I saw this video about heart attacks in women on YouTube.
Here is another great video to showcase heart attacks in women. Check it out. It could save your life. For more information on medical emergencies, read Save Your Life, What to do in a Medical Emergency and learn what is a medical emergency, when to call 911 and what to do after you call.
It’s bad enough that every cigarette you smoke shaves about 7 minutes from your life. But now comes another review in the February 2012 issue of Menopause that shows smoking lowers the age of natural menopause.
First the background. Natural menopause, the kind that happens from normal aging and not from surgery or chemotherapy, happens on average at age 51 in the United States. Subtle changes start up to a decade sooner, but things pick up about age 47 and those symptoms last for about 4 years. I’m talking about hot flashes, problems sleeping, vaginal dryness, painful sex and other unpleasantries that affect quality of life and that we’ll discuss in future blog posts.
Now the facts on smoking and menopause. A number of studies have found an association between smoking and menopause, but a new study actually quantifies it by combining the data from 11 prior reports to make the conclusions stronger. The technique is called meta-analysis. Drum roll please: Smokers go into menopause on average 1.12 years or 13.5 months earlier. Another meta-analysis study of 109 prior reports found similar information (Parente RC, et al. Maturitas 2008:61;287-298).
What it means to you. If the issue of an earlier menopause isn’t enough, you already know smoking is bad for you. If you are tying to conceive, it increases your risk of ectopic (tubal) pregnancy, miscarriage and stillbirth and if you smoke while pregnant, it increases the chances of your baby becoming addicted to cigarettes. The baby will also be smaller sized.
Earlier menopause is associated with more menstrual cycle irregularity, and increases the risk of heart disease, blood clots and osteoporosis, to name a few.
And what if you live with a smoker? Not ideal. Second hand smoke contains 7,000 chemicals of which 250 are harmful. It causes 3,000 deaths from lung cancer and nearly 50,000 deaths from heart disease and other illnesses every year plus more hot flashes and more of the other typical menopausal symptoms.
It’s national heart month. And smoking isn’t good for you. Live longer, delay menopause, and improve the quality of your life. Quit smoking.
Click here for instant access to my FREE Ebook on Hormone Therapy: Is it right for you.
Women are waiting longer today to have their first baby. And even in the best of conditions, making a baby can take time; up to one year.
For young women, fertility begins to fall off after age 27. The research shows that for women between the ages of 19 and 26, the chances of conceiving in any given month is about 50% if they had intercourse two days before they ovulated. For women ages 27 to 34, the chances of conceiving in that month dropped to 40%. By the age of 35 the probability dropped to 30%. At age 40 the chances for conception in a single month drop to 5% and after age 42 they are even lower.
In a study that I published looking at women who were trying to get pregnant who had no fertility problems but were using sperm donor insemination to conceive, about 60% of the women got pregnant within 4 months, about 75% of the women were pregnant within 6 months, and about 95% of the women got pregnant within 12 months. This means that even if you don’t have any fertility problems, it can take up to one year to conceive.
Here are some things you can do to improve your chances for conception at any age.
1) Eat a healthy diet.
2) Don’t smoke.
3) Take a multivitamin daily
4) Exercise regularly
5) Avoid excessive drinking or taking any street drugs
6) Make an effort to control your level of stress through exercise, yoga, meditation, prayer or whatever works for you.
7) Have intercourse about twice per week.
Here are 3 tips on when to see a fertility doctor.
1) If you are 30 to 34 years of age and don’t get pregnant within 9 months
2) If you are 35-37 years of age or older and you do not get pregnant within 6 months,
3) If you are 38 years of age or older and thinking of starting a family, see a fertility doctor at that time and don’t wait. Time is the most important commodity in having a baby as a woman ages beyond 35.
This isn’t to say that many women won’t be successful starting their families as they age. It’s just important to realize that making the baby takes time. To see a short cartoon video called Making a Baby Takes Time, click here.
Great article by Carey Goldberg on CommonHealth about using music to change our relationship with patients and our approach to healthcare. It’s all part of a triple aim put forward by the Institute for Healthcare Improvement to provide better health, better health care and lower cost. http://commonhealth.wbur.org/2012/02/singing-doctor-mache-seibel/#more-18684
The boomers or gaining in numbers and so is their incidence of STDs (sexually transmitted diseases). Maybe it’s all the Viagra giving sex a greater likelihood of occurring with aging. Since pregnancy isn’t an issue, people might just not be thinking about STDs. Seems they should be. For additional info. Click here for a link to a video on painful sex which my patients say often accompanies Viagra.
