The Hot Years™: My Menopause Magazine

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The Hot Years

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My Menopause Magazine

Exercises To

Strengthen Bones

6

Tips for Better Intimacy

How to fix a leaky bladder

Dr. Holly Thacker

N 33 o

Flibanserin:

The “Little Pink Pill� for women Yoga

and Menopause

+ A Hot Tip That Improves Menopause You Never Expected


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Exercises To

Strengthen Bones

7

Tips for Better Intimacy

Flibanserin:

The “Little Pink Pill� for women Yoga

and Menopause

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How to fix a leaky bladder

Dr. Holly Thacker

A Hot Tip That Improves Menopause You Never Expected

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The Hot Years

No 33

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My Menopause Magazine

In this Issue: How to fix a leaky bladder

Dr. Holly Thacker

Flibanserin:

Yoga and Menopause

A Hot Tip That Improves Menopause

6 Tips for Better Intimacy

News You Can UseTM

Exercises To Strengthen Bones

Change Your Negative Mind Into A Positive One

Rocks and Ripples

The “Little Pink Pill” for women

You Never Expected

Highlights from ACOG


Editorial

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About The Hot Years:

My Menopause Magazine FOCUS Our focus is on the health and wellness of women in and around menopause. The Hot Years: My Menopause Magazine is a Web Health Award winner and the first digital magazine focused specifically on menopause

Mache Seibel, MD is one of America’s leading experts on women’s wellness and menopause, and magazine founder. He is a widely sought after speaker, healthcare consultant and media expert. Seibel served on the Harvard Medical School faculty for 20 years. His best selling book, The Estrogen Window explains away the confusion and fear of taking estrogen. Associate Editor: Sharon Seibel, MD is a Harvard Trained psychiatrist focusing in women’s mental health and wellness in and around menopause. She has played an active role in patient education for over two decades.


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EXPERT CONTRIBUTORS Suzanne Andrews is the original creator of Functional Fitness on PBS. Her show is seen each week on PBS across the United States. Suzanne provides easy to do exercises that help women stay fit and functional. She specializes in bringing evidenced based workouts for specific health conditions such as bladder health, bone health, arthritis, etc. Ed and Deb Shapiro are nationally known meditation and mindfulness gurus, coaches and corporate consultants who bring meditation, mindfulness, spiritual counseling, and mind-body awareness to the world. They have spent time with the Dalai Lama and other spiritual leaders. Deb is the author of the award-winning book Your Body Speaks Your Mind: Decoding the Emotional, Psychological, and Spiritual Messages That Underlie Illness, now in 19 languages.

Dr. Caroline Apovian is a New York Times best selling author of nutrition and diet books, Associate Editor of the Obesity Journal and is co-editor of the Obesity and Nutrition Section of Current Opinion in Endocrinology and Diabetes. Dr. Apovian serves on the Expert Panel on Weight Loss Surgery for the Massachusetts Department of Public Health and is Professor of Medicine and Pediatrics at Boston University School of Medicine. Hari Kaur Khalsa Master Kundalini Instructor, CoFounder, Hari NYC. Hari is a world renowned master teacher of Kundalini Yoga and Meditaiton as taught by Yogi Bhajan. For ten years, Hari worked alongside Yogi Bhajan, Master of Kundalini Yoga, directing his teacher training programs. Hari is part of the first wave of yoga teachers that pioneered the teaching of Kundalini yoga and meditation in the west.


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Educate to Advocate

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s I have been traveling around the country attending meetings, or speaking to organizations and enthusiastic groups of women about my new best selling book, The Estrogen Window, I’ve talked to hundreds of women about their concerns and fears surrounding menopause. There is a huge need for more information on menopause and accurate information about estrogen. Just a few months ago in the March 3 issue of the New England Journal of Medicine, the authors reported how difficult it is for women to get accurate information because many of the newer graduates, primary care physicians and even gynecologists have not had adequate training in menopause or hormone therapy. That’s why I tell my audiences, “Educate to Advocate!” Get the information you need to advocate for the care and treatment you need. It’s why we’ve created MenopauseQuiz.com, AskDrMache. com, MenopauseBreakthrough.com and many other resources. Starting with this issue, we’re making some changes with My Menopause Magazine. First, based on reader feed-

back, the name is changing to The Hot Years: My Menopause Magazine. Second, it’s going to be free to everyone, both the App and the magazine. Third, it’s going to be a quarterly publication instead of a monthly one. The months of publication will be March, June, September and December. We know people are busy so we’re consolidating the latest information for you. This issue of The Hot Years will feature Dr. Holly Thacker of the Cleveland Clinic who explains what you need to know about sensitive bladder. You’ll discover “the little pink pill” for women, Yoga and Menopause, One hot tip to improve menopaue you never expected, 6 Tips for Better Intimacy, and exercises to protect your bones. Enjoy this issue of the magazine and be sure to share this magazine with your friends and Like us on Facebook.



