The Hot Years Magazine Issue 41

My Menopause Magazine

AntiAging Exercises

Josie Gardiner

Co-Founder Zumba Gold on Why You Should Keep Exercising

N 41 o

Cardiac Risk Factors

Know Your Numbers

Finding Your

Lost Libido

+

Are You At Risk For Osteoporosis

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The Hot Years

No 41

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My Menopause Magazine

In this Issue: Josie Gardiner

Josie Gardiner: Why You Should Keep Exercising.

Cover image with Zumba Gold Co-Founder Joy Prouty Finding Your Lost Libido

Listen up to Prevent the Silent Disease Osteoporosis

What You Should Know About Fat In Your Blood

A New Estrogen Alternatives Now Available

Are You Feeling Pressure to Lose Weight?

Recipe Strawberry and Lime Jelly Mousse

Stay In Shape With These AntiAging Exercises

Adam and Your Atoms

Editorial

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The

Summer Issue Get the latest tips on exercise, weight control, symptom relief, heart and bone health and more

I

t’s Summertime and that means getting out your swimsuit. And this issue of The Hot Years has some terrific articles to help you look and feel good wearing it.

about a new estrogen alternative for hot flashes and other symptoms of menopause, and a recipe from a new best selling book on balancing your hormones with food.

We’ll introduce you to the co-founder of Zumba Gold, one of the most popular and effective exercise methods for women over 50, and include some easy to do and highly effective antiaging exercises.

There’s also a few other surprises in store for you in this issue of The Hot Years. Enjoy it and share it with your friends by sending them to www.HotYearsMag.com.

You’ll discover tips to help you find your lost libido, protect your bones from thinning, drop weight from your belly, and protect your heart from developing hardening of the arteries.

Since Summer can increase hot flashes, we’ve included an article

Yours in good health, Dr. Sharon Dr. Mache

Editor

Associate Editor

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Josie Gardiner

Zumba Gold Creator Josie Gardiner shares her journey from the Boston Ballet to Zumba Gold and beyond, and the results have helped millions of women around the world.

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umba Gold creator Josie Gardiner is passionate about helping women maintain their core strength and balance throughout life. Her innovative programs and teaching methods have earned her numerous awards including IDEA Instructor of the Year, 2002, and the American Council on Exercise Instructor of the Year, 2005. Josie shares how she helped create one of the most successful dance and exercise programs on the planet Dr. Mache Seibel: Josie, I’m curious how you got started in dance?

Josie Gardiner: From the time I was 11 until I was 21 years old, I danced with the Cambridge School of Ballet. After that I studied at Boston Ballet for 11 years under George Balanchine during the time of Virginia Williams, until a pulled groin muscle curtailed my ballet career.

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At college I played varsity field hockey, varsity lacrosse, and varsity basketball, so I started doing sports that I had never really done before because I was always dancing. Then I got married at 23, and my husband was stationed in Panama for a year. When we came back, he went to Harvard Business School, and then worked for an investment company in Lima, Peru, for about four years. While I was there, I had a baby and got out of shape, so I went to a ballet school just to get back into shape.

programs. We did the trainings worldwide for 25 years. I hooked up with a wonderful woman named Joy Prouty who was a member of The Rockettes.

Dr. Mache: The ones that kick their legs in Radio City Music Hall?

Josie: Exactly. Joy just went to her 50th reunion of being a Rockette.

She’s 76 years old now. Joy and I worked together on many projects, but deep in our heart was the 50 to 80 plus market. For the past 25 years we’ve been developing exercise DVDs, music CDs for instructors, chair programs, and light aerobic programs.

We did eight DVDs for Fit Over 50 with the American College of Sports Medicine’s Healthy Learning Series. We feel like we were really in the right spot at the right time as the baby boomers were aging.

Everybody wants to dance and Zumba Gold is for everybody

In 1976 they asked me if I would consider teaching a dance exercise class for all the expatriate United State women that were there, and I said sure, even though I had not idea what I was going to do. So I started teaching a dance exercise class that I made up. After we moved back to Beverly Farms, Massachusetts, I had many friends ask me if I would teach a dance exercise class, so I opened a studio in 1978. In four months, I had 350 students who came two or three times a week, and I had that studio for about 17 years. Then in 1985, I became a Master Trainer for Reebok International and was on the original team of 13 that wrote the manuals and made up step, and walking, stretching and flexible strength

Ten years ago, we got asked by Zumba International, the dance company, if we would help develop a program called Zumba Gold. That’s a dance program geared towards the 50, 60, 70, 80 plus. We even do it sitting in a chair. We developed the program with Beto Perez, the head dancer. That program is owned by Zumba Internation-

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al. Worldwide, we’ve trained about 50,000 to 60,000 instructors , and we have 40 international trainers teaching that program. It’s a great program because everybody wants to dance and this program is for everybody.

