“Beauty’s but skin deep…
Nay, it is not so…” John Davies, Hereford, 1616
I was at the hairdresser this morning reading a trashy mag and ran across an advert for Curel Lifestages Moisturizing Lotion for Menopause and Beyond. If you interested in checking out the product, web page copy claims that studies have shown that this product increases hydration and skin elasticity.
Hmmm. Menopause skin. I’ve never heard of it. Sure, I’ve heard that the skin loses its elasticity as we age and becomes thinner and dryer. In women in particular, the decline in estrogen levels has been linked to dry skin mostly around the vaginal area and also within the vagina. Obese women appear to be at risk for developing thickening, itching skin on soles of their feet and palms of their hands.
Dry skin in older women occurs as a result of a decline in the amount of sebum, or the surface film of natural oils and broken down cells; this occurs as a result of declining estrogen levels. Sebum slows down the evaporation of moisture from the skin. Note that men don’t experience a similar decline until they are in their 80s.
So what can you do about it? Sure, moisturizing can temporarily help skin appearance but aging is aging and there’s little we can do about the inevitable. Hormone replacement therapy can definitely assist with vaginal thinning if that is what ails, but if you’re like me and can’t “do” hormones, well, it seems that the option is a slippery slope.
I suspect that there are many desperate perimenopausal sisters out there willing to try anything. Me? I’ll stick to the devil I know!
Read MoreNavigating the Maze, Part 2
In my last post, I wrote about navigating the maze of perimenopause symptoms and treatments. This is a continuation of an interview I had with NYC-based acupuncturist and Chinese Medicine Specialist, Elaine Stern.
When I last left off, we were discussing useful Western herbs for addressing perimenopausal symptoms.
Are there other herbs than black cohosh that are helpful for perimenopausal symptoms?
Chaste tree berry is a very useful herb for perimenopause since it targets the “luteal phase” of the menstrual cycle. It helps the body become more efficient in terms of ovulation and progesterone production, and may be useful for women experiencing irregular cycles or PMS symptoms.
You mentioned nutrition earlier. How is this different than herbal medicine? Afterall, we’re taking supplements, right?
Nutrition, like acupuncture and herbal medicine, is a fairly diverse field. However, unlike the literature has not caught up with its practice. It’s also confusing because we may read the newspaper one week and see a study saying we should take vitamin X, and then the next week, see that it’s been linked to cancer.
When it comes to nutrition, it’s important to understand the body’s physiology and biochemisty and focus on nutrients to increase natural function and actions. With regards to perimenopause, you may recall that we discussed the build-up of excess estrogen. Vitamin B6 has been shown to be very important in helping the liver clear the estrogen out of the body. While things like diet are undoubtedly the most efficient way to obtain B6, well, the way that we eat and the way that our food is grown can interfere with the ability to get as much as is needed. With a little extra, we can assist the body’s ability to clear the estrogen, thereby addressing water retention and other PMS symptoms.
Do women need to stay on treatment the entire menopausal transition?
Well, it’s important to stay on some sort of program for a period of time. This will vary from person to person.
What should women look for in a practitioner?
With Chinese medicine and acupuncture, the practitioner should be licensed and have national board certification. If their specialty is nutrition, it’s helpful to inquire about education and experience. And most of all, find out if the practitioner has a specific interest or area of practice that focuses on gynecology and internal medicine.
Anything else you’d like to add?
I want reiterate that herbal and nutritional products are completely unregulated and there’s a huge variety in quality. Whatever you can learn about the way that a product is manufactured and with what type of oversight, the better. So, I’d recommend that women look at the labeling for buzzwords like “standardized,” “good manufacturing of products,” things like that, but with the knowledge and understanding that there is no oversight with regards to the marketing of these substances. Again, this is a good reason to see a practitioner, at least to get started as he or she can be useful for creating a program and guide you to good sources for herbs and nutritional products.
Finally, this is medicine. Women need to understand that they are tinkering with their hormonal balance and even if the products aren’t toxic, it’s important to look beyond the symptoms and understand what’s going on physiologically. So, I truly believe in the importance of speaking to someone who can understand your individual changes and then recommend something. At the very least, women should see someone at least once to insure that they are on the right track.
Read MoreIs it real? Or is it…
An interesting report from the American Herbal Products Association highlights the dangers of simply going into a drug store and buying an herb right off the shelf. A study in the Journal of Agriculture & Food Chemistry shows that 3 of 11 black cohosh supplements purchased did not contain black cohosh but rather, a less expensive Chinese herb called cimicifuga that do not have the same chemical compounds or uses as the North American variety (which contains cificifuga racemosa).
