Archive for hot flashes



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I was recently contacted by the NIH regarding my thoughts on the use of HRT for treatment of menopausal symptoms. I was asked to review a brochure from NIH (National Institute of Health), to see if viewers may find some benefit from their information.

Hot flashes can can certainly be a very difficult symptom of the menopausal transition. They can interfere with sleep, affect our confidence at work as well as concentration. They are embarrassing, make us feel old; and can make coping with social situations difficult. Some of us have it bad, others not so much.

Now, according to a recent study, they are costing the companies we work for; in the form of lost time at work.


A recent analysis of data looking at the insurance claims of 500,000 menopausal women, all of whom were insured by Fortune 500 companies. Half suffered from hot flashes, and half did not. This analysis took place over the space of a year.

This analysis revealed a surprising 1.5 million more health care visits in the group with hot flashes compared to the control group. The cost of lost work by this group was estimated to be over 27 million dollars and the cost of this additional health care almost 340 million!

I am not sure that 250,000 hot flashing women could actually rack up this amount of cost to their employers and health insurers; but the point is noted. Hot flashes affect women and affect productivity.

This change has apparently been amplified since the Women’s Health Initiative findings of an increased incidence of stroke and heart attacks to users of HRT; resulting in more women opting not to use hormone replacement.

While hormone replacement therapy may carry an increased risk of breast cancer and cardiovascular events if you are in a high risk category for either of these, it can also be very safe to use for several years. This can be a life saver if you are someone suffering from hot flashes.

For my readers following me for the past few years, you are probably aware that I am a proponent of HRT if you are low risk. I feel they are safe to use for a limited time and can help ease the transition.

The following link to an NIH brochure containing information regarding Hormones and Menopause will allow you to review the position of National Institute of Health regarding the safety of hormone use for many women at low risk for cancer and heart disease. It contains some good information that I basically feel is sound. The brochure can be read online or ordered for free.

So check it out! Don’t be afraid to discuss possible use of hormones to ease your menopausal symptoms if they are interfering with work and social activities. As they did for me, they may help ease the worst of it for a few years, and help you establish some changes in your routine to accommodate the changes that menopause can bring!

ps. There is no financial incentive for me promoting this brochure, I receive nothing from NIH or any other organization; and the brochure is free.

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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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Sleep can be one of the most important and frustrating aspects of our lives to be disrupted during the menopausal years.

Many women enter menopause with poor sleep habits, only to find their sleep really becomes a miserable nightly event. Even though not all women have problems sleeping as they go through menopause, most are affected to some degree. Having healthy sleep hygiene (habits) helps to prevent insomnia, and it is not too late to establish this.

Sleep hygiene is a term used by sleep specialist to describe the habits that will best help foster sleep initiation. In other words, there is a list of do’s and don’ts that contribute to the ability to fall asleep and stay asleep.

Our bad habits at the beginning of menopause can set us up for problems during menopause, as we additionally go through physical changes that can disrupt sleep. Changes such as hot flashes, joint pain, stress and anxiety to name a few.

Bad habits that can prevent your from falling asleep can include:

  • Computer use until bedtime, or worse, late into the night. The light from the computer screen is felt to stimulate the awake center of the brain.
  • Drinking caffeine into the evening. Caffeine is a stimulant this can interfere with relaxation and production of melatonin. Melatonin is the substance our brain produces to help make us sleepy.
  • Drinking alcohol. This surprises many people as alcohol is a depressant and can make many people tired. In some, it interferes with melatonin production and can cause a rebound wakefulness after the alcohol is metabolized.
  • Eating late at night.

There are several lifestyle changes you can make to improve your sleep.

  • Exercise! While you may not feel like it, exercise will tire your body and help with sleep.
  • Avoid stimulation prior to bed. In other words, keep noise, music, lights, activities low in the hour before bedtime. Avoid meals, sugar and caffeine for several hours before bedtime.
  • Establish a regular bedtime. This will allow your body to produce melatonin which is the sleep hormone.

What can you do if none of this works?

First, see your medical provider to ensure there are no medical conditions inferring with sleep.

Next, you can try herbal supplements and over the counter sleep aids. These can be helpful, however check with your provider if you are on any medications before starting a new supplement.

