Men. Oh. Pause. Rewind.

I’d like to welcome guest blogger Amy Ferris.

Amy writes about all things women. She is an author (a greater goode, Houghton Mifflin Publishers; The Buddha Next Door, Anthology, Middleway Press), a screenwriter (Mr. Wonderful, Anthony Minghella, Director, and Funny Valentines, Julie Dash, Director) and  an editor. Following is an excerpt from her new book, ‘Marrying George Clooney – Confessions from a Midlife Crisis‘ (Seal Press) which is available by pre-order from Amazon.com.

Show Amy some love!

Imagine this scenario if you will: you’re in the Holland or Lincoln Tunnel, all of a sudden, without a warning, all the lights go out, including all the headlights on all the cars. You’re stuck. There’s no going forward; there’s no going backwards. Complete and utter darkness. And you know in your soul that others are going through the exact same thing – but no one, not one person gets out of their car.

Welcome to menopause.

I have been depressed, anxious, forgetful, lost in a fog, angry, and resentful, with an emphasis on ‘angry’. I have been filled with tremendous hope, and in the next unexpected moment, filled with the exact amount of despair. I have cried uncontrollably from my gut, and I have laughed from the depths of my soul. I have felt like throwing my life away, as in literally jumping off a bridge. I have witnessed my body grow one full size while sleeping so undly.

In the midst of this fresh hell, I decided to quit smoking. I’m not sure if it was an act of courage or just simply self-destructive behavior. Much to my husband’s grand delight, not to mention my friends and family, I decided to divorce the one constant that kept me from experiencing my feelings fully – a cigarette.

So, not only were my hormones doing a ferocious dance – now my suppressed, discarded feelings were vying for attention.

This is the point in the story I get to introduce my husband. Please raise your hand if any of you have turned into the devil doll on a dime. You know what I’m talking about – that moment when your husband (or wife, or partner) says or does something trivial, innocuous, a casual throw-a-way and without a moments hesitation you respond by burning a hole in their heart with your tongue. And it’s all down hill from there. The only word that comes to mind to describe my behavior is vile. The only word to describe my husband’s reaction is stunned.

Along with weight gain and mental anguish, insomnia is yet another ‘side dish’ accompanying menopause. So, late one night while unable to sleep and tossing a coin – heads, Ambien, tails, Ambien – it occurred to me that it was time for me to put into practice what I deeply believe. To a) truly embrace and love every single part of me. Not just the good and kind and generous, but the bad and unattractive and mentally unstable. And b) find the enlightened side — it was my obligation and responsibility to acknowledge and hold dear the privilege of my very own life.

Every single woman I know, without exception, has or will experience some deep inner turmoil or upheaval because of menopause. It is a part of being a woman. Period. I have known women of great equilibrium to wobble horrifically because they were in the process of dealing with this huge change of life. The good news: most women credit this hell as the single most profound experience, which has enabled them to uncover their own greatness. I can definitely embrace that.

And here’s the enlightened side: Menopause is just like couture fashion. Some of it is just really ugly.

Welcome to my world.

Wednesday bubble: sexuality during menopause – blurring the lines

This week’s Bubble comes to us care of the University of Sao Paulo, Brazil and a fascinating study in the journal Latino American Nursing Reviews. The report attempts to address the limitations imposed by solely examining physical aspects of sexuality during the menopause as opposed to the intimate and relational dimensions.  In others words, signs and symptoms of the climacteric (the period marking the transition from reproductive to non-reproductive status) that specifically relate to sexuality, such as vaginal dryness and painful intercourse, are less important than the sum of their parts.

In this study, which involved interviews with postmenopausal women between the ages of 48 and 55, the researchers confirm that sexuality involves more than biology and rather, encompasses a woman’s subjective experience with her partner, her world, her perceptions of her body, how she experiences pleasure and displeasure and her values and behavior. In fact, sexuality does not “end with hormonal deficiency” bur rather changes over time.

They ask: are we overvaluing the biological aspects of sexuality at the expense of the emotional expression of experience, cultural factors and how we relate to others?

