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Health and Wellness at the Crossroads, Feb. 2S, 1998
Transition time...
Few women escape menopause
transition without physical,
emotional problems
Special to Health and
Few women are completely unscathed,
both physically and emotionally,
when their bodies make the transi
tion from fertility to menopause
This transition - called perimenopause -
generally begins in the late 30s or early 40s
and continues until women cease ovulating
The average age of menopause onset is SI,
said Medical College of Georgia nurse prac
titioner Saundra Turner, so perimenopause
can be a lengthy stage of life And a trying
one.
Symptoms of perimenopause, caused by a
woman’s decreasing hormonal level, include
irregular periods, hot flashes, memory loss,
sleeping problems and irritability. "A lot of
women, especially in this day and age,
attribute the symptoms to stress,” I)r TVirner
said. “The forties are a stressful time for
most women anyway, especially if they’re
juggling job and family ”
Women with penmenopausal symptoms
should consult a health care professional,
because help is available. Dr Tlirner
stressed. Supplemental estrogen often curbs
the symptoms, but because the hormone can
induce ovulation, women who take it may
become more likely to conceive Therefore,
penmenopausal women often are prescribed
birth control pills, which combine estrogen
and progesterone.
“Birth-control pills are much safer than
they used to be; the dosages are much
lower," Dr. TUrner said However, those who
smoke or have hypertension should probably
avoid birth control pills because of an
increased risk of blood clots, she said
Once women complete perimenopause and
are completely menopausal, their hormone
replacement therapy can be adjusted
accordingly, Dr Tbmer said
Many of Dr. Turner's patients are becom
ing increasingly interested in alternative
treatments, such as herbal therapies. “I
think there are a lot of good herbal remedies
to look into, but we have to be careful Just
because it’s an herb doesn’t necessarily
mean it’s safe," she said
Perimenopausal women also should tend
to their emotional needs, Dr. I\irner said
"During this period of time, women may be
experiencing an empty nest, job problems
and other stressors [in addition to peri
menopausal symptoms],” she said “This can
lead to depression."
Anti-depressants may help, and Dr. TXirner
doesn’t hesitate to refer patients to mental
health professionals when necessary. But
she also espouses the benefits of healthy
lifestyle habits, such as exercise, a good diet
and plenty of sleep. And she always offers a
listening ear.
“One of my main priorities in patient care
is health promotion - helping people look at
their lives and maximize their health," she
said “I really bond with my patients. A lot of
them come in just to talk. They can ask me
anything at all without feeling stupid or
reluctant And that can mean a lot.”
I \ ft Vlri r V—,* y ■
High-Risk pregnancies demand
vigilant medical care
By Christine Dekiso
Mum Al CnLU.I.K ill tinmi.lA
Every expectant mother knows that
pregnancy harbors both the highest
of hopes and the deepest of fears Of
course, most pregnancies proceed normally
and result in a healthy baby. But what if
something goes wrong?
The most important step in ensuring a safe
and healthy pregnancy is identifying women
at risk of complications, according to Dr.
Lawrence Devoe, Chairman of the Medical
College of Georgia Department of Obstetrics
and Gynecology And the best time to identi
fy them is before they get pregnant
“Sometimes the true status of an individ
ual’s risk is unknown,” Devoe said "Because
of that, the most important thing is regular
medical care if you’re considering getting
pregnant"
Factors such as lifestyle, family health his
tory and the mother’s overall health offer
important information about potential risks,
Dr Devoe said For instance, women over
age 35 are considered at higher risk than
younger women for pregnancy-related com
plications. Chronic health problems such as
diabetes or high blood pressure also require
particular care during pregnancy.
But some women don’t fall into a high-risk
category until they become pregnant.
“Pregnancy puts stress on borderline sys
tems,” said Dr Devoe, noting that a weak
cardiovascular system, for instance, may not
produce symptoms until the added stress of
pregnancy occurs. Pregnancy also can
induce conditions, such as hypertension,
“and pregnancy increases the potential for
conditions such as urinary tract infections,”
Dr. Devoe said.
Multiple births, an increasingly common
But every woman can bolster her
odds of a healthy pregnancy by main
taining a healthy lifestyle particu
larly by eating well and refraining from
non-prescription drugs, including alco
hol and receiving regular medical
care.
occurrence because of fertility medication,
are also considered high-risk
Some factors, such as the mother’s
advanced age, are considered low-risk
enough for a generalist to handle More com
plicated risk factors, such as diabetes or
recurrent miscarriages, often require the
services of high-risk specialists, according to
Devoe.
TVeatment during a high-risk pregnancy
varies according to the circumstances If the
mother has a chronic health problem, for
instance, the condition is treated according
ly. If the health of the baby is at risk, the con
dition can be monitored and sometimes even
treated during pregnancy. Sonograms are a
common tool to monitor the progress of the
fetus
But not every pregnancy complication is
diagnosable, Dr. Devoe stressed. “Patients
need to understand that some conditions are
difficult to diagnose at any time, and some
outcomes can’t be changed."
But every woman can bolster her odds of a
healthy pregnancy, he said, by maintaining a
healthy lifestyle particularly by eating
Well and refraining from non-prescription
drugs, including alcohol and receiving
i*egular medical care.