Archive for Menopause and Lifestyle

Mar
15

SEX AFTER MENOPAUSE-JOIN ME IN A LIVE EVENT!

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We women deal with many physical and emotional changes during and after menopause. Some of these changes can take a real toll
on our relationships, including our sex life.

To complicate matters, it’s often difficult to find straightforward,
trustworthy information about how to deal with issues like changes in our
libido, pain during sexual intercourse.

That’s why I’m excited to share with you that Vibrant Nation, the leading
online community for women 45+, is having its first ever Live webcast
discussion, Sex After Menopause. On March 31, 2015 at 1:00pm EST,
Vibrant Nation sexual health expert and blogger Dr. Barb DePree will lead
a panel of women in sharing their stories and advice for getting that spark
back in the bedroom.

Disclosure: I am participating in a Vibrant Influencer Network campaign. I
am receiving a fee for posting; however, the opinions expressed in this
post are my own. I am in no way affiliated with Pfizer and do not earn a commission or percent of sales.

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For years and even decades, research and guidelines on prevention and treatment for various diseases and conditions have been studied almost exclusively in men, then applied to women. This environment of medical research is now changing and the new stroke guidelines issued by the American Heart Assoc. and American Stroke Assoc. reflect this.

Stroke is now the 3rd leading cause for death in women, with over 55,000 more deaths in women than in men occurring annually. The new guidelines are intended to reduce this incidence and hopefully help prevent more strokes in women by increasing awareness of symptoms  and risk factors for both patient and medical providers.

First, lets review what a stroke is. A stroke occurs when the blood supply to a portion of the brain is interrupted either by a clot, or by bleeding. These types of stroke are called embolic or thrombotic, and hemorrhagic. A stroke caused by a blood clot occurs when a clot lodges in a blood vessel within the brain, having traveled there or forming at the site.  A hemorrhagic stroke occurs when a blood vessel ruptures and bleeds into the brain space, either from a weakening in the blood vessel wall or from trauma.

Both situations cause the brain that is supplied by the blood vessel that is now damaged, to die. A stroke can give a variety of symptoms, depending on what part of the brain the damage occurs in. Some of the symptoms of stroke can include:

  • loss of  balance, or use of arms and legs, weakness
  • confusion
  • visual loss or change, trouble speaking or finding the words you want
  • numbness or tingling of face, arms or legs
  • facial drooping, slurring of words, trouble eating
  • a sudden severe headache

It is important to get to an ER immediately if you feel you or someone you know may be having a stroke, as immediate help can prevent the long term impairment from a stroke and prevent death of brain tissue.

The new guidelines are now recognizing conditions that are either unique to women or occur more frequently in women. These risk factors include:

  • Use of hormone replacement therapy and oral contraceptives
  • presence of migraine with aura
  • history of pre eclampsia in a prior pregnancy (high blood pressure during pregnancy)
  • history of central retinal vein occlusion (blood clot to the vein supplying the nerve of the eye)
  • atrial fibrillation which occurs more commonly in women than in men

Other risk factors applicable to both men and women include:

  • hypertension
  • diabetes
  • high cholesterol
  • nicotine use
  • inactivity
  • obesity
  • a blood clotting disorder
  • having a family  history of stroke
  • having high blood pressure, diabetes and high cholesterol AND smoking is very high risk.
  • excessive alcohol use and use of some recreational drugs

Discussing your risk factors with your medical provider will help guide any specific treatment or lifestyle changes that are most important for you. A DASH diet low in sodium has been found in studies to reduce the risk of stroke.

It is key that you stop smoking especially if you are taking a hormone preparation at any age. Additionally, smoking cessation will reduce your risk of stroke substantially,  if you develop diabetes or hypertension as well as high cholesterol.

You do have the power to reduce your risk of stroke by:

  • staying active
  • controlling weight
  • controlling blood pressure and glucose levels, as well as cholesterol
  • using alcohol in moderation, no nicotine!
  • You may want to discuss with your provider whether a low dose aspirin is appropriate for you.

Most importantly, knowing the signs and symptoms of a stroke and getting to qualified help such as a major medical center; can save your life.

For additional information on stroke, visit the AMA/ASA website!

