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A guide to natural and bioidentical hormones


"Your website is so helpful because it 
informs us,about symptoms our mothers never spoke about, except Hot Flashes. 
I can not thank you enough for easing my worries.".... Laurie P.

 

A WOMAN’S GUIDE TO NATURAL AND BIOIDENTICAL HRT

By Michael P. Goodman, M.D.

Since the publication of Suzanne Somers’ “The Sexy Years”, and my book (“The Midlife Bible--A Woman’s Survival Guide”)  interest has peaked in alternatives for therapy of pre-menopause, peri-menopause and menopausal symptoms to improve quality of life in middle and later years.  Much of this interest has centered around the use of bioidentical hormones. 

No longer are women satisfied (nor should they be) with a comment from a clinician to the effect of “That stuff doesn’t work” or “I don’t know much about bioidenticals”.  No longer are women or their partners satisfied (nor should they be) with quick ten-minute office assessments and a prescription for “estrogen pills” to treat this complex set of circumstances.  Women and their partners rightfully desire and demand information about sexual health and androgen therapy, information about and therapy for stress-induced adrenal fatigue and adrenal burnout, and they would like to do it in a way most naturally accepted by their bodies.  Thus the interest in bioidentical products.

Often erroneously referred to as “natural hormones”, a bioidentical hormone is a compound synthesized in the lab from a “natural” source (usually soybeans in the case of estrogens and testosterone; wild Mexican yam in the case of progesterone and sometimes testosterone) to exactly mimic the chemical structure of the naturally occurring compound it is supplementing or replacing.

In contradistinction, a “natural” substance is a compound directly produced from a plant or animal source.  By that definition then, Premarin (made from pregnant mare’s urine) is a “natural compound”.  Although it may make sense to eat “naturally” and organically, “natural” does not always mean “safe” or “good”.  “Natural” has become more of a sales gimmick than anything. 

Better to use the words “botanical” to describe plant-sourced and herbal remedies, and “bioidentical” to describe hormonal therapies utilizing products resembling as close as possible those that the human body (used to) produce.

If disturbing pre/peri- or menopausal symptoms (hot flashes, crawly skin, mood and memory alterations, poor sleep quality, sexual disinterest, joint aches, depression, fatigue, palpitations, etc.) are mild, and you have some time to experiment, herbs and botanicals work approximately 50% of the time.  Most likely to help are a combination of increased isoflavones (consuming increased amount of soy and other beans, flax seed, flax seed oil, isoflavones from soy or red clover sources) and black cohosh, chasteberry, evening primrose oil and sometimes dong quai in combination with other Chinese herbs (dong quai alone rarely works). 

If symptoms are severe and disrupting home or work function, or if diminished vaginal lubrication and other sexual issues are disturbing, botanicals usually do not provide adequate relief and it is only after re-stabilization with hormones (estrogen, frequently testosterone only, also with or without progesterone) that relief is obtained.  While relief is frequently just as profound with synthetics as with bioidentical hormones, for a variety of reasons, the “nod” goes to the bioidentical products.

While synthetic hormones are usually only available in oral form, bioidentical hormones are available in a variety of delivery systems (oral, transdermal patch, cream, lotion or sublingual drops, as well as a vaginal ring).  Bypassing the GI tract and liver on the “first pass” can be advantageous for the body, plus transdermal delivery usually leads to better and more consistent hormonal tissue levels.  Additionally, it makes intellectual sense to give a compound (e.g., estradiol, testosterone, progesterone) that the body is used to metabolizing, rather than a synthetic, which may be metabolized and react differently than expected in a given individual.

Significant (peri-) menopausal symptoms, especially sexual dysfunction, is usually the result of sudden fluctuations or lowering of both estrogen and testosterone levels.  Most times, testosterone as well as estrogen needs to be supplemented.  Sadly, this is rarely done.  It is only by proper testing and frequently compounding bioidentical products that the balancing is successful, as unfortunately the only commercially available product that has both estrogen and testosterone in it is an oral form of synthetic estrogens and testosterone (“Estratest”), which works for many women but is frequently suboptimal. 

Most of the time estradiol alone (estradiol is the hormone made in greatest quantity by the normally functioning ovary) is satisfactory--and it is available commercially in patches (Vivelle Dot, Climara, Alora, etc.), lotion or gel (Estrasorb, Estragel) vaginal ring (Femring) and oral (Estrace) forms.  Occasionally, however, a true balancing is necessary, and bioidentical estriol (“E3”) and/or estrone (“E1”) are carefully compounded with estradiol (“E2”) by a knowledgeable healthcare practitioner as necessary.  Bioidentical testosterone certainly helps with sexual desire, energy and quality of life issues.  Frequently bioidentical progesterone is helpful to diminish anxiety, help with sleep and aid in adrenal support.  Synthetic progesterone (e.g. Provera) is absolutely worthless in this area although it (as well as bioidentical progesterone and other synthetics) can help protect the uterus against endometrial cancer.

