Hot Flashes? Can’t take Hormones? Here’s some help with the Heat!

Hot flashes occur in over 85% of women during the years around menopause.  For many women, hormone therapy may not be an option for turning down the heat from night sweats and hot flashes.  After release of the Women’s Health Initiative (WHI) in July 2002, many women abruptly stopped their hormone therapy (HT) while others questioned their  safety.    Initial results from WHI showed an increase in breast cancer, heart attack, and stroke.  With a decade of hindsight we now better know the true risks and benefits of HT.  Even with this new evidence showing a major benefit in women starting hormone therapy near the time of menopause (within 10 years), there may still be many women who may not be able to take estrogen.   What are some of their options? 

Hot flashes, also known as hot flushes are very commonThese are commonly known “vasomotor symptoms” in the research and are categorized by severity and frequency:

  •  Mild: a feeling of warmth in the face, neck and chest.
  •  Moderate: feeling of warmth with sweating
  •  Severe: feeling of warmth, with sweating and loss of concentration

 

 

What are the options available for women who cannot take HT?

After reviewing numerous studies, I have compiled a list of non-hormonal prescription  and non-prescription medications which have been shown to decrease hot flashes.   Interestingly, many of these clinical trials were done in women with a history of breast cancer, receiving tamoxifen.  Furthermore, many of these trials had a very high placebo rate, i.e. those women not receiving the study medication   (placebo pill) showed  a high rate of benefit compared to those receiving the actual study medication.  This is known as the “placebo effect”.  In these studies, the placebo response rate ranged from 18-40%.

 

 

Non-hormonal/ Prescription Medications                                         

1)      SSRI’s/SSNRI’s : Best results occurred with Venlafaxine ( Effexor)  with 63% reduction in hot flashes in patients receiving 75 mg dose, vs. 45% in those receiving lower dose ( 37.5 mg) compared to 20% reduction in placebo group.  The next best was Paroxetine (Paxil), followed by Fluoxetine (Prozac).

2)      Gabapentin ( Neurontin); 45% decrease in hot flashes vs. 29% placebo, at dose of 300 mg three times a day.

3)      Clonidine ( Catapres): very few studies with only short term use, up to 12 weeks, reduces hot flashes by 15-20%., with dose of 0.1 mg/day.

4)      Belladonna/ergotamine tartrate/Phenobarbital combination ( Bellergal): decreased hot flashes by 75 % vs. 68% in placebo, dose of one tablet three times a day.

   Black Kohash plant

Non-hormonal /Non-prescription Options

1)      Black Kohash: This is the most studied and popular herb for treatment of hot flashes.   Results of studies show inconsistent results and dosages varied.  American College of Ob/Gyn ( ACOG) states that black kohash may be helpful in the short-term ( less than six months) treatment of women with vasomotor symptoms.

 

2)      Soy isoflavones: Studies showed inconsistent results. Some showed significant reduction in women with moderate to severe hot flashes.    ACOG recommends that soy and isoflavones  be used in the short-term , less than 2 years and that they should be used with caution in women with an estrogen-dependent cancer,  given the possible interaction with estrogen (39).

 

3)      Red Clover, Ginseng, Evening Primrose oil, Wild Yam: In clinical trials, no significant difference in hot flash reduction compared to placebo.  I have included these because many patients  frequently do use these remedies and do find some relief, although for only a short period of time

Take Home Tips:

1)      Hot flashes occur very frequently in women around the time of menopause and can significantly affect a woman’s quality of life.

2)      A thorough medical history should be taken to rule out other causes for hot flashes, such as thyroid disease.

3)      Evaluation of current medications and conditions should be considered with you and your health care provider to determine the best option for you, be it hormonal, or non-hormonal. 

4)      There are prescription medications available as well as herbal remedies.

5)      Consult with your health care provider before initiating any treatment.

Then you too, can be lying in the green grass…calm, cool and collected!

 

Lighting the way…

Dr. Diana

 

Citations:

  1. 1.      Roussouw, JE. Et al.  (2002) Writing Group for the Women’s Health Initiative Investigators.  Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized control trial.  JAMA; 288: 321-33.

