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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the
Estroven® brand, i-Health, Inc., or DSM.
Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her new film, LOVE, SWEAT & TEARS shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause—that there is hope, and that the third part of a woman’s life can be the best and most romantic.
I think that the biggest fear that perimenopausal and menopausal women have is weight change. Most women understand that something happens to their metabolism when they reach their 40s and 50s. Is it aging? Is it menopause? No one knows the exact mechanism of how or why weight changes at this sensitive age. What I do know is that a woman must take this metabolism change seriously. It is much easier to maintain one’s weight than to try to lose it. Even if it is just two pounds per year, that adds up to 10 pounds over five years and 20 pounds over 10 years. Here are 11 tips to help prepare for these changes.

  1. Have knowledge of the caloric counts of foods and practice portion control. We are used to massive portions from most fast food establishments, but these should not be the norm. Avoid fast food places and processed food—if you can’t avoid a fast food restaurant, choose a fruit or salad.
  2. Aim for five servings of vegetables and fruit every day, if you can! Fill up on these low-calorie foods.
  3. Consume fish at least twice a week.
  4. Limit intake of saturated fats, trans fats and cholesterol. Try using large lettuce leaves instead of bread for a sandwich!
  5. Minimize the intake of beverages and foods with added sugars. Soft drinks, sweet tea and lemonade have a lot of calories. Don’t like water? Consider sparkling flavored water.
  6. Choose and prepare foods with little or no salt.
  7. Decrease alcohol consumption—almost every patient of mine who has successfully lost weight quit drinking alcohol.
  8. Aim for six small meals a day instead of fewer larger ones. Chew your food slowly and enjoy the meal. Are you eating because you are hungry or because it is a habit? Try not to eat within three hours of going to bed and maybe take a walk after dinner.
  9. Consider Estroven® Weight Management + Healthy Metabolism, formulated with Synetrim CQ® to balance declining serotonin levels to safely help manage weight.*
  10. Get plenty of sleep. Staying up later gives you more opportunities to eat. You need sleep to exercise and burn off those calories tomorrow. Give your body the rest it needs and deserves!
  11. Exercise! Walking at work is not exercising. Try to engage in a stand-alone exercise program at least six days a week. Exercise is the key to maintaining your weight during menopause. Do something you love! Take a walk, ride a bike, dance or go swimming. Play with your kids, pets or grandkids outside. Get some friends together and take up a sport.

Learn from those who already have been there. We care and we are here to help!

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

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According to Dr. Pam^, one of the biggest fears that perimenopausal and menopausal women have is weight change. Here she offers 11 tips to help prepare for these changes.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the
Estroven® brand, i-Health, Inc., or DSM.
Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her new film, LOVE, SWEAT & TEARS shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause—that there is hope, and that the third part of a woman’s life can be the best and most romantic.
One of the most common questions in my practice is, “How will I know that I am in menopause?” My answer: there are a constellation of signs and symptoms that may at first be very subtle but become more obvious as time goes by.
1. Joint Pain
Many of these changes are also associated with aging in general and can happen to men as well. Take joint pain for instance. As people age, the constant wear and tear of daily activities can take their toll. Cartilage between bones gets thinner and recovery from injuries takes longer.
2. Weight Change
There is a shift in metabolism as we age that contributes to weight change. This is probably the most upsetting for my patients. A perimenopausal woman must be cognizant that this will occur and prepare for it by maintaining physical activity and decreasing caloric intake.

