1. BREEZE THROUGHMENOPAUSE WHILE DANCING! Dr.Maninder Ahuja Chairperson Mid Life Management committee of FOGSI President FOGS(Faridabad Obst&gyane society)Founder Secretary IMS Faridabad chapter(Past) chairperson Public awareness committee of IMS Secretary General IMS Ahuja Hospital &Infertility Centre 526 sector 17 Faridabad

2. WOMAN IS THE PIVOT OF UNIVERSE! Woman is the axlearound whom thefamily, society nay!The whole universeis revolving .So herhealth is of utmostimportance at allstages of life moreso in Menopause.Dr.Maninder ahuja01/28/13 2 3. Why important? Life expectancy is increasing!!! Remember - in 1900 people wereconsidered old in their 40s; just 40years ago people seemed old in their60s; but today many do not feel old intheir 80s a phenomenon and we saynever feel old and remain walking tillthe final recall! From 30 yrs to 76 yearsDr.Maninder ahuja 01/28/13 3 4. Comparison of world widepostmenopausal women over the years 1990 2030World wise population 470nmillion 1.2 billionDeveloping countries40% 24%Developed countries 60% 76% DR.MANINDER AHUJA 01/28/134 5. QUALITY OF LIFE IS IMPORTANT In these Golden Years she wants to have herown identity!AAJ PHIR JEENE KI TAMMANNAHAI , AAJ KUCH KARNE KA IRADA HAI!!!!!!!Dr.Maninder ahuja01/28/135 6. FIT AT FORTY , STRONG AT SIXTYAND INDEPENDENT ATEIGHTY !!Dr.Maninder ahuja 01/28/13 6 7. WHAT IS MID LIFE CRISIS INTERFERING WITH QOL Weight gain Metabolic syndromesVasomotor symptoms Mood changes Increased risk of CHD Hot flushes Hypertension Depression Diabetes. Sleep disturbancesMusculoskeletalUrogenital symptoms Sarcopenia Dryness of vagina Dysuria Osteoporosis Frequency of urine, Late sequelae Incontinence Alzheimer sexual problems Dr.Maninder ahuja 01/28/13 7 8. Which one is Quality life?Dr.Maninder ahuja 01/28/13 8 9. Bhagwati oza 72 !this is QOL Age and sex are nodeterrent At 70, she cycles 30kmfor a swim.Amountaineer whotrained under TenzingNorgay, a qualifiedpilot and a doctor,Bhagwati Oza, who isset to represent Indiain an internationalswimming meet, saysshe lives to make herlife worthwhiledr.maninder ahuja01/28/139 10. My role is motivation!! Initially only tools man hadwas his own hands In this mechanised worldthe only muscles we areusing are our fingers forvarious controls. The only weight we arecarrying is our own bodyweight. In all, a sedentary lifestyleaccounts for some 250,000premature deaths annually Dr.Maninder ahuja01/28/13 10 11. A SMALLA small truth to make life100% TRUTH TOWhat isand enjoyable! 100%making life MAKE LIFE 100%Dr.Maninder ahuja 01/28/13 11 12. Dr.Maninder ahuja 01/28/13 12 13. Hard Work H+A+R+D+W+O+R+K8+1+18+4+23+15+18+11 = 98%Knowledge K+N+O+W+L+E+D+G+E11+14+15+23+12+5+4+7+5 = 96%Dr.Maninder ahuja 01/28/13 13 14. Love L+O+V+E 12+15+22+5 = 54% Luck L+U+C+K 12+21+3+11 = 47%( dont most of us think this is the most important ??? ) Dr.Maninder ahuja 01/28/13 14 15. Then what makes 100% ? Is it Money ? ... NO ! ! ! M+O+N+E+Y 13+15+14+5+25 = 72%Leadership ? ... NO ! ! ! L+E+A+D+E+R+S+H+I+P12+5+1+4+5+18+19+9+16 = 89% Dr.Maninder ahuja 01/28/13 15 16. ATTITUDE A+T+T+I+T+U+D+E1+20+20+9+20+21+4+5 = 100% It is OUR ATTITUDE towardsLife and Work that makes OUR Life 100% ! ! !Dr.Maninder ahuja 01/28/13 16 17. Every problem has a solution,only if we perhaps change our attitude.We cant help you if you donthave positive attitude !what we really need to go further... a bit more... Dr.Maninder ahuja01/28/13 17 18. Change Your Attitude And You Change Your Life ! ! ! Dr.Maninder ahuja 01/28/13 18 19. "Happiness keeps you Sweet,Trials keep you Strong,Sorrow keeps you Human,Failure keeps you humble and Successkeeps you glowing, but onlyFaith & Attitude Keep you going... Dr.Maninder ahuja 01/28/1319 20. Live A Life That Matters 21. Living a life that matters doesnt happen byaccident. Its not a matter of circumstance butof choice.Choose to live a life that matters!!! 22. MENOPAUSE AND DETRIMANTSOF QUALITY OF LIFE The researchers conclude thatstrategies that may help to improve thequality of life of postmenopausalwomen: Positive attitudes toward aging. Encourage a healthy lifestyle 23. Don,t limit Laughing to morning only!Dr.Maninder ahuja 01/28/13 30 24. Keep only cheerfulfriends.The grouchespull you down. 25. Never let the brain idle. "An idle mind is thedevils workshop".And the devilsname Alzheimers. 