YOUR HEALTH

THE STAR, TUESDAY 21 MARCH 2023

Vaginal dryness and menopause

VAGINAL dryness is a common
condition that can occur at any
age, but the likelihood increases
particularly with menopause.
According to the Malaysian
Menopause Society (MMS), more
than 55% of Asian women aged
between 45-75 years suffer from
vaginal dryness.(1)
With the onset of menopause,
oestrogen levels start to decrease.
Oestrogen deficiency can lead to
tissues in the vagina and bladder
thinning and shrinking. This leads
to less vaginal fluid being Specific moisturising creams are known to counter the symptoms of
produced and the skin becomes vaginal dryness.
thinner and more prone to injury.
These are perfectly normal ageing and seeking advice was not to be non-inferior as compared to
changes but they may be necessary.(1) an estriol-containing vaginal cream
associated with considerable With menopause being with regards to the improvement
discomfort as an increase in associated with changing hormone of subjective symptoms of vaginal
vaginal and urinary infections can levels, Oestrogen-based hormone dryness. A study looking at efficacy
be the consequence. replacement therapy, whether oral and tolerability found that the non- More than half of Asian women aged 45-75 suffer from vaginal dryness.
Due to the intimate nature of or topical, is often a first-line hormonal vaginal moisturising
these symptoms, women can be treatment option. However, some cream was statistically not inferior creams to counter their symptoms Management of menopause in
reluctant to seek advice about women may not want or be to estriol 0.1% cream for symptoms of vaginal dryness, a hormone-free Malaysia 2022, p13
menopausal symptoms. According allowed to use hormone such as feelings of dryness, itching, moisturising cream may instead be (2)
Garcia de Arriba et al. ‘Vaginal
to a Pan Asian Revive Study, a replacement therapy. burning sensation and pain. Both an effective and safe solution. hormone-free moisturising cream is
questionnaire-based study which Those women may choose a showed a significant improvement not inferior to an estriol cream for
also involved Malaysian women, hormone-free vaginal cream to in impairment of daily life after six n For more information, visit treating symptoms of vulvovaginal
half of the women suffering from ease their symptoms. Studies weeks of use.(2) www.vagisan.my atrophy: Prospective, randomised
menopausal symptoms felt that focusing specifically on that For those women that may not study.’ PLoS One. 2022. 17
these problems were part of revealed that the cream was found want to use estriol-containing (1)
Clinical Practice Guidelines, (5):e0266633.
2 Your Health THE STAR, TUESDAY 21 MARCH 2023

Assessing coronary artery

CORONARY artery disease implies the
presence of narrowing or blockages within
the arteries that supply oxygen and
nutrients to the heart muscles. At present, a
coronary angiogram remains the gold

disease using FFR

standard for the assessment of coronary
artery disease. While it may be an invasive
procedure, the overall risk of major
complications associated with a coronary
angiogram remains very low.
A fractional flow reserve (FFR) is an
assessment performed as an extension to a
coronary angiogram to determine the
significance of a particular blockage. The
significance of a blockage would depend on
the location of the blockage within an
artery. If the blockage is at the beginning of
the artery, it would lead to more problems
as opposed to it being at the end of the
artery.
Think of the artery as a water hose with
numerous connections to other water
sprinklers in the middle of the hose. If there
is a blockage at the beginning of the hose,
then the effect would be more detrimental
as compared to the presence of a blockage
at the end of the hose.
Blockages of a similar degree may also
confer different consequences if they are
present in different arteries as some are
larger and are more important compared to
the rest. Dr Lee Zhen-Vin.
The FFR assessment is performed using
a wire known as a pressure wire. On the abnormal FFR reading. An FFR value of less
wire, there is a pressure sensor located than or equal to 0.80 is considered
close to its tip to measure the pressure abnormal and a coronary angioplasty is
within the artery itself. Pressure will first be required. In contemporary practice, the
measured at the beginning of the artery and ultimate step of a coronary angioplasty
once this is done, the pressure wire will would involve the implantation of a stent.
then be passed across the blockage to A blockage with an FFR value of more than Although there appeared to be a significant blockage in the diagonal artery on the coronary
remeasure the pressure after the 0.80 can be left alone without the need for angiogram (green arrow), the FFR value was 0.88 (not significant) and angioplasty was not
administration of a medication to ensure coronary angioplasty and treatment with performed.
that blood flow through the artery is appropriate medications would suffice.
maximal. The FFR is a ratio whereby the The FFR is particularly helpful when reduction in the number of implanted stents for a repeat coronary angioplasty.
pressure after the blockage is divided by the dealing with scenarios whereby blockages as well as the length of the stents, both of In summary, the FFR is pivotal in the
pressure at the beginning of the artery. are present within multiple arteries or which are factors known to impact the facilitation of decision-making and its use
Theoretically, blood flow is proportional when multiple blockages are present at overall rate of stent failure. allows judicious coronary angioplasty to
to pressure. Hence, if there is presence of a different segments within the same artery. Studies have also shown that the FFR is a be performed.
severe blockage leading to a reduction of An FFR can be used to accurately determine very cost-effective modality and its use has – By Dr Lee Zhen-Vin, consultant
blood flow, the pressure after the blockage which blockages require angioplasty and been shown to reduce the combined rate of interventional cardiologist at KPJ
will also be reduced. This would yield an which do not. This leads to an overall death, non-fatal heart attack and the need Damansara Specialist Hospital 2

