Did you know your hormones affect your urinary tract and vaginal health?* Before menopause, your hormones rise and fall with your menstrual cycle, causing you to be more likely to develop an imbalance in your vaginal microbiome in the two weeks following the beginning of your period.1 Additionally, the hormonal shifts that come with perimenopause and menopause also affect urinary tract comfort.2 As well, disruption to your hormone levels may also cause a range of symptoms like PMS;3 heavy or light periods;3 tender or swollen breasts;4 weight gain around the butt, hips, waist, and back of arms;5-7 low mood; anxiousness; fatigue;7 and reduced libido.7 Here are some foods to eat and others to avoid to help keep your hormones in harmony: Another way to ensure you’re getting the nutrients you need to support your health is to add supplements like Wellness Essentials® Women or Wellness Essentials Women’s Prime to your daily regimen.
For additional urinary tract and vaginal health, consider taking a probiotic specific to urinary tract and vaginal health.* References
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By Monazza Ahmad, B.Pharm, MSc To ensure best health outcomes in a healthcare setting, it is important to establish open, effective, and respectful communication between a patient and a healthcare practitioner. As a patient, it is not only your right but in your best interest to ask your doctor for clarification or further explanation on your health condition and treatment plan. As a healthcare provider, it is your responsibility to provide a safe and comfortable environment for your patients to openly discuss their health concerns and make sure your diagnosis and treatment plan is well understood. That said, menopause can trigger many complex and confusing symptoms that can be uncomfortable to talk about, which can make managing the symptoms difficult. When should I talk to my doctor about menopause?1 First of all, don’t feel awkward. Menopause is a natural phase of life, and your doctor is likely familiar with all possible symptoms. Describe your condition and symptoms in detail and explain how they are affecting your lifestyle and relationships. The provider needs to rule out any other underlying conditions before determining it is menopause. Reach out to your doctor if:
Don’t forget to tell your doctor if you have any allergies or other health conditions. Also mention any medications or supplements you’re already taking for menopause symptoms or other conditions. What shall I ask my doctor? Medical appointments can be stressful, and we often feel rushed. When you have a delicate issue to bring up, being prepared can help. Here are some of the questions you can ask your practitioner:
How can healthcare providers ensure the right care during menopause? Often, the reluctance from healthcare professionals to address these female issues can also cause lack of awareness. It is the healthcare provider’s obligation to make sure patients feel comfortable in discussing their menopausal concerns and understand the treatment plan.2 According to a survey by NIH, patients are likely to discuss menopause transition with providers who don’t make them feel rushed, are good listeners, and have expertise in this area of women’s health. Here are some ways to help your patients receive the best care:
What to ask your patients:3
The menopausal rating scale and symptoms evaluation form can be used to track symptom improvement to see what treatment options are working:4,5 Menopause symptoms evaluation form and rating scale (click to enlarge)Menopause is a natural phase in a woman’s life, and its challenges need to be accepted and understood at work, at home, and on a social as well as a societal level. Unless these concerns are progressively communicated in a healthcare setting, it will be tough for us to understand the impact of this condition on a woman’s life.
References:
Glyphosate, first registered for use in the United States in 1974, is an herbicide widely used to kill broadleaf weeds and grasses and regulate the growth of certain plants.1,2 It is employed in agriculture, forestry, in lawn and garden maintenance, and for weed control in industrial areas.1
