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Post Menopause Women Tend To Grow Fat

enopause is associated with aging. As women age the metabolism decreases and they are unable to burn the calories that are consumed through the day doing nothing. Weight gain during menopause is a natural process of aging. The extra pounds that are gained every year with decreasing BMR, along with the extra calories during the mid-stage of their life can lead to obesity. Consequences of obesity are severe as it exposes the women to a risk of stroke, hypertension, sleep apnea, cancer, arthritis, mental health problems and various cardiovascular disorders.? If not controlled, over time it can give rise to serious issues and aggravate all the disorders (such as diabetes and hypertension) which can give rise to health problems. This can be fatal or cause irreversible damage. One of the most fatal diseases which are prevalent in this phase of a women’s life is heart disease. The rates of death due to heart failure are more common than breast cancer though it is preventable. More than two 60 % of American women are clinically overweight and women post menopauses are the more vulnerable. It also a known fact that women have a slower BMR than men and as they age, their BMR decrease further making them more prone to weight gain and getting obese. It has also been observed that post menopause; women gain the maximum weight around their abdomen. This could be due to the fact that

  • Women post child births already have a tendency to put on weight at the abdomen
  • Estrogen level decrease on reaching menopause. Due to this the fat distribution shifts and there is an increase in the androgen-estrogen ratio. Once the fat distribution changes, a women’s body is designed as such that the fat accumulation is more around waist and stomach, giving her a protruding tummy.
  • Most women undergo mood swings and experience severe depression. Due to this they end up overeating which leads to piling on of the calories.

This makes it important for the doctor to be aware of weight gain during the perimenopausal and postmenopausal years as they need to be counseled on weight loss strategies. Loosing weight and preventing weight gain during menopause is beneficial for women. The phenomenon of weight gain is natural, so it cannot be totally avoided by adapting a few healthy ways which can make a world of difference. This includes working out regularly, having a balanced diet and avoiding stress. A common issue that women face in menopause is that of a bladder dysfunction. Women usually experience urine inconsistency which causes dribbling of urine when they laugh, sneeze or lift heavy weights. Due to this doctor usually recommend pelvic exercises as this strengthens their pelvic muscles and help to control the inconsistence. Controlling weight post pregnancy also helps to delay the onset of other related medical disorders such as diabetes, osteoporosis, arthritis and hypertension. It’s also beneficial for the heart and helps to avoid fatalities like heart attacks and strokes. It’s not a difficult task, a slight shift in the lifestyle and avoiding stressful situations helps to keep the weight in check

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Causes Of Weight Gain

Losing weight has become a difficult or an almost impossible task for most of us while on the other hand gaining weight for a normal person goes without any effort. Most people think that they gain weight when they eat more than what they can burn off. This can be termed as the foremost reason for being overweight. In simple words, you gain weight when you eat more and do moderate or no form of exercise. However, this principle does not always hold true. You can gain weight due to various health problems like hypothyroidism, anxiety, organ disease, food sensitivity, blood sugar imbalance, and kidney, liver or hear disease. Weight gain is also associated with Cushing’s syndrome, which is a rare disorder resulting from abnormally greater levels of cortisol hormone in the blood. Body’s hormonal systems are impaired due to high levels of cortisol, this leads to various problems including weight gain. Sometimes, people suffering from this syndrome also face severe complications like osteoporosis, hypertension and diabetes. This syndrome is most common amongst young and middle age women. Reasons for Weight Gain: Almost each one of us is struggling to maintain weight. Several diets are prescribed to individuals who want to lose weight, but there seems to be a dearth of knowledge on how to maintain your ideal weight. This is because most individuals are unaware as to why they are overweight and what the reasons behind their gaining extra weight are. Listed below are some of the causes that lead to weight gain. The possible reasons that may lead to overweight are listed below.

