Have you been trying hard, but can't lose or keep off the weight? Is your sex drive stuck in neutral? Energy in the gutter? What's the truth about bio-identical hormonal replacements in women before and after menopause? The MidLife Health Guide for Women addresses these and many other common concerns of middle-aged women: IBS, addictions, mood concerns, breast health, birth control and more. It's all covered here. Be proactive about your number one commodity-your health. MidLife is the time to do it! In his companion to The Midlife Health Guide for Men, Chris Rao, MD explains cutting-edge methods to obtain optimal health through his integrative approaches. It's all about Pro-Aging and Pro-Health! Follow three women, our Maggies, in various stages of midlife-their thirties, forties and fifties. Laugh, cry, and be enlightened as they share their health concerns and journey to optimal health. You will be the better for it. Dr Rao covers all the facts and options on • Diets Learn the secret behind finally losing the fat. Avoid the "crash and burn" phenomena. • Exercise Learn how to exercise intelligently; increase your energy and metabolism. • Supplements Confused? Discover the truth about which ones do you the most good. • Toxins and Heavy Metal What you and your doctor don't know can hurt you. • Testosterone, Menopause, Thyroid, HGH and all hormonal options Are they safe and effective for your situation? Ladies, get back in the groove.

The MidLife Health Guide for Women

By Chris G. Rao

iUniverse, Inc.

Copyright © 2010 Chris G. Rao
All right reserved.
ISBN: 978-1-4502-3400-9

Contents

List of Illustrations....................................................................xvPreface..................................................................................xviiAcknowledgments..........................................................................xxiI. Introducing Our Middle Aged Gals, Here are Maggies 1, 2 and 3........................1II. Why and How Do We Age?...............................................................12III. Diet Basics: You Are What and How Much You Eat!.....................................35IV. Weight Loss: This Time, You Will Lose Weight.........................................78V. Exercise: Use it or lose it!..........................................................115VI. Supplements: Helpful, or Are You Just Urinating Your Money Away?.....................139VII. Fluids and Toxins: Detoxing Your Way Back to Health.................................176VIII. Andropause and Testosterone. Not Just for Men, Anymore!............................193IX. Pregnenolone and DHEA: The Testosterone Precursors...................................207X. Menopause.............................................................................218XI. Stress and Sleep: Cortisol and Melatonin's Role......................................251XII. Human Growth Hormone: The Fountain of Youth?........................................275XIII. Thyroid: The Gas Pedal of the Body.................................................295XIV. Special Concerns....................................................................303XV. Summary Maggies' Success Stories....................................................334Index-Glossary...........................................................................343Appendix.................................................................................357Resources................................................................................393

Chapter One

Introducing Our Middle Aged Gals, Here are Maggies 1, 2 and 3.

Middle age does make up the majority of a woman's life. Undoubtedly, there are many changes and different concerns that will arise. With those, come many questions. This book is set up in the following way: Since women are more in tune with conversation, relationships and stories, I present three women named Maggies—all in different stages of middle age. In essence, you're sitting down with them and relating to their medical concerns and health goals. It's more like sharing all your life's stories over a cup of coffee. Each chapter has a topic and offers core, factual information that is then subdivided into historical points, pros and cons of various options, and so forth. The intent is for you to identify with our Maggies and follow along their path of discovering ways to feel more alive and youthful. For your convenience, resources and references are given within the text so you can personalize your reading experience. At the end of every topic, each Maggie with her unique set of problems relates how she's progressed along with any other concerns or comments. We then agree on their best individual approach to obtain optimal health. As you follow their stories throughout the book, you'll get pumped up and start your own path. All of you will benefit.

"Welcome Maggies and thank you for volunteering. I'm grateful you came to openly discuss your health concerns and goals in order to help our readers. I asked you three here because you represent the spectrum of mid-life our readers can identify with—early, middle and late middle age. After a brief introduction, we'll identify the common, underlying causes for your concerns and discuss how they are connected. Armed with this knowledge, we'll review the scientific data and your options. After weighing the pros and cons, we'll mutually design a comprehensive plan that's unique for you and your situation. After all, no two women are alike.

