Menopause, & When Not To Let Your Guard Down
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This is Dr. Jessica Shepherd, a physician Fellow of the American College of Obstetricians & Gynecologists, CEO at Sanctum Medical & Wellness, and CMO at Hers.
She’s most well-known for her expertise in the field of the menopause. So, what does she want us to know?
Untreated menopause is more serious than most people think
Beyond the famous hot flashes, there’s also the increased osteoporosis risk, which is more well-known at least amongst the health-conscious, but oft-neglected is the increased cardiovascular disease risk:
What Menopause Does To The Heart
…and, which a lot of Dr. Shepherd’s work focuses on, it also increases dementia risk; she cites that 60–80% of dementia cases are women, and it’s also established that it progresses more quickly in women than men too, and this is associated with lower estrogen levels (not a problem for men, because testosterone does it for them) which had previously been a protective factor, but in untreated menopause, was no longer there to help:
Alzheimer’s Sex Differences May Not Be What They Appear
Treated menopause is safer than many people think
The Women’s Health Initiative (WHI) study, conducted in the 90s and published in 2002, linked HRT to breast cancer, causing fear, but it turned out that this was quite bad science in several ways and the reporting was even worse (even the flawed data did not really support the conclusion, much less the headlines); it was since broadly refuted (and in fact, it can be a protective factor, depending on the HRT regimen), but fearmongering headlines made it to mainstream news, whereas “oopsies, never mind, we take that back” didn’t.
The short version of the current state of the science is: breast cancer risk varies depending on age, HRT type, and dosage; some kinds of HRT can increase the risk marginally in those older than 60, but absolute risk is low compared to placebo, and taking estrogen alone can reduce risk at any age in the event of not having a uterus (almost always because of having had a hysterectomy; as a quirk, it is possible to be born without, though).
It’s worth noting that even in the cases where HRT marginally increased the risk of breast cancer, it significantly decreased the risk of cancers in total, as well fractures and all-cause-mortality compared to the placebo group.
In other words, it might be worth having a 0.12% risk of breast cancer, to avoid the >30% risk of osteoporosis, which can ultimately be just as fatal (without even looking at the other things the HRT is protective against).
However! In the case of those who already have (or have had) breast cancer, increasing estrogen levels can indeed make that worse/return, and it becomes more complicated in cases where you haven’t had it, but there is a family history of it, or you otherwise know you have the gene for it.
You can read more about HRT and breast cancer risk (increases and decreases) here:
…and about the same with regard to HMT, here:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Lifestyle matters, and continues to matter
Menopause often receives the following attention from people:
- Perimenopause: “Is this menopause?”
- Menopause: “Ok, choices to make about HRT or not, plus I should watch out for osteoporosis”
- Postmenopause: “Yay, that’s behind me now, back to the new normal”
The reality, Dr. Shepherd advises, is that “postmenopause” is a misnomer because if it’s not being treated, then the changes are continuing to occur in your body.
This is a simple factor of physiology; your body is always rebuilding itself, will never stop until you die, and in untreated menopause+postmenopause, it’s now doing it without much estrogen.
So, you can’t let your guard down!
Thus, she recommends: focus on maintaining muscle mass, bone health, and cardiovascular health. If you focus on those things, the rest (including your brain, which is highly dependent on cardiovascular health) will mostly take care of itself.
Because falls and fractures, particularly hip fractures, drastically reduce quality and length of life in older adults, it is vital to avoid those, and try to be sufficiently robust so that if you do go A over T, you won’t injure yourself too badly, because your bones are strong. As a bonus, the same things (especially that muscle mass we talked about) will help you avoid falling in the first place, by improving stability.
See also: Resistance Is Useful! (Especially As We Get Older)
And about falls specifically: Fall Special: Be Robust, Mobile, & Balanced!
Want to know more from Dr. Shepherd?
You might like this book of hers that we reviewed not long back:
Generation M – by Dr. Jessica Shepherd
Take care!
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Why You Can’t Deep Squat (And the Benefits You’re Missing)
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Matt Hsu fought his own battle with chronic pain from the age of 16 in his feet, knees, hips, back, shoulders, elbows, forearms, wrists, hands, and head. Seeking answers, he’s spent a career in corrective exercise, posture alignment, structural integration, orthopedic exercise, sports medicine, and has more certifications than we care to list. In short, he knows his stuff.
Yes you can (with some work)
The deep squat, also called Asian squat, Slav squat, sitting squat, resting squat, primal squat, and various other names, is an important way of sitting that has implications for a lot of aspects of health.
Why it’s so important: it preserves the mobility of our hips, ankles, and everything in between, and maintaining especially the hip mobility makes a big difference not only to general health, but also to reducing the risk of injury. It also maintains lower body strength, making falls in older age less likely in the first place, and if falls do happen, makes injury less likely, and if injury does happen, makes the injury likely less severe.