Road to healthy living

LEADING a healthy lifestyle is easier said being mindful of these fundamentals will
than done. In this day and age, parents are help make smarter food choices.
often busy with work during weekdays
while children too, spend many hours in
school or attending co-curricular activities or
Get active
additional tuition. Many families make it a point to come
When the weekend comes, family together for game nights or movie nights,
members may also be involved with various but often forget that it is equally important
social commitments. As such, making to exercise together. Among the common
healthy life choices might not be the top of excuses people give is that families find it
everyone’s priorities. hard to find the time to do so, or that
Families must start making tweaks to their nighttime is the best opportunity to unwind
lifestyles for better physical, mental and and relax.
emotional health. Doing so can reduce the Family exercise does not have to take
chances of developing diseases such as multiple hours, nor leave you feeling
various forms of cancer and diabetes, that exhausted, dizzy or tired for it to be
has often been linked to unhealthy lifestyles. effective. It can be as simple as dancing to a
Within families, parents play an important few of your favourite tunes. For families that
role in guiding their children. It is important struggle to find common time together, even
to create and develop healthy habits early on a short workout session of 20 minutes can
so that children will continue to practise help family members feel better physically. It
these habits throughout their lives. is also a timeframe that is much easier to set
aside as compared to an afternoon in the
park.
Eat good, feel good
A healthy life starts with living a healthy > TURN TO PAGE 4
diet. As the saying goes, we are what we eat.
Incorporating vegetables and fruits into your Short exercises can help
diet can make you feel more energised to families bond and also
conquer the day. feel healthier.
Contrary to what some may believe,
there is more to healthy eating than
skipping certain foods and eating
more greens. Health and medical
professionals swear by having a
balanced diet of macronutrients
such as carbohydrates, proteins
and fat. An unbalanced meal can
cause unnecessary weight gain and
loss of energy and concentration.
Having home-cooked meals is the
best way to start eating right as a
family as you would always be in
control of the portions for each
ingredient and food choices.
Practising a balanced diet can be a
challenge, particularly with the food
options available in Malaysia. However,
3 Your Health THE STAR, TUESDAY 21 MARCH 2023

