Posts Tagged "perimenopause"

Chamo chamo chamomile-on

Posted by Liz on Apr 16, 2010 in anxiety, depression, herbal medicine | 2 comments

[youtube=http://www.youtube.com/watch?v=JmcA9LIIXWw]

Is chamomile the ultimate chameleon, good for both anxiety in depression?

Back in February, I posted information about a small study that showed that a daily chamomile tablets (containing 220 mg of pharmaceutical grade extract) significant reduced anxiety and improved well-being among postmenopausal women. Thanks to a fellow reporter and Twitter colleague Miriam Tucker, I learned that the researchers of this study presented findings at a recent Anxiety Disorders of American meeting that might be of equal interest, i.e. that benefits of chamomile might extend to depression as well.

In a second part of this study, the researchers looked at the effect of chamomile on the same women who currently suffered from anxiety and depression, who had a past history of depression or who had never had depressive symptoms. Although the results were not as striking as in the first study, they did see what they characterized as meaningful reductions in depression ratings among women who had both anxiety and depression. Across all the groups, the researchers observed significant declines in depressed mood, guilt and thoughts of suicide).

Women entering perimenopause have twice the risk for developing depressive symptoms than during other phases of their lives. Researchers have also shown that attitude towards menopause can also increase the risk. While various interventions including antidepressants, exercise and maybe even moderate intake of red wine may help, it’s wonderful to know that scientists are seriously looking into the role of chamomile and studying it under controlled conditions to prove or disprove its power over our moods.

Is chamomile the ultimate panacea when it comes to mood swings and the blues? Perhaps not. But it may provide a wonderful option to women and men alike, who are seeking solutions out of the medicine cabinet.

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.

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.

Wednesday Bubble: What did I forget/hear/see/say…

Posted by Liz on Jul 22, 2009 in exercise, memory/learning, menopause | 7 comments

If  you’re anything like me, you are starting to forget things. Things you need to do, why you walk into rooms, shopping lists, things you said, the whole nine yards. For me, it’s become the norm, not the exception and while I spend a lot of time making jokes about it, it also drives me crazy.

Yet, today’s Bubble is not one that I’m likely to forget. I’d like to think of it as one part inspiration and one part WTF? And it leaves me with a whole lot of questions to boot.

Study findings suggest that gaining weight during menopause may increase the risk for loss of gray matter. Gray matter refers to the cortex of the brain, which contains nerve cells. It is involved in muscle control, sensory perception (seeing/hearing), emotions, speech and finally, memory.

In this study, which was published in the online edition of the journal Psychosomatic Medicine, researchers evaluated brain imaging data, demographic information (height, weight) and behavioral measures (perceived psychiatric stress) obtained from 48 healthy postmenopausal women. Data were collected over a 20-year period.

The findings showed a unique association between increase in body weight during the transition from peri- to post-menopause (as measured by body mass index or BMI) and a 22% reduction in grey matter volume. These findings occurred in women who were otherwise healthy, had no history of heart disease or psychiatric illness and did not meet the threshold for obesity (>30 BMI). All women had also undergone natural menopause.

The researchers suggest that weight gain during menopause is a “highly modifiable risk factor” that may help to prevent or slow “potential alterations in brain function that are important to quality of life.”

I’ve written previous posts on cognitive issues during menopause, whether they be linked with life stressors, HRT or aging. Now it seems that researchers are telling us that weight gain may also be a risk factor.

Less clear is how much weight gain and what we should do about it. In general one solution to combating weight gain in midlife is restraint. Coupled with exercise, this may just be the magic formula. In the meantime, I think that we need a few more studies to take a closer look at brain matter changes in midlife.

What do you think?

I just forgot why I’m asking you that…!