Understanding Menopause

Menopause is the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period.

Menopause is a natural biological process, not a medical illness. Even so, the physical and emotional symptoms of menopause can disrupt your sleep, sap your energy and — at least indirectly — trigger feelings of sadness and loss.

Even though menopause is not a disease, you shouldn't hesitate to seek treatment for severe symptoms. Many effective treatments are available, from lifestyle adjustments to hormone therapy.

Technically, you don't actually "hit" menopause until it's been one year since your final menstrual period. In the United States, that happens at about age 51, on average.

But in the months or years leading up to that point, you might experience these signs and symptoms:

·         Irregular periods

·         Decreased fertility

·         Vaginal dryness

·         Hot flashes

·         Sleep disturbances

·         Mood swings

·         Increased abdominal fat

·         Thinning hair

·         Loss of breast fullness

When to see a doctor
Schedule regular visits with your doctor during the years leading up to menopause (perimenopause) and the years after menopause (postmenopause) for preventive health care as well as care of medical conditions that may occur with aging.

If you've skipped a period but aren't sure you've started the menopausal transition, you may want to see your doctor to determine whether you're pregnant. Always seek medical advice if you have bleeding from your vagina after menopause.

Menopause can result from:

·         Natural decline of reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone, the hormones that regulate menstruation. During this time, fewer potential eggs are ripening in your ovaries each month, and ovulation is less predictable. Also, the post-ovulation surge in progesterone — the hormone that prepares your body for pregnancy — becomes less dramatic. Your fertility declines, partially due to these hormonal effects.

These changes become more pronounced in your 40s. Your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually, your ovaries stop producing eggs, and you have no more periods. It's possible, but very unusual, to menstruate every month right up to your last period. More likely, you'll experience some irregularity in your periods.

·         Hysterectomy. A hysterectomy that removes your uterus, but not your ovaries, usually doesn't cause menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone. But an operation that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does cause menopause, without any transitional phase. Your periods stop immediately, and you're likely to have hot flashes and other menopausal signs and symptoms.

·         Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during the course of treatment or within three to six months.

·         Primary ovarian insufficiency. Approximately 1 percent of women experience menopause before age 40. Menopause may result from primary ovarian insufficiency — when your ovaries fail to produce normal levels of reproductive hormones — stemming from genetic factors or autoimmune disease, but often no cause for primary ovarian insufficiency can be found.

Several chronic medical conditions can develop after menopause:

·         Cardiovascular disease. When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men.

·         Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women are especially susceptible to fractures of their hips, wrists and spine.

·         Urinary incontinence. As the tissues of your vagina and urethra lose their elasticity, you may experience a frequent, sudden, strong urge to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). Strengthening pelvic floor muscles with Kegel exercises or using a topical vaginal estrogen may help relieve symptoms of incontinence.

·         Weight gain. Many women gain weight during the menopausal transition. You may need to eat less — perhaps as many as 200 to 400 fewer calories a day — and exercise more, just to maintain your current weight.

Don't eat your way through Stress!

Stress is indeed damaging for our health. Apart from "gifting" us hypertension, diabetes, acne, hair fall, etc., it can also make us fat. Not only do you eat when you are actually not hungry, you tend to crave for high-fat stuff like ice-cream, doughnuts, cookies, or deep-fried stuff. You don't feel the slightest desire to munch on carrot sticks or nuts at such times. Experts are of the opinion that women tend to use food to stave off worries concerning family, finance as well as work. However, once they start overeating, food becomes another stressor.

A study was done last year by researchers of the University of California at San Francisco, which showed that women who feel stressed quite often end up eating high-fat treats. They also indulge in skipping meals, keeping irregular food timings, as well as cutting out certain foods completely from their diet.

Studies show that when you impose a lot of restriction in your diet, counting each morsel, it causes a lot of stress inside. This could result in you gaining more weight than losing.

