Hello and welcome to
"Health for a Lifetime"
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I'm your host Don Mackintosh
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We're glad
you've joined us today.
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We're going to be talking about
women's health issues today,
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and joining us to talk
about this vital subject
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is Dr. Eric Shadle
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Welcome Dr. Shadle. Thank you
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We're glad that you're with us.
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Now, you know, you've been
in obstetrics and gynecology,
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I guess is the
subspecialty that you're in,
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for about what, 15-16
years now. Yes, that's right
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And so you've seen a
lot of things that deal with
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women's health issues,
but today we're going to be
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talking about menopause. Yes
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And, is this a big
problem, a lot of people
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coming to see you about this?
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Actually, it's
probably one of the
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bigger problems
that I'm consulted for.
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Of course, all women,
if they live long enough,
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go through the menopause,
and so it's something that
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is a big issue for most women.
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What exactly is menopause,
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and what are the
stages involved in that.
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Well there are at least 2 stages
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that I'd want to
talk about today...
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One, is the perimenopause,
that's the first stage,
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and that's the time when the
ovaries function is decreasing;
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it's making less
and less estrogen,
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and there could be a variety of
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symptoms associated with that.
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And then there's the menopause
itself which is when the
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ovaries stop
functioning altogether.
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So really, that's what
the word "meno-pause" means
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a pausing or cessation maybe
of the menses or the period.
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Yeah, that's right... And
I think you have a graphic
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about this that kind of gives
us the details and there it is.
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It talks a little bit
about the definitions.
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The perimenopause
actually the average age is 47,
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though it can
last for several years.
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I think the graphic talks about
that it can last for 2-6 years,
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and it may not occur at all,
though sometimes the ovaries
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just stop functioning
until you have regular periods
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right up into the menopause...
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And then the average
age for menopause is age 51,
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and 90% of women actually go
through the menopause by age 55,
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so it's rare to go
beyond the age of 55.
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So then in making
the diagnosis, I mean...
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the age factors into it
and other different things...
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What kind of things do you say -
Hey, this is what's happening...
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Well the most common
way to make a diagnosis
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of the menopause
is simply by history.
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The clinical history -
when a woman comes in and says,
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"Well, I haven't had period
for 6 months or for a year"
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...then I know
that she is menopausal;
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her ovaries aren't functioning.
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But we can confirm
that with laboratory tests.
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There is a laboratory
test, something called "FSH"
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That's "follicle
stimulating hormone"
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That's a hormone made
in the pituitary gland that
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controls ovarian function
and it is secreted by the
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pituitary gland to tell the
ovary... what to do and when.
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That's right... And when
the ovary stops functioning,
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the pituitary glad
goes into overdrive,
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and keeps reminding
the ovary to function
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even though it won't do
it at that time because it's
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physiologically time for
the ovary to stop functioning.
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So it goes up - in other words,
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but there's no response
from the ovary. That's right
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And you can see that
in the blood and you say,
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"Okay, this is what's happening,
so you're at that stage
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and it's okay"
That's right - it's okay
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But interestingly
enough, that FSH does stay high
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throughout a woman's life.
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So, there's something
in the pituitary gland
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that keeps secreting that FSH -
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even though it
doesn't do anything,
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and so some of us in the field
believe that FSH probably has
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another function
because I don't think that
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God would have made a
woman's pituitary gland in a way
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that wouldn't down-regulate
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once it realized the
ovary was not functioning.
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I mean you're just trying
to figure out what that is,
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and don't know exactly...
Yeah that's right - not exactly
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Now you have down
here something about
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perimenopausal transition.
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It sounds like a big word
but I suppose it's talking about
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the transition from having the
regular periods to none at all.
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Is that what that
means? Yes, exactly,
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and that can be a
difficult time for many women...
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And in fact, menopausal symptoms
that most women talk about
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are actually in
this transition time,
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this perimenopausal transition
that can last for years,
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and can have a
variety of symptoms.
