Anxiety can have many different faces. It can manifest physiologically (e.g., sweating, muscle tension, nausea), cognitively (e.g., worry, poor concentration, always feeling on “high alert”), and even behaviourally (e.g., escape and avoidance from fearful situations). (3) When anxiety begins to interfere with day-to-day functioning, it warrants treatment, and is therefore considered a psychological disorder.4 Some disorders reported during menopause include Panic Disorder, Social Anxiety Disorder, Obsessive Compulsive Disorder, and Generalized Anxiety Disorder.(5,6,7,8)

Exact causes of menopausal anxiety are uncertain; however, it is widely recognized that hormones play a significant role in emotional change during the menopausal stages.(9) Although this is better studied in the context of depression, there is evidence to suggest that older women may have an exaggerated response to stress in comparison to younger women, and that estrogen therapy may help decrease this response.(9) Environmental stressors may be another factor behind menopausal anxiety. For many, midlife may be accompanied by shifts in social roles, interpersonal losses, and death of loved ones. (10,11) Also important to note is the challenge of coping with the menopausal symptoms themselves. When menopausal anxiety is reported by women, menopausal symptoms are often named as one of the sources.(12,13) In particular, it is not uncommon for anxiety to arise during a hot flash, or even during the anticipation of one.(3)

When anxiety begins to interfere with your well-being, it is important to learn how to manage it. Cognitive Behavioural Therapy (CBT) is one strategy that has been shown to be effective in reducing anxiety as well as menopausal symptoms like hot flashes.(14,15) One strategy within CBT is to monitor and reflect on your physiological and cognitive patterns during periods of anxiety.(3) For example, you may notice that every time you feel a hot flash coming on, you think, “Everyone is noticing and will think there is something wrong with me!” Further, you might also notice that your heart begins to pound even more rapidly following this thought. The trick then becomes intervening in this cycle by curiously challenging your thoughts: “How likely is it that everyone has noticed my hot flash? And even if they did, do they actually care?” This technique can help eliminate distorted thoughts and beliefs that underlie anxiety, and help to reduce anxious symptoms. Although the nature of the thoughts and anxious symptoms will vary from one person to the next, CBT can be used to identify and treat any patterns that may be increasing the presence of anxious symptoms.

It is important to remember that the experience of anxiety, including the struggles around managing it, is part of being human. According to Kristin Neff, a leading researcher in self-compassion, reminding yourself of this fact can go a long way.16 While we may feel alone with such struggles, many others are also affected or even burdened by
anxiety. If you recognize that anxiety is interfering with your life, consider reaching out to a health care professional to seek the help you deserve.

Gillian Potter, M.Sc.
Graduate Student in Clinical Psychology
University of Saskatchewan

Supervisor:
Paulette Hunter, Ph.D., R.D. Psych. (Reg. #945)
Assistant Professor
Psychology
St. Thomas More College
University of Saskatchewan

References available on request.

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Aside from tobacco use being a cause of earlier menopause, tobacco is the “number one cause of preventable death and illness in
Canada”. (2) Tobacco is referred to in all forms including: smoking cigarettes, pipes, cigars and using spit tobacco.

If you have tried to quit in the past and were unsuccessful, it is okay! It usually takes people more than three attempts before finally being able to quit
successfully. Everyone is different and each quit plan is different. What works for one person may not work for another.

Did you know that within two days of quitting your risk of heart attack decreases? And that within one year of quitting your risk of heart disease is one-half that of a smoker? Now that you may be thinking about quitting, there is help! Saskatoon Health Region offers Tobacco Cessation Counseling in person or over the phone for individuals wanting to quit or reduce their tobacco use. You will participate in developing your own Quit Plan and learn strategies to successfully quit.

In developing your own Quit Plan, you will be guided through five steps of quitting:

1. Get ready - set a quit date and have a quit plan. Suggestions include changing your environment - get rid of all of your tobacco products (cigarettes, ashtrays, pipes), review your past quit attempts and learn from them.

