September 1997

CyberHealth Index

Contents:

1. Hormones and sun tan
2. Why does Melatonin produce weird dreams?
3. Is obesity a breast cancer risk?
4. Obesity and prostate cancer
5. The wizened old crone syndrome
6. European HRT dosages
7. Why do some women do OK without HRT?
8. Fat without fear: those fabulous monos
9. Don’t over-restrict your carbohydrates in the evening
10. Un-drooping those eyelids
11. Care of the Soul: Revisioning Lott’s wife

Hormones and sun tan

Have you noticed that the elderly gradually lose the ability to tan? Just as the ability to sweat, which protects us from heat stroke, depends on sufficient steroid levels (the elderly eventually stop sweating too), so does the ability to produce the protective pigment melanin. This makes older people (particularly those who were always fair-skinned) more vulnerable to sunburn, UV damage, and skin cancer. The density and activity of melanocytes (melanin-producing cells) seems to depend on hormone levels. All estrogens, but especially estradiol, stimulate the growth and activity of melanocytes; progesterone also has that property.

If you become severely hormone-deficient after menopause, you will be losing melanocytes just as you lose skin thickness or bone mass. However, if you are afraid to use estradiol, you can still use a weak estrogen such as estriol; estriol and progesterone will together help prevent the loss of melanocytes.

What about men’s ability to tan in relation to testosterone? Unfortunately I found no entries when I searched Biosis (a biomedical data base more comprehensive than Medline) for testosterone and melanocytes. And yet testosterone must have an effect on melanocytes—whether directly, because it can use the same receptors as progesterone, or indirectly, because it can be easily aromatized to estradiol.

Hormones probably also influence the ability to produce hair pigment (which again is melanin, except in redheads). I don’t know if this has been anyone else’s experience, but once I was on good NHRT I was absolutely amazed to see my hair start out growing not only thicker, but also darker. The effect on melanocytes and our ability to tan is another example of the UBIQUITY OF SEX STEROID ACTION. All types of tissue seem to be affected by hormone levels.

While HRT helps us preserve good Melatonin production, and also keeps the skin thicker and more resistant to damage, we should still remember to use a good sunscreen. Personally I favor the natural kind, based on PABA and Vitamin C. And don’t forget that make-up is in effect a “second skin,” and also protects. (As for men, thanks to testosterone their skin is thicker to begin with.)

Source:

Maeda K et al. Effect of pituitary and ovarian hormones on human melanocytes in vitro. Pigment Cell Research 1996; 9: 204-12;

McLeod S et al. Effects of estrogens on human melanocytes in vitro. J Steroid Biochem 1994; 49: 9-14

WHY DOES MELATONIN INCREASE WEIRD, VIVID DREAMS?

“Melatonin gives me the weirdest dreams,” Bill Regelson admitted. Many people report the same. What could be the mechanism of this? Chemically, Melatonin is 5-methoxy-N-acetyl-tryptamine. Bear with me. Let’s call it a variety of tryptamine. Some tryptamines derived from plants are used by South American shamans as hallucinogens. It’s also interesting that LSD and cocaine increase Melatonin synthesis.

This is not to say that Melatonin is a hallucinogenic drug. It certainly does not lead to hallucinations while a person is awake. But in the sleep state, Melatonin may aid in the production of vivid dreams.

Estrogens increase Melatonin levels by first increasing serotonin. In bright-light conditions, estrogens slow down the breakdown of serotonin; after dark, estrogens accelerate the conversion of serotonin to Melatonin.

Many women complain that after menopause they no longer seem to dream, even if before they used to have frequent vivid dreams. The tie-in between estrogen levels, Melatonin, and the amount and vividness of dreaming is the probable mechanism here.

Sleep research has discovered that dreaming is a physiological necessity.

Poor memory is one of the consequences of dream deprivation.

Source: Lewis A and Clouatre D. “Melatonin and the Biological Clock,” Keats Publishing 1996

IS OBESITY A RISK FOR BREAST CANCER? (OH LUCKY, LUCKY PEARS)

Yes and no. PREMENOPAUSAL breast cancer appears to be in some ways a different “disease entity” than postmenopausal breast cancer, and obese premenopausal women actually appear to have a somewhat lesser risk. The situation changes drastically after menopause. Now obesity is regarded as a major risk, especially if the woman is also tall. Large women, those who weigh over 154 lbs and are over 5’6″, appear to have 3.6 times the breast cancer risk of women under 132 lbs and 5’3″.

Just recently I leafed through a drug store pamphlet on breast cancer. It listed being over 10% overweight as a risk factor, right there with family history and childlessness. Barry Sears states: “In predicting the likelihood of developing breast cancer, obesity turns out to be an even greater risk factor than a prior family history” (“The Zone,” p. 173).

THE CASE AGAINST ABDOMINAL OBESITY

Some experts, however, insist that ONLY ABDOMINAL OBESITY is a risk factor (just as it is a significant risk factor for heart disease and diabetes). This is actually in line with Sears’ reasoning, since it’s abdominal obesity which is associated with elevated insulin levels and the inflammatory/immunosuppressive cascade that follows.

Based on his findings from the massive Framingham study, Ballard-Barbash (1990) states: “Only women with the highest central to peripheral body fat demonstrated an increased risk of breast cancer” and “increased central body fat distribution predicts breast cancer independently of the degree of adiposity, and may be a more specific marker of a premalignant hormonal pattern than the degree of adiposity.”

Because women with abdominal obesity typically have high levels of insulin (because they are insulin-resistant), they also have low levels of sex-hormone-binding globulin (SHBG), essential for regulating the ratio of free to bound steroids. In addition, they are likely to have defective estrogen metabolism, with excess 16-hydroxy-estrone produced. Strong estrogens, such as estradiol and 16-OH-estrone, and insulin are among the chief tumor growth factors.

High insulin, low SHBG (meaning high biologically active free estradiol), and high 16-OH-estrone are all characteristics of the abnormal endocrine pattern of breast cancer patients. (But let’s not forget that a slender woman is not immune to breast cancer; she’s simply at a lower risk.)

YOUR WAISTLINE IS YOUR LIFELINE

I’ll never forget how I first learned that abdominal obesity is a breast cancer risk. I happened to be driving and listening to Dr. Laura, a talk-radio psychologist. “Today I’m going to save your butt,” she announced, giggling. She instructed female listeners to measure their waist and hips, and divide the numbers: is the ratio lower or higher than .8? THE POINT-EIGHT WAIST-HIP RATIO SEEMS TO BE THE GRAND DIVIDE WHEN IT COMES TO A VARIETY OF HEALTH RISKS.

For almost half an hour Dr. Laura continued giggling in a state of euphoria, being herself a lucky pear. I did not need to use a measuring tape to confirm that I was a pear; the classic ten-inch difference between my waist and hips was nice, but ever since mid-adolescence I’d gone through endless idiotic agony trying to “spot reduce” my thighs.

It’s only now that I understand the hormonal mechanism associated with being a pear vs an apple, and bless my grandmother for having fattened me up somewhat during what must have been a critical period during early adolescent development, ensuring sufficient estrogen levels. To put it in a nutshell, it’s not the majestically buttocked, heavy-thighed “female female” who is at a high risk of breast cancer; it’s the large hyperandrogenic woman.