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Their vaginal bleeding
can be very unpredictable.
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It can be heavy or
they may miss periods,
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and it could be very light
and it all has to do with the
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fluctuation in estrogen levels
that's occurring in the ovary.
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So it really has some things
that affect how someone feels
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emotionally and
this and that. Yes
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I've never been through that
myself and neither has my wife,
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you know, we're not
quite to that stage.
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These kind of things though
I certainly have heard about,
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and we certainly know about.
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So what are some real symptoms
then of the perimenopausal time?
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Well, we have symptoms of
the perimenopause which...
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Like up here in the graphics
like hot flashes... That's right
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Hot flashes, the irregular
periods that I talked about -
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that can be periods that
a woman may miss periods,
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or she may have
frequent periods.
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It can include mood swings,
fluid retention which can
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be one of the symptoms of
fluid retention may be bloating;
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memory problems, headaches -
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Those are some of the
perimenopausal symptoms
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that we see and we...
So when people come in
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and they have that,
how do you help them,
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for instance, can you
help someone with hot flashes?
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Yes, we can help
women with hot flashes.
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I guess you're going to talk
about that a little bit later...
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And with all these things,
there are things that you do
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that help them. Right
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And depending on the level...
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There are specific
symptoms and we can either
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look at it as treating
each individual symptom
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or try to treat the underlying
cause which many of those
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may be an estrogen deficiency,
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but that's another
issue that maybe we can get to
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a little bit later.
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And really, you know,
let's say we're talking in a
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Western medical
model... That's right
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We're talking in America and
we're talking Western medicine,
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but later on
sometime, we can talk about
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what you would do if
these things started happening
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in your country or
if you're in a place
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where you can't go
see someone like you.
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What does that mean?
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That's
perimenopause, the hot flashes,
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and all those
things we talked about.
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What are the
symptoms then in menopause?
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Well the first symptom
I would describe would be
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vaginal dryness.
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There can also be
symptoms such as skin changes,
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urinary problems,
decreased sexual drive or libido
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is described as well as some
of the symptoms of menopause.
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Skin changes, what
do you mean by that?
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It can be skin
dryness, wrinkling
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can occur more and more.
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Is this because there
is not as much estrogen?
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It is thought that
estrogen certainly plays a role
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in that because it increases
the elasticity of the tissue
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and so as estrogen is withdrawn,
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there is less elasticity in this
dryer skin and more wrinkling.
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So these kind of things
though can really cause -
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what would you say
- maybe disruptions or
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fluctuations in
someone's relationships too
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I mean, these are very intimate
things we're talking about.
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And do you find
yourself talking not just to
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the lady but also the man
sometimes in these situations?
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For menopausal symptoms,
actually I don't have husbands
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coming in with
their wives very often.
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That occurs in other
situations in my practice,
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for example, infertility
issues, couples that are wanting
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to get pregnant...
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But generally, women in the
menopause, of course, are mature
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and they kind of have
their own ideas on what
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their issues are and
they generally don't bring
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their husbands with them.
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But you're right, it
does impact the couple;
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it can impact them greatly.
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So how should a man be reacting
at this particular time?
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I mean, I know that's
a really open question,
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but are there some
pointers that you sometimes -
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you would say? I
know this is not on our
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list of things but
how should they react;
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just sensitively
and... Absolutely
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I think a man needs to
understand that there are
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changes that occur in a
woman that are physiologic.
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There are changes that
occur because she's going
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through hormonal fluctuations
and that has real effects
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on her body.
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It's not imaginary, she's
not imagining these things...
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And mood swings could
occur that we haven't listed
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on graphics but mood
swings certainly can be
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one of the things that
women have in the transition
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or even in the menopause.
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So then, what is the
timing here of the menopause?
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We've talked
about how it comes...
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There is the perimenopause
which is physiologically,
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but what more about
timing do we need to know about?
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Well, timing is determined...
it seems to be predetermined
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in many ways by a programmed
loss of the ovarian follicles.
