Menopause: Making it the Best Years of Your Life

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Your Perfectly Pampered Menopause

WebMD Live Events Transcript

Colette Bouchez, author of "Your Perfectly Pampered Menopause," says menopause doesn't have to be difficult. From hormones to hair care, skin care solutions to putting the pizzazz back in your sex life, she offered up health, beauty, and lifestyle tips to help you make these the best years of your life when she joined us on June 1, 2005.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live Colette. Thank you for joining us. Please tell us why you think of menopause as "the best years of your life."

BOUCHEZ:
Well I think that it can be the best years if you know how to take care of yourself. You are more focused about yourself and your life; you know who you are, what you want and what you can do. You have a better sense of yourself. That all adds up to some pretty good years.

MODERATOR:
It sounds great -- as long as you don't get sidetracked by "symptoms" of something that is a natural part of aging, not a disease. How do you maintain a positive attitude and keep everything in perspective?

BOUCHEZ:
I think a lot of it has to do with having knowledge -- knowledge about what happens during this time of your life, knowledge about your own body and what to expect. Because the truth is that menopause is something different for every woman. I think the key is the knowledge; if you know what to expect and you know what you can do to counter some of the effects, it won't take you by surprise.

It's the element of surprise and confusion that can affect our ability to cope. One of the main reasons I wrote Your Perfectly Pampered Menopause is so that there are no menopause surprises. A woman will know what to expect from this time of life and from her own body, and that can go a long way in helping you cope and keeping you from getting sidetracked, as you say, by symptoms.

MEMBER QUESTION:
Do all menopausal women get hot flashes?

BOUCHEZ:
Well, hot flashes are not an absolute part of menopause but it certainly is the case for the vast majority of women. Since hot flashes are really the physiological result of falling estrogen levels, and every woman who goes through menopause experiences falling estrogen levels, it's kind of hard not to experience hot flashes. But the big difference is some women are affected by them more than others. It is just like some women can be in a hot crowded room and feel OK, while others may not. It's all according to how your body reacts and every woman's body is different.

"Write down every time you have a hot flash, and write down what you were wearing, eating and drinking right before. In about a week or so you may see a pattern starting to emerge and you'll know what your personal hot flash triggers are."

MODERATOR:
So what tips do you have for those who are having a rough time with hot flashes?

BOUCHEZ:
Believe it or not one of the main things that most women don't think about is the clothes they wear. And I'm not just talking about dressing in layers, because that's what everybody tells you. What I'm talking about is the fabrics you choose to wear. Many times fabrics made of nylon and particularly spandex, which I know is very popular right now, can hold the heat in and make that flash feel as if it's never going to end. So in this respect paying some attention to the kind of fabrics you are wearing, looking for fabrics that breathe and are open and airy can go a long way in keeping those flashes under some control.

The other thing is doing whatever you can to keep your environment cool. That's not always possible, I know, but if you can do small things like keep a thermal pitcher on your desk with cold water, or one of those cooling scarves they have -- the ones you put in the fridge and they stay cool for hours -- putting this on the back of your neck or on your wrist when you get the flash can bring the heat down immediately and make you feel a lot more comfortable.

MODERATOR:
What did you find out about diet and hot flashes -- the foods you eat affecting how you feel? Are there certain foods we should be eating or others we should be avoiding?

BOUCHEZ:
Everybody is a little different in terms of how they react to foods but in general there are some "rules" that can help. The first thing is to avoid spicy foods or very hot foods, in terms of the temperature of the food itself -- like hot soup or hot coffee. The same way it "warms you up" in the winter on a cold chilly night, it will "warm" you and bring on a flash. You should also avoid stimulating foods like caffeine, or high sugary foods which can also increase hot flashes in some women. And sometimes a very icy cold drink can do it.

Quick GuideWomen's Health: Nutrition and Health Care Reform

Women's Health: Nutrition and Health Care Reform

One of the best things I teach women to do in my book is to keep a hot flash diary for about a week or so. Write down every time you have a hot flash, and write down what you were wearing, eating and drinking right before. In about a week or so you may see a pattern starting to emerge and you'll know what your personal hot flash triggers are.

MEMBER QUESTION:
Can eating
soy help with menopause symptoms?

BOUCHEZ:
Soy is considered a phytoestrogen, which means it is a plant source of estrogen that is very weak -- much weaker than what your body produces. That said, it can have some of the same impacts of estrogen. So when your estrogen levels are dropping -- or as I like to say jumping around doing the tango, going up and down -- then yes, soy may have some beneficial effects. The thing you have to remember though, about soy, or any natural treatment is that if it's strong enough to have a pharmacological effect, it's strong enough to have a negative effect as well, and there can be too much of a good thing. The key is to use dietary soy, which is very hard to "overdose" on, and can provide benefits without many of the potential side effects.

