Posts made in June, 2011

Women’s health: “it’s a spiral, not a bulls-eye.”

Posted by Liz on Jun 6, 2011 in Inspiration, women's health | 3 comments

“A spiral is the path; it is the journey.  I walk it with you, and do not do it to you.  It represents life.  It represents women…”

My friend and colleague Regina Holliday wrote these words about a jacket that she has painted on my behalf, a jacket that represents women’s struggles to overcome the restrictions that challenge their right to adequate healthcare and a jacket that I will be honoured and privileged to wear this coming Tuesday during The Walking Gallery. She has depicted this struggle within the framework of a triskelion symbol, three interlocked spirals that is used to depict three reproductive cycles in a woman’s life  (maiden, mother, crone). In the Celtic belief system, the three-legged triskelion represents:

• personal growth
• human development
• spiritual expansion

as well as the phases of the moon, i.e. waxing, waning and full. I relate to this concept mostly because of its fluidity and the creative way in which Regina has characterized a woman’s struggle throughout her lifetime.

The jacket that I will wear is dedicated to all of my readers and to women everywhere who are under attack strictly because of their gender and their ability to reproduce. It seems sort of ridiculous doesn’t it? And yet, as I wrote last year in Disruptive Women in Healthcare, the other side of the aisle is not a political party but rather, women, gender bias and reproductive rights biases.

If you are local, I hope that you will come out and support the event (there are free tickets available), a wake up call that the patient struggle is very real and affects all of us. Regina describes this as follows:

If you can’t make it, I do hope that you’ll start paying attention to Regina because she is a patient advocate of the first degree and her generosity of spirit and pureness of heart is virtually unsurpassed. Trust me; she is someone you want fighting for you when the healthcare chips are down.

Thank you Regina…from my heart. I can’t wait to represent!

Puffing away the years: smoking and early menopause

Posted by Liz on Jun 3, 2011 in Early menopause | 1 comment

A few years ago, I wrote a post linking cigarette smoking to early menopause. And yet, questions remained about duration of smoking and the quantity of cigarettes in terms of their influence on timing. Hence, I thought that it might be worthwhile to take a closer look at the issue and see if there was more information.

A few facts:

It’s estimated that by the year 2030, there will be over 1 billion menopausal women in the world, with roughly 47 million women entering menopause annually. Yikes! That’s a whole lotta hot flashes, night sweats, mood swings and the like. And, what this means is that information is power (and empowering). Importantly, research has also shown that early menopause is associated with greater mortality, heart disease cases and osteoporosis. In fact, for every year that menopause is postponed, there is a 2% reduced chance of death due to heart disease. On the other end of the spectrum is late menopause, which is also associated with health issues, including an increased risk for breast, ovarian and uterine cancer.

So, what are the factors that appear to determine the timing of menopause? Well, things like obesity, alcohol consumption, mother’s age, social class, long menstrual cycles, multiple childbirths, oral contraceptive use and even exposure to pesticides have been linked to later menopause, while smoking has been shown in multiple studies to increase the likelihood for early menopause. This issue may be even more relevant for the late Boomer generation who came to age in the 70s, a time when cigarette and marijuana smoking were the norm and not the exception. That generation, by the way, is my generation.

Here’s what we know:

In a thorough review of 109 published studies, researchers have found the following:

• Current smokers appear to enter menopause anywhere from 2.5 months to 2.5 years earlier than non-smokers and have 1.3 to 1.7 times greater odds for early menopause
• Former smokers appear to start menopause as much as 2 years earlier than non-smokers, with the risk ranging from 30% to as high as 80%
• Although there is not a lot of information on the severity of smoking habit and menopause (i.e. number of cigarettes smoked daily), there is some indication that women who smoked more than 20 cigarettes daily were likely to start menopause as much as 2 years earlier than women who smoked 11 to 20 cigarettes daily
• The relationship between number of years having smoked and early menopause is unclear

There are numerous reasons why smoking may lead to earlier menopause, including interference with estradiol levels, an increased loss of eggs and an increase in the levels of androgen hormones, which counteract activity of estrogen in the body. And, despite the differences between the studies that the researchers examined, they say that a clear link was demonstrated between smoking and starting menopause at an earlier age. The impact of quantity and time (or years) smoking is less consistent and still not completely clear.

The overriding message is that if, like me, you are a former smoker, you might find yourself in a position of starting menopause a wee bit earlier than expected. Consequently, there’s no time like the present to start taking preventive measures, like increasing calcium intake, changing your dietary habits or improving your exercise regimen. Mind-body exercises like meditation or yoga can ameliorate stress and improve overall wellbeing. And black cohosh? Personally, I swear by it. In concert, these steps might shut down or at least keep the magic menopause dragon at bay.

Wednesday Bubble: is there a connection between dry mouth and osteoporosis?

Posted by Liz on Jun 1, 2011 in bone health, dry mouth, osteoporosis | 0 comments

This week’s bubble is neither burstable or good news. But it is important:

Dry mouth and bone mineral density appear to be related.

Say what?!!!

A bit of background is needed…

Osteoporosis is fast becoming a major health problem and as I’ve written time and again on this blog, is a significant characteristic of menopause, namely as the result of waning estrogen levels that lead to an imbalance between the build up and turnover of bone cells. Parathyroid hormone and cortisol have also been linked to bone turnover.

Dry mouth (i.e. a feeling of dryness in the mouth and need to use liquids while eating) and burning mouth syndrome (i.e. burning in the tongue or oral mucus membranes and taste alterations) are also common during menopause, affecting up to 40% of women. Until now, experts have not been able to adequately determine why these symptoms occur and more importantly, effective management strategies.

The link? Recent data have shown that estrogen levels may be significantly lower and both parathyroid and cortisol levels significantly higher in menopausal women who complain of dry mouth. Moreover, as the results of a new study in Menopause show, there may be a true relationship between these two conditions and that bone loss may be the actual cause of oral dryness and related symptoms. In this study, researchers evaluated 60 women in menopause (mean age 56) for the presence and severity of dry mouth and then based on their results, divided them into two groups. Dry mouth was confirmed by responses to a scientific questionnaire and collections of saliva. The researchers also measured bone mineral density at the spine.

Importantly, the participants were not particularly active and none engaged in any sports activity, except walking. The women were also matched by body mass index, age, or years of menopause. And yet, women with low bone mineral density, including relationship to other women in the same age group and 30 years younger, were significantly more likely to experience dry mouth and had significantly less saliva when their appetites were not stimulated.

Clearly, more research is needed. However, there are some things you can do now. The first strategy to combat osteoporosis and bone loss is to get measured for bone loss and disease markers. Steps like calcium supplementation, a healthy diet and regular exercise are critical. And if you suffer from dry mouth? You may want to speak to your dentist about a referral for a bone mineral density scan or better yet, have him or her contact your gynecologist or regular health practitioner for a pow wow. Not only may you help your bones, but you may actually change that dry feeling.