HOPE - For Menopausal Goddesses and Everyone Else

I never thought I’d live to see the day......

My grandmother’s favorite phrase was always accompanied by a huge sigh that rattled her slight frame., usually over something that disappointed her greatly. Usually over one of us. To me, it epitomized what “old” was about. It was continually being disappointed in life. It was cynicism, and the lack of a sense of wonder. I could elaborate on the dangers of “thinking old”, but will save that for a future blog - its too important to gloss over.

I’m echoing Grandma’s one line credo myself these last few days, not sighing but weeping - tears of joy. Regardless of your political persuasion, whether you’re a Boomer, Gen - Xer or Millennial, it’s difficult not to be moved by this history making election. Yes, I worked my arse off on Obama’s campaign helping to turn Nevada not just blue but indigo. (oops, my arse is still there - how’d that happen? Oh yeah, menopause.) Door to door, person to person, American to American.

How did we get here? A single perfect word: HOPE. Hope ignites, hope inspires, hope infuses us with the energy to do the hard work ahead of us. It’s time to shed old labels: Democrat, Republican, liberal, conservative, and just remember that we are all citizens - of America and of the world. President - elect Obama will challenge us to sacrifice and contribute, to truly manifest government of the people, by the people, and for the people. Hope will provide the fuel and we’ll provide the labor.

I never thought I’d live to see the day - and I’m so grateful that I did!

Support Access to Bioidentical Hormones: Join Us In National Call Congress Day on Wednesday, September 10.

Okay, menopausal goddesses, here’s a call to action from our friends at the nonprofit Women in Balance - www.womeninbalance.org. Their email is as follows:

“The estriol battle continues and we need your support.
Here's how you can help:
If you know who your Representatives and Senators are,
Dial 1-202-225-3121 and the receptionist will direct you to your Congressional Offical's office.

If you are unsure of your Representatives or Senators, you can find out who they are by entering your zip code at Congress.org Home Page
Once on the call, you may share the following points:

1. Encourage your official to support Resolution Senate Concurrent Resolution 88 or House of Representatives Concurrent Resolution 342
2. This resolution calls upon the FDA to stop their new policy of restricting women's access to prescriptions containing Estriol. This drug has been available in the United States for half a century and is chemically the same as natural estriol made in a woman's body
3. Protect women's access and preserve the choices women have for hormone therapy. Allow the continued availability of compounded bio-identical hormones like estriol that women need for quality of life.
4. Request that congress support this resolution and restore the rights of physicians and health choices of millions of American women.
5. Don't forget to add your personal experience.

Here's the background

In 2005, Wyeth Pharmaceuticals issued a Citizen's Petition to FDA urging them to stop compounding pharmacies from preparing bioidentical hormone replacement therapies (BHRT). In early 2008, FDA finally responded to the Wyeth petition about compounded hormone medicines with a set of new policies. Most critically, FDA announced that it will "halt" compounding of hormone treatments that contain estriol.

What is estriol?

Estriol is a common component of many compounded hormone treatments prescribed by doctors. Estriol is one of three estrogen hormones produced by a woman's body, and has been used in Europe and Asia for decades.

What are the Congressional resolutions calling on FDA to reverse its policy on estriol?

The U.S. House of Representatives and the U.S. Senate each have resolutions-H. Con. Res. 342 and S. Con Res. 88, respectively-calling for FDA to reverse its policy on estriol. The resolutions also call on the need for FDA to "respect the physician-patient relationship" and recognize that doctors, not FDA, are in the best position to "determine which medications are appropriate for their patients." They also point out that "FDA has acknowledged that it is unaware of any adverse events" associated with the use of estriol over the past three decades.

These Congressional resolutions are a key tactic to send FDA a message that its estriol policy is not in the best interest of women's health. However, not all Senators and Representatives are aware of FDA's new policy and the effect it will have on women's health. On Wednesday, Sept. 10, the BHRT National Congressional Call-In Day will flood Capitol Hill with phone calls from concerned constituents who will urge their elected members of Congress to sign on to their respective Congressional resolution. We appreciate your support on this important women's health issue.”

Join the Venuses along with hundreds of concerned women and physicians this week. Make your voices heard on Wednesday, Sept. 10. For more background on this issue, see previous blog entries on our mothership blog at www.menopausegoddessblog.org “Help Protect Access To Bioidentical Hormones” dated June 14, 2008 and “Bioidentical Hormone Access Threatened - Act Now” dated Feb. 7, 2008. The stakes are high - the time is now.

