WebMD Live Events Transcript
Event Date: 07/12/2000.
Trisha Posner discusses her views on a new perspective on menopause.
The opinions expressed herein are those of the guest's alone. 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's Mind and Body Auditorium. Today we are discussing This Is Not Your Mother's Menopause by Trisha Posner.
A few years ago, at forty-six, Trisha Posner left her annual physical feeling wonderful -- until her doctor called to report surprising news: Although Posner had not recognized her own symptoms, her blood tests indicated she was in full-blown menopause. When her gynecologist urged hormone replacement therapy, Posner balked, fearing it might increase her risk of developing breast cancer, which had already struck her mother and two aunts. Posner will discuss her quest for an alternative to a woman's usual choices: take hormones (as most doctors advise), or do nothing and risk the deterioration of her heart, bones, and mind. She will reveal how she developed a personal program to counter naturally the annoying symptoms of menopause, like hot flashes and headaches, as well as the more serious problems, like depression and loss of sexual desire.
Trisha, welcome to WebMD Live. What made you write this book?
Posner: I was thrown into finding out that I was in menopause by my doctor, and was dumbfounded because I was young and was still getting my period. I was perplexed and started to do research on where I was going and what I was going to do. My gynecologist was insistent at that time with hormone replacement. I was leery since there was breast cancer in the family. So, I decided to do the research and found there was little for me when I watched all the programs other than the hormone replacement. So, therefore, I went on this thing on my own to find out why I was so frightened of hormone replacement. Once I found everything out I needed to know, I felt it was necessary to put it down for other people because there didn't seem to be other choices around for people. How could I take everything that hormone replacement said it could do and duplicate that into a program for my heart, bones, desire, dreadful weight gain, dry skin and thinning hair? That's how it came about.
Moderator: Why another book about menopause and why is this one different?
Posner: I think it's very different because it's written as a personal journal. It's my journal and it takes you through my finding out about menopause and through the history of my family. I think many women can relate to the honesty in it, like the lack of sexual desire and depression. What I'm telling you in my book is that it's an empowering experience and a new beginning. It's a natural process and nothing that's abnormal. And it gives you an uplifting approach and I think a lot of women can say, "Yes, that's what I was feeling." I also think there's parts in the book that are excellent for women who are perimenopause, menopausal, postmenopausal. It's just a different approach. I think it's also an excellent book for male members of the family to read, for the husband, brother or boyfriend to see what we actually go through. My menopause was relatively not too bad at all compared with other women. There are a lot of women who've gone through this and their period just stopped with no symptoms and there are others with horrendous symptoms.
Moderator: Where you ready for menopause when your doctor told you that you were in it? Was there any denial involved of possible symptoms?
Posner: I think there was an unconscious denial, not because of the age thing, because I've never really been concerned about the age, but I think it was more, "Me? I couldn't possibly be in menopause. I don't have any symptoms." It was like a jigsaw puzzle and it was pointed out to me the slight mood swings, the bloating and the one big zinger, the hot flashes. And that was a hard one to deny. Every time I would ask Gerald if it was hot in the room I'd pray he'd say, "Yes, it is." But the time I stuck my head in the fridge was when you have to really look at it. It's like a relief you can't explain when your head's in the fridge. Once I knew this was going on, I had an interesting approach. Because I had done so much research I decided it was time to go to war and let's see what we could do.
lmae47_lycos: Are you talking about natural hormone replacement therapy? What about hysterectomy? How would you approach that?
Posner: That's different because that's someone who's put into straight menopause, which is not what happened to me, fortunately. But I do think that someone that has that can still approach it in the respect of taking all the right vitamins and herbs and exercising to keep the bones strong and doing good things for the mind and body. It depends also if the woman is of child bearing age or not. I think it's a much bigger shock to the body, particularly if the person is young. It's all of a sudden, you know, "My body has gone into menopause." I think it's far more scary, too, than just going into the natural menopause.
Moderator: Why and how did you decide that HRT (hormone replacement therapy) was not for you?
