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  Sue:
Menopause information can be confusing; is menopause a natural transitional stage
of a woman's life or a time of increased risk of disease that needs intervention? After
menopause, a woman faces the question of hormonal replacement therapy
(HRT). Should she take HRT on a long- term basis in the name of
disease "prevention"- or not?  Today's woman must educate herself about
menopause and the risks and rewards of taking HRT, nutritional supplements, and
homeopathic therapies. In this comprehensive
book, Dr. Carolle- Jean Murat covers the current needs and concerns of
midlife women, empowering her readers to make the right decisions. With humor,
candor, and plain non-technical language, Dr. Jean-Murat addresses many concerns,
including:
In this
interview:
Sue:
I'm pleased to interview Dr. Carolle Jean- Murat and welcome her to HotFlash! You
have written a wonderfully concise yet complete book. Not only does your book
Menopause Made Easy covers women's health needs, it also does a terrific job of giving us
a road map while driving through the perimenopause/menopause maze.
Selecting
over the counter products
Sue:
Perimenopause and menopause
have become big business. How would you instruct women on how to pick over the counter
products so that they choose safe and effective products?
Carolle:
Over-the-counter herbs and supplements lack quality control of content. There is
usually a batch-to-batch variation. Quality control also varies between manufacturers, and
there is a lack of human toxicological studies. Overall, this is a largely unregulated
industry. There are many brands of herbal medications on the market. Because they are
classified as a food, they are not regulated. Here are my recommendations:
- When you're shopping, look for
"standardized" ingredients.
This indicates that there has been an attempt to ensure that each dose contains the same
amount of active ingredients.
- Buy products that detail ingredients, dose, and
manufacturer.
Preferably from manufacturers who have been around for a long time such as
Schiff, Rexall, to name a few.
- Compare the Latin names to be sure which herb you're
buying.
Also, purchase herbs that indicate the percentage of active ingredients, and look
for other chemicals that may have been used in the preparation.
- Rely on medical research, not package claims.
- Always check with your health-care provider
before taking any over-the-counter medication.
Black
Cohosh
 Sue:
Black cohosh
is a very popular herb and is used by thousands of women to alleviate perimenopausal and
menopausal symptoms. What do you attribute the popularity of this herb to and what should
women know about it before using it?
Carolle:
Black cohosh (Cimicifuga racemosa) helps relieve hot flashes, night sweats, and
vaginal dryness; and emotional symptoms such as anxiety, depression, and irritability in
some women. It is commonly used in Germany in the drug Remifemin, and it is also available
in the United States. Black cohosh is available in pills, liquids, and extracts.
Short-term side effects include dizziness, diarrhea, and nausea. Black cohosh produces
endometrial stimulation and may cause vaginal bleeding. Because of the possible estrogenic
action, it should be used with caution after six months. The recommended dosage is
10 to15 drops, or three to four capsules per day. The long-term side effects are unknown.
Avoid use if you have heart disease.
 Black cohosh
Racial
Differences & Menopause
Sue:
In a recent study it was found that women of different ethnic groups experience
perimenopause and menopause differently for example African American women versus
Caucasian women. In your practice and experience what are these differences and how do
they affect the quality of care women receive?
Carolle:
How a woman views menopause depends upon her culture. For instance,
there is no word for menopause in the Japanese language. While African American women have
more menopausal symptoms such as night sweats, hot flashes, night sweats, incontinence and
vaginal dryness, than all other ethnic groups, they tend to view menopause in a much more
favorable light when compared with Caucasian women. When I asked my mother about
menopause, she told me that "what she liked best about menopause was that there were
no more periods, no more fear of pregnancy, and that the sex was better." I have
always looked forward to menopause. This longing started after my first menstrual cramp,
and later on when people around me and myself were tired of my premenstrual syndrome, or
PMS.
I recently turned 50 and can't wait to stop having periods.
I am lucky to realize that menopause is not only about hot flashes, vaginal dryness, and
soy or hormone replacement therapy. It is merely a stage in our life through which we must
pass, much like going through medical school and ending up in private practice.
You see, in my Haitian culture, women age gracefully, and
aging is associated with knowledge and wisdom. I grew up looking forward to growing old
and being wise, and respected. The opposite is true in American culture, where aging is
associated with mental and physical "deterioration."