Dr. Mache: If you say Zumba or Zumba Gold, people know what you’re talking about across the country and even across the world.

Josie: We’re in 189 countries, with over 12 million people a week doing Zumba.

Dr. Mache: Full disclosure, I came to meet Josie because she is teaching a class that my wife attends, and Sharon says, “I have this amazing teacher, and she was a founder of Zumba Gold.” A lot of people think going to gym is kind of unpleasant, and you have developed something that really makes it a fun and effective way to keep in shape.

Josie: I’ve taken a little bit of yoga, a little Pilates, a lot of dance moves, and a lot of strength, balance and stability moves and combined them into a flowing class we call Core Synergy or Core Strength. There’s a reason why I do the movement pattern. I’m not just doing things. I’m trying to really focus on core strength, on glute strength, on balance strength, on leg strength because as people age, if they have strong legs

I’ve taken a little bit of yoga, a little Pilates, a lot of dance moves, and a lot of strength, balance and stability moves and combined them into a flowing class we call Core Synergy and flexible ankles, they’re going to be able to get up and down off a chair for the rest of their life, or out of a bathtub, or off the floor.

Dr. Mache: For a lot of women who fall down, especially as they get older, they have to push a button for help to come because they literally can’t get up off the floor.

Josie: They can’t. In 1997, I was 51 years old, and I was diagnosed with a very aggressive form of uterine cancer. I was going to be at a Reebok training program for Cycle Reebok in L.A. I went to see my gynecologist I’d seen a week before with a normal Pap smear and he said, “Well, I’m just going to do a biopsy because you’re going away.” That was on a Friday, and on Monday, he called and said, “Cancel your trip. You’re going to have surgery on Thursday. I’ve already scheduled you.”

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You’re a doctor, so you’ll know. I had a papillary serous carcinoma, and I had a radical hysterectomy five days later. Because of the type of tumor, they decided that they would do full torso radiation for eight weeks. This was 21 years ago. Then I had internal radiation in the hospital. When I finished my cancer treatment I was so weak and had lost so much weight I couldn’t even dry my hair. For the first time in my life, I was not a fit person. I had always been a dancer, an athlete, a trainer. It was an interesting experience because I think I learned what it was like not to be fit for the first time in my life.

I had a real empathy for that, and when I went back to start training again I realized how I had to lay out a class so that everyone could do it and be successful. So I changed as an instructor because of my illness. And I wanted to do something to give back.

I was asked by the American College of Sports Medicine to give a lecture on getting back in shape with exercise after cancer. About 400 people piled

When I finished my cancer treatment I was so weak and had lost so much weight I couldn’t even dry my hair.

into the room. After the talk, I thought, “Well, if I’m going to really develop a program like this, I need to be involved with a team.” So Joy Pouty and I teamed up with medical writer Francesco Coltrera and Dr. Carolyn Kaelin, who was the head of the Breast Center at the Brigham & Women’s Hospital.

Dr. Kaelin wanted to offer a program to help breast cancer patients get back into shape, and she wanted that program to be accessible to everybody and not for a lot of money. We started working on our first book, “Breast Cancer Survivor’s Fitness plan,” and while we were working on it, she came down with breast cancer.

Our book got put on hold for about five years while she wrote “Living Through Breast Cancer.” When she came back, we went back to work on our book. And actually, the experience that she’d had plus the experience that I’d had made our book even better because now we were looking at it as a cancer survivor. We wrote “Harvard Medical School’s Breast Cancer Survivor’s Fitness Plan,” which is available on Amazon.

Joy and I did a series of workbooks for Harvard: the “Workout Workbook,” “Core Training,” “Stretching,” and “Balance Training.” Then we did the “Joint Release Workout Workbook”

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I don’t think about age.

