Explore all options with your doctor during menopause

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

The change of life sounds so dramatic. Life is always changing.

Hormonally, we have menarche (starting periods), cyclic changes (including premenstrual syndrome), pregnancy and postpartum hormonal changes, and alas — menopause.

It should probably be called meno‘stop’ rather than meno‘pause,’ because the ovaries have sputtered out and are not likely to get going again.

Women spend about one-third of their lives in menopause. The loss of estrogen in our bodies manifests itself in more ways than hot flashes. Estrogen receptors are present throughout our bodies and impact our mind, mood, heart, waistline and sexual function.

Estrogen receptors are abundant in the areas of our brain that are important for working and episodic memory. Limited clinical trial evidence has shown that women undergoing surgical menopause (having their ovaries removed) may benefit from the prompt initiation of estrogen therapy to preserve their ability to remember words.

Additionally, estrogen promotes neuronal growth and formation of synapses, acts as an antioxidant to protect the brain from damaging free radicals and elevates levels of neurotransmitters in the brain such as serotonin, which can have a profound effect on mood. Continue reading

Violence against women hurts us all

Dr. Jeff Temple

Dr. Jeff Temple

The arrest in recent weeks of more than 30 fugitives wanted in Harris County on domestic violence charges should bring home the fact that intimate partner violence is widespread. Last year, and the year before, the Harris County District Attorney’s office filed more than 10,500 cases of domestic violence. Thirty people were killed in cases of domestic violence in the county, the most in the state.

Violence against women is a pervasive and widespread plague on our society – one that crosses geographic, economic and racial lines. In the United States alone, the U.S. Centers for Disease Control and Prevention estimates that 1.3 million women each year are victims of physical violence at the hands of their partners; one in four will be physically assaulted by a boyfriend or husband in her lifetime. Texas is no exception to this problem.

While men also are victims of family violence, women overwhelmingly are the targets. In 2012, which saw nearly 200,000 instances of family violence, 114 women were killed by their partner in the Lone Star State. Continue reading

Fight back against stress

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

Just as I started writing this column on stress relief, I had an unexpected stressful event.

My mother had a subdural hematoma and emergency neurosurgery in California — with no other family around her.

I felt my adrenal glands squeeze and the stress hormones bathe my body as I sat by her intensive care bed.

What I realized at that moment was the thought of starting stress relieving measures at such a stressful time was overwhelming. The only way for stress relief to be there when we need it is if stress-relieving measures are part of our daily routine.

In a world where stress is a constant companion, what can we do to fight back?

  • Stop multi-tasking. Multi-tasking is a myth. That’s a difficult pill for women to swallow, because we are the queens of multi-tasking.

It seems that life demands that of us; however, we can truly only focus on one thing at a time. Continue reading

Stress affects every aspect of health

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

A fire races toward your house. This is definitely a stressful situation, but how you handle it may be programmed in your sex genes.

Fight or flight is typically a male response to this type of situation — sticking around to fight the fire or running as fast as you can away from it.

Women have a tend and befriend response to sudden stress. Estrogen blunts the fight or flight response, and we engage in nurturing activities to protect ourselves and our children.

These responses allow us to don a superman or superwoman cape and rise to the occasion. But what happens to our physical and emotional health when the stress is here day in and day out?

Most of us allow stress to sit on our shoulders like unwanted cellulite. You don’t want it, but it tenaciously hangs on.

Stress stimulates the release of various chemicals in our body. The primary stimulating response is the release of catecholamines and corticosteroids, or cortisol, from our adrenal glands. This rush can provide that superwoman response to acute stress. Continue reading

Women: Care for your heart, know your risks

Dr. Rafic Berbarie

Dr. Rafic Berbarie

“I’m worried about my risk of having a heart attack.”

Whenever I start my office notes in seeing patients, the first line I fill out is the patient’s chief complaint. The above statement is a common complaint in my general cardiology practice. But often the patients have no symptoms; rather, a friend or loved one just had a heart attack and so they are worried and want a heart “checkup.”

February is heart disease awareness in women month, and as a physician, I want you to know what can be done to help prevent heart attacks.

While awareness is growing, people are often shocked to hear that heart disease is the No. 1 killer of women in the United States. In fact, if you added up how many women died of cancer, the number still would not equal the number of women dying from heart disease.

