Category Archives: Menopause Symptoms

Menopause symptoms range from mild to uncomfortable to positively vexing, but there are solutions, options, and hope! These posts by Kyle and Candace explore the many facets of this phase of life.

Newsflash! PMS is Real! See Kyle’s TV interview about Hormones and Depression!

Good morning from Portland! I’m Anne, Menopausibilities’ “Blogmother”, with a link to Kyle’s interview with KOIN 6 News on the link between hormones and depression.

http://www.koinlocal6.com/news/local/story/Pearl-Womens-Center-knows-PMS-is-real/iwaDpTdw-kCiQSc5MsxNkw.cspx

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by | March 21, 2013 · 5:50 pm

Reflections on the ‘cleanse’ and more reasons to stay away from most sugars

Well, I made it through the past 10 days and amazingly, this was not as difficult as I had anticipated. Honestly I was a little nervous before I started, as I had re-developed the mid-morning and sometimes early afternoon coffee habit over the past 6 months….and I was worried that I would be falling asleep mid-sentence! I also love to savor a glass(or 2) of full-bodied red wine in the evening, as a way to separate the busy-ness of my work day from the relaxation that I like to enjoy when work is over. And all too often  I found myself sneaking in a few potato or corn chips or occasional bites of chocolate, without paying too much attention to how all of these things added up over the day. The bottomline was that I found myself reaching for the cup of coffee or the quick snack to rebuild my energy when it dipped so going without seemed a bit daunting.

So here it is 10 days later and this is what I noticed during that time:

1. I slept better than I had in years. BHRT(bio-identical hormones) have clearly improved my ability to sleep(no night sweats, more REM sleep, ease of falling and staying asleep) but by developing some of my previously mentioned habits, I was often tossing and turning in the middle of the night, unable to find that rest again. Not so these past 10 days: my sleep was deep and wonderful and I woke each morning feeling refreshed.  And for those of you who have sleep issues, you know how priceless a good night’s sleep is!

2. My head was clearer, memory sharper and I found it easier to do tasks that I might usually keep avoiding.

3. My energy level was terrific. I found that could swim and walk faster and my workouts gave me more energy back.

4. I lost almost an inch around my waist(that darned belly fat…even though I am relatively lean, I still struggle with that…and that is not the good kind of fat to have: it is directly correlated with a higher risk of diabetes, cardiovascular disease and breast cancer; Belly fat begone!), shed about 3 pounds  and my clothes fit better. And I felt full and satisfied after eating and I didn’t crave sugar or caffeine….astounding.

5. I had fun trying new recipes and teas…and I didn’t mind the 5 evenings when I was around family and friends who were having wine , beer and cocktails…it was actually very pleasant, not an issue at all.

Some healthy and delicious food choices, packed with powerful nutrients

So now I am on day 11 and actually have decided to continue for a few days longer. A few of my friends asked me last evening if I picked 10 days for any particular reason. My reasoning for that is I don’t think a week is long enough , 2 weeks sounds too long to many people, and  you can make it work so that you are only on it for one weekend. I also think you get to see more results if you make it the full 10 days. Again, this is just something I made up for myself to help me make a few small changes and gain a feeling of empowerment.  But I have heard quite a bit of positive feedback from the women who joined me(there are also 3 men…I would love to hear how they did as well!). Everyone noted better sleep, better energy, less sugar cravings and a feeling of control.  Wow, so small changes really had a big impact.  That is pretty powerful.

Kyle and Candace at our local farmers’ market: so many wonderful food choices, grown locally

I guess there are no coincidences after all. When I came home from work and started to read today’s Living section in our local paper, the Oregonian, I of course noticed the article skewering sugar and its relatives by Dr. Oz and Rozen.  Many points were made in this article. Here are just a few of the highlights: sugar alters essential proteins in the body, particularly if you already have insulin resistance; too much fructose(we are not talking about whole fruits here: more like High Fructose corn syrup, maple syrup, brown and white sugar, honey, agave and turbinado sugars) causes your liver to turn the excess fructose into fat: this in turn can lead to fatty liver and/or cirrhosis; drinking large quantities(30 oz of fructose-containing substances)/day can drive up your blood pressure; high levels of fructose are directly related to the development of diabetes.  Recommendations include: cut down on those sugars in general(try to limit consumption to 20 g or 3 Tblsp/day); eat fruit for dessert and use stevia as a substitute, in moderation of course.