Posner: Because being that my mom had breast cancer and the sister had breast cancer and my other aunt had breast cancer, I didn't dismiss it completely and felt I had to give it the benefit of the doubt and through my research to find out why I had the fears. I found that the risk, as small as it was, was not the route I wanted to go. I just couldn't afford to take that risk. If I could duplicate everything that HRT had for my mind and body then that's what I wanted to do and that's what I was able to do. That's what I managed to do and it worked very well for me.
Moderator: How did you develop your own program?
Posner: I first decided that I had to go and do as much research as I could, so I went straight to the Internet, of course, which is a fabulous tool. And, I used myself as a human guinea pig. The one thing I started with first, because 90% of women have hot flashes, I decided I would take the hot flashes as my number one guinea pig thing. I considered acupuncture and different homeopathic approaches, but in the end what worked for me, I found, was black cohosh and vitamin E. I was very careful because I had read a study in Germany where they tested the black cohosh. That study appealed to me. I must say this is very important here - I used very small doses here. I believe a little less is better. That was how that all came about. I'm very careful also which vitamins I use. I use a very high quality vitamin, so much so, I actually went to Boca to check out Rexall Sundown to see how the quality of their vitamins were made and they came up top grade with me. I actually went to their labs. Their herbs and vitamins are sold in chain stores. But I think you have to be very careful with quality. In the end, it's really a matter of trial and error for each person with this whole process as well.
lmae47_lycos: Being your mother and sister have had breast cancer, doesn't that still put you at great risk with or without HRT?
Posner: Yes, I think it does. But, you know, I think that I'm a very, very positive person. And I have to say that I gave up smoking 15 years ago. I drink very little alcohol. I do enjoy my wine. I'm extremely careful with my diet and I exercise. So, my lifestyle is very different from my mother, her sister and my aunt. I have a father who had colon cancer and died from it. I don't have the fear because I believe I take care of myself and minimize my risk, and on top of that not taking my HRT
Moderator: What did your doctor say about your own clinical trials?
Posner: This was in the beginning a difficult one because I adore my gynecologist, but he's always been estrogen gung-ho. So, I sat across the desk from him and my head was spinning as he was spurting out all this stuff for me: "Your skin will dry up, you'll get wrinkled, your hair will fall out, your bones will deteriorate, your mind will suffer. If anything," he said, "you're probably in failure right now." I was like, uh huh. But, in the end, once I finished my program and went for my second test, his words to me, which were like a dream come true, were, "Whatever you're doing, just keep it up. It's fine with me." I had all the baseline tests, too. Once I decided I would do this on my own, I took all the baseline tests, like blood pressure, cholesterol, bone density. When I redid the tests again, all my numbers were better than before.
Moderator: How should a woman prevent osteoporosis if she is not taking HRT?
Posner: The thing that a lot of people don't realize is that HRT will leave your bones at the level they are. So, your bones won't get any better or worse, they'll stay where they are. The only thing that can actually build bone is with weight bearing and resistance exercise. Either with using free weights or weight machines. It doesn't really matter if you use a two-pound weight or a 15-pound weight, but you need some form of resistance. That is the only natural thing to actually build bones. On top of that you'd have to incorporate calcium supplements and vitamin D, magnesium, some vitamin K, elements of boron. But you basically find out this is really an ongoing situation. In the news, one minute you're doing the right thing and the next you're doing the wrong. Enough to put you in the nuthouse. So, your calcium, and of course, not smoking. If you smoke, all the good you're doing is just erased. But the weight bearing exercises and the calcium are most important. And, trying to be aware and constantly keep up with what's going on. And, if you can go online and chat with other women, it helps. I'm learning every day something new, and incorporating something into my program and taking something out and it's an ongoing situation for all of us.
Moderator: Did you ever think about phytoestrogens (plant estrogen)?