Today I gave Grand Rounds at Mass General Hospital to a group of Ob/Gyn doctors. I spoke about the need for the medical community to interact more with patients, engage them and change the way we have been doing things to create a community of caring. I’ll be talking more about that in future posts, but for now, here is a short clip of a song I sang there called the Funky Labor. Enjoy! http://youtu.be/mjc3l_DNqRY
A few years ago Karen Giblin asked me to write a theme song called Red Hot Mama for her Red Hot Mama’s menopause organization. One of the lines in it goes – “Just because I’m in the ‘Pause doesn’t mean I’m dead.” That line underscores what a number of studies show; that sexual activity is alive and well as women age. Here is the whole truth about women’s sexuality and menopause.
A study in the New England Journal of Medicine from the National Social Life, Health, and Aging Project provided a baseline of information on women’s sexuality everyone should know.
In that 2007 survey of 1,500 women aged 57 to 85, sexual activity was shown to decline as age increases. Below is the sexual activity level in the past year among women who had a partner:
Of course, not everyone has a partner or spouse, but if they did have a partner and they were sexually active, no matter the age group:
The study also showed that about half of both men and women have at least one bothersome sexual problem. For women, the most common were:
So now you know that sex can decline with age and sexual problems can increase with age. But here is what I want you realize that can change your life: only 22% of women over the age of 50 have had a discussion with a physician about this problem. That’s only 1 in 5. The rest of you aren’t getting the help you need.
The following year another study shed more light on women’s sexuality. The authors surveyed 50,000 US households that included some 31,000 women over the age of 18 and found that 43% of women had some type of sexual problem, but it distressed only 12% of them. Interestingly, although the older women had more sexual problems than the younger ones, they distressed older women less. The most common distress occurred in women aged 45 to 64. In other words, it’s the women in and around menopause that have the most distressing sexual lives.
Often women with sexual problems were also struggling with another problem such as poor health, depression, anxiety or urinary problems. But as it was in the first study I told you about, only about one third of women had a conversation with their doctor about this problem and when they did, the woman rather than the doctor started the conversation 80% of the time. This tells you women have to speak up about sexual problems and be more assertive with their health care providers.
Going through menopause effects sexual activity in many women due to painful intercourse, or decreased sexual desire, frequency or arrousal. When some 3,000 women in and around menopause ages 42 to 52 were asked what affected their sex lives the most, the answers can back as:
In another report of sexual activity in menopausal women ages 41 to 68, 68% were sexually active within the past 6 months. The largest reason for not being active was not having a partner. Those women who were sexually active and who had the most enjoyment with sex were more likely to:
Other studies of women aged 40 to 65 have shown that vaginal pain and thinning of the vaginal tissues called vaginal atrophy or atrophic vaginitis are very strong causes of sexual problems. This is a very treatable problem if you discuss it with your doctor. I’ve made a video about painful sex if you’d like to hear more about it. Just a few months ago in the journal Menopause, 27,000 women aged 50-79 were studied for 6 years and they were evaluated for vaginal atrophy. Older age, health problems and loss of a partner were the main reason many of the women were less sexually active. Women who were on hormone therapy (HT) improved their vaginal atrophy symptoms significantly.
I’ll talk more about sexual function in other articles. But for now, here is what I hope you will take with you. Intimate relationships remain important to women and sexual activity is a natural part of aging, even to age 99. Those women with a partner and who are healthy enough to be sexually active continue to enjoy sexual relationships. But sexual problems are common, especially among women with other health issues. The good news is that most can be treated. But most patients don’t ask their doctors and most doctors don’t ask their patients about sexual problems.
So when you go to your doctor, ask him or her about your sexual problems. They will either help you or refer you to another person who can. Sexual problems are common, treatable and worth the effort.
Aging Americans can and do enjoy high levels of sexual satisfaction. A new study published in the January 2012 issue of the American Journal of Medicine on sexual activity in older American women contained both good news and potential concerns. The University of California, San Diego School of Medicine study,[1] followed 806 older women in a planned community for 40 years. They found that sexual satisfaction increases with age among sexually active older women, and even those women who were not sexually active reported satisfaction with their sex lives. However, the study also identified vaginal dryness as a concern for older women that could affect their sexual function.