My Menopause Featured Article

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Take Control of

Your Sensitive Bladder No more waiting! Women are often so embarrassed by their sensitive bladder that they wait five to seven years to tell their healthcare provider. Read on to discover all the latest treatments so you can speak up now.

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y guest interview is with Dr. Holly Thacker, Director of the Center for Specialized Women’s Health at the Cleveland Clinic and Executive Director of Speaking of Women’s Health. Their motto is, “Be strong, be healthy and be in charge.” Dr. Mache Seibel: Dr. Thacker, thank you so much for talking with me on this very important topic. Dr. Holly Thacker: It’s such a pleasure to be here and talk about a common problem that is not a normal part of aging and can be treated. Dr. Mache: How common is sensitive bladder?


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Dr. Thacker: Up to one in three women has some of these problems during their lifetime. It’s because the vagina is essentially a hole in the pelvic floor. Dr. Mache: It’s probably a little to do with having babies, too. Dr. Thacker: Absolutely, it’s affected by childbearing, childbirth, weight gain, aging. There’s only a tiny little band of muscles that support the bladder neck, which is very close to the top vaginal wall. With aging, we lose muscle tone all throughout the body, especially if we don’t exercise. The socalled stress urinary leakage, when we cough or jump or sneeze or laugh, is very treatable. It does not necessarily require surgery, although a lot of times it’s what’s offered first to women. Dr. Mache: I think a lot of women avoid talking about sensitive bladder because they’re under the impression that either nothing can be done or all that can be done is surgery. You’re saying surgery doesn’t have to be the first step and it may not ever be a step. Dr. Thacker: Absolutely correct. We have options to help prevent this problem from happening as well as to treat or cure it, and we also have a couple of new over-the-counter temporary options that are better than wearing diapers or pads or liners for women.

Dr. Mache: So, try nonsurgical treatments first and if it works you’re good to go and if it doesn’t there’s always the surgical follow up. If you were going to offer a woman an over-thecounter option for her bladder, what things would you suggest to her? Dr. Thacker: First you want to make sure you have the correct diagnosis. I routinely ask women during their pelvic exam if they have leaky bladder, any trouble with sexual function or bowel function. Then I have a woman do a Kegel exercise around my gloved finger while I’m doing the bimanual exam to check her muscle tone. Up to 30% of women don’t know how to contract these muscles, which are the same muscles that contract quickly and involuntarily during sexual climax. Having a strong pelvic floor not only helps prevent leaky bladder, it also improves your sex life. Dr. Mache: When you talk about pelvic floor, you’re talking about the muscles at the bottom of the pelvis when you’re standing up. These muscles surround the bladder to hold in urine, and when they relax , urine comes out. Dr. Thacker: Right, there is a group of muscles called the pelvic sling that lifts up the uterus, the bladder, and holds up the vagina and the rectum. If


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that’s weakened or injured from childbirth or surgery or a medical condition, it can affect bladder function, sexual function, and bowel function.

Dr. Thacker: Exactly, although there’s not a vibration per se. It is a wavelength of electrical stimulation that is not painful. In fact, at the end of the study with these devices, a lot of women wouldn’t give the devices back because they were climaxing.

