Progesterone Menopausal HRT: When, Why, And How To Benefit

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Progesterone doesn’t get talked about as much as other sex hormones, so what’s its deal? Dr. Heather Hirsch explains:

Menopausal progesterone

Dr. Hirsch considers progesterone essential for menopausal women who are taking estrogen and have an intact uterus, to keep conditions at bay such as endometriosis or even uterine cancer.

However, she advises it is not critical in those without a uterus, unless there was a previous case of one of the above conditions.

10almonds addition: on the other hand, progesterone can still be beneficial from a metabolic and body composition standpoint, so do speak with your endocrinologist about it.

As an extra bonus: while not soporific (it won’t make you sleepy), taking progesterone at night will improve the quality of your sleep once you do sleep, so that’s a worthwhile thing for many!

Dr. Hirsch also discusses the merits of continuous vs cyclic use; continuous maintains the above sleep benefits, for example, while cyclic use can help stabilize menstrual patterns in late perimenopause and early menopause.

For more on these things, plus discussion of different types of progesterone, enjoy:

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  • Drug Metabolism (When You’re Not Average!)

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    When Your Medications Run Out… Of You

    Everybody knows that alcohol can affect medications’ effects, but what of smoking, and what of obesity? And how does the alcohol thing work anyway?

    It’s all about the enzymes

    Medicines that are processed by the liver (which is: most medicines) are metabolized there by specialist enzymes, and the things we do can increase or decrease the quantity of those enzymes—and/or how active they are.

    Dr. Kata Wolff Pederson and her team of researchers at Aarhus University in Denmark examined the livers of recently deceased donors in ways that can’t (ethically) be done with live patients, and were able to find the associations between various lifestyle factors and different levels of enzymes responsible for drug metabolism.

    And it’s not always how you might think!

    Some key things they found:

    • Smokers have twice as high levels of enzyme CYP1A2 than non-smokers, which results in the faster metabolism of a lot of drugs.
    • Drinkers have 30% higher levels of enzyme CYP2E1, which also results in a faster metabolism of a lot of drugs.
    • Patients with obesity have 50% lower levels of enzyme CYP3A4, resulting in slower metabolism of many drugs

    This gets particularly relevant when we take into account the next fact:

    • Of the individuals in the study, 40% died from poisoning from a mixture of drugs (usually: prescription and otherwise)

    Read in full: Sex- and Lifestyle-Related Factors are Associated with Altered Hepatic CYP Protein Levels

    Read a pop-sci article about it: Your lifestyle can determine how well your medicine will work

    How much does the metabolism speed matter?

    It can matter a lot! If you’re taking drugs and carefully abiding by the dosage instructions, those instructions were assuming they know your speed of metabolism, and this is based on an average.

    • If your metabolism is faster, you can get too much of a drug too quickly, and it can harm you
    • If your metabolism is faster, it also means that while yes it’ll start working sooner, it’ll also stop working sooner
      • If it’s a painkiller, that’s inconvenient. If it’s a drug that keeps you alive, then well, that’s especially unfortunate.
    • If your metabolism is slower, it can mean your body is still processing the previous dose(s) when you take the next one, and you can overdose (and potentially die)

    We touched on this previously when we talked about obesity in health care settings, and how people can end up getting worse care:

    Let’s Shed Some Obesity Myths

    As for alcohol and drugs? Obviously we do not recommend, but here’s some of the science of it with many examples:

    Why it’s a bad idea to mix alcohol with some medications

    Take care!

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  • When A Period Is Very Late (Post-Menopause)

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    Knowledge Is Power Safety, Post-Menopause Too

    Note: this article will be most relevant for a subset of our subscribership, but it’s a very large subset, so we’re going to go ahead and address the reader as “you”.

    If, for example, you are a man and this doesn’t apply to you, we hope it will interest you anyway (we imagine there are women in your life).

    PS: the appendicitis check near the end, works for anyone with an appendix

    We’ve talked before about things that come with (and continue after) menopause:

    But what’s going on if certain menstrual symptoms reappear post-menopause (e.g. after more than a year with no menstruation)?

    Bleeding

    You should not, of course, be experiencing vaginal bleeding post-menopause. You may have seen “PSA” style posts floating around social media warning that this is a sign of cancer. And, it can be!

    But it’s probably not.