There really is no avoiding the news about sugar and its effects on our health.  So this cleanse for me came at a particularly powerful time, right before Halloween(yikes: just think how much candy we have all consumed as a result of that holiday!!) , Thanksgiving, Christmas and Hanukkah. I am motivated to find recipes that will rely minimally on added sugars and I will share them with you. Please do the same for us and all of our readers.  As always, wishing you joy and balance.

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Filed under Kyle Bell McAvoy, Menopause Symptoms, Whole Eating, Women's Health & Happiness

Day 5 of our ‘consciousness cleanse’: almost halfway there!

Checking in with all of you who have joined us on this 10 day mini-journey towards optimal eating and drinking: how is it going so far? I am sure it has had some challenges along the way, as breaking old habits can be really hard. I love to sit down with a lovely full-bodied glass of red wine after a long day at work so during these last few days, I learned to shift and focus instead on the incredible variety of teas I could brew up and savor.
For others, I have heard that cutting out sugar was the most difficult and required some pretty strong ‘won’t power’. Caffeine for some was the most challenging so perhaps not something to be eliminated this time…or maybe this is a time to simply cut down on the daily dose. Remember, this cleanse is for you and you need to make it work for your life and routine.
All in all, I have loved how I have felt each day: I have noticed that my sleep has been deep, restful and free of night sweats. Although I have been on BHRT for almost 12 years and usually symptom-free, after several glasses of wine in the evening, I often toss and turn and wake up throughout the night with mild night sweats(alcohol consumption is definitely linked to increased hot flashes and night sweats, so that is something you should be aware of). I have awakened each morning with an abundance of energy and mental clarity and I have found that I am not getting drowsy soon after lunch. You may remember that I am one of those ‘nuts’ who awaken at 4:30 weekdays so that I can get my workout in before heading off to work. Often a post- lunch siesta sounds very tempting. These past few days I have not felt the urge to crawl up into a little ball and catch a few zzzz’s after lunch so that has been a noticeable change for me.

I have also enjoyed the renewed focus on the foods I have been buying and preparing for my meals. On day one, I made a spicy and hearty pumpkin soup as well as a loaf of whole grain bread, served alongside a fresh green salad. I was inspired to make pumpkin soup in the spirit of Halloween and also because I know how many health benefits pumpkin has:  it is low in fat and calories , high in fiber(important to lower blood glucose and cholesterol, as well as important for smooth digestion), high in carotenes(anti-oxidants), which are crucial for our vision and our skin, plus it has critical nutrients such as vitamins C and E, and the minerals magnesium , potassium and iron. Often we add health-promoting spices to pumpkin recipes such as cinnamon , curry and cumin, which will further enhance pumpkin’s benefits.

Day one: Sunday dinner: yummy nutrient-full pumpkin soup and hearty organic whole grain bread plus green salad

The bread recipe came from Mark Bittman’s Food Matters Cookbook. It was so simple that it inspired me to make bread, something I did all the time years ago. It took me less than 3 minutes to toss the ingredients together. Next I let the dough rise for 2 hours, added some cooked millet, formed the loaf, let it rise again and cooked it for 40 minutes. There is nothing like a the fragrance and taste of a freshly baked loaf of whole grain bread to complete the meal…and it cost less than a dollar to make. In addition,  I was confident that the ingredients were organic as well as rich in nutrients.

As I have shared with you before, women come to me with a litany of complaints, frustrations and symptoms that are related to hormonal imbalance.  After testing has been reviewed and I have created a comprehensive ‘personal balance plan’, I always remind them that lifestyle changes are also a critical component in achieving and maintaining hormonal and health balance. That is why taking the time to pay attention to how you nourish your body each day is so pivotal to your overall health. The effects are longlasting and far-reaching. As my friend Molly said to me, we are on the 90 year plan so we have to realize that what we put into our body today has an incredible effect on our longevity as well as the quality of our life.

Hormonal balance depends on the entire package: testing, treating with appropriate hormones and supplements, eating nutritiously, regular exercise, stress management, maintaining nourishing relationships, pursuing the things that you love, spiritual practice  and the support of your personal village. 

I am looking forward to your comments on how you are doing. Let me know if you would like me to share the recipes I used for pumpkin soup and whole grain bread and I will post them on the blog.

Congratulations for making it this far and for keeping me company. Thank you.

