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.

Sheโ€™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, thereโ€™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

โ€ฆand, which a lot of Dr. Shepherdโ€™s work focuses on, it also increases dementia risk; she cites that 60โ€“80% of dementia cases are women, and itโ€™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:

Alzheimerโ€™s Sex Differences May Not Be What They Appear

Treated menopause is safer than many people think

The Womenโ€™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 โ€œoopsies, never mind, we take that backโ€ didnโ€™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).

Itโ€™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 havenโ€™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:

HRT: A Tale Of Two Approaches

โ€ฆand 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:

  1. Perimenopause: โ€œIs this menopause?โ€
  2. Menopause: โ€œOk, choices to make about HRT or not, plus I should watch out for osteoporosisโ€
  3. Postmenopause: โ€œYay, thatโ€™s behind me now, back to the new normalโ€

The reality, Dr. Shepherd advises, is that โ€œpostmenopauseโ€ is a misnomer because if itโ€™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, itโ€™s now doing it without much estrogen.

So, you canโ€™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 wonโ€™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 โ€“ by Dr. Jessica Shepherd

Take care!

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  • Mango vs Pineapple โ€“ Which is Healthier?

    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.

    Our Verdict

    When comparing mango to pineapple, we picked the pineapple.

    Why?

    It was close! Both of these tropical fruits have almost identical macros, and when it comes to vitamins and minerals, mango has slightly more vitamins while pineapple has slightly more minerals, so that balances out too. Their glycemic loads are 11 and 13 respectively, so: very low, and very similar.

    See also: Which Sugars Are Healthier, And Which Are Just The Same?

    In terms of what sets them apart:

    Mango has a lot of vitamin A, to the point that it can interfere with blood-thinners if you take those.

    Pineapple has bromelain, an enzyme with unique anti-inflammatory properties that we must devote a Research Review Monday to one of these days, because there’s a lot to say, but the short version is, it’s very powerful.

    Since bromelain is found only in pineapples, whereas vitamin A is easy to find in abundance in many foods, we went with the pineapple.

    Enjoy!

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  • Is Ant Oil Just โ€œSnake Oilโ€?

    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.

    We Tested Out โ€œAnt Egg Oilโ€

    Did you know?! Thereโ€™s a special protein found only in the eggs of a particular species of ant found in Turkey, that can painlessly and permanently stop (not just slow!) hair regrowth in places youโ€™d rather not have hair.

    Neither did we, and when we heard about it, we did our usual research, and discovered a startling secret.

    โ€ฆthere probably isnโ€™t.

    We decided to dig deeper, and the plot (unlike the hair in question) thickens:

    We could not find any science for or against (or even generally about) the use of ant egg oil to prevent hair regrowth. Not a peep. What we did find though was a cosmetic chemist who did an analysis of the oil as sold, and found its main ingredient appears to be furan-2-carbaldehyde, or Furfural, to its friends.

    Surprise! Thereโ€™s also no science that we could find about the effect of Furfural (we love the name, though! Fur for all!) on hair, except that itโ€™s bad for rodents (and their hair) if they eat a lot of it. So please donโ€™t eat it. Especially if youโ€™re a mouse.

    And yet, many ostensibly real reviews out in the wild claim it works wonders. So, we took the investigative reporting approach and tried it ourselves.

    Thatโ€™s right, a plucky member of our team tried it, and she reports:

    โ At first glance, it seems like olive oil. Thereโ€™s something else though, adding a darker colour and a slight bitterness to the smell.

    After waxing, I applied a little every few days. When the hair eventually regrew (and it did), it grew back thinner, and removing the new hairs was a strangely easy experience, like pulling hairs out of soft soap instead of out of skin. It didnโ€™t hurt at all, either.

    I had more of the oil, so I kept going with the treatment, and twelve weeks later there are very few hairs regrowing at all; probably there will be none left soon. Whateverโ€™s in this, be it from ant eggs or wheat bran or something else entirely, it worked for me!โž

    So in short: it remains a mystery for now! If you try it, let us know how it went for you.

    Hereโ€™s the โ€œinterestingโ€ website that sells it, though you may find it for less on eBay or similar. (Note, we arenโ€™t earning any commissions from these links. We just wanted to make it easier for you to dive deeper).

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  • Chia Seeds vs Sunflower Seeds โ€“ Which is Healthier?

    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.

    Our Verdict

    When comparing chia seeds to sunflower, we picked the chia.

    Why?

    It was close, and they both have their merits!

    In terms of macros, chia has more carbs and a lot more fiber, while sunflower has a little more protein and a lot more fat. While the fat (in the seeds, not processed seed oils!) is mostly healthy polyunsaturated fat in both cases, chia has a lot more omega-3. All in all, we’re calling it a win for chia on macros.

    In the category of vitamins, chia has more of vitmains B3 and C, while sunflower has ore of vitamins B1, B2, B9, and E. Thus, a win for sunflower seeds this time.

