Posts Tagged "menopause"

Bad to the bone

Posted by Liz on May 8, 2009 in bone health | 0 comments

[youtube=http://www.youtube.com/watch?v=_7VsoxT_FUY]

Are hot flashes and other vasomotor symptoms an indication of adverse bone health? According to data coming out of the Study of Women’s Health Across the Nation, they might possibly be. Notably, while studies have examined the association between vasomotor symptoms and bone mineral density (BMD) previously, they have not followed women as they undergo the menopausal transition and rather, focused on women after they completed menopause.

Here are some of the study’s highlights:

• 2,213 women, ages 42 to 52, were included in the five year study. all had a uterus, were not using hormones, and had not yet entered menopause (i.e. still had their periods)
• Menopause stage and degree of vasomotor symptoms were assessed each year by questionnaire
• Bone mineral density was measured at the study’s start and each year. Dimensions were taken at the spine, hip, and pelvis

Study findings, which were published this past March in Menopause, showed that bone mineral density was lower in women with vasomotor symptoms compered to those without. What’s more, these effects varied depending in the stage of menopause. For example, women in pre- and early perimenopause with vasomotor symptoms had lower bone density measures in their pelvic areas, while women in postmenopause with vasomotor symptoms had lower BMD in their spine and hips. Overall, bone mineral density was consistently lower in women who experienced frequent vasomotor symptoms versus those who did not. In these cases, lower bone density was more evident in the lumbar spine in early peri- and postmenopause, and in the pelvis among early pre-menopausal women.

Whew! What does it all mean?

According to researchers, the findings suggest that vasomotor symptoms in menopause are linked to bone density deficits, which vary depending on the severity of symptoms and menopausal stage. This may help women and their practitioners devise more targeted strategies to protect bone health at appropriate times, and potentially encourage regular screening to prevent osteoporosis, fractures and related problems. The National Osteoporosis Foundation’s Bone Tool Kit includes information on calcium, vitamin D and exercise. Yoga Journal also has some great advice regarding safe and helpful postures.

Hot flashes and night sweats may be bad for the bones. But there are many positive steps we can take to protect them. Afterall, we only have one set. There’s no time like the present to take better care!

Wednesday Bubble: Black cohosh strikes again…

Posted by Liz on May 6, 2009 in herbal medicine, hot flash, nightsweats | 5 comments

I’m beginning to see a pattern in my Wednesday Bubble posts. It certainly is not deliberate. But there’s more good news about black cohosh and I’d like to share it.

A Yale School of Medicine researcher and physician has presented findings of a web-based survey examining the use of Remifemin black cohosh standardized extract among 692 women, ages 35 to 45. The study results, which were displayed this week at the American College of Obstetrics and Gynecology annual meeting, demonstrate that women are using black cohosh to avoid HRT. Okay, no big news there; I’ve posted about the utility of standardized black cohosh in lieu of HRT for almost a year now.

However, not only did almost 90% of women report being satisfied or highly satisfied with black cohosh, but approximately 88% noted that they felt it was effective or very effective for treating their symptoms.

More importantly, however, the study revealed that women are discussing the use of this standardized form of black cohosh with their health practitioners (mostly ob/gyns or family doctors). And, over half — an estimated 53.7% — said that their physicians were supportive of their decision to use black cohosh.

Personally, I find these results very encouraging; not only do they support a long-standing contention that black cohosh, namely Remifemin, is effective for hot flashes, night sweats, and other perimenopausal symptoms, but they also provide evidence that the communication channels between menopausal women and their practitioners are starting to open.

Notably, black cohosh is one of the few herbs that has been consistently shown to alleviate vasomotor symptoms like hot flashes and night sweats. Although there has been some questions about its safety, particularly with regards to liver toxicity, there are accumulating data disputing some of these claims. Indeed, at this year’s ACOG meeting, another researcher examined and compared liver function in 142 patients taking standardized black cohosh extract and 138 taking placebo and found no statistically sigificant changes in liver function.  Moreover, analysis of a smaller group of with abnormal liver function values found only one case where there was a significant difference between the groups. This led the researchers to conclude that standardized black cohosh, namely Remifemin, can be used safely.

Personally, I’ve been using Remifemin for over a year now. Recommended by a health practitioner and endorsed by my Ob/Gyn, along with a variety of other Chinese and Western herbs, I’ve been fortunate and have  found significant relief from night sweats.

Like any herbal preparation, be sure to speak with a health practitioner who is certfied in practicing herbal medicine and can monitor your progress to insure that your regimen is safe and effective. But it is wonderful to know that traditional Western practitioners may be finally opening their eyes to HRT alternatives. Bravo!

‘Sad and saggy’

Posted by Liz on May 4, 2009 in appearance | 9 comments

I’ve been thinking a lot about body image lately, and what it means, both to women and to society at large. In fact, in recent weeks, I’ve been confronted with my own demons; “do I look attractive,” “do I have too many lines,” “is my butt fat/thin/jiggly/firm/too big/too small,” etc etc etc.

These insecurities stem from many places but unfortunately, are often perpetuated in the media, whose images of teenage girls dressed and made up to look like women only serve to send the wrong messages — not only to ourselves, but to our daughters, our partners, our friends and the like.

Hence, I was struck by the title of this article that I stumbled across: “Sad and Saggy.” Written by a UK-based gynecologist, it proports to inform women why their breasts sags and what’s more, what they can do about it.