A moment of balance , halfway up Saddle Mountain in the Oregon Coastal Range

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Filed under Bioidentical Hormones, Essentials, Hormone Imbalance, Hormone Replacement Therapy, Kyle Bell McAvoy, Menopause Symptoms, Whole Eating, Women's Health & Happiness, Women's Work/Life Balance

How the WHI turned things on its head and we have come a long way baby!! Happy 2012

It is hard to believe that 10 years ago this July, the first reports from the WHI(Women’s Health Initiative) first hit the press and caused a major upheaval in our country in terms of how we viewed hormone treatment for women.  Headlines appeared in all of the major newspapers, soundbites aired on TV and radio shows, all echoing the same information:  based on this study(despite conflicting evidence from dozens of studies prior to this one), it was felt that hormone replacement therapy was no longer something that should routinely be prescribed to postmenopausal women due to the increased risks of breast cancer and cardiovascular complications.

The release of this information was a veritable nightmare for clinicians like myself who have worked with women for years trying to find the safest and most effective treatment options to deal with the challenges of perimenopause and beyond. Suddenly everything we had trusted was brought into question and the reaction was loud, contentious and confusing. We were advised by our various medical organizations(such as NAMS:North American Menopause Society; ACOG: American College of OB/Gyn, AMA: American Medical Society, and so on) to get women off of HRT(hormone replacement therapy) and advise them of their risks.

I have been a Nurse Practitioner since 1988 and I can honestly say, this was a pivotal moment in my evolution as a clinician. I felt as though I was between a rock and a hard place. How do I honor the “wisdom of the powers that be” yet take excellent care of the women who trusted me to provide them with accurate, up-to-date health information and help them find relief for their innumerable symptoms of hormonal imbalance? This was not an easy task but in many ways, I am thankful for the stir caused by this study as it forced many clinicians like myself to take a hard look at the information coming to us from these large scale, big Pharma-financed studies. It was time for a seismic shift for me, that’s for sure.

I have always been more holistic in my approach towards health care than what I learned in my allopathic undergraduate and graduate programs.  I had long developed a mistrust from some of the “studies” and abstracts given to me by pharmaceutical reps and this new turn of events just confirmed for me the need for ME to sort through the information myself, to resist believing the latest “headline du jour”. And I was in a perfect position to change my approach to taking care of women approaching menopause.

Thankfully one of my patients at the time told me about a special that had aired on public television highlighting “Bio-identical Hormones”, something I had heard of but honestly, didn’t know much about. I sought out a local compounding pharmacist, Alison Johnston and asked her to teach me. Not only did she mentor me and turn me on to a whole new world of compounding, but she sponsored me to go to a conference put on by PCCA(Professional Compounding Corporation of America). This is where I learned about the value of saliva testing, met the wonderful folks of ZRT lab and from that point on , I knew I had found what I was looking for: a safe, non-invasive, accurate, comprehensive way to test actual hormone levels.

My next challenge was to learn to interpret these levels and then how to prescribe BHRT in PHYSIOLOGIC doses to help alleviate symptoms of hormone imbalance and provide the many benefits of hormone treatment(see our previous blog posts on this). I had no local providers to ask….I was completely on my own and sometimes it was a scary place. But I knew there was no turning back. I had the support of my local pharmacists and the providers and staff at ZRT lab. I continued to go to any conference I could find on the topic, I read countless books and articles and soon I was treating hundreds, then thousands of women.  Not just treating them but helping them regain balance, hope and quality of life. I will soon be sharing some of their testimonials with you all in future blogposts.

So that’s the story of how I became so passionate about saliva testing and BHRT. I see thousands of women every year and I get such joy out of partnering with my patients. So many of them are like some of the people who have commented on our blog: at their wit’s end. Help is just around the corner ladies. Stay tuned and we will continue to provide you with the information and optimism that you need to get on your own road back to balance.

Oh, and by the way, patience really is a virtue. After 10 years of arguing back and forth about whether hormones are safe for women, just this week a statement was issued by NAMS and supported by 15 major medical organizations that now states that hormone replacement therapy should be offered to women.  AMEN!!! Remember, we support the use of BHRT… but this is such a sweet victory for women and those who care for them. Here is the link to the article:

NAMS statement

One last thing in closing. Today is Candace’s birthday so wishing my dear friend and colleague a wonderful celebration of life and a toast to many decades of happiness and balanced living to come!

With love,

Kyle

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Filed under Bioidentical Hormones, Hormone Imbalance, Hormone Replacement Therapy, Kyle Bell McAvoy, Menopause Symptoms, Women's Health & Happiness, Women's Work/Life Balance

Hormones 101

What is a hormone exactly? 

How do I know if I have a hormone imbalance?

And if I do, what can I do about it anyway?

