MANAGING MENOPAUSE SYMPTOMS WITHOUT HORMONES

Many women are discontinuing use of hormones because they don’t want to accept the risks of using hormone replacement therapy. We do have many alternatives to moderate some of the worst symptoms of menopause. We encourage our patients at Lakeside Women's Health Center to always review all of their medications with their providers at least annually. Women should ask for the lowest dose of the most effective medication available to them after a review of their medication and allergy lists is completed. We also encourage women to involve their pharmacist when choosing to use over the counter complementary/ nutritional/ herbal supplements as these will need to be tracked by their health care provider and pharmacist to avoid harmful drug-drug or drug-herbal interactions. Hot flashes Dress in layers Avoid triggers (hot temperature, spicey food, alcoholic or caffeinated drinks) Black Cohosh (Remifemin©) Soy supplements Antidepressants Catapres (antihypertensive medication) Neurontin Vaginal Dryness Soy supplements Water based lubricant (Astroglide©) Topical Progesterone Cream Black Cohosh Vaginal Estrogen cream ring or tablets this works well externally with minimal risks of estrogen effect inside the body Fatigue Flax seed oil/ Primrose oil Good balanced diet Regular 30 – 60 minutes daily exercise Maintain a regular sleep schedule

WHAT WE CAN DO FOR YOUR BLADDER

We like to provide many treatment choices for our patients. Sometimes it is best to start with the simple, medical or physical therapy treatment choices to improve urinary and fecal incontinence. Even when we add a surgical treatment, our outcome will be the best in our patients with the best preparation. At Lakeside Women's Health Center, we like to teach our patients how to improve their bladder and bowel function with diet changes. Patients keep a diary of a day or two of urinary functions and diet intake of fluids. Many women get immediate relief of urinary frequency when they decrease caffeine intake or avoid their food triggers. Other women suffer sensitivities to fruit (even cranberry can be a trigger) or spices. We can use simple office tests to identify which types of incontinence our patient has. Women are taught simple exercises they can do daily to achieve dryness and reduce the time they have to spend looking for a bathroom.

Natural Family Planning

Lakeside Women’s Health Center offers intrauterine insemination. We also encourage our patients to practice Natural Family Planning or Fertility Awareness. It is important that women can identify signals of ovulation. When taught how to use this information, couples can use fertility awareness to avoid or achieve pregnancy. We start our patients with cycle calendars to track their body temperature, vaginal secretions, pain of ovulation, urinary testing for hormone changes, and timing of their previous cycle length to predict each month’s fertile time. For more information visit: www.ccli.org www.DoctorHolladay.com

MAKE YOUR LIST AND CHECK IT TWICE

We think all of our patients should carry a medical identification card in their wallets. At Lakeside Women's Health Center we encourage our patients to take a 3 x 5 card and outline their important information in case of emergency. 1. List your allergies (to medicine, food, bee stings, x-ray dye, etc.) 2. List your medicines, their doses, and reason for their use. (Don’t forget to include your contraceptive pills, Mirena, or Depo shots!) 3. List your medical problems 4. List your previous surgeries 5. If you need antibiotics before dental work note this on your card 6. List your supplements, vitamins with dose and directions 7. List your significant family medical conditions 8. List your recent immunizations for tetanus, flu and pneumonia 9. Living will information, organ donation status, and next of kin 10. Phone numbers for your immediate family/ friends 11. Blood type

TESTING AND TREATMENT OF PRETERM LABOR

Almost half a million babies each year are born prematurely in America. Birth before the 37th week of pregnancy puts babies at risk for cerebral palsy, mental retardation, death and blindness. Patients can miss the warning signs for pre-term labor since they can often be confused with a backache, diarrhea or vaginitis symptoms. We try to get our patients risk factors for premature labor identified early and teach our patients what they can do to minimize their risks. We want our patients to have the best nutrition, drink plenty of fluids, quit smoking, never drink alcohol or use drugs, and keep up with their dental care. Our “at risk moms” can be screened with ultrasound measurements of their cervix and a fibronectin test from their cervix to help us predict our immediate risks for premature delivery in the next few weeks. March of Dimes offers excellent information about pregnancy and pre-term labor prevention. We include this information in our prenatal packets. For more information please visit: www.modimes.org.

…TWICE A DAY KEEPS THE GYNECOLOGIST AWAY…

A simple, cheap and simple thing women can do to avoid seeing the gynecologist is to practice better “bottom care”. The vagina is self-cleaning. At Lakeside Women's Health Center, we recommend that our patients use only water or a mild, unscented soap (baby wash e.g.). We never recommend douching or use of “feminine hygiene products”. If you feel a vaginal irritation, treat yourself to a baking soda bath (one quarter cup of baking soda in your next tub bath). Twice daily use of Astroglide© has been known to prevent recurrent vaginitis in our patients. Women experiencing irritation after intercourse may benefit from use of baby wipes, Astroglide© the day after, and a baking soda bath. Hemorrhoids benefit from use of dietary fiber, baby wipes (not toilet paper), and topical soothing creams (Desitin©, PreparationH©, or witch hazel pads). For more information, visit our web site: www.DoctorHolladay.com or read Elizabeth Stewart, MD’s book, The V Book by Bantam Books publishing company 2002.