Weight Loss During Menopause – What You May Not Know

Weight Loss During Menopause

I cant seem to lose this ..... no matter how much exercise I do

Kate opened her session by saying

I have not changed my diet or exercise routines during menopause…but I have gained weight

So many menopausal women have said the same thing to me. To which I respond

That is exactly the problem. You need to change with “the change”. You need to change the way in which you eat and your exercise routines with the onset of menopause….not keep them the same

On average, women gain 12 – 15 pounds during menopause. Many woman gain much more.

Most women think that menopause causes weight gain. It does not. A comprehensive review by the International Menopause Society has found that going through the menopause does not cause a woman to gain weight. However, the hormonal changes at menopause are associated with a change in the way that fat is distributed, leading to more belly fat. Prior to perimenopause, women tend to store fat on their hips and thighs. During perimenopause, and after it, women tend to store fat around their mid-section.

What causes weight gain during menopause?

Two events — menopause and the natural aging process – coincide at this time. Menopause merely becomes the suspect because it happens, as many women notice weight gain. The actual cause of weight gain during menopause is aging. However, the symptoms of menopause do contribute to it.

Aging is associated with a slowing of the body’s metabolism

  • your metabolism actually starts to slow down sometime in your 30s
  • the reason for this decrease in your metabolism is a decrease in your muscle mass
  • you tend to lose a 1/2 pound of muscle a year after the age of 30. Between the ages of 30 and 70, you are likely to experience a 40 to 50% reduction in your muscle mass
  • loss of muscle mass decreases the rate at which your body uses calories
  • as you lose muscle mass, you gain weight in fat. If you do not change your eating routines, the same caloric intake is not going to burn off. Those unburned calories will be stored as fat

If you continue to eat as you always have and don’t increase your physical activity, you’re not likely to experience weight loss during menopause.

How do your menopause symptoms contribute to weight gain?

A majority of women experience protracted periods of stress and disturbed sleep during menopause. Stress and disturbed sleep have a significant impact on your weight.

When you are under stress, your body produces cortisol ….known as the stress hormone. Protracted stress results in high levels of cortisol in your body. High levels of cortisol in your body causes your body to store more fat. It also prevents your body from burning fat. In the presence of high levels of cortisol, regular exercise will not burn fat and you will not lose weight.

Protracted disturbed sleep leads to insulin resistance. It also leads to high levels of cortisol. High levels of cortisol brings about insulin resistance.

Insulin resistance, is a condition where the cells of your body become insensitive to insulin. Insulin is the key that unlocks body cells to allow glucose inside. Glucose provides your cells with energy. Your body makes glucose from the food that you eat. When your cells won’t ‘open’ for glucose, the glucose gets stored…..as fat. Insulin resistance also prevents fat loss. Even if you exercise daily, you will not lose weight.

How to lose weight during menopause

At the risk of sounding trite, weight loss during menopause does come down to diet and exercise, plus stress reduction. However…….you have to know HOW to diet and HOW to exercise. While diet does involve what you eat, another major component of diet is HOW you eat

  1. include a stress reduction technique in your life. Do yoga or meditation, or some other stress reduction technique, regularly. This will help to modulate the cortisol level in your body. It will also help you to sleep better
  2. eliminate all processed food from your diet. They contain sugar, which exacerbates insulin resistance. Eat only real food. Real food does not need labels – ie – unprocessed meat, fish, milk, eggs, legumes, fruits, grains and vegetables. You will find real food in the outer aisles of your supermarket. Stay away from foods in the inner aisles. They are the processed foods. Try to eat organic as much as possible
  3. time management of eating – do not eat 3 meals per day. You should be eating something every 2-3 hours, during waking hours. Eat a smaller breakfast, lunch and supper, than you have been accustomed to eating. In between each meal, and also after supper, eat a healthy snack…ie a piece of fruit, nuts, yogurt etc
  4. do not eat double carbohydrates in any meal. Do not eat bread with meals containing potatoes or rice or pasta. Eat just 1 of those carbs per meal. Another no – no is cereal and toast for breakfast. Just have one or the other
  5. reduce your consumption of alcohol. Keep it to a minimum
  6. do at least 30 minutes of aerobic activity/exercise every day. It is best to do it in the morning, if your schedule permits it. To achieve weight loss, the intensity level MUST be moderate. Do not do high intensity exercise for weight loss. You will lose more weight faster, if you can fit in 2 daily sessions of aerobic activity/exercise …. even if the second session is only for 15 minutes

I hope that you implement these steps. They will help you to achieve weight loss during menopause, and after it.

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Does Sleep Improve After Menopause?

Postmenopause Insomnia

My overnight reading has increased

“I am tired all day long. I go to bed tired, but I have trouble falling asleep. When I finally do fall asleep, I have trouble staying asleep. How I miss the days when I could sleep 9-12 hours like the dead.”

Could it be you saying this?

If you are expecting your sleep problems to vanish naturally when you reach menopause, you may be disappointed.