If you look like a fertility goddess, rejoice. I repeat: not the “female female,” but the LARGE HYPERANDROGENIC POSTMENO WOMAN is the type who is at highest risk. In one Italian study, postmeno women in the upper one-third of total native (non-HRT) testosterone levels had SEVEN TIMES the breast cancer risk compared with postmenopausal women in the lowest tertile.

It all depends on the ratio of male to female hormones. If the ratio is low, i.e. the estrogens are on the high side, we see an increase in the NUMBER of fat cells from the waist down; if estrogens are relatively low, the androgenic pattern emerges: the fat cells from the waist up stay the same in number but enlarge in size. You could say they become engorged, abnormal, misshaped. A vicious circle results, with high insulin synergizing with the luteinizing hormone to stimulate the production of androgens, leading to even higher male/female hormonal ratio.

Comparing breast cancer patients with matched healthy controls, David Shapira found that cases were not only heavier (by 7 lbs on the average), but had a significantly higher waist-to-hip ratio. The size of the hips did not significantly differ between the two groups. IT WAS THE SIZE OF THE WAISTLINE THAT DIFFERED BETWEEN BREAST CANCER CASES AND CONTROLS, by an average of about 2″.

The endocrine pattern associated with abdominal obesity is high insulin, high testosterone (in women only), and low sex-hormone binding globulin—meaning less ability to neutralize excess sex steroids. Both excess insulin and excess steroids can serve as tumor growth factors.

ESTROGENS’ ABILITY TO STIMULATE THE MULTIPLICATION OF FAT CELLS BELOW THE WAIST IS ONE OF NATURE’S GREATEST GIFTS TO WOMEN. These cells are normal rather than misshapen and insulin-resistant. Production of new fat cells in safe areas in a great way to create a safe fat dump, or “metabolic sink,” to put it politely. You can store fat without increasing your risk of heart disease, diabetes, or cancer.

The good news is that ABDOMINAL FAT IS THE EASIEST TO LOSE, and THE ENDOCRINE PATTERN NORMALIZES AS THE WAISTLINE SHRINKS. The slogan to remember is YOUR WAISTLINE IS YOUR LIFELINE. As your waistline expands, your life expectancy shrinks. As for the size of the thighs, some scientists even say, “the fatter the better” since the thigh and buttock fat attracts triglycerides into safe storage, away from the belly. SO BLESS THOSE FAT THIGHS! LOVE THAT CELLULITE! If the new thinking is correct, this is your health insurance.

IS THE TIMING OF WEIGHT GAIN A CRUCIAL FACTOR?

Dr.Noreen Aziz, on the other hand, has focused on weight gain between ages 20 and 30, which she says predicts the risk of breast cancer later. According to Dr.Aziz’s findings, a 10-pound gain increases the risk by 23%, a 15-pound gain by 37%, and a 20-pound gain by 52%. Others have looked at the overall long-term weight gain since early womanhood, and concluded that gaining more than 10 kg (just over 22 lbs) doubles breast cancer risk (while lean women had a greater risk of benign breast disease).

Dr. Ballard-Barbash states that WEIGHT GAIN AFTER MENOPAUSE IS ASSOCIATED WITH INCREASED BREAST CANCER RISK—perhaps because such weight gain is typically abdominal. Actually the trend toward abdominal obesity starts already in the forties. The closer the woman gets to menopause, the more likely it is that the hormonal decline will lead to rapid abdominal weight gain.

WARNING: EVEN PEARS CAN MORPH INTO THE WRONG FRUIT AFTER MENOPAUSE! And then there are those who think that BIRTH WEIGHT is crucial: extra-large female babies have an elevated risk later (especially if they go on to become extra-large women, both in terms of height and weight; being tall is an indepedent breast cancer risk, though not a particularly serious one). The confounding factor here is that extra-large babies are at extra-high risk of midlife obesity.

Moreover, the mother of a high birth-weight baby is herself at a higher breast cancer risk, probably because of her elevated blood sugar and high insulin levels.

In addition, obese breast cancer patients have been found to have an overall 49% greater mortality than lean breast cancer patients (this doesn’t hold true for hormone-independent tumors, however; but WITH HORMONE-DEPENDENT TUMORS, THE RISK OF DYING IS THREE TIMES AS HIGH FOR AN OBESE PATIENT AS FOR A LEAN PATIENT).

No matter what, in terms of the lowest possible risk there seems to be nothing better than being petite, Asian, and a mother of five or more. If you are “large,” should you despair?

BACK TO THE DANGERS OF “MALE BELLY FAT”

My own view: it depends WHERE you are large. Chubby, rosy-cheeked pear-shaped women strike me as enviably healthy. Lower-body fat appears to be harmless—and may even be good for you! Yes, that’s right: “female fat,” by which I mean those darling waist-sparing deposits on the buttocks and thighs, is increasingly seen by experts as harmless, or even beneficial in preventing atherosclerosis and diabetes—perhaps even breast cancer. Those jokes about majestic hips and thunder thighs—dear pears, now it’s your turn to laugh.

So if you’ve been agonizing over your thighs, stop this nonsense immediately. Drop on your knees and thank God/Goddess for your good estrogenic luck: the feminine fat distribution. But if you are an androgenic “apple,” i.e. most of your fat is on your belly and above (I call this the “male fat”) while your hips and thighs are relatively slender, you should take action.

Trade the refined carbohydrates (bread, bagels, mashed potatoes, corn flakes, soft, overcooked pasta) for salads, beans, and low-glycemic veggies and fruit such as broccoli (never overcooked, of course) and grapefruit, and get more exercise—and make sure your nhrt provides 2 mg of estradiol (Estrace) or equivalent in triestrogen or patch (opposed with sufficient progesterone, of course) in order to help keep the fat off the belly. If you are fully postmenopausal, the weaker patch just won’t cut it. As for the classic tri-est cream (.125mg E2) or capsules, it’s so weak it’s a laugh.

Judging from PEPI, .625mg Premarin is not very effective either at maintaining the pear-shaped fat distribution, while studies using stronger estradiol doses have reported clear “waistline preservation.” Some women cling to the weaker patch or mere 1mg Estrace, and then complain about their pot bellies, high cholesterol, poor sleep, memory loss and on and on. You can’t get the full benefits of estrogen with a suboptimal dose anymore than you can cure a headache with baby aspirin. Your serum estradiol should be around 100 or above.

Also bear in mind that even pears should take care not to gain extra weight after menopause. Ultimately estrogen replacement is not enough, it seems. As we produce less and less growth hormone, the waistline becomes endangered. In summary: first we had the news that it’s not how much fat we eat, but how fat we are; then the news that it’s not how fat we are, but WHERE we are fat (thighs vs belly). Now there’s a debate over WHEN we get fat. Preponderance of evidence points to abdominal obesity and the high insulin levels that go with it as creating a premalignant hormonal milieu.