I recently began using Estroven Nighttime, and have found it to be very effective for me. It contains Melatonin, which works by itself for some people; and Valerian root which has slight sedative properties. There a other herbs to help with hot flashes, such as soy and black cohosh.

Tylenol pm is one tried by many people. This is basically tylenol and benadryl mixed together, both of which are safe. It is important to not use too much Tylenol mixed in other products, as a total high dose can cause damage to liver and kidneys over time.

It is also important to keep your bedroom cool, use fans at night. Many houses in the south, where I live, have ceiling fans which are helpful. A small fan on the night stand can also work.

Establishing a consistent sleep routine takes some work, but it is worth the effort to gain the much needed rest and restorative healing that occurs during sleep. Try some of these tips and let me know how they work. Write in with any tips of your own to share with our readers!

Categories : Menopause Symptoms
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Fatigue can be a major part of the menopausal transition. It can be one of the first things that happens, often sneaking up on women without any identifiable cause.

Your fatigue can be from a variety of reasons, and most people will blame it on the inability to sleep that can occur with menopause. As many of us know, sleep is often a tenuous event every night. There are hot flashes that wake us up, and sometimes we find ourselves wide awake in the middle of the night for no reason.

The fatigue that occurs during menopause can lead you to reduce the exercise or activities you participate in, because you are just too tired. This can lead to weight gain; and weight gain can lead to diabetes, HTN, diabetes. All of this can predispose you to sleep apnea.

Sometimes fatigue is just from lack of sleep, and we are familiar with this form of weariness. But sometimes fatigue can be due to poor quality sleep that is a result of sleep apnea. You may feel that you stay asleep all night, but awaken worn out; as if you have not slept at all. This can be a sign of sleep apnea, as is snoring or interrupted breathing while sleeping.

It is important to address your fatigue with your medical provider. Other reasons for fatigue can include:

  • anemia-both iron deficiency and B12 deficiency
  • diabetes
  • medications
  • depression
  • joint disease or connective tissue disease
  • breathing problems such as asthma, COPD, lung infections
  • nutritional deficiencies and excessive dieting

Sleep apnea can occur to anyone as they age, but it is more likely to occur with being overweight. This can place  stress on the oropharyngeal structures, which result in collapse and obstruction of the breathing passages when laying down. Prolonged sleep apnea can then lead to a condition called pulmonary hypertension.

What can you do the prevent sleep apnea?

While you cannot prevent yourself from aging,  limiting weight gain as you age may be the most important deterrent to sleep apnea. This is best achieved through healthy diet and exercise. It is the weight gain in the neck which primarily the culprit bringing on sleep apnea.

Keep in mind that sleep apnea is not just a condition for men, woman are susceptible also! See your provider if you have unexplained fatigue, and work on healthy diet and exercise to control weight and improve your sleep.

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A reader recently posted a question:

What do you do when your health requires you to stop taking your hormone therapy?

Many specialists would simply say, stop your medication and in essence, deal with it. Your gynecologist or family practitioner could no doubt offer more advice than that. My first advice would be to contact your regular provider to ask their advice on controlling symptoms.

The time of menopause is also the time of increase risk of stroke, heart attacks, cancers, and blood clots or DVT ( deep vein thrombophlebitis). Estrogen and progesterone can cause inflammation of blood vessel walls, thus helping to cause stroke, blood clots, and heart attacks. Estrogens can fuel a breast cancer or other cancers of the female organs. Since having one cancer places you at risk for any other cancer, it makes sense to discontinue estrogen for any cancer a woman may experience.

So what do you do when you are told to suddenly stop the therapy which is helping you feel sane and in control?

There are many other therapies which are safe and can help control symptoms, but first you must check with you provider. One thing which will be vital for controlling the symptoms of menopause is a healthy life style. Because of how food is metabolized during this time, it is important to limit foods high in sugar as this can lead to fatigue and sometimes fuel hot flashes. It is also important to limit caffeine and alcohol as these items can trigger hot flashes both daytime and nighttime. Alcohol also causes difficulty with sleep mostly due to the sugar content.