Before providing some details about postmenopause insomnia, it may be helpful to first discuss what happens to the levels of estrogen and progesterone during postmenopause. They affect your sleep even more during postmenopause, than during perimenopause.

Estrogen and progesterone levels during postmenopause

Perimenopause is characterized by fluctuating estrogen levels. In postmenopause, estrogen levels bottom out and stay low. About 6 months before menopause, estrogen levels drop significantly. Estrogen levels continue to fall during postmenopause, but not to zero. While your ovaries no longer produce estrogen, your body makes estrogen in other ways.

During postmenopause, progesterone levels fall more than estrogen levels. While your ovaries no longer produce progesterone, your adrenal glands produce a very small amount of progesterone.

How low levels of estrogen and progesterone affects postmenopause sleep

  • low levels of estrogen causes a decrease in the levels of the hormone serotonin, which is used to create melatonin – a sleep hormone
  • low levels of estrogen slows down the intake and secondary production of magnesium, a mineral that helps muscles to relax. Muscle relaxation helps you to fall asleep
  • low levels of estrogen is linked to sleep apnea, which disturbs breathing during the night and therefor disturbs sleep as well
  • low levels of estrogen is linked to hot flashes and night sweats, which disturbs sleep
  • low levels of progesterone inhibits sleep. Progesterone helps you to fall asleep and fall back to sleep when your sleep is disturbed

Another factor that affects sleep during perimenopause is aging. A Sleep Foundation study has found that as women age, increasing numbers of women encounter sleep difficulties. More females between the ages of 25 and 34 experience disturbed sleep than females between the ages of 18-24. More women between the ages of 35 and 44 experience sleep problems than women between the ages of 25 and 34. The postmenopausal age group is more prone to insomnia than all younger female age groups.

The Sleep Foundation reports that 61% of women experience postmenopause insomnia.

Treatment options for postmenopause insomnia

As low levels of estrogen and progesterone cause postmenopause insomnia, you may want to consider hormone therapy to raise your levels of these hormones.

Coventional HRT can reduce disturbed sleep during postmenopause, but it carries increased risk of breast cancer, heart attack and stroke. An alternative is BHRT – hormone therapy that uses bioidentical hormones. According to Dr John Lee, MD, the foremost authority on bioidentical hormones, bioidentical hormone therapy relieves menopause symptoms, including insomnia, without increasing the health risks mentioned above. It will relieve postmenopause insomnia.

If you are averse to hormone therapy of any kind, there are many other natural treatments that have been proven to reduce insomnia

  1. There is compelling evidence that exercise can improve your sleep during menopause. Exercise even improves the sleep quality of menopausal women who experience hot flashes at night
  2. Studies have also shown that valerian, a herbal remedy, has improved the quality of sleep for menopausal women
  3. The Mayo Clinic reports that “the weight of scientific evidence does suggest that melatonin decreases sleep latency (the time it takes to fall asleep), increases the feeling of sleepiness, and may increase the duration of sleep”. You can increase your melatonin level by including certain foods in your regular diet or by taking a melatonin supplement
  4. Serotonin is a neurotransmitter (chemical messenger) that sends signals between nerve cells in the part of the brain responsible for the sleep-wake cycle. Low levels of serotonin cause insomnia. Eat foods rich in calcium, magnesium, and vitamin B to help with serotonin production. These include most fruits and vegetables, almonds, beans, cheeses (particularly Cheddar and Swiss), chicken, eggs, fish (especially high-oil fish such as herring, mackerel, salmon, sardines, and tuna), milk, peanuts, soy foods, turkey, and yoghurt. You can also increase the level of serotonin in your body by taking a serotonin supplement
  5. A review of 46 trials, covering 3,800 patients, has found that acupuncture is effective at relieving sleep disturbance
  6. Studies have found that yoga improves sleep quality and reduces feelings of fatigue. A new study conducted by MsFLASH has found yoga to be effective in reducing menopause insomnia. MsFLASH is an acronym for Menopause Strategies: Finding Lasting Answers for Symptoms and Health

Postmenopause insomnia tends to get progressively worse without treatment. It is important to have and follow a treatment strategy for it.

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Is Your Doctor In The Dark About Menopause?

Doctors Who Understand Menopause

A woman can tell if her doctor understands menopause

Have you come away from a visit to your doctor with the feeling that he or she does not really know much about menopause?

If you feel this way, it is not surprising. You share this feeling with the majority of menopausal women. This is because there are few doctors who understand menopause. They are not at fault for this, since they receive little to no medical training about menopause.

In May 2013, a survey of ob-gyn resident doctors, conducted by the Johns Hopkins University School of Medicine, found that there is a lack of understanding by ob-gyn residents in matters connected with menopause.

510 resident ob-gyns, from all over the country, were surveyed. Only 100 (20%) reported that they had received formal training in their ob-gyn curriculum in regard to menopause matters and only 78 had reported that they participated in a practical menopause clinic. That means that just 15% of those being trained as ob-gyns are receiving practical training to help you with issues that you are facing during menopause.

A positive take from this survey is that approximately 70% of the participants expressed a desire to learn more about menopause, its symptoms and its treatment.