I would be remiss, in a discussion of bioidenticals, not to discuss adrenal support, although space limits all but a mention.  Much more often than is realized in midlife women, the stress of the menopausal passage added on to the stresses of life accelerated at midlife (partnership issues, financial issues, care of aging parents, teenagers, stress in the workplace, etc.) impacts negatively on the adrenal glands, the “energy supporters” and energy regulators of the body.  Cortisol from the adrenals may be dysregulated; DHEA and/or pregnenolone not produced in adequate amounts and energy disruption and fatigue result.

A good clinician utilizes judicious judgment and laboratory testing as necessary to separate ovarian from adrenal causes and work out both the proper ovarian and adrenal hormonal balancing and oversee lifestyle modifications to ensure successful relief of symptoms and greatly improved quality of life.  Bioidentical DHEA, pregnenolone, progesterone and/or cortisol may all be compounded and supplemented to aid in this regulation, although obviously relief of stress through counseling, awareness, exercise, meditation and other lifestyle changes is important for long-term success. 

Although there are many reasons to recommend the use of bioidentical compounds for pre/peri- and menopausal relief, safety may not be one of them.  Don’t get me wrong, I unequivocally believe that these therapies (especially and including estrogen) can be given VERY safely to aid in the midlife passage; however, I find nothing in the literature or in common-sense biochemistry to suggest that the bioidentical products are any safer (e.g. less breast cancer, blood clots, etc.) than synthetics; however, if used in proper doses, in the proper way, and for relatively limited periods of time, there is no research, physiologic or common-sense reason to doubt their safety.  
 

Dr. Goodman is a peri-menopausal gynecologist in practice in Davis, California.  His website is www.caringforwomyn.com.  Dr. Goodman’s book “The Midlife Bible--A Woman’s Survival Guide” is available from his website and in bookstores.

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Menopause FAQ from Dr. Michael Goodman

TM 
 

MIDLIFE F.A.Q. SHEET


1. How do I know if I am menopausal or perimenopausal? 
2. Do herbs work? 
3. Is there something “natural” I can take? 
4. My sex drive is in the toilet.  What can I do? 
5. What about that big study [The WHI].  Aren’t estrogens  dangerous? 
6. Should I be on estrogens “forever”?  How do I stop? 
7. What about progesterone cream? 
8. I am miserable with hot flashes and moodiness and very poor  sleep.  What can I do? 
9. Why are my headaches worse? 
10. What will happen to my bones if I quit my estrogen? 
11. My doctor put me on Premarin, but I still was having hot  flashes, so she increased it, but I am still not better.   What should I do? 
12. I can’t seem to lose weight.

 

1. HOW DO I KNOW IF I AM (PERI) MENOPAUSAL?

“Menopause” is the time of a woman’s final menstrual period.  Of course, the only way to  know if it is your “final” menses is to see if any more follow. By definition, 12 months  without menses, in the presence of other “menopausal symptoms” equals menopause. 

Perimenopause is that (usually several year) time around (just before) the final menses.  It is frequently punctuated by the classical symptoms of peri-menopausal/menopause  including but not necessarily limited to: Hot flashes/night sweats, poor sleep quality,  
mood and memory dysfunction, vaginal dryness, heart palpitations, joint stiffness, “crawly skin”, depression, etc. 

Menopause is a normal, functional passage of life.  There are many life-style, nutritional,  botanical, herbal and pharmaceutical ways to ease the passage.

 

2. DO HERBS WORK?

For many women, yes. Whether this is secondary to a specific medicinal effect of the  compounds used, or secondary to the known 30-50% placebo effect of menopausal  supplements taken with the belief that they will provide relief, is unknown.  It makes no difference, however. If it works, causes no harm and is affordable, hurrah!! 

A brief definition: “Herbs” are the leaves of plants.  “Botanicals” can be from leaf, stem,  root or rhizome. Phyto-estrogens are botanicals that have specific estrogen-like effect on human tissues (within a specific dosage range).

Herbs/botanicals/phytoestrogens relieve (peri) menopausal symptoms in many women; however, their success rate (approximately 50-60%) is lower than that for hormones/pharmaceuticals. 

 

3. IS THERE SOMETHING “NATURAL” THAT I CAN DO?

What do you mean by natural? Nowadays, “natural” is little more than advertising gimmick, designed to “reel you in” to buying some probably untested nutritional supplement of uncertain medicinal or therapeutic benefit.

By definition, “natural” means “native to plant or animal”.  By this definition, Premarin, derived from pregnant mare’s urine, is “... natural”.