  1. Simple reasons:

Some of the simple reasons that may lead to weight gain are listed below:

  • Overeating
  • Pregnancy
  • Aging
  • Recent childbirth
  • Appetite changes
  • High carbohydrate diet
  • High fat diet
  • Excessive snacking
  • Inactive lifestyle
  • Less exercise
  • Lifestyle changes that may lead to reduced activity or increased eating
  • Comfort eating
  • Stress
  • Depression
  • Compulsive eating
  • Unhealthy eating behavior
  • Medications like contraceptives

2. Diseases: People suffering from certain diseases tend to gain weight.

  • Hypothyroidism
  • Certain hormonal conditions
  • Acromegalia
  • Familial obesity
  • Obesity
  • Polycystic Ovary Syndrome (PCOS)
  • Depression
  • Hypoglycemia
  • Diabetes
  • Cushing’s syndrome
  • Emotional conditions
  • Psychological Disorder
  • Hypothalamus disorder
  • Brain tumor or trauma
  • Brain disorder

3. Psychological disorder: It has been noticed that people suffering from some kind of psychological disorder gain weight. Certain psychological disorders that may lead to gaining weight are:

  • Comfort eating
  • Depression-related eating
  • Anxiety-triggered eating
  • Reactive hyperphagia

4. Fluid retention: Weight gain is not necessarily due to fat retention, it has also been observed in case of fluid retention. Some of such conditions are mentioned below:

  • Premenstrual bloating
  • Edema
  • Nephrosis
  • Congestive heart failure
  • Heart failure
  • Cirrhosis of the liver
  • Kidney failure
  • Lymphatic obstruction
  • Excessive IV fluid

Conclusion: Listed above are the possible reasons through which you can gain weight. However, the most common reason for gaining weight is your diet. Your diet plays a key role when it comes to weight gain. If your diet includes a lot of calories and fats, especially from fast foods, you are bound to gain weight.? You are advised to consume a well-balanced diet that is rich in variety of vegetables and fruits, wholegrain and also lean meats like chicken. Besides, you should also pay heed to your physical activity. If you desire to lose weight, you have to incorporate exercise in your daily regime. Physical inactivity is the second biggest reason for gaining weight. Women especially tend to ignore exercise and hence accumulate extra body fat. By doing exercise, you not only stay away from being overweight you also actively reduce risk of developing certain diseases mainly cardiovascular diseases.

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Diagnosis of Impotency

The diagnosis is divided into the following parts

  1. Case History
  2. Physical Examination
  3. Lab Examination
    • Blood tests
      • CBC
      • Fasting blood glucose test
      • Liver function test (LFT)
    • Hormone tests
    • Thyroid function tests
    • Urine analysis
  4. Other Tests

    • Imaging Studies
      • Angiography-
      • Dynamic Infusion Cavernosometry and Cavernosography:
      • Duplex ultrasound
      • Penile nerve function-
      • Ultrasonography-
      • Penile brachial index-
  5. Erectile Function Test

    • Vasoactive injections
    • Nocturnal penile tumescence
    • Penile tumescence monitor
    • Biothesiometry

Diagnosis of impotency

1.? Case History :
This involves taking an in-depth account of the background of the patient including his life style along with medical, personal and sexual history.

  • Medical History – Diseases like hypertension, diabetes, coronary disorders, scleroderma, and liver cirrhosis can constitute the etiology of erectile dysfunction. It’s important to know if the patient is suffering from any of these.
  • Surgeries – If the patient has undergone any surgeries in the past, it’s important to have a look into it as the surgery may have caused nerve damage.
  • Sexual History – It’s important to analyze the sexual history, right from the onset of erectile dysfunction to the severity of the situation. Questions will include the circumstances, frequency and durations of erections, if any. Strain in the current relationship and history of past sex partners should also be looked into.
  • Trauma or Injury – Any fall, injury or accident should be reported as it can lead the physician to any nerve damage or blood vessel damage due to external trauma.

2. Physical examination:
A thorough examination of the venereal can reveal some of the causes if erectile dysfunction. The physician can detect peyronie’s disease, hypospodiasis, and hypogonadism. Digital examination of the rectum (inserting lubricated, gloved fingers in the orifice of female sexual organ to check for abnormalities) can help detect prostrate abnormalities. Prostate can also cause nerve damage or block the arteries.
3. Lab Examination:
Lab examinations are based on the case history. It is not necessary that every patient has to undergo these tests.

