Menopause Medicines Treatment
This means permanent cessation of menstruation at the end of reproductive life due to follicular inactivity. Age of menopause is genetically predetermined, the average age being 50 years. Premature menopause is when menses stops at or below 40 years of age and delayed when menopause fails to occur even beyond 55 years.
Hormonal Replacement Treatment (HRT) ensures benefits and minimises risks, particularly in symptomatic women and also prevents osteoporosis, artherosclerosis, cardiovascular diseases, urogenital atrophy (thinning of inner layer of genital and urinary passage) etc. Oestrogen reduces the risk of Alzheimer's disease also.
Precautions: Undiagnosed genital bleeding, oestrogen dependent tumors, history of venous thromboembolism and liver/gall bladder disease. HRT can be continued as long as the benefits are desired, provided treatment is monitored. The increased incidence of breast cancer is debatable (see chapter on Methods of Preventing Pregnancy).
Urinary Stress Incontinence
In this condition there is leaking or flow of urine on coughing, sneezing or laughing. There is a rise in abdominal pressure during such stress. There is also laxity of muscles around vagina and weakening of muscle-rings (sphinctors). Stress incontinence causes extreme degree of embarassment and women avoid attending social functions. In addition, it leads to infections and must be treated. This disorder is more common in obese women and those who have sustained vaginal injuries due to repeated childbirths. General measures are weight reduction, treatment of cough and constipation. Pelvic floor exercises help in early cases. These are:
Drawing up of anus and tightening of vagina.
Stopping urine in between and squeezing the muscles (as if getting rid of last drops of urine)
Electrical stimulation of perineal muscles by physiotherapists.
If these measures fail then adrenergic drugs, hormones and implants around urinary tube (urethra) may help. Finally restorative surgery may be required.
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