Archive for Menopause
If you are a woman reading this post, chances are you have experienced a urinary tract infection at some point in your life. Burning with urination, frequency, and discomfort in the pelvic and genital region are all familiar symptoms to many of us by the time we reach menopause.
Having these symptoms and seeing a medical provider for antibiotics may seem like an automatic “no brainer” therapy. It would certainly be a surprise to be told there is no infection present. Your next questions would most likely involve what could be causing your symptoms.
All that burns is not a UTI! There is a condition that many women suffer from called Vestibulitis. The vestibula is the region inside the vulvar tissues and the entrance to the vagina. This area is loaded with nerves, and can easily become irritated by vaginal or urinary infections. For some women however, this irritation becomes cyclic and persistent, never seeming to completely go away with the standard UTI or vaginitis treatment.
Vestibulitis can be uncomfortable or downright painful. It can affect sexual relations, and it can affect the ability to exercise or even sit for long periods of time. This pain is often felt as burning, stinging, raw or an irritated sensation. Surprisingly it affects white women between ages 20-60 almost exclusively; researchers are unsure why this demographic is most affected.
The two main types of vestibulitis are cyclic and vulvar. Cyclic vestibulitis occurs mainly with triggers such as intercourse, bike riding for extended periods; and tends to be more intermittent. It is felt to be a reaction to a prolonged mild or undetected yeast infection. It is treated with an extended course of antifungal medications such as Diflucan.
Vulvar vestibulitis is more constant and unremitting. It too can be from an undetected yeast infection but can also be from atrophic tissues experienced in menopausal or peri-menopausal years. This type of vestibulitis is most likely to occur with menopause when it does occur. It can be treated with topical estrogen cream, sometimes with steroid creams for short periods of time.
Vestibulitis can become chronic primarily due to irritated nerves that release chemicals which further inflame the vestibular tissues, creating a vicious cycle. Because of the potential chronicity of this problems, treatment is usually carried out for many weeks. Along with medication to relieve the symptoms, dietary changes are often helpful. Taking calcium and consuming a low oxalate diet is felt to neutralize the urine and reduce irritation to vulvar tissues.
This problem can have a major impact on a woman’s life and it is important to get to a professional that specializes in vestibulitis if your symptoms are ongoing for months or years. Many medical centers and university hospitals have specialist within their gynecology divisions that specialize in vestibulitis. A specialist is often required for treatment as many gynecologist and family practice providers are not trained to treat this condition; as well as that surgery is sometimes required.
If you are experiencing vaginal or vulvar burning, first see your regular provider to get an exam. Your provider can examine you for a urinary tract infection, vaginal infection, atrophic changes, or other skin conditions that can cause your symptoms. A simple short therapy may take care of your symptoms. If it does not however, I suggest asking your provider for a referral to a specialist.
You may feel your symptoms are too embarrassing to discuss with a specialist, but pain that affects your life should be evaluated and treated. This will give you quality of life.
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!
Have you ever heard that song by Sting, Still My Beating Heart? Going through menopause has brought that song up from my memory recesses. Many a night I have been left to wonder what the heck was going on in there!
I make light of it, but the truth is that a pounding and flip flopping heart is a very scary thing to feel. Add to this a poor diet and lack of exercise, and many a women might think they are having a heart attack.
While heart disease is the number one killer of women, chances are what you are experiencing is from menopause. Yes, you heard me-MENOPAUSE.
Having said that, it is still important to see your medical provider if you experience these symptoms. You need to have an EKG which can determine an abnormal heart rhythm. You also need to have your cholesterol checked as this can alert you to a possible danger of heart disease if it is very high. Blood pressure, glucose, electrolytes and thyroid can also be contributing factors to an irregular heart beat.
Heart disease causes 1 in 3 deaths for women yearly as compared to breast cancer claiming 1 in 31 lives yearly! Not all women are susceptible, and knowing your risk factors can help guide you.
Family history of heart disease, smoking, diabetes, age are some of the major risk factors. Relative inactivity and being overweight, having high blood pressure and cholesterol factor in also.
