Although Men and Women have almost similar and comparable chronic Health difficulties, there are specific health problems that affect women differently. These Health Issues should be given more attention and concern in order to ensure that each woman advances in good health.

Here are some of the health issues that affect women the more frequently, along with all the Risk Reduction Measures you can take to battle them out: 

• POSTMENOPAUSAL CONDITIONS
  Women frequently experience difficulties during Menopause. With a median beginning age of 51 years, menopause is a complicated physiological process caused by the reduction in Ovarian Hormone Synthesis and Secretion.
  According to research your risk for some health issues may increase as a result of changes to your body in the years leading up to Menopausal Years. Firstly, Menopause marks a time period of Intense Hormonal Changes. Estradiol levels dramatically decreases with age until menopause, causing significant changes in the female body. Studies demonstrate a relationship between the circulatory system in women and the dynamic changes in hormones. Other menopause symptoms include Hot Flushes, Sweating (especially at night), Irritability, Memory Loss, Joint Discomfort, Dry Mouth and Urogenital Issues.

• CARDIOVASCULAR DISEASES
  According to recent studies, Cardiovascular Disease is one of the major causes of death in women. Additionally, studies indicate a potential connection between excessive variations in sex hormones, especially Endogenous Estradiol and Follicle-Stimulating Hormones, as well as Vasomotor Symptoms and the Circulatory System in Women. The high rise of Low-density Lipoprotein (LDL) and Triglyceride also contribute to the increased chance of cardiovascular disease. The reduction in Oestrogen, particularly 17b-oestradiol, during menopause is the most significant hormonal shift. This hormone is in charge of the increased risk of cardiovascular illness.
  Clinical diagnosis of cardiovascular disease, especially Coronary Heart Disease, is challenging in women because of the frequently unusual presentation of these conditions.Serensa Health provides Automated Equipment Treatment based on Quantitative Evaluation, Rehabilitation and a Comprehensive Therapy Program. The Therapy program combines Individualized Exercise Guidance and Training with cutting-edge functional and sport-specific rehab, as well as other pain management methods.

The Cardiac Therapy practiced under Serena Health has Three Phases:

1. Phase 1: 4-6 Exercises per unit over the course of 1-2 weeks for a brief period of time (15–30 min.) at a moderate intensity (20–30 beats/min.) for Preparation, Adaptability, Response and Adaptation.
2. Phase 2: To improve Muscle Strength, Fitness and Endurance, the duration is gradually extended up to 30-60 min with an intensity increase gradually  (40-60HR max).
3. Phase 3: The amount of Time and Intensity are gradually increased based on fitness testing to stabilize the progress over the long term. Enhanced consistency in engaging in routine exercise and physical activity.

• URINARY INCONTINENCE

More than 50% of Postmenopausal Women experience Urinary Incontinence (UI), a significant societal issue that causes Loss of Bladder Control. As a result of societal change that promotes a sedentary lifestyle, the number of patients grows yearly. It primarily has an impact on people whose jobs are comparatively idle, who use cars excessively, or people who don’t have enough time to engage in any physical exercise. The trend is especially noticeable in the elderly, who frequently spend their leisure time watching TV and do not engage much in physical activity.

There are major 5 types of Urinary Incontinence:

1. Stress Urinary Incontinence:

Stress Urinary Incontinence (SUI) is characterized by Leakage of Urine, caused by an increase in Abdominal Pressure. Stress Urinary Incontinence arises from weakening of the Pelvic Floor Muscles and Failure of Complex Musculo-Ligamentous and Fasciocutaneous Tissues. The most common causes of the disease are Childbirth, Trauma, Hormonal Disorders and a Reduction in Reproductive Organs and Operations. Stress Urinary Incontinence distinguishes between three stages of progression of the disease:

 Stage I – Symptoms occur only during a major effort, which causes an increase in Intra-Abdominal pressure. Account should be taken here of sneezing, coughing or laughing.  

Stage II – The symptoms appear during moderate exercises such as Running, Heavy Lifting or Sports. Produces a moderate increase in intra-abdominal pressure.

Stage III – Symptoms are observable with minimal physical exertion and a small increase in intra-abdominal pressure. Urinary incontinence can occur during walking, and also when changing the position from lying down to standing.

• Urge Incontinence (UI):
  Urge incontinence (UI), also known as Overactive Bladder (OAB), is a Micturition condition caused by an imbalance between the Detrusor activity of the Inhibitory and Excitatory mechanisms.

The primary Causes of UI are:

• CNS damage above Bridge.
• Spinal Cord damage at the S2-S4 level
• Spinal Cord damage above the S2-S4 level
• Overflow Incontinence:
   When the bladder accumulates a volume of urine that is larger than its carrying capacity, Overflow Incontinence symptoms occur. The pressure consequently causes the pee to pass through the urethra. This condition might also develop if there is a blockage, like Prostate Hypertrophy or if there is Neurological Problem.
  
  
• Mixed Urinary Incontinence (MUI):
  A mix of overactive bladder symptoms and UI symptoms.
  
