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Ellen Dolgen

  • A Game Plan for Abnormal Uterine Bleeding

    Posted on Monday, April 21, 2014 know when your best girlfriend tells you that she's gotta tell you something, or she'll blow up like a balloon. Almost against your will, you find out that her neighbors like to do the funky chicken, naked, in the backyard, under a full moon. Or you find out that the recipe you've been begging for is really a dish that you can buy in the market. Well...I'd like to talk to you about something too. It's not strange, like naked dancing neighbors, but it's a topic that doesn't get talked about enough. Abnormal uterine bleeding. There, I said it. It can happen during perimenopause and menopause. We need to pay as much attention to our uterus (uteri??) when we're going through perimenopause and menopause, as nabbing that recipe (or store brand goodie). .

    When we have normal periods, the lining of the uterine cavity usually sloughs off every 28 days. In menopausal women, the lining usually thins out and no longer sloughs off.

    You know how your mood can be all over the road when you have your period, well, during perimenopause (the 6-10 years before menopause) your period can really be moody. It can come and go when it wants; it can make a surprise visit or not show up at all. When you haven't seen her for 12 consecutive months, congratulations! You've graduated to menopause. (No cap and gown required.)

    Many women experience random bleeding during their perimenopausal and menopausal journey.Although menstrual irregularity is normal during perimenopause, unusual bleeding could be a sign of a problem. Unusual bleeding can be attributed to a variety of factors, including: thyroid problems, hormonal imbalance, thinning (atrophy) of the endometrial or vaginal tissues, uterine polyps, fibroids and cancer – just to name a few. Three of the most common causes, according to the American College of Obstetricians and Gynecologists (ACOG), are:

    • Polyps – Polyps are growths of tissue that are usually noncancerous. On the uterine wall or endometrial surface, they can cause irregular or heavy bleeding. On the cervix, they can cause bleeding after sex.

    • Endometrial atrophy – Due to low estrogen levels after menopause, the endometrium may thin out, causing abnormal bleeding.

    • Endometrial hyperplasia – This is the opposite of atrophy, as the uterine lining thickens due to excess estrogen (without enough progesterone). If the cells of the uterine lining become abnormal (atypical hyperplasia), this can lead to uterine cancer. However, endometrial cancer can be prevented with early diagnosis and treatment. ACOG notes that bleeding is the most common sign of endometrial cancer in postmenopausal women.

    If you suddenly experience out-of-the-ordinary bleeding, it's very important to be evaluated by your gynecologist/menopause specialist. Think of him/her as your coach to help you tackle your opponent.

    So how can you tell if your bleeding is abnormal? According to ACOG, any bleeding after menopause is abnormal. During perimenopause and menopause, alert your doctor if you experience any of the following:

    • very heavy bleeding

    • bleeding that lasts longer than normal

    • bleeding that occurs more often than every 3 weeks

    • bleeding that occurs after sex or between periods

    I've got abnormal bleeding - now what?

    In addition to a physical examination, ultrasound and endometrial biopsy are two ways your doctor can examine endometrial bleeding. Here's the possible team lineup from ACOG:

    • Dilation and curettage (D&C) – The cervix opening is enlarged and tissue is scraped or suctioned off the uterus then sent to a lab for testing. (Note that your vagina will be benched from the playing field for a few weeks after the procedure.)

    • Endometrial biopsy – A thin tube is used to extract a small amount of tissue from the uterine lining; the sample is then sent to a lab for testing.

    • Hysteroscopy – A hysteroscope (a thin, lighted tube with a camera at the end) is inserted into the cervix, providing a view of the inside of the uterus.

    I featured my own experience with bleeding in Menopause Mondays: D&C – Hysteroscopy – Polypectomy. I also featured Molly's story as I wanted to stress the importance of having ALL out-of-the-ordinary bleeding evaluated by your doctor.

    I received my test results - what's the game plan?

    Treatment, of course, depends on your diagnosis. ACOG outlines several options:

    • Polyps may require surgery.

    • Endometrial atrophy can be treated with medication.

    • Endometrial hyperplasia can be treated with progestin therapy, which causes shedding of the endometrium. However, you'll need regular endometrial biopsies as this condition puts you at increased risk for endometrial cancer.

    • Endometrial cancerusually requires a hysterectomy (removal of the uterus) and removal of nearby lymph nodes. (I'd like to point out that, while many women get hysterical over the thought of a hysterectomy, in this case it's the best option and certainly not the end of the world for women past childbearing age.)

