TEXT: Iva Hradilová, occupational therapist at the Paraple Center
This time I'll start with a text borrowed from a well-known TV show: So we're going to the finale and thank you very much for everything... But make no mistake, our series does not end completely with the topic of Menopause. For further use, we have decided to combine all the processed areas and supplement them with new information that we have obtained for you from experts and our other clients over the course of the year. We would like to prepare this comprehensive and extended information in one brochure during 2023. Please also take this as a challenge - if you would like to share with us your experiences from the intimate sphere or if you would like to give us feedback, please write to us by e-mail: paraple@paraple.cz (put Woman intimately in the subject line), we will be very advice.
But back to this issue. What will you learn in it? For example, what happens to your body during menopause, what is at risk, how to take care of it, whether menopause in a wheelchair has its specifics, what is osteoporosis, how to help yourself with herbs, and much more.
Finally, I would like to thank all the women who participated in the creation of this series, for their commitment, erudition and time. And also to Jiří Kříž, the head of the Prague Spinal Unit, for his expert commentary and to the graphic artist Lukáš Klingora for making the series visually tender and supremely feminine.
Menopause of women with spinal cord injury from the perspective of an occupational therapist
TEXT: Iva Hradilová, occupational therapist at the Paraple Center
Right from the start, I have to admit that of all the intimate areas discussed so far, the topic of menopause is the most distant to me. Even so, I hope that the following lines will reveal to you a little what areas occupational therapists can address with you with regard to this period of life.
Menopause is associated with older age, its onset is individual for each woman, the age is usually given between 45 and 55 years. However, both upward and downward fluctuations are quite common. It should also be taken into account that trauma, which is associated with spinal cord damage, can accelerate the menopause process.
It is well known that a woman loses the possibility of becoming pregnant naturally due to hormonal changes and gradually stops menstruating completely. One of the other changes is also a change in sexual libido, a change in figure and also the development of osteoporosis.
When a woman loses the possibility of becoming a mother (even if she no longer plans to), it affects her psyche in a significant way. Searching for yourself and your self and other possibilities for self-realization can be one of the things that an occupational therapist can help with. How? By helping you find a way to as active a life as you wish - by means of various activities, which are not only art and creative activities associated with ergotherapy, but also forms of employment, self-care, family care, etc.
In the area of changes in sexual libido in my clients during menopause, I perceive above all the need for intimacy, touch, hugs, space for sharing... The occupational therapist can discuss with you whether and what forms of sex are attractive to you at the moment, and based on that find the way to implement them. This may include the selection of suitable sexual aids, consultation of sexual positions or outlining other possibilities of getting to know your body.
And how is the work of an occupational therapist with women after spinal cord damage during menopause different in the area of sexuality? Above all, it is necessary to compensate for the handicap caused by the damage to the spinal cord, and such a search for ways, for example, with altered sensitivity, can sometimes be quite a challenge.
Hormonal changes also result in weight gain and fat deposition in certain body parts, most often in the hips, buttocks and legs. Some of these processes can be significantly influenced and slowed down, for example by a good lifestyle or various preparations. However, not every woman accepts this path.
From the occupational therapist's point of view, the mentioned body changes and also osteoporosis are most evident in the sitting posture and also in normal daily activities. It is necessary to respond to changes in posture and adjust the seat before, for example, a skin defect occurs. Bone thinning, or osteoporosis, is clearly also a big scare.
Since menopause is associated with older age, one of the tasks of an occupational therapist is to be able to find a way to save your body so that it serves you as long and well as possible. Most often, we discuss with you how to help yourself with various compensatory aids or where you can get help in your normal daily routine so that you don't switch unnecessarily. It is also in place to eliminate the possibility of falls when moving or riding in a wheelchair and, if possible, to show you less risky ways of falling.
In recent years, various types of additional drives have experienced a significant boom. They will definitely help you in a significant way when moving, especially outdoors. In order for them to serve you well and not mishandle, however, you need to adjust the entire seat adequately and solve the mitigation of shocks and possible falls that occur when using them.
Please remember that even in this period full of not always pleasant changes, we are here for you and don't hesitate and don't be shy to contact us.
Menopause and health
TEXT: Petra Hladíková, general sister of the Paraple Center
What is menopause
Menopause occurs when a woman stops menstruating. Although some people call the years before the last menstrual period menopause, this period is actually perimenopause . Menstruation can stop for a while and then resume again, so a woman who has not had a period for a whole year is considered postmenopausal.
The average age of a woman entering menopause is fifty-one years, but for some women it occurs even earlier, e.g. already in their forties.
Around menopause, it is common to experience various symptoms, such as hot flushes, headaches, irritability . After menopause, a woman can no longer get pregnant.
Menopause is a normal part of a woman's life.
What is perimenopause?
Perimenopause, sometimes called the menopausal transition , is the time before the last menstrual period. During this time, there are changes in the levels of the hormones estrogen and progesterone in the female body, which can cause various unpleasant symptoms. Some of these can persist for months or even years after a woman's period has stopped.
After perimenopause, a woman is in postmenopause , which lasts for the rest of her life.
Possible symptoms caused by low estrogen levels:
- Headache
- Mood swings
Mood swings are typical for a drop in estrogen levels, however, its low level can even lead to depressive disorders. A lack of estrogen can also cause a decrease in the production of serotonin (the so-called hormone of happiness).
- Fatigue
- Difficulty concentrating
- Irregular menstrual cycle
- Premenstrual syndrome
- Hot flushes and excessive sweating
- Hair Loss
- Skin deterioration
Dry and problematic skin prone to acne is also a symptom of low estrogen levels.
- Decreased bone density
Due to the low level of estrogen, the body may have a harder time absorbing calcium, thus contributing to the later development of osteoporosis.
- Loss of libido
- Vaginal dryness and painful intercourse
- Frequent urinary tract infections
- Weight gain
Low estrogen not only can affect the amount of fat stored in the body, but also affects the places where the fat is stored. During this period, the most fat begins to accumulate in the abdominal area. It is the so-called visceral fat, which accumulates around the organs. Visceral fat can be a trigger for diseases such as diabetes, stroke and various heart diseases. In the time around menopause, physical activity usually decreases, and this represents an even greater risk of weight gain. Therefore, it is advisable to be physically active throughout life.
The level of estrogens can be detected during control blood sampling. Women with low estrogen levels are usually offered treatment in the form of hormone replacement therapy, which is nothing more than the administration of high doses of estrogen. However, it is also possible to stimulate the level of estrogen by choosing a suitable diet rich in phytoestrogens lignans. These are substances that can affect the level of hormones and that can increase the level of estrogen. This type of phytoestrogens is most often found in strawberries, bran, chickpeas, vegetables (carrots, eggplant, tomatoes, beets, cauliflower, cabbage) or flaxseed.
Indications for hormone therapy
Hormonal therapy is indicated if the woman has moderate and severe vasomotor symptoms (night sweats, hot flushes) , urogenital symptoms, insomnia, poor sleep quality, decreased libido, etc.
Hormone replacement therapy serves to supplement the level of female sex hormones. This treatment is known as HRT (hormone replacement therapy), ET (estrogen therapy) and EPT (estrogen-progestagen therapy).
