hormones

Are YOU going through menopause?

The dictionary defines menopause as “the time in a woman’s life when menstruation diminishes and ceases, usually between the ages of 45 and 50.” It is identified as not having a period for one year. Perimenopause (peri is Latin for “around or near”) is the time prior to the cessation of menstruation when you experience hormonal changes and you are still having periods. Many doctors now refer to perimenopause as the menopausal transition. So I will also refer to it as the same. Postmenopause is the time after menopause when the symptoms of estrogen absence appear.

Going through the menopause transition is the reverse of puberty. Puberty was the transition in your life when your hormones were gearing up for your reproductive years to come. Remember your first period? Emotional outbursts, swollen breasts, restless nights, and feeling bloated? Now, at the menopausal transition you may experience many of the same symptoms, but for different reasons. Instead of “turning on” your hormones, your body is now “turning off” your hormones. Many women who had difficult puberties have challenging menopause. Women who got through adolescence easily often have the same experience with menopause. We are all different and menopause is no exception.

So how do you know you are going through menopause?

Let’s identify your symptoms. You may have one, some or all at different stages of menopause. Sixty to eighty percent of women experience mild to moderate symptoms, 10-20 percent suffer from severe symptoms, and 10-20 percent have no symptoms. Your symptoms can be a guide to what is happening in your body. These clues are the hard evidence you will need when deciding what course of action you may wish to exercise.

Do you experience any of these symptoms?

• Weight gain
• Mood swings
• Night sweats
• Heart palpitations
• Changes in your period
• Migraine headaches
• Bladder changes
• Vision changes
• Joint aches
• Nail and tooth problems
• Breast tenderness
• Memory loss
• Hot flashes
• Sleep problems
• Loss of libido
• Dry vagina
• Hair and Skin changes

These are all messages from your body.

If you are experiencing one or many of these “changes” you may be perimenopausal, menopausal, postmenopausal or having symptoms from surgical menopause (hysterectomy). You are not alone; 44 million women are going through similar transitions with 4,000 a day joining the club.

If you suspect that you are going through one of the stages of menopause, call you doctor and request a FSH (Follicle Stimulating Hormone) blood test. The results of this test will allow you and your doctor to determine how best to treat your symptoms.

While waiting for test results, start an exercise program. Regular exercise can improve the symptoms of menopause. It helps regulate weight, benefits your heart and bones, and contributes to a sense of overall well-being and improvement in mood.

Document your symptoms, develop a strong relationship with your health care provider, and discuss treatment options.

Posted in hormones

Understanding Menopause Symptoms

Understanding menopause symptoms is the first step to treating them. Symptoms can be caused by fluctuating hormones. Your body is giving you clues that will help you find balance again. Your symptoms will guide you throughout your menopausal journey and will continue to change until you reach post menopause.

Document your symptoms and discuss them with your practitioner.

Irregular Periods: At the onset of perimenopause, irregular periods can be the first symptom you notice. Your natural cycle is changing, some months you may ovulate and some months you may not. As a result, irregular periods may occur. Some months your period may be longer or shorter. Discuss your menstrual patterns with your health care provider.

Weight gain: Another early symptom, which is often the hardest to live with, is weight gain. I wish I could say all weight gain could be blamed on menopause; that would just make the experience a little easier to life with. Only some weight can be blamed on our ever-changing hormones. Many of us over the years had less time to exercise and eat properly, and when we enter menopause the effects are unforgiving. Getting back in shape and losing weight may feel like an uphill battle. A commitment to healthy lifestyle changes regarding food intake and exercise is now a necessary step to feeling better. This weight gain is a wake up call. As you gather information and make eating and exercise choices for your plan, you will start seeing and feeling results.
Breast Tenderness: Changing hormones may cause fluid retention in your breasts. Once your hormones are in sync again, you will notice this uncomfortable symptom alleviated. Cut back on caffeine and salt consumption.

Mood Swings: When you are experiencing life changes, whether emotional or physical, getting moody is perfectly understandable. Throw in hot flashes, weight gain, and vaginal dryness, and you wonder why you are moody? During menopause there are also biological reasons you may get moody and irritable. When your ovaries start making less estradoil (the active form of estrogen made in your ovaries) it starts affecting other bodily functions including the estradiol in the brain and that causes a decrease in your endorphin levels (the body’s natural feel-good regulator). When your endorphin levels drop, your brain sends out adrenaline that can increase your heart rate and dilate your blood vessels causing hot flashes and anxiety. This cycle can make the best of us cranky and moody. Then throw in life’s general ups and downs, you are now on a moody roller coaster. Declining estradoil that is fluctuating daily can ensure moods swings in many of us making it difficult to cope with daily challenges. If you are experiencing mood swings, this is a good time to start making time to relax, mediate, get a massage, take yoga, enjoy herbal teas and pamper yourself. Some women with severe mood swings that lead to depression consider taking Serotonin-reuptake inhibitors (SSRIs) a drug that can balance your brain chemicals. Exercise and a healthy diet can also help with moodiness.