What this means is that when you go shopping for herbs, well, they’re not all the same. Indeed, the best rule of thumb is to try to find a product that has been tested in clinical studies, or is manufactured by a reputable company. I’ll have more to say about this later in the week. But in so far as black cohosh goes? Remifemin, which is manufactured by Enzymatic Therapy, Inc, has been studied in clinical trials and is standardized, meaning that it contains the chemical compounds proven effective in alleviating certain perimenopausal symptoms. It may be slightly more expensive than the generic brand, but at least you know what you’re buying.
Read MoreRollercoaster
This is a picture of my favorite wooden rollercoaster. It’s in Coney Island, New York. I haven’t ridden it in awhile but I remember that the seat bar was always so loose that you had no real security during the ride. It was even worse in reverse. So it was always hard to know what to expect, when to expect it, and truly, what to do…other than hang on for dear life and hope for the best. But somewhere, in the recesses of your mind, you knew that the ride would end eventually and you’d be fine.
Just like perimenopause.
I’ve posted a few times about acupuncture, herbs, and most recently, about discerning information that comes out of studies. To help clear the confusion a bit, I spoke with acupuncturist and Chinese Medicine Specialist, Elaine Stern, L.Ac. I’ll be posting that interview over the next couple of days. Stay tuned! Oh, and have a hot dog on me!
Read MoreDazed and Confused
[youtube=http://youtube.com/watch?v=Xajqf-PhO8s&feature=related]
A gal pal mentioned to me this morning that she often feels so confused about study findings proving or disproving the value of certain medications or herbs that she often just throws up her hands and does nothing. Many of us are as dazed and confused as she is so that I thought that a few key points about clinical studies might help.
Mike Clarke from the School of Nursing and Midwifery at Trinity College in Dublin wrote a great article last year about the need to standardize results of studies for a specific disease ( in this case, rheumatoid arthritis). He defined the problem as follows:
“Every year, millions of journal articles are added to the tens of millions that already exist in the health literature, and tens of millions of web pages are added to the hundreds of millions currently available. Within these, there are many tens of thousands of research studies which might provide the evidence needed to make well-informed decisions about healthcare. The task of working through all this material is overwhelming enough without then finding the studies of relevance to the decision you wish to make…”
So what do you do? A few key points:
- Consider that every study has the potential for bias. Perhaps researchers are using 7 instruments to measure depression and only highlight findings from 3 of these in order to preserve the most positive or significant results. Clearly, the reader is being led towards certain outcomes and away from others.
- Study designs, types of patients studied, age of patients studied, gender, you name, can differ so it’s difficult, if not impossible to draw definitive conclusions when comparing results of one to another.
- Another issue of great interest to practitioner of Western medicine is whether or not a study is controlled. This means that two groups are compared that are identical in every way except one group is given an experimental treatment and the other, a placebo or standardized treatment. Note that often, real world conditions are often recreated rather than conducted in a real world setting and many studies are not controlled, meaning that the science behind the findings is questionable.
- Alternative and complementary medicines are still incompletely understood among many practitioners of Western medicine. What’s more, products are not regulated as carefully as medicinal agents and manufacturing practices vary. Consequently, studies of these agents or modalities are often inconclusive. And of course, often underfunded and under-appreciated.
No wonder we all feel so dazed and confused!
I’ve written several times about the importance of consulting a practitioner or medical expert before embarking on any regimen for perimenopausal symptoms. Even if you only see someone once, at least that dialogue may be useful for defining a regimen that may work best for you and what you’re going through. And if you live off the beaten track without access toa good practitioner, well then excellent resources like Medline or the American Botanical Council may be be of help in discerning what’s what.
The short answer is that there are no short answers. But with careful guidance and a bit of prudence, you may just be able see the light and smooth out the bumps on this rollercoaster ride we’re all on.
Read MoreCheers…literally!
Seems that moderate alcohol consumption helps overall well-being among perimenopausal women!
Recent study findings show that women undergoing the menopause ‘transition’ who consume alcohol at moderate levels (~ one drink daily), don’t smoke and exercise feel better than those who don’t drink. What;s more, another study suggests that older (i.e., 70 to 75 years of age) women who do not drink have a greater risk of death and poorer health-related quality of life than women who consumed one or two drinks a day.
Back in March of this year, I also reported that researchers had found a link between moderate alcohol intake in middle age and a decreased risk of heart disease, even among individuals who never drank before this time.
That’s part one of this story. Strangely enough, having risk factors for heart disease increases the likelihood for an earlier menopause. These data in particular, compiled from the landmark Framingham Heart Study and reported by the American Heart Association, actually go against common beliefs that a depletion in hormones causes an increased risk for heart disease in women after menopause.
Granted, one study does unequivocally prove something. But what is apparently clear from these three trials is that one or two drinks a day, especially red wine, may prove to help women decrease their risk for heart disease and also, provide a counterbalance for symptoms that cause moods to run amuk.
Sounds like good news to me. Cheers!
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