The participants ranged in age from 40 to 99, with a median age of 67. Researchers found that, while 61 percent of all women in the study and 78 percent of those women who were sexually active were satisfied with their overall sex life, sexual satisfaction increased with age among sexually active older women. Satisfaction with the amount of emotional closeness during sexual activity with a partner was associated with more frequent arousal, lubrication, and orgasm. However, frequency of vaginal lubrication during sexual activity decreased with age; 60.8% of the youngest women reported lubrication almost always compared with only 28.6% of women age 80 years or more. A similar trend was reported with frequency of and difficulty maintaining lubrication.
Previous studies support this study, having found that vaginal dryness ranks among the 10 most common problems occurring during menopause. Millions of women suffer from vaginal dryness. It’s a real problem that affects and interferes with their daily lives. The effects of vaginal dryness range from minor discomfort to chronic pain. But unlike other symptoms of menopause, like hot flashes or night sweats, which usually lessen or disappear within five years, vaginal dryness continues and often worsens throughout the rest of a woman’s life. I often recommend vaginal estrogen for this situation. But for the many women who either can’t or won’t take estrogen, or just prefer not to, I also frequently suggest Replens Long-Lasting Vaginal Moisturizer to address vaginal dryness issues. Replens is an estrogen-free, clinically tested over-the-counter product that not only helps replenish vaginal moisture, but also helps rejuvenate dry vaginal cells.
If you suffer from vaginal dryness, you are not alone. Discuss your options with your medical professional to see if the risks of hormone replacement therapy outweigh the benefits. A study in The New England Journal of Medicine[2] reported that over-the-counter Replens® is as effective at alleviating vaginal dryness as prescription hormones, stating that Replens® “provided relief of vaginal (dryness) symptoms that was equivalent to that of vaginal estrogen…” This study shows that staying sexually active can help to improve your sexual function and maintain your vaginal wall tissues. Don’t let aging end your sexual satisfaction. Use it so you don’t lose it.
[1] Susan E. Trompeter, Ricki Bettencourt and Elizabeth Barrett-Connor, “Sexual Activity and Satisfaction in Healthy Community-dwelling Older Women,” The American Journal of Medicine, Volume 125, Issue 1, January 2012, pages 37-43. http://www.amjmed.com/article/PIIS0002934311006553/fulltext
[2] Deborah Grady, “Management of Menopausal Symptoms,” The New England Journal of Medicine, November 30, 2006, pages 2338-2347. http://www.nejm.org/doi/full/10.1056/NEJMcp054015.
Rape is a topic most victims avoid. So much so you’d think it doesn’t happen. Perpetrators uniformly deny it so it seems no one would ever do it. But it happens often, victims suffer deep scars, and perpetrators typically get off without a scratch (see below). A new law is the beginning of that changing.
There were no laws about rape on the books until 1927, and no udpdated laws until January 5, 2011. That’s why I’m writing about rape now. The US Attorney General has just announced a revised definition of rape so that it can be more accurately reported and prosecuted. My hope is that by talking about it openly, it won’t happen to you or your loved ones; but if it does, offenders can be prosecuted and victims can more likely get justice.
Here’s how the new law differs from the old one. In 1927,“Forcible rape” had been defined by the UCR SRS (Uniform Crime Report (UCR) Summary Reporting System (SRS) the “national report card”) as “the carnal knowledge of a female, forcibly and against her will.” That means a man forces vaginal sex with a woman. It left a lot to be determined; required an immediate visit to the doctor to look for sperm in the woman’s vagina as well as any signs of trauma. There was no law for a woman raping a man or a man raping a child. During my on call training, many nights I was asked to examine women for alleged rape, and the details of what I wrote in the hospital notes had a great impact on whether or not an alleged rapist was convicted.
Here’s how the new law describes rape: “The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.”
So one person forcing an object (animate or inanimate) into another person is rape.
Susan B. Carbon, Director of the Office on Violence Against Women, states, “For the first time ever, the new definition includes any gender of victim and perpetrator, not just women being raped by men. It also recognizes that rape with an object can be as traumatic as penile/vaginal rape. This definition also includes instances in which the victim is unable to give consent because of temporary or permanent mental or physical incapacity.”
How common is it? According to the Centers for Disease Control (CDC) 1 in 6 women report that they have either been raped or an attempt has been made to rape them in their lifetime. The first time for 60% of these women was before age 18.
What is it? Sexual violence is any sexual activity for which you do not freely give consent. That includes both sex against your will and sex that happens when you cannot freely give your consent. If you have been drinking and suddenly find a man having sex with you, it is rape. If a man has sex with a woman who is under the influence, it is rape. Think of it like this, if you are under the influence, you cannot sign a consent form for a medical procedure, and you cannot give consent for a sexual act, either.