Heart Palpitations: If you suspect heart disease or it runs in your family, it is best to have these heart palpitations checked out by your doctor. No one knows for sure why some women suffer from heart palpitations during menopause. It is usually attributed to fluctuating hormones. Discuss this symptom with your practitioner.

Migraine Headaches: If migraine headaches are new to you, or only happened during the first few days of your period or during ovulation, it indicates that you are responding to changing estrogen levels. During perimenopause these fluctuating hormone levels may trigger more migraines than you experienced during a normal cycle. For some women balancing their hormones alleviates migraines. For others, hormone therapy makes it worse. The good news is those migraines that appeared during menopause will probably disappear during post menopause. The medical community is still trying to figure out the connection of female hormones and migraines. Practice relaxation techniques, keep a migraine journal and track your migraine triggers (caffeine, medications, dieting, stress). Discuss treatment options with your doctor.

Memory Lapses: Often short-term memory loss can be experienced during menopause. There are many factors that may affect your memory: stress, age, medications, lack of sleep, and overall health. Ask for support from your loved-ones, so they may nurture you through forgetful moments. Keep your mind stimulated. Use a planner and practice a healthy lifestyle.

Hot Flashes and Night Sweats: The number one symptom that most people associate with menopause is hot flashes. Feeling flush, overcome with perspiration, and dizzy, is no fun. Being disturbed from a good nights sleep with a hot flash (aka night sweats) that sends you to the bathroom to splash cool water on your face and change into a dry nightgown, is no fun either. When your estrogen levels suddenly plunge it can create a hot flash. Being overweight, diabetic, suffering from an under or over-active thyroid, and certain medications can also cause hot flashes. Wear layered clothing and bring a fresh blouse when you leave the house. In the summer, wear a cotton sundress and keep a stylish fan handy in your purse for instant hot flash relief. Discuss this symptom with your practitioner. Often low-dose hormone therapy can bring relief. Practice relaxation techniques, get regular exercise and maintain a healthy weight.

Sleep Problems: If you are experiencing night sweats due to changing hormones, it is no surprise you are not sleeping at night. A sleepless night may bring a day of irritability and mood swings. Non-menopausal sleep problems, such as consuming caffeine or alcohol before bedtime, may also cause sleepless nights. If these sleep problems are caused by menopause symptoms, discuss hormone therapy with your practitioner. Avoid caffeine and alcohol before bedtime. Prescription sleep aids can also bring relief. Practice relaxation techniques and eat a healthy diet.

Vaginal Dryness: Intercourse can be painful if you are experiencing vaginal dryness. When your estrogen levels drop, vaginal dryness can occur, your vagina can tear more easily from friction, and the vagina tissues can loose their elasticity and become smaller. Estrogen plumps up the cells in the vaginal wall so they produce more lubrication. Hormone therapy may bring relief. A bioadhesive lubricant, such as AstroGlide that can be purchased over- the- counter, may also bring relief. If vaginal dryness is your only menopause symptom, you may consider using local estrogen treatment.

Loss of Libido: If you are experiencing vaginal dryness and sleepless nights it is no wonder you lack interest in sex. Besides the effects of menopause, it is also normal for your libido to decline with age. Between the ages of 55 and 65 sexual activity slows for men and women. Don’t let a decrease in hormone levels blow the flame of desire out of your love life, visit your doctor, take the appropriate tests and discuss hormone treatment options. Certain medications may also contribute to a declining libido: blood pressure, depression, heart disease, or diabetes medications. If you need to treat your relationship, visit a counselor. A healthy sex life is possible during and after menopause.

Skin Changes: There is no escaping the aging process, but during menopause you really start seeing the effects of less estrogen. Your skin is supported by collagen and elastin fibers, which are supported by estrogen. That is why your skin looked so soft and contoured to your face before menopause. For those of you who loved getting a summer suntan, the affects of sun on your skin are damaging, with or without estrogen. Gravity plays a big role here too. After 40 plus years of being on this planet, gravity takes a toll on everyone. What most of us notice during menopause is that the elasticity and firmness of our skin decreases rapidly due to less estrogen production. Wear sunscreen (SPF 15+), exfoliate regularly, practice good skin care, and moisturize daily.

