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"The big O" does not mean "the big Ouch." Recapture the rapture in bed.
Pain during intercourse is called dyspareunia (Say what?). If you're experiencing pain during sex, you could be suffering from vaginal atrophy (VA). Vaginal atrophy is a thinning and inflammation of the vaginal wall. VA occurs when estrogen levels drop. Estrogens, produced by the ovaries, maintain the structure and function of the vaginal wall, elasticity of the tissues around the vagina, and production of vaginal fluid.
Unfortunately, like the rest of your menopausal body, your vagina is aging too.
Hot flashes, sleeplessness, memory loss and weight gain get top billing when it comes to menopausal symptoms. But vaginal discomfort is every bit as difficult and critical to deal with as those symptoms. Vaginal symptoms can negatively impact not only on your relationships and sexuality, but can affect your quality of life and self-image.
If you're experiencing these symptoms, you could have VA:
You're not alone. Vaginal dryness affects as many as 75 percent of postmenopausal women. Between 17 and 45 percent of postmenopausal women say they find sex painful, according to The North American Menopause Society (NAMS).
According to the Women's Health Concern, only 25 percent of these women seek treatment. What's more, according to the International Menopause Society, 70 percent of women say their healthcare providers rarely or never raise the subject with them.
The Closer survey revealed that vaginal discomfort caused 58 percent of the North American women who were surveyed to avoid intimacy and 64 percent to experience a loss of libido.
Pain during sex (or simply the fear of pain during sex) can trigger performance anxiety or arousal problems in some women, according to the NAMS. This also can cause dryness or involuntary — and painful — tightening of the vaginal muscles, called vaginismus. It's a Catch-22.
What's are your options?
I can't believe it's been about a decade since my vagina first committed mutiny and my libido went AWOL. I've since vanquished my vagina problems and located my libido. You can, too. Get your symptoms treated, and you can put the va-va-voom back in your vagina.
Suffering in silence is OUT! Reaching out is IN!
The American Cancer Society estimates that in 2014 about 21,980 women will receive a new diagnosis of ovarian cancer and approximately 14,270 women will die from ovarian cancer.
Although early cancers of the ovaries generally cause no symptoms, they list the most common signs and symptoms as:
Remember, be your own advocate for your health and pay attention to your body. You need to know what's normal for you. If you are concerned, contact your medical professional.
To learn more about this disease and the possible treatment options, I reached out to Dr. Laura Shawver, an ovarian cancer survivor (and ironically a cancer researcher) and the founder of The Clearity Foundation. According to Shawver, the treatment has remained virtually the same for many years and all women are treated alike in spite of what has become known about the molecular make up of cancers. The Clearity Foundation is working hard to change this. The foundation notes that, like all cancers, ovarian cancer is not a single disease, but a category of many diseases. What these diseases have in common is that they start in the ovaries or in the finger-like opening of the fallopian tube. But just as each woman who develops ovarian cancer is a unique individual; her cancer is unique as well. The foundation's goal is to help women with recurrent ovarian cancer live longer, healthier lives by enabling a more individualized approach to therapy selection.
According to Mayo Clinic, there are three different types of ovarian cancer based on the cell of origin but many, many more based on the genomic underpinnings that drive the cancer to grow and spread. The cell of origin categories are:
"As soon as I was told I had ovarian cancer," Shawver said, "I wanted to understand the blueprint of my cancer (genomic make-up or molecular profile) so I could match my cancer to a drug that would work best for me. As a cancer researcher, I thought I would have an 'in'! I even remarked to others when I had my diagnosis, 'Oh, I will just have my tumor profiled.' I was so surprised that not only was there no labs that would profile my tumor; there was no mechanism to get this done outside of a clinical trial. This service was not something that existed for ovarian cancer patients. I wanted to change that."
She launched the Clearity Foundation in 2008 to help ovarian cancer patients and their physicians make better-informed treatment decisions based on the molecular profile of the tumor, which she calls the "tumor blueprint."
"A tumor blueprint is a means to help prioritize your treatment options," she said. "In newly diagnosed ovarian cancer, everyone gets the same treatment: a combination of two chemotherapy drugs. Unfortunately, 75 percent of ovarian cancer is diagnosed in late stage and 75 percent recurs. These are horrible statistics. When it recurs, doctors have a choice of several agents and then there are clinical trials to choose from, too. A tumor blueprint provides some rationality to the choices rather than pick-out-of-the-hat treatment."
