Posts by Liz

Bouquet-Worthy, a guest post by Dr. Barb DePree, M.D., Menopause Care Specialist and founder of MiddlesexMD.com

Posted by Liz on Sep 10, 2010 in sexual desire, sexual health | 2 comments

I recently had someone comment that I write about sex often.

I wasn’t aware of that.

In fact, I don’t really. But reader impressions are always welcome; who knows what people see or read or think or interpret, right?

So, on the heels of the write about sex comment, I thought it would be appropriate to include a post about sex, more specifically a website geared towards sexual desire, function and expectations in mid-life. I liked what I saw when I perused the site, so much so that I felt that this post would be most appropriately written by MiddlesexMD.com’s founder, healthcare provider and menopause care specialist,  Dr. Barbara DePree.

A big bouquet of roses waited for me at the front desk of my clinic. It wasn’t my anniversary or my birthday. When I saw who sent them, I smiled that special “good sex” smile, even though the sex I was smiling about wasn’t my own.

I’ve been a women’s health doctor for more than 20 years, focused on midlife women for the past four. These flowers were not from a new mom or a patient with a difficult disease. These came from a patient who got her sex life back. That may not seem like a big win in the scheme of things, but it was a wake-up call for me.

My patient, now in menopause, was distraught that her sex life seemed to be over so soon — too soon. Sex was effortless for most of her life. It had been very satisfying. And suddenly, it wasn’t any more.

We talked about sexual response with her hormonal changes, all of the many factors that could be influencing her experience.  Then we talked about her options for managing these changes.  She tried different routes, but when I introduced her to a device — she had not used them before — that made the difference for her. With the help of a simple tool, she was able to adapt to her new reality, and enjoy sex again.

It was a fairly straightforward doctor-patient exchange, but not a common one. Women rarely talk to their doctors about sex. As a menopause practitioner, though, I know that changes in sexual response are a key source of distress for a lot of women and their partners at this age.

Is it a Doctor’s job to help their patients have good sex? I think it is, absolutely. A healthy sex life sustains our overall health and well-being. Sex is good for us, and helps us to remain vibrant and strong. Menopause isn’t a disease. It’s a natural process. The more we understand this process, and discuss it openly, the easier it will be for us to make adjustments to accommodate our bodies’ changes.

The roses were evidence that my patient’s sex life had been restored.

How many women like her have never raised the question with their doctors. Their gynecologists? Or sisters? Or friends?

I founded MiddlesexMD.com for women who aren’t ready to close the door on sex, and who aren’t sure how or when to talk with their doctors about their experiences.

MiddlesexMD is organized around five “recipe” elements – Knowledge, Vaginal Comfort, Genital Sensation, Pelvic Tone and Emotional Intimacy – that are essential to sexual well-being. It provides a factual guide on how they contribute to a healthy sex life, how they change with menopause, and how to use different techniques and products to make up for those changes.

I hope that MiddlesexMD gives you a trustworthy (and hopefully bouquet-worthy!) resource to explore issues you might be having, conditions that could be causing them, and steps you can take to enjoy sexuality for life.

About the Author

Barb DePree, MD, is a women’s health provider in West Michigan, specializing in menopause care. She founded MiddlesexMD.com, a safe, comfortable place where women can learn how aging affects sex after 40, find advice and techniques, and purchase specially chosen aids such as a personal vibrator, moisturizers and lubricants.

Wednesday Bubble: Your bones, your health. The lowdown on bisphosphonates

Posted by Liz on Sep 8, 2010 in bone health, osteoporosis | 0 comments

For decades, physicians have been prescribing a class of medications known as bisphosphonates (e.g. Fosamax, Actonel, Boniva) to preserve bone health in menopausal women and prevent fractures in both men and women with osteoporosis at high-risk for them).  Bisphosphonates are often offered as an alternative to hormone replacement therapy or HRT.

Studies have shown that after age 35, women (and men) start to lose their bone density at a rate of 0.3% to 0.5% a year.  However, as estrogen levels decline through menopause, the rate of bone density loss accelerates. In fact, during the first five years after menopause, women can experience as much as a 30% loss of bone density. What’s more, experts estimate that by the time a woman reaches the age of 50, she has a 40% risk of suffering a fracture due to osteoporosis for the rest of her lifetime.

If you consider these statistics, it seems that using bisphosphonates is a good thing, right?

