Is it hot in here?

menopauseMost women beginning in their mid-to-late 40s can identify with this image.  These are the all-too-familiar hot flashes that accompany mid-life transitional changes for most women.  And while this is a very common phenomenon that is perfectly normal given the physiologic and hormonal changes taking place, any woman losing sleep and suffering with excessive hot flashes, changing menstrual cycles and an emotional roller coaster can tell you that normal doesn’t make it nominal.  But the additional symptoms that accompany perimenopause and the options for dealing with them can be confusing territory to understand and navigate.

Being able to collect appropriate hormone-based history, family history, current symptoms and concerns is important in taking the next step to determine what testing may be needed and ascertaining whether treatment is warranted.  Hormones can be assessed most commonly via either bloodwork or saliva collection.  Finding a doctor who is knowledgeable about hormones makes this whole process much easier.  Being a doctor who has helped many women find some relief from hormonal imbalance has been an extremely rewarding part of my practice.

When hormone replacement is reasonable and beneficial, bioidentical hormones are really the best option.  Bioidentical hormones are derived from natural plant-based hormones that are biochemically the MOST like our own endogenous hormones, rather than the synthetic hormones that are chemically altered and sometimes many times more potent than our OWN endogenous hormones.  These bioidentical hormones can be dose-adjusted to individual levels and symptom-control, rather than a 1-dose-fits-all.  This allows us to use the lowest possible dose that controls symptoms, thereby limiting other potential consequences from overly aggressive hormone replacement.  Does every woman need hormone replacement to get thru menopause?  Certainly not.  But if you find yourself struggling with questions navigating perimenopause, you are not alone and we would love to help.

Dr. Jackie Hone has made women’s health and bioidentical hormones a part of her practice for the last 8 years and has gained valuable insight and experience in this area of medicine.  She is accepting new patients through the DPC practice structure for hormonal consultation or evaluation.  Feel free to bring your hormonal questions or refer friends or family struggling thru this transition. 




Mildly insufficient sleep has consequences…

… and even an hour of missed sleep (consistently) could drastically increase your odds for depression, hopelessness, restlessness and nervousness.  So how much is an optimal amount of sleep?  We should all be getting between 7 and 9 hours of sleep per night, as this has been proven to be an optimal sleep range.  But in a new survey just released, even an hour less than optimal sleep led to significantly higher rates of depression and anxiety symptoms.  And consistently getting 5 or less hours a night raised the odds to nearly 4 times normal rates for these psychological symptoms.

In the past year, I find myself asking patients about sleep more often than ever before.  I find many (if not most!) patients express either poor quality of sleep or difficulty logging the required hours frequently.  And I would certainly say that symptoms of depression, hopelessness and nervousness are on the rise in general.  So to see a direct link between even a mild amount of missed sleep and increased adverse mood symptoms, definitely caught my attention.  I wonder if perhaps in our current culture, that we might even brag on our ability to get by with less sleep… right up until we seek medical attention for depression and anxiety.

So this intriguing survey found that incorporating even 1 additional hour of sleep had tremendous benefits to lower odds for depression, hopelessness, restlessness or nervousness.  Even sleeping an hour more than the 7-9 hours optimal amount, continued to lower risk.  One extra hour for those with even mildly insufficient sleep, significantly lowered the odds of these symptoms, (a result that would like compound with even greater than 1 hour added sleep).  So perhaps before we reach for anxiety medications, stimulants and others to treat these symptoms, it may be a good time to assess our sleep and aim for 1 extra hour a day.  It could make a world of difference!

Could an aspirin a day keep cancer at bay?… yes, maybe!

Do you have questions about whether aspirin is right for you?  This is a great topic to discuss with your doctor during your physical… especially if you happen to be between the ages of 50 and 70!  In your 50s and 60s, there exists the greatest potential benefit for aspirin use.  A new study out this month shows a modest decrease in cancer mortality for both men and women with regular aspirin use over the age of 50.  Doctors have recommended aspirin to reduce cardiovascular disease for decades. But the evidence is building to make the case for cancer prevention as well.  Cancer mortality was found to be 7% lower for women and 15% lower for men who had taken regular aspirin for greater than 6 years between the ages of 50-69.  This includes a dose range from as low as 2 baby aspirin a week up to a daily dose of 325mg aspirin.  The greatest risk reduction has been seen in colorectal cancer, but regular aspirin use can also lower risk for breast, prostate and lung cancer as well.

It is interesting to note that this potential risk REDUCTION in cancer mortality is comparable to the effect size of the INCREASE in cancer mortality caused by obesity.  But while aspirin may lower cancer risk, a healthy lifestyle and healthy body weight are indisputably the best medicine!  I strive to spend time at the annual physical with each patient reviewing their individual risk factors for cancer and preventable diseases, and then reviewing preventative screening and strategies appropriate for that individual.

Of course, it is important to keep in mind that there are reasons why aspirin might NOT be a good idea.  For patients at risk for gastrointestinal bleed, or already taking blood thinners, aspirin may pose a greater risk or may be completely contraindicated.  This is why it is so important to discuss pros and cons of regular aspirin use with your doctor. Gastrointestinal hemorrhage and hemorrhagic stroke are risks that must be considered. But while not everyone should be on aspirin, it is important to consider whether aspirin could be right for YOU.

And FYI, if you haven’t yet scheduled your annual physical, don’t forget to take advantage of this important part of keeping you healthy!  And for those over 50… add aspirin to the list of things to discuss.