Life Line Screening Wanted to Keep Me Healthy. I Didn’t Listen.

Life Line Screening compensated FOF with an advertising sponsorship to write this post. Regardless, I started having its health screenings years before this, and I only recommend products or services that I believe will benefit others. Geri Brin, Founder, 

                  Carotid artery screening

I wasn’t overly concerned when the ultrasound test from Life Line Screening revealed mild fatty plaque in the carotid artery on the right side of my neck.  Two carotid arteries–there’s another one on the left side–carry oxygenated blood to the brain, neck and face, but the amount of plaque wasn’t a dire threat to my health, at least not immediately. Uncharacteristically, I dismissed the report recommendation to follow up with my doctor, too preoccupied with launching this website at the time.  That was in 2010. I felt good and had no signs of a problem. My weight was reasonable. I exercised. Didn’t smoke or drink. 

My blasé attitude had troubling consequences. 

By last year, my weight had spun out of control, I was working out less, and a new ultrasound showed a dramatic increase in the plaque. Now the bad stuff was narrowing the right carotid artery somewhere between 59 and 80 percent. That got my attention, even if there wasn’t a single symptom. If a piece of plaque broke off and blocked the blood flow, I could have a stroke. To make matters worse, my cholesterol numbers were dismal. My doctor started me on statin therapy right away to lower my cholesterol, told me to lose weight, and to take low-dose baby aspirin every day. 

I’m 15 pounds lighter today and my cholesterol numbers are excellent, thanks to statins. Another carotid artery scan is scheduled for the end of July, and hopefully the level of plaque hasn’t progressed. “It might even have regressed,” my doctor said. If more plaque shows up, surgery might be necessary to clear it out. Serious surgery! 

Ironically, most doctors won’t recommend a carotid artery ultrasound for asymptomatic patients with no family history of stroke. What’s more, Medicare doesn’t cover the test unless someone has experienced symptoms such as transient ischemic attacks, mini strokes lasting only a few minutes.  Without coverage, it’s costly to have tests like this done at a hospital.  The United States health system isn’t a shining example of how to practice preventive medicine. 

Having no reason to suspect any cardiovascular problems nine years ago, I actually arranged for the first ultrasound through Life Line Screening as a preventive measure. Life Line has provided preventive screening to millions, and at remarkably fair fees, since it began 25 years ago. When the original results showed mild plaque, it should have been fair warning not to let myself go. After all, that’s what preventive health care means. That’s what makes Life Line a smart idea.

The Life Line Screening Difference

When Life Line recently contacted me about introducing its screening service to my FOFriends, I didn’t hesitate. After all, they discovered the plaque in my carotid artery at an early stage, not to mention early bone loss, and suggested that I see my own doctor. Pretty foolish not to heed their advice.  “Every day we find people across the country with significant carotid artery disease,” said Dr. Keith Coffee, Chief Medical Officer at Life Line. 

                  A stroke in the brain

Besides the carotid artery screening for plaque, a Life Line special package offers tests for 1) Peripheral arterial disease, a circulatory condition in which blood vessels narrowed by plaque reduce blood flow to the limbs. P.A.D. usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach 2) Abdominal aortic aneurysma bulging, weakened area in the wall of the aorta, which is the largest artery in the body. Over time, the blood vessel balloons and is at risk for bursting or tearing, which can cause life- threatening bleeding and potentially death. 3) Heart rhythm aka atrial fibrillation or AFib, a quivering or irregular heartbeat that can lead to blood clots, stroke, heart failure and other heart-related complications and 4) Osteoporosisa loss of bone density or mass. 

It’s only $149 for all five screenings.

“We discovered about 62K overall health risks in 2017 alone,” Dr. Coffee said. A team of highly qualified, board-certified radiologists throughout the country, led by a vascular surgeon, reads all ultrasound images as well as the electrocardiograms for AFib. 

“These are screenings, not diagnostic tests,” Dr. Coffee stressed. “We encourage patients to share their results with their doctors so they can together discuss the appropriate treatment, if necessary.” (Remember, that’s what I didn’t do!)  Life Line doesn’t have physicians available who can discuss the test results with patients, and it doesn’t interact with patients’ physicians. They do provide a summary of the results that you can share with your doctor. “We simply provide the incentive for patients to take the right steps for their health,” Dr. Coffee noted. 

If Life Line Screening discovers a life threatening condition, however, such as an aneurysm that’s about to rupture, it will send someone right to the ER and call for an ambulance if they wish.  “Our customers tell us that we’ve possibly saved their lives. We get letters all the time from people who had no symptoms and thought they were just fine, but were at risk for having a large aneurysm about the rupture,” Dr. Coffee said. 

In and Out In 90 Minutes Or Less

    Peripheral arterial disease screening

An average of 50 people a day check into each Life Line location in 60 cities across the country. Teams at the screening sites include at least two ultrasound stenographers who hold certificates in ultrasound technology, and two medical assistants who are cross trained to perform tests including electrocardiograms for heart rhythm, fingerstick blood tests, and peripheral pulses. A nurse practitioner joins most of the teams to see people 65+ years old for Annual Wellness Visits, which are covered under Medicare.

While most people opt for the basic, five-test package I described earlier, many decide to get their cholesterol and glucose checked during the same appointment, Dr. Coffee told me.  Life Line Screening offers 15 preventive screening blood tests, including thyroid function, vitamin D, and hemoglobin A1C for diabetes. It also provides a take-home test for detection of colorectal cancer. A call center with 300 trained employees helps participants decide what tests are right for them, based on their age, risk factors and medical history.