 

  1. 2.      Carroll, DG. (2006). Nonhormonal Therapies for Hot Flashes in Menopause. Am Fam Physician, Feb 1; 73 (3): 457-464.

 

 

 

Is it “hot” in here? Getting Rid of the Heat- Introducing the “Kool Tool”!

Is it “hot” in here?  Getting Rid of the Heat- Introducing the “Kool Tool”!

Are you tired of those bothersome hot flashes?  Sweating during a meeting and losing your train of thought?  Soaking the sheets at night?

Well, you’re not alone!   Approximately eighty-five percent of the women in the United States are experiencing hot flashes of some kind as they approach menopause, and for the first few years after their periods stop.  In fact, 20-50% of women continue to experience them for up to 5 years and 15% will continue to have them their entire life!   Want some secret tips to turn down the heat?

 What are hot flashes?

A hot flash is a sudden, intense, warm feeling which occurs on the face, neck and upper body which can last for a few seconds, minutes or longer.   It can be accompanied by faster heart rate, sweating, and loss of thought.  Some women even experience an “aura”, an uneasy feeling just before the hot flash occurs, warning them of its imminent assault.   This flash is often followed by a flush, which leaves you reddened and perspiring.  At night, these same symptoms are called night sweats.

 

What causes hot flashes?

Hot flashes are usually caused by the hormonal changes occurring during menopause, specifically the precipitous decline in estrogen levels.   Some of these symptoms can also be affected by lifestyle and medications.  With the steep decline in estrogen levels during menopause, the brain experiences certain changes.  Specifically, the hypothalamus, the control center for appetite, sleep cycles, sex hormones and body temperature is affected.   The drop in estrogen confuses the hypothalamus to think that it’s “thermostat” is reading “too hot”.   

Because of this heat overload, your brain sends signals to vital organs to get rid of the heat.  Your heart rate quickens, blood vessels dilate and nervous system is activated with release of epinephrine, prostaglandins and serotonin.  Within seconds, the blood vessels in your skin dilate, radiating off heat, and sweat glands produce sweat to cool you off.    It has been reported that in some women the skin temperature can rise as much as six degrees Fahrenheit!  Your body cools down because it thinks it too hot, making you sweat during the middle of a board meeting or in the middle of a good night’s sleep.

Decrease hot flashes by avoiding these triggers:

  • Stress
  • Caffeine
  • Alcohol
  • Spicy foods
  • Tight clothing
  • Heat
  • Cigarette smoke

Get a Kool Tool!

This amazing product was developed by four incredible businesswomen living in San Diego, who are dear friends of mine.   I am an affiliate marketer with them.

 

 

Once I placed the Kool Tool around my neck a cooling sensation instantly spread across my neck and chest.  Wow, what a brilliant idea.  Now I’m using my Kool Tool at the office, on the tennis court, at the gym and while gardening outside.    It last for hours, is reusable, and is anti-microbial.  For me, it’s been a literal life-saver!

For my faithful blog followers, as an affiliate marketer, I am offering a special discount on the Kool Tool.  Simply go to my website: www.drdianahoppe.com and click the “store” button.  Then enter the following coupon codes:

Buy 2 and save $5: use coupon code:  DrD2for35

Buy 3 and save $10: use coupon code:   DrD3for50

Start feeling cooler today! 

 

 

 
Dr. Diana

Dr. Diana

Fifty Shades: From Baby Boom to Rope Shortage?

Fifty Shades : From Baby Boom to Rope Shortage?

Could this erotic trilogy be causing a virtual baby boom?   Not to mention an apparent shortage of certain rope in the United States?   The first of these queries was recently posed to me by an interviewer for Parent Magazine.  It piqued my interest into the possibility that this steamy, erotic novel is awakening women’s desire from water coolers to book club groups, and boardrooms to bedrooms.

