Episode 12: Menopause with Science and Soul with Dr. Judith Boice
Menopause. What images does it bring to mind? Hot flashes, periods of anger or depression, loss of fertility, a change of life? Few woman look forward to it and many fear it. For many others they endure it but it is much worse that it needs to be. Did you know that in some cultures woman don't have menopausal symptoms? Why is that? What can be done to make this time important, spiritually fulfilling and as mild as possible?
Our guest today, Dr. Judith Boice, author of Menopause with Science and Soul: A Guidebook for Navigating the Journey, will answer our questions and guide us to a safe passage. Dr. Boice is a naturopathic physician, acupuncturist, author and international teacher, and she has a special passion for working with wellness and women's health. She conducts trainings and public lectures on women's health, menopause, and osteoporosis. She's also the author of several books, including Menopause with Science and Soul: A Guide For Navigating the Journey. She describes menopause as a "journey" and shares with us how she came to that understanding. Her book includes interviews with women from several different spiritual traditions, and describes women's experience of menopause in other cultures. (In many cultures, women have no menopausal symptoms, while about 80% of women in our culture have hot flashes.); Dr. Boice says this is because of their similar spiritual traditions - these cultures honor each part of the life cycle: puberty, adolescence, menopause and becoming an elder. She gives examples of how you can celebrate each of these times in your own life.
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Peter Brill: Hello, and welcome to the Third Age with the doctor and the man from Hollywood. The doctor is me, Peter Brill, MD and the man from Hollywood is none other than David Debin. On this show, we turn the myth of aging upside down. We shore up the scientific and the trendy, medical and the cultural, and tell you everything you need to know about living in the Third Age. Remember, we guarantee, if you listen to us, you will never grow old.
David Debin: Thank you, Dr. Bill, and I'm David Debin, the man from Hollywood. The Third Age usually starts somewhere around age 45 or 50 and it's the time when you start to feel a strong desire for deeper meaning and fulfillment in your life. Your first age is childhood, your second age is building career and family, and the third age is a major change or transition to a whole new set of problems, values, opportunities, gratifications.
So join us as fellow explorers in this journey to discover what brings passion and purpose and joy into this unchartered time of life.
Peter Brill: Listen, you haven’t welcome me back.
David Debin: Well, I didn’t get a chance. I was doing all those things that had to be done.
Peter Brill: I understand you had a black cloud disease while I was gone.
David Debin: Yes, we did. You must have had people clean up your place because I don’t know about you and everyone else, but everyone I know had black, grime, and grit from those [xx] we had a couple of weeks ago, and still hanging around. I couldn't breathe, I was wearing surgical mask here in the studio. Imagine how good I sound.
Peter Brill: That must have been an improvement.
Marissa Sgobassi: Yes.
David Debin: Right, in looks anyway.
Peter Brill: Menopause, every woman in the sound who can hear my voice or has a friend who you can get to listen to this show or anybody who’s having trouble with this period of life, please get them on the radio and get them to listen.
What image does menopause bring to your mind - hot flashes, periods of anger, depression, loss of fertility, a change of life. Few women look forward to it and many fear it. For many others, they endure it but as much worse than it needs to be. Do you know, for example, that in some cultures, women don’t have any menopausal symptoms?
David Debin: Why is that?
Peter Brill: What can be done to make this time important spiritually fulfilling and as mild as possible? Our guest today, Dr. Judith Boice, author of “Menopause with Science and Soul: A Guidebook for Navigating the Journey” will answer our questions and guide us to a safe passage.
David Debin: Well, last week, we talked about male menopause and this week, we're going to talk about female menopause. It should be womenopause.
Peter Brill: Seems only fair.
David Debin: Why isn’t it called womenopause? Maybe Dr. Boice can tell us [xx].
Peter Brill: Did they answer that question? It's not there.
David Debin: Yes, welcome back.
Peter Brill: Thank you.
David Debin: Welcome back [xx].
Peter Brill: Did you have a great time while I was gone?
David Debin: Well, we did a lot of fun, but now we have to stop playing because the teacher is back.
Peter Brill: [xx].
Marissa Sgobassi: Yes.
David Debin: No, no, really, welcome back. You went to Turkey?
Peter Brill: Turkey, we went all over Turkey. The best part of Turkey is Cappadocia which is in the center of Turkey, which has these big huge spires of rock that go way up into the mountains. We took a balloon ride through them and all that, and then, into Istanbul. Then I went to cooking school in Italy, and seven women were there with me. I was the only male.
David Debin: You had seven women on your mind.
