The Hot Years™ - My Menopause Magazine

The Hot Years

TM

My Menopause Magazine

My Menopause Magazine

N 35 o

NAMS 2016

Hormone Therapy Position Statement

Dr. Mache’s Musings:

Renewable Energy

Heidi Houston Hot Flash Havoc

Meditation: Living a Mindful and Meaningful Life

During Menopause The Hot Years wins Digital Health Award

Top Bar | Tap & Hold the screen to show Home | Tap to return to the app home page

Howto

Read

This

Swipe Horizontally to go to the next page Tap & Hold the screen to show the pages Swipe Horizontally to quickly navigate pages Tap selected page to View

The Hot Years

No 35

TM

My Menopause Magazine

In this Issue: Heidi Houston discusses Hot Flash Havoc

Can Bisphosphonates Make Your Bones Weaker?

FDA Approves New Med For Painful Sex In Menopause

NAMS 2016 Hormone Therapy

Speed Weight Loss Using Weights

Position Statement

Grilled Orange Herb Chicken

Compounded Hormones Compound the Risks of HT

Meditation: Living a Mindful and Meaningful

Dr. Mache’s Musings:

Life During Menopause

Renewable Energy

Letter From the Editor

The Hot Years

TM

My Menopause Magazine

Lessons Learned from a

National Book Tour

O

ver the past months I’ve had the pleasure of speaking to women and healthcare professionals from Florida to San Diego, from Atlanta to Detroit, and many places in between. It’s all been part of the book tour for my best-selling book, The Estrogen Window.

I shared a lot of information and received some important information back in the form of hundreds of questions. The unfortunate truth is that women and many of their doctors are confused about and afraid of estrogen and hormone replacement therapy (HRT). And they have many unanswered questions about menopause. That translates into women not getting the information they need to make the best possible choices for their health.

Given that the average doctor’s visit lasts for only about eight minutes, it’s important to be a partner in your healthcare. And the only way to do that is to be armed with information when you go in for your visits.

One thing women enjoyed during my talks was gaining awareness and ac-

Mache Seibel, MD

cess to The Hot Years – My Menopause Magazine. We’re very proud that The Hot Years was just awarded a 2016 Digital Health Award, which honors the world’s best digital health resources.

I’m happy you are receiving this magazine. Let me know how it is helping you and what other stories would be helpful.

If you have friends and family transitioning into the hot years, please tell them about it. The subscription is free to help as many women as possible. And if you have a story about your menopause experience you would like to share with our audience, let me hear from you at info@MyMenopauseMagazine.com.

On behalf of my team and myself I want to wish you a healthy and happy holiday season and New Year.

Yours in good health, Mache Seibel, MD

The Hot Years

TM

My Menopause Magazine

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

Visit MenopauseQuiz.com to take the free Menopause Quiz.

It only takes a minute, then watch your email for your results and some suggestions on next steps to support you.

Your menopause mentor, Mache Seibel, MD

The Hot Years Featured Article

The Hot Years

TM

Hot Flash Havoc My Menopause Magazine

Meet Heidi Houston, Executive Director and Co-Producer of

A story of estrogen and its relationship to the women who need it and the doctors who prescribe it

T

here’s a new movie in town and it doesn’t feature any of the action film stars you may have heard about. It’s titled Hot Flash Havoc.

Dr. Mache: What led you to produce a film called Hot Flash Havoc?

Houston: In my early 40s, a doctor prescribed incorrect medication that forced me into early menopause. But I didn’t realize I was being forced into early menopause. I just suddenly started having a slew of symptoms, but not the typical symptoms.

First I started having headaches. Then I became depressed, so I was going to a doctor for depression. Then

The Hot Years Featured Article

The Hot Years

TM

My Menopause Magazine

within a month and a half, my feet and ankles began to hurt so badly I could barely move in the morning. I’d have to get up every morning and do a thousand stretches. So I went to several more doctors who wanted to put me on headache pills and antidepressants. Also, my cholesterol went way up, so they wanted to put me on statins. I refused to take all these drugs. I thought there must be some other reason this stuff was happening.

I did have mood swings, but didn’t connect them to menopause because I wasn’t having hot flashes.

Dr. Mache: So you’re going to one doctor for your bones, and one doctor for your mind, and one doctor for your heart, and one doctor for every other piece of you. But because you didn’t have hot flashes none of them suspected menopause?

Houston: Right. Not one single doctor put two-and-two together and suspected menopause. Each one wanted

I didn’t connect mood swings to menopause because I wasn’t having hot flashes

to put me on individual drugs. By the time I was 46, 47, I was miserable. I was firing people over the phone and my kids were threatening to move out.

So I called a friend who I co-founded the Aspen Center for Integrative Health with. She said, “I guarantee you, it has something to do with menopause.