 

Are Baby Boomers having more sex because of Fifty Shades of Grey? …

Yes,  according to Babycenter.com, a large online community of moms and expectant moms, over 150 women have posted that their pregnancies were directed related to sex inspired activity by the best selling trilogy.  The Huffington Post adds that an increasing number of women are reporting more spontaneity and frequency of sexual encounters (1).  Depending on whether contraception is being used, more pregnancies may be occurring due to the increased…More enthusiasm and creativity is entering the bedroom, not only leading to more conceptions, but also a boom in the sales of sex toys.  According to Lisa Lawless, Ph.D, creator of Holistic Wisdom website, “Women and men are benefiting from these books as it is allowing them to consider sexual creativity and exploration in ways that they perhaps had not considered.”(2)

 

Are Men interested in Fifty Shades? — Fifty Shades Too Boring?

According to a recent survey in the Village Voice, Fifty Shades of Grey: Do Dudes Even Care About E.L. James’ Steamy Trilogy?, the resounding answer was “no”. (3) One response from a 34 year-old business owner, summed it up.  “My wife is reading it right now.  I have no idea how it’s affecting our sex life.  I don’t know if it’s impacted it at all.  Maybe you should ask her.” Yet other sites have claimed that men are reaping the sexual benefits of their partner’s increased sexual desire, while not specifically reading the book themselves.

For those men who might not be so inclined to download it on their Kindle or i-pad, a special, shortened version  is available. Tom Paolangeli is the author of “A Guy’s Secret Guide to Fifty Shades of Grey”, a cliff note version of the original book by E.L.James written from a man’s perspective.   He advises, “Trust me – you do not want to read the book. It was written by a woman, for women. Most guys will find it dull, stupid, tiresome and waaaay too long. The ratio of tedious inner female monologue to sex scenes is about fifty shades of boring to one.”  But he also that by reading a few sections of the book, “…your odds of having hot sex with your sweetie will go up exponentially…” (4)

What does Dr. Oz think?

Recently, Dr. Oz offered his opinion regarding the impact of the E.L. James’ blockbuster trilogy.  “She has gotten people talking about sex in a way that no one else could get them to talk about it…. What it is about is people having an honest conversation about what sex should be like, what makes it feel better, what are the timing issues, how do we make it an important issue in our life rather than an afterthought.”

Well, Dr. Oz, I thought that was what my book, Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life, was supposed to do!  Perhaps my book took on a too clinical and practical approach rather than a bondage and submission angle.  Maybe then my book would be on the New York best seller list, too.   Brings back vague memories of how I should have bought Starbuck’s stock back in the early 1990’s.

When will this “Fifty Shades” bonanza end? 

Not anytime soon.   Apparently, a movie series is in the making with the cast being set as we speak.  In addition, E L. James has chosen a company in the United Kingdom, Caroline Mickler Ltd, as the global licensing agent for merchandise based on her racy books with a line of Fifty-Shades’ based lingerie/sleepwear, apparel, fragrances, beauty products, bedding , etc.”.(5)    Sales of sex toys are sky-rocketing, including the sale of rope.

According to the New York Post, New York hardware stores have seen a run on sales of rope, and other bondage gear, bought by female fans of Fifty Shades (6).  Watch out for the soon-to-be shortage of  hand-cuffs and riding crops!!

Share your views on the book.   

Feel free to use an alias or your initials with your post.  It’s a tender topic and I respect your views and candor.

Has it impacted your sex life?  If so, in what way?

Has the frequency of sex increased for you and your partner?

Has your partner read it?

Citations:

1)   www.huffingtonpost.com/2012/07/26/fifty-shades-of-grey-names_n_1707842.html

2)   www.holisticwisdom.com/fifty-shades-james-sex-toys-bondage.htm.

3)   www.villagevoice.com/runninscared/2012/07/fifty_shades_of_gre_men_react.php

4)   www.amazon.com/Secret-Guide-Fifty-Shades-ebook/dp/8008080RDFRU

5)   www.theadvocate.com/utility/homepagestories/2675013-129/men-are-fans-too-of

6)  www.nypost.com/p/news/local/ny_gals_learning_the_ropes_at_fifty_sVWWKeksj9WKUto2ITg/KK

 


Unhealthy relationship…with your “in-box” ?

Unhealthy Relationship … with your “in-box’?  

Is e-mail bogging you down?