I noted that on her site one article said that only 25 percent of women who receive chemo will benefit from it. If you ask me, those aren't very good odds. She agreed with me that these are horrible odds.
"What is more horrible, however," she said, "is that oftentimes women with recurrent disease go from treatment to treatment to treatment all the time suffering through the side effects and often without much benefit. In short, they never get their life back. That's why we are focused on helping them find a drug — either FDA approved for ovarian cancer, FDA approved for another type of cancer, or a drug that is in clinical trials that might have a greater chance of success — and we are the only foundation that provides women access to molecular profiling to facilitate this."
Dr. Shawver said Clearity navigates the waters to get a tumor specimen to the labs and coordinates the testing. "We consolidate the results from the different labs into an easy-to-read report for the physician. We speak with the patient about her results. We follow each woman to see what her doctor ultimately prescribed (was it based on the test results or something else?) and how she fairs. Clearity acts as both a back office for the doctor but, more importantly as a strong advocate for the patient to provide her and her physician additional treatment options when often there appear to be none. At Clearity, our mission is focused on women with ovarian cancer 'in the fight' where it is too late for early detection and they can't wait for cures for the future. No other organization does this."
As we know, pharmaceuticals are a business. I was curious as to how realistic/financially feasible it is for drug companies to provide personalized treatment of tumors. She answered me quite frankly: "For the cancers that are common — like breast, lung, prostate and colon — it is much easier for drug companies to provide drugs that match to subsets of patients based on tumor profiling or blueprints. The subsets are large enough to make it economically feasible. However, for ovarian cancer, which is one-tenth or less of the size of the larger tumor types, it is a huge barrier for pharma to choose ovarian cancer as an indication for clinical trials and registration of their drugs."
"There have not been any dramatic changes in survival rates from ovarian cancer since Taxol® was approved in 1992 in combination with carboplatin. There has been zero success in identifying which women will be cured (25 percent) and zero molecular-targeted agents have been approved for ovarian cancer as there have been for breast, lung, colon, prostate and skin cancer."
Shawver is hopeful that this will change, but she stresses that we need everyone's help; we need more pharma companies to have clinical trials in ovarian cancer, we need doctors to explore all options for their patients, we need insurance companies to cover the cost of the profiling and we need women to empower themselves with information so that they can best fight their battle. She fully expects that more women will get their cure as we are better able to match patients with treatments.
The sisterhood is powerful. When we speak out, we shake things up! Look at the strides we have made with Breast Cancer Awareness. When Dr. Shawver was diagnosed with ovarian cancer, she not only took care of herself, but she created a foundation to help others! It is important to note that The Clearity Foundation does not charge for the tumor blueprint.
However, the foundation does incur significant costs for the services it provides. In addition, it tries to help defray the cost of biomarker testing for women who need financial assistance. The foundation relies on charitable donations to make that possible. In honor of Ovarian Cancer Awareness Month, I shall be making a donation to The Clearity Foundation as a thank you for championing this tremendously important work.
Perhaps you can find a way to involve yourself in expanding ovarian cancer awareness to help support and advance this cause.
Together we CAN make a difference.
Suffering in silence is OUT! Reaching out is IN!
Hot flashes, anxiety and sleepless nights are part of the package and I'm the first to admit it can be hard to handle. That's why as I turn 61 this month I'm giving myself the gift of self-compassion. After all, living a joyful life and by extension being kind to others depends upon how kind you are to yourself.
Part of this new normal of being postmenopausal is that I've learned to pay closer attention to my own needs. Traveling down this road through the jungle of menopause, I've adapted by becoming more self-reliant, making me feel more fulfilled. That's very different from how the menstruation journey began years ago.
A friend of mine swears that the Miss Deb booklet left on her bed by her mother was the best dollar her mom ever spent! It was a pamphlet for 'little girls who would mature soon and pretty much took the onus off her mother having the 'birds and the bees' talk.
