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Archive for the ‘The Good Stuff’ Category

If the title of this post pulled you in, you’re likely part of the almost 50 percent of women aged 40 to 64 who have sleep problems. I’m sorry you’re a part of this club, but welcome! Sleep has been in the news a lot since—well, for as long as I can remember. It affects everything from mood and willpower to productivity and relationships. We all know how hard it is to gin up enthusiasm for romance when we’re sleep deprived.

Sleep also has implications for long-term health. Research shows that not getting enough sleep can lead to serious issues like diabetes and cardiovascular disease and a weakened immune system.

The evidence that we should make sleep a priority is pretty compelling. Perhaps you took the advice of our recent post on good sleep hygiene, and you have been going to bed at the same time every night, avoiding food, exercise, and alcohol several hours before bed, and keeping your bedroom cool and dark. Well done!

But if you’re still reading, those good habits may not be paying off for you. There are few things more frustrating to my patients than knowing all the reasons good sleep is important, following all the advice—and still not getting good sleep.

If you’ve tried all the normal ways to fix your sleep problems, and you don’t want to try medication, you might want to experiment with natural remedies.

As I’ve said before, herbal supplements are generally considered foodstuffs in the U.S., so manufacturers don’t have to conduct clinical studies about their efficacy or side effects. I can’t necessarily vouch for them, but few are known to be harmful. Some patients report one supplement or another has worked for them, and maybe one of them will work for you, too.

If you do want to try one, first consult with your doctor to make sure it’s safe for you, given your health and the medications you’re taking. I also recommend that you keep a sleep journal for a week before you begin and for 12 weeks after. Make a note of sleep hygiene factors, too, like when you ate and exercised and put away screens for the night.

Melatonin is a hormone that regulates when we sleep. When melatonin levels rise at night, body temperature falls and we feel sleepy. Melatonin seems to be most effective at helping people fall asleep rather than stay asleep. Calcium aids in the production of melatonin, which may be why some people find that drinking a glass of warm milk before bed makes them sleepy.

L-theanine is an amino acid that increases brain chemicals that are calming and reduces brain chemicals linked to stress and anxiety. Rather than acting as a sedative, L-theanine can improve the quality of sleep by lowering anxiety. It’s most often found in tea but can be bought in the form of supplements.

Valerian is an herb. Valerian root is thought to reduce anxiety by acting as a sedative, but research results on that have been mixed. It may help you fall asleep more quickly and improve the quality of your sleep, but you might need to use it every day for up to four weeks before it starts to help.

Magnesium is a mineral. Most adults get enough of it through their diets (leafy green vegetables, nuts, and whole grains are good sources), but it might affect the sleep of those who don’t; magnesium deficiency has been linked to higher levels of anxiety, which interferes with sleep. If you suspect you are low on magnesium, eat more of the above. Magnesium supplements often don’t play nicely with medications.

Lavender

Lavender is a popular natural sleep remedy. Many people say just the smell of it relaxes them and makes it easier to sleep. There is some research that shows that taking lavender oil by mouth for 6 to 10 weeks reduces anxiety and improves sleep.

Lavender—or any of the natural remedies above—may really work for some people. Or perhaps it’s just the placebo effect. If something is safe and it helps a patient get better sleep, I don’t care much about whether it’s “real” or placebo. And I suspect that you don’t, either.

Have you tried any of these or another that we haven’t included? I’d love to hear what’s working for you!

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Summer has finally arrived, along with the opportunity (and energy) for different kinds of date nights. My date night strategy in the summer is driven by the climate where I live: Summer is a short season, but the days themselves are blissfully long, with daylight that extends until 10 p.m. That makes it easier to plan date nights that are active. It’s a great time to change things up with your partner to keep things interesting. Here are a few ideas to get you started.

Couple walking beachPush a favorite activity in a new direction. If you already enjoy taking a leisurely evening bike ride together, that’s great! Your body thanks you and your relationship is likely stronger because of it. You already know that biking is something that works for both of you. Now just add a twist, perhaps by trying tandem biking, or by planning a daylong (or even overnight) bike trip. If you like to walk, consider doing more strenuous hikes. You might be surprised by how much tackling something that’s familiar yet challenging invigorates your relationship.

Get competitive! You and your partner might not think of yourselves as competitive. But competition has some things to offer a relationship. First, it gives you a common goal. Second, preparing for the competition—whether that’s a 5K or a chili cook-off—automatically carves out “couple time.” Finally, struggling together—the frustration, hardship, mutual support, and laughter that are all part of it—can strengthen the bond between you.

