Ask Marla

Dear Marla: I haven't had a period for 6 months but hot flashes and night sweats have recently intensified. How long can I expect this to go on? Diana, Redmond, WA

Dear Diana:

Your question is a good one. Unfortunately, there is no one-answer-fits-all. Approximately 85% of women will experience some degree of hot flashes, often starting during perimenopause. But every woman is different with a unique hormone profile and unique response to hormone changes in her body, so the intensity and duration varies from woman to woman. Most women experience hot flashes for one to five years, about a quarter for five to ten years and ten percent for more than ten years.

Triggers are different for each woman. Stress and anxiety, spicy foods, caffeine, hot drinks, alcoholic beverages and hot room temperature may all play a part. If you are having hot flashes, recording when they occur and if any of these factors are associated, may help you pinpoint and avoid some of the causes for you.

Dressing in light layers, sleeping in a cool room with light, natural fiber bedding and sipping cool beverages may help. Of course, we also recommend our ProCycle^® GOLD, formulated to help with hot flashes and other menopause symptoms. Black cohosh is another popular herbal supplement, and of course, estrogen replacement is an option to consider.

Dear Marla: Over the last few months, my vaginal area has become itchy and sex is downright uncomfortable. What can I do? Pam, Austin, TX

Dear Pam:

Almost every woman experiences vaginal dryness at some point in her life. Fortunately, there are several excellent prescription and non-prescription options available for relieving dryness and improving the health and comfort of vaginal tissue.

Vaginal dryness can be caused by many different things from soaps to chemotherapy to antidepressants. The most common cause is a decline in estrogen levels as a woman approaches menopause. Changes in hormone levels can also occur for many other reasons including childbirth, stress, and even exercise.

Over the counter products for relief of vaginal dryness generally fall into two categories. These are vaginal lubricants such as Astroglide and Creme de la Femme, which can be particularly helpful for improving vaginal comfort during intercourse, and vaginal moisturizers like our Vaginal Moisturizing Cream, which offer more widespread benefits. Used on a regular basis, vaginal moisturizers not only help with vaginal dryness but also promote healthy vaginal tissue, which in turn may help reduce development of vaginal infection.

For women who choose prescription hormone therapy, benefits can be systemic or localized. Estrogen therapy delivered orally or through a patch can help relieve symptoms of menopause including vaginal dryness. Localized hormone therapy delivered through a prescription vaginal cream, tablet, or suppository is another option for women whose primary concern is vaginal dryness and weakening of vaginal tissues.

The advantage of localized therapy is that it only delivers estrogen to the vaginal area without systemic effects or side effects. The localized effect helps rebuild the lining of the vagina and urethra by promoting collagen production, thereby reducing dryness, irritation and pain, helping maintain muscle tone and decreasing pH, which reduces the tendency toward infection. The disadvantage is that localized therapy will not relieve other menopause symptoms such as hot flashes or help in keeping bones strong.

You don't have to live with vaginal dryness! Your healthcare provider can help you decide which of these options is right for you. If you have additional questions, please call us at 800.558.7046.

Dear Marla: I had a total hysterectomy. I'm currently using natural estrogen. Should I also be taking progesterone?
Marie, Las Vegas, NV

Dear Marie:

I'm glad to hear that you are already taking a natural rather than a synthetic estrogen. It is important to remember, however, that estrogen and progesterone work together in a woman's body. When a woman enters menopause naturally, changes in estrogen and progesterone levels occur gradually. In the case of a hysterectomy, the change is sudden and profound. In either case, replacing estrogen without a progesterone usually does not make sense and can contribute to hormone imbalance.

Too much estrogen can result in weight gain, mood swings, water retention and bloating, breast tenderness and hot flashes. Balancing estrogen with progesterone can help eliminate these challenges. Other life-enhancing benefits may also include increased energy, improvements in bone and cardiovascular health, and anti-aging benefits.

You may also want to consider supplementing your natural testosterone level. Many women find this helpful, particularly with maintaining sexual desire and health.

The only way to know what combination of hormones is truly right for you is by first determining your hormone levels with an easy saliva hormone test. Once you know your current hormone levels, your health practitioner can prescribe the right combination of hormones and the right delivery system (cream, patch, tablet, capsule or suppository) for you.

If you or your health practitioner would like more information on hormone testing or replacement, please email or call us at (800) 558-7046.

Dear Marla: I know that exercise will reduce my stress level, but I am always so tired. I promise myself I'm going to exercise after work, but then I don't. What would help me get going? Carol

Dear Carol:

Fatigue and loss of energy are best friends with stress, so it's no surprise that you're too tired to do the things you know will help provide relief- it's a cycle that's hard to break. I have three simple suggestions that may help.

First, instead of trying to exercise at the end of your stressful day, what about exercising early in the day when there is nothing to get in the way. This time of year, when the days are longer, is a great time to try to establish a pattern of morning exercise. Even if you get yourself up and outside to walk or stretch for only 5 or 10 minutes, this simple beginning can help reset your body clock and give you more energy. Those few minutes early in the day may also help you sleep better at night. As you start to feel better, it will be easier to get up even earlier and increase your exercise time.

Second, testing your hormone levels may give you valuable information about why you feel so tired, so you can take corrective action. If you're under a lot of stress, your body is probably producing excess cortisol, the stress hormone. At the same time, DHEA, which influences your energy level, may have fallen below the normal range.

Testosterone is another hormone to check. Although testosterone is most often thought of as igniting the sexual spark, it also plays an essential role in a woman's energy level. As this hormone declines with age, many of us are left wondering what happened to the days when we could jump out of bed ready to face anything. If it turns out that either your testosterone and/or DHEA levels are below where they should be for a woman your age, that knowledge can help you choose among self-care and prescription options for regaining your energy.

Third, stop "doing" and breathe, even if it is just for five minutes a day. You'll be amazed at how closing your eyes for a few minutes of gentle but deep breathing at your desk, in the bathtub, or lying on the floor can help your body release the weight of the day.

Dear Marla: My chiropractor recently recommended that I purchase omega-3s. He said they are not made in my body but affect almost every area (especially the brain and cardiovascular system). What exactly are they? Is it really important to take them?
Gayle T., St. Paul, MN

Dear Gayle:

Omega-3 essential fatty acids are a family of polyunsaturated fatty acids that, like vitamins, must be obtained from diet. Since they were identified in the 1970s, thousands of studies and clinical trials have shown that omega-3 is essential to good health, can protect against disease, and can treat illness. Oil-rich fish (mackerel, herring, sardine, pilchard, salmon) and supplements such as fish oil and cod liver oil, are the richest and most readily available sources.

Your chiropractor is right to recommend a supplement. It is estimated that 90% of Americans are deficient in omega-3 because of our reliance on processed foods, meat, and dairy products instead of oily fish and nuts and seeds that provide vegetable-source omega-3.

How omega-3 helps prevent and treat various disorders appears to vary, however, many studies show omega-3 can help:

• improve heart and vascular health
• reduce hypertension
• improve rheumatoid arthritis, lupus, Raynaud's disease, and other autoimmune diseases
• support memory
• aid vision
• improve skin tone
• reduce joint pain and inflammation
•  relieve PMS and menopause symptoms
• aid in cancer prevention and cancer support
• support weight loss

And when it comes to supplements, our MaxEPA with twice the omega-3 of other fish oil supplements, is one of the best.