  • Blood tests
    • CBC – Complete blood test evaluates the level of lipids in the blood such as cholesterol, triglycerides which can lead to arteriosclerosis, which can lead to erectile dysfunction. Besides this it will also calculate red blood cells (RBC), white blood cells (WBC), total amount of hemoglobin in the blood, mean corpuscular volume (MCV), mean corpuscular volume (MCH), and mean corpuscular hemoglobin concentration (MCHC).
    • Fasting blood glucose test – This can help detect diabetes which can lead to erectile dysfunction.
    • Liver function test (LFT) – This involves examination of enzyme and serum creatinine levels. Live cirrhosis or impaired functioning can cause erectile dysfunction.
  • Hormone tests
    These tests are vital in cases where the patient is suffering from a diminished or absent libido, depression or signs of secondary sexual character (hypogonadism). In the morning, the hormone levels are the highest than any other time of the day. Hormone tests include measuring the morning serum testosterone levels which is a common endocrine cause.? A hormone test will give an estimate of

    • Sex hormone binding globulin (SHBG)
    • Estrogen-Etradiol (E2)
    • Total testosterone (T)-
    • Free Testosterone (T) or bioavailable testosterones are the ones that are getting used.
    • Dehydroepiandrosterone sulfate (DHEAS)
    • Dedydroepiandrosterone (DHEA)
    • Follicular stimulating (FSH)
    • Androstenedione
    • Luteinizing hormone (LH) – elevation of this hormone indicates that the pituitary gland is hyper functioning. The hypothalamus regulates the testosterone levels. High level of LH with low level of testosterones indicates primary testicular (Leydig cell) failure. Contrary to this, low testosterone level indicates a central defect.
  • Thyroid function tests
    Hyperthyroidism or hypothyroidism can cause erectile dysfunction. It’s important to determine that TSH is normal.
  • Urine analysis
    After collecting the urine, it is judged on the basis of its physical, microscopic and chemical appearance.

    • Physical appearance -This includes the color, clarity and its appearance to the naked eye.
    • Microscopic appearance – The urine is examined under a microscope to check the appearance of cells, foreign body, urine? crystals, mucus and presence of other microorganisms.
    • Chemical appearance – determined by a dipstick, this test determines the different substances present in the urine.

    This analysis helps to determine if there is kidney infection, diabetes mellitus and hypertension as presence of any of these diseases may lead to erectile dysfunction.? Post the completion if these lab tests, the physician should have a better picture about the status of the disorder, treatments and can suggest further tests, if required.

4. Other Test:
These tests are performed if the physician feels the need to study penile or pelvic blood flow, nocturnal erections and other blood tests.

  • Imaging Studies– this test is preformed in the case of trauma, accident or surgery, where there can be potential nerve and blood vessel injuries.
    • Angiography – This is performed in patients who have undergone vascular surgeries that have caused injury to some arteries or veins. These patients may require vascular reconstruction.
    • Dynamic Infusion Cavernosometry and Cavernosography -? This test helps to determine the penile vascular status in impotent patients. This test ascertains the arterial and/or venous insufficiency in the male sexual organ.
    • Duplex ultrasound – This test is used to evaluate the circulation of blood in the male sexual organ, venous leak, artherosclerosis and scarring or calcification of erectile tissues. Patients are injected with prostaglandin E1 (PGE1) to induce erection. A measurement of caversonal arteries within the corpora is taken. Through ultrasound, the vascular dilation is observed and the penile blood pressure measured. This is compared to the measurement of the male sexual organ in the flaccid state.
    • Penile nerve function – The bubocavernosus reflex test is used to determine the nerve sensation in the male sexual organ. The head of the male sexual organ is squeezed which results in the orifice of female sexual organ contracting under normal conditions. The latency between the squeezes is measured by inserting a gloved, lubricated finger in the orifice of female sexual organ.
    • Ultrasonography – This test helps to find any abnormalities in the testes and epididymides. Abnormalities in the prostate and the pelvis can be determined by transrectal unltrasonography.
    • Penile brachial index -This process involves measuring the blood pressure in the male sexual organ and that of the arm and comparing the two. This can help to detect obstruction in the arterial blood flow.

