New Hampshire Women Magazine by New Hampshire Women Magazine

COMPLIMENTARY

Vol 2 Issue 1

NEW HAMPSHIRE

WOM EN MAGAZINE celebrating the women of New Hampshire

Artistry on Ice

Caroline Mann professional figure skater “I passed the test. It reminded me not to give up.”

Inside:

Advanced Directives pg. 4

NHWOMENMAGAZINE.COM || 1

FROM THE PUBLISHER

NH WOMEN MAGAZINE

DON’T FORGET ABOUT YOURSELF! Happy New Year from New Hampshire Women Magazine! We hope you had a wonderful holiday season. Now that wintertime is upon us, it’s important to take care of ourselves. Let’s be honest, having it get dark before we leave work and that blustery wind prickling our faces when we get out of the car after a long day can be really hard. For me, by February, I am really looking forward to the warmth of spring. Last year, around this time, I had some blood tests done and found out that I was low in Vitamin D. I didn’t know what that really meant or how the sun played such a crucial role in the vitamin’s production, but I was told to get a supplement and to make sure I was taking it throughout the winter. After some research, I also decided to by a light therapy lamp as well. These two items alone have really helped my outlook on the cold winter months in New Hampshire. Have you made any modifications for the wintertime? One of my resolutions, which I haven’t been following lately, is to begin meditating again. About a year and a half ago, I took up Transcendental Meditation for stress and anxiety and made it my

daily practice for a solid year. Over that time, my stress levels significantly decreased. For whatever reason (work, life, etc), I haven’t practiced in months. I can feel my stress creeping back in and have also had my heart palpitations rear their ugly head in full force. As we all look ahead to this New Year, let’s try to focus a bit more on ourselves. It’s so easy to put ourselves last on the list, but look what happens when we do. Can’t we dedicate 20 minutes a day to breathing and about one minute more for taking some vitamin D? Drop me a line and tell me if you have some great ways of keeping your New Year’s resolutions. I am very interested in learning more. I know you’ll love this latest issue of New Hampshire Women Magazine! Here’s to a year of peace, love, and inspiration!

By Jill Sullivan Grueter, Publisher jill@nhwomenmagazine.com

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4 DARTMOUTH-HITCHCOCK: ADVANCED DIRECTIVES Shared Decision Making

empowers families to create plans for their future health care.

7 A new, More comfortable Mammogram

A new 3D mammography machine in New Hampshire is proving to provide more comfortable and better results.

8 Cover woman: Professional figure skateR caroline mann Take a journey

with local professional figure skater, Caroline Mann. Her story is inspiring and beautiful.

11: ask the pediatric surgeon Dear Dr.

Soukup, My 2 year old fell off a chair about 10 days ago and hit her head. She was checked out in the ED right away, but is still not acting like herself. Should I still be concerned? - Olivia W.

12: get the body you deserve

Here are a few areas Peak Recovery recommends you focus on to help you get the body you’re looking for.

13: teaching diversity

In an increasingly complex and global world, it’s critical we provide our children with opportunities to broaden their world view and deepen their understanding of other cultures and ideas.

15: from the obgyn: what is perimeno-

pause?

Looking to Join? NEW HAMPSHIRE

WOMEN MAGAZINE Melissa Diorio

Business Development Executive 603.591.4952 Melissa @nhwomenmagazine. com

NHWOMENMAGAZINE.COM || 3

ADVANCE DIRECTIVES

EMPOWER PATIENTS TO MAKE AND SHARE

CRITICAL HEALTH DECISIONS BY DARTMOUTH-HITCHCOCK CONTRIBUTORS

DARTMOUTH-HITCHCOCK’S HONORING CARE DECISIONS PROGRAM in the Center for Shared Decision Making empowers families to create plans for their future health care. The objective is to create a plan that respects your goals, values and wishes, and to designate a health care agent, such as a family member or friend, to communicate your decisions in the event you cannot.

