Posts by Liz

Giving voice

Posted by Liz on Aug 14, 2009 in HRT, voice | 0 comments

Did you know that the female larynx is sensitive to sex hormone changes? Evidently, along with some of the better known symptoms — sleep disturbances, mood swings, hot flashes, night sweats, weight gain, etc — vocal quality may also change in some women.

Experts say that fluctuating sex hormones, i.e. estrogen, progesterone and androgen, can result in a thinning and dryness in the vocal folds (or vocal cords). Because it takes greater effort to make sounds, voice changes can occur. Notably, studies have shown that not all women are affected by these changes nor are they affected in the same ways. However, when women are affected, their voices may get rougher/huskier, lose stability, lose their top notes and vocal range, and change their timbre. Professional singers or actors, or even consultants on the lecture circuit, all of whom rely on their voices to earn a living, are especially affected.

Researchers acknowledge that further study is needed to distinguish between vocal changes that occur as a result of menopause versus those that occur as a direct result of aging. Yet, regardless of the cause and degree that each factor contributes, voice changes can affect almost half of postmenopausal women.

Treatment options include:

• Hormone replacement therapy. Study results have been mixed, with some findings showing improvements in voice complaints and voice function/vocal quality and others, demonstrating none. Further research is needed that evaluates the effect of HRT on the larynx as well as its ability to prevent voice changes if instituted early. Of course, HRT is wrought with other dangers that might make its use, prohibitive or not worth the risk/benefit ratio.
• Voice therapy. Although many questions remain unanswered, vocal coaches  and speech pathologists say that voice therapy can help relieve vocal fatigue. There are exercises that work well to address aging vocal cords, rebuild muscle tone and help women learn how to use their voice more efficiently.The American Speech-Language Hearing Association has a great resource for finding a local professional in your area that specializes in vocal deficiencies.
• Vitamin therapy. Research has shown that multivitamin therapy that includes magnesium, mineral salts, vitamins B5, B6 and E may improve vocal quality and help keep the vocal folds moist. Although experts say that there is not enough evidence for the role of vitamins in voice, vitamins, minerals and anxioxidants play an important role in health regardless of whether voice changes occur.

A quick search on PubMed turned up numerous articles on voice changes during the menopause and the article I sourced for this post (cited below), specifically references nine of these.

I am wondering how many women who are in the menopausal transition are experiencing these problems and are seeing clinicians who might not be aware of the potential link.

What about you? How is your voice quality? Have you noticed any changes?

[Source: D’haseleer E et al. The menopause and the female larynx, clinical aspects and therapeutic options: a literature review. Maturitas (2009) In press.)

Wednesday bubble: Cheers! (Please, don’t let me burst this one!)

Posted by Liz on Aug 12, 2009 in sexual desire, sexual health | 0 comments

Can red wine help increase a woman’s sexual desire? Interesting data from an Italian study among 798 women between the ages of 18 and 50 suggest that indeed, it just might.

Researchers divided women without any sexual complaints into three groups:

• More than two glasses of red wine and other types of alcohol (including white wine) daily, and occasional drinkers
• One to two glasses of red wine daily (“moderate intake”)
• Teetotallars

All study participants were asked to complete a questionnaire measuring female sexual functioning, as well as report on their daily alcohol consumption. The questionnaire – the Female Sexual Function Index – contains 19 questions designed to assess desire, arousal, confidence, lubrication, orgasm, and the degree of pain during and after vaginal penetration.

The findings? Overall, women reporting daily moderate red wine drinking (one to two glasses) scored significantly higher in all domains of sexual functioning, including desire and lubrication, than women in the other two groups. More striking, however, was that the women who regularly drank red wine were reportedly older than women in the other two groups.

These study findings, which undoubtedly require more research and a larger study group, do suggest a link between moderate red wine intake and sexual desire, even among older women whose sexual functioning and desire, theoretically declines with age. Of course, there are many other factors that come into play for older women; we know that declining hormones affect the vaginal lining, causing pain and interfering with lubrication. We know that hormones can also affect weight and self-image, which affects desire. And of course, how we interact with our partners is also important.

But study after study all point to medicating ourselves back towards sexual desire. Could it be as simple as a few glasses of antioxidant rich red wine, which may help improve blood flow to key areas of the body, such as the vaginal region?