Well, not so fast. Earlier this year, I wrote a post highlighting reports of jaw bones collapsing among women taking bisphosphonates over a certain period of time. Included within the information were tips from the American Dental Association for protecting your jaw before any major dental procedures. This week, I want to add another facet to the bisphosphonate story, one that is definitely worth considering when weighing the benefits and risks of these drugs:

It is possible that use of oral bisphosphonates may increase the risk for developing cancer of the esophagus by as much as two-fold.

Here’s what you need to know:

• In this particular study, researchers compared over 15,000 men and women who had been diagnosed with esophageal, gastric or colon cancer over the age of 40 to five healthy individuals with similar characteristics. All study participants had been prescribed bisphosphonates at least once, with some receiving more than 10 prescriptions, which would imply that they used the drugs over time (over the 7-1/2 year period of times examined, a majority used bisphosphonates for at three years or more).
• Use of bisphosphonates over three years and having received at least 10 prescriptions was linked to a significant increase in cancer of the esophagus but not gastric or colon cancer.  People who used bisphosphonates for five years or more had twice the risk compared to those who did not. Note that these rates of cancer held regardless of the exact agent used.
• An increased cancer risk remained even after actors for esophageal cancer, such as age, smoking, alcohol and body mass intake, were accounted for.
• This increased risk, may be due, at least partly, to drug side effects that affect the esophagus directly, such as irritation and inflammation of the esophagus (i.e. esophagitis).

Now, mind you, esophageal cancer is extremely rare, affecting roughly 16,000 people in the US in 2010. However, death from esophageal cancer, is high and the disease is often fatal. Moreover, esophageal cancer tends to affect three to four times as many men as women, which is why this latest bit of information is as critical for men as it is for women entering menopause.

One important thing to keep in mind when you consider the risk and benefits of bisphosphonate therapy is that this particular study compared actual cases of these three types of cancer to healthy individuals in the population. Sometimes, the information yielded in these studies is not considered as conclusive as studies that are conducted proactively, and not retroactively. Still, this is not the first time that bisphosphonates have been linked to cancer of the esophagus.

Maintaining bone health and strength as we age, particularly as hormones decline, is critical to our health in the later years. It’s important to make the right decisions now, while we are still relatively young. Flashfree has plenty of posts on bone health and osteoporosis, and I encourage you to peruse them.  When it comes to your bones, it’s not just about ‘use it or lose it,’ but also, the three P’s:

Protection

Proactive

Prepared

Your bones, your health.

Random Roundup: news and tidbits picked just for you

Posted by Liz on Sep 6, 2010 in Uncategorized | 0 comments

[Credit: Special thanks to artist Darryl Willison of whimsicalwest.com. Please visit his site and support his work.]

I’ve decided to lose the monthly or quarterly Roundups and post them more sporadically. Moreover, since September marks the beginning of Fall, it seems like a great time to highlight some of the most interesting posts and news since July.  Be sure to check them out and feel free, always, to send me a note telling me what you’d like to see included in the next Roundup.

• A Different Kind of Hot Flash – Powerhouse blogger Erika Napolitano takes us down an often uncharted road: need not flashes.
• Is S-Equol the Next Big Thing? – This metabolite of soy isoflavones may actually be the key to reducing hot flashes, improving mood and promoting bone health!
• Are You Working Through the Transition? Or Is It Working You? – Women want their managers to understand how menopause can affect their work. The first step? Education.
• “Age-Appropriate” Dress for Women Over 50 – Welcome to the dark ages. Not for me, nnuh-uh.
• The Mommy Factor – It’s Personal – I may be childless. But I am not without children. You?

Women, O, pause! The book

Posted by Liz on Sep 3, 2010 in menopause | 4 comments

If you’ve ever visited the ‘About’ section, you know that a key reason I started this blog was that I took a look around the interwebz to see what was being written about menopause and it gave me “pause.”  I felt that there were voices that were being ignored or talked down to. And, I felt that the information was too limiting, too medical, not broad enough.

Hence, when I was approached by the publicity folks at Planned Television Arts/Ruder Finn to examine a new self-help book on menopause: Womenopause: Stop Pausing and Start Living (Authors Lovera Wolf Miller MD and David C Miller, MD), I thought, “sure, why not?”