he Center for Shared Decision Making is the first center in the U.S. dedicated to encouraging doctors and patients to make decisions together, and the staff of the Honoring Care Decisions program focuses on supporting and advocating for advance care planning. Sanders Burstein, MD, a consultant for Honoring Care Decisions, calls advance care planning “a gift.” He encourages patients to have conversations about what matters most to them, and to designate a health care agent. “You may lose the ability to speak for yourself, so prepare someone to speak for you. Prepare them to be informed and to be an advocate,” he advises. Terri Desrochers, RN, BSN, CCM, a program coordinator for Honoring Care Decisions, and a certified advance care planning facilitator and instructor, believes that many people do not want to talk about end-of-life decisions so they do not take steps to prepare, but they should. “There is a big difference between a family that knows and understands a person’s goals and decisions and one that doesn’t. It is really distressing to not know. You are relieving family members of additional stress by communicating ahead of time.”

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Additionally in New Hampshire, the state’s Surrogacy Law will dictate who will make decisions for you if you have not completed an advance directive designating a health care agent, explains Jennifer McCalley, MSW, ACHP-SW, a program coordinator for Honoring Care Decisions. Not having a health care agent may lead to someone whom you would not have chosen to speak for you and who may be unaware of your wishes having to make decisions. Even if the state appointed surrogate is the person you would have chosen, after 90 days they will have to go to court to become your legal guardian. You can avoid this situation by designating a health care agent in an advance directive. The advance directive process starts with a conversation between you, your family and your physician about your choices, so that those caring for you will have the peace of mind of knowing that they are advocating on your behalf according to your wishes. The Center for Shared Decision Making offers several ways to start this conversation: Contact the Honoring Care Decisions program to schedule a free individual or group planning session with a trained facilitator: 800-730-7577

Make an appointment with the Center for Shared Decision Making to have a conversation with a staff member or volunteer: 603-650-5578 Contact the Aging Resource Center if you are an older adult and need help completing the appropriate forms: 603653-3460 Advance care planning documents are also available at the New Hampshire Foundation for Healthy Communities at https://www.healthynh.com/website, the Vermont Ethics Network at http:// www.vtethicsnetwork.org/decisions. html and Prepare for Your Care an online self-guided advance care planning tool at https://prepareforyourcare.org/goto/d-h. These sites offer resources, guides, and tools to help you understand and develop advance directives. Additional resources are available on the Dartmouth-Hitchcock Advance Care Planning Resources webpage at https://www.dartmouthhitchcock.org/supportive-services/acpresources.html. Consider using times when your family is gathered together to have important conversations about care decisions. Empowering yourself to create an advance directive may be the most meaningful gift you can give.

ALLIYAH LIVES WITH SICKLE CELL DISEASE, BUT IT DOESN’T STOP HER FROM LIVING LIFE TO THE FULLEST.

Alliyah S. Manchester, NH

NEW HAMPSHIRE’S ONLY CHILDREN’S HOSPITAL. Born with sickle cell disease, Alliyah has relied on the Children’s Hospital at Dartmouth-Hitchcock (CHaD) her entire life. As the only children’s hospital in New Hampshire that offers advanced pediatric services, CHaD is dedicated to providing every child with outstanding and compassionate primary and specialty care. With a focus on innovative research and education, Dartmouth-Hitchcock is there for Alliyah and her family every step of the way.

go.d-h.org/kids NHWOMENMAGAZINE.COM || 5

Southern New Hampshire

Medical Center bringing some of

BOSTON’S BEST to NASHUA “As a specialist in oncoplastic breast cancer surgery, I have the unique privilege of working with my patients to assure the best cosmetic outcome, often preventing the need for additional reconstructive surgery.” -T. Salewa Oseni MD, FACS Mass General Breast Cancer Surgeon

If confronted with a breast cancer diagnosis, patients can find comfort in knowing that Southern New Hampshire Health is home to one of New England’s only reconstructive breast cancer surgeons. Through our affiliation with Massachusetts General Hospital, we offer some of the best diagnostic and treatment options, right in Nashua, with clinical expertise and research from one of the world’s leading institutions, Mass General Hospital. For more information call 603.882.8375.

