I once came across this wonderful and very timely quote, which I cited in
a past Power Surge Newsletter, but thought it beared repeating, for it truly captures
what most of us feel during peri / menopause:

"Physically my body really seems to be falling apart.
I honestly don't feel well, but I don't have an illness
that can be cured - just a process to be endured."

"Menopause used to be a subject women only 'whispered' about, and then only
when whispering about someone else. Now, it seems that you can't go anywhere
without hearing about someone's menopause symptoms."

"THIS year, alone, millions of female baby boomers will turn 50, placing them
in the targeted time zone."

MENO_TIDBITS TO KEEP YOU INFORMED

From a recent article by Colette Bouchez appearing in a NYC newspaper,

"Menopause And Effect":

"Clinically speaking, menopause marks the end of a woman's reproductive years, a time when the ovaries stop producing eggs and the menstrual cycle comes to a permanent halt. This, in turn, causes a rapid drop in estrogen. It's the rapid drop in estrogen, say experts, that is largely responsible for most menopausal symptoms. Low estrogen is also linked to Osteoporosis, a potentially crippling loss of bone mass, as well as to cardiovascular disease, according to Dr. Jamie Griffo, assistant professor of reproductive endocrinology at New York Hospital-Cornell Medical Center. For many years, a woman's only line of defense was Estrogen Replacement Therapy [ERT], in which the lost hormone is replaced with a synthetic form. While ERT helped alleviate symptoms, it was not without controversy, and studies continue to link ERT to an increased risk of several female cancers, including breast cancer, as well as to higher risk of liver damage, high cholesterol and stroke.

"These days, though, much has changed in the medical treatement of menopause. First, we discovered that small amounts of estrogen could work as well as large doses. 'That automatically reduced the risks without sacrificing the benefits,' notes Griffo. Doctors also learned that by adding small amounts of synthetic progesterone into the hormonal mix, they could more safely and easily re-create a woman's natural body chemistry, thus further reducing symptoms and risks. The new combined treatment was renamed Hormone Replacement Therapy [HRT].

"Making HRT still safer, say experts, was the development of the estrogen skin patch. Similar to the nicotine patch that is worn to quit smoking, the estrogen patch delivers an around-the-clock dose of hormone directly into the bloodstream, avoiding ocntact with the liver and further reducing health risks.

"Some HRT regimens now include trace amounts of the male hormone, testosterone, low levels of which are naturally found in a woman's body. The addition of testosterone, say experts, helps some women overcome the loss of sex drive that is often associated with menopause and can increase their feeling of overall well being.

"Perhaps the most exciting new treatment for menopause is one that experts recommend women begin 5 to 10 years before the symptoms become apparent - a period of time doctors are now calling 'peri-menopause.' Explains Griffo, 'This is a time when a woman is experiencing slight estrogen deprivation and vague symptoms.'

"The treatment of choice is a new low-dose birth control pill specially created for women older than 35. And while the use of any birth control pills after age 35 was once considered highly controversial, Griffo says that as long as patients don't smoke and are cancer-free, the new low-dose pills are fairly safe and can be beneficial.

" 'In addition to increasing feelings of well-being and reducing many of the symptoms associated with the early stages of estrogen decline, such as mood swings, bloating and irregular bleeding, the low dose pill offers protection against heart disease and osteoporosis,' observes Griffo. He adds that since the low dose pill also works as birth control, it can help women avoid those "Oops, I thought I couldn't get pregnant anymore" midlife conceptions. In addition, studies show that women who remain on the low-dose pill until menopause can undergo a smoother, easier transition, even if they decide against treatment with HRT. 'Those who do progress to HRT, says Dr. Shannon Diamond, associate professor or gynecology at the Mount Sinai School of Medicine and an expert in the treatment of menopause, 'can expect to remain virtually symptom-free as long as treatment continues.'

"While hormone therapy has come a long way, a downside still exists. New studies indicate that it must be used for a minimum of 10 years to reap bone-mass and cardiovascular benefits, and the jury is still out on whether continued HRT can increase a woman's risk of breast cancer, with roughly equal numbers of convincing studies on both sides.

"Finally, we must consider that in order to control symptoms fully, HRT must be used indefinitely. Currently, there are no definitive studies of the effects of uninterrupted, long-term use. Still, most doctors believe that the benefits seem to outweigh the reisks for most women.

"Notes Griffo, 'Treating menopause is still very much a quality-of-life issue, and exactly how and when to begin treating it must depend on what each individual woman is seeking."

