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Blog: MenoPause ~ take time to think about it

  • Hot flashes and night sweats before menopause

    by Margery Gass | Jun 17, 2013
    Hear “hot flash” and most of us think of menopause. But reproductive-aged women have them too. How many healthy premenopausal women have vasomotor symptoms (hot flashes and night sweats), and why?

    In women ages 45 to 56 with regular menstrual cycles, about 55% have experienced vasomotor symptoms at some point, shows new research in Menopause. The cross-sectional study examined 1,513 women in the Pacific Northwest. Native American women were most likely to report vasomotor symptoms (66.7%), followed by black women (61.4%), and white women (58.3%).  Asian and Hispanic women in the study were least likely to report ever having vasomotor symptoms (about 8% and 37%, respectively), similar to the patterns during the menopausal transition and early postmenopause.

    Why would premenopausal women have hot flashes? As levels of estrogen go down in the body, numbers of hot flashes go up. Estrogen naturally declines as a woman gets older, especially at menopause. But estrogen levels can fluctuate enough to cause hot flashes years before menopause. Some women have hot flashes right after giving birth. Some may get them from intense exercise or from illness.

    The relationship between reproductive status, general health, hormone levels, age, and vasomotor symptoms is complex and needs further investigation. But rest assured that it is perfectly normal to have hot flashes in the years before menopause. If you are still having regular cycles, these vasomotor symptoms do not necessarily mean menopause is beginning.

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  • It’s not your imagination: menopause memory struggles are real

    by Margery Gass | May 30, 2013
    Memory struggles at menopause are real, showed a study published in our journal Menopause. The study really struck a chord. News stories followed quickly, including two segments on The Today Show. One reason the study got so much attention is that it validated women’s experience. In the first segment on Today, co-anchor Savannah Guthrie interviewed Pauline Maki, PhD, from the University of Illinois at Chicago, who is one of the study authors and a member of the NAMS Board. The message for women, Dr. Maki said, is “You’re a very good judge of how good or how poor your memory is. It’s important that women recognize what they feel can be validated by scientific research, that it's not all in their head.” In the second segment Guthrie interviewed NAMS member Rebecca Brightman, MD, from Mount Sinai School of Medicine, who seconded that message, saying “You’re not crazy. This is real.”

    Dr. Brightman also offered reassurance—this isn’t something you’ll have to live with forever. Other studies have shown that women’s former memory levels usually return after the menopause transition is over, she pointed out.

    While you’re struggling with the problem, try to get enough sleep, because that can play a major role in helping you stay sharp. Use little tricks to help you perform better, such as making notes and lists. And have faith—it’s going to get better.

    The study, “Objective cognitive performance is related to subjective memory complaints in midlife women with moderate to severe vasomotor symptoms,” was published online in May and will be published in the December 2013 print edition of Menopause.
    Go comment!
  • Don’t worry, be (heart) happy

    by Margery Gass | May 21, 2013
    Here’s a pleasant way to lessen your risk of cardiovascular disease: Get happier.

    A 2007 study found that emotional vitality (a sense of enthusiasm, of hopefulness, of engagement in life, and the ability to face life’s stresses with emotional balance) appears to reduce the risk of coronary heart disease.

    If only it were that easy! you say. Are there ways to feel more happiness as an adult woman, fully-formed and set in your ways? The science says yes. It’s never too late to cultivate good mental health, emotional and social competence, and resilience. Tried and true methods include psychotherapy, meditation, faith-based activities, sports, and spending time with friends. Anxiety and depression (as well as happiness and optimism) are forged by both nature and nurture and are only 40% to 50% heritable.

    Finding a way to be in the moment, whether through playing music, practicing a sport, or engaging in any favorite pastime that allows you to lose yourself in the activity can help reduce stress and restore happiness.

    Other ways to be happier:
    • Optimism
    • Creating a supportive network of family and friends
    • Being good at self-regulation (bouncing back from troubles by staying physically active, eating well, avoiding risky behaviors, and knowing things will eventually look up again)
    • Training your brain: buy an attractive little notebook or journal and list the positive things that happen each day. Focus on those as you are drifting off to sleep. We can practice focusing on the positive and get better at it.

    And even if you try to cultivate more happiness in your life and find it’s not helping much, don’t fret, just wait a while: Happiness levels in the human lifespan have a U-shaped curve—people decline in happiness through their 40s and 50s (with the lowest point around age 46) then increase in happiness thereafter. It’s nice to know that scientific research shows that women in their 40s and 50s are going to feel happier as they grow older. Cheers!
    Go comment!
  • Will hysterectomy affect your heart health?

    by Margery Gass | May 17, 2013
    In the past, the results of research have been mixed. The news today is good. For 11 years, the Study of Women’s Health Across the Nation (SWAN) followed 3,302 women ages 42 to 52 who still had their uterus and at least one ovary and were not using hormone therapy. Over the course of the study, some women had a hysterectomy for such reasons as fibroids, heavy periods, and chronic pelvic pain. In general, however, trends in several heart risk factors did not differ in women who experienced a natural menopause versus those who had a hysterectomy.