Southern New Hampshire

Medical Center

Learn more at SouthernNHandMGH.org

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Local Health Innovcations

New, more comfortable mammogram The deNicola Breast Health Center at Southern New Hampshire Medical Center is one of the first in NH to offer the SmartCurve™ breast stabilization system, which is clinically proven to deliver a more comfortable mammogram without compromising image quality, workflow or dose. The SmartCurve system features a proprietary curved surface that mirrors the shape of a woman’s breast to reduce pinching and allow better distribution of force over the entire breast. In a recent clinical study comparing the SmartCurve breast stabilization system to traditional flat paddle compression, the SmartCurve system improved comfort in 93 percent of women who reported moderate to severe discomfort with standard compression. “With this new technology, we are not only able to provide a more comfortable mammogram, but can do so while maintaining clinical accuracy, which is key,” said Elaine Lavallee, Manager of Mammography Services. “Mammograms play such a critical role in the early detection of breast cancer and we’re hopeful that with the addition of the SmartCurve system, we’ll be able to lessen the pain and anxiety associated with mammograms and, as a result, increase screening compliance.”

hope for comfort The SmartCurve™ Breast Stabilization System on the 3Dimensions™ Mammography System. (above)

This latest innovation is part of the Medical Center’s ongoing commitment to superior breast cancer detection. As one of the first in southern NH to install 3D Mammography technology back in 2013, the Medical Center continues to invest in the latest technology to enhance imaging services for the benefit of patients.

“We’re excited to provide this first-of-its-kind technology to our patients and remain committed to offering the women of our community the best breast care possible,” added Lavallee. To complement SmartCurve™ the Medical Center installed Hologic’s Low Dose 3D MAMMOGRAPHY™ exam powered by C-View™ software. C-View™ Software supports early breast cancer detection further while lowering patient radiation dose and compression time, with the added benefit of greater patient comfort. In addition, the Medical Center has invested in the Affirm® Prone Breast Biopsy System as well as the Brevera® Breast Biopsy System to deliver faster, more comfortable procedures.

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NHWM

COVER CAROLINE MA

Written by Crystal Ward Kent Photograpy provided by David J. Murray, ClearEyePhoto.com

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ANN Artistry on Ice

PHOTOGRAPHY BY: WILBUR SMOOTH

hen Caroline Mann takes to the ice, people tend to watch. Under her skilled strokes, the ice becomes not a slippery, frozen sheet but a medium for expression. Curves and edges, spins, lifts, and spirals all flow together into one choreographed dance that takes skating beyond sport and into the realm of art. A professional figure skater and coach, Mann was late coming to the ice by figure skating standards. At age 11, she was captivated by the movie “Ice Castles.” Although she had been an avid pond skater, she had no formal training. After seeing the movie, she wanted to learn more. She started with group skating lessons at the Mass Bay Figure Skating Club in Lynn, then private lessons at the North Shore Figure Skating Club in Danvers, Massachusetts. Mann quickly worked her way through the figure skating tests, and as she mastered the required skills of footwork, spins and jumps, she also started competing in non-qualifying competitions. “I had started too late to embark on a competitive figure skating track, but I wanted the experience of competing,” says Mann. “I also knew I wanted to somehow pursue a career in skating.” For college, she headed to Colorado Springs, Colorado, partly because the area was home to the world-famous Broadmoor World Arena and Skating Club. The Broadmoor is home ice for Team USA Skating and legends such as Michelle Kwan. Once there, Mann was thrilled to discover that scenes from “Ice Castles” had been shot at the Broadmoor, and that one of her coaches had actually had a cameo in the movie. It seemed a sign that she was on the right track.

“Once I felt

stronger on the inside, I seemed to project more confidence, and that brought more students and more opportunities to me.” Mann started teaching group classes while in Colorado and found that she enjoyed teaching. She began to contemplate a career in coaching when an opportunity to skate with the Ice Capades came along. She auditioned and was accepted, but had to wait until a show opening materialized. “The openings were based in part on height,” she explains. “You had to fit with the rest of the ensemble. I would call every month to see if there was a part for me, and this went on for about six months. Finally, I got in but it was not good timing. I had just hurt my back pretty badly and was not at my best. I didn’t want to miss out, so I decided to skate anyway, but wound up only performing a short while with the troupe due to my injury.” Nonetheless, Mann loved her time with Ice Capades and the glamorous costumes. “There were a lot of costume changes for different

