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Menopausal Weight Gain NOT Inevitable

Thursday, May 8th, 2014

It may seem like weight gain is an inevitable effect of menopause. It is indeed common, and there are several reasons why, including:

  • Levels of estrogen, which appears to have a weight-regulating effect, drop significantly during menopause.
  • Older women are less likely to get enough exercise than younger women.
  • Muscle mass declines, and this has a slowing effect on your metabolism. This means that you may need fewer calories, but if you adjust your food intake accordingly, creeping weight gain will likely be the result.
  • Older women are more likely to have jobs that demand very little in the way of physical labor; they may also eat out more with the kids out of the house.

And weight gain isn’t just a cosmetic issue – it also increases your risk of many health problems, including diabetes, heart disease, high blood pressure, and several types of cancer.

However, you still have plenty of control over your weight during and after menopause, so don’t fall for the notion that weight gain is natural or that there’s nothing you can do about it. Even though weight control may be more of a challenge because of physiological and lifestyle changes that take place during menopause, it still boils down to taking in no more energy than you expend.

If you find the pounds adding up, your first line of defense is to eat less. In your fifties, you probably need a couple hundred calories a day less than you did when you were younger. Make your food choices more carefully. No one needs empty calories, but menopausal women should be especially careful to choose mostly vegetables, fruits, lean meats, whole grains, and low-fat or non-fat dairy products.

Exercise is another key step to beating menopause weight gain. Exercise gives you more energy and burns fat, while building muscle. And maintain or increasing your muscle mass is important because the more muscle you have, the faster you burn calories all day long. Adults up to 65 years old need at least 30 minutes of moderate-intensity exercise five days a week, such as brisk walking, and at least two muscle-strengthening workouts a week. You may need to add even more if your goal is to lose weight.

A good support system is also important. Enlist the support of your family and friends, or better yet, find a partner to work out with who can help encourage you and keep you motivated – and do the same for him or her.

The answer to menopause weight gain isn’t glamorous or easy, and there is no secret formula. But with concentrated effort to control your diet and exercise habits, you can absolutely maintain or even improve your weight at any stage of life. For more information on menopause, see my book, Inside Information for Women.

– Yvonne S. Thornton, M. D., M. P. H

Sex and Menopause

Monday, September 16th, 2013

Many women fear that aging and menopause will affect their sex lives negatively. The truth is that sexual satisfaction can and should last a lifetime. Menopause does present a few new challenges, but they can be easily overcome with the right information and a little patience.

First of all, if you are having sexual problems related to menopause, talk to your doctor about it. It may feel awkward, but your doctor can help you find effective solutions. Your doctor should take your concerns seriously. Your sexuality is an extremely important part of your life, and the basic human need for sexual contact does not diminish or go away just because we get older.

One of the problems women experience during menopause is painful intercourse. This is a symptom of atrophic vaginitis, which is characterized by dryness and painful intercourse as well as other related symptoms. If left untreated, atrophic vaginitis can lead to long-term sexual dysfunction and accompanying emotional distress. This condition is easily treatable with a 2-3 week course of estrogen cream applied to the vagina. Studies such as this one also show that continued, regular sexual activity encourages vaginal elasticity and lubrication.

Besides atrophic vaginitis, some of the other menopausal changes in a woman’s body can negatively affect her sex life if not addressed. The vaginal tissues naturally become thinner and drier, and vaginal secretions and lubrication often decrease. In addition, a menopausal woman is likely to take longer to achieve natural vaginal lubrication – several minutes, as opposed to the 30 seconds or so that younger women need.

These problems can be overcome simply by using a water-based lubricant such as Astroglide, and by being patient with yourself as well as expecting patience from your partner. Your thinner vaginal lining may also become more sensitive, so you should avoid products containing warming agents, flavors, artificial colors, or other chemicals that might cause irritation.

Waning energy is another issue menopausal women sometimes face. The sleep problems experienced during menopause can exacerbate the problem of diminished energy. Take steps to reduce stress and improve sleep, such as staying away from the computer for a couple of hours before bedtime, avoiding exercise late in the evening, and making your bedroom a relaxing (and sensual) sanctuary using soothing music, colors, or scents. Improving the amount and quality of your sleep will give you more energy all day long.

The bottom line is that sexual fulfillment can last the entire span of a woman’s life, and the more sexually active she is through the years, the fewer problems she is likely to experience in the bedroom later. In fact, nonexistent fears of pregnancy, more free time, and fewer inhibitions than younger women often have can make sex even better as you age. For more information on this topic, see my book, Inside Information for Women.