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Those follicles are
the eggs that a woman has.
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She has a certain
number of eggs in her ovaries,
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and several of them are
maturing each month due to
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hormonal stimulation and
so several of them are used up
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every single cycle...
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And at a given time, they're
all used up more or less,
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and that's when we see
the menopause occurring,
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and as I said before,
the average age is 51;
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55 is considered to be
the upper limits of normal
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of an age to go
through the menopause.
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If you smoke does
that make a difference?
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Smoking does cause the
menopause to come earlier.
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Also if a woman
has never had children,
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she could probably expect to go
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through the menopause earlier...
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And maybe that's because
for those 9 months of pregnancy,
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there are no eggs
being used each month.
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I just was going to ask
that so that explains it.
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So let's come back to
this issue of hot flashes.
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What exactly is happening
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physiologically
there, what's going on?
00:11:45.27\00:11:46.96
Well hot flashes actually occur
in about 75% of menopausal women
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It's a very common
symptom and we think it's due
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primarily to
estrogen deficiency...
00:11:57.58\00:12:00.14
But there can be a variety
of causes for hot flashes.
00:12:00.17\00:12:04.63
The first type of
causes would be physiologic
00:12:04.66\00:12:08.60
such as the menopause,
but other physiologic causes
00:12:08.63\00:12:13.15
would be hot drinks
or emotional distress.
00:12:13.18\00:12:16.41
So men can have hot flashes too.
00:12:16.44\00:12:18.72
I bet our viewers didn't realize
00:12:18.75\00:12:22.61
that actually men
can have hot flashes.
00:12:22.64\00:12:24.59
So when you mean "hot drinks,"
something you drink that
00:12:24.62\00:12:26.73
makes you feel hot? That's right
00:12:26.76\00:12:28.93
It can actually cause a response
that would cause a flushing
00:12:28.96\00:12:33.28
especially in the chest
and the face and the head.
00:12:33.31\00:12:36.85
So I guess if you take some
niacin too - some people tell me
00:12:36.88\00:12:39.94
that that will make you
have a serious hot flash.
00:12:39.97\00:12:42.41
That's exactly
right, a serious hot flash.
00:12:42.44\00:12:45.27
So what about, you have
down here also some drugs
00:12:45.30\00:12:47.78
that can make you
feel like you have a
00:12:47.81\00:12:49.42
hot flash-type symptom.
00:12:49.45\00:12:50.86
Yes, drugs and under
drugs I would include
00:12:50.89\00:12:54.27
not only medications
but drugs such as alcohol,
00:12:54.30\00:12:57.04
especially in Asian
women alcohol has a big effect.
00:12:57.07\00:13:02.06
There are other medications
that may have an effect as well.
00:13:02.09\00:13:08.54
That cause you to just feel
like you're flushed and flashed
00:13:08.57\00:13:12.00
and everything like that.
00:13:12.03\00:13:13.65
So you kind of have
to work through those.
00:13:13.68\00:13:15.07
It could be menopause
but it could be something
00:13:15.10\00:13:16.78
else you're taking...
There could be medications
00:13:16.81\00:13:18.06
that we'd have to look at
or could be actually diseases.
00:13:18.09\00:13:20.71
One of the most common
would be carcinoid syndrome.
00:13:20.74\00:13:24.22
It can be serious...
What is carcinoid syndrome?
00:13:24.25\00:13:26.89
It's actually a syndrome
where the body starts making
00:13:26.92\00:13:31.90
too much of a certain hormone,
00:13:31.93\00:13:33.86
and it can cause
dramatic effects on the heart,
00:13:33.89\00:13:37.79
blood pressure
and other effects.
00:13:37.82\00:13:40.54
So hot flashes then could
be from something you drink,
00:13:40.57\00:13:45.31
some medication or
drugs you're taking,
00:13:45.34\00:13:47.86
and then also various diseases.
00:13:47.89\00:13:49.21
So, if you're having hot flash,
basically the bottom line is...