We’ve got a woman coming to talk about that very topic.”

The speaker was an endocrinologist from Phoenix. She listed 40 symptoms that women don’t even know are signs of perimenopause, and talked about why women don’t know and why doctors don’t know. It was primarily because the WHI scared everybody from understanding menopause and/or hormones.

Dr. Mache: You’re talking about the Women’s Health Initiative study in 2002 that said, erroneously, that estrogen replacement therapy was responsible for breast cancer, blood clots, heart disease and a lot more.

Houston: Right. Halfway through the lecture I think, “Oh my god, this is a doctor I need to see.” So at the founder’s meeting that night I asked her, “What needs to be done? What do you need to get this information out?

I’ve been spending some time trying to find this kind of information.” She said, “To make a documentary. To educate

The Hot Years Featured Article

The Hot Years

TM

My Menopause Magazine

women on how menopause works, what the real answers are, what the truths are and what the facts are so they could make educated decisions.”

Four days earlier I’d started having hot flashes. I said “Can I come see you?”

She told me she was booked four months out, and at that very moment, I burst into a hot flash, with sweat running down my face and arms. She said, “Oh, dear, you’re in distress.”

I said, “You have no idea.” And she said, “I’ll see you next week.”

She changed my life in ten days. After doing tests and determining there was nothing wrong with me other than menopause, she helped me to where I had no headaches, no heart palpitations. The hot flashes went away within two-and-a-half to three weeks. I had no more joint pain. I felt like the person I probably would have been four or five years before. I wondered, if I’m fairly educated and have access to doctors and I couldn’t find any answers, how would the average woman on the street find any answers?

At that very moment, I burst into a hot flash, with sweat running down my face and arms.

Dr. Mache: So you found someone who explained the problem and gave you treatment that got you back on course and you had a message that you wanted to share.

Houston: Right. After a couple of days back home my 13-year-old son said, “Mom, I don’t know where you’ve been, but I’m really glad you’re back.”

At that point, I teared up and decided I had to make this movie.

Dr. Mache: Wow! Houston: I put together a business plan and a team. I called friends and acquaintances I knew cared about women’s health and I called people in the movie business. I hired one of the top investigative journalists in the United States to find out why women know nothing and why doctors know nothing about menopause and estrogen replacement. We put this movie together and we’re now on PBS, reaching up to 85 million households.

It’s an opportunity for women and men to get educated, because the movie isn’t just about hormones. It explains how the body works and why people are confused about menopause, what choices we have, how we find a doctor, how to get the help we need to help us age vertically, alert and sexual until we die.

The Hot Years Featured Article

The Hot Years

TM

My Menopause Magazine

The movie isn’t just about hormones. It explains how the body works and why people are confused about menopause…

Dr. Mache: There are 6,000 women a day entering menopause and there’s such a lack of information, it’s really important to educate women in as many different ways as we can. It’s one of the reasons I wrote my book called The Estrogen Window.

Houston: As we started working on the film, we found the information is there, in studies that are thirty and forty years old.

Dr. Mache: Some of it.

Houston: Some of it. But much of it is in study after study. The information that’s come out in the last ten years provides stronger reasons for women to understand what estrogen loss means to their bodies in their 40s, 50s, and 60s. If they don’t, they’re more likely to be the women who wind up in nursing homes early.

Those who take care of themselves and live better, eat better, and exercise more—they’re going to be the ones living to an average age of 83.

Dr. Mache: The title of the movie is Hot Flash Havoc, so let’s talk about hot flashes. Many people, including doctors, think hot flashes are just a nuisance that women have to grin and bear because they’re afraid if they take estrogen to treat them they’ll get breast cancer or have other problems.

But in fact, if changes in estrogen is having an impact on your ability to work, your ability to think and concentrate, on your love life, on your bone density, on the health of your heart and blood vessels, and on a spectrum of diseases and conditions, it’s not just a nuisance. Hot flashes are just the tip of the menopause iceberg.

Houston: Yes. Estrogen performs more than 400 functions in the body related not only to bone, joint, muscle and brain health, but also to mucous membranes. When you have a loss of estrogen, you don’t want things to shrivel up, so that sex is painful. Many people don’t think about why so many divorces happen between the ages of 45 and 55, but it’s usually because here’s this woman who doesn’t understand what’s happening to her, she’s

The Hot Years Featured Article

The Hot Years

TM

My Menopause Magazine

changing, she’s not as much fun, she’s tired. She doesn’t want to have sex.

She’s depressed. She’s yelling at people one minute, happy the next or completely sad the next. The husband is thinking, “What happened to my wife?