Posner: Yes, I did think about that. But, the thing is that the naturals, with the research I did, the amounts of estrogen and progesterone in the yam creams was a bit difficult to measure. They're being tested by labs and there are some tainted hormones in them, and they can't sell them that way so they sell them in more like a cosmetic cream. From what I could read, the studies haven't come in as of yet where these creams end up. They probably only end up concentrated in your saliva and not your uterus. So, that's why I decided it wasn't quite right for me. And the symptoms that the progesterone sometimes experienced were menopausal as well. But I know some women who use them are happy. We're all individuals and we have to inform ourselves and be aware which is right for you and which is right for someone else. I think it's important to make individual choices.
Moderator: How did you deal with thinning hair and dry skin?
Posner: I've always had very good skin, so this was a real shock for me. I started taking evening primrose oil, which I think is absolutely fabulous. Or, for women who have PMS (premenstrual syndrome), it's good to take evening primrose and vitamin C because it promotes collagen. Burdock, red root clover, echinacea, selenium. A whole bunch of things to see if they appealed to me and my body. I used richer creams, too. I've also recently changed again and am using Nivea CQ10. I'm happy with that.
Moderator: How did you take evening primrose - capsule or oil?
Posner: I take it in capsule and sometimes it will say take two to three a day. But, because I'm taking so many other oils, I only took one a day. And, also for the hair, the evening primrose oil is excellent as well.
Moderator: What does the royal jelly do?
Posner: Royal jelly is also very good for the skin and hair because it's an oil base as well. I'm very careful and decide how many of these things I need to take.
lmae47_lycos: Did you do any research on compounded HRT and, if so, how does it compare with over-the-counter products?
Posner: I did a little bit, but not a tremendous amount, I must be honest. I didn't do a lot of research into that. I thought it looked more effective than over the counter, but I didn't do enough research to really say to you this or that about it.
Moderator: How could you be sure your results would be good?
Posner: I don't think one really knows. It's like anything, you approach it and hope you're positive. It was about a year experiment and I didn't know, but I knew as I was doing it, things were definitely feeling different and I was feeling better so things had to be working. The exercise, for instance, I was just astounded.
Moderator: Let's talk about diet and exercise.
Posner: If this had not worked for me, then I might have had to reconsider HRT. I gave myself the benefit of the doubt and gave myself a good year. First of all, I was someone many years ago who used to do yoga and pilates, which I love. They're really good for the mind and body. And I had done the typical classes you have at any gym. And a little bit of weight training and stretching. But I found by using my dear husband as my trainer to give me this weight-training program, I started with tiny five-pound weights. I was just astounded, at my age, how my body changed. I couldn't believe it . It was so subtle. But bear in mind, I'm a very patient person and don't need instant gratification. If you said to me it would take six months to a year to see changes in your body, I'd say, okay, fine. I would look at my arms and say, are these really my arms? I wanted definition in my arms my whole life. Diet also. I'd take one bagel, which I found from research was a whole day's carbohydrates. I was astounded. I turned all the white products to brown products. White rice to brown rice, White bread to whole wheat. I'm not on any fad diet, I just call it an eating plan. I keep fats very low. I've never been a red meat eater, so chicken and fish was the main thing, vegetables and grains. I lost a considerable amount of weight and my body fat went from 34% to 17% It probably took about a good year, but I was in shock. People would come up to me and say, "Oh, you've lost so much weight." And I'd say, "Have I?" I'd go to a shop and try on a normal size that I usually tried, about a six or eight, and then I would just go to the next smaller size and said to the salesgirl, "Are these clothes cut larger?" I was amazed that I could do this at my age. I was always programmed to believe that after 20 and 30, forget about it. You won't get yourself in shape. But, with that weight loss and with that, my bone density test was even better. My heart was better. I was this person who hated gym exercise. Then, I started to get into it because it was so gratifying and I started to get like a high from it. And, I say to myself, if I can do it, anyone who puts their mind and a little bit of discipline, and if you want it badly, I don't think it's hard for anyone to attain this.
marionb1_webmd: Isn't her program a lot of work?? Seems so much more difficult than going on HRT, no?
