What You Should Have Been Told About The Menopause Beforehand
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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!
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Inverse Vaccines for Autoimmune Diseases
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Inverse Vaccines for Autoimmune Diseases
This is Dr. Jeffrey Hubbell. He’s a molecular engineer, with a focus on immunotherapy, immune response, autoimmune diseases, and growth factor variants.
He’s held 88 patents, and was the recipient of the Society for Biomaterials’ Founders Award for his “long-term, landmark contributions to the discipline of biomaterials”, amongst other awards and honours that would make our article too long if we included them all.
And, his latest research has been about developing…
Inverse Vaccines
You may be thinking: “you mean diseases; he’s engineering diseases?”
And no, it’s not that. Here’s how it works:
Normally in the case of vaccine, it’s something to tell the body “hey, if you see something that looks like this, you should kill it on sight” and the body goes “ok, preparing countermeasures according to these specifications; thanks for the heads-up”
In the case of an inverse vaccine, it’s the inverse. It’s something to tell the body “hey, this thing you seem to think is a threat, it’s actually not, and you should leave it alone”.
Why this matters for people with autoimmune diseases
Normally, autoimmune diseases are treated in one or more of the following ways:
- Dampen the entire immune system (bad for immunity against actual diseases, obviously, and is part of why many immunocompromised people have suffered and died disproportionately from COVID, for example)
- Give up and find a workaround (a good example of this is Type 1 Diabetes, and just giving up on the pancreas not being constantly at war with itself, and living on exogenous insulin instead)
Neither of those are great.
What inverse vaccines do is offer a way to flag the attacked-in-error items as acceptable things to have in the body. Those might be things that are in our body by default, as in the case of many autoimmune diseases, or they may even be external items that should be allowed but aren’t, as in the case of gluten, in the context of Celiac disease.
The latest research is not yet accessible for free, alas, but you can read the abstract here:
Or if you prefer a more accessible pop-science approach, here’s a great explanatory article:
“Inverse vaccine” shows potential to treat multiple sclerosis and other autoimmune diseases
Where can we get such inverse vaccines?
❝There are no clinically approved inverse vaccines yet, but we’re incredibly excited about moving this technology forward❞
~ Dr. Jeffrey Hubbell
But! Lest you be disappointed, you can get in line already, in the case of the Celiac disease inverse vaccine, if you’d like to be part of their clinical trial:
Click here to see if you are eligible to be part of their clinical trial
If you’re not up for that, or if your autoimmune disease is something else (most of the rest of their research is presently focusing on Multiple Sclerosis and Type 1 Diabetes), then:
- The phase 1 MS trial is currently active, estimated completion in summer 2024.
- They are in the process of submitting an investigational new drug (IND) application for Type 1 Diabetes
- This is the first step to starting clinical safety and efficacy trials
…so, watch this space!
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Seeds: The Good, The Bad, And The Not-Really-Seeds!
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Doctors are great at saving lives like mine. I’m a two time survivor of colon cancer and have recently been diagnosed with Chron’s disease at 62. No one is the health system can or is prepared to tell me an appropriate diet to follow or what to avoid. Can you?❞
Congratulations on the survivorship!
As to Crohn’s, that’s indeed quite a pain, isn’t it? In some ways, a good diet for Crohn’s is the same as a good diet for most other people, with one major exception: fiber
…and unfortunately, that changes everything, in terms of a whole-foods majority plant-based diet.
What stays the same:
- You still ideally want to eat a lot of plants
- You definitely want to avoid meat and dairy in general
- Eating fish is still usually* fine, same with eggs
- Get plenty of water
What needs to change:
- Consider swapping grains for potatoes or pasta (at least: avoid grains)
- Peel vegetables that are peelable; discard the peel or use it to make stock
- Consider steaming fruit and veg for easier digestion
- Skip spicy foods (moderate spices, like ginger, turmeric, and black pepper, are usually fine in moderation)
Much of this latter list is opposite to the advice for people without Crohn’s Disease.
*A good practice, by the way, is to keep a food journal. There are apps that you can get for free, or you can do it the old-fashioned way on paper if prefer.
But the important part is: make a note not just of what you ate, but also of how you felt afterwards. That way, you can start to get a picture of patterns, and what’s working (or not) for you, and build up a more personalized set of guidelines than anyone else could give to you.
We hope the above pointers at least help you get going on the right foot, though!
❝Why do baked goods and deep fried foods all of a sudden become intolerable? I used to b able to ingest bakery foods and fried foods. Lately I developed an extreme allergy to Kiwi… what else should I “fear”❞
About the baked goods and the deep-fried foods, it’s hard to say without more information! It could be something in the ingredients or the method, and the intolerance could be any number of symptoms that we don’t know. Certainly, pastries and deep-fried foods are not generally substantial parts of a healthy diet, of course!
