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The North American Menopause Society (NAMS) met in San Diego October 3 -6 2018.  This organization was founded in 1989. It is a non-profit whose mission is to promote the health and quality of life of women during midlife and beyond. The membership includes clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education.

Since we share the same mission, I am always excited to attend this conference. As you may imagine some of the info was over my layperson speak, however it is encouraging to note that the Menopause Specialists in the room received detailed explanation of how to test and treat the various symptoms of menopause.  They were also alerted about new promising drugs and non-hormonal treatments that could help deal with some of the life altering issues. Here are some of the key takeaways from the conference:

Sexual Dysfunction & Vaginal Health:

Sexual dysfunction has many clinical sub-names that you may hear your Menopause Specialist speak about. Here are just a few of them: Female Sexual Dysfunction (FSD’s), Genitourinary Syndrome of Menopause (GSM), Hypoactive Sexual Desire Disorder (HSDD), Vulvovaginal Atrophy (VVA). The sisterhood speaks about these issues using completely different words such as: painful sex, low libido, and failure to orgasm.

Sadly, the biggest problem is that we don’t speak about these issues openly with our doctors and many doctors don’t ask us questions to help evaluate whether we are experiencing these difficult issues.  Granted, sometimes we only have 15 minutes in the exam room with our doctors!  This is barely enough time for us to put on that gorgeous gown (!?!?!) and get into those warm-cozy stirrups, get our pap smear and breast exam.

The important take-away is that if you are experiencing vaginal discomfort you more than likely will avoid intimacy and experience loss of libido.  I always say if you would rather mop your kitchen floor than get in bed with your lover- get thee to your menopause specialist.  There are a variety of options to deal successfully with these issues.  Here are some to speak with your specialist about:

  1. Non-hormone options such as long-acting vaginal moisturizers and use of vaginal lubricants to decrease friction can reduce sexual discomfort.

There is a whole slew of moisturizers on the market.  Check them out here.

Check out these two products made of Hyaluronic Acid:  Revaree, Hyalo-Gyn.

If moisturizers and lubricants are not helping, time to speak to your doctor about local estrogen therapy or vaginal DHEA.  Remember when it comes to the vagina, thin is out!  Plump is in! FYI, NAMS continues to be upset that their efforts to get the  FDA to change the “box warning” on localized hormone therapy came to no avail. Currently, they use the same box warning for localized hormone therapy and systemic therapy.  NAMS will not give up!

I reached out to Dr. Rebecca Brightman who is a fellow of the American College of Obstetrics and Gynecology (ACOG) and the North American Menopause Society (NAMS) and is also a NAMS certified menopause practitioner, and an assistant clinical professor OBGYN and Reproductive Science at the Mount Sinai School of Medicine in New York City for her thoughts on this difficult menopausal symptom, she said, “I encourage my patients to be pro-active about maintaining vaginal integrity and not wait until the symptoms become too burdensome.  I present my patients with various therapeutic options so that we can make a treatment plan that best addresses their needs.”

  1. If you are a cancer survivor your Menopause Specialist will want you to consult with your Oncologist. Sadly, lack of data and safety on women with or at high risk of breast cancer has led to avoidance in treatment which has negatively impacted the quality of life (QOL) and partnership relationships in these cancer survivors. Due to this lack of data, clinicians will try to evaluate a women’s risk of recurrence, consider if she is hormone receptor negative vs positive, and whether she is on Tamoxifen vs Aromatase Inhibitors. Then discuss her QOL.  You are a partner in this conversation and should be comfortable with the protocol that you and your team decide.
  2. Orgasm – Guess what- the brain does speak with the vagina! The brain can, also, adapt to low interest in sex. Therefore, if you are not having sex, you can become ok with that new normal. However, your interest in sex can be activated again!  I learned that when we have an orgasm, we have increased blood flow, but nothing is going on in our brain.  So, for those seconds/moments we are orgasming we are not making To Do Lists.  Good to know!

If you are experiencing problems orgasming currently, Flibanserin is FDA approved for this issue. It is serotonin based. They stressed that this drug takes many months to work.  If you are using it, be patient!

The drug Bremelanotide(melanocortin receptor agonist) is currently being studied by the FDA.  This is an injection you would take one hour before sex. This is dopamine based.

Over the counter: ArginMax was mentioned as showing some promise.