 

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Feb
28

New Culprit in Memory Loss-Inflammation?

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Everyone becomes forgetful at some point in their lives, but when it occurs to someone already dealing with the symptoms of aging; dementia becomes the feared ailment.

Forgetfulness is one thing, dementia is a whole other beast. While there are some things you can do to avoid dementia, some of it is predetermined by genetics. Preserving your memory is as much as preserving your health.

It is all about inflammation. What we do and don’t do to our bodies and to our health, causes inflammation. Inflammation causes harm to our cells; it is unavoidable but definitely can be minimized.

Memory loss in the form of mild forgetfulness is a normal consequence of aging, as we do lose brain cells and volume over time. It is also a function of too much brain multitasking, so a thought or intention is not properly imprinted. In other words, doing too much at one time can crowd the brain circuits and make it difficult to remember, usually the lesser important thoughts.

There are also some medical conditions that can make memory harder to preserve. Think of your brain as a computer. If it does not get proper energy, it cannot work. It also needs a break once in a while in the form of sleep and relaxation.

Your brain needs oxygen, blood flow and glucose to work. If you are not breathing well, or you have a heart condition; your brain may not get what it needs. Usually there is enough glucose, so this is rarely an issue. It also needs the nutrients that nourish the nerves such as the B vitamins, fatty acids, even cholesterol! Thyroid hormone also is the metabolic booster for the body. If this is not in adequate supply, the engine can’t work as effectively.

Finally, there are our sex hormones that help with brain function. Both estrogen and testosterone help with brain function and memory. As these hormones decrease with aging, you may notice a decline in your memory abilities.

Inflammation is also felt to be a culprit in decreasing memory. Inflammation can come from a wide variety of sources including infections, arthritis, smoking, diabetes, hypertension to name a few. Excessive alcohol use is also detrimental mostly through poor nutrition.

So it would stand to reason that improving your memory, or at least keeping it from worsening; would include proper healthy treatment of the medical conditions that cause inflammation. In addition, treating conditions that improve blood flow to the brain as well as oxygenation are key.

Exercise will improve your heart and your lungs, helping to deliver an abundant supply of oxygen and nutrients to your brain.

A healthy, well rounded diet with foods rich in Omega 3 fatty acids, and the B vitamins will support nerve health. Limiting alcohol which can damage the nerves is equally as important.

Avoiding poor sleep habits will help you to get a good nights sleep, allowing your brain to repair itself.

Managing your blood pressure and glucose metabolism with a healthy lifestyle and  medication if needed, will help keep inflammation of your system down.

When do you worry? When your memory issues are impacting your life.

You don’t have to wait until you forget what city you are in to have your memory be a problem. Decreased work performance can be an indicator of a problem, or repeatedly forgetting names of people in social situations. Suddenly no being able to complete a set of chores that normally you complete in a day. These can all be indicators of a health problem.

See your medical provider to get some labs done. You will want to get your thyroid level checked, may be Vitamin B12 especially if you are a vegetarian. Vitamin D level may also be useful. You may need to review any medications you are on, statin therapy for cholesterol can be a big culprit in affecting memory.

Lastly, hormone therapy may be indicated. For women at low risk for heart problems and breast cancer, hormone replacement therapy is very useful at helping to restore memory. For men with a low testosterone, replacement with this hormone can also help to restore memory and erase the fogginess that low testosterone can cause.

While inflammation is an unavoidable consequence of aging, there is a lot we can do to minimize the inflammation in our body. Living as healthy as you can helps your brain as well as the rest of your system.

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Nov
14

The Value Of Positive Self Talk

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I recently came across this article regarding whether the point of exhaustion we perceive when exercising, is in fact our real point of exhaustion. It occurred to me that this concept can also apply to other areas of our lives.

It is all about self talk, and what we tell ourselves we can and cannot do. During menopause, this is particularly challenging as our bodies are changing and we often do not know how we will feel on a given day.

This study looked at the degree to which the subjects were able to push themselves past the point at which they thought they could do no more. The test subjects were counseled to engage in positive self talk while exercising vigorously. At the end of the study, those that engaged in positive self talk could go further and longer; and perceived their workout to be less of an effort than those subjects who did not employ positive self talk.

