Navigating through menopause isn’t always easy. The physical and mental challenges of a changing body come at a time when women face plenty of other challenges: too much work, not enough time, and taking care of everyone—the kids, the job, the aging parents, the community—except yourself. So I regularly give women these top 10 tips to help them stay healthy and happy at this time of their lives:
1. Make some time for yourself Schedule some time for exercise, friends, and yourself on your calendar. Use that you-time for things like meditation, mindfulness, yoga, prayer, reflection on where you are going in life, or to just enjoy the sunset.
2. Eat healthy and exercise Because your metabolism slows down at this time, you’ll gain weight unless you change your lifestyle, so eat less, eat healthy—a Mediterranean diet, for example—and schedule time for exercise. This will not only help you avoid heart disease and other health problems but will also help keep your brain healthy. A recent study published in the journal Neurology found that older adults who did not exercise or exercised only lightly experienced a decline in their cognitive function equal to 10 more years of aging compared with those who exercised moderately or intensely. No time for the gym? Try jump-starting your day with 7 minutes of vigorous aerobic exercise, and work in exercise in 5- or 10-minute time slots.
3. Sleep at least 7 hours every night Burning the candle at both ends not only zaps energy but also makes you less focused and less productive and increases the risk of Alzheimer’s disease.
4. Don’t fear hormones If you are under age 60 or within 10 years of menopause and have bothersome hot flashes, hormones can quell those while also protecting your bones and may benefit your heart and brain as well. But if you are older than age 60, don’t start hormones without a good reason because it may actually increase your risk of heart disease and cognitive problems. Do be afraid of compounded hormones because these are notFDA approved, regulated, or monitored and carry risks of over- or under-dosing or contamination. If you can’t take hormones, you don’t have to tough out the hot flashes. Some tested nonhormonal medications and alternatives can help, such as the FDA-approved low-dose antidepressant paroxetine or other antidepressants, gabapentin, clinical hypnosis, or cognitive behavioral therapy.
5. Keeping your relationship healthy with intimacy Sexual intimacy with or without intercourse is very important to healthy relationships. Painful intercourse can make you avoid sex, which can put your relationship at risk. So don’t be afraid to discuss painful sex with your partner and healthcare provider, and try lubricants and moisturizers. If those are not enough, low-dose vaginal estrogen has minimal absorption and is safe and effective, despite the warnings on the label, which are really for hormones that get distributed throughout the body (systemic), such as in pill or patch form. In addition, a new oral drug ospemiphene also treats painful sex if neither vaginal nor systemic hormones are right for you.
6. If you just don’t care about sex anymore, talk to your healthcare provider No longer being interested in sex can be detrimental to your relationship and could be due to medications, stress, overwork, fatigue, or other fixable causes. Medications may help, too, including the new FDA-approved drug flibanserin, which has a positive, although small, effect on desire for women who aren’t yet in menopause.
7. Know your numbers Know what your blood pressure, cholesterol levels, bone density, and heart disease and breast cancer risks are so you can head off problems with diet, exercise, and other lifestyle changes, or medications.
8. Get regular exams Keep up with pap smears, including the test for HPV, and mammograms. You can’t treat a problem that you don’t know about.
9. Don’t tough out tough times Know the signs and symptoms of depression and burnout. If you feel overwhelmed, isolated, guilty, sad, or depressed every day for 2 weeks, gain or lose weight, or sleep too little or too much, seek help. Get outside in the sunshine, try “walk and talk” therapy with friends, or get counseling. If you are depressed, don’t be afraid to take medication to help yourself through a tough time.
10. Don’t take lots of supplements, but do get enough calcium and vitamin D Get enough calcium and vitamin D from your diet and sunshine or supplements to protect your bones, but don’t take too much calcium, which can increase your risk of clogged arteries.
Work with your healthcare provider on these 10 tips, and if they can’t help you navigate the menopause transition and help improve your health, find someone who will. You can find a NAMS Certified Menopause Practitioner (NCMP) on the NAMS website as well as a wealth of information about women’s health and menopause on our For Women pages. Our Menopause Guidebook, which is the most complete and current discussion of menopause available anywhere, can be purchased through the NAMS store or on Amazon.
Although the medical community doesn’t really call a broken bone a “bone attack,” you should take a broken bone just as seriously as a heart attack! When you are over 40 and break a bone from a fall that’s not a big trauma—maybe from tripping on a curb and hitting the ground—that’s not something that could happen to anyone. It means your bones aren’t as strong as they should be, and you need to see your healthcare provider about it and take steps to strengthen your bones. Learn more about these breaks that we call “fragility fractures” and what to do about them in the new NAMS video here.