MEMBER QUESTION:
Most of what I eat is ice cold by the time that I actually get to eat. I start off with hot coffee and end up drinking it cold anyways. In the cooler months I'm not so anal about cold drinks, but in the summer and warmer months I wish that I owned stock in an ice company. I'd be rich now. Does my body temperature actually go up when this happens or do I just feel hot?

BOUCHEZ:
No, your body temperature actually does go up, but it's momentary. What actually happens in a hot flash is your body's temperature-regulating mechanism gets a faulty signal. Your body actually thinks you are cold, so it sends a signal to that effect. But moments later your body corrects itself; it's kind of like "Oops, she's not hot, cool her down." So it sends another message to dilate the blood vessels and let the heat out. It is actually that "release of heat" that you are feeling as the flush. So when you are flushing your body temperature isn't going up; it's your body releasing the heat. This is why sometimes some women get a cold chill following a hot flash, because it's a rapid release of body heat.

MEMBER QUESTION:
Night sweats are hitting me every night. Is that a normal progression?

BOUCHEZ:
Unfortunately it is normal. Actually, a night sweat is really a hot flash that occurs in your sleep. So the same way you are getting these hot flashes during the day, you are getting them at night as well.

One of the things about night sweats is that they also disturb your sleep. There is actually a mechanism that can disrupt the deeper sleep that we need to feel rested, which is one reason you can feel so exhausted all the time during menopause. The quality of your sleep is not as good as it was in the past. In this respect, what you wear to bed, particularly avoiding nylon night gowns and pj's can make a very big difference.

The Japanese believe that if your head is cool during the night your body temperature remains more regulated. So if night sweats are a real problem then you might want to invest in one of those cooling pillows. You fill them with water and they stay cool for many hours and absorb some of the heat from your head. And they can help you get a deeper and more restful night's sleep.

MEMBER:
I was always told that as well. Keep your head and feet cool.

MEMBER QUESTION:
Where can I find that pillow?

BOUCHEZ:
There are several different types out there, but one that I have used and found to be very effective is called the "Chillow". I believe you can do an online search and find it in a few places including Amazon.com. There are various prices so shop around, and you should be able to locate it online if you do a search under "chillow."

"First, bioidentical hormones are not natural hormones; they are made in a lab just like traditional HRT and they are synthetic."

MEMBER QUESTION:
Is interrupted sleep -- or needing less sleep -- a sign of menopause? It's becoming harder for me to stay asleep these days.

BOUCHEZ:
Oh definitely! In fact, for many women that is actually the first sign of perimenopause, when your hormones are just starting to "dance." Of course remaining asleep or having problems falling asleep can also be caused by stress, which can also impact how your hormones are "dancing".

If there is nothing going on in your life that might be causing you to have sleep problems, then it is very likely the first signs of perimenopause. Welcome to the club!

MEMBER QUESTION:
I can sit in front of the AC vent and still get hot flashes. I had one yesterday that a cold shower couldn't cool down. I have had the AC running in January and the heat running in August.

BOUCHEZ:
One of the things you may not realize is that sitting in front of the air conditioner or taking a cold shower may actually be making your flashes worse. Here's why: When you put the icy cold on your body, you confuse your temperature system even more. Since it's already out of whack -- due to hormones -- adding the icy cold can confuse your body even more.

The trick is moderation -- not icy cold, not overly hot. You may get more relief by taking a tepid shower, or by putting on the AC. But don't stand in front of it. You can put a cold pack on the back of your neck, the inside of your wrists or the inside of your elbows, which can also help, but try to stay away from extreme changes in temperature. It can make you feel good for the moment but may actually increase your hot flashes in the long run. Also, the direct blowing of the air from the AC or a fan on your skin can stimulate nerve endings and that may increase uncomfortable feelings when a flash does hit.

MEMBER QUESTION:
I'd like to know what you think about bioidentical hormones and are they as safe as some people say they are?

BOUCHEZ:
Well, it's a BIG topic right now, that is for sure. But I also think there is lots of confusion out there and I'd like to take a few minutes to explain some things you might need to know.

First, bioidentical hormones are not natural hormones; they are made in a lab just like traditional HRT and they are synthetic. However, what is natural about them is the end result -- they are identical to the hormones that the body produces.

Quick GuideWomen's Health: Nutrition and Health Care Reform

Women's Health: Nutrition and Health Care Reform

Some folks believe that because they are the same as what the body produces, that the body will process and assimilate them better, and this may be true. However, what we don't know -- and this is a big one, so listen up -- what we don't know is whether or not simply assimilating a drug better is going to make a difference in terms of how it will react down the line. Will it cause the same kinds of problems we saw with traditional HRT? The reason we don't know that is because there has been no long-term testing or studies done on bioidentical hormones and until there is we have to exert the same kind of caution that we do with HRT.

