Tuesday, March 3, 2015
YOLO COUNTY NEWS
99 CENTS

Ask the Expert: Caring for Women

Questions and answers with Dr. Michael Goodman

1. How do I know if I am (peri-) menopausal?
“Menopause” is the time of a woman’s final menstrual period. Of course, the only way to know if it is your “final” is to see if any more follow. By definition, 12 months without menses, in the presence of other “menopausal symptoms” equals menopause.

Perimenopause is that time around or just before the final menses. It is frequently punctuated by symptoms including but not necessarily limited to: Hot flashes/night sweats, poor sleep quality, mood and memory dysfunction, vaginal dryness, heart palpitations, joint stiffness, “crawly skin,” depression, etc.

Menopause is a normal, functional passage of life. There are many lifestyle, nutritional, botanical, herbal and pharmaceutical ways to ease the passage.

2. Is there something “natural” that I can do?
Nowadays, “natural” is little more than an advertising gimmick, designed to “reel you in” to buying some probably untested nutritional supplement of uncertain medicinal or therapeutic benefit.

By definition, “natural” means “native to plant or animal.” By this definition, Premarin, derived from pregnant mare’s urine, is “natural.” Know what you are taking (and whether it interacts with other supplements and pharmaceuticals you are ingesting).

That said, there are several things to try. Pick and choose with the aid of your healthcare practitioner:

* Bioidentical hormones, such as estriol, estradiol, progesterone, testosterone, DHEA. These are all synthesized from a plant source (soy or wild yam) to exactly mimic the molecule found in the body.
* Lifestyle changes are certainly natural! Try improving diet (increasing fresh fruits/veggies; decreasing meat, fats, convenience foods) and exercise!
* Vitamins, herbs, botanicals, which include but are not limited to soy isoflavones, black cohosh, chased berry, vitamin E, calcium, etc.

3. My sex drive is in the toilet. What can I do?
All sorts of things conspire to diminish libido in (peri-) menopausal women. It is hard to feel sexy if you are hot-flashing all over the place. Or if your vagina is dry and lovemaking is painful. Been married a long time? A few teenagers always in and out of the house? And what about your testosterone? Well before your estrogen levels fluctuate and then take a giant plunge, testosterone slowly but steadily declines, with frequent effects on energy, sex drive, perseverance, etc.

So, what can you do? Get your menopausal symptoms under control. Get to sleeping better. Work with your mate and perhaps a therapist on ways to rekindle you and your mate’s sexual connection, and definitely work with your healthcare practitioner to check on and improve your testosterone levels with transdermal or oral therapy.

4. I am miserable with hot flashes, moodiness and very poor sleep. What can I do?
Many books have been written to answer this. Here is an outline:
* Estrogens, either synthesized (ethinyl estradiol; conjugated estrogens; etc.) or a bioidentical (estriol; estradiol) can be delivered either orally or (better!) transdermally via patches, creams and lotions or (more rarely) via injection. Bioidentical progesterone, delivered via cream, lotion or capsules, can help with these symptoms. Bioidentical testosterone, usually given either as a transdermal gel or lotion eorks wonderfully along with estrogen to mitigate symptoms.

* Vitamins, supplements, and plant-sourced botanicals. Both those with “estrogen-like effects” (phytoestrogens) and those which are used for their helpful calming and psychological effects.
— Soy and other legume-derived isoflavones help some women’s hot flashes, especially when combined with other measures listed below.
— Black cohosh, chased berry (Vitex) and evening primrose oil have all been of help to some women.
— Mega-dose B vitamins and high-dose (800-1200 mg) vitamin E can help with hot flashes.

* Non-hormonal pharmaceuticals.
— Hot flashes: The anti-depressant Effexor and the anti-seizure/anti-depressant medication gabepentin, are quite effective in relieving nighttime flashes (daytime too, to some extent).
— Moodiness/depression/anxiety: Xanax and Ativan, in low doses, is great for anxiety/”panic”. (Both can aid in sleep also). Mood stabilizers/anti-depressants such as Prozac, Paxil, Zoloft, Celexa, Lexapro, Effexor, Wellbutrin, etc. may be quite helpful.
— Insomnia. Sonata lasts +/- four hours and is good for women with difficulty getting to sleep or middle-night awakening. Ambien lasts 6-7 hours. 5-hydroxytryptophan also works here. These medications are best used short-term until the problems causing the insomnia are brought under control.

* Lifestyle changes: Avoid “triggers.” Most women suffering from hot flashes are aware of situations such as heat, caffeine, spicy foods, stress, etc., that trigger their flashes.
— Exercise! Probably the single most important thing increasing quality of life in midlife women is exercise. A total of 30-40 minutes of strenuous “sweaty” exercise will go a long way towards clearing your mind, uplifting your mood and chasing away hot flashes. (As it releases endorphins, which increase the serotonin in your brain, exercise has appropriately been called “nature’s Prozac.”)
— Stress reduction: Peri-menopausal symptoms themselves are stressful. Stress reduction help such as meditation, paced respiration and muscle group tension/relaxation techniques are imperative, especially at bedtime.

—For many more FAQs and answers to your menopause and sexual health questions, go to www.DrMichaelGoodman.com

Comments

comments

Special to The Enterprise

  • Recent Posts

  • Enter your email address to subscribe to this newspaper and receive notifications of new articles by email.

  • .

