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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“Unfuck Your Body” In Under 10 Minutes A Day!
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There’s a lot that can go wrong with mobility, but fortunately, a few compound exercises will take care of most parts of it:
Full Body Mobility Routine
Eleven exercises, 10 minutes, follow-along video if you want it!
Kneeling side bend stretch:
- Targets obliques, lats, hip flexors, and spinal mobility.
- 10 reps total, focusing on stability and core engagement.
Seated ankle stretch:
- This one’s for ankle mobility and deep squat comfort.
- 10 reps, adjust intensity by leaning forward or pressing on knees.
Deep squat with prayer stretch:
- Improves hip, ankle, and lower back flexibility.
- 10 reps, maintain an upright chest and push knees outward.
Deep squat with high reach:
- Boosts thoracic mobility, hip, and ankle flexibility.
- 5 reps per side, focus on spinal rotation and open chest.
Deep shoulder stretch:
- Improves overhead mobility and shoulder tension relief.
- 10 reps in a child’s pose position with a forward reach.
Frog rocks:
- Opens hip abductors, groin, and inner thighs.
- 10 reps, keep spine neutral and adjust knee position if needed.
“World’s greatest stretch” (with variations):
- This is great for hip, spine, and shoulder mobility.
- 5 reps per side, integrates a deep lunge and rotational movements.
Hamstring stretch (from lunge position):
- Focus on hamstring and calf flexibility.
- 5 reps, maintain hands on the ground and shift hips back.
Pigeon stretch with forward crawl:
- Opens hips, glutes, and lower back.
- 5 reps per side, adjust foot placement if knee discomfort occurs.
Cat-cow stretch:
- Mobilizes spine, improves posture, and relieves back tension.
- 10 reps, synchronize movement with breath.
Couch stretch:
- Targets hip flexors and quadriceps mobility.
- 5 reps per side, add a forward lunge for a deeper stretch.
For more on each of these plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
5 Exercises That Fix 95% Of Your Problems
Take care!
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The Seven Principles for Making Marriage Work – by Dr. John Gottman
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A lot of relationship advice can seem a little wishy-washy. Hardline clinical work, on the other hand, can seem removed from the complex reality of married life. Dr. Gottman, meanwhile, strikes a perfect balance.
He looks at huge datasets, and he listens to very many couples. He famously isolated four relational factors that predict divorce with 91% accuracy, his “Four Horsemen”:
- Criticism
- Contempt
- Defensiveness
- Stonewalling
He also, as the title of this book promises (and we get a chapter-by-chapter deep-dive on each of them) looks at “Seven principles for making marriage work”. They’re not one-word items, so including them here would take up the rest of our space, and this is a book review not a book summary. However…
Dr. Gottman’s seven principles are, much like his more famous “four horsemen”, deeply rooted in science, while also firmly grounded in the reality of individual couples. Essentially, by listening to very many couples talk about their relationships, and seeing how things panned out with each of them in the long-term, he was able to see what things kept on coming up each time in the couples that worked out. What did they do differently?
And, that’s the real meat of the book. Science yes, but lots of real-world case studies and examples, from couples that worked and couples that didn’t.
In so doing, he provides a roadmap for couples who are serious about making their marriage the best it can be.
Bottom line: this is a must-have book for couples in general, no matter how good or bad the relationship.
- For some it’ll be a matter of realising “You know what; this isn’t going to work”
- For others, it’ll be a matter of “Ah, relief, this is how we can resolve that!”
- For still yet others, it’ll be a matter of “We’re doing these things right; let’s keep them forefront in our minds and never get complacent!”
- And for everyone who is in a relationship or thinking of getting into one, it’s a top-tier manual.
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Forks Over Knives: Flavor! – by Darshana Thacker
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It’s important to not have to choose too much between health and flavor, because the outcome will never be a good one, either for your health or your happiness. And what’s bad for your happiness will ultimately not work out and thus will be bad for your general health, so, the question becomes: how to get both?
This book handles that nicely, delivering plant-based dishes that are also incidentally oil-free, and also either gluten-free or else there’s an obvious easy substitution to make it such. The flavor here comes from the ingredients as a whole, including the main ingredients as well as seasonings.
On the downside, occasionally those ingredients may be a little obscure if you don’t live in, say, San Francisco, and the ingredients weren’t necessarily chosen for cooking on a budget, either.
However, in most cases for most people it will, at worse, inspire you to try using an ingredient you don’t usually use—so that’s a good result.
The recipes are very clear and easy to follow, although not all are illustrated, and the “ready in…” times are about as accurate as they are for any cookbook, that is to say, it’s the time in which it conceivably can be done if (like the author, a head chef) you have a team of sous-chefs who have done a bunch of prep for you (e.g. sweet potato does not normally come in ½” dice; it comes in sweet potatoes) and laid everything out in little bowls mise-en-place style, and also you know the procedure well enough to not have to stop, hesitate, check anything, wash anything, wait for water to boil or anything else to heat up, or so forth. In other words, if you’re on your own in your home kitchen with normal domestic appliances, it’s going to take a little longer than for a professional in a professional kitchen with professional help.