An important misconception: there is a popular, but unfounded, belief that the ability or inability to do this is decided by genes—or if not outright decided, that at the very least Asians and Slavs have a genetic advantage. However, this is simply not true. Westerners and others can learn to do it just fine, and on the flipside, Asians and Slavs who grew up in the West may often struggle with it. The truth is, the deciding factor is lifestyle: if your culture involves sitting this way more often, you’ll be able to do it more comfortably and easily than if you’re just now trying it for the first time.
Factors that you can control: you can’t change where you grew up, but you can change how you sit down now. Achieving the squat requires repeated position practice, and the more frequently you do so (even if you just start with a few seconds and work your way up to longer periods), the better you’ll get at it. And, on the contrary, sitting in chairs weakens and shortens the muscles involved, so any time you spend sitting in chairs is working against you. There are many reasons it’s advisable to avoid sitting in chairs more than necessary, and this is one of them.
10almonds tip: a limiting factor for many people initially is ankle flexibility, which may result in one’s center of gravity being a bit far back, leading to a tendency to have to change something to avoid toppling over backwards. Rather than holding onto something immobile (e.g. furniture) in front of where you are sitting, consider simply holding an object in front of you in your hands. A book is a fine example; holding that in front of you (feel free to read the book) will shift your center of gravity forwards a bit, and will thus allow you to sit there a little longer, thus improving your strength and flexibility while you do, until you can do it without holding something in front of you. If you try with a book and you’re still prone to toppling backwards, try with something heavier, but do use the minimum weight necessary, because ultimately the counterbalance is just a crutch to get you to where you need to be.
For more visual advice on how to do it, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Parent Effectiveness Training – by Dr. Thomas Gordon
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Do you want your home (or workplace, for that matter) to be a place of peace? This book literally got the author nominated for a Nobel Peace Prize. Can’t really get much higher praise than that.
The title is “Parent Effectiveness Training”, but in reality, the advice in the book is applicable to all manner of relationships, including:
- romantic relationships
- friends
- colleagues
- …and really any human interaction.
It covers some of the same topics we did today (and more) in much more detail than we ever could in a newsletter. It lays out formulae to use, gives plenty of examples, and/but is free from undue padding.
- Pros: this isn’t one of those “should have been an article” books. It has so much valuable content.
- Cons: It is from the 1970s* so examples may feel “dated” now.
In addition to going into much more detail on some of the topics covered in today’s issue of 10almonds, Dr. Gordon also talks in-depth about the concept of “problem-ownership”.
In a nutshell, that means: whose problem is a given thing? Who “has” what problem? Everyone needs to be on the same page about everyone else’s problems in the situation… as well as their own, which is not always a given!
Dr. Gordon presents, in short, tools not just to resolve conflict, but also to pre-empt it entirely. With these techniques, we can identify and deal with problems (together!) well before they arise.
Everybody wins.
Get your copy of “Parent Effectiveness Training” from Amazon today!
*Note: There is an updated edition on the market, and that’s what you’ll find upon following the above link. This reviewer (hi!) has a battered old paperback from the 1970s and cannot speak for what was changed in the new edition. However: if the 70s one is worth more than its weight in gold (and it is), the new edition is surely just as good, if not better!
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Top 5 Anti-Aging Exercises
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There are some exercises that get called such things as “The King of Exercises!”, but how well-earned is that title and could it be that actually a mix of the top few is best?
The Exercises
While you don’t have to do all 5, your body will thank you if you are able to:
- Plank: strengthens most of the body, and can reduce back pain while improving posture.
- Squats: another core-strengthening exercise, this time with an emphasis on the lower body, which makes for strong foundations (including strong ankles, knees, and hips). Improves circulation also, and what’s good for circulation is good for the organs, including the brain!
- Push-ups: promotes very functional strength and fitness; great for alternating with planks, as despite their similar appearance, they work the abs and back more, respectively.
- Lunges: these are great for lower body strength and stability, and doing these greatly reduces the risk of falling.
- Glute Bridges: this nicely rounds off one’s core strength, increasing stability and improving posture, as well as reducing lower back pain too.
If the benefits of these seem to overlap a little, it’s because they do! But each does some things that the others don’t, so put together, they make for a very well-balanced workout.
For advice on how to do each of them, plus more about the muscles being used and the benefits, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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The Problem With Active Listening
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The problem with active listening
Listening is an important skill to keep well-trained at any age. It’s important in romantic relationships, parent-child relationships, friendships, and more.
First, for any unfamiliar or hazy-of-memory: active listening is the practice of listening, actively. The “active” side of this comes in several parts:
- Asking helpful questions
- Giving feedback to indicate that the answer has been understood
- Prompting further information-giving
This can look like:
- A: How did you feel when that happened?
- B: My heart was racing and I felt panicked, it really shocked me
- A: It really shocked you?
- B: Yes, because it was so unexpected; I’d never imagined something like this happening
- A: You’d never expect something like that
- B: No, I mean, I had no reason to
And… As a superficial listening technique, it’s not terrible, and it has its place
But unfortunately, if it’s one’s only listening technique, one will very quickly start sounding like a Furby—that children’s toy from the 90s that allegedly randomly parroted fragments of things that had been said to it. In fact this was a trick of programming, but that’s beyond the scope of this article.