    As you go through perimenopause and menopause, check off your symptoms in a menopause symptom chart. If you notice anything unusual: spotting, or a sudden heavy flow, or have a "strange feeling," do yourself a favor, and check in with your doctor or menopause specialist. There's nothing wrong with erring on the side of caution. What you're experiencing could be a part of the whole perimenopause or menopause stage. If it is not, remember that early detection is the key to stopping any health problems before they become a royal pain in the uterus.

    Suffering in silence is OUT! Reaching out is IN!

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  • Smoking Can Create Early-Onset Menopause

    Posted on Monday, April 14, 2014 you're smoking while you're going through menopause, you may want to put down that cigarette. Almost every day, there are studies being released about what can happen to you if you smoke and are dealing with perimenopause or menopause. The information may help you quit smoking that much faster.

    In a recent research study published online in the journal Menopause, researchers from the Perelman School of Medicine at the University of Pennsylvania report the first evidence showing that smoking causes earlier signs of menopause. The study was supported by grants from the National Institutes of Health, National Institute of Environmental Health Sciences, Perelman School of Medicine Translational and Clinical Research Center, and the Perelman School of Medicine Center of Excellence for Diversity.

    In an announcement of the study's findings, it was noted that although previous studies have shown smoking hastens menopause by approximately one to two years regardless of race or genetic background, this study is the first of its kind to demonstrate that genetic background is significantly associated with a further increased risk of menopause in some white women who smoke. In the case of heavy smokers, this can be up to nine years earlier than average in white women with certain genetic variations. Genetic variation refers to diversity in gene frequencies, and can refer to differences between individuals or to differences between populations. In this case, we're talking about differences between individual women in the study. The genetic variants were present in 62 percent of white women in the study population.

    "We already know that smoking causes early menopause in women of all races, but these new results show that if you are a white smoker with these specific genetic variants, your risk of entering menopause at any given time increases dramatically," said the study's lead author, Samantha F. Butts, MD, MSCE (yes, that's really her last name), assistant professor of Obstetrics and Gynecology at Penn Medicine.

    Smoking can also make menopausal symptoms more severe. Dr. Sarah Nyante of the US National Cancer Institute just released a study that found that women smokers are 19% more susceptible to develop breast cancer after menopause than women who don't smoke after menopause. has four more great reasons to consider entering a smoke-free zone.

    Your Skin Ages FAST

    In addition to its effects on menopause, smoking can do a number on your skin. Smoking can cause skin to be dry, lose elasticity; you may get wrinkles sooner and even stretch marks. A smoker's skin tone may become dull and grayish. Your teeth will yellow and your fingers will have a brown tinge.

    Belly Fat

    Most women find that they suddenly start gaining weight and their pants shrink during menopause. As if that is not frustrating enough, many smokers find that those menopausal muffin tops are bigger than their non-smoking friends. Smokers also have less muscle tone than non-smokers and it's harder for them to control diabetes.

    Lower estrogen levels

    Did you know that smoking lowers your estrogen levels? There are so many other symptoms of low estrogen for example, dry skin, thinning hair, and memory problems. Women who smoke have a harder time getting pregnant and having a healthy baby.

    Other smoke-related health problems

    The average age for onset of menopause (when you have been without a period for 12 consecutive months) is 51. According to the North American Menopause Society (NAMS), during and after menopause, your risk of other health conditions rises, and smoking increases that risk even more, including: Heart disease , stroke, breast cancer and diabetes. There are so many other smoke –related health issues that you put yourself at increased risk for like: decreased bone density, rheumatoid arthritis, gum disease, ulcers, post-surgical complications, and depression.

    The good news

    Now are you ready to quit? Margery L.S. Gass, MD, NCMP, executive director of NAMS, has some good news to share with us. She notes that women who quit smoking before age 40 erase most of the risk of early death. The risk of stroke and heart disease drops quickly after you stop smoking. (The risk of cancers drops more slowly.) Women who quit by age 50 buy back about six years, and those who quit by age 60 gains about four years of the decade they'd lose if they didn't quit.

    When you add up all the risks that could happen when you're smoking and going through menopause, it could feel like you've got a losing hand in poker. If you want to better your odds, then it might be a good idea to quit smoking. Gamblers say that you can't beat the house. And if you want to stay in that house for a long time and oh, say, meet your future grandchildren, putting out that cigarette that you're about to light up right now, is just one step towards a smoke-free future.

    Suffering in silence is OUT! Reaching out is IN!