The main component of hormone therapy is estrogen. It is produced by the ovaries before menopause. In the period around menopause, its production decreases, and this causes various problems. Hormone replacement therapy is administered in the form of tablets or injections, creams or skin patches, subcutaneous implants, vaginal creams and nasal sprays.
HRT therapy works well to suppress the subjective problems associated with menopause. It has a preventive effect on mucous membranes, skin, hair and nails. It is suitable as a prevention of osteoporosis, cardiovascular diseases and others. Treatment should always be chosen individually for each patient. When choosing a preparation, it is necessary to know the patient's internal condition, her hormonal profile, lipid level, liver tests and check her blood pressure. A gynecological examination, cervical cytology, pelvic ultrasound and mammography are also considered necessary. Regular inspections are a matter of course.
Hormonal treatment is not an inevitable treatment, but it can improve a woman's quality of life and protect her from some diseases. When prescribing hormonal treatment, the most important thing is communication with the patient and the truthful presentation of information, i.e. the need to sufficiently explain the benefits and possible risks of the treatment and also prepare her for possible side effects. An individual approach and sufficient time are also essential.
Menopause and osteoporosis
TEXT: Lenka Honzátková, specialist in spinal issues at the Paraple Center
Osteoporosis, or thinning of the bones, is a chronic disease of the skeleton. It is characterized by loss of bone mass and disorders of bone structure with a subsequent increase in bone fragility and subsequent risk of fractures. A state of imbalance is created between the new formation of bone mass and its loss. As a result of the loss of bone mass, fractures occur without a previous injury or even with a small load on the bone. Fractures associated with osteoporosis most often occur in the hip joint, wrist and spine (thoracic and lumbar vertebrae).
In this short text, I will briefly introduce you to osteoporosis, which we included in the Menopause topic, as one of the most common complications associated with hormonal changes. In the autumn Umbrella Magazine, we will present you with the issue of osteoporosis in full, apart from the Woman Intimate series.
Significant osteoporosis develops after a spinal cord injury. From the first weeks after the appearance of a spinal cord lesion, there is significant loss of bone mass below the injury site, which gradually reaches up to 50% loss. The longer the time since the injury, the more likely bone loss is. The primary cause of osteoporosis associated with spinal cord injury is considered to be loss of mobility and thus insufficient load on the bones. Altered autonomic functions and hormonal changes also contribute to its development. Other general risk factors for osteoporosis include low body weight, lack of exercise, excessive alcohol consumption, smoking, lack of dietary intake of vitamin D and calcium, and regular use of certain medications for chronic diseases.
The symptoms of osteoporosis are mostly "silent". They are not manifested by pain or restriction of movement. The least common symptom is a fracture without a major external cause, when the bone is already very fragile. A fracture often occurs as a result of normal, routine movement. If osteoporosis is diagnosed only when the bones are already very fragile, then the treatment is more demanding.
Menopause in women after spinal cord injury and its effect on the development of osteoporosis
In general, women after menopause have a higher risk of osteoporosis, when the production of female sex hormones (estrogens and progesterone) decreases. 40-50% of women over the age of fifty will suffer a fracture due to osteoporosis during their lifetime.
Research focused on monitoring the state of bone tissue in women with a spinal cord injury describes an increased incidence already in the premenopausal period and a significant increase in the menopause period related to the loss of estrogen compared to the population of women without a spinal cord injury.
Diagnosis usually takes place in specialized osteological centers. It consists of blood, urine and densitometric examination (DEXA), which will allow you to determine bone density. It is a painless X-ray examination. Blood and urine samples are taken to determine the general condition of the patient, the level of calcium, phosphorus and magnesium, as well as the blood count, sedimentation rate and other indicators that allow to assess the rate of new formation and breakdown of bone tissue.
No clinical recommendations are yet available for the prevention and treatment of osteoporosis in women after a spinal cord injury during menopause, they are treated according to standard procedures.
- Hormone replacement therapy (prevention and treatment of postmenopausal osteoporosis, i.e. delivery of estrogens)
- Parathyroid hormone derivatives
- Bisphosphonates (antiresorptive therapy)
- Denosumab (monoclonal antibody)
- Calcium
- Vitamin D
Treatment should always be adjusted individually and with regard to possible benefits and risks. Don't be afraid to discuss everything thoroughly with your doctor.
Prevention of osteoporosis
The basic elements of osteoporosis prevention are a varied diet and enough suitable exercise.
A varied diet
Plenty of vegetables, fruit and fibre, healthy sources of fat and protein, limiting sugar and fat and alcohol and caffeine consumption.
You will learn more in the section of nutritional therapist Aneta Sadílková.
Regular physical activity
Exercise helps maintain the proper balance of bone formation and loss in areas of the body above the spinal cord injury. Physical activity promotes muscle growth and improves coordination of movements, thereby reducing the risk of injuries. An increase in joint mobility and spasticity is also of preventive importance. Standing, which is sometimes discussed, has not yet been proven to have a positive effect on the prevention of osteoporosis.
The best exercise is with your own body weight or strength training with a light load, during which the bones are not overloaded. Swimming or riding a handbike benefit the muscles and the heart, but they do not put the necessary strain on the bones and joints, so it is advisable to supplement them.
Resources:
Kriz J. et al. Spinal Cord Injury: Causes, Consequences, Organization of Care. Prague: Galén 2019, 532 pp. ISBN: 978-80-7492-424-8
Jiang SD, Dai LY, Jiang LS. Osteoporosis after spinal cord injury. Osteoporosis Int. February 2006; 17 (2): 180-92. [ PubMed ]
Battaglino, RA, Lazzari, AA, Garshick, E. et al. Spinal cord injury-induced osteoporosis: pathogenesis and new therapies. Curr Osteoporosis Rep 10, 278–285 (2012). https://doi.org/10.1007/s11914-012-0117-0
Varacallo M, Donald D. Davis, Pizzutillo P. Osteoporosis in Spinal Cord Injuries StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): 2/2022 , [ PubMed ]
How nutrition can help in menopause
TEXT: Aneta Sadílková, nutritional therapist, 3rd internal clinic of the 1st Faculty of Medicine, UK and VFN in Prague
During menopause, the body goes through hormonal changes, which have different intensity and different manifestations for each woman. This is a period often accompanied by unpleasant symptoms, such as hot flushes, sweating, sleep disorders, psychological deterioration and others. At the same time, weight gain often begins or accelerates. Nutrition can help significantly in many ways.
As a result of hormonal and metabolic changes during menopause, the risk of developing obesity, high blood pressure, type 2 diabetes, cardiovascular diseases, but also osteoporosis increases. However, these facts should in no way lead to the fact that a woman at the beginning of menopause gives up all care for herself and her health and just waits for her to gain weight and the aforementioned diseases appear.
On the contrary, during this period you need to focus on yourself, find out what the body needs, and give it that too. When it comes to the risk of the aforementioned civilizational diseases and weight gain, it is still our lifestyle that is decisive, not genes or age. So there is no reason to make excuses for menopause.
The metabolism slows down, but it does not stop!
