Sex & Menopause Why Bother?

Menopause is a process, not an event. Menopause is not a disease, does not always need treatment, and does not get “cured.” Rather it is a time of transition, with lots of changes in a woman’s body, not unlike the changes we understand as normal during puberty. It begins with a decline in estrogen production that ultimately results in cessation of ovulation, but a woman’s last period is by no means the end of the process. There are many adjustments that continue over time

A very, very common experience of menopausal and post-menopausal women is a major change in their libido, which, like other symptoms of menopause, results from the lack of estrogen. Women often tell me they have less interest in sex, they don’t feel the same,  don’t function the same, and they may think, “It’s all over for me.”

I think it is very important when you look at something like the Masters and Johnson model of sexual function, which envisions a start, a peak, and a finish to sexual activity, that you realize that process may be true in younger women and it may be true in men, but it is not true in menopausal women. Interestingly, a Vancouver-based researcher named Rosemary Basson proposed a different reality, one that has become well accepted in the medical community. Based on her research, first published in 2001, she has created a schematic diagram illustrating sexual function in women as they age, and that diagram portrays sexual experience not as a line with a start and a finish but rather as a circle.

Her research shows that, with menopause, women often lose interest in initiating sexual activity; however, if they are intimate, if they are close with their partner and the partner begins sexual activity, they can derive pleasure from it. I think her model is much more accurate regarding how women function because I know that a lot of the women in my practice feel this way. But many women, because they have lost interest in initiating sexual activity, and because the idea of sex doesn’t have the same appeal, often say, “No way. Why bother?”

It’s Not Just You

When I talk to women in my practice about sexual issues they often respond with a huge sigh of relief. Women tend to think it’s a completely personal problem; they think it is just about them or about their partner or their relationship. So, it is extremely reassuring for them to learn about Basson’s research. They say things like, “Oh! You mean it’s not just me?” And they begin to see possibilities for maintaining and deepening their relationship, possibilities they thought no longer existed for them. And so I do encourage women to maintain intimacy, to maintain closeness, and to allow themselves to continue to be involved sexually with their partner, because generally once they start and once they get involved they can go through that circle and to derive pleasure from the activity itself and satisfaction from the ongoing intimacy.

One menopausal symptom that does not go away with time is the genitourinary syndrome of menopause. That term may sound off-putting, but it is more medically accurate—and perhaps less alarming—than the name that was previously used: vaginal atrophy. So, what is it? Because of lack of estrogen the vagina gets dryer and the back wall of the bladder loses its estrogen support. This results in vaginal symptoms like dryness, burning, and itching; it also causes bladder symptoms such as loss of control and results in an increased risk of bladder infections.

Don’t get me wrong: estrogen is not a panacea; it does not solve everything. Adding back estrogen does not necessarily replace lost interest or replace the physiological response so that it is the same as when you were 30. But adding back estrogen can lubricate and make you more comfortable, and for many women, it is discomfort that convinces them they are past the time when sex can be good, can be enjoyable for them.

In Chapter 5 of my book, A Woman’s Guide to Healthy Aging- 7 Proven Ways to Keep You Vibrant, Happy & Strong, I go into a great deal of detail about hormone treatments and various options.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or healthcare provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

Optimal Aging Means Good Brain Health, Especially for Women

Optimal Aging Means Good Brain Health, Especially For Women

Women’s Brain Health Initiative

WBHI Logo

Women’s Brain Health & Why Grey Matter Now Matters

Women suffer from depression, stroke and dementia twice as much as men and an astounding 70% of new Alzheimer’s patients will be women. Yet research still focuses on men. We want to correct this research bias.

Women’s Brain Health Initiative creates education programs and funds research to combat
brain-aging diseases that affect women.

Thanks in large part to the work of the Women’s Brain Health Initiative (WBHI), science is now paying a lot of attention to women’s brain health. WBHI is a partner of the
Canadian Consortium on Neurodegeneration and Aging, which is an umbrella group that oversees all the brain research that is happening in Canada. Because of its significant funding clout, WBHI has been able to ensure that every participant group—in all brain research undertaken in Canada—includes enough women to matter. What do I mean by “enough women to matter”? I mean that there have to be enough women in each study to be statistically significant, so the research conclusions of the study apply to women, not just to men.