Key findings:

• It is critical to be present, open up to another being, allow oneself to be “permeated by co-existence” with our partners/lovers
• We need to connect with our bodies, remove barriers to experiencing physical pleasure — both alone and in relation to another being
• We need to be aware that we are affected by our sexual partners and their limitations, physical conditions, virility, etc
• We must embrace the ‘feedback of pleasure,’ i.e. be willing and able to not only give pleasure but to receive it as well
• Sexual satisfaction does not end (or begin) with orgasm

I have written previously on sex and sexual desire, often presenting the argument that the sum is greater than its parts, that it is time to understand and embrace the totality of the experience.

I admire these researchers for reaching outside the box and broadening the discussion about sexuality during menopause and midlife. Personally, I believe that within this new paradigm, we may finally be able to blur the lines between the biological, cultural, emotional and sociological to fully embrace that notion that menopause, and its accompanying issues, are not a “disease” to be reckoned with but rather, part of our “natural evolution” as women.

What do you think?

Acupuncture and hot flashes – a winning combination

There have been a lot of naysayers of late with regards to acupuncture. However, one of the largest studies to date examining its impact on menopausal hot flashes has been completed. The results? Acupuncture plus self-care can significantly reduce hot flashes and improve quality of life during menopause!

In the  ACUFLASH study, researchers randomized 399 postmenopausal women (1 year since last menstrual period) regularly experiencing at least 7 hot flashes daily to acupuncture or no treatment. Moxibustion was used at the practitioner’s discretion and sessions could also be extended by two weeks (from 12 weeks), if needed.  Although the practitioners met beforehand to discuss possible diagnoses and recommended treatment points, all treatment was individualized. Both groups of patients also received self care recommendations, which consisted of a one-page information leaflet on care of menopausal symptoms (e.g. soy, herbs, physical activity and relaxation techniques) which they were free to add at their own discretion.

Overall, the mean frequency of hot flashes declined by 48% in women receiving acupuncture compared with 28% of women using self-care methods only. This means that 50% of women receiving acupuncture experienced a 50% or greater reduction in how often their hot flashes occurred, compared to 16% of women using self-care. Significant reductions were also seen in hot flash intensity. Additionally, the acupuncture group reported significant improvements in vasomotor, sleep, and somatic symptoms over the course of the study.

The researchers have pointed out that previous studies (which have shown mixed results) have relied on smaller numbers of patients, have used  sham needles that did not penetrate the skin,  and have relied on a standardized practice. In contrast (and in keeping in line with the edicts of eastern  medicine) ACUFLASH practitioners individualized treatment according to patients’ needs. This may help to account for the positive results.

I have long argued for a need to modify western methods so that aspects of eastern practice that both make it unique and also form its foundation, may remain intact. This study remained true to the practice of acupuncture while also insuring that certain scientific tenets were followed. I  am hopeful  that the size of the study coupled with its approach, will open the door for future studies and provide an evidence-based path for women who choose a non-pharmacologic approach to menopause.

A flash….

and I’m gone! As my friend Sissy says, “let freedom ring.”

Have a safe and happy Fourth!

Wednesday Bubble: weathering your hot flashes

Hey Ladies! This week’s bubble comes to you c/o my Twitter friend Gloria Bell, who asked an interesting question: does climate affect hot flashes?

Apparently it does. Although there are not a lot of studies that have been conducted specifically on this topic, an extensive analysis of data from 54 studies suggests that climate may indeed, influence the frequency of hot flashes. Investigators focused the mechanisms underlying hot flashes ( i.e., small elevations in core body temperature within a temperature range where a woman would not normally shiver or sweat –also called the thermoneutral zone), hypothesizing that these zones might actually be climate-specific.

The study:

• Researchers examined information on the frequency of hot flashes from 54 studies and evaluated the correlations between hot flash frequency and geographical latitude, elevation and annual temperatures. Additional analyses were conducted on data derived from studies that included women no older than age 60.

What they learned:

• Among women up to age 60, the average temperature of the coldest month could actually predict how frequently women experienced hot flashes almost a third of the time.
• Among all women, the difference between the hottest climates and the coldest climates significantly predicted hot flash frequency about 26% of the time.
• A climate’s mean annual temperature also predicted hot flash frequency.