The use of glyphosate has skyrocketed since 1997, after crops genetically modified to tolerate glyphosate were first introduced.3 The broad usage has led to questions of whether glyphosate remains present in the food we eat and water we drink, as well as whether it is safe for humans to consume. Because glyphosate binds so tightly to soil particles after use, it is believed to be prevented from entering groundwater.4 However, this may not be the case. During a 2002 study of waterways in nine Midwestern states, glyphosate was detected in 36% of the 154 samples taken, although the highest measured concentration was still well below the maximum contaminant level (set by the Environmental Protection Agency) of 700 micrograms per liter.3 And in one study of an agricultural community in Mexico, glyphosate was detected in both groundwater and bottled water.5 Due to its lack of quick degradation in plants, glyphosate residue could be present in the food supply.4 In tests performed by researchers and consumer watch groups, glyphosate has been detected in a number of foods, including bread, honey, oat-based cereals, granolas, and snack bars.6,7 Common means of glyphosate exposure Pure glyphosate is said to be low in toxicity, but it is often mixed with other ingredients that can make the resulting product more toxic.1 Directions for applying glyphosate usually caution users to wear gloves and eye protection to avoid skin and eye irritation and to be careful not to breathe the compound to protect against nose and throat irritation.1 Although it isn’t easy for glyphosate to pass through the skin into the body, it is possible to ingest glyphosate by breathing it in while spraying or by eating or smoking after applying, without first washing your hands.1 When absorbed or ingested, most glyphosate tends to remain unchanged and leaves the body pretty quickly in urine or excrement.1 Despite that, swallowing glyphosate-containing products can result in nausea, vomiting, diarrhea, and burns in the mouth and throat.1 Intentional ingestion has resulted in fatalities in some cases.1 Because glyphosate products often contain additional chemicals, it can be hard to determine whether glyphosate alone is responsible for the adverse symptoms observed when humans come into contact with it.8 For instance, some studies suggest that the surfactant polyoxyethyleneamine used with glyphosate is more toxic than glyphosate alone.8 Agency opinions and glyphosate research Consensus on risks associated with glyphosate exposure has been tough to pin down. In April 2019, the US Environmental Protection Agency stated it “continues to find [glyphosate] poses no risk to public health when used as labeled and that it is not a carcinogen.”2 This follows a similar declaration by the European Food Safety Authority in 2015 that glyphosate is unlikely to be a carcinogen in humans.9 By contrast, the World Health Organization’s International Agency for Research on Cancer (IARC) stated in March 2015 that it had analyzed the results of over 1,000 studies and determined that glyphosate was possibly carcinogenic to humans.10 In an updated monograph released one year later, the IARC attributed the difference between its statement and the findings of other agencies to the source material, noting that most regulatory agencies reviewed nonpublic industry data from toxicological studies.10 Still, research into glyphosate’s possible carcinogenic effects continues. A recent analysis of human epidemiological studies confirmed a link between glyphosate exposure and an increased risk for non-Hodgkin’s lymphoma.11 And in another lab study, glyphosate was shown to stimulate the growth of a certain type of hormone-dependent breast cancer in cells by acting on estrogen receptors, indicating it may be an endocrine disruptor.12 Researchers are also investigating glyphosate’s impact on the human reproductive system. In one study, exposure to glyphosate-based herbicides below the toxicity threshold decreased the activity of aromatase, a key enzyme in balancing sex hormones.13 Another study in prepubertal male rats showed a decrease in testosterone levels in those given soy milk supplemented with glyphosate.14 And results of a study in pregnant mice indicate that glyphosate can cause the ovaries to fail and interfere with secretion of hormones.15 There have been cases of accidental exposure to concentrated glyphosate solutions causing neurological lesions, suggesting glyphosate could be neurotoxic in high doses.16 In a model of the blood-brain barrier, researchers observed that a high dose of glyphosate resulted in neurological damage and altered metabolism of glucose.16 Glyphosate and antibiotic resistance Recent research has uncovered a worrisome link between glyphosate use and the growing problem of antibiotic resistance.17,18 It is believed the use of glyphosate is leading to changes in microbiome composition and, as a result, increases in resistance to critical antibiotics.17 Researchers note that when bacteria are exposed to non-antibiotic chemicals such as herbicides, they can be inclined to develop resistance to antibiotics more rapidly: in some cases, 100,000 times faster.18 Looking to avoid glyphosate? The Detox Project offers Glyphosate Residue Free and Gold Standard Detox certification to bring a new era of transparency to the food and supplement industries. References:
Onions are an overlooked vegetable. Whether they’re being sautéed for a soup, sliced for a burger, or pickled for a salad, onions rarely steal the show of a meal, although they often inspire a sob story.