00:13:49.24\00:13:52.15
and you don't
know what's causing it,
00:13:52.18\00:13:53.85
or you have any
suspicion, they really should
00:13:53.88\00:13:55.81
see somebody like
you, is that right? Yes
00:13:55.84\00:13:58.15
Because that can be a
real sign of something.
00:13:58.18\00:14:00.22
It can be a sign of something,
but we learn something
00:14:00.25\00:14:04.05
in medical school -
if you hear hoof beats,
00:14:04.08\00:14:06.06
you generally think
of horses not zebras,
00:14:06.09\00:14:08.55
and so we look
for the most common.
00:14:08.58\00:14:12.11
So you have a woman who is 51,
00:14:12.14\00:14:14.04
she had her last period 8 months
ago and she's having hot flashes
00:14:14.07\00:14:20.36
...then we know that that's
most likely menopausal symptoms.
00:14:20.39\00:14:25.12
It's due to an
estrogen deficiency,
00:14:25.15\00:14:26.86
and something that
we need to look at.
00:14:26.89\00:14:28.06
What is you're having
hot flashes and you're 17?
00:14:28.09\00:14:30.63
Or if you're having hot
flashes, and you already
00:14:30.66\00:14:33.91
went through
menopause, and now you're 70,
00:14:33.95\00:14:35.78
and you're having those
again, that's a different thing.
00:14:35.81\00:14:38.03
That may be a
different thing altogether.
00:14:38.06\00:14:39.65
Okay, so that's
something that we need...
00:14:39.68\00:14:41.90
When the light
goes off in the car,
00:14:41.93\00:14:43.63
you know - that
dummy light that says,
00:14:43.66\00:14:45.67
"Hey, you better
get it checked out"
00:14:45.70\00:14:47.02
This is that kind
of thing. That's right.
00:14:47.05\00:14:49.24
Anything else about hot flashes?
00:14:49.27\00:14:50.55
We don't want to
miss anything on that.
00:14:50.58\00:14:51.82
Well, they are caused
by, we think what we'd call
00:14:51.85\00:14:55.54
a thermoregulatory
dysfunction in the brain.
00:14:55.57\00:14:58.92
The brain actually
controls our temperature,
00:14:58.95\00:15:05.64
and there is something
there that can reset that,
00:15:05.67\00:15:09.98
and it is sensitive to estrogen,
00:15:10.01\00:15:12.67
that's why we do think that
estrogen is a major part in that
00:15:12.70\00:15:15.83
Do we ever get over hot
flashes, or will they leave?
00:15:15.86\00:15:18.35
I mean, maybe people just
starting that and they say,
00:15:18.38\00:15:20.08
Man, I can't do this anymore...
They get over them? Generally
00:15:20.11\00:15:24.52
Hot flashes are self-limited
but that self-limiting factor
00:15:24.55\00:15:29.40
can be for 5-6 years,
so it's pretty hard to tell
00:15:29.43\00:15:31.65
a woman who has just
started hot flashes in the last
00:15:31.68\00:15:36.03
few months - to tell
her, "Don't worry about it,
00:15:36.06\00:15:38.03
they'll go away in 6 years"
00:15:38.06\00:15:40.55
because she may have several
a day and they can be very
00:15:40.58\00:15:44.74
disturbing to her;
they may be embarrassing
00:15:44.77\00:15:46.96
because she may feel like
she's red even though she's not,
00:15:46.99\00:15:50.63
and she feels like everybody can
00:15:50.66\00:15:52.88
see her and it can be
very distracting to her.
00:15:52.91\00:15:56.93
We're talking
with Dr. Eric Shadle
00:15:56.96\00:15:58.60
He is a specialist in
women's health issues,
00:15:58.63\00:16:01.77
obstetrics and gynecology.
00:16:01.80\00:16:03.12
We've been talking about some
very practical issues today.
00:16:03.15\00:16:06.19
When we come back, we're
going to be talking about
00:16:06.22\00:16:07.86
more things that occur with the
00:16:07.89\00:16:10.03
body at or after
the time of menopause.