Perimenopause, menopause and postmenopause are far more difficult to comprehend, and even Miss Deb wouldn't be able to explain their ins and outs in a small pamphlet. One thing is for sure—charting your own destiny can be extremely liberating providing you first lighten up—on yourself! Have some self-compassion.
Be All You Can Be
This simple slogan used in U.S. Army commercials for 21 years inspired a generation to seek its full potential.
Menopause triggered that same desire in me—to be the best I can be—right now! Meaning, you can either shrink away into nothing or decide that you're still young enough to remain relevant. Hmmm...decisions, decisions!
Adversity can only keep you down if you let it or as Henry Ford put it, "When everything seems to be going against you, remember that the airplane takes off against the wind, not with it."
Make the decision to live a purposeful life using the tools you own now and not the ones from 30 years ago. The only constant in life is change.
My own purposeful life led me to a wonderful project called, Notes to Our Sons and Daughters: A Celebration of Wisdom. In this I shared my own menopausal transition. I found out above all else, that changing adversity into strength begins within me.
Embrace Who and What You Are
Embracing who you are without fear of judgment or rejection is a beautiful side effect of the change. One scientific study found women wait until elder years to let go of, "I've got to look and be perfect," self-talk. Why not start a little sooner? After all, is how you look in a swimsuit really that critical? Ease up—especially on yourself.
It's OK to Be Vulnerable
My best approach to embracing vulnerability was to bring menopause out in the open, and that in turn opened all kinds of doors to new opportunities. It was the foundation of my own slogan: "Suffering in silence is OUT! Reaching out is In!"
Bottling up your emotions is dangerous but sharing this menopausal experience with others will surely affect someone else and might even change their life. Now, that's powerful!
When Things Aren't OK, You Don't Have to Hide It
It was incredibly liberating for me to realize that after years of 'soldiering through,' caring for kids, aging parents, house and career, that I could actually say out loud, "Everything is not always ok," without worrying about sounding like I was whining.
Suppressing emotion has a powerful negative effect on your body called oxidative stress. Free radicals form when you're anxious or stressed out. If you combine those free radicals with hormonal deficiencies, then low-density lipoproteins, for which you need anti-oxidants to fight at the cellular level, are diminished.
Caregivers, Not Care Receivers
Try devoting as much time to the woman in the mirror as you do to everybody else. Studies show that society expects women to do the majority of caregiving--there's a surprise. AARP actually did the math and found that collective caregiving is worth more than $450B a year. So, it stands to reason that if it's worth that much to society, then so my dear, you are worth the effort, as well!
New research says being kinder to you at the very least helps suppress hot flashes, which might be triggered by stressful situations. This seems to be a gender-related psychological marker as according to the study, "Women typically have lower self-compassion than men. Our research indicates that midlife women may benefit from including themselves in the circle of compassion."
Do Well By Doing Good
Giving to others is an admirable quality, but that starts with treating yourself with a healthy dose of kindness.
Self-compassion starts within, so I've decided my best birthday gift this year won't be in bright shiny paper. Instead, I'm making a promise to myself to practice self-acceptance and self-love before ever walking out my front door to help others.
And, you know what? I feel better already. I like the new me and now I'm ready to live the rest of my life with a wink and a smile.
I really do deserve a break today!
Suffering in Silence is Out! Reaching Out is In!
As we get older, it seems like our visits to doctors become more and more frequent. An ache here, a pain there. Truth is, one way to reduce the number of doctor visits in perimenopause and menopause is to actually schedule a few crucial medical tests. That way, you can nip any pending medical conditions in the bud and get on with your, "I'm-not-gonna-let-this-hold-me-back" life.
Please note: This is not intended to be medical advice. Consult your menopause specialist about the best course of action to take, as every women has unique needs.
Did you know that menopause symptoms can mimic those of other conditions? According to the North American Menopause Society, these symptoms are similar to those of thyroid disease, for instance. Depending on your medical history, it may make sense to undergo medical tests to rule out such conditions.
Am I really in menopause?
Follicle-stimulating hormone (FSH) levels are sometimes measured to confirm menopause. Because these levels vary, you can't rely on a single test. If, after several tests, your FSH blood level is consistently 30 mIU/mL or higher, and you haven't had your menstrual period for a year, you're probably a member of the menopause club. Note: If you're using certain hormone therapies (such as birth control pills), an FSH test is not valid. Some doctors prefer to test the Anti-Mullerian Hormone (AMH) levels instead, because they are not affected by birth-control pills. During menopause, AMH levels are decreased.