Womenopause has an interesting approach in that it encourages women to be proactive rather than reactive to menopause.  This philosophy is one that I’ve long ascribed to because I do believe that prevention is often the best medicine. In fact, when younger women tell me that this blog is not for them, I usually tell them that there are steps that they can take now to prevent some of the challenges that accompany the transition, such as weight gain/redistribution, bone loss and heart disease.

Moreover, I love that the authors acknowledge menopause as a milestone, not for its finality but for the fact that is simply another stage that “transforms women within the context of an already convoluted life and within the complexities of a marriage and/or dynamic relationships.” I love that Womenopause offers thorough, readable information about the processes that are going on in a woman’s body to cause various symptoms of menopause, an area that I’ve been hesitant to approach simply because I feel that there is a lot of good information out there, if you know where to look (for example, check out the Flashfree Blogroll on the home page).  And I applaud the authors for their inclusion of real-life cases.

However, this is where my love affair with the book ends and the questions begin.

The authors of Womenopause ask their readers to chart their baseline symptoms and basic health and then record their course through four weeks using something they have named the ‘ωScore.’ Theoretically the goal is to help identify health problems, for example, the severity and emotionality of hot flashes, sexual or skin issues or sleep problems to raise awareness and potentially, spark conversations with their healthcare practitioners. Each of these areas is thoroughly discussed in the book in both a serious and thoughtful fashion, accompanied by an attempt at a lighter side. Although I think that records can help identify issues and promote helpful dialogue, I know that personally, I don’t want to take a quiz, keep a journal or score a “hot dread.” Huh? Hot dread is defined as emotional components – aura and anxiety, that may accompany a hot flash. The overall tone of the Womenopause interactive program — “fit, feminine and fabulous in four weeks,” feels a wee bit touchy feelie, “woo woo” to me, and frankly, when I am night sweating or flashing, I’m really not feeling my fabulosity or my femininity.  As I’ve mentioned time and again, this ain’t no tropical vacation and I’m not really interested in ‘Menopauseland,’ the theme park.

When it comes to physical information, Womenopause is truly, a great guide. However, buyer beware! The majority of solutions to the common problems of menopause are medically/pharmaceutically-based and in fact,  the authors repeatedly dismiss alternative and complementary therapies as unproven and no better than placebo. As someone who is well-versed in reading and analyzing data, and who has devoted the past two years to examining and sharing the evidence behind alternatives to hormone replacement, I take great issue with this approach and it makes me pause; by not taking adequate time to thoroughly explore studies on alternative approaches, the authors have truly done a huge disservice to women who are hungry for information and need to be empowered to make the right decision for themselves, even if that decision does not involve HRT. Moreover, for a book that devotes more than on thorough discussion to sexual desire and other menopausal issues, I am very surprised not to find Christiane Northrup, MD, listed in the Recommended Books section.

Overall, I would encourage readers of this blog to take a look at Womenopause, with the full understanding that this may not be your cup of tea. It certainly is not mine. However, if you are looking for concise medical information about the changes that are occurring in your body during the transition, and a wee smattering of helpful advice, Womenopause is a great resource. Just be mindful that fab, fabulous and fit in four weeks sounds like a dream, not a reality.

Tell me, what are your favourite resources or reads?

[Disclosure: I was not paid to review Womanopause. However, the publicity folks did send me a free copy of the book.]

Wednesday Bubble: The “De’s” have it

Posted by Liz on Sep 1, 2010 in new approaches | 0 comments

This week’s Bubble is truly straight out of bubble-land. Flashing? There’s a drink for that. Not on your game? There’s a drink for that. Finding that you can’t handle the demands of daily life? There’s a drink for that too?

Sigh.

Yes ladies, you can ‘deFlash,” deBug” and “deCompress” with EYL – Enrich your Life drinks.

Look, I’m a huge supporter of alternative therapies, Traditional Chinese Medicine, herbal remedies, etc, so long as they are thoroughly studied. But time and again, we see enriched nutritional products that are long on promises and short on delivery. And while functional foods — foods that deliver more than nutritional benefits — are certainly the wave of the future, I do believe that these foods need regulation and evidence behind them. Japan may be one of the few countries that actually regulates functional foods.

So before you spend your hard-earned dollars on drinking your flashes away, why not do some research and see which alternatives actually pack a powerful punch beyond their marketing claims?

The “De’s?” How about “deceptive?”