Survival Kit for Staying Fit After Menopause - Q&A
a 2009 Menopause and You event, guest speakers Beverly
Vaughn, MD; Marilyn
Ryan, MD; Kevin
Walsh, MD; and Judy Matusky, RD, LDN, answered questions from
the audience about maintaining health and fitness after menopause. This
is a summary of that Q&A session.
Beverly Vaughn – Gynecology
Does flaxseed oil have estrogenic effects?
Flaxseed oil does not provide hormonal effects. Soy products such as soy
milk, tofu, soy nuts and edamame beans can be beneficial to a woman
because of their similarity to estrogen. These products are also good
sources of calcium. Soy supplements in the form of pills do not provide
the same benefit as the soy products and therefore, are not helpful to
I am postmenopausal. How often should I get a DEXA scan and Pap
Generally, your physician will recommend that you get a DEXA scan every
two years to monitor your bone health and to evaluate effectiveness of
any treatment that has been initiated. DEXA scans are recommended for
everyone at age 65. If you have additional risk factors, such as smoking
or family history of a hip fracture, 60 is the recommended age. In terms
of PAP smears, a woman age 30 or older who has had negative results on
three consecutive annual PAP smears, may have repeat PAP smears every
2-3 years. With the advent of adding HPV screening to pap smears of
women 30 an older, we have gained the ability to make screening more
accurate. HPV is the virus that causes the majority of cervical cancer.
If the cells on the pap smear are normal and there is no evidence of the
HPV virus your next pap is due in 3 years. Some organizations state that
if you are 70 years old or older and have had 3 normal recent pap smears
you can stop. This does not mean that you do not need an annual gyn exam
as there are other health issues that are addressed. Annual PAP testing
should occur for higher-risk women who including women who have HIV, are
immunosuppressed, were exposed to DES in utero, previously diagnosed
with cervical cancer. These are guidelines for screening and individual
care should be discussed with your physician.
Can a woman with a history of breast cancer use testosterone?
Taking Testosterone would not be recommended for a woman who has a
history of breast cancer. In some studies there has been a small
increase in breast cancer in women taking testosterone. It has not been
studied well enough to use it in women with a breast cancer history.
I am having trouble sleeping throughout the entire night without
making one or two trips to the bathroom at night. What can be done?
Once you are over 50, it is normal to get up once or even twice a night.
Urinary frequency can be caused by a high and frequent intake of fluids.
Therefore, fluid awareness, timing and management is a good place to
start. Caffeine, which is found in coffee and tea, and alcohol can
irritate the bladder causing frequency. If fluid awareness and
management does not provide adequate relief, there are several
medications which are effective in treating urinary frequency. You can
discuss these options with your physician.
Marilyn Ryan – Endocrinology
What part does heredity play in body shape and size?
There are most certainly some aspects of heredity that affect your body
size and shape, but heredity is only one factor. There can be a number
of things which contribute to our appearance as women including our
lifestyle, eating habits, exercise, hormones, childbirth and the aging
process. Although there may be physical traits we cannot change, our
eating behaviors and habits and our pursuit of exercise can help us make
the most of what we have and help us feel comfortable with our body
What can be done regarding facial hair growth?
There are three approaches to the treatment of facial hair removal: Self
removal at home, treatment by a trained personnel or prescription
medication. Treatment at home can include tweezing, snipping with
scissors, or the use of depilatories. Tweezing and depilatories can
cause skin irritation. Another approach is to seek treatment provided by
others and includes waxing and laser treatment. Waxing can cause skin
redness and irritation. Laser treatments can cause pigment changes in
some skin types. A final option would be the use of oral prescription
medications and a topical cream, which slows the growth of facial hair.
These treatments could be obtained by consulting with your physician. If
facial or body hair is excessive, hormonal evaluation by an
endocrinologist is suggested.
What effect does a one day per week fast have on BMR? Can I fast
one day per week and just drink fruit juices?
The BMR is the amount of energy required to maintain the optimum
functioning of the body at rest. Energy is required to keep the body
going. Fasting lowers the BMR; therefore, a one day per week would
effect the BMR. However, I cannot give you an exact numerical value.
Fasting one day per week and drinking fruit juices as a weight loss
strategy most likely would not be very beneficial to you or your body.
Fruit juice tends to be of little nutritional value; high in calories,
carbohydrates and sugar. You would be providing your body a poor source
of energy for the day and there may be little or no weight loss using
Kevin Walsh – Exercise
What music for weights or bands would be good since just doing
bands or weights can be boring?
Any music that you enjoy can be a good motivator to starting and
sticking with exercise. Types of music could include: classical,
hip-hop, rock, disco, country, and contemporary religious music. A
variety of music can be found on many FM stations here in the Delaware
Valley. Most local libraries have a wide selection of CD’s that you can
check-out and try for free to see what you would enjoy the most.
Can you build muscle mass if you are 55 years or older when you
Yes, you can build muscle mass at any adult age. It is never too late to
start and you are never too old to build muscle with exercise. You can
also build bone density with exercise which is very important for women.