If you're still menstruating, your hormone panel (blood test) should be done during the first three days of your period. It can test for the following hormones:
If you're already in the midst of perimenopause or menopause, here are other important tests to consider:
This test, also called a bone scan or DEXA scan, can reveal whether you have osteopenia or osteoporosis. When you enter perimenopause and menopause, the drop in estrogen can do a number on your bone mass. Don't worry; the scan is quick and exposes you to very little radiation.
CA-125 (cancer antigen 125) is a protein best known as a blood marker for ovarian cancer. It may be elevated with other malignant cancers, including those originating in the endometrium, fallopian tubes, lungs, breasts and gastrointestinal tract. If your test comes back positive, don't panic; this test is notorious for producing false positives!
Like your moods, cholesterol levels change in perimenopause and menopause. An excess of cholesterol can build up artery plaque, narrowing blood vessels and potentially causing a heart attack. A cholesterol panel usually includes checking your HDL (high-density lipoprotein or the good cholesterol), LDL (low-density lipoprotein or bad cholesterol) and triglycerides (molecules of fatty acids). You'll need to fast for 12 hours before this test (a perfect time to step on the scale!).
This vitamin helps maintain normal blood levels of calcium and phosphorus, keeping your bones strong.
A friendly reminder
I'd be remiss if I didn't remind you about your monthly breast self-exam and your annual mammogram. You also should schedule an annual checkup with your general physician, and an annual pelvic exam with your gynecologist. And, I hate to tell you, but if you're 50 or older (45 for African Americans), you need to schedule a colonoscopy, according to the American Society of Colon and Rectal Surgeons.
And don't forget to floss. Seriously. Regular dental checkups are important, too, as untreated gum infections can lead to more serious health issues. According to the American Academy of Periodontology, people with periodontal (gum) disease are almost twice as likely to have heart disease.
Remember that, when you're in perimenopause and menopause, it's important to not only focus on "down there," but on your body as a whole. That includes your mental and emotional health as well. Now, more than ever, you need to take time to take care of you. So schedule your tests... then schedule a spa appointment.
Suffering in silence is OUT! Reaching out is IN!
September 7th is Grandparents Day!!!!!!!!!!!! On August 8th in Seattle, Washington, our daughter Sarah and her husband Sol, brought a beautiful pink bundle of joy into this world. I am now a Grandma! Now, I understand why grandparents go on and on, bragging about their grandchildren.
I'm proud, and not the least bit embarrassed to be a Grandmother. I don't think that being a grandmother ages me. In fact, it's just the opposite! When I hold my Granddaughter Aviva in my arms and look into her eyes, I feel overjoyed and energized. (The fact that I'm not the one getting up in the middle of the night to feed her may help account for that!)
I didn't make up Grandparents Day just so I could have an excuse to brag about Aviva. (Who needs an excuse?!) National Grandparents Day originated with Marian McQuade of Fayette County, West Virginia. She wanted to champion the cause of lonely elderly in nursing homes. She also wanted grandchildren to tap the wisdom and heritage of their grandparents. In 1978, President Jimmy Carter, proclaimed that National Grandparents Day would be celebrated every year on the first Sunday after Labor Day.
So, getting back to my granddaughter.... Actually, most of my conversations these days somehow end up back on the subject of Aviva. I guess I could blame it on my menopausal, forgetful mind, but the truth is I wake up each morning anxiously awaiting a morning text flooded with pictures of her sleeping, or a mini video of her bath. Yesterday we had lunch together, thanks to FaceTime!!!
You know, it's interesting how our instincts kick in. As parents and grandparents, we go into protector mode when it concerns our babies. Even my daughter and son-in-law's dog, Jazz (their 14 year old Golden Retriever), is jazzed about the baby and eager to protect her.
When I became a mother for the first time in 1980, there was no "use and care" manual that came with a newborn. Most of us just winged it. However, today's parents do have the Internet and even apps to help them prepare for and cope with the responsibilities of parenthood. But no website or app can teach you how to love your child. That simply comes with the territory. The flood of love and tenderness that is unleashed with the birth of a baby is beautiful to watch and share.