Preventatively, all women should know how to contract those muscles and do Kegel exercises and if they don’t or if those muscles aren’t strong Dr. Mache: That’s a good testimonial. enough, get physical therapy or overDr. Thacker: Yes. the-counter pelvic So, they made a stimulating devicAt the end of the study, nonmedical dees to strengthen them. Three of a lot of women wouldn’t vice, which is these devices are give their APEX devices the same as the APEX, but they available over the back because they were added a clitoral counter and two climaxing vibrator. You can connect to a comget the pelvic conputer that talks to tractions and the the woman in a clitoral vibration for primary orgasmic prescriptive way. dysfunction or you can insert it in your One over the counter device is called pelvic floor and have the option of the APEX (Automatic Pelvic Exercising vibration of the clitoris. Device) It’s battery operated, hand Dr. Mache: Do these require a preheld, inserted into the vagina, pumped scription or can you go in and buy one? up so there’s a snug fit, turned on, and there’s a simple pulsation that causes Dr. Thacker: APEX was initially a a really intense Kegel. You can actualprescription but at the beginning of ly see the device being pulled into the 2016 it became over the counter. So, vagina during the exam. I prescribe it to women if they have a flexible spending account or need a Dr. Mache: So, it’s like a vibrator; A prescription because it’s a few hunvibrating linear object that’s placed into dred dollars and if they want to purthe vagina and it pulses and the pulse chase online, they can. I think it’s best causes the vaginal muscles to contract to work with a physician or a nurse a little and pull it in a bit.


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practitioner to examine you and make sure you’re using it optimally. We need to determine where you get the best contractions, with the leads either in the north-south or east-west position. There is some technique to it. The third device is the APEX-M. That gives two wavelengths of stimulation. One for pelvic contractions to treat stress incontinence and strengthen the pelvic floor. It gives a lower frequency vibration or sensation, that feels like a tapping sensation and that relaxes the detrusor muscle of the bladder. Dr. Mache: The one that lets the urine out. Dr. Thacker: Right. Many women have an overactive bladder where their detrusor muscle is contracting and stimulating too much and it gives them the feeling, “I got to go. I got to go.”

Dr. Thacker: Exactly. In the past, women took medications that can cause dry mouth or constipation, or they sometimes get Botox injections in their bladder, which are expensive and painful. I think most women would rather spend money on Botox for their face than their bladder. The second lower electrical stimulation in APEX-M actually relaxes the bladder but strengthens the pelvic floor. For women with urge leakage, overactive bladder or the woman who has stress incontinence and urge incontinence, this APEX-M, which up until very recently was only available by prescription, is also now over the counter and priced very competitively with a lot of the prescriptive bladder medications.

APEX-M is also now over the counter and priced very competitively with a lot of the prescriptive

Dr. Mache: So, for women who have some difficulty with loss of urine either because of stress incontinence leaking when she coughs, sneezes, laughs and so forth, or for women who have the urge to go but just dribbles a little and don’t really have to, either way, there are some over-thecounter products that with a little bit

bladder medications

Dr. Mache: So, they have a muscle that’s functioning in an abnormal way that gives them a sensation that they have to go, whereas in reality their bladder isn’t necessarily full.


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of direction cannot only improve the problem but may also improve sexual function and enjoyment.

some of the muscles, in the sling of muscles across the bottom of the pelvis

Dr. Thacker: Yes. There’s anothDr. Thacker: And cure them and allow er treatment option. It’ a temporary them to not wear pads or liners, which fix but some women may only leak can add up to $700 or more a year. with jumping on a trampoline or doing high-impact aerobics. They might Dr. Mache: Plus save enormous wear a pad, which they don’t like to embarrassment and the awkwardwear with their exercise clothes, or ness and unpleasantness of having to even a super sized tampon in the vadeal with that. gina to push up the bladder. There is a new over the counter intravaginal Dr. Thacker: device. It’s like a Absolutely. Some disposable pesImpressa is inserted like sary. It’s shaped of the prescription devices like a tampon a tampon, but it’s not actually have a but actually gives absorbent so it’s not to be bladder neck computer talk to you, tell you support for up used during bleeding what to do, meato eight hours. sure your muscle It’s called Poise strength and provide visual and verbal Impressa and a lot of women may be biofeedback. They are more sophisseeing that at the grocery store, or at ticated for more complex types of inTarget or Wal-Mart right next to the continence. There’s also a smaller mini pads and liners. It comes in three difversion with a tiny balloon for women ferent sizes based on what feels most with very small vaginas or for those comfortable and it lasts up to eight that have fecal incontinence. For men hours. It looks and is inserted just like who have urinary incontinence the a tampon, but it’s not absorbent so it’s device is placed into the rectum to get not to be used during bleeding. those pulsations to their bladder. Another option for women who have Dr. Mache: So, fecal incontinence (acmild degrees of stress incontinence or cidental loss of gas or feces) occasioneven a little urge incontinence espeally happens in women with a difficult cially in women past menopause who delivery or a forceps delivery that tears were low in estrogen, is the use of a


