Thursday, January 21, 2021

CASUSES OF PAIN DURING MENOPAUSAL YEARS

 

Once the periods finish in our later years of life women generally feel very happy. Once you have not had a period for one   year it is called menopause. It is a normal phase in our life cycle, it does mean that we cannot have a pregnancy any more. We feel excited that the menstrual aches and pains will go away, but different types of problems raise their hands, just before the periods completely stop.

In the peri menopausal years, i.e. just before menopause, our periods become erratic due to lack of regular ovulation. When this happens the period that starts after a long cycle is often very heavy and painful. For the control of these irregular periods woman are often given the normal oral contraceptive pill or some special pill which regulates the cycle, stops too much bleeding, stops hot flushes and are also contraceptive, so it is great for relief of this particular situation. The other pain you may continue to have is pain due to migraine. This may be the same as you used to have. It is variable, sometimes it goes away with menopause, or it can start for the first time after menopause. Your GP or Endocrinologist will be able to help. The other important cause of pain is ovarian pains. These could be due to preexisting problems such as residual ovary syndrome after hysterectomy or less often endometriosis, adenomyosis (this is the endometriosis of the uterus) polycystic ovaries. It is nor rare for a cyst to appear de novo in the ovary. The clinicians have to be very careful about these as they can often be cancerous and need proper work up to exclude or confirm this diagnosis.  The extent of treatment will depend on the nature of the cyst.  One very common cause of pain during menopause is what is called fibro myalgia which signifies pain all over our bodies, why we do not know or understand. We live on pain killers, maybe massage and whatever variable treatments. More common causes of pain like in both sexes are different types of arthritis. Women also get some different types of pain due to osteoporosis. This does not cause serious pain except for stress fracture of the spine, or  fractures of the bones, such as hip, and wrist or and  anywhere else such as an ankle. More serious causes of pain are cardiac.   Pain due to cardiovascular disease, venous thrombosis. Never ignore them. One of the commonest cause of death in post-menopausal women is cardiovascular disease. Cardiovascular pain can also imitate shoulder, jaw pain and often stomach pain like an ulcer pain. Please seek medical advice should you feel any of these pains as this requires special investigation. During menopause the immunity decreases that results in infections, these surely cause pain. One such infection at this time is shingles. This is caused if a woman has suffered chickenpox in the past. It appear in the torso like a vesicular rash and is very painful. This is infectious in the air and by symptoms touching.  Until a crust forms on the rash women need to be isolated for ten to fourteen days. Treatment involves pain relief and antiviral such as acyclovir.  If left untreated it can cause fatal complications, such as a stroke, pneumonia, encephalitis (inflammation of the brain). It can also cause blindness if it occurs near the eye.

Management of these pain problems is self-care, exercise, correct diet, humor, group activities, fun, and regular clinical advice.

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