We've all heard that there is a peak age for ovulation; a time when your body is ripe with baby-making magic, and there are eggs as far as the sperm can swim! Well, too bad that age is about 18, and by the time we're actually ready to have babies, your egg count has gone down. Way down...

Contrary to what you may be thinking right now, this post is not meant to freak you out, or make you fall into a series of depression-induced, Ben and Jerry's-related brain freezes. Nope. This information is GOOD to know. Women in their thirties are not thinking about [Link Removed] (the 6-10 years before menopause) can begin as early as 35 years old. Come to mama. I'm here to help.

Perimenopause is the stage of your life that is, unfortunately, home to most of the symptoms we associate with menopause. Menopause is simply defined by the absence of your period for 12 consecutive months. Period. Perimenopause precedes this.

Rapid egg decline (this is what I like to call it) goes like this: fertility is highest between the ages of 18-22. Once you reach 30 years old, it begins to decline. At 35, it has gone down sharply. By the time you reach 40 years old, only about [Link Removed].

So, how do you know if you're in perimenopause? What are some symptoms that you can expect from being in this stage of your life? Brace yourself: the answers aren't all that pretty...

MENTAL/EMOTIONAL
memory lapses (sticky notes aplenty)
overly sensitive
uncontrollable crying
unusually depressed or withdrawn
overall sense that I'm not OK
tense (like a rubber band ready to snap)
overwhelmed
anxious
irritable
bursts of anger
violent
[Link Removed]

PHYSICAL
oddly dry skin
headaches/migraines
exhausted
hair loss
PMS-like bloating
sore or ballooning breasts
increased chin whiskers
deepening voice
pimples galore
[Link Removed] or flushes
night drenches
sleepless nights
heart palpitations
weight gain (shrinking pants)
stiffness, aches, and pains
bladder issues
vaginal infections
excessive vaginal discharge
breakthrough vaginal bleeding
dry vagina (sex hurts)
harder to reach orgasm²

On the plus side of things, women rarely experience all of these symptoms. (Thank you, Mother Nature!) Some women glide right through perimenopause without even realizing they're in it. Just know that if you feel like you're going crazy, you begin to experience weird issues that make you scour the web, late at night, searching for solutions, and you're between the ages of 35-45, then you're probably experiencing perimenopause to some extent, and this is normal. Your friends may not admit it, but they're probably going through it too. The best advice I can give you in these early stages of transition, is to gather your girlfriends (otherwise known as The Sisterhood), and talk. Help yourself and them out by facilitating some perimenopause communication. You'll all be glad you did.

What's that? You're so happy to have found this awesome information that you feel the need to jump up and down and cheer for all to hear? Why not host a [Link Removed]! They're all the rage- and rage is indeed part of perimenopause...

Want to know more about the perimenopause and menopause (PM&M) experience? Pick up a copy of [Link Removed], the first book on menopause of its kind.

Remember: Reaching out is IN! Suffering in silence is OUT! If you're confused, chances are your friends are, too.

Here are more great links to further perimenopause discussion:
[Link Removed]

¹ For more information about fertility, please visit [Link Removed]

Follow Ellen Dolgen on [Link Removed].

Shmirshky, Your links have been removed, please consider upgrading to premium membership.

Approximately 70 million Americans suffer from digestive issues.¹ That's crazy! Afflictions range from Irritable Bowel Syndrome (IBS) to Inflammatory Bowel Disease (IBD), and from celiac disease (the inability to process gluten) to acid reflux (GERD). Even certain cancers and lactose intolerance fall into this category of digestive despair that seems to be taking over a huge portion of our American population.

If you're feeling bloated, gassy, or that maybe your gut has decided it's on lock-down, then you're not alone. What's changed in the last ten years to make your stomach hate you? You still love it...somewhat...Digestive issues are definitely part of menopause, but what does gut health have to do with it? As IF we need another thing to worry about, and worrying makes it worse! Grrr...

First of all, the most common period in one's life to develop a digestive disease is either immediately following onset of adulthood (usually very early 20's), or the few years leading up to menopause, known as [Link Removed].² This stage typically occurs in the late 30's to mid-40's.

