8 Important Medical Tests For FOF Women

Most of us have self-consciously slipped our bare feet into the metal contraptions on the gynecologist’s examining table, year in and year out, for our annual PAP smears. At last, we don’t have to go through this female ritual quite so often. Read on to find out why, and to learn what other female-specific medical tests we need to do, and how often.

FabOverFifty got the lowdown from one of our favorite doctors, Alyssa Dweck, who specializes in treating menopausal and postmenopausal women.

1. PAP SMEARS

“This is all the rage right now in regards to changes in guidelines. The Pap smear can now be done as infrequently as every three to five years in women 30 and older who’ve had normal Pap smears for a while.  The test for Human Papillomavirus (HPV is a sexually transmitted virus that can lead to cervical cancer) is performed simultaneously.  Most women over 65 years old no longer need Pap smears since the risk for cervical cancer is quite low for women in this demographic. (more…)

Sexy Talk With Cheryl Hines

FabOverFifty previously collaborated with AMAG Pharmaceuticals as part of its PAINFULLY AWKWARD CONVERSATIONS campaign. Make sure to learn more about Cheryl’s important mission here and here.

I read that members of the cast of Curb Your Enthusiasm improvised their dialog based on a bare outline for the popular sitcom starring Cheryl Hines and Larry David.  But when I recently asked Cheryl if she’d ad lib a funny line that women could use to open up a conversation about painful sex, she was stumped. No surprise there. Painful sex isn’t an especially funny subject, even for a comedian.

Why in the world would I be talking to Cheryl about painful sex in the first place?

Well,  Emmy nominated actress Cheryl has partnered with AMAG Pharmaceuticals to start the conversation about the subject, which can be mighty uncomfortable for many women. Through a series of lighthearted vignettes, Cheryl and a few of her friends want to empower you to begin your own discussion with your pals, partners and healthcare providers.

“I think It’s hard for women to talk about painful sex because they’re unsure if other women are experiencing it,” Cheryl told me. “It’s easier to talk about something when you feel pretty sure other women are going through the same thing. I was drawn to AMAG’s PAINFULLY AWKWARD CONVERSATIONS campaign so we could help make it easier to approach one another.”

 

When Cheryl was thinking of getting involved with the AMAG campaign, she talked to her friends, and “across the board they told me I have to do it,” she said. “It was eye opening for me. Painful sex is a women’s health issue and we shouldn’t be shy about it.  I want to open the door for women to bring up with their healthcare providers since there are things they can do about it.

“Men today freely talk about erectile dysfunction because treatment is available,” Cheryl explained. “The same thing should be happening with painful sex. If you’re in a private setting, and you’re talking with your friends about guys, fitness, or just having some mimosas, throw the subject out there and ask if it’s just you or if they’re feeling the same way.”

John P. Johnson/HBO

Side note:  I was happy to hear that Cheryl is shooting another season of Curb Your Enthusiasm. “I directed an episode, which was very exciting,” she told me. She expects it will air this year, “perhaps in the fall.”

6 Reasons To NEVER Drink Another Diet Soda

Is this the one vice
every FOF needs to give up… now?

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When Dr. Vincent Pedre, MD, one of New York City’s most sought after internists, meets a new patient, he always asks her: “How much soda do you drink? How much diet soda do you drink?”

“I don’t wait for her to volunteer the information,” says Pedre. “Soda consumption is an important part of the overall health history.” The fact is, millions of us drink diet soda because we’re (a) trying to lose weight; (b) like it more than water; and (c) compared to soda, it’s the lesser of two evils… right?  Wrong, says Dr. Pedre, who insists that diet soda is just as bad if not worse for your body… and for your waistline.  Here, he offers seven reasons to stop drinking it right now.