With so many social media networks, literally at our fingertips, it’s no wonder that we can’t keep up with them.  They are taking a toll on our nerves… as well as our libidos!  Every day we are bombarded by hundreds, or potentially thousands, of e-mails, texts, tweets and Facebook messages.

How are we supposed to juggle all of them?
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Where is YOUR “Red Room”?

Where is your “red room”?

If you could fantasize about having a hot, sexy encounter anywhere in the world, where would it be?

My last blog highlighted the nation’s infatuation with the female erotic novel, Fifty Shades of Grey. In this romantic novel, the virginal female protagonist, Anastasia Grey, engages in sexual encounters with the gorgeous, multifaceted male hero, Christian Grey. In his house, Christian and Anastasia explore the boundaries of their sexual relationship in a small, ….. coined, “ the red room”.

And while we might fantasize about having a “red room” built into our own homes, where else would you dream about fueling the fires of desire?

Can you guess what the #1 place was for women? For men?

An intriguing study, recently done by the Durex Corporation, posed this exact question to 1,000 American adults, ages 18 and older, between March 16- March 23, 2012. Interestingly, the Durex Corporation manufactures condoms and conducts multiple titillating trials on sexual health every year. In this particular study, called the InSync Study, the top tryst sites to “get it on” were surveyed.

What was the number one place for women? The Eifel Tower! Yes, the highest percentage of women interviewed, 33 percent, fantasized about a sexual rendezvous at this romantic icon nestled in the heart of Paris.

For men? Amazingly, the White House! Thirty-one percent of the men polled chose the site associated with extreme power — and where some of our past presidents have even engaged in romantic interludes.

How can we explain these results? Interestingly, quite easily. Women, in general, love romance. Just imagine hearing the sweet sound of French music playing in the background, the smell of….in the air, the slight breeze brushing across your cheeks, the taste of his gentle kiss as you both gaze upon the river Seine. Wow, even I was being carried away with that one!!

For men, sexual fantasy is more about power. The White House is the ultimate symbol of authority, respect and command of our nation.

Why do we fantasize about having sex in mysterious places? Because too many of our sex lives are in a “rut” and need some major resuscitation! In fact, half of Americans interviewed in this same study were dissatisfied with their bedroom escapades. Of respondents interviewed, 37% admitted that their intimate time ends far too quickly. On the flip side, 14% revealed that sex lasts longer than they would like.

Some good news…

Even before Fifty Shades of Grey hit the shelves and heated women’s sexual desires across the country, Americans were already becoming more adventurous in the bedroom. According to another study by Durex, called the Durex Global Sexual Wellbeing Survey , which interviewed over 29,000 adults, aged 18 and older, between Sept 6 and October 3, 2011, American couples are actually trying new things to spice it up and get more “in sync” in the bedroom. These included using new types of lubricants (53%), adult toys and aids (39%), and rings (11%).

Can’t fly to Paris or Washington, D.C.? Or build your own red room?

Well, here are some places to heat things up in your home.

Top 5 places to have sex – around the house!
1. In the shower. Lathering each other with body wash can get you both incredibly squeaky clean as well as get you feeling sensuous.
2. In the bath tub. If the shower sounds a bit too acrobatic, run a bubble bath, soak in the wonderful…. And give each other a foot massage. Then feel free to massage other places.
3. In the kitchen. Remember the scene from “The Mailman Always Rings Twice”? Maybe while cooking up a delicious meal with your honey, sipping a glass of wine, slowly stirring the garlic simmering in the olive oil… you get the drift!
4. In the backyard. Just make sure that there are some trees or other shrubs to obstruct your neighbor’s view!
5. In the laundry room… think spin cycle.

Citations:
1) InSync Study, Durex Corporation, http://www.prnewswire.com/news-releases/durex-survey-reveals-what-americans-really-want-in-the-bedroom-149464045.html
2) Durex Global Sexual Wellbeing Survey: http://www.durex.com/en-ca/sexualwellbeingsurvey.

Sex Improves Brain Health

Can’t remember the last time you had sex?

Well maybe it’s time to share some intimacy with your partner!