When digestive issues occur around the time of perimenopause, symptoms usually include bloating and excessive gas, which is completely linked to a hormonal imbalance.³ There's also (eek!) constipation to worry about. This, on its own, brings on a whole new set of digestive concerns. It's as if once the ball starts rolling, it will just keep on, gathering speed, until it hits a roadblock.

So, what's this roadblock I speak of?

The good news about digestive issues is that typically, they are fully controllable by you. You need to initiate the roadblock. Too many women (woman are twice as likely to suffer from digestive problems as men are.⁴ I know--no surprise there...) assume that digestive issues that stem from the onset of menopause are inevitable and untreatable. Not so, ladies! Read on...

Here are some ways to combat [Link Removed] and improve overall gut health during menopause:

1- Think about what you are eating. Every bite of food than enters your body will have an effect on your gut. By supplying your tummy with foods that are easily digestible and full of nutrients, you can help your body ward off most symptoms, such as constipation, gas, and bloating. A friend of mine, who has written extensively about gut health, recommends the following:

• Know where you're at in regards to lactose intolerance. People who cannot process dairy products easily (this is MOST of us) are much more likely to have way more gas and bloating. Dairy contains [Link Removed], which is sugar. When sugar is broken down, it creates gas. Which brings us to...
• Limit your sugar. This includes [Link Removed]. (Don't cry--I said limit...) Sugar equals gas. Gas equals bloating. Plain and simple.
• Know if your foods are high in animal hormones. Extra hormones from our food contribute highly to extra hormones in our bodies. Menopause is NOT the right time to allow extra hormones to run amuck. Cows raised for beef have often been injected with a ton of growth hormones. Same for dairy cows. If you eat alot of red meat and dairy, opt for organic products, because those have not been hormone-injected.
• Drink alot of water. Water detoxes your body, and this is important. It also helps to flush out fat, which we all know is a major issue for menopausal women. That spare tire around your middle should not be inevitable when you combine the right hormone treatments with the correct diet.
• Think "nutrient-dense." Everything you eat should contribute to cell growth and repair, ideally. When your body is fighting through menopause, you can give it a leg up by supplying it with foods that are extremely high in vitamins, minerals, anti-oxidants, fiber, etc. Fiber helps with constipation, and the rest helps to create an optimal state of health; particularly in the gut. I also take 400 mg [Link Removed] once a day, every night, and this has helped me with this issue. Ask your doctor!
• Consider taking digestive enzymes and probiotics. These magical little pills make a world of difference to your gut flora. They can help break down sugars, starches, proteins, etc. If you are sensitive to a certain food, or perhaps just have an overworked, overloaded gut, these health-food store superstars could become your new BFFs! (Just don't tell Susan- she wouldn't understand.)

2- Move that body! Exercise helps to stable hormone levels, improve mood, and...regulate the digestive system! By going for twenty-minute walks every day, you can improve menopause symptoms, as well as combat constipation.

3- Consider [Link Removed] (HRT). By regulating your hormones, you will regulate your digestive system, and, in turn, improve gut health.

4- I realize that this is easier said than done, but try to limit stress. Stress is disease-provoking, and creates a situation within the body called "fight or flight." When this occurs, systems that your body deems temporarily unnecessary are slowed down. One such system is the digestive system. Chronic stress creates a slow, inefficient gut. This increases constipation, and diminishes overall health. Perceived stress also is very much tied to the gut, itself. A little known fact is that we have just as many nerve endings in our gut, as we do in our brain and spinal cord. Since menopause can be very stressful, please try and practice stress-relieving techniques that will help your emotional health, as well as your digestive health. Practices such as yoga, meditation, and deep breathing help reduce menopausal symptoms (and improve digestive health) considerably.

Since digestive disorder numbers are only on the rise, prevent yourself from being a statistic. By practicing good habits for improved gut health, you will also improve your experience with menopause. Who doesn't want a truly great menopausal experience?! If you ever find yourself in a situation where you're staring your food down, western-style, begging it to show you some kind of goodness that you can benefit from, then it's probably not a good food. Good food doesn't have to justify itself- bad food does. If you are having a hard time deciding what food is good or bad- just go with your gut!

Remember: Reaching out is IN! Suffering in Silence is OUT!

