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One minute you're screaming at a colleague to get that project done now! The next you're in tears over a cat food commercial. WTF is going on? Women often hear the word "emotional" used interchangeably with "hormonal," and it's not usually a compliment. But there are legitimate reasons why your emotions are in upheaval during the process of menopause.
"Menopause, itself, is a stressful life event because of the various types of change that occur," says Dr. Jeff Brown, a professor of psychology at Harvard Medical School
Hot flashes are tightly linked with stress and anxiety, according to a six-year study published in Menopause. Researchers found that anxiety and stress preceded hot flashes among perimenopausal and post-menopausal women.
Stress is your body's reaction to any kind of demand—good or bad. Acute, or brief stress can make us more efficient and effective (think: deadlines), too much stress or chronic stress, on the other hand, can be harmful to your mental and physical health.
What's more, chronic stress can compromise our immune systems, making us more prone to illness. Between 50 and 60 percent of all medical issues originate from stress or stress-related events, he says.
So how can you tell the difference between a stressful situation and a real stress rut? Signs that you've hit your acute-to-chronic tipping point include changes in appetite and sleeping patterns, headaches, crying, irritability, and even panic attacks, according to Brown.
"When it comes to stress and menopause, it's crucial to keep your finger on the pulse of physiological, psychological, and relationship aspects of your life. Change is occurring and knowing yourself well is vital," he says.
Of course, you likely won't feel the exact same way pre-menopause as you do post-menopause, and some of that is natural. But there's no need to feel like a totally different woman, especially if that woman is stressed all of that time. You can slash your stress levels. Remember, though, that while your old stress-busting tactics like bubble baths, exercise, and meditating still work, you might have to go above and beyond them to beat stress during menopause, especially when menopause is the actual stressor.
"Each woman who deals with menopause may find that her typical stress-coping strategies need to be adjusted because of the high levels of stress that may be occurring as a result of physical changes during menopause," Brown says.
Here are three tips for fighting menopause-induced stress:
According to [Link Removed] to download my free eBook, MENOPAUSE MONDAYS: The Girlfriend's Guide to Surviving and Thriving During Perimenopause and Menopause
Let's face it, love can hurt. And I'm not talking about the he-left-me-for-a-younger-model-and-broke-my-heart kind of hurt. I'm talking about the physical pain that can be associated with intercourse during menopause.
There's actually a medical term for painful intercourse: dyspareunia (really??) If you're experiencing pain during sex, you could be suffering from vaginal atrophy or VA (I used to think VA stood for Virginia, which ironically, is for lovers.). VA is also known as vulvovaginal atrophy or VVA. The latest appellation, courtesy of the North American Menopause Society (NAMS), is genitourinary syndrome of menopause (GSM), a blanket term to describe menopausal symptoms that occur to the vulva, vagina, and lower urinary tract as a result of estrogen deficiency. Who makes up these words? Once again, the vagina gets the short end of the stick! I can't even pronounce "genitourinary"! Perhaps NAMS should call in the Opi Nail Color Labeling Committee?
Anyway, vaginal atrophy is just that: a thinning of the vaginal wall thanks to a drop in levels of estrogen, whose job it is to maintain the structure and function of the vaginal wall, elasticity of the tissues around the vagina, and production of vaginal fluid.
We seem to hear more about hot flashes, insomnia, and memory loss, but vaginal discomfort is every bit as difficult—and critical—to deal with as other menopausal symptoms. Vaginal symptoms can negatively impact not only on your relationships and sexuality, but your quality of life and self-image.
In my experience, most women don't even know what VA is, nor understand that it is a chronic problem that requires ongoing treatment and IS treatable.
What are the symptoms of VA?
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 [Link Removed], this is a safe and effective technique. A physical therapist uses massage and gentle pressure to relax and stretch tightened tissues in the pelvic area. You also learn exercises to help strengthen your pelvic floor muscles, which may have been weakened by aging, childbirth or hormonal changes. Now that's a massage with a happy ending!
Personal Lubricant or Moisturizer
Both can go a long way in the bedroom. However, your vagina may need more. Non-hormonal vaginal lubricants can help decrease friction and discomfort during intercourse. Be sure that they are water-based and designed for vaginal use. Petroleum-based lubricants can harbor bacteria in the vagina and lead to infection, as well damage latex condoms. Vaginal moisturizers, similar to facial moisturizers can help relieve dryness and rebalance the acidity of the vagina, and most women find these helpful to use every day. Both lubricants and moisturizers provide temporary relief of symptoms but often do not treat the underlying condition of vaginal atrophy.