  1. Low Libido – If you have a penis there are over 30 drugs for this issue. If you have a vagina, we do not have an FDA approved drug yet. (Grrrrrrrrrr) However, many specialists are using testosterone off label for women and with great success. Nevertheless, if you  or your partner are having libido issues it was recommended to have your Free and Total Testosterone and Sex Hormone Bind Globulin levels (SHBG) evaluated.

Currently being studied but not on the market yet:

Lybrido which is an oral testosterone. It contains testosterone and sildenafil – same ingredient that is used in Viagra.

Lybridos contains testosterone and buspirone which is a type of anxiety medication.

Sildenafil is currently used off label for women.

  1. Over the counter products mentioned that could help sexual dysfunction:

Stronvivo, Foria, Zestra, Fiera

  1. Dry Vagina – Local estrogen therapy (LET) comes in an estradiol tablet, ring, or cream. Another option is vaginal DHEA – Intrarosa.  Osphena – oral pill.

Laser Treatment – Clinicians use either a CO2 or YAG laser. This laser treatment is currently not FDA approved for the vagina. Many doctors are using this off label. The FDA recently sent warning letters to 7 companies that market these laser devices for vaginal rejuvenation. Good News -there is going to be a double-blind sham-controlled study coming soon.  Stay tuned!

  1. Pelvic Floor health! Who knew???  Listen up………50% of post-menopausal women have GSM. What’s the pelvic floor have to do with it???  For more information on this read: MENOPAUSE MONDAYS Incontinence and Pelvic Floor Issues.
  1. Sexual Therapy – This was talked about with great hope. Apparently, there is much success in you and your partner doing some therapy.  Remember Dr. Ruth?  She always ended every interview with this same sentence, “Find a good sex therapist!”
  1. On a side note – if you or your daughter, daughter-law, or niece are prone to UTI’s…….check out this over the counter supplement – Ellura.

Longevity and Telomers:

 Of course, I know what longevity means.  Having just turned 65, my hope is that I lead a long healthy life. But, what in the world is a telomere?  According to PubMed.com, “Telomeres are dynamic chromosome-end structures that serve as guardians of genome stability. They are known to be one of the major determinants of aging and longevity in higher mammals. Studies have demonstrated a direct correlation between telomere length and life expectancy, stress, DNA damage, and onset of aging-related diseases.”

Do we want long or short telomeres? Turns out, long telomeres as shorten telomers have been associated with age related diseases such as cancer, stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis and diabetes. So, what can a gal do to lengthen them?  A lot!  Studies suggest that estrogen exposure increase telomerase activity in the body, the enzyme that protects and elongates the telomeres.  Also, not smoking, a healthy weight (Mediterranean diet), and exercise elongate those babies! In addition, stress and environment can affect the rate of telomere shortening and health.

After this symposium, I have decided to get check out my telomere score.  I am going to ask to have this test incorporated into my yearly physical, so my internist can keep track of the rate and direction of my telomere changes.  This way we can adjust my nutrition, weight, exercise routing and other lifestyle modifications.  As to supplementation there was no specific recommendation because there is no science yet on efficacy of telomere supplementation.

Breast Health

Who needs genetic testing???

Did you know that 12-14% of breast cancers are related to hereditary cancer predisposition syndromes? Approximately, 35,000 cases of breast cancer every year are attributable to hereditary risk.

The good news is that there are many new advances in cancer genetic testing.

The Speakers on this topic stressed to clinicians that patients with hereditary predisposition to breast cancer need to be identified at an early age more like 20 years old to ensure that they can benefit from better preventive protocols and care.

Here are some of the questions your doctor should ask you to screen for hereditary cancer:

  1. Have you or anyone in your family had cancer?
  2. What type and what age?
  3. If breast cancer, did it involve both breasts or was its triple negative?
  4. Is there a family history of ovarian cancer, male breast cancer, metastatic prostrate cancer of pancreatic cancer?
  5. Are you of Ashkenazi Jewish ethnicity?’
  6. Have you or anyone in your family had genetics testing for cancer?

When possible, encourage family members who are cancer survivors to get genetic testing.  If they are worried about the cost, let them know that the Patient Protection and Affordable Care Act identifies BRCA testing as a preventative service.  Medicare provides coverage for affected patients with qualifying personal history. Also, 97% of commercial insurers and most state Medicaid programs provide coverage for hereditary cancer testing.

If you were screened before 2013, it was recommended that you get another test as there are more snips and information available now.

I reached out to Dr. Brightman for her thoughts. Here is what she told me, “Women frequently feel that screening for BRCA 1 and 2 is enough, 10% of women at risk who are negative for BRCA 1 and 2 will be positive for another mutation that may be associated with an increased risk for hereditary cancers. While commercial kits are available to consumers, women should discuss which screening tests or panels are right for them.  If their healthcare provider doesn’t offer genetic screening tests, then the patient should seek out genetic counseling services for appropriate screening.”