Peter Brill: The lady who is the teacher of the cooking school, Carmen, she says, “Men are born stupid. As they age, they get stupider.” That really made me feel uncomfortable, but fortunately, the ladies took good care of me.
David Debin: [xx]. They felt sorry for you.
Peter Brill: I bet for that. [xx]
David Debin: You probably paid Carmen to say that. Right?
Peter Brill: I'd never done any dough before, you roll out any dough to make pasta.
David Debin: I thought Cappadocia was an Italian appetizer. What is it? Oh, it's [xx]. I got it, OK.
Peter Brill: Yes, anyway, David, you know what time it is?
David Debin: Oh, I almost forgot. It's time for the new story, isn’t it?
[sound of gong]
David Debin: It's a good thing I'm here.
Peter Brill: It is.
David Debin: But it's a good thing you [xx].
Peter Brill: It's a good thing I'm here. Am I here?
David Debin: We have some interesting things that are going on in the world, but there's one that’s--this is not so funny but it's really good. We ought to try that here. In Milan, we probably we’re close to.
Peter Brill: Yes, we [xx] Milan.
David Debin: Right. Well, did you know that overweight residents from an Italian town will be paid to lose weight? Did you know that? Did you know about that?
Peter Brill: Yes, yes. I read that.
David Debin: Isn’t that fabulous?
Peter Brill: Yes.
David Debin: Men living in the northwestern Italian town of Varallo will receive €50 or just $70 for losing nine pounds a month and women will get the same amount for shedding seven pounds a month. Now, so you get $70 from the government if you lose nine pounds or seven pounds. If they keep the weight off for five months, they get another $280.
Lots of people are saying, “I really need to lose some weight but it's really tough so I thought why don’t we go on a group diet?” said Buonanno who said he was about 13 pounds overweight himself. The town of 7,500 people started the campaign on Friday, this is in September, and some residents have already signed up. Around 35% of Italians are overweight or obese according to European Union figures with waistlines expanding as the country’s healthy Mediterranean diet has given way to processed foods rich in fat, sugar, and salt.
Peter Brill: My [xx] diet.
David Debin: Well, how was your diet in Turkey, by the way?
Peter Brill: Turkey is really a healthy diet. They have cucumbers and tomatoes and olive oil and eggplant and I mean, it's really very healthy.
David Debin: That sounds great!
Marissa Sgobassi: I know.
David Debin: They're all fresh, all good.
Peter Brill: All fresh, and then you have kebabs.
David Debin: Did it taste good or was it bland?
Peter Brill: It tasted good, to me it was fabulous, and the eggplant is really good. The kebabs are OK.
David Debin: OK, lamb kebabs.
Peter Brill: Yes, lamb and chicken.
David Debin: Chicken I don’t mind but lamb, I can just feel the sheep on skewer it's so [xx].
Peter Brill: [xx].
Marissa Sgobassi: I can’t.
Peter Brill: You like lamb, feel those lambs.
David Debin: Hey, we're going to get complaints from our audience.
Peter Brill: Boy, will we ever?
David Debin: We're really on trouble now. What about this thing though? Isn’t this something that we should be doing here in America? Peter, isn’t that something we should be doing here in America?
Peter Brill: In terms of our diet?
David Debin: Yes.
Peter Brill: Yes, in terms like what we'd be paid to lose weight? Absolutely.
David Debin: Yes, eventually, isn’t it going to tip the scales in terms of a positive cash flow because with all the money that’s spent on…
Peter Brill: No question about it. If we change the way we incentified [sp] our health care system, we would save a ton of money and people would live an enormous and longer time.
David Debin: Yes.
Peter Brill: If we just, for example, with diabetics but I mean everybody, it's just amazing. Wellness is going to be one of the themes for this year for us in the program, David.
David Debin: Yes, it's a no-brainer but it doesn’t seem to be--because it's not a big profit thing right now for people, they don’t take it up.
Peter Brill: Well, there's a big wellness industry emerging.
David Debin: We have something we'd like to ask all of our listeners to do, if you don’t mind, just take a moment. In our opinion, we're perfect. This show is absolutely perfect, it's funny, it's entertaining, it's informative; but we'd like to know in your opinion, what we could do to make this show better. And if you would send us an email--you can give your name or be anonymous or whatever you want--send it via through the Third Age Foundation, go to our website.
Peter Brill: That’d be ThirdAgeFoundation.com.
David Debin: Yes, go to our website and send us an email through Contact or you can email me at [email protected]. Tell me what you think that we can do here on the “Third Age” to make this a better show.
Peter Brill: Or, maybe why you like the show or [xx] by yourself.
