The longer I live in my body the more amazed I am at how connected my mind and body is.  So many women who are  bothered by hot flashes and even urge incontinence do not realize that they may actually have some control over some of their symptoms by training their minds.  There is good scientific evidence that this is so.  Practice the exercise below during a hot flash or with urgency to urinate.  Concentrate on relaxing your abdominal muscles.  Don’t give up if you don’t see results right away.  Like anything, it takes practice to achieve effective performance.  It is not hard but takes just a little persistence. Good luck.

Paced respiration

With regular paced respiration, women reportedly achieve a noticeable drop in the number of hot flashes they have, as well as a lower average skin temperature (used to measure hot flashes).

Paced respiration takes practice. Try to do paced respiration twice daily, for 15 minutes at a time. Also, when you first feel a hot flash coming on, stop what you are doing, find a quiet place, and practice paced respiration until you are feeling comfortable again.

• Sit in a comfortable, quiet place.
• As you breathe, keep your rib cage still. You will be lowering and raising your diaphragm to fill and empty your lungs.
• Inhale for 5 seconds, pushing your stomach muscles out.
• Exhale for 5 seconds, pulling your stomach muscles in and up.
• Repeat this cycle of breathing until you feel calm and relaxed or your time is up.

To reduce stress, you can also use paced respiration for 1 to 2 minutes in the middle of a busy day.

written by Deborah McBain, CNM MSN

It amuses me when I hear about studies trying to prove things that seem pretty obvious to me.  So when I read about a study led by Hilary A. Tindle, M.D. at the University of Pittsburgh which showed that women who were happy were healthier than those who weren’t, I just thought- Duh!    And then I thought that maybe being healthier makes you happier.  In any case, happy and healthy go together and and in case you need it there is scientific proof!

Women’s Health Initiative (WHI) followed 97,000 postmenopausal for more than 8 years and found that optimistic women had a lower rate of heart disease than those with higher levels of cynical hostility and mistrust.  In fact, cheerful women had a lower risk of dying from any cause.

This is not the first time optimism and better survival has been looked at.  A study published in the British Medical Journal last year found that optimistic women had a 25% less chance of breast cancer than pessimists.

Other studies have not found a link between optimism and survival rates but a positive outlook has been found to be linked to reduced pain and eased side effects of cancer treatments.

The whole mind-body connection has achieved much more attention in recent years.   Several books are available addressing the subject.  Leslee Kegan M.S., FNP from the Mind-Body Medical Institute at Harvard wrote a book and developed a whole program called Mind over Menopause.    Check out this link for her essay on the North American Menopause Society site-  http://www.menopause.org/positivepassage.aspx.   There are some great suggestions about getting into a positive frame of mind. 

 But if life is really getting you down and you are tending toward crotchity as you get older, what else can you do to put a smile on your face?   How about Laughter Yoga.  Just going to the web site and looking at the video will crack you up! Go to www.laughteryoga.org.

For the sake of your health find ways to cultivate your happiness.  As  Abraham Lincoln himself once said-” Most folks are about as happy as they make up their minds to be.”

written by Deborah McBain, CNM MSN \\ tags: mind-body medicine

Would you consider paying to allow someone to poke needles in your body?  No?  What if I told you that the result may be less hot flashes, better sleep, return of sex drive and more energy?  Got your attention?  Well,  then read on about acupuncture.

Acupuncture has been around for about 5,000 years.  Very thin “needles” are placed in key areas of the body called meridians to stimulate and balance the flow of energy through the body.  It has been used by an estimated 8.2 million U.S. adults.  Benefits have been published in peer-reviewed western medical literature and studies conducted by the National Institutes of Health

Acupuncture is often used in combination with Chinese herbal medicine and referred to as Traditional Chinese Medicine (TCM).  Increasingly TCM and other alternative health modalities such as mind/body therapy and massage is being combined with conventional ( allopathic) western medicine to achieve enhanced results.  Referred to as Integrative Medicine it is hoped, by practitioners in both camps, to bring the best of both worlds together.  TCM is being used for various women’s health issues such as menopausal symptoms,  cancer support, emotional health issues and chronic disease management.  All issues close to the hearts of many of us of a certain age.

In 2008 Henry Ford Health System oncologist, Dr. Eleanor Walker with the assistance of  acupuncturist, Beth Kohn conducted a study with 47 breast cancer patients.  These patients were all on tamoxifen or Arimidex to reduce cancer recurrence.   Hot flashes are a common side effect of these two drugs.  Half of the women received acupuncture treatment and half were given the antidepressant venlafaxine (Effexor).  Effexor has also been shown to reduce hot flashes.  At the end of 12 weeks both groups reported 50-75%  fewer hot flashes.  The acupuncture group reported no side effect and other improvements such as  improved sense of well being, more energy and higher sex drive.  The antidepressant group did not experience these benefits.