Onions are most known for their pungent flavor, not necessarily their nutritional value. Their white flesh (even in red onions) isn’t always perceived as being as nutritious as vibrantly colored vegetables like kale, broccoli, or beets. But that’s no reason to snub onions. Although some onion varieties are lacking in color, onions in general are one of the highest natural sources of a powerful flavonoid: quercetin.1 What is quercetin? Quercetin is a flavonoid, which is a chemical compound found in plants. In addition to onions, quercetin is also found in many other fruits and vegetables like capers, asparagus, and apples, as well as tea and red wine.1 A single serving of onions is considered to be one medium onion, which contains around 52 milligrams (mg) of quercetin.2 But most people tend to not eat a whole onion in one sitting (unless they really like onions), so you’re probably not getting quite that much quercetin when you eat onions. Even with all these natural sources of quercetin, it’s estimated that most people following a typical Western diet (think higher in simple sugars and animal products and lower in produce) only get 0 to 30 mg a day.1 That’s not a lot, considering research shows that some of quercetin’s health benefits are reached at supplemental intake levels, not from a food source, of 500 to 1,000 mg per day.3 Quercetin and health Quercetin is one of the most studied dietary flavonoids and is associated with multiple health benefits. Two of this compound’s most notable benefits are supporting heart health and protecting against oxidative stress. Heart health: Quercetin plays a positive role in supporting healthy blood pressure and endothelial health.4 The endothelium is the thin layer of cells lining the body’s blood vessels and heart. It is considered an active organ in the body as it helps control when blood vessels relax or constrict.5 Protection against oxidative stress: Everyone undergoes oxidative stress, which is caused when there is an imbalance of harmful free radicals, which damage cells and tissues. This process happens inside the body, so although you may not feel immediate effects from oxidative stress, it can affect both health and the immune system over time. Antioxidants can help quell some of that stress. And since quercetin acts as a free radical scavenger and supports antioxidant processes, it’s especially good at this.3 Getting the most quercetin out of onions Because these health benefits are mainly seen at higher levels of quercetin intake, it’s important to maximize what you can from the diet. Here’s how you can get the most quercetin when eating onions.
Onions are a rich, natural source of the flavonoid quercetin. High intakes of quercetin are associated with cardiovascular benefits and oxidative stress protection. However, quercetin is not a “magic bullet” to health. Instead, focus on eating a plant-forward diet with lots of produce and know that onions, albeit smelly, are a healthful choice. References:
Feeling bloated during pregnancy? While inconvenient and uncomfortable, most forms of swelling—also known as edema—are perfectly normal for expecting mothers.1
Why does swelling occur during pregnancy? Among the many changes the body goes through during pregnancy is its production and retention of water, blood, plasma, and other fluids to support the needs of the developing fetus.2,3 The swelling supports the mother’s development, as well. Not only does the extra fluid help her body expand to accommodate the baby, it also helps with her body’s necessary changes to prepare for the actual delivery process.1 Most mothers-to-be have swelling in their extremities, as well as in the face.1 Swelling tends to peak during the third trimester, often becoming more noticeable at the end of the day, when extra fluids, blood volume, and the growing baby can affect blood flow in the ankles and feet.4 What other factors affect swelling during pregnancy? A number of factors in addition to the changes taking place in your body can affect swelling.1 These factors include: 1
While mild swelling is acceptable during pregnancy, a very sudden bout of edema could actually be more concerning.1 Contact your doctor immediately if the swelling is uneven and painful, if it comes on suddenly, or if it is accompanied by shortness of breath or chest pain.5 How can you address swelling during pregnancy? There are a number of strategies you can leverage to reduce swelling during pregnancy.1, 5-7 You might make a point of:
Dietary tips to reduce swellingThere are also a number of dietary tips that can help to reduce swelling during pregnancy. These include:
Additional therapies to tryIn addition, pregnant women might try to lessen swelling and related symptoms by engaging in therapies like:
You can either ask your partner to gently massage your feet and legs with the essential oil or soak your feet in a bowl of warm water mixed with essential oil.6