00:16:10.06\00:16:12.89
We hope that you
join us when we come back.
00:16:12.92\00:16:22.53
Have you found yourself wishing
00:16:22.56\00:16:23.99
that you could
shed a few pounds?
00:16:24.02\00:16:25.66
Have you been on a
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00:16:25.69\00:16:27.94
but not found anything that
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00:16:27.97\00:16:30.72
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00:16:30.75\00:16:33.68
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00:16:36.86\00:16:39.54
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00:16:39.57\00:16:41.78
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00:16:52.53\00:16:55.48
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00:17:00.85\00:17:03.64
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It's absolutely free of
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00:17:18.48\00:17:22.75
Welcome back, we've been talking
about women's health issues.
00:17:27.99\00:17:30.35
We've been talking
about menopause really,
00:17:30.84\00:17:32.59
an exciting subject or a subject
that a lot of people deal with.
00:17:32.62\00:17:36.70
We've talked about hot flashes.
00:17:36.73\00:17:38.48
We've talked about when
we know we're having that;
00:17:38.51\00:17:41.56
what we should be looking for.
00:17:41.59\00:17:43.12
We've talked about
the fact that a hot flash
00:17:43.15\00:17:45.49
at the right time in life is
really, what would you say...
00:17:45.52\00:17:49.43
no big deal but it tells us
that menopause is occurring,
00:17:49.46\00:17:52.81
but if it's
happening at other times,
00:17:52.84\00:17:54.49
we may want to look and
see what is really occurring.
00:17:54.52\00:17:58.18
We wanted to talk a little
bit more about the health issues
00:17:58.21\00:18:03.48
that occur during or
after menopause with ladies that
00:18:03.51\00:18:08.01
maybe they don't
occur before that time.
00:18:08.04\00:18:10.33
And one of the things
we have down here is about
00:18:10.36\00:18:12.92
urinary problems - talk
with us a little bit about that.
00:18:12.95\00:18:16.24
Well, several urinary problems
that seem to be directly
00:18:16.27\00:18:20.81
related to an
estrogen deficiency.
00:18:20.84\00:18:23.50
The base of the
bladder and vaginal tissue have
00:18:23.53\00:18:27.65
a high number of
estrogen receptors,
00:18:27.68\00:18:30.65
and when estrogen is not
binding to those receptors,
00:18:30.68\00:18:35.57
then we lose elasticity
not only in the vagina,
00:18:35.60\00:18:40.00
but in the base of
the bladder as well.
00:18:40.03\00:18:42.37
It also, those estrogen
receptors, increase the amount
00:18:42.40\00:18:48.29
of glycogen in those cells.
00:18:48.32\00:18:50.52
It helps maintain vaginal pH
as well as the pH in the bladder
00:18:50.55\00:18:57.23
and thus it can decrease the
number of bladder infections,
00:18:57.26\00:19:01.21
and it can decrease the,
what we call, vaginal prolapse
00:19:01.24\00:19:07.41
or symptoms of
vaginal relaxation.
00:19:07.44\00:19:13.06
Okay, so after menopause these
things then start to occur,
00:19:13.09\00:19:16.89
you have problems
with all those things;
00:19:16.92\00:19:20.32
maybe urination, maybe leakage,
00:19:20.35\00:19:22.57
all those different
kind of things. That's right
00:19:22.60\00:19:24.52
The leakage - there are 2
main types of urinary leakage
00:19:24.55\00:19:29.08
that we find...
00:19:29.11\00:19:30.14
One is what we call
"stress incontinence"
00:19:30.17\00:19:32.59
and that's due to not
only that loss of elasticity,
00:19:32.62\00:19:39.02
but it's also due to the
fact that there's an angle
00:19:39.05\00:19:43.19
between where the
bladder and the urethra join
00:19:43.22\00:19:46.42
and that angle needs to
be at the proper angle or
00:19:46.45\00:19:52.20
else there can be - when
you cough or any increase in
00:19:52.23\00:19:56.68
intraabdominal pressure
will cause a loss of urine.