Time for a lube job? Here are the three basic categories of lube:
Water Based lubes can contain a number of plant based ingredients (in addition to water), such as aloe (aloe barbadensis), guar gum (Cyamopsis tetragonolobus), flax seed extract (Linum usitatissimum), and locust bean gum (Ceratonia siliqua). They are often combined with preservatives—some natural, such as tocopherols (vitamin E) and citric acid, and in other cases synthetic preservatives, such as potassium sorbate, parabens and propylene glycol. They can also contain glycerin, xylitol and phenoxyethanol. They tend to dry out much faster than oil or silicone based lubes and can become tacky (heaven knows, we don't want to wear anything tacky) and sticky. However, they clean up easily, do not stain the bed sheets, and get along just fine with latex condoms and toys. Some newer lubricants contain carrageenan (a seaweed product), which minimizes the tackiness or stickiness associated with water based lubes.
Oil Based lubricants, which cannot be used with latex condoms or latex toys, can be either pure natural oils, a mix of natural and petrochemical oil, or pure petrochemical oil. If condoms are required, either Polyurethane or Polyisprene condoms can be used. As natural oils, some people use Organic 100% Sweet Almond Oil (this contains oleic and linoleic essential fatty acids, which helps your muscles relax) or Organic 100% Virgin Coconut Oil (this can help prevent yeast and bladder infections) as a lubricant. These oils will not burn or inflame the vagina or the penis.
Silicone Based lubricants are, you guessed it, silicone based. Dimethicone (Polydimethysiloxane or PDMS) is the form of silicone used in the better silicone lubricants. It does not dry out as some water based lubricants do, has a thick lush feeling, and is generally considered to be non-toxic and non-irritating (this, of course, can depend on the individual user). It does cause damage to silicone toys, is difficult to wash off, and can stain bed sheets.
Test all the lubricants on your skin first for potential irritation. Try the inside of your elbow or another spot where the skin is delicate.
I conducted an informal survey among my readers to see which lubes/moisturizers are most popular. Here are their top choices:
If you are all lubed up and still have no relief, see your menopause specialist to see about medical interventions that can help. You do not need to suffer. Talk to your specialist about the various hormone treatment options available. There are two types:
Local Estrogen Therapy (LET) is estrogen applied directly to vaginal tissues, so it goes directly to the affected area with minimal absorption of estrogen into the bloodstream. LET is available in creams, a ring (def not jeweled) and a tablet.
Systemic Hormone Therapy allows estrogen to circulate throughout the bloodstream to all parts of the body. It's available in many forms: a pill, injection, patch, gel and spray. Systemic HT is most often prescribed for multiple whole-body symptoms of menopause, including night sweats, hot flashes, and others. Some women need a combination of treatments.
Above all, communicate with your partner. Honesty is definitely the best policy. If you're avoiding sex due to pain, your partner could misinterpret it as your dissatisfaction with the relationship (or the sex). Remember the guy who called in to the radio show about the collapse of his marriage over this very issue? Ask your partner to join you at the doctor visit so he or she can be part of the solution. If sex is a vital part of your relationship—it takes two, as they say—then make this part of your journey a partnership, too.
Are you experiencing your own internal heat wave? Do you wake up at least once during the night in a sweat? Do you have to get out of bed, towel off, change clothes and then try to get back to sleep, only to experience a repeat performance? Do you have to prod your partner to move over a bit to avoid sleeping in the "wet spot." (No, not the fun one.) Do your nights of interrupted sleep seem endless? If so, you're not alone, and this is not being caused by global warming.
According to the North American Menopause Society, about 75 percent of women report perimenopausal symptoms such as night sweats and hot flashes. If you're one of them, you know it's more than a seasonal heat wave. And you know that the symptoms — a flushed face, drenching sweat and rapid heart rate — will only be compounded as the numbers on the thermostat continue to climb. Before you move to the North Pole, let's examine this common symptom a bit further.
What exactly is a hot flash?
During perimenopause and menopause, the body's levels of estrogen, progesterone and testosterone begin to fluctuate. When estrogen levels go down, they can trigger your body's thermostat to send a signal that you are overheated. This causes your body to send out an all hands on deck alert: your heart pumps faster, the blood vessels in your skin dilate to circulate more blood to radiate heat, and your sweat glands release sweat to cool you even more. Like so much about the process of menopause, there is no "one size fits all" for the timing, duration, frequency or pattern of menopausal hot flashes.
