Menopause

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Fertility after Forty

Monday, February 11th, 2013

Many of my older patients come to me to find out whether or not it’s too late for them to have a baby. It’s not surprising in the modern world, as many women are waiting to start families until they have reached a comfortable place in their career and financial stability. However, there are risks to waiting. I’ve discussed these risks before, and I don’t necessarily recommend trying to have a baby after your biological clock has proverbially run out of batteries. However, I understand the desire for women older than 40 to reproduce, and it’s okay to try with the assistance of your doctor and OBGYN. The childbearing years (fertility years) typically are from 15 to 44 years of age, according to the definition.

If you’re hoping to have a baby after your early thirties have come and gone, discuss the risks thoroughly with your doctor. You should consider genetic consulting to make sure chromosomal abnormalities aren’t a threat, and you should be in the best shape of your life if you expect your body to take on the task of birth.

Once you start trying, you’ll realize you’re a lot less fertile than you used to be. By the time you turn forty, you only have approximately 2% of the eggs you were born with, so there is less of a chance for successful fertilization.

After age 40, you might want to consider fertility treatments if you’re serious about trying to conceive. Additionally, there are some natural ways you can boost your fertility. By achieving a healthy weight, you will improve the health of your reproductive organs, which is essential in the fertilization process. Eat a healthy diet and stay active. Relaxation is another proven method for enhancing fertility, so enroll in a yoga class and avoid stress when you can

If you really want to give birth after age 40, no one can stop you. Technology allows us to see into the medical future of our babies, so take advantage of it and decide if the risks are worth it. Just remember, conceiving and having a baby after age 40 is one thing. Raising a child after age 40, is another. We all have different plans in life, and though yours might be riskier than someone else’s, there is no reason for you to deny yourself the joy of motherhood.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Fertility & Infertility | No Responses »
Tags: age, fertility, Menopause, Pregnancy

Soy is the Secret to Hot Flash Reduction in Menopause

Monday, February 4th, 2013

There’s no sugar coating it – menopause is the pits. We become more and more irritable until our family members can’t take it, we wake up drenched in sweat in the middle of the night, and we can’t even sit through a movie without taking a few bathroom breaks. Many women would gladly take their periods back to avoid these uncomfortable menopause symptoms. While menopause is largely out of our control, a recent study shows that there is one symptom we can actually reduce by altering out diet.

Hot flashes and night sweats are both considered vasomotor symptoms. They’re caused by the reduction of hormones that are meant to regulate the dilation of your blood vessels. Menopause greatly decreases the levels of estrogen in your body, and your blood vessels will expand quickly for reasons unbeknownst to you in that moment. When the blood rushes through your body, you’ll feel as though you are suddenly sitting inside an oven, which is a hot flash. Night sweats occur for the same reason.

How can your diet control these symptoms? An adjustment in your dietary intake which includes decrease in caffeine intake and avoidance of hot, spicy spicy foods is an excellent start. Research shows that women who eat more soy in their diets experience fewer hot flashes and night sweats. Soy is one of the single best sources of phytoestrogens, which have been shown to have a modest effect on hot flashes, but there are no conclusive evidence-based or long-term studies. For that reason, younger women are advised against eating too much, as the human body can only take so much at a time. However, for women who are going through menopause and have less estrogen than ever before, soy may be the perfect solution. This could easily be the reason only 7% of Japanese women experience hot flashes during their menopause. Their diets are rich in tofu and natural bean ingredients. Considering 55% of American women suffer from vasomotor symptoms, it might be time to take the hint.

As if this news wasn’t good enough, adding more soy to your diet isn’t hard at all. Many of the foods that are rich in soy are also delicious and offer fun alternatives to the usual American diet. To get more soy, consider adding tofu, miso, soymilk, soy nuts, and soy sauce. However, I must admit that soy in these forms is an acquired taste. I don’t want to be hypocritical, but my palate wasn’t too thrilled with soy intake. Though it might take time to get used to these new tastes, if you’re not already used to them, they’ll all taste delicious when you consider the alternative.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Menstruation, Women's health issues | No Responses »
Tags: estrogen, Hot flashes, Menopause, soy

Research Shows Cause of Dry Mouth during Menopause

Thursday, January 31st, 2013

If you’ve ever had dry mouth, you know how uncomfortable it can be. No matter how much water you drink, it always comes back, and it makes both talking and eating laborious tasks. Dry mouth is a common symptom of many conditions, but one of the most common is menopause. Many women who are going through menopause struggle with dry mouth. Though finding a permanent solution can be difficult, a recent study actually defined the root of the problem, which could make treatment easier from a physician’s perspective.