Testing is done in churches, at community centers, fraternal organizations and occasionally in hotel ballrooms.  When Life Line works with affiliates, such as hospitals, anyone with abnormal results is referred back to the hospital. It also offers exclusive screenings for employees of large corporations as part of their healthcare plans. “Our goal is to get people in and out in 60 to 90 minutes, which includes paperwork and waiting time,” Dr. Coffee said. 

                           Results package

A results package arrives in the mail about three weeks after your screening. It reports on every test you took and on your risk for stroke and cardiovascular disease in general, taking into account factors including smoking, high cholesterol and family history. “We give you all the information we can to help you make lifestyle changes and modifications if you need to,” Dr. Coffee explained.  If a major issue such as Afib is discovered, a Life Line representative will call you directly, rather than having you wait for the results package. 

People generally have their first Life Line screenings at 55 years old. “We have patients in their 40s who just want to know where they fit healthwise, or maybe they have a family history of early strokes. And, we have people in their 90s,” Dr. Coffee said. Returning patients account for about half of Life Line’s annual screenings, and close to 90 percent of all patients have their own physicians. 

Please learn from my error: Get preventive screenings once you’re in your mid-fifties, whether or not you have symptoms.  And pay attention to what you learn.

for peace of mind or early detection 

Your Bone Health After 50

FabOverFifty recently polled 100 women from our community to learn about your bone health.

What You Should Know About Dementia and Alzheimer’s, But Were Afraid To Ask!

I met Dr. Michael Serby about 35 years ago, when our toddler boys played together at the local playground. He did research in Alzheimer’s and had a practice in geriatric psychiatry, but those subjects were not uppermost in my mind at the time. Now they are, so I decided to ask Dr. Serby if he’d be willing to do an interview with me about his life’s work. I’m delighted he accepted my invitation, because so many of us have seen Alzheimer’s wreak a horrific toll on family and friends, and are frightened it will hit us, too.

FabOverFifty: What happens to our minds as we age?

Dr. Serby: Some people have long-standing psychiatric problems that started when they were young, or younger, and have become more of a problem. Maybe the frequency of their problems increases. Maybe they don’t have the family they once had to help them.

“Many people have diminishing cognitive function as they get older, that may begin as early as their 50s, but I know one woman who is 106 and is as sharp as can be; not a sign of diminishing cognitive function. So it’s not age, per se, that’s responsible for the development of cognitive change. It’s just more common as you get older.”

How do you define many and what happens what exactly is diminishing cognitive function?

“The majority of people over 50, certainly over 60, will experience some change in their cognitive functioning. They can’t find the right word, for example. They’ll say ‘it’s on the tip of my tongue,’ this kind of thing. That’s considered normal.

Your bones may change with age. Your joints may change with age. Your skin may change with age. Everything changes with age, but if there’s nothing pathological in those areas I mentioned, that’s great. Your memory for words also may show some change, but it’s not significant if it doesn’t affect your daily life, your functioning. You can continue to work as a lawyer or a writer. But some people panic as soon as they can’t think of a word. They’re looking for that first clue that they’re going to get Alzheimer’s. People are being evaluated in dementia centers all the time who are considered ‘normal.’”


How do you know when your ‘diminishing cognitive function’ is out of a range considered ‘normal’?

“You might have trouble planning, with language, with spatial skills.* It’s pretty noticeable, and gets in the way of your daily ability to function, but it hasn’t gotten to the point of dementia When this happens we call it Mild Cognitive Impairment (MCI).”

* Visual-spatial skills are critical for success in solving many tasks in everyday life, such as using a map to guide you through an unfamiliar city (pre-GPS); merging into high-speed traffic, and orienting yourself in your environment, as when you’re learning your way around a new office. Some tasks that require visual-spatial ability include packing for a trip (deciding if a certain box is large enough for the objects you want to put into it) and using mirror images (as when you comb your hair while looking into a mirror).

If you’re diagnosed with MCI, will you automatically get Alzheimer’s?

“About half of patients with MCI will go on to dementia, but many seem to hang there and continue (with MCI), maybe forever.”

Let’s say you and your husband have driven the same route to the mall, hundreds of times over the last 35 years, but one day he forgets which way to turn when you’re at the exit. Is this cause to worry?

“You shouldn’t hang your hat on one episode like that, because there are many possibilities that have nothing to do with dementia. Perhaps the husband didn’t sleep well the night before, and he had an isolated memory lapse; maybe a TIA is beginning, which is common in older people. (Note: A transient ischemic attack is a brief interruption of the blood supply to part of the brain that can result in confusion, temporary memory loss, sudden fatigue, difficulty speaking, vision changes, and poor balance. High blood pressure is a major cause of TIAs, but they also can be caused by issues including diabetes and high cholesterol, according to popular website
couple“If this happens, and the person gets more confused that day, it would suggest that he be seen by a doctor. They might need to get cardiac and neurological exams.

“Alzheimer’s is very slow, but a wife who experiences an incident like you described might say to me: ‘I can tell you exactly when the Alzheimer’s started.’ That’s not true. It’s just when she noticed something because it was so clear cut. You can associate a stroke with a specific event, but not Alzheimer’s. Don’t make any assumptions without an evaluation.”