Know what you are taking (and whether it interacts with other supplements and pharmaceuticals you are ingesting, That said, there are several things:  Pick/choose/mix ‘n match with the aid of your healthcare practitioner: 

 1. Bioidentical hormones: Estriol, estradiol, estrone, progesterone, testosterone.  These are all synthesized   from a plant source (soy or wild yam) to exactly mimic the molecule found in the body. 
 2. Lifestyle changes (are certainly natural!). Proper diet (increasing fresh fruits/veggies; decreasing meat, fats, convenience foods) and exercise! 
 3. Vitamins, herbs, botanicals, phytoestrogens (see above   F.A.Q. #2). Include but not limited to soy isoflavones, black cohosh, chasteberry, Vitamin E, calcium, etc., etc. 

 

4. MY SEX DRIVE IS IN THE TOILET.  WHAT CAN I DO?

You are not the only one!  All sorts of things conspire to diminish libido in (peri) menopausal women. It is hard to feel sexy if you are flash-flushing all over the place.  Or if your vagina is dry and lovemaking feels like sandpapering a sore. Been married a long time?  A few teenagers always in and out of the house?  And what about your testosterone?  Well before your estrogen levels fluctuate and then take a giant plunge, testosterone slowly but steadily declines.  The same testosterone that is responsible for energy, sex drive, perseverance, etc.

So:  What can you do?  Get your menopausal symptoms under control. Get to sleeping better. Work with your mate and perhaps a therapist on ways to rekindle you and your mate’s sexual connection, and definitely work with your healthcare practitioner to check on and improve your testosterone levels with transdermal or oral therapy.  
 

 

5. WHAT ABOUT THAT BIG STUDY [THE WHI]?  AREN’T ESTROGENS  DANGEROUS?

Much misinformation and questionable interpretation headline-highlighted by the media has followed the reports in the Journal of the American Medical Association of the findings of the Womens Health Initiative [WHI], a large double-blind study of the effects of “hormones” (estrogen and artificial progesterone or “progestin”) on cardiovascular function in postmenopausal women.

To be specific and explanatory would take many paragraphs, so I shall succinctly summarize what WHI found: 

 1. Giving estrogens, especially estrogen and the synthetic progestin Provera, to older women, possibly with pre-existing cardiovascular disease may increase risk (especially in the short term) of an “event”. Therefore, it is inappropriate to give estrogens,    especially estrogen and synthetic progestins to older women for the singular purpose of diminishing risk of cardiovascular disease. 
 2. Bathing one’s organs in estrogen, especially estrogen and progestin, for years beyond what they normally would get/encounter increases the relative risk of breast cancer (even though the actual risk remains extremely low). 
 3. Adding a progestin (synthetic progesterone), specifically Provera to estrogen may increase both cardio-vascular and breast cancer risk. 
 4. Starting estrogens well after menopause for the purpose of decreasing risk of Alzheimer’s Disease is probably not appropriate. 

 

6. SHOULD I BE ON ESTROGENS FOREVER?  HOW DO I STOP?

The most common usage of estrogen supplementation is to ease the passage through menopause, taking control of your shifting and suddenly diminishing estrogen levels.  Understanding this, there are not many reasons to be on “estrogen forever”.  Taking control of the (peri-) menopause rollercoaster, after a modest amount of time, most women can start a slow, progressive tapering off (after you have tapered off, you and your health-care practitioner may wish to start you on another medication to help with other issues such as bone loss, breast cancer protec-tion and abnormal lipids, which could lead to a higher risk of cardiovascular disease--by far the largest killer of women).

How do you taper off?  Slowly!!  Don’t do this “cold turkey” or in a week or three.  The easiest to taper is the patch.  You simply cut off a bit, slowly, over months, working down to the next lowest dose (e.g. one-eighth off for a month, then one-quarter off for a month, then down to the next lower dose...and repeat again), until you are either off all together or on a mini dose if you wish to continue hormones or have trouble tapering off all together.  With pills?  Combine the next lowest dose with your present pill:  Substitute the lower dose every third day for a few weeks, going to every other day, then two out of three days at the lower dose and on to the next lower dose.  Do the same thing to taper off to zero from the lowest dose. 

You may, because of quality of life issues, wish to remain on estrogens.  If so, remember:  Lowest possible dose.  There truly is very little increased actual risk for adverse events! 