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prescription vaginal ring that the woman inserts into her vagina and it stays there for three months releasing little bits of natural estrogen that thickens up the vagina and the urethra and the base of the bladder. And as long as the vagina or bladder isn’t protruding outside the lips of the vagina, it also gives a little bit of a pessary-like support. When the bladder or vagina drop down like that, women end up having hysterectomies or prolapsed repair surgery. It’s very common, especially if it runs in families or if women have lots of big babies or even if someone who has not had babies but has lighter-eyes and lighter-skin. We think it has something to do with the collagen support of their pelvis.

Dr. Mache: So, if it feels like something is really pressing down in your vagina, or you touch yourself and you feel something inside the vagina and you don’t know what that is, it could be the uterus dropping and this is something to tell your healthcare provider about. Dr. Thacker: Yes, and a healthy diet with adequate protein, water, fluid and magnesium helps avoid constipation, which makes bladder leakage worse when you bear down. And weight


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gain of even five pounds in the abdomen can tip a woman from normal bladder function to leaking. Dr. Mache: Since 14 is the new average dress size in the United States today, there are a lot of women who are struggling with their weight and you’re saying in addition to health issues like blood pressure, diabetes and heart disease, it’s also a contributor to urine loss. Dr. Thacker: Yes, absolutely.

Dr. Mache: Can B-complex vitamins be negative for the bladder? Dr. Thacker: Yes. In some women, because B-vitamins are water-soluble and excreted through the kidneys, sometimes high concentrations from lots of supplements can irritate the bladder. Caffeine is another very common bladder irritant.

Dr. Mache: You’ve been talking about over-the-counter and some prescription remedies women can use as firstline options that may be restorative. If these methods fail, what is the next level that It’s very important to rule a woman might out bladder infection, have to do before hormonal deficiencies, surgery?

There are surgical options if nothing else works; slings to lift the bladder, and potential cancers or prolapse repair Dr. Thackpre-cancers of the bladder surgery and er: It’s very ima lot of other portant to rule options. Women out bladder infection, hormonal deshould not think it’s part of aging and ficiencies, and potential cancers or they should not just go buy so-called pre-cancers of the bladder or the pel“sexy diapers” or liners. They should vic floor. There are also certain food look for a medical cure, which now substances, especially caffeinated is available. If anyone wants to take beverages, citrus products and pepa look at those pelvic stimulating permint that actually can give women devices or the things we talked about, the sensation, “I have to go.” visit my vaginal boot camp column on speakingofwomenshealth.com.


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Little for Pink Pill

Women’s Libido Under Debate Flibanserin is a new FDA approved medication for low sex drive in women. How effectve is it?

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t the recent American College of Obstetricians and Gynecologists (ACOG) meeting in Washington, DC there was a panel debate about the pros and cons of a new “Viagra” for women called flibanserin and sold under the name Addyi.

The question being asked was, “Should you prescribe this medicine,” and the feelings were very much like this election year – very divided. Here’s a little background. The drug company Boehringer Ingelheim (BI) first developed the pill as an antide-


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pressant, but never sold it for that. Since the women in the original study noticed a slight improvement in libido, BI decided to market the medication for low libido. On June 18, 2010, a federal advisory panel to the U.S. Food and Drug Administration (FDA) unanimously voted against approval of flibanserin without more studies, because they felt the benefits were not worth the risks (more on this in a moment). BI decided not to invest more money in the medication and sold it to a company called Sprout, which did additional studies and resubmitted the medication to the FDA. On June 4, 2015, the FDA Advisory Committee recommended approval of the drug with the requirement that women be informed of the drug’s side effects. On August 18, 2015, the FDA approved Addyi (flibanserin) for the treatment of

premenopausal women with low sexual desire that causes personal distress or relationship difficulties. A lot of publicity and a lot of social activism followed to give women equal access to a pink pill just like men had their blue pill. With all the excitement about the potential benefits, the drug seemed it would be a blockbuster and on August 20, 2015, just days later, Valeant Pharmaceuticals and Sprout Pharmaceuticals announced that Valeant would purchase Sprout for approximately $1 billion in cash, plus a share of future profits based upon the achievement of certain milestones. So far it has been all about the money. But what about the sex?