Keep your bones

strong and healthy
BONES are a very important organ in our
body and have many functions. Its role
includes providing structure, protecting
internal organs, anchoring muscles and
storing calcium.
They also facilitate movement and are
important for blood cell formation.
Therefore, maintaining bone health is very
important for everyone.
Normal bone metabolism is the complex
sequence of bone turnover (osteoclast
activity) and bone formation (osteoblast
activity). The bones are continuously
changing, where the old bones are broken
down and replaced by new bones. This
process is regulated by hormones such as
parathyroid hormones, calcitonin,
oestrogen, androgens, growth hormone,
thyroid hormones, Vitamin D and steroids
such as glucocorticosteroids. Dr Ruzaimi Md Yusoff..
Consultant orthopaedic surgeon at MSU
Medical Centre Dr Ruzaimi Md Yusoff says, Calcium supplements may also be
“Most people reach their peak bone mass prescribed by a doctor if needed.
around the age of 30. After that, bone Adequate vitamin D intake is important
remodelling continues, but you lose slightly for calcium absorption. For adults aged 19
more bone mass than you gain because of a to 70 years, the RDA of vitamin D is 600
decrease in osteoblast activity. international units (IUs) a day. The
“The higher the peak of bone mass, the recommendation increases to 800IUs a day
less likely for us to develop osteoporosis at a for adults aged 71 years and older.
younger age.” Good sources of vitamin D include oily
fish such as salmon, trout, whitefish and
tuna. Sunlight also contributes to the body’s
What affects bone health production of vitamin D. Supplements may
The following are the risk factors which also be prescribed if indicated.
can affect bone health. Physical activity especially weight-
Modifiable risk factors are: bearing exercises such as walking, jogging
l Diet. A low calcium intake will cause and climbing stairs can build strong bones
low bone density and will lead to early and slow the process of bone loss. Last but
bone loss causing a higher risk of fractures. not least, avoid smoking and limit alcohol
Not getting enough vitamin D can also intake to help delay osteoporosis.
increase the risk of osteoporosis.
l Physical activity. Not exercising and
not being active for long periods can
Signs of bone health problems
increase the chances of getting osteoporosis. There are some signs of osteoporosis that
l Body weight. Maintaining an ideal we should look out for:
body weight is important for bone health. l Receding gums. A dentist might be
This is because an extremely thin individual the first person to spot signs of
will have lesser bone mass. osteoporosis. Research suggests that if
l Smoking. Research suggests that there is significant bone loss in the jaw, it
tobacco will increase the risk of could be a sign of bone loss in other areas
osteoporosis. Women who smoke also go of your body.
through menopause earlier than those who l Chipped or brittle nails. Chipping a
don’t smoke. nail frequently could be a sign that other
l Alcohol. People who consume a lot of bones may also be brittle. Those who have
alcohol are more likely to get osteoporosis. low levels of collagen or calcium in their
l Medicines. Certain medications can nails also do not have enough calcium in
affect bone health. Prolonged usage of their bones.
corticosteroid medications such as l Weakened grip. Have you started to
cortisone, prednisolone and dexamethasone notice that you cannot turn the doorknob
can be damaging to the bone. easily? The strength of the handgrip and
the density of the bones in the arms, hips
Non-modifiable risk factors are: and spine are directly related.
l Age. Advanced age causes thinning l Fractured bones. The hips, spine and
and weakening of the bone. wrists are the most common body parts to
l Gender. Women have a greater risk of fracture. Fractures occur from trivial
osteoporosis as they have less bone tissue trauma such as slight knocks, bending over
than men. Women also lose bone faster or lifting items.
than men because of hormonal changes
that occur after menopause.
l Ethnicity. Caucasian and Asian women When to see a doctor
are more prone to osteoporosis. It’s important to seek medical attention
l Family history. A strong family history for any type of bone pain, especially if the
of osteoporosis predisposes an individual to pain is severe, persistent, worsening over
develop osteoporosis at an earlier age. time or associated with swelling, redness,
warmth, a fever, unintentional weight loss
or a palpable mass or lump.
Maintaining healthy bones Since osteoporosis does not have any
Maintaining bone health is important to symptoms until a bone breaks, it is
prevent or slow down the process of bone important to talk to your doctor about your
loss. bone health.
Dietary calcium intake is extremely If your doctor feels that you are at risk
important. The recommended dietary for osteoporosis, a bone density test may be
allowance (RDA) of calcium for female performedto measure the density of your
adults aged 19 to 50 years and males aged bones, and assess for osteoporosis and risks
51 to 70 years is 1,000mg per day. The of breaking a bone.
recommendation increases to 1,200mg a Doctors may prescribe medicine if your
day for women aged 51 years and older and bones are weak and have a higher risk of
for men aged 71 years and older. osteoporotic fracture in the future. These
Good sources of calcium include dairy include bisphosphonates, oestrogen
products, almonds, broccoli, kale, canned agonists/antagonists, calcitonin,
salmon with bones, sardines and soy parathyroid hormone, oestrogen therapy
products such as tofu. and hormone therapy.
4 Your Health THE STAR, TUESDAY 21 MARCH 2023

Glow from within

Parents are crucial role
models in leading a
healthy lifestyle.

