Knowledge Is Power Safety, Post-Menopause Too

Note: this article will be most relevant for a subset of our subscribership, but it’s a very large subset, so we’re going to go ahead and address the reader as “you”.

If, for example, you are a man and this doesn’t apply to you, we hope it will interest you anyway (we imagine there are women in your life).

PS: the appendicitis check near the end, works for anyone with an appendix

We’ve talked before about things that come with (and continue after) menopause:

• What You Should Have Been Told About The Menopause Beforehand
• What Menopause Does To The Heart
• Alzheimer’s Sex Differences May Not Be What They Appear

But what’s going on if certain menstrual symptoms reappear post-menopause (e.g. after more than a year with no menstruation)?

Bleeding

You should not, of course, be experiencing vaginal bleeding post-menopause. You may have seen “PSA” style posts floating around social media warning that this is a sign of cancer. And, it can be!

But it’s probably not.

Endometrial cancer (the kind that causes such bleeding) affects 2–3% of women, and of those reporting post-menopausal bleeding, the cause is endometrial cancer only 9% of those times.

So in other words, it’s not to be ignored, but for 9 people out of 10 it won’t be cancer:

Read more: Harvard Health | Postmenopausal bleeding: Don’t worry—but do call your doctor

Other more likely causes are uterine fibroids or polyps. These are unpleasant but benign, and can be corrected with surgery if necessary.

The most common cause, however is endometrial and/or vaginal atrophy resulting in tears and bleeding.

Tip: Menopausal HRT will often correct this.

Read more: The significance of “atrophic endometrium” in women with postmenopausal bleeding

(“atrophic endometrium” and “endometrial atrophy” are the same thing)

In summary: no need to panic, but do get it checked out at your earliest convenience. This is not one where we should go “oh that’s weird” and ignore.

Cramps

If you are on menopausal HRT, there is a good chance that these are just period cramps. They may feel different than they did before, because you didn’t ovulate and thus you’re not shedding a uterine lining now, but your body is going to do its best to follow the instructions given by the hormones anyway (hormones are just chemical messengers, after all).

If it is just this, then they will probably settle down to a monthly cycle and become quite predictable.

Tip: if it’s the above, then normal advice for period cramps will go here. We recommend ginger! It’s been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:

See: Effect of Ginger and Novafen on menstrual pain: A cross-over trial

It could also be endometriosis. Normally this affects those of childbearing age, but once again, exogenous hormones (as in menopausal HRT) can fool the body into doing it.

If you are not on menopausal HRT (or sometimes even if you are), uterine fibroids (as discussed previously) are once again a fair candidate, and endometriosis is also still possible, though less likely.

Special last note

Important self-check: if you are experiencing a sharp pain in that general area and are worrying if it is appendicitis (also a possibility), then pressing on the appropriately named McBurney’s point is a first-line test for appendicitis. If, after pressing, it hurts a lot more upon removal of pressure (rather than upon application of pressure), this is considered a likely sign of appendicitis. Get thee to a hospital, quickly.

And if it doesn’t? Still get it checked out at your earliest convenience, of course (better safe than sorry), but you might make an appointment instead of calling an ambulance.

Take care!

How To Be An Expert Nap-Artist

There’s a lot of science to say that napping can bring us health benefits—but mistiming it can just make us more tired. So, how to get some refreshing shut-eye, without ending up with a case of the midday melatonin blues?

First, why do we want to nap?

Well, maybe we’re just tired, but there are specific benefits even if we’re not. For example:

• Increased alertness
• Helps with learning
• Improved memory
• Boost to immunity
• Enhance athletic performance

What can go wrong?

There are two main things that can go wrong, physiologically speaking:

1. We can overdo it, and not sleep well at night
2. We can awake groggy and confused and tired

The first is self-explanatory—it messes with the circadian rhythm. For this reason, we should not sleep more than 90 minutes during the day. If that seems like a lot, and maybe you’ve heard that we shouldn’t sleep more than half an hour, there is science here, so read on…

The second is a matter of sleep cycles. Our brain naturally organizes our sleep into multiples of 20-minute segments, with a slight break of a few minutes between each. Consequently, naps should be:

• 25ish minutes
• 40–45 minutes
• 90ish minutes

If you wake up mid-cycle—for example, because your alarm went off, or someone disturbed you, or even because you needed to pee, you will be groggy, disoriented, and exhausted.

For this reason, a nap of one hour (a common choice, since people like “round” numbers) is a recipe for disaster, and will only work if you take 15 minutes to fall asleep. In which case, it’d really be a nap of 45 minutes, made up of two 20-minute sleep cycles.

Some interruptions are better/worse than others

If you’re in light or REM sleep, a disruption will leave you not very refreshed, but not wiped out either. And as a bonus, if you’re interrupted during a REM cycle, you’re more likely to remember your dreams.

If you’re in deep sleep, a disruption will leave you with what feels like an incredible hangover, minus the headache, and you’ll be far more tired than you were before you started the nap.

The best way to nap

Taking these factors into account, one of the “safest” ways to nap is to set your alarm for the top end of the time-bracket above the one you actually want to nap for (e.g., if you want to nap for 25ish minutes, set your alarm for 45).

Unless you’re very sleep-deprived, you’ll probably wake up briefly after 20–25 minutes of sleep. This may seem like nearer 30 minutes, if it took you some minutes to fall asleep!

If you don’t wake up then, or otherwise fail to get up, your alarm will catch you later at what will hopefully be between your next sleep cycles, or at the very least not right in the middle of one.

When you wake up from a nap before your alarm, get up. This is not the time for “5 more minutes” because “5 more minutes” will never, ever, be refreshing.

Rest well!