A common myth associated with the menopause is that the metabolism slows down. There is a widespread belief that it is impossible to lose weight after menopause, and what is more, that it is normal to gain weight. As an argument, the statement is used that after menopause, a woman's basal metabolism decreases, which is the energy expenditure required to maintain the basic vital functions of the organism. This natural energy expenditure does decrease, but not so much that it is a reason to give up trying to maintain a healthy weight.
A gradual, but very moderate, decrease in the body's energy needs actually occurs from around the age of thirty. The reason is the gradual loss of active body mass (muscles), which happens naturally. And it is the amount of muscle tissue that is the main factor influencing the size of the basal metabolism. Simply put, the more muscles we have, the more it "burns".
How much energy from food should we take in daily?
The energy requirement depends on the total daily energy expenditure of our body. It is different for everyone and consists of three basic components:
As a result of the significant hormonal changes associated with the transition, there is an accelerated loss of muscle tissue, which is replaced by fat. At the same time, the less a woman engages in regular physical activity, the more this negative development is supported. In practice, this means that in order to maintain the same weight after menopause, it is necessary to take in less energy from the diet or to increase energy expenditure through exercise. A combination of both is ideal.
Exercise as a cure for everything, including menopause
Nowadays, no one doubts the importance of movement for the overall health of the body. Movement in a regular dose and at a reasonable rate is the best possible "cure" for all civilizational diseases, including obesity. Unlike classic drugs, it is free of unwanted side effects and overdoses occur only very rarely.
Even all the negative symptoms of menopause can be alleviated by regular physical activity, whether it's walking, dancing, working out in the gym, yoga, cycling or swimming. The important thing is not to force yourself into an activity that you really don't enjoy, and to choose one that you will enjoy even a little. If you don't want to do anything at all, that's totally normal, but you have to get over it.
Image: Benefits of physical activity in menopause
How to change your diet during menopause
Goal number 1 is not to increase energy intake . Although it does not occur to most women at all, it happens to them often. It is very easy to eat and drink more calories than the body needs without feeling overfed. These are mostly "snacks" consumed in the afternoon, evening or between meals, such as nuts, chips, bars, chocolate, biscuits and the like. Even in a small portion, these foods contain a large amount of energy (from fat and sugar), at least 1000 kJ (240 kcal) in 50 g. In the same way, alcohol easily contributes to a creeping increase in energy intake (2 dl semi-dry wine or prosecco contains 600 kJ/140 kcal, 1 beer 700 kJ/170 kcal, etc.)
Goal number 2 is to slightly reduce daily energy intake. By how much? Fortunately, not by much. About 500 kJ (120 kcal). For example, 2 slices of cheese, a glass of wine or 2 chocolate candies add up to this. It may seem insignificant, but if the body is "in surplus" by 500 kJ per day (energy intake is 500 kJ higher than output), then in total for the year it is 183,000 kJ, which corresponds to less than 5 kg of fat, which is to take such situations realistically.
You will get the best control over your energy intake and the composition of your diet if you write down your actual diet for some time . According to the principle "what you put in your mouth, put it on paper", or ideally in one of the applications that will calculate and add everything for you (for example, www.kaloricketabulky.cz ). Only then will you realize how easy it is to increase your calorie intake with some foods. In this way, you can plan your diet, make compromises and maintain a stable average energy intake.
The optimal daily energy intake for a menopausal woman cannot be determined universally. It depends a lot on the amount of muscle tissue and its "use", i.e. on physical activity.
- The average resting energy consumption (i.e. without movement) for a woman aged 51-64 years is 5100 kJ (1220 kcal).
- Taking into account normal physical activity without regular exercise, the average daily energy requirement could then be approximately 7100 kJ (1700 kcal).
- When taking into account regular physical activity beyond normal activities, about 8200 kJ (2000 kcal).
In people with a spinal cord injury, due to the lower amount of skeletal muscle, the basal metabolism is also naturally reduced, or resting energy expenditure. The degree of reduction is very individual and depends, among other things, on the level of the spinal cord lesion. But if the average resting energy consumption of a walking woman were the aforementioned 5100 kJ, it could be approximately 4000 kJ/day for a woman with a spinal cord injury.
How to make a meal plan
The basis of the daily menu are three well-composed main meals - breakfast, lunch and dinner. Each main meal should contain a source of complex carbohydrates, a source of protein and an additional source of fiber in the form of vegetables or fruit. There may or may not be a snack, but at most one in the morning and one in the afternoon.
It is important that at least 80% of the food in our diet is as little industrially processed as possible.
Sources of complex carbohydrates :
Cereals – bread, oatmeal, pasta, couscous, potatoes, sweet potatoes, rice, legumes, etc.
Low-fat protein sources :
Cottage cheese, cottage cheese, gervé, mozzarella (light), yogurt, kefir, bone-in ham, lean meat, fish, eggs.
Sources of fiber :
Vegetables, fruits, nuts, seeds, legumes.
Industrially processed foods with a high content of fat and sugar should form the smallest possible part of our diet , as they do not bring any benefits to the body, on the contrary, they burden it disproportionately and lead to weight gain. These are cold meats, fried foods, fast food, soft baked goods (doughnuts, cakes, etc.), cakes, cookies, ice cream, semi-finished products, and the like.
A bogeyman called osteoporosis
After menopause, in connection with the drop in the level of female estrogen hormones, the risk of developing osteoporosis also increases. The amount of bone mass decreases, the bone becomes more fragile, and thus a fracture can easily occur. That is why, especially during menopause, it is important to pay attention to a quality diet and regular physical activity, which are two basic factors supporting bone health.
Sufficient intake of calcium in the diet is important, which is contained in milk and milk products in the most usable form. The daily intake should be 1000-1200 mg, while for example in 100 g of milk, yogurt or cottage cheese there is approximately 120 mg of calcium, in hard cheeses such as edam it is more, between 500-900 mg depending on the type of cheese. In combination with calcium, vitamin D is necessary, most of the population is deficient and its sources from the diet are limited, so it is often necessary to supply it in the form of a dietary supplement. Vitamin K and magnesium contained in fruits and vegetables, nuts, legumes and cereals are also important. The set of measures for the prevention and treatment of osteoporosis also include minimal or zero alcohol consumption and not smoking.
Resources:
Reference Values for Nutrient Intakes (DACH), Society for Nutrition, 2019, 2nd Edition
Menopause. An even more intense journey into the interior
TEXT: Danuta Sliwková, psychologist at the Umbrella Center
We started this purely female series with the topic of self-care and will end it with that. The period of transition is a chance for every woman to connect with herself even more intensely and really deeply, to the inside of herself. Reason goes aside and you need to listen even more to the voice of your heart and let your soul speak. This path leads from the physical body through our emotions, mind, energy and spiritual plane. It is an ideal opportunity to give time and care to yourself.
Harvest season
In the course of life, we have gathered valuable experience, we have learned a lot, lived through, gone through many somersaults, invested a lot of energy in relationships, family, work, etc. So let's collect everything we have learned, collect it in the deepest interior and let this wisdom , let it permeate us and spill out in all directions. In short, we now have the opportunity to draw on everything we have experienced so far, and at the same time grasp it from another level - from the level of wisdom and love. And of course, I'm not talking only about the beautiful and pleasant, but also the painful and hurtful, which, of course, will teach us the most. It is through pain and trauma that we grow and mature.