3. Skin Changes
Skin starts to sag and wrinkle because of the redistribution of fat under the skin, loss of muscle mass and loss of collagen. About 30% of skin collagen is lost during the first five years after menopause.1 Perimenopausal women may notice this most visibly on their face, neck and upper arms. Acne results from an increase in oil or sebum production due to an abundance of male hormones compared to estrogen. Dry skin is also a common condition of aging skin and results from decreased water and lipid content of the skin as well as reduced oil production and sweating.
4. Hair Loss
Female pattern hair loss is more common after menopause and is thought to be due to the altered estrogen-to-androgen (male hormone) ratio. There may be a gradual shedding of hair on the top of the head. It may first be noticed because the hair part appears to be widening; unlike male pattern hair loss, the front hairline is maintained. While a menopausal woman may be losing hair on the top of the head, whiskers may start forming on the upper lip, chin and cheeks. The occasional “rogue hairs” on the chin may seem to appear overnight!
5. Dryness
Another subtle change starts with drying out of the mucous membranes. The eyes may become very dry, often requiring frequent administration of lubricating drops. The mouth may become dry. Vaginal dryness is also common, potentially leading to pain during intercourse.
6. Changes in Menstruation
The menstrual changes may seem overwhelming when they initially occur. Menses may become more frequent and heavier before they lighten up, space out and eventually stop.
Managing Menopause
Is it all doom and gloom? Absolutely not! Menopause can be a wonderful time of freedom from periods and worries of pregnancy. All women are not going to have every symptom. In general, I recommend the following to help manage menopause:

  • Maintain a healthy weight. It can help with hot flashes, acne and menstrual problems
  • Engage in physical activity to protect your bones, reduce stress and help manage weight changes
  • Try Estroven® Maximum Strength + Energy, which is formulated to help with hot flashes and night sweats*
  • Take care of skin, hair, teeth and eyes with preventative visits to healthcare providers
  • Avoid excessive alcohol, as it can increase stress and lead to sleep troubles
  • Practice stress reduction techniques and decrease caffeine use to help feel calm and in control
  • Take the advice of those who have already experienced menopause to help prepare for the changes, and support other women with your own advice
  • You can do this! I promise.

    1 Menopause Practice. A Physicians Guide 5th Edition. Chapter 2: Midlife Body Changes p 21-38. North American Menopause Society. 2014

    ^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

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One of the most common questions Dr. Pam^ receives in her practice is, “How will I know that I am in menopause?” Her answer: there are a constellation of signs and symptoms that may at first be very subtle but become more obvious as time goes by. Read more for specific signs, plus ways to manage the symptoms.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the
Estroven® brand, i-Health, Inc., or DSM.
Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her new film, LOVE, SWEAT & TEARS shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause—that there is hope, and that the third part of a woman’s life can be the best and most romantic.
Joint pain can have a vast impact on a woman’s life, and unfortunately, up to 60% of midlife women report joint aches and pains. Joint pain, loss of range of motion and loss of overall use of a joint can result from issues with bone and cartilage, inflammation of joint spaces, and the amount and quality of joint fluid. Bone loss begins during the menopausal transition and is the highest one year before the final menstrual period and two years after completion of menopause.1 This pain can lead to lack of mobility, limitation of activity, a diminished recreational and social life and interference with work.2
Osteoporosis
Osteoporosis is characterized by a loss of bone mass and a decline in bone quality, and has a fivefold greater prevalence in women than in men. Common problems that may contribute to osteoporosis include celiac disease, gastric bypass, gastrointestinal surgery, high caffeine intake, excessive alcohol intake, smoking, and use of blood thinners, seizure medication and anti-estrogen chemotherapy agents. A higher peak bone mass achieved early in life correlates with lower fracture risk later in life, making exercise important at all ages. Weight bearing, resistance exercises and aerobics have a beneficial effect on spine bone mineral density; walking is best for the maintenance of the hips.3 Physical activity, adequate nutrition and overall good health also are imperative.
Osteoarthritis
Osteoarthritis is inflammatory joint pain that results from the wear and tear of everyday life on our bodies and is a disease in which the x-ray evidence of joint damage frequently does not correlate with the presence and severity of joint pain and disability. Recommendations include weight loss, performing weight-bearing exercises and muscle-strengthening exercises, taking the appropriate amount of vitamin D and calcium, stopping smoking and avoiding secondhand smoke, reducing alcohol intake and adopting fall-prevention strategies.