Who is this person? This isn’t who I married.” If they both understood what was going on and that they could fix it, I think couples’ lives and happiness would be better served.

learn the symptoms of menopause beyond hot flashes, so when they begin to age and think there’s something wrong, they know to see their gynecologist and ask, “There are these changes, things are happening. Does this have something to do with perimenopause or menopause?”

Let’s start treating the whole woman instead of one piece at a time.

I think couples’ lives and happiness would be better served if they understood menopause

Dr. Mache: It’s about helping people to optimize their lives, their health and their potential. It’s not for all, but estrogen is safe and beneficial for most women.

Houston: Yes. But it’s not happening on the outside where you could see it—there are things happening on the inside. With lower estrogen, bones start to deteriorate. There’s probably no question the risk of heart disease increases and cholesterol goes up.

We get dry eyes, dry noses. I think most women will become depressed to some degree, even if they’ve never had depression. Women need to

Dr. Mache: Exactly. You have to educate to advocate. If you’re not educated about what’s going on with yourself, you can’t advocate for yourself and get the things you need. One way to do that is to see Hot Flash Havoc. How can people find when it’s airing?

Houston: Go to www.hotflashhavoc.com and click on the PBS tab. It will show the schedule for the entire United States. And if you don’t see it showing in your area, get a group of women (and men) to call your local PBS station to ask for it. If you do, your station will play it.

The Hot Years Bone Health

The Hot Years

TM

My Menopause Magazine

Can

BISPHOSPHONATES

Bones Weaker?

Make Your

Mache Seibel, MD

Length of treatment may alter bone health medication effectiveness

O

steoporosis, or thinning of the bones, is a huge health concern. According to the National Osteoporosis Foundation, of the approximately 10 million Americans with osteoporosis, 80 percent are women. In addition, approximately one in two women over age 50 will break a bone because of osteoporosis. To put this in perspective, a woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer.

the 2002 Women’s Health Initiative (WHI) study incorrectly reported that estrogen caused breast cancer.

HRT is an excellent medication for lowering the risk of osteoporosis and hip fracture. But HRT declined after

Bone is always being remodeled. Old, brittle or damaged bone is continuously reabsorbed into the body and

It’s not surprising, then, that when non-hormonal medications called bisphosphonates were found in clinical trials of more than 35,000 women to lower fracture rates by 30 to 50 percent with few complications, millions of women in menopause chose to take these medications rather than estrogen. Examples of bisphosphonates are Fosamax and Boniva.

The Hot Years Bone Health

The Hot Years

TM

My Menopause Magazine

replaced with new bone. Bisphosphonates slow this remodeling process by more than 90 percent. It’s how they prevent further bone loss.

But does it matter how long you take bisphosphonates? Can this positive turn into a negative that affects outcome?

This question was addressed in the November 2016 issue of the journal Menopause.

body for 8-10 years they negatively affect bone health. So just because you stop taking a bisphosphonate doesn’t mean it no longer affects your bone health.

These findings may not apply to women without breast cancer, but it looks like stopping the medication after five years offers less chance of having a bone fracture than taking it for a longer time period of time. Ask your healthcare provider what’s best for you.

Women who took bisphosphonates for 8 or more years had a higher risk of bone fracture

Rebecca Drieling, MPH, PhD and colleagues at the University of Washington studied 887 postmenopausal women who were enrolled in the WHI study from 1993 to 1998 and who had a diagnosis of breast cancer. Because of some of the treatments, women with breast cancer have more bone fractures due to osteoporosis than women who don’t have breast cancer.

In this study, women at risk for a bone fracture who took bisphosphonates for eight or more years had a higher risk of bone fracture than women who took the medication for two to three years.

The researchers suspect that because some of these medicines stay in the

The Hot Years Sexuality

The Hot Years

TM

My Menopause Magazine

FDA Approves New Med For Painful

Sex In

Menopause Looking for relief from painful sex in menopause? Read on…

O

n November 17, 2016, the Food and Drug Administration (FDA) approved a new medication to treat moderate to severe pain during sexual intercourse caused by drying and thinning of the vulva and vagina in postmenopausal women.

The new medication, prasterone (Intrarosa, Endoceutics Inc.), is a vaginal insert that’s used once a day. In clinical trials of healthy postmenopausal women ages 40 to 80 years, Prasterone significantly reduced the severity of pain during sexual intercourse compared with a placebo, with few side effects.

The most common ones were vaginal discharge and abnormal Pap smear.

Prasterone also is sold as a dietary supplement called dehydroepiandrosterone, or DHEA, but hasn’t been proven to be effective or safe for that use.

In a press release, Audrey Gassman, MD, Deputy Director of the Division of Bone, Reproductive and Urologic Products in the Office of Drug Evaluation III in the FDA’s Center for Drug Evaluation and Research, said, “Pain during sexual intercourse is one of the most frequent symptoms of vulvar and vaginal atrophy (thinning of the tissues) in postmenopausal women. Intrarosa provides an additional treatment option for women seeking relief.”