Rape is more than unwanted sex. It’s an act of violence and it’s a crime.
Who commits it? Unfortunately, all kinds of people; a current or former intimate partner; a family member, friend, or acquaintance; a person in a position of power or trust, or a stranger. According to the CDC, in a nationally representative survey that looked at the first rape experience of female victims, perpetrators were reported to be intimate partners (30.4%), family members (23.7%), and acquaintances (20%). This means that the victims knew over 71% of the perpetrators.
What are the risks? The short-term risks are getting pregnant (for women), acquiring a sexually transmitted disease, or being injured. But there are also long-term risks that can affect your physical or emotional health:
What can I do to prevent it?
What do I do in case of rape?
Resources:
http://www.justice.gov/opa/pr/2012/January/12-ag-018.html
http://www.cdc.gov/violenceprevention/sexualviolence/
http://www.cdc.gov/Features/SexualViolence/?source=govdelivery
As a child, I was extremely fat. At the ripe old age of 29 months, there was a front-page article about me in the Galveston Daily News: Mighty Mite – the fattest child in Galveston County. My grandparents thought a fat baby was a healthy baby. We now know a fat baby is often not a healthy baby and more likely to be an unhealthy adult. In 2012, 1 in 3 children are obese. Mission Readiness, a nonprofit, nonpartisan organization run by retired military leaders dedicated to investing in America’s youth, discovered that today, 27% of 17- to 24-year-olds, some 9 million, are too fat to meet the basic minimum standards required for military service because they are too fat.
I was very fortunate; I was able to change my exercise level, my diet, and ultimately my body size. Today, I’m at my ideal body weight. But that was not an accident. It took a conscious decision on my part to change my dietary habits – both what food choices I made and how much of it I ate. The US Department of Health has addressed America’s growing obesity epidemic by giving us a simple, objective way to look at the food we eat. It’s called MyPlate. Click here for my video on portion control and MyPlate.
The image of MyPlate is a plate divided into 4 parts. Something as simple as knowing how much of which food to put on our plate has the potential to curb obesity, lower the rate of heart disease and diabetes, and improve our chances for a longer and healthier life.
MyPlate is much easier to understand than the Food Pyramid system, which it replaced. It’s much easier to use than the Ornish diet, the Atkins diet or the South Park diet. If we pay attention to MyPlate, we don’t have to consider any of these or any other dietary approaches or measure ounces of food. This new approach was released last year, and can be found at http://www.dietaryguidelines.gov. These recommendations promote health, reduce the risk of chronic disease and represent an effort to decrease the obesity epidemic in the United States with improved nutrition and physical activity. You can find lots of great recipes in my cookbook Eat to Defeat Menopause.
The new food pyramid is a very simple image of a plate divided into four parts. These 4 unequal quadrants represent vegetables, fruits, grains, and protein with a circle (representing the top view of a glass) off to the side to represent dairy. You can find an image of this at http://www.ChooseMyPlate.gov. Basically, the plate is divided with half of the plate containing fruits and vegetables. One of the two remaining quadrants contains grains (primarily whole grains) such as rice, bread or cereal, and the final quadrant contains proteins including meat, fish, poultry, beans, soy or eggs.
MyPlate primarily follows the Mediterranean diet. That diet is high in legumes, grains, nuts, fish, fruits, and vegetables but is low in dairy and red meats. I was recently able to visit the Pompeii exhibit at Boston’s Museum of science, and was pleasantly surprised to find that in 79 A.D., the diet we are discovering today was already very well established. Another observation that was present in 79 A.D. that we can also learn from today was the fact that the size of a plate was much smaller than the ones we eat from in most kitchens in 2012. So cleaning your plate meant you were eating a lot fewer calories.
This diet is very high in monosaturated fatty acids and low in saturated fatty acids. Scientists analyzed 12 pre-existing scientific studies and combined their total results. This is called a meta–analysis study and it involving over 1.5 million people. showed that the more one adhered to a Mediterranean-type diet the lower the incidence of death and cancer. Of course, My Plate alone won’t solve the problem of obesity and rising rates of obesity and heart disease. But the plate is one more step in carrying out the message that includes encouraging people to enjoy your food but eat less, switch to fat-free or low-fat milk, choose foods lower in sodium, make at least half your grains whole grains and drink water instead of sugary drinks. It’s time to make MyPlate your plate.