We all know a bad night sleeping can lead to

  • fatigue, which leads to
  • low energy and avoidance of exercise,
  • leads to convenient food choices for comfort and ease of preparation.
  • lack of sex drive
  • difficulty concentrating
  • all of the above leading to low self esteem and possibly depression over lack of control

How do you gain control of all this?

A diet high in antioxidants helps. This means fresh fruits and vegetables, brightly colored or deep leafy green. Consuming less sugar, caffeine, and alcohol. If you are sensitive, a diet low in dairy. If you are not sure how dairy sensitive you are, stop all dairy for 1-2 months and see how you feel. You may have more energy, less respiratory problems and skin problems. Exercise of any kind that gets your heart beating faster and uses your muscles in a way not normally used in your average day.

For medical help when the above measures are not enough, there is clonodine or effexor (low dose) which can help with hot flashes. There are sleep aids which are generally safe for short periods of time. Doing cross word puzzles or other memory type games can help some with “brain fog”, as does some low dose antidepressants if applicable. Herbal products should be used with extreme caution if they contain soy or black cohosh; these products can theoretically be irritating to blood vessel walls as they are estrogen like in their action.

There are measures you can take to control your symptoms, nothing may be as completely relieving as hormone replacement therapy. Talk to your medical provider to get advice targeted to your health situation. Then, write us back and let us know what worked for you! Share your successes with our readers.

Anne V. PAC

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I have come to appreciate a saying I heard often in my younger years but did not fully understand-“Aging is not for sissies”.

Hot Flash Relief

Many bewildering things can begin to occur sometime after 40, and menopause is the most profound for women. Men do have changes they experience, my sense is this change is slightly more gradual. Menopause however, can be swift and sudden. This often leaves many women feeling as if they must be going crazy or they must have some dreaded ailment or disease.

When you are feeling suddenly more fatigued than normal for you, you are noticing more profound mood swings, you have muscle or joint pains that come and go for no explainable reason, your are having unusual problems falling asleep and/or staying asleep-you may very well be experiencing menopause.  Your periods may still be very regular, you may notice more severe PMS than what you have felt for decades.

It is important to see your medical provider to find out if what you are experiencing is menopause or an illness with similar symptoms. The following are medical conditions which can have a similar set of symptoms:

  • thyroid disease- either hyper or hypothyroidism
  • diabetes
  • anemia
  • other hormonal issues such as adrenal problems or hyperparathyroidism (regulates calcium absorption)
  • leukemia and lymphoma
  • arthritis and other connective tissue disorders

It is important to discuss your concerns with your provider. To help you organize and focus any specific health concerns, it is helpful to make a list on paper so you do not forget your questions. Most providers will take the time to address specific concerns when a patient has a written list they are referring to. A written list helps to give more weight or power to a patients’ concerns as it keeps both you and your provider focused.

Lab tests are often ordered to help  determine the cause of what you are experiencing. The following is a list of some of the lab tests your  provider may order depending on your symptoms and situation:

  • CBC with differential-relates to immune system and anemia
  • glucose, possibly HgbA1c -relates to diabetes
  • electrolytes, calcium and magnesium-relates to muscle disorders
  • FSH, LH, estradiol and possibly progesterone- relates specifically to menopause
  • TSH, free T4, free T3- relates to thyroid illnesses
  • Erythrocyte sedimentation rate, maybe ANA and rheumatoid factor- depending on degree of joint problems

Not all of these tests have to be ordered, but this is a general guideline for your provider to get a clear picture on how well different functions within your body are working.

If you do none of this, usually the answer becomes clear with time. If it is menopause, your periods will eventually become quite irregular, hot flashes will begin as well as many of the above symptoms waxing and waning. Even if this is the case, it is probably time anyway to see your provider to ensure your heart is healthy and that there is no breast/cervical/ovarian disorders. And of course there is the dreaded colonoscopy.

Anne V. PAC

Like I stated earlier, Aging Is Not For Sissies! I would like to hear your story on this topic. What have you experienced? What nugget can you pass on to the readers? Perhaps you just have a question. Leave a comment. If you are more shy, sign up to be a free member – then your comments will only be visible to other members and me.

Categories : Menopause Symptoms
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Hot Flash Relief

Hot Flash Relief

What is a Hot Flash?