The Hot Years Hormones

The Hot Years

TM

My Menopause Magazine

NAMS 2016

Hormone Therapy Position Statement

More than 20 experts considered new data and updated the benefits and risks of hormone therapy.

T

here is much more understanding of the benefits and risks of HRT than in the prior report…

Hormone therapy (HT) is in the news again! At the 2016 Annual Scientific Meeting of the North American Menopause Society (NAMS) in Orlando, Florida, I spoke to JoAnn Pinkerton, MD, Professor of Obstetrics and Gynecology at the University of Virginia, and Executive Director of NAMS about the new position statement on HT. Here is what she had to say:

It wasn’t easy to gain a consensus among the 20 experts involved on HT because there were many differences of opinion on certain points. But over a 9-month period, the experts were able to develop guidelines for clinicians using new evidence to confirm their recommendations.

The experts were most in agreement that HT is beneficial in treating hot flashes and preventing bone loss in women, as I explain in my book, The Estrogen Window.

Here are the key findings of NAMS’ 2016 statement, which applies to FDA-approved HT. Note that FDA-approved HT includes prescription products purchased at chain drug stores. Compounding

The Hot Years Hormones

The Hot Years

TM

My Menopause Magazine

pharmacy HT and pellets containing hormones are not FDA-approved.

• for hot flashes and night sweats • to help prevent bone loss and fracture in postmenopausal women at high risk for fracture (primarily those under age 60 within 10 years of menopause onset) • to treat symptoms caused by genitourinary syndrome of menopause (GMS), such as dryness, burning, and irritation in the genital area, painful sex, and painful urination

• for early-onset menopause in women up to age 52 who have hypogonadism, primary ovarian insufficiency, or surgical menopause and no medical reason to avoid HT • at least until age 51 (the median age of menopause for women with early onset menopause) • consideration among women with a family history of breast cancer, although family history is one risk among many for breast cancer that should be assessed • benefit/risk consideration for women with a BRCA gene mutation who have undergone risk-reducing oophorectomy • consideration of systemic use until the median age of menopause— after appropriate counseling and in the absence of HT contraindications, with longer duration of HT use individualized • for some women after age 60 based on individual health and symptoms (women older than 60 who start HT beyond 10 years of starting menopause may have elevated risks of coronary heart disease, stroke, venous thromboembolism, and dementia)

The Hot Years Hormones

The Hot Years

TM

My Menopause Magazine

The 2016 bottom line on HT The risks of HT vary among women depending on the type of therapy they’re given, how long they’re on it, how it’s given, at what point during menopause they start taking it, and whether a progestogen (either natural or synthetic progesterone) is needed.

(With longer HT use, estrogen therapy is more favorable than estrogen-progestin therapy.) Therefore, HT should be individualized and reevaluated periodically to maximize the benefits as well as minimize the risks, according to the position statement.

Nonhormonal therapies for menopausal symptoms NAMS also released its position on nonhormonal treatments for hot flashes and night sweats. Based on 340 research articles and 105 systematic reviews, experts recommended the following non-HT treatments: • cognitive-behavioral therapy • clinical hypnosis • low-dose salt of paroxetine (FDA approved for menopausal VMS management) • other SSRIs/SNRIs such as prozac or effexor • gabapentinoids (a pain medication) • clonidine (a drug also used to treat high blood pressure, ADHD, and anxiety disorders)

The Hot Years Fitness

The Hot Years

TM

My Menopause Magazine

Using

Weights Speeds Weight Loss Discover the exercises you need to speed up weight loss and look great in your new clothes.

D

on’t have time to go to a gym or money for a membership? You can get the same benefits of lifting heavy barbells at the gym by using hand weights at home for weight bearing workouts. In as little as 30 days, it’s possible to lose two dress sizes if you include weights in your workouts. Consistency and a sensible diet are key.

Weights also strengthen the stabilizing muscles that help you balance when walking or climbing. Since we start to lose our balance around the age of 40, it’s very important to keep your balance muscles strong so you don’t end up being one of the 11 million people over the age of 65 who fall every year.

It’s possible to lose two dress sizes in as little as 30 days if you include weights in your workouts

The Hot Years Fitness

The Hot Years

TM

My Menopause Magazine

When you recruit more muscle fibers by performing exercise with weights, you activate nerve activity and that boosts your ability to do your daily living activities.

Best Lower Body Exercises For a Firm Butt and Legs Dead lifts, squats and lunges with dumbbells are extremely effective in

toning and firming leg and buttocks muscles. Not only are light weights more comfortable to use than a barbell, squats and lunges with hand weights will put less pressure on your lower back and spine. Nice feature.

