Men naturally have more muscle than women and muscle uses up a lot of energy (calories) every day just to exist. That’s why a man would need to eat more calories each day than a woman of the same age, height and weight just to survive. Women naturally have more body fat than men which is what gives us most of our curves.
Even though you’re a woman you can still overcome this slight disadvantage if you’re smart about the way you eat and exercise.

Women can also build muscle which helps you to lose fat and keep it of in the long run. When you talk to women about building muscle, they automatically get this mental image of Arnold Schwarzenegger with lumpy arms, chest and everything else.

It doesn’t have to be that way. It’s next to impossible for you to look like that if you’re a women unless you’re on steroids which build muscle artificially. So relax. Build some muscle and you can lose the fat as easily as any man.

If you’re starting out on a “weight loss” program, don’t focus on what the bathroom scales are telling you so you don’t become unnecessarily frustrated. Take a look at your clothes and see how they fit. Are they looser around the hips, the waist, the thighs? Do you need to move your belt in a notch to make it fit? Can you fit into the skirt or jeans that you could’t fit into before?

If you’re particular, you can take your measurements- bust, waist, hips and thighs for example, and write them down and compare them as you progress.

But I did think that my level of activity was enough to balance out what I was taking in. Well, think again Einstein! obviously I was very wrong. So I dug out my pedometer which measures the number of steps you’ve taken in a day. I managed to clock 12,781 steps 2 days ago. I’ve also dusted off my weights. Weight training is a great way to lose weight because your muscles keep burning fat for some time after you finish exercising. Ive also started my aerobics again, especially the low impact type.

I filled the fridge with fruit. Mangoes are in season now which is good because I love mangoes. When I feel like a fattening snack, I grab some fruit. I like pears as well. The good thing about these fruit for me is that you don’t need a lot of fuss to eat them, just wash and eat. I love convenience.  In a while, I’ll asses my progress or lack thereof.

Apart from this, these is the cultural aspect of the problem. Women don’t want to talk about menopause because it marks the end of their reproductive life. They may feel less feminine and fell that those around them see them as not being real women. In some respects, its almost as if it’s something to be ashamed of even in the more “enlightened” societies.

Working as doctors in the developing world, there are so many problems we face and obstacles we encounter that prevent us from giving our patients the quality of care that they deserve. Treating symptoms of and managing menopause pales into insignificant when compared to life threatening diseases arising from ignorance and poverty – the young girl who has had an illegal abortion whose uterus is so damaged she can’t have any children or the mother of 5 who labors until she bleeds to death.

Many menopausal women we see may think we’re insensitive to their condition but some of us are not. In spite of everything we have to cope with, theirs is still a real problem, a real predicament, a real and disruptive influence in their lives. We, as doctors, should try not to forget that we need to explore alternatives which, yes, may be less effective than estrogen/progesterone hormone replacement therapy, but can still help to ease the transition a little for some of these women.

The amount of resistance I got was enormous.   Every day, my children would follow me around begging to watch tv but I refused. My husband even joined in asking me to let them watch, but I dug in my heels. I can be very stubborn when I’m convinced I’m doing the right thing, especially when it comes to my children. It took them some weeks to get used to it, but eventually, they stopped asking me about tv except on fridays and saturdays. Sometimes they watch for an hour or two on sunday. Now, even on days they are allowed to watch tv they always come and ask me first before they put it on.

Sometimes, we don’t do the right thing because we’re afraid of upsetting our children. Of course they will get upset, they want to have their own  way (much like adults in fact!). Children are always testing the waters to see how much they can get away with. It’s our job s parents to set realistic targets and boundaries so that children know what is expected of them and the consequences that come from disobedience.

Since I took this decision, I’ve noticed that my kids are calmer, better behaved and they have fewer nightmares (there are some pretty scary cartoons on Cartoon Network which could give me nightmares! Needless to say, I stopped them from watching them). They love reading the storybooks that I buy for them, I buy new ones regularly to give them something to get excited about. I read to them every night before they go to bed – from the Bible and their storybooks.

I keep a close eye on what they watch on tv. I also buy dvds with the kind of animated films and cartoons that I think are suitable, especially bible stories.

We’re so busy as parents (and particularly mums) trying to keep things together and everyone happy, whether working outside the home or within it, that we sometimes neglect our children and lose sight of the big picture. We use television to anaesthetize them and keep them out of the way so we can get some other things done. If you take a look at your life, you may find that there are some things that take up your time that aren’t that important in the grand scheme of things. There may be favours that you are doing for others or projects you’ve been roped into that you just don’t have the time for, but you just don’t know how to say ‘No!’ Practice makes perfect.

Now I’m looking at other areas where I need to make some hard decisions and make some rules. I’ve cut down the number of hours I spend in front of this laptop for a start.

It’s hard work, especially at the beginning, because you’ll feel like yours is the lone voice in the wilderness. In the end, I know it will be worth it and my children and the whole family will reap the rewards.

Every parent wants their child to “do well”. But we need to ask ourselves exactly what that means in the grand scheme of things. All work and no play makes Jack a dull boy. On the other hand, all play and no work may leave Jack a very miserable guy when he grows up.

A typical example is the mad rush to get into some popular secondary schools. Are all the children that go to the “best schools” the most respectful, hardworking, enterprising, successful? I don’t think so. And what does success mean anyway? I think different people would define it in their own way.