Osteoporosis

It is interesting to note that in 1970, there were no drugs under study for osteoporosis. Estrogen was used but there wasn’t much info helping to determine the correct dose for preventing bone loss. Today we understand that fractures are a disease and should not be regarded as part of normal aging.   Huge advances have been made that help specialists understand the process of bone remodeling on both a macroscopic and cellular level.

It was recommended that doctors use goal directed treatment. Here is how it was defined in the session:

“Goal-directed treatment proposes that treatment should aim to achieve goals, such as BMD “T-score” that is at least higher than -2.5 (indicating osteoporosis) and freedom from fracture. For patients who start with a BMD T-score below -3, treatment with an oral bisphosphonate such as alendronate has a very low probability of reaching that BMD goal. Thus, patients with more severe osteoporosis and high risk of fracture, the best initial choice is a stronger agent that is more likely to improve BMD above the goal. In goal-directed treatment, follow-up focuses on progress toward achieving the goal with measurement of BMD and history of fracture – not “response” to treatment. However, response is less important than progress toward the goal. A patient may “respond” with a 2% increase in BMD but remain very far from a goal. In that case, for example, it would be warranted to switch to a more potent treatment despite the biological “response.”

Hopefully, this blog will give you some talking points with your Menopause Specialist. If you don’t have one – find one! The practitioners at this conference were given concrete tools to help them evaluate and address the issues of menopause. Therefore, I stress that you find a trained Menopause Specialist to be your partner in this menopause business.

Remember:  Suffering in silence is OUT!  Reaching out is IN.

Download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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Got Menopause???? Then you have landed in the right place!

EllenDolgen.com is here to be used as your online perimenopause, menopause, and post-menopause library!  It took me ten years to compile all this material and has been my life’s work.  Now it is yours for the taking….and for free!

While I am not a doctor or scientist, I have “talked the talk” with countless menopause experts, to be able to “walk the menopause walk” and share my keys to this menopause kingdom with you. The information is delivered to you in layperson speak, along with a pinch of humor and a lot of love. My goal is for you to feel at home here as if you are having a cocktail with your best friend, who happens to know a lot about perimenopause, menopause, and post-menopause.

Here is some of what you can find at EllenDolgen.com:

  1. An easy to understand explanation of Perimenopause and Menopause.
  2. Oodles of Menopause Mondays® Blogs on all things menopause and women’s mid-life.
  3. Health News Flashes to keep you up to date.
  4. A Search Button to look up that nagging symptom or a mid-life question.
  5. Tips on how to find a Menopause Specialist.
  6. A downloadable Menopause Symptoms Chart to help you explain how you feel to your Menopause Specialist.
  7. A Singing Uterus Video to help Explain Perimenopause and Menopause.
  8. A free downloadable e-Book, MENOPAUSE MONDAYS® The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.
  9. Menopause TV on my YouTube Channel.
  10. Learn how to throw a Menopause Mondays Party and break open the conversation with your friends or co-workers.
  11. Learn about the latest information on hormone therapy.

Remember to always trust how you feel – you know when you don’t feel well. Reach out and get the help you need and deserve.

You are not alone! EllenDolgen.com is always here for you….. even during those sleepless nights.

I am handing you the keys to the menopause kingdom delivered with commitment, attention to your optimal health, love, light, and laughter.

Here’s to your good health!

My motto is: Suffering in silence is OUT! Reaching out is IN.

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Wouldn’t it be great to be able to jump on an airline that caters to menopausal women this holiday season?

Welcome to Jet Orange: The Menopause Airline.

Here at Jet Orange, we cater to your every menopausal need. Our cabins are temperature controlled to cool and comfortable 53 degrees. We will supply thermal blankets for your loved ones shivering next to you.

Can’t remember what seat number you had? Don’t worry, we don’t have seat numbers, so it doesn’t even matter that you can’t remember a thing.

Flight attendants on Jet Orange are here for your safety and their own. Our flight attendants are wearing helmets and protective gear and can handle any violent outbursts that may occur.

Remember, no sharp objects are allowed on Jet Orange flights. Our flight attendants will collect all sharp objects once you board such as your pen, table knives, and swords.

