Could it Be Menopause?

 

from the Menopause Health Center

 

You’re 40 and suddenly it seems as if you’re falling apart. You wake in the morning soaked in sweat, despite the ceiling fan above. You can’t lose those last five pounds no matter how hard you try. Your interest in sex has gone the way of…well it’s just gone. And suddenly you’re spending more time browsing the face cream aisle than the ice cream aisle.

 

Could this be the start of menopause?

 

Before we try to answer that question, let’s get the nomenclature right. First, there really is no “start” to menopause. Menopause is actually just one day — the day on which you’ve gone twelve consecutive months without menstruating. Normal menopause can occur any time between ages 40 and 58, although the average age is 51.4.

 

The day after that magical day of menopause, you’re considered postmenopausal. The day before: premenopausal. Then there’s this other phase called perimenopause. And that, my friend, may be the realm you’ve entered.

 

Perimenopause refers to the transitional time before menopause. It can last a few months or, most likely, a few years. It usually starts in your forties, although it can begin earlier in some women. The primary cause is loss of follicles in the ovaries, leading to slowly declining estrogen levels as your ovaries age. This decline isn’t consistent, however, which is why your symptoms may come and go as often as your college-aged children.

 

Tests Not Available

 

Unfortunately, there is no conclusive test that can tell you that you are, indeed, in the menopausal transition. No, not even those over-the-counter tests that purport to pinpoint your hormone levels. That’s because those tests, with names like Estroven, Menocheck and RU25 Plus, are designed to measure levels of a hormone called follicle stimulating hormone, or FSH. Your body releases this hormone when estrogen levels drop, because it signals the ovaries to produce more estrogen. So, the thinking goes, if FSH levels are high, it means estrogen levels are low, ergo you’re approaching menopause.

 

And indeed, for years gynecologists used this hormonal measurement as an indicator of menopause. But it turns out that estrogen levels fluctuate nearly as much as the stock market — not only day-to-day, but from morning to night. So a single FSH measure, even a couple, is really no indication of menopausal status.

 

Instead, you’re better off evaluating your status by your symptoms. These include:

 

• Hot flashes and night sweats.
  Called vasomotor symptoms, we’re still not sure what causes them. Somehow, it seems, declining estrogen plays havoc with your body’s temperature controls, increasing your core temperature and triggering your body’s cooling attempt — sweating. Hot flashes are the second most common menopause-related symptom, affecting about 75 percent of women. It’s also one of the most bothersome. The bad news: In some women, they continue even after menopause itself.
• Irregular periods.
  Fluctuating hormone levels mean strange things may be happening to your periods. You may find them coming more often — every 24 days instead of every 28 days, for example — or less often. You can even skip several periods in a row only to have them return on a regular basis. You may also find that your periods are considerably heavier or lighter than they used to be, and that they last longer or shorter than they used to.
• Problems sleeping.
  We don’t really know if fluctuating hormone levels contribute to the sleep problems women say are so common during this time of life. It could be that the night sweats interfere with sleep, or that the stresses of this time of life, including teenaged children, aging parents and career transitions, keep you awake. Regardless, studies find that more women report insomnia as they move through midlife, primarily the type that involves waking up in the middle of the night.
• Headaches.
  You may find you’re having more headaches, particularly around your period. And if you’ve always been prone to premenstrual headaches, you may find they’re more severe and last longer. The good news? Once you reach menopause, you should experience far fewer headaches.
• Mood swings.
  There’s good evidence that perimenopausal women experience more irritability, fatigue and “blue moods,” during the perimenopausal transition than before. Again, this could be related to shifting hormonal levels, but is more likely related to midlife stressors. If these mood swings become so intense they interfere with your normal life, however, you should seek professional help.
• Vaginal dryness.
  Estrogen plays a key role in maintaining the moistness and flexibility of the vagina. So as levels drop, you may find you feel “drier” down there. You may notice other changes, such as a discharge or odor, and you may even find you have problems with some urine leakage.

 

Although all the symptoms listed above are representative of perimenopause, they can also be caused by numerous medical issues. So regardless of whether you think your symptoms are from this midlife transition, it’s important to see your health care professional for a complete medical and psychological evaluation. He or she can rule out any other medical conditions and confirm whether you are or aren’t in the menopausal transition.

