Medcan Women’s Health Forum

1. Medcan Women’s Health Forum Smooth Sailing Through the Stresses of the Sandwich Generation

2. Smooth Sailing Through the Stresses of the Sandwich Generation

3. What is Perimenopause? • The period of time leading up to Menopause • Menopause= when a woman has not had a period for a period of one year unrelated to pregnancy, body weight or another medical condition • Menopause is only ONE day • Before=Perimenopause • After=Postmenopause • During Perimenopause periods tend to get heavier, closer together and then later further apart • Perimenopause can last for years

4. Symptoms of Perimenopause • Hot flashes • Mood Swings • Irregular periods • Breast tenderness • Worsening PMS • Decreased libido • Minor Memory Problems • Fatigue • Vaginal Dryness • Urine leakage when coughing, sneezing or laughing • Urinary Urgency • Difficulty Sleeping

5. Hot Flushes/Flashes • 2/3’s of women experience • Momentary sensation of heat • Sweating • Fast heart rate • May turn red or flush

6. Treatments for Hot Flashes • Avoid: • Stress • Caffeine • Alcohol • Spicy food • Tight clothes • Heat • Tobacco • Supplements and Meds: • Vitamin B • Vitamin E • Ibuprofen • SSRI’s • Gabapentin • Clonidine • HRT

7. Mood Swings and Worse PMS

8. Why Mood Swings…

9. Why Mood Swings…

10. Why Mood Swings…

11. WHY Mood Swings…

12. Why Mood Swings? • “PMS” becomes disjointed from the period • Fluctuating hormone levels (particularly estrogen) affect mood • Stressors that are specific to this time period • Lack of sleep and hot flashes contribute • Feeling out of control of one’s body and reactions contributes

13. Life Stressors • Elderly parents • Kids at home • Kids leaving home • Men and their mid-life crises • Career Issues or Lack of Career Issues • The Economy • Being “on” 24/7

14. What can a woman do?

15. Eat Healthy!!

16. Exercise!!

17. Be with Friends!!

18. Hormonal Options: See Your Gyn!

19. Over the Counter Options…

20. OTC: Supplements and Herbals • Calcium 600mg twice a day- PMS • Black Cohash • Chasteberry • Siberian Ginseng • USP Progesterone Cream

21. Prescription Medications • Antidepressants (particularly Selective Serotonin Reuptake Inhibitors) • Gabapentin (Neurontin) • Sleep aides • Avoid Benzodiazepines

22. Practice Acceptance

23. Practice Mindfulness…

24. Mindfulness Defined

25. Focus on the Here and Now

26. Get Rid of Mind Clutter…

27. Mindless versus Mindful Mindless Mindful • Judging • Opinionated • Thoughts are real • Focus on past and future • Lost in Reaction • Avoidance • Reactive Impulsive Behavior • STRUGGLE • Non-judging: Accepting • Based on fact • Thoughts are mental events • Awareness • Calm and alert • Interested, focused, attentive • Focus on NOW • ACCEPTANCE

28. Mindfulness Exercise

29. Did you feel this way?

30. Or this way?

31. Ways to Practice Mindfulness • Unplug! • Eating • Driving • Exercising • Sit outside • Practice Meditation at a specific time each day • Yoga • When feeling stressed • Hot flashes

32. Ways to Practice Acceptance • Practice Letting Go- first with small things then bigger ones • Remember that 99% of what goes on with other people has nothing to do with you • Stop trying to be perfect. Including with being Mindful. • Stay positive- Exercise your brain by finding something positive about everybody and every situation you encounter. Including you! • Use positive reinforcement, not negative, with others- you will find it empowers you.

33. How Do You Know if Need to See a Doctor? • Your mood swings seem extreme and cause you and everyone else distress • Your mood is consistently low and is accompanied by hopelessness, lack of enjoyment and changes in sleep, appetite, energy and concentration • If you have any thoughts of suicide or wishing you were dead • You seems to have continual conflicts with everyone • You have physical symptoms that seem extreme or unusual • You are self-medicating with drugs or alcohol

34. Remember: Depression is Treatable!

35. Perimenopause: Hold on for the Ride!

36. Thank You!