“No matter how long the winter, spring is sure to follow"

- Proverb

Dear Red Hot Mamas:

There is an adage that March “comes in like a lion, but goes out like a lamb”.  The saying is meant to demonstrate the unpredictable weather that often occurs as the seasons change – from severe snowstorms to tornados that have occurred this month.

Menopause is a girls-only club. And, we know that the journey can often catch us by surprise.  Many of us remember the time of puberty when our dancing hormones went full blast into action.  Once those hormones settled in, there was calmness.  Now at menopause, the hormones are changing gears again. 

So, like the month of March, the timing and the variability of our symptoms, is certainly unpredictable.  We never really know how it will hit and how long our symptoms will last.  Menopause is a great time to establish healthy habits.  We hope that “The Menopause Minute” will provide you with some great information to help you understand the changes in your body. 
           
This month, most of our clocks will spring forward one hour.  Daylight Saving Time begins at 2:00 am on the second Sunday in March (March 11th, 2007).  We are not simply “losing an hour”.  This time change allows us to soak in more sun and enjoy summer evenings longer.  In this month’s Menopause Minute, we share some great tips on how to acclimate to the change easier. 

March is also National Women’s History Month where women’s achievements in all facets of life are recognized – science, community, government, literature, art, sports, medicine.  It’s a good time for Red Hot Mamas to recognize the accomplishments of women in our own families, as women across America.      

I hope this information will be of interest to you:  Women by the Numbers; from the U.S. Census Bureau (www.infoplease.com/spot/womencensus1.html):

152 million
The number of females in the US as of Nov 1, 2006.  That exceeds the number of males (148 million).  As of July 1, 2005, males outnumbered females in every five-year age group through the 35 to 39 age group.  Starting with the 40 to 44 age group, women outnumbered men.  At 85 and over, there were more than twice as many women as men. 

Motherhood
82.5 million
Estimated number of mothers of all ages in the US

Earnings
$32,168
The median annual earnings of women 16 or older who worked year-round, full time in 2005.  Women earned 77 cents for every $1 earned by men.

Education
26.1 million
Number of women 25 or older with a bachelor’s degree or more education in 2005, more than double the number 20 years earlier.

Businesses
More than $939 billion
Revenue for women-owned businesses in 2002, up 15% from 1997.  There were 116,985 women-owned firms with receipts of $1 million or more.

Voting
65%
Percentage of women citizens who reported voting in the 2004 presidential election, higher than the 62% of their male counterparts who cast a ballot.

Military
203,000
Total number of active duty women in the military, as of Sept. 30, 205.  Of that, 35,000 women were officers, and 168,000 were enlisted.

Marriage
63 million
Number of married women (including those who are separated or have an absent spouse) in 2005.  There are 55 million unmarried (widowed, divorced or never married) women.

This month’s Red Hot Mamas Program Spotlight is on Good Samaritan Hospital in Baltimore, Maryland.  Their first Red Hot Mamas meeting, on January 31st, was a huge hit! They had 114 registered and 92 came -- a fantastic turnout for their launch event.  In addition, their upcoming scheduled meetings are already filling up. The evaluations from the participants were great and lots of positive comments were shared. 

Red Hot Mamas Program Directors for Good Samaritan, Debbie Bena and Karen Kansler, identified a new female gynecologist as the speaker.  The attendees loved the speaker – Debbie and Karen both agreed that she is sure to get some new patients from their event! The dinner and decorations had a Mexican theme and each attendee was garnished with a red boa as they entered the room. The hospital president was delighted with the program and very impressed with the number of attendees.  In closing, Debbie shared, “I can't say enough in regards to how pleased we are with the program.”  Thank you Debbie and Karen for all of your hard work to make the launch of the Red Hot Mamas Program a great success in Baltimore!

On a final note, I encourage all of you to acknowledge not only National Women’s History Month,  but also to accept responsibility for your health, becoming proactive through the menopause transition, and reassessing your health needs as they change through the years.

And remember, we always like hearing from you, so please don’t forget to:

1. Tell us if you would like a Red Hot Mamas program in your area
2. Log onto our Bulletin Board - chat with others experiencing menopause
3. Ask the experts – get answers to your health related questions

Good Health To You All,

Karen Giblin

Hormone Patch Proves to be Safer than Pill

In February 2006, the findings from a recently published study, gave a bit of hope to women taking hormone therapy.  Hormone skin patches and gels, it seems are far less likely than pills to cause blood clots.  Women who used the transdermal (through the skin) delivery method were at no higher risk for blood clots than women who did not even take hormones.

The Estrogen and Thromboembolism Risk Study (also called ESTHER) was conducted by French researchers and presented in the medical journal Circulation.  Eight hundred and eighty-one women took either estrogen only or an estrogen-progestin combination.  Women who took hormone pills were four times as likely to suffer a serious blood clot. 

This is great news for those of us who once thought the option of hormone therapy was a “dead end”.  When the Women’s Health Initiative (WHI) study was halted in 2002, our concern for blood clots greatly increased.  WHI found at least 44 percent of the adverse effects of HT were related to blood clots.  The WHI study left us wondering if results would have been different if they changed the type of estrogen and/or delivery method. 