While research offers mixed results on the link between reflexology and swelling, some experts believe the practice can minimize the discomfort associated with swelling.8 Interested in scheduling a reflexology session? Be sure to select a registered specialist who has extensive experience treating pregnant women. Ultimately, there are a number of best practices for reducing swelling during pregnancy.1,5-8 If you still experience swelling after delivering your baby, simply be patient and allow your body time to heal.5 You may still be going through hormonal changes that exacerbate the swelling.5 And of course, feel free to reach out to your healthcare provider at any time if you have questions. References: 1. American Pregnancy Association Staff. Swelling During Pregnancy. https://americanpregnancy.org/pregnancy-health/swelling-during-pregnancy/. American Pregnancy Association. Accessed August 13, 2019. 2. Widen et al. Body composition changes in pregnancy: measurement, predictors and outcomes. Eur J Clin Nutr. 2014;68(6):643-652. 3. Vricella LK. Emerging understanding and measurement of plasma volume expansion in pregnancy. 2017;106(Suppl 6):1620S-1625S. 4. Tanveer F et al. Frequency of lower extremity edema during 3rd trimester of pregnancy. SAJMS. 2015;1:41-43. 5. UnityPoint Health Staff. Things That Make You Swell When You’re Pregnant.https://www.unitypoint.org/livewell/article.aspx?id=e668bf44-c376-459e-b263-41f48810373a. LiveWell with UnityPoint Health. Accessed August 13, 2019. 6. Baby Centre Medical Advisory Board Staff. Swelling (natural remedies).https://www.babycentre.co.uk/a549316/swelling-natural-remedies. BabyCentre UK. Accessed August 13, 2019. 7. Tobah YB. What causes ankle swelling during pregnancy—and what can I do about it?https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/swelling-during-pregnancy/faq-20058467/. Mayo Clinic. Accessed August 13, 2019. 8. Embong NH et al. Revisiting reflexology: Concept, evidence, current practice, and practitioner training. J Tradit Complement Med. 2015;5(4):197–206. By Cassie I. Story, RDN
Have you begun to feel the cool crisp air on your skin? Perhaps you have noticed the leaves turning from emerald green to pale orange. On the other hand, maybe you live in a mild-tempered climate that stays the same year round, with the ocean waves leaving little hint for seasonal changes—but traces of fall and pumpkin spice everything have made their way to stores near you. While planting a garden may seem so last season, it is not too late to enjoy homegrown (literally) produce that will be ready just in time for a fall harvest. Not only can starting a garden bring you a literal bounty of food, research has shown that it offers a host of health benefits as well. Studies have shown that gardening may improve an individual’s life satisfaction, vitality, and psychological wellbeing; supports cognitive function; and can increase a sense of community and togetherness.1-2 A 2017 meta-analysis suggests that gardening activities have various significant positive effects on health including reductions in stress, mood disturbance, and body mass index.3 The analysis also notes several enhancements in quality of life measures like a sense of community, increased physical activity levels, and improved cognitive function.3 Several possible mechanisms were suggested through which gardening may promote health, although it may be difficult to unravel the causal relationships between gardening and health.3 The pathways that the authors suggest for the health impact of gardening may be the benefits of direct experience with nature, the uptick in physical energy expenditure, the opportunity to engage with members in the community via community gardens or produce sharing, and lastly by increasing fruit, vegetable, and herb intake.3 Gardening has been shown to improve quality of life and health across the lifecycle. Intervention studies on children and college-aged students have shown an increase in daily fruit and vegetable consumption when participants recently participated in gardening activities.4 Observational studies on aging populations have found that maintaining a home garden is associated with restorative and physical benefits, increased positive feelings, and a sense of pride, creativity, and achievement.5 If you are ready to dig in, there is no need for space or climate to be an issue. If you are new to getting your hands dirty, a container garden can be an easy and less intimidating way to start! Here is your step-by-step guide to getting your container garden growing. 1. Choose your container(s). Start with a large container or pot that is at least 15 inches deep and wide. If you are a beginner gardener, bigger is better because you can hold more soil and lock moisture in longer. Large flowerpots, barrels, baskets, planters, or any other large container will work—get creative and choose something that speaks to you. The container or pot must drain well. Ensure there is at least one hole in the bottom for water to flow out. If your container does not have drainage holes, use a drill to create 4-6 holes throughout the bottom for even clearance. Choose one vegetable or herb for each container, especially if this is your first time gardening. It is important not to overcrowd the pots. 2. Place container in an appropriate area. Choose an area that receives about six hours of sunlight a day. You may need to move the container throughout the fall depending on the weather (frost, wind, etc.). If you live in cooler areas of the country, you may need to cover your produce with a light cloth overnight to prevent frostbite. If you have room, try placing it on a small cart or wooden box so that you can easily move it to a more desirable area as the weather and sun pattern change. 