For more information on gut health and its relation to menopause, please check out the following links:

¹ [Link Removed]

² [Link Removed]

³ [Link Removed]

⁴ [Link Removed]

Follow Ellen Dolgen on [Link Removed].

Shmirshky, Your links have been removed, please consider upgrading to premium membership.

Well, the holidays are officially over. Many of us have spent the last week or so removing holiday decorations, and dreaming up how we can possibly lose the five-to-ten pounds we've accumulated thanks to a never-ending supply of eggnog and sugar cookies. (Ugghhhh....)

The end of the holidays signify a new beginning, and we're often forced to confront issues that we may have been putting off. Is hormone replacement therapy (HRT) right for you? As if there wasn't enough to be generally confused about leading up to and during menopause (the great [Link Removed], an expert from PhysioAge Medical Group in New York City, has been a guest on my blog before, and we love him. He's back with some Q and A, and I for one, am a happy girl.

Ellen: Doctor, what would you say are some simple truths about hormone replacement therapy?

Dr. Trutt:

• Earlier is better. Starting HRT within ten years of menopause gives much greater benefit than starting later. In women who are younger than age 60, oral estrogens decrease the risk of both heart attack and stroke! In addition, starting HRT within eight years of menopause cuts your risk of Alzheimer's disease in half.


• Using oral non-bioidentical estrogen (such as Premarin or ethinyl estradiol), at any age, will increase the risk of blood clots. When you swallow it, it gets metabolized in the liver, and increases the formation of clotting proteins. And using it together with fake, altered progestins increases the risk of clots even more. Using it in women with other risk factors for blood clots, such as obesity or smoking, raises the risk even further.


• Transdermal estrogen (meaning through a cream or a patch) does not increase the risk of blood clots, in either older or younger women.


• Oral estrogen that is started more than ten years after menopause is more likely to cause a stroke or heart attack in that first year after starting HRT. The reason is, estrogen protects women from building up plaque in their arteries. After menopause, estrogen is not being produced– so unless she goes on HRT, she will start building up plaque. Therefore, if a woman has had ten years without any estrogen, she will have built up significant plaque in her arteries. If she then starts oral estrogen, the plaque that has formed over starts to reorganize, and can become unstable in that first year, causing a heart attack or stroke.


• Synthetic, altered progestins like Provera (medroxyprogesterone), norethindrone, and norethisterone, all increase the risk of breast cancer slightly. Estrogen with natural, bioidentical progesterone does not increase the risk of breast cancer. Estrogen given alone for HRT actually decreases the risk of breast cancer.¹

Ellen: The majority of women fear that HRT will cause breast cancer. Does it?

Dr. Trutt: The Danish Osteoporosis Prevention Study is a large, prospective, placebo controlled trial on HRT, and included over 1000 women who were within a few years of menopause.

These women were on HRT for ten years and were followed for 16 years total. None of the women had an increased incidence of breast cancer, and in fact, there was a decreased incidence in breast cancer for the women who used estrogen-only HRT. So, it would appear that there was no increased risk of breast cancer, or any other type of cancer.²

For more information about HRT and breast cancer, please visit [Link Removed] by Marina Johnson, MD.

Ellen: The 2002 Women's Health Initiative was a huge prospective trial of HRT. What were some general conclusions coming out of this study?

Dr. Trutt:

• For women who took oral estrogens but did NOT take Provera, the risk of breast cancer– in all age groups– went DOWN. That's right: contrary to what you hear in the news, taking estrogen alone without Provera actually DECREASED the risk of breast cancer. In the WHI trial, and in many other trials like it, the fake, non-bioidentical altered version of progesterone (called "progestins") is what caused a small increase in breast cancer. Estrogen does not. Estrogen with bioidentical progesterone also does not increase breast cancer risk.


• In the women who were younger than age 60, the risk of heart attack and stroke went down and their risk of "total death," meaning death from any cause, went down.³

Ellen: Do "mainstream" docs agree with what you are saying?