Ways to Overcome Stress Eating

The habit of eating when you are stressed kind of catches up with you and changes your eating habit even when you are not stressed. Wrong foods could again make you stressed, and stress makes you choose wrong foods. To avoid getting into this vicious circle, try these tips to modify this habit:

·         Awareness is the Key: Being aware of your actions helps you modify them. During stressful times, your mind is embroiled in those thoughts, and you hardly realize what you ate. So, when stress beckons you to go open the fridge, stop in your tracks and ask whether you are really hungry or what was your previous food and when did you have it. You will be able to do this only if you are aware of your actions. Taking time out to do such interrogation will help you understand the reason for your eating at that point in time. If hunger was not the cause of that particular craving, then even if you eat at that point in time, you will not be satisfied, and you may reach out for more unhealthy stuff.

·         Lay a Strong Foundation: Lay down a nutritious foundation of eating, wherein you eat a healthy food every 4 to 5 hours. This will not only keep your blood sugar stabilized, but also keep your emotions balanced. This will also help you tackle your problems in a calm way without getting stressed. The mind-body connection is a very intriguing vicious cycle. When you look after your body well, your mind will be calm. On the other hand, a calm mind will help you take care of your body well. To achieve both of this, awareness and mindfulness is required. Have a pep talk with yourself from time to time, saying there is nothing to be stressed about.

·         Complex is Good: Lead a simple life, but eat complex carbohydrates. These carbs help your brain release a feel-good hormone called serotonin, which helps with stress busting. Whole-grain breads, oatmeal, whole-grain pasta, brown rice, beans, skimmed milk, vegetables, and fruits should all form part of your diet. This will make you stay satiated for longer periods of time, preventing odd-time cravings for simple carbs and sweets.

·         Opt for Natural Sweetness: If you have a sweet tooth, you will crave for sweets when you are stressed. Having loads of ice cream, candies, and pastries will spoil your digestive health apart from giving you extra tires. On the other hand, fruits provide natural sweetness which will check your refined sugar cravings as well as providing the much-needed fiber to your digestive system. So, even when you are stressed, motivate yourself to reach out for fruits.

·         Crunchy Way to Health: People who like crunchy foods will reach out for crunchy stuff when they are stressed. And, the easiest crunchy foods one can lay hands on are chips, potato wafers, pretzels, crackers, etc. If crunchy is what you like, keep some carrots or celery ready in the refrigerator. Other good options are soy or ragi chips or roasted, oil- and salt-free nuts.

·         Smart Shopping: Plan out your shopping list in advance taking into consideration your's and your loved ones' eating habits. As you are caught off-guard when stress and cravings occur, you are likely to eat whatever you have stocked. Therefore, your shopping list should contain healthy foods. Shop for plenty of fruits and small packets of unsalted, unsweetened nuts (which you can even carry to office in your handbag). These will help you tide over your stressful periods. Another very important factor while venturing out to shop is never shop when you are hungry, as you will most certainly make the wrong food choices.

·         Hide Them:They say, "out of sight is out of mind" which is very true in your eating patterns too. When you stock junk foods and unhealthy snacks visibly at home, the temptation to reach out for them when you are stressed is much higher. Ideally, banish all such foods from home. However, if you must stock these snacks for the sake of children or guests, keep them out of sight. Store them behind larger packages or in closets or lofts which are difficult to reach. Even in the freezer, if you have to stock ice-creams, hide it behind frozen peas or meat. Similarly, when commuting back from work, avoid the places where junk foods are available. This is the time you are stressed and famished, and if you see a junk food joint, the chances of falling for it is big.

·         Think Out of the (Snack) Box: When you are stressed, think of other ways to beat it. Taking a walk in the park, playing with your pet, listening to music, meditating, talking to a friend, cleaning up and rearranging your cupboard are all stress-busting activities. Choose something you enjoy doing. Take care to hang out with positive people when you are stressed.

Don't get beaten down by stress, instead beat it and control your life the way you want to lead it. Writing down your thoughts when you are stressed is also a good way of avoid getting bogged down by the stress. Don't eat your way through stress, sit up and take charge of your life!

Is your friend your sex buddy?

He loves me, he loves me not. She'll call back, she won't." Well, not all tales that begin with plucking petals or waiting for a call, end up in bed.

