Tests Every Woman Should Have as She Goes Through Menopause

Let the truth be told, women are much better than men about screening tests, office visits to the doctor, and taking their medications than their male counterparts. Let me review tests that women should do after menopause.

If a middle age woman hasn’t had a menstrual period for a year, she’s probably a member of the menopause club. Of course, there are other causes of absent periods but menopause is the most common in middle age women

Blood Tests Every Woman Should Have

If you’re still menstruating, your hormone panel (blood test) should be done during the first three days of your period. It can test for the following hormones:

• DHEAS (DHEA sulfate) – a hormone that easily converts into other hormones, including estrogen and testosterone
• Estradiol- the main type of estrogen produced in the body, secreted by the ovaries. If yours is low it can cause memory lapses, anxiety, depression, uncontrollable bursts of anger, sleeplessness, night sweats and more.
• Testosterone – Free testosterone is unbound and metabolically active, and total testosterone includes both free and bound testosterone. Your ovaries’ production of testosterone maintains a healthy libido, strong bones, muscle mass and mental stability.
• Progesterone- If yours is low it can cause irritability, breast swelling and tenderness, mood swings, “fuzzy thinking,” sleeplessness, water retention, PMS and weight gain.
• TSH (thyroid-stimulating hormone) – If yours is irregular, you may need to have your Total T3 and Free T4 checked as well.

If you’re already in the midst of perimenopause or menopause, here are other important tests to consider:

Bone Density

This test, also called a bone scan or DEXA scan, can reveal whether you have osteopenia or osteoporosis. When you enter perimenopause and menopause, the drop in estrogen can do a number on your bone mass. Don’t worry; the scan is quick and exposes you to very little radiation.

Cancer Marker for Ovarian Cancer

CA-125 (cancer antigen 125) is a protein best known as a blood marker for ovarian cancer. It may be elevated with other malignant cancers, including those originating in the endometrium, fallopian tubes, lungs, breasts and gastrointestinal tract. If your test comes back positive, don’t panic; this test is notorious for producing false positives!

Cholesterol

Like your moods, cholesterol levels change in perimenopause and menopause. An excess of cholesterol can build up artery plaque, narrowing blood vessels and potentially causing a heart attack. A cholesterol panel usually includes checking your HDL (high-density lipoprotein or the good cholesterol), LDL (low-density lipoprotein or bad cholesterol) and triglycerides (molecules of fatty acids). You’ll need to fast for 12 hours before this test (a perfect time to step on the scale!).

Vitamin D3

This vitamin helps maintain normal blood levels of calcium and phosphorus, keeping your bones strong.

And one more suggestion…

Even during and following menopause, women still need to conduct a monthly breast self-exam and your annual mammogram. Woman should also schedule an annual checkup with a primary care physician, and an annual pelvic exam with your gynecologist.

Women and men also need to schedule a colonoscopy, according to the American Society of Colon and Rectal Surgeons.

Bottom Line: Remember that when you’re in perimenopause and menopause, it’s important to not only focus on “down there,” but on your body as a whole. That includes your mental and emotional health as well.

For more information on “down there”, I recommend my book, What’s Going On Down There- Improve Your Pelvic Health, available from Amazon.com (http://www.amazon.com/Whats-Going-Down-There-Siddighi/dp/1477140220/ref=sr_1_13?ie=UTF8&qid=1442165577&sr=8-13&keywords=What%27s+Going+On+Down+There)

What’s Going On Down There-Improve Your Pelvic Health (amazon.com)

Ladies, Is Testosterone The Answer To The Low Libido Question?

Almost everyone knows that testosterone is the man’s hormone and is responsible for his sex drive or libido. But few know that testosterone is also the hormone for women’s sex drive and libido. This blog will discuss the role of testosterone in women and what you can do if your sex drive is in the tank.

If you are a menopausal woman, chances are pretty good that your sex drive has slowed down since your “roaring twenties and thirties”.

Some of you will go so far as to say that you have no interest in sex whatsoever. There is a really good physiological reason for this decrease in interest, by the way. When women hit their forties and beyond, the ovaries start their journey toward menopause. That means that we are getting closer to the end of our ovarian production of both estrogen and testosterone. These hormones play a critical role in women’s sexual health and wellness. The decline in testosterone is a normal part of aging, but it can have a profound physical and emotional impact on some women.

