VALENTINE’S DAY BLUES!

Another Valentine’s Day has come and gone, and even this commercially-imposed day of eros did not have any positive effect on my libido!

I have been taking a low dose of bio-identical hormones for 2 months now and have been experiencing some very positive changes. I’m sleeping better, I no longer have hot flushes or night sweats, and the vaginal dryness is gone.

However, as yet, there’s been no change in my libido – it’s still stuck in neutral!

I used to have a pretty healthy libido, but now it’s no where to be found. It’s not that I don’t enjoy some one-on-one action with my husband. I’m OK once things get rolling, it’s just that I’m not the least bit inclined to initiate anything. I just don’t think about it anymore!

I know that this is not normal, at least not for me, but I’m not sure what to do about it, short of just including it on my to do list, with the hope that eventually things get back to normal. Just ‘do it’ as they say!

I’d love to hear how others are dealing with a low libido. Any suggestions would be very welcome!

OPRAH IS MENOPAUSAL!

Menopause will finally be on everyone’s radar now!

That’s because Oprah has discovered that many of her problems during the past year – including heart palpitations, increased blood pressure, trouble sleeping, weight gain and depression – are due to the change of life. Duh! Does this sound familiar anyone?

She has now done a number of shows recently on peri- and post-menopause and hormone replacement.

If you missed these shows, or don’t watch Oprah (I don’t), then you can access the information from her shows at her web site: http://www.oprah.com/dated/oprahshow/oprahshow_20090114_bioidentical.

For those of you out there like me, who have done a lot of research already, you may not learn much that is new to you, but she does have some interesting chat rooms, etc. If you have any friends or relatives that are less informed, this could be a good staring point for them.

What Oprah did for reading and book clubs she may be able to do for menopause too.

Maybe, at last, most women will feel comfortable talking about, and dealing with, this natural life transition!

SLEEPING LIKE A BABY NOW, BUT ‘DIAPER RASH’ HANGING ON!

I can’t believe that 2009 is already a week old!

I’ve been so happy to finally be getting a good night’s sleep that I wasn’t as bothered lately by the “diaper-like rash” I’ve been enduring, lo these past few months. Actually it’s been for over a year now, but it has been much worse in the past few months. And, I’m not talking about dry skin ladies!

Well, it’s not really a rash, it just feels like one. And, I couldn’t resist the sleeping like a baby and diaper rash connection! At the risk of being too graphic, I have been experiencing intermittent itching and a burning sensation on the outside of my vagina (the vulva). Although I’ve only been on HRT for a month, and quite a low dose at that, I thought I’d see a little relief by now, especially since I’m also using Replens twice a week. However, the dryness and itching persists.

The hot flashes decreased almost as soon as I started HRT, and my sleep improved right away too, so I thought the dryness and itching would have disappeared quickly also. But, I’ve been examined by three different doctors in the past year (the last one a month ago), and all of them agree that it is nothing to worry about, and that it is most likely hormone-related. I guess I’ll have to be patient with this, and give it at least a couple of more months!

Has anyone else had similar dryness and itching problems? If so, what has worked for you?

Happy New Year everyone.

HORMONE THERAPY FIRMLY TIED TO BREAST CANCER?

I see this headline a week after I decide to start HRT!

After researching like crazy, talking to 3 different doctors, including one at a women’s health clinic, I finally felt comfortable with the decision to try HRT for a short trial. My sleep deprivation was really driving me crazy, affecting every facet of my life. In other words, my quality of life sucked! And, with everything I’d read, and after discussions with various doctors, I felt that the health risks, including for breast cancer, were very small, especially if a low dose HRT is taken for less than 2 years.

I’m taking a low dose regimen of Estrogel (0.75 mg of estradiol = to 1 pump) and a progesterone pill (containing 100 mg of Prometrium). These are also both considered to be bio-identical, for what that’s worth? The improvement in my sleep was almost immediate, but so far I’ve not had any changes to my other symptoms. But, the sleep improvement is wonderful!

However, in light of the study which prompted the above headline, I’m going to be very conservative. I’ll reassess the HRT decision in 3 months time, when I see my doctor for follow-up. I was going to do this anyway, but now, if in 3 months time I have no other symptom relieve except my sleep improvement, I may to have to look at other options.

FYI, the study can be viewed at: http://www.healthzone.ca/health/article/554016.

