May 2013

It Is Time To Hop On Your Bike!

Are you one of those people with creaky joints? If you have them, then you know that they can make exercise challenging. Biking is something that you can do that is a great aerobic activity, good for maintaining a healthy weight and is just plain fun. And, it will make you feel like a kid again!

Riding a bike is good for an overall workout. It is good for your legs, core and balance. If you don’t want to go outside you can use a stationary bicycle. If you want a real workout, go to your local gym club and find out about spinning classes. There you can ride a bike to music and be led up and down virtual hills with a group. It is social, fun and you can work up quite a sweat.

If you want to burn calories, biking is a good way to do it. If a 130-pound woman rides ten miles, she burns 400 calories. It is a very efficient way to stay in shape and have fun at the same time. It is also a great stress reliever that boosts endorphins.

Bicycling outside can be made easy if you find level ground. Start out slowly, and of course wear a helmet. It will feel good to get out into the fresh air. If you want to make it more competitive or social, find local bicycle races that map out rides. You don’t actually have to race. The key to incorporating exercise into your life is finding something that is fun to do.

May is National Bike Month. Consider taking this opportunity to put on your bike helmet, hop on your bike and ride to work. You may have fun and notice that you feel good as well!

I Love My Fitbit

A couple of months ago a patient of mine came in wearing a pedometer known as the fitbit. I was intrigued. It calculated her steps; calories burned and could be used at night to see how well she was sleeping. I decided to try it out and experience it for myself.

What I found was something that has taught me quite a bit about my own health habits. First of all, I realize that there are some days when I feel that I have run myself ragged at work, and in reality I have taken half as many steps as I would have guessed.

In addition, I burn far fewer calories than I expect regardless of how many steps I take. I wondered why I was unable to lose weight recently. Now I know why. I am just not burning enough calories in spite of how much I am exercising. I eat a healthy diet but apparently my portion sizes need to be smaller.

As far as sleep goes, I now know that it takes me an average of 7 minutes to fall asleep and I move on average 10 times during the night. My fitbit program gave me a 95% sleep efficiency rating, and I am satisfied with that.

When the people at work saw my fitbit, they all decided to get one and before I knew it they were starting a competition. I have been trying to get them all fired up for fitness for the last couple of years. I have tried nutrition games, biggest loser competitions, and many other programs and finally I found a hook. They have all lost weight and they are looking really healthy.

There are many slick pedometer and sleep monitoring programs out there. In addition to the fitbit there are bracelets. One is Up by Jawbone and the other is the Nike fuel band. They all do the same thing. The bracelets are definitely more stylish. I like the fitbit because it clips to anything and has a firm fit. It is light and inconspicuous and it talks to me in the morning.

When I pick it up off the counter it flashes all kinds of words of encouragement to me. It tells me that I rock. No one recently has told me that! I love it. It encourages me to keep walking and burn calories. I look forward to what it has to tell me every morning.

If you need encouragement to keep walking, and you want to know how much exercise you are doing and what you are burning, I suggest any one of these devices to help you. It is amazing what you might find yourself doing to add to your steps for the day. What is even more wonderful is that these little devices will put a spring in your step and a healthy glow on your face.

HRT-A New Twist?

Once upon a time, people used to think that hormone replacement therapy after menopause was a risk-free proposition. In fact, way back when, some doctors thought that every woman ought to go on hormones at menopause and stay on them for the rest of her life. Then came the Women’s Health Initiative, raising questions about the safety of these hormones, and women got scared. I have many patients who come to me terrified of taking hormones, and as a result they have suffered with severe hot flashes, insomnia, mood swings, and vaginal dryness.

But the truth is somewhere in the middle: These hormones are too big a risk for some women, but can be a big help for others. So it’s worth noting that a recent consensus statement, published on behalf of seven international menopause and women’s health societies, has deemed hormone replacement therapy (HRT) to be relatively safe in women who are under 60 years of age or within 10 years of menopause. Here are some of the highlights of the statement:

– HRT may prevent osteoporosis-related fractures in women who are at risk of these debilitating bone breaks.

– The use of estrogen-only hormone replacement can help in the prevention of heart disease.

– When these hormones are taken orally (as opposed to being used in skin patches, for instance), they can increase the risk for blood clots and stroke.

– Women who use a combination of estrogen and progesterone may have a slightly higher risk for breast cancer.

I am glad that the relative safety of HRT for women under 60 has been acknowledged. But even this consensus statement makes the therapy seem a little riskier than it is when it’s prescribed with care. Why do I say this? The societies’ statement expresses caution regarding the use of estrogen and progesterone in combination. However, the clinical studies on which they based their opinion actually used progestin, not progesterone—and there is a big difference between the two.

Progestin is a synthetic hormone. This type of hormone is known to increase the risk for blood clots, fluid retention and high blood pressure. Natural progesterone is the “feel good” hormone of pregnancy. It reduces inflammation, acts as a natural diuretic and helps to keep blood vessels dilated so that blood can flow smoothly. Women can get a bioidentical version of progesterone (not progestin) by prescription, and that is what I recommend to my patients who need it. I do not recommend progestin, which is also called Provera.

As for estrogen, I agree that the oral form increases a woman’s risk of blood clots and other problems. Because of that, I recommend using estrogen in a transdermal (through-the-skin) form—in a gel or patch. It can also be used under the tongue. Any of these routes will help to avoid blood clots.

Many women breeze through menopause. The rest of us have symptoms that can be debilitating (in addition to making us hard to live with). The key, if you are in the latter category, is to find a doctor who understands the benefits and risks of HRT and realizes the need for a good quality of life. Then, the two of you can find a treatment that works for you.


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