Three Exercises for Joint Pain
Goals should be set to better manage joint pain. Mobility is the first step to making regular exercise more feasible. Loss of at least 10% of body weight through a combination of diet and exercise has been associated with a 50% reduction in pain scores in overweight patients in as little as 18 months.2 Start with these short-term, achievable steps:
1. Start slowly with stretching exercises or yoga
2. Next, move on to walking for 10 minutes, three days a week
3. Once that is possible, aim to walk for 30 minutes every day
Other Options for Joint Pain
Vitamin D3 and calcium supplementation are especially important for bone quality—vitamin D deficiency results in softer, poorly mineralized bone which can lead to osteomalacia in adults,3 and prolonged calcium deficiency can lead to osteoporosis. A few supplements such as chondroitin and fish oil may have some effects on patients with a mild form of these diseases. Surgical treatment is achieved by total joint replacement and is recommended in severe cases only.

1 https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-...
2 https://www.uptodate.com/contents/overview-of-the-management-of-osteoart...
3 ACOG Practice Bulletin No. 129, Osteoporosis 2012

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

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Joint pain can have a vast impact on a woman’s life, and up to 60% of midlife women report joint aches and pains. Dr. Pam^ outlines a few key ways joint pain can be managed.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.

Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS, shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

Menopausal women routinely come into my office, lean forward and whisper, “I think I have Alzheimer’s disease.” I fully understand where they’re coming from. My children might text me five times that we need milk and bread; they may even text me so much that I get aggravated with them. Still, I somehow forget the milk, even though I pass a grocery store on the way home. Does that mean my patients—or I—have dementia? No! But I understand the concern. We all can relate to a lapse in social memory. Maybe you can’t remember the name of someone that you have known for years. Or maybe you decided to not write down something because you were sure that you would never forget it…and then you forget it.

It’s not uncommon to worry about dementia, but there’s a difference between dementia and occasional memory issues during menopause. Dementia is a decrease in mental function that involves learning, memory, language, function, attention, motor skills and social memory.1 Patients that have dementia have trouble retaining new information. They also struggle to handle complex tasks like balancing a checkbook and may find themselves getting lost in familiar places. For a diagnosis of dementia, the memory loss has to be severe enough to interfere with daily function and independence. Alzheimer’s disease is the most common form of dementia in the elderly and accounts for up to 80 percent of cases.1

For most of my patients, they’re more likely to be experiencing occasional memory issues, which are normal and not necessarily indicative of dementia. For example—you may not remember why you walked into a room several times today, but you remember where your hair salon is located. Self-reported memory issues do not appear to correlate with the development of dementia; informant-reported memory loss (in which a family member reports the memory loss to the healthcare provider) is a better predictor of the presence and future development of dementia.1 I make a point to tell my patients that if they had the type of memory issues that they should be worried about, they probably wouldn’t know they had it.

What can you do to help maintain good brain function? Keep the blood flowing to your brain. Give your brain a workout by watching a quiz show, working on crossword puzzles, playing sudoku or doing puzzles. Maintain a regular sleep schedule. Socialize with other adults—do not isolate yourself. Good conversation and active debate keep your brain working!

I also recommend Estroven® Stress Plus Mood & Memory to my patients, which can be purchased over-the-counter in most pharmacies. It’s formulated with naturally sourced ginkgo biloba to support healthy brain function, including mental sharpness and memory support.*

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

1Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 85

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Many menopausal women experience occasional memory issues during menopause. Dr. Pamela Dee^ weighs in on what to expect.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.

Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS, shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

Just like puberty, menopause is a normal event in a woman’s life. There are probably close to 50 million women in the United States alone that are menopausal, with an estimated 6,000 women entering menopause every single day.1 With a woman’s life expectancy in the western world estimated to be 81 years, a woman can expect to spend approximately 1/3 of her life post-menopausal,1 but most women have not heard much about menopause prior to entering it. In general, the medical profession successfully prepares pubescent girls for puberty, but that preparation is not always extended to women on the verge of menopause.