It has long been known that exercise may have many health benefits, decreasing mortality, improving cardiovascular function and decreasing risk of heart attack, enhancing cognitive functioning and improving depression. This effect has been shown in older individuals as well as in individuals who complain of memory difficulty. Many of us may fear that we are developing “pre-senile dementia” when we experience minor memory lapses during the day. Most likely these are due to fatigue and brain overload, rather than true brain pathology. Yet, if we implement new health strategies, like more sex and exercise, we will be improving our brain function.

When do we start seeing decreased mental sharpness?

It is now estimated there are more than 36 million people in the US over the age of 65 and that many of them will be impacted by cognitive decline and brain atrophy associated with normal aging. Strong evidence indicates that memory and cognitive skills start declining by age 50. (1). The prevalence of dementia ranges from 5% to 10% (2.) and that of mild cognitive impairment (MCI) ranges from 12% – 18% (3). This decline in cognitive tasks has a critical impact on the quality of life. To improve the quality of life, it is essential for individuals of all ages to implement healthy strategies to improve brain health –and wouldn’t having more sex be a fun way to do this?

How does having more sex help the brain?

With any form of exercise – and let’s face it, sex is a form of exercise – blood flow increases. The increased circulation of blood transports oxygen-enriched blood to the hypothalamus, the center of the brain for memory and learning. One study done by Yaffe and colleagues followed over 5,900 women (more than 65 years old) for 6 to 8 years with baseline self-report exercise measures (4). Women with a greater physical activity level at baseline experienced less cognitive decline during the 6 to 8 years of follow-up: cognitive decline occurred in 17%, 18%, 22% and 24% of those in the highest, third, second and lowest quartiles of blocks walked per week, respectively.

This also holds true for men. In a study of 2,257 men, the risk of dementia was 1.8 fold increased in men who walked the least (less than 0.25 miles/day) compared to those who walked more than 2 miles/day (17.8 versus 10.3/1,000 person-years) (5).

Interestingly, a recent review of over 11 studies of aerobic exercise programs for healthy older persons also indicated improved cognitive function with fitness improvement. The most consistent effects were seen with thought processing and attention, as well as memory, language and visuospatial skills (6).

So what are we waiting for?
Get out there and start spending some time with your partner frolicking in the hay!

Yet, if you or your partner is not physically able to have sex, think of some creative and romantic ways to be intimate. One idea: pack up a picnic lunch and go for a long stroll on the beach or in the mountains. Hold hands, enjoy the view and the connection with your partner— knowing that you’re helping your hearts, your brains and raising spirits!

Citations:

1. Salthouse, T.A. Memory aging from 18-80. Alzheimer Dis Assoc Disord. 2003; 17: 162-167.

2. Plassman, BL et al. Prevalence of dementia in the United States; the aging, demographics and memory study. Neuroepidemiology, 2007; 29: 125-132.

3. Petersen, R. et al. The Mayo Clinical Study of Aging: Incidence of Mild Cognitive Impairment. Alzheimers Dement 2008; 4: T130.

4. Yaffe,K et al. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med. 2001; 161: 1703-1708.

5. Abbott, RD et al. Walking and Dementiain physically capable elderly men. JAMA. 2004; 292:1447-1453.

Angevaren M, et al. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2008. P. CD005381

Gratitude: A Hidden Key To Better Health

It’s no secret that stress causes us to become sick – leading to heart disease, diabetes and depression, among many others. In fact, up to 90% of all doctor visits are due to stress related conditions.

What if I told you there is something you could do today, right now, to lessen your level of stress? And it wouldn’t break the bank doing it!

A few weeks ago, I shared the intriguing research and Satisfaction of Life Scale of Edward Diener, Ph.D, a.k.a, “Dr. Happiness”. I proposed the concept of a “gratitude” journal, writing what you are grateful for in your life.

Why keep a gratitude journal?

Because gratitude, it turns out, helps us better manage stress and life’s challenges and leads to sounder sleep, less anxiety, higher long-term satisfaction with life and kinder behaviors toward others, including our romantic partners (1). Now, wouldn’t that put a smile on your, as well as your partner’s, face?

