Shmirshky (12 page)

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Birthday Friend Forever

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I'd love to see the census people knocking on doors asking shmirshkies if they are in PM&M. Most common response: door slam.

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Shmirshky Parties are the best! Have the gals over for cocktails, laughter, and love. You can visit shmirshky.com to find fun tips for your next Shmirshky Party!

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PMS (premenstrual syndrome) refers to the symptoms that shmirshkies often get before their period arrives. In addition to what's mentioned above, you may get a headache and feel unusually emotional, irritable, tired, anxious, or depressed, just to name a few. Sounds like fun, right?

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By permission. From
Merriam-Webster's Medical Dictionary
© 2005 by Merriam-Webster, Incorporated (www.Merriam-Webster.com).

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Definition by permission of Dr. Margery Gass, Executive Director, North American Menopause Society.

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I wish I could tell you exactly at what age this storm will start to brew, but it's different for every shmirshky. Most shmirshkies begin to experience symptoms in their forties or fifties. Early storms can also occur for some shmirshkies, which in some cases is referred to as premature menopause. You can find more on this in chapter 6, “How to Schedule PM&M.”

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Alzheimer's disease is a form of dementia. It's a progressive, degenerative brain disease that affects one's capacity for memory and thought.

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You may come across another term called
early menopause.
Early menopause describes both natural and induced menopause before the age of forty-five, which includes all cases of premature menopause. I hate to be early to a party, personally, but everyone's got their own style! However, there are some resources that don't consider surgically induced menopause before the age of forty to be premature menopause. I know this may be confusing, and you're probably thinking, “Who gives a rat's ass about these definitions? All I want is to feel good.” Since these terms are out there in the PM&M world, I do want you to understand what they mean. Knowing where you fit into the PM&M calendar can help you feel calmer and better equipped to work with your doctor.

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Why aren't there any traditions to make this easier? When you turn seven, you take your first Communion; when you turn thirteen, you're bat mitzvahed; when you start throwing cans of soup at your partner, you're in PM&M.

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Thyroid conditions affect the thyroid gland, which is a small, two-lobed gland in your neck that uses iodine to make thyroid hormones that help regulate your metabolism.

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Hyperthyroidism, or an overactive thyroid gland, is usually caused by the autoimmune illness called Grave's disease. In this condition, the body's immune system produces an antibody that stimulates the gland to make an excess amount of T3 and T4, the two forms of thyroid hormone. (By the way, the 3 and the 4 refer to the number of iodines in that form of the hormone.) If you're a “hyper,” you may experience some of these symptoms: enlarged thyroid gland (goiter), bulging eyes, sudden weight loss, rapid heartbeat, increased appetite, nervousness and anxiety, irritability, tremor in the hands and fingers, sweating, changes in menstrual patterns, increased sensitivity to heat, more frequent bowel movements, and difficulty sleeping.

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In hypothyroidism, the thyroid gland doesn't produce enough thyroid hormone, which slows down the body's metabolism. If you're a “hypo,” you may experience weight gain, increased sensitivity to cold, dry skin and hair, slow pulse, low blood pressure, constipation, depressed mood, muscle aches/weakness, hair loss, low energy, and all kinds of sluggishness. It is usually caused by Hashimoto's disease (see below). Studies show that by the time shmirshkies hit age fifty, one out of every ten to twelve has some degree of hypothyroidism. By age sixty, it's one shmirshky out of every five or six.

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TSH stands for thyroid stimulating hormone. An imbalance in your TSH levels is one of the main indicators of a thyroid condition.

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Hashimoto's disease is also called chronic lymphocytic thyroiditis. The immune system attacks the thyroid gland, which causes inflammation and leads to an underactive thyroid (hypothyroidism).

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An endocrinologist is a medical expert specializing in the diseases of the endocrine system (glands and hormones). Thank God for these doctors!

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Ultrasound uses high-frequency sound waves to take pictures of the internal systems of the body. There is no exposure to radiation. You don't feel a thing!

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Some shmirshkies find that they do have thyroid cancer, but in many cases it's a very treatable cancer.

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Yep, Maria was a hyper (
not
a hypo, like me). This means she had an overactive thyroid, which is usually caused by the autoimmune illness called Grave's disease.

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I love my Gay Husbands! This is someone who not only gives you all the love and support of a husband but also enjoys shopping and getting mani-pedis, and knows how to throw a fabulous party.

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Who says there can't be a sexy story in a menopause book?

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There are so many books to choose from, and new ones arrive on the market all the time. Sift through the options and find the books that work for you.

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HRT is short for hormone replacement therapy. The term HRT is pretty misleading, as no one fully “replaces” all of her hormones. Also called HT (hormone therapy or hormone treatment).

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A Pap smear is an examination of cells scraped from the cervix. This sampling is then examined under a microscope by a pathologist to determine if any of the cells are cancerous or precancerous.

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A mammogram is an X-ray picture of the breasts. It is used to find tumors and to help tell the difference between noncancerous (benign) and cancerous (malignant) disease. You younger shmirshkies have the wonderful mammogram in your future! Be sure to take advantage of this test! It has caught many precancers and reduced the number of breast cancers in this country. If you can, find a place that has digital mammography, especially if you have dense (bumpy/lumpy) breasts.