numbers,” she recalls. “In one show, we did a jazz dance number from the 1920s with these glittering, pink sequined dresses. This was followed by us being Vegas showgirls skating in sequined bikinis; we wore backpacks filled with giant palm fronds and had fruit basket ‘hats’ on our heads. The Ice Capade numbers all required a lot of precision skating, like what we call synchronized skating today. Timing was important and everyone had to match.” After Ice Capades, Mann once again re-evaluated her skating career. “I certainly didn’t arrive where I am today by any conventional route,” she laughs. “Over time, I tried at least three different careers because I wasn’t sure I could make enough money with skating. I was even an airline pilot for a time—that was definitely one of my more unique career choices! However, skating always pulled me back. I also took a good look at myself. I had struggled with self-confidence my whole life, and I finally took the time to work on my feelings of self-worth. Once I felt stronger on the inside, I seemed to project more confidence, and that brought more students and more opportunities to me. I knew then that the other career opportunities I had tried did not work out because skating was where I was meant to be. Once I embraced that, things came together.”

Flying on Ice During her skating journey, Mann began to pursue ice dance in more depth. Typically, skaters pursue either free-style tracks or ice dance, as the two disciplines require different skill sets as skaters advance. She had taken group ice dance as a young student and now wanted to see how far she could go. “Of course, this was also atypical, as I was already 30,” she says. “But this form just called to me. I wanted to be out on the ice and skate Continued on next page. NHWOMENMAGAZINE.COM || 9

continued from previous page

that close to someone. When you perform in ice dance, it’s like flying across the ice but with a partner. I love the look and feel of it, the way the dance embraces the music. I also love the partnership. You and your partner must be on the same page in every way. You have to be on exactly the same edge at every moment. At times, your blades are barely an inch apart—sometimes they may click together on moves such as 3-turns. It requires great trust and discipline.” Mann has had three partners since pursuing ice dance, and says she has been very lucky that “lightening has struck three times,” as each one was excellent; it can be rare in ice dancing to find one great partner, let alone threes. With partner Will Eastler, she would win the Gold Medal at the Silver Dance Level at Adult Nationals, her one and only ice dance competition. “You have to learn all of these dance patterns and they are very specific,” she explains. “We also did some free dance, and it was the free dance that captivated me. I knew I wanted to explore that further.” Today, Mann skates with Erik Nylund, a former student, and performs regularly as part of Portsmouth, New Hampshire’s Vintage Christmas Celebration at Strawbery Banke. She, Nylund and a small troupe of ice dancers skate in Victorian costume (no easy feat as long skirts and blades can lead to disaster) at the LaBrie Rink to routines created by world-renowned choreographer Douglas Webster. “I love working with Doug,” she says. “It’s an honor. His work highlights the essence of skating—deep edges, flow, the pure quality of movement. He also always creates performances that have unparalleled emotional depth. He is inspiring. He’s also pushed Erik and I to up our game. We are doing lifts and moves that we have not done before and it’s great. I’m loving every minute!” Being a professional skater and coach is not without its challenges. While Mann now has enough of a reputation that she does not lack for students she must take care of her health in order to teach and perform continuously. “After my back injury, I made sure to pay more attention to body alignment, strength conditioning and doing lots of yoga,” she says. “You need to be strong yet flexible so I train and follow a fitness program daily.” Skating is also mentally challenging, as in ice dance, Mann teaches both males and females, so she must be able to skate either the lady’s role or the gentleman’s, depending on who she 10 || NEW HAMPSHIRE WOMEN MAGAZINE