WBHI has been able to make sex & gender part of core research in Canada

And it is not that women are a priority only in the research today that is being done today. Governments come and go, and researchers’ interests shift, and those changes can also alter research priorities. But WBHI has been able to make sex and gender—and therefore women—part of the core value of all the brain research that is going on. And core values are impervious to the fickle winds of change. We may not know today why more women than men suffer from Alzheimer’s, but because of the inclusion of women as a core value in research we will know at some point in the future.

In fact, there is a lot of research going on now to discover ways to identify cognitive decline earlier in women. This includes research on issues around Alzheimer’s disease, which is now being recognized as “a woman’s disease” because so many more women than men suffer from it, as mentioned above. Drug development is another important area of research because the drugs we currently have for treating brain problems may not work as effectively in women as they do in men.

Lifestyle Choices Can Affect Brain Health

The current research also includes a focus on lifestyles choices. We know some of the things that can contribute to cognitive difficulties in old age, and many of them are things we can control. For instance, we know we can alter smoking, diet, exercise, stress, blood pressure, and blood sugar levels—all of which can have a big impact on cognitive health, or to put it another way, on cognitive decline. As with any research, there is always the possibility of unexpected results. For instance, one study showed that the most important decade of life to impact brain health through exercise is your 20s. That’s right, exercise in your 20s makes the biggest difference to your brain 50 years later! So, realistically, you are never too young to start thinking about your brain and how to keep it healthy.

WBHI Celebrates 5 years 

I have been fortunate to be a member on the board of the directors of the Women’s Brain Health Initiative founded by Lynn Posluns five years ago.  The  www.wbhi.org website has the most comprehensive information on women and brain health including research, events and healthy aging tips plus ways to get involved.  I urge you to take a few moments and visit their site.

On May 10, WBHI will be celebrating its 5th Anniversary and honouring the individuals, including myself as a Catalyst who have been involved in helping make Women’s Brains Matter.  6pm-9 pm at the Gardiner Museum. Tickets for $60 can be purchased on the WBHI site under events. 

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Boning Up on Bone Health for Healthy Aging

Why Bone Health is Important for Healthy Aging

What do we need to ensure we all age well and do so in a healthy vibrant way?
How can we be the architects of our future, not the victims. Aging and wellness are popular topics in magazine and talk shows, but we need to be clear about what is evidence based as opposed to trendy, what has true merit, rather than anecdotal stories.

The number one event that is common to both men and women over the age of 50 is the risk and the likelihood of fracture. Slipping and falling is very, very common, but not everyone fractures. Some people will bounce and NOT break. What is the secret? How can we have strong robust bones?

Essential Vitamins

Well, bone health starts for us all when we are young. We need calcium and Vitamin D. No, I don’t work for the Milk Marketing Board of Canada, but in truth, they ae quite right. Calcium is essential and is absorbed by the body from milk, cheese and yogurt, much more efficiently than from tablets. For people over the age of 50, Osteoporosis Canada, out guideline body says we need 1200 mg per day. That is 3-4 servings of dairy. Yes, we can get some calcium from broccoli and from almonds and salmon, etc., but dairy products pack the biggest punch. Vitamin D is from the sun. See any of that lately? Even in the summer, when we do see sun, the sunblock we use to prevent skin cancer, blocks out the vitamin D absorption, so we need 1000-2000iu (international units) as adults over 50.

Our children should be having milk and calcium containing products and vitamin D. And you know our grandmothers and great-grandmothers fed us cod liver oil! They were right.

What does this mean. Our bones will be stronger and more able to stand the expected slow loss of bone with age.

What Bone Density Tests Tell You

By age 65 everyone, men and women need a bone density test. This tells us how much bone we have, the quantity of bone. It does not tell us, the quality of that bone. Bone quality is not as easily measured but we do know any fracture past age 40 should be evaluated to determine if it was a fragility fracture or a traumatic fracture. If you are hit by a truck, any fracture is traumatic. If you step of the curb, a fall from your standing height or 1-3 steps higher, that is generally a fragility fracture. And a fragility fracture is a predictor of weak bones, risk of hip fractures. A fracture is the event that warns us that our bone quality is not ideal.