Haven’t slept in 6 weeks? Just check the seat pocket in front of you, and you’ll find an assortment of complimentary items to help make your sleepless flight more enjoyable. (Sleeping mask, sticky notes to write down your kid’s names, tweezers and a hand mirror so you can spend hours plucking those chin hairs.)

We know that your emotions are wildly erratic and sometimes you just need to cry it out, so we run the movie, The Notebook on repeat throughout the whole flight.

We have an all you can eat sundae bar – open throughout the trip.

The best part is, here at Jet Orange, you won’t have to worry about remembering your flight, or your name. We’ll come pick you up.

Join us on Jet Orange: The Menopause Airline brought to you by MENOPAUSEMONDAYS®.

Our motto: We Will Get You There in a Flash!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

Download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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“Let’s host the main holiday meal at our place,” always seems like a good idea at first.

That’s in November.  When December rolls around, you’re already getting anxious about what you’ll serve and who’ll sit where.  What’s a girl to do?

Your menopausal hormones are in high gear and you’re already worried that you’re spending money on holiday gifts as if it was water.   Really—silently in your head—you’re voicing the words of the old TV commercial, “Calgon: take me away!”

Give Yourself a KISS

Don’t let your Type-A personality take over. My motto for holiday hosting is KISS:  Keep it Simple Sistah!

Creating an innovative theme for your holiday meal can change things up a bit and not overtax you or your wallet. One year, I only made the turkey and asked everyone to bring their favorite dish (along with their partner)!  I asked the guests not to tell me what they were making! I wanted it to be a surprise. The guests brought their surprise food offering covered with tin foil. Once I put all the dishes on the buffet table, cocktail in hand, we unveiled the dishes and guessed who made them. Can’t get any more KISS than this!

I have to admit, that at most holiday dinners I do find myself overeating (shocker!) Usually, sneaking off to my bedroom to rip off those pesky Spanx! So one year, my holiday gathering was a Pajama Party.  Everyone came comfy and relaxed.  That holiday dinner was a huge hit! Warning: it was hard to get everyone to leave! I had to remind them it was not a slumber party.

Manage your stress

Any psychologist will tell you that striving to be perfect relates back to the fear of failure…needing to please everyone…and is a critical anxiety trigger.

There are already cognitive changes in your brain during menopause due to hormonal fluctuations.  These can result in brain fog, which anxiety only serves to exasperate.

Since stress can be contagious, take some measures to help make this a stress free holiday.  If you are enjoying your holiday dinner, so will your guests.

To help manage holiday stress, try to maintain your healthy routine during the days leading up to the holidays.  Oh, we all fall off the wagon when it comes to diet and drinking, but at least make the attempt to eat clean for the most part.  Try to curb your overwhelming taste for alcohol at this time of year and remember to exercise to burn off those pesky stress hormones caused by frequent bursts of adrenaline.  Scientists now say it will likely lead to stubborn belly fat, which is really unhealthy for your heart, particularly during menopause.   However, if you need just a small glass of wine, one study in Oregon found that a little drink every now and again might strengthen your bones.  As if you need an excuse for a good Chardonnay!

Schedule in some “me” time.

Your schedule is crazy busy, but if you put yourself on your own “To Do List”, you can make time for a casual walk, a bike ride, or some yoga. Taking time for quiet mindfulness through meditation is critical to your wellbeing and will provide you the reboot you’ll need to pull off a successful, peaceful family gathering.

While you are decking the halls with holly remember to set the mood for a good night’s sleep! Sleeplessness can be a real problem for women who are going through menopause – the North American Menopause Society (NAMS) lists trouble falling asleep as one of their main five symptoms of menopause.

Before you hit the sack try some tricks to help relax your body and get you into the sleeping mode. For example, do something calming like reading a book while sipping on some chamomile tea, enjoying a candlelight bath, or just closing your eyes and listening to some soft music. As it gets closer to sleep time, prepare your bedroom so there are no distractions — eliminate as much light and sound as possible.  This means no cell phones or late night gift-wrapping.  Your bedroom should be a tranquil sanctuary during this hectic holiday season!

A Little Social Time

Finally, try to remember why you wanted to play hostess in the first place. Isn’t it all about the camaraderie and sense of family during the holidays?

Let the love in!  Relying on your loved ones to prop you up, lend some advice or just tell a few jokes is vital to a successful holiday event. Laughter relieves tension. It’s like getting an emotional message. The fabulous Lucille Ball had it right—life will get zany and humor is important.  Learn to roll with it.