Let me end with this sadly neglected statement by Dr. Sears: “CALORIE RESTRICTION—coupled with correct macronutrient composition—IS FAR MORE EFFECTIVE THAN ANY DRUG IN THE PREVENTION OR TREATMENT OF CANCER.” Probably the main mechanism is the dramatic drop in insulin, and possibly the consequent rise in DHEA.

Please pass the celery sticks (rich in insulin-lowering soluble fiber) and get your walking shoes ready. And for your heart’s and breasts’ sake don’t quit after only half an hour, because you’re not yet in the fat-burning stage! First you have to burn off excess serum glucose, then glucose stored as glycogen, and only then will your body give you the energy-high of fat burning. When you get that “second wind” and start feeling great, that’s your belly fat going bye-bye.

Main source:

Ballard-Barbash R. Body fat distribution and breast cancer in the Framingham study. J National Cancer Instance 1990; 82:286-90.; also

Shapira DV et al. Abdominal obesity and breast cancer. Ann Int Med 1990;112:182-6;

Terry R. Contribution of regional adipose tissue depots to plasma lipoprotein concentrations in overweight men and women: possible protective role effects of thigh fat. Metab 1991; 40: 733-40;

Andersson B et al. Estrogen replacement therapy decreases hyperandrogenicity and improves glucose homeostasis and plasma lipids in postmenopausal women with diabetes. J Clin Endocrin Metab 1997; 82: 638-43

IS OBESITY A RISK FOR PROSTATE CANCER?

I think women need to know a few things about prostate cancer too. After all, prostate cancer is significantly related to nutrition and the amount of body fat, and it’s women who typically determine much of what their mates eat.

A recent large-scale prospective Swedish study found that the risk of prostate cancer started growing when the body-mass index reached 26. For BMI greater than 29, the risk was increased by 80%. The study also looked at the intake of particular foods in relation to prostate cancer. Only heavy consumption of potatoes was found to be related; on closer analysis, however, it could not be separated from obesity. Obesity was the best predictor of prostate cancer risk. Four other studies have also found significantly increased prostate cancer risk in obese men.

The paradox here is that obese men are hypoandrogenic (low testosterone and DHEA levels) and hyperestrogenic compared to lean men. One possible explanation may lie in their high DHT/T ratio: though their testosterone is low, their “strong testosterone,” or dihydrotestosterone (DHT), the stimulator of prostate growth, is relatively high. We see the same situation develop simply with aging: the ratio of DHT to testosterone increases, and so does central obesity (“the bigger the belly, the lower the testosterone”).

Thus we see increased risk of breast cancer in obese hyperandrogenic women, and increased prostate cancer risk in obese hypoandrogenic/hyperestrogenic men.

Besides weight loss, there are nutritional means through which a man can significantly decrease his risk of prostate cancer.

LYCOPENE, found chiefly in tomatoes and tomato products, has been found to be important in preventing prostate cancer. If someone you love is at a high risk, I’d consider getting A LYCOPENE SUPPLEMENT for him, since it’s rather difficult to consume enough tomatoes, tomato sauce, soup, etc. every day (though by all means keep eating tomatoes).

SELENIUM has been found to dramatically lower the risk of prostate cancer in a well-publicized recent study (200mg/day cut incidence by 63%). Men lose selenium with every ejaculation. ZINC is also essential for testosterone production.

Because the prostate has both estrogen and progesterone receptors, hormonal prevention might also be a possibility. The estrogen receptor in the prostate is of the beta type, which easily binds GENISTEIN, an anti-carcinogenic plant estrogen found in soy beans. Progesterone has been used for relief of benign prostate enlargement, and it too might be protective.

Gillian Ford discusses this cutting-edge use of progesterone in her book, “Listening to Your Hormones.” Bill Regelson discusses the use of MELATONIN to protect the prostate in both of his books. The herbs saw palmetto and pygeum seem to inhibit the conversion of testosterone to the stronger, prostate-stimulating dihydrotestosterone (DHT). A lot of men are now taking these not only to reduce prostate enlargement, but even in absence of any problems, simply as prevention.

Finally, exercise and regular sexual activity seem very important in preventing prostate cancer.

Source:
Gronberg H et al. Total food consumption and BMI in relation to prostate cancer risk. J Urology 1996; 155: 969-74.

HOW TO CALCULATE YOUR BODY-MASS INDEX

Body-Mass Index (BMI) is emerging as an important predictor of risk for heart disease, diabetes, and cancer. It’s derived by dividing weight (in kilograms) by height squared (in centimeters). Here is an easy way for those of us who know these figures only in pounds and inches:

1. multiply your weight by .45
2. multiply your height in inches by .025
3. square the result obtained in # 2 (let’s say the figure you obtained was 1.65; multiply 1.65 x 1.65)
4. divide your weight as calculated in #1 by your height squared, as calculated in #3 (typically the result falls between 19 and 30+)

WHAT DOES YOUR BMI MEAN?

• If your BMI falls between 20 and 25, you are in the normal, low-risk range.
• Those with BMI between 25 and 28 can be considered MILDLY OBESE.
• Moderate obesity starts at BMI of 28 (though some might argue for 30).
• Past BMI of 35, a person is considered SEVERELY OBESE.
• A BMI higher than 25 signals increased risk for heart disease, breast cancer, diabetes. The higher the BMI, the higher the risk—but don’t forget to look also at the TYPE OF FAT DISTRIBUTION. If you are a pear, you can afford to have a somewhat higher BMI.

** WHY DON’T WOMEN KNOW THIS? **
THE PILL, COMBINED HRT, AND REDUCED OVARIAN CANCER RISK

The little handout promoting the UC Berkeley Wellness Letter says, “Women have been misinformed about birth control pills . . . The truth is that the health benefits of the Pill far outweigh the risks. Not only does it provide safe, reliable contraception, IT DRAMATICALLY REDUCES THE RISK OF OVARIAN CANCER. The risk decreases the longer the Pill is used and lasts at least 15 years after it is discontinued. Indeed, women at high risk for ovarian cancer can protect themselves simply by going on the Pill. Why don’t women know this?”

Oh, come on. We know very well why women don’t know this and many other potentially life-saving facts. The Pill is also known to help protect against endometrial cancer and benign breast disease; when breast cancer is found in former users, it’s more likely to be a lower grade tumor. Why don’t women know this? Well, is anyone making the effort to tell them?

For most women, the Pill is considered safe to take until menopause, and is in fact recommended for conditions such as irregular cycles, heavy peri-menopausal bleeding, PMS, endometriosis (it won’t cure it, but it should arrest it), ovarian cysts, and for the prevention of osteoporosis. One kind has been approved for the treatment of acne. Why don’t women know this? Is there a taboo against publicizing the benefits of the Pill?

Not surprisingly, considering its similarity to the Pill, combined HRT has also been found to be protective against ovarian cancer (the evidence from the Leisure World Study indicates a 40% risk reduction) — but how many doctors are aware of this, much less women?