So what does this hormonal meltdown feel like?
You may experience one or more of these:
Fortunately, there are lots of options for treating hot flashes beyond wearing easy-to-strip-off layers, or attaching a small fan to your forehead. Since every woman is different, you will have to explore which options work best for you with your menopause specialist.
Options needing prescriptions:
Non prescription options:
It's helpful to be aware of some of the typical hot flash instigators. You can try eliminating these triggers one at a time to see if that helps alleviate your symptoms. For example, reduce your [Link Removed] to download my free eBook, MENOPAUSE MONDAYS: The Girlfriend's Guide to Surviving and Thriving During Perimenopause and Menopause
Are you Sleepless in Seattle? Does Disney's Sleeping Beauty make you hostile? Does the sight of a blissfully snoozing infant make you weep? Do memories of teenage sleepathons that last 12 hours make you misty with nostalgia? Take heart, you've got a lot of company.
Insomnia is a problem many women encounter when they enter perimenopause. I have always been a very busy, multitasking kind of person, who worked hard in the daytime and slept hard at night (including falling asleep mid-conversation, but we don't need to get into that). All of a sudden in my forties, not only was I having trouble sleeping, but multitasking became more difficult, too. My focus and memory kept failing me. I felt like an alien had taken over my body and I was no longer in control. My insomnia was getting the best of my ... what was I just about to say?
If you're suffering through insomnia, you are not alone. Only 45% of peri-menopausal women report getting a good night's sleep almost every night, says the National Sleep Foundation. Hormones connect your brain and body. When they change, the way your brain and body function does, too. Progesterone is a very important hormone for sleep, but progesterone levels drop when you enter perimenopause, making your body chemically less capable of sleeping well.
The North American Menopause Society (NAMS) lists trouble falling asleep as one of their main five symptoms of menopause. According to the National Sleep Foundation (NSF), most women complain of sleeplessness during perimenopause to post-menopause, with about 61% of post-menopausal women having issues with insomnia.
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. 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.
Here are four tips to help you get back in touch with Mr. Sandman:
To get a good night's sleep, you may have to 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.
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, try some tricks to help relax your body and get you in the sleeping mode. For example, do something calming like reading a book while sipping some chamomile tea, enjoying a candlelight bath, or just closing your eyes and listening to some soft music. As it gets closer to sleep time, prepare your bedroom so there are no distractions—eliminate as much light and sound as possible, and definitely keep your bedroom a smart phone free zone (phone sex is permitted). In fact, experts suggest you turn off all the electronics at least an hour before bedtime.
Hot flashes can be another reason why women in menopause have a hard time staying asleep. To help combat the heat, be prepared by wearing loose-fitting clothing to bed and by making sure your sleeping area is well ventilated.
An article published in Menopausal Medicine—the journal of the American Society for Reproductive Medicine—says that studies have found HT helped menopausal women with sleeping issues, and helped them get more productive sleep. If sleeplessness is a major issue for you, this is an option you may want to discuss with your menopause specialist.
There's no need to stumble through your day like an extra on The Walking Dead. Ditch your inner zombie and get your snooze back!
My husband David and I met 39 years ago on a blind date. Yes, ladies go on those blind dates! You just never know, you might meet your soulmate!! David is my life partner. Over the many years we have been together, we try to encourage each other to lead healthy and rewarding lives. I came to the marriage with high cholesterol and David came with periodic migraines.
I take great care to eat healthy and exercise. David supports me in this by doing the same. Over the years, David has found a fabulous migraine specialist who has figured out the right protocol to take care of those migraines when they hit. This is all well and good, but now that we are in our 60's, I wanted to figure out if there was something we could do to help prevent those migraines instead of managing them after they occur. So, with that in mind, David made an appointment for a consult at Scripps Integrative Medicine.
The doctor suggested that David try TM, (Transcendental Meditation). He explained the science behind it and added that he and many medical professionals, corporate executives, even celebrities mediate twice a day for 20 min. I was a bit skeptical, but willing to try anything that would help David. On the way home in the car, I called the TM center and made an appointment for us to have the training. I thought if I did it with him, it would help David do it.
When we arrived for the training, we were each taken to a different room with a different trainer. There was something very calm about this place. I couldn't put my finger on it. As I sat with my trainer, I thought, this is so easy and is going to be so helpful to David.
After maybe a minute, I was quite sure that the 20 minutes was almost up. When was the last time I sat calmly for 20 min? I was perplexed by how relaxed I felt. I learned to let go and just "be", something not very familiar to me, or for that matter, our culture as a whole.
