I was at the National Women’s Show (NWS) in Toronto this weekend raising awareness about vaginal dryness.
Between 10% and 40% of menopausal women have at least one of these signs and symptoms – vaginal dryness, itching, burning, and discomfort or pain during sex. And even though this is a common problem, very few women talk about it and get relief for it.
At the NWS I would approach women and ask them if I could ask them a question about the health of their vaginas; sometimes I would ask them if they have discomfort, dryness, or itching, sometimes I would show them a card with this question:
TRUE OR FALSE
Vaginal dryness affects millions of women worldwide?
About 10% of the women ignored me, 20% quickly moved away from me as if I had a contagious disease, 20% said they didn’t have any problems, and 50% of women engaged in conversation to varying degrees (some of them mainly wanted a drink of water from the fountain we offered at our booth!).
Testimonial wall about vaginal dryness at the Replens booth, National Women’s Show, Nov 2019
Here’s some of what I heard:
Some women who’d had breast cancer had been told by their oncologists to use hormone-free lubricants during sex.
Some women were seniors and had vulvar (the fleshy parts that touch your clothes) dryness and itch, and needed some relief externally.
Some women shocked the female friends they were with when they told me that sex had become uncomfortable and they had tried lubricant—it was obvious women aren’t sharing these intimate issues with their friends!
When we started talking about how important it is for us to talk about these issues all agreed and some shared that they were going through similar experiences. It goes to show the importance of awareness and how many women are affected and yet so few speak up and seek help.
I also spoke to women who confided to me that they had stopped having sex because it was painful but they would love to be intimate with their partners again. How could I help them? My motto on the weekend was, SAY NO TO PAIN, NOT TO SEX!, added to my usual motto, There’s help. I can help you!
There are several products that can help restore moisture to the vagina, decrease discomfort and pain, and increase pleasure during sexual activity. There’s no need to suffer alone and in silence and jeopardize your relationships.
Let’s get into causes and relief.
CAUSES
One of the most common causes of vaginal dryness is menopause. Menopause is the natural transition that all women experience – it is the end of ovarian function, ovulation, menstruation, and fertility. As a result of menopause, estrogen levels decline, and because estrogen is the predominant female hormone and acts in so many tissues and organs of the body, many women experience physical, emotional, and cognitive changes during the menopause transition, like hot flashes and night sweats, sleep disturbances, mood swings, and vaginal dryness.
Most women experience menopause as a transition that occurs over the course of many years. There are three stages of menopause:
Peri-Menopause
5 to 10 years prior to actual menopause when physical signs of menopause begin due to hormone fluctuations.
Menopause
Confirmed when a woman hasn’t had any bleeding for 12 consecutive months. In North America the average age of menopause is 51 years. Menopause can also be caused by the surgical removal of the ovaries, or by certain medications that damage ovarian function, like chemo and radiation to treat certain cancers.
Post-Menopause
The years after menopause. Because Canadian women are expected to live until 84, many of us will spend one-third of our lives in post-menopause.
During the menopause transition most symptoms, like hot flashes and night sweats, get better with time, but vaginal dryness tends to get worse. Estrogen helps keep vaginal tissues healthy by maintaining normal vaginal lubrication, tissue elasticity, and acidity, and low estrogen levels can affect the vagina and urinary tract during menopause.
Over time, the vaginal lining can get thinner, dryer, and less elastic.
Women may feel vaginal burning and itching, more frequent vaginal and urinary tract infections, and frequent urination and decreased lubrication during sex which can lead to painful intercourse.
When a woman is sexually stimulated her vaginal tissues produce lubrication that aids with sexual penetration. In menopause, due to lack of estrogen, the vaginal cells do not produce as much moisture and sexual penetration may become uncomfortable and even painful. Vaginal dryness worsens 5 to 10 years following menopause because of this lack of estrogen on the vaginal tissues.
RELIEF
Several treatment options are available over the counter, without a prescription, and some can be prescribed by your family physician or gynecologist.
Treatment options available over-the-counter:
Vaginal moisturizers and lubricants
Moisturizers and lubricants can help relieve vaginal dryness and painful sexual intercourse. Moisturizers are used on an ongoing basis and lubricants are used during penetration.
These products offer relief but do not treat the problem – the thinning of the tissues that line the walls of the vagina and the shrinking of the external features of the vulva (labia minora, labia majora, and the clitoris).
Treatment options available on prescription:
Vaginal Hormone therapy
Some women experience narrowing of the vaginal opening which can make penetration painful. In this case the best treatment is local, low-dose topical hormone therapy (HT), available by prescription.
