EMOTIONALLY CHARGED CONVERSATIONS : React + Interact Di erently

We know communicating with family members and friends can be di cult at times, but living through a global pandemic has made it even more challenging. People who love each other have had to face emotionally charged di erences of opinion on things like mask wearing, social distancing and presidential elections. Now we are faced with global pandemic fallouts such as unemployment and uncertainty about returning to our “normal” lives. Here are a few tips to use in preparing for di cult conversations with loved ones to help increase the likelihood of a successful discussion.

Speak for yourself!

Use “I” and “we” statements such as “I feel concerned and worried about our nances because you don’t have a job. What do we need to do di erently?”

Using “I” and “we” puts you on the same team (rather than you versus me) and prevents you from making assumptions about the other person’s feelings, intentions and motives.

Stay curious.

When you have a di erence of opinion with someone, it can be hard to have an open, honest conversation if you believe your opinion is “right.”

Ask questions and stay genuinely curious to learn about why the other person believes what they believe (“That’s interesting. Help me understand your thoughts on that.” Or, “Can you tell me more about that?”).

You do not have to agree with them, but you can then at least understand where they are coming from.

Watch your nonverbals.

Nonverbal behaviors (tone of voice, posture) are crucial in all conversations, but particularly important when having a challenging conversation. Make sure you keep your tone of voice even, volume normal, and tone conversational rather than confrontational. Be mindful of your posture so your arms are not crossed in front of you, and you are not using an intimidating stance (e.g., hands on hips, being too close). Ideally, you would have your arms open and be sitting or standing in a non-threatening manner with appropriate distance between you and the other person.

Reduce technology to a minimum.

All di cult, emotional conversations should be done face-to-face when possible. As mentioned above, nonverbal behaviors are important aspects of conveying your message so being in-person is best for di cult conversations. If in-person is not possible, try to use a video call platform for the conversation. Texting and emailing are NOT useful ways to conduct important conversations because you completely lose tone of voice, and misinterpretation is easier.

While these tips can increase your likelihood of success, they are not guaranteed. If the conversation becomes unproductive, you can always end the conversation and agree to disagree. We can only control our behavior; we cannot control the behavior of others, and all are entitled to their opinions and feelings. Please reach out to local mental health professionals for more training on assertive communication for more complicated situations.

We are pleased to announce that Anne Carlsen has integrated its Behavioral Health & Autism Services, Therapy Services, and Early Intervention Services in one Fargo location! Anne Carlsen is dedicated to continually improving the quality and accessibility of our services. These services are also available through telehealth.

Anne Carlsen Services:

FOR MORE INFORMATION, contact us at Becoming Balanced.

Desiree Zielke, Ph.D, LP (left), Trishia Powell, MSW, LCSW (middle) and Rachel Blumhardt, MEd, LPCC, LPC, NCC (right) becomingbalancednd.com | 701-551-1840

WORDS : HEATHER NOVAK, RPh, PharmD

Genitourinary syndrome of menopause (GSM) also known as vaginal atrophy, or atrophic vaginitis is a painful condition that many women suffer through silently.

Commonly, as women start menopause (usually around the age of 50, but sometimes sooner), their hormone levels decrease which can cause the vaginal lining to become drier and thinner.

Symptoms

According to a review article from the Journal of Menopausal Medicine:

50-60% of post-menopausal women experience symptoms of GSM during their lifetime. These symptoms can include:

 dryness

 genital itching

 vaginal discharge

 burning with urination

 urgency with urination

 recurrent urinary tract infections

 dyspareunia (pain during sex)

 decreased vaginal lubrication during sexual activity

 spotting after intercourse

Low-estrogen state in the postmenopausal period causes many health problems. In contrast to vasomotor symptoms (ex. hot flashes and night sweats) that are often improved over time, GSM symptoms are chronic, rarely resolve spontaneously and often progress if left untreated. Although these symptoms are not life-threatening, they are progressive and may have a profound impact on the quality of life of postmenopausal women by negatively affecting self-esteem and intimacy with their partners.1

Unfortunately, many women hesitate to seek treatment for this very common and treatable condition. This reluctance may be due to a feeling of embarrassment discussing GSM symptoms with a healthcare provider or because they falsely believe these symptoms are just part of getting older and there is nothing that can be done about it.

Treatment

There are two primary ways most healthcare providers approach treatment for the symptoms of GSM — by addressing the loss of estrogen and by treating the symptoms.

Loss of estrogen can be addressed by starting hormone replacement therapy. Either systemic treatment with oral hormone capsules, or localized treatment with vaginal creams or gels may be suggested by your healthcare provider. For women using vaginal estrogen creams or gels for GSM, there are a variety of products available that each incorporate a di erent kind of estrogen. Most of these estrogen creams and gels are available at any retail pharmacy. A certain bio-identical estrogen called estriol, which is often used vaginally to address GSM symptoms, is only available in custom compounded products prepared by pharmacies specializing in compounding.

In addition to hormone replacement, or as a stand-alone option, local symptoms can be targeted through the use of overthe-counter lubricants or moisturizers to help relax the vaginal lining and improve the feelings of dryness.

For patients who are unable or would rather not use hormone treatment, there are also novel prescription options that can be custom-made at specialized compounding pharmacies. These products target GSM symptoms, but are hormone-free.

Patients may have different reasons for not seeking help for GSM symptoms, but it is important to note that good treatment options are available that offer hope and can really help many of these women.

IF

You Are Interested

in learning how InHealth Specialty Pharmacy works with local healthcare providers to help patients suffering from GSM symptoms, please contact them at 701-365-6050.

InHealth Specialty

Pharmacist Heather Novak RPh, PharmD is a 2004 graduate of NDSU College of Pharmacy. With specialized training through Professional Compounding Centers of America, Heather has over 15 years of experience in compounding and hormone therapy. She has a passion for helping patients with their hormone and nutritional health.