Posner: No, I really don't think it is a lot of work because it just becomes like a way of life, like getting up and cleaning your teeth. Let's say you're scared of hormones and so you take one HRT pill and worry for the rest of your life what's going to happen to you. Everyone wants the one pill to just take care of everything. It's really not such a lot of work. We're willing to work hard at other things, but when it comes to our mind and body, we don't want to do it. I know more women who spend more time researching a hair dresser than they would research menopause. But, no, I say to you it's such an easy thing for me to do now. It's no work whatsoever. It's a little discipline, maybe that's the word to use.
Moderator: Do you think that the women of the Baby Boom generation are going to change the face of menopause over the next 15 years?
Posner: I hope so. I pray so. I mean, it's just, we need to pull down the walls and say, hey, I'm in menopause and it's just great. We've got to get rid of the shame The most important thing is that we must get rid of the shame because it's no shame. It's a fabulous time. We've got to tell people we're great, I feel great, I'm in a new stage of my life. For me, it was like a rebirth, like saying, "Okay, I'm going to reinvent my self all over again."
Moderator: Why do you think there is so much shame associated with it?
Posner: I think here, my cousin in London just got the book from the library out there. She's about 54 and we were having this discussion, and we believe there is such an age-obsessed country here in the U.S. And, the sexuality thing. Women are scared that men are going to think that now that she's not menstruating then she's not sexy. Just read that book, Feminine Forever written in 1966 by a New York gynecologist, Robert Wilson and you'll see. It was a best selling book and it was financially backed by medical labs that produced the most widely prescribed estrogen replacement. He talks about his mother as being like the most dreaded thing for him that ever happened and that women, once we stop menstruating, are like castrated. He was classifying it as an estrogen deficiency disease, and it's just a natural thing. I think that the women of our generation have the power to say, that is it, there's nothing wrong with this, this is a great time of life and we are menopause babes and we're out there and we're coming out. We have choices. That's why I call it, This is Not My Mother's Menopause, because my mother who's 87 went to the doctor one day and he said, "You have to take this pill," and she went home and took the pill and that was the end of it. But we have so many choices and have so much power in our hands and we just don't realize it. I have an extraordinary relationship. But, I always say I paid my dues in finding the man of my dreams and we've been together 20 years and we're partners and we work together. I must say this to you that, believe it or not, a lot of guys send me letters thanking me for this book. I've had guys saying, "This book has really helped me understand my sister, my mother, my wife. I've read it twice and the things you talk about in there relate to me as a man in my fifties." I think a third of the reviews are from men and I'm very proud of that.
lmae47_lycos: Now that I don't understand. Why shame? Every woman will go through this, it is not a disease. I have heard it referred to as that too
Posner: No, it's not a disease. It's just a natural thing. It's like getting our periods was a natural thing. It's just another passage that we go through. Quite frankly, for me, it was so liberating for me to burn those tampons!
Moderator: You actually burned your tampons?
Posner: You know, it's very funny, I am a little bit of a whacko when it comes to shopping. Being British, I love all these big places like Costco and all that. And Gerald always says I'm stocking up for World War III and I bought so much of them. And I used to say to him as soon as menopause hit I'm going to burn those things. And he took me quite literally and we had a nice little bonfire. That's why I say the book does have that side of humor to it, which you can really appreciate.
sammy49_webmd: May I ask the title of the book?
Posner: My book is called, This is not Your Mother's Menopause: One Woman's Natural Journey Through Change and it's available at www.barnesandnoble.com. The web site is www.posner.com where you can also find out more and get the book. You can also find my husband's work there, too. He also has a show on the History Channel every Sunday morning at 10:30. It's a wonderful little show. He's one of a panel of four men on this show
lmae47_lycos: Off the subject a little: You say your father had and died from colon cancer. Have you had the screening for this?