5. Erectile function test:

  • Vasoactive injections – Injecting certain chemical in the male reproductive organ can cause erection by vasodilatation (dilating the blood vessels). These injections can produce an erection that can last for 20 minutes. A special dye is injected in the blood stream and penile pressure and x-ray is measured.
  • Nocturnal penile tumescence – This test involves covering a special elastic band around the male sexual organmale reproductive organ for two three consecutive nights. This is especially useful in finding out if the cause is psychogenic or organic. If the male reproductive organ gets erect during rapid eye movement, the force and duration are noted on a graph. If the erection is absent or inadequate, it indicates an underlying physiological cause while presence of an erection suggests psychogenic cause.
  • Penile tumescence monitor – This is a special monitor that is used to measure the size of the erection. This monitor is placed near the base and at the corona of the male reproductive organ. Another device is connected that monitors the graph recording the force and duration of erections occurring during the sleep. This monitor is trapped to the leg. The patient has to undergo this test for several nights to get an accurate reading of the erections.
  • Biothesiometry – The vibration sensitivity of the male reproductive organ is detected by the means of biothesiometry. A small electromagnetic test probe is placed on the right and left sides of the shaft and the glans. The amplitude of the vibration is adjusted until the subjective sensory threshold is reached, which is indicated by the patient. The vibrational sensory threshold is determined on each location. This test helps to detect sensory failures which can lead to erectile dysfunction.
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Obesity Overview

Obesity is defined as having a body mass index (BMI) greater than 30. The BMI is a calculation of the body weight with that of the height is used to define underweight, overweight and obesity in individuals. After tobacco, obesity is rated as the second most common cause of preventable death in the U.S. The developing nations have also seen a rise in prevalence of this disease. With rich supply of food and physical labor being reduced due to high dependability on machines, obesity has taken the form of an epidemic. The medical field views obesity as chronic disease which occurs due to years of negligence of health and acts as the pioneer for many leading diseases. Body mass index, also known as the Quetlet index is calculated as weight/height2 where weight is in kilograms and height is in meters. These values are age independent for both the sexes.  WHO classification of obesity
Grade 1 – overweight is a BMI of 25-29.9 kg/m2
Grade 2 – obesity is a BMI of 30-39.9/m2
Grade 3 ‘ severe obesity is greater than or equal to 40 kg/m2   Studies suggest that fat distribution across the body affects the incidences of a concomitant but unrelated pathological or disease processes. A degenerated metabolic process resulting in android obesity could be due to high abdominal fat content including visceral and subcutaneous abdominal fat. Gynecoid obesity is due to heavy fat distribution on the gluteal region.   Though there are still debates over obesity being the cause of a host of concomitant disorder, medicos have observed an aggravation of the underlying pathological or diseased condition whenever a person has diagnosed with obesity.  
Pathophysiology
An increase in adipocytes is said to be the main cause of obesity. Adipocytes are cells that are specialized in synthesis and storage of fats. These cells serve the function of maintaining proper energy balance. They store all the calories in form of lipids and when stimulated they mobilize energy sources in response to hormonal stimulation.   The pathogenesis of obesity is multifaceted and stretches beyond the simple explanation of excess energy intake in comparison to decreased energy output. It been observed that children with obese parents tend to get obese, while in case of twins, mostly if one twin is obese the other one also tends to? be overweight directing the study to the fact that obesity could be genetic in predisposition .  
Etiology
The factors responsible for the development of obesity can be classified as  