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  • Suicide Risk Increases in Middle Age—Is Menopausal Depression to Blame?

    Posted on Monday, April 7, 2014 and friends were shocked when L'Wren Scott, glamorous model-turned-designer girlfriend of Mick Jagger, committed suicide in her upscale New York apartment. Once again, life is not always as it seems and fighting to maintain that illusion can be deadly, especially as women grow older. Scott's suicide, at the age of 49, is raising the question of whether undiagnosed menopausal depression played a role. Although that is just a theory, experts now know that the risk of suicide increases dramatically as we cross the threshold of middle age.

    Although there's no definitive link between celebrity designer L'Wren Scott's suicide and menopausal depression, the tragedy spurred a fellow celeb to hop on Twitter and get the conversation rolling about menopausal depression and whether women are really paying attention to the signs. Recently, a study by the CDC showed that suicides in middle-aged persons (ages 35-64) increased by 28% over a 10-year time frame. It's probably no coincidence that those high numbers reflect the transition of vibrant baby boomers into middle and older age.

    If you really don't feel like your "normal" self and are struggling to find any joy in your day, please take the time to be evaluated and treated by a knowledgeable doctor. If these feelings of depression are happening in partnership with perimenopause or menopause, step back and take stock. It could be menopausal depression creeping in alongside the hot flashes and insomnia.

    Know the Triggers

    The Massachusetts Women's Health Study looked at more than 2,000 women and found an increased risk for depression during the transition from reproductive years into menopause beginning long before your last missed period. It found that mood disorders occurred in up to 17% of menopausal women, confirming what most of us suspected, which is that menopause affects not only our bodies, but especially our emotions and brain functionality. Hormones impact endorphin levels, so when your brain neuromodulators of estrogen and progesterone are up and down so is your sense of well-being.

    Lack of those feel-good hormones lead to mood swings and those in turn can result in your family heading for the nearest exit! Cleveland Clinic lists some helpful signs of depression such as: sadness, loss of energy, feelings of hopelessness or worthlessness, loss of enjoyment from things that were once pleasurable, difficulty concentrating, uncontrollable crying, difficulty making decisions, irritability, increased need for sleep, insomnia or excessive sleep, a change in appetite causing weight loss or gain, thoughts of death or suicide or attempting suicide.

    Menopausal Depression

    The North American Menopause Society outlines the different types of depression and goes so far to say that if you suffered from PMS, then menopausal symptoms are likely to be rougher. Many menopausal women can tell you that mood swings are often accompanied by anxiety and insomnia. That's a pretty clear invitation for depression to join the party.

    Here's the difference: feeling blue sometimes is common, but if you're continually feeling hopelessness, emptiness and persistent anxiety, it is likely time to locate a good menopause specialist. A great way to prepare for your first visit is to chart your symptoms so you're ready to share some hard evidence when you go in. Remember, during perimenopause and menopause you can find that your memory is not as sharp as it used to be. My Menopause Symptoms Chart is an easy and simple way to help you communicate to your doctor exactly how you are feeling. Start tracking those symptoms tonight!

    Hormonal Testing and Treatment

    Talk to your doctor about doing a hormone panel. Fortunately for us, when it comes to testing for hormone levels – no pencil is needed, and you really can't fail! If you're still menstruating, have your hormone panel (blood test) done during the first three days of your period. Here are the tests to ask for:

    • DHEAS: DHEA sulfate is a hormone that easily converts into other hormones, including estrogen and testosterone. This adrenal hormone triggers puberty and is of the highest concentration of the hormones in the body. DHEAS is the sulfated form of DHEA in the blood. While DHEA levels fluctuate throughout the day, DHEAS blood levels are steadier and more reliable.

    • Estradiol: Estradiol is the main type of estrogen produced in the body, secreted by the ovaries. Low levels can cause memory lapses resulting in sticky notes aplenty, anxiety, depression, uncontrollable bursts of anger, sleeplessness, night drenches and much more.

    • Free and Total Testosterone: Free testosterone is unbound and metabolically active, and total testosterone includes both free and bound testosterone. In women, the ovaries' production of testosterone maintains a healthy libido, strong bones, muscle mass and mental stability.

    • FSH: Follicle-stimulating hormone is a pituitary hormone that stimulates the growth of the ovum (the egg and surrounding cells that produce ovarian hormones. This test can help indicate whether you've entered menopause. However, the suggested normal ranges need to be examined along with your Menopause Symptoms Chart, so that your doctor can properly evaluate the test results. There is no one-size-fits-all correct test result. What is normal for your best friend, sister or mother may not be normal for you.