1. It actually makes you fatter.

Scientists at the University of Texas Health Science Center San Antonio followed 474 people for 10 years and found that the more diet soda the subjects drank, the fatter they got. Diet soft drink users experienced 70 percent greater increases in waist circumference compared with non-users. Those who drank two or more diet sodas a day saw their waists grow 500% bigger than non-users, even when controlling for things like age and exercise. Wait… what? How could America’s favorite diet drink be making us fat? “We still don’t know for sure, why,” says Dr. Pedre. “One theory is that when you eat something sweet, it triggers insulin and the cascade of hormones that make you feel full. Diet soda triggers the sweet receptors on your tongue, but not the insulin, so you never feel full. It actually causes you to crave—and probably eat—more high-carb, processed foods.”

2.  It increases risk of stroke, heart attack and cardiovascular disease.

A recent study of 2,564 adults over 40 living in Manhattan (published in the Journal of General Internal Medicine) concluded that daily consumption of diet soda was independently associated with an increased risk for stroke, heart attack and death. Shockingly, consumption of regular soda was not associated with an increased risk. “Again, this doesn’t tell us why,” says Dr. Pedre, “but we know that people who drink diet soda seem to gain weight and have a greater chance of developing metabolic syndrome,” an increasingly common syndrome associated with abdominal weight gain, high blood pressure, high blood sugar, insulin resistance, an increased risk for heart disease and diabetes.

3. It gives you a super-powered sweet tooth.

“The level of sweetness in these diet drinks—the strength with which they stimulate your sweet receptors—is so strong, that you can lose the ability to taste the natural sweetness in foods like fruits and vegetables,” says Dr. Pedre. “You end up wanting to eat things that are going to stimulate those receptors, such as processed foods and other sweets. When you put someone on a detox, and take these things out of their diet for a while, their taste receptors come back. Suddenly they’re able to eat a blueberry, which maybe tasted bland before, and appreciate how delicious it is.”

4. It leaches calcium from your bones.

Diets high in phosphoric acid are associated with lower bone density, hip fractures and osteoporosis. Guess what contains phosphorous? That’s right, cola. Phosphoric acid gives your diet Coke that tangy, acidic taste that’s so fun to drink, plus it prevents mold and bacteria from forming in the can. Yum? “The addition of caffeine also causes reduced calcium absorption,” points out Dr. Pedre. “If you’re drinking a diet cola or two a day, you’re really setting yourself up for osteoporosis in the long run.”

5. Some experts insist that artificial sweetener is a neurotoxin.

The debate has long raged as to whether artificial sweeteners cause cancer. “It’s fine!” says your friend as she swirls five Equals into her coffee. “That answer is still up in the air,” admits Dr. Pedre, “But, aspartame is a neurotoxin, which means it causes irritation and over-stimulation of the nerves.” This is also a highly controversial statement. The FDA has assured consumers that aspartame is safe, however the debate has raged on, and in recent years many European brands have been slowly removing aspartame from their products. In addition, a minority of very vocal doctors, including Dr. Joseph Mercola, a Huffington Post blogger, and Dr. Russell Blaylock, a board certified neurosurgeon, have led crusades against the additive, insisting that it causes longterm nerve and neurological damage, with common symptoms being headaches and migraines. According to a widely quoted article by Dr. Mercola, “100 percent of the industry funded studies supported aspartame’s safety, while 92 percent of the independently funded studies identified at least one potential health concern.”

6. The caramel color is a carcinogen.

Coca Cola and Pepsi both use a chemical called 4-methylimidazole (4-MI) to give their drinks that signature brown, caramel color. Looks yummy, but 4MI is a known carcinogen that, in high doses, has been linked to cancer in mice and rats. As part of California’s new Proposition 65, a company must inform consumers if its products contain any substance “known to cause cancer or reproductive toxicity.” Reluctant to put a “toxic” warning on millions of cans, Coca Cola released a statement this week saying: “We have asked our caramel manufacturers to modify their production process to reduce the amount of 4-MI in the caramel.” Is the additive gone? No. Is this language sort of hazy? Yes. “The FDA has let this slide because they say the quantity of 4MI in the sodas isn’t enough to be harmful,” explains Dr. Pedre, “But these toxins are stored in fat, so if you’re overweight or carry weight in your mid-section, I can tell you that you’re likely not flushing this toxin out of your body. Each time you drink a soda, more toxins are going in than are coming out. That cumulative effect is very hard to account for.”

