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  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!