26. Enjoy the simple things. Laugh often, long and loud. Laughuntil you gasp for breath. The tears happen. Endure, grieve, and move on. The onlyperson, who is with us our entire life, isourselves. 27. Be ALIVE while you are alive. Surround yourself with what you love , whether its family, pets, keepsakes,music, plants, hobbies, whatever. Your home is you refuge. 28. Cherish your health: If it is good, preserve it. If it is unstable, improve it. If it is beyond what you can improve,get help. 29. Dont take guilt trips. Take a trip to the mall, even to thenext county; to a foreign country but NOT to where the guilt is. 30. Major domains of QOL Being Belonging BecomingDr.Maninder ahuja 01/28/13 37 31. Being this would help you to breezethrough menopause ( Health PLUS Forum)Physical Being includes aspects of Physical health, personal hygiene, Nutrition, Exercise, Grooming, clothing, and physical appearance.Psychological Being includes the personspsychological health and evaluations concerningthe self, and self-control.Spiritual Being reflects personal values, personalstandards of conduct, and spiritual. beliefs whichmay or may not be associated with organizedreligionsDr.Maninder ahuja01/28/1338 32. WHEN TO START LIFE STYLE MODIFICATIONS? AT THIRTY FIVE PLUS OR MID THIRTIESdr.maninder ahuja01/28/13 39 33. Bone mass with age 34. What happens in mid thirties ! 35 yrs onwards you lose bone mass at 0.5 to 1% per yr(initial quality Imp) Around menopause loss is upto 4-5 % per year You also lose muscle mass from 35 years onwardsvitamin D receptor, estrogen receptor, transforming growth factor, interleukin-6,interleukin-1 receptor 2, type I collagen genes, and collagenases are for genetic causes 35. WHAT ARE LIFE STYLEMODIFICATIONS? ATTITUDE CHANGE DIET EXERCISE CALCIUM VIT D OR SUN EXPOSURE Alcohol NOT MORE THAN30 ml/day No smoking neither active nor passive Meditationdr.maninder ahuja01/28/13 42 36. Components of fitnessExercise is designed to improve the fivekey components of physical fitness: Body composition Cardio-respiratory endurance, Muscle strength Muscle endurance, Flexibility .Dr.Maninder ahuja 01/28/13 45 37. Other advantages Mood elevation Sexuality Decreased incidence of estrogendependent cancers Osteo arthritis Balance Fall prevention 38. Weight loss Is it a losing battle?Dr.Maninder ahuja 01/28/13 47 39. MOTIVATION!Dr.Maninder ahuja01/28/13 48 40. WEIGHT LOSS BY CALORIERESTRICTION IS BIG NO! AS YOU LOSEMUSCLE ALONGWITH FAT MUSCLES ARE NO!!!!!!!!!!!RESPONSIBLE FOR20% OF YOURESTING ENERGYEXPENDITUREDr.Maninder ahuja01/28/13 49 41. Cause for weight gain Your metabolism slows by 5 percenteach decade. Compared to age 25, youll burn about100 fewer calories a day at 35 and 200fewer at 45. Do nothing, and you could gain eightto 12 pounds a year. 42. Fat burns less cakories The metabolic difference between apound of muscle and a pound of fat isdramatic: Muscle burns at least threetimes more calories. A woman whoweighs 130 pounds and has a healthy25 percent body fat will burn about 200more calories per day than a 130-pound woman with about 40 percentbody fat a typical level for women atmidlife, 43. Important tricks women who skipped breakfast were 30percent more likely to be overweight. When things get extra-hectic, yourlevels of cortisol, a stress hormone,shoot up. Sleep deprivation increases theappetite-stimulating hormone, ghrelin,and decreases the satisfactionhormone, leptin,so meditation or walk 44. SARCOPENIA(MUSCLEWEAKNESS)By the age of 70, you only have about 50% to 55% of your muscle mass left Dr.Maninder ahuja 01/28/13 53 45. Weight control in elderly Caloric restriction, Exercise. Strength &Resistance trainingDr.Maninder ahuja 01/28/13 54 46. Ideal weight and WHR BMI of 18-23normal.(20-25 ) BMI of 23-28 isoverweight(25-30) BMI of over 28 isobesity(>30) BMI of over 35 ismorbid obesity BMI is Wt.in Kg /ht insqM Ideal WHR 0.8 Ht in cms-100 is wt in KgsDr.Maninder ahuja01/28/13 55 47. New factor neck thickness 1. Average neck 4. For every nearly-3 cmcircumferences were more of neck, men had 3.040.5cm in men and 34.2 cm mg/dl more blood glucosein women. levels. 