00:19:56.71\00:19:59.71
So when the elasticity
changes, then the angle changes
00:19:59.74\00:20:04.61
and then things that
wouldn't have caused that before
00:20:04.64\00:20:06.65
start to cause
that. That's right
00:20:06.68\00:20:08.07
The other type
of urinary leakage,
00:20:08.10\00:20:11.45
we call "urinary incontinence"
would be what we call
00:20:11.48\00:20:15.27
"urge incontinence" and so
the bladder as it gets full
00:20:15.30\00:20:19.99
but maybe not as full as
it should be to be able to
00:20:20.02\00:20:23.75
cause those
symptoms, the woman then has to
00:20:23.78\00:20:27.66
get to the
bathroom and go right away;
00:20:27.69\00:20:29.64
otherwise, the urine comes out.
00:20:29.67\00:20:31.75
And these are good
things to know because
00:20:31.78\00:20:34.37
I mean, look - you're going
through this and you've never
00:20:34.41\00:20:37.44
been able to talk
to someone like you,
00:20:37.47\00:20:38.92
and you can
understand what's happening.
00:20:38.95\00:20:43.80
You know, are there any other
significant medical problems
00:20:43.83\00:20:47.72
that occur after or... you know,
00:20:47.75\00:20:50.56
I guess it would
be after menopause?
00:20:50.59\00:20:53.33
Yes, there are 3 main concerns,
serious medical concerns
00:20:53.36\00:20:59.34
that we have...
00:20:59.37\00:21:00.72
Well let's talk
about those a little bit.
00:21:06.45\00:21:08.12
What about the osteoporosis,
why is this a problem?
00:21:08.15\00:21:11.78
It is a huge
problem in this country.
00:21:11.81\00:21:15.98
It involves over a million
women and it is a problem where
00:21:16.01\00:21:23.57
up to 1 to 5% of
bone is lost each year.
00:21:23.60\00:21:27.23
Wow - that's a lot of bone.
00:21:27.26\00:21:28.34
That's a lot of bone
and women seem to be losing
00:21:28.37\00:21:33.38
more bone after the
menopause or during those years
00:21:33.41\00:21:37.96
after age 50 or so.
00:21:37.99\00:21:39.66
So we have to look at that and
that's something that seems to
00:21:39.69\00:21:42.80
accelerate then after our
periods stop or after menopause.
00:21:42.83\00:21:46.36
Then what about heart disease?
00:21:46.39\00:21:48.37
Heart disease also increases
dramatically after a woman
00:21:48.40\00:21:52.53
goes through menopause.
00:21:52.56\00:21:54.22
Before that time, her
incidence of heart disease is
00:21:54.25\00:21:59.94
quite a bit less than
men, and then after menopause
00:21:59.97\00:22:03.78
her incidence starts
rising rapidly to get to about
00:22:03.81\00:22:09.21
the same level as men.
00:22:09.24\00:22:10.92
So there's some kind
of protective element
00:22:10.95\00:22:12.70
that seems to go away.
00:22:12.73\00:22:13.80
That seems to go away -
at least that's one of the
00:22:13.83\00:22:15.98
theories that we have
that it's easy for us to
00:22:16.01\00:22:19.34
try to draw that
conclusion based upon this
00:22:19.37\00:22:22.08
menopausal timeframe.
00:22:22.11\00:22:23.90
And then probably, one of
the things that causes the most
00:22:23.93\00:22:26.91
fear in women is when you say
"breast cancer" - That's right
00:22:26.94\00:22:29.20
And that seems to
occur more after menopause?
00:22:29.23\00:22:32.41
Breast cancer incidence
does rise with age whether it's
00:22:32.44\00:22:37.25
due to something in the
menopause or whether it's
00:22:37.28\00:22:41.27
just an
age-related phenomenon...