Walk—or foster—a dog. Sometimes seeing your partner in a new light can make you swoon all over again, almost as hard as you did when you first fell in love. The Humane Society has lots of opportunities for volunteers, including playing with and walking dogs. What better way to enjoy each other’s company than spending quality time with small fluffy animals? (Just make sure you know where you both stand on actual adoption.)

Be a tourist in your own town. This is something you can do even if—perhaps especially if!—your town is not a true vacation destination. Put together a short list of the best places in your area, and then spend a date night visiting them. Maybe it’s a museum, or a small park that has rare flowers, or a kitschy attraction just off the nearest expressway. You may have to get creative and keep a sense of humor, but that’s part of the fun. Miniature golf, a river that’s great for tubing, or a pick-your-own farm—all are fair game. You may develop a whole new appreciation for where you live, but at minimum you’ll have fun trying together to achieve that appreciation.

Intercourses CookbookPack a picnic that feeds your relationship. What would a summer date night list be without this old chestnut? Incomplete! What can make this traditional summer date night special is what you choose to talk about while sitting on a blanket nibbling on cheese and grapes. Choose something romantic, like how you met. Or something important, like what keeps you awake at night or what impractical thing you still dream of doing. Or work together to create a list of where you’ve celebrated every anniversary since you first got together. All of these topics feed your relationship. They open you to insight about each other and reminding you why you were attracted to each other.

If you forget everything here, I hope you’ll remember the underlying premise: Get out together! Get moving together! Both are sure to bring you together emotionally, and that is where intimacy begins.

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Walk into any drug store and confront the aisles of skincare products: cosmetics, conditioners, lubricants, lotions, potions, and creams. If you’re looking for the safest, least allergenic product for your particular skin—good luck.

You walk up to a counter and how do you begin? How do you interpret the labels; how do you cross-reference which products might have been the irritant? It’s an impossible task to do as an individual.

You could read the teensy print on dozens of bottles and attempt to identify which unpronounceable ingredient might be causing your itchy rash. You could try to find products without parabens or Methyldibromo Glutaronitrile (yeah, that’s a thing). You could buy something expensive because the label says it’s “dermatologist tested” or “hypoallergenic.”

Or, you could go to the SkinSAFE website where that analysis has already been done on tens of thousands of products that touch your skin, from shampoo to cosmetics to sexual lubricants. There you can find products with the “TOP Allergen Free” designation, meaning that they contain none of the ingredients that have been identified as highly allergenic. You could also scan your favorite product into the SkinSAFE app on your smartphone to find out how that product ranks on the TOP Free scale and what allergens it might contain. Both the app and the website are intuitive, easy to use, and give you information that was impossible to find before.

 

You just need to know. Information is power.

This gargantuan effort is the result of decades of patient data painstakingly collected by dermatologists at Mayo Clinic and compiled in a user-friendly internet platform by Michelle Robson, creator of EmpowHER, a website dedicated to providing credible health information for women. (Michelle describes her journey in my podcast series, Fullness of Midlife.)

According to its clinicians, the number one complaint that brings patients to Mayo Clinic is skin conditions. Research also suggests that up to 45 percent of contact skin allergies could be avoided by using allergen-free products like those with the TOP Free designation on the SkinSAFE website. This kind of scientifically sound, third-party ranking of everyday products according to their allergenic properties is a huge public service, not to mention one that could avoid many trips to the dermatologist.

Top Free Uberlube LubricantSkinSAFE is a significant tool empowering consumers to make informed buying choices in an industry that’s been confusing at best and misleading at worst. It creates a meaningful designation—Top Allergen Free— based on science rather than marketing hype; it eliminates price from the equation. Neither price nor labels like “organic” or “hypoallergenic” are indicators of a product’s allergenic properties. Maybelline products, for example, are just as likely to receive the TOP Free designation as more exclusive brands. (And Uberlube is among the TOP Free products you’ll find in our shop.)

“There are a lot of myths about skin-care products,” says Dr. James Yiannias, a dermatologist at Mayo Clinic and co-developer of SkinSAFE, “so if you choose a product that says ‘hypoallergenic’ or ‘dermatologist-tested’, unfortunately, it doesn’t really mean a whole lot.”