The lead study author Mindy S. Christianson, a clinical fellow in the Division of Reproductive Endocrinology and Infertility in the Department of Gynecology and Obstetrics at the Johns Hopkins University School of Medicine said

It’s clear from the results that the residents who responded admit that their knowledge and clinical management skills of menopause medicine are inadequate

The results of this survey explains why women are finding it hard to find doctors who understand menopause. If just 15% of ob-gyn residents have received practical training in menopause, what do you think is the likelihood that your GP has received any training at all in menopause?

An earlier study of ob-gyn residents found that most residents did not feel comfortable managing menopause patients with 75.8% reporting feeling “barely comfortable” and 8.4% feeling “not at all comfortable.”

Now researchers have examined more closely the menopause training received by ob-gyn residents. They reported their findings in the November 2013 edition of the Menopause journal. Most residents reported that they had limited knowledge and needed to learn more about these aspects of menopause medicine

  • menopause symptoms (67.1%)
  • hormone therapy (68.1%
  • nonhormone therapy (79.0%)
  • bone health (66.1%)
  • cardiovascular disease (71.7%)
  • metabolic syndrome (69.5%)

Only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and 16.3% had a defined menopause clinic as part of their residency.

What can you do if your GYN or GP is not helping you to relieve your menopause symptoms?

You need to find a GYN or GP who can help you.

What to look for in a doctor who can help you with menopause

  1. You want a doctor who has received training about menopause
  2. You want a doctor who has experience in helping menopausal women
  3. You want a doctor who listens to you and is a caring human being

1 above, may be easier to find than you may think. 2 may be a little more difficult to find than 1. Unfortunately, 3 is not taught in medical curriculums. It is a case of “suck it and see”.

How to find doctors who understand menopause …. in your vicinity

The North American Menopause Society (NAMS) has recognized this gap in the training of doctors. It has developed a menopause competency examination. All licensed healthcare providers (including doctors, nurses, and physician assistants) are eligible to sit for this examination. Those who pass this rigorous competency examination, have demonstrated their expertise in the field and are awarded the credential of NCMP, which stands for NAMS Certified Menopause Practitioner.

There is a directory of menopause healthcare providers, on the NAMS site, that will help you find doctors who understand menopause. Just enter your zip code and the search results will reveal doctors in your vicinity. It is advisable to tick the box that limits the search results to NCMP practitioners, because the NAMS directory also contains details of doctors who do not have the NCMP credential.

What to do if there are no NCMP practitioners near you

Get appointments with several doctors in your local area. Interview them to determine their understanding of menopause and their experience in helping menopausal women. Some questions that are good to ask are

  • What kind of menopause-specific training have you had?
  • For how long have you been helping menopausal women?
  • What is your approach to treating women who are in menopause? (What kinds of menopause treatments do you prefer?)
  • What is your view about treating menopause symptoms using complementary medicine therapies?
  • What is your view about treating menopause symptoms using alternative medicine therapies?

After the interview, decide if you will feel comfortable talking with that doctor about very personal issues, including sexuality. You’re not bound to stay with the same doctor. If you find that you’re not getting the care you need, you can start your search again.

Good luck in finding doctors who understand menopause.

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Would You Like To Revive Your Sex Drive?

Loss of libido

I would like to enjoy sex again

Many women experience a decrease in libido during perimenopause. That decrease intensifies after menopause. One survey of 580 postmenopausal women, conducted by Siecus – the Sexuality Information and Education Council of the United States, found that 45 percent of the women reported a decrease in sexual desire after menopause, 37 percent reported no change and 10 percent reported an increase.

Have you experienced a loss of libido?

To answer that question requires a definition for loss of libido. According to the North American Menopause Society (NAMS), libido has 3 components

  1. your sex drive, which is purely a physiological matter. It generally declines with age
  2. your beliefs, values, and expectations about sexual activity
  3. your motivation, which is your willingness to engage in sexual activity with a given partner
  4. As your sex drive likely has declined with age and as you probably have been experiencing some combination of menopause symptoms that has a negative affect on your mental and emotional states, it is hardly surprising if you experience a loss of libido.

    However, a more useful question to ask, instead of “have you experienced a loss of libido?”, may be “do you have low libido?” This injects a more subjective element into the equation. Low libido is a relative term. It is relative to the circumstances in your life.

    Your libido is low if your lack of desire for sex causes stress or unhappiness for you. Dr Barb Dupree, MD, who was recently named the 2013 Certified Menopause Practitioner of the Year by the North American Menopause Society for “exceptional contributions” to menopause care, has said the following

    if you’re perfectly comfortable with your sex drive, you don’t have low libido. But if you do have low libido, you’re in the company of almost half of women over 40.

    The ideal level of sexual desire is as individualized as a thumbprint. One woman’s idea of low libido may be another woman’s idea of nymphomania. The number of times in a week when you think about sex or pursue it is good to note, so you can notice increases and decreases in that number, but it’s worthless for comparison with some national average.

