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MenoPause Blog

  • For now, let the buyer beware of supplements

    by Margery Gass | Dec 18, 2013
    Three new studies of dietary supplements with dismal results were released this week (Annals of Internal Medicine). The problem is very basic — most supplements on the market have not been tested for safety and have not even been tested to see if they actually work. The Food and Drug Administration (FDA) estimates 50,000 adverse reactions to dietary supplements every year. Supplement sales in the U.S. reached $28 billion in 2010. That is a lot of money to give away for no benefit and possible harm.

    On the positive side, a few manufacturers do provide a written guarantee that the product is made under the FDA’s “good manufacturing practice” conditions and a Certificate of Analysis assuring that what is written on the label is what is in the bottle. That’s good, but it’s not common enough. If you are taking supplements, look for “USP Verified” on the label -- it means the supplement has been inspected and approved under the United States Pharmacopeia Convention. Unfortunately, less than 1% of the 55,000 products on the market have this label. 

    “The real answer is that, until the day comes when medical studies prove that these supplements have legitimate benefits, and until the FDA has the political backing and resources to regulate them like drugs, individuals should simply steer clear,” write Dr. Paul Offit and Dr. Sarah Erush of Children’s Hospital of Philadelphia in an op-ed in the New York Times this week.
    Go comment!
  • Video from our 2013 meeting: Physical therapy for painful sex

    by Margery Gass | Nov 19, 2013
    Over the next weeks, we’ll be sharing highlights from our October meeting in Dallas, Texas. First up, physical therapist Hollis Herman gets frank and funny on the topic of sex after menopause and pelvic floor problems in women. 

    She explains comfortable positions for those with hip problems and pelvic pain, what you need to know about lubricants and dilators, and the location of the g-spot. You’ll learn fun facts (did she say boomerang?) and vital information about sexuality and aging. Frankly, it’s a must-see.

    Watch it here

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  • Take a walk with Mother Nature and enjoy some measurable benefits

    by Margery Gass | Nov 05, 2013
    You know how good it feels to take a walk. Scientific research suggests even more benefit from walking in the woods or a park. It can make you healthier.

    Part of the benefit is stress reduction: Walking in a forest or park can lower pulse rate, blood pressure, and levels of the stress hormone cortisol. Plants also emit chemicals called phytoncides that protect them from rotting and insects, and recent Japanese studies showed that when people breathe in phytoncides, they experience increased immune function — higher levels of white blood cells and natural killer cells that help to protect our health. As American naturalist John Muir wrote, “Keep close to Nature’s heart…and break clear away, once in awhile, and climb a mountain or spend a week in the woods. Wash your spirit clean.”
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  • Antidepressants and your bone health

    by Margery Gass | Oct 21, 2013
    There’s good news about your bones this week: Women in middle age do not need to worry about the bone effects of using antidepressants. No association between use of antidepressants and later changes in bone mineral density was found in a new study, analyzing 10 years of data from 1,972 women in the Study of Women’s Health Across the Nation. The women were ages 42 to 52 years at the beginning of the research period. Selective serotonin reuptake inhibitors and tricyclic antidepressants were the specific medications studied.
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  • Compounding pharmacies come under scrutiny

    by Margery Gass | Oct 02, 2013

    An investigative reporter published disturbing findings about compounded hormones in the October issue of More Magazine. Cathryn Jakobson Ramin found that the pills in 12 prescriptions filled at different compounding pharmacies and tested by Flora Research Laboratories in Grants Pass, Oregon, did not contain what they were supposed to: all had less estriol than was prescribed, most had more estrone and estradiol than was prescribed, and nine out of twelve did not contain enough progesterone.

    “Had the compounded products we tested been commercially manufactured pharmaceuticals, none would have passed the FDA’s requirements for finished drugs, which mandate that the contents be no less than 90 percent or more than 110 percent of the prescription as the physician has written it,” writes Ramin.

    Compounding pharmacies made news after last fall’s tragic meningitis outbreak caused by contamination in a Massachusetts pharmacy. It spurred the US government to draft new legislation that begins to require greater regulation of pharmacy compounding.