    When it comes to minerals, chia has more calcium, iron, magnesium, manganese, phosphorus, and selenium, while sunflower has more copper, potassium, and zinc. A 6:3 win for chia here.

    Adding up the sections makes for an overall win for chia, but by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    The Tiniest Seeds With The Most Value: If Youโ€™re Not Taking Chia, Youโ€™re Missing Out!

    Take care!

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Related Posts

  • Why Going Gluten-Free Could Be A Bad Idea
  • Healthy Longevity As A Lifestyle Choice

    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.

    7 Keys To Healthy Longevity

    This is Dr. Luigi Fontana. Heโ€™s a research professor of Geriatrics & Nutritional Science, and co-director of the Longevity Research Program at Washington University in St. Louis.

    What does he want us to know?

    He has a many-fold approach to healthy longevity, most of which may not be news to you, but you might want to prioritize some things:

    Consider caloric restriction with optimal nutrition (CRON)

    This is about reducing the metabolic load on your body, which frees up bodily resources for keeping yourself young.

    Keeping your body young and healthy is your bodyโ€™s favorite thing to do, but it canโ€™t do that if it never gets a chance because of all the urgent metabolic tasks youโ€™re giving it.

    If CRON isnโ€™t your thing (isnโ€™t practicable for you, causes undue suffering, etc) then intermittent fasting is a great CR mimetic, and he recommends that too. See also:

    Keep your waistline small

    Whichever approach you prefer to use to look after your metabolic health, keeping your waistline down is much more important for health than BMI.

    Specifically, he recommends keeping it:

    • under 31.5โ€ for women
    • under 37โ€ for men

    The disparity here is because of hormonal differences that influence both metabolism and fat distribution.

    Exercise as part of your lifestyle

    For Dr. Fontana, he loves mountain-biking (this writer could never!) and weight-lifting (also not my thing). But whatโ€™s key is not the specifics, but whatโ€™s going on:

    • Some kind of frequent movement
    • Some kind of high-intensity interval training
    • Some kind of resistance training

    Frequent movement because our bodies are evolved to be moving more often than not:

    The Doctor Who Wants Us To Exercise Less, & Move More

    High-Intensity Interval Training because unlike most forms of exercise (which slow metabolism afterwards to compensate), it boosts metabolism for up to 2 hours after training:

    How To Do HIIT (Without Wrecking Your Body)

    Resistance training because strength (of muscles and bones) matters too:

    Resistance Is Useful! (Especially As We Get Older)

    Writerโ€™s examples:

    So while I donโ€™t care for mountain-biking or weight-lifting, what I do is:

    1) movement: walk (briskly!) everywhere and also use a standing desk
    2) HIIT: 2-minute bursts of hindu squats and/or exercise bike sprints
    3) resistance: pilates and other calisthenics

    Moderation is not key

    Dr. Fontana advises that we do not smoke, and that we do not drink alcohol, for example. He also notes that just as the only healthy amount of alcohol is zero, less ultra-processed food is always better than more.

    Maybe you donโ€™t want to abstain completely, but mindful wilful consumption of something unhealthy is preferable to believing โ€œmoderate consumption is good for the healthโ€ and an unhealthy habit develops!

    Greens and beans

    Shocking absolutely nobody, Dr. Fontana advocates for (what has been the most evidence-based gold standard of healthy-aging diets for quite some years now) the Mediterranean diet.

    See also: Four Ways To Upgrade The Mediterranean Diet โ† this is about tweaking the Mediterranean diet per personal area of focus, e.g. anti-inflammatory bonus, best for gut, heart healthiest, and most neuroprotective.

    Take it easy

    Dr. Fontana advises us (again, with a wealth of evidence) Mindfulness-Based Stress Reduction, and to get good sleep.

    Not shocked?

    To quote the good doctor,

    โThere are no shortcuts. No magic pills or expensive procedures can replace the beneficial effects of a healthy diet, exercise, mindfulness, or a regenerating night’s sleep.โž

    Always a good reminder!

    Want to know more?

    You might enjoy his book โ€œThe Path to Longevity: How to Reach 100 with the Health and Stamina of a 40-Year-Oldโ€, which we reviewed previously

    You might also like this video of his, about changing the conversation from โ€œchronic diseaseโ€ to โ€œchronic healthโ€:

    !

    Want to watch it, but not right now? Bookmark it for later

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

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  • Which Tea Is Best, By Science?

    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 kind of tea is best for the health?

    Itโ€™s popular knowledge that tea is a healthful drink, and green tea tends to get the popular credit for โ€œhealthiestโ€.

    Is that accurate? It depends on what youโ€™re looking forโ€ฆ

    Black

    Its strong flavor packs in lots of polyphenols, often more than other kinds of tea. This brings some great benefits:

    As well as effects beyond the obvious:

    The Effect of Black Tea on Blood Pressure: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

    โ€ฆand its cardioprotective benefits arenโ€™t just about lowering blood pressure; it improves triglyceride levels as well as improving the LDL to HDL ratio:

    The effect of black tea on risk factors of cardiovascular disease in a normal population

    Finally (we could say more, but we only have so much room), black tea usually has the highest caffeine content, compared to other teas.

