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Mom started having trouble breathing earlier in the day, and then at approximately 2 in the afternoon, just stopped breathing as she sat in her TV chair. She had what one would call a blessed passing. She did not suffer, it was peaceful.
Although she was 95 years young, I was not ready.
As it was with menopause and that stage of life's journey, no one really prepared me for death and dying. Frankly those words were not spoken in our household. My parents had lost their first born, my brother Gary, at the tender age of 4. He choked to death on a piece of bread. Tragically, no one knew the Heimlich maneuver in those days. As a parent, frankly, I do not know how they survived that horrific day. My sister was 2. I was born approx. 9 months later. Then 8 years later my brother was born.
There was a beautifully framed picture of a little boy on my Mom's dresser. It never moved and no words were ever spoken of it. I knew it was something very fragile - never to be touched. It took me years before I got the courage to ask my maternal Grandma who was that boy in the picture. It was Gary.
In my teens, I first experienced loss when my maternal Grandpa died. I was scared at the funeral, and had no idea what to expect. I accidentally looked at the open coffin. That's something I will never do again. It took me years to erase the picture of dead Grandpa from my memories.
I adored my father, but sadly he battled terrible heart disease and he passed away at the young age of 58. My Mom's love for him was unmatched, beautiful and beyond most couples' wildest expectations. David and I had just had our daughter, Sarah. She was 3 months old, and was born on my parent's last anniversary together. I was 27, devastated, and not prepared to lose my father.
My husband was loving, patient and a rock for me during those dark days. However, I think having my new little baby girl to take care of is what got me out of bed in the morning. Holding her, that baby smell, her giggles, and need for love and mothering surrounded me with the joys of life. Some days I would nurse her with tears running down my face, but her little face, tiny fingers, and helplessness would bring me back to life again.
When our son was born two years later, I named him Jack after my beloved father. A few months later, my Grandma passed away. My Grandma was my confident and definitely my biggest fan. Having my new beautiful son in my arms and a two year old toddler running around the house got me through the grief of losing my sweet Grandma.
My beloved Mother lived a sharing, caring and charitable life with effortless grace and tremendous modesty. Although she was petite, refined, and delicate - she was strong and wise. She adored her parents and her brother, Jack, who is 90 and lives in Flint, Michigan. Mom's entire being was devoted to her family. Every breath she took was dedicated to all of us.
Sarah is the mother of our first grandchild, Aviva. In March of this year, on Mom's 95th birthday, she was able to meet Sarah and Sol's new bundle, Aviva. Aviva just sat on the arm of Mom's chair with her little hand on Mom's shoulder – they were both completely smitten with each other.
At her burial, as I watched my Mother's grave be covered in dirt, I started having trouble breathing. My son-in-law, Sol, gave me Aviva to hold and immediately I calmed down. It was as if he gave me a tranquilizer. As Aviva squirmed in my arms all giggles and smiles, I was once again comforted by the circle of life...a baby - a new life – love, hope, and joy. I feel blessed to have Sol as a member of our family.
Lucky for me, in June I read the fabulous free eBook, Love on the Other Side by Arielle Ford. This is a must read! Thanks to this beautiful book, I know that my Mom and Dad are in each other's arms again. This brings me great comfort.
Towards the end of my Mom's life our daily phone calls were brief – her short term memory was gone, but she was still aware and alert.... I always ended with, "I love you, Mommy." She replied, "I love you too, Ellen Gail."
I had no idea July 5th would be the last time I would hear her voice. I am going to miss our daily phone calls so much. I know that in time, I will stop reaching for the phone to call her. I will forever look at the world partly through her eyes and hear her words of wisdom and guidance.
My husband is circling me with love and encouragement to grieve ...to just be. I am so fortunate I can speak openly and honestly with my children, Sarah (35 years old) and Jack (33 years old), about life and death as I cherish their love, support, and wise words of wisdom.
This is hard for me....I am not used to feeling so sad, so numb, so detached.
My favorite scholar, Pooh Bear once said, "How lucky I am to have something that makes saying goodbye so hard."
Yes, Pooh's right. This is very hard.
However, once again I am reminded about the circle of life. Sarah, Sol and Aviva moved back to San Diego mid July. Lucky me! On August 8th Aviva was 1.
It seems so fitting that when the grief comes and the tears flow, it is my sweet little granddaughter, Aviva who helps me feel joy, giggles, and happiness again. She reaches out her hands for me to hold her, but in truth it is she who is holding me as life circles on.............