    This new research published in the Journal of the American College of Cardiology suggests that hysterectomy (with or without removal of the ovaries) does not increase a woman’s risk of heart disease.
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  • How much (or how little) salt do you need?

    by Margery Gass | May 16, 2013
    New research says there’s no good reason for most Americans to limit their total sodium intake to less than 2,300 mg per day (about a teaspoon) and for Americans at high risk of heart disease and stroke to 1,500 mg per day (about 1/2 teaspoon)—the levels now recommended by government guidelines.

    However, the American Heart Association is still concerned about the large amount of salt in processed food. Most Americans actually get about 3,400 mg (about 1.5 teaspoons) of sodium per day, partially because of their intake of processed and prepackaged foods. These folks should still lower their intake.

    For those at higher risk (people over 50, African Americans, and people with high blood pressure, diabetes, or chronic kidney disease), cutting sodium intake is more important, but moderation is important—the Institute of Medicine points out that sodium intake must not be too low or it can actually increase risk of heart attack and health problems. Sodium is needed in the body to transmit nerve impulses, contract and relax muscle fibers, and maintain balance of fluids.

    What to do:
    If you’re under 50 with normal blood pressure (under 120/80 mm Hg) and in good health, you probably don’t have to worry about sodium intake—around 2,300 mg per day is a safe amount for you.

    If you are high risk, 1,500 mg per day remains a good limit. Just don’t go too low! Eat mostly fresh foods, watch the salt content of condiments, read labels, take care when eating in restaurants, and use nonsalty spices to liven up your meals.
    Go comment!
  • Angelina Jolie and genetic testing for breast cancer

    by Margery Gass | May 15, 2013
    Angelina Jolie has shared her personal decision-making process regarding her genetically increased risk of breast cancer in a New York Times op-ed. Her experience and decision provides an opportunity for all women to consider their family health history and how that history may impact their own breast caner risk. 

    Who should be tested for the high risk gene? Experts have researched this question and provide solid recommendations for all of us. Women with a relative who has a BRCA1 or BRCA2 mutation and women who appear to be at increased risk of breast or ovarian cancer because of family history should consider genetic counseling to learn more about their risks and about BRCA1 and BRCA2 tests. The full recommendations can be found at the following links:

    National Cancer Institute
    US Preventive Services Task Force
    Go comment!
  • Results of our survey on nonhormonal treatment for menopause symptoms

    by Margery Gass | May 14, 2013
    Do women really need more nonhormonal options to treat hot flashes? Last February we asked you and the answer was a resounding yes. In addition, we learned that most of you had already tried to combat your symptoms without hormones. No wonder you said you need something more!

    Here are the results of our poll, which we presented to the Food and Drug Administration Advisory Committee in April.

    • 88.6% of respondents experienced hot flashes
    • 49.4% of hot flashes were moderate, 34.2% were severe, and 16.3% were mild
    • 89.6% of respondents believed women need a nonhormonal prescription therapy for menopause symptoms
    • When asked why, 84.9% responded that it was because traditional hormone therapy (HT) was unsafe, 29.8% because they had experienced an adverse reaction to traditional HT, and 37.6% had a contraindication to HT
    • Women had previously tried lifestyle changes (71.5%), over-the-counter products (52.8%), HT (41.3%), compounded HT (12.9%), other prescription drugs (10.8%), or nothing (10.7%) to combat their symptoms
    Thanks to all who responded to the survey!






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  • Why women should not douche

    by Margery Gass | May 09, 2013
    In truth, the vagina is like a self-cleaning oven—it doesn’t require any special cleaning method to stay healthy and you shouldn’t put any products or creams inside of it (unless you are prescribed a medication by your healthcare practitioner). Yet many women still practice douching to clean their private parts, which can paradoxically cause infection.

    Douching means washing out the vagina with water or other mixtures. Some women were raised to believe they should douche monthly to wash away period blood or prevent odor. Some believe it will prevent STDs or pregnancy (not true).

    Douching can change the acidity and bacterial makeup of the vagina, causing infections, which may spread to the uterus, fallopian tubes, and ovaries. It has been associated with bacterial vaginosis, yeast infections, pelvic inflammatory disease, and adverse events in pregnancy.

    A recent study showed that 81% of respondents douched or put products like sexual lubricants, petroleum jelly, oils, or antifungal creams into the vagina. Women who used petroleum jelly intravaginally during the previous month were 2.2 times more likely to test positive for bacterial vaginosis.

    Ladies, there’s no need to douche or apply products internally. You can keep your vagina healthy by simply washing of the vulva with water during your daily shower or bath.
    Go comment!

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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