The hot flash or hot flush is a temporary problem with temperature regulation in the body of a woman or man who has lost the ability to produce the sex hormone Estradiol (commonly called Estrogen).

Yes, guys who are treated for certain cancers and have their sex hormones blocked, will feel hot flashes like the woman who has had her ovaries surgically removed or who is menopausal. Men produce some estrogen just as women produce some testosterone.

Why don’t little girls and boys have hot flashes prior to puberty?

The reason I say hot flashes are all in your head is because they originate in an organ called the Hypothalamus.  One of the jobs of the Hypothalamus is to regulate body temperature.

When a person has had a heat stroke, the Hypothalamus is believed to be permanently damaged and that person is very susceptible to heat injury in the future.

With hot flashes or flushes, the hypothalamus is reacting to the lack of estrogen, or at least lack of Estradiol is now believed to be an indirect cause of hot flashes. It takes years of exposure to Estradiol before the lack of it will trigger the hot flash.

What does Estradiol (estrogen) do for the brain?

The brain’s primary fuel source is glucose – sugar!  Since the brain does not produce its own fuel, sugar has to get into the brain from the blood.  There is protective mechanism of the brain called the blood brain barrier that prevents what is in the blood from entering the brain directly.

A few things can cross this barrier easily and the result is usually addiction to that substance. Examples that cross quickly are nicotine, cocaine, heroine, i.e. most narcotics.  Sugar, the primary fuel source, has to be shuttled from the blood to the brain.  This active transport system is greatly influenced by Estrogen.

When Estradiol (estrogen) production stops, the production of new transport molecules is hampered and the brain suffers fuel shortages.  When the hypothalamus runs low of glucose, temperature regulation is affected.  This problem affects other areas of the brain. Women in menopause often complain of having “Brain Fog”. This is probably a temporary shortage of our primary fuel source for the brain – glucose, in other areas of the brain.

The Brain

The Brain

What can a peri or post-menopausal woman do about this?

There are several options.  One is to take estrogen replacement.  There is controversy surrounding this. First there is the possibility of cancer and stroke.  These appear to be very small risks if a woman is healthy and under the age of 60.  I am not sure that there is anything magical about turning 60, it appears to be a number beyond which statistically significant numbers of women begin to suffer side-effects of hormone therapy.

There is a small amount of evidence that using estrogen to ameliorate these transport problems, even temporarily, leads to better brain function later in life. The estrogen replacement needs to begin during peri-menopause for the protection to be extended later. It is not clear that the estrogens have to be bio-identical

Another option is to provide the brain with its second favorite fuel. This fuel does not need to be actively transported into the brain and is readily used by the brain cell called a neuron. The idea for this type of solution actually came from pediatric neurology.  Some children suffer a form of epilepsy caused by a faulty glucose shuttle system (genetic aberration).  They can not feed the brain enough glucose and suffer seizures as a result.  The treatment protocol for these children is called a keto-genic diet.

Ketones or ketone bodies are the end result of using fat as a fuel. When we starve, are carbohydrate restricted or are unable to use glucose as in diabetes,we burn fat.  Fat breaks up into the same size carbon chains as glucose but a chunk on the end is left and that chunk is a Ketone body or just a ketone.  I was taught that ketones had no good physiological function but we now know that the brain and heart like them as fuel. To provide the brain with ketones, the best fatty fuel source is something called Medium Chain Triglycerides.

Guess who knew it was a great fuel source for many years now – body builders! The shelves of stores catering to their needs are full of Medium Chain Triglyceride (MCT) Oil.  Another source is coconut oil which I buy from my local grocery store.  It is a solid at room temperature, is able to withstand high temperatures so is good for cooking and has a pleasant taste. It also meets another criteria for me to use it. Like extra-virgin olive oil, it has not been processed.  No other oil can make that claim except those two.

What is a good Brain Diet for Women beginning Menopause or suffering from Hot Flashes?

First of all, don’t over eat.  If you have a weight problem or want to avoid the weight gain during menopause, see the free report we give away on the home page of Female Menopause Mentors.