3. Plant! Purchase high-quality, organic potting mix designed to retain moisture well, along with quality plant starts or seed packets from your local garden store. Fill the base of the container with an inch or two of small rocks or pebbles to help drainage and to prevent mold or mildew. Add soil to the container, leaving about two inches of space from the top. Thoroughly water the soil and let drain for a few hours before planting the seeds or starter plant. For seeds, plant according to package directions. For starter plants, dig a hole deep enough for the soil to reach the same level they were growing in the container in which they came. 4. Water your new plants. Maintain moisture levels. The soil should feel moist about one to two inches below the surface. Depending on the climate you live in, you will likely need to water your plants multiple times per week. In the intense Arizona sun, where temperatures can continue well over 100 degrees Fahrenheit through November, I oftentimes find myself watering twice a day to maintain optimal moisture. Watering in the morning is preferred to the evening, because it helps the plants stay hydrated during the heat of the day. Late summer, early fall vegetables What to plant from a plant start (with fruit already on the vine):
Ten seed vegetables to plant in late summer for a fall harvestPlant the seeds half an inch to a full inch deep and about one inch apart in each row: Beets, broccoli, cabbage, carrots, cauliflower, peas, radishes, sage, snap peas, squash Whether you are a novice or seasoned gardener, planting a container garden can be an easy and rewarding experience. I hope this article inspires you to get your hands dirty and play with your food! References: 1. Gonzalez MT et al. J. Adv. Nurs. 2010;66:2002-2013. 2. Wood CJ. J. Public Health. 2016;38:e336-e344. 3. Soga M et al. Preventive Medicine Reports. 2017;5:92-99. 4. Loso J. J Acad Nutr Diet. 2018;118(2):275-283. 5. Scott TL et al. SAGE Open Med. 2020;8:2050312120901732. By Michael Stanclift, ND
Coenzyme Q10 (CoQ10) may sound like a code name for an eccentric secret agent, but this versatile compound’s aliases indicate how common it is in the natural world. CoQ10 also goes by the names ubiquinol or ubiquinone.1 It’s a fat-soluble antioxidant that affects all cells in our bodies and is especially important for the powerhouses of our cells, our mitochondria.1 Most of the benefits from CoQ10 come from its ability to protect cells and their components from oxidative stress and its ability to produce energy in our mitochondria.1 So who might benefit from CoQ10? Anyone looking to enhance the health of these bodily systems: Musculoskeletal health: Our muscles have a ton of mitochondria in them, and in turn they really like CoQ10.2 If our muscles don’t have enough CoQ10, they can become tender, and we might experience more fatigue.1 In some cases, taking CoQ10 supplementally can help with discomfort, tenderness, and fatigue.1 Cardiovascular health: On a related note, our hearts are also loaded with mitochondria and are essentially muscles that never rest.3 CoQ10 can help improve contractility of our heart, prevent the oxidation of LDL (bad) cholesterol, maintain healthy blood pressure, and support the delicate endothelial layer that lines our blood vessels.1 Some medicines, like HMG-CoA reductase inhibitors, commonly known as “statins,” inadvertently blunt our ability to make our own CoQ10, so can reduce what we have available.1 In situations such as this, supplementing CoQ10 may help.1 Glucose control: Research shows CoQ10 supplementation can support long-term healthy blood sugar levels.1 Neurological protection: Our highly active brains don’t make up a big percentage of our weight, but they certainly consume a lot of our energy in calories.4 All that energy consumption has the potential to result in oxidative stress, requiring a steady supply of antioxidants.1 Also, remember that our brains have a lot of fat in them, and as CoQ10 is the only internally produced fat-soluble antioxidant, it is precious in our cranium-encased think organs.1 Research shows that CoQ10 levels in our brains are important, and having an adequate amount can be protective.1 Sperm health: Sperm have the important job of delivering half a set of genes to an egg, and the “delivery” part of that job relies on, you guessed it, mitochondria.5 You’ve probably seen a microscope view of sperm, those tadpole-shaped cells with a head (housing DNA) and a tail. Between the head and tail are a collection of tightly wound mitochondria, which power and propel the whip-like tail and cause the sperm to swim.5 Therefore, CoQ10 plays an important role in the health of sperm. Because CoQ10 is pivotal in our abilities to produce energy in our cells and protect them from potential damage from this energy production, it’s needed in all cells. CoQ10’s importance becomes most apparent in our most metabolically active tissues such as our muscles, hearts, and brains. If you’re looking to enhance the health of these organs, then ask your healthcare provider if supplementing CoQ10 is a good idea for you. References:
By Michael Stanclift, ND You’re feeling that rush as you catch your stride on your morning run. The air is perfect. Suddenly a cramp or muscle ache stops you dead in your tracks. You try to shake it off, but it just grabs more. Ah! We still don’t completely understand why muscles tighten up involuntarily. Exercise, pregnancy, electrolyte imbalances, nerve compression, and diminished blood supply to the muscle all may contribute.1,2 So what can we do to combat these harmless but pesky discomforts? In this article we’ll look at what the research says. Surprisingly, some popular natural remedies don’t shine through in the current medical evidence. What might not help with cramping Magnesium and Epsom salts: A Cochrane Review found that oral magnesium wasn’t likely to help with muscle cramps in older people, and the findings were inconsistent in pregnant women.3 A recent randomized, placebo-controlled trial in pregnant women found no difference in leg cramps with magnesium compared to placebo.4 Epsom salt (magnesium sulfate) baths have long been a go-to for muscle relaxation, and “float” centers with sensory deprivation tanks full of the magnesium-rich water have popped up as an urban refuge from the constant stimulation of modern life. A study in nonathletic healthy men found a one-hour float (in magnesium sulfate) after exercise reduced pain perception compared to one hour of passive recovery.5 However, these findings are tough to attribute to magnesium, as the study’s control didn’t match other potentially therapeutic factors, such as body positioning and sensory deprivation.5 So a relaxing bath may help with cramping and muscles, but it’s unclear if adding Epsom salt makes a significant difference. Active cool-down and static stretching: Many believe after exercising intensely a period of low-to-moderate intensity will prevent muscle soreness and injuries, but this doesn’t appear to be true.6 A 2018 review found evidence on active cool-downs shows it doesn’t significantly reduce soreness, stiffness, or range of motion and may inhibit muscular glycogen resynthesis (energy storage).6 This same review found that static stretching before or after exercise didn’t reduce muscle soreness.6 What might help with muscle cramping: Foam rolling: This surprisingly simple tool can be valuable if you suffer from muscle soreness and cramps. Using a foam roller after exercise can reduce muscle soreness and improve athletic performance the following day.6 Physical therapists from Harvard agree that 30-120 seconds per area can be helpful in relieving sore muscles and preventing cramps.7 Muscle soreness: Tart cherry or pomegranate juice: A small randomized, double-blind, placebo-controlled trial found 355 ml (~12 oz.) of tart cherry juice drunk twice a day for a week before a 26 km (16-mile) run reduced the amount of pain reported from participants.8 A research review found similar effects from drinking tart cherry juice twice a day, and one study found pomegranate juice reduced soreness.9 But the research on these two drinks in relation to muscle soreness has shown mixed results.9 A recent study compared tart cherry, pomegranate, and placebo drinks to analyze the impact on muscle soreness in nonresistance trained men.10 In this study, the researchers were surprised to find that neither of the fruit drinks appeared to help with muscle soreness when compared to placebo.10 Ginger: In a small double-blind, randomized, placebo-controlled trial in experienced runners, 5 days of powdered ginger supplementation (1.4 g/day) moderately reduced muscle soreness from a run (on day 3) during the supplement period.11 A review of randomized clinical trials found that consuming up to 4 g of ginger postintense exercise can reduce muscle soreness and improve muscle recovery.12 Lower single dosages of 2 g ginger did not help with muscle soreness when compared to placebo.12 This suggests it may take multiple days or higher doses to get the effect. Curcumin: It’s no surprise that curcumin, a bright orange compound from the spice turmeric is making news again. A research review found curcumin in a wide range of doses (150 mg-5,000 mg) can reduce muscle soreness after exercise.13 Curcumin can work when used on an “as needed” basis, with even a single dose (150-200 mg) showing effectiveness for muscle soreness following exercise.13 Interestingly, in this review they found small doses (90 mg twice a day) of curcumin taken for 7 days before exercise had no effect on postexercise soreness, while the same dosage taken after exercise for 4 days was effective.13 Other studies in the review at similar doses did not find curcumin improved muscle soreness compared to placebo, so differences in the trial participants and types of exercise may influence the effects.13 Conclusion:Cramping and muscle soreness can ruin a good exercise session, but they don’t have to. When it comes to combatting these annoying aches, you have numerous options—but beware that some popular natural treatments might be more hype than help.