    If your desire is too low for your own happiness, then it is too low, and you may want to pursue ways of increasing it.

    What causes your libido to be too low for your own happiness

    Loss of libido during postmenopause is caused by

    • testosterone levels that have fallen to a lower level than prior to perimenopause
    • permanently low estrogen levels

    First let me address testosterone because its affect on libido is simpler to explain. Research shows that the hormone testosterone, often incorrectly thought to be the male sex hormone, has a direct affect on the female sex drive. It is the hormone of sexual desire. Lower levels of testosterone, during postmenopause, contributes to loss of libido.

    Permanently low levels of estrogen during perimenopause can bring on a condition called vaginal atrophy. It is a condition in which the walls of your vagina become thinner and more fragile — as well as becoming less elastic. The color becomes a pale pink, which reflects a lack of blood supply. Your vagina loses the quality of being open, expanded, or unblocked.

    Vaginal atrophy decreases a woman’s desire for sex. It causes vaginal dryness, burning and itching, painful urination and pain during intercourse. It is experienced by 50% of women during postmenopause. If left untreated, it gets worse. It is estimated that by age 75, two out of every three women are affected by it.

    What you can do to revive your libido

    As loss of libido is caused by low levels of testosterone and estrogen, your libido can be revived with hormone therapy. It will increase the levels of those hormones and helps to manage them relative to your other hormones. Testosterone therapy is widely prescribed for postmenopausal women in the United States. Estrogen therapy is somewhat more controversial.

    Most conventional medicine and CAM (Complementary and Alternative Medicine) practitioners agree that estrogen therapy reverses vaginal atrophy and provides relief from it.

    Conventional medicine practitioners will more often than not prescribe synthetic estrogen therapy to treat vaginal discomfort, in the form of a pill, cream, or vaginal ring. The pill taken orally, enters the blood stream. It increases your risk of breast cancer. The cream or vaginal ring is inserted in your vagina. It carries a lower risk of breast cancer, because it is localized. It doesnt enter your blood stream.

    CAM practitioners are more likely to favor natural estrogen therapy…. bioidentical estriol therapy…. taken as a vaginal cream …. to reverse vaginal atrophy and reduce its symptoms. Estriol is one of 3 estrogens that your body produces naturally. Advocates of natural estriol therapy emphasize that it does not bear the health risks of synthetic estrogen therapy and that researchers have found that it actually protects against breast and uterine cancers.

    It is also advisable to use a vaginal moisturizer. Moisturizers work, over time, to moisturize and strengthen vaginal tissues. They eliminate dry vaginal skin, protecting the vagina from irritation, itching, burning, and soreness …. not only during sex …. but throughout the day.

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When Your Estrogen Dries up … So Too Can Your Vagina

Vaginal Atrophy

I dont like to talk about what's going on "down there"

During postmenopause, your vagina gets shorter and more narrow.

Your mama probably didnt know this and didnt explain this to you….neither did your doctor. Dr. Barb DePree, who the North American Menopause Society (NAMS) named as one of the best menopause practitioners in 2013, says that most doctors are not trained in such matters that are related to menopause.

During postmenopause, you can expect the walls of your vagina to become thinner and more fragile — as well as becoming less elastic. The color becomes a pale pink, which reflects a lack of blood supply. It loses the quality of being open, expanded, or unblocked. This is caused by low levels of estrogen.

The low levels of estrogen brings on a condition known as vaginal atrophy in 50% of postmenopausal women. The symptoms include vaginal dryness, burning and itching, and painful intercourse or urination. While women are likely to talk about the more common symptoms of menopause, they are reluctant to talk about their vaginal discomfort, making it a “taboo” subject and therefore many women suffer in silence unnecessarily.

It is unfortunate that most postmenopausal women do not talk about their vaginal discomfort. Vaginal atrophy does not go away. In fact, it worsens if left untreated, according to Dr Wulf Utian, founding president of NAMS and a leading OB-GYN. He says that by age 75, it’s estimated that two out of every three women are affected.

Vaginal Atrophy Affects Relationships

An ongoing study has been examining the affects of vaginal atrophy on relationships. It is called CLOSER (CLarifying vaginal atrophy’s impact On SEx and Relationships). The study involves 8,341 postmenopausal women with vaginal discomfort and their partners from nine different countries, including the US. Findings from the U.S., which had 1010 participants, have recently been released

35 percent of women reported they do not feel sexually attractive anymore and 31 percent had lost confidence in themselves as a sexual partner. Women were also likely to experience a sense of isolation in the relationship, with 24 percent reporting that they felt emotionally distant from their partners.

The survey also showed women are not the only ones affected: 65 percent of men worried that sex would be painful for his partner, and almost a third of both men and women reported that they have stopped having sex with their partners altogether because of the discomfort.

Compared with other countries surveyed, U.S. women experienced higher rates of vaginal atrophy-related consequences on sexual health and interpersonal relationships.

If you are uncertain about whether you are experiencing vaginal atrophy, you can assess your symptoms at this site.