The research continues. But, I’m sleeping and feeling better! I’ll keep you posted on my progress.

Happy Holidays!

HRT – the final frontier?

I didn’t realize how hard it would be to make a decision about HRT!! I thought I would just have to look at the risks vs. the benefits, do a pros and cons list, and that would be it. But, in addition to all the controversy re: risks vs. benefits, there’s also a lot of politics surrounding HRT, which just adds to the confusion!

I set a deadline for my decision for Dec. 1st, but I’ve had to extend it because there is so much stuff to consider. Everything I read just creates more questions. Also, I couldn’t get an appointment with my family doctor until December 3rd to discuss HRT. My doctor was not able to answer most of my questions to my satisfaction, and to her credit, she referred me to a clinic specializing in women’s health issues. I was able to get an appointment for next week, so I’m hoping to get my questions answered!

I have some of the usual symptoms: hot flushes, night sweats, some vaginal dryness and itching, and problems sleeping (and not just from the night sweats). And my cholesterol has been creeping up, despite no changes in diet or exercise (actually an increase in exercise, but no weight loss). In fact, it’s the lack of sleep that is the most bothersome for me. It affects my mood and my ability to concentrate, not to mention my libido and energy levels. I’ve never really been a night person, but now I fade by 10 pm! My spouse is a night person, so it’s always been a bit of a struggle for the two of us in this regard, but now it’s ridiculous! And, I’ve tried various things to help with the sleep, including valerian, to no avail.

These are just some of my questions/concerns:
1. Is HRT really relatively safe to use in the short term (from what I’ve been reading the consensus is yes, if you take it for less than 2 years, or some say less than 4 years, and you use the lowest dose necessary to relieve your symptoms)? And, what is considered low dose?
2. What is the best form, pills or gels? The gels provide a first bypass of the liver, but are more cumbersome to use. And, I’ve read progesterone creams are not effective.
3. Cyclical or continuous, or to bleed or not to bleed, that is the real question?
4. Will HRT cause me to put on weight, help me lose weight, or make no difference?
5. What type of progesterone is safest/best to use? I’ve read that some cause more side effects and/or more severe side effects.
6. Will HRT help me sleep better overall, and improve my other symptoms (vaginal dryness, etc.), or just reduce the hot flushes? I’ve read that low dose HRT is effective for hot flushes, but not for many of the other symptoms.
7. Does the potential overall improvement in my quality of life (QOL) make HRT worth the risk (albeit a small risk from what I’ve read), if taken in low doses and for short term (less than 2-4 years).
8. Are there better, or just as good, non-hormonal options out there?
9. Is there really a difference between the so-called bio-identical vs. synthetic hormones?
10. Do they know if there are long term risks for HRT, even if you take it short term?

I would just like to get over the hump, so to speak, and improve my QOL. I’ve read that symptoms often subside within a couple of years of the onset of menopause. My last menstrual period was mid-February of this year, so I’m almost there. In fact, my doctor confirmed that recent lab work indicates that I’ve reached menopause.

I recently found out about a great brochure put out by the Calgary Health Services (thanks to Wendy at www.menopausetheblog.com). It offers detailed information about non-hormonal options for menopausal symptoms. You can download the brochure from: www.calgaryhealthregion.ca/clin/women/2007/MenopauseBrochure.pdf.

It was developed by the University of Calgary and the Alberta Health Services (in Canada). The purpose of the brochure is to help women make sound decisions about complementary and alternative treatment options from an unbiased source.

Because of this brochure I tried valerian for my sleep problems. A lack of qood quality sleep is my biggest problem so I’d thought about trying valerian in the past, but I wasn’t sure if it was safe and/or a waste of money. This scientifically sound and unbiased source of information gave me the confidence to give it a whirl! But, although many people have found it helpful, unfortunately it did not work for me.

So, my quest continues. I’ll be posting again after my appointment at the women’s health clinic. I’m hoping to get most of my questions answered and finally be able make my decision by the new year!

In the meantime, if anyone has some pearls of wisdom to share I’d love to hear from you.

GO ON A DIET, GAIN MORE FAT!

Most of the experts seem to agree that weight management is different during perimenopause. When the ovaries start reducing the amount of estrogen that they produce our fat cells play a bigger role in estrogen production. But here’s the kicker – my research shows that our fat cells actually increase in size and their ability to store fat. Unfortunately this hormonal shift tends to redistribute some of our fat from other areas on our bodies to our middles.