For example, we often think of botanical ingredients as “natural” and thus harmless. We’d rather put something natural on our skin than a product laced with unpronounceable chemicals, right? But botanicals can be just as allergenic as synthetic ingredients. One of the major allergy-causing ingredients in skin-care products is fragrance. And “fragrance” can include natural botanicals, such as balsam of Peru, which is highly allergenic.

For most of us, this information just helps us make better choices in skincare products. But for those of us who truly suffer from skin sensitivities or allergies (which often only become more severe with age), it’s critically important information. The SkinSAFE website has a special section for those with very sensitive skin that allows you, presumably along with your doctor, to create a “personal allergy code” (PAC) that filters out products with your specific allergens and only shows you products that are safe for you to use based on your individual profile.

The SkinSAFE app and website are a tremendous resource intended to empower consumers and clinicians alike with current, credible, and badly needed information. And we’re adding SkinSAFE ratings to our product pages and submitting not-yet-rated products for SkinSAFE review. Because as Michelle Robson says, “You just need to know. Information is power.”

 

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How We Get Turned On

The Female Sexual Response Cycle

As we’ve said (many times) before, our sexual responses are complicated and unpredictable. And this becomes especially true once we’ve embarked upon this menopausal transition. That doesn’t mean we can’t respond sexually anymore, just that we respond differently from men and differently even from the way we did before.

Way back in the 1960s, Masters and Johnson, the groundbreaking sexologists, developed a graph of the sexual response cycle. It was a simple, linear depiction that purported to track both men and women from arousal to afterglow in four stages—arousal, plateau, orgasm, and resolution. Sort of like a visual depiction of the wham-bam-thank-you-ma’am version of sex that women used to think was normal.

It did not contain a lot of room for nuance.

Fortunately, concepts about how we respond sexually have evolved over the years. Lately, Rosemary Basson, professor of psychiatry at the University of British Columbia, proposed another model of how women, specifically, experience sex. Guess what? It’s different from men. Her graph is circular. It includes elements that previously weren’t linked to sex, like relationship satisfaction and self-image, and our previous sexual experiences. It leaves room for skipped steps and a non-linear response to sex. This woman gets us.

Take feeling desire, for example. Basson’s model doesn’t get all hung up on desire. You may not feel spontaneous desire—the old “horny” thing—the way you used to. Or maybe you’ve never felt horny. According to a 1999 study from the University of Chicago, fully one-third of women never feel desire. “[Women] may move from sexual arousal to orgasm and satisfaction without experiencing sexual desire, or they can experience desire, arousal, and satisfaction but not orgasm,” according to this article.

You may not feel desire until you’ve begun to have sex; you might not feel desire even then. You might not feel desire even if you orgasm.

Likewise, for a lot of us, sexual satisfaction doesn’t even depend on having an orgasm, necessarily. We may have lovely, satisfying sex because it satisfies our partner and affirms the relationship and enhances our feeling of intimacy. Or, we may engage in sex for negative reasons, such as not wanting to lose a partner or avoiding the unpleasantness of turning him down.

Basically, Basson’s work tells us that however we experience sex that works for us and our partner is good sex. We may not “feel like” sex (experience desire), but once we get into it, desire might come tripping along like a puppy on a leash. Or, it might not, but the sex might be good anyway.

According to the literature, the sex that seems to work best for most couples is light-hearted, flirty, playful sex. It isn’t rushed. It has nothing to prove. It’s a mature, evolved celebration of the fact we’re still here, still loving each other. It’s the kind of sex worth working for.

Couple in kitchenSo, let’s give ourselves a break. If we’ve been honest with ourselves, our sexual response very often depends on stimuli that has little to do with sex—how safe and happy we are in our relationship; how long we’ve been in the relationship; how we feel about ourselves (confident, sexy, desirable; or fatigued, stressed, distracted); whether sex has been painful (it’s hard to look forward to an experience that’s associated with pain).

The most important thing that’s necessary for sexual satisfaction in your relationship is the willingness to pursue it in whatever way works for you.

Oh, and the more sex you have, the more you want it. There are lots of ways to make sex comfortable after menopause: That’s what this website is all about; lube up and laissez le bons temps rouler.

 

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In the last post, we examined where we are right now in life in order to identify where we might want to be in the future: the health of our bodies, our spirits, and our relationships as well as the dreams or passions we have not yet pursued (or maybe even identified).

