What You Should Have Been Told About The Menopause Beforehand
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
What You Should Have Been Told About Menopause Beforehand
This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.
When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?
And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!
So, what does Dr. Gunter want us to know?
It’s a time of changes, not an end
The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.
And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.
Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and not to mention but we’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).
However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.
Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.
Bridges can be dangerous to cross! But they can also get us safely where we’re going.
Ok, so how do we manage those things?
Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.
See also: Meet Goop’s Number One Enemy
For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).
This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.
Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.
To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:
Dr. Gunter’s Guide To The Hormone Menoverse
What about natural therapies?
There are some non-hormonal things that work, but these are mostly things that:
- give a statistically significant reduction in symptoms
- give the same statistically significant reduction in symptoms as placebo
As Dr. Gunter puts it:
❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.
In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.
Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”
You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞
However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!
For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:
Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended
Want to know more?
Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Everything You Need To Know About The Menopause – by Kate Muir
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Kate Muir has made a career out of fighting for peri-menopausal health to be taken seriously. Because… it’s actually far more serious than most people know.
What people usually know:
- No more periods
- Hot flushes
- “I dunno, some annoying facial hairs maybe”
The reality encompasses a lot more, and Muir covers topics including:
- Workplace struggles (completely unnecessary ones)
- Changes to our sex life (not usually good ones, by default!)
- Relationship between menopause and breast cancer
- Relationship between menopause and Alzheimer’s
“Wait”, you say, “correlation is not causation, that last one’s just an age thing”, and that’d be true if it weren’t for the fact that receiving Hormone Replacement Therapy (HRT) or not is strongly correlated with avoiding Alzheimer’s or not.
The breast cancer thing is not to be downplayed either. Taking estrogen comes with a stated risk of breast cancer… But what they don’t tell you, is that for many people, not taking it comes with a higher risk of breast cancer (but that’s not the doctor’s problem, in that case). It’s one of those situations where fear of litigation can easily overrule good science.
This kind of thing, and much more, makes up a lot of the meat of this book.
Hormonal treatment for the menopause is often framed in the wider world as a whimsical luxury, not a serious matter of health…. If you’ve ever wondered whether you might want something different, something better, as part of your general menopause plan (you have a plan for this important stage of your life, right?), this is a powerful handbook for you.
Additionally, if (like many!) you justifiably fear your doctor may brush you off (or in the case of mood disorders, may try to satisfy you with antidepressants to treat the symptom, rather than HRT to treat the cause), this book will arm you as necessary to help you get what you need.
Grab your copy of “Everything You Need To Know About The Menopause” from Amazon today!
Share This Post
-
100 Things Productive People Do – by Nigel Cumberland
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This is a book of a hundred small chapters (the book is 396 pages, so 2–3 pages per chapter) which makes for a feeling of quick reading, and definitely gives an option of “light bites”, dipping into the book here and there.
Cumberland offers a wide range of practical wisdom here, and while the book is (per the title) focused on productivity, it also includes all due weight to not burning out and/or breaking down. Because things productive people do does not, it turns out, include working themselves directly into an early grave.
But—despite the author’s considerable and obvious starting point of social privilege—nor is this a tome of “offer your genius leadership and otherwise just coast while everyone does your work for you”, either. This is a “brass tacks” book and highly relatable whether your to-do list most prominently features “personally manage the merger of these Fortune 500 companies” or “sort out that junk in the spare room”
Bottom line: we’d be surprised if this book with 100 pieces of advice failed to bring you enough value to more than pay for itself!
Pick up your copy of 100 Things Productive People Do from Amazon today!
Share This Post
-
Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial.
UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom.
Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. Chronic UTIs are typically diagnosed when a person experiences two or more infections within six months or three or more within a year.
They can happen to anyone, but some are more prone due to their body’s makeup or habits. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area.
Up to 60% of women will have at least one UTI in their lifetime. While effective treatments exist, about 25% of women face recurrent infections within six months. Around 20–30% of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments.
Why are chronic UTIs so hard to treat?
Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach.
The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments.
This ability to evade treatment has led to a troubling increase in antibiotic resistance, a global health concern that renders some of the conventional treatments ineffective.
Some antibiotics no longer work against UTIs.
Michael Ebardt/ShutterstockAntibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted.
But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead.
Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria.
Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions.
The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence.
For post-menopausal women, estrogen therapy has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur.
Lifestyle changes, such as drinking more water and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role.
Some swear by cranberry juice or supplements, though researchers are still figuring out how effective these remedies truly are.
What treatments might we see in the future?
Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of vaccines aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu.
Emerging treatments could help clear chronic UTIs.
guys_who_shoot/ShutterstockAnother new method being looked at is called phage therapy. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus.
Researchers are also exploring the potential of probiotics. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves.
Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response.
Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.
Iris Lim, Assistant Professor, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
Related Posts
-
Cupping: How It Works (And How It Doesn’t)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Good Health By The Cup?