How To Relieve Vaginal Atrophy

Most conventional medicine and CAM (Complementary and Alternative Medicine) practitioners agree that estrogen therapy reverses vaginal atrophy and provides relief from it.

Conventional medicine practitioners will more often than not prescribe synthetic estrogen therapy to treat vaginal discomfort, in the form of a pill, cream, or vaginal ring. The pill taken orally, enters the blood stream. It increases your risk of breast cancer. The cream or vaginal ring is inserted in your vagina. It carries a lower risk of breast cancer, because it is localized. It doesnt enter your blood stream.

CAM practitioners are more likely to favor natural estrogen therapy…. bioidentical estriol therapy…. taken as a vaginal cream …. to reverse vaginal atrophy and reduce its symptoms. Estriol is one of 3 estrogens that your body produces naturally. Advocates of natural estriol therapy emphasize that it does not bear the health risks of synthetic estrogen therapy and that researchers have found that it actually protects against breast and uterine cancers.

Natural or synthetic estrogen therapy taken as a vaginal cream will also act as a lubricant to reduce friction during intercourse.

It is also advisable to use a vaginal moisturizer. Moisturizers work, over time, to moisturize and strengthen vaginal tissues. They eliminate dry vaginal skin, protecting the vagina from irritation, itching, burning, and soreness …. not only during sex …. but throughout the day.

Regular sexual intercourse also helps to relieve vaginal discomfort. It increases blood flow to the vaginal area.

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A Pleasurable Technique That Can Reduce Your Menopause Symptoms

Mindful Eating

Foodies take the time to smell and taste the food that they eat

I dont have to tell you that menopause is a time of increased stress.

Stress is difficult to define because it is subjective. What causes you to feel stress during menopause, may not cause me to feel stress … and vice versa. Having said that, here is a definition of stress that I favor

Stress is a feeling of anxiety and tension brought about by anything that you perceive to be a threat to your well being. It is a physiological, mental and emotional reaction to that threat.

The definition of stress is an academic matter, when it comes to menopause. What is more important is to identify your stressors …. those things that bring about your stress during menopause …. and what you can do to reduce your stressors.

In a sense, you could think of your symptoms of menopause as stressors. However, what brings about stress is not so much your symptoms, but your reactions to those symptoms. For example

  • mood swings can upset relationships. Upset relationships is the stressor
  • hot flashes or night sweats disturb your sleep. Disturbed sleep is the stressor
  • weight gain changes your physical appearance. Your physical appearance is the stressor
  • memory loss embarrasses of frustrates you. Embarrassment or frustration is the stressor

When you experience stress, your body automatically goes into a hardwired inbuilt survival mechanism called “fight or flight”. It produces increased amounts of cortisol. Cortisol, known as the stress hormone, increases sugars (glucose) in the bloodstream to give you the energy you need to combat the threat.

This “fight or flight” response was developed as a short term response mechanism to enhance your survival. After a real threat has been dealt with, cortisol levels return to their pre-threat levels and your other body functions normalize.

For many women, menopause is a time of persistent stress. Persistent stress causes your cortisol level to remain higher than it would normally be. As a change in the normal level of any hormone in your body, affects the levels and functioning of all of the hormones in your body, a higher level of cortisol exacerbates your menopause symptoms.

An effective way to reduce stress

Medical researchers have found that meditation helps to

  • improve sleep
  • reduce the affects of hot flashes
  • reduce mood swings
  • reduce memory lapses
  • reduce fatigue
  • reduce anxiety
  • reduce irritability
  • improve weight management

There is a form of meditation that is called mindfulness. Mindfulness could be described as maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment.

Today medical schools are offering a program that teaches techniques that enable a person to be mindful, because mindfulness has been proven to alleviate many health conditions. That program is called Mindfulness Based Stress Reduction MBSR. MBSR is offered at the University of Virginia Medical School, University of California Medical School, University of Massachusetts Medical School and several other universities.

An easy to do mindfulness technique that can reduce your symptoms

Many women cannot afford to do an MBSR program, from a financial and time perspective. I want to tell you about an alternative … mindful eating. Eating is something that we all do every day, so it does not require additional time or money.

Mindful eating is a way to eat that enables you to combine the consumption of food with stress reduction. It has also helped people to lose weight. Instead of mindlessly shoveling food into your mouth, while using your iPad or reading or watching tv, or doing any number of other activities when eating, this is how to eat mindfully according to Jan Chozen Bays, M.D. and author of the book Mindful Eating

Mindful eating involves paying full attention to the experience of eating and drinking, both inside and outside the body. We pay attention to the colors, smells, textures, flavors, temperatures, and even the sounds (crunch!) of our food. We pay attention to the experience of the body. Where in the body do we feel hunger? Where do we feel satisfaction? What does half-full feel like, or three quarters full?

My mindful eating routine

I want to share my mindful eating routine with you, because it may be helpful to you. I

  1. sit down with a plate of food in front of me
  2. smell the food
  3. pick up the fork
  4. collect a small amount of food on the fork and put it in my mouth
  5. put the fork down
  6. taste the food
  7. notice the texture of the food
  8. swallow the food
  9. notice the sensations as the food makes its way down to my stomach
  10. repeat steps 3-10

This routine consumes little time, reduces stress, and results in eating less food at mealtimes.

