Timing

A woman with regular monthly cycles often ovulates [releases eggs] on the mid-cycle days [about the 14th day of a 28-day cycle]. The period over the second or third day before or after ovulation is known as the fertile period. Having intercourse during this time gives the best chance of pregnancy. You can detect ovulation with the help of home tests that use saliva or urinary samples.

Lubrication

The next time you reach out for that jar of cold cream or oil, remember that most of the creams, gels and oils can harm a man’s sperm quality. Instead, try something like a romantic dinner, a glorious massage or soft music with wine and chocolates. This can build the mood and give you the most natural lubrication… with fringe benefits too! Or else, good ol’ water or a water-based lubricant prescribed by your gynaecologist should do the trick.

Ignoring genital and urinary infections

Urinary burning, persistent or foul-smelling white discharge, and pelvic pain in women and urinary complaints with or without testicular pain in men can signal genito-urinary infection, which may lead to tubal block and uterine inflammation in women and blockage of the vas deferens [the tube that carries sperms to the exterior] in men. Report these to your doctor immediately and get them treated.

Weight issues

If you have a weight problem, get back to your ideal body weight for your height. This is because obese women have reduced fertility due to less frequent ovulation. They also risk developing Polycystic Ovarian Syndrome [PCOS]. Very thin women too may have fertility issues, due to less oestrogen in their body to support ovulation. Such women benefit from putting on some weight.

Lifestyle

Regular exercise can ward off stress, restore hormonal balance, and help you maintain your body weight. It also improves pelvic circulation. So put on your jogging shoes or don that swimsuit. Choose an exercise option that suits you best.

Putting off pregnancy

Though there are numerous examples of older moms delivering healthy babies, it is always wise to plan a pregnancy in your 20s or early 30s. After 35, there is a steady decline in fertility among women, with more miscarriages and poor pregnancy outcomes. There is also an added risk of developing abnormalities in the baby as age advances.

Expecting too much too soon

How often do we hear these words, “We have been trying for three months now, but nothing seems to be happening!” Sometimes, it is one of the partners, who ‘wants a baby badly’. This can subconsciously work to increase stress in your partner and can even precipitate erectile dysfunction in some men! Don’t let sex become work. Let nature take its course.

In the best of times, you have about 20 per cent chance of conceiving in a given month. Most couples take about five to six months to conceive a baby.

If you do not get pregnant after a year of regular unprotected intercourse, seek professional help. If you are older than 35, or if you have reasons to believe something is amiss [say irregular cycles or pelvic pain], you may consult the doctor sooner.

Being unfaithful

Having more than one sexual partner can increase your risk of contracting sexually transmitted infections and jeopardise fertility. More the number of partners, more the risk.

Diet

Junk food lives up to its name. It can load your digestion, cause constipation and build-up harmful by-products and chemicals, which can damage your reproductive health. Sperms are particularly vulnerable and men who swear by junk food had better decide to go the healthy way.

Women should steer clear as well, to maintain a healthy body weight, optimum menstruation cycles and ovulation.

On the other hand, healthy foods like whole grain cereals, legumes, nuts, seeds, veggies and fruits contain micronutrients that boost general health and fertility.

Blame game

A baby should be the culmination of a beautiful relationship, and certainly not the reason for strife. Playing the blame game, subtly or overtly, is not only unfair, but is also damaging to the relationship. It adds to stress, which can lead to failure of your fertility treatment.

The demands of fertility treatment [regular visits to the doctor, programmed intercourse and financial drain] can worsen stress levels. So, be supportive and communicative and stay in it together.

Denial

This is a common problem with couples, especially men, who would like to believe that there is nothing wrong with them. Men often delay semen testing [a very simple test] for fear that there may be a problem. Any couple, which has been trying for two years to conceive should not postpone treatment. Delay in the diagnosis of certain conditions, which affect fertility can worsen your prospects of conceiving.

Consulting quacks

Beware of ‘self-styled doctors’ who promise magical results. There are no guarantees in fertility treatment. Wasting time with quacks can cause more harm than good—it can delay getting proper treatment, or worse, get you faulty treatment.

Switching doctors

Seek references, find an infertility specialist you trust and then give him/her time. Gather information, ask questions and understand the treatment. Then stick it out for at least six months. Changing doctors frequently leads to unnecessary duplication of tests and treatment, and gets you nowhere.

No matter how badly you might want a baby, it is important to understand that brooding will do no good. Take the right steps and leave the rest to Him. Man proposes, God disposes—this dictum is best applicable to fertility treatment. Let go, relax and enjoy all the goodies that life has to offer even while on treatment.

Couples that have explored all options and have given sufficient time but have not succeeded, should probably consider adoption. Coming to terms with reality is also an important aspect of life.

Unhealthy habits

Smoking, even in moderation, can reduce fertility in men by affecting sperm quality and quantity. In women, it affects ovulation. It also increases risk of miscarriage. Alcohol should be limited to social occasions, and caffeine intake to not more than two cups of coffee or 3 – 4 cups of tea per day.If you really want that baby, recreational drugs are a strict no-no.

Hurry and worry

Stress is one of the main reasons today for marital discord, infrequent sex among partners, irregular cycles and ovulatory disorders such as PCOS.

Couples need to spend more time with each other and prioritise their relationship. Working couples may practise yoga or go for walks together. Meditation is a great way to relax the mind and body. Try meditating before hitting the bed or early in the morning.

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Oestrogen plays an important role in the proper functioning of the urinary system, maintenance of bone mineral density and lipid profile. It also maintains skin texture and hydration, cognitive function, memory and sexual function.

In the 8 – 10 years preceding menopause [a period also known as the perimenopause], the body experiences a steady decline in oestrogen levels. Therefore, it is not only after she enters menopause that a woman should wake up to these issues, but as soon as she turns 35.