That doesn’t mean that women have to deal with menopause all on their own. In the past, menopausal women lacked support and information in regards to the changes they were going through, but now there are physicians, menopause societies, women’s groups and friends who are not only willing to talk about it, but are happy to help them prepare for and manage every possible symptom. It may surprise many women who are entering menopause that up to 51% of US postmenopausal women surveyed in a Gallup Poll reported being happiest and most fulfilled between the ages of 50 and 65.2 Relationships improved, self-fulfillment was high, sexual relationships were maintained and lifestyle changes were initiated. This is a time of great opportunity for women to finally spend some guilt-free time on themselves.

It’s important to remember that you are never alone when it comes to managing hot flashes, weight change, fatigue, occasional sleep trouble and irritability. There are wonderful over-the-counter products to help with these symptoms (be sure to talk to your healthcare provider). A good place to start is with the fabulous line of Estroven® products. I routinely recommend Estroven® Maximum Strength + Energy, Estroven® Weight Management & Healthy Metabolism, Estroven® Sleep Cool® & Calm and Estroven® Stress Plus Mood & Memory to my patients to manage the various symptoms of menopause.*

Once you have picked the appropriate product to help with your symptoms, find other women to talk to about your experience. The internet has been a wonderful resource to help women form relationships with people from all over the world who are also going through menopause. There are many support groups on Facebook and Twitter for women to share successes, stories, symptoms, fears and worries.

Always remember—you are never alone out there.

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

1Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 1
2Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 2

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Menopause is a time of immense change for women given symptoms like hot flashes, menopausal weight change, occasional sleep trouble and menopausal stress. Dr. Pamela Dee^ discusses the resources available to women to help them manage the symptoms of menopause.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.

Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS, shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

A woman is officially “menopausal” when she has not had a menstrual period for 12 months. From this point on, she should consider vaginal bleeding an abnormality, one that necessitates a trip to the doctor. First and foremost, it’s vital that a woman’s healthcare provider screens for cancer in the vagina, cervix, uterus, fallopian tubes or ovaries to determine if the bleeding is symptomatic of a larger issue. Once that determination has been made, there are many options to treat this bleeding.

1. Oral Contraceptive Pills

One option for bleeding during menopause is to take oral contraceptive pills (OCPs, or birth control pills). If there are no contraindications, a woman may take birth control until her mid-50s. If they are taken continuously (meaning that the placebo pills are skipped), a woman may go many months without having a withdrawal bleed. While the risk of blood clots forming from birth control pills increases as a woman gets older,1 the pills used now are available in extremely small doses.

2. Progesterone Intrauterine Device

Not only is a progesterone intrauterine device (IUD) less expensive than birth control pills in the long run (over five years), the risk factor for blood clots is lower than with OCPs.1 The use of a progesterone IUD for abnormal uterine bleeding is considered an off-label use by the FDA, so as always, it is very important that a woman speak with her doctor before considering this option.

3. Endometrial Ablation

Endometrial ablation is a minor surgical procedure that works wonderfully in the menopausal age group. I personally prefer a woman to be 40 years of age or above to do an ablation. The procedure involves destroying the endometrium (the lining of the inside of the uterus), which usually reduces or prevents uterine bleeding. The body has a unique ability to heal, and sometimes the uterus “heals” and starts bleeding again. In my experience, the older the patient is, the less likely that she will start bleeding again.

4. Hysterectomy

Some women come in to my office requesting a hysterectomy. This could be an appropriate option if her uterus is full of benign fibroid tumors or if other methods have failed, but generally if a woman experiences bothersome peri-menopausal bleeding, she should explore conservative treatment options first: OCPs, progesterone IUD or ablation. A hysterectomy is major surgery with increased chances of risk, such as a bowel injury, blood loss or a bad infection. It is best to consider the aforementioned options before resorting to something serious. A woman should always consult with her healthcare provider about the available options best suited to her unique needs.