According to Dr. Robert Emmons, psychology professor at the University of California , Davis, “ Gratitude research is beginning to suggest that feelings of thankfulness have tremendous positive value in helping people cope with daily problems, especially stress.” (2) In fact, showing gratitude and having a positive outlook can boost your immune system. Dr. Lisa Aspinwall, a psychology professor at the University of Utah, compared the immune systems of healthy, first-year law students under stress and found that, by midterm, students characterized as optimistic ( based on survey responses) maintained higher numbers of blood cells that protect the immune system, compared with their more pessimistic classmates. Optimism can also have a positive health impact on people with compromised health, such as patients confronting AIDS (3). By showing gratitude and optimism, higher levels of white blood cells (CD4) cells and slower disease progression was seen in these patients.

Cultivating an “Attitude of Gratitude”

Here are 6 Tips from Dr. Emmons for getting the most from your gratitude journal (4).

1. Don’t just go through the motions. Journaling is most effective if you first make a definite conscious decision to become happier and more grateful. “Motivation to become happier plays a role in the efficacy of journaling, “says Emmons.

2. Go for depth rather than breadth. Elaborating in vivid detail about a particular event for which you are grateful for carries much greater benefit than a superficial list of many things.

3. Get personal. Focus on people to whom you are sincerely grateful, rather than material things.

4. Try subtraction, not just addition. Reflect on what your life would be like without certain blessings, rather than just tallying up all of the good things.
5. Savor surprises. Record events that were unexpected or surprising, as these tend to elicit stronger feelings of gratitude.

6. Write in moderation- Don’t over-do it. According to certain studies, writing once a week for six weeks reported boosts in happiness compared to those people who wrote more frequently, three times a week(5). I believe this is very individual – find the amount of journaling that is right for you.

In addition, Dr Emmons recommends that you “relish and savor” these gifts of gratitude. “In other words, we tell them not to hurry through this exercise as if it were just another item on your to-do list. This way, gratitude journaling is really different from merely listing a bunch of pleasant things in one’s life.”

So what are you waiting for? Order your own gratitude journal today and start reaping all of the benefits. Recognize the meaning of events occurring around you, create a deeper connection with your partner and sense of purpose in your life!

Click on this link right now and start your attitude of gratitude!

Citations:
1. http://www.nytimes.com/2011/11/22/science/a-serving-of-gratitude-rings-healthy-dividends
2. http://women.webmd.com/features/gratitute-health-boost
3. Ironson, G., Hayward, H. 2008. Do Positive Psychological Factors Predict Disease Progression in HIV-1? A Review of the Evidence. Psychosomatic Medicine, 70 (5): 546-554.
4. http://greatergood.berkeley.edu/article/item/tips_for_keeping_a_gratitude_journal/
5. Lyubomirsky, S. et al. 2005. Pursuing Happiness: The architecture of sustainable change. Review of General Psychology, 9: 111-131.

8 Weeks to a Better Brain! – Try some mindfulness meditation

In our frenetic world of 24/7, cell phones, i-pads, blackberries and other various technological gadgets, it may seem like there is not enough time to breathe, eat or sleep, much less find time to meditate.

Well, you may want to start making a conscious effort to FIND that time to quiet your mind after reading the intriguing new research which shows that practicing Mindfulness Based Stress Reduction (MBSR) can literally change your brain… for the better, of course!
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The Science Of Happiness: What Truly “Lights You Up”?

What really makes you happy, light up and want to jump out of bed in the morning? Is it money or a youthful appearance? Well, a new niche within the field of Psychology, called Positive Psychology, is delving into these intriguing questions (1).

For over two decades, Edward Diener,Ph.D, a.k.a. “Dr. Happiness” and professor of psychology at the University of Illinois, has been examining what makes us feel satisfied with life (2). Is it wealth? Education? High IQ? Youth? Healthy sex life?
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Women: The Ultimate Multi-Taskers – Why We Owe It To Ourselves To Learn To Say “No”

As women, we are the ultimate multi-taskers and multi-pleasers. We want to DO and BE everything for everyone at every time of the day. But how realistic is this?

Why does it seem so difficult to say “no”? Can we really learn to start saying ”no” gracefully and not feel guilty about it?
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