    Endometrial cancer (the kind that causes such bleeding) affects 2–3% of women, and of those reporting post-menopausal bleeding, the cause is endometrial cancer only 9% of those times.

    So in other words, it’s not to be ignored, but for 9 people out of 10 it won’t be cancer:

    Read more: Harvard Health | Postmenopausal bleeding: Don’t worry—but do call your doctor

    Other more likely causes are uterine fibroids or polyps. These are unpleasant but benign, and can be corrected with surgery if necessary.

    The most common cause, however is endometrial and/or vaginal atrophy resulting in tears and bleeding.

    Tip: Menopausal HRT will often correct this.

    Read more: The significance of “atrophic endometrium” in women with postmenopausal bleeding

    (“atrophic endometrium” and “endometrial atrophy” are the same thing)

    In summary: no need to panic, but do get it checked out at your earliest convenience. This is not one where we should go “oh that’s weird” and ignore.

    Cramps

    If you are on menopausal HRT, there is a good chance that these are just period cramps. They may feel different than they did before, because you didn’t ovulate and thus you’re not shedding a uterine lining now, but your body is going to do its best to follow the instructions given by the hormones anyway (hormones are just chemical messengers, after all).

    If it is just this, then they will probably settle down to a monthly cycle and become quite predictable.

    Tip: if it’s the above, then normal advice for period cramps will go here. We recommend ginger! It’s been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:

    See: Effect of Ginger and Novafen on menstrual pain: A cross-over trial

    It could also be endometriosis. Normally this affects those of childbearing age, but once again, exogenous hormones (as in menopausal HRT) can fool the body into doing it.

    If you are not on menopausal HRT (or sometimes even if you are), uterine fibroids (as discussed previously) are once again a fair candidate, and endometriosis is also still possible, though less likely.

    Special last note

    Important self-check: if you are experiencing a sharp pain in that general area and are worrying if it is appendicitis (also a possibility), then pressing on the appropriately named McBurney’s point is a first-line test for appendicitis. If, after pressing, it hurts a lot more upon removal of pressure (rather than upon application of pressure), this is considered a likely sign of appendicitis. Get thee to a hospital, quickly.

    And if it doesn’t? Still get it checked out at your earliest convenience, of course (better safe than sorry), but you might make an appointment instead of calling an ambulance.

    Take care!

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  • Is still water better for you than sparkling water?

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    Still or sparkling? It’s a question you’ll commonly hear in a café or restaurant and you probably have a preference. But is there any difference for your health?

    If you love the fizz, here’s why you don’t have to pass on the sparkling water.

    Brent Hofacker/Shutterstock

    What makes my water sparkle?

    This article specifically focuses on comparing still filtered water to carbonated filtered water (called “sparkling water” or “unflavoured seltzer”). Soda water, mineral water, tonic water and flavoured water are similar, but not the same product.

    The bubbles in sparkling water are created by adding carbon dioxide to filtered water. It reacts to produce carbonic acid, which makes sparkling water more acidic (a pH of about 3.5) than still (closer to neutral, with a pH around 6.5-8.5).

    Which drink is healthiest?

    Water is the best way to hydrate our bodies. Research shows when it comes to hydration, still and sparkling water are equally effective.

    Some people believe water is healthier when it comes from a sealed bottle. But in Australia, tap water is monitored very carefully. Unlike bottled water, it also has the added benefit of fluoride, which can help protect young children against tooth decay and cavities.

    Sparkling or still water is always better than artificially sweetened flavoured drinks or juices.

    Isn’t soda water bad for my teeth and bones?

    There’s no evidence sparkling water damages your bones. While drinking a lot of soft drinks is linked to increased fractures, this is largely due to their association with higher rates of obesity.

    Sparkling water is more acidic than still water, and acidity can soften the teeth’s enamel. Usually this is not something to be too worried about, unless it is mixed with sugar or citrus, which has much higher levels of acidity and can harm teeth.

    However, if you grind your teeth often, the softening could enhance the damage it causes. If you’re undertaking a home whitening process, sparkling water might discolour your teeth.

    In most other cases, it would take a lot of sparkling water to pass by the teeth, for a long period of time, to cause any noticeable damage.

    How does drinking water affect digestion?

    There is a misconception drinking water (of any kind) with a meal is bad for digestion.