 

7. WHAT ABOUT PROGESTERONE CREAM??

 

Progesterone has a definite place in the therapy of peri-menopausal travails.  Bioidentical progesterone (synthesized usually from wild Mexican yam to mimic the molecule found in nature) is different from and possibly “safer” than the commonly used (and stronger) artificial progesterones, called “progestins”. Although bioidentical progesterone is synthesized from wild yam, wild yam itself contains no progesterone, nor is the human body capable of metabolizing it into progesterone.  There are a plethora of over-the-counter creams containing progesterone in the market.  The problem is finding out how much progesterone each contains and how much to use per dose. Better is to have a compounding pharmacy prepare a preparation (cream or lotion) to your and your doctor’s specifications.  The usual therapeutic dose is 25-75 mg per day.  If you buy and over-the-counter cream, ask the pharmacy personnel if they can tell you how much progesterone is actually in each quarter or one-half teaspoon full.

Since absorption is a problem from different areas of the skin, make sure you use only the inner aspect of your upper arms or inner thighs, where the skin is soft and thin.  Since bioidentical progesterone can cause sleepiness in some people, it may best be used at night. What can it be used for?  May women find it helpful in miti-gating PMS symptoms as well as hot flashes (especially nighttime flashes) in menopause.  It is cardiac and breast neutral; there is no evidence that it helps improve bone density.  It is very safe.  

 

8. “I AM MISERABLE WITH HOT FLASHES AND MOODINESS AND VERY  POOR SLEEP.  WHAT CAN I DO?” 

I. Hormonal:

 a. Estrogens, either synthesized (ethinyl estradiol; conjugated estrogens; etc.) or a bioidentical (estriol; estradiol; estrone) can be delivered either orally or transdermally via patches, creams and lotions or (more rarely) via injection.  
 b. Progesterone:  Bioidentical progesterone, delivered via cream, lotion or capsules, can help with these symptoms.  
 c. Bioidentical testosterone, usually given either as a transdermal gel, lotion or capsule, or synthesized testosterone supplied in pill form works wonderfully synergistically along with estrogen to mitigate symptoms.

II. Vitamins, supplements, and plant-sourced botanicals. 

Both those with “estrogen-like effects” (phytoestrogens) and those which are used for their helpful calming and psycho- logical effects: 

 a. Soy and other legume-derived isoflavones help some women’s hot flashes, especially when combined with other measures listed below. 
 b. Black cohosh, chased berry (Vitex) and evening primrose oil (singly or in combination) have all been of help to some women.  
 c. Mega-dose B Vitamins and high-dose (800-1200 mg) Vitamin E can help with hot flashes.

 

III. Non-hormonal pharmaceuticals.

 

a.   Hot flashes:  The anti-depressant Effexor and the    anti-seizure/anti-depressant medication Neurontin, used in low-ish doses are quite effective in relieving   nighttime flashes (daytime too to some extent).  The old standby Bellergal is less helpful.  The anti-hypertensive Clonidine, in patch form, helps some.  
 b. Moodiness/Depression/Anxiety:  Xanax and Ativan, in low doses, is great for anxiety/”panic”.  (Both can aid in sleep also).  Mood stabilizers/anti-depressants   such as Prozac, Paxil, Zoloft, Celexa, Lexapro, Effexor, Wellbutrin, etc. may be quite helpful.

c. Insomnia. Sonata lasts +/- four hours and is good for  women with difficulty getting to sleep or middle-night   awakening.  Ambien lasts 6-7 hours. Restoril and Halcion last a bit longer. These medications are best used short-term until the problems causing the  insomnia are brought under control.

 

IV. Lifestyle Changes:

 
a.  Avoid “triggers”.  Most women suffering from hot  flashes are aware of situations such as heat, caffeine, spicy foods, stress, etc. that trigger their  “flash”. 

b. Exercise! Probably the single most important thing  increasing quality of life in midlife women is exercise. A total of 30-40 minutes of strenuous “sweaty”  exercise will go a long way towards clearing your  mind, uplifting your mood and chasing away “flashes”.  (As it releases endorphins, which increase the serotonin in your brain, exercise has appropriately been  called “nature’s Prozac”).

c. Stress reduction: Peri-menopausal symptoms themselves are stressful. Stress reduction help such as meditation, paced respiration and muscle group tension/ relaxation techniques are imperative, especially at bedtime.  
 

9. WHY ARE MY HEADACHES WORSE? 

Headaches, especially migraine, are exquisitely sensitive in women to stress and hormonal changes. Midlife and peri-menopausal symptoms are stressful; hormonal levels roller-coaster. Both hot flashes and many headaches are centrally mediated by areas in the brain that are exquisitely sensitive to hormonal fluctuations.

More often, headaches are secondary to the “valleys” after hormonal peaks, but in many women the generally elevated levels of estrogens during the peri-menopause exacerbate their head-aches.

 

10. WHAT WILL HAPPEN TO MY BONES IF I QUIT ESTROGEN?

By far the greatest amount of bone loss in women occurs in the 1-2 years following menopause.  For women taking hormone therapy to ease the menopausal transition, the same situation obtains after discontinuing their estrogen therapy. 