David Debin: That’s begging for compliments.
Peter Brill: I'll beg, I'll beg.
I'd like to introduce our guest today. Dr. Judith Boice is a naturopathic physician, acupuncturist, author, and international teacher. She has a special passion for working with wellness and women’s health. She conducts training and public lectures on women’s health, menopause, and osteoporosis. She's the author of several books including “Menopause with Science and Soul: A Guide for Navigating the Journey”. Welcome to our show, Dr. Boice.
Judith Boice: Thank you so much for having me.
Peter Brill: Well, I want to first start, if you don’t mind, I know we're going to get on to menopause which is of great interest to our listeners. But I'd like to just talk a little bit about naturopathic medicine and what it requires and what it is. Is it legitimate and so forth?
Judith Boice: Right, well, I'm trained with a four-year medical school training and in all 14 of the states where we're licensed including California--California is the most recently licensed state--we're licensed as family physicians. So we're trained not to do things like brain surgery and specializations, but we're trying to be family physicians, to look at the whole picture of what's going on with the person. Some of the basic tenants of naturopathic medicine are to treat the whole person, to use the most natural noninvasive method of treatment, and also to invoke what's called this medicatrix naturae, the healing power of nature, the healing power that’s an innate property within each of us. That’s one of the major focuses.
Peter Brill: Would it be fair to say that naturopathic medicine carries with it a more of an eye to augment the natural healing processes in addition to try to heal pathology than regular medicine?
Judith Boice: Yes, and that is part of what differentiates both naturopathic and all of what I call the “classical” medicines. Classical medicines include [xx] medicines, Chinese medicine, all of the medicines that predate today’s conventional medicines. They had message of tonifying and rebuilding the body, and those words are pretty much left the conventional medical world. We used to have tonics even within the conventional medical world and we don’t have that now. Most medicines that what we think of as conventional medicines gets people from lying down to standing up.
Peter Brill: Is it also true that there are more visits to complimentary and alternative medicine practitioners these days than there are to standard medical practitioners?
Judith Boice: I think that is becoming truer and truer depending on what you're using to define it. If you included massage therapist and acupuncture, I think that would be an accurate figure because I think people are learning that they need to invest in their health, just like we need to put savings in the bank. We need to invest in our health which is different from just going to be treated to be given pills to make symptoms go away.
Peter Brill: So what you're speaking from is a high degree of professionalism, international lecturing, tell us about menopause. Why do you call it a journey?
Judith Boice: It's a journey because it's a process of changes that a woman goes through that must give us a very familiar if we think back to the difference and, for example, being an eight year old and being a eighteen year old. There's a phenomenal level of change that happens to puberty to that transition in our life. From my perspective, there's a similar magnitude of change that happens for most women between 45 and 55 years of age. It's not something that happens overnight, and those changes are physiological, they're hormonal, and there are also internal, there are a lot of inner changes that a lot of women go through as their body changes.
Peter Brill: Well, why is it better to look at it in that perspective rather than as just the standard way people look at menopause?
David Debin: A condition, you mean.
Peter Brill: Yes.
Judith Boice: A condition that is not a medical problem
David Debin: It's a condition.
Peter Brill: Yes.
Judith Boice: Exactly. About 20 to 25 years ago, we began to consider menopause a medical issue or a medical problem. If it's a medical issue, then you can medicate it. That’s when we began to see a huge industry going for Prempro up until the times Viagra was created, Prempro, Primarin, Provera was the biggest selling drugs in the world.
So now that we've realized that there's some downsides to medicating menopause, we're starting to take a different view, a different look that this is a normal natural life transition. Like with puberty, it doesn’t all happen in a day. From my perspective, that’s actually helpful that it doesn’t all happen in a day because the body needs time to adjust to the hormonal and physiological changes that are occurring during menopause.
David Debin: So you're saying that as in puberty, there's no medicine you have to take for it. You just evolve in a way or go through it. That it's possible that menopause is the same type of…
Peter Brill: Wait a minute, I don’t want to stop [xx] you puberty again.
David Debin: Well, did you take any medicine for it when you were going through it?
Peter Brill: I wish I could have. Maybe I did.
Judith Boice: Actually, now, for young women, they're being told, “Oh, don’t suffer with PMS. Here, just take this birth control pills and you'll have a period four times a year.” So we are now medicalizing puberty as well.
Peter Brill: So answer the question that I asked in the opening part of it, are there cultures that don’t have menopausal symptoms?
