Archive for fatigue
Fatigue can be a major part of the menopausal transition. It can be one of the first things that happens, often sneaking up on women without any identifiable cause.
Your fatigue can be from a variety of reasons, and most people will blame it on the inability to sleep that can occur with menopause. As many of us know, sleep is often a tenuous event every night. There are hot flashes that wake us up, and sometimes we find ourselves wide awake in the middle of the night for no reason.
The fatigue that occurs during menopause can lead you to reduce the exercise or activities you participate in, because you are just too tired. This can lead to weight gain; and weight gain can lead to diabetes, HTN, diabetes. All of this can predispose you to sleep apnea.
Sometimes fatigue is just from lack of sleep, and we are familiar with this form of weariness. But sometimes fatigue can be due to poor quality sleep that is a result of sleep apnea. You may feel that you stay asleep all night, but awaken worn out; as if you have not slept at all. This can be a sign of sleep apnea, as is snoring or interrupted breathing while sleeping.
It is important to address your fatigue with your medical provider. Other reasons for fatigue can include:
- anemia-both iron deficiency and B12 deficiency
- joint disease or connective tissue disease
- breathing problems such as asthma, COPD, lung infections
- nutritional deficiencies and excessive dieting
Sleep apnea can occur to anyone as they age, but it is more likely to occur with being overweight. This can place stress on the oropharyngeal structures, which result in collapse and obstruction of the breathing passages when laying down. Prolonged sleep apnea can then lead to a condition called pulmonary hypertension.
What can you do the prevent sleep apnea?
While you cannot prevent yourself from aging, limiting weight gain as you age may be the most important deterrent to sleep apnea. This is best achieved through healthy diet and exercise. It is the weight gain in the neck which primarily the culprit bringing on sleep apnea.
Keep in mind that sleep apnea is not just a condition for men, woman are susceptible also! See your provider if you have unexplained fatigue, and work on healthy diet and exercise to control weight and improve your sleep.
A reader recently posted a question:
What do you do when your health requires you to stop taking your hormone therapy?
Many specialists would simply say, stop your medication and in essence, deal with it. Your gynecologist or family practitioner could no doubt offer more advice than that. My first advice would be to contact your regular provider to ask their advice on controlling symptoms.
The time of menopause is also the time of increase risk of stroke, heart attacks, cancers, and blood clots or DVT ( deep vein thrombophlebitis). Estrogen and progesterone can cause inflammation of blood vessel walls, thus helping to cause stroke, blood clots, and heart attacks. Estrogens can fuel a breast cancer or other cancers of the female organs. Since having one cancer places you at risk for any other cancer, it makes sense to discontinue estrogen for any cancer a woman may experience.
So what do you do when you are told to suddenly stop the therapy which is helping you feel sane and in control?
There are many other therapies which are safe and can help control symptoms, but first you must check with you provider. One thing which will be vital for controlling the symptoms of menopause is a healthy life style. Because of how food is metabolized during this time, it is important to limit foods high in sugar as this can lead to fatigue and sometimes fuel hot flashes. It is also important to limit caffeine and alcohol as these items can trigger hot flashes both daytime and nighttime. Alcohol also causes difficulty with sleep mostly due to the sugar content.
We all know a bad night sleeping can lead to
- fatigue, which leads to
- low energy and avoidance of exercise,
- leads to convenient food choices for comfort and ease of preparation.
- lack of sex drive
- difficulty concentrating
- all of the above leading to low self esteem and possibly depression over lack of control
How do you gain control of all this?
A diet high in antioxidants helps. This means fresh fruits and vegetables, brightly colored or deep leafy green. Consuming less sugar, caffeine, and alcohol. If you are sensitive, a diet low in dairy. If you are not sure how dairy sensitive you are, stop all dairy for 1-2 months and see how you feel. You may have more energy, less respiratory problems and skin problems. Exercise of any kind that gets your heart beating faster and uses your muscles in a way not normally used in your average day.
For medical help when the above measures are not enough, there is clonodine or effexor (low dose) which can help with hot flashes. There are sleep aids which are generally safe for short periods of time. Doing cross word puzzles or other memory type games can help some with “brain fog”, as does some low dose antidepressants if applicable. Herbal products should be used with extreme caution if they contain soy or black cohosh; these products can theoretically be irritating to blood vessel walls as they are estrogen like in their action.
There are measures you can take to control your symptoms, nothing may be as completely relieving as hormone replacement therapy. Talk to your medical provider to get advice targeted to your health situation. Then, write us back and let us know what worked for you! Share your successes with our readers.
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Ovarian cancer is the 9th most common cancer women can have and is the 5th leading cause of cancer deaths in women.