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You might find that you don't need all of the tests I've listed or that you might need a few tests that aren't included in this list. More is not necessarily merrier when it comes to medical testing. It's more important to get accurate results for the tests you need. Always be conscious of false positives and ask your doctor about the accuracy of each test. It is so important to have a clear and accurate diagnosis before you begin any medical treatment.

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The suggested normal ranges listed here are for shmirshkies of all ages, except when otherwise specified. These ranges can change from year to year. There are always new advances and discoveries that result in new tests and different standards. There is no one concrete source for suggested number ranges. Different labs, hospitals, and doctors often have different suggested ranges. Be sure to consult with your doctor in order to home in on what range is best for you. All of these ranges and definitions are from the MedlinePlus Medical Encyclopedia, retrieved on October 9, 2010, from
http://www.nlm.nih.gov/medlineplus/encyclopedia.html
, unless otherwise noted here or in Additional Notes. For more detailed sources, see the corresponding Shmirshky Not-So-Fun Terms on page 136.

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Osteoporosis is a medical condition in which the bones become brittle, typically as a result of a hormonal deficiency or reduced calcium or vitamin D levels.

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Estrogen is the primary female hormone. Estrogen is responsible for the development and maintenance of female reproductive structures.

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T-scores between -1 and -2.5 generally indicate the beginnings of bone loss, also known as osteopenia. T-scores at or below -2.5 typically indicate osteoporosis.

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The normal value range for CA-125 varies slightly among different laboratories. Unfortunately, this test can result in false positive results. Be sure to talk with your doctor about the pros and cons of this test.

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The suggested ranges for Total cholesterol, HDL, LDL, and Triglycerides are from the American Heart Association. The suggested range for Cholesterol/HDL is from Lab Tests Online.

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The FSH suggested ranges are from LabCorp.com. Please make sure you check with your doctor and blood lab about the suggested ranges for your FSH test, as each lab tends to use a different range.

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You see, shmirshkies are always getting ready for something! Progesterone is like a hair and makeup person for your uterus: hustling to get you ready for the big event of pregnancy. In fact, the entire menstrual cycle is like getting ready for a ball that you rarely attend. You put on all your makeup, put your hair up all snazzy, and squeeze into a fancy dress. Then once you're ready to go, you decide, “Nah, let's just order in.”

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T3 and T4 are thyroid hormones that get released into the bloodstream and control the body's metabolism.

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There is a great deal of discrepancy in the medical world regarding the suggested ranges for T3, T4, and TSH. There are many different institutions and doctors with varying opinions. The science seems to be ever evolving. My doctors recommended these ranges to me, but please do not take these ranges as gospel. Be sure to consult with your doctor to determine what range is most appropriate for your body.

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Depending on how you feel and your particular medical situation, your endocrinologist may want to keep your TSH lower than 3. Everyone is a little different. I happen to function best when mine is below 1.

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The suggested range for Vitamin D3 is from the American Academy of Orthopedic Surgeons.

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Hormone replacement therapy; also called HT (hormone therapy or hormone treatment).

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The most common bioidentical hormones prescribed for PM&M shmirshkies are estradiol, estrone, estriol, progesterone, and testosterone.

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Don't be fooled by a hormone with two names. Even if one of those names is the name of your body's hormone, the presence of another name should tip you off that you are NOT dealing with a bioidentical hormone. For example, estradiol is bioidentical, but ethinyl estradiol is NOT.

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Defining the terms
natural hormone
and
synthetic hormone
can be complicated and confusing. Many different Web sites, books, and journals use conflicting definitions for these terms. For the purposes of this book, I am using very simple and technical definitions as recommended by my doctors. Please note that some experts and resources might use different definitions for these terms, but I am choosing to define them in a way that I believe is the most technically accurate, the least confusing, and the most helpful.

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If this doesn't make total sense the first time around, don't feel bad. It took me years to fully understand what all this stuff means. Try reading the last few paragraphs again, this time slower and without grinding your teeth! If you're still confused, just go to shmirshky.com or e-mail me at [email protected] and I'll walk you through it!

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Keep in mind that there are many schools of thought on this, and it is up to you to educate yourself and draw your own conclusions about what is best for your body.

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The Women's Health Initiative was created by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health under the U.S. Department of Health and Human Services. The WHI conducted a series of clinical trials and observational studies on postmenopausal shmirshkies.

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The Food and Drug Administration is a federal agency that oversees the safety regulations of most types of food, supplements, drugs, vaccines, and medical products.

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Whooaaaaa, horsie! Horses are such huge animals. I already feel so big; I don't need any help in that department. Horses are beautiful, don't get me wrong, but couldn't we get urine from something petite and lithe... like a
Cover Girl
model?

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Progesterone gets the uterus ready for pregnancy and the breasts ready for milk production. After ovulation, progesterone helps make the uterus ready for implantation of a fertilized egg. Remember, shmirshkies are always getting ready for something! When your ovaries stop producing progesterone and estrogen, you're in M, and you don't have to get ready for the pregnancy party that you usually don't end up going to each month.

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Estradiol is the most important form of estrogen produced in the body.

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Estrone is one of the three most common types of estrogen secreted by the ovaries.

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Estriol is the weakest of the three main types of estrogen.