Do you find yourself suddenly needing to mop the kitchen floor or organize the recycling when your spouse suggests it's time for bed, hoping he or she will have fallen asleep before you get there? Do you find yourself wondering whatever happened to that wildcat who couldn't wait to get her partner alone? And more importantly, do you find lack of intimacy time is creating an emotional chasm with your partner? Thanks to the changing levels of hormones women experience during menopause, your libido may be taking a nosedive.
You may have noticed the countless television and print ads for pills and creams and power drinks that support a man's virility—there's that "little blue pill" and that couple who inexplicably watch a sunset in separate bathtubs (last time I checked, you need to be in the same tub if you want to get busy).
So where's the help for women? Research shows that sexual dysfunction occurs in about 30% to 50% of women (and that's just those who report it). Common complaints include low sexual desire, difficulty attaining or maintaining sexual arousal, and inability to achieve an orgasm.
Are we meant to resign ourselves to live out the second half of our lives as though we're holed up in a convent? No! Just because you've reached a certain age, it doesn't mean you no longer have a need for good sex in your life. In fact, some people find mid-life sex far better than the sex they had when they were young. "As we age, most of us become more aware of what we need in the bedroom and how to get there. We feel more deserving of sexual pleasure and are more willing to ask for what we want from our partners," says Hilda Hutcherson, M.D., Clinical Professor of Obstetrics and Gynecology at Columbia University Medical Center. "In our 50s we are more likely to focus on our pleasure than in our 20s, when we tend to focus almost exclusively on his experience."
Women have the right to toe-curling, earth shattering orgasms, just like men. But due to this double standard, having a fulfilling sex life after menopause may not be a reality for all women.
However, all is not lost. Read on.
If your sex drive seems to be firmly stuck in park—or worse, reverse—and you're worried that it may never come back, there are several things to consider. Is low estrogen to blame or could something else be going on? Dr. Hutcherson suggests for many women it's just boredom, although "Medical problems and medications certainly can wreak havoc on desire." Whatever you do, don't fake it! "Faking orgasms will guarantee that your sex life with your partner never improves," she says.
There is some good news for women! For women who experience what the experts call hypoactive sexual desire disorder (HSDD), we finally have a "pink pill". Addyi (pronounced add-ee), known generically as Flibanserin,is the first everFDA-approvedtreatment for women's most common form of sexual dysfunction made bySprout Pharmaceuticals. It is a once-daily, non-hormonal pill.
Dr. Michael Krychman, Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, California, explains, "While estrogen is critical, it is my belief that there is interplay between lowered estrogen and lowered testosterone levels in women as they age."
Here is a testosterone 101, courtesy of Dr. Krychman:
Testosterone is part of our hormonal makeup. Testosterone is a steroid hormone primarily found in men, but smaller amounts are also produced in women's body: one specific place is the ovaries. Testosterone is necessary for muscle tone, a healthy libido, and strong bones. Women begin experiencing low "T" during their menopausal journey, which may begin a decade earlier than when menstrual periods stop.
Testosterone isn't just for guys. Women with low testosterone levels can experience depression, fatigue, weight gain, bone and muscle loss, and cognitive dysfunction. Then there is the whole "loss of libido" issue, which can be dramatically decreased. As for orgasms, if we have them, they can be more "ho-hum" than "woo hoo!" if your "T" level is down, according to a report from the North American Menopause Society.
There are many benefits of testosterone supplementation. Supplementing with testosterone can benefit your heart, mood, energy, and bone and muscle health. Additionally, testosterone can sustain skin elasticity and tone, encourage heart health, boost libido, help prevent osteoporosis risks, decrease body fat and increase muscle strength.
Here are some tips to help you find that lost libido:
Schedule a visit with your menopause specialist to rule out any other medical problem. Underactive or overactive thyroid, for example, can also affect your energy level, libido and general physical health or well being.
Talk to your specialist about testosterone testing. Total testosterone and "free" testosterone are typically measured and calculated. Free testosterone, measures your levels of bioavailable testosterone that is not bound by the blood proteins. It is the active portion. Ranges vary between post-menopausal and premenopausal women, with a gradual decline as we age, says Dr. Krychman. However, he adds, "I advise treating symptoms, not lab values. A comprehensive assessment with a good differential is the rule. Testosterone supplementation is not the panacea. It is important to remember that this there is also approximately 40% placebo effect."
Discuss the various treatment options with your menopause specialist. If your testosterone levels are below norm and you have the symptoms, your health care professional may suggest an "off-label use" of testosterone, with or without estrogen. Why "off-label? Because the FDA has yet to approve any testosterone drug for women. According to WebMD, when you take it orally (by mouth) and it gets processed by the liver—which can result in a change of cholesterol levels. But that same effect doesn't occur when testosterone is administered by skin patch, gel or cream (a.k.a. transdermal) or in pellet form (the size of a grain of rice) inserted under the skin. "What form to use depends on many facets including patient tolerability, patient price, side effects and clinician preference," says Dr. Krychman.