Photo by David J. Murray, ClearEyePhoto.com is partnering. “I recently had to skate both roles back to back for a test session in Boston. It’s a wonder I remembered which part I was doing, but I did and they passed,” she laughs. Role-switching aside, Mann loves coaching and feels it is the relationships she builds with students that bring her the most joy. “The great thing about skating is that you are never too old to start, and you can stay in the sport as long as you want and at whatever level you want. I have young students, students who have been studying with me for 20 years, and two ladies in their eighties who are learning ice dance. I also have an ice dance pair where the man is in his seventies and his partner is 60. Seeing all of these different people find joy in something that I love is wonderful. Whenever I see a student hit a perfect position or achieve

an element for the first time, I get excited. Helping other people achieve their goals is what it’s all about.” Mann admits that her field is not an easy one in terms of building a career, but says it can be done. “You have to be dedicated to achieving a certain level of skill if you want to coach or perform, so that determination needs to be there. But, otherwise, I believe if it’s meant to be your calling it will happen. I remember I once fell during a freestyle test— one of the few times I’ve fallen when performing. I figured, that’s that; I’ve failed; with the pressure off, I skated the rest of the program full out and it went very well. To my surprise, because I skated so passionately after the fall, I passed the test. It reminded me not to give up. You can make things happen if you want to.”

Ask the pediatric surgeon Question: Dear Dr. Soukup, My 2 year old fell off a chair about 10 days ago and hit her head. She was checked out in the ED right away, but is still not acting like herself. Should I still be concerned? - Olivia W.

Dear Olivia, Before I respond to the medical aspect of your question, I think it is important to embrace your “parent instinct” in situations like this. When you are concerned and something seems “not right” with your child, listen to yourself and seek help! It sounds like your daughter had a concussion, and the evaluation in the ED would have ruled out more significant or dangerous brain injuries. There is a huge scientific organization called PECARN (Pediatric Emergency Care Applied Research Network) which has studied hundreds of thousands of children to identify those who are at highest risk for significant injuries. Using data like this can help us choose the children who most benefit from a CT scan, in order to minimize radiation exposure and at the same time, not miss any injuries. Typical symptoms of concussion include headache, nausea and vomiting, dizziness or balance problems, fatigue, sensitivity to light and noise, and disturbances in emotion and sleep. Our littlest kids demonstrate these symptoms

as fussiness and unwillingness to eat. Most kids recover quickly from a concussion but it can sometimes take substantially longer, rarely even weeks or months to return to normal behavior. Although we consider concussion a “mild” traumatic brain injury, it is still a serious event. The CDC recently published guidelines on the diagnosis and management of pediatric concussion, including recommendations regarding rest and gradual return to activities, as well as avoidance of repeated injuries, which can be much more serious. As we are well into ski and snowboard season, I’ll use this opportunity to plug for helmet use while participating in these high intensity sports! Prevention is the best cure. Thanks for your question! -Dr. Soukup askthepediatricsurgeon@elliot-hs.org #askthepediatricsurgeon #cdcheadsup

Elizabeth S. Soukup, M.D., M.M.Sc. Pediatric Surgeon

Dr. Soukup is a Pediatric Surgeon at the Elliot Hospital and has an interest in educating families about pediatric health and wellness. Her mission is to provide expert specialty care for children of all ages in New Hampshire - newborns through teenagers striving to keep them close to their families and communities. If you would like more information, call 603-663-8393 for an appointment, or visit our website at http:// elliothospital.org/website/pediatric-surgery.php. Check out previous articles at #askthepediatricsurgeon. Dr. Soukup earned her Bachelor of Science from the Massachusetts Institute of Technology and her Doctor of Medicine from the University of Chicago Pritzker School of Medicine, where she received the Outstanding Achievement Award in Medicine, graduating first in her class. She completed her General Surgery training at the Massachusetts General Hospital and her fellowship in Pediatric Surgery at Children’s Hospital Boston. During her time in Boston, she also completed a Masters of Medical Sciences degree in clinical investigation

from Harvard Medical School. She was awarded Elliot Hospital’s “Physician of the year” for 2018. She is board-certified in both Pediatric Surgery and General Surgery. She has specialized training and experience in minimally invasive surgical treatment for babies, children and teenagers. Her practice includes all areas of general pediatric surgery, including common pediatric surgical problems as well as neonatal surgery, congenital anomalies, minimally invasive surgery, and complex thoracic surgical problems.

