Posts Tagged "Hormones"

Wednesday Bubble: this is your brain on midlife

Posted by Liz on Mar 31, 2010 in memory/learning | 13 comments

Got brain? If you still have yours’, maybe you’ve seen mine also.

I’ve noticed that as the days and weeks pass, my recall seems to be declining. I remain uncertain as to the cause – is it overload, life or declining hormones? Has middle age truly taken my brain? If so, I’ve got a small but important request for the universal goddesses: I’d like it back.

Just last week I received an important notice from the New York State Division of Taxation with approval to dissolve my Corporation. Any of you who know me or know of my former company know that this has been a drawn-out and arduous process. But I got the letter! And permission for closure. The thing is…I lost it.

Perhaps it’s in the black hole of all things Liz, amongst single earrings, lone socks and that piece of family jewelry that I’ve been looking for for over a year now. Maybe I threw it out; I have a genetic disease that I refer to as ‘anti-hoarder syndrome or AHS,’ as in, “I must discard any bit of clutter that enters my humble abode.” (My father has this illness so it resonates deeply with me, irritatingly so I  might add.) Or maybe, it’s sitting in that pile that I’ve gone through about 15 times and will bare its ugly head once I receive its replacement.

If you’re wondering what this has to do with bubbles or bursting illusions, well I’d like to take a stab at one that’s been bothering me for some time now; memory in midlife (aka, your brain on midlife). Researchers who specialize in women’s health and menopause have been consistent in their attempts to decipher the ever-present mind meltdown, attributing it to declining testosterone, a loss of the brain’s gray matter or as I suspect, stress. Yet, regardless of its cause, I am becoming increasingly aware of its presence and the fact that its become a part of who I am.

Whether I am entering a room with a mission or surfing the web, I seem to constantly arrive without my original purpose and then stand (or sit) there desperately seeking the key as to why I went there in the first place. Typically, that key reappears during inopportune times when the goal has lost its relevance, or when I am nowhere near a computer or a room to complete the task.

This is my brain on midlife. Forgetful, spacey, devoid of information. A blank bubble lingering above my head.

Truly, if you run across it, can you send it home?

WISHFIT: women’s research takes a village.

Posted by Liz on Mar 19, 2010 in exercise, heart disease, menopause, weight gain | 3 comments

I was heartened to read that the folks at Rush University Medical Center in Chicago have partnered with a community of local women to fight obesity and promote a healthier menopausal transition. What’s especially novel about this program, which is called WISHFIT (Women in Southside Health FIT), is that during the first year of the five-year study, it will be relying on “pioneers” for guidance in designing and testing the program and subsequently spreading the word. One of the program’s primary researchers, Dr. Sheila Dugan, who is an Associate Professor in the Department of Physical Medicine and Rehabilitation at Rush University Medical School, characterizes the approach as “community-based participatory medicine,” with a critical grassroots component. I would go one step further and call it a health 2.0, social media approach to medical research.

The goals of WISHFIT are to ultimately change the behavior of women who are sedentary or engage in physical activity only occasionally in order to help reduce the fat rolls around the midsection (called visceral fat). If you’ve been reading Flashfree for awhile, you will recall that visceral fat is a common problem in menopausal women that is likely related to fluctuating hormone levels as we age. Not only is it unattractive, but the development of fat around the midsection is dangerous because it has been linked with metabolic syndrome, a variety of symptoms that in concordance, increase the risk for heart disease.

Importantly, the National Institutes of Health, National Cancer Institute, National Institute of Diabetes, Digestion and Kidney Diseases are joining forces with Rush to take the study out of the laboratory setting and into the community. In fact, Dr. Dugan explains that research has shown that “there are millions of studies out there that show if we bring women into the University and have them exercise, they will lose weight and improve their fat composition. But when they are left to their own devices, they go back to themselves.”  She says that by having a community of postmenopausal women involved in developing a ‘tool kit’ of physical and stress-reducing activities or activities that help them to embrace healthier eating habits, the researchers are hoping that they can help their premenopausal peers incorporate new ways of thinking and acting so that they can get through menopause in healthier ways. She also points to data showing that change is better maintained not only by motivating the individual but also through the support of friends and social networks, which are needed for change to last.