These products are available as ovules (estradiol) and cream (conjugated estrogens) that are inserted in the vagina. Because they are used locally in the vagina, studies show that the hormones are not absorbed systemically (do not cause any effects on other parts of the body) and have fewer adverse effects than HT used in pill form or patch.
A new medication recently approved in Canada for the treatment of post-menopausal vaginal atrophy contains prasterone (DHEA), a natural steroid.
Another prescription product to treat vaginal dryness may be available in Canada soon and it is a hormone-free tablet, taken by mouth.
If your doctor doesn’t ask you about the health of your vagina and how it may be affecting your quality of life, self-esteem, and relationships—unfortunately the majority of doctors do not give women an opportunity to discuss these topics—I hope you have read enough here to encourage you to approach your family doctor, gynecologist, or me to discuss what’s going on with your vagina and how to improve your symptoms, sex, and quality of life.
Let’s break the menopause taboo. Let’s talk about menopause.
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Gen Xers Struggle with Perimenopause
/in Perimenopause/by Teresa Isabel DiasMatt Galloway is the new host of The Current and on his first day on the job he interviewed Ada Calhoun author of the new book “Why We Can’t Sleep: Women’s New Midlife Crisis”. I’m not discussing the book here because I haven’t read it yet, but I am personally and professionally very pleased that Ada identified the hormonal changes of midlife, perimenopause, as one of the causes of Gen X women’s struggles. Yes, Gen Xers struggle with perimenopause.
For me it is refreshing to hear people talking about menopause on the radio because it is still a taboo subject, hardly spoken about in private, much less in public (radio)! I appreciate that Ada researched the subject and explained how some women experience symptoms akin to those of mental illness—anxiety, feeling overwhelmed, and much stress—during this natural phase of life. And now we’re seeing Gen Xers struggle with perimenopause.
Perimenopause can start for some women in their late 30s or early 40s and just because it is natural and all women go through it, that doesn’t mean it’s easy. This can be a challenging phase for some women and affect their quality of life, relationships, and work.
Most women in their 40s aren’t aware that the fluctuation and decline of estrogen in midlife can cause physical, cognitive, and emotional changes, and they don’t associate the menopause transition with what their minds and bodies are going through. Unfortunately, most women aren’t aware of menopause and it catches them by surprise. It may even scare some into thinking they are experiencing some physical or mental illness. Furthermore, menopause not only affects the woman but also those around her: her partner, children, family, friends, and co-workers.
Ada writes in her book that “in the middle of the night, I wake up feeling warm. I open the window and pull my hair back into a ponytail and drink some water. Then I glance at my phone, delete a few things, and see some spam. I hit unsubscribe and go back to bed. Then I lie there thinking, What if by opening that spam email I got myself hacked? What if I just sent everyone in my contact list a Burger King ad at two in the morning? Now wide awake, I move on to other concerns: my parents’ health, my stepson’s college tuition, pending deadlines”…
As someone who helps women navigate the change, I’ve heard countless times about nights like Ada’s. Nights like these happen to many women in midlife.
Dr. JoAnn Pinkerton, MD, NCMP, executive director of the North American Menopause Society says:
“The unique confluence of stressors and hormonal shifts poses a sort of chicken-or-egg problem for Gen X women: the symptoms of hormonal fluctuation (like sleeplessness) are exacerbated by stress, while those symptoms (like not sleeping) in turn raise stress levels”. “How well your ovary functions depends on your cycle and your mental and emotional state. It’s all tied together”.
Women who need support navigating the change can’t find it easily, especially not from the medical community. The majority of physicians have very little menopause training in school and therefore aren’t very comfortable with or up-to-date on how to help women in menopause and how to provide individualized and customized care. Moreover, the way our healthcare system limits the amount of time one is allowed at the doctor’s office at each visit doesn’t even give a woman time to explain what she’s feeling and going through.
I’m hearing more and more that Gen Xers struggle with perimenopause. I don’t want to medicalize menopause, but as a pharmacist and a NAMS* Certified Menopause Practitioner I know how hard it is for women to find appropriate support and how much women appreciate being listened to. Women want to be taken seriously and to hear that “what you are telling me is not just in your head” and “you are not alone, millions of women worldwide are going through similar challenges during this phase of life” and “this is normal and I can help you”.
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #12 BE THANKFUL & ENJOY YOURSELF
/in Mental health/by Teresa Isabel DiasBe thankful and enjoy yourself! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
Menopause Tips – How to Thrive in the Holidays
#12 BE THANKFUL & ENJOY YOURSELF
There’s a lot of pressure for us to be happy during the holiday season and for some it’s when we feel less so. In midlife we may have lost loved ones or have loved ones away, unable to join us.