With this in hand, let’s move on:

Step #2. Same drill. Quiet place; journal in hand. Read through your initial entry. Anything to add or edit? Does it still feel honest?

What leaps out at you from your work? Do you notice any patterns—boredom and overeating; stress and impatience; lack of self-assertion and a feeling of victimhood?

Did you identify something you always wanted to pursue or to learn? Are there disappointments you uncovered? Are some elements of your life story simply incomprehensible to you—how did you end up here, you ask?

Sit with these for a minute. What tugs at your heart? What calls to you? What sounds absolutely awful or completely thrilling? What needs a closer look?

Also read over your assessment of your primary relationships. Any action plan needed here? Fences that need mending or habits that need adjusting?

You aren’t writing anything, necessarily. You’re just noticing habits, patterns, ways of thinking, and how yesterday’s work makes you feel today.

Now. Begin creating your reinvention plan. This is the eulogy moment. What do you want people to say about you after you die? How do you want to feel about your one and only life? Begin to articulate the big, sine qua non items. The ones you cannot die without having accomplished. Make a list of them. Not an overwhelming list—the top three or four. The big ones.

Choose one. This is your project for this year. And maybe for next year. If it’s that important, you may work on it for the rest of your life. Break this goal down into manageable steps that you can start doing tomorrow. What’s the first step, then the second? Travel to Africa? You’ll start by researching your options with the goal of having a plan in place this year. Lose 35 pounds permanently? Research your options with a goal of having identified a realistic, lifelong approach this week that you can begin practicing next week. Learn how to play the flute? You’ll need to find an instrument and a teacher…

Next, review those primary relationships—kids, extended family, spouse. Have you identified tendencies to work on? Habits to develop or break? Relationships that need attention? Relationships that need special nourishment or a new approach?

Don’t overlook the one relationship that is most critical to your longevity and quality of life. “If you’re in a happy marriage, you will tend to live longer. That’s perhaps as important as not smoking, which is to say: huge,” says Lyle Ungar, one of the researchers of that data-driven longevity calculator I mentioned in the first post. Knowing that someone in the world knows you intimately, loves you, and has your back adds measurably to quality of life. It makes sense, then, to focus especially on this relationship in your life review—to test its soundness and ponder how it might be strengthened.

List one or two specific steps you can take immediately that will make any of these relationships stronger. Also write down one or two habits or personality traits that impede them—that you should work to change.

With a path identified (for the year, at least) and the initial steps delineated, you’re ready to begin. Let me just add the wisdom of a few professionals and life-reinventers who have walked this path before.

Practice gratitude. Every day.  “…allow yourself to be grateful for the things you…have. Anger is never inspirational but gratitude is,” writes the best-selling albeit hyperactive author, James Altucher.

Goals, such as those you just articulated are important because “if you don’t have long-term goals, you run the risk of doing lots of little things every day—cleaning the house, sending emails, catching up on TV—without ever making a contribution to your future,” says Art Markman, psychology professor and author in this article.

Stay flexible. Change is never static. Reinvention is an ongoing process. You’ll have to rinse and repeat again next year (or next month) to make sure the goals you set today are still relevant and important and that your progress is unfolding according to plan. “Too often, we give up just when we need to push harder, and persist when we actually should quit,” writes one author.

Change is never easy. Expect setbacks; anticipate resistance. Anything really challenging and worthwhile will take time to accomplish, so if it’s really important, don’t shortchange yourself. Persevere through the tough spots. “The most successful self-reinventors are those who understand that they have time and are willing to use it to invest in their own skills and education,” writes this author.

Declutter. Yes, you read that right. Downsizing, clearing out, cleaning up can feel both psychologically freeing and is also metaphorically linked to ridding your life of things that hold you back—mental clutter, too many commitments and obligations, relationships that are buzz-kills or worse, according to Margaret Manning, blogger and creator of sixtyandme.

There. You did it. I hope you feel empowered or at least optimistic. You should now have a roadmap for the months ahead. I’d love to hear how the project is working for you and if you have suggestions to refine it.

Good luck.

The Fullness of MidlifeNeed inspiration? Some of our “The Fullness of Midlife” podcasts are on topic: Lesley Jane Seymour on reinventionKate Convissor on overcoming fearsDeborah Robinson on appreciating our own bodies and treating them wellI, Joan Vernikos on how movement keeps us capable.   

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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.

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2017, It’s a Wrap!

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.

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