It’s the time of year when we celebrate our health and happiness. Keep your scale on your good side, take time for YOU, and you’ll also slash stress and be able to enjoy the holidays’ finer things: family, friends, and health! Happy holidays!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

Download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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Are you drowning in holiday stress?

I am sending you a lifesaver!

Naomi Gauthier Berry MC, LPC  has some easy to implement professional tips on how to get back on track and enjoy the holidays.

Berry says, “Grumpy people, family dynamics, crowded stores, too much to do, and an over-stretched pocketbook may create a recipe for stress. You may be feeling guilty for not being joyous enough about the season—or maybe you’re overwhelmed and want it to be January already.  Don’t resign yourself to the stress. Your days are likely to be busier than normal but if you can follow these 5 essential stress busters, you will have a more merry and meaningful holiday season.”

1. Don’t Spread Yourself Too Thin

Do you think that the perfect holiday is the one where you make everybody else happy? Perfect doesn’t exist, but you can prioritize your involvement and make your holiday better than ever. Make a priority list of your holiday must-haves and let go of the less important tasks.  To paraphrase the holiday song “Let it Snow”: “Let it go, let it go, let it go!”

For example, some gift purchases are non-negotiable, as is your attendance at certain events. But you could make your life easier by sending Holiday cards to relatives instead of a detailed letter or skipping the neighborhood cookie exchange. Only you can decide what you want to cut from your to-do list, but you get the idea. You will likely discover that you can reduce the number of things that you think you have to do and you probably won’t even miss them.

2. Delegate, Delegate, Delegate

There’s a tendency during the holidays to think that you have to do everything. You don’t have to shoulder this responsibility by yourself, simply delegate, delegate, delegate. When you entrust other people that you know are competent to help you with holiday tasks, it will likely take away some of your stress. Maybe your significant other can do some of the gift shopping, or you could invite family over to do the baking or meal preparation that you usually take on.

3. Stick to a Budget

Money is one of the most stressful aspects of the holidays for most people. The easiest way to avoid this stress is to plan ahead. If you haven’t planned ahead by saving money for the holidays, you might find yourself financially stressed when the credit cards come due. Stick to your budget! You’ll be grateful a month from now when you’re not dealing with a debt hangover.

4. Find Time for Yourself

Treat yourself to fun and relaxation. Sometimes we get so wrapped up in trying to create the perfect holiday experience for our loved ones that we’re miserable in the process. It doesn’t have to be that way! Set aside some time for yourself that is focused on fun and relaxation. Allow yourself to recharge and stay present. A series of self-focused interludes can work wonders for your state of mind and is a great stress buster! Mindful of our goal of sticking to a budget, taking time for yourself does not have to be expensive. It may be as simple as a warm bath, a pleasant walk, or watching your favorite show. Make self-care a priority and do some things for yourself that bring you joy.

5. Make Sure You Get Enough Vitamin Z

In other words, make sure you get enough sleep! There’s no real way to create more hours in the day, but do not rob yourself of sleep or you will pay the price in stress and be less productive. Getting enough sleep will also boost your immune system, which is so important during the cold and flu season. As difficult as it may seem at times, get some rest!

As Berry says, “The holidays do not have to be ho-ho horrible.”

She reminds us that taking on holiday stress is also something you need not do alone.  If, in spite of your efforts, you find yourself struggling to have a less stressful holiday, reaching out to a counselor can work wonders as well.

Remember:  Suffering in silence is OUT!  Reaching out is IN.

Download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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With Thanksgiving under our belts (literally) and December holidays around the corner, you may be considering putting your meals on hold for a month to compensate. Don’t be silly! All you have to do to eat your way to holiday happiness is reach for the right things.

Celebratory eating is one of the great pleasures of life.  However, when you are not at a holiday party, try to make a few changes in your eating to help you keep your energy level high without the discomfort, regret, and ill health effects of a bulging waistline. Here are the top 3 foods to avoid or cut back on and the top 3 foods to indulge in.

To Avoid or Cut Back on:

#1 – Cheese. Oh, I know you love cheese. We all do—it’s practically a drug (google “casomorphins”). Loaded with saturated fat and cholesterol, there’s hardly a worse dietary choice than cheese. Pull it off the top of whatever it has its greasy hands on. Imagine the feeling of the grease on your skin—kind of gross, right? That’s what greasy stuff is like on the inside too. Try instead a delicious cashew cream recipe instead blend: 1 cup cashews with 2 cups water, add salt to taste, and experiment with spices such as garlic, oregano, smoked paprika, or cilantro.