Sometimes it is the way we see things, it is our attitude. As Hamlet put it, “there is nothing either good or bad, but thinking makes it so”. And not everything is bad at the same time, so let’s find the positive and what’s good in our lives during the holidays and always, and cultivate a positive attitude. I’m sad because my older son is in Vancouver and won’t be coming home for the holidays for the first time but I’m happy that he’s healthy and when we meet again we’ll celebrate Christmas then!
Gratitude is in fashion and that’s for a good reason. There are so many things to be grateful for and in our busy lives we forget about them and forget to be grateful for them.
I found this article “Giving thanks can make you happier” on the Harvard Medical School website. It reads “The word gratitude is derived from the Latin word gratia, which means grace, graciousness, or gratefulness (depending on the context). In some ways gratitude encompasses all of these meanings. Gratitude is a thankful appreciation for what an individual receives, whether tangible or intangible.
With gratitude, people acknowledge the goodness in their lives. In the process, people usually recognize that the source of that goodness lies at least partially outside themselves. As a result, gratitude also helps people connect to something larger than themselves as individuals — whether to other people, nature, or a higher power.
In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.
People feel and express gratitude in multiple ways.
They can apply it to the past (retrieving positive memories and being thankful for elements of childhood or past blessings), the present (not taking good fortune for granted as it comes), and the future (maintaining a hopeful and optimistic attitude). Regardless of the inherent or current level of someone’s gratitude, it’s a quality that individuals can successfully cultivate further”.
I hope it helps you be grateful and happier.
Happy holidays to you and your loved ones!
If you missed the earlier tips (or just want to read them again), you can find them on my blog:
#1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards)
#2 PLAN AHEAD, #3 KEEP IT SIMPLE
#4 BREATHE, #5 BET ON HUMOUR
#6, #7, & #8 – ASK FOR HELP AND BE MINDFUL!
#9 DON’T GIVE UP EXERCISE
#10 SLEEP
#11 BE KIND TO YOURSELF AND OTHERS
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #11 BE KIND TO YOURSELF AND TO OTHERS
/in Mental health/by Teresa Isabel DiasThis is supposed to be the season of peace and love — so be kind to yourself and others! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
Menopause Tips – How to Thrive in the Holidays
#11 BE KIND TO YOURSELF AND TO OTHERS
Don’t expect and don’t aim for perfection. So what if your sister-in-law last year had a Christmas out of a magazine page? She’s 10 years younger than you and her hormones aren’t bothering her yet (just wait and see!).
Set reasonable and achievable expectations. Lower your standards if you have to – read more about that on #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards).
Put yourself and your needs first (for a change?). We are our own worst enemy and critic. In midlife we should change the status quo if it no longer serves us right.
With mood swings, anxiety, anger, rage, and all other emotions experienced in perimenopause and menopause, it’s hard to be kind to our loved ones during the stress of the holidays. Try not to say anything you’ll need to apologize for later. That’s easier said than done. The best time to shut up is when you feel that if you don’t say something you’ll explode. Count to 10 before saying anything, breathe—read more on that on #4 BREATHE (intentionally, deeply and often)—and the urge will go away and you will feel much better for having kept your cool. If you know a certain person triggers the worst in you, recognize it and try to avoid it this year. If you can, tune that person out, focus on other people, breathe deeply and slowly, and bite your turkey…It will be over soon and you’ll be so proud that you kept it together. You can do it! Think positive thoughts, this person is not worth your anger, and your mind deserves peace and calm.
If you missed the earlier tips (or just want to read them again), you can find them on my blog:
#1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards)
#2 PLAN AHEAD, #3 KEEP IT SIMPLE
#4 BREATHE, #5 BET ON HUMOUR
#6, #7, & #8 – ASK FOR HELP AND BE MINDFUL!
#9 DON’T GIVE UP EXERCISE
#10 SLEEP
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #10 SLEEP
/in Sleep, Mental health/by Teresa Isabel DiasSleep is good for you! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
Menopause Tips – How to Thrive in the Holidays
#10 SLEEP – As much as you can
During menopause many women report difficulty sleeping: trouble falling asleep, waking up in the middle of the night and not being able to go back to sleep, and waking up early.
I’ve been able to sleep well even though I wake up every night with a hot flash. I am able to go right back to sleep. If you want to know how I do it, contact me.
Lack of sleep can make you even more stressed, depressed, and grumpy during this demanding Holiday season. Sleep is good for you!
