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MenoPause Blog

  • Don’t DIY With Herbs and Supplements for Menopause

    by JoAnn Pinkerton | Jun 06, 2016

    You’ve seen the ads, articles, and testimonials pop up on the Internet touting this kind of supplement or that kind of herb to relieve hot flashes or help with depression and mood during menopause. But if you’re thinking of trying any of these products to self-treat your symptoms because you’ve heard bad things about hormones, you’ll likely be wasting your money and may even be courting danger. A published report last fall found that thousands of people wind up in hospital emergency departments every year after taking supplements they believed were safe but that had harmful side effects.

    NAMS brought together a team of experts to take a critical look at all the available studies on herbs, supplements, and other nonhormonal approaches for treating hot flashes. What did they find? They found that besides maybe soy foods and supplements, no other herbal or supplement showed an effect any greater than a sugar pill (placebo). Soy did get a qualified nod from the team because it may help some women, but only women whose bodies can use soy to produce a compound called equol. An equol supplement that may help other women is being developed, but it’s not on the market yet. The popular black cohosh, which is an ingredient in many over-the-counter combinations advertised for menopause symptoms, not only does nothing for hot flashes, but it may cause liver damage. And proponents of yam creams probably don’t know that they often don’t even contain yam. In fact, some have been adulterated with steroid drugs, including estrogen and progesterone-type compounds.

    If you are reluctant to use hormones for your menopause symptoms, there are some nonhormonal approaches you can consider. Studies show that a form of cognitive-behavioral therapy, and to a lesser extent, clinical hypnosis can help. Talk to your healthcare provider also about nonhormonal prescription drug therapies proven to reduce hot flashes. And, unless there’s a medical reason you cannot take hormones, you might want to revisit the risks and benefits of them with your healthcare provider, because we have learned over the past few years that hormone therapy begun early after menopause may not pose the dangers that later hormone therapy may.


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  • Straight Talk on Talc

    by JoAnn Pinkerton | May 20, 2016

    There have been several stories in the news about legal victories for women and their families who have sued manufacturers of talcum powder over claims that it caused their ovarian cancers. If you have used products containing talc on your body, particularly in the genital region, you may be concerned. Many studies have looked at the possible link between talcum powder and ovarian cancer, but the results have been mixed. It’s true that some retrospective case-control studies have found a slightly increased risk, but these types of studies often rely on a person’s memory, in this case of talc use many years earlier. Two studies that followed individual women over time, which did not have the potential for bias, did not find an increased risk. Some experts suggest that if there is an increased risk of ovarian cancer with genital talc use, it is very small at an increased relative risk of 1.2 (20% risk) over a woman’s baseline risk of 1.3%. Ovarian cancer is relatively rare, with approximately two out of 1,000 women developing ovarian cancer in 10 years of follow-up. If this small increased risk is true, this would mean an extra four cancers found out of 10,000 women over 10 years of follow-up. Research continues, but until more information is available, women should be cautioned against using genital talc powder. For women who have used genital talc in the past, there are no new recommendations for ovarian cancer screening, because current screening methods are not recommended for women at average or slightly increased risk. Read more on what the American Cancer Society has to say about talc here.


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  • The ABCs of SERMs

    by JoAnn Pinkerton | May 02, 2016

    If you are going through menopause, you probably have heard about alternatives to estrogen therapy that can treat your hot flashes and other menopause symptoms. These include selective estrogen receptor modulators (SERMs), which as their name implies, selectively activate or block estrogen receptors in certain areas of the body and not in others. That can make them safer than estrogen alone and result in fewer side effects.

    There are FDA-approved SERMs to selectively target, prevent, and treat several diseases, including breast cancer and osteoporosis, as well as the genitourinary syndrome of menopause, also known as vulvovaginal atrophy, which can lead to painful sex.

    And although there is no SERM that alone can relieve hot flashes, there is a SERM combination being used for hot flashes that combines estrogens with the SERM bazedoxifene. Together, they form what’s called a tissue-selective estrogen complex, or TSEC. This drug has been FDA approved to treat hot flashes and to prevent osteoporosis in women with a uterus.

    You should talk to your clinician about SERMs if you are experiencing hot flashes and have a history of breast cancer, have been told you have low bone density, want to avoid uterine bleeding or changes in breast density, or sex is painful for you. For a more thorough discussion about SERMs, see the NAMS video What Selective Estrogen Receptor Modulators (SERMs) Can Do for You.


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  • Dr. Pinkerton's Top 10 Tips for Menopause

    by JoAnn Pinkerton | Mar 29, 2016

    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.


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  • Have You Had a Bone Attack?

    by JoAnn Pinkerton | Mar 11, 2016

    We're pleased to have a guest post from Dr. Risa Kagan.



    Risa Kagan, MD, FACOG, CCD, NCMP

    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.

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  • Send Your Heart a Valentine

    by JoAnn Pinkerton | Feb 05, 2016

    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.


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  • You Can Tame Hot Flashes—Even with Breast Cancer

    by JoAnn Pinkerton | Jan 11, 2016

    We're pleased to have a guest post from Dr. Andrew Kaunitz. 



    Andrew M. Kaunitz, MD, FACOG, NCMP

    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.


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  • Make Healthy Resolutions for 2016

    by JoAnn Pinkerton | Jan 01, 2016

    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:

    • Work on your relationships with your family, your partner and your colleagues

    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.

    • Learn a new skill

    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.

    • Buy a step counter and improve your personal health and fitness

    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.

    • Choose a new, healthy habit AND get rid of the unhealthy habit

    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.

    • Focus on your spiritual life

    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.

    • Get ambitious! Set a new career, family, or social goal

    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!

    • Support a worthy cause by volunteering your time or money or donating to a new cause

    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.

    • Give or throw away something every time you bring a new item into the house

    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. 


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MenoPause Blog

We strive to bring you the most recent and interesting information about various aspect of menopause and midlife health. We accept no advertising for our website. We want you to have accurate, unbiased, evidence-based information. 


JoAnn V. Pinkerton, MD, NCMP
Executive Director

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