Menopause: Taking Charge (cont.)

LadyByrd_WebMD: If you have heavy bleeding with clots, could this possibly mean menopause is not far off?

Dr. Hann: Heavy bleeding with clots is really not related to menopause, itself. With menopause, bleeding actually tapers off. Periods become fewer, in amount and duration. Anything outside of that requires evaluation to determine the cause.

Moderator: What suggestions do you have for women struggling with memory loss?

Dr. Steinman: First of all, if you feel your memory loss is abnormal, it is important to have it evaluated. That way, you can determine whether there is any medical process that is abnormal or requires treatment. If nothing out of the ordinary is found, the most important first step is to relax! Certain changes in memory are normal with age, and most are not related to Alzheimer's disease. The more anxiety we experience with regard to forgetfulness, the more interference we create for our memory! There are also some tips to help optimize your memory. For example, use input from a variety of sources to reinforce learning. Read the info to be remembered, write it down, and repeat it out loud. Another tip involves reviewing new info immediately, since research suggests that most forgetting occurs in the first few minutes. So, the next time you are introduced to someone, use their name in your next sentence. Estrogen may help memory, and may help in the slowing of the onset of Alzheimer's disease.

plath11976_WebMD: Is it safe to take estrogen after having a hysterectomy (ovaries still intact)? That is along with having endo.

Dr. Hann: After hysterectomy for endometriosis, one has to be careful in using estrogen. It can bring the endometriosis back, because the ovaries can harbor it.

LadyByrd_WebMD: Do changes in hormones cause blemishes again like when we were teenagers?

Dr. Hann: Skin changes during menopause is very common, including dry skin, blemishes, more moles, uneven skin tone, are more common. Also, malignant and non-malignant skin conditions can be more common.

Flooz_WebMD: What about all the talk about soy products included in daily supplements?

Dr. Hann: Soy products can work in reducing hot flashes. It may be a placebo effect, or a perception. It may also promote a feeling of well-being. We don't have any scientific data to prove these effects at this time.

Moderator: Lifestyle: Many of us are all too familiar with the physical effects of menopause. What lifestyle changes can have a positive impact on one emotionally during menopausal years?

Dr. Steinman: If there were just one change to suggest, I would have to say it would be exercise. I doubt there is much I can say that people don't know about its beneficial effects. Some of the chemical changes that occur with exercise affect brain chemistry in ways that help improve mood and stress tolerance. Exercise can also enrich your sex life and, of course, can help with heart and bone health. Make sure you get the "OK" from your health care providers prior to starting a program. Also, make sure to make it realistic, convenient, and enjoyable.

Dr. Hann: Other lifestyle changes are diet changes - low carbs, low fat, high protein (in moderation), smaller portions, less caffeine, less alcohol and, of course, no cigarettes!

Flooz_WebMD: At age 47, I still don't know what symptoms to look for to know if I am going through menopause. I feel normal up to this point. Still taking the pill.

Dr. Hann: Even if you're on the pill, when you start menopause, there will be some changes. First, you might notice hot flashes. Insomnia, vaginal dryness, mood swings. Of course, you may start late, and/or may have minimal changes that you will notice. Very lucky, if that's the case!

Moderator: Sex: Let's talk now about sex after menopause... In The Menopause Workbook, you have a page titled: A Prescription for a Good Sex Life. Could you tell us about this?

Dr. Dosh: During menopause, there are changes that will occur in sex life. It's not something to fear. However, it does require communication between partners and some adjustments in your lovemaking. You will perhaps need to take into consideration vaginal dryness, change in sexual desire (either more or less) More frequent sexual activity may help optimize lubrication ability. The old saying, "Use it or lose it" applies here.

Dr. Hann: There are testosterone creams and testosterone tablets available on the market, by prescription. DHEA in low doses also can help. FOREPLAY IS THE KEY!!! AND LOTS OF IMAGINATION AND FUN HELPS!!!

Dr. Steinman: Many people are surprised to learn that some women actually experience an increase in sex drive at this time.

Moderator: Mood: Does menopause cause depression?

Dr. Steinman: It used to be thought that the two went hand in hand. In fact, there was even a term, "Involutional Melancholia" to describe depression at this time in life. However, there is no evidence that menopause causes an increase in "clinical" or "major" depression. It is important to remember that there is a big difference between a depressed mood and the illness of clinical depression. Many women do report an increase in depressed or anxious moods, especially in perimenopause. It is important to remember that some of these symptoms, such as irritability and fatigue, may be caused by sleeplessness from hot flashes. Also, there may be a number of life changes or stressors at this time of life that may be associated with depressed mood, such as relationship changes, or illness in self or others, or $ problems. Some women who are prone to clinical depression may be at higher risk for a recurrence at this time in life, especially if they have had mood disturbances associated with hormonal changes. Do keep in mind, however, that the rates for clinical depression in women are highest between ages 25 and 44.

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