- On December 28, 2016
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There are many important women in my life: friends that I have grown up with, cousins who share my heritage, and family members who continually fill my life with support, love, and inspiration. Women have the propensity to care for others first, and only then to care for themselves. We give and share, support and nurture, only to find ourselves exhausted and without sufficient energy to care for ourselves. A caregiver’s health is perhaps the most important health to be cradled. Hold your health in high regard – spend the necessary time to watch over it, listen to your body, and be sure to reach out for answers when you have concerns. To that end, I will discuss 3 important symptoms that arise in older women. As in previous ‘Most Commons’ posts, the intention is to reassure you that you are not alone, and that your symptoms are real. They may be real symptoms with benign consequences, or they may in fact be symptoms worthy of investigation. Either way, it’s time to care for yourself. Let’s start the conversation. Here are 3 topics which affect a large percentage of women – and explanations to soothe your worries.
1. Urinary incontinence.
Urinary incontinence is not, in and of itself, a disease. Rather, it is a symptom. The prevalence of urinary incontinence increases with age, and has been found to be upwards of 38% in the older female population. There are 2 main types of urinary incontinence – stress incontinence and urge incontinence. Stress incontinence is an involuntary loss of urine with increased intra-abdominal pressure, that is to say that anything that might increase pressure on your bladder (coughing, laughing, sneezing, walking, or running) can cause the involuntary loss of urine. Urge incontinence, on the other hand, is a loss of urine that is associated with an abrupt, and sudden, urge to void. It is most generally the latter that will require treatment.
There are many risk factors for stress incontinence, from age to smoking, pelvic surgery to vaginal deliveries. Treatment is usually conservative (do you know how to do Kegel exercises?) yet surgical treatments are sometimes recommended.
Urge incontinence is due to an “overactive bladder”. The cause is 90% idiopathic, and can be occasionally due to the detrusor muscle being overactive or unstable. Treatment includes behavioral modification first – reducing caffeine and liquid intake can help, as can smoking cessation, and a regular voiding schedule. Kegel exercises have been shown to help individuals with urges as well. Lastly, medications can drastically help – anticholinergics act by inhibiting the involuntary contractions of the bladder, thus diminishing the urges. They also increase the capacity of the bladder and delay the initial urge to void. Side effects of these medications may be a dry mouth and constipation, so make sure to drink plenty of fluids, and include fiber in your diet. If need be, speak to your doctor about using a stool softener. If you are performing Kegel exercises, make sure that you are performing them correctly. Google ‘how to’, or use your fingers to make sure the muscles are in fact contracting. Do not feel embarassed about your desire to fix the problem. I want you to improve your quality of life, and not worrying about sudden surges will make the world of difference. In addition, be aware that if your physician prescribes an anticholinergic (Detrol or Vesicare for example), the medication may take up to 4 weeks to reach its full effect. Be patient, and have a conversation about your options if your urges are still impacting your daily activities.
2. Blood in the stool.
It is a scary sight to see blood in the toilet bowl. Armed with information though, you will come to realize that even something as scary as blood, can be a rather benign symptom.
If you notice bright red blood on the toilet paper, or in the toilet bowl, you may have hemorrhoids. Hemorrhoids are swollen and inflamed veins in your anus or rectum. They are very common and by the age of 50, half of adults will have experienced them. Depending on the location of the hemorrhoids (they can be internal or external), there might be pain associated with the bleeding. Generally, an internal hemorrhoid will be associated with painless rectal bleeding, whereas external hemorrhoids are associated with pain after a bowel movement. Of importance to you is to notice the color of the blood – if the blood is red and coats the stool, it is likely originating from a location near the rectum. Changes in your diet (increasing your fiber intake) and taking sitz baths can help with internal hemorrhoids. If the blood seems brown, or you notice clots, then the bleed may have originated further ‘upstream’ – and you should consult with your doctor immediately. That said, although hemorrhoids are common, any rectal bleeding should be ruled out for more serious conditions like colon cancer.
3. Osteoporosis and bone health.
After menopause, your estrogen levels diminish, and you have decreased bone mass and an increase in bone fragility. Osteoporosis can be commonly asymptomatic, and it is therefore important to take proactive measures to prevent osteoporosis from occurring. Most importantly, make lifestyle changes that promote bone health. A meta-analysis that included people aged 50 years or older was published in the Lancet in 2007, and revealed the following findings:
Important lifestyle changes include the following:
– Elemental calcium 1000-1200mg/d and Vitamin D 1000IU/d
– 3 x 30 minutes of weight bearing exercises/wk
– A reduction in caffeine, and smoking cessation
There you have it, 3 important topics for the older, yet still young at heart, woman. Please share this post with important women in your life. They will thank you. And remember, it is your body, and you have every right to educate yourself and empower yourself with information.