You can perform calf raises holding a dumbbell in either hand and raising up on the balls of your feet. Squats and lunges target the quads but also work the calves, glutes and hamstrings.

The Hot Years Fitness

The Hot Years

TM

My Menopause Magazine

Best Uрреr Body Exеrсіѕеѕ for Firm Arms Dumbbells are very effective in firming muscle quickly in your upper body.

Single arm rows tone and build the back muscles (think less over-the-brastrap fat) and rear deltoids.

Weights also can be used to build a firm chest and toned shoulders. (Think sleeveless dress!) While performing flat, decline or incline bench press you create an increased range of motion that targets the all the muscles in the chest for a firmer bust line. Dumbbells can be used to perform flyes on the bench to target the muscles in the chest.

And of course, you can tone the biceps, triceps and the forearm muscles, which helps you carry just about anything with greater ease. Standing alternating bicep curls really help to firm up the arms, and triceps extensions are great for tightening that behind-the-arm flap.

When beginning any workout routine, start with light weights so your muscles adjust safely to the new stress.

As you become stronger, you can increase the amount of weight you lift.

Over time you’ll your ability to do activities of daily living becomes easier.

So stop waiting and use weights for a slimmer, trimmer and more active you!

Dead lifts, squats and lunges with dumbbells are extremely effective in toning and firming legs and buttocks Founder of Functional Fitness on PBS, Suzanne Andrews produces a unique series of Functional Fitness DVDs for specific health needs which includes 30 Day Bladder Fix, Total Body Conditioning, Osteoporosis, Arthritis DVDs and more. Get healthy with Suzanne today at http://healthwiseexercise.com/

The Hot Years Recipe

The Hot Years

TM

My Menopause Magazine

Grilled

Orange Herb

Chicken

Author: Catherine Katz

Serves: 4

INGREDIENTS • 2 organic free range whole chicken breasts (skinless, boneless) • Juice of 2 oranges (about ½ cup) • 2 Tbsp olive oil • ½ tsp dried herbes de Provence • ½ tsp salt • Fresh ground pepper to taste

INSTRUCTIONS

1 2

Rinse and pat dry the chicken breasts.

Place all marinade ingredients in a medium bowl and stir.

3

Add the chicken breasts to the bowl and poke them a few times with a fork to allow the marinade to seep in. Stir well to coat. You can cook them right away or put them in the fridge for a few hours until you’re ready to grill.

TO GRILL ON A STOVE TOP

1

Preheat a nonstick grill pan over a high flame until hot. Do not oil the pan.

2

Place the chicken breasts on the pan and cook on each side for 6 to 7 minutes, turning them only once.

Discard extra marinade.

The Hot Years Recipe

The Hot Years

TM

My Menopause Magazine

3

If the chicken breast is thick and doesn’t cook all the way through, turn off the stove and cover the pan for 5 to 8 minutes before slicing.

TO GRILL ON A GAS GRILL

1 2

Prepare grill for direct cooking over high heat (450-550 F).

Place the marinated chicken breasts on the grill, reserving the marinade, and close the lid. Set a timer to 5 minutes.

4

When the timer goes off, remove the chicken and serve.

Dr. Catherine Katz is French-bornand-raised foodie and lover of luscious cuisine. She is also a scientist with a PhD in neuroscience from Princeton University and is married to Yale Professor Dr. David Katz. Together they have perfected the recipe not only for a beautiful family, but also for wonderful, healthy cuisine. Visit Cuisinicity.com to learn more and get delicious recipes!

3

When the timer goes off, turn the chicken over, pour the remaining marinade over it and close the lid again. Set the timer for 5 minutes.

NON-STICK GRILL PAN Perfect for grilling on the stove

The Hot Years Weight Control

The Hot Years

TM

My Menopause Magazine

Holiday

Weight Control Caroline Apovian, MD

Toolkit

Women gain on average five pounds around the holidays.

Here are some valuable tips to help you be the exception to that rule

I

t is no secret that many women start putting on weight around menopause, and the holidays are a particularly rough time for the midriff. It would be nice if

HOT FLASHES burned calories, but the reason for hot flashes is the hormonal changes that occur. These ups and downs can cause mood changes that cause a dysregulation of appetite and loss of appetite control.

In addition, as one ages muscle mass is lost again for a variety of reasons. It’s a condition called sarcopenia. The muscle mass loss reduces your basal metabolic rate and you cannot burn as much energy as you did when you were younger – translation - you gain weight.

Can you combat this with lifestyle changes? You bet your 6-pack abs you can!

The Hot Years Weight Control

The Hot Years

TM

My Menopause Magazine

Resistance exercise plus more lean protein in the diet can prevent muscle loss Here’s how: Resistance exercise training PLUS more lean protein in the diet can prevent that loss of muscle and therefore the lower basal metabolic rate.