The point is: the above technique, if used indiscriminately and/or too often, starts to feel like talking to a very basic simulacrum.
Which is the opposite of feeling like being listened to!
A better way to listen
Start off similarly, but better.
Ask open questions, or otherwise invite sharing of information.
People can be resistant to stock phrases like “How did that make you feel?”, but this can be got around by simply changing it up, e.g.:
- “What was your reaction?” ← oblique but often elicits the same information
- “I’m not sure how I’d feel about that, in your shoes” ← not even a question, but shows active attention much better than the “mmhmm” noises of traditional active listening, and again prompts the same information
Express understanding… But better
People have been told “I understand” a lot, and often it’s code for “Stop talking”. So, avoid “I understand”. Instead, try:
- “I can understand that”
- “Understandable”
- “That makes sense”
Ask clarifying questions… Better
Sometimes, a clarifying question doesn’t have to have its own point, beyond prompting more sharing, and sometimes, an “open question” can be truly wide open, meaning that vaguer is better, such as:
- “Oh?”
- “How so?” ← this is the heavy artillery that can open up a lot
Know when to STFU
Something that good therapists (and also military interrogators) know: when to STFU
If someone is talking, don’t interrupt them. If you do, they might not start again, or might skip what they were going to say.
Interruption says “I think you’ve said all that needs to be said there”, or else, if the interruption was to ask one of the above questions, it says “you’re not doing a good enough job of talking”, and neither of those sentiments encourage people to share, nor do they make someone feel listened-to!
Instead, just listen. Passive listening has its place too! When there’s a break, then you can go to one of the above questions/prompts/expressions of understanding, as appropriate.
Judge not, lest they feel judged
Reserve judgement until the conversation is over, at the earliest. If asked for your judgement of some aspect, be as reassuring as you can. People feel listened-to when they don’t feel judged.
If they feel judged, conversely, they can often feel you didn’t listen properly, or else you’d be in agreement with them. So instead, just sit on it for as long as you can.
Note: that goes for positive judgements too! Sit on it. Expressing a positive judgement too soon can seem that you were simply eager to please, and can suggest insincerity.
If this seems simple, that’s because it is. But, try it, and see the difference.
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Tuna vs Catfish – Which is Healthier?
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Our Verdict
When comparing tuna to catfish, we picked the tuna.
Why?
Today in “that which is more expensive and/or harder to get is not necessarily healthier”…
Looking at their macros, tuna has more protein and less fat (and overall, less saturated fat, and also less cholesterol).
In the category of vitamins, both are good but tuna distinguishes itself: tuna has more of vitamins A, B1, B2, B3, B6, and D, while catfish has more of vitamins B5, B9, B12, E, and K. They are both approximately equal in choline, and as an extra note in tuna’s favor (already winning 6:5), tuna is a very good source of vitamin D, while catfish barely contains any. All in all: a moderate, but convincing, win for tuna.
When it comes to minerals, things are clearer still: tuna has more copper, iron, magnesium, phosphorus, potassium, and selenium, while catfish has more calcium, manganese, and zinc. Oh, and catfish is also higher in one other mineral: sodium, which most people in industrialized countries need less of, on average. So, a 6:3 win for tuna, before we even take into account the sodium content (which makes the win for tuna even stronger).
In short: tuna wins the day in every category!
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught (It Makes Quite A Difference)
Take care!
Don’t Forget…
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Parsnips vs Potatoes – Which is Healthier?
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Our Verdict
When comparing parsnips to potatoes, we picked the parsnips.
Why?
To be more specific, we’re looking at russet potatoes, and in both cases we’re looking at cooked without fat or salt, skin on. In other words, the basic nutritional values of these plants in edible form, without adding anything. With this in mind, once we get to the root of things, there’s a clear winner:
Looking at the macros first, potatoes have more carbs while parsnips have more fiber. Potatoes do have more protein too, but given the small numbers involved when it comes to protein we don’t think this is enough of a plus to outweigh the extra fiber in the parsnips.
In the category of vitamins, again a champion emerges: parsnips have more of vitamins B1, B2, B5, B9, C, E, and K, while potatoes have more of vitamins B3, B6, and choline. So, a 7:3 win for parsnips.
When it comes to minerals, parsnips have more calcium copper, manganese, selenium, and zinc, while potatoes have more iron and potassium. Potatoes do also have more sodium, but for most people most of the time, this is not a plus, healthwise. Disregarding the sodium, this category sees a 5:2 win for parsnips.
In short: as with most starchy vegetables, enjoy both in moderation if you feel so inclined, but if you’re picking one, then parsnips are the nutritionally best choice here.
Want to learn more?
You might like to read:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Should You Go Light Or Heavy On Carbs?
Take care!
Don’t Forget…
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