Most likely your symptoms on palpitations do not represent any serious medical condition; but it is important to have your heart health evaluated as you enter menopause.
The American Heart Association campaign: goredforwomen is designed to educate women regarding heart disease and has a wealth of information.
This is one issue of aging that is important to be knowledgeable of!
In case you missed this issue in the latest election, a proposition was up for approval in California. While you may want to stop reading now, thinking “what is California up to now?”; knowing about GMO food is important. This proposition would have required food manufacturers in California to label whether their product contained any genetically modified material.
What! How did genetically modified food get into our lives and exactly what does this mean? It turns out we have been eating GMO food for a few decades! Corn for one, has been modified. Today’s wheat has not exactly been genetically modified, but it has been changed from the type of wheat that humans were eating centuries ago. Most of these modifications are done to increase crop production, and to decrease the chance of damaging pests and bacteria affecting a crop.
You many wonder why genetically modified food is potentially dangerous. When producers of food want to create a crop that is more drought resistant, or one that yields more fruit; they have traditionally chosen plants that breed the type of product they want. This is typically time consuming and can take many years to get to the type of plant that is desired. It is however, a more natural way of creating a new strain of plant. It is yet unknown though, if this process is slow enough to allow the human body to adapt.
GMO fruit and vegetation has been altered in the laboratory to produce the desired effects. A gene part from one plant may be introduced to the gene part of another plant in order to enhance a certain characteristic. It is sort of like fast forwarding evolution with a science fiction twist!
Not a big deal you think, after all we are just talking about a redder tomato that stays ripe longer. Or a corn stalk that is able to survive drought and pests. The potential problem and criticism is that these crops can affect surrounding insects, and other crops; altering the natural course of nature. GMO food may also have the potential for introducing new allergens that our bodies may not have any resistance to. That is one of the theories behind the increase and severity of peanut allergies in young children.
So what can you do?
You can inform yourself regarding the brands of GMO foods that are commonly in grocery stores, the following is a link to help you with this: The Non-GMO Shopper’s Guide. Additionally, you can become aware of any initiatives in your state regarding the labeling of GMO food.
You may be asking yourself what this has to do with menopause? My answer to you is this: food is essential to our lives; and healthy food is essential to healthy living and aging. We baby boomers are perhaps the first generation to live our entire lives consuming mass produced foods obtained from manufacturing facilities thousands of miles away. We are now able to get many foods from parts of the world that our parents and grandparents could only eat if they traveled to that part of the country or world. Have you ever wondered how that fruit lasts so well when it travels from Chile to Maine? We are eating food before its’ prime, or food that is altered to reach its’ prime long after nature intended.That must have some effect on us.
Your action on this topic could be to chose locally grown foods, at least within your half of the country, when buying your groceries. Think about what you are putting in your mouth, and ask yourself: how healthy is my food?
There is not much worse in menopause than the growing belly. When I was a very young girl, I used to look at older women who appeared pregnant and was mystified as how this could happen! Of coarse now I understand the forces at work here, and one has to wonder why nature has laid this problem on us!
We must understand however, that this process of belly fat is in part our own fault. While some people are more genetically prone to develop belly fat, how we eat and live our lives plays a very large part in this.
You may be wondering why belly fat is different from what you have always thought of as the usual fat. We have fat that sits below our skin, or subcutaneous fat. This is the fat that you have all over your body to some degree. Belly fat is deposited within the abdominal cavity, not below the skin. It is also called visceral fat, as it is between the layers of the organs of our abdomen.
This is a more dangerous fat because it secretes hormones. Hormones that can raise blood pressure, affect food metabolism and hormones that can also increase your risk of cancer. So this belly fat is not only disfiguring, but it is medically dangerous.