 

 For more information on the health topics mentioned in this article visit

 

the HealthyWomen.org areas below.

 

 

 

Menopause: www.healthywomen.org/condition/menopause

 

 

 

Menopause Health Center: www.healthywomen.org/healthcenter/menopause

 

 

 

 

 

© 2011 HealthyWomen.  All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (toll free). On the Web at: www.HealthyWomen.org.

 

Insulin Therapy and Your Life

 If your doctor just started you on insulin therapy, you’ve likely had diabetes for a while and you know the importance of following a healthy diet, exercising regularly and monitoring your blood sugar levels. Nothing changes in terms of these requirements now that you’re on insulin. Hopefully, you’ll find it easier to keep fasting blood sugar levels in your target range and to reach an A1C of less than 7 percent.

You may be wondering about the effect of insulin on other aspects of your life. Here’s what we know:

Your sex life. You may have noticed changes in your libido and sexual life since your diagnosis of diabetes. High blood sugar can reduce vaginal lubrication, leading to dryness and pain during intercourse. It can also increase the risk of vaginal infections, which can make sex more painful. Long-term damage to small blood vessels can occur when diabetes isn’t well controlled, resulting in decreased arousal. Since insulin should provide better control of your blood sugar, with fewer episodes of high blood sugar levels (hyperglycemia), you may see these symptoms improve.

Pregnancy. Having diabetes during pregnancy can increase the risk of miscarriage, early labor and delivery, as well as preeclampsia and congenital defects in the baby. However, the best thing you can do to prevent these issues is to control your blood sugar levels before and during your pregnancy. In fact, all guidelines regarding pregnancy and diabetes recommend starting insulin therapy before getting pregnant so women can achieve target blood sugar (glucose) levels before conceiving. Taking insulin during your pregnancy is perfectly safe. One study that reviewed 10 years of pregnancy outcomes in women with type 2 diabetes found those taking insulin during pregnancy had significantly lower rates of complications. If you use oral medications for blood sugar control, talk to your health care provider about whether they are approved for use during pregnancy.

Menopause. Once you are menopausal, your body’s production of insulin drops even further, increasing insulin resistance. The fact that you’re already taking insulin is a good thing, but be sure to monitor your blood sugar for changes in your insulin requirements after menopause. As for hormone therapy, the decision is up to you and your health care professional. Replacement estrogen and/or progesterone therapy is recommended only for short-term use to address symptoms such as hot flashes and vaginal dryness in perimenopausal and postmenopausal women, but not for long-term use. The same recommendations apply if you have diabetes. An analysis of 107 studies found that hormone therapy reduces insulin resistance and fasting blood sugar levels in women with type 2 diabetes. However, if you have any significant risk factors for heart disease, talk with your doctor about whether hormone therapy is right for you and about other steps you can take to reduce your risks.

Other medications. People with diabetes often need other medications, such as a statin to control cholesterol and blood pressure-lowering drugs. Some drugs can increase your response to insulin; others can reduce it. Those that may increase the blood sugar-lowering effects of insulin include ACE inhibitors, fibrates, certain antidepressants, most oral anti-diabetes medications, some anti-arrhythmia drugs, certain pain relievers, hormones and antibiotics. Drugs that can reduce the blood sugar-lowering effects of insulin include certain steroids, niacin, diuretics, albuterol, certain hormone medications like thyroid hormones and estrogen and progesterones in oral contraceptives, as well as some psychiatric medications such as olanzapine and clozapine. Beta blockers, clonidine and lithium can make you more susceptible to hypoglycemia, while pentamidine can cause hypoglycemia, sometimes followed by hyperglycemia. Remind every health care professional who prescribes any drug for you that you take insulin, and ask if the drug will affect your blood sugar levels. Taking insulin for your diabetes doesn’t have to change your life. In fact, given the evidence regarding the benefits of insulin therapy in diabetes, it will help you have a longer, healthier life.

This content was developed with the support of sanofi aventis. For more information on the health topics mentioned in this article visit the HealthyWomen.org areas below.