    News

    Nominees sought for city’s human rights awards

    By Special to The Enterprise | From Page: A1

     
    Pedal power: It’s a different kind of March Madness

    By Felicia Alvarez | From Page: A1 | Gallery

    STEM-Tastic Sunday highlights summer opportunities

    By Chloe Lessard | From Page: A1 | Gallery

     
    County: Baby Justice was on Social Services’ radar

    By Lauren Keene | From Page: A1 | Gallery

    Budget standoff leaves California college hopefuls in limbo

    By The Associated Press | From Page: A1

     
    Appeals court upholds protection for threatened seabird

    By The Associated Press | From Page: A2

    House to vote on Homeland bill without conditions

    By The Associated Press | From Page: A2

     
    State to supply just 20 percent of water

    By The Associated Press | From Page: A2

    Bob Dunning: Rampant crime on the streets of Davis

    By Bob Dunning | From Page: A2, 1 Comment | Gallery

     
    For the record

    By Enterprise staff | From Page: A2

    Pets of the week

    By Enterprise staff | From Page: A3 | Gallery

     
    Embroiderers will discuss needlework tools

    By Enterprise staff | From Page: A4

     
    Tuleyome needs volunteers for work party

    By Special to The Enterprise | From Page: A4 | Gallery

    ‘Pearls Before Swine’ joins daily comics lineup

    By Enterprise staff | From Page: A4

     
    Winter market wraps up Wednesday

    By Enterprise staff | From Page: A4

    Public broadband, on ‘Davisville’

    By Enterprise staff | From Page: A4

     
    Alcoholic liver disease strikes Hispanics years earlier

    By Special to The Enterprise | From Page: A4

    Join a fitness party at Zumba class

    By Enterprise staff | From Page: A5

     
    Logos Books hosts conversation groups, poetry readings

    By Enterprise staff | From Page: A5

    Get a taste of Middle Earth at library

    By Enterprise staff | From Page: A5

     
    Holmes’ talent showcased

    By Enterprise staff | From Page: A5 | Gallery

    Bingo games Sunday will benefit DHS Madrigals’ trip

    By Special to The Enterprise | From Page: A5

     
    Go all in for fun at Texas Hold ‘Em tournament

    By Special to The Enterprise | From Page: A5

    DCC Nursery School hosts open house

    By Special to The Enterprise | From Page: A5

     
    City says it did not OK Ygrene mailers

    By Dave Ryan | From Page: A6

     
    Sure and begorrah!

    By Enterprise staff | From Page: A6

    Overeaters get support at meetings

    By Enterprise staff | From Page: A6Comments are off for this post

     
    Cycle de Mayo kicks off Bike Month

    By Enterprise staff | From Page: A6

    Klein’s book featured at Authors on the Move

    By Special to The Enterprise | From Page: A6

     
    .

    Forum

    One more family insult

    By Creators Syndicate | From Page: B5

     
    The kids aren’t interested

    By Creators Syndicate | From Page: B5

    Climate changes are inevitable

    By Letters to the Editor | From Page: A8

     
    Act for our children’s future

    By Letters to the Editor | From Page: A8

    UCD alums will want to stay

    By Letters to the Editor | From Page: A8

     
    End the use of this word

    By Letters to the Editor | From Page: A8

    Thanks for act of kindness

    By Letters to the Editor | From Page: A8

     
    Tom Meyer cartoon

    By Debbie Davis | From Page: A8

    Cannery CFD creates unequal taxation patchwork

    By Special to The Enterprise | From Page: A8

     
    .

    Sports

    Lady Blue Devils in semis Tuesday night

    By Enterprise staff | From Page: B1

     
    Aggie men host two big ones this week

    By Enterprise staff | From Page: B1

    Dream run ends for Davis’ master wrestlers

    By Evan Ream | From Page: B1 | Gallery

     
    Devil boys net an easy tennis victory

    By Enterprise staff | From Page: B1 | Gallery

    In the Clubhouse: Summerhays Jr. talks about new post at El Macero CC

    By Bruce Gallaudet | From Page: B1 | Gallery

     
    Sports briefs: Aggie lacrosse team takes home opener

    By Enterprise staff | From Page: B3

     
    Newly acquired Smith scores in Sharks’ victory

    By The Associated Press | From Page: B3 | Gallery

    Blue Devil girls look for revenge in the pool

    By Kellen Browning | From Page: B10 | Gallery

     
    DHS boys aim to repeat as section swim champs

    By Kellen Browning | From Page: B10

    .

    Features

    Name Droppers: Dunn graduates from Marine Corps basic training

    By Enterprise staff | From Page: A7 | Gallery

     
    .

    Arts

    Thursday Live! features Keith Cary, Wyatt Hesemeyer

    By Special to The Enterprise | From Page: A9

     
    Songs of the Civil War to be performed by Anonymous 4

    By Jeff Hudson | From Page: A9 | Gallery

     
    Davis Chorale starts year with demanding music

    By Special to The Enterprise | From Page: A9

    .

    Business

    .

    Obituaries

    Dieter W. Gruenwedel

    By Special to The Enterprise | From Page: A4

     
    Otto Vasak

    By Special to The Enterprise | From Page: A4

    .

    Comics

    Comics: Tuesday, March 3, 2015 (set 1)

    By Creator | From Page: B5

     
    Comics: Tuesday, March 3, 2015 (set 2)

    By Creator | From Page: B7