Fri07252014

Your Health

Sexy and savvy for all seasons: A local approach to menopause


Every woman has a story of what she wished she had known going into menopause. Some are nuanced – for instance, the ways in which physical changes can affect emotional relationships. Others are strategic – watch for a drop in bone density so that you can start addressing the problem before it becomes osteoporosis.

Barb Dehn, the nurse practitioner based in Mountain View known as “Nurse Barb” in the clinic and on TV health segments, just published “The Hot Guide to a Cool Sexy Menopause” (Basic Health Publications, 2014). Her goal: to offer straightforward advice on what to expect and how to weigh your options.

Dehn founded Blue Orchid Press to publish short health guides for women. Local hospitals stock her pamphlets on pregnancy and breastfeeding. For the story of menopause, however, she wanted to move beyond bite-sized information.

“I was going through menopause myself, and patients were asking me detailed questions,” she said. “I wanted to use vignettes that would help women connect and realize that they were normal and one size doesn’t fit all.”

Because menopause presents so differently for different women, treating its symptoms requires personal evaluation of each option and its risks. Dehn used real stories to offer a navigable path through complicated information.

User-friendly health information

In her work at the Women Physicians GYN Medical Group, Dehn has stayed abreast of the all-encompassing changes that women experience as their bodies produce less estrogen and progesterone.

“Let’s give information in the most friendly, warm, approachable way,” she said.

The 55-year-old has spent her career working as a public health nurse, first in a pediatric intensive-care unit and then as a women’s health specialist. Some subjects – like decreased bone mass – require a straightforward rundown. As reduced estrogen leads to reduced bone mass, women should know which tests can flag the problem and find ways to protect their bones through diet, exercise, supplements and sometimes the use of prescription medications.

Very private topics that don’t always receive a public airing – for instance, the physical changes that can affect a woman’s sex life and relationships – are addressed not just mechanically, but also emotionally in Dehn’s book. How do partners discuss the change?

Dehn’s book includes communication tips about how intimacy can change as children leave the home and couples rediscover how to talk with each other.

“I’ve been married for almost 28 years, and we’re an ordinary couple – it’s a lot of work,” Dehn said, using herself and her husband as an example. “There are times I bite my tongue, and I know he does the same thing.”

Beyond touchy-feely discussions of feelings, Dehn knows to poke fun at some of the embarrassing and infuriating aspects of dealing with the side effects of hormonal change.

“We don’t want to admit that we’re peeing in our pants, but we’re peeing in our pants! We need to laugh about it and talk about it,” she said. “And there are not just surgical options and not just prescription drugs. We have lots of treatments, such as pelvic-floor physical therapy.”

Hormone replacement options have driven recent news and anxiety about menopause. Dehn addresses the risks and benefits to treating menopause symptoms with hormones.

“Estrogen is phenomenal – it works, but there’s no free lunch,” Dehn said, describing the slight increased risk of breast cancer that has changed the calculus on whether symptoms are so bad that it’s worth choosing to take the risk.

For more information, visit nursebarb.com.

Keeping cool through summer hot flashes

“That first hot flash can arrive like lightning – no warning, just intense, searing heat,” Barb Dehn writes.

She offers two tools to say cool:

• Eliminate hot-flash triggers. Try to avoid drinking hot liquids and cool your hot showers way, way down. Wearing too many layers of clothing or even drinking wine can trigger a hot flash.

• When you’re out in public, even though it’s tempting, don’t jump into the nearest swimming pool or pour ice water over your head in a restaurant. Instead, try taking slow, deep breaths, approximately six per minute. This is like the deep breathing you may have done with yoga or with a mindfulness class. Research has shown that six breaths a minute for one to two minutes will not only decrease the intensity of a hot flash, but can also make it go away faster.

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