Diabetes Health Center : www.healthywomen.org/healthcenter/diabetes Healthy Living Center : www.healthywomen.org/ages-and-stages/healthy-living Midlife & Beyond: www.healthywomen.org/ages-and-stages/midlife-and-beyond Pregnancy Center : www.healthywomen.org/healthcenter/pregnancy Menopause Center: www.healthywomen.org/healthcenter/menopause References American Diabetes Association. Standards of me dical care in diabetes–2010. Diabetes Care. 2010;33(Suppl 1):S11-61. Ekpebegh CO , Coetzee EJ, Merwe Lvd, et al. A 10-year retrospective analysis of pregnancy outco me in pregestational Type 2 diabetes: comparison of insulin and oral glucose-lowering agents. Diabetic Medicine. 2007;24(3):253-258. Giraldi A, Kristensen E. Sexual dysfunction in women with diabetes mellitus. J Sex Res. 2010;47(2):199-211. Lantus [product information]. Bridgewater , NJ : Sanofi Aventis; 2007. Mahmud M, Mazza D. Preconception care of women with diabetes: a review of current guideline recommendations. BMC Womens Health. 2010;10:5. Wedisinghe L, Perera M. Diabetes and the menopause. Maturitas. 2009;63(3):200-203.

© 2010 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (toll-free). On the Web at: www.HealthyWomen.org.

Women and Heart Disease Across the Lifespan (Part 2 – Baby Boomers)

During this show we will discuss heart problems women may start to experience around menopause. “The Menopause Triple Threat” – weight gain, high blood pressure & cholesterol problems. Heart attack & stroke risk factors, “Broken Heart Syndrome”

Listen to internet radio with Heartstrong on Blog Talk Radio

Menopausal status and ethnicity impact stroke risk factors

 

This is an abstract from a research study we conducted and presented at the International Stroke Conference in San Antonio Texas last month. 

Menopausal status and ethnicity influence the incidence of modifiable stroke risk factors, according to a new study.
Researchers examined the presence of modifiable risk factors in 2,259 women categorized by ethnicity and menopausal status, diagnosed cholesterol disorders, hypertension and metabolic syndrome.
In the study:
• 60 percent of the women were post-menopausal (57 percent Caucasian, 25 percent African American and 14 percent Hispanic).
• 30 percent were pre-menopausal (34 percent Caucasian, 22 percent African American and 38 percent Hispanic).
• 9 percent were peri-menopausal.

Significant increases in the incidence of hypertension and cholesterol disorders occurred in all ethnic groups, while African Americans and Hispanics also had significantly higher incidences of metabolic syndrome, high triglycerides and diabetes. Caucasian women had increases in metabolic syndrome and cholesterol disorders between peri- and post-menopause. Stroke risk scores were consistently higher in African-American women across all menopausal stages.

Risk factors were high in the 3 percent who experienced premature menopause: 45 percent for hypertension; 45 percent for metabolic syndrome; 42 percent for cholesterol disorders and 92 percent for overweight.
The high incidence of stroke risk factors in women with premature menopause indicates age of menopause onset is not significant, the scientists said.

“Ideally, healthcare providers should evaluate for stroke risk factors when women are pre-menopausal and closely monitor them as they progress through menopause,” the investigators said. “Early risk factor identification and patient education can empower women who take control and reduce their risk for stroke.”

Increased Testosterone (Not Decreased Estrogen) Causes Weight Gain in Menopausal Women

For years we have believed that pre-menopausal women were protected from heart disease and stroke by estrogen and when estrogen levels decreased after menopause this lead to the increased risk for heart disease.  A new study published in the August 2009 issue of Obesity suggests that changes in testosterone levels may play an important role.  The SWAN (Study of Women’s Health Across the Nation) study examined the relation between testosterone blood levels and visceral fat in women at different stages of menopause.  They found that higher testosterone levels were more likely to be associated with increased visceral fat (belly fat) than lower estrogen levels.  Previous studies have reported an increased incidence of the metabolic syndrome (pre-diabetes) in women with higher testosterone levels.

 These are early results but suggest that increased levels of male hormones (testosterone) may be contributing to the weight gain, high blood pressure, and high cholesterol that occur around menopause. 