Ready to crack open an ice cold cola? Yeah… we aren’t either. So what should we drink? “Water,” says Dr. Pedre. “I can also get on board with sparkling water and a touch of organic berry juice or lemon. Bottom line: If you drink water, herbal tea and eat lots of plants, you just don’t have to worry about this stuff.” How… refreshing.

We’re curious… do you drink diet soda?

Adults 65+ Don’t Want A Surprise Visitor Like This!

This post is sponsored and developed in part by Pfizer; however, the opinions are my own

Let’s say you and your husband, both in your mid-60s, can’t wait to celebrate your anniversary doing something you love, like hiking or golfing. You’re both as active today as you were when you married decades ago, and every year since you’ve become empty nesters, you go hiking or golfing in a new spot. But what if you never make it to this year’s destination because one of you comes down with pneumococcal pneumonia? Instead of visiting an exciting place like The Grand Canyon or St. Andrews, imagine that you’re stuck at home or in severe cases, maybe even in the hospital.

Don’t let pneumococcal pneumonia pay you a surprise visit. Active boomers who watch their diets like hawks, get the recommended eight hours of sleep every night, and work out in the gym, can still get pneumococcal pneumonia. That’s because the immune system naturally weakens as we age. This makes us more vulnerable to a potentially serious bacterial lung disease like pneumococcal pneumonia. As a matter of fact, adults 65 years or older are over 10 times more likely to be hospitalized with pneumococcal pneumonia than adults 18 to 49.1,2

Considering there are more than 47.8 million adults 65 or older in the United States today3, pneumococcal pneumonia has the potential to sideline any of us from the experiences that our vibrant generation loves. Pneumococcal pneumonia may cause symptoms including coughing, difficulty breathing, high fever, excessive sweating, shaking chills and chest pain.4 It can be life threatening in severe cases. It can strike anywhere, anytime and may start quickly with little warning.

Another critical fact you might not know: You can help protect yourself against pneumococcal pneumonia with Centers for Disease Control and Prevention (CDC)-recommended vaccinations. As of September 2016, less than 19 percent of adults 65 years or older were fully vaccinated with both recommended pneumococcal vaccines, according to the CDC.5

Pfizer recently launched the All About Your BoomTM campaign to help educate adults 65 and older about this potentially serious bacterial lung disease and the importance of staying up-to-date on CDC- recommended vaccinations.

Check out this website for more information, and be sure to watch the short, fun video here featuring football legend and analyst Terry Bradshaw, who partnered with Pfizer to spread the word about the campaign. We all love Terry for his keen sense of humor, but he knows this is one subject that’s no laughing matter.

Don’t become another statistic. If you’re 65 years or older, talk to your doctor about your own level of risk, and whether vaccination to help prevent pneumococcal pneumonia is right for you.

PP-PNA-USA-3460-3 © 2018 Pfizer Inc. All rights reserved. December 2018


Ramirez J. Adults Hospitalized with Pneumonia in the United States: Incidence, Epidemiology and Mortality. Open Forum Infectious Diseases. 2017; 4: Figure 2.
2 Data on file. Pfizer Inc, New York, NY.
3 U.S. Census Bureau. Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2014.
Centers for Disease Control and Prevention. Pneumococcal Disease: Symptoms & Complications. http://www.cdc.gov/pneumococcal/about/symptoms-complications.html. Accessed April 4, 2017.
5 Black CL. Morbidity and Mortality Weekly Report (MMWR). 2017. https://www.cdc.gov/mmwr/volumes/66/wr/mm6627a4.htm. Retrieved July 17, 2018.

Please Join Us This Holiday Season To Help The Children of Yemen

A five-year-old girl is treated in a Save the Children therapeutic feeding centre in Hodeida, Yemen. Photo: Ali Ashwal/Save the Children.

 

One of the missions of FabOverFifty is to bring you reliable and exclusive information about crucial health issues, such as the One-Day Medical School presentations from five super smart, Yale Medical School doctors about our hearts, bladders, bones, breasts and hormones. But while we’re blessed with the ability and resources to take care of ourselves as women in the United States, millions of people around the globe aren’t so fortunate.