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What You Can Do, If Your Doctor Is In The Dark About Menopause

Relieve Menopause Symptoms

Today there are more visits to CAM practitioners than primary care physicians

The majority of menopausal women say that their doctors are not helping them to relieve their menopause symptoms. They say that their doctors do not seem to understand menopause and that they just push HRT on them.

This is not surprising. The majority of doctors do not understand menopause. They receive little to no medical training about menopause, during medical school or during their residency training. An earlier study found that most OB-GYN residents do not feel comfortable when dealing with menopausal patients.

If ob-gyns are not being trained in menopause matters, what training can you expect your internist or general practitioner to have had about menopause?

It is estimated that there are approximately 50 million menopausal women in America today. Therefore almost every doctor is seeing menopausal patients and being asked for advice to relieve menopause symptoms. As doctors are not taught about menopause in their medical training, they have to become informed about it in other ways.

Most doctors get their “menopause training” from pharma companies. As pharma companies have invested billions of dollars in research and development of their HRT products and they have made billions of dollars from them, pharma companies “teach” doctors to prescribe their HRT products to relieve most of the menopause symptoms experienced by their patients.

If you feel that your doctor does not understand menopause and just pushes HRT on you, you can get help to relieve your symptoms elsewhere.

What can you do?

You can turn to Complementary and Alternative Medicine (CAM) practitioners for help for relief of your menopause symptoms. A telephone survey of more than 850 women age 45 to 65 showed that 76 percent used alternative therapies and 89 percent reported that they found these therapies to be “somewhat” or “very” helpful.

Recent surveys in the United States demonstrate the substantial presence of complementary and alternative medicine (CAM) in our health care system. Visits to CAM practitioners exceeded visits to primary care physicians by more than 243 million.

Pharmas, and doctors who support pharmas, tend to denigrate CAM practices in connection with menopause relief. They argue that medical studies have not been done to prove that CAM practices relieves menopause symptoms. This argument is flawed. Almost all medical studies are funded by pharmas (for their own financial benefit). Pharmas are not about to fund trials for CAM therapies.

What’s more, medical studies conducted on the HRT products of pharmas, have found that HRT users are at higher risk of health conditions that can kill …. than non HRT users

Today the medical establishment is increasingly recognizing the important role that CAM plays in relieving menopause symptoms. A 2013 study found that

A considerable level of CAM use was observed among women in menopause. Many menopausal women use CAM concurrently with their conventional medicine. However, communication regarding CAM between menopausal women and healthcare providers seems less than optimal

The researchers concluded that healthcare providers should prepare to inform menopausal women about all treatment options, including CAM.

How to find a CAM practitioner that suits you

Your first step is to decide if you are happy to work with a CAM practitioner, independent of a physician, or whether you would prefer to work with a CAM practitioner who is also a medical doctor.

Today there are medical doctors who practice holistic medicine, sometimes referred to as integrative medicine. Holistic medicine combines conventional and CAM treatments. It considers the whole person — body, mind, spirit, and emotions — in the quest for optimal health and wellness. Holistic medicine practitioners believe that the whole person is made up of interdependent parts and if one part is not working properly, all the other parts will be affected. In this way, if people have imbalances (physical, emotional, or spiritual) in their lives, it can negatively affect their overall health.

If you would like to explore help from a holistic practitioner near you, here are 3 three directories that you can use to find holistic medicine practitioners in your vicinity

Practioners of holistic medicine 1

Practioners of holistic medicine 2

Practioners of naturopathic medicine

Here are directories that can help you to locate practitioners of alternative medicine in your vicinity.

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How Your Doctor Is Influenced By Pharma Menopause Marketing

Menopause Marketing

Pharmas pay physicians who prescribe their products

In 2002, researchers of the government funded Women’s Health Initiative (WHI) study found that HRT produced an increased risk of breast cancer, heart attack, stroke and blood clots. This was the largest study of HRT ever conducted.

Since then, all studies have confirmed these health risks from taking HRT

Since the findings of the 2002 WHI study, there has been at least 3 large studies conducted to gauge the attitudes of OB-GYNs to HRT. The last study was conducted in 2009. These studies found that the majority of OB-GYNs were dismissive of the findings of the 2002 WHI study. To this day, they continue to encourage women to take HRT.

This raises an important question.

Do physicians understand menopause?

A recent survey of ob-gyn resident doctors, conducted by the Johns Hopkins University School of Medicine, found that there is a lack of understanding by ob-gyn residents in matters connected with menopause.

510 resident ob-gyns, from all over the country, were surveyed. Only 100 (20%) reported that they had received formal training in their ob-gyn curriculum in regard to menopause matters and only 78 had reported that they participated in a practical menopause clinic. That means that just 15% of those being trained as ob-gyns are receiving practical training to help you with issues that you are facing during menopause. The results of this survey explains why you are finding it hard to find a doctor who understands menopause.