For the girl or guy you save the last dance for, need not be the one you spend your life with. But, that's ok. Isn't it? For, till you find your ideal partner, you can have fun with a buddy. All you have to do is just give a call or drop a message and he or she will be there at your doorstep. Yes, having a f**k or a sex buddy is cool, comfy and fun, feel the youth. We talk to them on what they call a "win-win situation."

A friend in need, is a friend indeed!

Who else, but your buddy to best understand your needs. "A bed buddy keeps one happy, 'coz there are no strings attached. And it's not a new trend, just that now it's a fad, just like having a boyfriend or a girlfriend," says Prateek, a manager with a city eatery.

"It's hassle-free and convenient," feels Neha, a bank employee. She adds, "It surely is more than a one-night stand. It lasts much longer, after all, friendships last." But, how does it all begin? "In my case, it was not like a thought out decision. I was lonely and looked for comfort in a friend and it worked. Today, we know we are there for each other, whenever and wherever," lets in Amit, a bank employee. "It's all about fulfiling an instinct and since social norms don't permit it otherwise, one goes to a friend," reasons Prateek. Dhruv, a student of computer applications says, "It's about helping a friend enjoy the pure pleasure of sex. It might feel wrong the first time, but then, with friends there are no hang-ups."

Cool 'n' clear
"It is a zero complication situation, as both the friends are clear on what they want," says Dhruv. Both the buddies have to be clear about the terms of the relationship or else emotional problems follow, says Megha, a budding architect. "Sex buddies come in handy, for they're just a call away," feels Preeti, who is doing her MBA. "It's pure sex. One is not even required to engage in any post-sex sweet talk," she adds. Agrees Vikas, a scribe, "That's quite a relief, as one is not made to feel guilty if one forgets to send flowers the next morning. The passion never dies, for you know why you are into it." Adds Prateek, "Cheater and a f**k buddy are two different terms."

In the fast lane
"Today's pace of life doesn't allow one to devote hours to nurturing a relationship," feels Gaurav, an executive working in a call centre. "Gone are the days when one had to wait for marriage to have sex. It's also not about being a girl or a guy," says Megha. "It's thrilling to meet one's needs with a friend, rather than wait for a girl to shed her hang-ups," chips in Amit.

Fun bhi, safety bhi?
"I have been staying alone in the city for five years and have had a couple of regular sex buddies all these years," says Vikas, adding, "At times, it was to avoid loneliness, and many a times for fun." Admits Gaurav, "I have never felt ashamed while experimenting when with a friend. You can let your fantasies loose." Some feel such a relationship ensures safe sex. "A friend would never leave you infected with a virus," feels Prerna.

No right or wrong
"I would never consider having a serious relationship with a man who I know has had a sex buddy," says Kanika, who is studying commerce. But then, there are no rights and wrongs feel those who have such buddies, and they reiterate that it's about personal choice.

(Names have been changed to protect identities)

Pre-marital counselling, a must

An engaged couple lays out its anxieties to a marriage counsellor before the wedding.

The initial period of any relationship is called the honeymoon period; and after that fairytale, marriage can be a rude reality check. In most cases, quarrels over money, family and trust break a couple apart. Mikhail Shahani and Reshma Rajwani wanted to go into their marriage with eyes open and decided to undergo a pre-marital counselling session to know what to expect. The 27-year-old chef and 26-year-old management graduate come from different backgrounds and met only six months ago. Shweta Kansara from Mind Temple clinic says, "A pre-marital session helps partners accept each other better and avoid future complications or conflict."

Getting started
Asked why they're getting married, Reshma says, "I live in Mexico and was introduced to Mik on a trip here. After I left for Mexico, we continued communication and fell in love. The distance was hard and the pressure from families, intense. So we decided to get married in 2012." Mikhail says, "We were constantly fighting because of the distance. So we figured, if we've decided to get married what's the point of waiting longer. Reshma's family is conservative and her father was unhappy she was marrying a chef - he had an old-school view of 'bawarchis'. Once they met me, things eased up."