Remember the children’s story about the train going up the hill, saying “I think I can, I think I can?” What a valuable lesson to learn at a young age! How easy it is to lose sight of that lesson as we age and experience the trials and disappointments that life can present to us.

Self talk can save us from a challenging day; turning our day completely around. Or it can be our undoing. When we are tired and stressed, it can be very hard to put forth the energy to be positive. It seems easier to let events happen, and then just react. How often though, does this turn out well?

Recently while driving to work after a particularly bad night of sleep, I was feeling the challenges of the day weigh on me. A recent reading about positive self talk crept into my consciousness and I seized on it. Telling myself that fatigue is only that, and that I could survive one day at least; I repeated to myself that my day will be good, and I will be patient and thoughtful with my interactions. It worked, and that day has become a template for other similar sleep deprived days.

Coming back to the above mentioned study, our perceptions of what we are capable of can always be challenged and extended when we feel positive and in control. Menopause challenges that sense of control but does not have to control us.

Take a moment when you are rested and feeling contemplative, and write down some positive phrases that are motivating for you. Make these phrases about your success, and ability to control the outcome of a task or situation. Practice these phrases so that they sound genuine to you, and feel that they are an extension of you.

The next time you are faced with a challenge, remind yourself that the outcome can be good if you approach it that way. Take some time to repeat your phrases, and engage in positive self talk.

You may find that this strategy helps you successfully overcoming obstacles to changes you want to make!

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Sep
22

KNOW YOUR RISK FOR UTERINE CANCER

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Uterine cancer affects tens of thousands of women yearly, roughly 49,000 new cancers diagnosed a year! It is the most common female cancer and you may be at risk for this!

This sort of cancer occurs when there is a production of estrogen without progesterone to counter estrogen’s affects on the uterine lining. Estrogen does many things for our bodies, and when we are still menstruating; it thickens the uterine wall. Progesterone stabilizes that lining and with an increase in production once a month, the lining separates from the uterine wall and comes out. So without progesterone, this lining would develop without any periodic shedding, and a potential cancer can then occur.

At this point you may be saying to yourself  “Anne, I am menopausal and do not have periods any longer. What is the big deal?”

Unopposed estrogen may still be occurring even without your ovaries working!

It is true that the bulk of estrogen production comes from our ovaries, but a little is made by the adrenal glands. This production is minor and helps keeps us going after the ovaries stop functioning. It has very little impact on the uterine lining. There is another source of estrogen that can contribute to uterine cancer however, and that is adipose tissue, or fat.

That’s right, the fat we develop at middle age is active and secretes hormones. It can store and secrete estrogen. This is the reason for the increased risk of breast and uterine cancer with excess weight gain and obesity. The uterus is especially susceptible to developing cancer from being obese and having higher estrogen levels.

Does that mean you will get uterine cancer if you are obese, or if you gain 20 or more pounds following menopause? Probable not, but you should know your risk. While being overweight can increase your risk of uterine cancer, researchers at the American Institute for Cancer Research state that your risk can be reduced by 60% with 30 minutes of exercise daily leading to better weight control.

In addition to weight control and a healthy diet;  taking HRT will for menopausal symptoms should always be accompanied by progesterone  in order to prevent uterine lining development.

The signs of uterine cancer is almost always unusual vaginal bleeding and discharge. Most uterine cancers are diagnosed in women after 60, well beyond the years of normal menstruation. Any vaginal bleeding that occurs post menopausal requires immediate attention. Pelvic pain can also be a symptom and this should be reported also.

Lessening your risk of endometrial cancer, or uterine cancer; can be as simple as a healthy diet and regular exercise. If there is a strong family history of uterine cancer, avoiding hormone replacement therapy may be advised by your medical provider. Regular checkups and reporting any unusual vaginal bleeding, discharge or pelvic pain immediately can usually catch a problem early.

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Jul
14

This One Big Easy Change Can Improve Your Life!

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OK, so you just came back from your yearly physical and your provider told you that  your blood pressure and cholesterol are too high, your are in the obese category, and you need to lose 30 lbs.