References: 1. Young G. Leg cramps. BMJ Clin Evid. 2015;2015:1113. 2. Mayo Clinic Staff. Muscle cramps. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/muscle-cramp/symptoms-causes/syc-20350820#:~:text=Overuse%20of%20a%20muscle%2C%20dehydration,Inadequate%20blood%20supply. Accessed February 11, 2021. 3. Garrison SR et al. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev. 2012;2012(9):CD009402. 4. Araújo CAL et al. Oral magnesium supplementation for leg cramps in pregnancy-An observational controlled trial. PLoS One. 2020;15(1):e0227497. 5. Morgan PM et al. The acute effects of flotation restricted environmental stimulation technique on recovery from maximal eccentric exercise. J Strength Cond Res. 2013;27(12):3467-3474. 6. Van Hooren B et al. Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries and the long-term adaptive response. Sports Med. 2018;48(7):1575-1595. 7. Harvard Health Staff. Roll away muscle pain. Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/roll-away-muscle-pain#:~:text=Foam%20rollers%20are%20easy%2Dto,from%20exercise%2C%20and%20reduce%20injury.&text=As%20you%20age%2C%20occasional%20muscle,lightweight%20cylinder%20of%20compressed%20foam. Accessed February 11, 2021. 8. Kuehl KS et al. Efficacy of tart cherry juice in reducing muscle pain during running: a randomized controlled trial. J Int Soc Sports Nutr. 2010;7:17. 9. Bowtell J et al. Fruit-derived polyphenol supplementation for athlete recovery and performance. Sports Med. 2019;49(Suppl 1):3-23. 10. Lamb KL et al. No effect of tart cherry juice or pomegranate juice on recovery from exercise-induced muscle damage in non-resistance trained men. Nutrients. 2019;11(7):1593. 11. Wilson PB. A randomized double-blind trial of ginger root for reducing muscle soreness and improving physical performance recovery among experienced recreational distance runners. J Diet Suppl. 2020;17(2):121-132. 12. Rondanelli M et al. Clinical trials on pain lowering effect of ginger: A narrative review. Phytother Res. 2020;34(11):2843-2856. 13. Yoon WY et al. Curcumin supplementation and delayed onset muscle soreness (DOMS): effects, mechanisms, and practical considerations. Phys Act Nutr. 2020;24(3):39-43. Difference between vasomotor and other symptoms of menopause
By Monazza Ahmad, B.Pharm, MSc Menopause is undeniably the most confusing phase of a woman’s life. The irregular menstrual cycle and unpredictable biological changes and emotional state can negatively affect her social, work, and daily life. Seeking help for these symptoms could feel awkward since many times women don’t know how to communicate these concerns and whether it would be empathetically understood or not. At times, the complex medical terms associated with menopause can make it tough to follow the course of treatment plan. Let’s discuss the major signs and symptoms of menopause and the terminologies associated with it that may help you understand your situation as well as convey your concerns to your provider. What are vasomotor symptoms (VMS)? The word “vaso” is originated from the Latin1 meaning vessel, and “motor” relates to movement. So vasomotor symptoms are the movement of blood vessels characterized by their constriction and dilation that causes temporary irregular blood pressure that in turn alters the body temperature, making us feel hot or sweat.2 This temperature alteration results in hot flashes and night sweats that are the most common indication of perimenopause and menopause.3,4 Other chronic and progressive symptoms are characterized by vaginal dryness, painful intercourse, and reduced lubrication. It is seen in both premenopausal and postmenopausal phases.5 Why do I feel like I’m the only one suffering from these symptoms? During menopausal transition, the vasomotor symptoms impact about 80% of the women in the US and differ widely from region to region.6,7 Even though a variety of symptoms is common during menopause, some are not much reported due to their mild and nonspecific nature. Up to 84% of postmenopausal women tend to just deal with the menopausal discomfort rather than seeking medical attention.5,8 How long do these symptoms last? Don’t worry if you have been experiencing vasomotor symptoms for more than a few years. For many women, it can last over a decade or two, with 4-20 hot flashes daily being common during menopause.9 A new long-term study of women from various races and ethnicities suggests that hot flashes and night sweats can take up to 11 years to resolve for some women. Interestingly, the study further discovered that hot flashes lasted longer, for 9-10 years, if started before the menstrual period ended, while their duration was much shorter, with 3.5 years if women had their first hot flash after the periods ended.10 Some menopausal symptoms can get worse with age as opposed to the other menopausal symptoms that improve with time. How do these symptoms impact women’s quality of life? Hot flashes, night sweats, vaginal dryness, low libido, sleeplessness, and menopausal anxiety all add to the decline in quality of life. The sudden outburst of sweat with hot flashes can be daunting when it occurs in a gathering, making women nervous. Vaginal dryness and decreased interest in sexual activities go hand in hand, impacting intimate relationships. All of these stressful changes in daily routine are enough to make any woman anxious.5 Some of the other concerns include brain fog, urinary incontinence, weight gain, hair loss, bone loss, and heart health, to name a few.11 Therefore, women are highly encouraged to not ignore menopausal discomfort and instead have informed discussions with their