Overall, women who lived in warmer temperatures tended to report fewer hot flashes than those in the coldest regions. Hot flashes also tended to increase in areas where there were more seasonal fluctuations.

Although climate plays a role, other factors, such as hormonal imbalance, smoking and diet have also been shown to influence hot flash severity and frequency. Still, it is interesting to learn that where we live may influence the challenges we may face when weathering the menopause storm!

The Roundup: June’s News and Tidbits

[Credit: Special Thanks to artist Darryl Willison of Whimsicalwest.com  Please visit his site and support his work.]

I’ve decided to start a new monthly feature – The Roundup.

Developed for my dear readers who only visit this blog periodically, The Roundup will provide an ‘at-a-glance’ overview of the month’s posts. The goal? To help you save time and access the posts you care most about.

I’ll be curious to hear your thoughts about this new feature so please, share your comments.

Hence, without further ado, here are June’s highlights:

• More news on the HRT front: lung cancer – Preempro shown to increase the risk for death among women who develop lung cancer.
• Something for da guyz – Writer Dana Jennings shares his personal experience with hot flashes. Yes, “his!”
• Gal pals – your second self – Emotional closeness boosts progesterone levels. Can friendships help in ways we’ve never imagined?
• She’s so hot and it’s so cold – A new book lays the groundwork for how western medicine has turned menopause into a disease, and what we can do about it.
• Age ain’t nothing but…. – Is it possible that some of the symptoms we associate with menopause are actually associated with aging?
• Feeling irritable? – Researchers finally pinpoint the exact hormones responsible for irritability towards others during menopause.
• Early menopause, part I - Ever wonder about the distinction between early and regular menopause? Here’s a brief primer.
• A panacea for aging skin? An anticancer creams fights wrinkles. But should you try it?
• Hot, hot hot! - Did you start and then stop HRT? Your hot flashes are likely to return.
• Are you rubberstamping the cougar narrative? Meet Lina, a hot Brazilian 73-year-old who is defying boundaries in more ways than one.
• Flava flavonoid - Good news for all you berry lovers. Tastes good and good for you…in ways that you could never imagine!
• Something to chew on – menopause gum -  A one-stop shop for gum chewers? Or another scam?

Something to chew on: menopause gum

Hey ladies! Now you can just chew the menopause [blues/anxiety/hot flashes, mood swings, night sweats, heart palpitations, urinary problems AND vaginal dryness] away! Wow – who knew it was so simple? In fact, Zoft Menopause Gum will cure what ails you in just weeks if not days, with the added benefit of fighting dental decay.

So what’s in this miracle gum you ask?

“Zoft Menopause Gum is a space age blend of Dong Quai Root, Black Cohosh Root Extract, Damiana Leaf, and Mexican Wild Yam Root.  Until now, no culture has had all these ingredients in a single formula.”

This space-age product has evidently been featured on ‘The View’ not once, but twice, which of course, provides an authoritative testimonial as to its efficacy.

Wait! There’s more….the company also offers breast gum to enlarge your breasts WITHOUT surgery, and hoodia gum to help you get back into that size 4 pair of jeans.  And just in case your partner feels left out, the company also manufactures stress gum and virility gum.

Guess if you order now you might even get ‘My Lil Reminder’ as an added bonus.

Wednesday bubble: flava flavonoid

With the acai berry craze hitting its peak, I thought it was high time to devote a post to flavonoids (compounds found in plants, fruits and beverages that have been shown to have antioxidant and anti-inflammatory properties) — namely, those found in berries.

Yes, berries, This sounded a bit preposterous until I dug a bit deeper and located a current review in Maturitas, suggesting that berry flavonoids might be important for long-term health in menopausal women. However, researchers still can’t define the most important details, for example:

• berry type
• preparation
• regimen

The amount of berry flavonoid that becomes available and used by the body after eating also varies by individual make up and by the different types of flavonoids.