Natural manifestations of female maturation
Menopause occurs in every woman's life, it is a completely healthy and natural manifestation of the gradual maturation of the female body . The function of the ovaries fluctuates, and then the function of the ovaries decreases, the level of female hormones (progesterone and estrogen) decreases. Menopause symptoms come gradually, sometimes even inconspicuously. These are changes when a woman's body leaves the reproductive phase and prepares for the rest phase.
The changes that take place are both physical and psychological in nature. It can be mood changes, increased irritability, more violent behavior, depressed mood, anxiety states, insomnia .
A woman sometimes has a hard time coping with the aging process and the fact that she can no longer have children. Her whole body also changes significantly. The skin ages faster, dries out, wrinkles increase, pigmentation increases, breasts are no longer flexible, the overall proportions of the body change, weight gain or, on the contrary, emaciation appears, swelling of the body, digestive disorders, rushes of blood to the head, feelings heat, excessive sweating. All this results in a woman having less energy and needing more rest. Self-confidence can therefore decrease rapidly.
The good news is that even this period can be passed pleasantly on the wave of experiencing the present moment, the flow and intensive self-enjoyment. Our former life is reflected here - how we lived, how much we invested in ourselves. The more we were focused on performance, haste, neglected and suppressed our needs, the more pronounced the accompanying climacteric phenomena will be. However, a reduction in physical performance may not be a loss, but rather a reward – it will allow us to slow down and deepen our intuition.
Professional support
In the evaluation of the seriousness of a woman's psychological state in the transition period, as in the past phases of life, the criteria of transience and the intensity of the manifestations are essential. If the described manifestations persist, are very intense, or even deepen, then they can turn into depression, anxiety, long-term insomnia, etc.
In such a case, it is advisable to discard any shame and seek the help of a gynecologist, ideally a psychogynecologist, psychologist or psychotherapist. If it is really necessary, these experts will then recommend a consultation with a psychiatrist.
Mental cleansing
In this phase of life, we have an ideal opportunity to deal with ourselves in depth, which means building our internal and external resources, healing our old psychological injuries, resetting our boundaries, investing energy in working with emotions and the body, solving difficult conversations and thus improving our relationship with ourselves and secondly, to remove prejudices and change negative beliefs. Everything goes better with a smile on your face and the perception of even the smallest joys that life brings us.
Witch, goddess, queen, empress, priestess
All these archetypes are associated with the transitional and advanced phase of a woman's life. The woman in her is mature, free and connected to her inner strength. The dimension of creativity and sexuality is important here. The uterus is a symbol of the creation of life - children, but during menopause it becomes a symbol of creative energy in the form of ideas, missions, creations, in short, what we enjoy and what we give way to.
Many women experience a drop in libido, but it doesn't have to be that way at all. On the contrary, a mature woman "queen, goddess, priestess" may experience an increase in sexual energy and a deepening of the intensity of passion and sensuality.
For this period, I can recommend taking sufficient care of yourself, including through rituals, and also being part of a circle of women, community, mutual help and support.
A charming goddess does not have specific body proportions, hair color, house type, car make or number of children. She is a woman who is happy with herself, loves life and everything it brings! Whether you walk through life or ride in a wheelchair, you can enjoy it.
Dear women, you give me a lot just by being around and allowing me to walk part of your life's journey with you. Going through life in a wheelchair is often really hard work, so I bow down to you all the more.
How to face menopause with physiotherapy and exercise
TEXT: Hana Vatěrová and Zuzana Červenková, physiotherapists at the Paraple Center
Menopause is not a disease, but a natural process of the female body. Nevertheless, it can evoke many negative ideas in us – slowly coming old age, loss of femininity, emotional lability, bone thinning, physical unattractiveness, etc.
But let's try to think about menopause as a challenge. Let's try to use it as motivation to change our lifestyle and exercise habits so that we still feel as good as possible in our bodies. Our own vitality and mental well-being should be at the forefront of each of us.
Menopause and its effects on the body
Hormonal changes caused by menopause have a significant effect on the body. The loss of hormones is noticeable, which is why you can sometimes feel "different", even very uncomfortable. Typical symptoms appear such as hot flushes, sweating, irritability, insomnia, headaches, palpitations, digestive problems and sometimes even depression.
The cause is the aforementioned change in hormone levels, which until now have regularly supplied your body. The organism was used to their abundance and now copes with their decrease. The goal for this period should therefore be to reduce the intensity of unpleasant difficulties, slow down significant changes in hormone levels and allow the body to gradually adapt.
Change in thermoregulation
Menopause is usually accompanied by a change in thermoregulation, which you can feel as so-called hot flushes and which can be associated with changes in blood pressure.
Try to adapt the organism in a natural way - through sports or more intensive physical activity. Hardening can also play a role, when hot and cold water are applied alternately. But start hardening very carefully and slowly. We recommend it especially to women who have preserved sensitivity and do not have difficulties with autonomic dysreflexia.
General weakening
A lack of the hormone estrogen also leads to a decrease in the tension of the skin, soft tissues, breasts, vagina, urethra, pelvic floor, or the suspensory apparatus of the uterus. Therefore, infections or prolapses of the vagina or uterus occur more often in the general population in this age category. However, in the population of women after a spinal cord injury, this fact is not fully documented or its incidence is not at all higher. However, it is possible that you will have more frequent problems with urinary tract infections.
Effect of physiotherapy and physical activity
The positive effect of physical activity is also indisputable in this case. Movement leads to greater mental well-being, can help prevent fatigue, positively influence changes in the sleep cycle, and supports the activity of the cardiovascular and locomotor systems. In addition, regular activity acts as a prevention of weight gain.
The cardiovascular system may be more susceptible to the development of other diseases such as hypertension, atherosclerosis and other diseases due to estrogen deficiency. Even in such a case, it is appropriate to include an aerobic activity when you feel an increase in breathing intensity or shortness of breath during its implementation.
You can slow down the decrease in breast tension with regular exercises targeting the pectoral muscles. In the case of a decrease in the tension of the soft tissues in the vagina and the possibility of active exercise of the pelvic floor muscles is maintained, you strengthen both the mentioned muscles and, in addition, the entire spine stabilization system. In pelvic floor therapy, however, it is initially advisable to seek out a physiotherapist who specializes in pelvic floor problems. The pelvic floor has a relatively complex structure, and a physiotherapist should act as an expert-guide here, who will set you up with a suitable therapy tailored to your body.
In connection with a change in the sitting posture in the wheelchair due to the weakened posture of the trunk, the release of tension in the soft tissues and the musculoskeletal system, complications associated with overloading the upper limbs may worsen (more frequent occurrence of e.g. tendinitis or muscle adhesions, strait syndromes, more shoulder pain appears) . These difficulties can be solved therapeutically quite well, but it is better to seek help already at the initial stage of the development of difficulties. Therapy is then easier and can bring a better result.
During menopause, you are also at risk of a greater loss of bone mass, the result of which is bone thinning (osteoporosis). Sitting in a wheelchair also encourages bone loss due to insufficient body movement. Therefore, a woman in a wheelchair after menopause is much more at risk of osteoporosis.