– Yvonne S. Thornton, M. D., M. P. H.

Are Hormones Giving You Breast Cancer?

Thursday, April 18th, 2013

When we are young and fertile, we take hormones for birth control.  As we age and go through menopause, we take hormones to control our bodies in other ways.  It seems as women, we are never happy with the natural course our bodies take, and so we constantly manipulate them with hormones. Although for most of us this method works, there are side effects, and sometimes, they can be deadly.

If you’ve been involved in any kind of female hormone therapy, you know that the two main ingredients are estrogen and progestin.  This kind of treatment can balance older women out so they don’t have to deal with hot flashes, mood swings, and other symptoms of menopause, but it can also lead to dangerous imbalances that lead to illnesses like cancer.  An observational study by the Los Angeles Biomedical Research Institute found that women who initiated hormone therapy involving estrogen plus progestin has a higher incidence of breast cancer than in women who did not use such therapies.  Additionally, they found that the closer to menopause hormone therapy was used, the higher the risk.  Estrogen plus progestin also increased the mortality rate in women who developed breast cancer.

If menopause is making you miserable, obviously you need to find some form of relief.  Instead of jumping into hormone therapy though, talk to your physician about all of your options.  There are many lifestyle changes you can make to reduce your symptoms that have to do with diet, exercise, and routines.  For instance, hot flashes may be reduced by avoiding spicy foods, caffeine, and alcohol.  Sleeplessness may be remedied by regular workouts, a strict sleep schedule, and stress reduction.  Mood swings could be controlled by the same diet and exercise strategies or even therapy.  Your physician may also be able to administer less extreme medications for only your most severe symptoms instead of taking the wide-scale approach of hormone therapy.

For women who absolutely must go on a hormone therapy regimen that involves estrogen plus progestin, make sure you start out on the lowest dose possible.  Your physician can always increase it if needed, but there’s no sense getting more than you need.  Also, as soon as symptoms are under control and hormone therapy is no longer needed, get off of it.


– Yvonne S. Thornton, M. D., M. P. H.


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.

Estrogen and Anxiety

Thursday, August 16th, 2012

While some men may believe that fear and anxiety in women comes down to all that estrogen, it’s actually quite the opposite.  It is low estrogen that is more likely to make an anxious woman according new research from Harvard.

During your menstrual cycle, your estrogen levels tend to ebb and flow (no pun intended), and your mood and mental state are then prone to these fluctuations.  Extremely high estrogen levels seem to protect women from emotional disturbance, and low levels make them more vulnerable to trauma.  This knowledge isn’t being limited to PMS and birth control though, they are also considering a much more widespread use.  Researchers believe that they can create a pill that will influence estrogen levels, much like birth control does, but to prevent post-traumatic stress disorder.  Their research shows that women who experienced traumatic events while their estrogen was low suffered emotional trauma for a much longer period.  Before heading into perilous situations or even right after, an estrogen pill could protect their mental states.  Even in men this tactic could be used.  Men’s testosterone is converted to estrogen in the brain, so even though they are less likely to suffer from depression and anxiety disorders as a whole, they still use estrogen to remain stable.

Professor of Psychology Larry Carhill says that, “The single biggest bias in neuroscience research is the belief that sex differences are insignificant or small,” but the truth is there are many differences and learning them could be the key to treating clinical disorders in the future.  As with any good treatment plan, it is best to treat the individual as a whole person, and not just as a statistic.  That means understanding what makes their systems work, even when it comes to gender differences, so we can restore both men and women to good health.


– Yvonne S. Thornton, M. D., M. P. H.


Danish study links hormone replacement therapy to ovarian cancer. Should you worry?

Tuesday, July 14th, 2009

In the news today is a Danish study, published in the Journal of the American Medical Association (JAMA), that indicates there may be an increased risk of ovarian cancer among users of hormone replacement therapy.

While this may sound like scary new information, it’s not actually news. Thirteen years ago, for my masters degree in public health, I wrote my final epidemiology paper on the link between hormone therapy and ovarian cancer.

Other studies link hormone replacement therapy, especially estrogen alone rather than estrogen plus progesterone, to breast cancer and endometrial cancer.

After reviewing the available information, you and your doctor may still decide that estrogen’s benefits outweigh any risk. Or you may want to try a different tactic to alleviate menopausal symptoms. As I mentioned in a previous blog post, other treatment options, including SSRIs and blood pressure medications, may work as well and cause fewer concerns.

– Yvonne S. Thornton, MD, MPH