This is useful information to those of us who may be struggling with menopausal symptoms but do not want the side effects of hormone therapy or antidepressants.  Although most health insurance companies do not cover the cost of acupuncture, it is eligible for reimbursement from a health care  flexible spending account.  Many large health care organizations around the country have Integrative Medicine Centers were you can be assured of getting well trained, reliable practitioners.  If you are interested in more information and live in  southeastern Michigan, contact Henry Ford Center for Integrative Medicine  at 248-380-6201.  Tell them you are “poking around” for some answers.

written by Deborah McBain, CNM MSN

Much confusion exists among consumers about the term “bioidentical hormones”.  Strictly used this term simply means hormones which are identical to those produced by the body.  As a marketing term it often refers to custom-compounded hormones.  These are drugs made by a compounding pharmacist from a individualized prescription.  What is the truth about bioidenticals?  Are they better or safer?  This is what you should know.

1.  Many well-tested brand name products containing bioidentical hormones are approved and available commercially.  Cost for these approved products are often covered by prescription insurance plans.

2. All hormonal drugs contain filler ingredients to hold drugs together such as for pellets suppositories or tablets or provide a vehicle to administer such as gel, cream or liquid.  Custom-compounded hormones can vary greatly and are not tested for batch standardization, purity, safety or efficacy.  Commercially approved formulations have been tested and  are subject to regulation.

3.  FDA investigations have found some compounding pharmacies have made false and misleading claims about the safety and effectiveness of individually compounded hormones.

4.  Salivary or hair testing used to adjust custom hormone levels is not justified on any scientific basis.  This may be recommended by practitioners who advocate custom-compounding.  Beware of this because these same practitioners may profit monetarily from selling the services and products they are advocating.  Many health care systems have worked very hard to eliminate the influence of drug companies on the practitioners who prescribe the drugs.  You want drugs prescribed for your benefit, not for the benefit of the practitioner.

5.   There is no evidence that bioidentical hormones or custom-compounded drugs are safer or work better than other hormones or commercial drugs.   It is presumed they carry at least the same risks as any other hormones.  Custom-compounding has the advantage of offering doses, ingredients or routes of administration not available commercially but carries the risk of being untested and at greater cost to the consumer.  Be smart about where you get your information,  who is writing your prescriptions and mixing your drugs and who is apt to benefit the most.

written by Deborah McBain, CNM MSN

Among the myriad of perimenopausal and menopausal symptoms, hot flashes seem to be among the most troublesome.  This post will address this burning issue (burning, get it?).  Ahem, yes, well what causes hot flashes?

What causes hot flashes is a question that even the experts continue to debate!  Although why hot flashes occur is not fully understood, it is generally agreed it is related to decreasing estrogen in the body.  There are hot flashes and then there are HOT FLASHES.  Some women have just a few and can live with them and some have frequent and severe flashes and are totally incapacitated by them.  Some women may not experience hot flashes at all.   Many women learn to recognize certain things which trigger hot flashes or make them more severe and frequent.  Stress, alcohol, spicy foods, hot foods, warm temperatures are common triggers to hot flashes.  Some medications or cancer treatments may cause hot flashes or make them worse.  Hot flashes may start years before the actual menopause (remember, that is 12 months after the last menstrual period)  and some women may continue having hot flashes ad infinitum!  Experts estimate an average of 6 years of hot flashes. (But I know someone who shall remain nameless who is going on 10 years)

Many women may be able to lessen hot flashes by avoiding triggers mentioned above.  Dressing in layers and keeping homes cooler is a common sense solution.  Slow, controlled deep rhythmic breathing, known as paced respiration, practiced twice a day can decrease hot flashes. Take a slow, deep breath, hold it for a few seconds, and exhale just as slowly. Paced respiration may also help relieve a hot flash when started as the hot flash begins.  Herbs have not been shown in studies to be particularly helpful and may have side effects.  Herbal supplements are not well regulated and some brands may not have very much of the herb in them at all.  Although Black Cohosh has been shown to help some women with hot flashes, long term effects are not known.  It has been associated with irregular uterine bleeding and is not recommended to be used longer than 6 months.

For those women whose hot flashes are disrupting their ability to function, estrogen therapy may be a saving grace.  HT has gotten a bad rap since the Women’s Health Intitiative (WHI) stopped a study of  women on estrogen and progestin therapy (EPT) in 2001 after they had a larger than expected number of cardiovascular complications.  The women in the study who had a history of hysterectomy and were on estrogen therapy (ET) alone, without progestin did not experience these side effects.  Women with a uterus and taking estrogen need progestin to prevent cancer from forming in the lining of the uterus.  Since that time there has been a better understanding about how EPT effects heart and blood vessels in women in different age groups.  There is evidence that women starting EPT in perimenopause or within 5-10 years of reaching menopause do not have the same risks on EPT as women starting at an older age.  It also appears that it is the progestin in combination with the estrogen which may contribute to a slight increase in breast cancer, but only after 5 years of use.  Clinicians and researchers are looking at different ways to give progestin to minimize this risk.  HT is considered by menopause experts to be reasonably safe for many women and can dramatically improve quality of life for those who suffer severe symptoms.  Some women are not good candidates for HT because of health conditions such as a history of blood clots, heart disease or breast cancer.  For those women, relief can sometimes be found in non-hormonal medications such as clonidine, gabipentin or effexor.  Beware of individually compounded bioidentical hormones.  There is no evidence that these are safer or more effective than FDA approved products.

written by Deborah McBain, CNM MSN