Keep Reading…

8 Skin Conditions That Pop Up After You Turn 45

Named a 2016 top doctor by Castle Connolly, the esteemed publisher, Dr. Jessica J. Krant practices as a dermatologic surgeon at the Laser & Skin Surgery Center of New York. She is board certified by the American Board of Dermatology and has provided medical and cosmetic dermatology for 13 years.

Dr. Krant is a fellow at the American Academy of Dermatology (AAD), and a member of the American Society of Dermatologic Surgery (ASDS) as well as the Women’s Dermatologic Society. (more…)

Powerful New Supplement Fights The Aging Brain

This is a “sponsored post.” Percepta compensated FOF with an advertising sponsorship to write it. Regardless, we only recommend products or services that we believe will be helpful for our readers. All insights and expressed opinions are our own. —Geri Brin

The place where I learned to think. And the supplement helping to keep my thinking sharp!

I look hipper when my brilliant stylist turns my aging hair from grey to red, and rejuvenated when my dedicated dermatologist treats my aging skin. Now an exciting new supplement is helping me fight my aging brain. After taking two Percepta capsules every morning for one month, I absolutely know my mind is clearer and sharper. I’m back to remembering dates without looking at my calendar, recalling phone numbers without writing them down, and can actually point out each of the 50 states on an outline map. 

I realize that you might disdain my firm decision not to “age gracefully,” at least physically. But, please consider my advice to try Percepta for at least one month if you have even the slightest concern about future memory loss. Because there’s nothing graceful about losing your mind. Although this article may not be the breeziest you’ll read all week, it explains what makes this supplement a game-changer in the study of aging. And why taking it should be a “no brainer.” 


Simply put, Percepta is a natural plant-based supplement that’s more powerful than any other for targeting out-of-control brain “plaques” and “tangles,” the real reasons we lose memory as we age.  Losing my mind petrifies me!

“We’re all walking around with a bunch of plaques and tangles in our brains, starting in our early to mid-20s,” said Dr. Alan Snow, one of the two neuroscientists behind the new supplement. “We now know they’re there, but no one knows with certainty why they accumulate and cause memory loss in people as they age.”


        Brain tangles of tau protein

Harmful protein fragments that settle between nerve cells in the brain, plaques are destroyed by the immune system in a healthy brain. In some people, however, the immune system actually produces more harmful plaques and neuroinflammation, and kills healthy brain cells. This prevents our nerve cells from talking to each other and prevents us from forming coherent thoughts or sharp memories.  Twisted fibers that live inside the cells, tangles normally support essential structures that carry nutrients and other important substances from one part of the nerve cell to another. In brain aging, this  protein may be abnormal, the structures collapse and the cells die.

Newer research has also uncovered the link between neuroinflammation and memory loss, “although we don’t know the cause of the inflammation,” Dr. Snow added. “We think some people might have problems with brain inflammation later in life. Others can live to be 100 years old and have brains filled with plaques and tangles, but their memories stay basically intact.  They don’t have inflammation in the brain.” Dr Snow calls the combination of plaques, tangles and inflammation “the memory loss trilogy.”


       Cat’s Claw


Percepta is made with PTI-00703® cat’s claw, a natural plant extract from a wild, woody vine located at a high elevation in the Amazon rainforest. “I’ve been working in the drug development field for brain aging for over 30 years and have never seen a more potent inhibitor of plaques, tangles and inflammation than the cat’s claw that we discovered,” Dr. Snow said confidently. 

Dr. Snow tested this exceptional cat’s claw on mice that had been genetically engineered to grow plaques in their brains as they aged. A major ingredient, newly discovered by the Snow research team, decreased plaques in older mice by 52 to 58% and in younger mice by 74 to 83% over a three-month period. The reduction of brain plaques also led to a 58% improvement in short-term memory, almost back to normal.


Oolong tea acts potently on brain plaques

The Inca civilization actually used cat’s claw for medicinal purposes. Today, dozens of brands market cat’s claw capsules, liquids and powders for everything from fighting viral infections to stimulating the immune system. But the Percepta® cat’s claw, and the exclusive process to extract and concentrate it into a powder, are superior to any other, asserted Dr. Snow, who tested brands from 18 different companies worldwide. A second ingredient in Percepta is MemorTeaTM, a specific oolong tea extract from the mountains of China that acts more potently on plaques than black and green tea. 

Percepta holds 50 global patents that cover cat’s claw for brain health, including cognition, short term memory, focus, concentration and executive function. 

“Exercising, sleeping well, and reducing stress have everything to do with helping to clear out the plaque load that accumulates in your brain so it will function better. One-third of memory loss cases can be prevented by lifestyle changes,” Dr. Snow stressed.  And make sure to add Percepta to your smart schedule. Each two-capsule dose works for about 24 hours, which is how long it takes for plaques to turn over in our brain. “Most people see an increase in memory, focus and/or concentration within a few weeks,” Dr. Snow said.  “One woman with brain tangles from multiple concussions had memories she hasn’t had in 13 years after she started taking Percepta.”

and use code FOF10 (all caps) for 10% off one pack of Percepta for your optimal brain health!

Ask Dr. Barb: Making Menopause Manageable!

You consider yourself a strong, savvy, independent woman who prefers to face challenges head on by gathering all the facts and dealing with them coolly, calmly and intelligently.

Except when it comes to your sexual health and well being. You’ve experienced unpleasant changes in your body, and they’re affecting your relationship with your partner. Yet, you’ve remained uncharacteristically passive about them, figuring they come with aging and they’ll eventually go away. (They won’t!)