On top of all this, you are menopausal, hot all the time, tired all the time and can’t think straight. Your head is screaming WHERE DO I START?

Oh, and did I mention you did not get any advise on how to accomplish all this!

Don’t give up and throw in the towel, letting it all go. You can start with changes, one at a time. It will be slow, but steady progress with a result in a lower blood pressure, cholesterol and weight. Oh, and you may get rid of those troubling menopausal symptoms as a side benefit!

OK, lets get started.

First is diet. Throw out the sugar and go just 3 days, only 3 days without sugar. This means no sodas, no sweet tea, no candy, desserts. It ALSO means no dairy as this has lactose which is a type of sugar, and yes that includes cheese. No fruit, as this has sugar. No starches as these cause spikes of blood sugar and fuel cravings for sugar. REMEMBER, this is only 3 days.

What good will this do you may wonder? It gives you control over your blood glucose, it detoxifies your system, and it lessens food cravings. And it may just make you feel better! Exercise is important, but diet needs to come first. Food is like a medicine, it profoundly affects your body system and can heal you, or kill you.

Sugar and refined packaged foods are the most destructive things to our health, other than cigarettes. Choose these 3 days of no sugar to eat as much natural food as you can. Go for salads, fresh cooked vegetables, and water…lots of water. You can eat small amounts of nuts, this will give you some healthy fats which will help you feel full. You can eat protein, pick leaner cuts of meat not hot dogs or sausages as these are processed and very high in fat. You can have a few eggs. Try an omelet with veggies for breakfast, salad with some meat and a light salad dressing for lunch, a lean meat and 2 cooked vegetables for dinner. Snack on nuts, raw veggies and humus. Drink water, water, water; you can squeeze some lemon in it for flavor.

Ok, so you have detoxed from sugar for 3 days. What’s next?

You may be surprised what the scale has done and hopefully this will motivate you to continue with some diet changes. For the next few weeks, slowly add in some cheese, then other dairy and some fruit. Not all at once, but 1-2 things every day. As you do this, you should continue to notice a benefit in how you feel. It is still important to avoid processed foods and sweets.

Some strategies to avoid complete deprivation of the foods you like is to pick one day a week, and allow yourself some foods that you enjoy. Don’t go overboard, and get right back on track the next day. If you feel yourself really craving these foods, you may need to avoid doing this and pick only one day a month. You may actually find though, that your stomach does not like these fatty processed foods after you haven’t eaten them for a while. This is progress!

This is a start, it will not solve all of your problems but it is a significant help. Blood glucose spikes fuel cravings making us eat more. Eating more causes weight gain which makes the heart work harder, and what isn’t used for energy is stored as fat or cholesterol. Blood glucose spikes can also trigger hot flashes and make them more powerful. A higher plant based diet can provide you with the plant version of estrogen called phytoestrogens; which can help lessen menopausal symptoms.

Coming home from your medical providers office needn’t make you feel dome and gloom. Make this one small change to start and see what happens. Check in with me later to see other changes that can help you reverse any negative biological process going on!

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Jul
02

IMPORTANCE OF DECREASING STRESS

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Stress. Something that is part of our daily lives, something we all try to mitigate the effects of when we are aware of it affecting us.

Most of us do not need researchers to tell us the ill affects of stress on our lives; lack of sleep, higher blood pressures, weight gain. Stress, and the hormonal reaction it can cause in our bodies can change how well our heart is working, how well we are breathing, and how well we digest food; not to mention the quality of our choices in all of that.

But it appears that even the perception of our stress can have these effects also! A recent analysis of a study done in the U.K. following several thousand people since 1985 recently revealed this fact.

These subjects were questioned over time regarding their stress levels, and their perception of the degree to which the stress was affecting them. There was a whooping 50% increase in the rate of heart attack among the subjects who rated their stress as affecting their health “a lot or extremely”! Similar findings have occurred in other studies conducted among French workers. Those that did not perceive their stress as adversely affecting their health, has a significantly lower rate of heart attacks.

The importance of these studies illustrates the need for an awareness of one’s stress level and obtaining help for decreasing stress in our lives. If you feel your stress is affecting your health, than it most likely is.