#2 – Meat! Meat, especially fatty meat, is the other poor dietary choice as it is high in cholesterol and saturated fat.   If your family tradition is to have a roast for Christmas, I say go ahead and have some and enjoy it.  But, try leaning toward eating more fish and/or a plant-based eating plan for your daily regime.

#3 – Watch those Added Fats.  Use that oil and butter sparingly!  Stay away from any fried foods. I never order my salad with dressing on it.  Instead, I ask for balsamic vinegar and olive oil.  Use a drizzle of each. If you want to try eliminating oil at home when you cook, try out an oil-free sauté by using seasoned water, vegetable broth, or mirin instead of oil.

To Indulge (finally, the good part!):

#1 – Beans. Beans are high in fiber, and most of us just do not get enough of the stuff in our diets! Fiber helps us feel full, which naturally prevents over-eating, and cleans our insides. They are high in calcium and protein, as well as numerous other phytonutrients that are certain to keep you feeling healthy and satisfied. Here’s a quick and easy recipe: Make a bean salad by tossing three types of beans and some chopped veggies and just drizzle a little olive oil and balsamic vinegar. If you make a big bowl of this, you can grab this when you are on the run.

#2 – Greens. Green leafy vegetables are loaded with calcium. There are so many varieties from which to choose: Bok choy, collard greens, swiss chard, kale … pick one or two that look interesting and give them a try. Try a greens sauté using mirin and salt instead of oil, with a dash of sesame seeds on top!

#3 – Whole foods. Take a look at your next meal and ask yourself—is this whole, or processed?  Whole foods are better for us.  Whole foods are foods that have not been processed or refined. Or, if they have, it has been very little. They are either natural or very close to their natural state, and they do not contain the harmful additives that are found in processed foods. Take a look at your pantry and purge some of those processed foods.

As we age, these dietary choices become even more important—for optimal functioning of the brain, immune and endocrine (hormone!) systems, as well as maintaining a healthy weight, which is a key ingredient for chronic disease prevention.

Just a few changes in your daily regime will help enable you to maintain your energy and good health during the holidays and beyond!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

Download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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Heart disease is the #1 killer of women.  In order to be your own best health advocate, it is essential to keep up on the latest info and studies.

Since the WHI (Women’s Health Initiative)  hoopla in 2002, there has been lots of confusion about heart health and HT (hormone therapy). Remember, part of the issue with the first reporting of the study as it related to cardiovascular health is that women who had previously experienced heart problems had not be excluded in the study.  Many of the women were over 60 years old and already had heart conditions…………therefore, the initial reporting in 2002 was not really helpful to us heart healthy women. Grrrrrrrrrrrrrrrrrrrr!

However, there has been new critically important studies since 2002. It is important to keep up!  Let’s recap what the current consensus is about HT and heart health:

  • Currently, the benefits of estrogen and heart health are universally accepted.
  • Estrogen has rapid beneficial vascular effects on heart health.
  • The shorter periods between the onset of menopause (Remember, you have graduated to menopause when you have been without a period for 12 consecutive months.) and the initiation of HT,  the greater protection a woman has against cardiovascular disease.

Let’s recap about what we know about The Danish randomized control study:

  • This study tested whether hormone therapy can reduce cardiovascular endpoints in women if started early after menopause. The conclusion:  “After 10 years of randomized treatment, women receiving hormone replacement therapy early after menopause had a significantly reduced risk of mortality, heart failure, or myocardial infarction, without any apparent increase in risks of cancer, venous thromboembolism, or stroke.”
  • According to Dr. JoAnn Pinkerton, the Executive Director of the North American Menopause Society and Professor of Ob-Gyn at the University of Virginia, “The decline in estrogen may be a factor in the increased heart disease seen in postmenopausal women. There may be a critical window of timing with the heart in that women within 10 years of menopause benefit from estrogen. Those who are older with already developed atherosclerotic plaque may be worsened with estrogen. Estrogen may decrease total cholesterol, decrease plaque formation or improve the inner layer of the artery wall.”
  • You might find this interesting as well. This study that looked at women who have had a hysterectomy and were NOT put on estrogen therapy (ET).  (Hysterectomized women do not need progesterone therapy.)  ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality. 

It is important to note that not only is HT beneficial to our heart health, but it also has protective benefits for bone health, vaginal health, VSM prevention, joint and muscle pain, mood changes, and sleep disturbances for women under the age of 60 or within 10 years of menopause.