You’re embarrassed to talk to your doctor, and even when you do get information from here and there, it’s often incomplete, inaccurate and inconsistent.

Enter Dr. Barb DePree, a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past decade.

The founder of and director of the Women’s Midlife Services at Holland Hospital, Holland, MI, Dr. DePree wants every woman in midlife to know that she can successfully overcome the challenges she faces during menopause. And have a wonderful and satisfying relationship.

Ask Dr. Barb any question at all about an issue or issues on your mind that are affecting your sexual health and well being. She’ll use her wealth of experience and unbridled passion about women’s health to give you solutions or recommendations which she’ll address in a series of Facebook Live sessions on the FabOverFifty Facebook page.

Write your ANONYMOUS question below. The most important thing is that you find out what you need to know to give menopause a kick in the keister!




Survey Reveals What Women Really Want in a Treatment for Vaginal Symptoms Due to Menopause

This is a “sponsored post.” Duchesnay compensated FOF with an advertising sponsorship to write it. Regardless, we only recommend products or services that we believe will be helpful for our readers. All insights and expressed opinions are our own. —Geri Brin

Ask a woman who hasn’t yet experienced menopause the first things that come to mind about this life transition and she’ll likely say, “hot flashes, night sweats, weight gain and mood swings.” Now ask the same question to a woman who’s experiencing menopause and she’ll respond, “vaginal dryness”, but she’ll probably say it in a hushed tone.

The most common bothersome symptom, vaginal dryness, can make everyday life, not to mention sexual activity, extremely uncomfortable. Unfortunately, women rarely talk about it and so they’re not getting the relief they’d want—and deserve. While some hope or think vaginal dryness will go away on its own like some symptoms of menopause, others have issues with the treatment options available to them. What’s more, many women aren’t even aware of all their treatment choices. 

To find out what women look for to treat their vaginal symptoms of menopause, FabOverFifty recently published over the summer an online survey sponsored by Duchesnay USA, a pharmaceutical company that specializes in women’s health. A total of 235 women answered this survey, of which 163 respondents matched the target demographic: self-described postmenopausal women reporting experiencing vaginal dryness and/or painful sex.*

What Women Don’t Want

The survey revealed that of the 69% (n=163/235) of respondents who reported experiencing vaginal dryness and/or painful sex, 79% (n=129/163) had tried a topical treatment, but 40% (n=52/129) of them rated their experience as inconvenient. The overwhelming majority (87% (n=45/52)) pointed to messiness as their biggest complaint. 

For decades, treatments for vaginal symptoms of menopause have been limited to topical moisturizers, lubricants, creams and inserts. Many women find these products uncomfortable and inconvenient to use; some require daily vaginal application and/or interfere with sexual intimacy.

What Women Do Want

Given their lack of enthusiasm for topicals to treat vaginal dryness, it wasn’t surprising that 45% (n=74/163) of respondents who had experienced vaginal dryness and/or painful sex due to menopause indicated that they’d prefer to take an oral pill.

The Majority Prefers Non-Hormonal Treatment

Although hormone replacement therapy or estrogen-based products might help some women with vaginal dryness, serious safety concerns continue to surround these options: 59% (n=95/163) of survey respondents expressed apprehension about using a product with estrogen and 68% (n=111/163) indicated that they’d prefer a non-hormonal treatment.

The Treatment Women Wished They Had

Now there’s exciting news for menopausal women who haven’t treated their vaginal symptoms, either because they found topical options inconvenient and uncomfortable or because they were reluctant to use a hormone-based treatment. It’s a once-daily, non-hormonal oral pill called Osphena® (ospemifene). Osphena® is a prescription medication from Duchesnay USA that is FDA-approved for the treatment of moderate to severe vaginal dryness and/or painful sex, symptoms of VVA due to menopause. Osphena® has a Boxed Warning regarding endometrial cancer and cardiovascular disorders. Possible side effects include hot flashes, vaginal discharge, muscle spasms, headache, excessive sweating, heavy vaginal bleeding and night sweats.

Osphena® is convenient to take and won’t disrupt intimate moments. It is not an estrogen, so women who were reluctant to take an estrogen-based treatment can feel confident asking their doctors if Osphena® is the right option for them.

Raising Awareness About Osphena®

Although nearly half (n=74/163) of survey respondents indicated that they’d prefer an oral pill to a topical treatment, only 28% (n=46/163) knew that an oral pill is now available. That’s why it’s so important for women to break their silence about the vaginal symptoms of menopause.

Although hot flashes and weight gain may be easier to discuss than vaginal symptoms like dryness and painful sex, there’s no reason to suffer when a treatment is available. If your doctor doesn’t ask you about vaginal symptoms, start the conversation yourself. Osphena® may be the treatment for you. 

         Dr. Barb DePree

FabOverFifty and Duchesnay USA hope that the availability of Osphena® as an additional treatment option will help broaden awareness and open the dialogue about the vaginal symptoms of menopause. 

To learn more about Osphena® and find valuable information about the vaginal symptoms of menopause, including several informative videos from ob/gyn and menopause specialist Dr. Barb DePree, visit

*No screening was performed to confirm identity of and/or answers provided by survey respondents. 


Indication: What is Osphena?

Osphena is a prescription oral pill that treats moderate to severe painful intercourse and/or moderate to severe vaginal dryness, both symptoms of changes in your vagina, due to menopause.

Most Important Information you should know about Osphena

Call your healthcare provider right away if you have unusual vaginal bleeding, changes in vision or speech, sudden new severe headaches, and pains in your chest or legs with or without shortness of breath, weakness and fatigue.

