FabOverFifty recently polled 100 women from our community to learn about your bone health.
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 healthline.com)
“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.”
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…)
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
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.”
THE MEMORY LOSS TRILOGY
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.”
THE POWER OF CAT’S CLAW ON THE AGING BRAIN
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.
THE PERCEPTA DISTINCTION
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.”
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 middlesexmd.com 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!
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.
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 https://www.osphena.com/.
*No screening was performed to confirm identity of and/or answers provided by survey respondents.
IMPORTANT SAFETY INFORMATION INCLUDING BOXED WARNING AND INDICATION
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.
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.
POSSIBLE SIDE EFFECTS
Serious but less common side effects can include:
Less serious, but common side effects include:
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.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.
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
Before menopause, the inner lining of the vagina is moist and thick with ridges (called rugae).
As estrogen levels fall during menopause:
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
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.
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:
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 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 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.
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.
“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.
(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.
FABOVERFIFTY: WHAT CAUSES IBS-D?
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.”
WHO IS MOST AFFECTED BY IBS-D?
“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.”
BESIDES THE SYMPTOMS DAWN COBB EXHIBITED (E.G. STOMACH CRAMPS AND PAINS THAT WOULD LAST FOR WEEKS AT A TIME AND DEBILITATING, UNCONTROLLABLE DIARRHEA), ARE THERE OTHER SYMPTOMS ASSOCIATED WITH IBS-D?
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.'”
WHY DID IT TAKE 18 YEARS FOR DAWN COBB TO GET AN OFFICIAL DIAGNOSIS?
“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.”
HOW IS AN IBS-D DIAGNOSIS 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.”
WHAT IS XIFAXAN AND HOW DOES IT WORK?
“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.”
WHAT IS THE COURSE OF TREATMENT AND SUCCESS RATE?
“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 www.fda.gov/medwatch/ or call 1-800-FDA-1088.
For product information, adverse event reports, and product complaint reports, please contact:
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.
EQUELLE compensated FabOverFifty with an advertising sponsorship to write this post. Regardless, I only recommend products or services that I believe will benefit others. Geri Brin, Founder, faboverfifty.com #EquelleAmbassador
No matter how many articles I read about hot flashes, or how many women described theirs to me in excruciating detail, I never could have imagined how wretched they’d actually make me feel. Like contractions during labor, until you personally experience a whole bunch of hot flashes, you’ll never understand the anguish they can cause.
If you’re currently suffering through hot flashes due to menopause, you surely don’t need an essay about them from me. If you haven’t yet had one, nothing I say will make it any easier when you do. Both groups of women, however, should know about a new non-hormonal  supplement, EQUELLE, that can help alleviate the frequency of hot flashes as well as muscle aches associated with menopause.†
The most common menopause symptom and the second most common in perimenopause, hot flashes affect 75 percent of women in the US , many for as long as a decade. While some women might experience just a couple of hot flashes every day, others might have several every hour. Considering how debilitating they can be, EQUELLE is a potential godsend to millions of ladies.
Happily, scientists are discovering how to replicate crucial chemical reactions in our body, without using hormones, so that vital biological processes aren’t hindered as we age. Although the exact cause of hot flashes isn’t known, they’re definitely linked to the decline of estrogen during menopause, and its effect on the brain’s ability to regulate our body temperature. We may no longer need estrogen to conceive when we’re 50 years old, but when our estrogen level starts falling, it can take quite a toll on a woman’s body. A sudden feeling of feverish heat, accompanied by profuse sweating, especially on the upper body, is one of the most distressing reactions.
HOW EQUELLE THROWS “COLD WATER” ON HOT FLASHES
Of course, not every available treatment works the same on every woman. What’s more, many women don’t want to treat their hot flashes with some of the drugs and supplements on the market, such as hormone therapy. The beauty of EQUELLE is that it does its job without a single hormone.  Its active ingredient, S-equol, is naturally produced from a plant compound in soy through an exclusive process. It helps to alleviate the frequency of menopause-related hot flashes and muscle aches by binding to select estrogen receptors (groups of proteins) inside our cells.†
“The active ingredient has a structure similar to estrogen, and can be an option for those seeking different solutions due to potential risks associated with systemic estrogen therapy for certain women,” explained Dr. LeeCole Legette, a principal scientist at Pharmavite, the company that manufactures EQUELLE. LeeCole did the research for her PhD on the effects of botanical compounds such as S-equol on our health. Now she’s delighted women have the option to take a nutritional solution to help them feel their best during the menopausal transition. Interestingly, about three out of 10 U.S. women naturally produce S-equol, LeeCole told me, which might account for why some women have fewer menopause symptoms like hot flashes. EQUELLE recreates this natural compound so more of us can get its benefits, which have been clinically shown.
Women taking a daily oral dose of EQUELLE (with 10mg S-equol) in a 12-week clinical study saw a 58.7% reduction in the frequency of their hot flashes, significantly more than the 34.5% reduction experienced in women who received a placebo. They also had significant improvement in the severity of their neck or shoulder muscle stiffness compared to those on a placebo. While clinical studies showed benefits in four weeks, optimal results were achieved within eight to 12 weeks.
Only on the market a few months, EQUELLE is getting impressive reviews. Consider this 5-star review from Pam M in San Francisco, who participated in a sampling program:
“Prior to taking EQUELLE, I felt like I had lost the ability to function in everyday activities. I was too tired, always sweating, getting hot flashes that would lead people to ask, ‘Are you ok?’ (all because I would flush deep red). Then I began taking EQUELLE, and the hot flashes dropped to almost zero so I could sleep easier and wake up with more energy! I stopped being embarrassed because the hot flashes were not as extreme, and people stopped asking, ‘Are you ok?’ I felt more like myself and able to return to more normal activities!”
EQUELLE is so confident you’ll see relief from hot flashes and muscle aches, it invites you to try it for 60 days, and, if you “aren’t feeling EQUELLE,” you’ll get your money back.
†This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
 Free from human or animal hormones. Contains trace amounts of isoflavones, a type of naturally occurring plant hormone
 US Office of Women’s Health. Menopause symptoms and relief. Available at: https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief#13
 Free from human or animal hormones. Contains trace amounts of isoflavones, a type of naturally occurring plant hormone