Keep your processed carbohydrate to zero.  Get your carbohydrates from sources high in fiber like cruciferous vegetables.  Unless you grind the grain yourself, avoid anything made from flour or that has some form of sugar as a major ingredient (glucose, sucrose, fructose).

Add MCT oil – one or two tablespoons a day to your diet or like me eat a couple of tablespoons of coconut oil. (Coconut oil is 66% MCT.)  Each tablespoon of oil contains about 90 calories so you have to account for those in your diet.  Don’t just add 180 calories a day or you will soon notice it on your waist and this is another health problem you do not need.

I also suggest you consume 500mg of Krill oil a day for the EPA and DHA content which are good for your brain and heart health.

Some researchers think flax seed oil is also good, but I prefer my patients to consume fresh ground flax seed. Ground flax seed contains the oil but also is rich in lignans (anti-cancer compound) and is very high in fiber.

Americans do not get enough fiber and do not drink enough water. One quart of water for every 50 pounds of lean body weight a day is about right and 35-40 grams of fiber per day (15-17 is average in the US).  Other supplements to consider are:

Vitamin D3 (without added vitamin A) about 1000 – 2000 IU per day if you are not getting 20 minutes of sun on your skin each day or are over age60.

Vitamin K2 - found in fermented foods like Natto, Cheeses and Sauerkraut, There is a pill form but because there were so many problems with Pills of Vitamin K1, I prefer to eat one ounce (30 grams) of aged cheese daily (that is the size of a pair of dice)

Magnesium as magnesium oxide – this can be a laxative so beware but it relaxes smooth muscle, helps with sleep and catalyzes hundreds of reactions within the body.  Serum levels are not always reflective of intra-cellular levels just like potassium and can not be used to gauge need. Begin slow and work your way up to 500-600mg per day. Some experts like Dr. Larry McCleary recommend magnesium chelate (Mag malate or taurinate)

Who are the experts in this area?
Dr. Larry McCleary – he wrote The Brain Trust Program
Dr. Sharon Dormire of the University of Texas School of Nursing – look for her name on studies on this subject
Dr. John Ratey – wrote the book Spark
Dr. Mary Newport – CoconutKetones
Dr. John M. Freeman – The Ketogenic Diet
Categories : Menopause Symptoms
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SLEEP-ZZZZZ What Happened?

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Insomnia during MenopauseOh for the days when we laid our head down at night and the next thing we knew, the sun was up and the birds were chirping. Are those nights gone forever? Will I have a roving bedroom forever? Well not necessarily, but like everything else, it has morphed into a different version.

The causes for sleep disturbance during menopause can be related to several factors and it is important to identify what is causing your sleeplessness, so you and your medical provider can treat and manage the problem. Reasons for sleep disturbance can include hot flashes and night sweats, development of obstructive sleep apnea(OSA), restless leg syndrome(RLS), depression, and/or the development and continuation of poor sleep habits. I will talk about the different causes and possible solutions in this article.

For most women who have not had sleep problems prior to menopause, the change in sleep pattern most likely occurs because of

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a spike in body temperature during the night. This can cause the sleep stage to shift from the deeper restorative stage to a lighter stage where awakening can occur more easily. This is believed to occur because of lower progesterone and other hormonal changes. Then, after the temperature spike, you get the hot flash- sounds familiar doesn’t it?

Most of this cause of sleep disturbance happens more in the early or transition stages of menopause when hormonal fluctuations are greatest.

Later in menopause, a different pattern emerges, one of early morning awakening. This is felt to be due to changes in breathing patterns (you mean I snore?!!) and possible sleep apnea from weight gain and changes in muscle tone in neck and throat area.

So for causes from temperature issues, it is important to sleep in lighter clothing than you may have used in past, perhaps keep a fan near your bedside or use ceiling fan if you have one. A low dose aspirin before bed (if you have no stomach sensitivity to aspirin or not allergic to aspirin) will help keep body temperature down; and lastly, HRT (hormone replacement therapy)  is very helpful at restoring hormonal balance so you can sleep. Some women are more progesterone sensitive and when levels fall during peri-menopause, this can trigger sleep disturbance.

