomfortable menopause symptoms, the SLMC-registered gynaecologists on oDoc will help you navigate them, providing improved health and well-being.

Sources

  1. Menopause – Symptoms and Causes, Mayo Clinic (2020)
  2. Perimenopause – Symptoms and Causes, Mayo Clinic (2021)
  3. 11 Natural Remedies for Menopause Relief, Healthline (2022)
  4. Menopause, The University of Utah (2022)
  5. Bleeding after menopause: Is it normal? Mayo Clinic (2020)
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All you need to know about Gestational Diabetes

All you need to know about Gestational Diabetes

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Did you know that gestational diabetes mellitus, also known as GMD, is one of the most common medical complications of pregnancy?

What is GMD? Why does it happen? Can you prevent it? Keep scrolling for answers.

So, let’s start with the basics. What is gestational diabetes?

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. Many hormones are involved in maintaining the blood sugar level. As the hormone levels fluctuate during pregnancy, they prevent the body from using insulin effectively, leading to insulin resistance. This causes  glucose  build-up in the blood instead of being absorbed by the cells. Typically, the pancreas can make additional insulin to overcome insulin resistance, but when insulin production is not enough to overcome the effect of the placental hormones, gestational diabetes results.

A study conducted by Kai Wei Lee et., found the prevalence of GDM in Asia was 11.5%. GMD can happen at any stage of pregnancy but is more common in the second or third trimester.

But why is that?

Scientists have not been able to identify the exact hormone that causes GDM in pregnant women. But, many scientific theories suggest that as the placenta grows, more and more hormones are released, which increases risk of  insulin resistance. Thus, symptoms of GMD are seen more often in the 2nd and 3rd trimesters. 

What are the symptoms of GMD?

Many women who have GMD do not show symptoms, but the most common ones are: 

  • Increased thirst
  • Urgency to pee more often
  • Dry mouth
  • Tiredness
Gestational Diabetes Causes

These symptoms are relatively common during pregnancy and not necessarily a sign of GMD. If you are pregnant and have noticed these symptoms, you should speak to a VOG doctor or a general physician, via oDoc who will provide a prescription for a lab test. You can carry out the lab tests from the comfort of you home via oLabs too. 

Who is at risk?

GMD can affect any woman, but a list of risk factors identified by scientists increases the chances of developing GMD. 

The risk factors include

  • Being overweight before pregnancy
  • Having a family  history of diabetes 
  • Being Prediabetic (if you have a blood glucose level higher than normal but not high enough to be classed as diabetic.
  • Having PCOS 
  • Being older than 25 as they are at a greater risk for developing gestational diabetes than younger women
  • Having high blood pressure, high cholesterol, heart disease, or other medical complications
  • Having  given birth to a large baby (weighing more than 9 pounds)
  • Having had a miscarriage

How does GMD affect the mother and the baby?

More often than not, women who have GMD go on to have normal pregnancies and deliver healthy babies. However, in other circumstances, GMD can lead to:

  • Macrosomia. This is where the baby grows very large as they absorb the excess glucose in the mother’s blood and convert it into fat and are deposited. This leads to difficulties during labour, causing doctors to opt for induced labour and c-section. 
  • Too much amniotic fluid (the fluid that surrounds the baby) in the womb can cause premature labour or problems at delivery, known as polyhydramnios.
  • Premature birth
  • Low blood sugar (hypoglycemia) in the baby after delivery. This happens because the mum’s high blood sugar level also causes the baby to have a high blood sugar level, and after birth, it no longer has the high level of sugar from its mother, resulting in the newborn’s blood sugar level becoming very low.
  • Obesity and type 2 diabetes later in life for babies. Babies of mothers with gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth. Untreated, gestational diabetes can result in a baby’s death before or shortly after birth.
  • Future diabetes for the mother. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older.

What are the treatment options?

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation. 

If you are found to have GMD, don’t worry, as it can be treated, and complications can be reduced. The doctor may ask you to monitor your blood sugar level often, exercise often, eat healthily and maybe give insulin injections if necessary. 

How is it prevented?

There are no guarantees for preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better.

So don’t forget to 

  • Eat healthy – Choose foods high in fibre and low in fat and calories.
  • Exercise often – Exercising before and safely during pregnancy can help protect you from developing gestational diabetes.
  • Start pregnancy at a healthy weight. If you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy.
Preventing Gestational Diabetes

If you are pregnant and experiencing any of the symptoms mentioned above or have any questions, you can speak to one of the Obstetricians, Gynaecologists or GPs on the oDoc app. Click here to download the app.