A woman who came to one of my lectures said that because her mother had died of ovarian cancer, she’d contacted the Gilda Radner Association for advice on HRT in terms of ovarian cancer risk. She was told to stay away from HRT. No word of explanation of why HRT was supposed to be dangerous while the Pill is protective. This woman went on to suffer hot flashes, night sweats, low energy, and sexual dysfunction, ultimately losing her marriage and ending up traumatized. I don’t think the Gilda Radner Association has done her a favor.

Likewise, why don’t women generally know that HRT helps protect against arthritis, tooth loss, cataracts, colon cancer, diabetes, and many other degenerative disorders. not just heart disease, stroke, osteoporosis, and Alzheimer’s?

Because their doctors either themselves don’t know the recent research, or can’t/won’t take the time to educate their patients, while the news media present information at such rapid pace and in such a superficial way that it doesn’t really register, squeezed between endless info-junk and commercials.

Alternative health industry will generally not present any information that doesn’t promote their own products. Besides, the naturist position makes it very politically incorrect to acknowledge that millions of lives could be saved through correct use of the right hormone therapy (including, very much, men’s lives, as the coming decade will show, I predict). Quality, unbiased health publications are few—but they do exist. Feel free to write me so we can compile a list of the readers’ favorites.

The Berkeley Wellness Letter is right: the Pill has been found to be very effective at reducing the risk of the often-lethal ovarian cancer. Taking the Pill for one to two years has been found to reduce the risk of ovarian cancer by 30%; for five to nine years, by 60%; for ten years or more, by 80%. Why don’t women know about it? Because they haven’t been told.

Because the most logical approach to cancer, PREVENTION, is still not regarded as a medical priority.

But the Pill has side effects that make it unacceptable to many women. We badly need a version based on natural hormones, not on progestin; Dr. Michael Cohen’s Melatonin-based contraceptive is also of great interest.

(By the way: did you know that Dr. Cohen himself takes the same dose of Melatonin as his female subjects: 75mg of time-release Melatonin every night? He was impressed with the effects on cholesterol in the women on the Melatonin pill, and their overall well-being. Neither he nor they report any grogginess.)

In the meantime, of course women need to be told about the benefits of the Pill. And they should also be warned about the risks of staying on it too long, say over 20 years, such as gallbladder problems. Educate, educate, educate. As a Chinese sage said, the greatest disease is ignorance.

Source:

Breckvoldt M et al. Benefits and risks of HRT. J Steroid Biochemistry 1995; 53: 205-8.

Reduction in risk of ovarian cancer associated with oral. New England J Med 1987; 316: 650-55)

THE WIZENED OLD CRONE SYNDROME: A READER’S REPORT FROM ENGLAND

I asked one of our overseas readers, Elizabeth in the UK, to comment on Germaine Greer, the author of “The Female Eunuch,” a one-time best-seller which claimed that women are castrated by the patriarchal culture, and more recently of “The Change,” a book which opposes HRT and recommends that we embrace aging, with its loss of libido (GG doesn’t seem to be much concerned with the loss of bone, muscle, teeth, hair, memory, energy, clean arteries, etc).

In direct antithesis of Wilson’s “Feminine Forever,” GG champions “feminine no more,” or, more explicitly, “sexual no more.” She suggests that estrogen is the “contented-cow” hormone; it makes women “receptive.” GG’s grasp of the biology of menopause is slippery at best; she repeatedly refers to menopause as “the death of the womb” (she also refers to dementia as “softening of the brain”).

GG stresses the cultural factors and states that “the climacteric is a time of mourning” and “the antechamber of death.” She seems to suggest that a sexless, defeminized “crone” (dare we call her “the female eunuch”?) is a role model for us all.

Elizabeth writes:

I haven’t read the book, but intended to. However time marches on and I am not a very political creature (I skirt around it). I did see her do TV and read some press interviews and my feelings are mixed. On the one hand I felt OK, cool, if she wanted to become a “wise wizened old crone”, and was happy (her words, not mine), that was her right. She looked fine: like a wise old woman.

On the other hand I considered her enthusiasm was damaging to those women who were unsure whether to take HRT or not. It encouraged them NOT to fulfil their rights as females to have a smooth menopause and to live potentially healthier lives into their old age.

I recall being irritated by the media emphasis at the time on GG’s opinions about the myth of anti-ageing through the use of hormones. The sooner the pharmaceutical companies stop using youthfulness or anti-aging as the main marketing reason for HRT, the better. That’s not to say it doesn’t help one to feel youthful, horny, attractive, want to take care of onesself, etc. (as opposed to the reaction I had to meno which was deep depression, lack of self-esteem and worth, loss of libido, I can’t be bothered…. It’s history…there is no point dwelling on it).

But as with any medication, it is a medication and its medical worth should be the main selling point.

I am sure that GG also touched on the topic of pharmaceutical mega-giants; wealth is in illness, not health; etc. We have all heard it and know the music that accompanies such lyrics (irony).

Sure, I can share the perception that not having periods or getting pregnant any more move one from one level of life to the next, but I don’t see any teeth in the argument that it is also OK to stop being a sexually responsive creature; or makes it OK for you to suffer through menopause and then live out your old life, possibly (but not for sure, I hasten to add) suffering from osteoporosis, (Alzheimers?), tolerating / suffering the functional deterioration that old age meant to, say, my mother’s and grandmother’s generations, blah de blah de blah: a drain on our offspring and on society.

Quite honestly, I don’t care about GG. Except she has power because of her fame and I think she tries to use it wisely; though she is obviously influenced by her feminist beliefs.

I recently had visitors from abroad. Sandra is 46 (I am 50). She is into menopause in a serious way but has taken the GG the view that it’s natural, and if she has lost her libido, then that’s natural too, and (excuse the following) her husband can just go wash his penis in the bathroom as often as he wants, because she is not going to assist him.

He is desolate. He loves Sandra desperately and it isn’t just the sex act that he needs, but the tenderness and the loving. But her reaction to menopause has been so severe that she just cannot bear to be touched. Her skin creeps and she starts to sweat and get itchy patches (flashing in the US, flushes in the UK – nothing to do with lavatories ;-)).

I tried to persuade her to see the gynaecologist at her clinic to take advice, but no, she will not. “If it’s good enough for my mother, it’s good enough for me”. Cool. That’s her right. But later that evening, the husband passed me a note across the table after Sandra had gone to the living room. “Why are you like this? Is it the hormones? I want to **** you”. I was appalled, of course, but I cannot help but wonder how she can willfully risk destroying her marriage because of her views. Incidentally, Sandra’s mother passed away earlier this year, in the final stages of senile dementia. Comme on dit: “It’s a rum world”.

And on a closing note, Ivy, all the friends of mine who chose HRT seem to bloom. I had a difficult time until I found the right one, but for the past 2 years I have been a different person. Trouble is menopause creeps up on you. One minute you’re say 40 and then suddenly you are becoming a grey haired “wise wizened old crone” (per GG).

The new generation of pre-menopausal women will not tolerate osteoporosis, losing their hair, their teeth, becoming wizened, suffering from menopause symptoms, ill health, depression, Alzheimers, etc, and I see myself and some of the women who’re a little older than me, as pioneers. Rather a nice thought to hold for the day.

