Posts Tagged "postmenopause"

Meditation in motion: Tai Chi and the ‘pause

Posted by Liz on Jul 11, 2011 in aging, heart disease, mind-body therapy | 0 comments

I’ve written about yoga and meditation/mindfulness training and how both may help with menopausal symptoms in terms of alleviating stress and improving overall wellbeing. However, what about Tai Chi?

Tai Chi is an ancient Chinese martial arts practice that uses a self-paced system of soft flowing movements to improve respiration and deep relaxation. It has also been shown to boost muscle strength, coordination and physical condition, improve balance and like yoga and mindfulness training, benefit overall wellbeing. On the health side, it’s been linked with better sleep quality and duration, enhanced circulation and in fact, is considered a weight-bearing exercise akin to aerobic exercise of moderate intensity. As such, it may even help prevent osteoporosis. Yet, unlike regular strength training Tai Chi appears to offer an important means by which risk of metabolic heart disease during menopause may be reduced.

For women specifically, hormonal changes – namely a steeply progressive increase in testosterone — can contribute to a risk of developing metabolic syndrome (i.e. the cluster of risk factors — abdominal fat, high blood pressure and cholesterol levels and insulin resistance –that increases the likelihood of developing heart disease and diabetes). Moreover, as women age, the ability to effectively metabolize blood fats and maintain ample antioxidant defenses in their bodies requires higher maximal aerobic capacities (which inherently decline with age). Conversely, being sedentary deteriorates the efficiency by which fats are burned or utilized by the body and also negatively affects antioxidant defense lines and their ability to adapt to sudden or chronic exposure to oxidative imbalances in our bodies that can wreak havoc on cells and lead to build up of plaques and heart disease.

Where does Tai Chi fit in?

Yogic pranayma breathing has been linked to improvements in antioxidant capacity and in lower oxidative stress markers. Moreover, it may also improve cardiorespiratory function. Tai Chi combines postures with slow, deep breathing (i.e. 6 breaths per minute) and may also convey the same benefits. In a recent study published in the Journal of Aging Research, 8 premenopausal and 7 post menopausal sedentary women were asked to participate in an 8-week Tai Chi program that involved the following:

• 75 minute training sessions twice weekly consisting of  a 5 minute check in, 10 minutes of stretching/warm-up, and 60 minutes of a modified 18-posture Tai Chi and Tai Chi fan style. The Tai Chi routines coupled breathing to music, took a minute to a minute and a half per motion. The women learned five to 10 postures per week and the complete set was practiced for two weeks. Instructors were also sure to monitor and correct postures during each class.
• Twice-weekly, 60 minute at-home practice that also included completion of a log that detailed the practice (to insure compliance).
• Measures of body weight, diet, physical fitness, balance, flexibility, muscle strength, maximal aerobic capacity and blood samples.

Not only did 8 weeks of Tai Chi practice significantly improve balance, muscle strength and flexibility in both groups, but also produced as much as an 18% decline in a major marker for heart disease risk (i.e. plasma total homocysteine). Additionally, Tai Chi combined with measured, slow deep breathing improved the activities of antioxidant markers in the bloodstream that play a role in defending cells against damage from oxidative stress.

Although this study is quite small and bears repeating with significantly higher numbers of women, the findings do imply that Tai Chi and slow deep breathing have the potential to play an important role in improving functional/physical declines that occur during menopause and equally if not more importantly, improve antioxidant defenses against metabolic diseases, especially heart disease. Tai Chi is not only low impact, low-velocity and safe, but within the framework of menopause, it may prove to be a golden ring amongst alternatives to prevent disease. Meditation in motion, indeed.

Is your sleep elusive?

Posted by Liz on Nov 5, 2010 in sleep disturbance | 6 comments

Ever since I discovered Zeo, I’ve become pretty interested in sleep and in discovering the reasons why my sleep (and so many other women’s that I know) is lousy. What I’ve learned is that it’s while it’s easy to define the problem, it’s not so easy to assign an overriding factor. In fact, it appears that the more researchers delve into this elusive but necessary component of our lives, the less they truly understand.