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Heart Healthy Vitamins and Supplements

6 Affordable and Effective Exercise Essentials

 If you need inspiration to become more physically active, a push to get going or just want to have more fun, here are six of the best, easy-to-afford and effective pieces of exercise gear.

 Using just one of these regularly will improve your fitness without straining your budget:

Resistance bands: Stretchy and fun, they do the work of weights but pack easily in a purse or pocket. Versatile for several body areas. ($3+)

Jump rope: Remember when you could jump for hours with your friends? You don’t need hours now—just 5 or 10 minutes of jumping (indoors, if you prefer) will boost your activity level and burn calories. ($3+)

Exercise mat: You’ll be more comfortable, with a safer grip, than exercising on a carpet or bare floor. That will help you be active more easily, for a longer time. ($15+)

Hand weights: Keep a set by the computer or TV and use while watching something entertaining. ($5+)

Exercise ball: Sized for your height, most of these come with their own pump for easy inflation (and reinflation). Great for strengthening various muscle groups. Use as a chair and you’ll get a bit of a workout just from balancing on it. ($15+)

Pedometer: Just put it on and in a day or two you’ll be more aware of how much (or little) you’re moving every day. Aim to increase your average daily steps by 5 percent every week until you reach 10,000 steps a day, a goal that the American Heart Association and other experts suggest. Then add more to increase benefits. ($10+)

Often, you can find fitness items such as exercise DVDs, roller skates, workout clothing and more at yard or garage sales for just a dollar or two.

If you’re interested in acquiring big home-gym equipment, yard sales and online community boards are great places to find barely used items. Recently, one site had offerings that included treadmills for $35 to $75, a weight bench for $1 and an elliptical machine for $180. Just remember that you’ll probably have to arrange for transporting the big and heavy pieces—as well as find a space for them in your home.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.

Preventing Heart Disease in Women

Do Hot Flashes Lead to High Blood Pressure?

 Women who experience hot flashes have been found to have higher blood pressures than those who don’t.  Systolic blood pressures (top number) were found to be significantly higher in women who have hot flashes regardless of menopausal status.  The higher blood pressures were consistent even when differences in weight, ethnicity and age were evaluated.  This study was conducted on 154 women 18 to 65 years old with no history of heart disease and normal blood pressures (published in the Journal of the North American Menopause Society March 2007).

 Hot flashes are believed to be caused by an increase in the activation of the sympathetic nervous system (this is the “fight or flight” system which leads to an increase in heart rate and constricts blood vessels).  This logically can also then lead to an increase in blood pressure.

 Women experiencing hot flashes should make sure they closely monitor their blood pressure.  Remember a normal blood pressure should be less than 120/80.

For more information about menopause, high blood pressure and other risk factors for heart disease see our new book “Take Charge: A Woman’s Guide to a Healthier Heart” at www.heart-strong.com

Three Pool Exercises That Won’t Embarrass You

Three Pool Exercises That Won’t Embarrass You
from the National Women’s Health Resource Center’s e-newsletter, HealthyWomen Take 10

You’ve heard it time and again: water exercise is a great way to build fitness, flexibility and strength without straining your joints. But, let’s face it, some of us feel a little self-conscious about working out in a pool.

Kay Smiley, aquatics specialist for YMCA of the USA, suggests these easy pool exercises to burn calories, improve balance and tone your body without drawing a lot of attention to yourself:

Exercise 1: Pool Walk

• Walk heel-to-toe across the pool, swinging opposite arm and leg (as you swing your right arm forward, step forward on your left leg).
• When you reach the opposite side, walk backward, using toe-to-heel steps. (Or just walk the return lap facing forward.)
• Option: March across the pool, lifting your knees with each step.

Exercise 2: Scissor Arms

• Cross your arms in front of your body at hip level.
• Move each arm behind your back, one at a time, and recross them.
• Return arms to front, one at a time, and recross.
• Repeat, alternating left arm over right, then right arm over left.
• Option: Wear webbed gloves, designed to add resistance and help with balance.

Exercise 3: Side Stretches

• Hands on hips, bend slowly to one side.
• Return slowly to standing position.
• Repeat on opposite side.
• Option: Stretch arms out to your sides before bending.

Remember to exercise in shallow water if you’re not a swimmer. Always swim when a lifeguard is present.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.