    • Progesterone: Progesterone is a hormone that stimulates the uterus and prepares it for pregnancy. It also regulates the menstrual cycle, and low levels of progesterone can cause irritability. Results will vary depending on when the test is done.

    • Thyroid Workup: This usually includes checking your TSH (thyroid-stimulating hormone). If there is an irregularity with your TSH, you may need to get your Total T3 and Free T4 checked as well. (Free means it won't be affected by your estrogen status, not free of charge!) Remember that the symptoms for perimenopause and menopause and a thyroid disorder can be very similar.

     This hormone panel, along with the information you gathered on your Menopause Symptoms Chart, will help your specialist evaluate the cause of your depression and help create an individualized treatment program just for you.

    Natural Methods for Fighting Depression

    I know that you're eager to feel better right now! You can start by improving your diet and 'eating clean'. In addition to the obvious benefits of keeping obesity at bay, you'll feel good about taking control, not to mention healthy diets can even" target="_blank">stave off the effects of dementia, particularly if you modify prior to age 50.

    "Exercise, exercise, exercise is the best proven natural method for fighting depression," according to Dr. Julia Frank. This is good news for the more than 120 million around the world suffering from the disorder. It's not even like you have to be an athlete, or hit the gym every day, but do drive up your heart rate for at least 30 minutes with an activity you enjoy, which could lead to even more fun in the bedroom!

    Say farewell to any embarrassment associated with addressing your perimenopause and menopause symptoms. A little self-care will go a long way toward preventing us from becoming a statistic. Simon and Garfunkel preached it in the '70's—build your own 'bridge over troubled water.' Taking that critical first step to banish menopausal depression could be the most important one you ever take.

    Suffering in Silence is Out! Reaching Out is In!

    Enter our April Giveaway: Learn how to regain your libido and enjoy deeply satisfying intimacy from Dr. Lauren Streicher's new book, "Love Sex Again!"

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  • Osteoporosis – the other big “O”

    Posted on Monday, March 31, 2014 big "O" brings to mind mood music, our favorite lover, and moans of ecstasy. For those in menopause and postmenopause, the new "big O" can also bring to mind osteopenia or osteoporosis. You are probably familiar with osteoporosis, but may never have heard of osteopenia. Yet, according to the latest figures released by the National Osteoporosis Foundation, 43 million Americans over 50 have osteopenia!

    Osteopenia means low bone mass that places you at increased risk for osteoporosis and broken bones. When it comes to your bones, being dense is a good thing. However, Dr. Diane Schneider, author of The Complete Book of Bone Health, explains, "A diagnosis of osteopenia doesn't necessarily mean you'll develop osteoporosis. Osteopenia is not a disease, either."

    Detecting osteopenia

    So how do you gauge your bone density? There is a test for most everything and bone density is no exception. Bone density is determined via a bone scan or bone mineral density (BMD) test. The most common – and most accurate – test is a dual-energy X-ray absorptiometry (DXA) scan. Try saying that real fast! The bones in the spine, hip and sometimes the forearm are those most commonly tested.

    If you're worried about radiation, have no fears. A DXA scan uses low-dose X-rays. According to the National Institutes of Health, you receive more radiation from a chest x-ray.

    To scan or not to scan, that is the question.

    Are you a candidate for a bone scan? The National Osteoporosis Foundation suggests that you should consider it if you can answer "yes" to these two questions:

    • Are you a postmenopausal woman or man age 50 or older?

    • Have you recently broken a bone?

    The test itself only takes about 10 minutes, so you can't use "I've got no time" as an excuse. However, not all insurance plans cover bone scans, so be sure to check with your carrier first. The average cost of a DXA scan of the spine and hip is $140.

    Your T-score and what it means

    The T-score is the result of the scan (and we're not talking golf). The Mayo Clinic explains that your T-score compares your bone density with that of a healthy young adult of your sex.

    According to the criteria established by the World Health Organization, here's what your T-score means:

    -1 & above normal
    Between -1 to -2.5 osteopenia or low bone density
    -2.5 & lower osteoporosis

    If you have a T-score of -1, you have twice the risk for bone fracture as someone with a normal BMD. If your T-score is -2, you have four times the risk.

    A study published in the Journal of the American Medical Association in 2001 reported that a 50-year-old white woman with a T-score of -1 has a 16 percent chance of fracturing a hip, a 27 percent chance with a -2 score, and a 33 percent chance with a -2.5 score.