For most of us, it is near impossible to remove stress from our lives. The silver lining of these studies may be however, that our ability to control how the stress if affecting us can lessen the damage to our bodies.

So while you may not be able to control the stress in your life, you can control how you react and deal with it!

How can you do this?

Exercise, meditation and deep breathing are all methods to lower stress hormones and help the “calming” part of your brain become more in control. These measures do help, but what can you do in the moment?

Stressful situations can trigger the part of our brain that is there for survival, quick action. That is fine when you need to run from danger; but doesn’t work with stressful situations in the car, at work or at home.

It does always help to take a few slow, deep breathes. You may need to take at least a mental step back, if not a physical step back.

Practicing imagery before being in the moment will help you call upon your tools when in the midst of a stressful situation. When not “in the moment”, bring up a pleasant song that always relaxes you. Think of a person you respect who is strong and measured and often has insightful advise for you. Picture this person. Lastly think of a scent you like that is also relaxing.

You have now activated 3 different sensory aspects of your brain; visual, auditory and olfactory (smell). If you can practice imagining this scenario while imagining a stressful situation; your next stressful event may find the anger and fear diluted by these 3 positive thoughts or associations.

It is all about the mind, and trying to better control the immediate emotional responses that can undermine our physical and emotional health. Working on your emotional health and ability to deal with stress can indeed make you calmer and ultimately happier. But it appears, it can also make you physically stronger and healthier!

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Mar
23

DEPRESSION, HEART DISEASE AND MENOPAUSE-IS THERE A LINK?

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Heart disease claims the lives of 1 in 4 women. It continues to be a significant issue for women and unfortunately, often presents in different ways as compared to men. For this reason, it is often overlooked as a potential problem for menopausal women.

The factors that contribute to heart disease for women are still unknown. It is felt that lack of natural estrogen somehow potentiates plaque formation in the large and small arteries supplying heart muscle.

Recent analysis of date from a nurses study has also highlighted the increased degree of heart disease in depressed women. Again, the mechanisms for this are not yet fully understood. There has long been observation and knowledge that depression can occur after a heart attack or heart surgery. The question remains, which came first and is this a coincidental association or is there a link?

It is not new that menopause can be a challenging time! With sleep deprivation, fatigue, problems with concentration; it is no surprise that women feel over whelmed and at times moody and depressed. Not every women however, becomes clinically depressed.

The unknown however, is whether the estrogen fluctuations of menopause can cause someone to experience depression for the first time. And if experiencing depression for the first time, do you have an increased risk of heart disease? There is 2 fold increase in the rates of depression known to occur during menopause; and depression has been shown to increase rate of cardiovascular disease.

There is currently a study undergoing at UNC called the PERT study, the Peri menopausal Estrogen Replacement Trial; to look at this issue further. This study is evaluating the (hopefully) beneficial effect of the use of estrogen in treating a new, or newly recurrent depression in perimenopausal women. They will be evaluating the incidence of heart disease for women being treated for depression with estrogen, to determine the efficacy of this treatment for both depression and heart disease in depressed women.

If you are interested in participating in this trial, or would like to know more; click on this link: UNC PERT study.

Knowing the potential cause of a woman’s depression can help tailor treatment, as well as determine what sort of pharmacological treatment may be most beneficial in alleviating symptoms. Knowing the link between depression and heart disease may help dictate surveillance testing for heart disease as you transition through menopause.

Because this is a major cause of illness and death in post menopausal women, it is important to educate yourself regarding your risk factors for heart disease. Many factors are known to contribute to heart disease, such as diabetes, elevated cholesterol, smoking, obesity and family history. It important for women to now understand that  depression is now added to the list of risk factors.

Know your risks, know the symptoms of heart disease; and change what you can!

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Feb
10

GENES, NOT JEANS, AND WEIGHT LOSS

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Is it possible to actually get a lab test to see what diet may work for you?

Believe it or not, there is a genetic test available to determine how well a low fat vs a low carbohydrate diet will work for you. For those of you who have tried the Adkin’s diet and not lost significant weight, this may be the answer! A small study done many years ago compared women on either the Adkin’s diet, Zone diet, or Ornish diet. The research found that women whose diets matched their genetic predisposition were far more successful at weight loss.