Rough corners
Shweta asks them where they expect conflict and what is expected of them. Mikhail says Reshma is short-tempered. "It is true that I get agitated and tear up instantly," she replies. "I like to be left alone in such a mood." Mikhail says, "I can't leave her alone if I know she's upset and try to cheer her up." He adds that she may take time to get used to the Indian culture.

Reshma says, "Mikhail lives with his mother and they are very close. She is a cool, forward-thinking lady but staying with her may bring in its set of concerns." Mikhail says he worried about finding someone who wouldn't be able to adjust to his family. "My mother, sister and I live together and I was always very afraid of someone creating a divide. But seeing how Reshma has adjusted and how fond my family is of her, really eases my worry."

Counsellor speak:
It is essential to discuss roles, baggage and unresolved issues if one wants the partner to accept and support him/her. If Reshma is short-tempered, her childhood issues could be the cause. While feeling angry is natural, how we express it is learnt from our environment. The couple went through a few exercises.

A. Descriptive writing
Reshma and Mikhail were asked to write a few lines on each other. While he wrote an essay in a heartbeat, she paused to get her thoughts in order. She brought up his laidback attitude to health.

This exercise helps the couple see how the other person views them. They should tell each other if they've missed anything out or if they disagree on something.

B. The big six
While talking about religion, lifestyle, sex, children, behaviour and recreation, they agreed on most things but had trouble in the financial aspects. Reshma says, "Mik needs to buy a good brand to feel his money is well spent and finds my thrift shopping a waste of money."

Mikhail replies, "She spends so much money trying to source the cheapest thing, it seems pointless. I just look for the best value for my money."

By discussing each of these topics in detail, the couple ensures sensitive subjects are talked about and the partners know where the other stands. Agreement on religion and lifestyle help deal with the changes that a new family and home will bring. Sex and children are crucial subjects for family planning and keeping intimacy alive. A couple should discuss how long it would like to wait before having a child, birth control options and the plan for the lifestyle change. It is also important to discuss how one behaves with the other in private, in front of famly and in public.

Cranking game
Shweta drew up another list with the following heads -Family, career, self, friends, health (physical and emotional), purpose of life and money. She asked the couple to rate each category on a scale of 10 and then rank according to priority on in their own lives. They were then asked to introduce 'Partner' as a new category and carry out the ranking again. While Mikhail placed his family, partner and career in the top three slots and reserved health for a latter ranking, Reshma gave health and family a high ranking with self and career set a little lower.

Discussing discrepancies, Shweta says, "It's important to level out on most subjects so that the relationship is on an even keel. One's priority of self needs to have more importance."

What it does:
Prioritising these heads in front of each other helps the partners know the challenges the other is facing at the time. It helps them acknowledge their weakness and helps the other step up and be more accepting and supportive.

Some fruit drinks have no fruit in them

Fruit drinks marketed with tall claims of providing hydration to children contain as little as 5 per cent fruit, while some others have none at all, health experts have claimed.

And to make matters worse, many are loaded with added sugar.

The experts found Ribena squash promotes its vitamin C content without making clear that 90 per cent of the vitamin content is artificially added to the drink because it contains such a small amount of fruit juice.

Fruit Shoot Hydro doesn't contain any fruit at all, while Still Vimto and Ribena have only 5 per cent fruit and contain more added sugar than fruit.

A Vimto marketing campaign emphasises the drink's raspberry content, says the report, despite the fact that raspberry juice makes up just 0.1 per cent of its ingredients, equivalent to about ten drops in a 500ml bottle.

Less than one-eighth of Capri-Sun drink is fruit, and it has significant added sugar, says the report.

The report, called Soft Drinks, Hard Sell, comes after the soft drinks industry reported its highest growth rate in seven years in 2010, with UK consumption reaching 14.6billion litres annually.

"Our survey found some truly misleading marketing blatantly used to drive sales and increase children's soft drinks consumption, which contributes to tooth decay and the UK's record rates of childhood obesity," the Daily Mail quoted The Children's Food Campaign's Clare Panjwani, who wrote the report, as saying.