  
• Transient Incontinence:
  Transient Incontinence occurs when the signs are short-lived.

Treatment Options for Urinary Continence:
 According to International Continence Society Guidelines, conservative therapy should be used as the first line of treatment for UI.  When conservative therapy is ineffective, surgical intervention should be used.

Up to 80% of patients with Stage I SUI and mixed form and 50% of patients with Stage II SUI, respond favorably to physical treatment.

Other forms of Treatment Methods include- Muscle Training, Strength Training, Training with High Resistance and Using Resistance Devices, Vaginal Resistance Devices, Local Muscle Endurance Training, Pelvic Floor Muscle Training (PFMT), Kegels and Adopting Facilitation Techniques or Recruitment of PFMs.

• OSTEOARTHRITIS (OA)

The most prevalent type of Arthritis is Osteoarthritis (OA), with a 47% lifetime chance for women. It is a condition that affects all of the organs, including the Ligament, Bone, Synovium and Articular Cartilage. It results in progressive bone changes that cause classic “Osteophytes” on X-rays, Joint Pain, Swelling and Function Loss, as well as Gradual Loss of Cartilage. Being the most frequent cause of Total Joint Replacement and the cause of joint failure for many people, OA has a significant socioeconomic cost.

Numerous lines of epidemiological evidence suggest that sex hormones, particularly Oestrogen, play a role in osteoarthritis.  Due to which there is a prominent female predominance in osteoarthritis incidence and recurrence, which begins around menopause.

Treatment and management of Osteoarthritis:
 Osteoarthritis management can be divided into four main categories:

• Non-pharmacological (such as joint-specific exercises or devices like Base of Thumb Splints, or Knee Braces that physically “offload” joints)
• Supportive/lifestyle measures (encouraging weight control or loss, general exercise).
• Pharmaceutical treatments, followed by Evidence-Based surgery procedures like Joint Replacement.

• POSTMENOPAUSAL OSTEOPOROSIS

Medical Research has shown that the Rate of Fractures caused by Osteoporosis Predominantly increases in Postmenopausal Women. Postmenopausal Osteoporosis is characterized by Skeletal Fragility and Microarchitecture Degeneration. The high chance of Postmenopausal Fractures is associated with Low BMD and Qualitative Changes in Microarchitecture, according to the conceptual definition of Osteoporosis. Hip fractures are particularly dangerous and are frequently caused by osteoporosis, especially in elderly women. Osteoporosis prevalence varies depending on whether fracture frequency or Low BMD is used to measure the disease.

Treatment and Management of Postmenopausal Osteoporosis:

• Exercises involving Resistance and Weight-Bearing can Boost Muscular Mass and BMD Momentarily.
• Weight-Bearing Exercise lowers the chance of fractures. Studies using High-Resolution Computed Tomography over time have revealed positive effects on Skeletal Microarchitecture in connection with specific types of regular exercise.
• Exercise and balance classes (like yoga and tai chi) may result in improved balance as well as improved muscle tone.
•  Avoid drinking too much Alcohol and Excessive Smoking.
•  Proper Daily Vitamin D consumption (600 to 800 IU), a Good Calcium Intake (1000 to 1500 mg daily) and the use of an Antiresorptive medication can also be proved beneficial for Postmenopausal Osteoporosis.

What Role do Physiotherapy Interventions Play in Antenatal Healthcare During Pregnancy?

Pregnancy is the most delicate and important phase in a woman’s life. During pregnancy, it is very important to take proper care and consideration of a Woman’s Health.

It is important to understand that many physical changes occur in a mother’s body during pregnancy, which lasts up to 40 weeks from conception to birth.

Some of these changes include:

• Increase in Body Weight
• Increased Abdominal Strain
• Postural Misalignment brought on by Hyper Lordosis
• Lower Extremities Feeling Heavy
• Incontinence
• Upper and Lower Back Discomfort
• Obesity
• Depression
• Extreme Muscle Deterioration

Another phenomenon that has steadily increased in recent years are Caesarean Sections. The advantages of physiotherapy during the childbirth can help you prevent Excessive Pregnancy Weight Gain, Gestational Diabetes and even Severe Back Pain.

Before Resorting to any Physical Exercise or Physiotherapy Intervention, it is important to have a good understanding of your own body and the respective antenatal care treatments.

Here are some treatment and management interventions that can help you during Pregnancy:

• Prenatal Exercises including Core Stability and Abdominal Routines.
• Respiration Drills.
• Proper Exercises for Back Care and Postural Instructions.
• Kegel Movements or Pelvic Floor Exercises to strengthen the Pelvic Floor Muscles and Improving Stress Urinary Incontinence.

These Treatment Management Practices and Physiotherapy Interventions can serve as your main road map for overcoming serious health problems. It is very important to keep in mind that bad health has an impact on not just the women but also their infants and other family members. Thus, every woman must have access to the Right Information, Proper Diagnosis and Appropriate Treatments for the range of problems that affect Women’s Health.

By Dr.Pulkita Srivastava

PT (MSK), Serensa Healthcare