    While theoretically water could dilute stomach acid (which breaks down food), the practice of drinking it doesn’t appear to have any negative effect. Your digestive system simply adapts to the consistency of the meal.

    Some people do find that carbonated beverages cause some stomach upset. This is due to the build-up of gases, which can cause bloating, cramping and discomfort. For people with an overactive bladder, the acidity might also aggravate the urinary system.

    Interestingly, the fizzy “buzz” you feel in your mouth from sparkling water fades the more you drink it.

    Is cold water harder to digest?

    You’ve chosen still or sparkling water. What about its temperature?

    There are surprisingly few studies about the effect of drinking cold water compared to room temperature. There is some evidence colder water (at two degrees Celsius) might inhibit gastric contractions and slow down digestion. Ice water may constrict blood vessels and cause cramping.

    However other research suggests drinking cold water might temporarily boost metabolism, as the body needs to expend energy to warm it up to body temperature. This effect is minimal and unlikely to lead to significant weight loss.

    Which water wins?

    The bottom line is water is essential, hydrates us and has countless other health benefits. Water, with carbonated bubbles or without, will always be the healthiest drink to choose.

    And if you’re concerned about any impact to teeth enamel, one trick is to follow sparkling water with a glass of still. This helps rinse the teeth and return your mouth’s acidity back to normal.

    Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow, Medical Program, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Related Posts

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  • Superfood Broccoli Pesto

    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.

    Cruciferous vegetables have many health benefits of their own (especially: a lot of anticancer benefits). But, it can be hard to include them in every day’s menu, so this is just one more way that’ll broaden your options! It’s delicious mixed into pasta, or served as a dip, or even on toast.

    You will need

    • 4 cups small broccoli florets
    • 1 cup fresh basil leaves
    • ½ cup pine nuts
    • ¼ bulb garlic
    • 3 tbsp extra virgin olive oil
    • 2 tbsp nutritional yeast
    • 1 tbsp lemon juice
    • 2 tsp black pepper, coarse ground
    • 1 tsp red pepper flakes
    • ½ tsp MSG or 1 tsp low-sodium salt

    Method

    (we suggest you read everything at least once before doing anything)

    1) Steam the broccoli for 3–5 minutes. Allow to cool.

    2) Blend the pine nuts, garlic, lemon juice, and nutritional yeast.

    3) Add the broccoli, basil, olive oil, black pepper, red pepper, and MSG or salt, and blend in the food processor again until well-combined.

    4) Serve:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Canned Tuna vs Canned Sardines – Which is Healthier?

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    Our Verdict

    When comparing canned tuna to canned sardines, we picked the sardines.

    Why?

    This comparison is unfair, but practical—because both are sold next to each other in the supermarket and often used for similar things.

    It’s unfair because in a can of tuna, there is tuna meat, whereas in a can of sardines, there is sardine meat, skin, and bones.

    Consequently, sardines outperform tuna in almost everything, because a lot of nutrients are in the skin and bones.

    To be completely unambiguous:

    Sardines have more vitamins and minerals by far (special shout-out to calcium, of which sardines contain 6000% more), and more choline (which is sometimes reckoned as a vitamin, sometimes not).

    Tuna does have marginally more protein, and less fat. If you are trying to limit your cholesterol intake, then that could be an argument for choosing tuna over sardines.

    All in all: the sardines are more nutrient dense by far, are good sources of vitamins and minerals that tuna contains less of (and in many cases only trace amounts of), and for most people this will more than offset the difference in cholesterol, especially if having not more than one can per day.

    About that skin and bones…

    That’s where the real benefit for your joints lies, by the way!

    See: We Are Such Stuff As Fish Are Made Of

    Enjoy!

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  • Dreams: Relevance, Meanings, Interpretations

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    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    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

    ❝I have a question or a suggestion for coverage in your “Psychology Sunday”. Dreams: their relevance, meanings ( if any) interpretations? I just wondered what the modern psychological opinions are about dreams in general.❞

    We’ll indeed do that one of these Psychology Sundays! Thanks for suggesting it.

    What we can say in advance is that there’s certainly not a single unified scientific consensus yet, but there are two or three prevailing views definitely worth covering, e.g. randomly generated, a by-product of reorganizing information in the brain, or expressions of subconscious thoughts/feelings.

    There are also differences between a top-down/bottom-up approach to understanding dreaming, and efforts to tie those two together.

    Watch this space!

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