As we age, our normal hormones decline and we lose muscle mass. This causes a decreased need for calories, or food; because we do not need as many calories to maintain the muscle. If you do not adjust your diet, then you will end up eating more calories than you need. This creates an excess, which is then stored as fat. At the same time, this hormonal change coupled with aging causes a stressful condition within your body. Stress hormones are secreted, and these are the very same hormones which cause the body to store excess fat in the visceral area. This visceral fat then secretes more hormones which contributes to the unhealthy cycle. Scary, huh?
Luckily, we can combat and control this to some degree. The measures which work at losing belly fat and decreasing the stress hormone levels are all within your control. They include:
- Eating a healthy diet low in animal fats, sugar and refined carbohydrates (white starches-rice, bread, potatoes, pasta)
- Consuming more vegetables and fruits; both of which are higher in volume and lower in calories
- Calorie balance by eating healthier and smaller meals, with lean protein, veg. and fruits, whole grains (wild rice, quinoa, whole couscous, sweet potatoes to name a few)
- Get enough sleep! Many important things happen during sleep including appetite balance
- Start moving more to increase calorie needs and using the calories you are eating
- Do some strength training a few times a week to build your muscles and keep calories needs high; this help balance out what you are eating.
- Relax! Regular activities that help you to relax and lower your stress, also lower the stress hormone production.
There are a lot of diets and programs that claim to melt belly fat away! If you look closely at them, they are programs that include all of the above: healthy diet low in simple sugars, exercise and strength training, and relaxation. It is as simple at these 3 things. There are no short cuts, but these changes can be easy and fun if you get your mind behind them!
Have you ever wondered why it is difficult to make changes, even important ones? Many women find themselves in menopause, evaluating their habits and wondering why they are not sleeping as well, maintaining their body and muscle tone.
There are many times of our lives when it is important to make changes in order to be successful and productive in any new endeavor. Think about your first important job and the changes you had to make in order to be viewed as a trusted and valued employee.
We may be lulled into thinking we have figured out what works for us, but what works changes with each stage of life. Menopause is a time when you must work on new habits, as the old habits will most likely fail at maintaining or improving whatever it is you need to maintain or improve.
As Charles Duhigg states in his book The Power of Habit , a new habit is like a muscle; it must be practiced daily or regularly in order to grow strong. He talks about keystone habits; habits that when developed, spill over into other areas of our lives. Habits can be infectious; starting one often allows you to have the ability to improve other areas of your life.
Habits of course require willpower. As many of us have experienced, willpower can diminish if used over and over again. The key to making a new habit stick is not relying just on willpower, but with making this habit automatic. This will prevent breakdown of a habit when your hit a point in the day when you are stressed and tired. By making your actions automatic, you take away the energy needed to make a decision. This allows you to preserve your willpower, allowing it to last longer and be wider reaching.
So, how do we develop a habit? When you decide what you want to change, you need to determine what your goal is and how attaining this goal will help you. That is the prize at the end of the road-success and feeling better about yourself. Determining the triggers that prevent you from exercising a new habit is important knowledge. You can then visualize how you will respond to these obstacles or difficult moment. Write out a plan for circumventing, imagine your day or evening overcoming your obstacles and practicing this habit.
Establishing a new habit is accomplished when you decide on your future behavior, visualize and practice this behavior regularly. Your willpower will be strengthened so that when you encounter resistance, you can revert to this new automatic behavior without wearing down your willpower.
For more on this topic, visit my squidoo lens on Willpower, Decisions and Habits. In this series, I talk about this very issue. Strengthening willpower to allow better decision making and thus better habits is important in everyone’s life. Menopause presents us women with a point of time when it becomes clear that some habit changes are needed if we want to live the life we imagine and want to live.
There are many injustices suffered by a woman in her lifetime. But none can quite match the fear and sometimes horror of hair loss during menopause. I suppose if we knew when it would stop, we could know whether to start searching for the wig stores! But like much in menopause, we feel and are to some degree, out of control of our bodies.
Our hair is one thing that defines us. It is the representation of the kind of care we take of ourselves. It can indicate our style, like the clothes we wear. Compared to most men, we have spent a small fortune at the hair dresser getting the perfect cut, coloring, and perming.