And while there are established screening guidelines for several cancers, there are no unifying screening guidelines for heart disease in women.

My first recommendation is to have a good primary care doctor who is reviewing your risk factors for heart disease. Continue reading

A simple solution to menopausal weight gain?

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

The weight gain around the middle that accompanies midlife can creep up on you and then hang on for dear life.

Loss of muscle mass that accompanies aging and decreased physical activity are the primary contributors to a slower metabolism; however, there are other potential contributors to the midlife spread.

Eating out, alcohol, sleep deprivation, stress, medical problems and family genetics can all pack pounds around our waistlines. With the scale creeping up an average of one pound a year, how can you fight back?

I know you guessed the right answer: diet and exercise!

Maintaining your figure after menopause means cutting calories — approximately 200 calories per day — and increasing your activity level. Estimated caloric needs (to maintain weight) for menopausal women are 1,600 calories (for sedentary women), 1,800 calories (moderately active women) and 2,000-2,200 calories (active women). A calorie deficit of 500 calories or more per day is a common goal for women who want to lose weight. Continue reading

Is weight gain inevitable for all women during menopause?

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

You look in the mirror and see gray hair sprouting on your head and wrinkles streaming across your face.

As you glance further down, chins are forming and a muffin top spills over your jeans.

The average weight gain during midlife is 10 to 15 pounds. Is aging a battle that we must lay down our weapons against and accept as an eventuality?

Many women have picked up the sword to fight aging by covering up that gray hair or using skin products or Botox to soften wrinkles.

But what about the pounds in the middle? There are many changes in our bodies and activities as we age that can lead to weight gain.

Hormonal changes define menopause. Estrogen and progesterone are no longer produced in a quantity that will allow menstrual cycling.

Hot flashes, mood changes and vaginal dryness are only a few of the symptoms women experience. Is midlife muffin top also a symptom of hormone deprivation? Continue reading

Breast cancer awareness is more than mammograms

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

Breast cancer awareness means more than mammograms

This month my scrub cap for surgery is decorated with pink ribbons. Football players are wearing hot-pink cleats. During October, a variety of products and events encourage us to commit financially to finding a cure for breast cancer.

One in 8 women will be diagnosed with invasive breast cancer in our lifetimes. While men can develop breast cancer, it is 100 times more common in women. The American Cancer Society estimates that in the year 2013, there will be 232,340 new diagnoses of invasive breast cancer.

Each of these “cases” is a daughter, mother, sister or friend. Continue reading

Breast cancer: Making the tough decisions

Drs. Techksell Washington & Karen Powers

Drs. Techksell Washington & Karen Powers

The BRCA1 and 2 gene mutations that predispose women to aggressive breast cancer got a lot of attention this year when actress Angelina Jolie shared her preventive double mastectomy with the world.

In honor of Breast Cancer Awareness Month, and as breast specialists at the University of Texas Medical Branch, we think it’s a good time to take another look at some of the details surrounding genetic testing, treatment options and reconstruction decisions.

Jolie’s public sharing of her personal story surely resonated with many women who think they may be at risk. If you were one of them, we advise speaking with your primary care physician about genetic testing.

UTMB’s Breast Health and Imaging Center has a high-risk clinic with genetic counselors who can guide patients through screening and potential genetic testing for the BRCA1 and 2 mutations. Women with those mutations have a more than 80 percent chance of developing breast cancer and a 40 percent chance of developing ovarian cancer during their lifetimes. Continue reading

More than just mammograms

Dr. Angelica Robinson

Dr. Angelica Robinson

As the director of breast imaging at the University of Texas Medical Branch at Galveston, I am often asked to give public talks during Breast Cancer Awareness Month. Invariably, during the question and answer period, someone in the crowd timidly asks me to explain what exactly I do as a radiologist.

Radiologists are doctors who interpret images from X-rays, ultrasounds, CT scans, PET scans, MRI scans and mammograms. We have many years of specialized training – four years of undergraduate education, four years of medical school, five years of residency training in diagnostic radiology and a final year of subspecialized fellowship training for those of us who choose to focus on a specific aspect of radiology (such as breast imaging).

Radiologists do not “take” the actual images. Radiology technologists are the health professionals who do that. Our job is to review the final images, interpret the findings in the context of the patient’s clinical history and provide a written report that details the findings and provides an impression of those findings. Continue reading