Judith Boice: Absolutely. Two cultures that have been studied--they're not the only cultures--but two that had been studied are Japanese women and traditional South American Mayan women. In those two cultures, women have very few to no menopausal symptoms. In our culture, about 80% of women have some kind of symptoms, 20% don’t. The reverse is true in a lot of other cultures.
So for example, I had a patient I worked with who was going to a Kaiser HMO physician who was in [xx] Asian woman. When this patient with [xx] this older woman about her menopausal symptoms, this doctor looked at her like she was from Mars. I tried to explain to the patient, “She wasn't being cruel, she wasn't being mean. She really has no idea what you're talking about.” And most Asian languages, there is no word for “hot flash”.
Peter Brill: So, that they just haven’t discriminated it or is it that the culture somehow makes it so it doesn’t happen?
Judith Boice: Well, I think there are at least four factors that play into why women may or may not have symptoms. One is diet, and we know that the better a diet is for that particular woman, for her particular needs, the more nourished she’ll be, the easier the transition will be. Most Japanese and Mayan women are not living on Hamburger Helper and Big Mac.
Another piece is exercise. Again in many traditional cultures, women don’t have to join a gym to get exercise, they're getting exercise through the flow of their daily life, taking care of things in their home, in their yard or the farm, walking places. We know from studies in this culture, women who exercise at least three hours a week--not three hours all at once--but three hours over the course of the week, tend to have about 70% fewer hot flashes.
So exercise is hugely important also for our bone health, for stress reduction, from improving sleep, there are a whole bunch of reasons that exercise becomes more and more of an ally as we go through menopause.
David Debin: And three hours a week is what still called exercise?
Judith Boice: Right.
David Debin: Because some people are under the impression that if you don’t go to the gym everyday for an hour, that you're going to fall apart.
Judith Boice: Right, and at least in this particular study that we've done, it showed about 30 minutes a day, six days a week would be adequate if you're working with hot flashes. That’s to be able to maintain health as well, not necessarily to be building muscle or anything.
Peter Brill: So diet, exercise…
Judith Boice: Another factor is exposure to what are called “xenoestrogens”, xeno means foreign. So xenoestrogens are substances in our environment like [xx] from plastics, pesticides, insecticides that act like estrogens in our bodies. For women in this culture, we tend to have tremendous amounts of xenoestrogen exposure. That makes us more prone to having what are called “estrogen-dominant” symptoms, too much estrogen activity. It makes us women more prone to breast cancer or less seriously fibrocystic breast disease, even fibroids, and more seriously, endometrial cancer or ovarian cancer and for men, prostate and testicular cancer.
David Debin: Wow! Very interesting stuff. If you will stay with us, Dr. Boice, we will take a word from our valued sponsors and we will be right back. This is the “Third Age”, stay with us.
Peter Brill: Welcome back to the “Third Age”, I'm here with my co-host, Dr. David Debin. I'm Dr. Peter Brill. We're here with Marissa Sgobassi who’s our student and our associate producer, and Dr. Judith Boice, who is a naturopathic physician, an acupuncturist, international teacher/author. We're talking about menopause, and she's written a book called “Menopause with Science and Soul: A Guide in Navigating the Journey”. Welcome back.
Judith Boice: Thanks.
David Debin: We have a caller, Peter.
Peter Brill: We have a caller, all right. We'll put the caller on here.
David Debin: We have a question for Dr. Boice.
Peter Brill: Hello.
David Debin: Hello. Who is this?
Ellen: This is Ellen.
Peter Brill: Hi, Ellen. How are you? Welcome to the show.
Ellen: Thank you.
Peter Brill: What's your question or comment?
Ellen: My question is somewhat of a concern because as the doctor was describing the differences why Asian women may have less menopausal symptoms than Caucasian women, she didn’t mention genetics. I'm aware of a number of ways in which Asians react differently to different medical issues such as obesity. I think it would be expected that there’ll be genetic differences between races and also just the luck of the draw that you have a friend who had no symptoms and you had some symptoms and you have another friend that has a lot of symptoms. It may have less to do with what they're doing than just their genetic make up.
Peter Brill: Now, are you a scientist or a physician?
Ellen: I'm not, I work in clinical research.
Peter Brill: Clinical research, that’s why you know. OK, Dr. Boice?
Judith Boice: A couple of different things. Genetics--as far as menopause go--the main thing that genetics controls and menopause is when we're going to menopause, so the timing is predictable from our genetics. So I'll go into menopause around the same time my mother or grandmother or great grandmother went into menopause. But the genetics does not necessarily determine the quality of the passage, but something very different. We also know from studies--and this is not specifically menopause but for example breast cancer--we know that Japanese women who leave their traditional diets and began to eat a conventional Western diet--the sad standard American diet--their risk for breast cancer goes up right along with all the rest of us.