2. Get support - tell your family, friends and co-workers about your plan to quit.

3. Learn new skills - recognize what “triggers” make you want to smoke. For example, after a meal. Suggestions for alternatives include leaving the table and going to another room, distracting yourself by taking a walk, brushing your teeth, or changing your routine.

4. Get medication and use it correctly - Nicotine Replacement Therapy (NRT) can help you quit. These products, gum, patch, lozenge, inhaler or spray, provide clean nicotine delivery to your body and help with cravings and the withdrawal period while adjusting to quitting. Electronic cigarettes are becoming popular. Health Canada does not recognize these devices as a successful tobacco cessation aid or safe delivery of nicotine.

5. Be prepared for relapse in difficult situations - most relapses occur within the first three months after quitting. Do not be discouraged, it does not mean you cannot succeed at quitting smoking.

For more information about the Saskatoon Health Region’s Tobacco Cessation Program, please call 306.655.7777

 

1. Current Smoking at Menopause Rather than Duration Determines the Onset of Natural Menopause. Author(s): Kristel M. van Asselt, Helen S. Kok, Yvonne T. van der Schouw, Diederick E. Grobbee,
Egbert R. te Velde, Peter L. Pearson and Petra H. M. Vol. 15, No. 5 (Sep., 2004), pp. 634-639.

2. Are you thinking about quitting smoking or other tobacco products? You can do it! Saskatoon Health Region

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Diagnosing IBS often begins by ruling out other conditions like lactose intolerance, celiac disease and inflammatory bowel disease (Crohn’s or colitis). If you think you might have IBS, it is important to discuss your symptoms with your doctor.

So what exactly is IBS? It’s a disorder of how we digest and move food through the intestine. As mentioned above, symptoms include cramps, diarrhea and/or constipation, gas, bloating, heartburn and nausea to name the most common. A person with IBS can have all of these symptoms or only one or two. Symptoms could come and go or they could happen on a daily basis. The cause of IBS is unknown, but it has been linked to having prior infections, using certain medications, taking antibiotics and hormone changes. Often a person’s symptoms are brought on by certain “triggers”. These can be specific foods, changes in schedule, stress, caffeine or medications. The challenge in diagnosing and treating this condition is that it is different for everyone. The foods that trigger one person maybe be totally harmless for someone else. Also, because the cause is unknown and the triggers can vary, there is no specific IBS medication that is available to help cure this condition. Medications are often used to simply help alleviate the symptoms that a person experiences.

Besides medication, there are a few lifestyle modifications you can try to help manage your IBS. If you know what your triggers are, the best way to manage is to avoid those things as much as possible. If you are not sure what your triggers are, you can begin by doing some food and symptom tracking. There are even apps available to help with this if you are tech savvy! Once you have a couple of weeks recorded, you can start to look for patterns in what you are eating and when your symptoms occur.

Another option is to try probiotics. The goal of taking them is to increase the amount of healthy, digesting bacteria in your intestines that helps to push out all of the gas-causing bad bacteria. There are some foods that contain probiotics already, but for someone dealing with IBS, taking a supplement may be more beneficial as there are more bacteria in the supplement which is in a capsule that protects them from being destroyed by your stomach acid so they actually reach your intestine.

A relatively new treatment for IBS is called the low FODMAP diet. FODMAP stands for Fermentable Oligo-, Di- and Monosaccharides, and Polyols. In less scientific terms it means reducing specific types of carbohydrates in your diet that are more prone to fermentation in your gut. Researchers studying this diet have found that often it can help alleviate symptoms of gas, bloating and diarrhea. Before trying something like the low FODMAP diet, be sure to talk with your doctor or dietitian. It can be very challenging and requires careful planning to ensure you meet your nutrient requirements.

For more information on IBS (and FODMAPS!) or other digestive conditions,
please visit the Canadian Digestive Health Foundation at www.cdhf.ca.