Dr. Dugan notes that two Southside Chicago communities- Beverly and Morgan Park – have been the subject of prior research (Study of Women’s Health Across the Nation or SWAN) that identified the link between hormonal changes and visceral fat. In fact, some of the data also firmly established the link between markers of chronic disease and stress and sedentary lifestyles. The 30 Pioneers selected to lead the project will be women who participated in SWAN.

The five-year program also includes two studies examining 1) how social networks play a role in influencing health behaviors, and 2) if positive reinforcement works as well as financial incentives in getting women to change their lifestyle and become more physically active. An additional component entails before and after ‘person on the street’ interviews to educate and engage the community about what happens during menopause, heart disease and other risks and steps that can be taken to combat it.

“Midlife women already have all sorts of concerns on their minds. They need to have support around allowing themselves to take care of themselves and give themselves the freedom to actually step out of all their roles to do so. Our goal,” she emphasizes,”is to bring energy — spiritual and financial — to the community because we truly believe that the only way that these women will have a chance to take care of themselves is by everyone around them buying into how important it is.”

Noting that they are taking a three-pronged attack that entails community, social and individual level interventions, Dr. Dugan adds that community and social support are the links that have been missing in obesity research in particular.  I’d like to believe that these links have also been missing in gender research that focuses on women; in fact, perhaps this model isthe breakthrough  that is needed to change some gender inequities in our healthcare.

It really does take a village, doesn’t it? Only time will tell.

When it comes to physical fitness, forget the hormones

Posted by Liz on Jan 11, 2010 in exercise, HRT, physical fitness | 2 comments

[youtube=http://www.youtube.com/watch?v=pnVT0HGVNwY&feature=related]

Hey. We’re all going to get there one day – slowing down, lower coordination, challenged balance, right? Hmm, maybe not. At least I’d like to think that it’s possible to delay or stave off the natural physical decline of aging. So what’s the deal anyhow?

Estrogen strikes again!

Declining levels of estrogen as a women ages are linked to changes within the body that directly affect physical function. And like many other age-related changes that occur, hormone therapy has been overpromised as a panacea for physical functioning. In fact, for years, women have been advised the hormone therapy might benefit and even improve overall functioning. Yet, reports supporting this particular benefit of hormone therapy have been inconsistent, with some showing improvements and other, actually showing detriment.

The latest evidence to emerge against hormone therapy comes from a comprehensive analysis of 2,400 older postmenopausal women who had taken HRT or placebo tablet. The women had all been part of the the Women’s Health Initiative Study, which, as you may recall, was halted when HRT was found to increase the risk for heart attack, stroke, blood clots and breast cancer.

In the analysis, women were assessed for physical function (i.e., grip strength, chair stand – the number of times a woman could stand up from a chair without using her arms and timed walk – the time it took to walk a 6-meter course)  at the study’s start, and at 1, 3 and 6 years.

What they found.

Over the study’s course:

• Grip strength declined by 12%
• Chair stands declined by 3.5%
• Walk pace slowed by 11.4%
• No differences in physical function were seen in women taking HRT compared to those who had taken placebo

The overall conclusion? Hormones will not slow or benefit physical declines that occur as we age.

So, are we all doomed?

Studies suggest that to stave off physical declines as we age, we need to keep moving! Walking for 30 minutes a day can help to maintain bone strength.  Yoga and bo su can help build and maintain balance.  Tai Chi or Chi Gung can assist with focus and keep those muscles suppple. Whatever you do, it’s a use it or lose it proposition.

What’s your strategy?

Want to read more? Reuter’s Health has an excellent write-up on this study. (Special thanks to Executive Editor Ivan Oransky for pointing me to these data.)

Got sleep?

Posted by Liz on Oct 9, 2009 in sleep disturbance | 0 comments

How many nights do you lie awake, staring at the clock and just hoping for a wee bit of shut-eye?