My daughter, Sarah, created a blog to share her pre-Mommy thoughts and feelings. I was so proud of how honest she was about her pregnancy. She shared the good and the difficult times. I had her blog made into a book for Aviva. I think it will be wonderful for her to read her Mommy's thoughts while she was growing inside of her. I titled the book, Smiles Curls and Baby which is the name of Sarah's blog. By sharing our own stories we help others.
Welcome to the world, Aviva! I hope you will help to make it a kinder, more caring and gentle place. Grandma is going to encourage you to embrace your role as a female in this world. Learn the delicate balance between cherishing your femininity and embracing your power to do anything that you set your mind to. Oh, and yes, I shall teach you to be prepared for perimenopause and menopause.......but for now I need to teach you spa etiquette. You aren't supposed to poop during your bath.
While Sarah and Sol are sleepless in Seattle, I stare at her lips, tiny fingers, every sound on the videos and rejoice that I have finally joined the Grandparents Club. I am madly in love!
Gotta go – time to book my next trip to Seattle!
Suffering in silence is OUT! Reaching out is IN!
Right up there with hot flashes, insomnia, grumpiness and weight gain, forgetting what you were going to say, when only half the words are out of your mouth, can make you feel out of your mind! Is what was once crystal-clear now just a tad fuzzy?
Welcome to brain fog. It can be frustrating because it impacts how well you perform everyday tasks such as adding up a tip after a restaurant meal, paying attention during long drives or plowing through a challenging book.
Here's What Gives
As hormones fluctuate in your body during menopause, cognitive functions are affected. Doctors say self-reported memory problems are common in women 33-55. Additionally, the Study of Women's Health Across the Nation (SWAN) showed that the cognitive decline you think you feel is real, coupled with the fact that it is also more difficult to learn new things as you go through menopause. However the good news is that the study suggests that this cognitive decline might be time-limited, so as you near the later stages of menopause, you do feel more clarity. The study says hormone replacement therapy works better when you begin early on, say before your last period or by 53 years of age and might have a detrimental effect if you begin hormones much later in the game—three or four years after your last period.
The University of Rochester Medical Center released information that shows what women perceive as memory problems, may actually be related to your ability to learn new information. This is called 'encoding' and can lead you to believe that your memory is going, going, gone.
Plus, there can be underlying issues such as depression that affect how you encode new information during menopause. Turns out your mental state of well being has an impact on your mood and even disturbances in your sleep. More evidence that treating your depression is even more critical during menopause.
Study or no study, I can tell you once I went on bioidentical HRT my brain fog lifted and I was a fully functioning again!
Fight or Flight: Trouble Around Every Corner
You know those signs you see in gift shops everywhere that say, "Keep Calm and Carry On?" There is a reason they're so popular. It is extremely important to settle down, stay focused and remember the critical information, while letting go of the other stuff.
We're overloaded with activities, which can send our bodies into 'fight or flight,' which in turn sends corticosteroids into overdrive. These are the hormones we all secrete during adverse events. They're okay for a while, but if you stay in high alert, they hang around like a bad dream. Best not to get stressed over every little thing because memory is connected to the very way that we funnel our emotions. Each time you process, encode and retrieve information, it is based on emotions and anxiety.
Let it Go
Spending your precious time worrying about everything can be dealt with through mindfulness based stress reduction or MSBR. You can reach that state through meditation and it's extremely helpful in lowering blood pressure and minimizing the effects of depression.
Here are some other great tips to help you remember:
Bottom line—help yourself as best you can by staying physically active, mentally active (think crossword puzzles or word games) and learn to let go of things over which you have no control.
I recently spoke with Ruth Curran who is the author of Cranium Crunches about embracing perceived weaknesses, and treating them as strengths. This has to do with metamemory, which requires you to recognize your 'failings' and turn those 'deficits' into greatness. If you acknowledge which parts of the memory process affects you most, such as focusing on tasks or keying in to the point of a story, you'll understand what needs work. Pay attention to what mental tasks are challenging for you and incorporate brain teasers into your daily routine.
Finally, take a deep breath and relax! Just as soon as you remember!
Suffering in Silence is Out! Reaching Out is In!