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Here are the pros: • Increases the number of “satisfying sexual experiences” from 2.8 to 4.5 times/month compared with those taking a placebo who experienced an increase from 2.7 to 3.7 • Addyi reduced distress due to sexual desire in all trials • The Female Sexual Function Index (FSFI), a tool that measures sexual desire, increased statistically significantly in all studies

Addyi is an imperfect medication, but it does offer women an option if they have a low libido Here are the cons: • The medication had to be used daily, not just before sex like Viagra • Some women experienced dizziness, nausea, feeling tired, sleepiness, and trouble sleeping. • Drinking alcohol while on flibanserin may result in severely low blood pressure that produced symptoms after only 2 glasses of wine (in 17%) • Cost is about $800/month • Doctors must take a short certification process to prescribe it so not everyone is able to prescribe it and patients need to submit a written agreement to not drink alcohol while taking it So you can see why there was debate at the ACOG meeting. Addyi is an imperfect medication, but it does offer women an option if they have a low libido. It’s not for everyone; but for some, the value of taking it makes a huge difference in their lives.


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Yoga and Menopause My Menopause Magazine

Mache Seibel, MD

Yoga is a wonderful alternative treatment for the symptoms of menopause. A new study helps determine if it is for you

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f you’ve followed my writing, you know I’m a huge fan of yoga. I’ve even written a book about it with Hari Kaur Khalsa called A Woman’s Book of Yoga. Now a short study in the


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journal Menopause has added some interesting science to show how yoga can benefit women in menopause and improve their quality of life. The study was an early one and only involved two women in menopause who were not taking any hormone therapy or supplements, not obese and did not have any chronic illnesses. They attended regular yoga classes with a certified yoga instructor for one hour twice a week and had never done yoga or meditation before participating in this study. The researchers found that these two women increased their estrogen levels (estradiol) from postmenopausal levels to levels typically only seen in women taking estrogen (pretreatment levels were <10 pg/mL and 17 pg/mL

Yoga increased estradiol from postmenopausal levels to levels typically only seen in women taking estrogen and after 4 months of yoga were 94 pg/mL and 137 pg/mL respectively for the two women) and using a type of test called Quality of Life Questionnaire, their quality of life improved. Although this is a small sample size, it really suggests how beneficial yoga may be for women in menopause. The authors speculate that the lower stress and lower stress hormones that occurred as a result of doing yoga caused the changes in estrogen and improved quality of life. Whatever the reason, this preliminary study makes yoga seem like a great choice for women whether or not they are taking estrogen to improve their menopause experience.


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A Hot Tip to Improve Menopause:

Teach Your Spouse About It You’re trying to make sense of the changes in menopause. Would it make a difference if your spouse had a clue?

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ot flashes, brain fog, vaginal dryness. You’re trying to make sense of all these changes and you’re pretty certain your spouse hasn’t got a clue. You’re probably right. But even if he did, would it make a difference? A recent study in the journal Menopause suggests that it would!


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This may surprise you, but the women whose husbands attended the menopause training had a significantly improved quality of life. The women whose husbands did not attend the Women whose training showed husbands attended no difference in menopause training quality of life.

One hundred women between the ages of 45 to 60 and their spouses were included in had a significantly a study. Half the improved quality of life This could be a game changer. husbands attended If you think your three monthly trainhusband doesn’t get it, you’re probaing sessions about the management bly right. That can change with a little and health of menopause symptoms. education and make a huge difference The other half of the spouses did not in your life. Give it a try. Sign up for receive any training. Knowledge and my free on-line menopause training at understanding of menopause was asMenopauseBreakthrough.com‌ find sessed in all the spouses after three some comfortable chairs and bring months and all 100 women were asyour husband along. It could be the sessed for their quality of life before start of something fabulous. and after the three-month study.


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Got Questions? Ask Dr. Mache!

Tune in for the monthly AskDrMache.com HouseCall® • Thursday June 16th • Thursday July 21st • Thursday August 18th 9:00 pm EST/6pm PST

Bring your friends, ask your questions, get your answers. Go to AskDrMache.com for call in information and to submit your questions.