Sleep issues tend to plague both men and women as they age. Indeed, deep sleep (or at least its electrical representation, also known as “electroencephalographic wave amplitudes”) has been shown to dwindle was we grow older, resulting in lighter and frequently interrupted sleep. Add factors such as hormones, health, life strain/midlife issues and psychological stress and you may end up exacerbating an already existing sleep deficiency or creating an entirely new problem. Moreover, researchers have shown that distinct sleep patterns might be associated with different influencing factors. For example:

• Difficulty falling asleep may be associated with menopausal symptoms in general, stress, and lower stress hormone levels.
• Awakening during the night might be associated with age, being late in the menopausal transition (before moving into full-blown menopause), having had early menopause, hot flashes, depressed mood, joint pain and stress.
• Early morning awakening may be associated with age, hot flashes, depressed mood, anxiety, joint pain, stress, and lower estrogen/higher fallopian stimulating hormone (FSH)  levels.

Let’s add to the confusion, shall we?

In a study appearing in the upcoming November/December Menopause journal, researchers evaluated health, menopausal status and sleep difficulties in 962 women who were assessed annually from birth through the ages of 48 to 54. The findings?

• The percentage of women experiencing moderate (trouble sleeping a little) or severe (trouble sleeping a lot) sleeping difficulties increased by more than 10% between the ages of 48 and 54.
• Menopause status (i.e. perimenopausal, postmenopausal, perimenopausal, early menopause due to hysterectomy or initiation of hormone therapy) appeared to be related to the presence/severity of sleeping difficulties. In fact, women who had had a hysterectomy, were postmenopausal or had started hormone therapy in the previous year had 2 to 3.5 times greater odds of severe sleep difficulty compared to premenopausal women. Of note, some of these women had not experienced poorer physical or psychological stress than their peers.
• However, with regard to moderate sleep difficulties it becomes more difficult to pin down: once the researchers accounted for certain factors that might skew the results, such as psychological stress, vasomotor symptoms/hot flashes and depression, only women who had had a hysterectomy remained at risk. Although the reasons for this are not entirely clear, the researchers say that sleep difficulties among these women in particular may be related to underlying health before they entered menopause.

The key take-away of this study is that for some women, menopause transitions (i.e. hormonal shifts as they go from pre to perimenopause, and then from peri to postmenopause) influence the severity of sleep disturbances regardless of age or other life or emotional factors. This finding is in line with findings from other studies, which have linked specific hormone-related symptoms such as night sweats to sleep disturbance/fragmented sleep.

However, having had a hysterectomy appears to lead to moderate interruptions in sleep, possibly as a result of prior health issues. So, severe sleep issues = menopause, and moderate sleep issues = ???

The downside of this research truly lies with semantics: how do you define moderate sleep disturbances and in turn, treat them? Do you look for  and address the cause or influencing factors? As noted in an accompanying editorial, multiple factors in various combinations in certain women may very well contribute to overall sleep quality.

In other words, when it comes to sleep, treat the individual, not the masses. Aging, life, hormones all come into play in certain individuals at certain times.

When it comes to sleep, one size does not fit all.

Flashfree food for thought: lignans and breast cancer risk

Posted by Liz on Jun 7, 2010 in breast cancer | 1 comment

I’ve written previ0usly about the potential benefits of flaxseed in boosting bone health and alleviating hot flashes.  Now, researchers are suggesting that flaxseed and other foods that contain high levels of lignans –  a type of phytoestrogen with both weak estrogen and antioxidant activities - may also help lower the risk of breast cancer in postmenopausal women.