There is nothing more unnerving than seeing children who are starving and dying in war-torn Yemen, where growing poverty is causing the world’s worst humanitarian emergency. Approximately 85,000 children under 5 years old have died in Yemen from severe hunger since the start of civil war in 2015, according to the charity Save the Children.  On the ground in 120 countries, the organization works “to reach every last child through international programs that focus on health, education, protection and disaster relief.”

Save the Children has treated close to 100,000 children suffering from malnutrition, has given close to 300,000 children vital nourishment,  and is operating mobile health clinics in difficult-to-reach areas, thanks to donations from around the world. But over 11 million children in Yemen need help, which makes contributions more vital than ever.

With this horrific situation in mind, FabOverFifty will donate to Save the Children one-third of the revenue from the on-demand streaming of One-Day Medical School.  That means we’ll give Save the Children $5 each time we receive $14.99 from a woman who wants to benefit from the health lessons of five exceptional doctors. And we’ll donate the $5 in your behalf!

Please join us to help the children of Yemen. They may be thousands of miles away, but we must hold them close to our hearts.

And help the children of Yemen

(You can use any credit card to register)


THE LESSON
 PLAN
                  

KEEPING ABREAST
DEMYSTIFYING BREAST CANCER TESTING AND TREATMENTS

Professor: Dr. Erin Wysong Hofstatter, Co-Director, Yale Cancer Genetics and Prevention Program, speaks about breast health, including risk assessment, genetic testing, and screening regimens.

AT THE HEART OF THE MATTER
HOW TO ATTACK WOMEN’S PUBLIC ENEMY #1
Professor: Dr. Jeffrey R. Bender, Director, Yale Cardiovascular Research Center, talks about heart health, including preventive and screening strategies, and effects of menopause and estrogen therapy on heart
disease.
STAYING IN CONTROL
MASTERING THE MATTER OF THE BLADDER
Professor: Dr. Oz Harmanli, Chief, Yale Urogynecology & Reconstructive Pelvic Surgery, addresses bladder issues, including incontinence and pelvic floor health.
 
BONING UP
TAKING YOUR SKELETON OUT OF THE CLOSET
Professor: Dr. Elizabeth H. Holt, Co-Director, Yale Endocrine Neoplasia Disease Team, discusses bone and thyroid health and weight and metabolic issues.
 
HOLY HORMONES!
THE JOURNEY THROUGH MENOPAUSE, PERI TO POST

Professors: Dr. Mary Jane Minkin, Yale Clinical Professor, Obstetrics, Gynecology & Reproductive Sciences, with Dr. Rose Tamura and Dr. Julia Edelman, North American Menopause Society Certified Menopause Practitioners, provide diverse views of menopause and treatment strategies.

And help the children of Yemen

(You can use any credit card to register)

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

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 www.fda.gov/medwatch 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 www.osphena.com.

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. http://www.imsociety.org/downloads/world_menopause_day_2010/slides.ppt.
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.

Stream Five Priceless Women’s Health Lectures and Receive a Special Gift

Stream five exclusive and priceless lectures from Yale doctors on your heart, hormones, breasts, bones and bladder, and receive a gift of Replens exceptional, long-lasting vaginal moisturizer. Estrogen and fragrance free, it provides immediate alleviation of dryness symptoms. Valued at $17.

 

THE LESSON PLAN                  

KEEPING ABREAST
DEMYSTIFYING BREAST CANCER TESTING AND TREATMENTS

Professor: Dr. Erin Wysong Hofstatter, Co-Director, Yale Cancer Genetics and Prevention Program, speaks about breast health, including risk assessment, genetic testing, and screening regimens.

AT THE HEART OF THE MATTER
HOW TO ATTACK WOMEN’S PUBLIC ENEMY #1
Professor: Dr. Jeffrey R. Bender, Director, Yale Cardiovascular Research Center, talks about heart health, including preventive and screening strategies, and effects of menopause and estrogen therapy on heart
disease.
STAYING IN CONTROL
MASTERING THE MATTER OF THE BLADDER
Professor: Dr. Oz Harmanli, Chief, Yale Urogynecology & Reconstructive Pelvic Surgery, addresses bladder issues, including incontinence and pelvic floor health.
 