Evaluate Your Risk

It is reasonable to evaluate your risk, whether you have fractured since age 40, whether your parent had a hip fracture, what drugs you may be on that can have an effect on bone, what underlying diseases, such as rheumatoid arthritis that may impact bone health. By focusing on bone health, you may be doing great, or you may need some intervention, but the goal remains the same for you and your doctor:  maintain your activity, independence and ability to age in a healthy way for years to come.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Obesity 2x higher than in 1981

Obesity rates for both men and women are about twice as high today as they were in 1981. In Canada, approximately 25 percent of adults are obese. Along with its growing prevalence, obesity is also becoming more severe, and the research shows that overall fitness levels are decreasing as the incidence of obesity rises. If we include statistics on overweight along with statistics on obesity we find that 67 percent of Canadian men and 54 percent of Canadian women aged 18 to 79 are overweight or obese, according to results from the Canadian Health Measures Survey (2009-2011).

A study published in the New England Journal of Medicine looked at obesity among American adults and found that obesity rates increased by approximately 50 percent through the 1980s and 1990s after having been relatively stable in the 1960s and 1970s. That was likely the start of it all. An article in the Journal of the American Medical Association (April 4, 2016) found that age-adjusted death rates in 2015 increased significantly from the year before; causes of death related to obesity were a major factor in the increase.

Life Expectancy Decreases

The same article points out that life expectancy in the U.S. increased consistently between 1961 and 1983, but between 1983 and 1999 life expectancy decreased for men and for women in U.S. counties where obesity was prevalent. The article states that “in addition to the health-related effects, the economic effects of obesity-related disease are substantial and predicted to worsen.” So, yes; I think we can conclude that there really is an obesity epidemic. And not just in the U.S.

But what exactly do we mean by obesity? Obesity refers to excessive weight for your height and body frame, based on Body Mass Index (BMI) guidelines. (You can use the BMI chart in the Appendix to calculate your own BMI.) This is a useful tool, but it has its drawbacks. For instance, it is based on the ratio of a person’s weight in kilograms divided by their height in meters squared, but it does not take into account how much of their weight comes from fat and how much from muscle. Because muscle weighs more than fat, people who are muscular may have a higher BMI and still be in excellent health.

If we don’t know the fat/muscle breakdown, another—and perhaps even more useful—way to measure obesity is to look at waist circumference. For women, a healthy waist circumference should be no more than 90 centimeters (35 inches). Healthy waist size varies, of course, based on a number of factors, including a woman’s height and bone structure, and even ethnicity: as a rule, for Asian women it should be no more than 80 centimeters (31.5 inches).

Waist circumference is a helpful health indicator because it correlates more closely with a number of health risks than either weight or BMI alone. And it turns out that the old apple or pear comparison is accurate. If we look at two women who are the same height and who are equally overweight, and one carries most of the excess weight in her hip area while the other carries it mostly in her protruding belly, we find that the second woman is more at risk than the first not only for heart disease but also for diabetes and other metabolic conditions.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Common Sense Solutions & Dieting

 

One thing I’d like every woman to understand is the true meaning of diet. I cannot emphasize enough how much potential harm comes from our society’s insistence that diet simply means restricting caloric intake to lose weight.

The current trend in maintaining a healthy weight is the non-diet approach for health, and although I say trend, it is more than just trendy.  It is not like the dozens of fad diets that have had brief popular appeal over the past fifty years that promise quick weight loss and often don’t deliver.

In my book—A Woman’s Guide to Healthy Aging- I look at some of the problems associated with our modern diet and consider some common-sense solutions that can help reduce your health risk for the long haul, I call this the non-diet diet.