But don’t let that detract from the honestly very good recipes.
Bottom line: if you’d like to level-up your plant-based cooking, this will definitely make your dishes that bit better!
Click here to check out Forks Over Knives: Flavor!, and dig in!
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Non-Alcohol Mouthwash vs Alcohol Mouthwash – Which is Healthier?
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Our Verdict
When comparing non-alcohol mouthwash to alcohol mouthwash, we picked the alcohol.
Why?
Note: this is a contingent choice and is applicable to most, but not all, people.
In short, there has been some concern about alcohol mouthwashes increasing cancer risk, but research has shown this is only the case if you already have an increased risk of oral cancer (for example if you smoke, and/or have had an oral cancer before).
For those for whom this is not the case (for example, if you don’t smoke, and/or have no such cancer history), then best science currently shows that alcohol mouthwash does not cause any increased risk.
What about non-alcohol mouthwashes? Well, they have a different problem; they usually use chlorine-based chemicals like chlorhexidine or cetylpyridinium chloride, which are (exactly as the label promises) exceptionally good at killing oral bacteria.
(They’d kill us too, at higher doses, hence: swill and spit)
Unfortunately, much like the rest of our body, our mouth is supposed to have bacteria there and bad things happen when it doesn’t. In the case of our oral microbiome, cleaning it with such powerful antibacterial agents can kill our “good” bacteria along with the bad, which lowers the pH of our saliva (that’s bad; it means it is more acidic), and thus indirectly erodes tooth enamel.
You can read more about the science of all of the above (with references), here:
Toothpastes & Mouthwashes: Which Help And Which Harm?
Summary:
For most people, alcohol mouthwashes are a good way to avoid the damage that can be done by chlorhexidine in non-alcohol mouthwashes.
Here are some examples, but there will be plenty in your local supermarket:
Non-Alcohol, by Colgate | Alcohol, by Listerine
If you have had oral cancer, or if you smoke, then you may want to seek a third alternative (and also, please, stop smoking if you can).
Or, really, most people could probably skip mouthwashes, if you’ve good oral care already by other means. See also:
Toothpastes & Mouthwashes: Which Help And Which Harm?
(yes, it’s the same link as before, but we’re now drawing your attention to the fact it has information about toothpastes too)
If you do want other options though, might want to check out:
Less Common Oral Hygiene Options ← miswak sticks are especially effective
Take care!
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Stolen Focus – by Johann Hari
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Having trouble concentrating for long periods? It’s not just a matter of getting older…
Johann Hari outlines twelve key ways in which our attention has not merely “wandered”, so much as it has been outright stolen.
By whom? For what purpose? Obvious culprits include social media and outrage-stoking news outlets, but the problem, as Hari illustrates, goes much deeper than that.
He talks about how we cannot truly multi-task, and can only switch beween tasks, at a cost. And yet, the modern world is not at all friendly to single-tasking!
Writer’s note: as I write this, I have active two screens, containing four windows, one of which has three tabs open. I am not multitasking; all those things pertain to the work I am doing right now. If I closed them between use, it’d only cost me more time and attention opening and closing them all the time. And yet, my working conditions are considered practically “hyperfocused” in this century!
- We learn about how the working world has changed, and the rise of physical and mental exhaustion that has come with it.
- We learn about the collapse of sustained reading, that started well before the modern Internet.
- We learn about factors such as dietary shifts that sap our energy too.
…and more. Twelve key things, remember.
But, it’s not all doom and gloom. There are things we can do to fight back. Some are personal changes; others are societal changes to push for.
The last part of the book is given over to, essentially, a manifesto (and how-to guide) for reclaiming our attention and thinking deeply again.
Bottom line: if you struggle with maintaining attention; this is a book for you. You might want to put your phone in a drawer while you read it, though
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JoyFull – by Radhi Devlukia-Shetty
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We haven’t done a recipe book in a little while, so here’s a good one!
The focus of this book is getting more plants and spices into your diet, and doing it deliciously.
Healthwise, there is nothing controversial here: the recipes are all plant-based, mostly whole-foods, and the items that aren’t whole foods are things like “vanilla extract”.
The recipes themselves (of which there are 125) are presented clearly and simply, one to a double-page (although sometimes there will be a suggested variation on the same double-page), ideal for use in a kitchen bookstand. For each recipe, there’s a clear photo of the end result, so you know what you’re working towards.
The ingredients are not too obscure, and can be acquired from more or less any large supermarket.
Bottom line: if you’re looking to expand your plant-based cooking repertoire in a way that’s not just substitutions, then this book provides an excellent variety.
Click here to check out JoyFull, and get a taste of Ayurvedic cooking!
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