Dr. Trutt: The Endocrine Society did a review of HRT in 2010. They were a very "mainstream" group of endocrinologists. Not all types of HRT are appropriate for all women, and they said that. But very importantly, they also pointed out that Menopausal Hormone Therapy was associated with a 40% reduction in mortality in women in trials in which participants had a mean age below 60 yr or were within 10 years of menopause onset,⁴ and that is exactly what they found in the Danish Osteoporosis study which was just released. Imagine finding a medication that lowers your risk of death by 40% for as long as you take it! That is what HRT offers when taken appropriately.

So, despite all of the misleading information out there regarding HRT, the conclusion that I have come to with Dr. Trutt is this:  hormone replacement therapy is not a necessary evil; it is necessary and not evil. It is extremely important, however, to discuss exactly what type of HRT is right for you. That means you need to find a doctor who cares. Visit [Link Removed].

For additional resources on hormone replacement therapy, see my other blogs on the topic at:

[Link Removed]

[Link Removed]

[Link Removed]

[Link Removed]

Remember: Reaching out is IN! Suffering in silence is OUT!

What steps are YOU going to take to determine whether or not HRT is right for you?

¹ For more detailed information, visit [Link Removed]

² For more information about the Danish Osteoporosis Prevention Study, visit [Link Removed]

³ For more detailed information, visit [Link Removed]

⁴ For more information about the above mentioned endocrine study, see Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement. JCEM July 1, 2010 vol. 95 no. 7 Supplement 1

Follow Ellen Dolgen on [Link Removed].

Shmirshky, Your links have been removed, please consider upgrading to premium membership.

Wish you could look at your reflection in the mirror and see a new, younger you? You do it every day! What the human body is capable of reproducing, repairing, and regenerating each year is nothing short of miraculous. You are literally a revised version of what you were last year, and a completely different you than seven years ago. Sound strange? I think it's inspiring! A new year brings a new you. A better you. If you are considering the idea of making a positive shift towards better health and happiness, then knowing what your body is automatically accomplishing should motivate you to push yourself even further. Here are some interesting facts about why you're even more amazing this January than you were last:

• Your skin has regenerated itself up to 52 times. Every 7-28 days, it has completely different skin cells than it had one to four weeks earlier.¹ Cuts and scrapes take about 1-2 weeks to completely heal. That's amazing. Infants and small children heal faster than adults, but adults still have the ability to regenerate new cells at practically lightning speed.


• Your body has replaced an insane amount of other types of cells, too. While most of us are aware (or were at some point in our child-bearing years) that sperm cells live for about 3 days, did you know that colon cells are replaced every 4 days, and blood cells are replaced every month to a year, depending on if they're red or white?²


• Think about how fast your hair and nails grow. Hair grows at an average of 1/2 an inch every month,³ and fingernails grow about 1/3 an inch every 90 days.⁴ This means that your nails take about 3 months to become completely different than they were at the time of your last manicure.


• When you observe how fast it takes for a broken bone to heal, a virus to pass through your body, your body to recover after delivering a baby, or the quick time it took for your body to turn one cell and one egg into a baby ([Link Removed]), that's enough to make you wonder if we are indeed divine.


• Some organs of the body, such as the liver, are especially known for their fast regeneration. (This is why liver transplants work well – one small piece of another's liver will grow into a full-sized adult liver in just 4-8 weeks.⁵ Amazing.) In traditional Chinese medicine, this organ is often thought to be the epicenter of human emotion,⁶ so it's interesting to think about the connection between liver health and a good psyche. If your liver is not in great shape, whether it be because of excess drinking, an illness, or some other reason, your state of mind is usually not up to its awesome potential, either. Hmmm...

Ladies! The message is this: view this brand new year as an opportunity for purposeful change, and I'm not just talking about the "brilliant" ideas that are the result of a champagne-induced coma! Improve yourself. Inspire, motivate, and love yourself. If you're suffering from any kind of health roadblock that could be improved by simply making conscientious lifestyle choices, then please do it! There's only one you, and your inevitable evolution will be even more fabulous when you take control, and steer yourself into the land of not just positive thinking, but doing. Be even more amazing than you already are. If you believe you're fabulous, you will be. Happy New You!

Remember my motto: Reaching out is IN! Suffering in silence is OUT!

How will YOU be even more amazing in 2013?

• ¹ [Link Removed].

Follow Ellen Dolgen on [Link Removed].

Shmirshky, Your links have been removed, please consider upgrading to premium membership.