ALTERNATIVE PHARMACIES / HEALTH PRODUCTS SUPPLIERS

MENO_RESOURCE LIST

• Dixie PMS Center
  2161 Newmarket Parkway
  Suite 222
  Marietta, GA 30067
  800 767 9232
  

• Madison Pharmacy Associates
  429 Gammon Place
  PO Box 9641
  Madison, WI 53715
  800 222 4767
  

• Professional and Technical Services
  333 Northeast Sandy Boulevard
  Portland OR 97232
  1 800 648 8211
  

• Women's International Pharmacy
  5708 Monona drive
  Madison, WI 53719- 3152
  800 279 5708
  

• Nutrition Warehouse
  106 East Jericho Turnpike
  P.O. Box 311
  Mineola, N.Y. 11501-0311
  800-645-2929
  

• Nutrition Headquarters
  One Nutrition Plaza
  Carbondale, IL 62901
  800-851-3551
  

• Phillips Nutritionals
  [Yamcon _TM_; Natural Progesterone]
  27071 Cabot Road
  Suite 121
  Laguna Hills, CA 92653
  800-714-5824
  

• Puritan's Pride
  1233 Montauk Hghwy.
  P.O. B. 9001
  Oakdale, NY 11769
  800-645-1030
  

MENOPAUSE NEWSLETTERS

• Power Surge Newsletter™
  c/o Dearest@AOL.com
  America Online - Women's Interests Power Surge Reading Room
  Newsletters Can Also Be Found At Power Surge Web Site
  Newsletter is free if charge
  URL - /news.htm
  

• A Friend Indeed Box 515
  Place du Parc
  Station Montreal, Quebec
  Canada H2W 2P1
  514 843 5730
  

• Menopause News
  2074 Union St.
  San Francisco. CA 94123
  1 800 241 MENO
  

• National Women's Health Network
  514 Tenth St, NW,Suite 400
  Washington, DC 20004
  Information Clearinghouse
  1 202 628 7814
  

• Women's Health Hot Line
  Beckwith Communications
  Charlotte Libov
  71 Judson Lane
  Bethlehem, CT, 06751
  203/266-5904
  

INFORMATION ON HRT OR MENOPAUSE

• North American Menopause Society
  c/o University Hspital's Dept. of OB/GYN
  2074 Abington Road
  Cleveland, OH 44106
  

FREE SEMINARS

Check your local newspapers for articles/announcements regarding menopause/women's health; telephone your local hospitals / women's clinics for information regarding seminars, support groups, free health clinics.

SURGING MENO NET CHAT

Lady A: "Have you tried homeopathic lachesis for the hot flashes? It sure took care of mine, as well as the mood swings."

Lady B: "What is homeopathic lachesis? I know I am trying something called 'Femeca MENOFEM' which is supposed to be a homeopathic remedy drops I take three times a day only when I'm hot flashing. I find this difficult as I am hot flashing constantly and was instructed to use only three times a day."

Dearest heard from the peanut gallery, "Why not have your doc hook up an IV of the Femeca Menofem?" :)

VITAMINS/HERBS/MINERALS

Women's Preparations For Menopause

Those of you who can't or won't participate in HRT, try empowering yourself with as much information as possible about alternative treatments to help you better grapple with the myriad symptoms of menopause, such as mega-vitamin therapy coupled with herbs, natural progesterone creams; holistic/homeopathic/naturepathic methods. The most natural, and oft overlooked, efforts such as exercise can make a vast difference in the way you feel even though you've decided that HRT is not for you. There's no shame in opting for the natural route. You lose not a fraction of political correctness in choosing the least invasive and most natural way to make this most significant transition in your life. Nor do you fashion yourself a martyr of sorts for choosing to go it au naturel. The bottom line is *choice*... and, in a day and age when it seems everything is tainted, polluted, unhealthy, you should stand proud that your respect for your body includes trying to cope with the difficulties of menopause in the most simple and least invasive way. Bottom line - Empower Yourself. Own Your Body!

Power Surge Newsletter, Issue XIII contains a complete description of progesterone and the purpose it serves in our bodies, and how to replenish the lost progesterone in the most natural way via creams, sublingual drops, and tablets such as Yamcon [TM] - available through Phillips Nutritional, and other suppliers included in the list above under "Alternative Pharmacies / Health Food Suppliers." In Issue XIII of the newsletter, I've provided you with all the information required to get you started on adding progesterone to your body, including phone number, address, as well as cost which, by the way, is still under $20.00 through the end of October. Oh, and Yamcon [TM] contains the highest concentrate of Progesterone than any other comparable product on the market today. I use it. I'm pleased with it. I endorse it simply because it works for me. Hot flashes diminished... worth everything! You can find a copy of the newsletter in AOL's Women's Interests - Power Surge Reading Room or at the Web site's reading room.

MORE NET CHAT

"I was quite constipated at that time. It turned out that it was from Tums 500 which this list caused me to take so as to save my bones. Everything else began to be "saved" also. Calcium carbonate was not good for me. Calcium citrate is much better tolerated by me.