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

1https://nwhn.org/hormonal-birth-control-blood-clot-risk/

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During menopause, women can expect changes to their period. Dr. Pam^ discusses the way vaginal bleeding changes during the different stages of menopause.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.

Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS, shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

Dryness during menopause can affect women in multiple ways. The most common dryness issues include drying of the skin, mouth, eyes and pelvic tissues.

Dry Skin

Dry skin is the most common condition of aging skin and is a result of decreased water, oil and lipids. Estrogen receptors are located throughout our skin, so it is understandable that with the loss of estrogen after menopause, the skin is affected. The decline in skin collagen after menopause is initially rapid, with up to 30% of skin collagen lost during the first five years after menopause.1 Increases in wrinkling and decreases in skin elasticity will also occur. The best way to take care of your skin is to stay out of the sun and stay well-hydrated.

Dry Eyes

A very common complaint associated with menopause is dry-eye syndrome. It is characterized by dryness, pressure, foreign-body sensation, scratchiness, burning and intolerance to light. Women with dry eyes can use eye lubricants such as drops, gels and ointments to provide a temporary decrease in symptoms, but these unfortunately will not cure the problem. Women can also speak to a healthcare provider to see if anti-inflammatory medications, topical corticosteroids or prescription Cyclosporin A may help.2

Vaginal Dryness

One of the most common and well-known symptoms of menopause is vaginal dryness. The lining of the vagina and urinary system relies on estrogen to keep the tissues thick, healthy and well-lubricated. Estrogen decreases result in vaginal dryness and itching which can lead to pain with intercourse. Early in menopause, the first sign of low estrogen levels may be a slight decrease in vaginal lubrication upon sexual arousal. Symptoms of dryness of the vaginal and urinary tract are progressive and worsen as a woman ages.3 With continued loss of estrogen, women may notice vaginal dryness during daily activities that are not associated with sexual activity such as sitting, biking or even walking. On examination, the vagina typically appears pale, with loss of the vaginal folds and a decrease in diameter and length. The opening of the vagina narrows, and a woman may lose pubic hair.4 For my patients, I recommend a daily vaginal moisturizer, vaginal estrogen or vaginal DHEA, and regular intercourse or physical therapy to increase vaginal blood flow and to help maintain the diameter and length of the vagina.

Dry Mouth

Postmenopausal women tend to have drier mouths which leads to an increased susceptibility to gum disease. It is clear that an adequate intake of calcium and vitamin D is important for bone health of the jaw and teeth. For each 1% per year decrease in whole-body bone mineral density, the risk for tooth loss more than quadruples, showing a definite relationship between low bone mineral density and gum disease.5 Women should floss and brush teeth daily with a fluoride-containing toothpaste, see their dentist regularly and maintain adequate vitamin D and calcium to prevent and treat osteoporosis-associated periodontal disease.6

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.

1Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 29-30
2Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 35
3Casper, Robert F., Barbeiri, Robert L., Crowley, William F., Martin, Kathryn A., UpToDate. Clinical manifestations and diagnosis of menopause.
4Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 60
5Menopause Guidebook: A Clinicians Guide. 5th Edition. North American Menopause Society 2014. p. 37 and 38
6https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768179/

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Dryness during menopause is very common—especially vaginal dryness. Dr. Pam talks about this menopause symptom here.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.

Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS, shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

As an OB/GYN, I answer many questions from worried patients in the privacy of the examination room. But especially after the debut of my documentary on Netflix, Love, Sweat, and Tears, I began receiving many questions on my website. Since many of these questions are recurring, I would like to share some of the most common.

#1. Do you think that I have Alzheimer’s Disease?