In Tuesday’s newsletter, we asked you for your opinion of cupping (the medical practice), and got the above-depicted, below-described, set of responses:
- About 40% said “It may help by improving circulation and stimulating the immune system”
- About 26% said “I have never heard of the medical practice of cupping before this”
- About 19% said “It is pseudoscience and/or placebo at best, but probably not harmful
- About 9% said “It is a good, evidence-based practice that removes toxins and stimulates health”
- About 6% said “It is a dangerous practice that often causes harm to people who need medical help”
So what does the science say?
First, a quick note for those unfamiliar with cupping: it is the practice of placing a warmed cup on the skin (open side of the cup against the skin). As the warm air inside cools, it reduces the interior air pressure, which means the cup is now (quite literally) a suction cup. This pulls the skin up into the cup a little. The end result is visually, and physiologically, the same process as what happens if someone places the nozzle of a vacuum cleaner against their skin. For that matter, there are alternative versions that simply use a pump-based suction system, instead of heated cups—but the heated cups are most traditional and seem to be most popular. See also:
National Center for Complementary and Integrative Health | Cupping
It is a dangerous practice that often causes harm to people who need medical help: True or False?
False, for any practical purposes.
- Directly, it can (and usually does) cause minor superficial harm, much like many medical treatments, wherein the benefits are considered to outweigh the harm, justifying the treatment. In the case of cupping, the minor harm is usually a little bruising, but there are other risks; see the link we gave just above.
- Indirectly, it could cause harm by emboldening a person to neglect a more impactful treatment for their ailment.
But, there’s nothing for cupping akin to the “the most common cause of death is when someone gets a vertebral artery fatally severed” of chiropractic, for example.
It is a good, evidence-based practice that removes toxins and stimulates health: True or False?
True and False in different parts. This one’s on us; we included four claims in one short line. But let’s look at them individually:
- Is it good? Well, those who like it, like it. It legitimately has some mild health benefits, and its potential for harm is quite small. We’d call this a modest good, but good nonetheless.
- Is it evidence-based? Somewhat, albeit weakly; there are some papers supporting its modest health claims, although the research is mostly only published in journals of alternative medicine, and any we found were in journals that have been described by scientists as pseudoscientific.
- Does it remove toxins? Not directly, at least. There is also a version that involves making a small hole in the skin before applying the cup, the better to draw out the toxins (called “wet cupping”). This might seem a little medieval, but this is because it is from early medieval times (wet cupping’s first recorded use being in the early 7th century). However, the body’s response to being poked, pierced, sucked, etc is to produce antibodies, and they will do their best to remove toxins. So, indirectly, there’s an argument.
- Does it stimulate health? Yes! We’ll come to that shortly. But first…
It is pseudoscience and/or placebo at best, but probably not harmful: True or False?
True in that its traditionally-proposed mechanism of action is a pseudoscience and placebo almost certainly plays a strong part, and also in that it’s generally not harmful.
On it being a pseudoscience: we’ve talked about this before, but it bears repeating; just because something’s proposed mechanism of action is pseudoscience, doesn’t necessarily mean it doesn’t work by some other mechanism of action. If you tell a small child that “eating the rainbow” will improve their health, and they believe this is some sort of magical rainbow power imbuing them with health, then the mechanism of action that they believe in is a pseudoscience, but eating a variety of colorful fruit and vegetables will still be healthy.
In the case of cupping, its proposed mechanism of action has to do withbalancing qi, yin and yang, etc (for which scientific evidence does not exist), in combination with acupuncture lore (for which some limited weak scientific evidence exists). On balancing qi, yin and yang etc, this is a lot like Europe’s historically popular humorism, which was based on the idea of balancing the four humors (blood, yellow bile, black bile, phlegm). Needless to say, humorism was not only a pseudoscience, but also eventually actively disproved with the advent of germ theory and modern medicine. Cupping therapy is not more scientifically based than humorism.
On the placebo side of things, there probably is a little more to it than that; much like with acupuncture, a lot of it may be a combination of placebo and using counter-irritation, a nerve-tricking method to use pain to reduce pain (much like pressing with one’s nail next to an insect bite).
Here’s one of the few studies we found that’s in what looks, at a glance, to be a reputable journal:
Cupping therapy and chronic back pain: systematic review and meta-analysis
It may help by improving circulation and stimulating the immune system: True or False?
True! It will improve local circulation by forcing blood into the area, and stimulate the immune system by giving it a perceived threat to fight.
Again, this can be achieved by many other means; acupuncture (or just “dry needling”, which is similar but without the traditional lore), a cold shower, and/or exercise (and for that matter, sex—which combines exercise, physiological arousal, and usually also foreign bodies to respond to) are all options that can improve circulation and stimulate the immune system.
You can read more about using some of these sorts of tricks for improving health in very well-evidenced, robustly scientific ways here:
The Stress Prescription (Against Aging!)
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Unlock Your Air-Fryer’s Potential!