Resistance and aerobic exercise raises an enzyme level in the body called AMPkinase that can restore energy regulation. Higher levels of AMPkinase burn body fat.

In last weeks Obesity Week keynote lecture, Dr Farooqi of the UK talked about a mutation in the KSR2 gene that causes it to stop working and leads to obesity in children because it lowers metabolic rate, ie, it slows metabolism.

Resistance and aerobic exercise raise the metabolic rate for many people.

They can also use metformin, which is a drug that raises AMPkinase levels.

It may be that even though most people do not have this mutation, in some people it may be turned on or off during periods of life or altered due to lack of good diet or physical activity.

It may be that in menopause, a series of on and off switches are changed that favor weight gain and a lowering

of metabolic rate. Plus we also know that sleeping at least 7-8 hours per night prevents weight gain in adulthood due to hormonal changes that promote weight gain. Perhaps we are also turning ON a weight gain or metabolic switch that lowers metabolic rate by not sleeping enough.

WHAT CAN YOU DO BESIDES RUN THE MARATHON?

1

10 minutes three times per week of resistance exercise or weight lifting upper and lower extremities and slowly increase to 30 minutes three times per week

2

Change your diet - Eat more of the macronutrients that burn energy and less that store energy. Examples are protein and good fats like avocado, walnuts and olive oil and less simple carbohydrates like table sugar, fruit juice, milk, yogurt, honey, molasses, and maple syrup.

3

Get enough sleep 7-8 hours each and every night. How to do this if you are in menopause and unable to sleep due to hot flashes?

Talk to your doctor about hormone replacement therapy (HRT). As long as there is not a specific contraindication to hormones, most will be able to safely take HRT to prevent hot flashes, weight gain and get your rest.

The Hot Years Weight Control

The Hot Years

TM

My Menopause Magazine

4

Exercise your stress away.

Stress can alter fat metabolism due to elevated levels of cortisol, the stress hormone. Yoga is a great way to get some exercise and lower stress plus combining it with resistance exercise and aerobics will really push those anxious thoughts away. Meditation for 10 minutes per day can also help quell anxiety and stress.

Remember the FOUR PILLARS OF HEALTH:

1

Diet – best antioxidant foods/high protein foods to eat which will prevent aging : berries like blueberries and raspberries, pomegranates, legumes like beans( high fiber and protein), salmon for omega-3s, and avocado!

2

Exercise - resistance exercise plus aerobic for strength and muscle building – make sure protein is part of each and every meal – good protein sources: nuts and seeds, eggs, fish; eggs are very important because they contain follistatin which prevents the breakdown of muscle!

3

Sleep – need a sleepy time drink?

Try my fast asleep drink before bedtime – it contains tart cherry juice concentrate - tart cherries have the highest levels of melatonin in any fruit

4

Stress - Green Leafy Vegetables.

Dark leafy greens like spinach are rich in folate, which helps your body produce mood-regulating neurotransmitters, including serotonin and dopamine

WHAT NOT TO EAT IF YOU ARE STRESSED? Sugar, especially high fructose corn syrup but any kind of sugar, simple carbs like white bread and processed foods like crackers. SSBs or sugar sweetened beverages should be considered poison!

Dr. Caroline Apovian is a regular contributor to The Hot Years, My Menopause Magazine. She is Director, Center for Nutrition and Weight Management at Boston Medical Center and author of the New York Times bestselling book, The Age Defying Diet.

Find out more at www.DrApovian.com.

The Hot Years Hormones

The Hot Years

TM

My Menopause Magazine

Compounded

Hormones Compound the Risks of HT

J

oAnn Pinkerton, MD, is the Executive Director of the North American Menopause Society (NAMS) and Professor of Obstetrics and Gynecology at the University of Virginia. Here’s what Dr. Pinkerton had to say about compounded hormone therapy at the 2016 NAMS conference.

Dr. Mache: The topic of compounded hormone therapy is a big one. Many women use it. What has your research found about their safety? Do they work?

Dr. Pinkerton: After the Women’s Health Initiative (WHI), when everyone was frightened of hormone therapy, many women found their way to compounding hormone therapy believing

it was safer and more effective and would actually decrease the risk of breast cancer. Now we have bioidentical hormones that are tested in trials and approved by the Food and Drug Administration. The FDA monitors and regulates them. With FDA approved drugs, you know what the dose is and you know what you’re getting.

With FDA approved drugs, you know what the dose is and you know what you’re getting

The Hot Years Hormones

The Hot Years

TM

My Menopause Magazine

The levels of estradiol from compounding pharmacies ranged from 59% to 259% higher than prescribed Dr. Mache: Are these estrogens the same as you’d get from a compounding pharmacy?

