Articles on women's health & longevity

Striking without any warning in the day or night, one of the most noticeable and unpleasant symptoms of perimenopause and menopause is hot flashes. These sudden surges of internal heat can make it feel like your body has been thrust into an oven. They can cause your face and neck to flush, your heart to race, and leave you drenched in sweat or overwhelmed with anxiety.

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Though 75% of women in this phase of life will have hot flashes, your experience will be unique. Hot flashes may be a mere blip on your radar, barely noticeable, or they might significantly impact your quality of life. The duration, intensity, and feeling can also vary. Your hot flashes may come and go within 30 seconds or linger for up to five minutes. You may feel an intense, full-body surge of heat or warmth that radiates from a specific part of your body. Your hot flashes may occur from six months to more than ten years, and the frequency might intensify in the two years following menopause.

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While this might sound daunting, the good news is that several strategies and treatments are available to manage hot flashes effectively. 

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What causes hot flashes? 

Researchers are unsure why we get hot flashes, but one idea points to the hypothalamus. This small yet essential part of the brain controls heat production and loss. During perimenopause and menopause, hormonal shifts can destabilize the hypothalamus, with fluctuating progesterone and estrogen levels steering your body's heat balance onto an unpredictable rollercoaster.

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What can you do to manage hot flashes?

There are two ways to manage your hot flashes. The first is to try lifestyle changes to prevent them from happening. The second is to treat the source. As we’ve mentioned, every woman is different, but working with a healthcare provider knowledgeable about this life transition can infinitely improve your experience.

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Preventing hot flashes with lifestyle adjustments

Whether or not you’ll experience hot flashes is mainly out of your control, but you may start to spot patterns or triggers by becoming more mindful of what you’re doing, wearing, or eating when they occur. This self-awareness can be a powerful tool, helping you possibly reduce the frequency and intensity of your hot flashes. 

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Triggers for hot flashes can vary significantly from person to person, but common ones include: 

• Alcohol - especially red wine
• Bending over
• Caffeine
• Eating spicy foods
• Feeling stressed or anxious
• Hot weather or being in a hot room
• Using hair dryers or curling irons
• Smoking or being exposed to cigarette smoke
• Tight clothing
• Poor sleep

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To figure out what might be triggering your hot flashes, start keeping a journal about your symptoms. Write down everything you can think of related to each hot flash in your journal. What were you doing right before it happened? What had you just eaten or drunk? How were you feeling emotionally? What were you wearing? 

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Keep your notes as detailed as possible. After a few weeks, look over your entries to see if you can identify any patterns. Once you've identified potential triggers, work on avoiding them. This might mean making some changes, like cutting back on caffeine, wearing looser clothing, or learning new stress-management techniques. Remember, figuring out which changes work best for you might take some trial and error, so be patient with yourself.

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Review your medications

You should also consider whether any medications you take contribute to your hot flashes. Certain medicines, including some high blood pressure and cholesterol medications, can trigger hot flashes in some women.

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It's important to review all your medications, including over-the-counter drugs and supplements, with your healthcare provider. They can help determine whether any of your medications could be causing or exacerbating your hot flashes and discuss possible alternatives if needed. Never stop taking a prescribed medication without first consulting with your healthcare provider.

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Medical Treatments

When lifestyle changes aren't enough, it's time to consider medical treatment. Society has taught us that menopause is something that women must endure as a “normal part of life” and that the symptoms are something we can cope with. 

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We disagree. 

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Addressing the root cause of the symptoms you’re experiencing during menopause can help you find relief and enjoy these years of your life rather than simply “getting through” them. 

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Hormonal Hot Flash Treatments

Hormone Replacement Therapy (HRT) is the gold standard for managing hot flashes. HRT helps replace the estrogen lost during perimenopause and menopause, thereby alleviating symptoms. 

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Bio-identical hormones offer a more natural approach to hormone therapy. They are chemically identical to your body's hormones, which makes them different from the synthetic hormones used in traditional HRT.  Bio-identical hormones can be found in both FDA-approved prescription products and pharmacy-compounded products. Compounded bio-identical hormone therapies are tailored to your individual hormone needs and are another method of effectively treating your menopause symptoms. 

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Before starting any form of hormonal treatment, it's crucial to have a thorough discussion with your healthcare provider. Together, you can weigh the potential benefits against the risks and side effects, which can vary depending on your personal health history and the specific hormone therapy used. 

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Hormone therapy is usually safest and most effective when initiated within the first ten years of menopause and is often recommended for a limited period. Regular follow-ups with your healthcare provider are essential to monitor your response and adjust your treatment as necessary.

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Non-Hormonal Hot Flash Treatments

In addition to hormonal treatments for menopause, non-hormonal medications such as gabapentin, selective serotonin reuptake inhibitors (SSRIs), and clonidine have also been effective in reducing hot flashes.