When you are 55 years or older, how hard should you work out?
Avoid over exertion. Exercising harder doesn’t necessarily lead to
functional improvement. Exercise within your tolerance. There is
research that states if you have joint pain that lasts longer than two
hours; this may be a sign of over exercising. Some tips to avoid
“over-doing” could include: Resting between repetitions or activities,
decreasing your speed, go a shorter distance, take two or three short
walks instead of one long walk, and do shorter periods of exercise.
Is using stretch bands the same as lifting weights for strength
and building muscle?
Both bands and weights can build muscle and improve strength. However,
bands have some advantages over weights. Exercise bands are small,
inexpensive and easy to store. They are very light so they can be
transported easily and taken with you. Bands can be safer to use because
put less stress on the joints, they won’t contribute to back problems
and since they are light, will not cause injury if they are dropped out
of your hands.
Can you exercise on a soft surface and get the same results as
being on a hard surface?
If you wear well-fitted and well-made exercise sneakers, the shoe will
equalize the surface you are exercising on and there will no difference
in the results.
What do you suggest in terms of eating after exercise? I have
heard you should eat shortly after or you will overeat if you wait until
It is best to eat a combination of carbohydrates and protein within 30
minutes of exercise. Your body needs to refuel and replace what has been
used during exercise. You also need to rebuild muscle. If you are going
to eat your next meal within an hour or two of exercise you could have a
small snack, (i.e. piece of fruit) right away. It is also important to
re-hydrate as well.
I joined a gym in January and go 2-4 times a week for 1 ½ hours
each visit. I had lost 12 lbs., but since I started working out, I have
gained half of the weight back. Will the weight start to come off again?
There may be a combination of things going on. First, muscle weighs more
than fat, so if you are exercising and building muscle, this may explain
the weight gain. Additionally, you may be eating more since starting to
exercise and this may contribute to weight gain. If you are enjoying
your exercise routine and are comfortable with it, keep it up and don’t
focus so much on your weight. Your weight will fluctuate naturally
depending upon many factors including calorie and fluid intake. The
important thing to remember is that you have started a healthy routine
with many health benefits, so keep it going.
I exercise but have osteoarthritis. How do I deal with it and
maintain an exercise routine?
For osteoarthritis, the purpose of exercising is to provide low-impact
cardiovascular conditioning, increase flexibility, and build strength.
Some good low impact activities would be walking, biking, pool therapy
and swimming. Many YMCA’s offer pool classes specifically for arthritis
sufferers. Strength exercises could include using the stretch tubes or
an exercise machine. You can use an exercise ball for flexibility
exercises which can involve stretching or working specific joints. Ball
therapy can also improve balance and coordination which can help
If you have pain with exercise, you can hot or cold therapy on joints,
depending upon what works for you. You can also talk to your doctor
about taking non-prescription analgesics. Exercise within your tolerance
and don’t over do it.
What about glucosamine, chondroitin and MSM supplements?
Some women report that taking these supplements help improve joint
mobility and decrease joint pain, particularly in the knee. Research has
been done that shows there may be some benefit to taking these
supplements for the treatment of mild to moderate osteoarthritis.
However, the findings are inconclusive and not definitive.
Matusky, RD, LDN – Nutrition
What is the best oil to use for cooking and baking?
Canola and olive oil are both monounsaturated fats and are healthy
choices for cooking your favorite dishes. Canola oil would be a good
choice for baking.
Flaxseed oil goes bad fast. What can you do to preserve it?
Flaxseed oil should be stored in the refrigerator and ground flaxseeds
should be stored in the freezer. Due to the omega 3 fatty acid content,
the oil and the ground seeds are susceptible to becoming rancid if kept
at room temperature.
I have olive oil that is not old, but I see particles in it. Is
it any good?
Olive is best used within 3-4 months of purchase and should be stored
away from light and heat. You can keep a small amount in a bottle at
room temperature, away from the stove for easy use, but the rest of the
oil should be refrigerated. When chilled, the olive oil will solidify
slightly and turn cloudy, but once returned to room temperature, it will
regain its original appearance.
How do I know if oil is processed? Is there any indication on
Hydrogen can be added to vegetable oil in a process called
hydrogenation. The oil that results from this process is called
partially hydrogenated oil and it is a source of trans fat. Trans fats
raise the “LDL” which is the bad cholesterol. Nutrition Facts panel
found on products will list the amount of trans fats in a product. You
can also look at the list of ingredients on the label to see if the
product contains partially hydrogenated oil.
Butter has natural ingredients so isn’t it better to use than
Butter is made from animal fat and it contains cholesterol and high
levels of saturated fat. Margarine is made from vegetable oil. A tub
margarine that is trans fat free and low in saturated fat is the best
choice to use.
What are some examples of whole grain breads?
Examples include 100% whole wheat, rye and pumpernickel. The product
label should say that it contains 100% whole grain.
What is the difference between whole wheat and multigrain?