I’d love to think so.

The jury’s still out. But me? I’m planning on drinking a few glasses of red wine tonight…! I’m inspired; are you?

[Many thanks to my friend Daphne Swancutt for directing me to these data!]

Midlife metamorphosis

Posted by Liz on Aug 10, 2009 in Inspiration | 5 comments

[Used with permission. Dan Collins. http://www.dancollinscartoons.com]

In Laura A. Munson’s poignant “Modern Love” post, ‘Those aren’t fighting words, dear”  she writes about the crisis of self that may seem familiar to many  in midlife who are watching or have watched their husbands or partners implode. In the post, (which I highly recommend if you’ve not read it) Laura writes:

And I saw what had been missing: pride. He’d lost pride in himself. Maybe that’s what happens when our egos take a hit in midlife and we realize we’re not as young and golden anymore. When life’s knocked us around. And our childhood myths reveal themselves to be just that. The truth feels like the biggest sucker-punch of them all: it’s not a spouse or land or a job or money that brings us happiness…

The premise that happiness comes from within is not a new one. However, the midlife spin on it can be a wake-up call of epic proportions, when we start reaching for a gold ring that actually resides out of sight. Yet, why are we yearning for what was rather than what is to be? Aren’t life’s many transitions, including the one that our partners and each of us are facing, movements into the next phase of productivity or change or growth, rather than a loss of self?

I’ve had many conversations with women who are facing or have faced situations that are similar to Laura’s. Overwhelmingly, they say that women tend to themselves a little at a time so that the crises never quite reach the precipice. That many women are able to deal with their physical and emotional changes incrementally so that the ultimate metamorphosis — who they are during and at the end of their lives — is not a monumental shock.

Dick Roth, in his wonderful book “No, It’s Not Hot in Here,’ devotes a chapter to men in midlfe. He says that men should repeatedly ask themselves three questions:

• What won’t pass away when my youth does?
• Who will I be after my career is over?
• Who would I be if everything else was gone but my mind and feelings?

Referencing the book The Diving Bell and the Butterfly, Roth adds that the protagonist’s lack of self-pity and ability to cherish his soul provided him with the foundation to overcome his physical confinement (the author, who was completely paralyzed by a stroke except for a single eyelid, was only able to communicate by blinking this one eye).

Cherish your soul. Sounds a lot simpler than it is. Or does it?

As much as we expect our partners to understand what we are going through as hormonal changes wreak havoc on our psyches and our bodies, we must also be willing to offer the reverse, to acknowledge the changes and struggles that our partners are going through, their self-confinement, and perhaps their inability to cherish or tap into their souls.

Midlife doesn’t have to be a four-letter word. What rings true for women, also rings true for men.

Seize it.

Buyer beware: on snake oil, false promises, male menopause and Michael Jackson

Posted by Liz on Aug 7, 2009 in menopause | 2 comments

Snake oil. Can’t live with it. 

Patented snake oil remedies have been around since the early 1700’s, lending credence to the hypothesis that preying on an individual’s healthcare needs is a well-honed art. For months now, I’ve been exposing various menopausal remedies that offer relief for anything and everything that ails.  I’ve found supplements, chewing gum and magnets, audio tapes, creams, rubs and lotions… the whole nine yards. Mind you, some do contain ingredients that, on their own and in standardized formulations, may alleviate or prevent symptoms from worsening or peaking. However, I have long fought against the “one size fits all” proposition, instead arguing that the best therapeutic approach is individualized, evidenced-based, methodical, fluid and supervised by a licensed healthcare professional.

The menopause market is huge, with latest industry projections topping, if not exceeding $4 to $8 billion, depending on who you speak to. And this number is expected to grow as the population ages. So, it’s not surprising that there are increasing numbers of players who want a piece of the action. And, that the action is not just geared towards women, but to men as well.

Wait! Women are the only one’s who go through menopause, right?!

Readers of this blog know what I think about male menopause and I continue to question the terminology as well as its comparison to what women experience during the transition. Yet, regardless of my beliefs, I object to predators, period.

So, it troubled me when I ran across the following headline:

“Michael Jackson could have been going through ‘male menopause’ says SimplyAgeless411.”

Hmmmm. The rat is back. And he’s smelling even worse.

