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Month: June 2016

Menopause Management and Treatments

Menopause isn’t an illness; it’s a natural stage of a woman’s life. Menopause is defined as occurring 12 months after your last menstrual period and marks the end of menstrual cycles. This transition in life can happen in your 40s or 50s, but the average age is 51 in the United States.

The hormone changes that happen around menopause affect every woman differently. Some changes that might start in the years around menopause include:

Irregular periods. Your periods may:
– Come more often or less often
– Last more days or fewer
– Be lighter or heavier
Hot flashes. These can cause:
– Sudden feelings of heat all over or in the upper part of your body
– Flushing of your face and neck
– Red blotches on your chest, back and arms
– Heavy sweating and cold shivering after the flash
Trouble sleeping. You may have:
– Trouble sleeping through the night
– Night sweats
Vaginal and urinary problems. Changing hormone levels can lead to:
– Drier and thinner vaginal tissue, which can make sex uncomfortable
– More infections in the vagina
– More urinary tract infections
– Urinary incontinence
Mood changes. You might:
– Have mood swings
– Cry more often
– Feel crabby
Changing feelings about sex. You might:
– Feel less interested in sex
– Feel more comfortable with your sexuality
Other changes. Some other possible changes at this time include:
– Forgetfulness or trouble focusing
– Losing muscle, gaining fat and having a larger waist
– Feeling stiff or achy

Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

Hormone therapy. Estrogen therapy remains, by far, the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you. Estrogen also helps prevent bone loss. Hormone therapy may benefit your heart if started within five years after your last menstrual period.

Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.

Low-dose antidepressants. Certain antidepressants may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.

Gabapentin (Neurontin). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can’t use estrogen therapy and in those who also have migraines.

Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures.

Some women try herbs or other natural products that come from plants to help relieve hot flashes. These include:

Soy. Soy contains phytoestrogens, substances from a plant that may act like the estrogen your body makes. The best sources for soy are foods such as tofu, tempeh, soy milk and soy nuts.

Other sources of phytoestrogens. These include herbs such as black cohosh, wild yam, dong quai and valerian root.

Calcium intake. Ingest 1,000 to 1,500 mg of calcium a day. Combine this with regular weight-bearing exercise to avoid osteoporosis and maintain general good health.

Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options regularly, as your needs and treatment options may change. Learning how to cope with your symptoms now can bring you months of comfort as you transition to the next phase of your life.


Just Dad

I get a lot of questions from friends and family about my job. The most frequent question I get when I tell people my chosen profession is “Why would you choose that?” The second is “Did you deliver your own babies?”

My answer to the first usually depends on where I am, who I am with, and (most importantly) what kind of a mood I’m in. If I’m well rested, and I think you are actually interested in my response, I’ll tell you about the first baby I delivered; how it was one of the most awe-inspiring moments of my life, and what a privilege it is to help women welcome a new life into the world. If I’m tired (or at a dinner party), I’ll tell you “I thought it would be a good way to meet chicks” or “the proctologists weren’t hiring.”

My answer to the second, however, is always the same. “No. I just wanted to be the dad.”

I’d probably delivered close to six or seven hundred babies by the time my wife brought our first child and only son Jack into the world. While I will tell you assisting in the birth of a child is never routine, and I am always amazed every time I get to do it today, most of the time there is a anticipated routine that is going to play out. I coach pushing the same way, deliver the baby the same way, and make the same bad jokes about the not charging you if you cut your own baby’s umbilical cord. So as the due date approached and the overnight bag for the hospital sat patiently by the backdoor, I waited, with much overconfidence and arrogance I might add, for her water to break, or for contractions to start, so we could get on doing the same thing I had done hundreds of times before.

Then it started. Somewhere between the screams of pain (peppered with some of the most colorful profanity I have ever heard coming from my sweet Southern Bell of a wife) and the not-so-great fetal heart rate tracing, it became abundantly clear I was in way over my head. I had a head full of knowledge. I knew where L&D was, I knew how to diagnose labor, and I even knew when a C-Section would be indicated. I was technically proficient, but lacked true experience. I was prepared for the what, the when, the where and the how. What I wasn’t ready for was the who. What I wasn’t ready for was to see what labor looked like for MY WIFE.

I knew the definition of labor and how frequent someone needs to contract, but I didn’t know the look of pain on my wife’s face during a really bad set of contractions. I knew sometimes the baby’s heart rate dropped as the cervix was changing, but I didn’t know how it would feel to hear MY baby’s heart rate go to the 60s and sit there (it was really scary, by the way). I certainly have counted to 10 hundreds of times, but I was completely unprepared for how momentous it was to see the woman I love bring another human being into this world with a startling combination of determination, courage and love. I knew how to help deliver a baby, but I never really understood what it meant until I watched my wife make me a dad.

Dad’s, if you feel unprepared for your wife’s upcoming labor, you are. If you are nervous about what’s going to happen, you should be. If you’re scared about all the stuff that could go wrong, that’s OK. And if you think there is anything I can tell you that can get you ready, there isn’t. My wife has given me so much over the years (except my fair share of the comforter… she takes way more of that than she is entitled). But the gift of fatherhood is second to none. I thought I married a strong woman before she gave me Jack and Katherine. Turns out I didn’t know what strong was.

So fellas, be prepared for the unexpected. Trust the amazing staff at Greenville Women’s Clinic and Vidant to take excellent care of your wife and to bring your healthy child into this world. And enjoy every second of being “just dad.”

David Ryan

P.S. Tell the proctologists I’m all set.