"Maggies, I'm grateful to you for disclosing your personal health concerns. You three represent the gambit of midlife and its challenges:

Maggie 1 is not menopausal, only early middle aged in her thirties, but has valid health issues, IBS, and feels tired.

Maggie 2 is perimenopausal in her early forties, yet has health problems as cholesterol, hypertension, and is confused about her options. She has metabolic syndrome including diabetes, osteopenia, asthma, weight gain, anxiety, and she smokes and drinks alcohol too much.

Maggie 3 is post-menopausal, proactive, yet feels like she's losing her earlier gains. Off HRT three years, she doesn't want to go back on hormones because of all the negative press. Feeling achy, she has signs of metabolic disorders as well.

Let's have you three Maggies tell us your stories in your own words. A brief assessment follows and then we'll start our journey. Each subsequent chapter in the book addresses a certain aspect of women's health—diet, exercise, hormones and so on. At each chapter's end, we will review your progress and mutually design a tailored approach to a healthier you. Midlife is the time get your health in top gear! Are you ready, ladies?!"

A. Maggie 1

"Hi, I'm 32 years old, married and have two young children. I feel blessed for that; but, working part-time from home, I find it very hard to balance all my daily duties. I hardly have any time for myself and I know I'm always putting myself last. Despite being quite physically active and eating right when in high school and college, I realize I've been putting my health last for the past few years and am now beginning to feel the effects. Please help me.

I listed my concerns so I wouldn't forget:

Maggie 1

1. Feeling tired during the day with lack of energy and drive. Overall, I'm just not feeling as great as I once did.

2. Being anxious, yet feeling down much more often than before. I'm yelling more at my husband and children. Afterwards, I feel worse. Some of my friends say this is just a phase of getting older and the stress of staying home. Others say I'm in a rut and should seek help. Even my regular doctor tried prescribing me a few antidepressants, but these only made me feel worse or weird.

3. Craving for junk food and eating more fast food. I know I shouldn't; this makes me feel even guiltier. I hide this from my husband; he's a health nut. I want to set a good example for my kids, too.

4. Gaining weight, especially in the hips and thighs. Losing the definition I had before, I now have flabby arms, a thinner face, and thinner calves. One of my biggest fear is coming true—in many not-so-good ways, I am starting to become like my older sister!

5. Feeling less intimate with my husband, I could care less about sex. I'm not sure if that's a reflection of how I feel about me or him ... or us, or just life in general. Regardless, I'm quite fearful about this. We used to have a very wild, crazy sex life and it was a big part of our relationship. The way he used to grin when I'd strut into the bedroom wearing my latest lingerie ... that look said more than any words and it made me feel so special. He used to brag all the time to his jealous buddies. Now, I'm too tired to even think about sex.

6. Not sleeping well. I have a hard time getting to sleep with all of my worries and wake up often during the night. Tossing and turning all night, I may take an hour or so to get back to sleep. I wake up feeling quite tired.

7. Feeling a lot more bloated and constipated than before. I may go three days without having a bowel movement. Then, it's just small pellets; occasionally I have loose bowels. 8. Not getting the results of dieting and exercising the way I used to. Before, I could drop the weight easily. For the past few years, I've eaten less, tried many crash diets and magic pills, and exercised my butt off, yet I can't lose and keep the pounds off. This has discouraged me from any exercise or diet regimen. Must I simply give up and accept my fattier fate as my diabetic mom suggests? I'm certain my hormones are off, but my doctor says my thyroid is fine and I'm not even close to menopause. I'm feeling more hopeless and helpless than ever.

I guess overall, I feel okay ... just okay at best. My doctor says nothing is wrong; it's all in my head and I just need to accept getting a middle-aged spread—it's in the genes! I'm grateful for all I do have in life. Deep inside; though, I know things are off. I used to feel great! I want to feel like myself again before it's too late. Help!!"