One study from Johns Hopkins University found that only one
in five low-income African-American women used HRT, and that less than half of the women
in the study knew that the risk of heart disease increases after menopause. There is also
the possibility that the reason fewer black women take HRT could be that since most are
poor, they aren't given the option when they visit their doctor. But it could also be that
Caucasian women tend to view menopause as a disease that needs to be cured, while black
women tend to perceive menopause as a "normal stage of life" and rely on other
remedies for relief of menopausal symptoms.
In my medical practice which is based on the most advanced
research available on menopause, I work with women from all racial and ethnic backgrounds
that are tired of a "cookie-cutter" approach to perimenopause and menopause. I
take into consideration their belief system as well as their nutrition, emotional life,
physical, spiritual, financial and social lifestyle. Using both allopathic medicine and
alternative medicine, I don't just treat symptoms. I treat the WHOLE WOMAN. I empower
women to participate in their medical decisions and take control of their health!"
Chapter
10 Stress and Depression
Excerpted with permission of the author from
Chapter 10, Menopause Made Easy, ©1999 by Carolle Jean-Murat, MD, All rights reserved,
May not be reproduced without the expressed written permission of the author.
Stress is something that Mother Nature built
into us way back in evolutionary times to prepare us to meet and survive the unexpected.
Stress induces the "fight or flight" response, enabling us to overpower
our enemies or escape from them. When we react to something we perceive as
dangerous, the body pumps out hormones that make us more alert and ready to act. The
heart beats faster, blood pressure increases, and muscles tense. If we act on these
signals with out physical body-by running or fighting- the excess energy is used up.
 In our modern society, stress can impact us at work
or at home, although not usually in the form of a lurking saber-tooth tiger! Stress
keeps pumping hormones into the bloodstream until they assault the blood vessels, the
heart, the immune system, and the liver. This can produce problems such as high
blood pressure, increased susceptibility to illness, viral and bacterial infections,
ulcers, headaches, chronic muscular tension, high cholesterol levels, heart attacks,
hormonal imbalances, and even cancer. Among women, it can also cause menstrual
irregularities.
Unsuspected
Stress
Many life
events, both the positive and the negative, can precipitate stress. Some examples of
stressful triggers are getting married or divorced; bearing children; children moving away
from home; changes in partners; a chronic illness (or a partner with one); shifts in
financial status; changing or losing a job; the death of a friend or family member;
moving, selling, or buying a home; accidents; and environmental stressors; to name but a
few.
A Personal Story
Another stressor that few people recognize until it
happens is the loss of an animal companion. I never had a pet growing up, and didn't
realize just how attached a person could become to a dog until my ex-husband, Thomas,
acquired, Czar, a most beautiful and intelligent German shepard. Czar became my best
friend. This was the first time I experienced what is often referred to as
unconditional love. When I had to put him to sleep after seven years because he had
cancer of the spine, it was the most painful thing that I've ever had to do. I cried
and cried for a long time. This was a new stressful event in my life.
Some patients have come into my office with many symptoms
suggestive of stress. After talking with them for awhile, I would sometimes discover
that they had recently lost an animal companion. Talking about the loss helped them
to realize that they had been more affected than they realized.
depression
Overcoming Depression & Finding Happiness
excerpted from
"Family Desk Reference to Psychology"
by Chuck T. Falcon
 Depressed people often lose interest in many activities and
social contacts because of loss of pleasure in and enthusiasm for their usual activities.
There are many effective ways to overcome depression. In this essay from author and
Counseling Psychologist Chuck Falcon, he illustrates the causes and treatment of
depression; how activity can help break the depression cycle along with a step-by-step
guide on things that you can do to feel better. Don't forget to join our discussion groups
where you can ask your questions and share your feelings.
Meet The Author
Steven R. Goldstein,
MD
"Could It be Perimenopause?"
hosted by Sue Spataro, RN, BSN
 Interviews, excerpts & support group
  Dr. Goldstein is renowned for his pioneering work
in ultrasonography. He lectures physicians through out the United States
about the latest techniques and equipment in this specialized field. He discovered the
incredible need for further awareness about perimenopause through his work in
ultrasonography.What is perimenopause? Many of the signs and symptoms can be subtle and
are OFTEN confused and misdiagnosed in young women in their 30's and 40's. Do you have it?
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