If you can’t get a good night’s sleep, then NAP. Napping is healthy. Take a short nap, 15-20 minutes. A longer one may not make you more energetic, in fact it may make you sluggish. Nap after lunch, but before 3 PM so as not to disrupt your night’s sleep, and you’ll get a second wind. It works like magic. You can read more about “Napping: Do’s and don’ts for healthy adults” here.
If you are well-rested you are less likely to feel the need to fill up on caffeine and eat sugary treats. That’s another reason why sleep is good for you.
When you are well rested you are more likely to cope with the demands put on you during the busy festive season.
Here are some more tips for a better sleep:
Don’t drink caffeine past 2 PM. Caffeine can linger in your body for up to 8 hours.
Don’t drink alcohol close to bedtime, it disrupts your sleep and cuts down the amount of deep, restful sleep you’ll get.
Don’ watch TV mindlessly – go to bed early. The most restful sleep happens early in the night. Aim to be in bed by 10 PM.
Don’t look at screens at least one hour before bed. The blue light decreases your levels of melatonin, tricking your body into thinking that it’s not time to sleep.
Get a bedtime routine that allows you to relax and stretch before bed. Brains don’t have an on and off switch. Our brain doesn’t shut off automatically at bedtime after a long and busy day when we reach a certain age. We need a bit of time before bed to “dim the lights” in our brain before falling asleep. This is a routine that works for me. I get my exercise mat on the floor and do some easy yoga – some back, neck, and leg stretching listening to calming music. That slows down my brain.
Take a warm shower before bed. It helps to cool you down and you’ll fall asleep faster.
Drinking a glass of milk sweetened with honey increases levels of tryptophan and helps you fall asleep (and the calcium is good for your bones). But at least 3 hours before bedtime. That should be the cut off to ingesting any liquids to prevent getting up in the middle of the night to use the bathroom.
Magnesium at bedtime helps you sleep. Ask your pharmacist, or contact me, to learn if it is safe for you and how much you should take.
Sleep in a quiet, dark, and cool room.
If you missed the earlier tips (or just want to read them again), you can find them on my blog:
#1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards)
#2 PLAN AHEAD, #3 KEEP IT SIMPLE
#4 BREATHE, #5 BET ON HUMOUR
#6, #7, & #8 – ASK FOR HELP AND BE MINDFUL!
#9 DON’T GIVE UP EXERCISE
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #9 DON’T GIVE UP EXERCISE
/in Diet, Exercise/by Teresa Isabel DiasIn this season of stress (and often, over-eating), remember, don’t give up exercise! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
Menopause Tips – How to Thrive in the Holidays
#9 DON’T GIVE UP EXERCISE (chewing doesn’t count as exercise)
With so much to do it may seem easy and OK to eliminate your workouts in the weeks before the holidays. Don’t do it. Even if your New Year’s resolution is to work out three times a week in 2020, don’t give up exercise in 2019.
Five reasons why you don’t want to give up exercise:
1.Exercise makes you happier and healthier to endure the holiday demands.
2.Exercise keeps you from putting on weight.
You’ll eat more during the festive season, so to avoid gaining weight you must burn those extra calories.
3.Exercise is good for your brain.
Exercise increases blood circulation to your brain making your thinking sharper (less menopause brain fog).
4.Exercise improves sleep.
Many women in menopause complain of poor sleep. Exercising improves sleep.
5.Exercise releases endorphins, brain transmitters that boost mental health.
That’s why exercise makes you feel good, energized, and more alert; and it may even help you tolerate your annoying guests better! You can read more about “8 Ways Walking Changes Your Brain For The Better, According To Science”, here.
If your excuse is that there’s too much to do and you don’t have time to exercise, cut out something less important from your To Do List – read more on #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards).
Exercise = health. Nothing this holiday is more important than your health and the health of your loved ones.
You have choices, chose what’s best for you – good nutrition and movement!
Go for walks outside as often as you can. It’s good for your body especially if you walk after meals (which burns calories and decreases weight gain).
Walk after your holiday meal and catch up on each other’s lives while walking.
How often do you get the chance to talk with your son or daughter and burn calories at the same time?
There’s an added bonus for those living in cold weather – your body has to work harder to keep its temperature up, burning calories more quickly!
Don’t think of exercise as a chore, think of it as an investment in your health now and in the future! Over the holidays, don’t give up exercise!
If you missed the earlier tips (or just want to read them again), you can find them on my blog:
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #6, #7, & #8 – ASK FOR HELP AND BE MINDFUL!
/in Mental health/by Teresa Isabel DiasAsk for help and be mindful! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
Menopause Tips – How to Thrive in the Holidays
#6 ASK FOR HELP
For me this is one of the hardest things to do, especially outside my immediate family because I think people are busy and I’m bothering them. But when someone asks for my help, for the most part I feel honoured and very willing to lend a hand if I can. But I also learned to say YES less often, for less-important tasks, to keep with my plan for an easier and healthier life (during the holidays and afterwards).
Tensions rise during the holidays (read more on #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards). Everyone (except the “children” who are living with us still!) is busy and stressed and has a million things to do.
There’s the pressure to clean the house, write and send cards (mass email saves me time and trees), decorate, cook, bake, buy and wrap gifts, and on and on – DELEGATE.
Ask for help and be mindful! Any help is better than none. Don’t have enough help? Then put fewer things on your To Do List and give yourself the gift of an easier holiday.
#7 BE MINDFUL OF WHAT YOU EAT AND DRINK (in your house and at parties)
Alcohol can trigger hot flashes and increase the risk of breast and other cancers. Only go to parties that make you happy or a better person (fundraisers, for example).
Plan ahead how much you’ll eat and drink, such as “I’ll have one alcoholic drink and one plate of food”. This will keep you from overeating and drinking too much alcohol that would add to your weight (alcohol is high in calories) and disrupt your sleep. Remember to drink a glass of water for each glass of alcohol to avoid dehydration. This tip will also keep you from drinking too much because your bladder is only so big and your skin and your brain will thank you for the extra water. Two more reasons to drink wisely are the fact that alcohol can trigger hot flashes and more than one alcoholic drink per day increases the risk of breast cancer above the average.
#8 BE MINDFUL OF WHAT YOU WEAR
Hot environments, crowded rooms, and alcohol are all great hot flash triggers. Keep the kitchen well ventilated. Put a spray bottle filled with water in the fridge and spray your face and neck when you feel flushed.
When you go out to parties, wear layers so you can take some off when you get hot and put them back on when you get cold. Get outfits free of scarves and avoid turtlenecks and the heavy Christmas sweater.
My cold flashes bother me more than my hot flashes these days, and since I never know what the temperature will be where I’m going I wear something light (blouse or short sleeve dress) and another layer (a cardigan, throw, pullover, vest) that I can put on if it’s cold.
Do what you can and don’t feel guilty. Ask for help and be mindful!
If you missed the earlier tips (or just want to read them again), you can find them on my blog, starting with #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards) , #2 PLAN AHEAD, #3 KEEP IT SIMPLE, and #4 BREATHE, #5 BET ON HUMOUR.
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #4 BREATHE, #5 BET ON HUMOUR
/in Mental health/by Teresa Isabel DiasBreathe, and bet on humour! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
#4 BREATHE (intentionally, deeply and often)
Inevitably, regardless of how well you planned everything and how much you trimmed down, something will go awry and you’ll feel anxious and stressed. It’s normal and expected.
Sit down, stop thinking, and start breathing, deeply.
Close your eyes, breathe in through your nose, slowly, to a count of five, hold for five, breathe out through your mouth slowly for a count of five, wait for five, and then repeat a dozen times or until you are calmer and ready to go on. Try it now. Stop reading this and breathe this way for 10 breaths. Aren’t you feeling MUCH calmer? It’s an amazingly easy thing to do and has such great effect!
It’s good for your mind, your heart will slow down, and you’ll reduce your stress and the amount of cortisol which consequently will reduce hot flashes, fat around the waist, and anxiety.
Ideally you remember to do this breathing exercise throughout the day at regular intervals and often. Not just for when you’re “losing it”. Remember, whenever things get out of hand STOP THINKING AND START BREATHING DEEPLY.
#5 BET ON HUMOUR
My life would be a lot worse without humour. Do you rely on humour to put things into perspective? To see the pettiness of some of the things you do? I do and it’s great. Humour helps me to see the (big) things that are worth “sweating” for – I already get hot (flashes) unwillingly, so I don’t want to add self-imposed sweating to it!
If you find your phone in the cutlery drawer and the sugar in the fridge, just LAUGH! Remember, it’s not Alzheimer’s, it’s lack of estrogen! If you bought presents in advance and can’t remember where you hid them, LAUGH! Life is too short!
Do what you can and don’t feel guilty. Breathe, and bet on humour!
If you missed the earlier tips (or just want to read them again), you can find them on my blog, starting with #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards) and #2 PLAN AHEAD, #3 KEEP IT SIMPLE.
If you need help finding a personalized path to hormone happiness, I can help you!
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays, #2 PLAN AHEAD, #3 KEEP IT SIMPLE
/in Menopause and work, Mental health/by Teresa Isabel DiasPlan ahead and keep it simple! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
#2 PLAN AHEAD
Plan EVERYTHING AND WRITE IT DOWN (don’t figure out on Christmas morning that you forgot to buy the turkey).
Memory loss and brain fog are normal and common in menopause. It’s easier and saner to look at a list of things to do and cross items off as they get done than trying to remember the million things you need to do in the next few weeks.
Make a list of things you need and want to do and things you don’t have or don’t want to do.
You know, those things you only do because it’s the right thing to do or because it is expected of you?
Ask yourself do I HAVE to do it? Why? If the answer doesn’t stand your scrutiny for an easier and healthier holiday (like going to parties that leave you drained, too full, or too drunk, calling your negative friend who only talks about midlife diseases and makes you feel so down, getting your nails done at the expense of gym time, going to the mall for the third time in a week looking for that special gift), then DON’T DO IT.
#3 KEEP IT SIMPLE (if you haven’t in the past this is a great year to start)
Take stock of what your holiday traditions have been and assess what must stay and what can go to make your life and your holidays simpler, easier, and more enjoyable. Decide what can be trimmed down, eliminated, or delegated. Simplify and declutter your holidays (and your life).
Let your loved ones know what you have in mind for this years’ holidays so you don’t get pushback by unexpectedly changing traditions – more on this in #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards). Peace is expected during the holidays …
Use the way you feel (menopause is making you exhausted, overwhelmed, on edge, angry, drained, etc.) as the driving force to simplify, plan, and enjoy a holiday that is as stress-free as possible.
Do you really need three sets of lights on the staircase? And to decorate the house and the yard with a million Christmas decorations? Do you need to bake three different recipes of cookies to share? Won’t three batches of the same recipe make it easier and just as delicious and acceptable? Or even better, save yourself some work and skip the cookie exchange at work this year.
Do what you can and don’t feel guilty. Plan ahead and keep it simple!
If you need help finding a personalized path to hormone happiness, I can help you!
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Menopause Tips – How to Thrive in the Holidays – #1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS
/in Menopause, Mental health/by Teresa Isabel DiasMake your life easier during the Holidays! Keeping your life under control while experiencing poor sleep, memory problems, hot flashes, fatigue, mood swings, and other unpleasant menopause challenges is hard enough. Add to that the stress and “must dos” of the Holiday season and you may want to get under the bed and resurface on December 26th, or go on a vacation by yourself.
I’ve been there! But I’ve learned some useful strategies not only to survive but also to thrive and enjoy the holidays that I want to share with you:
#1 MAKE YOUR LIFE EASIER DURING THE HOLIDAYS (and afterwards)
I can hear you: “easy for you to say, you have no idea what I have to do!”
Bingo!
Do you really have to do all of it? Can’t you simplify the holidays? When you feel different (like going through menopause), things should be different.
The pressures of the holiday season are real but don’t put unnecessary, unhealthy pressure on yourself. Don’t expect to be perfect, to have the perfect house, the perfect meal… Perfection is impossible to achieve and shouldn’t be the goal. The holidays should be about religion, family, and friends. Make your life easier during the Holidays!
High levels of stress increase cortisol which in turn messes up your hormones, disrupts sleep, causes hot flashes, causes food cravings, increases weight and fat around the belly, and none of this is healthy or desirable.
Keep your expectations realistic.
If you need to lower your standard (your personal standard is higher than anyone else’s standard for you) and do much less than usual, that’s OK. It is common to feel fatigued and overwhelmed in menopause. If you think you’ll go crazy if you have to do or think about one more thing, don’t.
Make it easier on yourself.
Let others know that this year the holiday tradition is going to be slightly adjusted. Just because it’s been done the same way for many years doesn’t mean it must continue to be so.
You (and your body) have changed, and holiday traditions can change too. Just remember to let your family know about your thoughts and plans – communication is key for household peace. They should know that you feel tired and not up to so much fussiness as in the past.
And, it is OK—and even recommended—that you let your family members and friends know how your hormones are making you feel and why. Yes, you should talk about menopause! Your partner will be relieved to know it’s not (all) his fault, it’s your hormones! And you will get brownie points – it’s not your fault, you’re not mad, it’s your hormones.
If you have daughters they will appreciate (in the future, when they experience their own menopause) your sharing. And if you have sons they will benefit too, because they live, interact, and work with women and should be educated about menopause. If your mother or mother-in-law is around you could discover what their menopause was like.
Family bonding time! By bringing up the subject with family and friends you also help other women going through menopause, who may not know why they’re feeling the way they do, who think they are the only ones and are suffering alone. Telling your loved ones what you’re going through and how you feel may not be 100% clear to them but should elicit some understanding, support, and compassion (and hopefully some help with the holidays too!)
Do what you can and don’t feel guilty.