There is still a relatively small amount of resources (in the Czech Republic and abroad) that would professionally address the topic of menopause in women in wheelchairs and offer a background for possible questions. This can be quite annoying if you are already actively taking care of your health or would like to start taking care of it. Therefore, it is rather difficult to recommend the intensity or type of physical activity. However, it is important to keep the organism in good shape in all respects and indulge it in regular endurance activity (it is recommended at least three times a week for thirty minutes). Furthermore, it is good to keep in mind the risk of a possible fall, which could lead to greater complications. Therefore, even in the home environment, remove any obstacles and make sure that the wheelchair seat is properly adjusted.
A sedentary way of life in a wheelchair should also be compensated with well-chosen mechanotherapy, when your own movement will help to support or replace the device. There are a large number of available aids on the market, such as motomeds for upper and lower limbs, motrens, rotrens, etc. At the same time, if it is possible to ensure a certain non-burdensome form of verticalization in the home environment, then it is advisable to use it.
A number of women in wheelchairs have adopted a physically active lifestyle despite all the barriers (not only environmental barriers, but also the workload of assistants, complications with defecation, reluctance to move).
Whether you will be able to overcome all the barriers is certainly determined by several factors, including personality traits and your settings. The Paraple Center can also help you with this, offering the possibility of individual and group exercise programs as well as psychosocial support, for example.
Come to it
Women who engage in regular physical activity during menopause usually confirm lighter subjective unpleasant symptoms of the transition, sometimes even their complete disappearance.
The benefit of physiotherapy and physical activity
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A physiotherapist can help evaluate a woman's movement potential and help choose a movement activity that will be suitable, healthily well chosen and targeted.
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Exercise has a positive effect on all organ systems of the body, reduces the perception of pain and produces healthy body fatigue, which can prevent sleep problems.
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During physical exercise, endorphins are released, which contribute to the reduction of pain and promote the creation of pleasant feelings in the body.
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In simple terms, it can also be said that exercise distracts attention from anxious self-observation.
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Shaping the body during regular physical exercise also has a positive effect on self-confidence.
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Relaxation exercises can induce and improve overall relaxation of the body and mind improve the balance of all functional systems in the body.
Resources:
Kolář, P.: Rehabilitation in clinical practice, Galén, 2012.
Kříž, J., et al.: Spinal cord injury, Galén, 2019.
Menopause as a period of great changes
TEXT: Sylvie Dundáčková, head of the movement therapy section of the Paraple Center
I perceive the period of menopause as a big change both in the physical sense and especially in the sense of the perception of femininity. I see it as an opportunity to work with energy that will go inside the woman herself and become her source. I also associate wisdom, knowledge and kindness with this theme.
It is said that a woman's perspective on this process will greatly influence how her menopause will proceed. Although menopause is a time of great change, it is also a unique opportunity to take stock of your life so far and explore new avenues that can lead to improved health and overall well-being during and after menopause.
It is certainly good to look for ways to concentrate. For example, using gentle exercise, yoga, aromatic massages. It is extremely important to maintain bone density, both during and after menopause. And even though bone mass and density will decrease naturally, it is possible to focus on strengthening exercises or proper nutrition, both of which help keep bones healthy.
YOGA AND YOGA KIT FOR THE MENOPAUSE PERIOD
Regular yoga and its supportive and strengthening poses help increase the flexibility of joints and tissues. They can also help improve the unwanted side effects of menopause – from fatigue to anxiety to insomnia.
The set of positions I present to you here focuses on grounding and calming ones (sitting and lying down). I also included positions in which slight rotation of the spine is performed for better digestion and relaxation of the lower abdomen.
I would like to thank Lucia Muller very much for documenting this assembly together.
What you need to exercise
For this set you need a mat, a blanket, a belt, notepads (or maybe books) and a chair. The goal of the exercise is pleasant relaxation, calming, gentle activation and stretching. Last but not least, strengthening the bones and harmonizing the body and mind.
How the exercise goes
The assembly is only done on one side in the attached photos. When you get to the end of it, you can go directly to the other side. We start with sitting positions, then the set continues to lying positions. It's best to follow the order of the positions I list. However, specific positions can also be performed individually. Move between poses slowly and consciously. Find the level of effort that is just "just right" for you. Reach a position where you feel the stretch and hold for a moment. Use your breath and, thanks to it, progress through the individual positions safely and effectively in a deeper and more relaxed manner. Be sensitive to your body. If you feel pain or discomfort, go back a little or find a position so that these feelings disappear.
Position #1
Relaxed sitting with palms together in front of the body
We try to find a free seat. Straighten the entire spine upwards, release the shoulder joints and shoulder blades downwards. We bring attention to our breath. We try to be present in our thoughts. We can mentally conclude what happened on this day, what happened to us. After that, we can tell ourselves that we will be present as much as possible within this lineup. When we feel ready, we can bring our hands together in front of our chest for a short moment. If this is not possible, we leave the palms pointing upwards on the lower limbs.
Position #2
Raised hands in the mountain - Urdhva Hastasana
With an inhale, we bring the joined palms towards the head (if this is a more acceptable option for us) or we bring them all the way above the head. We make sure that there is no bending in the lumbar and also in the thoracic spine. In the area of the thoracic spine, the first three ribs in particular open upwards, below their level the lower ribs close downwards, as if they wanted to "look" at the navel area. With exhalation, we loosen the shoulder joints downwards and try to "root" the seat bones downwards into the mat or seat cushion. The gaze may be directed upwards towards the outstretched upper limbs. If the cervical spine starts to hurt, it is possible to lower the head or look forward.
We stay in the position for three to five inhalations and exhalations.
Position #3
Full Forward Bend – Uttanasana
With exhalation, we move into a forward bend. We can choose a gentler version of this pose with our forearms resting on our thighs, in which we can use a yoga bolster if we have one available. But we can also replace it with a pillow on which we lean. Or we can try a variant of full forward bending, during which we rest our chest on our lower limbs and place our palms on the footrests or on the ground. With each exhalation, we try to relax the upper half of the body, including the head and cervical spine.
We stay in the position for three to five inhalations and exhalations.
Position #4
Half Forward Bend – Ardha Uttansasna
To straighten up, we use the support of the forearms on a bolster (pillow) or push off from the palms. We push the area of the pelvis and sit bones in the opposite direction and down. With a breath, we straighten the spine upwards, as if we want to pull ourselves up behind the head.
We stay in the position for three to five inhalations and exhalations.
Position #5
Pulling the right knee to the chest
With a breath, we pull the knee towards the chest or as far as the body will let us go. Then we exhale. With another breath, we straighten the spine and gently pull ourselves upwards. We stay in the position for three to five inhalations and exhalations. Then we lower and place the right lower limb back down and return to the basic position.
Position #6
Relaxed sitting with joined palms
We join our palms and rest them on our chest. The view is forward.
We stay in the position for three to five inhalations and exhalations. We try to be present with our breath. The pose serves to bring attention to our body and breath.
Position #7
Spinal rotation
Option number one is very subtle. We start the position by straightening the spine upwards with an inhale and turning the body to the right with an exhale. Then we try to place the right hand to the area of the right hip or to the back.
Option number two offers the possibility of a deeper rotation. In the position, we have joined palms and bent elbow joints. We rest our left elbow behind the right knee joint and push ourselves towards the right and back from it.