Ivy replies:

Thank you, Elizabeth, for your frank commentary. I agree: the new generation of women has no intention of allowing themselves to become wizened old crones. The idea that as we grow older we must become withered and shriveled is going to become as archaic as the phrase itself. The same goes for “little old lady” and “little old man.” It’s time to understand that osteoporosis is 100% preventable.

As for the word “crone,” a feminist friend tells me that the preference in her circle is for dropping it in favor of “queen” (virgin, mother, queen). Sandra’s insensitivity to her husband’s needs is shocking. Perhaps her symptoms make her so miserable that she can’t really think about the needs and feelings of others. I hope that she doesn’t lose her marriage, and that she does something to protect herself against Alzheimer’s disease, since she may have a genetic susceptibility.

One thing I fail to understand about anti-HRT feminists is that these very women are all in favor of effective birth control, including the pill. If a woman chooses to stay on the Pill for 15-20 years, that’s politically correct; if she wants HRT, she’s somehow “betraying the sisterhood.” Avoiding pregnancy is OK, but avoiding osteoporosis, atherosclerosis, and Alzheimer’s is “unnatural”? The pill is liberation, but HRT is enslavement to the patriarchal “menopause industry”?

I don’t follow the logic, unless we accept GG’s view of menopause as a “liberation” from sex drive or Dr.S. Love’s view of young womanhood as “estrogen poisoning” and menopause as a liberation from “the domesticating hormones” (Love chooses a milder vocabulary than the “contented-cow hormone”).

I can’ help but wonder: would any “masculinist” suggest that men try to liberate themselves from testosterone, that “happy-bull” hormone? Fortunately many pro-HRT female physicians also consider themselves to be feminists, and we have strong pro-woman voices such as Dr. Penny Wise Budoff, an early proponent of combined HRT, Dr.Christiane Northrup, Dr. Elizabeth Vliet, or Dr. Theresa Crenshaw (a breast cancer survivor). They speak out of knowledge and a deep caring for women, not out of ideology and ignorance.

Finally, Elizabeth’s last comment is right on: the new generation of women will not tolerate needless suffering and preventable degenerative disorders. These women are more daring, more activist, and definitely not ready to retire just because their ovaries fold up. They’ll use menopause as another step toward liberation, yet another chance for flowering. * *

A NOTE ON EUROPEAN HRT DOSAGES

You may be wondering what kind of HRT Elizabeth uses. She takes 1.25mg Premarin and 10mg Provera every day (continuous regimen). Note that this is twice the usual American dose of Premarin and QUADRUPLE the dose of progestin. While most of you know that I vastly prefer real progesterone over progestins, in this case it’s the dose that’s of interest; Elizabeth obviously gets a lot more protection against endometrial problems, and possibly against breast cancer, than a typical American HRT user.

In other words, HER ESTROGENS ARE MUCH MORE ADEQUATELY OPPOSED than is standard U.S. practice.

This amount of Provera also has some antioxidant activity. Nor is Elizabeth at any danger of bone loss.

Natural progesterone is available in the UK only in the form of ProGest, or by ordering from U.S. compounding pharmacies.

With oral estradiol, the starting European dosage tends to be 2mg, and 4mg is not unusual. The standard 5g dose of French Oestrogel delivers 3mg of estradiol dermally. An example of a continuous regimen used in Germany is 2 mg estradiol + 1 mg estriol + 1 mg norethisterone/day. What makes these higher dosages safe? As with the birth-control pill, the crucial point is to use a sufficient dose of progesterone or progestin. It was actually British medical research which introduced the concept of COMBINED hormone replacement.

BUT HOW COME SOME WOMEN DO PRETTY WELL WITHOUT HRT?

Gail writes: “I think you need to be very careful about painting the negative picture of postmenopausal women NOT on HRT. I think there are a lot of postmenopausal women out there who are strong, healthy, and beautiful and doing very well without HRT, and who would feel quite affronted at your depiction of women not using HRT in negative terms (withered, forgetful, etc).”

Ivy replies:

I don’t know about “a lot”—but I remember reading somewhere that one-third of women appear to do pretty well without HRT. Is it a coincidence that there is also this piece of statistics: one-third of American women are considered obese by medical definition of the term.

More significantly, there is the consistent finding, study after study, that HRT USERS TEND TO BE MORE SLENDER AND HAVE AN EARLIER MENOPAUSE THAN NON-USERS.

Before HRT there used to be a saying that a woman had to choose between her figure and her face. If she stayed “youthfully slender” after fifty, her face would look more and more haggard; the only way to preserve a smooth, plump, relatively youthful-looking face was to be overweight. Gail Sheehy calls it “sacrificing the fanny for the face.”

I know two women in their mid-late fifties who appear to be doing reasonably well without HRT. Both had a late menopause and both weigh over 200 lbs. In spite of their weight, both of them exercise every day; the one who exercises more is doing especially well.

Body fat is really a kind of “third ovary” when it comes to the production of steroid hormones. Heavy women tend to have lovely skin and generally look ten years younger than their skinny sisters. Often they are more cheerful too! Gynecologists have observed that there are basically two kinds of menopause: “the thin’s woman’s menopause” and “the plump woman’s menopause.” (There are individual exceptions, of course; we can’t assume that every thin woman suffers terribly while every chubby woman hardly at all.) Consider this quotation from Dr. Robert Wilson: “The unpalatable truth must be faced that all postmenopausal women are castrates. THERE IS VARIATION IN DEGREE but not in fact.” (Emphasis mine)

There is definitely a great variation in degree. Some women become extremely hormone-deficient; other women’s considerable peripheral production of estrone and testosterone (even ovarian testosterone: some women’s ovaries continue to produce a significant amount of androgens) helps them function much better.

Has anyone noticed how low some women’s voices become after menopause? You never hear such a husky voice in a twenty or thirty-year-old woman. Deep, gruff, and flat, such voices reflect testosterone’s enlarging effect on the voice box. A virilized woman may not be appealing, but she doesn’t care; she’s got PMZ, that special zestful assertiveness and energy that Gail Sheehy, for one, explains in terms of increased androgen/estrogen ratio.

In summary: PART OF THE ANSWER IS THAT SOME POSTMENOPAUSAL WOMEN ARE LESS HORMONE-DEFICIENT THAN OTHER POSTMENOPAUSAL WOMEN.

But that is obviously not the whole answer. Hormones are not the sole factor in our well-being, although an important one. Having learned how to be happy is possibly even more important. Dr. David Weeks, an Edinburgh neuropsychologist, studied women judged to look 12-14 years younger than their age. He found that these women 1) had positive attitudes; 2) were married or in a relationship; 3) socialized with younger people; 4) ate a lot of fruits and vegetables; 5) exercised regularly.

Menopause wasn’t studied here, but probably all these factors apply at any age past 35 (I choose this age because some experts feel that’s when hormonal decline and other kinds of aging really begin to show). I am not surprised that positive attitudes came first. Negative attitudes promote stress; stress breeds free radicals; free radicals are a major cause of aging. A supportive relationship also serves to reduce stress. Let’s face it, all the vitamins and other supplements are like a band-aid on a wound unless we take steps to reduce stress.

