Feeds:
Posts
Comments

Archive for January, 2018

I had a shock the other day.

In an unguarded moment, I ran across one of those life expectancy calculators. You know, the kind that will tell you how many years you have left on earth after 10 minutes of softball questions.

Basically, I believe that predicting how long you’ll live is a fool’s errand—any of us could get hit by alien laser rays or a schoolbus tomorrow. But my data-driven heart was sucked in by this calculator, which was developed by professors at the University of Pennsylvania Wharton School and based on 400,000 data samples collected by the National Institutes of Health and the AARP.

Now, I know that I fall in a healthy category for weight, activity level, and absence of chronic disease. But, still, the results shocked me.

Ninety-six. My estimated life expectancy is 96.

This is enough time to live a second adult life. This is enough time to start another career or follow a dream or pursue a passion. This is not enough time to waste.

So, that’s the challenge I put before you (and myself) this January: the macro view; the life-reinvention perspective. Because no matter how much time we have (or think we have), why squander it in self-defeating, fearful ways? Or simply by drifting through a handful of years without direction?

Reinvention isn’t a quick-fix project; it isn’t a lose-five-pounds resolution. It’s a project we could (and should) work on for the rest of our lives, periodically reviewing and adjusting our goals to see if they still fit.

Now—today—is a good time to start.  So I put before you the proprietary MiddlesexMD Reinvention Project. Ready?

Step #1. Take stock. No shortcuts here. Sit yourself down somewhere quiet. Open to the first page of the Reinvention journal that you bought for this occasion. (You did get one, didn’t you?) Today’s task is to examine the important aspects of your life. As realistically and objectively as possible. You can’t envision a new you without a solid understanding of who you are now, right?

How’s your health? (Obviously my first question.) Are you content with how you feel? How do you feel about your eating/exercising habits? Your weight? Your overall mobility? Your blood pressure and cholesterol levels? Your mental acuity? Do not indulge in guilt or leap to quick, feel-good resolutions, just assess your physical self realistically.

How’s your spirit? Do you feel lonely? Optimistic? Afraid? Content? Discontent? Restless? Do a full-spirit wellness scan. Are the physical and spiritual linked in some way—being overweight and depressed, for example? Are you handicapped by free-floating fears or anxieties? Does stress nibble at the corners of your life—or maybe devour the whole enchilada? Do you feel unsettled and discontent or grateful and happy?

What is the source of your greatest joy or satisfaction? What are you good at? What are you happiest doing? Where does your passion—or your pleasure or your interest—lie? What have you always wanted to attempt? Do you have dreams that you decided had passed you by or that you are too afraid to try? Is there anything you would regret not having done before you die?

Examine the health of your most important relationships. Our closest relationships are the sources of our greatest joy and satisfaction as well as our greatest heartbreak and frustration. We expend a lot of  energy repressing, denying, or making excuses for broken relationships, whether with family, lovers, or friends. Does this sound true for you?

Are you keeping up with friends and loved ones, or have you let important relationship wither on the vine? We also sometimes endure relationships that kill our spirits, that are toxic to our psyche and sometimes our bodies. Resolve now to examine them with a clear eye. You don’t have to do anything today except be honest with yourself.

Write it all down in the journal. This is the first day of your new you.

Okay. Take a deep breath. You’re done for today.

The Fullness of MidlifeNeed inspiration? Some of our “The Fullness of Midlife” podcasts are on topic: Lesley Jane Seymour on reinventionAmy Eller on intentional life designDruscilla French on understanding ourselves.

Read Full Post »

Even though vaginal dilators have been around for decades, they still elicit lots of attention and a few quizzical looks even from healthcare professionals whenever we display our wares at medical conferences. My patients sometimes have questions, too, and we get phoned-in and emailed questions here at MiddlesexMD.

Dilators are one of the most straightforward medical devices you’ll run across. They are a set of tubes that gradually increase in diameter from about a half-inch to about an inch and a half. They are usually made of high-quality plastic, but may also be made of silicone, which gives them a softer, more flesh-like quality. Both types are washable with soap and water. Dilators are used to increase vaginal “patency,”—its capacity and ability to accommodate the things that vaginas are made to do, like a speculum, a baby, a penis—some pretty important stuff, in other words.

Dilators are used to:

  • Prevent scar tissue from forming after some cancers or pelvic radiation therapy.
  • Increase vaginal capacity and length after certain procedures, such as a total hysterectomy.
  • Maintain vaginal capacity during times when sex isn’t an option for whatever reason.
  • Improve vaginal capacity after a long time without sex (remember the old use it or lose it adage).
  • Help to address vaginal shortening and tightening due to hormonal changes of menopause.
  • Treat conditions, such as vaginismus, that make penetration difficult.

Since some vaginal conditions might require additional treatment, such as localized estrogen or muscle relaxants, you should always discuss any vaginal pain or change in your ability to have sex with your doctor, as well as how you might benefit from using dilators. From there, if it’s simply a matter of conditioning or maintenance, our shop has a selection of high-quality plastic and silicone dilators.

I recommend any of these sets. Choose the features and sizes that appeal to you. The first set that we found and offered remains a favorite. It’s available with five or seven dilators, depending on your starting point, and the straight, solid cylinders are easy to handle and clean.

The silicone kit is firm yet flexible with a softer touch. (Bright colors don’t hurt, either.) Be aware that silicone lubes will degrade the surface of these dilators, so use them only with water-based lubricants.