Ellen: Yes, but for example, in obesity, Asians develop type II diabetes, much lower BMI levels than Caucasians, for example. That’s true whether they're in Japan or in the United States, there are genetic differences.
Judith Boice: Yes, that’s absolutely true, but I've also said that Mayan women which are completely different genetic stock of people. The point that I'm trying to make is that yes, there are things that we don’t have so much control over, but there are things we do have control over. There’s a lot of information showing that we can do the best we can to control the factors that we have control over and that can may make a difference.
Part of the point I'm making in the book also--and we haven’t had a chance to cover this--is there are 14 women interviewed in the book, and I'm trying to have women understand that there's no one right or wrong way to go through menopause. That there's some women who’ve done everything correctly. They've eaten the perfect diet, they’ve exercise well, and they still have tremendous symptoms going through menopause. That doesn’t make them wrong. There are other women who really haven’t done much of anything for their health and they’ve breezed through menopause.
Peter Brill: So, Ellen, certainly their genetic factors can affect the intensity, but as you pointed it out, there are differences but we can try to do what we can do about it. Fair enough?
Ellen: Right. It sounds fair. Thanks so much. Bye bye.
David Debin: Thanks for calling.
Peter Brill: Thanks for your call.
David Debin: You want the fourth factor.
Peter Brill: I want the fourth factor.
Judith Boice: The fourth factor. Actually, there are five.
Peter Brill: You said four.
Judith Boice: I do, am I only get four.
David Debin: Four out of five isn’t bad.
Judith Boice: How about this? We could come back to phytoestrogens if it’s appropriate.
Peter Brill: No, I'm just kidding.
Judith Boice: One of our biggest personal and cultural attitudes about aging, have a phenomenal effect on the experience going through menopause. These two cultures I mentioned--Japanese and most Asian cultures and also the Mayan culture--women would actually be gaining in social stature, they’d be gaining in social respect at this point in their lives. That’s pretty much the [xx] experience from most women in this culture.
Peter Brill: Dr. Boice, you don’t much about our show. I know that we're called the “Third Age” but one of the things that we strongly advocate and we're working very strong at Third Age Foundation is changing what we call “the myth of aging”. What this society tends to do--David and I and others are strongly fighting it--which is because of the youth orientation and materialism, it tends to devalue people as they age and we're trying to find a way to change that myth and value things such as wisdom, experience, and kindness to others.
Judith Boice: I'm right with you, and absolutely, because one of the things that I've experienced over and over again for myself and also other women is often the most creative, productive, exciting years come after menopause or during menopause.
Peter Brill: Exactly.
Judith Boice: It's not that we're dried up and shriveled and thorny and our life is over. It's often the beginning of some tremendous things at this point in the life of [xx].
Peter Brill: So how did different spiritual positions deal with all these?
Judith Boice: In the book, there are several different cultures mentioned, I'll just mention a couple of them. In some native American cultures, there are still intact traditions where each part of the women’s life cycle and men’s life cycle would be honored. So puberty would be honored, becoming a parent, going through menopause, and becoming an elder is even another stage beyond menopause, becoming a respected honored elder in the community.
Sadly, and even in some native American traditions, there has been a reconstruction or an attempt to reconstruct. There's some--even among the native American traditions--that have been lost. So in most of the contemporary Western culture, we've lost a lot of those traditions, these ways of respecting and honoring. So one of the things I really encourage women to do is find our own ways of celebrating. I could give a couple of examples if that would be appropriate.
Peter Brill: I will love it. I will love it.
Judith Boice: I had one patient who turned 50 and she had been very gregarious, outspoken sociable woman. She was the minister of the Unity Church and she decided on her 50th birthday, she would go away for a week on the Oregon coast and spend a week by herself. She said, “You know, I was kind of afraid.” She said, “I had not been by myself in my entire adult life.” She found out she really liked her own company. She spent the week walking on the beach and cooking and writing in her journal. She had a wonderful time.
Peter Brill: Can I just before you do the second one, just underline a couple of things. I found working as a psychiatrist, that one of the most important developmental steps that I ever saw for anybody was the ability to spend time by themselves three or four days a week and to find out who you are and what you feel at the bottom of all that. That this lady found that she enjoyed herself…
Judith Boice: Absolutely.
Peter Brill: …is no small developmental process.