An earlier study of ob-gyn residents found that most residents did not feel comfortable managing menopause patients with 75.8% reporting feeling “barely comfortable” and 8.4% feeling “not at all comfortable.”

If ob-gyns are not being trained in menopause matters, what training can you expect your internist or general practitioner to have had about menopause?

Given this information, it is clear that the majority of physicians are not trained in menopause. Therefore they are not equipped to understand it or really help you.

Why do doctors continue to push HRT today?

It is estimated that there are approximately 50 million menopausal women in America today. Therefore almost every doctor is seeing menopausal patients and being asked for advice to relieve menopause symptoms. As doctors are not taught about menopause in their medical training, they have to become informed about it in other ways.

Unfortunately, the education provided to doctors about menopause comes from pharmaceutical companies. The pharma industry has been aggressively and unscrupulously marketing HRT as THE solution for menopausal women for the past 50 years. They have invested billions of dollars in research and development of their HRT products and they have made billions of dollars from them.

How does the pharma industry educate doctors?

To fully understand the answer to this question, I suggest that you read the following
articles

  1. Menopause, as Brought to You by Big Pharma – an expose about the marketing of menopause by pharmas
  2. Promotional Tone in Reviews of Menopausal Hormone Therapy After the Women’s Health Initiative: An Analysis of Published Articles – a medical study, led by a prominent OB-GYN, that is eazy for the lay person to understand

Here is a synopsis of how the pharma companies educate doctors about menopause

  • ghostwriting – ghostwriting involves writing an article in the name of an “authority”, who is paid for lending his/her name to the article. Pharma companies employed specialist firms to write articles that promoted the benefits of their products, without mentioning the risks and side affects. They paid prominent doctors and medical professors to allow the articles to be published in their names. These articles were then placed in medical journals that were read by physicians to influence their prescribing habits in favor of HRT
  • physicians are invited to conventions and lectures paid for by the pharma – often held at attractive vacation venues.
  • physicians are visited by pharma sales reps who leave “free” samples of their HRT products and promotional literature about those products

This is how pharma menopause marketing works.

Perhaps the most unscrupulous aspect of the relationship between pharmaceutical companies and physicians is that the pharmas pay physicians who write prescriptions for their products.

Researchers have discovered that pharmas have paid more than $2 billion to 17,000 doctors since 2009. You may be able to learn if, and how much, your doctor has received from pharma companies by clicking here.

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How Pharma Marketing Of Menopause Affects You

Marketing Of Menopause

How pharma pills are pushed at you

Advertizing executives know that the key to a good pitch lay in the skillful manipulation of two emotions: fear and desire. The pharma industry has aggressively used these two emotions in their marketing of menopause for decades. From HRT to antidepressants …. from sleep aids to weight loss pills, pharmas have played on the emotions of menopausal women.

The main money maker for pharma companies has been HRT products. They have invested billions of dollars in them and they have made billions of dollars from them.

Estrogen was discovered in 1923, by Dr Edgar Allen. It was first approved by the FDA as a treatment for menopause in 1942, despite the fact that Dr Edgar Allen published a paper in the journal Cancer Research, around that time, saying that his most recent research showed estrogen to be a carcinogen.

Estrogen therapy (HRT) really began to take off in the 1960s, as a result of aggressive and often misleading claims by pharmas that played on fears and desires of menopausal women. The pharma strategy was to make HRT standard treatment for middle-aged and older women in America.

In 1966, Robert Wilson, MD, published a book entitled “Feminine Forever”. Dr Wilson used a potent mix of both fear and desire, promising women the moon while playing off their insecurities. He called menopause a “living decay”, during which women descended into a “vapid cow-like” state. Women and their physicians, Dr. Wilson wrote, should regard menopause as a degenerative disease that could be prevented or cured with the use of hormone drugs. By giving estrogen, Dr. Wilson claimed, he could magically transform a “dull cow” into a supple, younger-looking wife.

In the book, he wrote

Instead of being condemned to witness the death of their own womanhood . . . they will remain fully feminine

and

Women… shouldn’t have to live as sexual neuters for half their lives. Many physicians simply refuse to recognize menopause for what it is–a serious, painful and often crippling disease

“Feminine Forever” became a best seller. Women were going to doctors and demanding “the pills that will keep me from growing old”. Wyeth Laboratories made billions of dollars from sales of Premarin … their leading HRT product.

Although it was barely mentioned at the time, and is nowhere to be found in his book, both Dr Wilson’s research and “Forever Feminine” were in fact quietly funded by Wyeth Laboratories. Later, Dr Wilson’s son confirmed the payments from Wyeth to his father.

Eventually, the FDA banned Dr. Wilson from certain research because of his unsubstantiated claims that HRT could prevent aging.

