The Menopause Answer Book: Practical Answers, Treatments, and Solutions for Your Unique Symptoms

434 Pages·2004·4.7 MB·English

by  Marsha Speller MD

M THE
Q
How do I know whether my symptoms are normal signs of menopause or MENOPAUSE
whether I’m at risk for disease? Are natural remedies safe and eff ective?
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Should I be making lifestyle changes or is it too late?
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& During menopause, estrogen levels fall and health risks increase. At the
same time, a lifetime of bad habits and genetic predispositions to disease O ANSWERBOOK
A TM
can lead to a plethora of symptoms—some temporary, some chronic, and
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some life-threatening. The Menopause Answer Book allows women to assess
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their own symptoms and then seek out the right tests and treatments for
their own unique Menopause Action Plan. U
(cid:2) Am I at risk for osteoporosis, heart (cid:2) What tests should I have and S Practical Answers, Treatments, and
disease, cancer, depression, or other what do their results mean?
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Solutions for Your Unique Symptoms
diseases related to menopause?
How can I get immediate relief for
A (cid:2)
N (cid:2) What do natural remedies have symptoms such as hot fl ashes,
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S to off er and how do I fi gure out mood swings, and loss of libido? N (cid:2)(cid:2) WW hhaatt tteessttss sshhoouulldd yyyooouu
W which ones are right for me?
(cid:2) What can I expect my doctor to have and how often
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How do I know whether hormone do for me and what do I need to
E (cid:2) should you have them?
W
R replacement is right for me? do on my own?
B * (cid:2) Are you at risk for
Includes checklists and quizzes to help you determine what your
E
O symptoms mean, whether to seek medical advice sooner rather than osteoporosis, urogenital
R
O later, and what your best options for treatment are. disorders, or breast or
K B
The Menopause Answer Book ovarian cancer?
Written in an easy-to-read format, helps you understand
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your symptoms and develop a plan to get you the help you need.
(cid:2) Are there lifestyle
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Health/Health Care
$14.95 U.S./ $17.95 CAN/ £7.99 UK changes you should be
Marsha Lynn Speller, MD, is the ISBN-13: 978-1-4022-0259-9 K
ISBN-10: 1-4022-0259-8
founder and executive director of making immediately
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Women’s HealthSource, Inc., which off ers to reduce your risks?
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Change of Life seminars to women and EA
women’s midlife health education programs (cid:2) Are your symptoms
to businesses. She is a psychiatrist, a certifi ed
temporary, chronic, or
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menopause clinician, and participates in UP Speller
life-threatening?
clinical research pertaining to menopause
symptoms and treatment.
WWW.SOURCEBOOKS.COM
MARSHA LYNN SPELLER, MD Susan Ashley, PhD
Menopause_int.qxp:Menoupase_int 2/27/08 10:16 AM Page i
MTMHE EENNOOPPAAUUSSEE
ANSWERBOOK
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MARSHA LYNN SPELLER, MD
Menopause_int.qxp:Menoupase_int 2/27/08 10:03 AM Page ii
Copyright © 2004, 2008 by Marsha Lynn Speller, MD
Cover and internal design © 2008 by Sourcebooks, Inc.
Cover photo © iStockphoto
Sourcebooks and the colophon are registered trademarks of Sourcebooks, Inc.
All rights reserved. No part of this book may be reproduced in any form or by any electronic or
mechanical means including information storage and retrieval systems—except in the case of
brief quotations embodied in critical articles or reviews—without permission in writing from its
publisher, Sourcebooks, Inc.
This publication is designed to provide accurate and authoritative information in regard to the
subject matter covered. It is sold with the understanding that the publisher is not engaged in ren-
dering legal, accounting, or other professional service. If legal advice or other expert assistance
is required, the services of a competent professional person should be sought.—From a
Declaration of Principles Jointly Adopted by a Committee of the American Bar Association and a
Committee of Publishers and Associations.
This book is not intended as a substitute for medical advice from a qualified physician. The intent
of this book is to provide accurate general information in regard to the subject matter covered. If
medical advice or other expert help is needed, the services of an appropriate medical profes-
sional should be sought.
All brand names and product names used in this book are trademarks, registered trademarks, or
trade names of their respective holders. Sourcebooks, Inc., is not associated with any product or
vendor in this book.
Published by Sourcebooks, Inc.
P.O. Box 4410, Naperville, Illinois 60567-4410
[phone]
Fax: [phone]
www.sourcebooks.com
Originally published in 2004. Revised in 2007.
Library of Congress Cataloging-in-Publication Data
Speller, Marsha Lynn.
The menopause answer book: treatments and solutions for your unique symptoms
/ by Marsha Lynn Speller.
p. cm.
Includes bibliographical references and index.
1. Menopause—Popular works. 2. Middle aged women—Health and hygiene—Popular
works. I. Title.
RG186.S699 2004
618.1’75—dc22
2004001037
ISBN 1-4022-0259-8
Printed and bound in the United States of America
BG 10 9 8 7 6 5 4 3 2 1
Menopause_int.qxp:Menoupase_int 2/27/08 10:03 AM Page iii
Acknowledgments
I want to acknowledge my husband, Wes, and my editor, Deborah
Werksman, for their unfailing support, help, and advice.
Menopause_int.qxp:Menoupase_int 2/27/08 10:03 AM Page iv
Menopause_int.qxp:Menoupase_int 2/27/08 10:03 AM Page v
To my children and
all women,
young and old,
to help you
prepare for the inevitable . . .
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Menopause_int.qxp:Menoupase_int 2/27/08 10:03 AM Page vii
Table of Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Part I—How Hormones Work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 1 Getting Personal about Menopause. . . . . . . . . . . . . . . . . . . . . . . 3