Can it help some women? Definitely. But it should not be taken lightly or used without some thought as to potential problems.

MEMBER QUESTION:
HRT is very controversial. Who is and who isn't a good candidate for this treatment?

BOUCHEZ:
The first thing we all have to come to realize, I think, is that women, each of us, are different. We all come to menopause with a different health background, different genetics and different lifestyles. There is no "cookie-cutter menopause woman" -- thank goodness.

Because we are all different, we are all affected slightly differently by HRT. That said, there are some parameters that do impact many of us. And one of the things I try to do in my book is to walk each reader through her own personal situation to help her make that decision. In general, if you have a high risk of breast cancer in your family, you are probably not a good candidate. If, on the other hand you have no history of breast cancer, but you have a history of osteoporosis, or hip fractures at an early age -- you might be the best candidate. The idea here is to make personal assessments based on your needs, your family and personal health history and your current health status. It's a matter of balancing risks vs. benefits.

MEMBER QUESTION:
What can you tell us about natural treatments for menopause symptoms that we can use instead of HRT?

BOUCHEZ:
As far as natural, there are a number ways to go. One natural treatment that got a lot of attention was black cohosh. This is an herb that has been used for hundreds of years to help with menopause symptoms. The confusing thing about black cohosh is that when it was studied in clinical trials it was not found to have any greater effect than a placebo! But, if you talk to women who actually use it, on a one-to-one basis, it seems that it does help. So, not to confuse you, the idea here is that you can try it and you'll know right away, within a few weeks, if it does help you. If it does then you've found it! If it doesn't, then obviously don't take it, and move on to something else.

For many women -- many, many women -- a lot of help can be found in dietary means, particularly adding foods that are high in essentially fatty acids. This would include flax seed, flax seed oil and walnuts. All of these foods can have some very important effects on hormone levels and more importantly on helping your body to adjust to changing hormone levels. While they won't take the place of estrogen, for example, they can help your body cope with having less estrogen. Soy foods can also have a similar effect and may offer some help. Also, what many women don't realize is the power of dairy foods - low-fat dairy foods. Most of the time we think of them for our bones alone, and that is important, but there is some research to show that, overall, low-fat dairy products may help you simply feel better during menopause.

"You have to keep the vaginal tissue lubricated all the time because as your hormones are dropping you are losing the natural moisture in your V Zone."

MEMBER QUESTION:
In what ways does dairy make you feel better during menopause?

BOUCHEZ:
Calcium is really the key. We think of calcium as something important for our bones, and it is, but calcium also plays important roles in many bodily functions including the regulation of blood pressure and even our heart rate.

Calcium supplements are good, and they can help. But calcium-rich foods are also important, and low-fat dairy products are a good source. If you don't like dairy foods there are other sources as well, like some leafy green veggies.

MEMBER QUESTION:
Do you have any advice on vaginal dryness? Maybe if I wasn't so dry I could find my lost libido.

BOUCHEZ:
The search is on! I'm sure you know about vaginal lubricants and how much they can help. But what many women don't realize is that you don't just use them right before intercourse, which is actually how many women think they should be used. The lubricants have to be used all the time -- first thing in the morning after your shower, and if necessary refreshed during the day, and again at night before you go to bed. You have to keep the vaginal tissue lubricated all the time because as your hormones are dropping you are losing the natural moisture in your V Zone. Think of it like facial moisturizer. You wouldn't expect to use it one time and see a difference. You have to use it every day to see a difference. Well, think of your V zone in the same way. It's not the same kind of moisturization, but the loss pattern is similar. So the replenishing pattern has to be similar as well. Use it more often; you will definitely see a difference!

MEMBER QUESTION:
My face gets red and dry during this time as well. It seems like nothing works anymore.

BOUCHEZ:
What you put on your face is important, but what you put in your body is important as well. Try increasing your intake of water, for starters, and your intake of essential fatty acids. Both can have an important impact on skin.

The next thing is to pay attention to how you cleanse your face. Are you using soap? Unless it's a very mild soap, like Dove, which is one of the best for middle-age skin, then the soap itself could be stripping away your natural pH. That's the protective acid on the surface of your skin that can cause the redness and dryness you talk about.

Are you using a shower gel and does it get on your face? That can cause problems as can certain shampoos and hair conditioners which many women also don't realize can dry their skin.

The idea here is to do a little detective work and see what else, other than your skin care, may be affecting your skin. As to treatments -- the new copper creams -- Avon has a great one and so does Neutrogena. It's moderately priced too, and can actually help rebuild collagen in the skin; that can go a long way in alleviating some of your problems.

MEMBER QUESTION:
My hair has lost its shine and feels very dry. Is there something I could use to bring my hair back to life?