Dr. Rao responds. "Maggie 1, to summarize your situation, it appears you're trying to exercise and diet more than ever, yet aren't getting the results you easily achieved when younger. You feel emotionally and physically tired. Trying everything, and even consulting with multiple doctors, you've not been helped much. You now feel somewhat hopeless. You may be surprised to find out that many of your concerns are common in middle-aged women. These do have underlying causes that can be improved. We need to identify these and come up with a lifelong plan that's going to help you feel better.

Your personal medical history reveals you have enjoyed good health so far. You quit smoking a few years ago, but have recently begun drinking more alcohol. Poor rest, lack of energy and many other concerns you expressed are only worsened by having irritable bowel syndrome and allergies. Lastly, you have a positive family history for diabetes, hypertension, and coronary artery disease.

As we go through each chapter in this book, we will review your symptoms, findings and my recommendations. That way, we can compare and contrast with our other Maggies and discuss the many options available to reach your personal health goals."

B. Maggie 2

"Well, hello. I'm 44 years old and have been lucky enough to have a very healthy life. Marrying my childhood sweetheart, I have three fully grown children; two are in college. I've kept active my whole life by playing golf, tennis, and going on many vacations. I'm currently semi-retired, helping my husband run his business. I've always believed in supplements, complementary medicine, and eating right. Currently, I'm on the Macrobiotic Diet. Recently, my gynecologist said I'm perimenopausal—just starting to go through menopause. Many of my friends are going through much the same thing. I noticed the ones on hormonal replacements are doing much better in many ways. My doctor, though, is against this for fear of increased risks for cardiovascular disease and breast cancer. Instead, she offered to put me on a blood pressure pill, cholesterol pill, sleeping pill, and an antidepressant to help with the hot flashes—these are very disturbing, especially during work. I've read many books on biologically identical hormonal replacements, but am still unsure because of all the conflicting news about them. All I know is that for the past four months, my world has become topsy-turvy. I'm an emotional mess at home, at work and at play. My concerns and health "wish list" includes:

Maggie 2

1. Maintaining my healthy lifestyle and aging gracefully, inside and out. Reluctantly, I had some plastic surgery done only a few years ago and am now looking like I need it again. I have wrinkles and folds around my lips and finding it tougher to maintain the shape I'm in.

2. Keeping up with my active husband and kids. More energy and strength would be nice. I now get short of breath while exercising.

3. Controlling hot flashes without medications. I'd prefer a natural approach. My Naturopath gave me a few things, but they didn't work well.

4. Improving sleep. I wake up soaking wet.

5. Maintaining a satisfying sexual relationship with my husband. Lately, I've had more vaginal discomfort during sex.

6. Preventing osteoporosis. I know hormones help that. My mother now uses a cane because of a broken hip.

7. Preventing breast cancer, heart attack ... and I definitely wouldn't want a stroke.

8. Stopping smoking. I've gone back after quitting for ten years! Blame it on the stress of menopause with its darned hot flashes—it's like I'm riding an emotional roller coaster. My husband has been quite patient with me, but wants me to quit."

Dr. Rao responds. "After reviewing your medical history, I believe you are at risk of having metabolic syndrome and osteoporosis. I agree with your gynecologist; you're probably just starting to go through menopause, but you may have other hormonal imbalances as well. It sounds like you really need to get aggressive with lifestyle changes which include proper exercise and dieting. Your other concerns, like osteoporosis, asthma, and trying to prevent a heart attack or stroke are best prevented by eliminating smoking and excessive alcohol.

As will be revealed in the hormonal chapter, new research indicates starting hormonal replacement therapy, HRT, in a woman your age doesn't worsen, but may reduce your risk for heart disease—the biggest killer of women. Its number of victims is ten times that of breast cancer. Counter to what you may believe, breast cancer was reduced in the younger subjects taking estrogen in Women's Health Initiative, WHI. In addition, users of HRT have lower rates of invasive breast cancer. HRT also helps reduce your risks for the metabolic syndrome. Having metabolic syndrome would greatly increase your risks for heart attack, stroke, cancers, and dementia. Lastly, HRT would also help improve your bone density and body composition. For elderly women, a hip fracture has an overall worse prognosis than breast cancer. However, taking sex hormones does increase your risk of getting a stroke or deep venous blood clot, DVT, in your legs. These benefits and risks are discussed further in later chapters."