This new study reported at NAMS was done to see what happens to a woman’s arterial function if she discontinues her HT and is age 60 or under. Here is what they reported about this new Finnish study which involved more than 400,000 women with no prior cardiac or stroke events:

  •  “The discontinuation of HT was associated with an increased risk of cardiac and stroke death during the first post-treatment year, especially in women who discontinued HT aged younger than 60 years. This increased risk was not observed in women aged 60 years or older at the time of discontinuation.”
  • Dr. JoAnn Pinkerton, NAMS Executive Director further explained, “Since the initial Women’s Health Initiative reports, studies have shown that hormone therapy has many benefits and is safer than originally thought. This is especially true for symptomatic menopausal women younger than age 60 and within 10 years of menopause, as these women had fewer heart events and less risk of mortality. This new study suggests that younger women may have a higher risk of heart disease and stroke during the first year of discontinuation. Thus, women and their healthcare providers need to consider the benefits and risks of starting and stopping hormone therapy before making any decisions.”

If you are thinking of discontinuing your HT before the age of 60…………….please take this information in with you to your Menopause Specialist and have a serious conversation with about what age you should stop your treatment.   If you don’t have a Menopause Specialist, here are some tips on how to find one!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

For more great tips on how to find a menopause specialist and deal with menopause, download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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As promised, this is part II of my updates from the North American Menopause Society (NAMS) that met in Philadelphia October 11-14 2017.  If you missed part I, which brought you the latest updates on insomnia, depression, dry vagina, painful sex and migraines you can read all about it here.

Since 1989, NAMS has been promoting the health and quality of life of women during midlife and beyond. The membership (approx 2,000 leaders in the field of mid-life) includes clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education.

Here are a few more important takeaways from the conference:

Can transdermal estradiol help with treating and preventing perimenopausal depression? A one-year intervention was conducted by a team of doctors at the University of North Carolina at Chapel Hill, Dr. David Rubinow and Dr. Susan Girdler, that demonstrated that transdermal estradiol was effective in preventing clinically significant depression among women in early menopause transition.  This study suggests that stabilizing fluctuating estradiol levels (which occur during a women’s menopause transition) with a transdermal estradiol patch, may be a great option for preventing perimenopausal depression. Apparently, the treatment was most effective in women who reported a greater number of stressful events in the six months preceding the enrollment in the study.

Long-term treatment of osteoporosis was clarified.  As I have mentioned in previous blogs about bone health, osteoporosis is a common problem among postmenopausal women. Sadly, there is no cure for osteoporosis.  Long-term treatment is often needed to help protect against fractures. The question remains how long does one stay on some of these treatments? If you are on bisphosphonate therapy a commonly prescribed treatment for osteoporosis, it would be helpful for you to know that The American Society for Bone and Mineral Research has clear recommendations about, “bisphosphonate holidays.”  It was stressed that the concept of a “holiday’ from taking treatment only refers to bisphosphonate drugs, not to other osteoporosis treatments, such as raloxifene, teriparatide, and denosumab.  If you stop those treatments, the beneficial affects (protection from fractures) are lost quickly.

Dr. JoAnn Pinkerson, NAMS Executive Director states, “Prevention of osteoporosis should be a goal for those treating menopausal women, as up to 20% of bone loss occurs within the first five years of menopause. Once diagnosed with osteoporosis, the goal becomes lowering the risk of fractures as fractures can be life changing and life limiting.”

Despite the fact that the current data points to the effectiveness of Hormone Therapy (HT) for the relief of menopausal symptoms, women are still so skeptical.  The current published evidence from the WHI (Women’s Health Initiative) suggests that HT is a relatively safe solution for menopausal women under the age of 60 or within 10 years of postmenopause. In addition,  HT does not need to be routinely discontinued in women aged older than 60 or 65 years and can be considered for continuation beyond age 65 years for persistent hot flashes, quality-of-life issues, or prevention of osteoporosis after appropriate evaluation and counseling of benefits and risks. (You can read more about HT here.)

One of the issues causing women to hesitate to get the help they need is that the healthcare providers have “knowledge gaps” on the safety of HT. (That’s a nice way of putting it!)

Granted today, we have many other options available to us. But, it is important to note, that HT still ranks as the most effective treatment for those often life changing and debilitating symptoms of menopause.

“This study tells us that there remains an unmet need to educate women about the safety and effectiveness of hormone therapy for most symptomatic women. The benefits go beyond the relief of hot flashes and include improvement in night sweats, sleep disruption, prevention of bone loss and fewer heart events,” says Dr. JoAnn Pinkerton.