(Gail reminds me here that “negative attitudes” can be due to hormone deficiencies; true, mental and physical factors are intricately interrelated.) The anti-aging benefits of socializing with young people may come as a surprise to some readers. I think this finding is in line with the actuarial statistics which show that women married to younger men have a much lower all-cause mortality than the rest of the female population, while women married to older men have a higher all-cause mortality. (Believe me, I hate these findings!!) It could be that women married to younger men are healthier to start with, but it could also mean that there are special health benefits due to greater amount of sexual activity, as well as possibly just being around an energetic young person (pheromones? energy fields?)

And then, as we all know, some women simply have great genes. A passion for life and a reason to live are more important than supplements – nobody doubts that.

I certainly don’t wish to offend those women who feel fine without HRT. But many of us do not fall into that category, and also feel offended by those authors who preach that if only we exercised twice as hard and ate more tofu we’d never need hormonal supplements. I did eat tofu and did exercise every day – and still do – but perhaps because of my low body fat and/or other factors, I certainly wasn’t doing well (to put it mildly) until I found the right natural HRT.

As for the idea that if only we lived like our ancestors and ate natural food we’d never need hormones, I wonder why it was that menopause was called ” l’enfer des dames ” (the hell of women) already in the Middle Ages, and even centuries ago, long before the discovery of hormones, physicians insightfully spoke about “the wellspring drying up”? I say hooray for the women who do well without HRT, and I say hooray for the women who do well on HRT. In the case of women at a high risk for heart disease, stroke, osteoporosis, Alzheimer’s disease, colon cancer, arthritis etc, I hope that they get the latest information and not let paranoia, misinformation, and the extremist naturist attitude — “We should not interfere with the aging process” — prevent them from considering a potentially life-saving treatment. In the case of women at high risk of breast cancer, I hope that developments such as Raloxifene will solve their HRT dilemma (Caroline points out that estriol and 3-E might be just as safe, and of course are vastly less expensive, but unfortunately there is no commercial interest in them).

Above all, I say: do not let yourself be intimidated by the supposed experts, whether mainstream or alt health. LISTEN TO YOUR BODY.

THOSE WILD NONAGENARIANS: THE POWER OF STAYING MENTALLY ACTIVE

The brain is truly a use-it-or-lose-it organ. Bob writes:

We have many ladies of advanced age here who play competitive duplicate bridge. The two oldest are 97 and 95. Two years ago we had a tournament here with the top players from Albuquerque and Los Alamos. At the last minute, one of the Los Alamos engineers had a change in schedule that allowed him to make the Friday night event, but needed a partner. I called our oldest player, then 95, and drove over to pick her up. Upon arrival at the game, she rushed out of the car before I could get around to help her, and to my horror she fell down. She picked herself up, went in to play with a partner she hardly knew, … and won the event.

Ivy replies:

A wonderful story. Not to compare us with rats, but we do know from animal research that rats kept mentally stimulated by being given new toys every day (this must have kept the scientists mentally stimulated as well) live much longer than un-stimulated rats. Keeping happily active might indeed turn out to be more important than anything else.

* * * NUTRITION RESEARCH * * *
FAT WITHOUT FEAR, PART I: THOSE FABULOUS MONOS

After decades of brainwashing the public about the need to cut back on fat and preaching that we should avoid the “fat-loaded” avocadoes, nuts, and salad dressings with olive oil, nutrition gurus, without one word of apology, are now telling us that there is hardly anything better for us than avocadoes, nuts, and olive oil; for best health, we should consume these items every day. Nuts, like fish, contain the precious omega-3 fatty acids. Avocadoes, almonds, and olive oil are terrific sources of monosaturated fatty acids.

Omega-3 fatty acids and monosaturated fatty acids have been found to be cardioprotective and anticarcinogenic, unlike Omega-6 fatty acids (corn oil and most vegetable oils, margarine), which can promote heart disease, inflammation, and tumor growth.

For now, let us concentrate on those wonderful monos. MONOS LOWER BLOOD SUGAR, INSULIN, CHOLESTEROL, AND TRIGLYCERIDES. By preventing the development of insulin resistance, they guard against abdominal obesity and all the health risks that go with it.

Among the sources of monos, AVOCADOES are number one. In fact, we would do well to eat an avocado a day. Never mind the price: it’s worth it (compare the price of liver-toxic Pravachol). Avocado is a superfruit, with more potassium by far than bananas (60% more potassium per ounce), and with lots of fiber and health-giving phytochemicals, such as glutathione, which prevents the absorption of the dangerous peroxidized fats.

The diets of southern European countries (Greece, Spain, Italy, etc) derive 40% or more of calories from fat, and yet the incidence of heart disease and breast cancer is much lower than in northern Europe or North America. Part of the answer lies in the consumption of olive oil.

The women on the island of Crete have the lowest breast cancer mortality in the world. They derive 45-60% of their calories from fat, mainly fresh olive oil. (The olive oil we typically get is not that fresh and does contain some peroxidized fatty acids—hence some experts recommend buying only a small quantity, squeezing some Vitamin E capsules into the oil, and using it fast, discarding it if the taste turns distinctly bitter [bitterness signals rancidity, or peroxidation]. Also, glutathione, an antioxidant compound manufactured by our bodies and contained in plants such as avocadoes and asparagus, helps protect us.)

What happens if you start consuming more good fats? You feel sated sooner and eat less.

Sophia Loren attributes her youthful looks to eating olives (not the canned kind, I’m sure) every day—her favorite snack. The benefits for the skin have been known since antiquity.

Olive oil also contains phytoestrogens, but since so many foods provide all manner of phytohormones, I’m not sure if that’s a significant factor. ALMONDS are another wonderful source of monos you might consider eating several times a week. And almonds supply magnesium, an extremely important mineral for heart and bone health.

MACADAMIA nuts, if you can afford them, are practically synonymous with monos. They make a marvelous snack. A natural food that tastes this good is surely special.

Instead of the usual load of dead, processed carbohydrates for breakfast (what a ghastly way to start the day!), try this experiment: have cottage cheese (or whatever source of protein you prefer; eggs are a wonderful source of nutrition) with a generous serving of avocado, and maybe half a grapefruit, some blueberries, or any other summer fruit of your choice. Note that you are getting carbohydrates together with protein and healthy fat — but these are not the dead, processed carbohydrates. No bread, no cornflakes, no dead, stale, commercial orange juice devoid of life-giving enzymes (a whole orange is OK; that’s live cells, with active enzymes, plus lots of nutrients and fiber).

See how you feel afterwards. Amazing, isn’t it? No bloating, no fatigue, no hunger, and all this weird energy that lasts and lasts . . . And the cheerful mood — could it be that every cell in your body is singing for joy at the respite from sugar and yeast?

Low-fat diets have proved to be a miserable failure. Instead of losing weight by avoiding fat as much as possible, people seem to get fatter and fatter as they munch on non-fat potato chips.

