1. Please feel free to chat amongst yourselves until we begin at the top of the hour.

2. Seminar Agenda Equilibrium and the Human Body Second Cousin Tilly and Menopause Aging Male Syndrome Questions & Answers

3. Any questions?

4. Change Change is inevitable The only thing constant is change If nothing ever changed, there’d be no butterflies. What ones have you heard?

5. Equilibrium and change Occurs in living and non-living systems In humans: Sweat to cool down our body Release hormones to absorb more glucose (sugar) into the blood Increase breath rate when exercising Other examples?

6. Equilibrium & the Human Body

7. Equilibrium: a state of balance or equality between opposing forces → When a new condition is introduced into the system, an adjustment may be necessary for the system to come to equilibrium Homeostasis: the ability of the organism’s body to seek and maintain a condition of equilibrium or stability within its internal environment

8. Equilibrium & the Human Body What are some examples of the human body achieving homeostasis?

9. Cousin Tilly & Menopause What is menopause?

10. Menopause: re-equilibrium Pre-puberty Puberty Reproductive hormone cycle emerges Post-puberty Menopause Re-equilibrium of reproductive hormones Estrogen and progesterone decrease Women in 40s, 50s, and 60s Natural stop in menstrual cycle and fertility Definition: 12 months without having a period

11. Cousin Tilly & Menopause Why do we “treat” menopause? What are we treating?

12. Cousin Tilly & Menopause What treatments exist for menopause?

13. Cousin Tilly & Menopause How safe and effective are these treatments?

14. Treatment – easing symptoms Symptoms affect every women differently Common symptoms: Shorter/longer/heavier/lighter periods Hot flashes Night sweats Trouble sleeping through night Vaginal dryness Mood changes – especially if you had these during pregnancy and postpartum Hair thinning on head; hair growth on face Forgetfulness; trouble concentrating Why? Estrogen decline or rise/fall

15. Treatment – bigger issues Increased risk osteoporosis Heart disease Why? Decreased estrogen; estrogen is protective against both

16. Hormone replacement therapy (HRT) Treatment to replace estrogen and progesterone that are declining Improved symptoms Less bone loss However….. Increased risk for heart disease and stroke Increased risk of blood clots Increased risk of breast cancer Current recommendation from USDA: use HRT for shortest time and lowest doses possible More information: http://www.nhlbi.nih.gov/whi/http://www.nhlbi.nih.gov/whi/

17. Dietary foods and supplements Eat well. Food first. (then supplements) Need just as many nutrients but fewer calories. Eat nutrient dense foods. Increased need for vitamin B12 and B6 Calcium needs increase to 1200mg/day Vitamin D increases to 600 IU/day (800 IUs at 71 years +) Talk to physician about… Soy and plant estrogens (eg, red clover) – to mimic estrogen Not recommended in families with higher female cancer risk Black cohosh (little evidence of effectiveness; may harm liver) Ginseng (help with mood and insomnia but not hot flashes) Dong quai (not effective for hot flashes; thins blood) Kava (ease anxiety but not hot flashes; liver damage risk)

18. Treatment – being active Exercise can help bones, heart, and mood! Recommendations: at least 2 hours and 30 minutes a week of aerobic activity 2 days a week of strength building activity

19. Other lifestyle treatments Keep cool. Slight increases in body temp can trigger hot flashes Dress in layers Sip cold drinks Avoid spicy foods and alcohol Relax. Yoga, meditation, etc. to stop hot flashes and improve sleep Don’t smoke. Smoking is linked to increased hot flashes (and heart disease, cancer, and stroke).

20. Cousin Tilly & Menopause What are the drawbacks to these treatments?

21. Cousin Tilly & Menopause If Tilly has been a smoker all her life, how might this alter her transition through menopause?

22. Cousin Tilly & Menopause Why are hot flashes are very rare among Japanese women?

23. Aging Male Syndrome Myth or reality? What is Aging Male Syndrome?

24. Aging male syndrome Men produce less testosterone later in life Testosterone is responsible for: Maintain sex drive and sperm production Maintain muscle and bone BUT, testes do not stop making testosterone like ovaries stop making estrogen (do not lose fertility)

25. Aging male syndrome Symptoms: Weight gain Insomnia; Depression; loss of energy Less interest sex; Erection problems Nervous/irritable Testosterone drugs are becoming more popular Need to rule out other diseases that cause these symptoms

26. Any questions?