No, I do not. Women are over-worked, under-appreciated and spread too thin. Almost every woman I know or take care of has a job and is the primary caregiver to her children and/or her parents. There are so many important things to remember every day that the little things—like the reason for walking into a room—get overridden by the next thought. It’s important to remember that self-reported memory loss is rarely dementia, but if this remains a real worry, have a family member administer the Mini Mental State Examination, which is available online and see your healthcare provider.

#2. I cannot have an orgasm during intercourse—only with manual clitoral stimulation. Is there something wrong with me?

Absolutely not! This is probably the most common question I’m asked. Most women have not had an orgasm with intercourse. That doesn’t mean that it doesn’t feel good—it just means they require manual or oral stimulation in order to climax. There is nothing wrong at all. For some women, this may start happening after menopause when estrogen and blood flow to the genital area dwindles. She should make sure her partner understands this and takes the time to stimulate her to an orgasm first; and then it will be more likely that she could perhaps have one during intercourse. But don’t worry—this is normal.

#3. I am frightened about taking estrogen. Is there something that I can do about hot flashes?

If a patient cannot or does not want to take estrogen supplementation, there are still options to help her manage hot flashes—please be sure to discuss all options with your healthcare provider first! My first recommendation is to try Estroven® Maximum Strength + Energy, which is safe, available over-the-counter and formulated with Black Cohosh and Soy Isoflavones to help reduce hot flash severity and frequency.* Next, lifestyle changes help as well. Wearing layered clothing to take off as hot flashes hit, keeping personal fans on-hand, getting regular exercise, quitting smoking and avoiding triggers such as caffeine and alcohol are also known to help.

#4. I am struggling with my weight. Can you help me?

The absolute key to managing weight change after menopause is exercise. Something happens to our metabolism when we go through menopause—a calorie-restricted diet is just not enough anymore. “Walking a lot at work” doesn’t cut it either. Prioritize a stand-alone daily exercise program. I like to do DVDs in my home. Try an exercise class or get a personal trainer at a local gym or YMCA, but a stand-alone exercise routine is necessary. I also recommend Estroven® Weight Management + Healthy Metabolism, a wonderful over-the-counter and very safe product formulated with Synetrim® CQ to help manage weight change.*






^Dr. Pamela Dee is a paid spokeswoman for Estroven®.



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As an OB/GYN, Dr. Pam sees many patients experiencing menopause symptoms. Here, she lays out the most common, and offers advice for dealing with them.
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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.
Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

A woman is menopausal when she has not had a menstrual period for 12 consecutive months, or if both ovaries have been removed or rendered inactive due to medications or radiation therapy. Because natural estrogen is no longer released from the ovaries, many bodily changes may occur, but it can still be an exciting and carefree time of life. To start, a woman no longer has to worry about menstrual periods or the risk of pregnancy! If she has children, they have likely already left or are about to leave home for college, allowing her to concentrate on herself.

That said, there are also problems that arise with the loss of estrogen. The most common symptoms include night flushes, fatigue, hot flashes, mood swings, panic attacks, weight change, an increase in urinary tract infections, incontinence of urine, sleep trouble and vaginal dryness. Women also lose the protection that estrogen affords to bone mass which makes them susceptible to bone fractures, the most serious of these being fractures of the hip and spine. Whether a woman is menopausal or not, medical problems become more common with age. Type II diabetes mellitus, heart disease, hypertension, high cholesterol, arthritis, depression and many cancers may occur.

It may seem like the unfortunate parts of menopause outweigh the good parts, but I promise that it is not hopeless! I have several solutions.

#1. Watch Your Diet
Remember that your caloric needs will lessen as you get older. Exercise is the absolute key to maintaining weight as one ages, and it will help your bones stay strong. When I have a newly menopausal woman in my office, I try to explain that metabolism decreases as people age. It is much easier to maintain your weight than to try to lose weight, so focus on weight maintenance.