BONING UP
TAKING YOUR SKELETON OUT OF THE CLOSET
Professor: Dr. Elizabeth H. Holt, Co-Director, Yale Endocrine Neoplasia Disease Team, discusses bone and thyroid health and weight and metabolic issues.
 
HOLY HORMONES!
THE JOURNEY THROUGH MENOPAUSE, PERI TO POST

Professors: Dr. Mary Jane Minkin, Yale Clinical Professor, Obstetrics, Gynecology & Reproductive Sciences, with Dr. Rose Tamura and Dr. Julia Edelman, North American Menopause Society Certified Menopause Practitioners, provide diverse views of menopause and treatment strategies.

 

for the best lessons of your life…for your life!

(You can use any credit card to register)

ONE-DAY MEDICAL SCHOOL IS HONORED TO HAVE THESE EXCEPTIONAL PARTNERS

Silence is Not Golden When it Comes to This Painful Problem

This post was developed in partnership with AMAG Pharmaceuticals

Does this describes you: You’re about 55 years old, in menopause, and you’re experiencing at least one of these symptoms: Weight gain, sleeplessness, decreased libido, vaginal dryness, hot flashes and depression. Worse, sex has become uncomfortable, maybe even painful, but you haven’t discussed your problem with your healthcare provider because a) you don’t think he or she can do anything about it b) you can live without sex or c) you’re embarrassed.

Chances are I’ve described you to a tee, but I’m not a psychic. Millions of women in the U.S. silently experience pain or discomfort during sexual intercourse, caused by the changes in their bodies after menopause. As a matter of fact,  60 percent of women suffer from VVA, or vulvar and vaginal atrophy, a common condition that can lead to painful sex, according to an exclusive FabOverFifty survey of 293 women. Yet, over half of you haven’t even talked to your healthcare provider, and you have all your excuses lined up.

Woefully,  a whopping 41 percent of smart women are unaware that there’s
anything their healthcare providers can do to treat their vaginal atrophy, 27 percent of you are embarrassed to talk about it, and another 31 percent simply are willing to accept your discomfort or pain and live sans sex, according to the FabOverFifty survey.

Yes, FOFriends, There is a Treatment

Please let me set the record straight about two of these facts: Vaginal atrophy absolutely can be treated, so you don’t have to live with discomfort or pain, and you can have the chance to enjoy sex again!  A number of treatment options, including estrogen and non-estrogen prescription medications, are available to help alleviate your painful sex due to menopause.  Ninety percent of those who participated in the FabOverFifty survey reported they’d be willing to treat the problem if they learned sex doesn’t have to be painful.  

But, how are you, usually a pretty smart lady, going to address a problem if you’re too embarrassed to talk about it with anyone, including your friends, your partner, no less your healthcare provider?

Here’s how: First, drop in on Emmy nominated actress Cheryl Hines and a few of her friends as they start the conversation about painful sex related to menopause. Cheryl knows how uncomfortable it can be to talk about this subject, so she’s partnered with AMAG Pharmaceuticals for its PAINFULLY AWKWARD CONVERSATIONS campaign to empower you, using her wonderful sense of humor, to begin the discussion with your pals, partners, and healthcare providers. 


Finding a Healthcare Provider Who Understands Menopause

Second, make sure to find a doctor who understands what happens to our bodies as we move from peri to postmenopause. You might be surprised to learn that many, many doctors, including OBGYNs, are sadly uneducated about a woman’s body after her child-bearing years. Thankfully, this is starting to change, and exceptional doctors and other healthcare providers across the country, including nurse practitioners, are focusing on the health and wellness of the millions of menopausal women. Many local medical centers have menopause clinics, and The North American Menopause Society (NAMS) provides a listing of doctors in your area who are menopause specialists.