00:22:41.30\00:22:43.39
And one could say the
same with the others that
00:22:43.42\00:22:46.51
we just talked about -
osteoporosis and heart disease
00:22:46.54\00:22:49.11
as well because that may be
more of an age-related issue
00:22:49.14\00:22:54.18
though we see a big rise
at the menopause making us
00:22:54.21\00:22:57.85
wonder if there's a specific
cause related to the menopause.
00:22:57.88\00:23:02.81
I know that this subject
of estrogen and heart disease
00:23:02.84\00:23:05.73
is pretty controversial
and maybe we'll talk about
00:23:05.76\00:23:08.23
that more some other
time, but there seems to be
00:23:08.26\00:23:12.00
a real focusing in on
the things that are secreted
00:23:12.03\00:23:15.24
by the body and before
menopause and then afterwards
00:23:15.27\00:23:18.22
saying - Hey, this must have
something to do with it. Yes
00:23:18.25\00:23:21.29
Okay, let me ask
you this question...
00:23:21.32\00:23:23.57
I know you're a
Christian physician,
00:23:23.60\00:23:25.17
and you practice not only
as a physician but also you've
00:23:25.20\00:23:32.18
done some pastoring as well.
00:23:32.21\00:23:34.98
And this is kind of a
philosophical question too,
00:23:35.01\00:23:38.16
I would imagine - Is
menopause a natural thing?
00:23:38.19\00:23:40.95
Did God create us to be
that way or women to have
00:23:40.98\00:23:44.55
menopause?
00:23:44.58\00:23:45.61
Is it a natural state?
00:23:45.64\00:23:46.72
I believe that
menopause is a natural state,
00:23:46.75\00:23:49.59
and we know that in
Biblical times, early on,
00:23:49.62\00:23:53.87
we know Sarah must have
had concerns about menopause,
00:23:53.90\00:23:57.36
and not being
able to have children.
00:23:57.39\00:24:00.26
The child of
promise - That's right!
00:24:00.29\00:24:01.75
So it's not
something that is new.
00:24:01.78\00:24:04.83
It's not something that we've
seen just in the last 100 years.
00:24:04.86\00:24:07.96
I think it's
something that's been there
00:24:07.99\00:24:10.15
whether it came as a
result of sin is certainly
00:24:10.18\00:24:15.40
open to debate, but it is
something that every woman
00:24:15.43\00:24:20.20
goes through.
00:24:20.23\00:24:22.15
It's hard for me to
define something as a disease
00:24:22.18\00:24:27.59
if 100% of the
population has it.
00:24:27.62\00:24:30.56
We generally think of a disease
as something that is different;
00:24:30.59\00:24:33.76
something that has a specific
cause, and when you have
00:24:33.79\00:24:39.23
menopause, this is a condition
that every woman goes through.
00:24:39.26\00:24:43.68
So really, the way you relate to
patients then is not a disease
00:24:43.71\00:24:47.10
model that says - This
is something wrong with you;
00:24:47.13\00:24:49.31
we're going to fix it,
but this is something that...
00:24:49.34\00:24:53.47
This is
something that's natural.
00:24:53.50\00:24:54.77
This is something that
every woman goes through,
00:24:54.80\00:24:57.27
and we need to
individualize as to what type of
00:24:57.30\00:25:01.10
treatment would be appropriate;
00:25:01.13\00:25:04.04
what is the best for a
particular woman based upon
00:25:04.07\00:25:07.92
her own specific
symptoms as well as
00:25:07.95\00:25:11.21
her own lifestyle patterns;
00:25:11.24\00:25:13.35
what type of diet is she eating;
00:25:13.38\00:25:16.08
what type of exercise;
00:25:16.11\00:25:17.54
what kind of
stress is in her life,
00:25:17.57\00:25:19.06
and what has been in her
life for the 50 years or so
00:25:19.09\00:25:22.47
before she goes
through the menopause.
00:25:22.50\00:25:24.75
So in other words, looking
at a natural state then would
00:25:24.78\00:25:27.02
cause them to actually
look at all these things
00:25:27.05\00:25:29.16
throughout their
life rather than -
00:25:29.19\00:25:30.46
Okay, we could do
whatever we want until we get to
00:25:30.50\00:25:33.05
that state... Is
that what you're saying?
00:25:33.08\00:25:34.37
Absolutely... I think
that what we find is that in
00:25:34.40\00:25:38.82
Western society, in the
United States in particular,
00:25:38.85\00:25:41.86
we find that we live
almost unnaturally, I would say.
00:25:41.89\00:25:47.87
We eat foods that stimulate.
00:25:47.90\00:25:50.57
We keep hours that stimulate.
00:25:50.60\00:25:53.11
We have
lifestyles that stimulate.
00:25:53.14\00:25:56.25
We have a lack of exercise.
00:25:56.28\00:25:58.76
And all these things create
tremendous stress on the body
00:25:58.79\00:26:02.85
that when a woman then
goes through the menopause,
00:26:02.88\00:26:05.89
she starts feeling
things being out of balance,
00:26:05.92\00:26:10.15
and all of a sudden, it
starts clicking for her.
00:26:10.18\00:26:13.36
There is
something not right here.
00:26:13.39\00:26:14.98
There is
something out of balance,
00:26:15.01\00:26:16.37
and so she comes to me to say
- Help me get back into balance.
00:26:16.40\00:26:20.25
And what she's really
looking for is a pill.
00:26:20.28\00:26:23.27
And so it's very easy to
give her estrogen, for example,
00:26:23.30\00:26:26.84
because what we've thought
is that she's estrogen-deficient
00:26:26.87\00:26:29.91
So it makes some
sense to give her estrogen,
00:26:29.94\00:26:33.16
but MAYBE that's not
why she's out of balance.
00:26:33.19\00:26:36.01
Maybe she's out of
balance because of her diet.
00:26:36.04\00:26:38.34
Maybe she's out
of balance because
00:26:38.37\00:26:40.17
there is stress in her life...
00:26:40.21\00:26:41.59
And, I think we need to
look at those underlying causes
00:26:41.63\00:26:45.07
that are impacting
her at the menopause.
00:26:45.10\00:26:48.16
As a Christian physician, all
of these stages of transition...
00:26:48.19\00:26:52.70
Do you find that at these times,
00:26:52.73\00:26:54.33
people are very
open spiritually?
00:26:54.36\00:26:56.39
Do you have these kind of
conversations ever with them,
00:26:56.42\00:26:58.60
or do you see that as
an opportunity for us to
00:26:58.63\00:27:01.51
maybe reevaluate
our lives in that way?
00:27:01.54\00:27:04.33
Absolutely -
Anytime we have big changes,
00:27:04.36\00:27:07.38
we go into transition,
we're open to other changes
00:27:07.41\00:27:13.19
because we're searching.
00:27:13.22\00:27:14.79
I think health is related
to spiritual things in that
00:27:14.82\00:27:22.85
to be healthy, we need
the spiritual side of life.
00:27:22.88\00:27:26.93
I really think that
that is important; I mean,
00:27:26.96\00:27:29.98
what a time of transition and
00:27:30.01\00:27:32.15
what an
opportunity that you have.
00:27:32.18\00:27:33.72
We're glad that men like
you are there to be able to
00:27:33.75\00:27:36.80
help us and help the ladies
with these different problems.
00:27:36.83\00:27:40.28
You've been looking at
"Health for a Lifetime"
00:27:40.31\00:27:42.25
and we hope that you
have enjoyed this program.
00:27:42.28\00:27:44.36
We hope that it will
help you in the different
00:27:44.39\00:27:46.89
transitions in your life.
00:27:46.92\00:27:48.30
We hope that, as a
result, you'll have
00:27:48.33\00:27:50.70
Health that
Lasts for a Lifetime!
00:27:50.73\00:27:52.65