KEEPING your skin healthy and glowing can making supplementation a necessity.
be a constant battle, especially in a tropical Setria L-glutathione is a patented
country that gets strong sunlight all year. A ingredient from Japan that has been
little sunshine is good, but too much clinically proven to raise glutathione levels
exposure to the sun’s UV rays can harm your in the body. It works synergistically with

Taking the right steps

skin which results in pigmentation and signs other skin-nourishing nutrients like
of skin ageing. L-cysteine, astaxanthin, alpha lipoic acid
(ALA), vitamin C, zinc and grape seed extract
to inhibit dark pigment production for the
The sun and your skin clear, flawless skin you desire.
UV rays are one of your skin’s worst > FROM PAGE 2 The more irregular the sleep patterns, the
enemies. Too much of it activates the This informational article is brought to higher the risk of obesity, hypertension, and
enzyme tyrosinase which leads to the you by VitaHealth. Another activity families can do together elevated blood sugar and the higher the
overproduction of melanin, a pigment that is to take a 30-minute walk each night after projected risk of developing heart disease
gives skin its colour. There are two major n For more information, call 1800 183 288 or dinner. After a long day of work or studies, over the next decade.
forms of melanin – eumelanin (dark visit https://linktr.ee/vitahealthmy. why not take in the sights and let your mind When your body develops a natural
pigment) and pheomelanin (light pigment). wander and relax? rhythm and starts to settle into a regular
Excessive melanin production results in its Besides exercise, it is always advised to sleep-wake cycle, you can fall asleep and
uneven distribution in the epidermis, L-glutathione protects your skin avoid smoking and excessive consumption of wake up easily.
showing up as skin darkening, uneven skin from dark pigment and UV damage. alcohol as these actions are linked to cancers
tone and appearance of unsightly dark spots. of the lung and liver respectively.
When your skin is exposed to UV rays, it
Let’s talk about it
will produce large amounts of reactive Being healthy is more than just being
oxygen species (ROS) which can cause
Eight hours a night physically fit, you have to worry about the
oxidative damage to your skin. This induces Along with nutrition and exercise, sleep is emotional and mental side of it as well.
photo-ageing, characterised by the formation one of the three pillars of a healthy lifestyle. Changes in our mental health can lead to
of wrinkles, fine lines and skin dryness. A good night of rest makes us feel more changes in our physical health too.
energetic and alert and allows us to Individuals struggling with mental health
concentrate better in the morning. may feel unmotivated to lead a healthy
Unveil your skin’s natural glow with Missing out on rest increases the lifestyle and this can in turn lead to other
L-glutathione likelihood of sleep deprivation symptoms. It serious health complications including
is also important to note that catching up on obesity, heart disease, high blood pressure
A healthy, glowing complexion does not a missed night of sleep isn’t quite the same and a weakened immune system.
work solely on external protection alone but as getting the sleep you need in the first It is crucial for family members to always
should start with nourishment from within. place. look out for one another and to be quick in
L-glutathione, your body’s master As the sleep debt mounts, health spotting behavioural changes among family
antioxidant, has been in the spotlight for its consequences increase, putting us at growing members. Sharing comforting words assures
efficacy in skin lightening. It helps block risk for weight gain, diabetes, heart disease, the family member that you have their back.
dark pigment production, reverse the stroke and memory loss. Sleep deprivation On the other hand, family members must
synthesis of dark pigment and protect your can also cause fuzzy-headedness, irritability, always be encouraged to share any thoughts
skin from UV-induced damage to ward off and fatigue. and emotions that are weighing them down.
wrinkles and fine lines. Most adults need eight hours of sleep a Family members must have an
Your body produces glutathione. However, night for optimal health and productivity. To interpersonal relationship and dependence
the levels naturally decline with age. Poor ensure better sleep, adults should avoid on each other and the key to living healthily
diet, environmental toxins and stress can common disrupters such as alcohol, tobacco together is continuous love and support
quickly drain your glutathione stores, and caffeine towards the end of the day. from each other.