Many people lose weight on a high protein, low carbohydrate diet. Since most westerners consume a diet high in processed carbohydrates. Many of these carbohydrates that are processed are basically broken down quickly to sugar, therefor the weight loss is often related to calorie restriction. Most of these diets severely limit starches, which contain a fair amount of calories. However, another cause may be the lack of inflammatory foods in a high protein, low carb diet.

There is also the theory that inflammatory diets are contributing to weight gain. This is not so much through the actual calories consumed, but more related to inflammation causing a  hormone response that triggers fat deposition. When you consume too many processed carbohydrates, the sugar in your blood stream rises. Over time, your body can become resistant to the forces that should be taking care of this rise in blood sugar. With no where to go, the sugar, or glucose, gets converted to fat for storage. Additionally, you body becomes resistant to the signal that you are full.
Having insulin resistance and leptin resistance is not a good situation for weight loss!

Inflammatory foods for you may be dairy, yes that includes cheese/yogurt/milk; sorry. It most certainly contains sugar in all forms, including alcohol (wine,beer, distilled liquor). Wheat can be a big culprit also as gluten sensitive people can tell you.

An anti-inflammatory diet would contain many vegetables, fruits, chicken and maybe beef. Lamb and pork, as well as turkey would need to be tested. Nuts and seeds are usually fine, but they are high in calories so you need t watch quantity. Grains can be tested by adding one at a time, say every few days. If you become bloated, tired, or puffy; this may be a sign that a specific food may be inflammatory for you.

So to fit into your jeans, you don’t need to have your genes tested. Devise a stream lined diet without inflammatory foods, and consume this diet for several days. Then, slowly add in a few of your favorite foods and see how your system deals with it. Trial and error will tell you what foods to consume to lose weight and keep it off.

Doing so will teach you to become more in tuned with your body, as well as allow you to chose how much of a given food you want to make as part of your diet.

Again, it is all about choices. Knowledge gives you the ability to make the choices that are best for you, in order to help you achieve your goals.

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Dec
17

Reducing Stress-Important during Holidays

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We all know that stress can be detrimental and disruptive to our physical and mental well being.  Many significant illnesses can be caused by or worsened by stress. And if you are a menopausal woman, your body is already under stress.

That is why it is important for you to take every measure possible to reduce stress and its affect on your body. We often forget to take care of ourselves properly when we are very busy.

The holidays can be very busy for many of us, and are no different in terms of stress as any other time of year. Even though the holidays are associated with celebration and joy, they can provoke many stressful reactions. The extra tasks and obligations that come with the holidays can displace time spent relaxing, exercising and sleeping. The holidays are a difficult time if you are not happy with your life, or have had loss in your life.  Work can also include a heavier load with year end duties needing to be accomplished. If you are in retail, or medicine, it is often far busier than at other times of the year.

Some tips for keeping stress under control include:

Making a list of important items to accomplish and prioritizing.

Set aside a few evenings that you will work on your task list, the other evenings are for your usual tasks as well as relaxing.

Set a firm bedtime and stick to it. Remember, you may not be able to everything you want and it may not be perfect.

Keep the big picture in mind, Christmas is more about feelings and thoughtfulness than a physical gift. Concentrate on showing the people important to you that you care by helping them, listening to them, laughing with them.

Stick to your healthy diet at meals that are no associated with a party. You can make a good effort to eat healthy at social occasions, but most of us don’t. Just go back to healthy meals the next day, maybe eat a small healthy snack in place of a  meal now and then if you had a big lunch or dinner.

Stick to your exercise routine as much as possible, aim for at least 3 days a week exercise and one strength training a week as a minimum. You can get back to more exercise after the holidays.

Try to set aside a few minutes every day to sit quietly and meditate. Just 10 minutes will help tremendously, and don’t forget to breathe deeply several times a day!

I see many more people coming into the clinic where I work with stress related symptoms, such as chest pain and irregular heartbeats, during the time period between Thanksgiving and Christmas.  Most the time it is all from stress.

This year, try some of the suggestions above to see if you will feel less of a burden of performance over the holidays; and more of the inner celebration of peace and love.

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