Bladder changes: Just as lower levels of estrogen can affect your skin, it can also change the flexibility of the muscle fibers around the urethra (the tube that lets urine out of the bladder). Age, obesity, family history, and hysterectomy may also contribute to bladder changes. Kegel exercises are a great option to reduce these effects and help firm up your urethra muscle. Just squeeze your vagina muscles and hold them for 10 seconds, then relax and count to 5, then repeat. It is best to do 5 sets 3 times a day. You will see a difference within a month. Also, start wearing a light mini-pad; they are much easier to change than your panties or slacks. You may notice when you balance your hormones this symptom improves. If not, your doctor may suggest medications.

Hair Changes: Almost 50% of women complain of hair changes during menopause. Age, family history, high blood pressure, medications, depression, thyroid disease, stress and hormones can be factors contributing to hair loss or excessive hair growth. You can have thinning hair and you can sprout some hairy growth on your face. For a few rogue hairs or peach fuzz try tweezing, Jolen Hair Bleach (sold at most pharmacies), electrolysis, and waxing works well. If you are suffering from hair loss, Rogaine 2% may bring relief.

The more educated you are about your body’s changes going through menopause, the more you will be able to embrace this transition. Fluctuating hormones, age, genetics and lifestyle can all affect your menopause journey. Empower yourself to take action and manage menopause.

Posted in hormones

Irregular Periods

In No Mood for a Period during Vacation

Dear Crabby,

My husband and I are going on a cruise in about 3 weeks. I thought I would have my next period by now but haven’t. Actually I had one in June on the regular date and skipped July and had another in August but about 2 weeks before the normal date.

This all does not bother me because I do know these are all symptoms of menopause starting. But my question is, about anything I can do to control my period not starting on the trip.

I can’t get into my regular doc before we go.

Thanks!

In No Mood for a Period during Vacation

__________________

Dear In No Mood for a Period,

The most common symptom women notice during perimenopause is both menstrual flow and frequency changes. Per the North American Menopause Society, approximately 90% of women experience 4 to 8 years of menstrual changes before natural menopause. Some women experience lighter bleeding while others have heavier bleeding. The cycle length may also change, or you may completely skip a period. Every woman will experience a pattern that is irregular for her. We are all different.

Changes in your menstrual patterns and flow are considered normal during perimenopause, and are attributed to decreased frequency of ovulation and changing levels of ovarian secreted hormones.

Whether a woman is menopausal or not, wishing to manipulate your period start date, so it does not occur on a special occasion, is an age-old desire!

Many women who have irregular periods find success using a low-dose combination estrogen-progestin oral contraceptive. Clinical trails have demonstrated that oral contraceptives have normalized irregular bleeding and decreased menstrual flow.

Seasonale and Seasonique are oral contraceptive products that are formulated so you get your period about once every three months. Lybrel is another low-dose extended-use combined oral contraceptive that is formulated to be taken for one year with no breaks, no periods. These products also provide birth control, something perimenopausal women must consider until they have reached menopause (12 months without a period). Oral contraceptives may also provide relief for hot flashes, night sweats and menopausal crankiness.

Discuss these options and your risk factors (are you a smoker, high blood pressure, personal history of stroke, heart attack, blood clot or liver disease, breast or uterus cancer, or history of thrombosis) with your doctor.

You mentioned that you cannot get in to see your doctor, try a phone call – a brief conversation may answer your questions and/or requests.

If you are not a good candidate for oral contraceptives or prefer not to take them, consider embracing Mother Nature.

Have a wonderful cruise!

Signed,
Dear Crabby

Write to Dear Crabby and get advice about your menopausal symptoms.
If you have:
• Hot flashes
• Itchy skin
• Breast tenderness
• Mood swings
• Memory lapses
• Fuzzy thinking
• Night sweats
• Sleep problems
• Loss of libido
• Dry vagina
• Irregular periods
• Headaches

Dear Crabby has tips to make your life easier.
She wants to hear from YOU.
Send your questions to: DearCrabby@MenopauseMakeover.com

Resources:
The North American Menopause Society, “Menopause Practice a Clinician’s Guide”
www.menopause.org
Mayo Clinic
www.mayoclinic.com

Posted in hormones, ask the expert

Heart Palpitations

POUNDING HEART FROM OREGON

Dear Crabby,

How long do heart palpitations last going through menopause? I have had them for almost 2 years. I already had my heart checked and all is okay. I am on oral natural progesterone which helps some. Is this a fairly common symptom of menopause?
Signed,
Pounding Heart from Oregon

Dear Pounding Heart,

Yes, for some, heart palpitations can be a common occurrence during menopause.