Dr. Pinkerton: Absolutely! They start from the same soy product and get changed into estradiol, which goes to pharmacies or compounding pharmacies. It’s the same product.

But when you get something compounded, it means the pharmacist hand-mixes it according to a prescription. It sounds great. The doctor says, “I’m going to tailor this to you, I’m going to use salivary testing.

It’s going to have no risk.” But when More magazine sent out 12 trial prescriptions to different pharmacies and evaluated them, the levels of estradiol ranged from around 59 percent to 259 percent and the progesterone, which is not absorbed well by the skin, was only 60 percent of what was prescribed. This high estrogen and low

progesterone imbalance leads to an increased risk of endometrial cancer.

It’s as if the woman isn’t taking progesterone and that’s a problem.

Dr. Mache: So a woman could be getting way more estrogen and way less progesterone than was written in her prescription with compounded hormones, which puts her uterine lining at risk of developing uterine or endometrial cancer?

Dr. Pinkerton: Exactly. So you never know, are you being underdosed or overdosed? And does that change your risk for uterine cancer or breast cancer? There’s also a question of safety. For example, there’ve been 64 deaths caused by contaminated steroids made in a compounding pharmacy. Because of the measurement issues and the potential for contaminants, the government has the Drug Quality Safety Act looking at the big compounding pharmacies to try to get them to be more regulated. The states regulate the local ones, and there is a credentialing organization called the Pharmacy Compounding Accreditation Board (PCAB). If you want to check to see if a compounding pharmacy is at least jumping through the hoops to be credentialed, you can go to PCAB.org and plug in the zip code. But at the end of the day, the doctor who signs the prescription is the person who’s

The Hot Years Hormones

The Hot Years

TM

My Menopause Magazine

responsible, so whether you’re a provider or a patient, you have to know there are risks. If you can use a government-approved product from chain drug stores, you should. If you have an allergy or another specific reason to opt for compounding hormone therapy, it’s important to recognize the risks.

Dr. Mache: Why is there an increased risk of uterine cancer with compounding hormone therapy?

Dr. Pinkerton: Progesterone is a big molecule, so it doesn’t absorb well and the women gets much less progesterone into her blood system. That means a woman potentially could be getting higher levels of estrogen and lower levels of progesterone. She needs the progesterone to protect her uterine lining from uterine cancer after estrogen is given.

Dr. Mache: Can you talk about the Wiley Protocol?

Dr. Pinkerton: The Wiley Protocol is based on the hormones of a 21-yearold. But you don’t need that much estrogen as you age. We actually decrease the dose as women go past 60 to minimize those risks. The bottom line: It’s really important to ask for estrogen replacement therapy that’s FDA-approved.

It’s really important to ask for estrogen replacement therapy that’s FDA-approved

The Hot Years – Mindfulness

The Hot Years

TM

My Menopause Magazine

Meditation:

Living a Mindful and Meaningful Life During Menopause

“Meditation is the cornerstone to a woman’s well-being. It is the next frontier of medical research, and attaining the truest wellbeing a woman is seeking throughout all the changes in her life.” Hari Kaur

M

enopause is a powerful transition for women. During this time, they are often called upon to play many roles, and the demands on their time and energy can be extensive. Many women are over-stressed and overworked. Balancing a modern lifestyle with self-care can be difficult, and selfcare is often neglected.

If a woman can access the light of wisdom inside her from her years of experience, and if she can relax and calm herself, then the difficulties of menopause can be effectively managed. A mindful approach to life and the practice of meditation during menopause can bring meaning, empowerment, peace, and great insight.

The Hot Years – Mindfulness

The Hot Years

TM

My Menopause Magazine

How, When, Where to Meditate Meditation is both a philosophical approach to living and a practice. You can meditate any time, anywhere. The best meditation environments are quiet and uncluttered. But since meditation is exercise for your mind, sometimes challenging environments will bring positive results as you manage to find peace despite the chaos.

There are many types of meditations—mindful meditation, chanting meditation, breath meditation, walking meditation, meditation on wisdom teachings, etc. If you’re new to meditation, it can be helpful to try various approaches and then develop a daily practice based on the ones that work best for you.

Your mind can be your best friend or your worst enemy. As an ally, your mind can organize your world and effectively guide your actions. As an adversary, it can be jumpy, unfocused and can easily attach to negative patterns of thinking that stem from your fears and insecurities. Practicing meditation, especially during times of physical challenge and life transitions, can help you develop a positive relationship with your mind and teach you how to direct it’s power towards the realization of your full potential.

A Mindful Meditation Practice: Breathing into Awareness Sit comfortably with your spine lengthened and your hips relaxed. If you’re sitting in a chair, rest your feet comfortably on the floor.

Close your eyes.