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Tips

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for

Better

Intimacy

If your love life needs a boost, here are 7 helpful tips to lift your libido

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f you are too tired for sex or have trouble getting in the mood, or you just want to add some closeness and intimacy to your relationship, here are 7 tips from certified sex specialist Susan Kellogg Spadt to help you get your mojo back.

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Use it or lose it. Stay sexually active. Weekly sexual activity with a partner, self stimulation or use of a dilator gets the blood flowing and keeps the tissues healthy, lubricated and able to stay elastic.

Weekly sexual activity gets the blood flowing and keeps the tissues healthy, lubricated and able to stay elastic


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2

Get some good vibrations. Changes in sensation can occur with perimenopause and menopause and a handheld or hands-free vibrator during sexual activity improve sensation and blood flow. It can also get you in the mood. Brands like Fiera, Magic Wand, We-Vibe, and Smart Wand are examples.

3

Show yourself some love. Keeping your body in good shape by exercising, eating healthy and lowering your stress will keep you feeling good about your body and more open to love making.

4

Have naughty thoughts. Sexually stimulating thoughts or reading erotic material 20 minutes several times a week helps women (and men) more easily get in the mood

Sexually stimulating thoughts or reading erotic material 20 minutes several times a week helps women (and men) more easily get in the mood

5

Don’t just do it; talk about it. Keep you partner in the loop about any pain, discomfort or concerns you might have. Being aware allows for adjustments to make things feel good again.

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Make a date. Don’t just hope tonight is the night (or isn’t). Set a time for some uninterrupted closeness. Plan a back massage, “touch time,” fondling or sex. When people are busy, schedules are full and it’s easy to go till you drop. Having a designated time is the best way to be sure you don’t run out of time.


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News You Can Use

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Highlights from ACOG

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rs. Mache and Sharon Seibel recently attended the annual meeting of the American Congress of Obstetricians and Gynecologists in Washington, DC where there were many important topics covered. Watch these videos to get up to date with “News You Can Use.”

Should women in menopause use testosterone? In an interview with Dr. Jim Simon, a Clinical Professor from George Washington School of Medicine in Washing-

ton, DC, the feeling was very positive. Women who would benefit most are those who go into early menopause, who have low energy or low libido, who are losing muscle and gaining fat, or who have had their ovaries removed. The reason: your ovaries make most of your testosterone and removing them or early loss of them due to early menopause or taking medications that block hormone production sends levels to near zero – and that may be too low to optimize your life. Click below to listen to our interview with Dr. Simon.


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New laser treatment for dry, sites across the country. It uses the same laser technology used for the painful or irritated vaginal tissues. If you are a women struggling with face and neck but adapted to the dry, painful or irritated vaginal tissues sexual tissues. It works by causing due to low estrogen, or some types new blood vessels to come into the of itching of the vulvar skin around tissues, which helps to combat dryness, painful sex, and some forms the lips of the vagina, you know how of irritation. The procedure is done in challenging this can be. Estrogen the office, takes can be a very only minutes, helpful and reis painless, and storative treatA new type of laser must be 3 times ment, but not treatment called Mona over 4-6 weeks. every woman Lisa Touch helps to After a year, you can or will take combat dryness, painful may need a one estrogen. So sex, and some forms of time “touch up.� what else is vaginal irritation Unfortunately, not there to try? yet covered by A new type insurance. Prices of laser treatment called Mona Lisa vary. Click below to watch the video Touch is now available in selected interview with Dr. Mickey Karram.


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The Impact of One Person I went to hear a lecture by Dr. Earnie Bodai, a general surgeon who is responsible for the post office issuing a stamp to bring awareness to breast cancer. I was not expecting much from this discussion; why was it even being given. But I was pleasantly surprised. This was a powerful discussion of one man’s mission to convince a resistant Congress of the United States to get behind a postage stamp that would bring attention to a very important

The breast cancer stamp has generated over $85 million for breast cancer research disease. He faced many closed doors and overcame much resistance. And to my surprise, this beautiful stamp also has generated over $85 million for breast cancer research. Watch this video. It’s very powerful. It’s inspirational because it shows what one persistent and dedicated person can accomplish.