The emerging new thinking is that it’s not so much the amount of fat you eat, but the KIND OF FAT you eat that makes the most difference to your health. In fact, YOU MUST EAT SOME HEALTHY FAT WITH EACH MEAL in order to insure optimal metabolism and keep blood sugar and insulin within healthy range. If you leave out the fat, you’ll feel tired and hungry much sooner. Forget the non-fat salad dressing! That’s an example of sheer non-sense.

The future belongs to a good-fat diet.

P.S. MORE ON THE CRETAN DIET.

The Cretan diet is regarded as one of the best in the world. Starr, who has been to Crete, writes that Cretan women consume a lot of fish, yogurt, goat cheese, some meat, grapes. Starr adds: “The women do all the work. The men do nothing.”

* * * Q & A * * *
WHAT’S LOVE GOT TO DO WITH IT?

Gayle writes: “When I fall in love, I lose weight without even trying. How come?”

Ivy replies:

Being in love is an interesting physiological state. Typically, in premenopausal women, there is an increase in both estrogen and testosterone levels. Higher estrogen levels lead to higher serotonin, which suppresses appetite, and to greater release of growth hormone, which melts belly fat. Testosterone increases the release of dopamine, which results not only in greater sex drive but also in a higher metabolic rate. Being in love is the opposite of a sluggish, hypometabolic state.

Another factor is the production of PEA, or phenylethylalamine. This is a natural feel-good neurotransmitter (also present in chocolate), and it has an amphetamine-like action. Again, our metabolism gets a boost from this “love chemical.”

Also, when we are intensely in love, we hardly notice food. Our attention is focused elsewhere. If we’re having fantasies, it’s not about chocolate brownies or cream pies. And we don’t need the pleasure of food as much, now that another kind of pleasure is much more important. There is nothing like joyful excitement to make you literally forget about food. The calories burned during sex are probably the least of it. I suspect the main factor is being in a more youthful hormonal state and being mentally and physically “revved-up.”

Incidentally, there is a European saying, “A woman in love doesn’t catch a cold.” It’s certainly plausible that being in love enhances the immune response. Higher estrogen levels increase immunity through several mechanisms, while just speeding up the metabolism makes T cells more active. It’s exciting to be in love, but romantic love isn’t the only kind of passion. When we do creative work, or even read a fascinating book –”when our emotions are truly engaged, and we love what we are doing” — our whole biochemistry changes in the direction of the biochemistry of joy, and excess weight melts off effortlessly.

DO NOT OVER-RESTRICT CARBOHYDRATES, ESPECIALLY IN THE EVENING

Linda writes,

I have drastically cut down on carbs and substituted fats and proteins. I picked up Dr. Atkins Diet Revolution and found some helpful information from him. I still have my oatmeal/almond breakfast sometimes, but w/o sugar. I’ve cut way back on orange juice. I’ve added cottage cheese with microwaved bacon, peanut butter on celery or pumpernickel bread, sour cream instead of non-fat salad dressings, and more eggs, lean beef and mozzarella to name a few. I’m not sure I could handle sardines, yet—maybe I’ll try soon.

Benefits I’ve noticed: No metallic taste in my mouth when I’m hungry, less hunger, lost 2 pounds (but that’s not a goal, though inches on my belly are), more energy with less afternoon drowsy times. Also, and I’m not sure if this is good or not, my heart seems to be beating much faster when I go to bed at night. Instead of 2 minutes, it takes me 10 or more to fall asleep — it’s like my body is still racing.

Ivy replies:

Unfortunately, it is bad. If your body is “racing,” your dopamine and norepinephrine are too high. Protein is great at releasing dopamine, which then turns into norepinephrine (adrenaline), giving you great energy. But that’s not what you want at bedtime . . .

Once I made the mistake of having cottage cheese as my bedtime snack. I was superbly energized for two more hours — the last thing I wanted at 11 p.m. I am all for increasing carbohydrates in the evening. “Energize with protein, relax with carbos,” could be the slogan here. Protein is fine in the morning and mid-day, but the evening meal is a time to concentrate on quality carbohydrates. Protein is like strong coffee; use with restraint. Rice is wonderfully soothing, and actually contains Melatonin. Half a banana (Atkins would faint) never hurt anyone. Evening is the time for cutting down on stimulation. So go easy on protein, and make sure you get those serotonin-boosting carbohydrates. Not by themselves, of course: every meal and every snack should be balanced, and the carbohydrates opposed with enough protein and healthy fat to prevent an insulin surge and assure a SLOW RELEASE of glucose.

Where Atkins errs is in being too extremist. Plant food, even when relatively high on the glycemic index, provides calming nutrients such as magnesium and potassium, not to mention endless beneficial compounds. I’m in favor of eliminating or severely restricting breakfast cereal, bread, bagels, pasta, mashed potatoes, and similar PROCESSED carbohydrates’but not the GOOD CARBOHYDRATES you get from vegetables and even from high-glycemic foods such as rice and carrots (don’t overcook them). You need those—especially in the evening.

If the thought of eating rice makes you nervous, now that you know it’s way up there on the glycemic index, make it the somewhat less glycemic brown rice. Oppose the rice with low-glycemic vegetables such as bok choy, broccoli, china peas. Also, be sure you have a salad (the best carbohydrates are raw carbohydrates) with dinner, and be generous with olive oil. The fiber and the oil will make the rice a “slow-release” food. Beans can do the same. Overall, you’ll consume fewer calories WITHOUT OVERDOING THE PROTEIN.

While I’m not against red meat, it seems to be a particularly energizing form of protein (more so than fish or chicken breasts, for instance). Steak may be great for lunch, but some people at least should avoid it late in the evening, or they risk insomnia. (And always, always choose lean cuts such as top sirloin. Atkins is too permissive about saturated fats.) For a more balanced approach, I suggest Barry Sears’s “The Zone.” I can’t recommend “The Zone” highly enough. It’s the only book that really explains the hormonal consequences of various kinds of food. Can a single meal really affect your neurotransmitters? You bet. Dr. Sears emphasizes that food is the most powerful drug there is. If a dopamine surge is desired, one can “do protein.” But it’s best to avoid stimulating foods after 6 p.m.

Even Dr. Sears is not to be followed uncritically. The first rule is to listen to your body.

* THE BEAUTY CORNER * *
UNDROOP THOSE EYELIDS: TRULY AN EYE-OPENING, EYEBROW-RAISING EXERCISE

With age, something nasty happens to the eyebrows and eyelids. Somehow the eyebrows end up lower, and the eyes, crowded by our more and more droopy eyelids, start to look rounder and smaller. Gone is the beautiful almond shape. Simone de Beauvoir refers to this “the eyebrows slipping down toward the eyes.”

I remember meeting a woman who was once celebrated as a classic beauty. Now she was 58. Talking to me, a young man casually referred to her as “the older lady with the small eyes.” I winced.

Not everyone can afford the surgical solution, called blepharoplasty. It costs up to $6000, and recovery can be very uncomfortable. The best we can do for free is try to strengthen the tiny muscles of this area through the right exercises.

Enter Contessa Maria, whose rather grim video I bought for $1 at a garage sale. She could use a little more lip development, in my view, but her smoldering femme-fatale almond-shaped eyes and and undrooping eyelids are an inspiration.