That's when it hit me.......perhaps it wasn't just David who needed to learn to meditate! OY!
TM where have you been all of our lives!!??
Being a bit Type A (understatement), I had to meditate perfectly. But what was I supposed to do with all those thoughts that kept gushing into my mind as soon as I closed my eyes ...what is my next blog.....what am I making for dinner......... I have to get back to my computer ASAP and answer emails from menopausal women in stress.......did I send out that birthday card -you name it the thoughts came flooding in. Yet I found that with this effortless technique the thoughts did not detract from my transcending experience. Every time I meditate this wonderful calmness and inner peace washes over me. I am energized, alert, and way more creative. After 20 min, I feel like I went through a de-stress car wash. My stress just washes away. I love the feeling!
Later, I began reading more about meditation and how it can affect overall health and well-being. A study in the Journal of Alternative and Complementary Medicine, October 2013: meta-analysis of randomized controlled trials (RCTs) found significantly greater effect of TM in reducing trait anxiety than treatment-as-usual and other alternative treatments, including mindfulness-based therapy (MBT) and other meditation and relaxation practices.
I reached out to Dr. Josh Trutt, a healthy aging specialist for his thoughts on meditation. He explained, "When we relax, our heart rate slows down, But when we meditate, the interval between each beat of our heart changes and becomes smoother. That interval between each beat is called Heart Rate Variability (or HRV), and smoothing it out is what lets those Yogi masters live longer—in fact in 2010 the American Journal of Cardiology reported that maintaining a healthy HRV as we age actually predicts longevity!"
We all know that heart disease is the number one killer of women. I was thrilled to find out that The National Institutes of Health has funded over $26 million in research on the Transcendental Meditation technique for prevention of heart disease.
Research on TM has shown:
There are days when David has to peel me from my desk chairs to go meditate. My Type A personality hasn't changed but my stress level and quality of life has thanks to TM.
You don't need to have candles and incense lit in order to meditate. You can mediate in your car between appointments, on the airplane, or in a quiet corner during your lunch hour. It can become part of many happier, healthier, and stress-free days to come. Try it! [Link Removed]! Help me spread the word!
Once in a while, when I can't remember where I put my keys or forget someone's name, I think about my brain, and wonder if I take good care of it. After all, it is one of our biggest organs, weighing about 3 pounds. I think my hips are next in weight, but not defined as an organ....but I digress!
A few years ago, I needed an MRI of my brain as I was having some sudden scary dizziness (fortunately it turned out that I just needed to tweak my thyroid medicine...who knew??). After I got off the MRI table my first thought was that I was relieved they found a brain in there! Good to know. As a boomer, sometimes I experience things that make me think mine is shrinking.
Our brains have a HUGE job! The brain consists of some 100 billion nerve cells. It is comprised of two kinds of matter...gray and white. (mine probably has orange in it-my fav color). The brain houses our thoughts and highly coordinated physical actions, and regulates our unconscious body processes, such as digestion and breathing. It gives us the capacity for creating and enjoying art, language, moral judgments, and rational thought. It's also responsible for our individual personality, memories, movements, and how we sense the world.
So what happens if that brain becomes injured? How does it heal? How do you find your path to being "Okay" again? Ruth Curran, author of Being Brain Healthy shares the car accident that resulted in her brain injury and then she meticulously walks us through the recovery from that injury and how it taught her how to build better thinking skills and changed her life. You feel like you are inside her brain, experiencing it all firsthand.
Curran shares the most cutting edge research (in layperson speak), helps us understand how the brain works, how it works together with our body, and shares the stories of others who are in recovery from brain challenges. She very cleverly divides the book into easy to understand sections: Be Active, Be Engaged, Be Social, Be Purposeful, and Be Complicated. Don't you just love these?
As Curran puts it, "The journey to wellness when coming back from a brain injury can be a long one."
For Curran, there was a point in her recovery process where she made a shift in focus that moved her from seeking treatment and looking for intervention to empowering her to turn up the volume on the quality of her life. You can almost feel her move that volume control.
Thank you, Ruth, we hear you loud and clear! Your road to "Okay" is not only an inspirational one of a brain injury survivor who empowered herself by thinking, acting and doing, it has also encouraged me to want to elevate my thinking and expand the use of my brain!
Be sure to read Ruth's wonderful book, Being Brain Healthy: What my recovery from brain injury taught me and how it can change your life.
Gotta go to Be Active, Be Engaged Be Social, Be Purposeful, and of course, Be Complicated!