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Simple Exercises Combat

Osteoporosis Thinning bones are a major risk factor for women in menopause. Here are some helpful tips to make exercise safer and more effective

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steoporosis is known as the silent disease because most women don’t know they have it until they either break a bone or get a bone density test, which is often done after they fracture a bone! Some thinning of the bone is called osteopenia; osteoporosis means enough bone is lost to cause a significant risk of breaking a bone. As important as it is to work out when you have osteoporosis, it’s equally important to know what movements are safe for thinning bones.Â


My Menopause Fitness SIGNS AND SYMPTOMS OF OSTEOPOROSIS • Back pain, caused by a fractured or collapsed vertebra • Loss of height over time • A stooped posture • A bone fracture that occurs much more easily than expected If you have osteoporosis, it’s important to remember not to round your back. Some of my patients that I have on my caseload fractured their back bending down in the shower. Yes, if you have thinning bones, fractures are not always caused from a fall. Fractures can be caused from the wrong move. You’re better off investing in a $10.00 reacher so you can pick up items without rounding your back. Be sure to talk with your healthcare provider about best treatment options and taking supplements such as vitamin D and calcium. But In the mean time, bone-building exercises are vital for bone strength as is talking. Since walking for bone strength is easy and fun, it’s a good option for bone health. Sometimes those Spring showers can stop the best of intentions of going for a walk outdoors, so if you don’t have much space in your home, here’s four fabulous walk moves to help you get stronger bones in a small space. Put on some walking music and enjoy!

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March in Place

If you have osteoporosis, marching in place is a terrific way to build strong legs. Begin with good posture. Keep you back upright, chest lifted and raise your knees as high as you can without rounding your back. Do this for 5 minutes.

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Walk in Place

Walk in place by swinging your left arm forward and tapping your right toe forward followed by swinging your right arm forward and tapping your left toe. Swing your arms and make sure to keep your elbows close to your waist. Do for 5 minutes.


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Side Steps

With your back upright, shoulders slightly back and eyes looking directly ahead, step your right leg to the side. Bring it back to center and repeat with your left leg. Do for 5 minutes.

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The Hot Years

Back Steps

Suzanne Andrews Functional Fitness Tip To increase the intensity and add weight-bearing resistance to your walk, use 2-3 pound dumbbells and ankle weights according to your tolerance level. Suzanne Andrews founded Functional Fitness in 2008, the most popular fitness series for boomers and seniors broadcasting on over 159 Public Television stations throughout the US and Canada. Read Suzanne’s inspiring comeback story of how she survived a near fatal accident, From Deaths Door to Producing a National Fitness Series. Feel free to send Suzanne a message here.

Step back with your right leg followed by your left leg. Make sure to keep your foot in line with your hip. Tighten your buttocks as your bring your leg back and you’ll lift your backside too.

Get Suzanne Andrews Get Stronger Bones DVD that includes her osteoporosis-walking workout at www.amazon.com/Suzanne-Andrews-Stronger-Workouts-Osteoporosis/dp/B01BM2X6GY


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Find out how much your menopause symptoms impact your health, your happiness and your life.

Click here to take the free Menopause Quiz. It only takes a minute, then watch your email for a summary of your results and some suggestions on next steps to support you. Your menopause mentor, Mache Seibel, MD


My Menopause Mind

The Hot Years

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Change Your Negative Mind

Into A Positive One

Ed and Deb Shapiro

It not always easy to stay positive, but it is always benenficial when you do

I

sn’t it amazing that a water lily doesn’t grow in a pure mountain lake but in murky, muddy and dank pond water thick with weeds, and yet its beautiful flower appears on the surface totally pristine? All life starts in the dark, either in the earth, mud, or in the womb: the darkness contains the nourishment needed for life to emerge.

This is important as it shows how all the mud in our lives — all the difficulties, fears, concerns, doubts, insecurities, hurts, conflicts, everything that seems so impenetrable and difficult to wade through — is actually the very stuff needed for growth. Without it we would have no ground, no strength, no nourishment. That’s why we can’t just make the darkness disappear or deny its presence.