Kiwi, on the other hand, we can answer… Or rather, we can direct you to today’s “What’s happening in the health world” section below, as there is news on that front!
We turn the tables and ask you a question!
We’ll then talk about this tomorrow:
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Walk Yourself Happy – by Dr. Julia Bradbury
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Notwithstanding her (honorary) doctorate, Dr. Bradbury is not, in fact, a scientist. But…
- She has a lot of experience walking all around the world, and her walking habit has seen her through all manner of things, from stress and anxiety to cancer and grief and more.
- She does, throughout this book, consult many scientists and other experts (indeed, some we’ve featured here before at 10almonds), so we still get quite a dose of science too.
The writing style of this book is… Compelling. Honestly, the biggest initial barrier to you getting out of the door will be putting this book down first.If you have good self-discipline, you might make it last longer by treating yourself to a chapter per day
Bottom line: you probably don’t need this book to know how to go for a walk, but it will motivate, inspire, and even inform you of how to get the most out of it. Treat yourself!
Click here to check out Walk Yourself Happy, and prepare for a new healthy habit!
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How to Find Happiness In Yourself – by Michelle Mann
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A lot of books about happiness tell you what to pursue, generally. What things to focus on, and that’s good, but incomplete. This book does cover those things too (complete with academic sources to back up what really works), but also goes further:
Michelle Mann gives 25 key habits that will cumulatively build happiness, which is what it’s really about. After all:
- If you watch your favourite movie, you’ll be happy for 90 minutes (or 9 hours if it’s The Lord of the Rings).
- If you build daily habits that add happiness to you, your surroundings, and those around you, you’ll be happy for life.
They do also cover happiness while going through difficult times, such as divorce, job loss, illness, or bereavement.
Sometimes, knowing what we “should” do in theory is the easy part. Where Mann excels here is in providing explanations of each habit. This means that rather than it being some platitude, the principles underlying it are truly understood… and thus motivate us to actually apply the advice and build the habits into our life.
While the explanations are therefore the greatest value of the book, we do recommend copying out the 25 habits (which are effectively subchapter headings) and putting them somewhere to read often.
Bottom line: we recommend getting yourself (and/or your loved ones!) a copy of this book. You (and/or they) will be happy you did!
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What you need to know about FLiRT, an emerging group of COVID-19 variants
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What you need to know
- COVID-19 wastewater levels are currently low, but a recent group of variants called FLiRT is making headlines.
- KP.2 is one of several FLiRT variants, and early lab tests suggest that it’s more infectious than JN.1.
- Getting infected with any COVID-19 variant can cause severe illness, heart problems, and death.
KP.2, a new COVID-19 variant, is now dominant in the United States. Lab tests suggest that it may be more infectious than JN.1, the variant that was dominant earlier this year.
Fortunately, there’s good news: Current wastewater data shows that COVID-19 infection rates are low. Still, experts are closely watching KP.2 to see if it will lead to an uptick in infections.
Read on to learn more about KP.2 and how to stay informed about COVID-19 cases in your area.
Where can I find data on COVID-19 cases in my area?
Hospitals are no longer required to report COVID-19 hospital admissions or hospital capacity to the Department of Health and Human Services. However, wastewater-based epidemiology (WBE) estimates the number of COVID-19 infections in a community based on the amount of COVID-19 viral particles detected in local wastewater.
View this map of wastewater data from the CDC to visualize COVID-19 infection rates throughout the U.S., or look up COVID-19 wastewater trends in your state.
What do we know so far about the new variant?
Early lab tests suggest that KP.2—one of a group of emerging variants called FLiRT—is similar to the previously dominant variant, JN.1, but it may be more infectious. If you had JN.1, you may still get reinfected with KP.2, especially if it’s been several months or longer since your last COVID-19 infection.
A CDC spokesperson said they have no reason to believe that KP.2 causes more severe illness than other variants. Experts are closely watching KP.2 to see if it will lead to an uptick in COVID-19 cases.
How can I protect myself from COVID-19 variants?
Staying up to date on COVID-19 vaccines reduces your risk of severe illness, long COVID, heart problems, and death. The CDC recommends that people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring.
Wearing a high-quality, well-fitting mask reduces your risk of contracting COVID-19 and spreading it to others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of COVID-19.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Should Men Over 50 Get PSA?
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.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Loved the information on prostate cancer. Do recommend your readers get a PSA or equivalent test annually for over 50 yr old men.❞
(This is about: Prostate Health: What You Should Know)
Yep, or best yet, the much more accurate PSE test! But if PSA test is what’s available, it’s a lot better than nothing. And, much as it’s rarely the highlight of anyone’s day, a prostate exam by a suitably qualified professional is also a good idea.
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Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
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