Women make plenty of testosterone from their ovaries, starting at puberty and lasting a few until menopause or until the ovaries stop producing estrogen and testosterone. Testosterone has several duties, including improving our sense of well-being and energy, maintaining bone health and, of course, assisting estrogen in the pursuit of sexual health and normal functioning.

Testosterone therapy is approved by the FDA in menopausal women who have the diagnosis of hypoactive sexual desire disorder (HSDD).

Bottom Line: Women with low sex drive might want to speak to their doctors and have their testosterone level checked. If the testosterone is low and the women complains of a decrease in her sex drive, then testosterone replacement in women is an option.

Menopause or Andropause-Not the “Pause” That Refreshes Either Women or Men

Around age 50 women have a drop in their hormones and enter into menopause. At about the same age men start experiencing a decrease in testosterone occurs. This is the male hormone that is responsible for sex drive, muscle mass, bone strength, and even erections. This condition in men is referred to as andropause and it affects millions of American men.

The symptoms of andropause include hot flashes, fatigue, night sweats, mood swings; all the fun things that females going through menopause may endure. Men lose one percent testosterone for every year past 30 but usually don’t develop symptoms until age 50. As testosterone decreases, estrogen increases. Abdominal fat causes excess estrogen and low levels of testosterone may also lead to prostate problems. Ever wonder why suddenly you are gaining weight around the middle? It could be your hormone levels are unbalanced.

The diagnosis is easily made with a blood test to measure the testosterone level. Men more than 50 years of age should also have a digital rectal exam to check their prostate gland and a PSA test which is a screening test for prostate cancer. Treatment options include testosterone replacement therapy. This can be administered with self injections of testosterone, topical gels, or the insertion of testosterone pellets under the skin.

Bottom Line: Testosterone deficiency in middle age and older men affects millions of American men. The diagnosis is easily made and effective treatment is available. You don’t have to suffer this common condition. Help is available. See your doctor.

Caffeine and Menopause-Say Adieu to the Brew

Menopause can cause uncomfortable and often incapacitating hot flashes. In most instances these are temporary and will subside without any treatment.

I suggest that if you are suffering from hot flashes, then limit your caffeine consumption. Higher caffeine intake could lead to more severe hot flashes and night sweats during the menopause.

A survey of more than 2,500 women who presented with menopause-related issues at the Mayo Clinic’s Women’s Health Clinic. Researchers then compared the data from those who used caffeine with those who did not.

The study shows that those who used caffeine were more likely to report more severe hot flashes and night sweats.

However, caffeine intake was also linked to experiencing fewer problems with mood, memory and concentration, indicating that it also has its benefits. Mayo Clinic said this could be because caffeine is known to enhance arousal, attention and mood.

Bottom line: While these findings are preliminary, our study suggests that limiting caffeine intake may be useful for those postmenopausal women who have bothersome hot flashes and night sweats.

Menopause Doesn’t Mean Goodbye To Sex

The loss of estrogen and testosterone following menopause can lead to changes in a woman’s sexual drive and functioning. Menopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and foreplay — which can result in decreased interest in sex.
In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to become dry and cause painful intercourse.
A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman’s interest in sexual activity during menopause and after. These include:
Bladder control problems (incontinence)
Sleep disturbances
Depression or anxiety
Stress
Medications
Health concerns
Some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly. Do not use non-water soluble lubricants such as Vaseline, because they can weaken latex (the material used to make condoms, which should continue to be used until your doctor verifies you are no longer ovulating and to prevent contracting sexually transmitted diseases). Non-water soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy or in women who are prone to recurrent urinary tract infections.
Vaginal moisturizers like Replens and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy.
A oral drug taken once a day, Osphena, makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.
Estrogen replacement may help raise the sex drive after menopause which is associated with a decrease in estrogen. Estrogen can also make intercourse less painful by treating vaginal dryness.
Doctors are also studying whether a combination of estrogen and male hormones called androgens may be helpful in increasing sex drive in women.
Bottom Line: Sexual desire and enjoyment from sexual intimacy can be preserved after menopause. It may dry the vaginal lining but it doesn’t have to dry up the desire to be sexually intimate with your partner.

