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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!
This stage signifies a new chapter in a woman's life. Don't write yourself off! Instead, many women simply decide to rewrite their entire book. For example: More than 60 percent of divorces are initiated by women in their 40s, 50s or 60s — the menopause years — according to a survey conducted by AARP Magazine.
We're all too familiar with the physical changes that accompany the change of life — weight gain, mood swings, hot flashes, etc. That's why many of us menopausal women seek to find balance, often focusing on the spiritual as well as the physical. Our priorities often shift as we take this opportunity for self-reflection and inner focus. We may find a renewed sense of purpose.
Two Key Attributes of Living with Purpose
Contemplation and activation are two core practices for living with purpose, according to an article by expert Richard Leider for the Center for Spirituality and Healing at the University of Minnesota. Contemplation means seeking answers about who you are, how you should live, and where you belong. Activation is living your truth.
How can you achieve these goals? Start with these exercises:
What's Your Purpose?
If you don't have a clue, ask yourself the questions below and following the steps to help uncover your purpose, according to a Psychologytoday.com article by Dr. Brad Klontz.
Mindfulness Benefits Your Mind
While we're told that word puzzles, dancing and other exercise can help our aging brains, the same can be said for living with purpose. Research from the Rush Alzheimer's Disease Center in Chicago revealed that individuals with high purpose scores were 2.4 times more likely to remain free of Alzheimer's than those with low scores; they were also less likely to develop mild cognitive impairment, often a precursor. In a study of 246 people who died at the center, autopsies found that many of those with high purpose scores also showed the distinctive markers of Alzheimer's.
Living a purposeful life also appears to protect people from developing disabilities. Purposeful people also had a lower mortality rate than those with low purpose.
A purposeful life also can lead to a longer life. Another study, by Dr. Patrick Hill, Department of Psychology at Carleton University in Ottawa, Canada, found that purpose in life promotes longevity. Both the Rush and the Carleton teams controlled for numerous other factors correlated with well-being — social relationships, chronic medical conditions and disability, work status — and found that purpose in life alone appears to improve and extend lives.
I'm keeping my promise to myself to living life more fully, with greater meaning. I challenge you to do the same. How can you give your life more meaning, make your life more purposeful? Are you up for the challenge?
Suffering in silence is OUT! Reaching out is IN!
Hot flashes. Mood swings. Weight gain. Osteoporosis. Just a few of the many symptoms of perimenopause and menopause. Add breast tenderness to that never-ending laundry list. For some women, "tenderness" is a gross (and I mean gross!) understatement.
It's ironic, isn't it? From our "tender" preteen days, most of us couldn't wait until that first sign of womanhood. We couldn't wait to buy — and wear — our first training bra.
Of course, you've got to be careful what you wish for. My daughter, Sarah, was a late bloomer and prayed for boobs. They didn't appear on the scene until she was about 18 or so. Fast forward 16 years, Sarah now writes a wonderful blog called, smilescurlsandbaby – lessons, joys, and laughs in baby making and life! She found pregnancy took her breasts to a whole new letter, "Ain't Nothin' But a G-Thang....Baby...."! Now if only we could train our breasts to not be so sore all the time!
Now if only we could train our breasts to not be so sore all the time!
Pregnancy is not the only life cycle phase that can affect intimacy. During perimenopause, sore breasts can cause marital intimacy to suffer as well. "My breasts are off-limits to my husband when I'm mid-cycle" said one perimenopausal friend. "He can't even look at them without getting the 'evil eye' from me! My breasts are so painful that sometimes I can't even bear to have the shower head pointed toward them."
Another woman told me there's no way she can sleep on her stomach. And mammograms are out of the question. She suggested that clinics make accommodations for women who suffer from painful breasts. She said she'd probably pass out if she had to undergo a mammogram when her breasts are tender. Since her periods (and thus her sore breasts) are unpredictable, she wishes a few appointment slots could be kept open each month. That way, women like her could make last-minute appointments when their breasts are not tender.
Can you relate? Are you yearning to go back in time to the '60s, when bra-burning was popular? Throughout our lives, MC Hammer's "Can't Touch This" appears to be a recurring theme. It's important to note that breast tenderness is manageable and is unlikely to indicate a serious problem.