  • Primary
  1. Metabolic factors
  2. Genetic factors
  3. Level of activity
  4. Behavior
  5. Endocrine factors
  6. Race, sex, and age factors
  7. Ethnic and cultural factors
  8. Socioeconomic status
  9. Dietary habits
  10. Smoking cessation
  11. Pregnancy and menopause
  12. Psychologic factors
  13. History of gestational diabetes
  14. Lactational history in mothers
  • Secondary
  1. Hypothyroidism
  2. Cushing syndrome
  3. Insulinoma
  4. Hypothalamic obesity
  5. Polycystic ovarian syndrome
  6. Genetic syndromes (eg, Prader-Willi syndrome, Alstr??m syndrome, Bardet-Biedl syndrome, Cohen syndrome, B??rjeson-Forssman-Lehmann syndrome, Fr??hlich syndrome)
  7. Growth hormone deficiency
  8. Oral contraceptive use
  9. Medication-related (eg, phenothiazines, sodium valproate, carbamazepine, tricyclic antidepressants, lithium, glucocorticoids, megestrol acetate, thiazolidinediones, sulphonylureas, insulin, adrenergic antagonists, serotonin antagonists [especially cyproheptadine])
  10. Eating disorders (especially binge-eating disorder, bulimia nervosa, night-eating disorder)
    Hypogonadism
  11. Pseudohypoparathyroidism
  12. Obesity related to tube feeding
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Myths and Facts Of Dieting for Weight Loss

Dieting is must for the weight loss, but how it should be done is very important. There are many misconceptions about the dieting for weight loss that along with the weight loss deteriorates the health of the individual very badly. IN some cases of dieting serious problems are noted to arise due to the improper or wrong knowledge about the dieting. So, here is the information about the myths and facts about dieting for weight loss:  
1. Myth: Culminate the intake of fats and carbohydrates completely
Fact: It is absolutely wrong to cut down the intake of the fats and carbohydrates. Remember that fats and carbohydrates are the essential nutrients for the body through which it produces the necessary amount of the energy required for various body processes. Yes, certainly you need to reduce the intake of the fats and carbohydrates, but stopping their intake completely would lead to the health problems.  
2. Myth: Skipping breakfast helps to lose weight
Fact: This is another prominent dieting myth that is observed commonly among the people who want to lose weight. The breakfast is essential as your urge of hunger is maximal at this time. If you quit breakfast then your digestive system would function improperly and would have the excessive acidic juices in stomach that would give rise to acidity. Never to skip the breakfast, either way you can reduce the amount you eat but to quit it is not recommended.  
3. Myth: Fruit juice is better than eating entire Fruit in a dieting process
Fact: Yes, fruit juice is good in dieting process, but not better than whole fruit. If you eat the whole fruit then you would get the better and faster weight loss results than that of the fruit juice. Even your overall health status would be improved as fruits contain the necessary amount of the nutrients that are present in juice too but in lesser amounts. Even the weight loss process is better augmented by eating raw fruits than drinking the juice of the fruit.  
4. Myth: Fasting makes you lose weight
Fact: Fasting is not good for the health. Stopping the intake of the food completely will have a lot of adverse impact on the health of the individual. Rather than a dieting tip this looks out to be a punishment for the person. The fasting may sometimes results into severe health problems instead of losing weight. It is completely restricted to do the fasting to lose weight. Please don’t do fasting even any dietician suggests it, but this would make it clear that this particular dietitian is not perfect for you.  
5. Myth: Stop the meat intake completely
Fact: Stopping the meat intake completely is not recommended as it rich source of the proteins, fats, and carbohydrates. Yes, you must not eat it regularly. It is recommended to eat it not more than once in a week. This way you would stay away from the adverse effect of eating meat. Also make it sure to eat it in a limited quantity so that your digestive system is not stressed out to digest it. So it is not necessary to give up the eating habit of meat completely as a pert of dieting.   The advice of the dietician and your family physician should be taken before you opt for any of the dieting procedure. The dietician may guide you best in making the perfect dieting plan. So, stick up the dieting plan and don’t follow any of myths about the dieting as they would help you to attain the weight loss.