In a large analysis of 21 studies examining possible links between lignan intake and breast cancer risk, the researchers found that including large amounts of lignan in the diet reduced the risk of developing breast cancer by as much as 14% in postmenopausal women. What’s more, risk was reduced by as much as 16% in studies that specifically examined levels of compounds called “enterolignans,” which are created with dietary lignan enters the stomach and interacts with bacteria residing in the intestines. The researchers say that lignan may offer moderate protection against breast cancer because it blocks estrogen activity that promotes tumour growth, perhaps mostly when natural estrogen is low (i.e. during menopause). However, the study did not provide details as to what constitutes “large” amounts of the compounds.

Flaxseed is one of the richest dietary sources of lignan, although it is also found in other foods including sesame seeds, sunflower seeds, whole grain breads, muesli, kale, broccoli, white cabbage and brussel sprouts, apricots and strawberries. You can find a full list of the lignan content in foods here.

Should you start eating more lignan? The good news is that the foods that are richest sources of the phytoestrogen are also quite healthy.  And, wth the potentially added benefits of preventing osteoporosis and lessening hot flashes, it seems that boosting lignan intake is a win-win all around!

Want to read more? Reuters Health has an excellent write up with additional information on the study.

Little Girl Blue

Posted by Liz on Apr 26, 2010 in depression | 0 comments

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

Depression in the perimenopause and postmenopausal years is no joke. I’ve written about it several times on this blog and will continue to do so until experts figure out an effective, acceptable strategy for combating the blues.

As I’ve noted before, researchers are not quite sure of the exact reasons for the depression surge during the transition,  (e.g. dramatic surge and declines in hormones, vasomotor issues, sleep issues, life stress and prior history). However, they do acknowledge that many women tend to suffer the blues during this time.

In the latest bit of research, published in the online edition of the journal Menopause, researchers found that over 40% of women studied (out of a pool of 685) suffered from symptoms of depression. What was more interesting, however, is that depression was almost twice as likely to develop in the peri/post menopausal stages than before menopause. (Note that other studies have found this likelihood to be as high as 4 times during the perimenopause). Moreover:

• Women who reported having had experienced some sort of negative event in their were 3.6 times likelier than those who hadn’t to develop depression
• Weight appeared to play a role, with obese women twice as likely as those of normal weight to develop depressive symptoms

Although I’ve discussed some potentially effective strategies for combatting the menopausal blues (e.g., exercise, chamomile, antidepressants, red clover, St. John’s Wort, soy isoflavones), none are a quick fix or a ‘one size fits all.’

Personally, I’ve noticed that fluctuating hormones coupled with elevated stress tends to heighten depression at specific times, while at other times, it’s easier to deal with. Pile it on and well, I become a pile of mush. My strategy entails an insane amount of physical activity, deep breathing, therapy and admittedly, some medication. Still, I’ve found that while I can usually keep the blues at bay, they do tend to crop up at the most inopportune moments.

What do you do to chase the blues away? Have they gotten worse or stayed the same during your transition? What advice do you have to offer for other readers? I’d love to hear!

News Flash: Hot hot hot

Posted by Liz on Jun 19, 2009 in hot flash, HRT | 0 comments

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

Think that hormone replacement therapy is going to get rid of those hot flashes forever? Think again. Indeed, researchers have discovered that the majority women who start hormone therapy because of hot flashes and then stop, may experience a recurrence of symptoms!

In this study, which appears in the Ahead of Print edition of Menopause, 1,733 women between the ages of 53 and 54 completed a validated questionnaire looking at menopause, hormone therapy and  vasomotor symptoms. Among the women who submitted completed surveys (~73%), 242 had previously used hormones and 69% indicated that they had vasomotor symptoms before starting therapy. Regardless of how long hormone therapy was used, symptoms returned in 87% women who stopped, even if they had completed menopause (although hot flashes were reportedly less frequent and bothersome).

The bottom line: Research has shown that disease risks, e.g. breast cancer, increase when hormone therapy is used more than five years. So clearly, remaining on hormones to address returning symptoms is not a wise option. Rather, safer and equally effective alternatives are needed to address return of symptoms as well as aid in disease prevention.