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Medcan Women’s
Health Forum
Smooth Sailing Through the Stresses
of the Sandwich Generation
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Smooth Sailing Through the Stresses of the
Sandwich Generation
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What is Perimenopause?
 The
period of time leading up to Menopause
 Menopause=
when a woman has not had a period
for a period of one year unrelated to pregnancy,
body weight or another medical condition
 Menopause
is only ONE day
 Before=Perimenopause
 After=Postmenopause
 During
Perimenopause periods tend to get heavier,
closer together and then later further apart
 Perimenopause
can last for years
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Symptoms of Perimenopause

Hot flashes
 Fatigue

Mood Swings
 Vaginal

Irregular periods
 Urine

Breast tenderness

Worsening PMS

Decreased libido

Minor Memory Problems
Dryness
leakage when
coughing, sneezing or
laughing
 Urinary
Urgency
 Difficulty
Sleeping
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Hot Flushes/Flashes
 2/3’s
of women
experience
 Momentary
sensation
of heat
 Sweating
 Fast
heart rate
 May
turn red or flush
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Treatments for Hot Flashes
 Avoid:
 Stress
 Caffeine
 Alcohol
 Spicy
food
 Tight clothes
 Heat
 Tobacco
 Supplements
Meds:
 Vitamin B
 Vitamin E
 Ibuprofen
 SSRI’s
 Gabapentin
 Clonidine
 HRT
and
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Mood Swings and Worse PMS
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Why Mood Swings…
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Why Mood Swings…
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Why Mood Swings…
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WHY Mood Swings…
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Why Mood Swings?

“PMS” becomes disjointed
from the period

Fluctuating hormone levels
(particularly estrogen)
affect mood

Stressors that are specific
to this time period

Lack of sleep and hot
flashes contribute

Feeling out of control of
one’s body and reactions
contributes
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Life Stressors

Elderly parents

Kids at home

Kids leaving home

Men and their mid-life
crises

Career Issues or Lack of
Career Issues

The Economy

Being “on” 24/7
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What can a woman do?
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Eat Healthy!!
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Exercise!!
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Be with Friends!!
+ Hormonal Options: See Your Gyn!
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Over the Counter Options…
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OTC: Supplements and Herbals

Calcium 600mg twice a day- PMS

Black Cohash

Chasteberry

Siberian Ginseng

USP Progesterone Cream
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Prescription Medications
 Antidepressants
(particularly Selective
Serotonin Reuptake
Inhibitors)
 Gabapentin
(Neurontin)
 Sleep
aides
 Avoid
Benzodiazepines
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Practice Acceptance
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Practice Mindfulness…
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Mindfulness Defined
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Focus on the Here and Now
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Get Rid of Mind Clutter…
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Mindless versus Mindful
Mindless
Mindful

Judging

Non-judging: Accepting

Opinionated

Based on fact

Thoughts are mental events

Awareness

Calm and alert

Interested, focused, attentive
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Focus on NOW
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ACCEPTANCE



Thoughts are real
Focus on past and future
Lost in Reaction

Avoidance

Reactive Impulsive Behavior
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STRUGGLE
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Mindfulness Exercise
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Did you feel this way?
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Or this way?
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Ways to Practice Mindfulness

Unplug!

Eating

Driving

Exercising

Sit outside

Practice Meditation at a
specific time each day
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Yoga

When feeling stressed
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Hot flashes
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Ways to Practice Acceptance

Practice Letting Go- first with small things then bigger ones

Remember that 99% of what goes on with other people has
nothing to do with you

Stop trying to be perfect. Including with being Mindful.

Stay positive- Exercise your brain by finding something
positive about everybody and every situation you encounter.
Including you!

Use positive reinforcement, not negative, with others- you will
find it empowers you.
+ How Do You Know if Need to See a
Doctor?

Your mood swings seem extreme and cause you and
everyone else distress

Your mood is consistently low and is accompanied by
hopelessness, lack of enjoyment and changes in sleep,
appetite, energy and concentration
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If you have any thoughts of suicide or wishing you were dead

You seems to have continual conflicts with everyone

You have physical symptoms that seem extreme or unusual

You are self-medicating with drugs or alcohol
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Remember: Depression is Treatable!
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Perimenopause: Hold on for the
Ride!
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Thank You!