A Different Kind of Fluid Retention
As your period nears, extra fluid in your breasts can make them feel more tender, lumpy, or swollen than other times of the month. Without a normal cycle to count on, it becomes pretty much impossible for perimenopausal women to know when those breasts are going to start throbbing, according to the National Cancer Institute.
Your hormone levels change in perimenopause. This can make your breasts feel tender, even when you are not having your menstrual period. Your breasts may also feel more lumpy than they did before.
If you're taking hormones (such as menopausal hormone therapy, birth control pills, orinjections) your breasts may become more dense. This can make a mammogram harder to interpret. Be sure to let your health care provider know if you are taking hormones.
The Shape of Things to Come
To make matters worse, without regular estrogen supply, your breasts can become dehydrated, inelastic, shrink, and lose their shape, according to Johns Hopkins Medicine. Blame it on hormones. Say ta-ta to perky tatas, and hello to sagging breasts! (It gives a whole new meaning to the term "floppy discs.")
Come perimenopause and menopause time, those hormonal ebbs and flows can become a veritable rollercoaster ride. Some post-menopausal women also experience breast discomfort. Your breasts don't have to hurt, however. Following are several treatment options to consider:
The Progesterone Approach
Estrogen levels typically fall as you approach menopause. During perimenopause, however, they can increase. Dr. Jerilynn C. Prior, an authority on menstrual cycles and the effects of hormones on women's health, notes that in perimenopause, estrogen is high but progesterone is not.
Progesterone treatments can keep estrogen peaks from over-stimulating the breasts and causing discomfort, according to Dr. Prior. If you're still menstruating (even haphazardly), progesterone treatment is typically prescribed for use during only a certain portion of the cycle, usually for about six months.
How about Hormone Replacement Therapy (HRT)?
Natural progesterone can also help alleviate breast soreness. Natural progesterone, identical to the hormone the body produces, is often easier to tolerate.
A word of warning: If you are on hormone replacement therapy and suddenly experience breast tenderness be sure to go back to your menopause specialist and have your HRT tweaked a bit. It is possible that you are on too much estrogen.
Perhaps It's Primrose Oil
Prefer natural remedies? Try primrose oil. According to the American Academy of Family Physicians (AAFP), primrose oil is rich in omega-3 fatty acids, which can reduce the inflammation associated with breast swelling and tenderness. Simply follow the directions on the back of the bottle. Vitamin B and E supplements also can help alleviate breast inflammation — and pain.
Breast tenderness/pain is a common symptom of perimenopause and menopause, and you should know it's unlikely to signal anything more serious, such as breast cancer. However, if you suspect that something is not right with your breasts, see your doctor. And don't forget to schedule your annual mammogram.
Remember the days when your breasts were a beautiful symbol of your womanhood, of motherhood? With a little TLC and treatment, you can again feel good about your body — from head to toes... to tatas.
Suffering in silence is OUT! Reaching out is IN!
Say what??? Make that: Long, sweaty days. Internal cook-offs. Lunging for the pool.
Summer can be a difficult if you're in the midst of perimenopause or menopause.
About 75 percent of perimenopausal women experience symptoms such as hot flashes, according to the North American Menopause Society. If you're one of them, you know the symptoms — a flushed face, drenching sweat and rapid heart rate — will be multiplied exponentially during the hot summer months.
Blame It on the Bad Guy: Estrogens
What's causes these sudden spikes in body temperature? Estrogens are the culprits, as they affect your body's thermostat. During perimenopause and menopause, your body's estrogen, progesterone, and testosterone begin to fluctuate. The hypothalamus, an area at the base of your brain that regulates body temperature, becomes more sensitive to slight changes in body temperature, according to the Mayo Clinic.
As estrogen levels begin to drop, they can trigger your body's thermostat to send a signal that you are overheated. This causes your body to send out an OMG! alert: your heart pumps faster, the blood vessels in your skin dilate to circulate more blood, and your sweat glands go crazy to cool you down.
The result? You're left soaking wet in the middle of a board meeting like me or in the middle of a (rare in this stage of your life) good night's sleep. If you've had your ovaries surgically removed and suddenly enter menopause, you can suffer severe hot flashes immediately after surgery that typically last longer than those in women who undergo natural menopause.
Regardless of how you got 'em, these hot flashes can disrupt daily activities, nighttime activities (i.e., sleep and intimacy), and cause you to feel anxious or out of control. Oh, the joys of being a woman.
You're In It for the Long Haul
For most women, hot flashes and other menopausal symptoms can last anywhere from six months to two years. For others, symptoms can stick around for 10 or more years. If you're in your first two years of perimenopause, the forecast calls for record highs. If you're in the midst of menopause, you may get a bit of a reprieve. However, hot flashes have been known to strike women even into their 70s.
Here are a few tips on how to nip hot flashes in the bud, or at least tame them.
Look at Your Lifestyle
If you like your latte and doughnut in the morning, a smoke and a cocktail after work, and turn into a coach potato at home, you may want to revisit your lifestyle choices. Think about reducing your intake of caffeine and alcohol, as well as refined sugar and spicy foods — all of which can contribute to hot flashes. And we know that smoking is detrimental to our health on many levels.
Your first step to finding hot flash relief is recognizing how they affect you personally. Chart your symptoms to pinpoint your personal hot flash triggers. Sign up for my free Menopause Mondays Newsletter and receive a Menopause Symptoms Chart to help with daily tracking. This chart will also help you communicate with your menopause specialist.
A Soy-ful Solution
Researchers at the University of Delaware did their homework. They reviewed 19 studies on 1,200 women and found that taking in at least 54mg of soy isoflavones a day, for six weeks to one year (about two glasses of soy milk or 7 ounces of tofu) eased hot flashes.
However, soy has gotten a bad rap when it comes to breast cancer. However, Breastcancer.org reports that for most women it's safe to eat moderate amounts of soy foods (1 to 3 half-cup servings) of soy a day as part of a balanced diet. If you're concerned about soy affecting your breast health, consult your physician.
Aim for Less Stress
Reduce stress in your life! (I know, it's easier said than done.) Not only can stress lead to high blood pressure and heart attacks in women, it also can increase hot flashes.
Take advantage of opportunities to relax this summer. Take an outdoor yoga class, for example. Recently, I went to a TM (Transcendental Meditation) class and learned how to meditate. I now do this for twenty minutes, 2X a day. I find I am more focused, calm and joyful. There are many ways to fight menopausal stress.
Find a Menopause Specialist
If you don't already have a menopause specialist, find one. Talk to your specialist about what tests can pinpoint where you are in your menopausal journey. Don't forget to bring your filled-out Menopause Symptoms Chart with you to your appointment. You and your specialist discuss your labs and health history, and develop an individualized plan for you.
Your specialist may recommend Hormone Replacement Therapy (HRT), which can treat hot flashes in a flash! Women with low progesterone but normal estrogen levels may experience hot flashes and night sweats. Various selective serotonin reuptake inhibitors (SSRIs) have been approved for the treatment of hot flashes. SSRIs are antidepressants that affect the brain's use of a neurotransmitter chemical called serotonin, and can conquer hot flashes, according to a 2014 study.
If you'd rather go the natural route, black cohosh is a popular choice. Some women find help with acupuncture.
A non-hormonal product called Relizen has made its U.S. debut. While Relizen is very new here, it has been used for more than 15 years in Europe. Ask your menopause specialist about it!
So stop singin' those sweat-drippin', fan-flippin', iced tea-sippin', hot flash blues. Start treating those hot flashes now, and you'll be singing a new tune this summer.
Suffering in silence is OUT! Reaching out is IN!
Seems like when you're raising kids or climbing the career ladder, it's all about checking off 'to do' lists. Constant activity, travel, ballgames and baby-sitters can make your head spin. Suddenly, you're done. The kids leave the nest; your career is winding down, leaving you to wonder, what's next?
You are not alone. It's estimated that there are nearly http://ellendolgen.com/menopause-blog/2013/12/30/menopause-mondays-make-your-2014-encore-in-perimenopause-and-menopause/" target="_blank">40 million women focused on what I like to call their encore career. After leading a full life, you probably still have 20-40 years ahead of you. It's time to pursue your passion, using your hard-earned wisdom as the foundation that writes your next story.
Summer and Menopause: Peri-retirement and Reflection
Menopause is a powerful catalyst to look at your own life, especially after taking care of everybody else's! Your might still be caretaking—we are the sandwich generation—but long summer days, even with hot flashes, offer time to take pause and reflect on what's next for the central character—you! It starts with taking all the time you need to http://brain.oxfordjournals.org/content/125/8/1808.short" target="_blank">examine what you've done. Summing up your best character traits and abilities is the first step to uncovering your real purpose and joy.
After years of running the kids to all of their practices, ferrying snacks to games and holding down a full-time job, it is finally time to let go and follow your own path and passion.
Give Yourself a Break!
http://www.myscience.org/wire/be_good_to_yourself_to_help_cope_with_symptoms_of_menopause-2014-Melbourne" target="_blank">Research shows that self-compassion goes a long way toward lessening the physical symptoms of menopause. When you feel better you think better. Find your perfect space, whether it's some nice shade outside, a meditation room—or even the front seat of your car to think about what's next.
That can be daunting—after all you're wiser, but do you still have what it takes? Some studies flat out show that http://www.ncbi.nlm.nih.gov/pubmed/24904185" target="_blank">motherhood affects wage earning, and that's okay, because what's different at this time of life, is that an encore career is not all about the bucks.
A television broadcast friend of mine used to call this, 'One for the meal and one for the reel,' meaning she did some news stories for the paycheck and others because she was insanely interested in the subject matter. Funny thing happened along the way—doing something because you love it somehow ensures life's bits and pieces fall into place—and the money soon follows.
Life Experience Rocks!
Everything you've done in your life can be a brick in building your encore career. Try to get your mind off hot flashes and insomnia. Difficult, because the focus in menopause research is almost always on the physical and learning how to 'deal with menopause,' and http://www.bristol.ac.uk/news/2014/june/menopause-symptoms.html" target="_blank">life experience is sometimes not even considered by many doctors when treating menopausal women. Time to flip menopause on its ear and start embracing this http://jag.sagepub.com/content/13/2/193.short" target="_blank">'time of your life.'
Know when it's time to retreat into your own sanctuary and rethink how you'll approach life's adventures. In addition to 'alone time,' call upon the sisterhood for advice because it's proven that http://www.anapsid.org/cnd/gender/tendfend.html" target="_blank">friendship is a powerful bond which strengthens your immune system and helps you live longer. Sharing plans for your next chapter will clarify things! It really helps to know how others approach their own third act.
Jeri enjoyed a long career as teacher and principal, but she feared retirement because of the associated boredom and lack of a firm schedule.
She stayed in the same career field and let colleagues know she was 'back on the market.' Then, the offers came in and she says it was the greatest feeling to still be wanted! Now, as a university mentor, she serves as an encourager for others and says that is what brings her renewed purpose and joy.
"I look forward to this next chapter because finally it will be about ME and what I want. My children are raised, my husband is happy. Time to relax!"
Time has a way of creeping up on you and it's better to choose your next chapter, rather than falling into it or having it thrust upon you. Look at it this way—from now on, your 'to do' lists will be all about things you want to do, not have to do!
Suffering in Silence is Out! Reaching Out is In!
A few decades ago, we had a totally different definition of "high." Today, as Baby Boomers, we often associate "high" with body temperature (translation: hot flashes), numbers when we step on the scale and, for some of us, blood pressure.
While it's easy to spot rising body temperatures (red faces and sweat-drenched clothes) and expanding waistlines (busted buttons and zippers and snaps — oh my!), an increase in your blood pressure may not be so apparent.
Not tonight, dear, I've got a headache
Take, for example, the recent experience of one of my colleagues. One night, she woke up in the middle of the night with a horrific headache at the base of her skull. So she popped an ibuprofen and managed to go back to sleep. The next night, deja vu. On the third night, she woke up and entered "headache base of skull lying down" in the web search engine.