What Culprits Send Cupid Out of the Bedroom?

Today is Valentine’s Day, the day that couples think about love and intimacy. However, there are relationships where love and affection have left the bedroom. There are many culprits that can affect intimacy between a man and a woman.

Medications

There are literally hundreds of medications that can impact a man or a woman’s sex life. Medications that are prescribed for stroke and heart issues can have devastating effects on sexual functioning. In addition, researchers have found that a family of antidepressants known as selective serotonin-reuptake inhibitors (SSRI) can take the wind right out of your sexual sails. These drugs include Prozac, Zoloft and Paxil.

Doctors can often reduce the dosage of these offending drugs or can change to another drug that can accomplish the same result without the sexual side effects.

Chronic Pain

People of both sexes can develop pain disorders as they get older, and that can have a big effect on sexuality. Arthritis and chronic back pain are just two examples. Those who suffer from chronic pain are advised to find the time of day when pain is at a minimum to engage in sexual intimacy. Also, those who suffer from chronic pain may need to take a pain pill before attempting to have sex. There are positions such as side by side that actually put the least amount of stress on your joints and your back and may make it possible to have successful intimacy.

Sex does not always equal intercourse. There are many successful relationships that do not have penis-vaginal intercourse. However, these people are able to engage in intimacy by sensual touching, massage and mutual masturbation.

Make Time for Rest and Play

The National Sleep Foundation recommends getting seven to eight hours of shut-eye a night. But with the stress of work, kids, bills and, oh yeah, your marriage, who can think about fitting in time to have sex, much less sleep? Still, you have to do your best to get a healthy amount of sleep.

Cupid likes to be included on regular dates. Plan some sex dates around times that you know you feel more energetic. You plan other things in your life and you don’t complain about it. You can do the same with sex.

Menopause and Testosterone Deficiency

Menopause and the accompanying decrease in sex drive and the appearance of vaginal dryness can wreak havoc on your sex life. Menopause results from a decrease in estrogens. The solution is as simple as applying a vaginal cream or a lubricant such as K-Y jelly or estrogens, which can be administered by a pill, a patch, topical gels, or a vaginal ring.

If you aren’t in the mood, you may be suffering from testosterone deficiency. This applies to women as well as men. Women also make low doses of testosterone and if the hormone is deficient, women may not be in the mood for sexual intimacy. The application of a topical gel or the insertion of a small pellet under the skin may quickly solve the problem of a lack of sex drive.

Bottom Line: Valentine’s Day is just one day a year. However, Cupid can be your best friend the other 364 days of the year. Try a few of these ideas to bring Cupid back into your bedroom. It’s the best threesome in the world!

This article appeared in the February 2014 issue of Health & Fitness Magazine

Hot Flashes? Exercise Your Way To Cool The Fire

Hot flashes are one of the most disturbing aspects of menopause. It makes women uncomfortable and can wreck havoc on their lives. This blog will describe how exercise can cool the hot flash.

Increased energy and a fit body are just a few of the benefits of exercising. There is another advantage of working out for women. For menopausal women who exercise, they experience fewer hot flashes in the 24 hours after physical activity.

Women who are inactive or obese are more likely to have a higher risk for hot Women in a study at Penn State had fewer hot flash symptoms following exercise. As well, women who were identified as overweight, had a lower level of fitness, or experienced more frequent or more intense hot flashes, sensed the smallest reduction in symptoms.

Bottom Line: Becoming and staying active on a regular basis as part of your lifestyle is the best way to ensure healthy aging and well being, regardless of whether you experience hot flashes or not.

The findings are published in the current issue of Menopause.

Brain Health and Your Blood Pressure-One More Reason To Check For and Treat Hypertension

Researchers at University of California, Davis found that high blood pressure could damage the brain’s structure and function in people as young as 40.

They found accelerated brain aging among hypertensive and prehypertensive individuals in their 40s, including damage to the structural integrity of the brain’s white matter and the volume of its gray matter.

This suggests that vascular brain injury develops insidiously over the lifetime with discernible effects. The study is the first to demonstrate that there is structural damage to the brains of adults in young middle age as a result of high blood pressure.

Structural damage to the brain’s white matter caused by high blood pressure has been associated with cognitive decline in older individuals.