All of these factors are critical to designing a strategy that will yield the maximum health benefit. Nevertheless, evidence from clinical studies suggests the following:

• The addition of berries to the diet can reduce the risk of heart disease by halting the inflammatory process, eliminating free radicals (which can harm the structure of cells), decreasing blood pressure, inhibiting the gathering of platelets (which can lead to clogged arteries) and increasing high density lipoproteins (HDL, good cholesterol)/ reducing low-density lipoproteins (LDL, bad cholesterol). Data points to cranberry juice, wild blueberries, bilberries, blackcurrant or strawberry puree, and chokeberry or raspberry juices.

• Cancer prevention. Note that this has been controversial since increased consumption of dietary fruits and vegetables and not just berries, have been shown to impact certain cancers such as esophogeal cancer. In the small studies that the researchers cite, cranberry juice and freeze dried black raspberry have been shown to control signaling that promotes the proliferation of cancer cells.

• Age-related declines in motor skills, learning and memory impairment, specifically, those linked to a decline in the body’s ability to fight circulating free oxygen radicals that can damage cells. Evidence for these benefits are primarily derived from animal and not human studies, and concentrate on strawberries, blueberries and cranberries.

The researchers caution that it’s impossible to define how much of a single berry or combination of berries might help in disease prevention. Hence, it’s too early to make any definitive claims about berry consumption. However, they do emphasize that to date, research supports the importance of berries as part of a healthy, balanced diet for menopausal women.

Personally, I love berries and health benefits or not, I plan to eat as much of them as I can get my hands on this summer.

Are you rubberstamping the ‘cougar’ narrative?

I’ve been somewhat amused and a wee bit miffed at the double standards placed upon women who “prey” on younger men. While their sugar daddy counterparts get away with endless forays into the dating world without nary a word, these women are dubbed “cougars” and frowned upon. However, have you ever considered that these younger men don’t feel preyed upon at all but prefer the company of a well-rounded, intelligent, sexy woman who can titillate their minds, souls AND bodies?

Perhaps the cougar ‘narrative’ and its fallacies should be put to rest.

If you have even a wee bit of doubt about what I’m saying, I’d like to introduce you to 73-year-old Rio de Janero resident Lina Merceis. Lina is the star of a documentary short entitled “Bye Bye, Cest Fini,” and the ultimate inspiration for any woman who believes that life ends at midlife and beyond. Lina, having suffered early disappointments in marriage and love, is now dedicating herself to herself. Lina deliberately chooses the single life, claiming that men are too much work. ‘Seductress to a slew of 30 somethings,  she enjoys her lovers, acknowledges her occasional loneliness, and confesses to a good friend (as they sit on the beach eying the candy) that sex and fun are her life prescriptions not options. Not surprisingly, the young men who are fortunate to become one of Lina’s lovers are happy to oblige.

My friend Twitter friend Erika over at Redheaded Fury wrote an interesting missive last week in response to a Denver Post article about ‘Cougars on the Prowl.’ Her point? That society’s caricature of the lonely older woman preying on younger men might not be entirely accurate. I think that Lina is a testament to that. More importantly, watching Lina onscreen taught me that  life gets started when you decide, not when something (or someone) else does.

Take the reins ladies; there’s no time like the present to write your own narrative (and be proud of it).

News Flash: Hot hot hot

Think that hormone replacement therapy is going to get rid of those hot flashes forever? Think again. Indeed, researchers have discovered that the majority women who start hormone therapy because of hot flashes and then stop, may experience a recurrence of symptoms!

In this study, which appears in the Ahead of Print edition of Menopause, 1,733 women between the ages of 53 and 54 completed a validated questionnaire looking at menopause, hormone therapy and  vasomotor symptoms. Among the women who submitted completed surveys (~73%), 242 had previously used hormones and 69% indicated that they had vasomotor symptoms before starting therapy. Regardless of how long hormone therapy was used, symptoms returned in 87% women who stopped, even if they had completed menopause (although hot flashes were reportedly less frequent and bothersome).

The bottom line: Research has shown that disease risks, e.g. breast cancer, increase when hormone therapy is used more than five years. So clearly, remaining on hormones to address returning symptoms is not a wise option. Rather, safer and equally effective alternatives are needed to address return of symptoms as well as aid in disease prevention.