I am post-menopausal, but I remember how confused, scared and clueless I was when I started my perimenopausal journey.  That is why I want to help impart the latest information as it comes out to help you base your healthcare decisions on facts instead of fear.

Please pass this information onto your family, friends, and co-workers.  Let’s all do our part to help the sisterhood so that we can all lead happy, healthy lives during our perimenopause, menopause, and postmenopausal years!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

Download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

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Do you or someone you know under the age 40 have irregular periods, hot flashes, irritability, and infertility?  It is possible that you are experiencing Primary Ovarian Insufficiency (POI).  Also called premature menopause.

When we share our stories – we help others!  So, I asked Christine Eads if she would share hers.  Christine is sassy and sharp!

When I first met Christine, she opened up about her own struggle to find hormone happiness. Doctor after doctor, and misdiagnosis after misdiagnosis, she listened to her body and didn’t give up on getting the help she deserved. Ultimately, she met a specialist who discovered that she suffered from primary ovarian insufficiency (POI) often called premature or early menopause.

Technically speaking this is when the ovaries don’t produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is common, however, it’s possible a woman with this condition could get pregnant with treatment!   Do not worry, there are treatments which may include hormone therapy and supplements to help prevent osteoporosis.
This is not the same as early menopause which is when you have reached menopause before the age of 45.  Remember, you are officially in menopause when you have not had a period for 12 consecutive months.  If you have not had a period for 6 months, and then you start spotting or have a full period – you must start the clock over.  Sadly, there is no cap and gown ceremony when you graduate from perimenopause to menopause.

This brave woman was happy to take a seat in the spotlight and let me interview her. Here’s what she had to say:

For all of the women out there who may not know, what exactly is primary ovarian insufficiency (POI)?

“Well, 11 years ago when I was diagnosed with this problem it was called premature ovarian failure. Since then, they’ve changed it to premature ovarian insufficiency (POI) because “failure” sounded so final, and it’s not! POI is the loss of ovarian function at an early age. Some refer to it as early menopause or premature menopause. It can be brought on by autoimmune and genetic disorders, chemotherapy or radiation therapy, but sometimes the cause is unknown.”

How are POI symptoms similar to the symptoms of perimenopause and menopause? What’s that like?
“First, the loss of your period, which sends you into major mood swings. Night sweats, no energy, dry eyes and not being able to sleep.”

I always say to trust yourself and listen to your body. How did you know that you needed help?
“When I was 24, my period just stopped coming altogether. Over the next five years, I saw a dozen doctors who told me that I had everything from depression to a sexually transmitted disease. Some told me I was too skinny. Others told me I was too fat. Some doctors said I needed to take birth control pills and others told me to stop taking birth control pills. Of course, all these diagnoses were wrong and that just brought me back to square one. Through all of that, I also had terrible mood swings and I would wake up in pools of sweat. I was told that was a side effect of the antidepressants I was taking. Then, when I was 29, someone recommended I see Dr. Nelson at the National Institutes of Health (NIH), so I did. He diagnosed me with POF, now POI.”

What did you feel like when you found out?
“I was devastated!!  They didn’t want to give me any false hope that there were any follicles and the thought of that was crushing. I wasn’t ready to have kids at that point in my life but I had always dreamed of having a huge family with tons of children. I felt that was being taken away from me and I was really angry at the doctors who didn’t diagnose me properly. I thought if they had, I might not be in this situation.”

Well, now you’re a mom! How did that happen?
“In the protocol at NIH—everyone there is amazing, by the way!—I was given hormone replacement.  I routinely went in for blood work and in August 2001 (10 months later) they asked me to retake a test. The next day, Dr. Nelson called to tell me I was pregnant. I wasn’t trying, but what amazing news! I was obviously taken out of the protocol and none of us could believe how great this was for me. It definitely gives hope to other women with POI that the condition isn’t so final.”

You are so hilarious, open and candid. What advice can you give women to help them become more outspoken when it comes to their health?
“You have to be your own advocate. No one cares about your health more than you. Don’t blow it off and say that it’s normal or it will go away. If you don’t feel right in any way, get to a specialist and ask a million questions until you are satisfied. Don’t be embarrassed to talk to family and friends about what is happening with you. You may not know that POI, or other disorders, may run in your family and you might find strength if someone else is feeling the same way. It is worth taking the time and doing the research to feel better.”

Thanks, Christine, for sharing your story.

Remember:  Suffering in silence is OUT!  Reaching out is IN.

For more great tips on how to find a menopause specialist and deal with menopause, download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

Be sure to sign up for my fun YouTube Videos!

 

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