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I hope that you are well and enjoying the change of seasons. In the newsletter survey I was asked to address the health issues affecting postmenopausal women so I will do that this month. There is a lot I could cover so I will begin this month with an overview of some of the issues affecting women over 50. In the provider section I discuss findings from some of the latest studies. I hope you find the newsletter informative. |
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WHH News
Integrative Guided Imagery Training
I will be traveling to Boston in early November to finish the fourth and final phase of my training. I have enjoyed the program very much and look forward to getting my certification. Please help me finish up my training by coming in for an imagery session at a very minimal cost. Information about Integrative Guided Imagery is on the WHH website. If you are interested in the training go to the Beyond Ordinary Nursing website. The program in open to all licensed providers.
Series Cancelled
The Women's Healthy Living Series was cancelled due to too few registrants. My apologies to those of you who were planning to attend, I was looking forward to offering the classes. If you are still interested in the series and would like me to offer it again, please let me know.
Upcoming Talks Libido Issues in Midlife Women at the Program in Integrative Medicine Alumni Association's Annual Meeting (PIMAA) October 4-7th in Tucson.
An Integrative Approach to Depression at the California Family Health Council 26th Annual Women's Health Update October 17-19th.
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Ask Dr. P
Focus on the Postmenopausal Woman
This month I would like to focus on the unique health issues that postmenopausal women face. First, let's review the definition of menopause. We say a woman has gone through menopause after she has had 12 months of no menstrual periods. A lot of women think about menopause as a time filled with hot flashes and moodiness. For very few women this may be the case. It's really important to remember that every woman is different and thus the degree to which women have these symptoms varies greatly. During the postmenopausal period, these symptoms diminish and other issues such as vaginal dryness and lack of libido can be more problematic. For vaginal dryness I recommend vaginal moisturizers or vaginal estrogen. During sexual intercourse vaginal lubricants can be helpful. Fortunately there are lots of fun vaginal lubricants to try if you want to spice up your sex life a little. Libido issues are another thing. Honestly, they are very difficult to treat. It's important to determine if there are other nonhormonal issues going on that are leading to the loss of libido. Many women have underlying depression (common during the menopausal transition) or relationship difficulties that lead to the loss of desire. If this is the case, treating these underlying issues can help boost sexual interest. If you come to see me with symptoms related to the menopausal transition I will ask you to complete the Menopause Rating Scale. This helps me objectively measure your menopausal symptoms, allows us to track your symptoms over time and determine if our treatment is working. It's also imperative to remember that menopause is a time of transition that is both physical and psychological. It is a developmental stage of life with many women experiencing changes in their roles and responsibilities at work and home (such as caring for aging parents and children leaving home).
Postmenopausal women have some unique health risks. After menopause, the two major health issues affecting women are cardiovascular disease (the major cause of death) and osteoporosis. In Marin County, we are particularly concerned with breast cancer since the rates are so high in our area. Our goal is to detect risk factors for these diseases and do our best to prevent these diseases from occurring. Screening tests are important: blood work, imaging (mammograms, bone mineral density testing) and physical exams for instance. It is also important to address lifestyle issues such as nutrition, exercise, stress reduction and spirituality. These are the things you have control over and they can have a major impact on your health. Making changes in these areas of your life can be very difficult and hard to maintain but once you do incorporate these changes into your life you will reap the benefits by feeling better and living a healthier life. It's always wonderful working with women because when they live a healthier lifestyle the whole family benefits! (For more information about current research concerning postmenopausal women, see the provider section below.)
