Posts Tagged ‘menopause’

The Estrogen Conversation

Monday, June 21st, 2010 by Ilene Rosenthal, Marketing

OK, gal pals.

You know,  I’m not a doctor.  So this is not a recommendation.  But I am in a tizzy over the recent article from the NY Times Magazine on April 18, 2010  on estrogen replacement in perimenopausal or early menopausal women. The article is called The Estrogen Dilemma, written by Cynthia Gorley.  

 The article is balanced and intelligent.  It details the research errors in the W.H.I study of the early 90′s that damned hormone replacement therapy [the misinformation surrounds the age of the women in the study (10+ years beyond menopause), the kind of therapy (the pregnant horse urine-derived hormone), and how conclusions about stroke and cardiac problems were surmised].

I don’t know about you, but I’m wrestling with this strange phase and wondering about how to manage it.  And there I was, in the voices of the scientists and the reporter in this article.  It is balanced, yes, and delineates all the uncertainties in any hormonal regimen.  But make no mistake:  when the author talks about Alzheimers, my phone is dialing my gynecologist asap.

Here’s a blip from the article.  The author is referring to her conversation with a woman, a scientist studying the brain at USC:

 ”We were sitting in a campus garage in her Prius one day, and I asked her what made her so sure her own midlife difficulties — she had the hot flashes, which were obvious, but also the sleep disruption and the infuriating distractibility — were the product of hormonal events, not some womanly existential crisis. We get a lot of that, societally. It’s meant to be empathetic. Your role in life is changing, Mrs. Brain Seized by Aliens! Your children are growing up, you’re buying expensive wrinkle cream, ice cream makes you gain weight now, of course you’re distraught! “Because with estrogen — ” Brinton looked at me sharply, and then smiled — “I don’t have attention-deficit disorder.”  ”

Read on, girlfriends.  Let me know your thoughts.

 http://www.nytimes.com/2010/04/18/magazine/18estrogen-t.html

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Sex and the City sparks interesting commentary – if nothing else – among reviewers

Thursday, June 10th, 2010 by Ilene Rosenthal, Marketing

OK, so by now you’ve all read the reviews of SATC2 and, sadly, it has become the punching bag of movie critics around the world.

But this piece from www.womenandhollywood.com is facinating in its review of, well, the reviewers.  Melissa Silverstein writes that the movie’s shortcomings have served as a conduit  for a “pent up torrent of misogyny against women” and has provided avenues for excessive ‘meanness’ that is, frankly, undeserved, regardless of  how bad the movie may be.

Silverstein makes her point, of course, by comparing the SATC2 commentary to Polanski’s escapades and the postively regarded movie, The Hangover.

It’s hard to ignore the claim in this article that the opportunity to unleash a venomous attack on aging women was too tempting to ignore.  Rather than read more bad reviews, take a minute to consider this perspective on women, the movies and critics of both.

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Women’s Sexuality Changes Through Life.

Friday, March 5th, 2010 by Bat Sheva Marcus LMSW MPH PhD

Don’t we know it?

What you loved when you were 18 might be totally different than what gets you going at 30 and may be completely different than what turns you on at 45.  Different life experience make us appreciate new things, new images may become imbedded in our brains, we may become more experimental or more conservative.  That’s life.

But what we don’t always take into account is how the physical changes in our body may also change as we age. I just saw one of our long-time patients here yesterday. She’s a wonderful woman who came to us about 4 years ago, distraught. She was depressed, her relationship was on the rocks and her sex life non-existent. Over the course of six-to-eight months, we worked with her, carefully addressed the obstacles in her sex life,  and her life gradually turned around. No longer depressed, with a renewed satisfying sex life, her relationship was back on track and she was one happy woman.  She stayed on the same regimen for about 4 years and things were fine.

Yesterday she came for one of her twice-a-year follow up visits. Things weren’t so great. She is going through menopause and it’s hitting her pretty hard. She’s having a harder time reaching orgasm. Her desire seems to be sliding a bit. I was so happy she was here; before things got really bad we could intervene. Together we worked out a new plan and over the course of the next few months we’ll keep working with her until things feel right again.

The take home message is this:  in order for us to address our needs as we change, first, we need to acknowledge and accept that we change. Our bodies, our minds, our relationships: nothing is static. In fact, change is what keeps things spiced up, interesting, moving forward.  We wouldn’t really want them to remain static, would we?

