dr.maninder ahuja chairperson geriatric gynaecology committe fogsi

Dr.maninder AhujaChairperson

Geriatric gynaecology committe FOGSI

Chairperson public awareness committee (IMS)

04/20/23 Dr.MANINDERAHUJA 1

Woman is the axle around whom the family, society nay! The whole universe is revolving .So her health is of utmost importance at all stages of life more so in Menopause

04/20/23 Dr.MANINDERAHUJA 2

Women have to spend more years in menopause as life expectancy is increasing from 26 yrs in Roman era to 65 yrs in India 80 yrs average world wide.

Average age of menopause is 46-52 yrs so they have to spend 1/3 of their life in menopause

More women are there in menopause and more problems are being recognised

No family ,social or state support system ,so they have to remain active.

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what is osteoporois?what is osteoporois?

Bone withOsteoporosis

NormalBone

Osteoporosis causes weak bones. In this common disease, bones lose strength . They become fragile and break easily. Fracture even on fall from standing height or silent vertebral fractures

Often called the “silent disease”

Bone loss occurs without

symptoms First sign may be

a fracture due to weakened bones

A sudden strain ,bendingor bump can break a bone

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The number of osteoporotic hip fractures has quadrupled in the past decade

1 out of 3 females in India suffers from osteoporosis, largest affected.

26 million with the numbers projected to increase to 36 million by 2013.(Osteoporosis Society of India (2003)

By 2050 1 out of 2 hip fractures would occur in Asia A woman’s risk of developing an osteoporosis-related hip

fracture is equal to her combined risk of developing breast  uterine and ovarian cancer.

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Osteoporotic Fracture1,200,000

Heart Attack513,000

Strokes228,000

BreastCancer 1,84,000

1 million

> 2.0 x

> 4.4 x

> 5.5 X

OSTEOPOROSIS IN WOMEN : CONCERN04/20/23 Dr.MANINDERAHUJA 7

NO OF FRACTURES IS MORE >

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“What will you do if you can’t drive?”

Osteoporosis robs you of your independence,

You can’t do anything

parlour

friends

doctorworship

shopping

“If somebody had told me sooner what I know now about osteoporosis, none of this might be happening to me!”

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HAD SOME BODY TOLD ME EARLIER!

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“Medications are expensive. But I can’t afford to let my condition get worse and this medicine will help stop or slow down the bone loss.”

Medicines ?cost?

Osteoporosis

Ispreventable

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Osteoporosis is for elderly women Fact is it can strike at any age

You’re never too young or old to improve bone health! So start at any age.

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By DXA SCAN

WHO CLASSIFICATION NORMAL A T-score

within 1 SD (+1 or -1) of the young adult

OSTEOPENIA A T-score of 1 to 2.5 SD below the young adult mean (-1 to - 2.5 SD)

OSTEOPOROSIS A T-score of 2.5 SD or more below the young adult mean (> - 2.5 SD)

It takes about 10 years for change of 1 SD

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For each standard deviation decrease in femoral neck BMD,there is an approximate 2.5-fold increased risk of hip fracture.

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wrist

spine

HIP

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Hip fractures account for 300,000 hospitalizations annually.Costs involved is very heavy in lacs for individual and in billions for the State

RISK OF DYING WIHTIN FIVE YEARS IS DOUBLEDYou may not be able to

walk again!!

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Most of time undiagnosed 500,000 spinal fractures,compression or wedge fractures,

Losing height .>2cms Back pain Kyphosis In extreme cases chest

compression Abdominal space reduced and

problems of eating and digestion

SILENT FRACTURES OF BACK BONES!

Dowager’s hump. Marked thoracickyphosis due tomultiple osteoporoticfractures in elderlywoman.

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200,000 broken wristsLimited movement Quality of life impaired

Calcium is deposited and withdrawn from bones daily.

Bones build to about age 30.

We need to build up a healthy bone account while young and continue to make deposits with age.

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After mid-30’s, you begin to slowly lose bone mass at increased rate of 4-5% /yr

Women lose bone mass faster after menopause,

Bones can weaken early in life without a healthy diet and the right kinds of physical activity.

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If you have any of these “red flags,” you could be at high risk for weak bones. Talk to your doctor.

04/20/23 Dr.MANINDERAHUJA 21

Older than 65

Broken a bone after age 50

Close relative has osteoporosis or .has broken a bone

Health is “fair” or “poor”

Smoke

Underweight for your height /BMI<19

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1

You started menopause before age 40

You never got enough calcium

You take more than two drinks of

alcohol .several times a week

You have poor vision, even with glasses ,poor hearing

you sometimes fall

you are not active 04/20/23 Dr.MANINDERAHUJA 23

2

You have one of these medical conditions: Rheumatoid arthritis Hyperthyroidism Chronic lung disease Cancer Inflammatory bowel disease Chronic liver or kidney disease Hyperparathyroidism Vitamin D deficiency Cushing's disease Multiple sclerosis

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3

You take one of these medicines: Oral glucocorticoids (steroids) Cancer treatments (radiation,

chemotherapy) Thyroid medicine Antiepileptic medications Gonadal hormone suppression Immunosuppressive agents

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4

Start building healthy bones while young.

Healthy diet and lifestyle are important for BOTH men and women.

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Latest reports say “in utero origin of osteoporosis also,genetic factorChan GM et al. Growth and bone mineralization in children born prematurely. J Perinatol 2008 Sep; 28:619

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AGE IS NO BAR

Get your daily recommended amounts of calcium and vitamin D.

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Engage in regular weight-bearing /resistance exercise.

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Even simple activities such as walking, stair climbing and dancing can strengthen bones.

Avoid smoking and excessive

alcohol.

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12 oz.

5 oz.

1.5 oz.

no more than 1 drink per day for women and 2 for men.

beer

wine

whiskey

Talk to your doctor about bone health.

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Have a bone density test and take medication when appropriate.

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Testing is a simple, painless procedure.

No loose rugs Good lighting at night Supports in the bath rooms Don’t lock bath rooms Proper glasses for eye sight Balance exercises No sedatives Proper hearing aids Vit. D also helps in fall preventio

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