These are common questions that Candace and I hear as we work with women everyday.  Sometimes we forget how many of us don’t know the basics about our own bodies so don’t feel embarrassed if you are among those who don’t. I rely on my car mechanic to sort through the ins and outs of my vehicle when IT is out of balance. But I always feel a little sheepish because I don’t even know the right questions to ask. In many ways, I think women feel the same way about their bodies when they begin to show signs of imbalance. So here is a brief overview to answer these questions and help you understand when it is time to do something about how you feel.
A hormone is a chemical that is produced in a gland(such as the ovary or the thyroid) which is released and has far-reaching effects on other parts of the body. These hormones have many functions, including regulating metabolism, fertility, fluid balance, mood, blood sugar regulation, to name a few. Hormones act on organs, tissues and cells throughout the body and are essential for optimal functioning.
Hormones work best when they work together and are balanced with one another.

Think of a symphony which consists of various musical instrument sections  coordinated in such a way  that each section comes in at just the right moment, volume and tempo to complement the other sections. When the conductor and the musicians work well together, the music is melodic and lovely. When they don’t, it is difficult  to hear the music at all(it sounds more like a bunch of noise!).
There are days when all of us wake up and we just feel ‘in balance’ and have energy to spare. Then there are those days that we know our balance is definitely off; everything seems off-kilter. This brings me to some of the symptoms of hormone imbalance. We have mentioned a few in previous blogposts but here are some you may(or may not ) be aware of: hot flashes, night sweats, mood swings, belly fat, irritability , depressed mood, anxiety, foggy thinking, feeling cold, hair loss, hair in new places, weak or peeling nails, insomnia, low libido, menstrual changes, dry skin, vaginal dryness, inability to concentrate, fatigue, memory changes…… I could go on but I think you get the picture.

If any of these sound familiar,  there is a good chance that something has caused your hormones to be out of balance.  Common causes include pregnancy, stressful life events, over scheduled and busy lives(sound like anyone you know???), lack of exercise, poor diet, toxins in our environment, toxic relationships, job stresses, and the simple act of moving into ‘midlife’ .We all have so many demands on us and often don’t have enough time in the day to get it all done, leaving us feeling depleted and ‘not like ourselves’.

Hmmm…got you thinking hopefully, so now what? Stay tuned and we will be posting a ‘checklist of symptoms of hormone imbalance’ in the near future so that you can do an inventory of your individual symptoms.  Once you have those identified, the next step will be to get your hormone levels tested.  Let us know if you would like to   get this done as we are working on putting together an offer for our readers and would like to get an idea of how many people are interested.  Just list your first name and first letter of your last name in the comments section.

As always, give us YOUR suggestions for future blogposts and feel free to ask us questions….there is no such thing as a silly question!

Wishing you balance

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Filed under Hormone Imbalance, Kyle Bell McAvoy, Menopause Symptoms, Women's Health & Happiness, Women's Work/Life Balance

Live discussion on hormone balance, testing and treatment options

Last year I did a televised interview at our local radio station, KINK.fm. The moderator asked me questions about hormone imbalance, hormone testing and possible treatments. I have had quite a few patients comment on how helpful it was to hear this interview so I would like to share it with all of you. Just click on the link and then scroll down to my photo and hit the play button I hope you enjoy it and would love to answer any questions you might have. Let me know what you think!

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Filed under Bioidentical Hormones, Hormone Imbalance, Hormone Replacement Therapy, Kyle Bell McAvoy, Menopause Symptoms, Women's Health & Happiness, Women's Work/Life Balance

Aging in Place: Brittle Bones on the Streets of Seoul Beg the Question of a Balanced Diet

My daughter "teacher Jess" and me at the old palace in Seoul

My family and I were recently in South Korea visiting my daughter Jessica who is teaching K-12 English in a private school outside of Seoul. In eight days Jess showed us what she’s discovered in the eight months she’s been there – from the high-tech towers, designer galleries, and uber-trendy coffee houses of this booming city, to it’s gorgeous ancient palaces and thousand-year-old temples.

We all slept and ate on the floor of a traditional Korean ‘hanok’ for seven nights, spent another in a hotel with our own private karaoke ‘singing room’,   explored the old villages, visited the Buddha in his temple late at night and drank plum tea in the ‘garden of morning calm.’  It was a trip.

But of the many images I came away with, one that stands out in my mind was the sight of so many older women on the sidewalks of Seoul hobbling hunch-backed over their canes. It seemed to me that nearly every one of them, old, and not so much older than me had bent spines, bowlegs or both! It was painful to watch these frail figures picking their way across the crowded streets and intersections: How is she going to make it to the other side??  OMG what a difference a few supplements could make!