For a product to be whole grain, the label must list “whole” before the
grain being used in the product such as “whole” wheat. Wheat flour is
simply white flour. A product that is multigrain, 9 grain, 7 grain etc.
is probably made with white flour with some other grains added to the
What is the best way to add bran and fiber to the diet?
Eat at least 5-7 servings of fruits and vegetables daily, add dried
beans like kidney beans, garbanzo beans or lentils and include nuts in
your diet several times a week. Select 100% whole grain products three
times a day.
Why does increased fiber help with weight loss?
Higher fiber diets can increase weight loss. Fiber makes us feel full
sooner and stays in our stomach longer than other substances. This slows
down the rate of digestion, keeping us feeling fuller longer.
What do you look for on a food label regarding fats and
The nutrition fact panel provides a wealth of information. For fats, you
can find the total number of fat grams per serving, the amount of
saturated and trans fat grams. Some labels will include more detail
about other fats as well. Keeping saturated fat as low as possible and
eliminating trans fat is the best advice. Whenever possible, it is
healthful to select “whole” foods that are minimally processed. This
helps to preserve the nutritional value of the food and minimizes added
salt, sugar and fat.
Are fresh, frozen, canned vegetables and fruits the same in
All fruits and vegetables have nutritional value. Fresh fruits and
vegetables are in the natural form, but can spoil if not eaten within a
few days. Frozen vegetables are a very good choice as they can be kept
fresh for a much longer period and you can cook one or several servings
at a time so less may be wasted. Canned vegetables are often high in
sodium and the high temperatures used during the canning process will
impact the level of some vitamins. When selecting canned fruits, be sure
to choose those canned in their own juices and not ones in sugary syrup.
Should you cut your meal in half or just fill up on vegetables?
It would be good practice to do both. Cutting your portion sizes in half
(especially while dining out) will reduce the overall caloric intake at
each meal. Adding more vegetables to each meal will not only help you
meet your daily vegetable goals but it is a low calorie, high volume,
high fiber way to fill up without adding many calories to your diet.
Sodium is everywhere. How do I avoid it when shopping and eating
Read your nutrition Facts panel for the sodium content in the product
and avoid buying foods that are high in sodium and foods with sodium
listed as the first ingredient. Foods that are low in sodium contain
less than 140mg of sodium per serving. Avoid cooking with salt or adding
salt to your food once it is prepared. Try to use herbs and spices,
lemon, flavored vinegars or salt substitutes for seasoning. When eating
out, you can ask if the restaurant has nutritional information available
for menu items and you can request that the food not be prepared with
Can I eat as much as I like of fruits and vegetables?
For most women, the recommended number of servings for fruits and
vegetables is about 7 servings per day or 2 ½ cups of vegetables and 2
cups of fruit (go to mypyramid.gov for recommended guidelines). Most
vegetables are less than 25 calories per serving so eating more than the
recommended number of servings per day will not significantly increase
your overall calorie intake. Fruits are higher in calories and
carbohydrate than most vegetables so keep your fruit intake to 2 cups
How do you handle eating at parties, especially buffets?
Eat a big vegetable salad first or a large serving of vegetables (but go
easy on the dressing and dips) which will fill you up. Select the lower
fat and calorie appetizers like shrimp cocktail, broth-based soups or
vegetable crudités. Watch your portion size of everything else (take
half of the portion). Avoid the breads or rolls and share your dessert.
Eat slowly and walk away from the buffet table when you have finished
your meal. Sometimes popping a mint or a piece of gum in your mouth is a
good way to signal the end of the meal.
Do carbonated beverages such as soda, sparkling water and beer
rob the body of calcium?
If you are drinking all of the above beverages in place of drinking
milk, it’s likely you are not getting enough calcium in your diet. The
phosphoric acid and caffeine in soda, especially cola-based soda, can
lower bone mineral density.
Do you recommend colon cleansing products to initiate weight
These products are not FDA approved and not supported by credible
research. Increasing fiber in your diet, increasing fruits and
vegetables, decreasing portion sizes and drinking plenty of water is a
I eat a lot of (Lean) protein. What are the downsides of too
The average adult woman requires about 50 grams of protein per day. A 3
ounce cooked portion of turkey breast or fish is equal to 21 grams of
protein (7 grams per ounce). But not all protein needs to come from
meat. There are plenty of plant-based protein sources like nuts, dried
beans and whole grains as well as low-fat and fat-free dairy products.
Extra protein is not necessary and too much protein may increase the
loss of calcium from bones.
When is Lankenau cafeteria going to make calories of the food
served available to the public?
A representative from Lankenau’s Food and Nutrition department says that
nutritional information is posted by the various food stations.
I have heard that when we think we are hungry, we are actually
thirsty? Is this true?
Sometimes your body may confuse your hunger and thirst signals. If you
are feeling hungry but you don’t think it’s time to eat, drink a glass
of water and wait 15-20 minutes to see your hunger subsides.
This article is part of the Menopause and Youlibrary,
a web-based program sponsored by Women’s Health Source.
It is intended as an information resource providing guidelines for
women. As always, check with your own health care practitioner with your
specific concerns and questions.
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