During menopause, heart palpitations can be scary, happening at inappropriate times. Sometimes palpitations accompany hot flashes.

Keep a hot flash/heart palpitation diary.

No one knows for sure why some women suffer from heart palpitations during menopause. It is often attributed to hormonal fluctuation. You may wish to discuss hormonal balance with your healthcare provider. Usually heart palpitations go away within a few months after your hormones have settled down. Hormonal balance often relieves heart palpitations.

If you suspect heart disease or if heart disease runs in your family, discuss these symptoms with your healthcare provider. From your inquiry it appears that you have had your heart health checked by your doctor. This is good news.

The most common non-hormonal cause of heart palpitations is ingesting too many stimulants: alcohol, nicotine, caffeine, decongestants, and diet pills all contain chemicals that stimulate the heart. Too much of these stimulants can confuse your heart and cause it to beat out of control.

Other causes of heart palpitations could be more serious and require medical attention: anemia, hypoglycemia, and certain thyroid conditions.

Stress can also cause irregular heartbeats. Practice relaxation techniques.

Consider:

-Limiting alcohol and caffeinated beverages
-Do not smoke
-Exercise regularly, after discussing with your doctor
-Avoid stimulant medications
-Decrease stress
-Keep blood pressure and cholesterol under control
-Manage a healthy weight
-Practice relaxation techniques
-Avoid activities that tend to activate or increase your palpitations
-Tracking your heart palpitations may help identify triggers.
-Make sure to share your heart palpitation journal with your clinician. Even if you have previously talked with your doctor regarding your heart palpitations, it is still important to inform her that they are continuing.

I am not a doctor, and encourage you to continue communication with your healthcare provider. I applaud your commitment to seek out information. We are all different. It is important to maintain good health, eat healthy and exercise during menopause.

Once I obtained hormone balance my heart palpitations disappeared. It took a few tries with different hormone therapies before finding a program that effectively managed my menopause symptoms.

If you need a second opinion, The North American Menopause Society has a wonderful list of healthcare providers:

http://www.menopause.org/cliniciansus.pdf

I hope the next heart pounding experience you encounter is one stimulated by love – not fluctuating hormones.

Signed,
A calmer Dear Crabby

NOTE: Pounding Heart from Oregon continued her search for heart palpitations solutions working closely with a naturopath. She discovered taking a compounded progesterone lozenger place under the tongue helped with heart palpitations. If her symptoms worsen she will consider estrogen/progesterone therapy. I applaud Pounding Heart for her extensive research and exercising an open conversation with her healthcare provider. It is the first step to managing menopause. We are all different. Each of us will have different solutions to treating menopause symptoms.

Write to Dear Crabby and get advice about your menopausal symptoms.
If you have:
• Hot flashes
• Itchy skin
• Breast tenderness
• Mood swings
• Memory lapses
• Fuzzy thinking
• Night sweats
• Sleep problems
• Loss of libido
• Dry vagina
• Irregular periods
• Headaches

Dear Crabby has tips to make your life easier.
She wants to hear from YOU.
Send your questions to: DearCrabby@MenopauseMakeover.com

Posted in hormones, ask the expert

Do you need birth control during perimenopause?

IN THE MOOD FOR LOVE IN CINCINNATI

Dear Crabby,

My doctor has informed me that I am in perimenopause. My children are grown and it would be a relief if I no longer had to worry about birth control. I have used a diaphragm most of my adult life with great success, but it is inconvenient and kills “the mood”. In addition, my periods have been irregular. Do I still need to use birth control?

IN THE MOOD FOR LOVE IN CINCINNATI

DEAR IN THE MOOD:

The good news is you are “in the mood”. Many women experiencing perimenopausal symptoms lose their interest in sex. If your only concern is birth control-lucky you!

One of the benefits of menopause or post menopause is not worrying about birth control.

First, let’s define the three stages of menopause:

Perimenopause begins about 6-8 years before you reach menopause. During this time the levels of hormones produced by your ovaries start to fluctuate leading to irregular menstrual patterns; such as, irregularity in the length of the period, the time between periods, and the level of flow. At this time you are ovulating on and off, so you could become pregnant. Other common perimenopause symptoms are: hot flashes, night sweats, mood swings, vaginal dryness, weight gain, fluctuations in sexual desire, fuzzy thinking, trouble sleeping, fatigue and depression.