The non-diet approach is a more balanced, realistic way to lose weight and maintain good health with nourishing foods, daily physical activity, positive thinking and smart life-style choices. This includes:

  • Making fibre your friend. Fibre keeps our digestive system running smoothly and also keeps us feeling full and satisfied longer.
  • Get cooking! Make healthier versions of your favorite take out—save time by buying pre-cut washed veggies.
  • Eat your fruit and veggies and your leafy greens
  • Boost vitamin B intake: Folate B12 and B6
  • Boost vitamin E intake
  • Add polyphenol-rich foods-brain foods that are powerful anti-oxidants: blackberries cherries plums, walnut halves
  • Reduce your fat intake
  • Increase your Omega 3-fatty acids
  • What your cholesterol
  • Get your daily calcium

Any way we look at it, regardless of our personal inclinations—whether we’re trim or we tip the scale, whether we live to run or we balk at running, whether we sleep like babies or get nothing better than a series of catnaps through the night—nutrition, exercise, and sleep are among the major factors that affect our health.

One very important thing to realize about these factors is that they are within our control.

Sure, other factors beyond our control also affect our health, including family history and genetic inheritance, sex, and age. We cannot modify those, but we can modify how we eat, how active we are, and how well we sleep. And for many of us, some modification is necessary if we want to live a long and healthy life.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Skin Cancer–Summertime and the Living is Easy. But Not for Skin Cancer

 

Don’t be fooled looking at celebrity photos of stars walking the beach in Malibu all bronzed and healthy. It gives the wrong impression that looking good means getting a good tan in the summer.

The truth.  Sun and skin cancer go hand in hand triggered by exposure to ultraviolet rays and artificial tanning beds. One in six Canadians born in Canada in the 1990’s will get skin cancer—the number one killer of women aged 25-30. Skin Cancer is the second most in common cancer in young adults aged 15-34 * (Canadian Skin Cancer Foundation)

As you head off to vacation or spend your days outside this summer the most important thing to remember is to use sun block. And lots of it. The most common mistake is not using enough.  Does it surprise you to learn that a family of four will use one bottle of sun block in just one day!

The Canadian Skin Cancer Foundation recommends that when you first apply sunscreen, it should form a film on your skin. The white streaks won’t last long; sunscreen absorbs quickly.

To protect your lips, use a lip balm or lipstick that contains sunscreen with an SPF of 30 or higher. Reapply sunscreen approximately every two hours, or after swimming or sweating, and according to the directions on the bottle.

Attention: parents of newborns.
Do not use sunscreen on babies under six months old. They are too small to absorb the chemicals and will be harmful.  The best way to protect your infant is to keep them out of the sun.

Although skin cancer is preventable and most often treatable, it remains the most common form of cancer.  So please protect yourself, your family and friends by passing this information on and practicing safe sun.

Disclaimer

The material contained in this blog is for informational and educational purposes. Considerable efforts have been made to maintain the quality of the content.  However, it is recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discuss

Workplace Health- Keeping a workplace healthy is all about prevention

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Workplace health is all about prevention. When one person gets sick, it can have a domino effect.  Soon everyone has ‘that cold so and so gave me’.  So, prevention is now more important than ever because this is the first generation that will not live longer than its parents. With an aging population and an increase in chronic health problems like hypertension, diabetes, and obesity on the rise, employers need to act. We can’t help getting older, but we can make changes in our lifestyle and prevent many of these illnesses.

Leading causes of death are all preventable. The way things are going now, 44 per cent of the population will be living with diabetes or pre-diabetes by 2025. The cost of diabetes to the Canadian economy will increase 25 per cent in seven years. Obesity is a trigger for other diseases and is also becoming more prevalent.  It doesn’t matter what diet or fitness regime one follows, it’s adherence that will make a difference.  As a family physician and Vice-President of Medical Affairs at Medisys Corporate health that provides employee health and wellness services to individuals and companies, we have a three-step philosophy to tackle this health issues.

  • The first step is to assess – identify major concerns within the employee population and define key performance indicators (KPIs).
  • The second step is to monitor – a physician will interpret the results and then monitor employee’s health changes and progress over time. They will determine the key focus areas for employee health services to address the issues.
  • The final step is to improve – deliver measurable wellness outcomes and drive employee engagement and participation in wellness programming.

According to a report by the SHRM Foundation, “more than 75% of high-performing companies regularly measure health and wellness as a viable component of their overall risk management strategy.” A survey conducted by Towers Watson and the National Business Group on Health “found that 83% of companies have already revamped or expect to revamp their health care strategy within the next two years, up from 59% in 2009. This year, more employers (66%) plan to offer incentives for employees to complete a health risk appraisal, up from 61% in 2009.

