1 AnswerPatricia Geraghty, NP, Advanced Practice Nursing, answeredFindings from the Women's Health Initiative Memory Study showed a doubling of the risks for signs of early dementia in women using menopause hormone therapy after the age of 65. This is not the typical age group where hormone use is recommended, and long-term data is not available to corroborate the finding of actual development of dementia. The risk of dementia from hormone use is younger women is not clear but appears to be absent or decreased.
1 AnswerThere may be changes in body fat distribution and body composition due to hormonal changes occurring during the menopausal transition. However reduced physical activity as women get closer to menopause is the main culprit for increase in weight gain. It is really important to keep yourself active during these days!
2 AnswersDr. Elizabeth Poynor, MD, Gynecologic Oncology, answered
Staying sexually active during menopause can help boost body image and mood, says Elizabeth Poynor, MD, PhD, a gynecologist-oncologist in New York City. In this video, she explains other advantages to staying sexually active.
1 AnswerDr. Lauren Streicher, MD, Gynecology, answeredOn average, women put on 1.5 to 4 pounds per year after age 50. A few extra pounds in a year don’t seem like a lot, but if you gain five pounds a year starting when you are 45, by age 55 you are looking at 50 extra pounds! However, it isn’t the lack of estrogen that puts on the pounds, but midlife changes in metabolism and lifestyle. Women who continue to menstruate until they are in their late fifties also start to gain weight even though their ovaries have not shut down. Estrogen does affect the distribution of weight, so you can blame menopause if you suddenly have a muffin top even if you haven’t gained a pound!
1 AnswerDr. Rovenia Brock, PhD, Nutrition & Dietetics, answeredIf you find you are having trouble remembering where you put your keys or your purse, don't panic. Many women experience memory and concentration problems during perimenopause and after menopause. Some scientists believe that you may be able to minimize these memory problems with blueberries. Pint for pint, blueberries may contain more antioxidants than any other fruit or vegetable. The most powerful health-promoting compounds in these little blueberries are anthocyanins, phytochemicals that belong to the flavonoid family -- which, in addition to combating the free-radical damage that leads to heart disease, may also boost brain power. In laboratory studies, aging animals fed a blueberry-rich diet for four months performed as well in memory tests as younger animals.
1 AnswerMenopause is a natural part of life, not a disease or a health crisis. However, menopause may occur when many other changes are happening in your life. For instance, your children may be marrying or leaving home, your parents may be ill or dying or you may be wondering what you'll do when you retire. That's why it is probably more helpful to think of how your daily activities and lifestyle could affect your postmenopausal years.
For instance, making sure that you exercise and eat right can make a real difference in how you feel and can even help prevent some of the long-term effects that are linked to estrogen deficiency (like osteoporosis).
Physical changes do occur with menopause and with aging. But the changes that happen during this period can be minimized by healthy living and a sense of purpose in life. If your symptoms are severe enough to interfere with your life, consult your doctor to go over your options for treatment.
1 AnswerReview the following questions about menopause so you're prepared to discuss this important health issue with your healthcare professional.
- How many women in my age group do you treat? What percentage does this number represent of your total practice?
- Are you comfortable treating perimenopausal and postmenopausal women? If not, can you refer me to a colleague who is?
- Do you consider yourself up-to-date on treatment options for perimenopausal and postmenopausal health concerns, including hormone therapy and other medical therapies?
- Can you arrange for evaluations for osteoporosis and heart disease? At what age should I have these evaluations?
- If I am interested in alternative therapies, will you work with me to help identify those that might be helpful or refer me to someone who is a safe and knowledgeable practitioner?
- I don't feel well in several different ways. Are my symptoms due to menopause or another condition?
- How do I know if my on-again, off-again bleeding is perimenopause or another problem?
- My sex drive is low. Can this be due to menopause or other factors in my life?
- Will my incontinence stop after menopause, and what can I do about it now?
- Can you discuss the most recent research about hormone therapy and its safety with me? How do the benefits and risks of hormone therapy apply to my personal health needs?
2 AnswersDr. Barbara Depree, MD, OBGYN (Obstetrics & Gynecology), answeredThat is a great question that is difficult to answer, but like most conditions we recommend treatment as long as there is benefit from the treatment. Most women are placed on hormone therapy (HT) for the amelioration of certain symptoms associated with menopause. It is possible that over time those symptoms will no longer be present. For instance, hot flashes, a very common symptom of menopause, will likely become better over time and therefore the benefits of HT will be less. On the other hand, some symptoms of menopause are not temporary, and will only worsen with time so discontinuing therapy may result in resumption of symptoms (for instance, vaginal dryness).
Each woman is so individual when it comes to managing menopausal symptoms. I typically recommend decreasing estrogen dosage over time and at some point stopping to see how she does, and then make the decision based on quality of life. I have women who have used HT for 30+ years and intend to continue, and some who can stop after 1 year and feel well. We don't know that there are specific risks that increase over time, so we really try to individualize the decision for each woman and her specific symptoms and risk factors.
1 AnswerSome hormones used in menopausal hormone therapy are called "bioidentical," meaning they are chemically, i.e., molecularly, identical to the substance as it occurs in your body. These hormones, however, don't come from your body (or another woman's body). Most bioidentical estrogens and progesterone come from soy (estrogen) or yams (progesterone).
They are also not "natural," or in their natural state, when you take them. To create a hormone women can use, the plant or animal-based hormones are synthesized, or processed, through a several-step process in a laboratory.
While all hormonal supplements, including bioidenticals, are made in a laboratory, the difference between a bioidentical hormone and a synthetic hormone is that the synthetic hormone is a patented molecular compound created in the laboratory to mimic the action of naturally occurring hormones and mass produced. Prempro, for instance, is a combination of two synthetic hormones.
Synthetic and bioidentical hormones work in the same way: by binding in a kind of lock-and-key process to special proteins on cell surfaces called receptors. Once a hormone -- whether synthetic or bioidentical -- locks onto these receptors, the messages from that hormone can be transferred to the cell.
There are two main types of bioidentical hormones: those that are FDA-approved and commercially available with a prescription, such as Estrace, Climara, Vivelle, EstroGel, Divigel and Estrasorb, and those that are produced on an individual basis for women, in compounding pharmacies.
2 AnswersDr. Michael Roizen, MD, Internal Medicine, answeredThe epilepsy and pain relief drug gabapentin has been shown to ease both the severity and the frequency of hot flashes by almost 50 percent. It may be the new best thing other than estrogen for the flash.
Also, a class of antidepressant drugs called SSRIs has been shown to reduce symptoms by 60 percent, as have alpha blockers such as clonidine (used to treat high blood pressure). All have side effects that many consider more problematic than estrogens, but some women prefer these choices.
I do not recommend clonidine because of the risk of rebound hypertension if it's abruptly discontinued. Patients are supposed to taper down use of the drug to avoid the side effects, but many patients don't comply with those rules, risking the chance of developing high blood pressure when they stop taking it suddenly.
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