    Beyond the numbers assessing the overall risk

    "Over the past decade, we have learned to use bone density scan results in the context of assessing one's overall risk of fracture," Dr. Schneider said. "The result of osteopenia must be evaluated along with other risk factors. For instance, if you compare a 55-year old woman with a 75-year old woman who both have the same T-score of -2.0, the 75-year old woman will have a higher risk of fracture based on her age alone. Various tools are being used to quantify fracture risk like the FRAX calculator. As a result, fewer early postmenopausal women are being treated with osteoporosis medicines."

    Medical options

    The National Osteoporosis Foundation recommends drug treatment for osteopenia in postmenopausal women and men age 50 and older who have at least a 20 percent risk of any major fracture (spine, forearm, hip, or shoulder) in the next decade or at least a 3 percent risk of a hip fracture.

    Johns Hopkins Medicine warns that taking bisphosphonates or other bone-building medications for osteopenia means you may be treating a condition that might never develop. These medications also can be costly, which may be a determining factor on when – or if – you begin taking them. You will want to make sure your risk is high enough to warrant starting on medicines.

    Medications used to treat osteopenia/osteoporosis include alendronate (Fosamax and Binosto), risedronate (Actonel and Atelvia), ibandronate (Boniva), and raloxifene (Evista). Other medical options include denosumab (Prolia) as twice a year injections, zoledronic acid (Reclast), given intravenously once a year or every two years, and teriparatide (Forteo), daily injections for a total of two years only. Estrogen is FDA-approved for prevention of osteoporosis if other options are not viable.

    Some doctors recommend taking medication for five years, taking a break, and then going back on medication. This may mitigate any potential rare negative side effects, such as femur fractures, jawbone decay and more.

    Non-medical options

    Harvard experts suggest if your T-score is closer to -1, you're better off getting more weight-bearing exercise, calcium (1000 mg/day), and vitamin D (800 mg/day). Weight-bearing exercises are usually those where your feet (not your tatas) touch the ground, such as running and walking. Strive for at least 30 minutes a day.

    Heavy drinking can increase your risk of osteoporosis, so, ladies, you've got to lay off the bottle... in moderation. One alcoholic drink a day for women and two a day for men is considered moderate.

    It goes without saying, but we'll say it anyway – you shouldn't smoke. Period.

    Osteopenia has been overmedicated in the past. Now that fracture risk is assessed, those with low fracture risk do not benefit from medicine, but those with high risk, as defined by the National Osteoporosis Foundation, do.

    If you've been diagnosed with osteopenia, consult with your physician to determine the best course of action.

    Keep the "O" in the bedroom; keep it out of your bones!
    Suffering in silence is OUT! Reaching out is IN!

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  • Menopause is a Long Time to Go Without Sleep

    Posted on Monday, March 24, 2014 you awake all night, and then dragging through the day with toothpicks holding up your eyelids? Then try not to snooze through this one. Sleeplessness can be a real problem for women going through menopause. In fact, the North American Menopause Society (NAMS) lists trouble falling asleep as one of the five main symptoms of menopause. I, suddenly, without any notice, was not sleeping beauty, once perimenopause hit my life!

    The Menopause Sleepless Society is a BIG club, Ladies! Why does menopause affect a woman's ability to catch her z's? According to the National Sleep Foundation (NSF), most women complain of sleeplessness during perimenopause to post-menopause, with about 61% of post-menopausal women continuing to have issues with insomnia. Why does menopause affect a woman's ability to catch her z's? The NSF says it has to do with the hormonal changes - estrogen and progesterone - that occur during menopause.

    A study conducted in 2013 by scientists at the University of California San Francisco found a lack of sleep can put adults at risk for a variety of chronic health issues. And a report published in Harvard University's Harvard Women's Health Watch in 2006 says adults who sleep less than six hours a night can suffer from such issues as memory loss, poor cardiovascular health, irritability, and problems with their metabolism and weight.

    Sound hopeless as well as sleepless? Don't despair. Get your snooze on and get back in touch with Mr. Sandman by trying these 4 tips:

    Get a Move On

    Move your body more during the day. Menopausal women who had more leisure physical activity during the day reported rating their sleep as good. Those same women who did household physical activity during the day – like vacuuming and mopping – found they were sleeping through the night more (not to mention having cleaner houses).