Menopause - New Growth or Going to Seed

I’ve been spending the last several days photographing and looking at flowers. In all stages. Buds, opening blooms, full-on vibrant blossoms, fading flowers. All different. All beautiful.

Since the advent of the Big M, I’ve suffered some confusion as to whether we goddesses are blossoming anew or beginning to wilt. Certainly, for me, the answer depends on the day. Or the hour. I sometimes feel like I’m the subject of one of those time lapse films where the flower goes from closed to open. Then in a diabolical turn, the film reverses and I go from open to closed. Closed, open. Open, closed. I don’t know if I’m blossoming or going to seed.

But what if it isn’t one or the other? What if it’s both? It seems that the nature of the menopause transition makes us more comfortable living with paradox. It sure makes us more comfortable dealing with change! Each of us may be growing and blooming into a new form, a new “me”. At the same time we have seeds of wisdom that we disseminate to ourselves and one another. Like the rosebushes in the garden, we are budding, bursting forth into the sunlight, flashing our brightest colors and dropping a few petals here and there. All at the same time. All different. All beautiful.

Who Are The Menopause Experts? Menopausal Women!

I had my mammogram the other day. And since the x-ray technician performing my exam was a menopausal goddess, we struck up an instant rapport. Upon finding out about the Venus group, she asked me to distill what we’d learned together - sort of a 25 words or less synopsis because other mammos were waiting to be grammed. I summed it up this way. “Every woman is different and has to conduct her own risk benefit analysis to decide what is best for her. And the way we get wisdom is through woman-to-woman sharing.”

After agreeing wholeheartedly, she shared that two of the gynecologists at the big medical center in our nearest city offer no other recommendations for women suffering menopause symptoms than HRT (Hormone Replacement Therapy.) “And they are young! In their 30’s still.” Proving what I’ve always suspected: that hardening of the attitudes is not an age-related phenomenon.

Although menopause is not a disease, it is still important to be followed by a physician. Notice that I say “followed” by a physician. It’s all too easy to find ourselves being be “led” by our health care providers. You and your primary care provider must work together. If you cannot form a partnership with your doctor, then find another who will work with you. I cannot emphasize this strongly enough. You are responsible for your own healthcare. Educate yourself.

My professional training in nursing school covered the area of women’s health as the “Reproductive” module. We learned a great deal about fertility, the birth process, and diseases of the reproductive system. We learned almost nothing about menopause. 1200 pages of textbook and virtually none of it dedicated to the second half of a woman’s life.

Even today many health care practitioners have learned little more, or they have only learned some standard practices that may exclude some of your choices. In all fairness, so little research exists on The Big M that it’s no wonder there is a dearth of expertise among health care personnel.

We must become our own experts in the areas of women’s health and menopause, and more specifically on our own individual bodies. Thankfully, there are a great many menopausal goddesses out there willing to share all they’ve learned and to offer support and laughter as we travel this journey we didn’t choose.

Hormone Replacement Therapy (HRT) - The HeaRT of the Matter

I was getting my hair done a couple years ago at my favorite salon, along with five other women 'of an age', when talk turned to the Change. Most of us were loudly proclaiming our favorite natural remedies and fixes. The woman in the chair adjacent to mine finally spoke up apologizing to the roomful of menopausal goddesses for having “caved”, finally starting HRT (Hormone Replacement Therapy)..

“It's just that I couldn't sleep,” she told us shamefacedly. “I couldn't sleep at all. I was so tired I couldn’t function. And nothing else worked.” We all leapt in to assure her that there was no need to feel guilty. The risk-benefit ratio seemed pretty clear to all of us. Underscored for us was that we women need to support one another through this process rather than judge anyone, including ourselves.

But I have to admit that I was feeling pretty smug and blessed that I was coping without HRT. My symptoms were manageable. What’s that thing they say goeth before a fall? Oh yeah, pride. I no longer have a surplus of that. I eventually ended up on low dose HRT myself. And honestly, I wish I’d taken it sooner.

First welcomed as a godsend, now seen as a terrifying, politically incorrect alternative for menopause symptom relief, HRT may actually be neither. In deciding whether we wish to consider HRT as a viable option, we really need to evaluate our personal risk-benefit analysis. In other words we need to list pros and cons, and then weigh those pros and cons in order of importance.