You are officially in menopause when you haven’t had a period for 12 consecutive months. At this point there are no more eggs left for your ovaries to release and pregnancy is impossible.

Post-Menopause is the period of life after you have reached menopause.

Since you are perimenopausal and still having periods it is advisable to continue practicing birth control because your ovaries have not completely stopped producing hormones. You may still ovulate and could become pregnant.

When your ovaries start producing lower levels of hormones you begin to experience symptoms associated with perimenopause. Irregular periods can be the first symptom you notice. Because your natural cycle is changing, some months you may ovulate and some months you may not. Menopause happens when the ovaries stop making enough hormones to stimulate your monthly cycle then your periods stop permanently. Only then can you stop worrying birth control. It is advisable you get confirmation from your doctor.

Since using a diaphragm for birth control can be inconvenient, and “kill the mood”, you may wish to consider one of these other methods of birth control.

Top five most popular forms of birth control

-Birth control pill, 96-99% effective. Using “the pill” is not only effective at birth control (diaphragms are only 85-90% effective) but the pill can help with perimenopausal symptoms. You may wish to discuss this option with your doctor.
-Condoms, 90-95% effective.
-Vasectomy, 100% effective. Many couples opt for this option after they have had their children.
-IUD (Intrauterine device) last six to ten years. This permanent device allows you to be “in the mood” without disrupting spontaneity.
-Norplant, a chemical contraceptive, is a match-sized rod that is inserted into the woman’s arm. It is time released into the woman’s system for up to five years.

Of course, abstinence is 100% full proof, but you signed your letter “in the mood,” so I’m sure that wouldn’t be an option. Continue practicing birth control until your doctor confirms that you are in menopause. If you have more than one partner, practice SAFE sex to avoid any sexually transmitted diseases.

Signed,
Less Crabby practicing birth control

Write to Dear Crabby and get advice about your menopausal symptoms.
If you have:
• Hot flashes
• Itchy skin
• Breast tenderness
• Mood swings
• Memory lapses
• Fuzzy thinking
• Night sweats
• Sleep problems
• Loss of libido
• Dry vagina
• Irregular periods
• Headaches

Dear Crabby has tips to make your life easier.
She wants to hear from YOU.
Send your questions to: DearCrabby@MenopauseMakeover.com

Posted in hormones, relationships, ask the expert

Low Libido and Vaginal Dryness

NO LONGER INTERESTED IN SEX AND THE DREADED DRY VAGINA

Dear Crabby,

My husband and I have been married for over 10 years and we’ve always enjoyed an active, healthy sex life. Lately, I have been losing sleep because I am no longer interested in sex. When we do make love, my vagina is completely dry and it makes intercourse almost impossible. My sex drive is completely gone. My husband has become very “Crabby”, and I have completely shut down physically.

I am 46 years old, and my periods have become irregular. I suspect that I may be perimenopausal. It has been almost six months since our last sexual encounter and I’m afraid my husband will start looking somewhere else for it. I feel guilty of not “pleasing” him anymore, but even more guilty of not even “wanting” to. Once a woman’s period stops, is it normal to not want sex because we are no longer “baby makers”? Am I “guilty” of losing interest in sex and not pleasing my husband?

GUILTY IN SEATTLE

DEAR GUILTY IN SEATTLE:

The only thing you may be “guilty” of is not having all the facts so you can continue to have a healthy sex life.

Vaginal dryness is a common menopause symptom. Intercourse can be painful if you are experiencing vaginal dryness. When estrogen levels drop, vaginal dryness can occur. Your vagina can tear more easily from friction, and the vagina tissues can lose their elasticity. Estrogen plumps up the cells in the vaginal wall so they produce more lubrication.

It is important to discuss this with your doctor to confirm that you are not suffering from a vaginal infection. Not only does the physical act of intercourse become a challenge with vaginal dryness, the emotional dialogue that goes on in your head when you no longer lubricate naturally, makes the whole encounter stressful. You ask yourself, “Why am I not turned on? He’s doing all the things I like.” Then you think, “What must HE be thinking? Does he think HE doesn’t turn me on?” Next you suspect, “It’s me, what’s wrong with me?” Your only option is to say, “I have a headache”, then roll over and cry yourself to sleep. No wonder you are sleepless and no longer interested in sex.

There is good news. Option #1: Low dose hormone therapy may bring relief. Option #2: A bioadhesive lubricant, such as AstroGlide that can be purchased over-the-counter, may bring instant relief. Option #3: If vaginal dryness is your only menopause symptom, you may consider using local estrogen treatment.