According to the two anti-aging consultants who are quoted in the press release, Michael Jackson, a “dark, troubled soul,” could have been suffering from male menopause for years, that the anxiety, depression, insomnia and fatigue that prompted his reliance on prescription medicines might have been easily treated had he gotten to the right doctor. The hook here is that if you “realize after taking a long hard look at the man in the mirror that male menopause might be sneaking up on you,” that you should talk to your doctor about hormone therapy. The close? That low hormone levels can be easily addressed through a regimen of tablets, and gels applied to the skin. Results they claim, are “dramatic and immediate.” Of note, a frequent contributor to this site’s Ezine is a Board-certified hormone specialist.

So, ladies and gents, gather round, the menopausal marketing circus is in town. And it appears that it’s here to stay. If the spotlight in the ring is on “dramatic,” “immediate,” “cure” or “guarantee,” money-back or not, you might want to avoid the big tent at all costs.

p.s. If you are looking for information about how to go about selecting an alternative therapy for menopause, Flashfree is the place. Throughout this blog and its various topics, I’ve explored many alternative therapies and the most current evidence that I can find supporting or disputing their use throughout the menopause; I encourage you to peruse the archives. You might also want to revisit ‘Navigating the Maze, Parts I and II,’ my interview with  NYC-based acupuncturist and Chinese medicine specialist Elaine Stern, about what to look for. I also recommend that you check out the links on the Blogroll, as they will take you to reputable sources of information.

Special thanks to Andrew Scherer and Scherer Cybrarian LLC for assistance with some of the research for this post.

Wednesday Bubble: Better living through chemistry? Your aging skin

Posted by Liz on Aug 5, 2009 in appearance, HRT | 2 comments

Still thinking that hormone replacement therapy (HRT) can improve the appearance of aging skin? You may want to think again.

This past March, dermatologists at the American Academy of Dermatologists’ annual meeting once again debunked claims that HRT can improve the appearance of aging, photo-damaged skin. Although I’ve written on this topic previously, the subject is interesting (and relevant) enough to revisit.

Undoubtedly, certain areas of the body are more receptive to estrogen than others, e.g., cells comprising the skin on the face. And while estrogen can increase collagen, help the skin retain water and promote elasticity, its ability to reverse the effects of aging remain questionable.

Dr. Margaret Parsons, assistance clinical professor of dermatology at the University of California-Davis, says that she does not prescribe estrogen to improve skin’s appearance because data have not consistently shown any benefit. Not only doesn’t she believe that topical or oral estrogens offer any sort of long-term solution, but she also points to the risks involved in their use, such as breast cancer.

Consider the evidence (or lack, thereof):

• In a study published last year in the Journal of the American Academy of Dermatology, researchers evaluated whether or not low-dose HRT could improve the appearance of fine lines and wrinkles, skin dryness/texture and sagging. Study participants were 485 women who had been menopausal for about five years.  No significant improvements were seen after 48 weeks of treatment, although researchers suggested that longer use of hormones or different doses might lead to better results.
• In another study, which I wrote about last year, applying topical estrogen to sun-damaged skin, likewise, did not improve the skin’s appearance, although it did appear to promote collagen production in areas that had not seen the light of day, i.e. the hip.
• A third study, published in the early 90s, suggests that use of a topical cream early in menopause and for a longer period of time, may improve the appearance of aging skin. However, this study was only conducted in 18 women over a period of six months, making it difficult to reach any definitive conclusions.

It appears that the jury is still out but deliberations don’t look too promising.

Think about it: are you willing to risk the adverse effects of HRT – cancer, death from lung disease, heart disease – for your appearance?

If you are deadset on erasing a few lines and a few years, there are effective therapies that dermatologist regularly suggest to improve skin’s appearance, for example retinoids, glycolic acid or procedures such as chemical peels, lasers, botox and skin fillers. While they might hit your pocketbook harder than HRT, most do not come with the same degree of health risks. You can learn more about taking care of mature skin in this issue of the American Academy of Dermatology’s SKIN e-newsletter.

Obviously, the best advice is to wear sunscreen regularly, avoid smoking and use a topical retinoid. We may not be able to turn back the clock but we can preserve what we have more responsibly. Estrogen might not be the ounce of prevention that works best.