Although my healthcare provider’s office is a two-hour drive, I am happy to make the trip because she can immediately make anyone feel comfortable. She won’t wait for you to introduce the subject of painful sex; she’ll come right out and ask you, in her unassuming style, and explain all your treatment choices.  “I like folks to understand what options they have,” she said. She’ll even send you home with notes about what she covered with you.

You may need to see a menopause specialist more often than I do, and want a healthcare provider closer to home, so my healthcare provider advises you to choose someone who will put you at ease.  Even if the person you’ve selected doesn’t introduce the subject of painful sex during your initial consultation, you can help him or her along by saying, “I’m having vaginal pain, and sometimes it hurts when we’re intimate.”  Good healthcare professionals “always want to know about your concerns,” my healthcare provider asserted. It may be a good idea to set up a separate appointment from your routine examination to discuss your menopausal symptoms. The FabOverFifty survey listed 11 of them.  Vaginal dryness ranked first, affecting 61 percent of the respondents!

Yes, postmenopausal painful sex is a fairly common condition. It’s time that you learned how you can do something about it. Go to www.PauseSexPain.com to learn more about the campaign and how to feel comfortable discussing this condition with your healthcare provider.

Earn a Yale ‘Medical Degree’ in a Single Day

 

 

 

DO YOU KNOW:

1. Which risk factor for breast cancer is greater than family history?

 

2. How obesity can affect your bladder?

 

3. If using localized estrogen in your vagina carries any risk?

 

4. How the calcium in your bones interacts with the calcium in your body fluid?

5. If cardiovascular disease is your greatest health risk?

 

I swear you won’t believe how little you understand about your own body until you stream five exclusive lectures from Yale doctors on your heart, breasts, bones, bladder, and hormones. I guarantee they’re going to give you wisdom that will absolutely help you stay  in control of your health. Knowledge is indeed power. And there’s nothing more powerful than remaining healthy. What’s more, you won’t get this priceless, honest information–right from the mouths and minds of preeminent doctors– anywhere else on the internet, no matter how much you Google.

I took the concept of One-Day Medical School to Yale last year because I knew women didn’t understand their bodies as they took the journey from peri to post menopause. I knew it because I was one of those women.  My own sisters were these women, and so were many of my friends. Even really smart women–with advanced degrees–don’t understand their bodies and how to protect them from illness. I don’t mean knowing about mammograms or  colonoscopies. We’re savvy about those, thanks to the decades-old pink ribbon campaign and women like Katie Couric. I’m talking about lots more, from understanding our risk for cardiovascular disease to knowing we absolutely can treat our dry vaginas and love sex again; from understanding whether we should be genetically tested for breast cancer to knowing what to do when our bladders start to leak!  

STREAM ANYTIME YOU WANT

One-Day Medical School was held before a “live audience” on October 25, 2018, at Yale University, and practically every woman who attended enthusiastically  told me how much she learned. Mind you, that was after listening to six hours of presentations. But, YOU don’t have to do this, or even leave the comfort of your own home.  You can stream the lectures anytime you want. Listen to Dr. Jeffrey Bender talk about how to attack women’s public enemy #1 (heart disease). Learn how to successfully take the journey from peri to post menopause from Dr. Mary Jane Minkin.  Hear Dr. Erin Hofstatter demystify breast cancer testing and treatment. Let Dr. Oz Harmanli explain how to master the matter of your bladder. Take your skelton out of the closet as Dr. Elizabeth Holt discusses your bone health.

One-Day Medical School is about you and for you, whether you’re 45 or 75. It’s for your health. For your happiness.  For your own sake. What’s more, the only requirement for admission is being a woman!

Ladies, I urge you to sign up right now. I guarantee you’ll thank Yale.

 

THE LESSON PLAN                  

KEEPING ABREAST
DEMYSTIFYING BREAST CANCER TESTING AND TREATMENTS

Professor: Dr. Erin Wysong Hofstatter, Co-Director, Yale Cancer Genetics and Prevention Program, speaks about breast health, including risk assessment, genetic testing, and screening regimens.