Because that’s when her body begins to age rapidly and subtle changes related to oestrogen deficiency take place, often without obvious symptoms.

The challenges of menopause need to be tackled with a healthy lifestyle comprising a balanced diet, suitable exercise regimen and adequate relaxation. And of course, regular check-ups for health hiccups.

General diet guidelines

A menopause diet is not some wonder diet but a simple balanced diet, as for anyone else, with a few adjustments, keeping in mind the unique hormonal and metabolic features of this period of life.

A diet low in saturated fats and refined sugars, and rich in proteins [to prevent muscle loss], antioxidants, vitamins, fibre and micronutrients, is essential. Consume high amounts of calcium and vitamin D for bone health, and of course, drink plenty of water to keep your body hydrated. It also flushes out toxins. Watch your sodium intake as it may put you at a risk of developing hypertension.

For minimising hot flushes

Phytoestrogens are plant compounds with mild oestrogenic actions. Isoflavones are a group of phytoestrogens and women whose diets are rich in isoflavones, such as women from Japan, experience fewer hot flushes during menopause and generally have better health.

Also, in countries where soy foods are consumed daily, women are much less likely to report menopausal symptoms. Phytoestrogens are found in abundance in foods such as legumes, beans, whole grains, nuts, flaxseeds, fish and apples. Avoid caffeinated drinks like tea, coffee and colas and minimise your intake of alcohol, spicy foods and refined sugars.

For healthy bones

In women, 75 per cent of bone mineral loss occurs between the age of 50 and 65. Calcium is the chief mineral found in bones. Vitamin D helps in the absorption of calcium from the diet as well as its utilisation by bones.

A woman’s requirement of calcium goes up by 50 per cent after menopause, and she must increase her calcium intake after the age of 35, to avoid a ‘negative calcium balance’. In addition, ensure adequate exposure to sunlight to help convert vitamin D to its active form.

Rich sources of calcium include:

• Dairy products like milk, yogurt, cheese
• Nuts, beans and pulses
• Green leafy vegetables, cabbage, broccoli, lotus stem, lady’s fingers
• Dry fruits like apricots, dates and figs
• Fish, meat and eggs
• Fruits like oranges, currants, black berries, apricots, plums and raisins
• Tofu and other calcium-fortified foods.

For healthy skin

At menopause, a woman’s skin starts to produce slightly less collagen and elastic fibres, which leads to accelerated wrinkling and sagging. A diet consisting of liberal quantities of seeds, nuts and grains, vegetables and fruits [antioxidants], supplemented by dairy foods, vegetable oils, honey and yeast helps maintain healthy skin. Drink lots of water daily to maintain moisture content, and keep up that glow.

For good memory

Remember, the best food for the brain is activity. Because, when it comes to the brain, if you don’t use it, you will lose it. It is important to remain physically and mentally active to prevent complications like Alzheimer’s disease and memory loss. In addition, stress management, relaxation and adequate sleep are essential to mental wellbeing.

Foods that enhance memory include vegetables like broccoli, cabbage, cauliflower, spinach and turnip greens, oranges, fish and asparagus.

For a healthy heart

Limit consumption of saturated fats [ghee, butter, cheese, animal fats, cream and coconut and palm oil] as they increase cholesterol in the blood, which hardens arteries and predisposes you to heart disease.

Monounsaturated fats [MUFA] and polyunsaturated fats reduce the total cholesterol and LDL [the bad cholesterol] while increasing HDL cholesterol [the good cholesterol]. Nuts, avocados and olive oil are good sources of MUFA. Seafood like salmon as well as corn, safflower and sunflower oils are high in polyunsaturated fats. Omega-3 fatty acids belong to this group.

For a healthy heart, avoid eating:

• Fried foods
• White bread, white rice
• Processed foods
• Excess salt
• Red meats.

For preventing cancers

Tomatoes, guava, and watermelons contain lycopenes. Broccoli, cabbage and cauliflower contain isothiocyanates, which prevent cancer. Pulses, nuts, garlic, whole grains and beans are other anti-cancer foods.

For weight management

Managing weight is one of the biggest challenges for a menopausal woman. Thanks to an altered ratio of female to male hormones, she starts putting on weight in the waist region, and acquires the ‘apple’ shape of her male counterparts as opposed to the ‘pear’ shape of premenopausal women. Slowing metabolism further compounds the weight problem.

• Eat small meals at frequent intervals
• Don’t skip breakfast
• Eat fruits rather than drinking juices
• Eat healthy snacks like salads, sprouts or nuts in between meals
• Follow an exercise regimen [for at least two hours a week]
• Avoid eating fried and junk food, eat more wholesome home food.

To prevent bloating

Water retention can lead to a ‘bloated feeling’ with swelling of feet and under your eyes.

• Avoid eating salty foods [pickles, butter, processed foods, ketchup, chutneys, cheese, among others]
• Restrict intake of sugar
• Add potassium-rich foods like fruits [melons, bananas, oranges] and dried fruits [apricots and figs] to your diet to balance sodium and water retention
• Don’t miss out on your exercise regimen.

For managing urinary leaks

• Limit your fluid intake towards the end of the day to avoid waking up at night for urination
• Consume small amount of fluids throughout the day
• Avoid drinking alcohol, caffeinated beverages and artificially sweetened drinks.

Every woman faces different issues depending on her constitutional make-up and there can be no universal diet for everyone. Also, there is no need to stick to a ‘fixed diet plan’. Unrealistic goals lead to unreasonable expectations, disappointment and unnecessary stress.

Following a healthy diet and a sensible, ‘easy to live up to’ exercise plan is a simple yet affective approach to menopause management.

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