History of breast or other reproductive cancers in your family would cause you to rate your risk higher. Family history of blood clots, stroke, or heart disease also put you at higher risk. If you have or have had any of these conditions yourself, the risk may be too high and you'll want to look elsewhere for help. And if you are a smoker? HRT is not a great idea for you; your risk of heart attack, stroke and other cardiovascular disease spikes.

On the benefit side, if your hot flashes are 30+ per day, so intense that you are nauseous, or your sleep deprivation from insomnia is making you psychotic, then HRT may be a valuable help in the short term. More risk is associated for all women with long term usage of HRT, so taking it to “get over the hump” may be an option. Above all, do not feel guilty if you decide that the herbal, natural route didn't work for you and you need to avail yourself of HRT. Our own Beej-Venus tried herbs and immediately stopped using them because they “gave me a rush”.

If you should decide to consider HRT as an alternative, be sure to stay aware and re-evaluate periodically whether you might be ready to slowly decrease and ultimately discontinue your hormones. Above all, be gentle with yourself and choose what’s right for you. (Next blog entry, we’ll examine briefly both bioidentical and synthetic hormones. Material partially adapted from our upcoming book -to be released very soon. We’ll keep you posted. For the latest, visit our mothership blog at menopausegoddessblog.org)

Soy For Menopause Symptoms: Oh Soy! or Soy Vey!

For just about a year, my hot flashes, insomnia, and mood alterations were down to a dull roar thanks to my natural progesterone cream. And then I started down the next dip on the Menopause roller coaster.

Early in perimenopause, progesterone levels drop. Later in the transition, estrogen levels decrease as well, causing a resurgence of hot flashes, mood swings, insomnia, vaginal dryness, and more. The progesterone cream that worked initially is no longer enough. We may feel the need for estrogen supplementation. I surely did. Following the rules and guidelines for remedies, I wished to start with the least heavy duty, most “natural” remedy first. Enter natural remedy #1: soy.

Natural Soy - The Good News
I decided to do a little research - here’s what I found. Soy has been touted as a healthy food alternative to almost everything: meat (tempeh, tofu), milk (soy milk), cheese (yep, soy cheese), appetizers (edamame soybeans), snacks (soy crackers and chips.) and so on. Soy is also a phytoestrogen or plant estrogen precursor. Ergo, if you want to have “natural” symptom relief from your hot flashes, insomnia, and the like - eat soy. Still have symptoms? Eat more soy. Don’t like the taste or texture of bean curd? You can ingest soy in the form of pills or capsules. A number of popular products can be found in the health food aisle of your grocery store, such as Estroven. For many women, soy has made the transition much milder.

Needless to say, this sounded like THE ANSWER. (However, in my excitement, I forgot the all important rule that “There Is No Silver Bullet” or single panacea for the menopause maladies.) I started taking a natural soy remedy and switched to soy milk.

And I got worse. My hot flashes increased. I couldn’t sleep. I was REALLY cranky. Add to this bloating, stomach aches, and nasal congestion and you have the makings of a Menopausal Monster. I decided a little MORE research was in order. And here’s what I found:

Soy Vey - The Bad News
While soy is a healthy choice for many people, it makes the list of the top 8 food allergens, along with milk, eggs, peanuts, tree nuts, fish, shellfish, and wheat. (source: Mayo Clinic.com) The FDA now requires that all food be labeled if it contains any of these.

Although it is estimated that only 1% of the population has true allergies to these foods, a large number of the population may be intolerant or sensitive to them. What “intolerance” means is that they can ingest small amounts of these substances with no ill effects, but with larger doses symptoms appear. (Those who have true allergies cannot tolerate even a tiny amount of the reactive food without a serious allergic reaction: difficulty breathing, hives, swelling of face, neck, tongue, or shock).

In a nutshell, many of us are unknowingly sensitive to soy. When we increase our intake of soy, we may develop symptoms consistent with food intolerance such as cramping, diarrhea, bloating, dizziness, nasal congestion, and flushing. If we are soy-sensitive, we may actually find our hot flashes and other Change symptoms increasing, as we stress our body beyond the already overwhelming stressors of menopause. Luckily, those of us with soy intolerance have the option of soy-free herbal preparations that contain phytoestrogens, which we’ll touch on in the next blog.