Who should not take OSPHENA?

Osphena should not be used if you have unusual vaginal bleeding, have or have had certain types of cancers, have or have had blood clots, had a stroke or heart attack, have severe liver problems, are allergic to Osphena or any of its ingredients, or think you may be pregnant. Tell your healthcare provider if you are going to have surgery or will be on bed rest.


Serious but less common side effects can include: 

  • stroke
  • blood clots
  • cancer of the lining of the uterus

Less serious, but common side effects include:

  • hot flushes or flashes
  • vaginal discharge
  • muscle spasms
  • headache
  • excessive sweating (hyperhidrosis)
  • heavy vaginal bleeding (vaginal hemorrhage) 
  • night sweats

Duchesnay USA encourages you to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.Tell your healthcare provider about all of the medicines and supplements you take, as some medicines may affect how Osphena works. Osphena may also affect how other medicines work.

Please read accompanying Patient Information for Osphena (ospemifene) tablets, including Boxed Warning in the U.S. Full Prescribing Information.

Painful Sex: The Menopause Symptom No One Talks About

Dr. Mary Jane Minkin

By Mary Jane Minkin, MD, FACOG, NCMP
Clinical Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale Medical School

An educational grant to help fund this article was provided by Duchesnay USA.

Due to improvements in public health and medicine over the past 150 years, the life expectancy for women in the United States has increased into the late 70s, while the age of onset of menopause has remained at around age 52. This means that American women now spend approximately one third of their lives in post-menopause!

Healthy women transition from their reproductive years to menopause when hormone production in their ovaries drops to a level that is no longer sufficient to maintain ovulation and menstruation. 1While many women are happy not to have to worry about monthly periods anymore, lower estrogen levels can cause a number of other, less pleasant symptoms, including hot flashes, night sweats, bone loss, weight gain, mood swings and sleep disturbances. While most women are prepared for these symptoms, one symptom that often comes as a surprise is pain during sexual intercourse. Also known as dyspareunia, painful intercourse is most often a symptom of Vulvovaginal Atrophy (VVA) due to menopause.

What is VVA?

VVA is a condition in which low estrogen levels due to menopause cause a number of bothersome urinary and vulvovaginal (affecting the vulva and/or the vagina) symptoms. Urinary symptoms can include increased frequency, nocturia (waking at night to urinate), urgency, incontinence, dysuria (painful or difficult urination) and recurrent urinary tract infections.

Vulvovaginal symptoms can include irritation, itching, burning, dryness, light bleeding after intercourse, abnormal discharge and dyspareunia (painful intercourse).2

What VVA looks like

Physiological changes in the vagina due to menopause:3

  • Increased pH level4
  • Fewer superficial cells5
  • More parabasal cells5
  • Diminished blood flow to the vagina, leading to decreased lubrication5

Before menopause, the inner lining of the vagina is moist and thick with ridges (called rugae).

As estrogen levels fall during menopause:

  • The inner lining gets thinner and loses its ridges.
  • Increased parabasal cells and decreased surface (superficial) cells, making the lining sensitive and dry.
  • Vaginal pH levels rise, allowing an overgrowth of harmful bacteria, which can cause vaginal infections and inflammation.
  • Vaginal elasticity decrease and connective tissue increases.
  • Lower estrogen levels decrease blood flow and lubrication.6

After menopause, a low number of surface cells result in the vaginal mucous membrane becoming sensitive and dry.7

With less stretchiness and less moisture, it is no wonder so many menopausal women find sex painful!

Impact of VVA Symptoms: the VIVA Survey

In order to determine what impact the effects of VVA were having on women’s lives, an international survey was conducted among 3,520 postmenopausal women aged 55 to 65 years. The study revealed that 45% of women (51% in the U.S.) reported symptoms of VVA.8

  • 75% said that VVA symptoms had a negative impact on their lives
  • 62% described their symptoms as moderate or severe
  • Over half (55%) reported symptoms lasting 3 years or longer

Why dyspareunia often goes untreated

Despite painful sex being one of the most common symptoms of menopause, it is also one of the most under-treated. Sadly, many women do not seek help for this condition for a variety of reasons. For some women, it is a sensitive topic that they are too shy or embarrassed to discuss with their doctor. Other women think painful sex is simply an inevitable symptom of aging.9 Still others are under the mistaken impression that their symptoms will eventually go away on their own.8  

Why treating dyspareunia is important

While some menopause symptoms, such as hot flashes, night sweats and fatigue, improve on their own over time, painful sex is a chronic condition. That means that without treatment, symptoms will not go away and may even get worse.10 

As mentioned, women spend an average of 30 years in menopause. That’s a long time to suffer from painful sex! Fortunately, there is no reason to suffer, because a variety of treatment options exist.

Over-the-counter remedies

If you are experiencing painful sex due to menopause, you can start with an over-the-counter vaginal moisturizer or lubricant. Lubricants are short acting and used primarily at the time of intercourse. Moisturizers are longer acting and inserted vaginally two or three times a week. While these options are available at your local pharmacy without a prescription, they may provide temporary relief, but do nothing to treat the underlying condition that is causing your pain.

Using a vibrator may also help moisturize vaginal tissues by increasing pelvic blood flow.