Weigh the risks vs. benefits with your menopause specialist. Dr. Krychman has a frank and candid conversation with his patients about the benefit versus the risk – safety and efficacy are always balanced, he states. He further recommends that before starting therapy you are aware of the benefits and risks and that once you start therapy, you need to have regular blood work to keep track of your levels. It is important to monitor your blood count and lipid panel, coupled with testosterone levels.
For some women, the sex drive is fine, but the ability to cross the finish line is a problem. If you're having trouble achieving orgasm, or your orgasms aren't as powerful as they once where, there are several ways you can strengthen your Big O.
Get the info you need to take charge of dealing with your faltering sex drive. Remember, sex is more than just fun. It's integral to most intimate relationships, and it's also great for your overall health (but, yeah, it's also really fun). Check out these benefits you probably weren't even thinking about when you started reading this chapter!
Stress relief. When you have an orgasm, the hormone, oxytocin, is released from the hypothalamus of the brain into the bloodstream. This creates an instant feeling of release and relaxation. And what better way to start off a good night's sleep than with an orgasm?
Pain relief. Research shows that [Link Removed] to download my free eBook, MENOPAUSE MONDAYS: The Girlfriend's Guide to Surviving and Thriving During Perimenopause and Menopause.
If you're anything like me, you woke up one morning and suddenly nothing in your closet fit. Has an alien mysteriously entered your closet during the night and shrunk all your clothes?
Maybe you try to cut back on the M&Ms and ramp up your exercise routine, but still the pudge keeps on coming.
Regardless of what number she sees on the scale, a woman's weight through menopause and perimenopause is largely determined by five factors: hormones, diet, exercise, stress, and genetics. Though you may not be able to control all of these factors on your own, a healthy weight is certainly within reach.
Here are five steps to help you shed those extra menopausal pounds (a.k.a. the menopot belly):
A positive attitude is the first step to feeling good and looking good. It's never too late to start living a healthier life. Your brain and body will thank you and so will those clothes collecting dust in your closet. Take the first step! Go ahead—you can do it!
You're in the middle of a conversation with a colleague, and lose your thought halfway through a sentence. You call your children by the dog's name. (If you name your dog after your first born, you might save yourself some embarrassment!). Your desk is plastered with sticky note reminders. You find yourself asking your significant other, "Honey, can you call my phone? I can't find it." You wish you could do the same with your keys and wallet.
It's not in your head: Menopausal memory loss is real.
As hormones fluctuate in your body during menopause, cognitive functions are affected. Doctors say self-reported memory problems are common in women 33-55. Many menopausal women have trouble with working memory, as well as keeping themselves focused, says a study from the University of Rochester Medical Center and the University of Illinois at Chicago. Additionally, the Study of Women's Health Across the Nation (SWAN) showed that cognitive decline is common, and that it can be more difficult to learn new things as you go through menopause. That translates to problems with even some of the most basic real-life tasks, like calculating a tip after a restaurant meal or adjusting an itinerary after unexpected flight changes. (Take a look at this clip of a Menopause Monday event on the TODAY Show discussing the research!)
FYI, the study says hormone therapy works better when you begin early on, say before your last period or by 53 years of age. There might be a detrimental effect if you begin hormones much later in the game—three or four years after your last period.
"If a woman approaching menopause feels she is having memory problems, no one should brush it off or attribute it to a jam-packed schedule. She can find comfort in knowing that there are new research findings that support her experience. She can view her experience as normal," lead researcher Miriam Weber, Ph.D., said in a statement. Between one-third and two-thirds of women report forgetfulness and other memory difficulties during perimenopause and menopause, according to Weber.
Still, "normal" doesn't always mean "good." And it definitely doesn't mean you have to accept it.
Here are five natural ways to help overcome some of these issues and keep a sharp mind during menopause:
Here are some other great tips to help you remember:
The good news in the SWAN study is that menopausal cognitive decline might be time-limited, so as you near the later stages of menopause, you do feel more clarity. And for me personally, once I started HT, my brain fog lifted and I was fully functioning again!
True self care is about more than your body. It's about your mind, which is the control center for everything you think, do, and are. Clear cognitive health allows you to be your healthiest, happiest self. Sure, it's easy to dismiss brain fog with late nights, busy schedules, and to-do lists as long as your arm, but you owe it to yourself to stop making excuses and to get to the real cause.
Remember, just because your challenges are "normal" doesn't mean you can't ease them. Be your own best friend—take good care of yourself!
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.