2. For every nearly-3 cm 5. For every nearly-3 cmmore of neck, men had 2.2 more of neck, women hadmg/dl less good HDL 2.1 mg/dl more bloodcholesterol.glucose levels. 3. For every nearly-3 cmmore of neck, women had2.7 mg/dl less good HDLcholesterol. 48. implications 3. In patients with a BMI 35 1. 1% reduction in HDLkg/m2, measurement of waistcholesterol increases the circumference is less helpfulchances of heart attack bysince it adds little to thepredictive power of the disease3% and vice versa.risk classification of BMI; 2. In adults with a BMI ofalmost all individuals with this22.9 to 34.9 kg/m2, a waist BMI also have an abnormalcircumference greater thanwaist circumference.85 cm for men and 80 cm for 4. A neck circumference of >women is associated with a42.5 cm is also associated withgreater risk of snoring with sleep apnea andhypertension, type 2subsequent high blooddiabetes, and dyslipidemia, pressure.and heart disease. 49. Calculate caloriesbanking of calories!For maintananceFor losing weight Multiply your current weight To lose one pound aby an activity factorweek, subtract 500between 10-20. Use ahigher number (15 - 20) if from your maintenanceyou are younger, caloric levelmoderately overweight or of To lose two pounds aideal weight and moderateweek, subtract 1000to very active. The lessactive and more overweight calories from theyou are, the lower the maintenance levelnumber should be, (10-14). dr.maninder ahuja01/28/13 59 50. Types of exercises Aerobic like walking,swimming,cycling,dancing,taichi,yoga Stretching exercises like Pilatees,yoga Weight training & resistive exercises Mindful exercises like meditationDr.Maninder ahuja 01/28/1360 51. Benefits of resistance exercise builds lean mass which will speedmetabolism helps prevent osteoporosis 52. Resistance exercises are must! Resistance exercises causesincrease in muscle mass, decrease in fat increase in BMR . Evidence now indicatesthat one is never too old tobenefit from exercise; this istrue even for frailinstitutionalized women asold as 100 years our women were doingthem! Dr.Maninder ahuja 01/28/13 64 53. This is the way you would be losing height! 54. Exercise and sexuality For proper sexual function you needexercise, cardiorespiratory, strengthbuilding ,endurance and flexibility ofyoga. Sex is also an exericse burning about88 cal. / hr. Relaxation of mind is there and qualityof life and good interpersonalrelationships 55. Strength training in osteoarthritis After 12 Week Strength Training Balance improved by 55 % Muscle strength increased by 14% Flexibility improved by 17% Self-reported pain decreased by30% Tibial cartilage volumeincreased. dr.maninder ahuja01/28/1369 56. You need stamina for walking!Dr.Maninder ahuja01/28/13 70 57. INTENSITY OF EXERCISE Moderate to severe in intensity How to know about intensity MHR : 60-80 % of MHR and MHR is 220_ age in yrs. At 50 yrs 220-50 = 170 and60 % is 102-136 Borg test of SPE Talk testdr.maninder ahuja01/28/1371 58. PILATES Low impact non aerobicstretching and strengthingexercises reducing muscle tension reducing joint pain improving posture improving back strength improving coordination promoting relaxationimproving overall muscletoneDr.maninder ahuja faridabad 01/28/13 72 59. Exercises Resistance and weight bearingStretching exercises 60. Leg press for leg musclesdr.maninder ahuja 01/28/13 76 61. This is one way of doing lunges !!!!Breeze through life while dancing !!! 62. Every body loves dancing! 63. Sexuality is a major contributor forQOL Kegels exercises cant be ignored ! 64. Sharmila TagoreDr.Maninder ahuja 01/28/13 81 65. It is never too late!Dr.Maninder ahuja 01/28/13 82 66. Don,t be left behind! , , , , Dr.Maninder ahuja 01/28/13 83 67. If you want to be free and flying!Make the journey of life beautiful! Come and exercise ,change attitude ,eat properly!!!!You dont have to lose anything except your fat!http://indianwoman35plus.com/Dr.Maninder ahuja01/28/13 84 68. dr.maninder ahuja 01/28/13 85