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In May 2023, the FDA approved a new non-hormonal medical treatment, Vezoah, or fezolinetant. Unlike HRT, fezolinetant blocks a specific neuron receptor in the brain that signals to increase body temperature. For women who can’t use or don’t wish to use hormonal treatments or SSRIs, Vezoah may provide the relief you’re looking for.

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As with most medications, there can be side effects such as diarrhea, abdominal pain, insomnia, and potential liver effects. However, these are generally not common and are manageable with regular monitoring by your healthcare provider. 

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What’s most important if you’re suffering from hot flashes is understanding that you don't have to suffer in silence. Many options are available to transform your menopause journey from a phase of endurance to a period of well-being. Remember, each woman's experience is unique, and so is her path to relief. With the right support, guidance, and a proactive approach, the horizon is bright for managing your hot flashes.

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Cardiovascular disease (CVD) is a leading cause of death worldwide, with millions of people affected by it every year. It is a complex disease with various risk factors, such as smoking, hypertension, high cholesterol, and obesity, among others. Early detection of CVD is crucial for prevention and treatment, and imaging tests such as the calcium scan and CT angiography (CTA) can help identify people at risk. Let’s explore the differences between calcium scan and CTA, their benefits and drawbacks, and how they can help prevent CVD.

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Calcium Scan

A calcium scan is a non-invasive imaging test that uses low-dose X-rays to measure the amount of calcium in the coronary arteries. Calcium in the arteries is a sign of plaque buildup, which can narrow the arteries and increase the risk of heart attack and stroke. A calcium score is calculated based on the amount of calcium detected in the scan, which can range from 0 to over 1,000.

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One of the advantages of the calcium scan is that it is low in radiation and very inexpensive, costing a few hundred dollars. It also doesn't require contrast dye, which some people may be allergic to or have adverse reactions. However, most insurance companies don't cover it, and patients have to pay out of pocket.

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The amount of calcium detected in the scan is strongly related to the amount of plaque in the arteries, and therefore, it can help identify people at risk of CVD. However, it's worth noting that an elevated calcium score is not always a predictor of adverse events, especially in intense athletes who may have increased calcium due to their training regimen.

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CT Angiography

CT angiography is a more advanced imaging test that provides more detailed information about the coronary arteries, including the presence of blockages or stenosis. It uses contrast dye and high-dose X-rays to create 3D images of the arteries.

Compared to the calcium scan, CTA provides more information about the arteries' structure and function, making it a valuable tool for diagnosis and treatment planning. However, it is more expensive, costing $2,000-2,500, and carries a higher radiation dose than the calcium scan. Most insurance companies don't cover it, and patients have to pay out of pocket.

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CT FFR and FAI

CT angiography can also be used in combination with other tests, such as CT fractional flow reserve (CT FFR) and fat attenuation index (FAI), to provide a more comprehensive assessment of the arteries.

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CT FFR is a non-invasive test that measures blood flow through narrow or blocked arteries and helps identify people who need invasive procedures such as stents. FAI measures the characteristics of the fat around the plaque and predicts how much inflammation is around the plaque due to the fat content.

Blood Pressure and Cardiovascular Disease

High blood pressure (hypertension) is a major risk factor for CVD and is defined as blood pressure above 120/80 mmHg. Recent studies have shown that even mildly elevated blood pressure can increase the risk of adverse events, and blood pressure should not be considered a normal process of aging.

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Ambulatory blood pressure monitoring (ABPM) is a gamechanger in medicine since patients usually get their blood pressure checked in-office 1-2 times a year, which may not accurately reflect their true blood pressure. ABPM provides more accurate and reliable readings, enabling better management of hypertension.

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The Best BP Management Medication

According to Dr. Weiss, a thiazide diuretic is the best medication for managing blood pressure. Thiazide diuretics are effective

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The best way to prevent cardiovascular disease is with early detection and the management of risk factors. Two imaging tests that can help with early detection are the calcium scan and CT angiography. While both have their pros and cons, the calcium scan is a more cost-effective and low-radiation option. Managing blood pressure is also crucial, and recent studies have shown that keeping it below 120/80 can significantly reduce the risk of adverse events. Thiazide diuretics are the preferred medication for blood pressure management, but ACE inhibitors and ARBs may be more suitable for certain subpopulations. Overall, it's important to address the four risk pillars of smoking, hypertension, ApoB, and metabolic health to prevent atherosclerosis and related complications

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Cardiovascular disease (CVD) stands tall as the foremost killer among women, 1:3 to be exact. This a statistic that is both troubling and wrought with opportunity. The data paints an interesting picture: before menopause, women generally experience a lower CVD incidence than their male peers. But post-menopause, that narrative changes significantly. Even though we continue to try to place the blame on a different factor, the culprit over and over again turns out to be a dramatic drop in estrogen levels, the dominant female sex hormone.

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Looking deeper, we find estrogen isn't just pivotal for its famed reproductive role. Dive deep into its molecular dance, and you'll discover it's a natural cardioprotective agent. In laboratory settings and animal tests, estrogen emerges as a hero for the heart. Its functions are multifaceted, supporting everything from healthy mitochondrial operation to normal blood vessel dilation. But its most standout role lies in countering oxidative stress.