And it’s working! The Public Health Agency of Canada reported that by implementing a physical activity program, Canada Life in Toronto improved productivity and reduced turnover and insurance costs while achieving a return on investment (ROI) of $6.85 per corporate dollar invested.

A win –win for everyone. A solid return on investment for the company and a healthier employee and individual.

Disclaimer
The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Spring Cleaning – it’s Time to De-clutter Your Life!

shutterstock_335890811 (1)Spring cleaning is a time-honoured tradition of doing a deep clean of one’s home or a room.

In modern times, it’s also used as a metaphor for a time to reflect on our lives and look for ways to simplify or invigorate our lives. I look at it as a time to review expectations of yourself and others around you over the past year and whether you have been conscientious about saying NO and YES to yourself!

What that means is learning to make time for yourself. Setting time aside for exercise or reading a book or just relaxing, rather than meeting the expectations of others.

I know, it’s not easy with so many demands on our time these days between family, work and other obligations. It’s easy to put yourself and your needs last on the list. But here’s a strategy to consider, a way to prioritize the demands. Learn to say no. That’s right, say no.

No, I cannot take on more work, no I cannot accept that task, no we as a family cannot do more.

Here are three easy steps to learn:

  1. Open your month
  2. Say NO, thank you. It doesn’t work for me. Sorry, No
  3. Close your mouth. DON’T say “I’ll try” or “Maybe”. It is a clear, though polite, NO

And when you say No to something, you are, in reality,  also saying yes.
Yes to your health, Yes to your family, Yes to your life, Yes to a different priority.
Enjoy the YES and you have empowered yourself by saying NO.

So yes, spring cleaning and to de-cluttering and learning to say NO and appreciating the YES

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

Are your immunizations up to date? Immunize Canada wants you to #getvax

shutterstock_164560082 (1).jpgImmunize Canada wants to make sure you #getvax and celebrate a healthy tomorrow.

100 years ago, infectious diseases were the leading causes of deaths worldwide.  In Canada, they now cause lets than 5% of all deaths, thanks in part to immunization programs across the country.

However, diseases don’t go away.  They are held at bay through rigorous vaccination programmes.  But suddenly in recent years, we have seen a resurgence of mumps across the country especially in certain age groups, born between 1970-1994. While this age group was immunized, they generally received only one vaccine against mumps, and we now know two are necessary. There are also individuals arriving from other nations where there are limited immunization programs, and they may be at risk.

Immunization week in Canada is April 22-29.  We have a lot to celebrate.   Our country was at the forefront of vaccine and drug discoveries when Connaught Laboratories at the University of Toronto, became one of the first to produce large-scale quantities of insulin in 1922 and continued to be a major supplier of insulin into the 1980’s.  Connaught continues to be active in vaccine production and research. When the Ebola outbreak resurfaced in West Africa between 2013 until 2017, Canada and the US partnered to develop a pioneering drug to fight the deadly disease which left 28,000 people dead and 11,000 more infected.

Arguably the most significant develop in public health over the past hundred years has been the development of vaccines.  While our vaccination rate is high, we can be doing a better job of reaching all at-risk groups including refugee immigrants, the mentally ill and those who are suspicious about vaccinations. All adults over the age of 65 are considered at risk as our immune system weakens with age.

New app helps keep track-CANImmunize

It is now easier to keep track, thanks to Immunize Canada and a new app, CANImmunize.  It helps you keep up to date with your vaccinations.  It also provides the ability to manage your families’ immunization records with the use of their smartphones or mobile devices. It also includes automatic reminders to schedule routine vaccinations and access to timely and trusted information about recommended vaccinations for children, adults, and travelers.  Available in the App Store for iPhones & iPads.

So this week and throughout the year, help yourself, your family and others stay healthy, by keeping up to date with your vaccinations and remember to #getvax

Disclaimer

The material contained in this blog is for informational and educational purposes only. Great effort has been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting a competent person such as your doctor, or health care provider.   As always, we encourage your comments on this blog or any others and hope you will join the discussions.