Posner: I'm going in November. I think actually a great person who has done wonders for that is Katie Couric. I think it's a test that all us ladies when we're at least 50 because it's one of those tests that if they find everything early you're just A-OK. My uncle had that done and he lost it for 20 years afterwards. I'm pretty good. I go for my mammograms. In fact, I'm going next week for that. I do all my tests each year, like my eye exams.
Moderator: Did you have to rethink your relationship with tofu and soy during menopause?
Posner: I did think about it, absolutely. I'm very open-minded and to be very honest with you, I cut down on it a little. It did bother me a little. I cut down a little on the soy supplements I was taking. The more I looked into it, it made a lot of sense on that. All that about Asian women are brought up on soy and in America we just incorporate it into our diets now and it made sense. I'm open minded that way and always willing to learn.
lmae47_lycos: Just a side note: I have had the colonoscopy. It is not the monster I thought it would be. It was quite easy, no pain, and my only complaint was that I was hungry, so I urge all to get this done. No one should have to die from colon cancer.
Posner: Fantastic! Thank you! I appreciate that. It makes me feel better. For November I'll make my husband take me out for a fabulous dinner after!
Moderator: Let's talk about the depression and the mental aspect of menopause.
Posner: That was a very interesting one. I am, by nature, a very up person. In the morning, as soon as I get out of the bed, I'm very happy and it was very confusing and scary. I would look at Gerald sometimes and I'd say I'm so blue I'm going to cry. He'd say why? And I'd have no idea. That was prior to my doing research into this. I'm not an expert because I'm not a doctor, but I think that the combination of all these hormone changes going on in your body and then all the information you're getting in itself can be quite downing. I have to really say this, that anyone who suffers from clinical depression I have such sympathy for them because mine was so mild. It's impossible to describe, but nothing can make you feel better. You feel like your soul has been robbed from you. But once I started to get control of my menopause, I think my mental attitude changed. I'm such a control freak that I think it gave me that little zest for it to come back. I don't really know which pill or which herb, but it could have been the gingko or the ginseng, or a combination of many things, or the exercise, or a bunch of things, but I did not try antidepressants because it wasn't consistent enough. I would have it and then it would disappear for days. The only thing I did consider was St. John's wort, but by the time I thought about it, I was luckily over that period. You feel like you're going mad, actually, and I really have a lot of sympathy for anyone who's going through it.
Moderator: You mention in the book that are other societies where women of this age are revered. Why are Americans so afraid of it?
Posner: I think, unfortunately, it goes back to we're obsessed with youth. I'll bring it into movie careers, like once a woman goes into her forties they're done, finished. It's not like that in England. I have a girlfriend where she's tried so many times in soap operas to introduce a healthy, vibrant woman going through menopause. They'll do gay issues, AIDS issues, incest, abortion, inter-racial relationships, single motherhood, but they will not put menopause in. In fact, she wanted to use me as this healthy vibrant woman going through this and they wouldn't have her put it in. They think it takes the sexiness away. I mean, why can't we be sexy?
marionb1_webmd: I've heard about essential fatty acids (EFA) being good for you. Do you use this and do you think it's worth adding?
Posner: Oh, yes, definitely. Being that I'm on a low-fat diet, I think essential fatty acids scare a lot of women. They're not fat. They're very good for the heart. And, it's just good for an overall thing, like high blood pressure, especially if you have a deficiency. It's especially good for cancer, allergies, arthritis, Your immune related diseases. But I recommend keeping them in the fridge during the summer. We can't manufacture them and that's why we need to put them in. That's why I eat a lot of fish, by the way, which contain the omega-3 fatty acids.
sammy49_webmd: Luckily I have a great little eight-year-old to keep me busy and feeling young, but what symptoms should I look for? I feel so young and cheery at age 49 that I wouldn't know what to expect! I will read your book!!!!
