ASK THE DOC
Specialist obstetrician and gynaecologist Dr Carol Thomas answers your questions.
Obstetrician/ gynaecologist Dr Carol Thomas answers your health questions
Q: I’m menopausal and I’ve noticed that my hair is thinning. Is there a special shampoo I can use, or a pill or supplement I could take to stop this?
A: Unfortunately, our hair starts thinning as we age in the same way that men’s hair thins as they age. Mainly, hair loss is due to our genetic makeup (check what the heads of the women in your family look like), rather than the commonly assumed ‘hormonal’ reasons. Women who have high testosterone levels, like those with polycystic ovary syndrome, may have hormone-related hair loss. The menopause does not directly contribute to hair loss, but then menopause occurs in ageing women! Your first port of call should be your dermatologist, and because I, too, need to know what to do about receding hairlines, I contacted Dr Sandra Pather in Claremont, who had this to say: ‘Remove harsh chemical treatments and hairstyling methods, check for hormonal and metabolic causes , use Minoxidil 2% solution daily (only works while you continue with treatment), or consider hair extensions. Finally, realise that hair transplantation might be the only thing that could give you the head of hair you want.’
Q: Do I just have to accept that weight gain is inevitable as I get older?
A: The only inevitability is the shape change, where your waist miraculously disappears with a particularly aggressive gravitational force that seems not only to pull downward but outward on your lower abdomen. The weight gain, which may range from half a kilo to two kilograms per year after 40, is not just an old wives’ tale. While we may not have changed our eating or exercise patterns, natural ageing processes constantly work against our adoption of the ‘50 is the new 40’ mantra, so often we assume we have a thyroid hormone problem! There are other hormones that your doctor may do well to check, (like insulin – with glucose to check for insulin resistance – and follicle stimulating hormone, to check for perimenopause), before a dietician steps in to assess your individual energy-in energy-out balance and advises on how to fight this.
Q: We tend to associate heart disease with men. But I’ve read that it’s just as much of an issue for menopausal women. How do I know if I’m at risk, and if I am, what can I do?
A: We all fear breast cancer as we get older, and rightfully so, because three percent of deaths in women globally are due to breast cancer. However, heart disease accounts for more than 34 percent(!) of all deaths and, as the obesity epidemic increases while we continue our toxic love affair with sugar, this figure will increase.
Our oestrogen protects our hearts because it dilates arteries, keeping them open and retarding cholesterol plaque formation. When we lose this protection at the menopause, our heart disease risk increases between three to five times. We also tend to be less active and lose muscle as we age – not a good thing when we want to keep our hearts healthy. The usual list of risk factors – smoking, increased weight, high blood pressure, family history, insulin resistance, diabetes and menopause – has not changed, and neither has the rather boring solution of controlling these risk factors. There is no real magic and we can’t change the DNA passed on by our parents, although I often try to blame them anyway. That increasing midriff is an important clue. Importantly, know your numbers. By this I mean not so much what your total cholesterol is, but how good or bad your HDL (good) cholesterol and LDL (bad) cholesterol levels are. There are many ways of calculating your risk of heart attack and this can be done online – try www. reynoldsriskscore.org. You will need to know some numbers from blood tests. Be proactive and ask for those on your next visit to your doctor.