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.

Get Cooking to Manage Your Weight

If you are like many busy modern women, you probably have the local pizza place on your speed dial. But delivery pizza—or even frozen pizza—is high in fat and sodium and often lacks fibre. You can make a healthier, portion-controlled version quickly and easily. I call it the Pita Pizza. Use a 6-inch whole-grain pita as your crust, add a low-sodium pizza sauce, lightly sprinkle on some low-fat mozzarella, and top it with your favourite veggies. Pop it in the oven or toaster until the cheese melts, and you’re done—in way less time than it takes for a delivery! And you can save even more time by buying pre-cut, washed veggies. You can control the portion by eating only one, and you can control the fat by limiting the amount of cheese and using more veggies.

This is just one example of how you can make healthier versions of your favourite take-out or restaurant choices at home. If you are looking for resources on healthy meal planning, you might consider cookbooks by Lucy Waverman, Bonnie Stern, and Rose Reisman.

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.

 

Alcohol Consumption-How much is OK?

How Much Alcohol Consumption is OK?

The reality for alcohol consumption and women is significant. Any more than 7-9 drinks per week for women can lead to breast cancer. I am not an abolitionist.  I do advocate drinking moderately. There is some evidence that moderate drinkers and those who drink just a little have a somewhat lower risk of heart disease and stroke than those that do not drink at all or who drink excessively.  And some of the newer data is looking at whether any amount is a risk.

Here is my take on the current guidelines.

So, what exactly is moderate drinking?

The Heart and Stroke Foundation defines moderate drinking for women as two drinks a day most days to a weekly maximum of ten; for men, its three drinks a day to a weekly maximum of 15.I have to smile when some of my patients try to demonstrate that they drink only moderately by saying they and their husband split a bottle of wine at dinner every evening. I smile only because few people really understand the word ‘moderate’ as it applies to alcohol.Half a bottle of wine is not quite within the bounds of ‘moderate.’ It’s actually two and a half glasses of wine, not two glasses!

The extra half glass of wine can add up.  In fact, it might be wise to limit your consumption of alcohol to considerably below the weekly maximum of 10 drinks.

As I said, I am not an abolitionist, but I will ask you to be careful with your alcohol consumption. Review what you are actually doing when you drink, tally how much you drink in a week—including the weekend bar-b-que and girls’ night out-and please make sure that your glass is not keg-sized. A serving of wine, for example is considered to be 4 ounces, not 6 or 9!

I know for me, I would rather have one or two servings when out for dinner, and that’s OK, as I generally am out for dinner once or twice a week, not nightly. So as we approach the holidays and parties, plan ahead, consider having a spritzer with only 2 ounces of wine, or having most nights with none, so you can have 2drinks at that party and enjoy.

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.

Mumps are making a comeback in Canada

shutterstock_337150673Check your vaccinations!
A rise in cases of Mumps in Canada has public health officials asking young adults to check if they need a vaccination booster. The standard vaccination is two doses starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults also should also be up to date on their MMR vaccination. *(measles, mumps & rubella)

Mumps is a viral infection that is contagious and spread through saliva and respiratory droplets, causing swelling of the salivary glands. **   Prior to having a vaccination against mumps available in the mid-sixties in Canada, mumps among school-age children was common in fact a rite of passage.   In early 1970’s the vaccine was combined to offer protection against measles, mumps. and rubella. (MMR).

But providing a second round of the vaccine wasn’t practiced until the 1990’s, which has led to a small gap in immunity for those born between 1970 and 1994.

The gap in immunity for those that have not had a second dose is one of the reasons, health officials believe there is a rise in the infection.  The other is because of growing numbers of individuals who have never been vaccinated for mumps and are infectious while coming into contact where are a lot of people sharing food and drinks. It takes between two to five days before the infection begins to show swelling and other symptoms. Once mumps has been diagnosed, the usual procedure is to keep the individual in isolation until the infection subsides.

The symptoms of mumps include fever, headache, fatigue, loss of appetite and inflammation and tenderness of one or both salivary glands

Mumps is serious and can have long term affects such as deafness, or sterility in males.

So, it is extremely important that you check your vaccination records with your family physician to ensure they are up to date.

______________

Mumps are making a comeback in Canada.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.

 

Sources:  * Center for Disease Control  ** Wikipedia -Mumps

New Guidelines for Zika Virus & Travel

Zika Florida inforgraphic 1200x628Canada’s Public Health Agency issued a travel health notice recommending that pregnant women avoid traveling to countries or areas where the mosquito-borne Zika virus has been found which includes popular destinations for Canadians, including Cuba, Mexico, the Bahamas, and Jamaica.

http://https://www.facebook.com/CTVNewsChannel/videos/1325413534186641/

My New Year’s Resolution– Is NO New Year’s Resolutions!

ChrisKornackiI will be honest; my issue is not wanting to exercise or take the time to work out. I have a very busy schedule and find it hard to fit in.   Although I know and talk about the importance of exercise and healthy aging, internally I find it hard to schedule.  I tell myself that’s because of work. However, enough is enough. I need to make this a priority.

So before the holidays,  I decided to make a commitment, set a reasonable goal and act on it.  For me, creating the challenge and then living up to it is always satisfying and I feel energized by the effort. This led to rearranging my work schedule, book with a trainer and just do it!  No more excuses.So my journey has begun.  I am meeting weekly with Chris, a young, bright,

So my journey has begun.  I am meeting weekly with Chris (pictured above), a young, bright, well-educated trainer in charge of TOTUM, the fitness facility in the Medisys location where I work on Thursdays.  I, therefore, changed from business attire to workout clothes and walked into a beautiful new facility for my assessment. Intimidating? YES. Important? YES. Part of my routine, well, I am trying to keep that focus and have booked a month of appointments, even pre-paying for them so I am less likely to cancel.

How am I doing? So far, less intimidated and starting to feel more positive. Not yet stronger or healthier, but it is early. I will let you know how it goes.

So, whether your goal is healthy eating, exercise or getting more sleep, don’t make a New Year’s resolution. Instead, dig deep within yourself for the answers and take responsibility. Be honest with yourself and you may just find the best resolution of all.

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.