One of the lesser known and understood symptoms that women can experience during perimenopause is an occasional irregular heartbeat otherwise known as a heart palpitation. The most important thing to do if you are experiencing this symptom is to make sure that it is not due to underlying heart disease. Before you blame perimenopause for your palpitations, you will need to see an internist or cardiologist for a basic workup that will include an EKG, Chest Xray and some labs.

Heart Palpitations and Perimenopause
The suddenness and unexpectedness of heart palpitations can be very scary. Your heart will feel like it is racing, pounding, fluttering or skipping beats. The overall experience is an unpleasant awareness of your own heartbeat. This can also be accompanied by feelings of panic, anxiety, sweating, weakness and fatigue.

Once you are sure that you do not have underlying heart disease, there are some natural ways to relieve an irregular heartbeat. Drinking cold water or splashing it on your face may provide an instant end to the sensation. Getting enough sleep and practicing relaxation techniques may also reduce the likelihood of experiencing an occasional irregular heartbeat. There are also triggers you can avoid, like caffeine, appetite suppressants, alcohol, and smoking.

Treating perimenopausal hormonal fluctuations with a continuous low dose birth control pill can often alleviate these palpitations. And if you are already menopausal, hormone therapy has been shown to be helpful as well for overall heart health when used early on in your menopause transition.

Women's Heart Health
The only heart flutters worth having are those that occur when we fall in love!

So let's start taking good care of our hearts. Cheers to heart health. I'll drink to that. Unless, of course, it cause a palpitation!

For more information, go to www.menopause.org.

Let's talk about brain fog. That is when you feel very foggy and fuzzy, and it's hard to focus or concentrate. This symptom affects as many as 2/3 of perimenopausal and menopausal women. So what is the cause of brain fog? No one knows for sure, but it has something to do with the fact that the brain is no longer enjoying the reliable estrogen supply it had when our ovaries were doing their jobs properly. And brain function is worse when women are not sleeping well because they are experiencing symptoms of hot flashes and night sweats. Like I always say, no good can come from a bad night's sleep!

Managing Forgetfulness and Lack of Focus
Difficulties with focus and concentration will definitely have a negative impact on your work and home life.

Try these few simple lifestyle changes to help improve your brain function:

-Create a comfortable workspace and de-clutter your desk. I should really take my own advice. You should see my desk right now!
-Exercise your brain. I like to read the New York Times.
-Break down your work projects into smaller and more manageable chunks. I am working on my blogs now. Tomorrow I will deal with my book chapter.
-Drink plenty of water. Hydration is great for your whole body.
-Exercise! Did you know that intense aerobic exercise can have the same impact on the brain's concentration ability as pharmaceutical stimulants?
-Prepare for the next day with a healthy dinner rich in brain friendly nutrients like fish, vegetables and nuts. And for goodness sake, turn off the computer and TV early enough to ensure a good night's rest. Stop looking at your email after 9p!
-As for hormone therapy, there does appear to be a lifting of the brain fog complaint when estrogen is used for the treatment of menopausal symptoms. My own patients experience this effect all the time. It is like having an Oprah AHA moment!

Go to www.menopause.org for more information on this very important topic.

Night sweats, the nocturnal cousin of hot flashes, are uncomfortable, disrupt your sleep and will be experienced by as many as 75% of perimenopausal and menopausal women.

What are Night Sweats?
Medically termed as "sleep hyperhidrosis", night sweats aren't actually a sleep disorder, but a common perspiration disorder that occurs during sleep in both perimenopause and menopause. These episodes of nighttime sweating can range in severity from mild to intense, and are caused by hormonal imbalances combined with environmental factors, such as an excessively warm sleeping environment. The symptoms can drastically disturb sleep patterns, which means the next day you will be fatigued, irritable and moody. You may also experience brain fog which means you cannot focus or concentrate. The stress and exhaustion that comes from a poor night's sleep will also contribute to a reduced libido.

Managing Night Sweats
The good news is that some of the environmental adjustments we discussed previously to assist with managing hot flashes will also improve night sweats like wearing light weight clothing, maintaining cooler room temperatures, cutting back on hot, spicy foods, alcohol and caffeine. You should also start exercising every day and making better nutritional choices. Losing some weight would improve sleep which would improve some of the symptoms that you are experiencing. Meditation, deep paced breathing, yoga and acupuncture can also be helpful. Drinking more water will also contribute to cooling down the body.

There really is nothing better than a good night's sleep!

Hot flashes – what are they and what causes them?

While nobody actually knows the mechanism for a hot flash, we do know that there is an area in the brain called the hypothalamus that regulates body temperature. For whatever reason, during the transition through perimenopause and menopause, the hypothalamus sends signals that cause women to get hot. It starts out as an ascending flush in the chest, goes up the neck, into the face and turns your face red. There is no rhyme or reason as to which woman will have a mild flash and which woman will have a severe one. Genetics can play a part, though. There is a relationship between when our mothers and sisters transition and the severity of their symptoms. So now would be a good time to talk to your mother and sisters to find out more about their experiences.