Judith Boice: I think that’s very important. So with some women, the right of passage can be marked in a very quiet, very solitary way but profound, that doesn’t diminish it at all. In fact, in some ways, it's the more profound choice.
Another example is a woman named Molly Scott who’s a singer and a songwriter. To mark her 50th year, she had a celebration where the women in her family ritually bathed her and she put on a dress that had been made from scraps of materials from a favorite garment she’d saved from her whole life. Then, she had a ritual of speaking the things she wanted to leave behind, the things she wanted to take with her, and the things she wanted to invoke in her future. Her whole extended family was with her for this gathering.
Peter Brill: Hold on, hold on a second here. I got to give equal time to Marissa. What, Marissa? Marissa here is laughing.
Marissa Sgobassi: I was just imagining my family bathing me.
Peter Brill: It's funny. You have to have the right family, I guess.
David Debin: Well, you have to be around 40 or 50 years old [xx]. I don’t think that at the stage of your life at 21, we're going to have your family bathe you.
Judith Boice: Right, hopefully, we'll left that behind with the crib.
David Debin: We're going to take a break. I just want to make sure I mention before we do, your book, Dr. Boice, “Menopause with Science and Soul: A Guide for Navigating the Journey”. It's a terrific book, get it on Amazon or any online store. Go to a store and pick it up, by Dr. Judith Boice. We'll be right back with the “Third Age”, don’t go away.
Peter Brill: Welcome back to the “Third Age”. I'm Dr. Peter Brill, I'm here with Dr. David Debin, that’s what he's called now, and Marissa Sgobassi and Dr. Judith Boice who’s an international renown physician in naturopathic medicine and teacher. She has written the book “Menopause with Science and Soul: A Guide to Navigating the Journey”.
So, OK, now we've done all these things, I guess we'll never get to factor five. But we're still have on symptoms.
David Debin: Why not? It might be interesting.
Peter Brill: You want factor five first?
David Debin: Yes, I do.
Peter Brill: Well, I'd like to know what factor five is.
David Debin: And the journey.
Peter Brill: We've got to save time for people to do if they're having symptoms despite all these.
David Debin: OK, let's do factor five quickly.
Judith Boice: It's phytoestrogens, phyto means plants, and plants substances that are 400 to a thousand times weaker than our own estrogens but they still provide some gentle estrogen support. They can actually help down regulate--and I can give an example if you want it. If a woman has too much estrogen activity and you're using phytoestrogens, instead of phytoestrogens down in the receptors site, you just put a weaker estrogen end, so it helps reduce too much estrogen activity. For menopausal and there is less estrogen activity, the phytoestrogen sit on the receptor and they increase the estrogen activity by giving a gentle estrogen support.
Peter Brill: Without stimulating increase breast cancer.
Judith Boice: Right.
David Debin: What's an example of a phytoestrogen? Put a name to it?
Judith Boice: [xx] about that right now, but clover, alfalfa, licorice those are all examples of phytoestrogens, pomegranates.
Peter Brill: [xx] licorice.
David Debin: Yes, OK, but you don’t need it.
Peter Brill: All right, so we've done all these things, the woman still comes in, she still having trouble negotiating the journey. She's having hot flashes, others symptoms, what do you do for her?
Judith Boice: The first step would be looking at the stress levels in her life because we know the more stressed a woman is under, there are more hot flashes and other symptoms she tends to have. So the first piece would be looking at what's going on? Has she suddenly had an increase in her work? Is she grieving a family member or taking care of a sick family member? What's going on in her life? Doing as much as we can to help minimize the stress and give her tools like debreathing techniques and other things to help work with the stress levels.
Another step then is looking at the phytoestrogens that we just talked about, that weak plant-based estrogens. Some women if they have some phytoestrogen support, that’s enough to take care of the symptoms. Another piece would be looking at their diets. There are certain foods that tend to heat the body more--and they're mostly all of our beloved foods like alcohol, coffee, a lot of meat and other animal products tend to heat the body more.
I'm not just talking about the fact that the coffee is hot, it's energetically heating for the body. So minimizing the foods that tend to heat the body. There are also Chinese herbs that help rebuild the yin, the nourishing cooling fluid aspect of the body which can help with hot flashes and night sweats. Then from there, I start looking at--if they're really severe symptoms--the bioidentical hormones. Our body’s bioidentical, the same thing that our body makes.
Peter Brill: For example?
Judith Boice: Progesterone is one of the hormones that we make and that is different from synthetic progestins like Provera. Provera is an altered hormone, it does not deliver the same message that our own body’s hormones do and hormone’s major job is to deliver messages in the body. So progesterone is usually my first choice. About 70% of women have reduction association of hot flashes using the bioidentical progesterone.