Many professionals criticize WHI because they used one type of estrogen pill (conjugated equine estrogen).  An alternative type of estrogen is used in hormone patches, gels and creams (17-beta estradiol).  The two delivery methods of the hormone are very different. 

When taken in pill form, the hormones pass through the liver.  When the drug is metabolized, the liver produces too many triglycerides and blood-clotting factors causing the negative side-effects we commonly see.  Transdermal delivery methods avoid these unwanted effects by absorbing estrogen through the skin. 

Estrogen patches are placed on the abdomen or buttocks.  Once the patch is placed on the skin, it releases the hormone.  A variety of patches are available. Some are worn for 3 days, others are left on for a week.  Some are the size of post-it-notes, others the size of postage stamps.  In the US, the patches are available in doses ranging from 1.125 to 0.1 milligrams per day. 

Estrogen creams and gels also contain 17-beta-estradiol that is also absorbed transdermally, through the skin.  They are often rubbed into the skin on the hands but can also be absorbed through the skin on the stomach, thighs or inner arms.  Creams and gels are usually applied one to two times per day. 

The following FDA-approved estrogen and combination estrogen-progestin skin patches/gels/emulsions are currently available in the United States:

 
Bottom line:  if you have severe menopausal symptoms, hormone therapy should be considered as an option.  Discuss your risks and benefits with your doctor.  Your doctor may recommend using the lowest effective dose for the shortest time necessary. While this study gives hormone therapy a positive outlook, far more research needs to be conducted.  More studies are investigating risks and benefits of various hormone drugs and delivery systems including the KEEPS study (Kronos Early Estrogen Prevention Study).  For more information about KEEPS, click here. 

References:
Parker-Pope, T. (2007). Hormone Patch Shows Benefit Over Pill. The Wall Street Journal.  Retrieved February 20, 2007, from http://money.aol.com/news/articles/_a/hormone-patch-shows-benefit-over-pill/n20070220120709990011

The Hormone Therapy Story. (2006).  The North American Menopause Society’s Early Menopause Guidebook:  Helping Women Make Informed Decisions.  Pp. 56, 58.

To Nap or Not to Nap - Preparing for Daylight Savings

Would you ever think that Thomas Edison, Napoleon Bonaparte, Salvador Dali, Winston Churchill, and Presidents Kennedy and Reagan had something in common? In fact, each of them enjoyed a regular nap.

Many people find that a 20 - 30 minute nap is restorative, especially during the normal afternoon circadian ‘dip’ that usually occurs between 2:00 - 5:00 p.m. Napping can help maintain or even increase alertness and performance, sharpen memory and reduce symptoms of fatigue, especially during long periods of being awake.

A nap can also help people adjust to the hour of sleep lost when Daylight Saving Time returns, at 2:00 a.m. Sunday, March 11. However, napping, in general, is no substitute for a good night’s sleep, says the National Sleep Foundation (NSF) and the Red Hot Mamas®.

“Naps can help people boost their alertness and performance – IF they are healthy and usually get sufficient sleep at night. But naps will not reverse total sleep debt and shouldn’t be thought of as a substitute for a good night’s sleep,” says Mark Rosekind, PhD, an NSF director. “If you get sufficient sleep at night on a regular basis, you should not need a regular daytime nap,” he adds. Dr. Rosekind is president and chief scientist of Alertness Solutions in Cupertino, CA, which specializes in fatigue management issues.

While napping isn’t a widespread occurrence at U.S. workplaces, one-third of respondents in NSF’s 2000 Sleep in America poll said they would nap at work if it was allowed. NSF’s 2005 poll found that more than one-thirdof America’s adults take two or more naps a week, and these last an average of 50 minutes.

Rosekind recommends a nap of around 30 minutes. “Even a shorter nap can take the edge off of sleepiness but you want to avoid getting into a deep sleep, which can occur after a longer nap of around an hour, causing you to awake groggy instead of feeling refreshed,” he notes. This sleep inertia or grogginess and disorientation that can occur when you awake from a deep sleep usually disappears in l0 - l5 minutes, but the accompanying lack of alertness can be critical at the workplace or when engaged in other activities such as driving.

If and when you nap, Dr. Rosekind and the National Sleep Foundation offer the following tips:

• Determine an optimal nap time. Try not to nap too late in the day which can disrupt your nighttime sleep. If you are having difficulty sleeping at night, don’t nap during the day.

• Find the right environment. Make the most out of your nap time and avoid surrounding distractions.

• Find a quiet place, block out light and noise; use an eye mask and/or ear plugs if necessary.

• Be sure to make a good night’s sleep a regular daily activity – on average, between seven to nine hours are recommended for most adults. Establishing this regular sleep habit may help you kick a nap habit. Do you know your real sleep need? Try to determine how many hours of nightly sleep you need to be alert and at your best performance throughout the day; then establish a nightly routine and make time for your needed sleep.

Here are some additional tips to help adjust to the return of Daylight Saving Time:

• Try to sleep a bit more than usual a few nights prior to and immediately following the time change to help reduce any sleep debt you may be carrying.

• Take a nap in the afternoon on Sunday if you need it, but not within a few hours of your regular bedtime. Remember, napping too close to bedtime can disrupt nighttime sleep.

• The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving understanding of sleep and sleep disorders, and by supporting sleep-related education, research, and advocacy.

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