It’s about what can that person do on that day. for exercise for the ankle, the shoulder, the knee, the hip, and the wrist and “Gentle Core” for the 50 plus market. We truly believe that exercise is for everybody, and you need to do it always. If you can figure out how to modify the exercises to fit the needs of the participants, then you’re going to be successful.

Yesterday I trained my oldest client.

He’s 94. This morning I trained my 88-year-old. I’ve been training her

for 20 years. My oldest client passed away at 102. Someone asked me one day, “What do you do with these people?” and I said, “I don’t think about age. It’s about what can that person do on that day.” Having been in the industry for so long, Joy and I know which exercises people can do with quality and form and really see results that are functional, meaning these exercises are going to enhance their activities of daily living and that’s probably one of the key things.

For more about exercises, read the follow- up article later in this issue.

Click Here to find out more about Josie’s books and videos.

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Finding Your

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Lost Libido

Are you wondering where your mojo went? Do you feel disinterested when your partner suggests a romantic evening alone? If you answered yes, you are not alone. Read on...

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ccording to Dr. James Simon, Clinical Professor of Obstetrics and Gynecology at the George Washington University, “It’s perfectly natural that women lose some desire and spontaneous interest in sex at midlife.

This has been shown in a number of studies - about 40% of women experience this.”

“We think it may have to do with a decrease in fertility and the hormones related to fertility.

As fertility goes down, spontaneous interest in sex tends to follow.”

Often times the partner

It’s perfectly natural that women lose some desire and spontaneous interest in sex at midlife. About 40% of women experience this. also experiences a decrease in desire and they are on the same wavelength, so there’s no discord. “But if the partners are out of sync, this can lead to tension, distress, or even concern in the couple’s marriage or relationship.”

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Unfortunately, many women blame themselves. They turn their lack of interest inward, assume it’s their fault, or they did something wrong, or they have something medically wrong.

Most women feel uncomfortable discussing this with their healthcare provider. And most healthcare providers don’t bring up the topic either.

Most women feel uncomfortable discussing sex with their healthcare provider.

And most healthcare providers don’t bring up the topic either.

That’s the real problem. If noone is talking about it, sexual problems remain a secret, which makes it impossible to address.

and why it works, and what you can expect for an outcome.

This leaves women feeling like they’re on their own and trying to figure it out alone. According to Dr. Simon, “Most women reach first for some kind of supplement or something they get off the Internet.” Most of those treatments have absolutely no information that’s credible to suggest that they work. I would say further, none of them have been adequately tested to prove that they work.” Clearly, if you want to use an over the counter supplement, or one you’ve purchased over the internet to increase libido, make sure it comes from a credible source and you understand how

The good news is there are effective treatments. But first it’s helpful to understand the underlying issue – whether it’s a hormonal issue, a medical issue, an aging issue, a psychological issue, or a relationship issue. And it may be a combination.

According to Dr. Simon, “Whatever the underlying cause, it often becomes multifactorial because people don’t have sex in a vacuum. If they’ve lost interest, yes, it’s a problem that they have.

But their lack of interest

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may spill over into their relationship or how their partner approaches them in the sexual arena.” It makes sense that if the cause is multifactorial, then correcting the problem will likely require a more holistic approach.

The first step, as difficult as it may seem, is to break the silence. If you’re able to, talk with your partner about how you’re feeling, what things you would like to change to make sex more enjoyable, and share your plan to get help. Then a good next step is to talk with your primary care or gynecologist and ask if they are comfortable treating this. If not, ask for an appropriate referral. Depending on your needs, this may be to a specialist in sexual

People don’t have sex in a vacuum. If they’ve lost interest, it may spill over into their relationship medicine, a reproductive endocrinologist, a psychologist, a psychiatrist, or a couple’s therapist. The important thing to keep in mind is that with treatment, it is possible to rediscover your lost libido and enjoy a renewed sex life.

Click below to watch Dr. Seibel’s interview with Dr. Simon at the North American Menopause Society annual meeting.

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What You Should Know

About Fat Your Blood

In

Dr. Maria Sophocles is a board certified OB-GYN in private practice in Princeton, New Jersey Dr. Mache Seibel: What should women know about when it comes to their cholesterol blood levels?