Please send your questions to: askthepediatricsurgeon@elliot-hs.org

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From the Experts at Peak Recovery & Health

Get The Body You Deserve While it may be true that only 8% off all New Year’s resolution goals are achieved, there is no better time than today to make a positive change in your life. Many women set goals to improve their physique and we have a few suggestions that can help you to achieve them. For starters, make sure you have smaller goals that help you build towards your big goals. Sometimes we know where we want to go, but its just too daunting to even think about getting there. Appreciate and recognize your gradual improvements as they come along. Contrary to that, you may be someone that doesn’t set goals in the first place. If that’s the case, you’re never going to get there if you don’t know where you’re going so define your goals so you can get on the right track. Here are a few areas we recommend you focus on to help you achieve get the body you’re looking for.

Amy

LaBelle

Manage Stress – More and more research is coming

out about how much stress negatively affects your overall health, your ability to lose weight or our ability to maintain a healthy weight. Sometimes you may be simply putting too much stress on your body to be able to lose weight, even when you’re putting in the time and effort that should promote weight lose. Consider doing some relaxing activities regularly for yourself like meditating or relaxing in a float pod or detoxifying your cells in an infrared sauna.

Diet – A balanced, high quality diet is essential for weight loss. Consider adding quality prebiotics, probiotics, and digestive enzymes to your diet. This could significantly improve the overall gut health. If you can minimize your sugar intake, especially after lunch, this could be a game changer for you as well. Lastly, many nutrition consulting companies now accept health insurance from the major providers so look into getting help from an expert very economically.

Exercise – Exercising four times or more per week is

going to significantly promote weight loss when done properly. Consistency is the key here so make sure you find a way to workout in a way that you enjoy. Training with a group, mixing it up on different days of the week and trying new things can really help as well. Don’t forget to have fun and maintain a positive mindset as your driving to make this part of your regular routine.

Before

After

9 Get rid of unwanted fat. Eliminate fine lines and wrinkles. Say goodbye to cellulite.

New Technology – There are new technologies out there

that are clinically proven to reduce fat. The Cryoskin for example, is a new technology that non-invasively produces fat loss and skin toning in just a single 30-minute session. This device is actually clinically proven to reduce visible fat. So if you have some weight to lose or just can’t seem to get rid of some excess fat on your stomach, thighs, arms or back, the Cryoskin could really help. We hope these suggestions help you get you where you want to be! Here’s to a great 2019 and beyond! 12 || NEW HAMPSHIRE WOMEN MAGAZINE

603.402.4564 PeakRecoveryAndHealthCenter.com

EDUCATION

Celebrate together

Teaching Diversity During Wintertime In an increasingly complex and global world, it’s critical we provide our children with opportunities to broaden their world view and deepen their understanding of other cultures and ideas. With all of us having our own customs, traditions, and beliefs, this season is the perfect time for parents to encourage their children to celebrate diversity and embrace multiculturalism.

Read Stories

SAMANTHA WINGATE DIRECTOR OF ADMISSIONS

WORLD ACADEMY 38 SPIT BROOK ROAD NASHUA, NH

When the days are short and the weather is cold, there’s nothing quite like huddling by the fire with your family and book. Children learn by seeing, doing, and forming connections between their own experiences and the information they’re given about the world around them. Reading stories that explore how different families express their values and beliefs will help your child develop an understanding of other cultures and traditions. With many multicultural books available, here are just a few of our favorites:

1. Winter Candle by Jeron Ashford This urban tale weaves together a beautiful story of community when a single candle is passed around a multicultural apartment complex to light each family’s winter celebrations. 2. Lights of Winter: Winter Celebrations Around the World by Heather Conrad

on family activity. Or, find a story that highlights how a holiday is celebrated in another culture and have your child help you cook a special dish from it. However you go about it, adding a little global cuisine to your table allows your child to see their own traditions from a different, yet relatable, perspective.

Be Crafty The best learning experiences are often the ones that inspire creativity through self-expression and play. Arts and crafts can be a fun way to infuse your winter holiday with a little global flair and cultural awareness. For inspiration, here are a few ideas: 1.

Paper Dolls: Explore different cultures and holidays by making paper dolls – allowing your child to see the visual diversity of our world cultures and play out their own stories of how these dolls might celebrate together.