#2. Reduce Stress
Take care of yourself and reduce your stress level. Learn to say, “No.” One of my favorite responses to someone asking me to take on another volunteer job or help with a project is, “I’m sorry, I can’t help you with that.” Look them straight in the eyes and don’t start explaining why you can’t help. It always works.

#3. Try a Menopause Relief Supplement
Be proactive! There are many over-the-counter options that can help with symptoms. For instance, Estroven® has a whole line of products for menopausal women that are specifically formulated with ingredients to help with hot flashes, mood, memory, weight management, fatigue and occasional sleep troubles.* Of course, let your healthcare provider know before starting any new medication or supplement.

#4. Have a Positive Attitude!
I know that you can do it!

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.
Estroven® is a trademark of DSM.

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Dr. Pamela Dee, OB/GYN, is a paid spokesperson for Estroven®. The information provided herein is for educational purposes only and is not intended to be construed as medical advice or to replace professional medical care. You should always seek the advice of a medical professional before starting any new medication or dietary supplement. The opinions stated herein are those solely of the writer and do not portray the opinions of the Estroven® brand, i- Health, Inc., or DSM.
Dr. Pamela Dee^ (Dr. Pam) is America’s leading menopause expert & OB/GYN, and she is on a mission to encourage honest dialogue about the physical and emotional symptoms that accompany menopause. Her goal is to de-stigmatize menopause and start the “Menopause Romance Revolution.” Her film, LOVE, SWEAT & TEARS shares an empowering message of hope and action. Dr. Pam^ won’t rest until every woman knows the truth about menopause, that there is hope and that the third part of a woman’s life can be the best and most romantic.

When you look back and realize that it has been a year since your last menstrual period, you can officially say that you have entered menopause. From now on, you will be a “menopausal woman.” It is normal to start the transition, which takes an average of four years,1 anywhere from age 40 to 55, with the average age of entering perimenopause being 47. However, the ages women enter menopause resemble a “bell-shaped curve,” with the mid-point being 51.4 years old. Symptoms begin at different times for every woman and may be anywhere from 40 to 62 years old. Menopause is experienced differently for every woman, similar to the age puberty begins for young girls.

Sometimes menopause can be accelerated by medical conditions or procedures. For example, a woman undergoing chemotherapy or radiation therapy might find that these therapies damage her ovaries and make them fail more quickly. When a menstruating woman has her ovaries removed during a surgery, such as a hysterectomy, she will wake up from anesthesia and be immediately menopausal. These examples are referred to as “induced menopause” because the medical procedure performed causes or induces the menopausal state. Some women prior to age 40 will have spontaneous and rapid failure of their ovaries. This might be due to an auto-immune disorder or genetic predisposition to early menopause and is called primary ovarian insufficiency (POI). Smoking cigarettes has also been shown to be a factor in causing an earlier menopausal transition.

By the time that your period has stopped for good, it’s likely that you (or perhaps your family, friends or co-workers) have noticed other signs of the menopausal transition. These signs include irregular and heavy menstrual cycles, hot flashes, night sweats, insomnia, mood swings, weight change, vaginal dryness and maybe even joint pain.

When it comes to hot flashes, night sweats and weight change, I recommend Estroven® Perimenopause/Menopause Support + Weight Management . It’s formulated with Black Cohosh extract and Soy Isoflavones to help manage hot flashes and night sweats, and Synetrim® CQ to help manage weight change in the beginning of menopause.* This may be all that you need or you might need to try other alternatives. I always recommend speaking with your healthcare provider to discuss starting a new supplement and other options.

^Dr. Pamela Dee is a paid spokeswoman for Estroven®.
Estroven® is a trademark of DSM.
Synetrim® CQ is a trademark of Icon Group, LLC and is protected under U.S. patent 7,175,859.

1Harlow SD, Gass M, Hall JE, et al. Executive Summary of the Stages of Reproductive Aging Workshop + 10: Addressing the Unfinished Agenda of Staging Reproductive Aging. Journal of Clinical Endocrinology and Metabolism 2012. 97: 1159

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