The third variant is more demanding on stability. It is possible to place a notepad or a book on the ground under your feet. Then we place the left palm on a pad or book and rotate the torso upwards and to the right. We pull the right arm upwards.
In all variants of this position, we stay for five inhalations and exhalations.
Position No. 8
Neutralization of the spine - straightening forward
In a gentler version, we place the forearm on the thighs or on a pillow/bolster. Then we push ourselves away from the lower limbs with our forearms and straighten the spine forward. The goal is to pull up behind the head. On the other hand, we lean the sit bones and pelvic area downwards and backwards. As if we were trying to take root in the mat, chair or cushion.
We stay in the position for three to five inhalations and exhalations.
In the second variant, we hold the frame of the cart behind the body. We pull the shoulder joints down from the ears and then try to straighten the spine and "grow" forward.
We stay in the position for three to five inhalations and exhalations.
Position No. 9
Different variations of forward bending
In a gentler version, we prepare a chair opposite each other. Place a bolster, pillow or blanket on it. Then we place our body on a chair and lean our forehead downwards so that the upper half of the body gets space for complete relaxation. We put our hands together behind our heads.
We stay for ten breaths.
If we don't have a chair, or this version is too demanding, we prepare a bolster, blanket or pillow for the lower limbs and rest our torso there (downward direction).
In the third variant, we intertwine the palms behind the body and then lead the body into a forward bend, the joined palms and the entire arms are lowered behind the head towards the extension. Our abdominal area rests on our lower limbs. This opens up the area of the shoulder joints and chest.
We stay for five inhalations and exhalations.
Position No. 10
Shavasana
At the end, we await the resting position of Šavasana. Before we engage it, we should practice the set on the other side as well, so that our body is in balance.
In this position we find final rest. We no longer have to focus on our breath. We try to relax individual parts of the body. We can cover our heads with a blanket, cover ourselves. We also have the option to play relaxing music or light a candle.
We stay for three to five minutes, but we can easily stay longer. After Savasana, we just straighten up, we can join the palms in front of the body and express thanks. Maybe for the fact that we made time for each other.
Continuation of the assembly on the mat on the ground
After position number nine, it is possible to move from sitting to the floor to the mat. The mat should be softer, it is possible to put a blanket on it. The goal of other positions is to stretch the lower limbs and rotate the spine. The set is again finished with Savasana, but this time lying down.
Position No. 11
Janu Sirsasana
The right lower limb is stretched, the left one is bent at the knee joint and its foot rests on the inner side of the right thigh. If we have the opportunity, I recommend supporting the bent left knee with a blanket, for example, so that it does not hang in the air. Then we bend the torso forward.
Again, I offer two options. During the first one, we can remain in a forward bend with a straightened spine on outstretched palms and with each exhalation we can get a little bit lower. We perceive signals from the body, it will manifest itself a little differently for everyone. In general, we continue forward bending until the first sensation of a pull, never going into pain.
In the second variant, we can place a block or pillow next to the right knee joint and remain in the position passively and relaxed. We are trying to get the left shoulder joint to the right knee joint. Thanks to this, we get our torso directly above the outstretched lower limb.
In both variants, we stay for ten inhalations and exhalations.
Position No. 12
Cross-legged seat
We go to the cross-legged sit. We will prepare a bolster, a pillow and a blanket. We put them in front of our body so that we can lie on them and rest our forehead or face. This will allow you to stay relaxed and passive in the position.
We stay for ten breaths.
Position No. 13
Cobra – Bhujangasana
The starting position is lying on your stomach, when you rest your forearms firmly on the mat and pull your shoulder joints back and down. We try to straighten the spine, including the cervical spine. We make sure that the head does not tilt. Then we push off from the forearms and pull up behind the head. In the same way, we lean in the area of the abdomen and pelvis downwards into the mat.
We stay for five inhalations and exhalations.
Option number two is more subtle and will allow us to remain in the position at least partially passively. We can place a blanket, pillow or bolster under the chest. We place our forearms behind the pad and try to pad the head as much as possible to stretch the cervical spine. We can use books or notepads for this lining.
We stay for ten breaths.
Position No. 14
Rotation lying on the back
In this position, let's be very receptive to ourselves and listen to what our body is saying. We will prepare a bolster, pillow or blanket for the right side. The right lower limb is stretched. We bend the left lower limb and place it on the right side of the body on the prepared aid at the level of the hip joints or as high as the body will let us. We spread our arms to the sides. The head can be turned to the left against the direction of rotation. If we feel a pull, we choose the variant in which our gaze is directed upwards.
We stay for ten breaths.
Position No. 15
Fish
We remain in the position of lying on our backs, but we prepare tools to hand. We place our palms under the ischial bone, if it is comfortable. Or we leave them next to the body and just support the shoulder blades with a blanket so that the head goes into a very slight tilt.
In the second variant, we lift the chest upwards. It is good to place the head a little higher on the blanket, so that the chest and shoulder joints are more open.
We stay for five inhalations and exhalations.
Position No. 16
Shavasana
The final position of Savasana is lying on your back. To make it as comfortable as possible, I recommend covering your head with a blanket and placing a bolster or pillow under your knee joints. Thanks to this, our body will be beautifully relaxed. We can put the palms further away from the body.
We stay for three to five minutes or longer, depending on taste and time options.
A technique for mental well-being and the present moment - body scanning
Let's take a moment to express gratitude for the miracle of our bodies. Let's turn our attention to our body, which we might otherwise take for granted. This scan helps us focus on the present moment. We will connect with all parts of our body by giving each one our attention in turn. Let's sit comfortably, or let's make our seat even more comfortable. We're getting started.
- Let's pay attention to our breath, where the breath leads the movement of the body.
- When we feel present and pleasantly breathless, let's start thinking about our nose and mouth. Let's appreciate all the functions they perform throughout the day. The fact that thanks to them we can smell, perceive smells and breathe.
- Let's slowly shift our attention to the eyes and ears. We think about how important they are to us every day of our lives. They allow us to hear and see everything beautiful.
- Let us think with gratitude of our arms, hands, legs and feet. Then let's shift our attention to the chest and abdominal area and direct loving feelings there.
- Let's put our hands on our hearts. Let's just listen to the beating of our hearts for a moment. Then we express our thanks for its excellence and what it does for us.
- Finally, imagine our appreciation and gratitude flowing into every part of our unique body. Let's slowly begin to bring our attention back to our breath. When we are ready, let's begin to slowly open our eyes.
How to take care of yourself
The following tips can serve as inspiration and as a guide to a holistic approach to yourself. If anything recommended works for you, try to include it regularly. Habits are formed after three weeks of regular repetition, so persevere and look forward to the results.
- Get enough rest.
- Slow down your current pace - look more within yourself.
- Regularly include physical activity (exercise at home, drives or walks in nature, yoga).
- Bring attention to your breath.
- In case of frequent hot flushes, drink boiled rice water.
Try to understand what is different in your body and what it needs. Get to know him. Try to be and live in harmony with your feelings and needs. Try to realize what would help you feel good during this period. Slow down and turn more to yourself and your inner self. Get enough rest. Include regular movement in any form. Maybe you go for a ride or a walk, maybe you do a short yoga set, or maybe something else entirely.