The loss of libido is another common symptom of perimenopause straight through post menopause. The loss of libido can also result from fluctuating hormone levels. Don’t let a decrease in hormone levels blow the flame of desire out of your love life, visit your doctor, take the appropriate tests and discuss treatment options.

Certain medications may also contribute to a declining libido: blood pressure, depression, heart disease, or diabetes medications.

If you need to treat your relationship, visit a counselor.

Besides the effects of menopause, it is also normal for your libido to decline with age. Between the ages of 55 and 65 sexual activity slows for men and women.

A healthy sex life is possible during and after menopause.

If buying lubrication, getting blood tests, and discussing hormones with your doctor seem like an effort, check out the amazing benefits of sex:

-Sex burns about 200 calories during 30 minutes of active sex.
-Regular sex promotes circulation and lubrication!
-Having sex three times a week can make you look and feel ten years younger, thus boosting self esteem.
-Sex is the safest sport you’ll ever enjoy.
-Sex releases endorphins into the bloodstream producing a sense of euphoria, that can reduce depression.
-Sex is a stress reliever. It is ten times more effective than Valium.
-Sex can relieve headaches by releasing the tension that restricts blood vessels in the brain.
-Sex is a natural antihistamine that can help with asthma and hay fever.
-Sex can lower your cholesterol by tipping the HDL/LSL (good kind/bad kind) cholesterol balance towards the HDL (good) side.
-Regular sex can boost estrogen levels. Estrogen keeps your hair shinny, skin smooth; helps reduce the chances of getting dermatitis, and rashes.
-The actual sex act triggers the release of oxytocin that promotes more good feelings.
-Sex can help you sleep better because the levels of oxytocin, a sleep-inducing hormone, can be 5 times higher than normal during love making.

Now, let’s chat about your “guilt”. Women get joy out of pleasing the people we love, especially our wonderful partners. Of the two species, women are usually the “pleasers”. When something changes and we can’t please everyone as we used to, it is common to feel guilty. During perimenopause, menopause and post menopause our bodies are going through natural changes. This is nothing to feel guilty over. Just as our bodies go through a transition during puberty, our bodies also go through a transition as we end our childbearing years. This is a time when we need to pamper ourselves. We may have a little less time to give to others as we devote time to ourselves during this menopausal transition. This is a good time to find other friends going through the same thing, share information, lend support and compare experiences. Talking about “it” can make you feel better. It is a perfect time to build strong communication skills with your partner. The more your partner understands your menopausal journey the more supported you may feel regarding your insecurities.

Purchase a bioadhesive lubricant (Astroglide), visit your practitioner and discuss treatment options, take time for pampering, and being sleepless should only happen because you are making love to your Prince Charming.

Signed,
Less Crabby and More Loving

PS. A note to menopausal women who are in the dating world with more than one partner…. practice safe sex. You may be able to get pregnant and you want to avoid getting a sexually transmitted disease or AIDS.

Write to Dear Crabby and get advice about your menopausal symptoms.
If you have:
• Hot flashes
• Itchy skin
• Breast tenderness
• Mood swings
• Memory lapses
• Fuzzy thinking
• Night sweats
• Sleep problems
• Loss of libido
• Dry vagina
• Irregular periods
• Headaches

Dear Crabby has tips to make your life easier.
She wants to hear from YOU.
Send your questions to: DearCrabby@MenopauseMakeover.com

Posted in hormones, relationships, ask the expert

Stress and Menopause

STRESSED OUT AND NOT IN THE HOLIDAY TO-DO MOOD

Dear Crabby,

It’s been a rough year suffering from miserable menopause symptoms. I have gained a lot of weight, I am always cranky, my skin has started to drastically age, my hot flashes hit me every few hours, and I feel like no one understands what I am going through. I am not in the “giving” mood this year, freaking out that I won’t get through my holiday “to-do” list, and feeling stressed out.
Bah, Humbug from Minnesota

Dear Bah Humbug,

The responsibilities during the holidays can be difficult with 99 percent of all women experiencing stress and panic attacks this time of year. Throw in one of the biggest transitions of your life, menopause, and it is no surprise you are freaking out, not in the “giving” mood, and feeling stressed out.

First, let’s address your physical menopause symptoms. Weight gain, irritability, skin changes and hot flashes are all symptoms of fluctuating hormones. Make an appointment with your doctor to discuss your symptoms and possible treatments. Once you decide on a program to treat your symptoms, you will hopefully start to feel better. Going through physical changes can be stressful.