Encourage them to create dolls that look different from themselves making sure to provide resources they can reference while they craft their different holiday outfits. We like: Children Just Like Me: Celebrations by Anabel Kindersley.

Create Your Own Tradition: Once you’ve introduced a few different traditions, invite your child to invent their own and craft the items they’d use to celebrate it. This is a great opportunity for them to be creative, contemplate the customs and traditions they value, and reflect on the aspects of other cultures they may want to include in their “new” tradition.

Also using the motif of light, this book explores different winter celebrations from around the world – from the familiar to the lesser known, like Teng Chieh, Soyal, and Las Posadas. 3. December’s Gift: An Interfaith Holiday Story by Ashley Smith-Santos

This tale follows a young girl, Clara, as she discovers the underlying meaning of both Hanukkah and Christmas through the stories, holiday memories, and cooking traditions of her two grandmothers.

Get Cooking With little hands often eager to help, the kitchen is a great place to incorporate lessons about different cultures. Have a relative that may have celebrated the holidays differently growing up? Invite them over to share their story and cook their favorite childhood dish for a hands-

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WOMEN’S HEALTH

From the OBGYN:

What is Perimenopause? Dr. Meinz received her Bachelor of Science in Biochemistry at Harvard University. She then completed her medical degree at Vanderbilt University in Nashville, TN. Dr. Meinz’ residency training was done at Women and Infants Hospital (Brown University) in Providence. She offers a full spectrum of obstetric care from preconception planning to high risk pregnancy management. Other areas of interest include infertility evaluation and treatment, in office surgical management of heavy periods, and management of abnormal Pap smears and cervical dysplasia. In addition, she is experienced in all aspects of gynecology including minimally invasive surgery and out-patient surgical treatment of urinary incontinence. She lives in Bedford with her husband and 3 children.

What is perimenopause?

DR. HEIDI L. MEINZ

MANCHESTER OB/GYN 150 TARRYTOWN RD MANCHESTER, NH 77 GILCREST ROAD LONDONDERRY, NH PHONE: 603-622-3162

Perimenopause is the period of transition from a woman’s reproductive years to her menopausal years. For most women, menopause is not an “on/ off switch” but is instead a process. This transition usually lasts several years, but the average age at which symptoms start is 47. At this age, the ovaries are not functioning as well as they once did, and start to produce less estrogen. This leads to the eventual end of menstrual bleeding and the symptoms we associate with menopause.

What are the most common symptoms? Perimenopause is most notable for menstrual and hormonal changes. Periods can change in many ways, including frequent periods, skipped periods, heavy periods, or irregular periods. Most women find the unpredictability of their cycles to be their most bothersome symptom. No longer can they mark on a calendar when they can expect their period! In addition, some of the symptoms most women associate with menopause actually start in the perimenopause, including hot flashes, night sweats, sleep disturbances and mood changes.

Are there medications women can take to lessen the symptoms? Whether or not medication is needed depends on how bothersome the symptoms are and where a woman is in the perimenopausal transition. For example, if a woman is having irregular and heavy periods, hormonal therapies

such as progesterone or the birth control pill can be used to regulate her cycles. If a woman has rare periods but is having frequent and disruptive hot flashes or night sweats, options for treatment include behavioral interventions (lowering the room temperature, dressing in layers, identifying and avoiding triggers) or medical therapy either with hormone replacement therapy or with nonhormonal medications that have been shown to help with these symptoms. Some women do find benefit with plant based or herbal therapies such as soy, black cohosh, or plant based estrogens, but the evidence that these treatments help is not conclusive.

How long does perimenopause last? When perimenopause ends is a matter of some debate – some would say perimenopause ends when menopause begins, and others would include the first few years of menopause as part of the transition process. Menopause is defined as the absence of a period for 12 months or more. The average age of menopause is 51.4 years, although this obviously varies widely. Although the bleeding changes of the perimenopause end with menopause, hormonal changes can persist for some time afterward. Most women continue to have hot flashes one year after their last period, but the good news is that they tend to become less frequent and intense, and, for most women, resolve without treatment completely in four to five years.

NHWOMENMAGAZINE.COM || 15

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16 || NEW HAMPSHIRE WOMEN MAGAZINE