If you are like many women in peri- or post-menopause, the answer is probably “a lot.” However, data presented at last month’s North American Menopause Society Annual meeting show that sleep problems do not change uniformly across menopause, which is why addressing them effectively can be difficult for some women.

Researchers examined the sleep patterns and symptoms of 286 women who participated in the Seattle Midlife Women’s Health Study. All participants completed daily menstrual calendars, which were used to track their experiences across the menopausal transition and rate the severity of all symptoms. For five years, they also provided the researchers with first-morning urine samples so that estrogen, fallopian stimulating hormone, and stress hormones could be measured.

The result? Depending on your sleep pattern, the relationship to certain factors changed. For example, nighttime awakening was mostly associated with age, being late in the menopausal transition (before moving into full-blown menopause), early menopause, hot flashe, depressed mood, joint pain and stress. Early morning awakening was associated with age, hot flashes, depressed mood, anxiety, joint pain, stress, and lower estrogen/higher FSH levels. On the otherhand, difficulty falling asleep was associated with menopausal symptoms in general, stress, and lower stress hormone levels.

However, regardless of whether women were having trouble falling asleep, awoke several times during the night or awoke in the early morning hours, sleep disruption was consistently associated with hot flashes, depression and stress.

In light of these findings, the researchers concluded that interventions to improve sleep might be more effective if they were targeted and focused, for example, towards night-time awakening and hot flashes, or difficulty falling asleep and depression, rather than clustered under the category of “sleep disruption” without examining exacerbating factors.

Of course, the greater implication here is that sleep-associated disorders during the menopause do not fall under the “one size fits all” approach and are better treated with individualized therapy. This is not to say, however, that certain interventions, like yoga or acupuncture can’t help address the cluster of sleep issues, hot flashes and stress, etc. Still, it’s best to consult with your practitioner before embarking on your own approach to solving the sleep woes. Personally, I find that I will be awake for hours in the nights preceding my menstrual period, regardless of the use of herbs, exercise or meditation. It just “is.” Yet, I’m glad to know there might be a better approach to addressing my specific woes.

What about you? What are you doing to get sleep?

Wednesday Bubble: blame it on…

Posted by Liz on Sep 23, 2009 in emotions, estrogen, menopause, women's health | 4 comments

I was struck by the following story that appeared two weeks ago on the BBC:

“Woman’s Death Blamed on Menopause.”

“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”

Menopause. The silent killer. Oh really?  Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”

Something.

Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).

Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.

Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.

So, are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves?

Interestingly, just a week after the menopause/train suicide story hit the interwebz, a rather controversial set of data also emerged: since 1972, women’s overall level of happiness has dropped. These findings held true regardless of child status, marital status and age. Researcher Marcus Buckingham, writing in the Huffington Post, said that women are not more unhappy than men because of gender stereotyping and related attitudes, due to working longer hours or because of the inequality of housework/responsibilities at home, but rather, the hormonal fluctuations of menopause may be to blame. What’s more, he leaves us hanging so we’ll tune in for part two of the piece to learn the true cause of our declining happiness or better yet, read his book (which evidently guides women through the process of finding the true role that they were meant to play in life).

Importantly, reactions to this study (and various pundits’ assessment of it) have been mixed. One of the most poignant comments I’ve read asks the question “how is happiness measured? What does it mean?”

I have no idea what caused Mrs. Drew to walk into a train two weeks ago and kill herself. Perhaps she was depressed. Clearly she was suicidal.

I have no idea why research shows that women are less happier than they were three decades ago.

However, is menopause the cause? Don’t these conclusions only serve to perpetuate societal myths that menopause is a disease that requires treatment? That as women, our attitudes, belief systems and actions are hormonally-based and driven? That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down?

Feeling angry? Blame it on menopause. Unhappy? Blame it on menopause. Not realizing your dreams? Blame it on menopause. Overworked, overstressed, undervalued? Blame it on menopause.

Blame it on menopause.

I don’t know about you but I’m tired, tired of hearing that menopause is not the symptom but the disease.

There’s no time like the present to burst this bubble.