    Thatโ€™s good or bad depending on your own physiology and preferences, of course.

    White

    White tea hasnโ€™t been processed as much as other kinds, so this one keeps more of its antioxidants, but that doesnโ€™t mean it comes out on top; in this study of 30 teas, the white tea options ranked in the mid-to-low 20s:

    Phenolic Profiles and Antioxidant Activities of 30 Tea Infusions from Green, Black, Oolong, White, Yellow and Dark Teas

    White tea is also unusual in its relatively high fluoride content, which is consider a good thing:

    White tea: A contributor to oral health

    In case you were wondering about the safety of thatโ€ฆ

    Water Fluoridation: Is It Safe, And How Much Is Too Much?

    Green

    Green tea ranks almost as high as black tea, on average, for polyphenols.

    Its antioxidant powers have given it a considerable anti-cancer potential, too:

    โ€ฆand many others, but you get the idea. Notably:

    Green Tea Catechins: Nature’s Way of Preventing and Treating Cancer

    …or to expand on that:

    Potential Therapeutic Targets of Epigallocatechin Gallate (EGCG), the Most Abundant Catechin in Green Tea, and Its Role in the Therapy of Various Types of Cancer

    About green teaโ€™s much higher levels of catechins, they also have a neuroprotective effect:

    Simultaneous Manipulation of Multiple Brain Targets by Green Tea Catechins: A Potential Neuroprotective Strategy for Alzheimer and Parkinson Diseases

    Green tea of course is also a great source of l-theanine, which we could write a whole main feature about, and we did:

    L-Theanine: Whatโ€™s The Tea?

    Red

    Also called โ€œrooibosโ€ or (literally translated from Afrikaans to English) โ€œredbushโ€, itโ€™s quite special in that despite being a โ€œtrue teaโ€ botanically and containing many of the same phytochemicals as the other teas, it has no caffeine.

    Thereโ€™s not nearly as much research for this as green tea, but hereโ€™s one that stood out:

    Effects of rooibos (Aspalathus linearis) on oxidative stress and biochemical parameters in adults at risk for cardiovascular disease

    However, in the search for the perfect cup of tea (in terms of phytochemical content), another set of researchers found:

    โThe optimal cup was identified as sample steeped for 10 min or longer. The rooibos consumers did not consume it sufficiently, nor steeped it long enough. โž

    ~ Dr. Hannelise Piek et al.

    Read in full: Rooibos herbal tea: an optimal cup and its consumers

    Bottom line

    Black, white, green, and red teas all have their benefits, and ultimately the best one for you will probably be the one you enjoy drinking, and thus drink more of.

    If trying to choose though, we offer the following summary:

    • ๐Ÿ–ค Black tea: best for total beneficial phytochemicals
    • ๐Ÿค White tea:best for your oral health
    • ๐Ÿ’š Green tea: best for your brain
    • โค๏ธ Red tea: best if you want naturally caffeine-free

    Enjoy!

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  • 6 Signs Of Stroke (One Month In Advance)

    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.

    Most people can recognise the signs of a stroke when it’s just happened, but knowing the signs that appear a month beforehand would be very useful. That’s what this video’s about!

    The Warning Signs

    • Persistently elevated blood pressure: one more reason to have an at-home testing kit and use it regularly! Or a smartwatch or similar that’ll do it for you. The reason this is relevant is because high blood pressure can lead to damaging blood vessels, causing a stroke.
    • Excessive fatigue: of course, this one can have many possible causes, but one of them is a “transient ischemic attack” (TIA), which is essentially a micro-stroke, and can be a precursor to a more severe stroke. So, we’re not doing the Google MD thing here of saying “if this, then that”, but we are saying: paying attention to the overall patterns can be very useful. Rather than fretting unduly about a symptom in isolation, see how it fits into the big picture.
    • Vision problems: especially if sudden-onset with no obvious alternative cause can be a sign of neural damage, and may indicate a stroke on the way.
    • Speech problems: if there’s not an obvious alternative explanation (e.g. you’ve just finished your third martini, or was this the fourth?), then speech problems (e.g. slurred speech, trouble forming sentences, etc) are a very worrying indicator and should be treated as a medical emergency.
    • Neurological problems: a bit of a catch-all category, but memory issues, loss of balance, nausea without an obvious alternative cause, are all things that should get checked out immediately just in case.
    • Numbness or weakness in the extremities: especially if on one side of the body only, is often caused by the TIA we mentioned earlier. If it’s both sides, then peripheral neuropathy may be the culprit, but having a neurologist take a look at it is a good idea either way.

    Click Here If The Embedded Video Doesnโ€™t Load Automatically!

    Want to learn more?

    You might also like to read:

    Two Things You Can Do To Improve Stroke Survival Chances

    Take care!

    Don’t Forget…

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