AT THE HEART OF THE MATTER
HOW TO ATTACK WOMEN’S PUBLIC ENEMY #1
Professor: Dr. Jeffrey R. Bender, Director, Yale Cardiovascular Research Center, talks about heart health, including preventive and screening strategies, and effects of menopause and estrogen therapy on heart
disease.
STAYING IN CONTROL
MASTERING THE MATTER OF THE BLADDER
Professor: Dr. Oz Harmanli, Chief, Yale Urogynecology & Reconstructive Pelvic Surgery, addresses bladder issues, including incontinence and pelvic floor health.
 
BONING UP
TAKING YOUR SKELETON OUT OF THE CLOSET
Professor: Dr. Elizabeth H. Holt, Co-Director, Yale Endocrine Neoplasia Disease Team, discusses bone and thyroid health and weight and metabolic issues.
 
HOLY HORMONES!
THE JOURNEY THROUGH MENOPAUSE, PERI TO POST
Professors: Dr. Mary Jane Minkin, Yale Clinical Professor, Obstetrics, Gynecology & Reproductive Sciences, with Dr. Rose Tamura and Dr. Julia Edelman, North American Menopause Society Certified Menopause Practitioners, provide diverse views of menopause and treatment strategies.

 

for the best lessons of your life…for your life!

(You can use any credit card to register)

 

ONE-DAY MEDICAL SCHOOL IS HONORED TO HAVE THESE EXCEPTIONAL PARTNERS

Out Out Darn Spots!

This post was developed in collaboration with the makers of ESKATA® (hydrogen peroxide) topical solution, 40% (w/w)

          Kirsten BEFORE

When Kirsten Dellecave was around 40 years old, she noticed raised spots popping up on her face, the side of her neck, and on her hairline. “I knew they weren’t Cindy Crawford-type beauty marks,” Kirsten chuckled. “Besides being raised, they had a little texture.” Although the growths didn’t hurt, they sometimes itched; some also had pigment. “They were annoying,” added Kirsten, now 51.

Kirsten tried covering up her newfound growths with makeup, but it made them look worse, she remembered. When she talked to a dermatologist about having them removed, Kirsten learned scarring was a possibility so she decided to leave her spots alone.

Kirsten had seborrheic keratosis (seb-o-REE-ik ker-uh-TOE-sis), commonly called SKs, which is one of the most common non-cancerous skin growths in older adults. “Thirty percent of people have at least one SK by the age of 40, and they affect over 75 percent of people by the age of 70,” according to the website Medical News Today.  

Benign But Bothersome

          Dr. Marina Peredo

“SKs are totally benign growths that should be diagnosed by a board certified dermatologist and are often called the barnacles of life or age spots,” said Dr. Marina Peredo, who has practiced dermatology in New York City for 23 years, and now specializes in aesthetic dermatology. “Most commonly seen on the face, neck, hairline and on the torso, SKs don’t show up on the palms, soles or in the mucus membranes, such as inside the mouth,” Dr. Peredo added. They can range from flesh color to pink, yellow, grey, tan, brown or black, can be round or oval shaped, flat or slightly raised with a waxy, scaly surface, and can be very small to over an inch. Some people can be covered from head to toe in SKs, others have only a few spots. When you see them on a visible area, like the hairline, they can be aging, Dr. Peredo noted. Besides using makeup to cover them, women will style their hair differently, or wear scarves and hats, she said.   

A visible concern to most patients, SKs can cause discomfort, itching and irritation if they’re located around the bra strap and if someone picks on them, Dr. Peredo explained. And, brushing your hair can irritate SKs near the hairline. Affecting women and men across the board, of all ethnicities, SKs can run in families, although the precise causes are unknown.

A Topical Treatment For Raised SKs

Like millions of others, Kirsten lived with raised SKs for years. But a few months ago, during an appointment with Dr. Peredo, Kristen’s growths got the dermatologist’s attention. “She was admiring my spots,” Kirsten laughed, “and told me that they were the perfect candidates for ESKATA® (hydrogen peroxide) Topical Solution, 40% (w/w) the first and only FDA-approved topical solution to treat raised SKs.” Comprised of 40 percent hydrogen peroxide, ESKATA was used to treat over 1,800 raised SKs in clinical studies, representing the largest body of research ever performed in patients with raised SKs. “Dermatologists were excited to start using this new product,” reported Dr. Peredo, who was one of a select group of opinion leaders in dermatology invited by the manufacturer to participate in an ‘early experience program.’ When Kirsten heard that ESKATA had a low risk of scarring (3% of patients) on treated raised SKs, she couldn’t wait to have the treatment.