"Anyway, the helpful ladies suggested all kinds of ways to ease constipation. Eating prunes caught my eye as a good idea. I actually like prunes. So I went and bought a box. I then absent-mindedly ate half the box -- about 40 prunes.

"The next day I was asking about excessive gas and if that might be a menopause symptom. It was revealed that I was to have eaten only three or four prunes and not half the box." :)

NATIONAL MENOPAUSE STUDIES

A new study reported in the Oct. 2nd issue of New York Daily News. "A Dr. Fredi Kronenberg, director of the Center for Alternative Medicine at the College of Physicians and Surgeons at Columbia-Presbyterian Medical Center, who has been researching hot flashes for over a decade is beginning a "first of its kind" double-blind, placebo-controlled, crossover clinical trial of a herbal prep for hot flashes. This will be a 13 month study. The formula contains a combo of 12 herbs, including ginseng and dong-quai." This is taken directly from the article:

"They are looking for participants for the study and I thought some here may be interested. The article says to qualify you:

• Experience a minimum of 6 hot flashes a day
• Never had cancer
• Never taken hormone replacement therapy
• No chronic health problems

If interested, telephone (212) 544-1069, Mon-Fri 9am-5pm.

MENOPAUSE FAQ

• Why can't I get to sleep, or if I do get to sleep, wake up too early?

Menopausal Insomnia

Insomnia is a common complaint during peri/menopause. This insomnia often takes the form of an inability to sleep through the night. Women often wake up in the wee hours of the morning and have great difficulty getting back to sleep.

Sometimes these awakenings immediately precede a night sweat or at least a warm period where one wants to throw off the covers. Some times a woman will wake up with heart pounding and in an anxiety state for no apparent reason. Very vivid dreams may wake up other women. Other times there doesn't seem to be any reason at all why one awakes at two and three and four a.m. unable to fall back to sleep for 20 or 40 minutes or even longer.

It is possible that these awakenings are due to the body's inability to maintain a consistent temperature due to hormone fluctuations. Even if a hot flush isn't apparent to the woman, it may be that the body temperature has risen to the point where continued sleep is impossible. It will then take a period of time before body temperature falls again making getting back to sleep difficult.

There are a number of things that a woman can try in the hope of getting a better night's sleep.

Health food stores sell a number of different herbal teas that help some women fall asleep more easily. One can also try sleeping potions such as Calms Forte, Snoozers, Easy Sleep, Super Snooze [see below] or Poppy Valerian [Valerian Root... a natural sedative] all of which are sold at health food stores.

Let's never forget the wondrous powers of certain herbal teas, especially Chamomile. Contains no caffeine, is pleasant to the taste, and effects relaxation.

Melatonin is a substance that helps many older people get a better night's sleep. As we mature, our bodies do not produce as much Melatonin as they once did [so, what else is new....sigh]. The usual dose is 3 mg. Seeing as how much isn't yet known about the effects of too much Melatonin on our bodies, it's advisable that you use very cautiously. I cannot help but keep remembering the old expression, "Too good to be true." Best not take it every night, if possible, but to use sparingly.

I use Melatonin on occasion. The product I use is called "Super Snooze," [Item 1137] and can be purchased from Nutrition Warehouse [see list of health product suppliers above]. Besides containing Melatonin, it also contains the following herbs:

Valerian Root 100 mg.
• Hops 75 mg.
• Skullcap 75 mg.
• Chamomile 75 mg.
• Passion Flower 50 mg.
• Calcium Carbonate 100 mg.
• Magnesium Oxide 50 mg.
• Inositol 50 mg.
• L-Taurine 50 mg.
• Melatonin .3 mg. [recommended dosage]

Excellent combination of herbs I've taken separately, and is wonderfully effective in inducing a very relaxed and relaxing sleep. Contains no yeast, corn, wheat, soy, salt, sugar, starch, preservatives, artificial color or flavors. Yeah!

Good sleeping habits will help some. "Sleep Right in Five Nights," by James Perl (Wiliam Morrow and Company, 1993) is a very thorough book written by a man who has done work in sleep labs. Some of his suggestions are: no caffeine after noon, no alcohol before bedtime (alcohol may help you to fall asleep but it also causes interrupted sleep), regular rising and bedtimes (even on week ends), a bedtime ritual, sleep in a cool bedroom, no daytime naps for longer than 20 minutes, rising if you are not sleepy and going to another room to read or watch TV, and exercise four or five hours before bedtime.

The book explains how to keep a sleep log which might help one determine why it is that on some night's one does sleep better.

Meditation and relaxation techniques help some women. Playing soft music or relaxation/subliminal tapes can be useful.

Benadryl which is an antihistamine can be taken safely. It helps some women when nothing else seems to.

Sleeping pills are probably not a good idea. They are meant for short periods of sleeplessness due to an unusually stressful event. Many sleeping pills are quickly addictive and the rebound insomnia when you stop taking them is worse than the initial insomnia. You might ask your physician about a new sleeping pill called Ambien which is new to the US but has been used in Europe for many years. It is claimed to be non-addictive and patients develop no tolerance to it.