Mind you, the article is informative and attempts to take an empathetic approach. But the following phrases gave me pause:

“At the end of the day, you’ll just have to accept your breasts, saggy as they are! Don’t obsess about how unattractive they look….”

“We can’t all be young, attractive teenagers…”

So, I’d like to take a moment to say a few things to some of the  individuals in the world who have missed the memo.

Women are beautiful whether or not they have a few bumps, straight hair, curly hair, a few lines, or saggy breasts. While we can’t all be young attractive teenagers (frankly, I have no interest in being a teenager, attractive or not), we  all possess a beauty within and it is that beauty truly defines our appearance, how we carry ourselves, how we are seen by the outside world, how we feel about ourselves relative to others.

I grow tired of trying to live up to impossible, unattainable standards set by air brushed, young nubile teens who are anything but women. I am weary of being told that because I am aging, I am no longer as pretty “as…” And I am insulted by the lack of empathy by the multitudes of physicians who want women to believe that midlife (and menopause for that matter) and its effects can be solved by “x.”

Let’s get the core of the problems and see if we can work from the inside out, shall we?

Saggy breasts or not, we’re all human, we are all imperfect. But if you ask me, we’re all pretty damn special.

Wednesday Bubble: sexual desire in midlife

Posted by Liz on Apr 29, 2009 in sexual desire | 3 comments

[youtube=http://www.youtube.com/watch?v=-bjNHzU81qY]

Since I’ve embarked on this blog, I’ve run across numerous studies and articles discussing sexual dysfunction and the lack of/declining sexual desire in women entering midlife and menopause. I’ve written quite a few posts about data that suggest that ingesting hormones can help to reverse these trends as well as a post that focuses on the often overlooked health aspects. If you’ve not read them, I encourage you to do so.

However, this post is not about me; it’s about you. It’s also excellent fodder for your partners and I hope that they derive some important tidbits.

I ran across some fascinating research in the online ahead of print edition of the Journal of Sexual Research that will hopefully burst a few bubbles about desire, more specifically, how women (versus researchers) define and characterize sexual desire and whether there is a huge difference between women with and without female sexual arousal disorder (FSAD, the inability to attain or maintain a sexual excitement (genital lubrication, swelling etc.).

The researchers, who based their study on one-one-one interviews with 22 women, mean ages 45 to 55, noted several challenges when characterizing sexual desire:

• Is it a  state or action?
• Is it spontaneous and responds to a stimulus?
• Does it  precede, follow or is it indistinguishable from sexual arousal?

They added that for women in midlife, social context is also important; mass media, for example, creates unrealistic expectations and culturally perfect images that are not easily recreated in real life or in midlife. Notably, the distorted views that midlife women have towards their bodies have been shown to influence sexual response more than menopausal status.

Here are some key findings:

• Both women with and without FSAD expressed that physical touch was a common trigger or enhancer  of sexual desire. Physical proximity was also important, that is, feeling comfortable or safe. Additionally, visual stimuli (e.g. seeing their partner or appealing aspects of their partner, watching erotic films) were common stimulators
• One of the most recurrent themes was that perceived desirability was important: if women felt desired by their partners, they felt more desire. However, their desire was also influenced by their partners’ desire, sexual response, and emotional state of mind, such as depression
• Nearly all the women said that experiencing an emotional and intellectual connection to their partner was essential and the “goal of her desire” (as opposed to simply reaching orgasm or having intercourse)

Overall, the researchers found that women’s descriptions of sexual desire varied little regardless of  arousal difficulties. They noted that current measures of sexual desire in clinical studies do not take into account factors such as emotional influences, responsive desire and the importance of context. Rather, they assess how frequently women experience spontaneous sexual desire.

They concluded that  “what is deemed dysfunction on a questionnaire might not be dysfunction in reality.”

The key take-away from this study is that women have varying definitions of desire that only become clear when they reflect on them for a period of time. The answers, rather than divergent based on medical conditions, actually converge the longer that women reflect on their experiences.

I am not suggesting that hormones have no role to lay in how we perceive sex and respond to sex as we age. But I find it heartening to see that there are other controllable essential factors that come into play. Be open to the experiences before you and don’t take the answers as THE answers.

And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.

Anais Nin

Erring on the side of black cohosh

Posted by Liz on Apr 27, 2009 in herbal medicine | 0 comments

I’ve written quite a few posts about black cohosh over the past year. Black cohosh (better know in the plant circles as Actaea racemosa and cimicifuga racemosa) is an herb shown to treat vasomotor symptoms such as hot flashes, night sweats and mood swings. Yet, concerns have been raised about its possible link to liver disease and toxicity.

Thus far, the evidence against black cohosh has been pretty lean. I’m happy to add a few more coals to that particular fire.

In a case report published in the Ahead of Print section of Menopause, researchers present evidence on nine cases of suspected liver toxicity in women who had used black cohosh.

The result: they excluded an potential link between the women’s symptoms and ingestion of black cohosh in eight of nine cases. In one case, they reported a possible association to liver disease for an unknown brand of black cohosh taken for two months but also state that the woman had factors that might have skewed the results.

They concluded that significant circumstantial evidence linking black cohosh to liver toxicity is missing.

Although this is a very small study, this is not the first time that upon examination, a lack of causality was found between black cohosh and liver disease. Of course, standardized formulations are a must, as is guidance from a healthcare professional who is well-versed in the use of herbs for menopause. Nevertheless, I am hopeful that eventually, black cohosh will become a respectable player in the field.