The study showed that women who were going through menopause often had dry mouth because of the elevated levels of salivary cortisol. There is cortisol in everyone’s saliva, but the amount is regulated throughout the day. The rise in cortisol is a result of the increased and altered levels of hormones in the body as menstruation ceases.

Though there is no quick fix for this problem, you should talk to your doctor about treatments for increased cortisol that are safe during menopause as these could solve the dry mouth problem. He or she might have recommendations for medicated treatments to increase saliva production. Until then, there are a few home remedies you can try.

Chewing gum is a great way to combat dry mouth because the chewing motion increases saliva production in the mouth as your body gets ready to break down food. Also, eating waterlogged food such as celery or lettuce is a great way to get the glands working. Of course, staying hydrated is extremely important and cutting down on dehydrating liquids such as coffee and alcohol will help a lot. Make sure you are extra diligent with your dental hygiene when you have dry mouth because the lack of saliva production will leave your teeth prone to decay and cavities.

If you’re struggling with dry mouth as you enter menopause, know that you’re not alone. It’s a common problem, and the severity might actually fluctuate as your hormone levels rise and fall. Talk to your doctor about treatments that might address the cortisone levels and try a few home remedies in the meantime.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | 1 Response »
Tags: dry mouth, hormones, Menopause

Your Menopause Might Cause Hair Loss

Monday, January 21st, 2013

Think of your menopause as a reversed pregnancy. When you became pregnant earlier in life, all of your hormones were running rampant as they made way for your baby’s development. Your hair grew thicker, your breasts grew larger, and your moods grew less stable as your belly grew bigger. Since menopause occurs when the body slowly stops all of its baby-making abilities, your hormones will do the opposite, but you will certainly still feel the effects. Menopause brings on a whole new set of hormone-driven problems and issues that you’ve probably never had to deal with before, and it can make you feel absolutely crazy. Generally, the symptoms usually last all the way through the menopause, which is markedly over when you haven’t had your period for an entire year. One unfortunate and common change that happens to women going through menopause is hair loss and hair thinning.

Because your hormones are so abnormal during menopause, you could lose a considerable amount of hair. For anyone going through menopause currently, I don’t have to tell you how heartbreaking this can be as it seems to be a fast-paced and permanent slide into the age of the elderly. However, don’t worry too much if you notice your hair thinning during menopause because the change is not necessarily permanent. Studies show that hair often grows back after menopause has run its course. Your hormones will become regulated again someday after they have settled back into their usual routine. If your hair doesn’t seem to go back to normal after menopause has ceased, your doctor might want to check you for a metabolic or endocrine disease as hair loss can be an indicator.

The fact that we could lose our hair during menopause truly only adds insult to injury. Though it’s disheartening, you should keep in mind that the change—along with all the other changes—is temporary. In post-menopause, all of your hormones will regulate once again, and you will return to normal. Your hair will grow back, and your mood will stabilize. To offset some of the symptoms during menopause, stay as healthy as possible by getting adequate exercise and eating a healthy diet.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | 5 Responses »
Tags: alopecia, hair loss, hormones, Menopause

How Kegel Exercises Can Help You Long after Birth

Thursday, November 22nd, 2012

Of course you’ve heard about Kegel exercises before. In fact, you probably did some of your own when you were pregnant. When you perform Kegel exercises, you strengthen the floor of your pelvis, which is an excellent way to prepare your body for birth and push more effectively in the delivery room when the big day finally arrives. Believe it or not though, Kegel exercises can be helpful even if you’re not planning on giving birth any time soon. Actually, they’re extremely helpful for women going into menopause. Studies show that Kegel exercises are a great way to prevent incontinence.

As we get older, our ability to hold in urine when we really have to go lessens. It’s simply a part of aging, and it usually comes on during menopause. Whether you’re having a laughing fit with the girls over brunch or rushing to the bathroom at a crowded sports game, you just won’t be able to hold it in like you used to. It’s common and nothing to be ashamed of, but regular Kegel exercises will improve your ability to hold it until you find a bathroom.

Your physician can help you learn how to do Kegel exercises if you’ve never done them before, but once you get the hang of it you’ll be able to do them anywhere. Your daily Kegel routine will involve contracting and relaxing the muscles for a short period of time every day. As stated in my women’s health book, Inside Information for Women, it takes about one to two hundred repetitions a day in divided segments of twenty at a time. It’s important that you don’t do your Kegel exercises while urinating though, as this could lead to a urinary tract infection. Never interrupt the flow of urine once it begins. These exercises are especially helpful in obese women who have reached menopause and are experiencing incontinence.