Then the next step--if that’s not enough--would be to add the bioidentical estrogen and that would be the second step. A few women also may need testosterone. As long as women have their ovaries, usually testosterone levels remain unchanged.
David Debin: You mentioned the heating substances that women can drink hot coffee, for instance. How long does that stay active in terms of helping to heat up the body because my wife, for instance, drinks a lot of coffee, she's in menopause, she has hot flashes and I've never noticed that she has hot flashes right after she drinks coffee.
Peter Brill: No, it's a general, it's an overall.
Judith Boice: Right, it's over a period of time, and the heating effect is not just that the beverage is literally hot, it's the food itself is heating. So for example, I could drink a glass of cold red wine and my hot flashes could be worse later in the evening.
David Debin: Is there a list that we can get of things not to do to look?
Peter Brill: It's in her book.
Judith Boice: In the book, and also it's an understanding if you're working with the Chinese positioner acupuncturist, they could also help you understand that, in general, it's coffee; a lot of black tea; alcohol, any form of alcohol; and a lot of animal products particularly chicken. Chicken is considered the most heating of the meats.
David Debin: Really, a hot chicken. I didn’t know chicken was hot, did you, Marissa?
Peter Brill: Now, where are you in practice, Dr. Boice? You’ll going to send a lot of people here. We've got them lined up outside the studio. Where are you in practice? Do you have a practice or something?
Judith Boice: I do, I'm in the western slopes of Colorado, Montrose, Colorado.
Peter Brill: That’s not too far, people.
David Debin: Not too bad. Sounds good.
Judith Boice: Right.
Peter Brill: Can they find your website? How do you say it?
Judith Boice: DrJudithBoice.com.
Peter Brill: OK, can they write you?
Judith Boice: Definitely, and there's a lot of information on the website, too. There are articles and different things that you can look at and also informational things.
David Debin: So I was thinking that Marissa over here is follow up from being menopause I guess maybe 30 years or so. Is there anything that you can do at a younger age to prepare your body for this so it's not such a difficult journey?
Judith Boice: Definitely. One of the things that many women become concerned about is bone health. As they go into menopause and actually the best time to support bone health is starting in our teens and twenties. So the better that we're exercising during our teens and twenties, the more peak bone mineral density we have. We reach our maximum bone density between age 35 and 40. So the more that we're doing early on our life to build that peak, the more we’d literally have to burn later in our lives.
Peter Brill: Well, Marissa, you're exercising plan. Right?
Marissa Sgobassi: I hope so.
Peter Brill: What do you do? How many hours a day do you do?
Marissa Sgobassi: No, I've been lazy.
David Debin: How else does she build bone density? What else can she do besides that?
Judith Boice: Another thing is to be eating lots of leafy, green vegetables. We've found that calcium and other minerals--calcium alone cannot build strong bones--but calcium and other minerals in plants are much better absorbed than calcium found in dairy products. So eating lots of leafy, green vegetables, carrots, [xx] things like that can really
Peter Brill: You don’t have others besides those two?
David Debin: I like [xx], it's fabulous.
Peter Brill: No, I like them, but it's just that you happen to mentioned the two I like the least.
Judith Boice: OK.
David Debin: Yes, but you're not worried about menopause.
Peter Brill: I'm worried about bone density.
Judith Boice: Right, absolutely.
David Debin: We're talking about younger people like Marissa.
Judith Boice: Right, and the other thing is avoiding [xx], I call [xx] bone bums because in one neat little package, they're sugar. The more sugar we eat, the more we acidify the body, the more calcium we lose. There's caffeine and cola and that also tend to make us lose calcium and there's also phosphorus in the carbonation. All three of those things together contribute to losing bone.
Marissa Sgobassi: Even diet?
Judith Boice: Even diet stuff like diet Coke, diet Pepsi. I call those bone bums.
David Debin: Wow, that’s [xx].
Peter Brill: How about seltzer water?
Judith Boice: I would actually go for, if possible, for just plain water.
David Debin: He's trying to move the [xx].
Peter Brill: I'm trying to slowly wean myself from all those things.
David Debin: Dr. Boice, we would like to thank you very much for being with us today. It's been really enlightening.
Judith Boice: Thank you so much for having me. It's been a delight.
David Debin: We want everybody to get your book because it's got all the pertinent information and all the lists in it. So anybody who’s listening, let's get “Menopause with Science and Soul: A Guide for Navigating the Journey” by Dr. Judith Boice. Thanks Dr. Boice.
Judith Boice: Thank you so much.
