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What You Should Have Been Told About The Menopause Beforehand

Plus: how to get better supplement quality

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The 10almonds Team
August 30, 2023

 

Today’s almonds have been activated by:

❝Today’s goals: coffee and kindness. Maybe two coffees, and then kindness❞

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⏰ IN A RUSH?

Today’s 30-Second Summary

If you don’t have time to read the whole email today, here are some key takeaways:

  • Resistance training, especially if it’s building muscle, can harm your flexibility.

    • However, it doesn’t have to

    • See today’s featured video for Liv’s excellent demonstration of why and how!

  • The menopause is not merely a cessation of menstruation; it’s a whole lot of changes.

    • Most of these changes are not, per se, fun. However, we can manage them if we understand what’s going on and what to do about it.

  • Today’s featured expert, gynecologist Dr. Jen Gunter, has made a career out of demystifying things that people would rather not talk about, and also taking down a lot of unscientific profiteering efforts that prey on people approaching, experiencing, or on the other side of, the menopause.

  • When it comes to supplements, sometimes cost is no guarantee of quality.

    • Ora combats this in three ways (see today's sponsor section for details!)

Read on to learn about these things and more…

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👀 WATCH AND LEARN

Is Weight Training Ruining Your Flexibility?

As Liv explains: it certainly can... but here's how it doesn't have to:

👵 MAIN FEATURE

What You Should Have Been Told About Menopause Beforehand

This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.

When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?

And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!

So, what does Dr. Gunter want us to know?

It’s a time of changes, not an end

The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.

And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.

Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and not to mention but we’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).

However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.

Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.

Bridges can be dangerous to cross! But they can also get us safely where we’re going.

Ok, so how do we manage those things?

Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.

For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).

This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.

Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.

To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:

What about natural therapies?

There are some non-hormonal things that work, but these are mostly things that:

  • give a statistically significant reduction in symptoms

  • give the same statistically significant reduction in symptoms as placebo

As Dr. Gunter puts it:

❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.

In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.

Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”

You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞

However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!

For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:

Want to know more?

Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.

Enjoy!

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❤️ OUR SPONSORS MAKE THIS PUBLICATION POSSIBLE

Ora | Purer, Cleaner, Stronger: Supplements That Work!

It’s easy to have an expectation of “you get what you pay for”, but one of the biggest problems buying supplements is that sometimes cost is no guarantee of quality.

In other words, you can pay too much and still get something that was made in someone’s shed and contains many impurities, or was manufactured in a way that completely defeats the purpose and robs the supplement of any effectiveness.

Ora combats this in three ways:

As for what they sell, they have a range of 28 products so far, for comprehensive all-around health.

Please do visit our sponsors—they help keep 10almonds free

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🌎 AROUND THE WEB

What’s happening in the health world…

More to come tomorrow!

📖 ONE-MINUTE BOOK REVIEW

The Mind-Gut Connection: How the Hidden Conversation Within Our Bodies Impacts Our Mood, Our Choices, and Our Overall Health – by Dr. Emeran Mayer

We've reviewed books about the mind-gut connection before, so what makes this one stand out?

Firstly, it's a lot more comprehensive than the usual "please, we're begging you, eat some fiber".

And yes, of course that's part of it. Prebiotics, probiotics, reduce fried and processed foods, reduce sugar/alcohol, reduce meat, and again, eat some greenery.

But where this book really comes into its own is looking more thoroughly at the gut microbiota and their function. Dr. Mayer goes well beyond "there are good and bad bacteria" and looks at the relationship each of them have with the body's many hormones, and especially neurotransmitters like serotonin and dopamine.

He also looks at the two-way connection between brain and gut. Yes, our gut gives us "gut feelings", but 10% of communication between the brain and gut is in the other direction; he explores what that means for us, too.

Finally, he does give a lot of practical advice, not just dietary but also behavioral, to make the most of our mind-gut connection and make it work for our health, rather than against it.

Bottom line: this is the best book on the brain-gut connection that this reviewer has read so far, and certainly the most useful if you already know about gut-healthy nutrition, and are looking to take your understanding to the next level.

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Wishing you the best of health today and every day,

The 10almonds Team