Dr. Sophocles: Cardiovascular disease is the #1 killer of women in America. There’s tremendous fear and a lot of media and medical attention on the diagnosis and treatment of breast cancer, but if you look at the numbers, cardiovascular disease kills about 10 times more women than breast cancer. In fact, cardiovascular disease kills more women than all cancers combined. About one woman per hour dies of heart disease.

And it’s a silent killer. A process that can begin in our 20s, in our 30s, in our 40s, and it’s accelerated by preventable things. Plaque builds up inside the arteries by a process called atherosclero-

Cardiovascular disease kills more women than all cancers combined. About one woman per hour dies of heart disease. sis. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. The plaque

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consists of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows the arteries. Atherosclerosis literally means “hardening of the arteries.”

Dr. Mache: So people can have heart disease beginning when they are younger, and it may ultimately be the thing that kills them when they’re 60 or 70 or 80. In fact, Bollywood superstar Sridevi Kapoor, 54, and British comic Emma Chambers, 53, died in the last year from heart disease at very early ages.

Dr. Sophocles: Right. The decision that our blood vessels make as to whether to get clogged and clotted or not is not always one we even have control over.

We can control diet. We can control our weight and our blood pressure and our blood sugar. We can decide whether to smoke or to eat healthy. But there’s also genetic factors that we may not even be aware of that can play an important role. So I think it’s very important for all healthcare providers to ask women about their family history.

Dr. Mache: What should women be asking their healthcare providers about their cholesterol levels? What blood tests should they get?

Dr. Sophocles: Just like most of us know our social security number, I think we should know our baseline cholesterol level. We all have heard the terms “good” cholesterol or HDL (High Density Lipoprotein) and “bad” cholesterol or LDL (Low-Density Lipoprotein). HDL helps to filter LDL cholesterol away from the artery walls and return it to the liver to be processed.

You should also be aware of your total cholesterol and triglyceride levels.

If your bad cholesterol is high, that is a predictor of cardiovascular disease, and so you might be thin and non-smoking, but if you have high LDL, that’s an independent risk factor for early heart disease, stroke and heart attack. A high “good cholesterol” is actually a good thing. It counterbalances a high “bad cholesterol.”

Total Cholesterol

HDL Cholesterol

LDL Cholesterol

Triglycerides

<200

≥40

<100

≤149

200-239

N/A

130-159

150-199

High

≥240

N/A

≥160

≥200

Low

N/A

<40

N//A

N/A

Good Borderline

Centers For Disease Control (CDC) (Values in milligrams per deciliter)

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Many women think that just because their cholesterol is normal, they can’t possibly be at risk. But a waist circumference above 35 inches is another risk factor

The other thing you really should always make sure your doctor knows is your family history. If you had a brother who had a heart attack at 54, don’t consider it a fluke. Consider it part of your genetic risk profile.

Dr. Mache: So family history, whether or not you smoke, your blood pressure, and your good, bad and total cholesterols levels are all important things every person should know about herself?

Dr. Sophocles: Yes, and I think it’s never too early to understand that. I myself, have something called familial

hyperlipidemia, and that’s a disease with genetic risk factors for heart disease. The receptors in the liver either do not work as well, or there’re not as many of them. This is much more common than we previously thought.

One in 250 people have this.

Dr. Mache: And the liver is the site where some of this cholesterol is actually produced?

Dr. Sophocles: Right, but cholesterol is also in our bowel from the food we eat, and there are medications we can take that don’t even go into the bloodstream. They just bind the cho-

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lesterol in the intestines and it passes out of the body. So there are super safe ways to reduce cholesterol without taking medications that go into the bloodstream.

But before you can worry about whether you need medications, you and your doctor have to have a mutual knowledge of whether you have risk factors, and what are they, and what are your cholesterol levels. And I don’t think it’s ever too early to know that.

Dr. Mache: Know your numbers.

Dr. Sophocles: Right, and know your risk factors. Many women think that just because their cholesterol is nor-

mal, they can’t possibly be at risk. But there are other risk factors, such as a waist circumference above 35 inches for women and 40 inches for men.

That’s its own risk factor. And waists often get bigger in peri and postmenopause. There’s more belly fat.

Dr. Mache: From pears to apples.

Dr. Sophocles: Pears to apples. If this sounds like you, and if it is you’re like many woman in America, we know that there is an increase in what we call visceral adipose tissue. That’s the fat around the viscera or organs inside our body, and that is another risk factor. If you don’t know your risk factors, you should talk to your doctor about it.

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Are You Feeling

Pressure

to

Lose Weight?

Are you struggling to get into your jeans? Do you have a closet full of clothes that are too snug? If so, you are not alone. According to the CDC, 67% of women are size 14 or greater.

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eight control is an ongoing issue for so many women, especially around perimenopause and menopause when the decrease in estrogen causes a redistribution of fat to the belly, making menopot and belly fat an almost universal complaint.

And even when people are comfortable in their own skin at whatever weight they may be, being overweight or obese is not just about looks.

Those extra pounds increase the risk of diabetes, high blood pres-

The brain doesn’t know the difference between hunger and thirst. So if your body is thirsty, it’s going to start screaming, ‘Starving! Famished! Ravenous!’

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sure, heart disease, joint problems, and cancer to name just a few.

So what can you do about this ever present challenge?

According to Barbara Schwartz, the CEO of Accu Weight-Loss, “The first step is to really know your genuine goal and where it fits in the priorities of your life. Why do you really want to lose this weight? Or, stated another way, what would it mean to you if you didn’t lose the weight?”

Her company’s approach to helping people with weight loss has three components: 1. Acupressure using beads that apply pressure on the ear lobe 2. Balanced nutrition and 3. Chi Gong (Qigong) breath She explains the process in detail in the podcast below. And it’s not just about what you eat; it’s also about what you drink.

According to Barbara, “The brain doesn’t know the difference between hunger and thirst. So if your body is thirsty, it’s going to start screaming, ‘Starving! Famished! Ravenous!’ You’re going to get a growling belly. Those are commonly signs that you’re mildly dehydrated, and water and electrolytes may be your answer, versus food.”

To make it easier to stay well hydrated, use bathroom size cups (3 oz or 5 oz) to do a shot of water every hour you’re awake.

Since some people don’t like to drink water, she offers a “Quick Tip” to make it easier to stay well hydrated, “Use bathroom size cups (3 oz or 5 oz) to do a shot of water every hour you’re awake. You’ll be drinking, depending on the size of the cup, between 48 and to 64 ounces of water a day, just by doing little shots.” “it’s a nice, simple way to introduce water into your diet. It’s not painful, because it’s not a lot of water. And, that small amount of water doesn’t make you run to the bathroom. We actually get better hydration from small amounts sipped over a long period of time taken in small amounts than guzzling a whole bottle.”

There’s a lot to consider when it comes to weight control. To listen to the full podcast with Barbara Schwartz, Click Here.

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Stay

In Shape With These

Anti-Aging Exercises W hen it comes to staying in shape, Josie Gardiner knows the recipe. It’s the four components of fitness - cardiovascular, strength/endurance, flexibility, and balance training. The following is excerpted from Josie Gardiner’s interview with Dr. Mache.

Ingredient 1 is walk, walk, walk to get your cardiovascular exercise. Josie thinks walking is one of the most underrated exercises - it’s free and you can do it anywhere. Use a pedometer, your phone or some type of device to count your steps and know how many you take on an average day. After that, try to increase it by 10% a day until you work up to 10,000 steps daily.

That’s about 5 miles.

Don’t worry about the intensity as much as the amount of time spent walking. It’s okay to start low and go slow. And it’s okay to break it up throughout the day. You’ll be happy to know that at the end of the year, you could be 10 pounds lighter just by adding 20 minutes of daily walking. A good target would be to go for a nice walk 5 days a week.

The second ingredient is strength training. According to Josie, strength staining is the magic bullet for the 50 plus crowd. As you age, you lose muscle and gain fat. Not only does fat burn less calories than muscle, which adds to weight gain, but also your metabolism slows down about 3% per decade. So overall your body is burning less calories with age. Building muscle

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with strength training helps counteract this change in metabolism. Strengthening exercises could be done two or ideally three times a week with a day of rest in between.

nate raising of the opposite arm and leg so you look like a dog pointing), and a plank (that can be done either as a high push up or on elbows and knees to vary difficulty).

“If I told you to do one exercise for the rest of your life, I’d tell you to sit in a chair and stand up and sit down and stand up and sit down and stand up,“ says Josie.

She recommends starting with 5 in the morning and 5 in the evening and building up to 10 each time. This is essentially a squat and will keep your legs strong, which is essential for being able to get up when you fall or get up off the toilet when you are older.

Flexibility exercises are the third ingredient to fitness and the key is to warm up first. Josie recommends not stretching when your body and your muscles are cold. “Get up and move around the house, or take a hot shower, or dancing and then stretch.”

Walking is one of the most underrated exercises - it’s free and you can do it anywhere

Josie also recommends using free weights (two pound soup cans can work as a substitute) to do some simple exercises that strengthen your back because your postural muscles help you stand straight and take weight off your bladder. You can start off with 10 and build up to 15 repetitions two to three times a week. Additional favorite core strengthening exercises include bridging, the bird dog (getting down on all fours with alter-

One simple and effective flexibility exercise is just lying on your back and putting one leg in the air so you’re stretching your hamstring. Bring that leg back down to the floor and raise the other one. Alternatively, lie on your back with your knees bent, put one foot on top of the other knee and with your arms, pull your legs up so you’re stretching through your buttocks.

That’s called the letter four stretch or the pretzel stretch. There are a number of stretches available with pictures online, and Josie wrote a Harvard Health series of books, each with about 60 to 70 exercises.

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The final ingredient is balance training. This will help prevent falls as we age. You can benefit from walking a narrow path like you’re walking on a tightrope, placing one foot in front of the other. There’s also an ankle strengthening exercise where you lift up on your toes, heel raised. Another would be single leg stands; just bend one knee and try to stand for a minute on the other foot. But don’t try it alone if you’re not holding onto something. Try to work up to 60 seconds.

Here are examples of exercises you can do at home to get you started.

Standing Biceps Curl - This exercise works the biceps, the muscles on the front part of the upper arm.

Stand tandem with one foot in front of the other to challenge your balance and engage your inner thighs. Please see picture. Keep your wrists firm and elbows tight to your sides. Exhale on the lift and inhale as you slowly lower the weights. Two counts up and two counts down. Repeat for 10 - 15 repetitions.

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If I told you to do one exercise for the rest of your life, I’d tell you to sit in a chair and stand up and sit down and stand up and sit down and stand up Exercise to work the front and middle of your deltoid muscles in your shoulder.

Begin with a single leg stance to challenge your balance (see pictures on right).

Lift weights up to shoulder height with thumbs up. Exhale on the lift and inhale as you lower the weights. Two counts up and two counts down. Repeat for 10 - 15 repetitions.

For more exercises, Click Here to find out more about Josie’s books and videos.

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Listen up to Prevent the Silent Disease

Osteoporosis Dr. Michael McClung, from the Oregon Osteoporosis Center in Portland, Oregon.

Dr. Mache Seibel: You headed a scientific session today on bone loss in menopausal women. How would a woman know that she was at risk for losing bone?

Dr. McClung: All women after menopause are at risk for losing bone. The estrogen deficiency creates a window of rapid bone loss that lasts for several years, and all women are subjected to that unless they are taking estrogen.

Then as both men and women age, bone loss is a part of the aging process. One can’t feel that they’re losing bone, but it happens in all of us.

Dr. Mache: So it’s a silent problem.

How would they test to find out if that was the case?

Dr. McClung: There are two or three ways that women can know whether they’re at risk or have osteoporosis.

The gold standard is to get a bone density test. We can measure the bone mineral content in the spine and in the hip and diagnose osteoporosis. Any women who has had a fracture of their forearm, of their ankle, and certainly a fracture of the spine or hip, should be evaluated. There are other risk factors such as simply being older. Osteopo-

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rosis is much more likely in women over the age of 65 than it is in 50 year old women. Those who are thin, and those who have a family history of hip fracture or osteoporosis are also at risk.

cause are risk factors for bone loss.

Women who are healthy are easier to understand, and there, age, bone density, prior fracture history, and family history are the big ones that we think about.

Dr. Mache: What about smokers?

7 Medications That can

Dr. McClung: Smoking and drinking heavily are modest risk factors for osteoporosis. The big three risk factors are 1) having had a fracture, 2) being older, and 3) having low bone density.

Dr. Mache: At what age would you tell people they ought to consider getting a bone density or some other indicator of bone loss?

Dr. McClung: Indications for bone density are: 1) Women ≥ age 65, or postmenopausal women who are 2) < 65 and thin, 3) Have had a fracture or have a family history of osteoporosis, or 4) Have some other disease that could alter or damage bone health. For women who’ve had a prior fracture or who have a strong family history, the time to have the bone density test done would be at the time of menopause.