The unknown is:  How much do you have to lose?  A woman’s peak bone mass is obtained in her 20s and is dependent on genetics, general health and nutrition, calcium consumption, physical activity and estrogen levels. If you are genetically challenged in the bone density department, if you didn’t drink your milk (see, your mother was right!), if your estrogen levels were chronically low secondary to a very lean body mass...well, you may have less leeway after menopause. 

Estrogen protects women against excessive bone loss, just as testosterone protects men.  The fact that males have a far lower incidence of osteoporosis is a testament to their testosterone not abandoning them (as estrogen abandons a woman) at midlife.  Of course, calcium, protein and exercise are necessary to build bone; hormones simply inhibit excess resorption or bone loss.  Woman at perimenopause and women stopping hormone therapy are well advised to get at least a peripheral (wrist or heel) scan; better is a “central” hip and spine (or DXA) exam to assess their risk.

Estrogens inhibit excess bone resorption.  Other non-estrogen substances that protect bone to a similar degree include alen-dronate (Fosamax), risedronate (Actonel), raloxifene (Evista), testosterone and possibly DHEA at a dose of 50 mg per day.  
 

11. ”MY DOCTOR PUT ME ON PREMARIN, BUT I STILL WAS HAVING HOT  FLASHES.  SHE INCREASED IT, BUT I AM STILL NOT BETTER.   WHAT SHALL I DO?

Don’t increase the Premarin!  There are many alternatives. Since oral estrogens are metabolized differently by different individuals, many women have “break through hot flashes” at night after a morning dose. You can experiment with supper-time dosing, or splitting dosage half in the morning, half at night. 

Transdermal patches give a more reliable and constant level of hormones. You might switch “laterally” to patch at equivalent doses.

In all cases, you might want to eventually slowly wean your dose down. If you do it slowly-slowly-slowly, you usually can accomplish this without return of flashes. 

Progesterone cream is also quite helpful, especially for “night sweats”.  A dose of 50-100 mg of cream at bedtime is the usual dose (made by a compounding pharmacist), or +/- one-half teaspoon of over-the-counter cream.

Also good for resistant hot flashes can be Vitamin E 400-800 mg in the morning and at bedtime. “Psychoactive” medications usually utilized for depression, but at lower doses, can also help with both daytime and evening hot flashes.  The most commonly used are Effexor, Neurontin and one of the SSRI meds (Prozac, Celexa, Zoloft, etc.).  
 

12. I CAN’T SEEM TO LOSE WEIGHT!

You and everyone else!!  It is “the way of life” that humans (especially women) gain weight around midlife. There is a physiological reason: 

As both men and women (especially women) pass through midlife (especially at peri-menopause), the ACTH (“growth hormone”) level from their pituitary glands slow down, stimulating less cortisol output from the adrenal glands.  This leads, basically, to a “slowing down” of the “idle” of the body’s engine.  Less energy/less calories being utilized minute-by-minute. Therefore, many midlife women can eat the same and exercise the same and expect to gain 3-5 or more pounds per year through the (peri-) menopause. 

Bummer!! Of course, this is not the same for all women.  (There are the lucky ones).

 

What to do?  Tough love here (sorry!).  There is no “magic bullet”.  Unfortunately, the only way to deal with this is to consciously cut down your calorie intake by 5-10% (eat a bit less) and at the same time increase your calorie output by the same.  You can do this by increasing exercise plus eating more but smaller meals (e.g. stretch out the food you normally eat in a day to 4-5 smaller meals instead of 2-3).  This gets your "digestive motor” working more times, burning a bit more calories.

You can also get used to a bit rounder figure...you’ll still look good!

Antidepressants Can Lead to Hot Flashes and Insomnia


 

"Your website is so helpful because it 
informs us,about symptoms our mothers never spoke about, except Hot Flashes. 
I can not thank you enough for easing my worries.".... Laura


 
 
                                                  As thoughts turn to love this February, which is also American Heart Month, I want to talk about how 
                                                   hormones affect our ability to give and receive love. Optimal hormonal 
                                                   balances lead to healthier relationships, but hormonal disturbances like irritability, 
                                                   lethargy, drop in libido, headaches and hot flashes can make it hard to connect and 
                                                   feel sexy. If you’re feeling the hormonal shifts of menopause, join me for a free call 
                                                   to learn how homeopathy can help adjust your hormones and bring clarity. Because 
                                                   when you don’t feel balanced—whether it’s because your body has too much estrogen 
                                                   (estrogen dominance) or declining levels of estrogen, you may feel less in tune with 
                                                   your partner and out of sync with life.