I think the most important thing is to bring up children that are balanced spiritually, morally and academically. That way we can equip them to survive in the big, bad world outside.

While I was busy worrying myself to death, an idea started to take shape in my mind. It’s so easy to get into a rut. Wake up, get the kids to school, dash to work, dash back to school, go home ….and the cycle continues. When we moved I actually had a chance to take a look at my life.

My husband’s work was very demanding with odd hours and he used to come home late. I had to ask myself, with hubby working so much could I really afford to spend so much time away from home and my children? Was I doing the best thing as the primary caregiver and supervisor of my children to continue running from pillar to post trying to juggle postgraduate training and my family responsibilities? What was best for my family and was I doing that?

O&G is one of the most strenuos medical disciplines. If I was away as well as my husband who would take care of my precious kids? A nanny, housemaid, servant? After one of my children was accidentally doused with hot water by my maid while I was at work, that didn’t sound like a great idea to me.

I battled with myself for months. My life had revolved around medicine for almost 2 decades. It was a major part of my identity. Could I afford to give that up? Would I feel complete without it? Wouldn’t I be wasting all my years of medical training?
I toyed with the idea of changing my discipline to work in a field of medicine that was less tedious and time consuming? Obviously I was finding it hard to let go. Whenever I met my collegues, naturally I was asked where I worked. After telling them I wasn’t working I always felt compelled to explain that I wanted to take care of my family and residency in O&G wasn’t letting me do that.

My problem is that I’m a bit of a perfectionist (I didn’t actually realize it until one of my closest friends told me that). If I do something I want to do it well. I remember when I was working. I would pray that there would be no patients to operate on on theatre days so that I would be able to get to the children’s school on time. If patients turned up I would pray for surgery to be over so I could rush to school. I’d be praying there’d be no emergencies so I could get to school. On clinic days I’d be seeing the patients at lightening speed so that…….. You get the idea!

So who am I? Do I have an identity apart from my profession? Can I be complete if I’m not doing what I’ve been training for so many years to do? I still feel a bit strange occasionally (like if I watch a medical show like Gray’s Anatomy) , but I’m getting over it. When people ask me what I do I simply tell them I’m a “domestic engineer” ( a senior colleague of mine gave me that particular gem of a phrase a few years ag)o. No long explanations trying to justify my actions because I don’t owe that to anyone. No silly patronizing comments about how my husband is forcing me to be a housewife against my will. By the time they’ve figured out what a domestic engineer is, I’m long gone.

I’m not under any illusions that every woman can or would even want to do what I’m doing. Some couples can’t really afford to have only one partner working and some women love and have put a lot into their careers or have other reasons for working in spite of the challenges of combining work and family life. Quite a few women used the opportunity of being downsized out of their jobs to start their own businesses so they could be in control of their working hours. That’s not a walk in the park either.

As with many things in life, time will tell if I’ve made the right decision. For me right now, I’m comfortable with it.

Unfortunately, we don’t have such accurate statistics here in Nigeria. But I’ve seen first hand the harm that episiotomies can do. Even if they don’t lead to incontinence, the discomfort arising from an episiotomy that isn’t repaired properly can linger for months. Naturally, this makes intercourse very uncomfortable among other things.

Many midwives in particular give episiotomies, even when the outlet is wide enough to allow the baby’s head to pass through. They are given almost automatically if the mother is having her first delivery. Totally unnecessary in many cases. Some education and a rethink is definitely needed.

Here are several ways you can check:

• Measure it. Use an ordinary tape measure and measure your tummy at a fixed point like the navel. If the numbers are going down, then you know you’re doing something right.
• Count the rolls at your side (don’t laugh!!!). When you turn sideways a little and look in the mirror, you may actually see rolls of fat, just like the Mitchelin man. These are popularly known as “spare tyres”. If the rolls are decreasing in number, you’re losing belly fat.
• Look at your hip creases where your leg joins your torso (the rest of your body). Sometimes, belly fat actually hangs down as well as projecting forward. This forms a fatty apron so you can’t even see your hip creases on either side. When you start seeing your hip creases, then you know you’ve lost belly fat.
• Look at yourself in the mirror sideways. Your stomach may be sticking out a bit less than it was before. This is pretty subjective because your imagination can play tricks on you.

I did the legs and back strength workout a few days ago and my backside is still sore. That is what’s called DOMS or delayed onset muscle soreness. It usually hits the day after you workout. I carry mine like a badge of honour. It doesn’t put me off working out, I just know that I worked hard.

I also did some walking and some time on my elliptical trainer but I think, in my zeal, I may have overdone it a little. From now on I think I’ll skip cardio on the legs and back day so I don’t hurt myself! Another thing is that the high impact pylometrics cardio dvd is going to be a killer for my knees and ankles so I’ve substituted one of my other dvds instead. I have Afterburn, a low impact aerobics dvd by Cathe Friedrich which I love. It’s interval training without a single jump. Believe me, that one is a killer. I’ve been working out for a while so I’ve learnt to customize things so they work for me.

I like the commitment of having to stick to a program for 3 months. Although I have a short attention span, I think I’ll be able to stick to it because there’s quite a lot of variety. I’ve written down my weight and measurements – chest, waist, hips. I’ll check them every two weeks to see how I’m doing. I’m looking forward to challenging myself for the next couple of weeks.