Herbs for mature women
TEXT: Petra Hloušková, general nurse of the Paraple Center, Iva Leszkowová, external general nurse of the Paraple Center
Climacterium, menopause, climax, transition. So many names for the same condition. Climacterium is a natural period and it happens to every woman once. It causes a decrease in the level of estrogen, which can be accompanied by a number of problems that reduce the quality of life.
There are more ways to solve these problems. If you do not want to use hormone replacement (hormone replacement) or if it is not suitable for you or if your problems associated with menopause are not so significant, you can again turn to nature for help. Some plants contain substances collectively called phytoestrogens. They are divided into four groups: isoflavones, coumestans, lignans and stilbenes. Phytoestrogens are structurally similar to the female sex hormones estrogens. They are plant substances of diverse chemical nature that induce estrogenic effects of varying strength. Recently, significant attention has been paid to clover and soybeans.
If your problems do not improve, do not be afraid to consult your general practitioner or gynecologist.
Now let's look at some plants that can help with certain symptoms associated with menopause.
Meadow clover ( Trifolium pratense )
Also called red. It occurs naturally throughout Europe. It is a perennial 10-40 cm tall plant. It can be found in dry meadows, pastures, roadsides and fields. It is often sown for feeding. It blooms between May and October. The flowers are reddish heads. As a drug (a medicinal plant, its organ, or a product modified, most often by drying, for use in pharmacy and medicine), the heads are collected at the time of flowering.
Clover tea
For tea, two spoons of the dried flower are poured over half a liter of boiling water. Let stand for five minutes. Drink the tea warm, in the amount of two to three cups a day.
Legume soybean ( Glycine max )
Soy is considered one of the oldest cultivated crops. It is a legume with a high protein content, the seeds contain up to 38% of them. The plant can grow up to 1.5 meters tall.
Alchemilla vulgaris ( Alchemilla vulgaris )
Popularly called a woman's mantle, because of the characteristic shape of the leaves resembling a skirt. It is most often found in wetter meadows and pastures. It is a perennial plant growing up to a height of 50 cm.
Kontrihel tea
For tea, use two parts of yarrow, one part of yarrow and one part of calendula. Pour two tablespoons of the mixture with half a liter of boiling water and let it infuse. Drink a cup in the morning and evening.
Antiperspirant tea mixture
Prepare a mixture of two parts sage, one part horsetail and one part horsetail. Pour two tablespoons of the mixture with half a liter of boiling water and let it infuse. Drink only for a limited period of two to three weeks.
Racemosa ( Cimicifuga racemosa )
The bed bug is found in the northern regions of North America. It grows in moist and shady places. It can grow over two meters tall. It has striking white downy flowers. Its rhizomes and roots are used.
Plantain extract suppresses the symptoms of menopause, such as hot flushes, dizziness, palpitations, neurovegetative changes or mood swings. 0.3-2.0 ml of the extract is used for problems.
A decoction can also be prepared from the dry roots by boiling for five to ten minutes.
In the pharmacy, there are a number of freely available natural preparations that help with the unpleasant symptoms of the climacteric. The mentioned plants are contained in them individually or in mixtures.
However, do not forget that herbs and other plants are not a panacea. Support the body with a healthy lifestyle. It includes exercise, a natural diet with enough vitamins, minerals and phytoestrogens. You can find them, for example, in soy products, whole grain products, peas, beans, lentils, apples, carrots, cherries, dates, garlic and flaxseed. Among other things, flaxseed also helps with constipation. They also contain sunflower seeds, poppy seeds, walnuts, cabbage, cauliflower or hop cones.
As we have already said in previous articles, even the use of herbs is not completely without risk. If you are taking medication or have been treated for any disease, consult your general practitioner or gynecologist before starting to use plant and herbal products. For example, St. John's wort, used as an antidepressant or for climacteric problems, reduces the effect of many drugs. These include blood clotting drugs, immunosuppressants, hormonal contraceptives, antiepileptics, etc. On the contrary, it can increase the effect of some antidepressants. When using soy, it is recommended that women who take medication to supplement thyroid hormones (e.g. Euthyrox) leave a gap of at least two hours between the medication and the consumption of soy. Soy can also slow the absorption of iron and reduce the effect of warfarin. Women taking tamoxifen (a drug used for breast cancer) and warfarin should also avoid red clover.
Resources:
Phytoestrogen. Wikipedia [online]. [feeling. 2022-03-13]. Available from: https://cs.wikipedia.org/wiki/Phytoestrogen
MALEČKOVÁ, Radka. The flatworm helps women during the climacteric period. Lékárna.cz [online]. 2017 [cit. 2022-03-13]. Available from: https://www.lekarna.cz/clanek/plosticnik/
RESLOVA, Taťana. Menopause - treatment of problems. Medicine for practice [online]. 2012, (9), 445-450 [cit. 2022-03-13]. Available from: https://www.medicinapropraxi.cz/artkey/med-201211-0007_Menopauza-lecba_potizi.php?back=%2Fsearch.php%3Fquery%3Dmenopauza%26sfrom%3D0%26spage%3D30
VOSÁTKA, Jan, Barbora VAŇKOVÁ, Simona DVOŘÁČKOVÁ and Josef MALÝ. Medicinal preparations and dietary supplements affecting unwanted symptoms of menopause. Practical pharmacy [on-line]. 2018, (14), 162-169 [cit. 2022-03-13]. Available from: doi:10.36290/lek.2018.031
KAŠPAROVA, Marie. Phytoestrogens from clover. Practical pharmacy [on-line]. 2013, (9), 201–203 [cit. 2022-03-13]. Available from: https://www.praktickelekarenstvi.cz/pdfs/lek/2013/04/11.pdf
KOSTIUK, Pavel. St. John's wort - an antidepressant with many interactions. Edukafarm [online]. 2007 [cit. 2022-03-13]. Available from: http://www.edukafarm.cz/c657-trezalka-antidepresivum-s-mnoha-interakcemi
Legume soybeans. National Agricultural Museum [online]. [feeling. 2022-03-13]. Available from: https://www.nzm.cz/co-roste-na-poli/soja-lustinata
HERMANN, Francis. 100 Czech medicinal plants . Prague: PLOT, 2007. ISBN 978-80-86523-81-1.
DUGAS, Dionysus. Our best herbs . Prague: Ottovo nakladatelství, 2015. ISBN 978-80-7451-477-7.
My story
ET, 60 years old
I would like to share with you my unpleasant experience that happened to me several years after the accident and spinal cord damage, more precisely in the last four years of living in a wheelchair. Just after the accident, when I was 48 years old, I completed menopause, i.e. a change in the level of hormones that are also responsible for the metabolism of calcium in the body. I was aware that I was a high-risk patient and that I had many prerequisites for osteoporosis (thinning of the bones) to manifest itself. I tried to move and exercise as much as I could, I watched my diet, I regularly went outside in the sun. The warning sign was a rib fracture that occurred without significant violence. I therefore made an appointment for a densitometric examination (special X-ray examination of bones) and a doctor who deals with metabolic disorders and osteology. Despite my best efforts, I was diagnosed with osteoporosis!