    Take Time to Relax a Bit

    While you are lathering yourself in your latest and greatest wrinkle reducing moisturizer, think about preparing yourself for sleep, too. Before you hit the sack do something calming like reading a book while sipping on some chamomile tea, enjoying a candlelight bath, or just closing your eyes and listening to some soft music to relax yourself and get your body in to sleep mode. Prepare your bedroom so there are no distractions -- eliminate as much light and sound as possible. Think about turning off the TV and giving your smart phone a time out!

    Keep Your Cool

    Hot flashes can be another reason why women in menopause have a hard time staying asleep. To help combat the heat, Cleveland Clinic suggests wearing loose-fitting, lighter weight clothing to bed. Make sure the sleeping area is well ventilated. And if spicy food is your thing, cool it on the spicy foods before bed!

    Consider HT

    Hormones matter! I'm talking Hormone Therapy (HT) here. An article published in Menopausal Medicine - the journal of the American Society for Reproductive Medicine - says that studies have found hormone therapy helped menopausal women with sleeping issues, and helped them get more productive sleep. If sleeplessness is a major issue for you, discuss this option with your menopause gynecologist. If you don't have one, use my Menopause Doctor Directory to find one near you.

    So put away the toothpicks. No need to walk around with your "Eyes Wide Shut" (no, Tom Cruise, not referring to you). Using these simple tools can help you get your snooze back!

    Suffering in silence is OUT! Reaching out is IN!

    Enter our March Giveaway: Exercise your pelvic floor with the Intensity Health and Stimulation Device and Pour Moi gel combo!

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  • March Madness? Not On My Watch: Tips to Conquer Your Mood Swings

    Posted on Monday, March 17, 2014 shoots....She SCORES menopausal symptom happiness! And the crowd goes wild! (Ahhhhh)

    When you say "March Madness" many people will automatically think of the NCAA March Madness college basketball tournaments. However, if you are speaking with a woman in perimenopause or menopause, "March Madness" is not a game she wants to go into overtime with. Menopausal symptoms like mood swings may cause her to be "slam-dunking" one minute, and the next her family is suspending her for "alley-ooping" for the other team. You'll be thinking your team player has turned into an out of control Dennis Rodman!

    And if being moody isn't enough, according to a six-year study published in Menopause, researchers found that women with the highest levels of stress were more than five times (I repeat, five times!) more likely than normally stressed women to report hot flashes. Mood swings and hot flashes, that combination is enough to make you want to turn in your final four tickets and bench warm it up at the bar!

    Before your perimenopause or menopause lady turns into Rodman, read my 4 simple tips to combat those mood swings:

    It's Warm Up Time!

    Throw on those sneaks and sweat bands ladies, it's warm up time! MsFLASH Research Network found working out had a positive effect on depression in both perimenopausal and menopausal women. A study from the University of Jyväskylä in Finland found that high-impact exercise can help postmenopausal women at risk for osteoporosis and osteoarthritis maintain bone health and physical function. According to research published in The Journal of Sports Medicine and Physical Fitness, exercise significantly reduces feelings of confusion, anger, fatigue, tension, and vigor. Are you convinced yet? Get up off that bench! Go out and walk your dog, pop in a work out video, or even put on your favorite beats and boogie around your house! Granny shots? See ya! It's time to "bring the house down" in your game of life!

    Relieve Stress

    Those perimenopause or menopause bouncing moods can be alleviated in other ways. For example, take a half-time break out of your busy day for yourself and do something that makes you an "All Star" – get a manicure, soak in a warm bath, or get a relaxing massage. In fact, massage has been found to be helpful in alleviating a number of stress-causing issues like anxiety, insomnia, headaches and other aches and pains. You may also want to try easing stress through meditation.

    Consult a Medical "Coach"

    Sometimes you may find you need some assistance to help with the ups and downs you're experiencing during perimenopause or menopause. Be sure that you have a winning coach (menopause gynecologist) to give you a play-by-play guide for your perimenopausal or menopausal journey. If you haven't found one, check out my Menopause Doctor Directory. Your menopause gynecologist can help evaluate whether your mood swings are linked to menopause or if you are suffering from some other medical issue. The treatments recommended will depend on this evaluation.

    Ask for Help.

    Get in the zone and back in the game! Share your issues with your "coach" and fellow "team members" so that you "swish" into menopause symptom happiness and don't go mad this March.

    Suffering in silence is OUT! Reaching out is IN!

    Enter our March Giveaway: Exercise your pelvic floor with the Intensity Health and Stimulation Device and Pour Moi gel combo!

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