Second, menopause usually happens as the natural aging process kicks in. If you’ve practiced a lifetime of poor eating choices and lack of exercise, it’s unforgiving during menopause. Now is the time to start eating nutritiously, exercising regularly, and dedicating time to pampering.

Regarding your skin, treat yourself to a holiday makeover. Visit your favorite make-up counter. A new cleansing/moisturizing program may restore your radiant complexion.

Visit your practitioner to discuss symptoms. Start eating a healthy diet and exercising. Make time to pamper yourself.

If you practice a few of these Stress-Free Holiday Tips you may just survive your “to-do” list and the holiday season.

10 Tips for a Stress-Free Holiday
1. Keep expectations reasonable. Planning parties and decorating are stressful tasks. Instead of planning a big holiday party, plan a day to celebrate the holiday at the spa with your closet friends. Keep your schedule open to attend a few parties, not give them. Instead of decorating your home and a Christmas tree, put a lovely wreath on the front door, place a small-planted evergreen in the living room and enjoy red candles around the home.
2. Communicate with your loved ones. Let them know you are going through changes, and that you plan to get some rest this holiday and would appreciate their support.
3. Limit your alcohol intake. Holiday parties are often centered on drinking. Try to “nurse” one glass of wine for the evening. Remember alcohol is loaded with extra calories. I ask for “water on the rocks with a twist” – it is fun, always gets a reaction, is calorie free and keeps you hydrated.
4. Quiet time. Plan a half hour a day to sit quietly. Find a spot in your home in a comfy chair. Close your eyes, and take long deep breathes. Breathe in thinking of good health and happiness and breathe out stress and frustration.
5. Eat a healthy diet. Eat more vegetables, whole grains, fruits and low-fat foods. You will have more energy.
6. Start exercising. Take a 30-minute walk. Not only will you burn calories, you will feel more relaxed.
7. Manage your time. Cut your to-do list in half this year.
8. Send e-cards this year. It is fast, easy, free and fun. This will save you time, money, paper and postage.
9. Have a sense of humor. Dealing with relatives over the holidays can be stressful. If relatives are visiting you for the holiday, ask them to book a hotel for their stay. Keeping your home a sanctuary during your menopause transition is important. If a relative is driving you crazy, try to be cheerful and laugh it off.
10. Keep a budget. Dealing with extra holiday expenses is also extremely stressful. To buffer this a bit, try making homemade gifts or let your loved ones know that this year the gift theme is ‘to spend less than $20 per person per gift’. Don’t forget, shopping on-line will save time and frustration at the malls.

Remember menopause is a natural transition. The holidays can be a joyful time if you embrace your changes and make a few holiday stress-free adjustments to your agenda. The greatest gift you can give…. is to take care of yourself, and when you do, you will want to give to others.

Signed,
A less stressed Dear Crabby wishing you a Happy Holiday!

Write to Dear Crabby and get advice about your menopausal symptoms.
If you have:
• Hot flashes
• Itchy skin
• Breast tenderness
• Mood swings
• Memory lapses
• Fuzzy thinking
• Night sweats
• Sleep problems
• Loss of libido
• Dry vagina
• Irregular periods
• Headaches

Dear Crabby has tips to make your life easier.
She wants to hear from YOU.
Send your questions to: DearCrabby@MenopauseMakeover.com

Posted in hormones, emotions

Suffering from hot flashes?

hormonesResize2Hot Flash 101

The most common and often the most irritating symptom associated with menopause is the hot flash. As many as 75 percent of women going through menopause in the United States experience hot flashes with 10% to 15% of women having severe or frequent hot flashes. I had miserable hot flashes that heated up at the most inconvenient times and sometimes flaring up every few hours. I tried every trick in the book to eliminate this miserable symptom – from herbs, to teas, to exercise, to diet, to praying hourly that they would disappear – but they persisted.

With confusing and conflicting information online and in best-selling books, I teamed up with leading menopause expert and co-author of The Menopause Makeover, Dr. Wendy Klein, to get the latest scientific information on alternative, complementary and medical options to relieve hot flashes.

Understanding available hot flash options will give you the opportunity to discuss menopause management with your clinician. This interview with Dr. Klein is the first in a series that addresses the various menopause symptoms.

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Wendy Klein MD150Hot Flash Interview

Staness: Dr. Klein, what exactly is a hot flash?

Dr. Klein: A hot flash is a sensation of extreme heat in the head and upper body generally associated with sweating.