BOUCHEZ:
Again, I hate to sound like a broken record here, but your diet is one of the main things that can impact hair shine. The essential fatty acids can help. What can also help is taking Biotin supplements. This is what many, many dermatologists recommend for healthy hair. It can add the shine back.

In terms of cosmetically giving your hair shine, there are a number of products on the market specifically to do this but I have found they can sometimes make the hair greasy and heavy so if your hair is fine I'd say skip it. You should always use a conditioner and you might want to try a cool rinse when you shampoo your hair; this closes the hair shaft, which is actually what gives your hair its shine. What a conditioner does is smooth the hair shaft so it lies flatter and reflects light better.

Quick GuideWomen's Health: Nutrition and Health Care Reform

Women's Health: Nutrition and Health Care Reform

MEMBER QUESTION:
Of all of the dumb things it's the facial hair that is making me crazy! I celebrate not having a period any more, but the chin hairs are embarrassing. I don't want to look like my husband! What can I do about it?

BOUCHEZ:
There are a wide array of options for you to try:

  • First, of course is the classic "waxing" which does remove the hair and keep it away for anywhere from several weeks to a month or more, depending on how heavy the growth is.
  • The next option is electrolysis, which is more costly, takes more time but removes the hair permanently. There are also some home electrolysis kits that work pretty well, though not as good as a professional treatment.
  • The latest in hair removal is done with a laser treatment. It's a little costly but it's totally pain free, permanent, and easy!
  • And you can always use a depilatory product -- something that removes the hair with a cream or liquid. It lasts a few weeks and has to be repeated but it does work.

The main thing to remember is that it is totally untrue that hair that is removed comes back thicker. It does not.

MEMBER QUESTION:
Why does menopause affect bladder control, and what can be done about it?

BOUCHEZ:
First, let me congratulate you for coming forward with this question! This is a topic that affects so many women and it remains in the dark because people are embarrassed. In fact I tell a very funny story in my book about this, but it's really no laughing matter.

The good news is there is help. First, let me explain that one of the reasons you have bladder problems in menopause is that the bladder itself has estrogen receptors just like your breast or your uterus. When those receptors are not getting fed because your estrogen levels are dropping, your bladder is affected. The thing you have to determine is the type of problem you are having. Is it "urge" incontinence -- meaning that you feel the urge to go all the time? Or is it "stress incontinence" -- meaning that when you sneeze or laugh or exercise you "leak"? The type of problem you have determines the type of treatment you need and yes, sometimes you can have both types!

"There are no cookie-cutter women and no cookie-cutter answers, but there are individual answers for each of us."

One of the simplest things you can do is simply monitor your fluid intake. First drink no more than 8 ounces at a time of any fluid including soda. Next is to limit your fluid to no more than 8 cups a day; this can be a big help.

The next thing is to do a little bladder "retraining." If you are going to the bathroom frequently, try to put yourself on a schedule, and try to "hold it" a little longer each time. If you routinely go very two hours, try to hold it first to two hours and 10 minutes, then 15, then 20 -- you get the idea. You can retrain your bladder to hold more fluid.

You can also try the infamous Kegel exercise; the same one you do after childbirth can be a major help during menopause. It helps tone the muscles of the bladder that is affected by estrogen loss. As the estrogen drops, these muscles weaken somewhat, which is what is causing the problems. By strengthening those muscles via exercise, you can often overcome some of the control problems you develop when estrogen levels drop.

I would try all these measure before turning to medications. But if they don't help then there are some drugs available that can help. I go into that in the book but you can also talk to your doctor.

MODERATOR:
Before we wrap things up for today, Colette, do you have any final words for us?

BOUCHEZ:
I do have something I'd like to tell everyone and ask you to keep in mind. My book, Your Perfectly Pampered Menopause , has lots of good information that I think can help you and it goes into great depth about a lot of the problems and issues we were discussing here today. But the thing I want everyone to realize is that menopause isn't just about the ovaries and the uterus. It's not just about missing a period or having a hot flash. There are changes that go on body-wide, and one of the reasons I wrote this book was to give women a full picture of what is happening in the body, and to give you a full array of options. As a journalist I have been trained to look at all sides of the story and what I have tried to do with this book, and here today, is to give you all the options and to show you there are many sides to each of our personal stories. I hope you will keep that in mind as you seek to solve your menopause problems and symptoms. There are no cookie-cutter women and no cookie-cutter answers, but there are individual answers for each of us.

MEMBER:
Thanks Colette! Very informative!

MODERATOR:
Our thanks to Colette Bouchez for joining us today. For more information, please read Your Perfectly Pampered Menopause: Health, Beauty, and Lifestyle Advice for the Best Years of Your Life . For more discussion on this topic, be sure to visit the WebMD message boards to ask questions of our online health professionals and to share questions, comments, and support with other WebMD members.



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Reviewed on 6/17/2005 5:19:45 PM

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