The research emphasizes the need for lifelong attention to vascular risk factors for brain aging.

Normal blood pressure has a systolic blood pressure below 120, and a diastolic pressure below 80. Prehypertension blood pressure range is a top number between 120 and 139, and a bottom number between 80 and 89.

Elevated blood pressure affects about 50 million Americans and is associated with a 62 percent risk of cerebrovascular disease, and a 49 percent risk of cardiovascular disease.

The study says there is evidence that lowering blood pressure among people in middle age and in the young elderly can help prevent late-life cognitive decline and dementia.

Bottom Line: People can influence their late-life brain health by knowing and treating their blood pressure at a young age, when you wouldn’t necessarily be thinking about it.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women’s health

When Your Sex Drive Crawls To A Halt

A decrease in your sex drive or a loss of your libido can result in physical and emotional disorders. If this is your problem, you will want to read the rest of this article and learn how to put fuel back in your sex drive.

Sex drive killers

Erectile dysfunction or ED
Nearly 33 million American men suffer from erectile dysfunction. ED is most common in men over age 40 but most men suffer in silence. This is a result of the myth that ED is a normal part of the aging process and it is primarily a psychological problem. The facts are that it is not part and parcel of the aging process and that older men who are healthy and have a partner can expect to successfully engage in sexual intimacy. ED is eminently curable with the help of drugs and injections or surgical procedures.

Menopause
In women, physical changes like menopause can affect physical intimacy and sexual drive. Although, menopause itself does not affect your ability to have sex, the reduced hormone levels may cause certain discomforts like vaginal dryness and pain during sex. This condition is also easily treated with hormone replacement therapy or just lubrication in women who cannot or wish not to take estrogens.

Depression
One of the major hallmarks of depression is reduced interest in sex. Be aware that both depression and antidepressant pills can affect your libido. If you are having a loss of sex drive as a result of using antidepressant medication, tell your doctor as he\she can alter the dosage or change to another medication that doesn’t cause a drop in your sex drive.

Less sleep
There is a direct connection between sleeplessness and reduced sexual urge. Loss of sleep can result in an increase stress hormone cortisol which plays a major role in reducing the testosterone levels, the hormone in both men and women that is responsible for maintaining your sex drive.

Parenting
Parenting is a one of life’s greatest stressors and can affect your physical and mental health including your sex life. A solution may be as simple as taking time for each other and making a regular date that doesn’t include the children.

Excessive alcohol
Excessive alcoholic consumption is linked to ED and infertility in both the sexes. It is true that a few sips of your favorite wine lowers your inhibitions and puts you in the mood for intimacy but it can also put your sex drive in the tank. Like everything in life, moderation can help preserve your sex drive.

Relationship problems
Marital or relationship problems like lack of trust and proper communication can act as major hindrance to experiencing enjoyable and satisfying sex. Counseling to sort out any personal indifference between you and your partner is effective in restoring your bedroom activities.

Bottom Line: One of the life’s greatest enjoyments is sexual intimacy with the partner you love and enjoy. However, the libido is very fragile and can easily be diminished. The good news is that most libido problems can be resolved and intimacy be restored.

