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:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- What Does “Balance Your Hormones” Even Mean?
- What You Should Have Been Told About The Menopause Beforehand
- HRT: Bioidentical vs Animal – A Tale Of Two Approaches
Take care!
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Treadmill vs Road
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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 😎
❝Why do I get tired much more quickly running outside, than I do on the treadmill? Every time I get worn out quickly but at home I can go for much longer!❞
Short answer: the reason is Newton’s laws of motion.
In other words: on a treadmill, you need only maintain your position in space relative the the Earth while the treadmill moves beneath you, whereas on the road, you need to push against the Earth with sufficient force to move it relative to your body.
Illustrative thought experiment to make that clearer: if you were to stand on a treadmill with roller skates, and hold onto the bar with even just one finger, you would maintain your speed as far as the treadmill’s computer is concerned—whereas to maintain your speed on a flat road, you’d still need to push with your back foot every few yards or so.
More interesting answer: it’s a qualitatively different exercise (i.e. not just quantitively different). This is because of all that pushing you’re having to do on the road, while on a treadmill, the only pushing you have to do is just enough to counteract gravity (i.e. to keep you upright).
As such, both forms of running are a cardio exercise (because simply moving your legs quickly, even without having to apply much force, is still something that requires oxygenated blood feeding the muscles), but road-running adds an extra element of resistance exercise for the muscles of your lower body. Thus, road-running will enable you to build-maintain muscle much more than treadmill-running will.
Some extra things to bear in mind, however:
1) You can increase the resistance work for either form of running, by adding weight (such as by wearing a weight vest):
Weight Vests Against Osteoporosis: Do They Really Build Bone?
…and while road-running will still be the superior form of resistance work (for the reasons we outlined above), adding a weight vest will still be improving your stabilization muscles, just as it would if you were standing still while holding the weight up.
2) Stationary cycling does not have the same physics differences as stationary running. By this we mean: an exercise bike will require your muscles to do just as much pushing as they would on a road. This makes stationary cycling an excellent choice for high intensity resistance training (HIRT):
3) The best form of exercise is the one that you will actually do. Thus, when it’s raining sidewise outside, a treadmill inside will get exercise done better than no running at all. Similarly, a treadmill exercise session takes a lot less preparation (“switch it on”) than a running session outside (“get dressed appropriately for the weather, apply sunscreen if necessary, remember to bring water, etc etc”), and thus is also much more likely to actually occur. The ability to stop whenever one wants is also a reassuring factor that makes one much more likely to start. See for example:
How To Do HIIT (Without Wrecking Your Body)
Take care!
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The Sweet Truth About Diabetes
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There’s A Lot Of Confusion About Diabetes!
For those readers who are not diabetic, nor have a loved one who is diabetic, nor any other pressing reason to know these things, first a quick 101 rundown of some things to understand the rest of today’s main feature:
- Blood sugar levels: how much sugar is in the blood, measured in mg/dL or mmol/L
- Hyperglycemia or “hyper” for short: too much sugar in the blood
- Hypoglycemia or “hypo” for short: too little sugar in the blood
- Insulin: a hormone that acts as a gatekeeper to allow sugar to pass, or not pass, into various parts of the body
- Type 1 diabetes (sometimes capitalized, and/or abbreviated to “T1D”) is an autoimmune disorder that prevents the pancreas from being able to supply the body with insulin. This means that taking insulin consistently is necessary for life.
- Type 2 diabetes is a matter of insulin resistance. The pancreas produces plenty of insulin, but the body has become desensitized to it, so it doesn’t work properly. Taking extra insulin may sometimes be necessary, but for many people, it can be controlled by means of a careful diet and other lifestyle factors.
With that in mind, on to some very popular myths…
Diabetes is caused by having too much sugar
While sugar is not exactly a health food, it’s not the villain of this story either.
- Type 1 diabetes has a genetic basis, triggered by epigenetic factors unrelated to sugar.
- Type 2 diabetes comes from a cluster of risk factors which, together, can cause a person to go through pre-diabetes and acquire type 2 diabetes.
- Those risk factors include:
- A genetic predisposition
- A large waist circumference
- (this is more relevant than BMI or body fat percentage)
- High blood pressure
- A sedentary lifestyle
- Age (the risk starts rising at 35, rises sharply at 45, and continues upwards with increasing age)
- Those risk factors include:
Read more: Risk Factors for Type 2 Diabetes
Diabetics can’t have sugar
While it’s true that diabetics must be careful about sugar (and carbs in general), it’s not to say that they can’t have them… just: be mindful and intentional about it.
- Type 1 diabetics will need to carb-count in order to take the appropriate insulin bolus. Otherwise, too little insulin will result in hyperglycemia, or too much insulin will result in hypoglycemia.
- Type 2 diabetics will often be able to manage their blood sugar levels with diet alone, and slow-release carbs will make this easier.
In either case, having quick release sugars will increase blood sugar levels (what a surprise), and sometimes (such as when experiencing a hypo), that’s what’s needed.