As a nutritionist I’m a firm believer in lifestyle changes vs. “dieting” when it comes to weight loss, and from what I’ve read dieting (which is never a good idea anyway) is even less effective as your estrogen levels decrease. This is because your fat cells just work harder at storing fat and that’s why dieting means more fat gain!

And if that doesn’t convince you that “dieting” is not the answer, bear in mind that dieting not only lowers your metabolism, but also lowers estrogen levels faster, which makes your perimenopausal symptoms worse! But don’t confuse gaining a little fat during this period as not being fit. Exercise and fitness are even more important during this time, and you don’t have to be skinny to be fit. This is why I started strength-training a few years ago. It’s so important to continue to build and maintain those calorie-burning muscles! It feels good to be strong and fit, even if my silhouette isn’t what it used to be!

Thankfully the research shows that post-menopause weight stabilizes and most women can lose weight at this point. But, we can’t just give in or give up until then! In order to keep the fat at bay, and maintain those fat-burning muscles, we have to continue to practice good “waist” management! That is, eat well and keep moving!

Until then, although fighting against our fat gain and changing body shape is more difficult, keep in mind that some weight gain is viewed as normal and beneficial. Go figure! Apparently those with more fat have been found to have fewer or less severe perimenopausal symptoms, sleep better, and have stronger bones. Confirmation that being too skinny is not healthy, and has it’s down side! Some research suggests that a gain of up to 10 pounds between the ages of 35 and 55 is healthy due to the estrogen factor (i.e. fat cells store estrogen, so more fat means less symptoms). Up to a point that is. Too much fat increases our risk for heart disease, diabetes, etc.

We need to work with our bodies, instead of against them. Don’t try to starve the fat away, because it won’t work! Even so, I’m going to make more of a concerted effort to try and lose a few of my “having too much fun” pounds. Not by dieting, of course, but by being a little more diligent in my workouts and more conscientious about my diet (less of those “extras”)! I’ll keep you posted on my progress. But, whatever happens, at least I know there’s “lite” at the end of the “menopause” tunnel!

And, if your “meno-pot” prompts the odd “when are you expecting?” from rude strangers (as it did for me recently, when I was feeling sexy and wore a tight-fitting outfit), look on the bright side, as I do – we must still look young enough to be able to get pregnant!

I’d love to receive any comments on the above, especially from women who have reached the “other side” and can offer some words of wisdom!

Next I’ll be looking into HRT. Is it worth the risk? Does it have any effect on weight gain or loss? Are there safer alternatives that work?

WEIGHTY ISSUES

First, some disclosure.  I’m a health professional, in fact a nutritionist, so I know how to lose weight.  And, I’ll admit to a love of food and wine!  So, despite a pretty decent diet, I do indulge in “extras” such as wine on a regular basis.  But, I’m also quite active.  I do strength-training twice a week and run or cycle or walk, etc. at least 3 times a week.  You’d think that would be enough!

But I know why I’ve gained some extra weight over the years: I’ve been having too much fun!

Despite an active lifestyle and healthy diet, I have been guilty of my share of overindulging now and again, and I’m certainly less active than I was in my twenties.  Also, I did not do much strength-training, at least not on a consistent basis, until the last few years.  And, nature has played a role; clearly my metabolism has slowed down.  And yet I haven’t really gained much weight lately; I just can’t seem to lose the accumulated “fun” from before!

I can’t stress enough how important strength-training is for women, especially after 40 years of age!  It not only expends energy but it increases your metabolism and makes you look fitter.  However, like many women I see in my practice I struggle with a recent migration of whatever excess weight I had around my body to my mid-section, and the inability to get rid of it. 

The only answers I’ve found that make any sense (and don’t involve anyone trying to sell me something) suggest that it’s a matter of “weighting” it out.  That is, maintain my healthy lifestyle and once I get to the “other side” the weight will come off.  (And, I do have a friend who can vouch for this!)  I knew there had to be something good about menopause.

Trust me, dieting is not the answer!

I’ll tell you why next time …

About Me

I’m a woman of a “certain” age who is going through the “change” and looking for answers.  Why can’t I lose weight, despite regular exercise and a pretty decent diet?  Should I go on HRT (short term) to relieve my symptoms, including a severe lack of sleep?  I’m hoping to connect with other women to share our stories and find some answers together.