When Things Aren’t Right “Down There”-When Women Should Call Their Doctor*

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.  However, there are a few symptoms that warrant a call to the doctor.  This article will cover when you should call your doctor for problems “down there”?
1. Pelvic Pain
Pain at the time of ovulation, is referred to as Mittelschmerz.  However, if you have pelvic pain that persists or doesn’t ease with simple home treatment, call your doctor.
When a woman has chronic pelvic pain, doctors will check for benign uterine fibroids and endometriosis. They will also look for pelvic inflammatory disease, which usually appears as a triad of pelvic pain, vaginal discharge, and fever.
In addition, abdominal pain and vaginal bleeding may signal an ectopic pregnancy, in which a fertilized egg implants outside of the uterus.  This is a medical emergency and you need to visit an emergency room if you can’t reach your doctor.
Ovarian cancer is another condition that can cause pelvic pain.  The symptoms of bloating, pelvic pressure and frequency of urination for more than two weeks is a potential sign that you should be checked for a possible ovarian cancer.
2. Irregular Bleeding
If you’re not on any kind of birth control and you have irregular bleeding that lasts for more than a month or two, you should always be checked.  Irregular bleeding includes: periods that last longer than normal, bleeding mid-month, having two periods per month, bleeding after sex, and other unusual patterns.  Abnormal bleeding may stem from multiple causes that aren’t serious, among them, perimenopause or uterine fibroids or polyps.
If you bleed every time after sex, that may indicate that the cervix is being easily irritated especially if there’s some infection of the cervix.  Sexually transmitted diseases, such as gonorrhea or chlamydia, can cause cervical lesions that bleed with sex.
If you’re postmenopausal, be especially vigilant about any vaginal bleeding; it’s a potential sign of uterine cancer. Uterine cancer, compared to ovarian cancer, is extremely treatable. It’s very curable because it’s generally found in an early stage and it has an early warning sign, which is postmenopausal bleeding.
3. Abnormal Vaginal Discharge
Abnormal symptoms include a strong odor; an unusually large amount of discharge; accompanying itching, burning, or irritation; unusual color; or blood in the discharge.
4. Vaginal Dryness
Vaginal dryness in postmenopausal women or vaginal atrophy can cause spotting after intercourse. Because older women have less estrogen, their vaginal tissue thins or atrophies and becomes dry and irritated.  Not only does vaginal dryness make sex painful, but vaginal thinning also leaves women more susceptible to infections and can contribute to urinary incontinence.
Most women can find relief with estrogen creams, rings, or tablets that are applied or inserted directly into the vagina.
5. Sores or Lumps
Sores in the genital area may point to herpes, a sexually transmitted disease, or cancer. Symptoms of cancer of the vulva include unusual lumps, wart-like bumps, or red, flat sores that don’t heal. Sometimes, the flat sores turn scaly or discolored.
Bottom Line: Most problems “down there” are innocuous but you should know when to call your doctor.  These are the five most common symptoms that need your attention and that of your doctor. 

*Modified from WebMD, 4-20-11

When Things Are Coming Out “Down There”-Pelvic Organ Prolapse

Pelvic organ prolapse is a common that affects more than 30 million American women in the United States.  Unfortunately, only 15% of women who have prolapse seek treatment from a doctor.  This article will define prolapse, discuss the symptoms of prolapse and discuss some of the treatment options.

Pelvic organ prolapse is a condition where there is a weakening of the support tissues or muscles of the pelvis.  The symptoms of POP include a bulge or lump in the vagina or a pulling or stretching sensation in the groin.  Women with POP may complain of difficulty with sexual intimacy.  They may also have urine and\or fecal incontinence.  They may also have difficulty with bowel movements or difficulty emptying their bladder.

The causes of POP include menopause, multiple pregnancies and childbirth, prior pelvic surgery, obesity, and as a consequence of the aging process.

Treatment options for POP

Conservative therapies including strengthening the pelvic floor muscles.  This can be easily accomplished with Kegel exercises.  These are exercises named after the doctor who devised the treatment, which consists of contracting and relaxing the muscles in the pelvis.  These are the same muscles which hold urine in and rectal gas in place.  A woman should do the Kegel exercises multiple times a day and should not expect any changes for several months until the muscles are strengthened.

For more information on Kegel exercises go to http://www.neilbaum.com/pelvic-exercises-for-women-kegel-exercises.html.

Another conservative therapy is the use of pessaries or plastic or rubber rings which are inserted into the vagina to restore the fallen organ back into the normal anatomic position.   Peccaries will work immediately but they have to be changed periodically in order to avoid vaginal infections.

Probably the most common treatment is surgical repair of the prolapse.  The surgery is used to strengthen structures around the vagina to maintain support of the structures and organs in the pelvis.  These procedures can usually be accomplished through the vaginal opening.  Most women can have the procedure on a one-day stay basis or remain in the hospital for just 24 hours.  Most women need little or no pain medication after the procedure and can return to all activities including heavy lifting, exercise, and sexual intimacy in 3-4 weeks after the procedure.

Most of the surgical procedures that restore the normal anatomy are 90% successful and most patients are very satisfied after the procedure.

Bottom Line:  If something isn’t right “down there” you don’t have to suffer in silence.  There are several treatment options to restore your normal anatomy.  You can have an improved quality of life and return to your normal activities within a short time.  If you have any questions, call your doctor.