When we see our hair falling out in clumps, we feel we are watching our womanhood fall down the drain also.
Why does this happen and what can we do to stop it?
First and foremost, understand that some hair loss is expected. If female baldness does not run in your family, you are most likely not going lose a significantly noticeable amount of hair.
Secondly, get yourself to your medical provider and make sure you are not anemic, have a healthy thyroid and iron levels, don’t have a connective tissue disease. These can be the major medical causes for hair loss.
Next, look at what sort of styling you are routinely doing to your hair. Persistent tugging and twisting of hair can strain follicles and cause them to shed their hair a little sooner. Believe it or not, most hair lasts 2-6 years, then falls out. That follicle then stays dormant for short time, then grows another hair. Harsh chemicals and dyes can dry the hair, causing early breaking off at any point on the length of the shaft.
Lastly, look at your diet and lifestyle. Do you get enough vital nutrients to feel the scalp and hair? Do you practice stress relieving activities to lower stress hormones. High levels of stress can cause the hair follicle to loosen the hair within the shaft and shed it; sometimes months after the stressful event.
Menopausal hair loss can last for up to 2 years, but usually your hair does recover most of its thickness within that time frame following the loss. You can accelerate this process by:
- Using gentle shampoos and eliminate any harsh chemicals and tight hair styling to lessen the stress on the follicle
- Consider taking hormones if you have other compelling reasons. The main reason you are losing this hair is a hormonal imbalance which makes the hair follicle less likely to grow new health thick shaft of hair. This is only a temporary solution, but it could give you time to work on healthy lifestyle changes including diet and stress reduction.
- Increase healthy nutrients in your diet by including foods high in iron, Vitamin E, vitamin D, calcium, as well as Omega-3 fish oil.
- Learn to meditate if you are stressed, or exercise to help reduce stress hormones.
- Drink plenty of water, eliminate cigarette smoking and drink alcohol only in moderation (7 drinks a week).
Hair loss occurs because of lower hormone levels, and as your hormones settle at a post menopausal level, the hair loss will stop. There are few medications for women other than topical rogaine, or the use of estrogen replacement.
The important thing is to take good care of yourself and your hair. Get plenty of rest and relaxation to keep stress low, consume a diet high in healthy nutrients. You may need to rethink your hairstyle or the chemicals you use. Don’t despair, your hair will most likely grow back.
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!
You may wonder why menopausal women need an awareness month! It is fairly clear what is happening when we are experiencing menopausal symptoms, both to ourselves and to our loved ones.
Perhaps you can remember when you were young and someone would remark on an older aunt or friend who couldn’t remember your name for a few minutes, or perhaps they would roll their eyes at a woman sitting in the corner fanning herself. You may have thought to yourself that you will never be that woman when you are older.
Well guess what! Here you are in menopause and now all things become clear-or are they becoming confusing?
That is why attitudes toward menopause need to be changed and there are many women working towards that. Some are doing this through education and professional article writing, and some are doing it with humor. We are still the same woman we were years ago, still wives/daughters/mothers/sisters and friends. Let’s remember this and have some fun.
Julie Clark Shubert has done exactly that; she has created a YouTube video and original song about menopause. It is a lot of fun and hits all the high points of menopause! Enjoy it: http://www.youtube.com/watch?v=5PWiZlzbgPc
In addition to enjoying this video, you can become more active in celebrating menopause!
There is a unique but popular genre being encouraged by a group of women called The Hot Flash Mob! This is a movement aimed at raising awareness of the unique and challenging time for women. This is the brainchild of Dr. Eve Agee and Jeanette DePatie. You can go to their website and learn about the moves of the dance and sign up for email alerts as to where a hot flash mob may be preparing to gather in your area!
As these women illustrate, menopause does not have to be a time of woe. It is important to pay attention to the changes you are undergoing and ensure you are adjusting your life style to maximize your health. BUT, it can also be a time to have some fun and celebrate some of the changes happening!
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
- 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.