For those who are not allergic or sensitive to soy, ingesting tofu, soy milk, and soybeans might be a godsend. Beware, however, of taking too many soy pills which contain high levels of soy isoflavones. More is not better. There is concern about interference with thyroid function (which translates to even more symptoms for a menopausal goddess). Monitor yourself and your response along with your trusted health practitioner. (See April 3 and March 28 blog entries for guidelines in “Choosing The Right Menopause Remedy for You.”)

So what happened? I stopped the soy. And while my menopause symptoms continued unabated, they decreased slightly while the bloating, stuffy head, and abdominal pains disappeared. (My MD tested me for food intolerances - the only one I was sensitive to was indeed soy.) I tried various other remedies: black cohosh, dong quai, primrose oil. None of them seemed to have any effect (except some flushing and heat sensations with the dong quai.) Yet, I knew women where each of these remedies had worked like magic.

What next? My estrogen levels were subterranean. My thermostat was in the nuclear zone. How was I going to cool off literally and emotionally? The saga continues in the next blog entry where we’ll discuss [ominous drum roll please] HRT, also known as Hormone Replacement Therapy.
(material adapted from our upcoming book “Venus Comes of Age”)

Natural Symptom Relief for Menopause

Early in perimenopause, I was complaining to Lei-Venus that I was feeling heat crest in waves over me, but even more upsetting to me was the change in my sleep patterns. Having always slept soundly, I was now waking every hour or two and experiencing nights of restless, broken sleep. Without a word, Lei grabbed me by the hand and pulled me bodily down the street to the health food store. She plunked a jar of Natural Woman progesterone cream in my hand, declaring “Buy this now - it may take up to two weeks to help, but you’ll be a new woman.” I felt the difference in two days. After a week, I was sleeping through the night again.

In the beginning of perimenopause, progesterone levels drop which can begin the annoying symptoms of hot flashes, insomnia, and mood swings. Natural progesterone cream is a good first step and may be all you need to weather the storm of symptoms. I can report that it was a godsend for some of us goddesses during this transition - and, sad to say, didn’t work much for others. Remember rule # 2 from March 28 blog entry on “Choosing The Right Menopause Remedy For You”? What Works for One Venus May Not Work For Another. You’ll have to try it and monitor your own response to see if it helps you.

Emerita’s Pro-Gest (www.emerita.com), and Natural Woman (www.prodnature.com) are the Venus group’s favorite natural progesterone creams but there are others on the market. A cautionary note: Mexican wild yam cream is not as effective as natural progesterone cream, as it is a precursor to the hormone and not in a usable form for our bodies.

Dong Quai, Burdock Root, Red Clover, Black Cohosh, Evening Primrose Oil, Cod Liver Oil
Studies show that women in Japan and China have much lower incidence of PMS or menopausal symptoms than do Americans. This could be due to DNA, but also could result from the facts that the usual Japanese diet is high in soy and dong quai is taken by many Chinese women from the time they are young.

Black cohosh, primrose oil, red clover, and burdock root are also time-honored remedies for menopausal symptoms. Blog reader Jacqueline has alerted us to cod liver oil as a remedy (Many thanks, J!) She recommends lemon flavor to overcome those nasty childhood memories of fish oil.

However, side effects do exist for these remedies and some women cannot tolerate these herbs. Natural does not necessarily mean completely harmless. Black cohosh and dong quai have been associated with high blood pressure in some women. Cod liver oil has been known to raise blood sugar and cholesterol, although it appears to be a dose dependant effect. It is also very important to assess whether there might be potential interactions with other medications that you are taking, before you take ANY supplements.

There are plenty of products that contain more than one of these herbs, however many also contain soy so read the labels if you are soy sensitive. (We”ll focus on soy next blog entry, since that’s a longer story.) Emerita makes a popular multiherbal supplement that contains no soy called “Menopause Plus Formula” (www. emerita.com). Remifemin is a popular black cohosh remedy. (www.remifemin.com) Both are sold in health food stores and many grocery stores as well.

Whatever remedies you choose, go slowly. Try one at a time and allow it sufficient time to work. Run all your choices by your trusted health care partner. Good luck and happy herbals to all goddesses in search of cooler days, restful nights, and emotional balance!