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Sleep disordered breathing includes snoring and a more severe form called Obstructive Sleep Apnea. Both occur when an increase in weight causes a slackening of muscles in neck and throat, which support the back area of the roof of the mouth. When a person lays flat, this area can partially collapse over the airway and block air from entering the lung passageway. Some people are more prone to this and it can also occur in men for the same reason-weight gain and age.

The brain does not like lack of oxygen, so it prevents a deeper sleep cycle and causes alot of body movement and change of breathing patterns to increase intake of oxygen.  People awaken often, and awaken in the morning feeling as if they haven’t rested. OSA can have some very serious health consequences involving your heart and lungs.  It is important to find out if this is the cause of your snoring.

A sleep study is the way to identify whether or not your snoring can involve OSA, and there are treatments for this including use of a device called a C-PAP machine or sometimes surgery involving the back of your mouth and throat. There are no pills to treat snoring or OSA, however, weight loss or prevention of weight gain through proper diet and exercise are often the best ways to avoid and help lessen the symptoms of OSA.

Restless leg Syndrome (RLS) is another disorder which interrupts sleep patterns and can occur in both men and women. It is more common as people age and for that reason can be more common in peri and post menopausal women.

It seems to be common within families, the cause is still unknown but several factors seem to predispose a person to this. It is felt that anemia from low iron can cause or make worse the symptoms of RLS. Other triggers include caffeine, tobacco, and alcohol. Most people will describe an unpleasant sensation over the legs and an irresistible urge to move the legs for relief. It can be treated with mediation that was originally developed for Parkinson’s disease, but at lower doses. As you can imagine, the constant need to move your legs because of abnormal sensations would interrupt anyone’s sleep.

Lastly, there is depression, which can also interrupt a normal sleep pattern. Depression can happen in anyone, however the hormonal changes causing mood swings can make this more prevalent in menopause. Some people are more prone to depression, believed due to an inherited lower production of neurotransmitters in the areas of the brain which manage mood control, desire, motivation, emotional energy. Treatment for depression can often restore the sleep cycle to normal.

I am going to briefly mention the sleep medications. There is Melatonin, which is an OTC herbal product which purports to help sleep. Melatonin is produced by the brain at the end of the day and is triggered in part by your natural circadian rhythm (ie. I’ve been awake all day, time to go to sleep), sun setting, slowing of activity level. The problem with Melatonin tablets is that not everyone gets it into the brain where it needs to work. So it is not effective for everyone.

There are the newer sleep medications called Ambien, Sonata and Lunesta. These also work in the brain by blocking the awake part of the brain. They are very effective but can be habit forming and can also have undesirable side effects.

Also used are some of the older antidepressants, such as Trazadone. These can be effective and are not habit forming, however some people experience day time drowsiness with their use.

Lastly, Gabapentin has been shown to be effective for sleep in women who are experiencing hot flashes as a cause of sleep disturbance. Researchers are not sure why, but it is known to help RLS and may diminish hot flashes.

Sleep habits are very important to establish and maintain during this period of time. Avoiding caffeine after noon, not eating a heavy meal or late meal with in several hours of bedtime, and also keeping noise and lights low within 1-2 hours of bedtime. Alcohol can also interfere with sleep even though it seems to help with falling asleep. The alcohol interferes with achieving and maintaining the deeper sleep stages, so it is more easy to be awakened by noise, movement or minor discomforts. Lastly, computer use can interfere with sleepiness as it is felt that the light of the monitor can up regulate the activity of the awake center of the brain.

So, to summarize, there are many causes of sleep disturbance. You and your medical provider can discuss the possible causes contributing to your changes and treat them specifically. As always, it is important to keep that balance we have discussed in other articles, so that you do not feel over whelmed and do not gain too much weight.

It is also important to continue to foster the relationships which enrich and sustain you through your day and week, and that you continue to find time to relax and feed your own soul. This is a time to tend to yourself, and this is not a selfish thing to do. Most women spend much of their adult lives tending to other people and putting themselves last, either due to work, family both immediate and extended, and community or church commitments. It is ok to take some time for yourself, this is when it is most important.

Use this information to discuss these issues with your doctor.  The reading of this material, being a member of this membership site, or leaving comments does not constitute a patient/provider relationship. You should discuss this information with your medical provider.

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