                                                   Don't worry--your body can bring itself into balance. I see this time and time again in 
                                                   my practice after I suggest a homeopathic remedy that acts as a re-set button, and I 
                                                   watch my clients start loving their lives again. Here are some tips for balancing 
                                                   hormones at home:


                                                   Tips for balancing your hormones


                                                   1. Eat cruciferous vegetables daily to regulate your estrogen levels. Broccoli, kale, 
                                                   cabbage, arugula and collard greens keep your liver clean and help process your 
                                                   hormones optimally so you can feel your best. Note: If you have a thyroid problem, do 
                                                   not eat rawcruciferous vegetables because they suppress thyroid function.


                                                   2. Choose organic vegetables since they are grown without added hormones or 
                                                   pesticides, which contain xenoestrogens that add an extra burden to your body. 
                                                   These outside hormone-like invaders mimic estrogen in your body, and often lead to 
                                                   increased symptoms like irritability when your liver is overloaded. 


                                                   3. Buy pastured chicken or grass-fed beef to avoid ingesting the added hormones and 
                                                   antibiotics typically used in farming practices, which can lead to hormonal imbalances 
                                                   in your body. The meats you find at the grocery and at restaurants are 
                                                   factory-farmed unless they are specifically labeled pastured /free-range or 
                                                   grass-fed. A great movie to see is Food, Inc., which shows a behind-the-scenes view 
                                                   of factory farming. Watch it here for free. The segment about chicken production 
                                                   (12:15) profoundly changed my desire to find good sources for the meats I eat.




                                                   Marnie Reasor, Classical Homeopath
                                                   www.ResplendentHealing.com

 



Lifestyle Recommendations During Menopause  
- Dr. Robert Hackman

Formula W™ by AdvoCare is an important development in women's health supplements. At AdvoCare, we also promote a wellness lifestyle, recognizing that no matter how sophisticated the supplement, nothing replaces or substitutes for wise dietary choices, regular physical activity and other health-promoting practices.

Many Formula W™ users are in the perimenopausal time of their lives - a period where a wellness lifestyle can make a huge difference in how one feels, looks and performs. A distillation of some of the top recommendations by leading health authorities includes:

Diet

Consume a diet rich in whole grains, vegetables and fruits (7-9 servings of vegetables and fruits per day). 
Consume oily fish twice weekly or take a scientifically sophisticated omega-3 fatty acid supplement. Remember, not all omega-3 supplements are of the same quality or effectiveness. 
Maintain bone health. At a minimum, consume at least 1,200 mg calcium and 800 IU vitamin D daily. Additional nutrients such as vitamin K, magnesium and key trace elements such as zinc, boron and manganese are also important for a complete bone health supplement. 
Moderate your intake of alcohol to one serving per day. 
Balance calorie intake with physical activity (calorie expenditure) to maintain a healthy weight. 
Avoid hot flash triggers, e.g., spicy foods, hot beverages.

Physical Activity

As we grow older, more physical activity is needed than when we were younger, since metabolism naturally slows down with aging. A wellness lifestyle includes some form of physical activity nearly every day. Most health experts recommend a minimum of 30 minutes and up to 60-90 minutes of physical activity, five or six days a week. Be sure to combine weight-bearing activity (to maintain muscle mass and strength) with aerobic activities to help burn calories and maintain cardiovascular health.

Lifestyle

Do not smoke. Because smoking is linked to a decline in estrogen levels, women who smoke reach menopause about two years earlier than nonsmokers. Smoking doubles a woman's odds of developing heart disease and is a major risk factor for osteoporosis. 
Be prepared to regulate your body heat. Dress in layers that can be removed if hot flashes occur. Use a hand-held or battery-operated fan for cooling. Take a tepid or cool shower before bedtime.

For more information and products contact Maggie Krukowski

All articles posted here are the opinions of the authors! 
Minniepauz.com does not condone nor condemn anyone's personal opinion!

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Menopause and Diabetes

 
 

Does that morning Danish leave you craving another treat two hours later? Do you grab a candy bar to cope with your afternoon slump -- and then reach for a cola to get out of your post-slump slump?

If you’ve found that munching sugary snacks just makes you crave more sugary snacks, you’re not alone. Eating lots of simple carbohydrates -- without the backup of proteins or fats -- can quickly satisfy hunger and give your body a short-term energy boost, but they almost as quickly leave you famished again and craving more.

How can you stop sugar cravings once and for all? Here's expert advice.



The Effects of Menopause on Diabetes 
Menopause is a rite of passage for women, but not always a pleasant one. And it can be even more troublesome for women with Diabetes. Menopause signals changes in a woman's body beyond your control, but if you know to expect, you can better deal with the changes ahead.