Spiced Up Butternut Squash Soup

1 butternut squash, peeled, seeded and cut-up
1 tsp oil
1 onion, chopped
2 garlic cloves, minced
2 tsp mild curry powder
3 cups low sodium chicken or vegetable broth
1/3 cup plain fat-free Greek yogurt (optional)
Salt & pepper to taste

In a soup pot or large saucepan, heat oil over medium heat and add onion, garlic and curry powder. Cook, stirring occasionally for about 2 minutes or until the onions start to soften. Add the chopped squash and broth. Bring to a boil, then reduce heat to a simmer. Cover and cook for 25 minutes, or until the squash is soft and mash-able. Add salt and pepper to taste.

Remove from heat and allow to cool slightly. Puree with an immersion blender, or ladle into stand-up blender to puree. Serve with a dollop of Greek yogurt.
Tip: Add other orange vegetables like carrots, yams or pumpkin!

Nutrition Information
(per 1 cup serving):

Calories 105 kcal, Protein 3 g, Fat 1 g, Carbohydrates 24 g, Fibre 4 g

 

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What is Shingles?
Shingles is a painful, blistering skin rash that usually develops as a band or stripe on one side of the face or body. It is also called herpes zoster.

What causes shingles?
The same virus that causes chickenpox causes shingles. After you recover from chickenpox the virus remains inside your nerve cells where it “sleeps” (is dormant). In some people it stays dormant forever. In others the virus “wakes up”, causing shingles. This happens more often when a person’s immune system is weakened from disease, stress or aging.

What are the symptoms of shingles?
Shingles is one of the most painful and debilitating pains in medicine. Burning or shooting pain, tingling or itching often precede the actual rash. The rash appears as groups of small, fluid-filled blisters that dry, scab over, and heal (like chickenpox) in a few weeks. Like chickenpox, shingles may leave scars.

What are the complications of shingles?
Shingles can cause inflammation of the brain, facial paralysis, blindness, hearing problems or even death. But it’s the ongoing pain that shingles is infamous for. In some, the pain of shingles persists for months or even years; long after the rash has healed. This is called postherpetic neuralgia (PHN). It can be severe enough to interfere with everyday activities. For some, even a breeze or the touch of clothing can cause severe pain.

Who’s at risk for shingles?
Anyone who has ever had chickenpox is at risk. Factors that increase the risk for shingles include:
• Getting older, especially after 50 years of age
• Being a woman
• A weakened immune system from disease (such as cancer) or medicines (such as steroids)
• Stress or trauma

Can shingles be prevented?
Vaccination is your best protection. The shingles vaccine Zostavax is a more concentrated version of the chickenpox vaccine that is typically given to children. Both are live, weakened forms of the chickenpox virus. Zostavax is recommended for most people 60 and older, but is also available for those between 50-59 years. It is given as a one-time dose.

What are the possible side effects from the shingles vaccine?
• Zostavax is safe, effective and well tolerated.
• Most side effects are mild and self-limiting such as redness, pain, swelling or itching at the injection site.
• Those with weakened immune sys tems or allergies to vaccine ingredients may not be able to receive it.

How effective is the shingles vaccine and where can I get?
Zostavax protects more than half of people who are immunized from getting shingles. When it doesn’t prevent disease, Zostavax reduces complications such as ongoing pain in approximately 67 out of every 100 people. Protection lasts at least 5 years, probably longer. Research is ongoing to determine the need for boosters.

Zostavax is available at the International Travel Centre (306-655-4780). Cost $200.00. Some private insurers may help cover this cost.

Kristi Fedoroff
RN, BScN, MN
Immunization Clinician
Immunization Department
Population and Public Health
Saskatoon Health Region

 

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Watch for Dr. Vicki Holmes on CTV News at Noon with Jeff Rogstad. A series of short segments on women’s health topics will be presented on some Mondays during the noon show. Jeff is planning to set up a bulletin board on the CTV site to host archived editions. Each topic will have a handout which will be on our website www.menopausecentre.org.