Now we all know it's not usually a great idea to self-diagnose based on Internet search findings. My colleague found everything from migraines (she had these before, but told me that this headache felt different) to an abundance of spinal fluid to brain cancer to high blood pressure.
Hypochondria or hypertension?
Trying not to panic (after all, it could raise her blood pressure), she called her doctor the next morning and managed to get an appointment the same day, citing her concern over elevated blood pressure. Even though she had low blood pressure her whole life, monitors her salt intake and exercises regularly, high blood pressure was the only diagnosis that seemed plausible.
Turns out, her self-diagnosis was spot on.
My colleague is not alone.
According to the National Institutes of Health, hypertension is by far the most important risk factor that affects women in the early postmenopausal years. About 30 percent to 50 percent of women develop hypertension before the age of 60. While you may experience many of these symptoms from menopause alone, mild to moderate hypertension may cause complaints such as non-specific chest pain, sleep disturbances, headaches, palpitations, hot flushes, anxiety, depression and tiredness.
The Mayo Clinic concurs, noting that blood pressure generally increases after menopause. This could be attributed to the hormonal changes of menopause or an increase in body mass index (BMI).
Is HRT the MVP?
While some types of hormone replacement therapy (HRT) for menopause may contribute to increases in blood pressure, many doctors prescribe transdermal (meaning through a cream or a patch) estradiol HRT for women early in their menopausal journey — under age 60 to help keep cholesterol levels down. Remember, there is no risk of thrombosis (blood clots) with transdermal HRT — it is the oral estrogen with progestin that increases the risk of thrombosis. When started more than 10 years after menopause, oral estrogen is more likely to cause a stroke or heart attack in the first year after starting HRT. According to the National Insititutes of Health, in women with severe menopausal complaints and who are at low risk for cardiovascular heart disease, the use of HRT in the years proximal to menopause may be very helpful.
It is also important to note that for women who only took oral estrogen, who did not take progestin and were younger than age 60, the risk of heart attack, stroke and death from any cause decreased. A Women's Health Initiative trial showed that women who start HRT before age 60 decreased their overall mortality by 35 percent.
The Endocrine Society also stated in its 2010 Scientific Statement on HRT: "Menopausal hormone therapy was associated with a 40 percent reduction in mortality in women in trials in which participants had a mean age below 60 years or were within 10 years of menopause onset."
It is important to note that throughout these studies it is clear that the sooner you start estrogen therapy after menopause, the better.
To control your blood pressure both before and after menopause, the Mayo Clinic recommends:
Your doctor will consider prescribing medicines if your blood pressure is 140/90 or higher — the threshold for high blood pressure.However, you may want to opt for beta blockers instead of calcium-channel blockers, as the latter have been linked to an increased risk of breast cancer. A study reported in the Journal of the American Medical Association noted that in women aged 55 to 74, use of calcium-channel blockers for 10 or more years was associated with higher risks of both ductal and lobular breast cancer. (My colleague mentioned this to her doctor, who wasn't even aware of this study. She is now taking a low-dose beta blocker.) Other medications used to treat hypertension include enzyme inhibitors, receptor blockers and diuretics.
"The risk of developing high blood pressure over a lifetime is extremely high if a person lives long enough," said Dr. Deepak Bhatt, professor of medicine at Harvard Medical School, and director of the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital. For post-menopausal women, this is particularly true. By the time they reach their 60s and 70s, 70 percent of women have high blood pressure. After age 75, that figure rises to nearly 80 percent, according to the Centers for Disease Control.
If left untreated, high blood pressure can lead to stroke and heart failure. It also can also contribute to dementia, kidney failure, vision problems (especially for those with diabetes), and sexual dysfunction.
As patients — and particularly as women patients — we've got to be our own advocates. If you suspect that something's amiss with your health, get professional advice. Politely (but firmly) insist that you need an appointment. In most cases, physicians will work to accommodate you. It's important to be in tune with your own body and in touch with medical updates so that you can make informed decisions when it comes to your health.
Suffering in silence is OUT! Reaching out is IN!