I am a 43-year old “post-menopausal” Thai woman. Since menopause, I have very little energy and feel tired all the time. Is this a normal part of menopause? And is there something that can be done to help?

Q: I am a 43-year old “post-menopausal” Thai woman. Since menopause, I have very little energy and feel tired all the time. Is this a normal part of menopause? And is there something that can be done to help?

A: In Thailand, most women reach menopause between the ages of 45 and 50, and chronic fatigue is a fairly common and normal occurrence for them. You appear to have experienced an early onset of menopause.

Early or premature menopause is often linked to an illness, surgery, or chemotherapy or radiation treatment. Genetics also appears to be a factor. A rapid decline in the level of the hormone estrogen is one possible explanation for your chronic fatigue. Stress and depression have also been shown to cause chronic fatigue.

Be sure to consult your doctor and have regular health check-ups to rule out any potential health problems.
  
Q: I have had migraine headaches off and on for the past few years. Are there “everyday” things I can do to reduce their frequency and severity?

A: Millions of people suffer from migraine headaches. A migraine “attack” can be intense and debilitating to the point of seriously impacting a person’s quality of life. At the onset of a migraine, medication can offer some pain relief. Studies have also shown that the duration and intensity of a migraine can be reduced by lying down in a dark quiet room, applying a cold pack or cold cloth to the forehead, and by massaging the scalp and the sides of forehead with strong finger pressure.

It’s also important to determine what activities or situations may be triggering migraines in your own personal situation so that you can avoid them whenever possible. Sunlight, alcohol, chocolate, cheese, lack of sleep, some contraception medications, and stress are among common migraine triggers. 
      
Q: I’ve been having some sharp jaw pain just below my ear. I want to have it checked out, but I have no idea whether I should see my dentist, an ENT (ear, nose & throat) doctor, or a bone doctor. (Or maybe a brain surgeon??!!) What should I do next?

A: Occasional minor pain in the jaw joint or chewing muscles usually goes away after a short period. If pain persists, consulting a dentist would be the best first step.

As for your problem, we consulted Dr. Panupen Sitthisomwong, a US board-certified dentist specializing in orofacial pain. “The symptoms you are experiencing may indicate a temporomandibular (chewing muscle) disorder (TMD) or temporomandibular (jaw) joint syndrome (TMJ)," Dr. Panupen explained. "These conditions may also cause headaches, toothaches, and pain in the ears, neck or shoulders, including difficulty in mouth opening. Some TMD patients also experience a clicking, popping or grating sound when opening or closing the mouth.”

TMD can result from frequent teeth grinding or jaw clenching (often during sleep or without being aware of it) as these repetitive motions can cause inflammation of the jaw muscles and joint degeneration.

Dr. Panupen noted that less serious cases of TMD usually respond to medication and resting of the jaw. Your dentist may recommend wearing plastic or rubber teeth guards to relieve jaw pressure.

“A preventive approach is always THE best,” Dr. Panupen advised.“See your dentist twice a year for regular check-ups and be sure to mention any jaw pain or other problems you may be having.” 

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