C. Maggie 3

"Hi there. First of all, where were you when I needed you ten years ago! Now at fifty-two, I can certainly empathize with what the other Maggies said. I began experiencing many of their concerns when younger ... and still have the same ones today, only they're more severe. I've either been to traditional doctors who didn't give me any good answers or to naturopaths who sold me many things that really didn't work. In the end, I was left feeling hopeless and somewhat scared. Yet, I've been working harder than ever when it comes to diet and exercise. I feel like giving up many times, but No Way!!"

"Can you expound on that, please?"

"Certainly. My gynecologist I've had for years says I went through menopause about three years ago. Taking hormones helped; however, I got off them about a year ago because of all of the health risks in the news. Since then, I've had unbearable night sweats ... heck, even day sweats. Over-the-counter items didn't help much, either. Recently, I've been reading a lot more about the hormones. Many recent reports state they may be beneficial in helping prevent osteoporosis and dementia—two of my biggest concerns. I'm still very confused about all of this and much prefer natural remedies.

I'm an emotional wreck at times—sad and crying over nothing or getting angry at the drop of a hat—a real proverbial bitch at times. That's not me! My doctor eventually offered me antidepressants. Once reading the side effects, I absolutely refused. My husband's a doll, though. Oh, how I feel for him at times. Sometimes, I don't know what he sees good in me and I'm scared he's going to run away with some perky, young bimbo! I'm ashamed to admit this, but my behavior spills over onto the kids and grandkids at times. Little Doodle Bug, that's what we call our new grandson, will just sigh and say, "G'Ma's just going through a phase."

Work helped me stay balanced; I couldn't wait to go in and get the staff energized. I was a real firecracker. Then, I gradually became bored, slacked off some and even got on many of the girls' cases, even alienating a few of them. Now, I'm retired and frankly bored. I've gained weight and lost the muscle definition in my arms I used to brag about. The gals in the gym used to call me Madonna Arms. But, not anymore. Now, my arms are more like Momma' Kass'! My health goals ... I would like the following:

Maggie 3

1. Improving body composition, to get those arms back and lose this. weight around my thighs and butt—ten pounds over one year. Also, my mother has osteoporosis and arthritis. Am I destined to become like her?

2. Increasing my energy level. I want to feel like me again.

3. Improving sleep. I have a hard time getting to sleep, and wake up a few times during the night. I find it hard to get back to sleep because of worrying about silly things.

4. Having great sex. In my forties I felt as if I was in my sexual prime. Now, I have less desire to have sex, I guess you could say libido, mainly because of how I feel about myself, somewhat less attractive. Vaginal dryness and less lubrication make sex uncomfortable at times. Climaxes are less intense.

5. Improving mood. Also, I'm very concerned about getting dementia; an aunt of mine has this horrible disease. I'm forgetting things more often and finding it harder to multi-task and focus.

6. Avoid taking medications! My primary care doctor shocked me at my last visit. After warning me that I have early diabetes, borderline high blood pressure and high cholesterol, she threatened to start me on a number of medications if I didn't improve by our next visit. I'm leery of all their side effects and afraid taking them may make me feel worse. As you know by now, I'm more into natural remedies. Yet, even some of them made me sick and didn't help much. Although reluctant to restart taking hormones, I've recently read where they may decrease the 1 Introducing Our Middle Aged Gals, Here are Maggies 1, 2 and 3. 11 risks for diabetes and heart problems. I did feel better while on them. Maybe they're worth a second look?

7. Feeling less achy. In the morning, I feel stiff in my back, shoulders, hips and feet. Because of this, I've had to stop running, which I loved, and occasionally do the elliptical machine or stationary bike."

(Continues...)

Excerpted from The MidLife Health Guide for Womenby Chris G. Rao Copyright © 2010 by Chris G. Rao. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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