When over-the-counter options are not enough

If over-the-counter remedies are not enough and you are looking for a solution that actually helps improve the condition of the tissues that are causing your pain, you have several options: 

Vaginal suppositories

Inserted nightly, these steroid hormones are absorbed by the cells in your vagina and converted into testosterone and estrogen. The estrogen helps increase vaginal moisture, while the effects of the testosterone are uncertain, but it may decrease pain and/or increase libido.

Estrogen therapy

Estrogen therapy has been shown to be very effective at reducing menopause symptoms, including vaginal dryness and overall sexual functioning.11 Estrogen comes in many forms, including vaginal rings, vaginal suppositories (tablets), creams and gels. When used as directed, all three forms ensure that only a minimal amount of estrogen is absorbed by your body.


SERMs are non-hormonal, synthetic molecules that work by binding to estrogen receptors in the body and have “tissue selective effects”.12 This means that SERMs have different effects depending on which tissues they are working in. In some areas of the body, SERMs bind to the estrogen receptor and mimic the effects of estrogen, without being estrogen. In other areas, SERMs bind to estrogen receptors and block the effects of estrogen. SERMs are used to treat a variety of medical conditions, but the one used to treat moderate to severe painful sex due to menopause is called “ospemifene”.

Sold under the brand name Osphena®, ospemifene helps counteract the changes in your vaginal tissues that resulted from low estrogen levels. By improving the condition of your vaginal tissues, ospemifene makes sex less painful. In other words, Osphena® provides the relief you need without hormones.

Osphena® may increase the risk of cancer of the lining of the uterus, so tell your healthcare provider right away if you have any unusual vaginal bleeding while taking Osphena®. It may also increase the risk of stroke and blood clots. You and your healthcare provider should talk regularly about whether you still need treatment with Osphena®.

In addition to being non-hormonal, Osphena® is the only treatment for moderate to severe dyspareunia due to menopause that comes in an oral pill. Many of my patients prefer taking a daily pill by mouth, either because they are uncomfortable using vaginal products that require an applicator, or because they are bothered by the staining and/or physical discomfort caused by vaginal treatments, which may also interfere with sexual spontaneity. Of course, this is a matter of personal preference, but only your doctor can determine if a specific treatment is right for you.  

Start the conversation with your doctor!

While menopause comes with many changes, a loss of sexual intimacy does not have to be one of them. I believe that sexual satisfaction is important at any age. Painful sex due to menopause may be a sensitive subject, but it is a women’s health issue that is simply too important to ignore. That’s why I regularly ask my menopausal patients if they are experiencing pain during or after intercourse. However, like every patient, every doctor is different, so if your doctor doesn’t ask, start the conversation!

Indication and Important Safety Information

Indication: Osphena® is a prescription oral pill that treats moderate to severe painful intercourse, a symptom of changes in and around your vagina, due to menopause.

Most Important Information you should know about Osphena®

Osphena® works like estrogen in the lining of the uterus, but can work differently in other parts of the body. Taking estrogen alone or Osphena® may increase your chance for getting cancer of the lining of the uterus. Vaginal bleeding after menopause may be a warning sign of cancer of the lining of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause, so tell him or her right away if this happens while you are using Osphena®.

Osphena® may increase your chances of having a stroke or blood clots.

You and your healthcare provider should talk regularly about whether you still need treatment with Osphena®.

Call your healthcare provider right away if you have changes in vision or speech, sudden new severe headaches, and severe pains in your chest or legs with or without shortness of breath, weakness and fatigue. Osphena® should not be used if you have unusual vaginal bleeding, have or have had certain types of cancers (including cancer of the breast or uterus), have or have had blood clots, have had a stroke or heart attack, have severe liver problems, are allergic to Osphena® or any of its ingredients, or think you may be pregnant. Tell your healthcare provider if you are going to have surgery or will be on bed rest.

Possible side effects of Osphena®

Serious but less common side effects can include stroke, blood clots and cancer of the lining of the uterus.

Common side effects may include hot flashes, vaginal discharge, muscle spasms and increased sweating.

Tell your healthcare provider about all of the medicines and supplements you take, as some medicines may affect how Osphena® works. Osphena® may also affect how other medicines work.

Duchesnay USA encourages you to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Please read Patient Information for Osphena®(ospemifene) tablets, including Boxed Warning, in the U.S. Full Prescribing Information, at

Important Safety Information, including Boxed Warning, and Indication

Indication: What is Osphena® (ospemifene)?

Osphena is a prescription oral pill that treats moderate to severe painful intercourse, a symptom of changes in and around your vagina, due to menopause.

Most Important Information you should know about Osphena®

Call your healthcare provider right away if you have changes in vision or speech, sudden new severe headaches, and severe pains in your chest or legs with or without shortness of breath, weakness and fatigue. Osphena should not be used if you have unusual vaginal bleeding, have or have had certain types of cancers (including cancer of the breast or uterus), have or have had blood clots, have had a stroke or heart attack, have severe liver problems, are allergic to Osphena or any of its ingredients, or think you may be pregnant. Tell your healthcare provider if you are going to have surgery or will be on bed rest.

Possible side effects of Osphena

Serious but less common side effects can include stroke, blood clots and cancer of the lining of the uterus.

Common side effects may include hot flashes, vaginal discharge, muscle spasms and increased sweating.

Tell your healthcare provider about all of the medicines and supplements you take, as some medicines may affect how Osphena works. Osphena may also affect how other medicines work.