healthcare providers to find safe solutions for their health needs.12 What are my relief options? There are several options to reduce the impact of these menopausal symptoms and claim your lifestyle back. The solutions include prescription medications, well-studied supplements, lifestyle changes, and nutrition. Since the trial and error of wrong choices can become painful and lengthy during menopause, it is important to discuss the best option with your provider at the right time. Hormone replacement therapy (HRT): This is the most common prescription option for hot flashes, but it is not usually the first choice. The common forms are tablets, gels, skin patches, injections, and vaginal inserts. HRT is generally best-suited for healthy women and those that are in the early phase of menopause. It is not recommended to start HRT after the age of 60. However, there are some side effects associated with HRT, and it is generally considered unsafe for people with a history of heart conditions, deep vein thrombosis, cancer, and smoking.12 Rheum rhaponticum (ERr 731®): This nonhormonal solution is the top recommended natural ingredient by OBGYNs. It has shown to improve 12 of the main menopausal symptoms by 83%. In addition to hot flashes and night sweats, it also improves sleep disturbances, mood swings, sexual discomfort, anxiety, vaginal dryness, and muscle and joint health, to name a few.13 Lifestyle: Daily physical activity is important for menopausal symptom relief. Weight management, stress relief, increased metabolism, and improved overall quality of life as a result of active movement are all related to better management of menopause.14 Eating habits, consuming a healthy diet, practicing relaxation or meditation, drinking enough water, getting quality sleep, and avoiding smoking and alcohol all help with relieving the menopausal discomfort.15 Nutrition: Taking necessary supplements or eating food rich in vitamin D, E, B6, folic acid, and omegas help reduce intensity of menopausal symptoms.16 Now that you have learned more about menopausal symptoms and their treatment options, you may want to discuss these concerns with your healthcare provider. In our next post, we will go over a few tips on how a patient and their healthcare provider can effectively communicate these menopausal challenges with each other to come up with the best treatment plan. References:
By Monazza Ahmad, B.Pharm, MSc To ensure best health outcomes in a healthcare setting, it is important to establish open, effective, and respectful communication between a patient and a healthcare practitioner. As a patient, it is not only your right but in your best interest to ask your doctor for clarification or further explanation on your health condition and treatment plan. As a healthcare provider, it is your responsibility to provide a safe and comfortable environment for your patients to openly discuss their health concerns and make sure your diagnosis and treatment plan is well understood. That said, menopause can trigger many complex and confusing symptoms that can be uncomfortable to talk about, which can make managing the symptoms difficult. Here are some tips for both patients and practitioners to start the conversation around menopause and its symptoms that we discussed in our previous post, Menopausal Symptoms. When should I talk to my doctor about menopause?1 First of all, don’t feel awkward. Menopause is a natural phase of life, and your doctor is likely familiar with all possible symptoms. Describe your condition and symptoms in detail and explain how they are affecting your lifestyle and relationships. The provider needs to rule out any other underlying conditions before determining it is menopause. Reach out to your doctor if:
Don’t forget to tell your doctor if you have any allergies or other health conditions. Also mention any medications or supplements you’re already taking for menopause symptoms or other conditions. What shall I ask my doctor? Medical appointments can be stressful, and we often feel rushed. When you have a delicate issue to bring up, being prepared can help. Here are some of the questions you can ask your practitioner:
How can healthcare providers ensure the right care during menopause? Often, the reluctance from healthcare professionals to address these female issues can also cause lack of awareness. It is the healthcare provider’s obligation to make sure patients feel comfortable in discussing their menopausal concerns and understand the treatment plan.2 According to a survey by NIH, patients are likely to discuss menopause transition with providers who don’t make them feel rushed, are good listeners, and have expertise in this area of women’s health. Here are some ways to help your patients receive the best care:
What to ask your patients:3
Menopause symptoms evaluation form and rating scale (click to enlarge)Menopause is a natural phase in a woman’s life, and its challenges need to be accepted and understood at work, at home, and on a social as well as a societal level. Unless these concerns are progressively communicated in a healthcare setting, it will be tough for us to understand the impact of this condition on a woman’s life.
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Certain persons, considered experts, may disagree with one or more of the foregoing statements, but the same are deemed, nevertheless, to be based on sound and reliable authority. No such statements shall be construed as a claim or representation as to Metagenics products, that they are offered for the diagnosis, cure, mitigation, treatment or prevention of any disease. PAIA Manual |