It is also possible for some women to simply get used to the idea that they will be awake many nights for some period of time. If one tries to stay calm and do restful, relaxing things with that time, the resultant sleep loss may not be dramatic. Some women actually report being grateful for the extra time to catch up with reading and have some quiet time to themselves while the rest of the household sleeps.

As homone levels even out this insomnia often becomes less of a problem. Starting Hormone Replacement Therapy also helps many women.

In any case, a peri-menopausal woman needs to be aware that it is quite normal to have these early morning awakenings. There are many menopausal sisters awake with her.

MENOPAUSE BOOK REVIEW

Lonnie Barbach -- The Pause -- Signet (division of Penguin), first printing April 1994.

-- "It is very good: clear, complete straightforward, covers every possible menopausal problem inagined! Very readable and great for a reference."

- "Barbach has a sense of humor. She talks about symptoms *no other book* mentions, like cognitive problems. She suggets symptom- management via western "medicine" *and* herbal, acupuncture, and other kinds of medicine -- symptom by symptom, not as a group. She tells the drawbacks of any particular symptom-management idea. The index is complete. The footnotes (which are actually all together at the end of the book) guide you to sources and more info. Read it! It's really helpful."

- "Lonnie Barbach has a section on hair in Chapter 6 of THE PAUSE. She talks about the changes in hair that can be brought on by shifting hormones. With a drop in estrogen your hair can get drier and start falling out and you may lose pubic hair. Yet at the same time facial hair increases. She outlines exactly what happens with shifting androgens and LH levels. She says that taking estrogen won't decrease the facial hair, but will prevent it from increasing whereas some women using natural progesterone cream can decrease facial and body hair."

- "She wrote the book after being told she could not be menopausal, she was too young, her hormone levels were OK etc.. It all was not true: she was menopausal and once she figured that out, with the help of a woman friend, she got onto managing the symptoms. After reading the book you can much better approach your health care provider with facts. -- and do take along Xeroxes of the relevant pages to be placed with your chart in the health provider's office.

- "includes dietary, exercise, homeopathic, vitamin/mineral, treatments for each major symptom. She also seemed to be more up to date on new forms of hormone therapy."

- "in paperback (only $6.95) and it is the best 6.95 you will ever spend, no matter what your opinion on anything about menopause. She covers almost everything, from every conceivable form of HRT (she even describes how you can let the pills dissolve under your tongue to make it easier on your liver) to a list of alternataive remedies such as homeopathy and herbs for a long list of symptoms. And she explains that estrace and ogen are more like your natural estrogens than premarin, which contains some estrogens only found in horses. And talks about how readily estrogen is absorbed through the vaginal walls, and some women who have had breast cancer may be able to use this form of therapy because you can use so much less. She goes into the sexual response, and a whole bunch of things you can do related to that, and spends pages and pages on homeopathy and chinese herbs. This book is *packed* with information of all kinds. Highly recommended!! p.s. lots about the weight problems, too. A Great Menopause Book!!!"

- "I devoured Barbach's book about a month ago and read from it almost daily to remind myself that I wasn't making up my symptoms. Now that I've been diagnosed as very peri-menopausal, I feel grateful to have started with some of the "home-care" recommendations before I had to deal with the issue of estrogen supplementation. Her list of treatments for each symptom is especially useful, and she's absolutely right about daily exercise. I think though that it needs to be somewhat more strenuous than walking. The book also made it much easier to ask the right questions about tests and treatment options."

- "She's great on all aspects of menopause, and especially good on "early" menopause. She goes into signs and symptoms, has ideas for herbal and non-western palliatives but also talks about western medical responses. She has a sense of humor and never forgets that she's talking about actual people. It's in paperback for $4.99. Best bargain I ever got!"

- "About the intermittent skipping of periods and menopausal symptoms -- My doctor's way of putting it is, "Well, your ovaries are sort of sputtering along.." She says (as do the books I've seen) that they can sputter along for some time before you actually stop for good. You might enjoy Lonnie Barbach's The Pause. She is helpful and thorough on this issue."

- "I found The Pause by Loni Barbach especially good -- in fact, the only *really* good -- book about HRT questions/answers. She goes into various variables, other possible routes to take, "full disclosure" about almost everything -- *and* follow-up sources, if you wish. And it's short. And it's cheap. Check it out."

- "Of all the (many) books I've read on this subject, hers is far and away the very very best. Forty-four years old is certainly not so young as to think that menopause has not started. Barbach began when she was 43."

- "It is very good: clear, complete, straight- forward, covers every possible menopausal problem imagined! Very readable and great for a reference to keep going back to."

[Reference: The Menopaus List]