1 Grady D. N Engl J Med. 2006;355:2338–2347.
2 Minkin MJ, et al. Female Patient. 2012;37:33-41.
3 International Menopause Society Vaginal Atrophy Slide Deck.
4 MacBride MB, Rhodes DJ, Shuster LT. Vulvovaginal Atrophy. Mayo Clin Proc 2010; 85(1): 87-94. 
5 The North American Menopause Society. Menopause. 2013;20(9):888-902.
6 Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010 Jan; 85(1):87-94.
7 Simon, J. Premenopausal VMI data and how VMI changes from menopause. Womens Health, 2011; 20(10): 1453-1465.
8 VIVA, Vaginal Health: Insights, Views and Attitudes Survey), Nappi RE, et al. Climacteric. 2012;15:36-44.
9 Kingsberg S., et al. J Sex Med.2013 May 16. [Epub ahead of print].
10 Winneker RC, et al. Clin Pharmacol Ther. 2011; 89:129-132.
11 Burger HG et al. Climacteric 2912; 15:281-287.
12 Pinkerton J. Thomas S. Use of SERMs for Treatment in Postmenopausal Women. Journal of Steroid Biochemistry and Molecule Biology 2013; accepted 2013:1-13; Wurz GT, Kao CJ, DeGregorio MW. Safety and Efficacy of Ospemifene for the Treatment of Dyspareunia Associated with Vulvar and Vaginal Atrophy due to Menopause. Clinical Interventions in Aging 2014; 9: 1939-1950.

After 18 Years of Suffering, One Patient Discovers a Treatment That “Finally Worked”

This is a sponsored post. Salix Pharmaceuticals compensated FabOverFifty with an advertising sponsorship to write it. Regardless, we only recommend products or services that we believe will be informative for our readers. —Geri Brin

Her illness first erupted with stomach cramps and pains that would last for weeks at a time. Debilitating, uncontrollable diarrhea followed. Dawn Cobb was 44 and married with three young children. She had always been healthy.

She had colonoscopies, CAT scans, lactose testing, and stool tests, but everything checked out okay. Diets to still the diarrhea didn’t help either. Dawn stopped eating nuts when the doctor thought she might have diverticulosis. She didn’t!  

Dawn’s life was in turmoil. The cramps and pain were bad enough, but never knowing when she’d have a surprise attack of diarrhea, Dawn stopped taking long walks with her friends and other activities that would prevent her from quickly getting to a bathroom. There was no pattern to her symptoms. Periodically, she’d even feel totally fine.

                     Dawn playing tennis

“I owned a retail shop at the time and I literally would bring changes of clothes or have to run home in the middle of the day,” Dawn said. “If I was going out to play tennis, I had to be really careful about what I ate that morning. I could just be sitting at home after having a cup of coffee and ruin my couch cover. I never knew what was going to happen.”

Dawn lived like this for 11 years, trying vainly to find a solution. “You can’t sit back and just accept that this is going to be your way of life. Doctors think you’re stressed, that you want attention, but you can’t let them think that you’re crazy. You have to know this isn’t right. Your body should not be doing this,” Dawn said.

Finally diagnosed with irritable bowel syndrome with diarrhea (IBS-D), Dawn at least knew she wasn’t crazy. But even if she had a name for her disease, there wasn’t a solution that worked for her, so she continued enduring her horrific symptoms for another five years. She also suffered in silence, not telling anyone–including her family–about her illness. I barely shared details about my episodes with my doctor, and she was a woman,” Dawn said.

When symptoms got out of hand about two years ago, and Dawn “just couldn’t take it anymore,” her doctor discussed different treatment options, one of which was surgical intervention. Seeming drastic to her, Dawn went to another gastrointestinal (GI) doctor for a second opinion. That’s when she learned about XIFAXAN® (rifaximin), a two-week treatment that received FDA approval in 2015 specifically to treat IBS-D in adults. Dawn told her long-time doctor about it, who agreed to write a prescription. Patients can be retreated up to two times if symptoms come back.


• XIFAXAN® (rifaximin) 550 mg tablets are indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

•XIFAXAN is not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.

(See additional Important Safety Information below and click
 here for full Prescribing Information for XIFAXAN®.)

XIFAXAN ultimately worked for me,” said Dawn, now 62 years old. Dawn responded to her initial course of treatment, but did experience recurring symptoms. She was retreated, and she hasn’t needed to go back to her GI doctor since. “My doctor had mentioned I may have side effects like nausea but I had no nausea at all. I have been able to do things like walk four miles, not petrified that I’ll make it back without an incident. I no longer walk onto a plane afraid of what’s going to happen if the bathroom is occupied,” Dawn explained. “I tell everyone about XIFAXAN. I want other women who suffer with the same symptoms I had, but don’t talk about them, to find out about it. This is my experience with XIFAXAN. If you’re experiencing IBS-D symptoms, talk to your doctor to see if XIFAXAN is right for you.”

To learn more about IBS-D and how XIFAXAN treats it, we spoke to Dr. Caterina Oneto, a gastroenterologist in New York City. 

Dr. Oneto is not giving medical advice. Patients should talk to their healthcare professionals about what is right for them.


DR. ONETO:  IBS-D is a complex and heterogeneous disease, and we don’t have a complete understanding of its cause or causes. Several factors seem to contribute to it, including an imbalance of the gut microbiota, visceral hypersensitivity (abnormal pain within the inner organs), motility abnormalities (uncommon intestinal contractions), psychosocial stressors  (the mental, emotional, social, and spiritual dimensions of what it means to be healthy), and environmental factors.


IBS affects about 10 percent of the population in the United States, and of those patients, about 60 percent have a diarrheal component.