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Oxidative stress isn't just a fancy term thrown around in biology and biohacking labs. It's pivotal in the CVD narrative. Estrogen has this remarkable knack for fighting oxidative stress thanks to its inherent antioxidant traits. Think of it as nature's firewall against harmful reactive oxygen species and a booster for protective molecules like superoxide dismutase (SOD). Estrogen's influence doesn't stop there. It has a profound impact on the brain, guiding neurons that oversee the cardiovascular system. Plus, it's a diplomat, quelling the fire of inflammation markers associated with ailments like atherosclerosis.

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But as nature has it, post-menopausal estrogen depletion is as natural as the setting sun. This depletion makes it all the more imperative for post-menopausal women to harness other heart-healthy avenues.

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Enter phytoestrogens. Think of these as nature's mimics, imitating estrogen but with a far milder potency. Compounds like genistein and spruce lignans are not just potential aides against those pesky menopausal hot flashes; they're intertwined with heart health, too. There's intriguing evidence linking these vasomotor symptoms with potential disruptions in cardiovascular wellness.

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But our toolkit continues after phytoestrogens. Gamma-oryzanol, a treasure derived from rice bran oil, shows promise in bolstering heart health, especially when considering lipid metabolism. Preliminary studies show that it might assist in reducing cholesterol and even easing menopausal symptoms.

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Add taurine to this health-promoting lineup. This little amino acid, brimming with antioxidant properties, could be a game-changer for post-menopausal women. Early studies spotlight its potential to enhance overall antioxidant status, a beacon of hope for heart health and graceful aging.

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The conversation around heart health is complete with discussing the potent potential of estrogen replacement therapy (ERT). As the modern world pushes boundaries in medicine, ERT emerges as a pivotal player in the post-menopausal arena. Reintroducing estrogen into the body isn't just about symptom relief or a throwback to youthful vitality—it's a calculated move toward cardiovascular protection. Recent studies are increasingly leaning toward the idea that ERT can help reinforce the heart's defenses, especially when initiated close to the onset of menopause. ERT bridges the post-menopausal cardiovascular gap by actively mitigating the sharp drop in estrogen, a hormone intrinsically linked to cardioprotection. However, like any medical intervention, ERT isn't a one-size-fits-all. The decision to embark on ERT should be deeply personal, guided by thorough discussions with healthcare professionals and an understanding of both the benefits and potential risks.
In sum, while the natural ebb of estrogen post-menopause is undeniable, it's far from the end of the story. The path to heart health is paved with innovative solutions, from phytoestrogens to taurine. For the women navigating the post-menopausal journey, embracing these nutritional allies might be the key to a heart-healthy future.

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Bi-est hormone cream, also known as"bi-est cream," is a type of hormone therapy that can be used to help balance hormones for those experiencing menopause symptoms. It's a combination of bioidentical estrogen and bioidentical estriol.

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Bi-est 80/20 refers to a specific ratio of the three estrogen hormones found in Biest hormone replacement therapy. The"80/20" refers to the ratio of estradiol to estriol. In this specific ratio, 80% of the hormone mixture is estradiol and 20% is estriol. This ratio is commonly prescribed because estradiol is the most potent of the three estrogens and is responsible for many of the beneficial effects of estrogenre placement therapy, while estriol is a weaker estrogen that is believed to have fewer side effects. This ratio is commonly prescribed to alleviate symptoms of menopause and to help prevent bone loss. However, it's important to note that it's always best to consult with a healthcare professional before starting any hormone replacement therapy.

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During menopause, our bodies go through changes that can lead to symptoms like hot flashes, night sweats, and mood swings. Bi-est hormone cream can help by providing the body with the hormones it needs to balance out these changes.

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The great thing about bi-est cream is that it's made with bioidentical hormones, which means they're chemically identical to the hormones produced by our bodies. This makes them safer to use and less likely to cause side effects than traditional hormone replacement therapy.

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The estrogen component in bi-est cream can help reduce hot flashes and night sweats, as well as improve vaginal dryness and bone health. The progesterone component helps to balance the effects of estrogen and can also help with mood swings and sleep disturbances.

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Many women have found bi-est cream to be very helpful in managing their menopause symptoms and enjoying a better quality of life. It's important to note that everyone is different and what works for one person may not work for another. It's always best to consult with your healthcare provider to determine if bi-est cream is right for you.

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It's also important to mention that bi-estcream should not be used as a form of birth control. It's also not recommended for women who have had breast cancer or are at high risk of breast cancer.

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Bi-est hormone cream can be a helpful tool for managing menopause symptoms. It's made with bioidentical hormones that are chemically identical to the hormones produced by our bodies, making them safer to use and less likely to cause side effects. If you're experiencing menopause symptoms, consult with your healthcare provider to determine if bi-est cream is right for you. Remember, every person is different and what works for one person may not work for another. But, with the right treatment, you can feel like yourself again and enjoy a better quality of life during this new chapter of your life