In recent years pharmas have marketed their menopause products to doctors. They have done this by

  1. ghostwriting – ghostwriting involves writing an article in the name of an “authority”, who is paid for lending his/her name to the article. Pharma companies employed specialist firms to write articles that promoted the benefits of their products, without mentioning the risks and side affects. They paid prominent doctors and medical professors to allow the articles to be published in their names. These articles were then placed in medical journals that were read by physicians to influence their prescribing habits in favor of HRT
  2. inviting physicians to conventions and lectures paid for by the pharma – often held at attractive vacation venues
  3. visits to physicians by pharma sales reps
  4. making payments to physicians for prescribing the pharma’s product

Pharma companies are marketing to you directly when you visit your physician’s office.

You may notice a display in your physician’s waiting room, containing a collection of pamphlets on a wide range of health topics, including menopause. Branded as “Healthy Advice”, it will acknowledge “the generous sponsors who support this educational program”. If you pick up the pamphlet on menopause, you will see that it is sponsored by a pharma who makes an HRT product.

If you look inside under a heading like “latest findings”, you are likely to see a caution about trying soy or other natural products to ease your menopause symptoms, because “the benefits are still questionable”. It is also likely that you will see advice that encourages use of that pharma’s HRT product to ease your menopause symptoms.

Vigorous marketing of menopause, by pharmas, continues today. Be aware and beware.

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Who Benefits From Menopause Misery?

Pharma Industry And Menopause

Do pharma companies want you on drugs for the rest of your life?

Women clearly do not benefit from menopause … nor do their families. It is hard for me to see how doctors benefit from it. However, there is a group of companies that benefit hugely from menopause.

In 2009, global revenues from prescription drugs topped $837 billion, and the United States took the largest bite out of the pharmaceutical pie, consuming $300.3 billion in prescriptions. As it is estimated that there are 50 million menopausal women in America, a significant portion of this will have been spent by them on drugs to help them deal with symptoms of menopause.

Menopause has been the subject of a long term marketing and public relations campaign by the pharma industry that began in the 1960s. The objective of the campaign was to alter the perception of menopause from a natural condition experienced by all women to a disease, that if left untreated by pharma drugs could result in fatal ailments. The assumption that menopause is associated with chronic disease further encourages widespread use of HRT.

The campaign was launched on the back of the publication of the book entitled “Feminine Forever”, by Dr Robert Wilson, MD. Dr Wilson called menopause a “living decay” during which women descended into a “vapid cow-like” state. By giving estrogen, Dr. Wilson claimed, he could magically transform a “dull cow” into a supple, younger-looking wife. It became a best seller. Women were going to doctors and demanding “the pills that will keep me from growing old”. Dr Wilson traveled the country on a lecture tour.

The pharma industry supported the book with an aggressive marketing campaign. Later it was discovered that Dr Wilson received payment for the book, and for the speaking tours, from a pharma company making HRT. His son confirmed the payments to the New York Times.

Over the next few decades, the pharma industry changed its approach from the message in “Feminine Forever” to scientific-sounding arguments that expounded the virtues of HRT. It engaged in unscrupulous practices to achieve this…..the most notable was ghostwriting. Ghostwriting involves writing an article or a paper in the name of a person other than the writer.

The pharma industry wrote papers about HRT and used the names of prominent doctors and academics to lend credibility to the scientific arguments that they were presenting about HRT. Ghostwritten papers were typically review articles, in which an author weighs a large body of medical research and offers a bottom-line judgment about how to treat menopause symptoms. The articles emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia. This was done extensively to influence the prescribing habits of physicians in favor of HRT.

A study revealed the extent that ghostwriting was used by the pharma industry to promote and sell HRT. The reviews and commentaries, published in medical journals and supplements, were used to promote unproven benefits and downplay harms of menopausal hormone therapy. The researchers recommended that the pharma industry renounce participation in ghostwriting, and that steps should be taken to ensure that unscrupulous relationships between industry and academia are avoided rather than courted.

It is even alleged by Dr Adriane Fugh-Berman, MD, that pharma companies were untruthful in the ghostwriting. Dr Fugh-Berman is an Associate Professor in the Department of Pharmacology and Physiology at Georgetown University Medical Center. She was an expert witness in the case brought against Wyeth Labratories that resulted in millions of dollars being paid out to victims of HRT. This is what she said

Perhaps the most successful marketing campaign convinced physicians that HRT prevented cardiovascular disease before one single clinical trial with cardiovascular disease end points had ever been done. Even after the first randomized controlled trial of HRT with actual disease end points—the Heart and Estrogen/Progestin Replacement Study (HERS)—failed to show a benefit of HRT in women with heart disease, pharmaceutical companies persuaded physicians that HERS actually showed a benefit.

Dr Susan Love, MD, a noted cancer researcher, said in a New York Times editorial that there was a lot of scientific theorizing about the benefits of HRT, but very little scientific research.

What happened is that medical practice, as it so often does, got ahead of medical science. We made observations and developed hypotheses — and then forgot to prove them.

The modern medical model supports a full-scale menopause industry that is profit-driven. The industry identifies menopause as a “disease” in order to induce a whole population of women over 50 to take hormones for the rest of their lives. This is consistent with the views of a growing number of doctors, who think that pharma companies invent diseases in order to sell their drugs and increase their profits.

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