Changes in blood sugar levels: Estrogen and progesterone affect your cells' response to insulin. As you go through menopause, changing hormone levels can cause your blood sugar to fluctuate, making it more difficult to control. You might need to check your blood glucose levels more frequently during menopause so they don't get out of control and lead to complications such as nerve damage, eye disease or cardiovascular problems.

Weight gain: One of the most dreaded effects of menopause, gaining weight can change the amount of insulin or oral medications you need to regulate your blood glucose levels. You can keep weight gain at bay if you make healthy lifestyle choices such as eating nutritious foods and exercising daily. Hopefully you have already implemented these behaviors so you don't have to make drastic lifestyle changes amid the radical physical changes your body is undergoing during menopause.

 Metformin cuts breast cancer risk in older women with diabetes 
A study in the Journal of Clinical Oncology found metformin-treated postmenopausal women with diabetes were 25% less likely to develop breast cancer after 11 years compared with women without diabetes who did not take the drug. Researchers also found that women who took diabetes drugs other than metformin had a slightly higher risk of breast cancer than women without diabetes. 

 Nuts for Diabetes 
According to Dr. Andrew Weil.... "If you don’t go overboard, munching on nuts daily can help lower your risks of developing metabolic syndrome, type 2 diabetes and heart disease." Read the full story 
 

 Diabetes: Blood sugar triggers fat deposits in arteries

Fat deposits are increasingly found in the heart muscle cells of diabetes patients as an expression of an impaired metabolism. The precise cause of this was unknown up until now. Now researchers at the Medical University of Vienna in the Division of Endocrinology and Metabolism in cooperation with the MR Center of Excellence Vienna have shown that high blood sugar in combination with insulin, not an influx of fats, results in such deposits within a few hours. 

These findings could serve as the basis for even more heart-friendly treatments of diabetes patients, particularly in the early stages of the disease. In the study published in the respected American journal "Diabetes", 18 healthy women and men were given a large amount of grape sugar intravenously. 

Fat deposits in the heart within hours

Already within six hours, the glucose already caused clearly visible fatty deposits in the heart. The injection of grape sugar, in combination with the release of insulin caused by the sugar, resulted in an overexertion of the heart’s metabolism. This proves that fatty deposits can occur without the direct influx of fats.

This was made visible for the first time using magnetic resonance imaging and spectroscopy. This method makes it possible to observe the beating heart, not only as it works, but non-invasively and without ionizing radiation as it metabolizes energy. 
 

 Although 24 million people have been diagnosed with diabetes, it's estimated that an additional 5.7 million people have the disease but don't know it. Type 2 diabetes doesn't always have clear symptoms, and often isn't diagnosed until found accidentally during a physical or check-up. Is the condition really symptomless or are there early warning signs that can sound the alarm?


 

Diabetes and menopause: What to expect

Menopause is the phase of life after your periods have stopped. Diabetes and menopause may team up for varied effects on your body, including:

  • Changes in blood sugar level. The hormones estrogen and progesterone affect how your cells respond to insulin. After menopause, changes in your hormone levels can trigger fluctuations in your blood sugar level. You may notice that your blood sugar level is more variable or less predictable than before. If your blood sugar gets out of control, you have a higher risk of diabetes complications.
  • Weight gain. Some women gain weight during the menopausal transition and after menopause. This can increase the need for insulin or oral diabetes medication.
  • Infections. Even before menopause, high blood sugar levels can contribute to urinary and vaginal infections. After menopause — when a drop in estrogen makes it easier for bacteria and yeast to thrive in the urinary tract and vagina — the risk is even higher.
  • Sleep problems. After menopause, hot flashes and night sweats may keep you up at night. In turn, the sleep deprivation can make it tougher to manage your blood sugar level.
  • Sexual problems. Diabetes can damage the nerves of the cells that line the vagina. This can interfere with arousal and orgasm. Vaginal dryness, a common symptom of menopause, may compound the issue by causing pain during sex.


It is known that women with type 1 diabetes have a delayed menarche and a greater prevalence of menstrual disorders than women without diabetes. However, before this research, little was known about the menopausal transition among type 1 diabetic women. The Familial Autoimmune and Diabetes (FAD) Study recruited both adult individuals who were identified from the Children's Hospital of Pittsburgh Type 1 registry for the years 1950-1964 and their family members. Unrelated non-diabetic control probands and their relatives were also evaluated. The study appears in Diabetes 50(8):1857-1862,2000 by Janice S. Dorman, Ph.D. et al.  

My Favorite Diabetes Links

DiabetesForum.com

WebMd Diabetes

Diabetes 101

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How calcium can help with menopause symptoms

Calcium, especially when contained in food, has a sedative effect on the body. A calcium deficiency in the body causes restlessness and wakefulness. For adults, doses of approximately 600 milligrams of liquid calcium have been shown to have a relaxing effect.