Make your life easier during the Holidays!
I believe in celebrating fuss-free, love-centred (not gift-centred), relaxed and enjoyable (not stressful) holidays. Through the years I’ve learned a few things that helped with my holiday preparation:
1.GIFTS
I have no problem giving or receiving a re-gift. A gift I have no use for (I’m a practical person living in a small space with very limited storage room) is someone else’s treasure. If you must buy gifts make a gift list and a BUDGET and stick to it. To save time and money, make an appointment on your calendar for shopping, and try to do it all in one trip. Shop wisely and be an environmentally-conscious shopper. Know the impact of what you’re buying – where it’s made, what it’s made of, who made it, how the workers who made it were treated, and what resources went into making it. Also think about the impact buying online has on the environment. If you drive to the mall and do your shopping in one trip (even better is to walk to shop in your neighbourhood or take transit), it has a smaller carbon footprint than buying something online. Because every time you order online there’s a truck on the road making a special trip to your door. Add up all your yearly online shopping and your carbon footprint may be very heavy even though you never left your house! Have you thought about it? Most people haven’t. We are making the environment pay the price for our convenience. It’s time to change that.
2.WINE
I’m no wine expert; my grandfather was but unfortunately his ability wasn’t passed down to me. I know if I like a wine or not but I can’t judge its quality. When I shop for wines I use the labels at LCBO to guide my purchase. I look for special tags on the shelves that show reviews from sommeliers (disclaimer: not all sommeliers are created equal) and I buy those with a score of 90 or above and stick to my budget $25/bottle or less. I have liked the majority of wines I’ve bought using this system. It works for wine I give to people and serve to my guests. If you would like more expert advice, ask the staff at LCBO and read this wine blog by my friend Shari Mogk-Edwards.
3.HOUSE
I’m a cook not a cleaner. I don’t like cleaning—I think it is the biggest waste of my time—but I can’t justify a cleaning lady because I live in a small apartment, so I just do it, very grudgingly. The best tip I learned about cleaning washrooms was from my aunt Mariana, “just make sure the faucets are shining and the mirror is clean and everything else looks clean too”.
Hide the clutter you usually have on the floor, counters, chairs, and sofa, in the closets none of your guests will be opening when they come over. Delegate the job of vacuuming and dusting to someone else in the house, if you can (I wish I could). Make your life easier during the Holidays!
4.COOKING
If you like to cook and bake like I do, cook as much as you can ahead of time. Bake things that freeze well months ahead of the holiday rush. I make apple pies from scratch, heck! I even pick the apples, and I bake the pies in October and freeze some for Christmas.
Some appetizers can be made and frozen ahead of time as well. No time? Buy frozen items and re-heat them.
Clean your fridge now (after you read this). Make room for the big bird, salads, and whatever else you’ll have to refrigerate the week of the holidays. If you have a garage that’s cold but doesn’t freeze think of it as an extra storage room for drinks, fruit, and root vegetables.
I used to store the seasoned, ready-to-go-in-the-oven turkey in my garage overnight and stick it in the oven Christmas morning to cook while we opened the presents. Make your life easier during the Holidays!
A lot of shopping—like flour, sugar, frozen items, gifts, drinks (some beer needs to be refrigerated all the time), nuts, napkins, aluminum pans (minimize your garbage output!), and decorations—can be done weeks ahead of time.
If you need help finding a personalized path to hormone happiness, I can help you!
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.
Vaginal dryness – no one talks about it but it’s common
/in Hormone therapy, Menopause, Sexual Health/by Teresa Isabel DiasI was at the National Women’s Show (NWS) in Toronto this weekend raising awareness about vaginal dryness.
Between 10% and 40% of menopausal women have at least one of these signs and symptoms – vaginal dryness, itching, burning, and discomfort or pain during sex. And even though this is a common problem, very few women talk about it and get relief for it.
At the NWS I would approach women and ask them if I could ask them a question about the health of their vaginas; sometimes I would ask them if they have discomfort, dryness, or itching, sometimes I would show them a card with this question:
TRUE OR FALSE
Vaginal dryness affects millions of women worldwide?
About 10% of the women ignored me, 20% quickly moved away from me as if I had a contagious disease, 20% said they didn’t have any problems, and 50% of women engaged in conversation to varying degrees (some of them mainly wanted a drink of water from the fountain we offered at our booth!).
Testimonial wall about vaginal dryness at the Replens booth, National Women’s Show, Nov 2019
Here’s some of what I heard:
Some women who’d had breast cancer had been told by their oncologists to use hormone-free lubricants during sex.
Some women were seniors and had vulvar (the fleshy parts that touch your clothes) dryness and itch, and needed some relief externally.