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Unlock Your Air-Fryer’s Potential!
You know what they say:
“you get out of it what you put in”
…and in the case of an air-fryer, that’s very true!
More seriously:
A lot of people buy an air fryer for its health benefits and convenience, make fries a couple of times, and then mostly let it gather dust. But for those who want to unlock its potential, there’s plenty more it can do!
Let’s go over the basics first…
Isn’t it just a tiny convection oven?
Mechanically, yes. But the reason that it can be used to “air-fry” food rather than merely bake or roast the food is because of its tiny size allowing for much more rapid cooking at high temperatures.
On which note… If you’re shopping for an air-fryer:
- First of all, congratulations! You’re going to love it.
- Secondly: bigger is not better. If you go over more than about 4 liters capacity, then you don’t have an air-fryer; you have a convection oven. Which is great and all, but probably not what you wanted.
Are there health benefits beyond using less oil?
It also creates much less acrylamide than deep-frying starchy foods does. The jury is out on the health risks of acrylamide, but we can say with confidence: it’s not exactly a health food.
I tried it, but the food doesn’t cook or just burns!
The usual reason for this is either over-packing the fryer compartment (air needs to be able to circulate!), or not coating the contents in oil. The oil only needs to be a super-thin layer, but it does need to be there, or else again, you’re just baking things.
Two ways to get a super thin layer of oil on your food:
- (works for anything you can air-fry) spray the food with oil. You can buy spray-on oils at the grocery store (Fry-light and similar brands are great), or put oil in little spray bottle (of the kind that you might buy for haircare) yourself.
- (works with anything that can be shaken vigorously without harming it, e.g. root vegetables) chop the food, and put it in a tub (or a pan with a lid) with about a tablespoon of olive oil. Don’t worry if that looks like it’s not nearly enough—it will be! Now’s a great time to add your seasonings* too, by the way. Put the lid on, and holding the lid firmly in place, shake the tub/pan/whatever vigorously. Open it, and you’ll find the oil has now distributed itself into a very thin layer all over the food.
*About those seasonings…
Obviously not everything will go with everything, but some very healthful seasonings to consider adding are:
- Garlic minced/granules/powder (great for the heart and immune health)
- Black pepper (boosts absorption of other nutrients, and provides more benefits of its own than we can list here)
- Turmeric (slows aging and has anti-cancer properties)
- Cinnamon (great for the heart and has anti-inflammatory properties)
Garlic and black pepper can go with almost anything (and in this writer’s house, they usually do!)
Turmeric has a sweet nutty taste, and will add its color anything it touches. So if you want beautiful golden fries, perfect! If you don’t want yellow eggplant, maybe skip it.
Cinnamon is, of course, great as part of breakfast and dessert dishes
On which note, things most people don’t think of air-frying:
- Breakfast frittata—the healthy way!
- Omelets—no more accidental scrambled egg and you don’t have to babysit it! Just take out the tray that things normally sit on, and build it directly onto the (spray-oiled) bottom of the air-fryer pan. If you’re worried it’ll burn: a) it won’t, because the heat is coming from above, not below b) you can always use greaseproof paper or even a small heatproof plate
- French toast—again with no cooking skills required
- Fish cakes—make the patties as normal, spray-oil and lightly bread them
- Cauliflower bites—spray oil or do the pan-jiggle we described; for seasonings, we recommend adding smoked paprika and, if you like heat, your preferred kind of hot pepper! These are delicious, and an amazing healthy snack that feels like junk food.
- Falafel—make the balls as usual, spray-oil (do not jiggle violently; they won’t have the structural integrity for that) and air-fry!
- Calamari (vegan option: onion rings!)—cut the squid (or onions) into rings, and lightly coat in batter and refrigerate for about an hour before air-frying at the highest heat your fryer does. This is critical, because air-fryers don’t like wet things, and if you don’t refrigerate it and then use a high heat, the batter will just drip, and you don’t want that. But with those two tips, it’ll work just great.
Want more ideas?
Check out EatingWell’s 65+ Healthy Air-Fryer Recipes ← the recipes are right there, no need to fight one’s way to them in any fashion!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
The Comfort Book – by Matt Haig
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This book “is what it says on the tin”. Matt Haig, bestselling author of “Reasons to Stay Alive” (amongst other works) is here with “a hug in a book”.
The format of the book is an “open it at any page and you’ll find something of value” book. Its small chapters are sometimes a few pages long, but often just a page. Sometimes just a line. Always deep.
All of us, who live long enough, will ponder our mortality sometimes. The feelings we may have might vary on a range from “afraid of dying” to “despairing of living”… but Haig’s single biggest message is that life is full of wonder; each moment precious.
- That hope is an incredible (and renewable!) resource.
- That we are more than a bad week, or month, or year, or decade.
- That when things are taken from us, the things that remain have more value.
Bottom line: you might cry (this reviewer did!), but it’ll make your life the richer for it, and remind you—if ever you need it—the value of your amazing life.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