Treating Hot Flashes

According to the North American Menopause Society, many women will not need any treatment for hot flashes. If hot flashes are bothersome, they can often be reduced with one or more of the lifestyle changes listed below:

1. Identify and avoid personal hot flash triggers like external heat (such as a warm room or hair dryer), stress, hot drinks, hot or spicy foods, alcohol, caffeine, and cigarette smoking.
2. Try meditation, yoga, bio-feedback, positive visualization, acupuncture, or massage.
Stay cool during the day by dressing in layers.
3. When sleeping, wear light cotton nightclothes.
4. Use sheets and garments that absorb moisture from the skin onto the surface of the fabric where it evaporates.
5. Wash your hands in cold water when you get a hot flash to cool down and feel refreshed.
6. Keep a small fan on your desk, by your bedside, even in your purse.
7. Keep a frozen cold pack under your pillow and turn your pillow frequently.
8. Learn techniques for getting back to sleep when awakened.
9. Take slow deep abdominal breaths in through the nose and out through the mouth at the beginning of a hot flash.
10. Lose weight if you are overweight

About 80 percent of women are going to experience hot flashes, which is the most common menopausal symptom. The average duration for experiencing hot flashes is 7 years. Some women will experience flashes for over 20 years! So do not let your hot flashes get you DOWN. Get UP and do what you can to feel better

Estrogen promotes the growth and health of the female reproductive organs. It also affects practically every tissue in a woman's body, including the heart, brain, bones, eyes, skin, colon and so forth. Fluctuating and ultimately reduced levels of estrogen can result in hot flashes, night sweats, mood swings, palpitations, insomnia, fatigue, decreased libido, vaginal dryness, irregular bleeding, bone loss and heart disease. Estrogen replacement therapy is considered the gold standard for the treatment of menopausal symptoms.

Progesterone

Progesterone is the hormone that prepares the lining of the uterus to accept a fertilized egg. During perimenopause, ovulation becomes unpredictable and so does the production of progesterone. During perimenopause, fluctuating levels of progesterone can cause periods to become heavier, longer and irregular.

When considering the use of hormone replacement therapy for menopausal symptoms, progesterone is necessary for women who still have a uterus. If you have had a hysterectomy, you do not need to take progesterone. Progesterone has only one job, which is to protect the uterine lining from abnormal overgrowth caused by the estrogen being taken to reduce menopause symptoms. It is the estrogen that is helping with your symptoms. It is the progesterone that is protecting your uterine lining. If you have had a hysterectomy, you do not need progesterone.

Testosterone

Although known as the "male" hormone, you might be surprised to learn that your ovaries have been producing testosterone since you first started getting acne and having periods! Testosterone continues to be produced by your ovaries for about 5 years after you have entered menopause and stopped making estrogen. Testosterone helps with your libido, feelings of well-being, energy, and bone health.

Who should consider a trial of testosterone?

The FDA has not approved the use of testosterone in women, so the answer is complicated. With my patients, I start with estrogen first, and most of the time I can manage symptoms just fine. If you have a uterus, you will also need progesterone. After 3-6 months, if you are still complaining of a reduced libido, it is time to consider adding testosterone. Since testosterone has not been FDA approved for use in women, you must make sure your health care professional knows what to do. Testosterone is generally safe at low doses for a short period of time.

More than 60% of women in their fifties and sixties are sexually active, and they can face sexual health challenges due to menopause. One of the most important issues is called postmenopausal vaginal atrophy or more commonly, vaginal dryness, which can lead to painful sex. This is due to the physiological changes of menopause and the loss of estrogen. Nothing reduces libido more than painful sex!

Women have choices when dealing with painful sex due to menopausal dryness. Vaginal lubricants and moisturizers can help improve the discomfort, but only estrogen can restore health to the vaginal tissue. Hormone therapy can be used systemically, which means that your whole body is exposed to the hormones, or locally, which means only your vagina and bladder get the attention they deserve!

I always tell my patients that it really does not matter whether they are sexually active or not. Women are still entitled to a healthy vagina! That requires some care and attention. Since all women will experience this menopausal change, it is important to get comfortable talking about vaginal health with a health care professional. I start the conversation with my own patients thusly, "Let's talk about your vagina!" Try a similar approach. Your healthcare professional may not be comfortable bringing up the topic until you do!

People who are sexually active live longer and healthier lives. So even though your libido is not what it used to be, which is a whole other menopause-related topic, use the motivation of health to be your inspiration. And since many of you may not have a partner, may not like your partner, or may not have a partner who is interested or capable of being sexual, you can always be sexual by yourself!

Get your facts about this and other topics related to [Link Removed] and continue to experience the joy of sex on your own terms as long as you are able.

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