Kirsten MID TREATMENT

A dermatologist applies ESKATA in a circular motion to the raised SK using a single-use, soft-tip pen-like applicator. Each raised SK is treated four times in a matter of minutes, Dr. Peredo said. “Once the solution has been applied, it looks like there is White Out on the growth.” The raised SKs stay white for awhile, followed by some redness and scaling, and then they may fall off the skin on their own, Dr. Peredo added.

A patient may require two treatments, but some of Kirsten’s raised SKs (she had about nine) cleared after a single treatment. “I had a huge one on my hairline, and when I pulled my hair back you could see it. I was afraid it would affect my hair or hairline, but it didn’t. It just fell off,” Kirsten said. A patient may feel itching and stinging during the ESKATA application, and see crusting, swelling, redness and scaling, “but it certainly wasn’t an unpleasant experience,” Kirsten stressed.

Success After Success

Kirsten FINAL RESULT (Day 106)

18% of patients experienced clearance of 3 out of 4 raised SKs treated with ESKATA vs 0% with vehicle (Day 106 end of study). Nearly all patients received 2 treatments. Serious eye problems and severe skin reactions have occurred. Most common side effects are itching, stinging, crusting, swelling, redness and scaling. Actual patient. Individual results may vary.

Dr. Peredo has successfully treated about 40 patients with ESKATA since it was introduced about five months ago. “We froze SKs, scraped them off, or used lasers to remove them in the past.”

If you think you have SKs, it’s advisable to see a dermatologist, who can best make the diagnosis and tell you whether you’re a candidate for ESKATA. Kirsten wouldn’t hesitate to have new raised SKs removed with ESKATA. “I’d absolutely recommend ESKATA,” she said.

“My sisters, who notice every wrinkle and blemish on my face, asked, ‘What happened to your spots?’ when they saw me after my ESKATA treatment!”

to learn more about raised SKs and to find a doctor in your area who can tell you if you’re a candidate for ESKATA®.

Important Safety Information and Approved Use
ESKATA can cause serious side effects, including:
  • Eye problems.  Eye problems can happen if ESKATATM (hydrogen peroxide) topical solution, 40% (w/w) gets into your eyes, including: ulcers or small holes in your eyes, scarring, redness, irritation, eyelid swelling, severe eye pain, and permanent eye injury, including blindness.
  • If ESKATA accidentally gets into your eyes, your healthcare provider will tell you to flush them well with water for 15 to 30 minutes.  Your healthcare provider may send you to another healthcare provider if needed.
  • Local skin reactions.  Skin reactions have happened in and around the treatment area after application of ESKATA. Severe skin reactions can include: breakdown of the outer layer of the skin (erosion), ulcers, blisters and scarring. Tell your healthcare provider if you have any skin reactions during treatment with ESKATA.
The most common side effects of ESKATA include: itching, stinging, crusting, swelling, redness and scaling.
Your healthcare provider will not apply another treatment of ESKATA if your treated area is still irritated from the previous treatment.
Tell your healthcare provider right away if ESKATA gets into your eyes, mouth or nose during application.  ESKATA is for topical use on the skin only, and is not for use in your eyes, mouth or vagina.
These are not all the possible side effects of ESKATA.
Approved Use for ESKATA
ESKATA is a prescription medicine used to treat seborrheic keratoses that are raised.
ESKATA is for use as an in-office treatment. ESKATA is applied by your healthcare provider and is not for use at home.
You are encouraged to report negative side effects of prescription drugs to the FDA. Contact Aclaris Therapeutics, Inc. at 1-833-ACLARIS or 1-833-225-2747 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Click here for Prescribing Information, including Patient Information.