It makes sense that Kegel exercises can help you better control the flow of your bladder. Just like any other muscular exercise, you will become stronger over time and have more control in general. The best part about the exercises is that you don’t need a gym or even privacy to do them. They are extremely discrete, so you could even do your routine at your desk or anywhere else you can sit comfortably. Of course, speak with your physician if your incontinence is seriously affecting your daily routine, but if it’s only a minor inconvenience, Kegel exercises might be the only treatment you need.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: incontinence, Kegel exercises, Menopause, women's health

Exercise Regularly to Maintain Physical Function in Menopause

Thursday, November 8th, 2012

We all dread menopause. We can lie about our age as much as we want to friends and family, but menopause will rear its ugly head about the time we’re 55 whether or not we’re still “39.” There is obviously a wide range of side effects from menopause. Hot flashes, irritability and frequent urination are some of the most common. Unfortunately, many women also experience a decrease in their physical function when they enter menopause. This is one of the worst symptoms, because as we try to stay positive and feel young, our bodies simply can’t perform like they used to.

Researchers aren’t entirely sure why our physical abilities decrease so rapidly when we start menopause. Some studies suggest it might be because the increase in estrogen causes bone mass to decline. Others show that women in menopause tend to gain weight and lose muscle, which makes simple chores such as bringing in the groceries or picking up a baby feel strenuous. A recent study showed that three-quarters of menopausal women now have some type of physical limitation that they had never experienced before.

Luckily, we can prevent the onset of this limitation by staying physically active as menopause bears down on us. If you’re over the age of forty, it’s time to start preparing for menopause by starting an exercise routine. You don’t necessarily have to pump iron with the meatheads at the gym, but even regular walks or a class at the YMCA will help you build muscle mass in preparation for your menopausal decline. Even taking the dog out for a walk around the neighborhood on most days of the week will help. By building muscle and increasing cardiovascular function early on, it will take longer for your body to decline. Therefore, you’ll only start feeling limited when it’s a result of your old age—not your menopause.

Don’t let menopause stop you from getting a workout. Always check in with your doctor before starting a routine, but keeping your muscles as strong as possible will help you offset some of the inevitable limitations brought on by menopause. The longer you keep up your physical function, the longer you’ll be able to fool your friends about your age.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: fitness, Menopause, women's health

“Is it hot in here – or is it just me?”

Friday, June 12th, 2009

If you’ve ever gotten a hot flash, you know how odd it can feel. Usually, hot flashes don’t have a major impact on a woman’s life but some women suffer more than others. About 80 percent of women experience hot flashes and night sweats, which are short bursts of intense heat of the face and neck. Usually they begin in the early years of the transition to menopause and peak one or two years after the last menstrual period, remain for several years and then resolve over a period of time. I’ve had patients come in to see me feeling downright miserable due to pre-menopausal and menopausal symptoms. Some complain of waking up dripping wet at 2:00 a.m. with night sweats or feeling like tiny bugs are crawling all over them.

These symptoms will pass as your hormone levels adjust but what do you do in the meantime? Other than buying a small hand fan, there’s no single answer. Treatment has to be individualized for each woman. Avoidance of triggers, such as cigarette smoking, hot beverages, foods containing nitrites or sulphites, spicy foods and alcohol, may help limit hot flashes. Blood pressure medications have been prescribed off-label with some success. SSRIs (selective serotonin reuptake inhibitors) such as Prozac^® and Zoloft^® or antidepressants such as Effexor^® (venlafaxine) also offer relief. Oral estrogens or transdermal estrogen patches have been found to be very effective in reducing the incidence and the intensity of hot flashes. However, if estrogen is used, unless you have had a hysterectomy, an additional hormone, progesterone, must be added to the estrogen in order to decrease your risk of developing uterine cancer. Relaxation techniques, such as deep slow breathing, may also help with hot flashes.

Some women think first of herbal remedies such as dong quai, evening primrose oil or red clover. However, I discourage my patients from using herbs as they’re often ineffective. Soy (a phytoestrogen or plant estrogen) has been touted as a remedy for hot flashes. However, there is no conclusive evidence for its benefit and there are no long-term safety studies. If you are convinced that you want to go the herbal route, I strongly urge you to discuss these remedies with your doctor beforehand. Don’t assume that because you get it over the counter, it’s safe. Herbs are not regulated through government health agencies and can have potent unintended effects, and may interfere with other medications or cause harmful interactions.

– Yvonne S. Thornton, MD, MPH

Posted in Hormone replacement therapy, Menstruation, Women's health issues | 1 Response »
Tags: drug interactions, herbal remedies, Hot flashes, Menopause, night sweats