Also, when it comes to sugar, a word on fruit:
Not all fruits are equal, and some fruits can help maintain stable blood sugar levels! Read all about it:
Fruit Intake to Prevent and Control Hypertension and Diabetes
Artificial sweeteners are must-haves for diabetics
Whereas sugar is a known quantity to the careful diabetic, some artificial sweeteners can impact insulin sensitivity, causing blood sugars to behave in unexpected ways. See for example:
The Impact of Artificial Sweeteners on Body Weight Control and Glucose Homeostasis
If a diabetic person is hyper, they should exercise to bring their blood sugar levels down
Be careful with this!
- In the case of type 2 diabetes, it may (or may not) help, as the extra sugar may be used up.
- Type 1 diabetes, however, has a crucial difference. Because the pancreas isn’t making insulin, a hyper (above a certain level, anyway) means more insulin is needed. Exercising could do more harm than good, as unlike in type 2 diabetes, the body has no way to use that extra sugar, without the insulin to facilitate it. Exercising will just pump the syrupy hyperglycemic blood around the body, potentially causing damage as it goes (all without actually being able to use it).
There are other ways this can be managed that are outside of the scope of this newsletter, but “be careful” is rarely a bad approach.
Read more, from the American Diabetes Association:
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Head Over Hips
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We’ve written before about managing osteoarthritis (or ideally: avoiding it, but that’s not always an option on the table, of course), so here’s a primer/refresher before we get into the meat of today’s article:
Avoiding/Managing Osteoarthritis
When the head gets in the way
Research shows that the problem with recovery in cases of osteoarthritis of the hip is in fact often not the hip itself, but rather, the head:
❝In fact, the stronger your muscles are, the more protected your joint is, and the less pain you will experience.
Our research has shown that people with hip osteoarthritis were unable to activate their muscles as efficiently, irrespective of strength.
Basically, people with hip arthritis are unable to activate their muscles properly because the brain is actively putting on the brake to stop them from using the muscle.❞
This is a case of a short-term protective response being unhelpful in the long-term. If you injure yourself, your brain will try to inhibit you from exacerbating that injury, such as by (for example) disobliging you from putting weight on an injured joint.
This is great if you merely twisted an ankle and just need to sit back and relax while your body works its healing magic, but it’s counterproductive if it’s a chronic issue like osteoarthritis. In such (i.e. chronic) cases, avoidance of use of the joint will simply cause atrophy of the surrounding muscle and other tissues, leading to more of the very wear-and-tear that led to the osteoarthritis in the first place.
So… How to deal with that?
You probably can exercise
It’s easy to get caught between the dichotomy of “exercise and inflame your joints” vs “rest and your joints seize up”, which is not pleasant.
However, the trick lies in how you exercise, per joint type:
When Bad Joints Stop You From Exercising (5 Things To Change)
…which to be clear, isn’t a case of “avoid using the joint that’s bad”, but is rather “use it in this specific way, so that it gets stronger without doing it more damage in the process”.
Which is exactly what is needed!
Further resources
For those who like learning from short videos, here’s a trio of helpers (along with our own text-based overview for each):
- The Most Underrated Hip Mobility Exercise (Not Stretching)
- Overcome Front-Of-Hip Pain
- 10 Tips To Reduce Morning Pain & Stiffness With Arthritis
And for those who prefer just reading, here’s a book we reviewed on the topic:
11 Minutes to Pain-Free Hips – by Melinda Wright
Take care!
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Thinking about cosmetic surgery? New standards will force providers to tell you the risks and consider if you’re actually suitable
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People considering cosmetic surgery – such as a breast augmentation, liposuction or face lift – should have extra protection following the release this week of new safety and quality standards for providers, from small day-clinics through to larger medical organisations.
The new standards cover issues including how these surgeries are advertised, psychological assessments before surgery, the need for people to be informed of risks associated with the procedure, and the type of care people can expect during and afterwards. The idea is for uniform standards across Australia.
The move is part of sweeping reforms of the cosmetic surgery industry and the regulation of medical practitioners, including who is allowed to call themselves a surgeon.
It is heartening to see these reforms, but some may say they should have come much sooner for what’s considered a highly unregulated area of medicine.
Why do people want cosmetic surgery?
Australians spent an estimated A$473 million on cosmetic surgery procedures in 2023.
The major reason people want cosmetic surgery relates to concerns about their body image. Comments from their partners, friends or family about their appearance is another reason.
The way cosmetic surgery is portrayed on social media is also a factor. It’s often portrayed as an “easy” and “accessible” fix for concerns about someone’s appearance. So such aesthetic procedures have become far more normalised.
The use of “before” and “after” images online is also a powerful influence. Some people may think their appearance is worse than the “before” photo and so they think cosmetic intervention is even more necessary.
People don’t always get the results they expect
Most people are satisfied with their surgical outcomes and feel better about the body part that was previously concerning them.
However, people have often paid a sizeable sum of money for these surgeries and sometimes experienced considerable pain as they recover. So a positive evaluation may be needed to justify these experiences.
People who are likely to be unhappy with their results are those with unrealistic expectations for the outcomes, including the recovery period. This can occur if people are not provided with sufficient information throughout the surgical process, but particularly before making their final decision to proceed.
What’s changing?