    That said, compounding pharmacies do provide valuable services in select circumstances. For example, if you are allergic to an ingredient in your medication, a compounding pharmacist can mix a special batch for you that does not contain that ingredient. If you buy medications from a compounding pharmacy, you can check whether your compounder is accredited by the Pharmacy Compounding Accreditation Board at www.pcab.org. Or you can ask your compounder if they do skip lot testing, meaning that they select random products monthly to test for purity and safety. Also be aware that all hormones carry risks and none is approved for anti-aging purposes because there is no adequate evidence to support the claim.

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  • Health of vagina influenced by microbiome

    by Margery Gass | Sep 16, 2013
    The vagina is one of the body sites under study in the Human Microbiome Project examining the 100 trillion good bacteria that live in and on the human body—our inner ecosystem. These helpful bacteria are essential for digesting food, synthesizing vitamins, and protecting us from disease-causing bacteria.

    In a healthy woman, bacteria called Lactobacilli produce the lactic acid that makes the vagina acidic and relatively unfriendly to harmful microbes. But when vaginal bacteria are out of balance, harmful bacteria may invade. Research shows that this is associated with health problems, including vaginal dryness and bacterial vaginosis, an unpleasant condition that increases the risk of other infections. Nearly 30% of American women suffer from bacterial vaginosis.

    Douching can cause the microbial imbalance that leads to bacterial vaginosis, and one in three American women douche. Don’t do it. Women may believe that they are practicing good hygiene, but they are actually increasing their risk of infection.

    Much more microbiome research is on the horizon. We hope to know more soon about the microbial changes that occur with menopause and aging, as well as how women can maintain the best balance of good microorganisms in their bodies. Stay tuned!

    Go comment!
  • Just 21 minutes for better relationships

    by Margery Gass | Aug 20, 2013
    Is it inevitable that your marriage will take a downhill slide? What sociologists call “marital quality” often declines over time, but researchers found a way to stop the slipping and it takes only 21 minutes. The heterosexual couples in this study had been married for an average of 11 years. Each wife and husband was asked to write for 7 minutes about a recent conflict in the relationship, but they had to write about it from the perspective of a neutral observer. Then, the researchers used email reminders to have the couple do this two more times for other disagreements. That’s all it took to eliminate the decline in the quality of the couple’s relationship. A very handy, inexpensive technique.

    The takeaway? To best handle conflict, step outside yourself and look at your disagreement with another person as if you were an observer with no vested interest. This advice will likely improve any type of relationship, not just marriage. Here’s to happy relationships!
    Go comment!
  • You got your wish! Nonhormonal alternatives have arrived

    by Margery Gass | Aug 12, 2013
    Earlier this year, we asked women whether they thought there was a need for prescription nonhormonal treatments for menopausal symptoms. Overwhelmingly (89%), women said “yes!” We took that message to the FDA. The good news is that now there are two new approved treatment options for menopausal symptoms. Ospemiphene (Osphena) received FDA approval in February for painful sex that can be a consequence of the changes in and around the vagina that can come with low estrogen levels. Then in June, the FDA approved low-dose paroxetine (Brisdelle) for moderate to severe hot flashes. Ospemiphene acts like an estrogen in some tissues, but not others. The major advantage is its estrogen-like activity in the vagina and surrounding tissues, which keeps them supple and moist. It acts on the uterus as well, so you and your healthcare provider need to be alert to any unusual vaginal bleeding. Paroxetine is a name you might have heard before because in higher doses, it’s sold as the antidepressant Paxil. It doesn’t take much to reduce hot flashes, so the dose is lower than that used for antidepressant activity. It carries the same warnings as the antidepressant formula, so be sure to discuss all treatment options with your healthcare provider to determine if it is right for you.

    This is a milestone year. For decades, hormone therapy has been the only medication approved for menopausal symptoms. Now there are choices. We hope this encourages others to conduct research in the field of menopause.

MenoPause: the blog!

Posts to our Blog are written by NAMS staff members and Dr. Margery Gass. All posts are reviewed and edited by Dr. Gass. 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. 

Margery L.S. Gass, MD, NCMP
NAMS Executive Director

An internationally recognized leader in the field of menopause, Dr. Gass became Executive Director of The North American Menopause Society in 2010. Dr. Gass has been an investigator on numerous research projects, including serving as a principal investigator for the Women’s Health Initiative, and has published and presented on a wide range of topics related to menopause, including osteoporosis, sexual dysfunction, and hormone therapy.


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