The Amielle kit is our high-quality, good-value choice. This set of five dilators is made of medical-grade plastic and includes a detachable handle that might make insertion easier.

Increasing vaginal capacity takes patience—often several months. For maintenance, you may need to use dilators regularly until you’re having sex regularly. The goal is to accommodate your partner’s penis (or your doctor’s speculum) comfortably and without pain. It’s a worthy goal, so accept that you’re in it for the long haul.

To use dilators:

  • Start with a warm bath to soften tissues and relax your pelvic floor muscles (along with everything else).
  • Find a comfortable and private place and lie down on your back, legs bent at a 45-degree angle and shoulder-width apart.
  • Consciously relax all your muscles, from head to toe. Do a mental scan for areas of tension around your eyes, brows, or anywhere else. Focus on breathing in; breathing out.
  • Begin with the smallest dilator and slather it with high-quality, water-based lubricant. (Not petroleum jelly or any kind of oil.) Generously lube your vaginal entrance as well.
  • Gently insert the dilator until you meet resistance. Pause. Breathe. Practice kegel exercises. Insert it a little farther if you can do this without discomfort. The dilator should fit snugly but without pain.
  • Keep it in place for twenty or thirty minutes. Watch TV or listen to a podcast or your playlist. Practice kegels.
  • You can try rotating it in place or moving it in a circular motion around the vaginal entrance or gently moving it in and out.
  • Clean with soap and water. Towel dry.
  • Move to the next size when you can comfortably insert the smaller one.
  • Do this 3-4 times per week or every other day.

You may bleed a little at first. This is normal. But if you soak a sanitary napkin or experience frequent bleeding, this is not normal. Stop using the dilator and call your doctor.

I like dilators because they’re both simple and effective. Granted, taking a pill is easier, but there are no pills that treat vaginal patency as such. If you stick to the regimen, dilators are very effective in both reconditioning the vagina and in maintaining elasticity during fallow sexual periods.

Read Full Post »

The Intensity Pelvic Tone Vibrator works in two ways: It has electrodes that stimulate the muscles of the pelvic floor, causing them to contract and therefore strengthen. The vibration feature of the Intensity, which you can control separately, improves pelvic floor muscle tone the same way any vibrator does: They all help the user to experience orgasm, which is intense contractions of the pelvic floor. Those contractions, whether from the electric pulses or orgasm, improve muscle tone, just like flexing your bicep does. The contractions also increase blood supply to the pelvis, which improves function and sensation, too.

Yes, orgasm is good for muscle tone! And improved muscle tone can strengthen future orgasms, as well as holding organs in place and preventing or minimizing incontinence. I guess I’d call that a virtuous cycle.

Read Full Post »

You asked. Dr. Barb answered.There are plenty of bioidentical pharmaceutical hormone options to treat menopausal symptoms. Over 90 percent of my hormone therapy patients use these, and most physicians who treat menopause are familiar with the options. There are brand name and generic products available; to list some of them: Estrace, Vivelle, Minivelle, transdermal estradiol, Prometrium, micronized progesterone.

You also mention weight gain. I hope you know you’re not alone! We had a series on this topic this summer that may be of interest to you: an overview of the reality, how you can respond with diet alterations, and how exercise can play a part.

If you need a provider who focuses on menopausal treatments you can find one on the NAMS website (North American Menopause Society) at this link. Enter your zip code and a list of nearby providers will be listed.

Good luck!

Read Full Post »

Life moves fast. That’s a truism for everyone, but this tumultuous year, time seems to have whizzed by on steroids. Still, I don’t want to tumble into 2018 (yikes!) without one last glance over my shoulder at the year that was.

Maybe my glass is half-full, but one word that comes to mind in describing the practitioner side is “innovation”—an unusual flurry of it. New treatments for menopausal symptoms, such as Intrarosa, have recently been introduced; it looks like Addyi may have new energy behind it; and new products, such as the women-designed vibrators from Dame, have come to market. I’d like to believe that this problem-solving innovation is a result of our many voices expecting answers along with a growing social awareness of both the normality and challenges of menopause.

“Community” is another word that comes to mind as I think about 2017. Not one, but many communities of women (and men) who are passionate about de-stigmatizing menopause, making it a normal, even exciting, transition to a different, yet still fulfilling life, and to keeping love and sexuality squarely in the middle of it. These include professionals like Dr. Pam, whose documentary we recently mentioned, and Mary Jo Rapini, just one of many colleagues whose work is all about living mindfully and abundantly.

I’m also thinking of online communities, like RedHotMamas—and this blog as well—that create an entertaining, informative space to address all things menopause. Here’s a list of the Top 50 menopause blogs from Feedspot. (Spoiler: We’re number 3!)

A natural outgrowth of our MiddlesexMD community is our new podcast, The Fullness of Midlife. In this series of interviews, we explore diverse stories, perceptions, and insights with the women (and men) who cross our path. Check it out! You’ll be entertained and inspired.

Then, of course, there’s you—the community of MiddlesexMD women who share your stories with me personally or on this blog. Who write to ask about our products. Who listen to our podcasts. You are the reason and motivation for everything we do here at MiddlesexMD. I am gratified and humbled every day by your trust, your stories, and your spirit.

So here’s to another year of opportunity, fulfillment, meaning, and challenge.

Read Full Post »

%d bloggers like this: