Understanding and managing the mid-life transition

Recently, while at a friend’s home, I helped myself to some delicious wrapped chocolate pieces.  I had three of them before I asked her where she purchased them. I found out that they were calcium chewies and I had just ingested 1500mg of Calcium plus vitamin D.   I purchased three bags the next day and I no longer forget to take my calcium twice a day!

Calcium chewies are the best known product in a growing category of “functional foods,” or nutraceuticals, which contain nutritional supplements and bioagents of foods such as anthocyanins (from berries) or beta-carotene that some research has shown to prevent or treat disease or illness.  We’re all accustomed to taking daily supplements like fish oil or calcium.  But there’s a growing industry of manufacturers that are wrapping these beneficial ingredients with delicious-tasting chocolate or concentrated fruit making them more appealing and convenient to consume.  Some claim to prevent urinary tract infections, while others are supposed to help ward off respiratory tract infections.  I don’t know if there’s any conclusive evidence to support all of the claims, but since they’re like small treats, I don’t think you’ll mind doing your own research to see if they work for you.  Here are a few products that you might want to try:  [click to continue...]

A urinary tract infection is one more thing that you can blame on menopause – or more accurately- the lack of estrogen in your body.  The decrease in estrogen, explains New York City-based Dr. Elizabeth Kavaler, causes the bladder to become less elastic, triggering an inability to empty the bladder completely. “Ultimately, not being able to empty the bladder completely can create a breeding ground for bacteria to multiply, leaving menopausal women at risk for developing a UTI.” [click to continue...]

Women use products every day that are regulated by the FDA including cosmetics, medicines and  hormones. But does an “FDA Approved” claim mean that it’s safe and effective?  In a recent article in the New England Journal of Medicine, “Lost in Translation- FDA Drug Information That Never Reaches Clinicians,” two researchers at Dartmouth wrote that;

“FDA approval does not mean that a drug works well.  It means only that the agency deemed its benefits to outweigh its harms.  Much of what the FDA knows about a drug’s safety and effectiveness is not included on the label. You really need to know more to see whether it’s worth the cost.”

So what does this mean for mid-life women whose physicians recommend hormone therapy to manage hot flashes, biphosphonates to prevent bone loss, sleeping pills to help with menopause-related sleep disorders and perhaps a little Zantac for heartburn?   [click to continue...]

Like many women concerned about the loss of bone mass during the menopause transition, I’ve added resistance training and weight lifting to my three-times a week workouts at the gym.  But a recent post in the New York Times Well Blog  suggests that this approach may not be helping at all.  Instead, some medical researchers now think that simply jumping up and down may be the best exercise for long-term bone health.  Learn more about what the latest research shows and why this is so important to our future health.

Do taking vitamin D and fish oil really lower the risk of cancer, heart disease, stroke and other illnesses as some research studies (and supplement manufacturers) have suggested?  Beginning in January, researchers at Harvard University and Brigham and Women’s Hospital will begin a double-blind, placebo-controlled study, the gold standard of research, to find out. The new study, called VITAL (VITamin D and OmegA-e TriaL), funded by the National Institute of Health, will involve 20,000 men and women. If you qualify (women must be 65 years or older and have never had a heart attack, stroke or cancer) you can participate too.

For details about the study and eligibility to participate, visit the VITAL website.

News came today that an appeals court has upheld a jury’s finding last year that Wyeth’s hormone-replacement drugs helped cause an Arkansas woman’s breast cancer.  At stake was $27 million in actual damages, an amount that was upheld by the three-judge panel.

The appeals court said “the evidence presented could allow a jury to find or infer that Wyeth was guilty of malicious conduct.”  According to the news report, Pfizer’s lawyers argued that the plaintiff received ample warning about the cancer risks tied to the company’s Prempro and Premarin drugs and chose to continue using them.

The ruling comes a week after a Philadelphia jury ordered Wyeth to pay an undisclosed amount of punitive damages to an Illinois woman who developed breast cancer after taking Prempro.   Six million women have taken Wyeth’s hormone therapy drugs for severe menopause symptoms and there are more than 9,000 lawsuits against the company. The menopause drugs are still on the market and many physicians continue to recommend and prescribe them to their patients.You can read the court’s summary of the case here.

If you’ve lost at least 30 pounds and maintained that loss for at least one year, you can participate in a research study that is investigating the characteristics of individuals who have succeeded at long-term weight loss.  The National Weight Control Registry was started in 1994  and more than 5000 individuals have enrolled, making it the largest study of its kind.  Participation requires filling out periodic questionnaires and annual surveys.

Interestingly, more than 80% of the registrants are women with an average age is 45.  Registry members have lost an average of 66 pounds and kept it off for 5.5 years. Duration of successful weight loss has ranged from 1 year to 66 years! According to the registry data, here’s how they did it:

• 45 %  lost the weight on their own, while the other 55%  had help from some type of program.
• Nearly all of the registry participants (98%) report that they modified their food intake in some way to lose weight.
• And, nearly all (94%) increased their physical activity, with the most frequently reported form of activity being walking.
• Most of the registrants continue to maintain a low calorie, low fat diet and doing high levels of activity (90% exercise, on average, about 1 hour per day)

Even if you don’t qualify, you’ll be inspired by the weight loss success stories that are posted on the NWCR website.

If you’ve lost a significant amount of weight, what’s been your secret to success?

I’m proud to see that my home town, San Francisco, is among the top five places for women to live according to Self Magazine’s annual Survey of America’s Healthiest Places for Women.  Their criteria for ranking 100 of the largest metropolitan areas included:

• rates of diseases such as cancer and depression
• factors that affect access to health care including the number of doctors per capita
• environmental and community measures such as air quality and crime rates

Interestingly, this year, “quality of sleep” was added as a determining factor.  Charleston, WV took the prize for being the worst sleeping area with the average woman experiencing insomnia 3 to 4 nights per week.  What’s going on there?

In front of San Francisco were Burlington, VT  in the top spot (which has 40 percent more ob/gyns than the list’s average), followed by Bethesda, MD, Portland, ME, and Cambridge, MA.

Additional results?  Women in Madison, WI exercise the most while those living in El Paso, TX have the fewest health clubs to choose from.  Raleigh, NC has the cleanest water but Riverside, CA has the most toxic sites.  Women in Las Vegas have the fewest Pap smears and Rockingham County, NH has the fewest STDs.  And even though San Francisco ranks high among the best places for women to live, we seem to have the most allergies and asthma.  I guess you can’t win ‘em all. It’s a beautiful city anyway.

Details of the survey can be found in Self Magazine’s November issue. You can log onto their website to see how your own state fared.

The American College of Obstetricians and Gynecologists  has recently launched a website for women who are approaching or going through menopause.  The website and the companion magazine, Pause, covers a lot of territory – from hot flashes to urinary incontinence.  The section on Menopause will likely be most helpful to women in the peri-menopause stage, who are still trying to figure out what’s happening to them.

However, there are sections on the site about Tests & Procedures, Conditions or Health Problems,  Cancer, and Your Annual Check-Up (about health screening tests women over 45 should have annually) that are all informative and important to know about.