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The choice is to get stuck in the mud or to use it as nourishment; to let our lives go by in a dream or to awaken with awareness; to wallow in self-pity, hopelessness, failure, procrastination, and the longing for things to be different, or to find a deeper acceptance for things just as they are. Our ability to use the mud as our means for growth will determine the strength of our plant, for the stem of the lily symbolizes our intention — a pledge to our sanity, to our awakening. When our intention is inner peace and unconditional happiness then we will slowly emerge from the mud, our roots always being fed by it, the bud of the flower heading for the sun. We need never be concerned about the flower opening for that happens by itself as a natural response to the light. Just as the stem uses the mud to produce a beautiful flower, so the transforming

It is the irritation of a grain of sand that causes an oyster to make a pearl: no irritation, no pearl power that can take a difficult or negative emotion and turn it into something positive and uplifting is within us all. Tibetan teacher Chogyam Trunpa called it the power to turn shit into gold. A peacock eats poisonous snakes and transforms that poison into beautiful of iridescent feathers. It is the irritation of a grain of sand that causes an oyster to make a pearl: no irritation, no pearl. Can you transform your irritation — all the doubt, fear, anger or frustration — into pearls of wisdom? We were sitting in a coconut grove, the sun shining through the broad, flat palm leaves. “Are you happy today?” As the monk spoke he broke into a wide grin from ear to ear, white teeth glistening in his crinkled, brown face, illuminated by his orange robe. “Are you happier today than you were yesterday?” Despite his humorous tone his question was a genuine one. A group of us were in retreat and had been practicing meditation all that day and all the previous day and there were eight


My Menopause Mind

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more days to go. If we weren’t beginning to feel happier as a result, then what was the point of being there? Every day for ten days he asked us the same question. And each day it drew us deeper into looking at ourselves while also highlighting our concerns, doubts and conflicts, how difficulties can actually feel more real and meaningful than joy, how hard it was to trust happiness, even that we had forgotten what happiness meant. What our Thai monk was telling us, in his own way, was that the very nature of life includes change and unfulfilled desire and the longing for things to be different from how they are, all of which brings discontent, sadness, and even mental illness, but that happiness was our birthright.

“What is this nature?” Achaan Maha Dharma Tam asked. “Look at how the rain falls to the ground and makes muddy water. And how the coconut tree takes that muddy water all the way up its long, long trunk to make sweet coconut milk. What is this nature that can take muddy water and make sweet coconut milk?” No one can change your negativity for you. We can change the way we look, where we live, even who we live with, but unless we connect with who we are inside then none of those external changes will make much difference. The commitment you make is not to anyone else — not to a teacher or even to your family — but it’s a commitment to a far deeper joy and happiness within yourself. That has to be made by each one of us. Can you turn muddy water into sweet coconut milk?


My Menopause Musing

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Rocks and Ripples The way we handle problems has a lot to do with the impact they have

O

ne day I was walking around a pond and picked up a rock and threw it into the water. At first I watched the rock as it found its way to the bottom. And then I began to look at the surface of the pond. The same rock that fell like a weight also caused ripples on the surface of the pond. It made me think about how people talk about their problems: weighed down, heavy, the weight of the world. Clearly problems are something many people carry with them. And like that rock I threw into the pond, if the problems continue to be carried, they can cause a person to reach “rock bottom.”

And like the rock, problems can also have a second way they create an impact; that is on the people around us. When we are troubled, our behavior has a ripple effect. It can splash those next to us and send out a wave that affects everything and everyone in our pond. It’s often not possible to make our problems go away. But we can control the size of the splash and the ripples. Sure misery loves company. But as you deal with the things that are weighing you down, take a deep breath and consider those around you. What’s going on in your pond and what impact are you having?


My Menopause Quote

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You may be disappointed if you fail, but you are doomed if you don’t try.

Beverly Sills

CLICK HERE to enjoy the Song of The Month. I wrote Summer Day to celebrate the joy of Summer. It always makes me feel happy and momentarily carefree. To listen or purchase this or other of my songs or CDs visit www. DoctorSeibel.com/store/cds. Every effort has been made to ensure that the information contained in this magazine is complete and accurate. However, neither the publisher nor the author(s) is engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions contained in this magazine are educational and not intended as a substitute for consulting with your physician. All matters regarding health require medical supervision. Neither the authors nor the publisher shall be liable or responsible for any loss, injury, or damage allegedly arising from any information or suggestion in this magazine. The opinions expressed in this magazine represent personal views of the author(s) and are not a substitute for medical care. All content in this magazine is Copyright Š HealthRock, LLC


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Exercises To

Strengthen Bones

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Tips for Better Intimacy

How to fix a leaky bladder

Dr. Holly Thacker

No 33

Flibanserin:

The “Little Pink Pill” for women Yoga

and Menopause

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