Let your body feel in balance, sit easily with the least amount of effort possible. If there are any sensations of stiffness or discomfort, simply notice them, adjust your posture, and con-

The Hot Years – Mindfulness

The Hot Years

TM

My Menopause Magazine

tinue to meditate. Become aware of the process of breathing. Sense your breath as a quality of motion and movement. Notice the places in your body where breath creates movement. Do not change or adjust your breathing, but do notice if it shifts in quality, depth or sensation. After a few breaths, connect with the rhythm of your breathing, noticing the inhalation, the top of the inhalation as it shifts to the exhalation. Notice the exhalation and the bottom of the exhalation as it shifts into an inhalation. Follow the movement of your breath as it moves throughout your body. If you like, you can count your breaths or add a mantra such as Sat (truth) on the inhalation, and Naam, (identity) on the exhalation. Using a mantra can be a powerful way to focus your mind and increase the power of your meditation.

Continue for 11 to 22 minutes.

The Experience of Meditation and Mindful Practice It is natural for your mind to wander and create thoughts as you meditate.

When that happens, return your attention to the practice of sensing your breath. This process of thinking and bringing your attention back to the breath is the meditative practice itself.

The practice of mindful meditation can lead you to be more tolerant of your

Using a mantra can be a powerful way to focus your mind and increase the power of your meditation physical and mental fluctuations during the transition of menopause. The tolerance and strength you develop with a mindful approach to menopause will serve you for the rest of your life.

To help you develop your meditation practice, consider taking yoga and meditation classes at a center near you. A good teacher can be very helpful in helping you choose the best meditation style for you and can guide you as you begin to practice. Many people find meditating in a group to be another powerful way to enhance their daily practice.

Hari is author of A Woman’s Book of Yoga written with Mache Seibel, MD (Penguin) and A Woman’s Book of Meditation (Penguin), which outlines many forms of meditation and goes into depth to explain the meditative process, especially as it applies to women in transition. If you have any questions or comments, you may write Hari at hari@harinyc.com.

Dr. Mache’s Musings

The Hot Years

TM

My Menopause Magazine

Renewable Energy

I

There is a lot of talk about renewable energy.

t’s energy from a source that is not depleted when used. Examples are wind-, solar- and water-powered energy. The benefits are we don’t have to deplete resources to create large amounts of energy. Tomorrow the wind will blow again, the sun will shine and the tides will come in and out. That’s very different from coal, oil and gas. Eventually, those resources will be depleted and all the engines that depend on them will no longer have an available source of fuel.

There is another type of energy that’s limited. It is the energy that we use to get us through the day. From wake up, to skip breakfast, to play full out at work, to rush through lunch, to wrap up the day, to rush through dinner, intense quality time with family, catch up on emails, to shower, rinse and repeat.

It’s a limited resource with limitless demands on it.

For most people, life is a blurring sequence of actions punctuated by too little sleep and an occasional pause for vacation during which time the routine just changes location.

When is the last time you slept until you woke up naturally? Spoke to your partner, parent or child and just listened to their issues? Meditated?

Chewed your food thoroughly before you swallowed it? Or just blocked out time to think?

Life without rest periods is a run-on sentence and no one wants to be sentenced for life. So take a break before you have one–or you run out of gas.

Ask yourself, “Am I making time to renew my energy?”

Click here to hear Dr. Mache narrate this over a soundtrack of his original music.

The Hot Years Quote

The Hot Years

TM

My Menopause Magazine

“We delight in the beauty of the butterfly, but rarely admit the changes it has gone through to achieve that beauty.�

Maya Angelou

CLICK HERE to enjoy the Song of The Month. I wrote Merry Christmas to celebrate the joy of the holiday. It makes people feel happy and momentarily carefree. To listen or purchase this or other of my songs or CDs visit www.DoctorSeibel.com/store 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

The Hot Years Q&A

The Hot Years

TM

My Menopause Magazine

Got Questions?

Ask Dr. Mache!

Tune in for the monthly AskDrMache.com HouseCallÂŽ The Third Thursday of Every Month Bring your friends, ask your questions, get your answers.

Go to AskDrMache.com for call in information and to submit your questions.

Dr. Trevor Cates

Subscribe to

The Hot Years

TM

My Menopause Magazine

What You Get Every Month

What women are saying about this magazine:

 Insight, Inspiration and Health

 Wonderful info from

 Edited by the Media Award

 Love this

 Articles, videos and audio

 Great Menopause

Information

recipient of the North American Menopause Society

 Answers to your questions  Get the latest health and

magazine. Great content from beginning to end!

resource with important emphasis on body, mind and spirit!

 Finally! A magazine

wellness information

 All this and more, absolutely FREE

a source you can trust

with answers to all the questions women have when entering into menopause.

Get Started. Click The Subscription Button Now Subscribe