Dr. Deb

3 shots of liquid protein a day was my most infamous crash diet in high school.  I starved myself drinking only 3 shots of foul smelling liquid protein a day. Sure the weight came off quickly, but so did loads of hair in my starvation mode. When I went off the diet, the pounds quickly returned, but the hair took much longer to grow back.

Hair Loss affects 10% of all women and can start as early as age 12. Unfortunately, after age 65, up to 75% of women will have hair loss.

Some hair loss every day is normal. In fact up to 100 hairs a day is normal. We have about 100,000 hairs on our head that grow about a half-inch per month. An individual hair usually grows for 2-6 years in the growth phase then enters a rest phase for a few months. At any given time 85% of our hair is growing while 15 % is in the rest phase. Finally it will fall out and a new hair grows in its place.  Learn more about the phases of hair growth here.

What are the main causes of hair loss in women?

There are many reasons for hair loss and I will highlight the most common ones.

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When the summer arrives so do my headaches and not just in the form of my four kids. Headaches can be a real pain this time of year, especially in children who play outdoor sports. Football camp started this week for my twins so here is a little info about summer headaches, what you can do to prevent them and when to be worried about something else.
Why are headaches worse in the summer?

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As a child I always prided myself on my memory. I could and still can remember specific childhood events as early as age 2 in vivid detail. Things started to blur during residency when I worked 36-hour shifts but nothing destroyed my memory  (as well as other body parts) like children.
The deep slide occurred after the birth of my twins when I boiled my breast pump after forgetting I left it on the stove.  The toxic smell of burnt plastic required the fire department to come and air out our apartment. That certainly ruined my chances for mother of the year. I realized 2 things. Hot soapy water is sufficient to clean a breast pump and hormones made me stupid. Certainly sleep deprivation had much to do with it but I remember the moment that I stood in the kitchen and realized my fantastic memory had slipped and I knew that it was related to my hormones.  Fortunately, my memory returned but I can’t wait to see what happens when I hit menopause.

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Did you ever feel old overnight?
Where did these wrinkles come from? How come I can’t read without squinting? Why does my family think I am a bitch? Is it hot in here? Why can’t I sleep? When is my period going to come..or stop? Why do I eat the same but gain weight?
Am I crazy?  No, you are just in perimenopause, my dear.
The really crazy thing is when you go to talk to your doctor about it he tells you, ”There is nothing wrong with you” or “You just have to live with it.”
That is simply not true and I think part of the reason why Susan Somers and bioidentical hormones have become so popular. The doctors are not listening, so patients are going to what appears “safe and more natural” which I hate to say, is not necessarily true.
First, what is perimenopause?
Perimenopause may begin as what appears to be increasing moodiness and irritability and is often accompanied by erratic periods, some of which can be quite heavy. The ovaries will also start to wind down in a sporadic manner producing normal estrogen one month and low levels the next. Low levels of estrogen account for most of the symptoms of menopause. These symptoms include hot flashes, night sweats, insomnia, vaginal dryness, decrease in the blood supply to the vagina and thinning of the vaginal mucosa or tissue. These symptoms typically begin in your late 40s but often start as early as mid 30s.
What can I do about it? A lot actually.
The first remedy is lifestyle changes. Your body is telling you, “If you keep putting crap in, you’ll get crap out.” PLEASE CLICK TO SEE MY PREVIOUS BLOG ABOUT LIFESTYLE CHANGES and HERBAL REMEDIES called Hot and Neutered
What can my doctor do to help?
TSH is the most important hormone to check if you are having irregular bleeding, fatigue, weight gain or simply not feeling well. TSH checks your thyroid or your body’s regulator gland. If it is off, your whole body will be off.  It is the most common endocrine problem as we age. Click here to learn more about your thyroid.
Many women will have their FSH checked. This hormone level is not that helpful in treatment. You can have a premenopausal level but still feel awful from hormonal fluctuations. This is the time that many doctors still say nothing is wrong with you, when in fact, everything feels wrong. You can also have a postmenopausal level one-month and back to premenopausal the next. I think it is important to base treatment on symptoms and not the level of this hormone. Read more about FSH.
What about hormone replacement therapy?
If lifestyle changes and herbal remedies do not alleviate symptoms, then many women benefit from hormone replacement therapy. The idea is to replace the hormones that your body is no longer making. The difficulty with perimenopause is that your body is still making the sex hormones, estrogen and progesterone, just at sporadic times and at sporadic levels. You cannot take a test by blood or saliva to match up what your body is supposed to make because this will vary from day to day until you go through menopause completely.
Many women in this time find birth control pills are of great benefit as they even out the hormones. They are strong enough to control the bleeding problems while taking care of the hot flashes as well as preventing pregnancy. Women still can get pregnant at this time. Many women who thought they were in menopause when their period stopped had quite the surprise when told they were pregnant.
What about bioidentical hormones?
Bioidentical is a term that means matching what your body makes. You can get bioidentical hormones from a drug company as well as from compounding pharmacies. I prefer to use the drug company form, as they must be made in FDA regulated laboratory and have rigorous testing.  I am concerned about the lack of regulation in the compounding labs as well as lack of testing of the products. I also am leery of the amount of out of pocket money many of these pharmacies charge, preying on women’s desire to feel younger and falsely touting its safety. The reality is that compounded pharmacies and drugs are not as rigorously tested or regulated as traditional pharmaceuticals but that does not mean they are not of benefit.

Compounded drugs are also very tricky to use in the perimenopausal patient as the hormones are fluctuating. They are often not strong enough to control hot flashes and bleeding. I have used compounded pharmacies, especially for drugs that do not have FDA approval in women yet, like testosterone. It really depends on your symptoms so make sure your doctor will discuss options and don’t settle for, “You just have to deal with it.”
How can medications help mood?
Often times evening out the hormones will even out mood. Some women that don’t want hormones or find they are not enough will benefit from antidepressant medications. Some women do not need to take them everyday and only use them the second half of their cycle. There are many medications such as Sarafem, Lexapro, Wellbutrin and Cymbalta that can help and often times it involves trial and error to find the right one at the right dose.

Learn more about PMS

You are not crazy and these changes are real. It is up to you to take the journey to feeling better. Maximize your lifestyle, minimize your stressors and consider supplements to help you in this discovery.

Learn more about Perimenopause

Dr. Deb

Whoa, It is HOT today!

I am hot and sticky today because it is 98 degrees outside. Many of you feel like this all year round because the thermostat both outside and inside can be boiling without notice. Reminds me of one of my patients, Sue. Could you be Sue too?

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