Sources 

  1. Alfadhli, E., 2015. Gestational diabetes mellitus. Saudi Medical Journal, 36(4), pp.399-406.
  2. Gestational Diabetes Mellitus (GDM). (n.d.). Johns Hopkins Medicine. Retrieved April 6, 2022, from 
  3. Gestational diabetes – Symptoms and causes. (2020, August 26). Mayo Clinic. 
  4. NHS website. (2021, November 29). Gestational diabetes. Nhs.Uk. 
  5. Lee, K.W., Ching, S.M., Ramachandran, V. et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 18, 494 (2018).
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The Second Trimester

The Second Trimester

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They say there is no better feeling than the movement of life inside of you and that is the most magical thing about the second trimester of pregnancy. You can feel the life inside you. 

By the second trimester, you probably are more used to all the changes you have been experiencing the last 12 weeks. So let’s have a look at what’s in store for the next 13 weeks of your pregnancy. 

If you haven’t read our blog on the First Trimester yet, we’d suggest you start there and then hop back to this. 

When does the second trimester of pregnancy start?

The second trimester of pregnancy starts at the beginning of week 13 and goes up all the way till the end of week 26. 

So, what changes happen to the body during the second trimester?

Breast tenderness reduces, nausea begins to cease, and adjustment to estrogen and progesterone levels occurs. Other changes that happen to your body are: 

  1. Increase in appetite as your baby starts to grow 
  2. Aches in your lower abdomen may occur as your uterus expands to make space for the abby. This puts pressure on the surrounding muscle and ligaments, causing cramps and pains. A warm bath, relaxation exercises, changing your body’s position, or pressing a hot water bottle wrapped in a towel to your lower belly can help ease the pain. 
  3. Increase in weight due to the increase in appetite
  4. The increase in weight can also cause backaches 
  5. Bleeding gums due to changes in hormone levels sending more blood to your gums, making them more sensitive and increasing the likeliness of bleeding. 
  6. Some women may experience tightening in their uterus walls for a minute or two (also known as Braxton-Hicks contractions). This is very normal and isn’t a sign of natural labour. 
  7. Further enlargement of breasts occurs as the mammary glands prep for lactation. 
  8. Congestion occurs as the mucus membranes lining your nose swells, leading to a stuffy nose. Your nose may tend to bleed more easily too.
  9. Some women may experience dizziness as the growing uterus presses against the blood vessels, reducing blood reaching your brain. 
  10. Unwanted hair growth
  11. Headaches 
  12. Increased Progesterone levels cause heartburn as it relaxes the muscle responsible for keeping acids in your stomach.
  13. Varicose veins may occur as extra blood flows through them and the growing uterus exerts additional pressure. 

Sounds a bit scary doesn’t it? But do not worry, it’s a few weeks of hardship for a lifetime of happiness. As soon as you see your little one’s face, all the hardship will be forgotten in seconds. 

It is important to note that these symptoms may or may not be experienced by all women, and the severity, occurrence and duration of these changes can change from woman to woman. 

 So, what changes does the baby go through?

It is said that the second trimester of pregnancy marks a changing point not only for the mother but for the baby too. This is when the fetus grows into a baby. All organs and systems are fully formed by the second trimester. During the second trimester, your baby will grow from around 7.5cm and weigh 30 grams in the 13th week to approximately 23cm and 820 grams by the end of the second trimester. Their heart moves 100 pints of blood a day. During the second trimester, the fetus begins to move and starts kicking. The mother can feel this, and it is known as quickening and trust me, this feeling is unmatchable. 

The baby grows eyelashes and eyebrows during the second trimester and it’s eyes and ears are formed so your baby can hear your voice when you speak. It is encouraged you speak to them to give them company. Their tiny fingers and toes separate and grow nails too. Development of reflexes such as swallowing and sucking also occurs. The baby starts reacting to external stimuli and starts interacting with the outside world while being inside

A fetus born at 24 weeks may survive in a neonatal intensive care unit.

If you experience any of the following, please seek medical help urgently.

  • Severe abdominal pain or cramping
  • Bleeding
  • Severe dizziness
  • Rapid weight gain (more than 6.5 pounds per month) or too little weight gain (less than 10 pounds at 20 weeks into the pregnancy)
  • Jaundice
  • A lot of sweating

These are signs that something could be wrong with your pregnancy. You should speak to your VOG doctor as soon as possible if you are experiencing any of the symptoms mentioned above.  

The second trimester of pregnancy is the best time to start building your birth plan. To know more about how to create your birth plan, click here. You can also consult a VOG doctor at any time and from the comfort and safety of your home via the oDoc app.

Source 

  1. Watson, S. (2010, February 4). Second Trimester of Pregnancy. WebMD. Retrieved January 11, 2022, from https://www.webmd.com/baby/guide/second-trimester-of-pregnancy#7
  2. The Second Trimester. (n.d.). Johns Hopkins Medicine. Retrieved January 11, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-second-trimester
  3. Second trimester. (n.d.). Pregnancy Birth and Baby. Retrieved January 11, 2022, from https://www.pregnancybirthbaby.org.au/second-trimester
  4. Mayo Clinic. (2020, February 27). 2nd trimester pregnancy: What to expect. Retrieved January 11, 2022, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047732?reDate=11012022
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