The video is not in the people-pleaser category. The Contessa’s message seems to be that if you want results, you must make the right effort. It’s not “beautiful eyes the easy way.” Would the Contessa lie to you? It takes intensity, it takes repetitions.

The basic exercise she recommends is simple: you raise your eyebrows as high as possible. Be sure that the whites of the eyes above the irises show to the maximum extent. In other words, open your eyes as wide as possible and raise your eyebrows as high as possible.

But doesn’t that cause wrinkling of the forehead? Yes. Here the Contessa’s genius asserts itself: to prevent this wrinkling and increase the intensity of the exercise, place both hands on the forehead and raise your eyebrows against the resistance. You can experiment with different placement of your palms: horizontal or vertical, high or low, and with different intensity of the pressure you exert.

What matters is that your hands are pressing on your forehead, preventing the formation of wrinkles. A quick and less intense way of bringing more circulation to the eye area is to blink rapidly for as long as you can endure it. To increase the benefits of this exercise, lightly press on the area at the outer corner of each eye with one or two fingers. Squint against the resistance.

These eyelift exercises need to be done every day, preferably soon after getting up, to tone the eye area, get rid of puffiness, and clear the sinuses. If you can do them three times a day, great. Think of it as trying to enlarge your eyes.

(Note: puffiness around the eyes can also be due to hypothyroidism, probably the most frequently undiagnosed and untreated hormonal deficiency in postmenopausal women.)

PERSONAL REPORT: THE EXERCISE FOR FULLER LIPS REALLY WORKS!

A friend has FINALLY NOTICED that my lips look fuller. I myself am very pleased with the results, which I noticed after only one week of doing the lip exercise. So keep sucking your finger, or at least puckering up. I used to be a total sceptic about facial exercises. They looked so crazy. Could a facial exercise actually work? I picked just one to try . . . a week later I was a believer. To me it was an amazing discovery to realize that one doesn’t have to be born with luscious full lips; one can use a simple exercise to make them fuller.

I also noticed the following: the slight facial asymmetry I used to have seems to have corrected itself thanks to this exercise. Another unexpected benefit was the rounding-out of cheeks as the facial muscles got stronger.

I want all slender women to take note, since one problem we skinnies have is growing hollow-cheeked after menopause, which creates a haggy, haggard, worn-out impression. Full cheeks, like full lips, signal youthfulness.

Almond-shaped eyes, full lips, and reasonably full cheeks. These can be restored and preserved, but you have to work at it. HRT is not enough; it takes exercise.

By the way, Gloria writes, “Thanks for mentioning lip thinning (few women speak of this) please add pubic hair thinning, skin thinning, appearance of veins, warts, growths, mole changes, i.e. seborrheic keratosis.” We’ll gradually discuss these nasties in future issues. I’m especially interested in the ability of nhrt to shrink bulging veins and fade liver spots, since I’ve seen and experienced some dramatic results.

There’s also a change in how postmenopausal women smell (pets can detect that), how much they perspire, how much sebum (skin oil) they produce, and very likely in the sort of bioelectric energy they produce (what exactly do we mean when we say that a woman looks “radiant”?) Even the composition of saliva becomes different after menopause!

GREAT QUOTATIONS: JEANNE CALMENT, THE OLDEST PERSON IN THE WORLD, ON WRINKLES:

“I have only one wrinkle, and I’m sitting on it.”

(Jeanne Calment died on August 4, 1997, at the age of 122)

* * * CARE OF THE SOUL* * *

Note: If you consider yourself an orthodox believer and do not wish to be exposed to a non-standard interpretation, please skip to the next section. I do not wish to offend anyone’s religious sensibilities.

RE-VISIONING LOT’S WIFE.

When it comes to Bible stories, everything depends on interpretation. As women, we do not have to accept the negative stereotypes propagated by many male interpreters. We do not have to accept sexist interpretations suggesting that women are weaker and morally inferior to men (ROFL). Let us take another look at Lot’s wife. Note that she is not even given a name, but the rabbinical (midrashic) tradition did name her, calling her Idit. Note also that the Bible never states WHY Idit turned around. Besides the two virgin daughters, Idit and Lot had two other daughters, who were already married. These stayed behind in Sodom, with their husbands and children.

When Idit was running away from Sodom, she kept wondering about the fate of her married daughters. Was there any chance they were still alive? Maybe in the last minute they too decided to flee. Finally the tension became too great: Idit turned around to see. She saw a devastation so horrible that instantly she knew her daughters were dead. Her mother’s heart broke and she started weeping. She wept and couldn’t stop. And her tears turned into salt.

This interpretation is not mine, nor was it recently invented by feminists. It is a part of an ancient rabbinical tradition. Since I was raised as a Catholic, I was taught to see Lot’s wife as a kind of second Eve, morally weak, seeking to see and know forbidden things. An alternative interpretation was that this woman, being morally weak, loved her hometown in spite of its sinful ways, as some people love New York or Los Angeles.

Thus it was thrilling for me to find this midrash, with its more woman-friendly and compassionate vision.

Fine, you may say; but if, according to this midrash, Idit is not a wicked woman but a loving mother, then why was she punished?

The midrash does not suggest that she was punished. After Idit realized that her children were dead, punishment was beside the point. What happened to her was a symbolic consequence of her grief; she turned into her grief.

I’m not suggesting that Idit makes a good “role model”! And again, I stress that this is just another interpretation.

CHRISTA WOLFE ON THE CHANGING VIEW OF “MORAL DEFICIENCIES” OF WOMEN THROUGH HISTORY

“I find it interesting that in every period of history the quality which men said that women did not have was the same quality which men regarded as the most valuable at that time. In the age dominated by medieval Christianity, women were said to lack the capacity for true faith. The word ‘femina’ (woman) was itself interpreted to show this. It was made up, medieval etymologists claimed, of the words ‘fides’ and ‘minor’, that is, “of less faith.” The question was raised as to whether women even had souls, and this led to a heated debate among scholars. Today, when the soul no longer counts as a valued possession, it is attributed ONLY to women.

In the postmedieval centuries, women were said to lack intellect; and today the missing quality is said to be efficient functioning.”

Christa Wolfe, “Selected Essays,” University of Chicago Press, 1993, p.75.

GREAT QUOTATIONS: GAIL SHEEHY ON BLOSSOMING IN MIDLIFE

“Around 50 women begin to take off. Straight through their fifties the women studied showed gains in inner harmony, mastery and life status as they register—with considerable surprise—that they are more fulfilled and enjoy greater well-being than at any other stage of their lives.”

New Passages, p.150

Coming up in future issues:

• The alpha and beta estrogen receptors
• Halloween and facial osteoporosis
• Bloated no more
• How green tea prevents tooth decay
• Beauty Corner: The Tao of rock-hard abs
• The wisdom of thinking small

Books by Joanna, a.k.a. Ivy Greenwell:

Disclaimer

This newsletter is presented as a free service for women and healthcare professionals interested in women’s health. Publication schedule will be irregular. The author gratefully acknowledges the help of our new editorial assistant, Gail Peterson.

The material contained herein is intended as information only, and not as medical advice.