The lack of calcium and magnesium can cause leg cramps during the night. Calcium and magnesium produce calming effects on the brain.

Calcium can help you SLEEP!

Calcium, especially when contained in food, has a sedative effect on the body. A calcium deficiency in the body causes restlessness and wakefulness. For adults, doses of approximately 600 milligrams of liquid calcium have been shown to have a relaxing effect.

Dosage: 1,500-2,000 mg daily, in divided doses, after meals and at bedtime.

Magnesium, in doses of approximately 250 milligrams, can help induce sleep. Magnesium deficiency is responsible for nervousness that prevents sleep. Magnesium-rich foods include kelp, wheat bran, almonds, cashews, blackstrap molasses, and brewer's yeast.

Dosage: 1,000 mg daily.

Note: The lack of calcium and magnesium can cause leg cramps during the night. Calcium and magnesium produce calming effects on the brain. They are essential for normal sleep. Calcium and magnesium taken 45 minutes before bedtime have a tranquilizing effect. Use a 2:1 ratio, such as 500 mg of calcium and 250 mg of magnesium in tablet or capsule form.

 

Ladies.............I've recently found out some interesting information about Calcium tablets. If you, your mom, sister, grandmother, anyone........who takes calcium tablets, please pass this info on to them.  Unless the tablets dissolve in your stomach right away, the calcium does NOT get into your bloodstream but passes through your intestines.  Therefore, you are NOT getting the calcium to your bones and you are wasting your money.  So......do this little test......put a tablet of your calcium into a small container with vinegar.  It should dissolve within minutes....THAT is good.

I have to take one with vitamin D and one without daily, so I tried it on both brands...........the first one dissolved in 5 minutes.  The 2nd one, Walgreens brand TOOK ONE HOUR TO DISSOLVE!!! I'm not going to throw them away, but instead I chew them up.........not so bad, just tastes like chalk but I won't buy them again.  I NEED the calcium.........so do you. Barb...CA

 

# Prevent osteoporosis. The body cannot absorb calcium from food or supplements without an adequate intake of vitamin D. If calcium levels in the blood are too low, the body will steal the mineral from the bones and supply the muscles and nerves with the amount they need. Over time, the loss of calcium in the bones can lead to osteoporosis, a disease in which bones become porous and prone to fractures. After menopause, women are particularly at risk for developing this condition. Vitamin D taken along with calcium plays a critical role in maintaining bone density.

In a study of 176 men and 213 women over age 65 done at Tufts University, those who took 500 mg of calcium and 700 IU of vitamin D daily for three years experienced a decrease in bone density loss. Moreover, the incidence of fractures was cut in half. In another study, of 3,270 healthy elderly French women, a daily dietary supplement of 1,200 mg calcium plus 800 IU of vitamin D lowered the incidence of hip fractures by 43% in just two years.

Osteoporosis

Note from Dee: I've been doing some research on calcium and have discovered that many of us are taking the wrong form. We need to be taking calcium with magnesium and vitamin D, in a liquid form, not in pill form. (this can be liquid or powder that you mix with liquid). We are wasting our money on calcium pills, because they do not get absorbed by our bodies before they are eliminated. 

The magnesium* helps your body absorb the calcium. Magnesium also works in tandem with calcium in many body functions, such as contraction and relaxation of all muscles – including the heart; transmission of messages down nerve cells; continuous growth and development of bones and teeth and assists in chemical reactions within the body such as the production of new cells and using energy. Here is a trustworthy source to get liquid calcium:

Natural Med Herbals 
You can ask questions directly to Pharmacist Erik Cornett on the Minnie Pauz Forum

Please check with your doctor to determine your personal needs in regards to taking and combining ANY supplements.

Women over 50 need at least 1,200 mg of calcium a day. Some experts suggest 1,500 mg for postmenopausal women. These calcium-rich foods will help you reach your requirement.

Food Serving Size Calcium Content (mg)
Skim milk 1 cup 302
Plain, low-fat yogurt 1 cup 415
Mozzarella cheese 1 ounce 207
Cottage cheese ½ cup  78
Salmon, canned (with bones) 3 ounces 167
Tofu (processed with calcium) 4 ounces 145
Spinach, cooked ½ cup  84
Broccoli, cooked ½ cup  68
Collards, cooked ½ cup 168
Calcium fortified cereal (total) 1 cup 300
Calcium fortified juice 1 cup 300
Resources: 

National Osteoporosis Foundation

http://www.betterbones.com

Interesting Notes: 
65% of Asian American women have low bone mineral density, one of the major signs of onset of osteoporosis,  
the most common bone disease in the world.  
National Asian Women's Health Organization

 

 

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