According to the new standards, services need to ensure their own advertising is not misleading, does not create unreasonable expectations of benefits, does not use patient testimonials, and doesn’t offer any gifts or inducements.
For some clinics, this will mean very little change as they were not using these approaches anyway, but for others this may mean quite a shift in their advertising strategy.
It will likely be a major challenge for clinics to monitor all of their patient communication to ensure they adhere to the standards.
It is also not quite clear how the advertising standards will be monitored, given the expanse of the internet.
What about the mental health assessment?
The new standards say clinics must have processes to ensure the assessment of a patient’s general health, including psychological health, and that information from a patient’s referring doctor be used “where available”.
According to the guidelines from the Medical Board of Australia, which the standards are said to complement, all patients must have a referral, “preferably from their usual general practitioner or if that is not possible, from another general practitioner or other specialist medical practitioner”.
While this is a step in the right direction, we may be relying on medical professionals who may not specialise in assessing body image concerns and related mental health conditions. They may also have had very little prior contact with the patient to make their clinical impressions.
So these doctors need further training to ensure they can perform assessments efficiently and effectively. People considering surgery may also not be forthcoming with these practitioners, and may view them as “gatekeepers” to surgery they really want to have.
Ideally, mental health assessments should be performed by health professionals who are extensively trained in the area. They also know what other areas should be explored with the patient, such as the potential impact of trauma on body image concerns.
Of course, there are not enough mental health professionals, particularly psychologists, to conduct these assessments so there is no easy solution.
Ultimately, this area of health would likely benefit from a standard multidisciplinary approach where all health professionals involved (such as the cosmetic surgeon, general practitioner, dermatologist, psychologist) work together with the patient to come up with a plan to best address their bodily concerns.
In this way, patients would likely not view any of the health professionals as “gatekeepers” but rather members of their treating team.
If you’re considering cosmetic surgery
The Australian Commission on Safety and Quality in Health Care, which developed the new standards, recommended taking these four steps if you’re considering cosmetic surgery:
have an independent physical and mental health assessment before you commit to cosmetic surgery
make an informed decision knowing the risks
choose your practitioner, knowing their training and qualifications
discuss your care after your operation and where you can go for support.
My ultimate hope is people safely receive the care to help them best overcome their bodily concerns whether it be medical, psychological or a combination.
Gemma Sharp, Associate Professor, NHMRC Emerging Leadership Fellow & Senior Clinical Psychologist, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
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Body Scrubs: Benefits, Risks, and Guidance
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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 was wondering whether I should be using a body scrub in the shower, rather than just soap. What should guide me in the choice of a body scrub, and are there any risks to be aware of?❞
Body scrubs are great for giving skin a healthy glow, but are best used sparingly—over-exfoliation leads to the opposite effect (unhappy skin, premature skin aging, etc).
As for contents:
- microplastics are now banned in most places, but you might want to check any products (and their containers!) are BPA-free, pthalate free, etc.
- fragrances in body scrubs are usually a bad idea, and many essential oils have been shown to be endocrine-disruptors, which you do not want:
About the microplastics, harmful artificial chemicals in general, and what constitutes “etc”:
About the fragrances’ (including “natural” essential oils’) endocrine-disrupting shenanigans:
Endocrine-disrupting chemicals: an Endocrine Society scientific statement
So, what might you want to use instead?
If you’re feeling adventurous, you might like to try treating yourself to a pineapple-based mask instead (a muslin cloth soaked in pineapple juice will work just fine; please don’t waterboard yourself though), as the bromelain enzymes (found very generously in pineapple juice) break down dead cells without the need for scrubbing.
Another option is a homemade salt- or sugar-scrub. Put your salt or sugar into a jar, add enough warm water to cover it, leave it for about a day, adding more water if it seems in danger of drying out, until it recrystallizes with a high water content keeping it malleable to the touch; congratulations, you now have a very simple scrub. This should still not be used more than, say, once per week, though.
Last but not least, you might consider investing in a konjac sponge; they gently remove dead skin without damaging living skin. Here’s an example product on Amazon, for your convenience
For more on gentle-yet-effective skincare, you might like to read:
Clean: The New Science of Skin and the Beauty of Doing Less
Enjoy!
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Finish What You Start – by Peter Hollins
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For some people, getting started is the problem. For others of us, getting started is the easy part! We just need a little help not dropping things we started.
There are summaries at the starts and ends of sections, and many “quick tips” to get you back on track.
As a taster: one of these is “temptation bundling“, combining unpleasant things with pleasant. A kind of “spoonful of sugar” approach.
Hollins also discusses hyperbolic discounting (the way we tend to value rewards according to how near they are, and procrastinate accordingly). He offers a tool to overcome this, too, the “10–10–10 rule“.
Also dealt with is “the preparation trap“, and how to know when you have enough information to press on.
For a lot of us, the places we’re most likely to drop a project is 20% in (initial enthusiasm wore off) or 80% in (“it’s nearly done; no need to worry about it”). Those are the times when the advices in this book can be particularly handy!
All in all, a great book for seeing a lot of things to completion.
Don’t Forget…
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Learn to Age Gracefully
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