David Debin: Peter, what have you learned? What are you going to do as a result of what you've learned today?
Peter Brill: I'm giving up softdrinks.
David Debin: You're going to give up the seltzer?
Peter Brill: Not the seltzer yet.
David Debin: OK, we'll see. We'll be back right away.
Peter Brill: Welcome back to the “Third Age”. I'm one of your host, Dr. Peter Brill, I'm here with David Debin and we just want to thank all of our sponsors and supporters. I do want everybody out there to utilize their services if you believe in our show. They’d make this show possible.
David Debin: Hey, we also want to remind you about that email we asked for. Email us at [email protected]. The question is what could we do to make this show better for you? What could we do to make the show better? Email us at [email protected].
Peter Brill: We also have a series of groups that people attend to work on their Third Age issues and you can get in one of those, there's practically one everyday. 969-9794, give us a call or you can call us about anything, just give us a call and tell us about what your…
David Debin: We're lonely.
Peter Brill: We're lonely, we need people to talk to.
David Debin: We're so tired of talking to each other.
Peter Brill: I know.
David Debin: That’s all we ever do is talk to each other. We actually had to hire somebody just to talk to us.
Marissa Sgobassi: A therapist.
David Debin: Yes, we have a therapist.
Peter Brill: So what have we learned about menopause? That’s what you asked me before.
David Debin: Well, before that, I even want to ask you a question as a physician. I was watching football last night and Brett Favre’s wife was on.
Peter Brill: Yes.
David Debin: Did you see that?
Peter Brill: Yes.
David Debin: Yes, she’d written a new book about Brett’s breast cancer and she was saying that the key to breast cancer is checking yourself every so often.
Peter Brill: Yes, that’s one of the diseases.
David Debin: Yes, before the mammogram, always to keep--and she said that also that men get breast cancer as well. I never heard of that before.
Peter Brill: There's about 5%.
David Debin: It is?
Peter Brill: Yes, of breast cancer in men.
David Debin: And is there an age range where it's more susceptible towards or is it all men?
Peter Brill: I think 66 is it.
David Debin: No, come on.
Peter Brill: I don’t know.
David Debin: You're the doctor. You should give and tell us.
Peter Brill: [xx], I'm sorry.
David Debin: OK, now people are wondering why I'm walking around feeling myself up. I can't stop touching myself and squeezing myself. I just want to make sure I don’t get it.
Peter Brill: But, there's a lot of other factors besides examining yourself which are of course all the things to do with diet, exercise, stress, the immune system, the toxins we're exposed to. There's a huge amount of evidence now growing that we are bathing ourselves--that’s one of the reasons I felt very excited--she was talking about all the chemicals that are in our environment that are mimicking for, and in this case, estrogen. That there are synthetic substances that are activating breast cancer, and it's just one of many, many toxins in this environment that we're just not coming into grips with.
David Debin: What are they? Like mercury? She gave us a list of them.
Peter Brill: Well for the breast, but I mean, even the stuff in the air, this sound crazy, but the stuff that you use to clean your carpets with, all those stuff all have effects that we've so many chemicals in the 20th century without knowing anything about the long term effects.
David Debin: That reminds me, there's another long term effect which has to do with the bee population. The bees are disappearing. There's a big thing on “60 Minutes”.
Peter Brill: I left town before I found out why.
David Debin: Yes, well, there's a big thing on “60 Minutes”. If it keeps happening…
Peter Brill: Yes, we'll going to have no flowers anymore.
David Debin: …well, how about vegetables and fruits? We're going to wind up paying double for vegetables and fruits because they just can't pollinate them. What they're finding--because they won't say it's final--is that because the bees, the toxins that are in the air particularly with the new fertilizer that they're using, that countries in Europe won't use that we're using here, the bees sense of direction is being interfered with and the bees can't find their way back to the hives, so they're disappearing.
Peter Brill: [xx] can't find their way home.
David Debin: Yes. It's not that they're dying, they cannot find their way back so they're disappearing. So if there's no bees, there's no pollination; if there's no pollination, there's no food. So look at it that way, the toxins that we all deal with [xx].
Peter Brill: Well, we want to give some thanks, right, to some people here?
David Debin: Go on.
Peter Brill: OK, we'll start there but how about [xx], Marissa Sgobassi for putting this show together today, and Lisa Headley who’s been a trainee here and [xx], Les Carol[sp].
David Debin: And myself, I'd like to thank myself. It's been great knowing me and I'm glad that I'm on the show. We'll see you next time.
Peter Brill: It's the “Third Age”.
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