"We need better regulation to protect children from marketing for soft drinks and other junk food, and better food labelling so that parents and children can tell more easily what's in the products they are buying," Clare added.

The report calls for a ban on junk food and drink advertising on TV before the 9pm watershed, as well as traffic light labelling on packaging that would display 'red' for added sugars.

Top 5 nutrients for your child

You may be having a tough exercise day running after your kids while asking them to eat what you want them to eat. And they will take the maximum advantage of your helplessness. They will laugh; they will hide at the remotest corners and will even shout and cry out loud. Guardians, neighbors and well-wishers will give you various opinions on the ways to control your child on food issues, but they will be mentioning about some common nutrients like calcium, fiber, potassium, vitamin D and vitamin E. These are the top 5 nutrients which a child will need during his growth phase:

1. Calcium

Calcium helps in the growth process. It makes bones strong. It also helps with heart rhythm, blood clotting and muscle function. When the kid consumes less calcium, the body draws calcium from the bones in order to fulfill its other functions in the body. A person, especially in the pre-teen years, is a lot less likely to develop problems like osteoporosis. You need to keep a tight eye on the caffeine intake of your kid since too much caffeine leads to calcium resorption from the bones. Some caffeine containing beverages are tea, coffee, cola and aerated drinks.

Sources: Milk and milk products like cheese, paneer (cottage cheese), green leafy vegetables, small fishes that can be eaten with bones, ragi and sesame.

2. Fiber

High-fiber foods are packed with vitamins and minerals to fuel growth and development. They also contain beneficial plant compounds called phytonutrients that boost a child's immunity. When part of a balanced diet, fiber helps head off type 2 diabetes and high cholesterol in adults and may work for kids too. Diets rich in fiber-filled foods may cut the risk of heart disease later in life. Fiber helps curb constipation by adding bulk to bowel movements stimulating the gut to pass waste with greater ease. Fiber also helps kids feel fuller. The market is now full of processed and fattening "convenient" foods. Chips and fries happen to be an all time favorite for all kids. Their attractions towards these foods take them away from the fiber -fruits and vegetables.

Sources: Fruits, vegetables, sprouts, whole grains and cereals and green leafy vegetables. Opt for whole wheat breads, noodles and pasta. This will ensure your child takes fiber in his favorite form.

3. Potassium

Potassium insures normal heart and muscle function, maintains fluid balance, participates in energy production and promotes strong bones. A potassium-rich diet helps head off high blood pressure in adults. Getting children in the habit of eating high-potassium foods may help them keep blood pressure in check as they age too.

Sources: Fresh fruits, vegetables, whole grains, dairy foods, meats and seafood. In general, the more processed the food, the less potassium it provides and the more sodium in a food, the lower will be the potassium content.

4. Vitamin D

A shortfall of vitamin D has been linked to adult conditions including osteoporosis, breast cancer, colon cancer, prostate cancer, heart disease, and depression. The role of Vitamin D in these conditions is still under research. Vitamin D is needed to absorb calcium and maximize bone growth and strength. Kids who get too little vitamin D can develop soft bones, a condition called rickets, early in life, and osteoporosis, which typically shows up later in life.

Sources: The body makes vitamin D when exposed to strong sunlight, storing extra for future use. Common foods rich in vitamin D include most milk and other fortified foods such as some brands of breakfast cereals, orange juice and yogurt. Other foods rich in vitamin D include fatty fish such as salmon and light tuna.

5. Vitamin E

It is important for strong immune system. It's a powerful antioxidant, meaning that it fights harmful by-products of everything from air pollution and cigarette smoke to ultraviolet rays and even your own natural metabolism. That makes it vital for building and maintaining a strong immune system.

Sources: Sunflower and safflower oils (especially in light salad dressings). Sunflower seeds are great snacks. Give your kids cereals fortified with Vitamin E. Wheat germ, nuts and nut butters are good, but peanut butter is not a good option since peanuts aren't true nuts at all.

You may get a bit pissed off in your attempt to convince your kids to eat healthy. Set examples. Take healthy foods in front of them and your kids will start following you. And remember, patience is the other name for parenthood and it really pays.