Menopause in diabetes - Coping with the increased complications
Menopause. Sounds like something to do with men, doesn't it? So what does menopause have to do with diabetes?
Dr Fay Whitbourne Morrison made the connection between menopause and diabetes in her presentation of the Hugh Lawson Shearer Distinguished Lecture on 'Menopause in Diabetes' at the 24th Annual International Diabetes Conference at the Jewel Resort, Runaway Bay, recently.
"How many of us really know what is menopause?" asked the family physician and certified menopause practitioner.
That brought everyone to an upright sitting position: medical doctors, nurses, healthcare providers, students, exhibitors, and other interested persons.
Surveying her mixed audience, she said emphatically, "There is need for more understanding and empathy for women at this stage of their life. This includes family and society."
WHAT IS MENOPAUSE?
Dr Whitbourne explained that menopause is "a natural phase in a woman's life when she ceases to have periods and to be able to get pregnant".
She added that menopause is also called 'the passage' or 'change of life', and that many women experience this between ages 45 and 55.
And here was the bombshell:
"Before a woman can be diagnosed as having reached menopause, the periods have to cease for 12 consecutive months. Many women are so happy to be free of a period; the first time it disappears they are ready to celebrate," she said.
Dr Whitbourne explained that menopause may be induced by factors such as surgical removal of the ovaries or exposure to chemotherapy before the woman has reached the time for her natural menopause.
SYMPTOMS OF MENOPAUSE
More elucidation on the topic of menopause continued.
- Hot flashes - Some women experience severe hot flashes: sudden feelings of warmth, usually most intense over the face, neck and chest. The skin might redden, as if you're blushing. Hot flashes are sometimes followed by profuse sweating. When they occur at night during sleep and are followed by a chill, they are called night sweats. Frequent night sweats interrupt the woman's sleep, leaving her tired and irritable.
- Mood swings - These can be quite severe, leading to panic attacks or mild to moderate depression. Mood swings may be the result of stress, loneliness, work, empty nest syndrome (children have left home) and having to care for elderly parents.
MENOPAUSE AND DIABETES
- What is diabetes?
Diabetes, often referred to as 'sugar', is a disease in which the body's ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood.
- Changes in blood sugar levels
Dr Whitbourne explained that both diabetes and menopause may produce challenges in blood glucose control, but by understanding how they interact, one will be able to better manage one's blood sugar.
During menopause, the levels of the hormones oestrogen and progesterone fluctuate and in turn may cause fluctuations and unpredictability in the woman's blood sugar levels.
- Weight gain
Some women gain weight during menopause. This may necessitate a higher dose of oral medication or insulin to maintain good blood sugar levels.
Having both diabetes and menopause leads to more infections in the bladder and vagina: in menopause, because of the decline in oestrogen; and diabetes, because of high blood sugar levels.
- Sexual problems
Diabetes can damage the nerves in the cells in the vagina, making arousal and orgasm more difficult. Menopause very often causes vaginal dryness, making intercourse unpleasant or downright painful.
Dr Whitbourne stressed that women should be aware that at midlife, many women develop diabetes mellitus, high cholesterol, heart conditions and cancers. It is therefore "prudent to have regular 'check-ups', including routine blood tests, mammograms, Pap smears and other appropriate tests on a yearly basis".
After menopause women lose bone mass; it is important that bone health be measured, and based on the results, be advised accordingly.
DR WHITBOURNE'S ADVICE ON HOW TO IMPROVE MENOPAUSE AND DIABETES SYMPTOMS:
- Exercise at least three times weekly.
- Eat a healthy diet rich in calcium; include soy products, lentils.
- Take vitamin D3 to enhance bone health.
- Get adequate sleep.
- Measure blood sugar night and day, keep a log, to help the doctor know how best to adjust your medication.
- With menopause, your cholesterol level increases. Ask your doctor if you need to start a cholesterol-lowering medication.
- If hot flashes and night sweats interrupt sleep, discuss this with your doctor.
- Vaginal dryness can easily be helped by using a lubricant or an oestrogen cream.
The 24th Annual International Diabetes Conference was hosted by the University Diabetes Outreach Programme, the University of the West Indies, University of Technology Jamaica, Northern Caribbean University and the Diabetes Association of Jamaica, under the theme: 'Diabetes Complications: How are we managing?'