But sometimes we have a hard time internalizing the fact that what works for us right now won’t work for us forever. And it’s hard for us to identify the times we need to take stock and re-assess what we’re doing and what might work better. The important message is this:  Keep an eye on your needs. If they’re not being met, perhaps there are changes in your mind or body or lifestyle that have also altered what makes you happy, sexy, satisfied.  The more we accept this our dynamic lives, the faster we can find healthy, productive solutions to the challenges we face.

Embrace change. It may even be fun.

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And the Survey Says……Sex!

Friday, October 2nd, 2009 by Ilene Rosenthal, Marketing

Why is it that we need a survey to prove that women are interested in sex?  And when we get the data, why is everyone so surprised at the results??

 A new online survey asked 500 women aged 35 to 49 about their interest in sex, and whaddaya know, 76% of women are “interested in maintaining a healthy sex life” and about 50% declare they “initiate sex with their partner.”

 Among respondants, 35% say sex improves with age and experience, and half of the women surveyed said that they have sex once a week or more.

 It’s not entirely surprising that this study is getting press.  The ‘middle aged’ woman who’s the CEO of a fragmented and unpredictable corporation called her family may be perceived as too busy, exhausted, or just generally distracted to be interested in intimacy.

There’s no arguing: the business of feeding, clothing and educating her children while cooking, cleaning and holding down a job is unimaginable sometimes.  But we also know from the women who come to the Center that a robust sex life can be an antidote to all that work; it can help let a little air out of the balloon of our full life and, like a sigh, allow us to enjoy ourselves, and the partners we love.

 In fact, the longer we are with our partners, the more comfortable we may feel, and the more we may be ok with asking for some sexual attention when we need it.

 Of course, we see many women who are not part of the 50% that have sex once a week, and who do not initiate sex, either because they don’t feel the desire, or because it hurts to have sex.  Well, that’s our work.  Data like this is an inspiration, even if it’s not a surprise.

 The survey was sponsored by Teva Women’s Health, the manufacturer of the ParaGard Intrauterine Copper Contraceptive.

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Bioidentical Hormones

Tuesday, September 29th, 2009 by Bat Sheva Marcus LMSW MPH PhD

There is so much confusion and misinformation when it comes to “bioidentical hormones.” Let me see if I can set the record straight.

• “Bioidentical hormones” does not mean that the hormones are “organic.”
• “Bioidentical hormones” does not mean that the hormones are “natural.”
• “Bioidentical hormones” does not mean that the hormones are “not really hormones.”

“Bioidentical hormones” means that the chemical makeup of the hormones exactly matches the chemical makeup in the same hormones in your body. It can be man-made but the molecular components are exactly the same as that same hormone in your body. For example, if you look at bioidentical estrogen under a microscope it would look exactly the same as the estrogen your body makes. It could have been created all chemically, in a laboratory, but the components of the compound match your body.

“Hmmmm…” you ask, why would anyone make non-bioidentical hormones to replace those in your body. Well, for one thing bioidentical hormones can’t be patented. The same way you can’t patent water, unless you add some flavorings to it, you can’t patent estrogen unless there is something different about your estrogen. So drug companies are incented to change the chemical compound. Sometimes makers of specific hormones suggest that the difference they have made is a “good” difference and thus justify the changes. We haven’t found that to be the case. In general we find that women seem to respond better to bioidentical hormones.

But don’t worry about the drug companies. Now that many realize that women prefer the bioidentical compounds they have found ways to patent their product by developing better or unique delivery systems: a specific cream to hold the compound, a patch, a pellet.

So, if a practitioner wants to prescribe a hormone, you can ask if it’s bioidentical…and now you’ll even know what that means.

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to use hormones or not to use hormones…

Wednesday, May 20th, 2009 by Bat Sheva Marcus LMSW MPH PhD

I get asked this all the time by perimenopausal and post menopausal women. And my answer always is… “It depends.” Once upon a time women used to have to suffer with hot flushes, memory loss, loss of libido and sleep disturbances. Then along came the hormone therapy like a white knight on a horse and made everyone better. Or so we thought. And the doctors were giving out hormone therapy like M&M’s. The some rumors started that the white knight was actually an axe murder and everyone went running the opposite direction screaming… and the results? Many, many miserable women who couldn’t sleep, didn’t want sex, argued all the time with everyone, soaked their clothes at inopportune moments and were overall not happy campers.

So what’s the real answer? Like everything else: moderation! If you need hormone therapy, use it. It will make your life better. But use as little as you need and don’t assume you will need it forever. After a few years your body may adjust and you may do fine without it. But please don’t suffer!

The white knight turned out not to be a knight or an axe murderer. He’s just the guy next door who, like most of us, have their good points and bad points!!

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