Dr. Mache: Are certain medications like steroids or other medicines a risk factor?

Dr. McClung: The risk factors for osteoporosis are a long, long list. Taking steroids and being sick from almost any

Cause Bone Loss and Bone Breaks

Synthetic Glucocorticoids (e.g. prednisone, dexamethasone) Prednisone 7.5 mg (or more) daily for 3 (or more) months (these do not have to be consecutive) in the previous year.

Breast Cancer Drugs Aromatase inhibitors anastrozole (Arimidex®), letrozole (Femara®) and exemestane (Aromasin®) prevent estrogen production and cause bone loss and increased risk of fractures, particularly at the spine and wrist.

“Heartburn” Drugs Proton pump inhibitors, such as Prevacid®, Losec®, Pantoloc®, Tecta®, Pariet® and Nexium®,are used to treat reflux, heartburn and ulcers. High doses used for several years can increase hip fracture risk in older adults.

Excessive Thyroid Hormone Replacement Elevated thyroid replacement in older adults can cause abnormal heart rhythms and muscle weakness, which

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increase the risk of falls and fractures. It can also lower bone mineral density and bone quality that can lead to fractures.

Anti-seizure and Mood-altering Drugs The anti-seizure drugs carbamazepine (Tegretol®) and phenytoin (Dilantin®) can reduce bone density by lowering vitamin D and absorption of calcium from the intestines. Mood-altering drugs can cause falls by causing drowsiness, confusion, or a blood pressure drop.

Blood Pressure Medication Some high blood pressure drugs increase the risk of falls and fractures in older adults during the first few weeks of treatment because of a drop in blood pressure. Be careful when first starting them.

All women after menopause are at risk for losing bone.

The estrogen deficiency creates a window of rapid bone loss that lasts for several years

Diuretics Diuretics, such as furosemide (Lasix®), increase urination and promote loss of calcium from the kidneys, leading to reduced bone mineral density at the hip and an increased risk of hip fracture within the first 7 days of use.

3 Other Drugs To Watch Out For 1. Acetaminophen (e.g. Tylenol®) after three plus years of use 2. Narcotic and opioid medications such as morphine may lead to dizziness or changes in balance that lead to falls.

3. Aluminum-containing antacids such as Maalox®, Mylanta®, Amphogel®, Gelusil® and Rolaids® may inhibit phosphate absorption from the intestine, which may reduce bone mineral density.

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Dr. Mache: Any other tips for women to protect their bones as they enter menopause?

Dr. McClung: All the general measures that women hear about all the time are always important. Get enough calcium and vitamin D, be physically active, avoid lifestyle factors like smoking that can adversely affect bone health. Whatâ&#x20AC;&#x2122;s really important to appreciate, though, is that those general approaches alone are not effective in preventing bone loss from happening.

The bone loss that happens at menopause is related to estrogen deficiency.

That interval of rapid bone loss lasts, on average, five or six years in individ-

ual women. So from the time women are 65, for example, the window of rapid bone loss has typically ended in otherwise healthy women. For women over 65, the lifestyle factors are effective in markedly slowing bone loss.

But those lifestyle factors have a much smaller impact on bone density during the years of rapid bone loss that are immediately after menopause.

Dr. Mache: Thatâ&#x20AC;&#x2122;s the time when maybe hormones might be helpful.

Dr. McClung: For women who come to menopause with a strong family history of osteoporosis or low bone density, doing something at the time of menopause when theyâ&#x20AC;&#x2122;re about to experience rapid bone loss is an opportunity that should not be passed over.

The bone loss that happens at menopause is related to estrogen deficiency.

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Estrogen Alternatives Now Available

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A New

I

f you’re suffering from menoreceptors that estrogen acts on so the pausal symptoms like hot flashes body thinks that it’s estrogen, but it’s not. and are looking for an estrogen When used for the management of alternative, meet Femarelle, the menopausal symptoms, about 70% of new “kid” on the block. According women studied had improvement in to Dr. Margaret Nachtigall, Assistant symptoms, but like Professor, OB/GYN most supplements, and Reproductive Medicine at NYU, Femarelle is a dietary It takes several weeks to know how Femarelle has been supplement that is effective it will be for available in Europe a mixture of DT56a each individual. and Israel and on(a soy extract) and line for a long time Since many womand will soon be flaxseed powder, and en who experience making its debut in acts as a selective menopausal sympthe United States. estrogen receptor toms either can’t or modulator (SERM) won’t take estrogen, Femarelle is a dietary it is helpful to have supplement that is a an additional estromixture of DT56a (a gen alternative option to discuss with soy extract) and flaxseed powder, and your healthcare provider. acts as a selective estrogen receptor modulator (SERM).