I am seeing a lot of perimenopausal and postmenopausal women in my practice these days. Many of us baby boomers are going through "the change". I really love working with women during this stage of life. They want to learn, are motivated to make changes, and they have wonderful insights into their bodies and the changes they are experiencing. If I can help you, please don't hesitate to give me a call. We can develop a comprehensive personalized health plan that includes information about your health issues, preventive health, nutrition, physical activity, mind/body health, and spirituality. Or during a brief visit we can focus on a specific issue of concern to you. |
Living Green Tip of the Month
Organic composting for your garden. If you don't already have one, now is a great time to put together a compost in your backyard. Composting is really easy! Collect your table scraps (just plant matter) and layer them with all those wonderful fall leaves you are raking up in your yard. Layer the "wet" table scraps with the "dry" leaves. Be sure you don't add any diseased or pest-ridden plants to your compost. You can just make a compost pile in the corner of your yard or put together a compost container made of plastic, metal or wood. There should be holes in the container for ventilation. Turn the compost pile occasionally and also add a little water every once in a while to keep it slightly moist. In 6-8 months you will have beautiful black dirt to add to your garden. You can also compost your table scraps by using worms. Worm bins are particularly nice if you have a limited amount of yard space. For the last 10 years we have maintained 3 worm bins. They produce gorgeous thick black dirt to augment the garden. Here is a link to the worm woman. By the way, worm bins and composting piles do not smell or attract pests if they are maintained appropriately. |
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For Providers
Recent Research on Postmenopausal Health
Regular moderate exercise reduces the incidence of colds. Overweight and obese postmenopausal women who participated in 45 minutes of moderate intensity exercise 5 days per week had fewer colds than women who participated in one 45 minute session of stretching exercises per week. One hundred fifteen women participated in this study that was conducted over a one year period. During the last 3 months of the study, the control group was 3 times more likely to get a cold than the exercise group. Other things to consider about this study: Although exercise was protective against colds it did not reduce the incidence of other types of upper respiratory infections. In addition, women who did not take multivitamins were more likely to benefit from the exercise. My thoughts: Here is another good reason to recommend exercise and multivitamins. We need more research to understand how exercise could provide protection against colds.
Taking Calcium Helps Prevent Fractures. You may have heard that the Women's Health Initiative study (a large national well funded study) found that giving calcium supplements with vitamin D did not reduce hip fractures in postmenopausal women. The results of this study were reported widely by the lay press and surprised many women (and their providers). I believe the WHI study results should be interpreted with caution. Many of the women who participated in WHI were already at low risk for hip fractures because they were already taking calcium when they started the study, they were above average weight and they were taking hormone therapy. All of these characteristics reduce fracture risk. Here are some new findings to consider. A group of researchers from Australia did a meta-analysis of 17 studies that included more than 52,000 people over the age of 50 who took calcium supplements. If the participant took more than 1200 mg of calcium, the fracture risk dropped by 20%. Combining calcium with 800 IU of vitamin D reduced the risk by 16%. Bottom line: Recommend 1200 mg of calcium (from food and/or supplements) taken with at least 800 IU of vitamin D. Weight bearing exercise is also critical for strong healthy bones. Link to the Lancet study abstract.
Eating Whole Grains Reduces Death from Inflammatory Diseases. Current research is focusing on inflammation and oxidative stress because it greatly influences the aging process and leading causes of death. This study examined the association between noncardiovascular and noncancer related deaths and whole grain intake among postmenopausal women who participated in the Iowa Women's Health Study over a 17 year period. Eating whole grains has been associated with reduced cardiac disease mortality in other studies. This study showed a reduction in other inflammatory-related diseases among women who ate whole grains. It is thought that the phytochemicals in the grains reduce oxidative stress. This was an observational study so the results do not tell us if eating whole grains directly effects mortality due to inflammatory diseases but leads us to believe there might be a link. In my experience, most women do not eat enough whole grains. There are many studies pointing to the health benefits of eating whole grains. I suggest that women experiment with grains such as kashi, quinoa, pearl barley and wheat berries. These grains offer lots of fiber, B vitamins and anti-oxidants needed to reduce inflammation (that leads to the major causes of death in women; heart disease and cancer). | |
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Women's Health & Healing believes that women want a provider that will guide them on their quest for health and healing based on experience, education and the ability to examine the scientific evidence that supports recommended treatments Join me in empowering women to lead healthier lives- forward this newsletter to a friend.
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Priscilla Abercrombie, RN, NP, PhD
Women's Health & Healing
415-457-1451 |
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