What's your exercise of Interest?

• Wellness Exercise and Osteoporosis
  Wellness can be achieved by preventing osteoporosis. Osteoporosis is a disease that can steal the strength from your bones, leaving you stoop-shouldered and at increased risk of fractures. By regularly exercising, research indicates that exercise can not only prevent but treat osteoporosis as well. The most important aspect is to know which exercises to do and how to do them properly.
  

• Wellness Exercise and Cardiovascular Risk Reduction
  Walking compared with vigorous exercise for the prevention of cardiovascular events in women.
  

• Kegel Exercise and Wellness
  Kegel Exercises are designed to exercise and strengthen the pelvic floor muscles. These muscles are important for proper tone of the bladder, urethra, vagina, uterus and rectum. Kegel exercises are often recommended in a variety of situations. They are commonly encouraged after the delivery of an infant. They are also utilized as a treatment for urinary incontinence and pelvic relaxation that often comes with the aging process. Lastly, they are recommended for improving sexual relations by improving pelvic floor control.

Wellness Exercise and Osteoporosis
Wellness can be achieved by preventing osteoporosis. Osteoporosis is a disease that can steal the strength from your bones, leaving you stoop-shouldered and at increased risk of fractures. By regularly exercising, research indicates that exercise can not only prevent but treat osteoporosis as well. The most important aspect is to know which exercises to do and how to do them properly.

By combining a healthy diet with adequate nutrition and sufficient calcium along with the correct forms of exercise, you will have helped reduce your risk of fracture.

Exercises typically include:

1. Weight-bearing activities. These include activities you do while on your feet with your bones supporting your weight. For example, walking, jogging and stair climbing are all excellent forms of weight-bearing exercise. By supporting your weight, they can slow the loss of minerals from your bones.
   
2. Resistance training or Strength training. These exercises are used to strengthen your muscles and improve bone thickness. Traditional weight lifting with free weights, weight machines, elastic bands and water exercises are used to provide resistance. Many gyms and/or health clubs offer guidance and training to select the best type of strength training for each individual.
   
3. Back-strengthening exercises. By working on the strength of your back muscles, you can improve posture. By improving posture via back strengthening, you may help treat or prevent osteoporosis related compression fractures along the spine. Exercises that gently arch and stretch your back can strengthen back muscles while minimizing stress on bones.

Optimally, daily exercise is the best way to obtain ultimate Wellness. However, work, family and personal requirements make it very difficult to find the time to exercise daily. Therefore, finding any extra time for these activities is vital. For example:

1. Walking during lunch
   
2. Using the stairs instead of the elevator
   
3. Waking up 30 minutes earlier for an early morning jog
   
4. Using free weights while watching television
   
5. Using back-strengthening exercises before going to bed

If you have found any other ways of fitting exercise into your daily routine and would like to share with others, please email MenopauseRx at:

Wellness@MenopauseRx.com.

Before starting any exercise program, please consult your health care provider. It is especially important to discuss your type of exercise program with your doctor if you already have osteoporosis.

Wellness Exercise and Cardiovascular Risk Reduction
Walking compared with vigorous exercise for the prevention of cardiovascular events in women.
(N Engl J Med 2002;347:716-25.)

A recent study by Dr. Manson and others in the New England Journal of Medicine prospectively evaluated a number of physical activities and sedentary activity in over 70,000 postmenopausal women between 50 and 79 years of age. Their data revealed that both walking and vigorous exercise were associated with substantial reductions in the incidence of cardiovascular events among postmenopausal women, regardless of race, ethnicity, and age or body mass index. They also noticed that sitting predicts increased cardiovascular risk.

Current guidelines endorse at least 30 minutes of moderately intense physical activity on most days of the week. This is in contrast to the previous recommendations of 20 minutes of activity at least 3 times per week. Unfortunately, at least 75% of Americans have less than the recommended level of activity. This study revealed that both walking and vigorous activity was both associated with substantial reductions in cardiovascular events. The researchers noted that women who either walked briskly or exercised vigorously at least 2.5 hours per week had a cardiovascular risk reduction of approximately 30%.

This study is important for a number of reasons. Importantly, it evaluated postmenopausal women among a variety of ethnic and racial backgrounds. Also, it evaluated the most common form of activity, walking, and compared it to vigorous exercise. It also evaluated the negative effects of a sedentary lifestyle on cardiovascular events.

In summary, this study provides good evidence that postmenopausal women can gain significant Cardiovascular Wellness by walking and vigorous exercise. When considering this study, please discuss starting a new exercise regimen with your health care provider.

Kegel Exercise and Wellness
Kegel Exercises are designed to exercise and strengthen the pelvic floor muscles. These muscles are important for proper tone of the bladder, urethra, vagina, uterus and rectum. Kegel exercises are often recommended in a variety of situations. They are commonly encouraged after the delivery of an infant. They are also utilized as a treatment for urinary incontinence and pelvic relaxation that often comes with the aging process. Lastly, they are recommended for improving sexual relations by improving pelvic floor control.

Multiple studies have been done with Kegel exercises showing success for urinary incontinence. A study in the Journal of Gerontology (J Gerontol 1993 Jul;48(4):M167-74) by Burns PA, et al showed that "biofeedback and pelvic muscle exercises are efficacious for sphincteric incompetence in older women. Benefits are maintained and improvement continues for at least 6 months post-intervention. These therapies may be useful before considering invasive treatment." A recent study by Cammu H, et al in the British Journal of Urology (BJU Int 2000 Apr;85(6):655-8) showed that pelvic floor exercises for urine incontinence, when successfully performed, had a 66% chance of favorable results for at least 10 years.

Unfortunately, women are poorly informed about the benefits from these exercises. The proper technique can often by initiated with proper teaching and continued on a daily basis. For optimal benefit, they need to be performed daily. The best part of these exercises is that they are free, painless, and can be done at any time of the day.

The proper technique relies upon finding the proper muscle group. Ask your physician about identifying this muscle group during your next gynecologic exam. Alternatively, this muscle (the levator group of muscles) is found by inserting your finger into the vagina and squeezing around it. If you feel pressure around your finger, you have found the correct muscle. This is also the muscle used to voluntarily stop your stream of urine. Try to isolate this muscle, while relaxing your legs, back, and abdominal muscles. Practice will make perfect. Initially, do these exercises while lying down or sitting comfortably. When comfortable with the technique, you can do these while driving, watching television, during meals, etc. To avoid confusing the bladder muscle, do not perform repetitively while urinating.

The correct number of exercises per day is variable. Evidence suggests that at least 50 repetitions are helpful. A repetition consists of squeezing the levator muscle for 5 seconds and relaxing for 5 seconds. Performing 10 repetitions five times a day will achieve the minimum 50 repetitions. You should be able to build up to holding the levator muscle for 10 seconds with practice. Do not expect miracles over night. Most women find improvement in urine incontinence and sexual relations after 4-6 weeks of therapy.

One of the most important aspects of these exercises (like any form of exercise) is persistence and a daily routine. Try to pick activities during the day to remind you of the exercises. Upon awakening, with morning tea, driving to work, at lunch, driving home from work, watching television, and before bed are common times for women to perform these exercises. Keep a calendar and monitor your improvement.

With a little persistence and patience, these exercises can be very effective.