This news initially paralyzed me so that I was afraid of any uncoordinated movement, fall or strong pressure. I was afraid of the slightest injury. I gradually calmed down because I was offered a certain solution. I was advised to limit more active sports. Subsequently, the doctor determined how to proceed further. I have to use it once every six months a specific drug (PROLIA), which I apply in injectable form and take calcium and vitamin D daily. I also occasionally add dietary supplements – collagen and hyaluronic acid and vitamin K 2 . I consume foods that contain enough important substances beneficial for bone building. At my last medical check-up, I received the gratifying news that the quality of my bones had improved. However, it is said that there will be no complete cure, only fifty percent prevention of fractures. But it is important for me that my condition does not get worse.
I am still interested in this disease, I read various articles (e.g. Meduňka magazine, 2018/4), I search for information on the Internet. I learned that osteoporosis is currently underestimated by many doctors, even though it can have quite serious consequences. It is very difficult to diagnose, one of its signs is a decrease in a person's height by up to six centimeters and a so-called round back. Of course, this disease also affects men in a smaller percentage. It is one of the most common diseases of civilization. The most important factors that can influence the development of osteoporosis are lifestyle, lack of exercise, diet, lack of sunlight, long-term use of certain drugs (e.g. corticoids, antidepressants), changes in hormone levels (menopause), repeated inflammation, digestive disorders, smoking etc. Sufficient exercise contributes significantly to the prevention of osteoporosis, and the Paraple Center certainly knows how to do that. Hormonal yoga is also an option for preventive exercise.
The good news is that there are now effective treatments for osteoporosis. But it is still true that much more important is prevention and the interest of each individual in his health.
In the Czech Republic, there is a patient organization League against Osteoporosis, which based in Prague and chaired by Věra Hrušková. The goal of the organization is to contribute to a higher awareness of this disease and to share one's own experience.
My story
LM, 51 years old
My name is Lucka and I am fifty-one years old. In April 2021, I had an accident, falling from a height while paragliding. I am now a paraparetic with cauda syndrome. During my rehabilitation stay in Parapleti, I met the amazing Sylva Dundáčková, who brought me back to practicing yoga. And since I've already gone through menopause, or rather I'm still going through it, she asked me to share my perspective on this part of life.
Transition or menopause. You know about it, but you don't pay attention to it until you start having symptoms. When I started to notice the first symptoms, such as hot flashes, irregular cycle, longer periods, heavier bleeding and more irritability, my husband noticed it even more. Suddenly there was a shock - does this mean I'm old now? But I didn't feel that way and I didn't mean to feel that way.
Because I am a migraine sufferer, I did not want support with hormones, so I tried various natural medicines, various nutritional supplements ( extracts from plantain, St. John's wort, vitamin D 3 , B vitamins, calcium, magnesium, zinc and a combination of enzymes with plant extracts). Although the symptoms were alleviated by use, the internal unpleasant feeling remained.
At a time when the children no longer needed our constant attention, on the contrary, my husband and I started paragliding, riding bicycles and motorcycles. The goal was our journey together and getting to know beautiful places. We just had a great time.
Then came an accident and it hit me again. Old and even less mobile. Perhaps the only advantage is that I no longer menstruate and do not have migraine attacks. And even other symptoms such as hot flashes and mood swings are starting to disappear, but unfortunately others have started to appear - osteoporosis and a change in figure. Now what?
My decision and thus my recommendation is to accept menopause as a natural part of your life. I have to realize that pleasant feelings and a sense of happiness depend on me alone. Despite all the troubles, I have a beautiful life, a reliable and wonderful partner, loving children, I met and still meet interesting and wonderful people, I practice yoga and start trying new things - monoski, handbike, tricycle and diving.
That is why she has experience and her advice to every woman in this period is to start filling her life with activities she enjoys, to try something completely new. I am convinced that with this approach to life, we women will not only significantly slow down aging and avoid emotional slumps, but that we will start a completely new stage of our lives.
HL, 66 years old
I never talk much at the hairdresser, but the hairdresser told me her stories. How she had to change all her clothes at night because she sweated during the night rushes, how nervous she was, her moods changed...
The gynecologist adjusted my menstrual cycle using hormonal treatment. I also ate very well, mainly Mediterranean cuisine in the summer, lots of fish, fruit, vegetables, and Czech cuisine in the winter. I was fine.
The change came when my dad got sick. His stroke, the paralysis, the hospital, taking care of him all took a toll on me. In half a year he went to heaven and my body responded. The gynecologist had to stop the hormonal treatment, because the cause of his death was cardiovascular disease of the blood vessels, so there was a hereditary burden. So he put me on phytoestrogens as a response to very long bleeding. Clover and hop extract, an Austrian remedy, worked best. I also lost a lot of weight. I have thyroid disease, T3 value is zero. The endocrinologist put me on euthyrox. Both drugs helped me significantly. The surges were mild, and I experienced them positively. I suffer from chills, so I warmed up, and low blood pressure, which leveled off. I wiped myself with a handkerchief and drove on. I attributed occasional heart palpitations, headaches or insomnia to work.
I was fifty-two years old when my cycle stopped. I took it on the bright side, as a new life stage. But I started gaining weight. The danger of cardiovascular diseases and increasing visceral fat drove me to the consultation room. After the blood analysis, I received a tailor-made menu. After some time I got to my dream weight. I was in great shape both mentally and physically. I didn't experience any problems even during intimate moments, no drying of the vagina, etc.
Another change occurred after an accident with a spinal cord injury, when the body from the waist down did not function as it should.
Spasticity of the lower limbs, anus, bladder and vagina, desiccation, atrophy,
gynecological inflammations, impossibility of normal intercourse, loss of orgasm. Everything was different. At first I am
she carried heavily because an organ that is not used becomes stunted. I knew that I didn't want to end my intimate life, and in addition, after the injury, I needed to train the muscles of the pelvic floor against spasticity. The gynecologist and the sexologist recommended medication and lubricants.
However, the lubricant acted like an anti-aphrodisiac on my partner. I tried to use it so he wouldn't notice, we extended the foreplay, but that didn't suit my partner. So we turned it around and I then indulged myself in the finale. I don't have an orgasm, but my partner is satisfied. He is not happy that nothing from "it".
I don't have it, so we try and keep looking. There are days when my appetite dwindles to zero. Especially when bleeding from the throat, even though I use lube. Friction is stronger than mucous. It hurts for the next fortnight and then I am treated by a gynecologist.
Another change came with the discontinuation of euthyrox by the endocrinologist and the recommendation to go for an examination called densitometry. Unfortunately, osteoporosis has proven itself.
Then came the covid period, everything slowed down, and I gained another ten kilograms. Even though I exercise, play sports and eat a balanced healthy diet, I can't turn visceral fat into muscle. My partner likes fuller shapes, I don't. I like to sin, so I'm not a picky eater yet. And I also got new medication, which gives me some hope.
The new life after menopause and after the injury makes me happy. I focused on versatile hobbies, sports, sophistication, the beauty of femininity and the art of relaxation.
Every woman is different and what works for everyone is different. But I think what helps everyone is healthy
lifestyle – movement, maintaining a healthy weight, trying not to get sick and having enough energy and joy in life.