Bent and bowlegged - my postmenopausal Asian counterpart

Evidently the traditional Korean diet of fish, rice, seaweed and fermented ‘kimchi’ cabbage of every sort

Calcium-free 'Kimchi'

though healthy in many respects (and I never saw an obese person the whole time I was there) has also been seriously lacking in a few basic nutrients: like calcium, magnesium, and Vitamin D for starters.  But as greater affluence creates greater awareness of healthy living the situation is improving.

Meanwhile, dismaying as it was to witness the stark effects of malnutrition  among my post-menopausal Asian counterparts, the ravages of osteoporosis are by no means a Korean problem; indeed it is still an all too common, and preventable, disease of aging in the US, not only in women (just the other day here in Portland, a friend’s mom, a woman in her mid-fifties, fell at the airport and broke her femur) but in men as well.  Roughly a third of hip fractures occur in midlife men (but I’ll leave that one for the MENopause blog)….

Candace and #2 daughter Ryan, with the emperors' food stores: keepers of the traditional diet of rice, fish, seaweed/greens and the famous 'kimchi'. Healthy in many ways, but not necessarily a balanced diet.

Blame it on  poor diet, sedentary living, chronic stress,  hormone imbalance, or menopause,  the cause of brittle bones on the streets of Seoul or at home in my own neighborhood boils down to a lack of the essential ingredients of balance. Take vitamin D-deficiency for example. Some experts say it’s epidemic especially in gray, rainy climates like the Pacific Northwest where I live, or for that matter anywhere people don’t get enough  sunlight. That’s significant because a lack of vitamin D is not  just about childhood rickets but is now known to be a major risk factor for obesity, heart disease, and breast cancer.

Apparently most people can’t get enough of this vital vitamin (which isn’t really a vitamin at all but a hormone made by the action of sunlight upon chemicals in the skin) either because we’re afraid of getting skin cancer

Wary of skin cancer: a billboard in Korea plugs sunglasses as big as your face, but covering up to the eyeballs against the sun can lead to vitamin D deficiency.

or, let’s face it,  because we  don’t get outside much – by some estimates we spend about 90% of our lives indoors. Fewer and fewer elementary or middle schools have recess or playgrounds anymore, and most of us work or play inside in front of  laptops, I-pads, I-pods, smart phones,  gameboys and Facebook. In the winter months the sun’s rays aren’t strong enough to provide sufficient D anyway, and even in the ‘sunshine state’ where the so-called sunshine vitamin should be readily available,  Florida physicians say patients are surprisingly deficient. Clearly it doesn’t matter where you live but how you live that makes the difference.

Turning awareness into action is a work in progress but progress is being made. I would be remiss not to mention that younger Koreans are undoubtedly taller and straighter-legged than their elders as food and supplemental sources of calcium, vitamin D and other necessary nutrients (though still pretty expensive) have become more widely available.

Balance begins early - younger generation Koreans know their nutrients

Balance starts early with 'Jess teacher" students

One woman I met even revealed  that her mother takes estrogen “for her bones”. That really pricked up my ears and I couldn’t resist asking if she was also taking natural progesterone…. but, alas, that question was met with a blank stare. Should I have been surprised? No, probably not. The concept of hormone balance vs. imbalance and the growing preference for bioidentical, natural hormones in this country only began to shift less than 10 years ago now when the Women’s Health Initiative reported its major findings in 2003 ( JAMA 2002 Jul 17;288(3):321-33.) about the definitive dangers of HRT.

High-tech buildings don't show signs of structural weakness like bones do

Pleasurable pursuits. Plum tea with the family in the garden of morning calm.

Sometimes we have to learn the slow, hard way from those who have gone before us – the women with the bent spines and flaking bones are the lesson – and we are learning from them. You can’t push the river, but you can learn to practice balance one day at a time.

If you are a woman in the menopause zone, your hormone levels are fluctuating and your nutritional needs are increasing with each passing day. Now is when the adrenal glands have to take over all hormone production from aging ovaries.  Now more than ever we need to practice the essentials of balance: adequate nutrition, exercise, sleep, stress relief (with emphasis upon the people, places, and pursuits that give us pleasure in life) and, last but not least, bio-identical hormones when and as needed. As the days get shorter and darker one of the first steps you can take is to test your vitamin D and hormone levels (www.zrtlab.com) to detect and correct imbalances that impact not only the health of your bones but of your whole body, heart, and mind. Want to jump in and join the conversation? Please do, leave us a comment!

This is our number one essential truth: Hormones in harmony and living in balance is an attainable goal.

Balance in being in the garden of morning calm (www.davidburchphotography.com)


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Filed under Bioidentical Hormones, Candace Burch, Menopause Symptoms, Women's Health & Happiness, Women's Work/Life Balance