IBS is more common in women; in fact, 60 to 80 percent of participants in most IBS clinical trials are women, generally 25 to 50 years old. But you can get it when you’re older.”


IBS-D symptoms can vary widely from one person to the next. However, the two most common are abdominal pain and diarrhea, which is what Dawn experienced. Having frequent and unpredictable diarrhea can be quite disruptive to a person’s personal and professional life and sometimes patients even avoid leaving their homes because they’re afraid to have ‘accidents.'”


“Sometimes patients don’t seek medical attention for their IBS symptoms. If they’re suffering from diarrhea and abdominal pain they may try to restrict their diet or use over-the-counter drugs. Or, they may accept their symptoms and tell themselves they just have a ‘sensitive stomach’. Patients who seek medical attention for their symptoms may just get antidiarrheals or antispasmodics, but a formal diagnosis will not necessarily be made.”


“The diagnosis of IBS-D, in most cases, can be made by taking a good history and performing a physical exam. When evaluating a patient with diarrhea and abdominal pain, it’s important to ask the right questions to determine if other symptoms are present, such as weight loss, rectal bleeding, anemia, and a family history of gastrointestinal cancers, IBD (inflammatory bowel disease) or celiac disease.  These symptoms should make the clinician question the diagnosis of IBS and consider further evaluation that may include lab tests, imaging (like an ultrasound or CT scan) and possibly a colonoscopy and/or endoscopy.”


“Approved for the treatment of IBS-D in 2015, XIFAXAN is an antibiotic that works on the gut microbiome, a possible factor in IBS-D. Unlike other antibiotics prescribed to combat issues such as sore throats, sinus and urinary infections, XIFAXAN is minimally absorbed into the bloodstream, but stays within the GI tract to inhibit the growth of bacteria. This makes it a well-tolerated medication with a side effect profile similar to placebo. In clinical studies, the most common side effects associated with XIFAXAN for IBS-D were nausea and increase in liver enzymes.”

 XIFAXAN was shown to provide relief from abdominal pain and diarrhea


XIFAXAN is taken by mouth, three times a day, for 14 days. In clinical trials, some patients achieved lasting relief up to six months (relief ranged from 6-24 weeks; average of 10 weeks) after only one course of therapy.

“Those patients whose symptoms return can be retreated up to two additional times. Many patients appreciate XIFAXAN because it lets them control their IBS-D symptoms without taking daily long-term medications.”


XIFAXAN® (rifaximin) 550 mg tablets are indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.


      • XIFAXAN is not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.

      • If you take antibiotics, like XIFAXAN, there is a chance you could experience diarrhea caused by an overgrowth of bacteria (C. difficile). This can cause symptoms ranging in severity from mild diarrhea to life-threatening colitis. Contact your healthcare provider if your diarrhea does not improve or worsens.

      • Talk to your healthcare provider before taking XIFAXAN if you have severe hepatic (liver) impairment, as this may cause increased effects of the medicine.

      • Tell your healthcare provider if you are taking drugs called P-glycoprotein and/or OATPs inhibitors (such as cyclosporine) because using these drugs with XIFAXAN may lead to an increase in the amount of XIFAXAN absorbed by your body.

      • In clinical studies, the most common side effects of XIFAXAN in IBS-D were nausea (feeling sick to your stomach) and an increase in liver enzymes.

      • XIFAXAN may affect warfarin activity when taken together. Tell your healthcare provider if you are taking warfarin because the dose of warfarin may need to be adjusted to maintain proper blood-thinning effect.

      • If you are pregnant, planning to become pregnant, or nursing, talk to your healthcare provider before taking XIFAXAN because XIFAXAN may cause harm to an unborn baby or nursing infant.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183


Please click here for full Prescribing Information.

The XIFAXAN product and the XIFAXAN trademark are licensed by Alfasigma S.P.A. to © 2019 Salix Pharmaceuticals or its affiliates.

New Website Addresses The Impact Of Vaginal Symptoms Due To Menopause

Fab Over Fifty works with many companies that specialize in women’s health, and one of the finest is Duchesnay USA, which markets a treatment for moderate to severe vaginal dryness and painful sex due to menopause. These may not be subjects women rush to discuss with their partners or best friends, but they’re real medical conditions that can be devastating–physically and emotionally–and they can be treated. 

Duchesnay has launched a new website for its drug Osphena, which has recently received FDA approval for the treatment of moderate to severe vaginal dryness due to menopause.  Osphena had FDA approval for the treatment of moderate to severe dyspareunia (painful intercourse) due to menopause. 

The site’s technological improvements, such as speedy downloading and easy navigation, are a small part of the story.  Women can access short videos packed with information from Dr. Barb DePree, Osphena’s new spokesperson, who specializes in menopausal care. Dr. DePree covers subjects including how to recognize the vaginal symptoms of menopause and what causes them to the reasons you should talk about painful sex to your doctor. “Talking about painful sex to a healthcare provider is as normal as talking about back pain or headaches,” Dr. DePree explains. 

You’ll also learn how Osphena works to improve the condition of specific vaginal tissues and why it’s an excellent option for women who are concerned about hormone-based treatments or uncomfortable with treatments that require vaginal application. 

Duchesnay USA is committed to empowering women to take control of their health at every stage of their lives. It is determined to raise awareness about some of the lesser known, yet most common and bothersome symptoms of menopause. It will consider itself successful if  it can get women to talk to their healthcare providers about treatment options.