It’s National Wear Red Day, a reminder that women need to take good care of their hearts because heart disease is their number one killer. When women have a heart attack, they may not even realize it because their attacks aren’t like men’s. Men often have dramatic symptoms, such as chest-clutching pain, when the plaque in a clogged artery ruptures and suddenly stops blood flow. But in women’s hearts, blockages often just keep building up slowly, producing heart attacks with subtle symptoms, such as weakness, nausea, lightheadedness, arm pain, fatigue, or feeling short of breath even though your chest doesn’t hurt. So if you have any of these symptoms, and your instinct says this just isn’t right, go to the emergency room.
Meanwhile, we can do our best to make sure a heart attack never happens. Exercise and a healthy diet are essential. And yes, your Valentine’s chocolate can be good for your heart—just without a lot of sugar, so eat it in moderation. And the other flavanoid-rich (and famous) heart health booster is red wine. But have that in moderation, too—one daily 5-ounce glass and not more. If you are 65 or older, a baby aspirin every other day can also be a healthy choice, but for younger women, its risks outweigh the benefits.
If you are currently being treated for breast cancer or if you are a breast cancer survivor, the hot flashes can be miserable, but conventional estrogen-based hormone therapy is not an option. That doesn’t mean you have to keep living in hot flash hell. Women who have been treated for breast cancer and are suffering from menopausal symptoms have more options than previously. These include lifestyle approaches as well as effective nonhormonal medications. Want to learn what can help and what’s safe and effective? Then tune in to this new video where Dr. Marla Shapiro and I discuss the options for you. As you move forward, it makes sense to seek help from a knowledgeable clinician, and you can look for one of those here. The NAMS Certified Menopause Practitioners listed have passed a competency exam in menopause practice and keep up with menopause professional education.
A new year is upon us. It is a great time to think about where you are and where you want to be. What are your personal health resolutions for 2016? Here are a few options to consider:
Research shows that just a few of the benefits of robust and positive social relationships for women are longer life, better health, and better sleep.
Taking on that challenge can improve your brain health even more than regular socializing. Older adults who learned new skills when they took up new hobbies got significant boost in memory—even more than those who socialized regularly.
Studies of people who use step counters show they increase their activity levels an average of 27% and walk at least 2,000 steps per day. Those little numbers can be big motivators.
Trick your brain! Research shows that willpower isn’t limitless, so don’t rely on willpower alone. Try substituting a good habit for a bad one. For example, if you sit and read to relax, try walking while you listen to an audiobook instead.
Being involved in spiritual and religious life has been linked to positive health outcomes, so stick with your meditation or prayer and stay involved with your religious or spiritual community.
People show more improvement in performance when they have specific and ambitious goals rather than easy or general ones. So go for the brass ring!
Volunteering and donating don’t just help change the world for the better. Many studies have shown that helping others makes people happier. Volunteering also boosts your self-confidence, gives you a sense of purpose, combats depression, and helps you get physically healthy, too.
This little trick can help you keep clutter under control. Clutter bombards your mind and sends your brain a message that life is out of control. If you keep it under control, you’ll reduce your stress.
There’s plenty of controversy surrounding the American Cancer Society’s (ACS) updated breast cancer screening recommendations for average-risk women (those without a family history or without dense breasts). The new guidelines recommend that the minimum age to start mammograms should be 45 instead of age 40 and that mammograms be done for women age 55 and older only every other year rather than every year. However, the ACS did qualify their recommendations, saying that women may begin mammograms at age 40 or have annual mammograms at age 55 and older if that’s what they want. The ACS also said that breast exams are not ever recommended.
Not everyone agrees with the ACS recommendations, including the American Congress of Obstetricians and Gynecologists, which continues to support yearly mammograms starting at age 40 as well as having a healthcare provider examine your breasts. Although some research supports the ACS guidelines, not all of it does, as breast-imaging specialist Jennifer Harvey, MD, outlined for NAMS. Regular mammograms reduce breast cancer deaths up to 48% for women ages 40 to 79, she says. She also points out that a high proportion of breast cancer deaths are in younger women, because they tend to have more advanced cancers and their tumors grow faster.
Proponents of the ACS guidelines cite the anxiety that false-positive mammogram results can cause as one reason for the changes, but Dr. Harvey says that this is usually just temporary and reminds us that finding breast cancer earlier may decrease the amount of treatment needed. For example, it can make the difference between having just a lumpectomy or needing additional therapies such as radiation, chemotherapy, or antiestrogen therapy. As for women age 55 and older, Dr. Harvey says, it’s difficult to figure out who is at average risk. It’s harder to see cancers in dense breasts, raising the risk of missing cancers. Depending on their risk, women who have dense breasts are candidates for 3D-tomosynthesis or other screening modalities that show more than regular mammograms but do have more radiation exposure.
Although annual mammography increases radiation exposure and increases risk of false alarms, mammography saves lives. Today, it is difficult to predict who has an early cancer that won’t progress, although that is being researched. If you want to have the best chance of detecting breast cancer early or if you are at higher risk because of your family history or you have dense breasts, you should discuss with your provider what your best screening starting age and frequency should be.
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JoAnn V. Pinkerton, MD, NCMP