Chapter 2 In the Beginning.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Chapter 3 The Normal Menstrual Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Chapter 4 The Power of Estrogen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Chapter 5 The Effect of Estrogen on the Body’s Organs. . . . . . . . . . . . . . 19
Chapter 6 Estrogen Withdrawal Symptoms . . . . . . . . . . . . . . . . . . . . . . . . 23
Chapter 7 Postpartum Blues and PMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Part II—The Individual is the Context. . . . . . . . . . . . . . . . . . . . . . . . . 41
Chapter 8 Your Medical History. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Chapter 9 Laboratory Tests and Screening Examinations. . . . . . . . . . . . . 57
Chapter 10 Recommended Tests and Screenings—By the Decade . . . . . . 65
Chapter 11 Early History Counts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Part III—How’s Your Health?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Chapter 12 Disease Risk Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Chapter 13 Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Chapter 14 Heart Disease, Hypertension, and Cholesterol. . . . . . . . . . . . . 93
Chapter 15 Urogenital Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Chapter 16 Osteopenia and Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Chapter 17 Thyroid Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Chapter 18 Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Chapter 19 Osteoarthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Chapter 20 Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Chapter 21 Alzheimer’s Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Chapter 22 Stress and Depression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Part IV—To Be or Not To Be on HRT . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Chapter 23 First Thoughts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Chapter 24 Is It Safe for Me? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Chapter 25 Recent Research Findings and Controversies. . . . . . . . . . . . . 155
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Chapter 26 What Products Are out There? . . . . . . . . . . . . . . . . . . . . . . . . . 163
Chapter 27 Your Initial Evaluation and Follow-Up for HRT . . . . . . . . . . 175
Chapter 28 A First Look at Alternatives to HRT. . . . . . . . . . . . . . . . . . . . . 183
Part V—Alternatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Chapter 29 What Is Meant by “Alternatives”?. . . . . . . . . . . . . . . . . . . . . . 193
Chapter 30 Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Chapter 31 Alcohol, Soda, and Caffeine . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Chapter 32 Vitamin and Mineral Supplements. . . . . . . . . . . . . . . . . . . . . . 213
Chapter 33 Food Basics: Protein, Carbs, Fats, Fiber, and Water. . . . . . . . 235
Chapter 34 Phytoestrogens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Chapter 35 Weight Gain and Muscle Loss. . . . . . . . . . . . . . . . . . . . . . . . . . 255
Chapter 36 Dieting and Exercise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Chapter 37 A Reference Guide to Minimizing Your
Change of Life Symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Chapter 38 A Reference Guide to Improving Your Health. . . . . . . . . . . . 313
Part VI—Let’s Talk about Sex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
Chapter 39 Hormones and Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Chapter 40 The Sexual Response Cycle. . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
Chapter 41 Sexual Attitudes and Aging. . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Chapter 42 What Is Sexual Dysfunction and How Common Is It?. . . . . 351
Chapter 43 How Does Menopause Impact Sexual Functioning?. . . . . . . 355
Chapter 44 Evaluation and Treatment Strategies. . . . . . . . . . . . . . . . . . . . 363
Part VII—The MAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Chapter 45 The SANE Approach to Developing Your MAP . . . . . . . . . . 381
Chapter 46 Completing the Menopause Action Plan. . . . . . . . . . . . . . . . . 383
Chapter 47 Part I—My Current Symptoms. . . . . . . . . . . . . . . . . . . . . . . . . 385
Chapter 48 Part II—My Medical History. . . . . . . . . . . . . . . . . . . . . . . . . . . 387
Chapter 49 Part III—My Disease Risks . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
Chapter 50 Part IV—My HRT Assessment . . . . . . . . . . . . . . . . . . . . . . . . . 391
Chapter 51 Part V—My Lifestyle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
Chapter 52 Part VI—My Sex Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
Afterword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 416
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Foreword
My editor, Deborah Werksman, asked me to expand and revise The
Menopause Answer Book with an emphasis on things we can do to
help ourselves through the “change of life.” In this revised edition,
I’ve added practical treatments you can use and recommendations
for remedies that you can get in your local pharmacies and vitamin
stores. This book is written to help all of us to take more responsi-
bility for our health, to become informed and knowledgeable about
change of life issues, to help us inform our daughters about our
experiences as women, and to help us embrace aging and become
less fearful of its consequences.
As a result of doing this work, there’s been an effect on my life—
those I love the most, my friends and family, are becoming more
health conscious and are starting to make healthy changes in their
habits (eating better foods, taking daily supplements, and even
exercising regularly).
Let’s face it: Our own doctors are overwhelmed with trying to
understand and learn new technologies and drugs and keeping
pace with the time-consuming demands placed on our practices by
medical insurers. We physicians have a lot less time to see our
patients, learn from them, and teach them the things we know.
Therefore, this book is bigger and, I hope, better.
After twenty-five years, I’m still passionate about my work and
I see it as a partnership between my patients and myself with this
goal: to learn how to live long and age well.