Click here to listen to Dr. Mache’s inAccording to Dr. Nachtigall, when takterview with Dr. Margaret Nachtigall and en orally by women, it acts on the same to get more information on Femarelle.

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Ask Dr. Mache!

Join the weekly Facebook LIVE HouseCall® The first Thursday of each month 9pm eastern, 6:00 pm pacific Ask Questions • Get Answers • Bring Friends Go to AskDrMache.com to submit questions in advance and join me at www.facebook.com/MyMenopauseMagazine

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Strawberry and Lime Jelly Mousse

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his is a delightfully refreshing dessert with no added sugar that kids devour in no time. An added benefit: Gelatin helps gut healing, skin elasticity, and nail and hair growth. Create your own signature creamy jellies using your favorite fruit. I’ve had lots of success in creating a banana, coconut milk, and chocolate jelly mousse or an orange and mandarin jelly made with freshly squeezed juice. Fruits that won’t set are kiwi, pineapple, papaya, and figs. If your strawberries are very tart, add a few more drops of stevia to sweeten the mousse.

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INGREDIENTS 1-pound fresh strawberries, stemmed 1 ripe banana, peeled and chopped ½ cup full-fat coconut milk 1 tablespoon freshly grated ginger root Freshly grated peel of 1 lime 20 drops liquid stevia (optional) ½ cup hot filtered water 1¾ tablespoons unflavored gelatin Add the strawberries, banana, coconut milk, ginger, grated lime peel, and stevia to the blender and puree until silky smooth, about 1 minute.

Transfer to a saucepan and heat the mixture until very warm but not yet boiling.

In a small saucepan, bring the water to a boil.

Remove from the heat and gradually whisk in the gelatin until fully dissolved.

SERVES 4 to 6

Slowly whisk the gelatin mixture into the strawberry mixture. If lumps are formed, transfer to the blender and puree until well combined.

PREP TIME 20 minutes

Pour into individual ramekins and transfer to the refrigerator until set, about 4 hours.

CHILLING TIME 4 hours

Keeps well in the refrigerator for up to 4 days. If not serving the mousse soon after chilling, cover the ramekins with plastic wrap.

EQUIPMENT High-speed electric blender or food processor, whisk

To learn more about cooking for hormone balance, visit http://cookingforhormonebalance.com/

Adam and

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Your Atoms Mache Seibel, MD

Living a long and healthy life requires developing good health habits. If you haven’t already, it’s time to get started.

E

ver since Adam took a bite of the apple we’ve known we’re not going to live forever.

(CLICK HERE to listen to Dr. Mache narrate this Podcast over a bed of his original music) But that doesn’t mean we have no control over the quantity and quality of our lives. It’s true no matter what we do we’re not going to live forever. But we can extend our lives by years or maybe decades if we live healthy lives.

As comedian George Burns said when he turned 100, “If I’d known I was going to live this long, I would have taken better care of myself.”

The real magic is in the quality of life people can achieve. It would be nice

if there were a silver bullet; something to take that would make life longer and better. Unfortunately, the only bullet is the reality of having to bite the bullet; change the fundamental habits by which we live. Lower stress, increase sleep, eat healthy, and exercise. Four steps on the ladder of life that take you to the next level.

Adam got it almost right. After a good night’s sleep with Eve, he woke up relaxed, put on his fig leaf, walked over to the tree of knowledge, stretched and climbed and got an apple, and ate a piece of fruit. Right idea. Wrong tree.

You can live a longer and healthier life. Your atoms can benefit a lot from Adam.

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The trick in life is learning how to deal with it.

Helen Mirren

CLICK HERE to hear the Song of The Month. To celebrate summer, listen to this original song by Dr. Mache called â&#x20AC;&#x153;Summer Day.â&#x20AC;? You can find this song and other similar health songs at healthrock.com/music/amp-up-your-health-3-cd-set 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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