Menopause at 42? I don’t know what to do

Dr Flo,
I am 42 years old and for three consecutive months I have not had my periods. Have I hit menopause or is there an underlying condition I should know about? What are the signs of menopause and can I still get pregnant without getting my periods? Will I ever get my periods again or are they gone for good?
Eve

Dear Eve,
It is possible that you could be going into early menopause, though it is diagnosed when you miss your periods for at least 12 months. The average age of onset of menopause is 51 years, though it can happen any time in your 40s or 50s. You may experience symptoms of menopause for several months or years before the periods end completely. The periods become irregular, and you may miss one or several months then they come back, and it is still possible to get pregnant. Other symptoms of menopause include hot flashes, night sweats, chills, mood changes, vaginal dryness, sagging breasts, problems with sleep, weight gain, thinning skin and hair.
There are other possible reasons for the changes in your menstrual cycle. You may be having hormonal imbalance or problems with functioning of the ovaries.  It could also be due to the use of hormonal contraceptives, thyroid disease, stress, significant change in body weight (either adding or losing a lot of weight) and excessive exercise. Sometimes, irregular periods could be linked to problems within the uterus like uterine polyps, fibroids or severe scar tissue formation within the uterus. Depending on the exact cause of the lack of menses, you may still be able to get pregnant.
You should see a gynaecologist for examination and tests to determine the exact cause of the menstrual delay. If a manageable cause is found, then it will be treated. Some medication can be prescribed to manage any unpleasant symptoms of menopause.

Dr Flo,
I am addicted to masturbation and I have been struggling to stop it without success. My semen is now colourless. Can I get children in future?
Tevin

Dear Tevin,
Masturbation is a common practice among men and women, though it is more common in men. Due to the hormones released (dopamine, serotonin, oxytocin and testosterone), it has a pleasure and reward mechanism, it relaxes the mind, and also bonds a person with the experience. This can make it a coping mechanism, which can lead to addiction. Excessive masturbation and addiction can lead to low self-esteem, depression, shame and guilt, anti-social behaviour, unrealistic sexual expectations due to the use of pornography, loss of productivity because of spending a lot of time watching pornography and/or masturbating, relationship problems and genital irritation. It can also lead to watching more “hard-core” pornography and may lead to engagement in sexually deviant behaviour in a bid to get new exciting ways to get sexual pleasure. For some people, it can interfere with normal sexual relations. However, it does not affect the ability to reproduce. Clear (colourless), white or gray semen is considered normal.
To manage excessive masturbation, the first step is to acknowledge that it is a problem then make deliberate efforts to stop it. It is best to get an alternative way to use your energy like exercise, creative arts or participating in volunteer programmes. Avoid being alone and interact with other people. Delete all pornographic material from your devices and, if possible, install a software to prevent access to unwanted sites, or one that notifies a trusted person which sites you are accessing. It is also beneficial to get psychological and social support. Therapy includes stress management, identification of triggers, coping mechanisms, behavioural modification, learning to replace mental imagery and couple therapy.

Dr Flo,
Our lungs are very delicate and important because through them, we exhale and inhale oxygen. How can one avoid getting respiratory ailments such as bronchitis, asthma, Covid-19 and cancer?
Alnashir Walji

Dear Walji
The lungs are part of the respiratory system, whose purpose is to help you breathe. All cells in the body need oxygen, and produce carbon dioxide as a waste gas. When you breathe in, the lungs remove oxygen from the breathed in air, and this oxygen passes into the blood stream and is supplied to each cell. The carbon dioxide is then released from the cells into the bloodstream which carries it back to the lungs and it is removed from the body when you breathe out. This process is essential for life. Therefore, the health of the lungs is vital.
It is impossible to completely prevent lung infections, inflammatory conditions like chronic bronchitis and asthma or cancer, but there are measures one can take to optimise lung health. One is to engage in regular exercise, so as to make the lungs more efficient, which also helps to delay the detrimental effects of ageing on lung health and the effects of lung diseases. Another way is to regularly perform deep breathing exercises. Also, avoid exposure to pollutants and irritants like smoke (cigarettes, charcoal, wood and other fuel), mould, dust, synthetic air fresheners and harsh cleaning products. Make sure your living space is always well ventilated. In addition, you can prevent infections by maintaining good general health, eating lots of fruits and vegetables, staying well hydrated, practising hand hygiene, avoiding crowded places, getting vaccinated and early treatment. To prevent Covid-19, practise social distancing, wear a mask, practice hand hygiene and get vaccinated.

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