Some women shocked the female friends they were with when they told me that sex had become uncomfortable and they had tried lubricant—it was obvious women aren’t sharing these intimate issues with their friends!
When we started talking about how important it is for us to talk about these issues all agreed and some shared that they were going through similar experiences. It goes to show the importance of awareness and how many women are affected and yet so few speak up and seek help.
I also spoke to women who confided to me that they had stopped having sex because it was painful but they would love to be intimate with their partners again. How could I help them? My motto on the weekend was, SAY NO TO PAIN, NOT TO SEX!, added to my usual motto, There’s help. I can help you!
There are several products that can help restore moisture to the vagina, decrease discomfort and pain, and increase pleasure during sexual activity. There’s no need to suffer alone and in silence and jeopardize your relationships.
Let’s get into causes and relief.
CAUSES
One of the most common causes of vaginal dryness is menopause. Menopause is the natural transition that all women experience – it is the end of ovarian function, ovulation, menstruation, and fertility. As a result of menopause, estrogen levels decline, and because estrogen is the predominant female hormone and acts in so many tissues and organs of the body, many women experience physical, emotional, and cognitive changes during the menopause transition, like hot flashes and night sweats, sleep disturbances, mood swings, and vaginal dryness.
Most women experience menopause as a transition that occurs over the course of many years. There are three stages of menopause:
Peri-Menopause
5 to 10 years prior to actual menopause when physical signs of menopause begin due to hormone fluctuations.
Menopause
Confirmed when a woman hasn’t had any bleeding for 12 consecutive months. In North America the average age of menopause is 51 years. Menopause can also be caused by the surgical removal of the ovaries, or by certain medications that damage ovarian function, like chemo and radiation to treat certain cancers.
Post-Menopause
The years after menopause. Because Canadian women are expected to live until 84, many of us will spend one-third of our lives in post-menopause.
During the menopause transition most symptoms, like hot flashes and night sweats, get better with time, but vaginal dryness tends to get worse. Estrogen helps keep vaginal tissues healthy by maintaining normal vaginal lubrication, tissue elasticity, and acidity, and low estrogen levels can affect the vagina and urinary tract during menopause.
Over time, the vaginal lining can get thinner, dryer, and less elastic.
Women may feel vaginal burning and itching, more frequent vaginal and urinary tract infections, and frequent urination and decreased lubrication during sex which can lead to painful intercourse.
When a woman is sexually stimulated her vaginal tissues produce lubrication that aids with sexual penetration. In menopause, due to lack of estrogen, the vaginal cells do not produce as much moisture and sexual penetration may become uncomfortable and even painful. Vaginal dryness worsens 5 to 10 years following menopause because of this lack of estrogen on the vaginal tissues.
RELIEF
Several treatment options are available over the counter, without a prescription, and some can be prescribed by your family physician or gynecologist.
Treatment options available over-the-counter:
Vaginal moisturizers and lubricants
Moisturizers and lubricants can help relieve vaginal dryness and painful sexual intercourse. Moisturizers are used on an ongoing basis and lubricants are used during penetration.
These products offer relief but do not treat the problem – the thinning of the tissues that line the walls of the vagina and the shrinking of the external features of the vulva (labia minora, labia majora, and the clitoris).
Treatment options available on prescription:
Vaginal Hormone therapy
Some women experience narrowing of the vaginal opening which can make penetration painful. In this case the best treatment is local, low-dose topical hormone therapy (HT), available by prescription.
These products are available as ovules (estradiol) and cream (conjugated estrogens) that are inserted in the vagina. Because they are used locally in the vagina, studies show that the hormones are not absorbed systemically (do not cause any effects on other parts of the body) and have fewer adverse effects than HT used in pill form or patch.
A new medication recently approved in Canada for the treatment of post-menopausal vaginal atrophy contains prasterone (DHEA), a natural steroid.
Another prescription product to treat vaginal dryness may be available in Canada soon and it is a hormone-free tablet, taken by mouth.
If your doctor doesn’t ask you about the health of your vagina and how it may be affecting your quality of life, self-esteem, and relationships—unfortunately the majority of doctors do not give women an opportunity to discuss these topics—I hope you have read enough here to encourage you to approach your family doctor, gynecologist, or me to discuss what’s going on with your vagina and how to improve your symptoms, sex, and quality of life.
Let’s break the menopause taboo. Let’s talk about menopause.
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
Grab a quick guide and subscribe to the MenopausED Newsletter on the MenopausED home page.
If would like to know how Teresa can improve your menopause transition then schedule a complimentary Discovery Call at MenopausED.org.