Posner: Well, I think it's very hard because I never would known, as we've just discussed, but I went for this test called FSH (follicle-stimulating hormone) which a lot of doctors give, a follicle stimulating hormone test. Normal ratio is between 2 and 10. Mine was 150! One hundred and fifty is you're out of here. You're a menopause baby ! You're gone! This is exactly what we're learning. I never knew this. My first thing is that I got my period and spotting is not a real period. So, I didn't believe him and went for another blood test. Menopause is technically one year after your last period. That's something we don't normally know. What we think of as menopause is really perimenopause. You could be in perimenopause and not be aware of it because eggs stop dropping at 40 anyway. Some periods will get shorter and some will get heavy clotty when you're in perimenopause as well. Some symptoms are so mild you're not even aware of them, like my migraines and tender breasts. Bloating. I've always had those. Things that look normal are so subtle that you keep making excuses. Well, I've gained weight around my waist because I'm 49. And you can always go and have that FSH test. A lot of things in the book are wonderful for any woman at any age. There's a little bit for everybody in there. I've had women on HRT that tell me they've picked up things from my book that have been helpful. I had a friend who had to go on HRT. She had that condition where her skin starts crawling and she was sweating through three uniforms. She still took parts of my book to help her as well. So, you can incorporate both.
Moderator: Has your doctor changed how he prescribes HRT since you've written this book?
Posner: I don't think so. I gave him the book and I wrote in the inscription, "I know we don't always agree but I'll still love you to the end." I showed it to his wife as well who's an allergist. I don't think my gynecologist will ever change. I think he's a hormone junkie. He believes in it and that's his thing. He's a great gynecologist and I wouldn't continue to go to him if I didn't think he was. It's just we have a difference of opinion.
Moderator: How long will you stay on this course of treatment? For the rest of your life?
Posner: Certain things, yes. But I've already started to eliminate the double estrogen. I've eliminated the black cohosh. It's always in motion. You're always changing. I had mentioned before about my eyes. I just added to my program bilberry and lutein, which I took because my mom has a macular degeneration. With my program, it's very different from HRT because with HRT if you stop taking it you actually lose the benefits. But, with me, I'm eliminating things. I no longer have the hot flashes so I'm eliminating those things. But, I won't eliminate the calcium or the 400 IU vitamin E, or the evening primrose oil. But, there are things I know my body doesn't need if I've been treating it for certain symptoms. There's always adding and taking things out. It's constantly changing.
Moderator: How long did your hot flashes last and how do you know that they've stopped if what you took covered up the symptoms?
Posner: First of all, I did the experiment with it. By eliminating the estrogen and ended up with my head in the freezer, because it boosted right up again. But I started to cut back and see what would happen. I would do every other day and then every three days. So far, since I've cut back and I'm back on my low dosage, nothing, thank God, is happening as of yet. I now take a low dosage of vitamin E and maybe occasionally I'll take the black cohosh every three or four days. So far it's been okay, but it's trial and error.
Moderator: What is your view of menopause now that you've passed through it? What can other women learn from your experience?
Posner: I think menopause for me was an empowering experience. I don't know why it gave me a zest and confidence I didn't think was possible. I think something women should listen to that comes from Margaret Mead, the post-menopausal zest, it's real and it's been the most fantastic experience of my life and I wish I could get like fairy dust and sprinkle it all over women out there and say it's going to be a brilliant time and not to worry. It's like a new stage and new life and everything new is coming up for me. I feel so free from it. I feel fantastic. I really wish I could share this with so many people, I wish I could take what I'm feeling in my body and put it in a bottle and give it out freely to everyone. It's just a wonderful time. Just get rid of the shame.
Moderator: Do you have another topic for your next book?
Posner: I'm toying with a few things. I might do something with nutrition with women and health. I think I like this whole thing with women and health. As I'm learning about my mind and body, it's a great thing to share with other women. I think I'll make it more on a thing about choices and being informed and independent and confident. Really out there for the consumer. I enjoyed sharing it. If I only hit one woman out there, then that's great.
Moderator: Trisha, thank you for joining us. WebMD members, please check the Live Events Calendar for the next live event.
The opinions expressed herein are those of the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
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