It is difficult to diagnose early, which can make it one of the more dismal gynecologic cancers a woman can have. Research is ongoing on methods of early diagnosis and detection, as well as trying it identify risk factors to aid in prevention.
- The American Cancer Society predicts that in 2010, 21,880 women will receive a new diagnosis of ovarian cancer and there will be 13, 850 deaths from ovarian cancer.
- These statistics are close to past years stats on diagnosis and death, although the rate of ovarian cancer has been declining slightly.
- 93% of women diagnosed in early stages of ovarian cancer live 5 yrs or more, however, only 19% of women with ovarian cancer are diagnosed in the early stages.
- Lifetime risk of developing ovarian cancer is 1 in 71, lifetime risk of dying from ovarian cancer is 1 in 95
- 50% of women diagnosed with ovarian cancer are over 60, risk is higher in white women over African American women.
- 3 in 4 women diagnosed with ovarian cancer survive at least 1 year, 46 % survive 5 years; women younger than 65 fair better than older women.
SYMPTOMS OF OVARIAN CANCER: many of the symptoms listed below can be present for completely normal or benign reasons, their presence does not ensure an ovarian cancer. Experts suggest however, that if many of these symptoms are new, unexplained, present daily or almost daily, last more than a few weeks; that evaluation is needed.
- Bloating, upset stomach, early satiety or difficulty eating a full meal, and constipation
- pelvic and/or abdominal pain, as well as back pain, pelvic or abdominal pain during intercourse
- Changes in menstrual pattern and especially post menopausal bleeding
- urinary frequency or a change in the pattern of urination, urgency to urinate
- unusual or unexplained fatigue
WHAT ARE RISKS OF OVARIAN CANCER?
- AGE: as mentioned above, incidence increases with age
- OBESITY: studies suggest a BMI of over 30 increases risk and death from ovarian cancer, although this has not been proven. Likewise, studies have suggested a diet low in fat and high in vegetables has shown a lower rate of ovarian cancer
- CERTAIN DRUGS: the use of fertility drugs for over 1 year especially if pregnancy was not achieved is associated with a higher incidence of low malignant potential tumors. These are tumors of the epithelial cell type which tend to grow slowly. Use of androgens (Donazol) has suggested a higher risk in a small study, however a larger study did not confirm this. Use of HRT, especially estrogen alone for more that 5-10 years has been associated with a higher rate of ovarian cancer.
- FAMILY HISTORY: 10% of ovarian cancers are from the genetic mutation on BRCA1 and BRCA2, many causes of epithelial ovarian cancers, which are the most common, are caused by inherited gene mutations and therefor identifiable through genetic testing. This is recommended for a family history of breast, colon and ovarian cancer even if on father’s side of the family.
- PRIOR BREAST CANCER: many of the same risk factors for breast cancer also exist for ovarian cancer, primarily the gene mutations mentioned above ; and possibly use of HRT. The presence of a prior cancer suggests a problem with DNA replication.
Other factors that have been looked at are use of talcum powder, use of analgesics, smoking and alcohol consumption. The use of talcum powder applied to the genital region, as well as sanitary napkins containing talcum powder; has been suggested as one possible cause of ovarian cancer. It is speculated that talcum powder used more than 20 years ago contained trace amounts of asbestos, which is a known carcinogen. The FDA has required all talcum powder to be asbestos free, and there is no association with use of corn starch containing personal hygiene powders with increased risk of ovarian cancer. Studies have failed to demonstrate and increased risk of ovarian cancer with use of aspirin, acetaminophen products, alcohol or smoking.
How can a woman reduce her risk of getting ovarian cancer? There is not a lot of data to give concrete answers but studies doe suggest that the following strategies can be considered:
- Use of oral contraceptives for 5 years or more seems to reduce risk by 50% over non users of birth control pills. Likewise, risks goes down with each pregnancy as well as breast feeding. This is most likely associated with lack of ovulation, or continued activity within the ovary month to month.
- Gynecologic surgery such as bilateral tubal ligation and hysterectomy is also associated with lower risk, exact reasons are unknown. These tests should only be done for valid, medical reasons.
- Genetic counseling is very important if there is a family history of cancer including the BRCA gene mutation. this is a complicated issue, but can identify women at risk and allow them to take recommended surgical action.
It is most important to see your medical provider for any new signs and symptoms of ovarian cancer, even if there is not a family history of cancer. Long term survival is best when this particular cancer is diagnosed and treated in the early stages. Regular exams and good dialogue with a medical provider you trust is key, tell your provider everything you are feeling even if it seems trivial!