We know from studying women that the internal core temperature does increase. You can a put a sensor on the skin and before a woman experiences a hot flash she will be able to tell you, “I am going to have a hot flash.” And sure enough, there will be an increase in internal core temperature followed by profuse sweating which is very uncomfortable. As you know, the purpose of sweating is to cool the body so there is often a reflex of sort of chill that follows the hot flash. It is a very uncomfortable and distracting sensation. It can occur at any time of the day. It can occur with tremendous variability, it can happen many times an hour or only just once or twice a day. Some women have one or two hot flashes a day, and get through menopause with no problems while other women have fifteen or twenty a day. We are all different.

Staness: What causes a hot flash?

Dr. Klein: We are still trying to understand exactly what causes hot flashes. We know that they are related to the hypothalamus, which is in the center of the brain and acts like the thermostat for the body. What we don’t understand is why some women are so troubled by them and others are not.

Certain women seem to have triggers. An alcoholic beverage may bring on a hot flash, or a change in external temperature can cause a hot flash for some women. In general, the hormonal flux or variation in hormone levels seems to be related to this sensation in some women.

Staness: Are there other causes?

Dr. Klein: We know that smoking is associated with hot flashes. Women who smoke have a higher risk of troublesome hot flashes, so obviously you should not smoke.

Also certain medicines can cause hot flashes such as certain antidepressants SSRI, Selective Serotonin Reuptake Inhibitors, are common antidepressants that can actually cause an increase in hot flashes. Yet, for some women, a very low dose can actually alleviate hot flashes, making antidepressants an alternative to hormone therapy.

Illnesses and fever can cause hot flashes, as can malignancies, and tuberculosis – many illnesses can cause hot flashes.

Increased BMI, Body Mass Index, has been associated with hot flashes. We used to think that women who were heavy had excess estrogen, and therefore fewer hot flashes. Now from the major study that was done in the SWAN, Study of Women Across the Nation, we know that women who are heavy, who have abnormally high body mass index, are at increased risk for hot flashes.

Staness: What’s a menopausal gal to do if she suffers from hot flashes?

Dr. Klein: The real issue is how troubled are you. Some women find that they can manage their hot flashes with simple lifestyle changes, such as wearing layered clothing, lowering the thermostat, carrying a fan, drinking cool beverages, avoiding triggers like caffeine and alcohol. Some women can have a few hot flashes a day and over time, seventy-five to eighty percent of cases the hot flashes will diminish and disappear. Then there is a subset of women for whom hot flashes are really troubling and don’t go away. Lots of women have recurring hot flashes waking them up over and over again and they can’t go back to sleep. They are not getting enough rest; they wake up grouchy, tired, and sweaty. If it is really a problem, there are hormonal therapies that will alleviate these symptoms. As you know hormone therapy can have side effects, so you must always weigh the benefit versus the risk. There are very low dose hormone therapies that are now available that can be extremely useful for alleviating hot flashes.

There are some other options to consider such as soy and black cohosh. The studies regarding soy are mixed, with some showing that soy can be helpful; while there are other studies that show soy may help with mild symptoms. Soy is benign and easily available and may be worth trying. Black cohosh is another herb and has been used in Europe widely, but you have to be careful because there have been reports of toxicity with high doses. Used in limited amounts in standardized doses black cohosh supplements may help some women with hot flashes. Again, there have been mixed studies, so whatever you do, and with anything you take, you should always discuss with your clinician.

You can also try lifestyle changes – wearing layered clothing, practice deep breathing, meditation and yoga, exercising – all of these things that can be really helpful in learning to live with the symptoms if they are moderate.

Another option to treat hot flashes is gabapentin. This is a drug that was originally developed as an antiseizure medicine. Gabapentin is widely used for pain relief, because it was discovered that with patients in whom it was used for seizures, it helped with pain. It was then found that it helped with hot flashes. Gabapentin is a reasonable alternative to discuss with your clinician if you do not want to or if you cannot take hormone therapy.

Staness: I was on birth control pills for years and had no idea I was perimenopausal until I stopped them, then the hot flashes started erupting. Are birth control pills a good option for hot flashes?

Dr. Klein: Birth control pills are a form of hormone therapy. They are a higher dose than standard menopausal therapy, but there is estrogen in most birth control pills and that keeps hot flashes away. If you are in the perimenopausal phase, birth control pills can also be useful for regulating your periods, plus they keep hot flashes away.

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Understanding the causes and solutions for hot flashes is the first step to managing your menopause. If you suffer from hot flashes, discuss your treatment options (alternative, complementary and medical) with your healthcare provider.

Posted in hormones