Karen Giblin is the founder of the Red Hot Mamas, the largest menopause education and management program in the United States and Canada.
Mache Seibel, MD, is the director of the Complicated Menopause Program at the University of Massachusetts Medical School and is the founder of HealthRock, a health education program that uses music to make learning a fun experience.
Caryn Hartglass: You’re listening to It’s All About Food. Thanks for joining me. We are going to be talking with Karen Giblin and Dr. Mache Seibel, the authors of Eat to Defeat Menopause. Karen Giblin is the founder of the Red Hot Mamas, the largest menopause education and management program in the United States and Canada; and Mache Seibel is the director of the Complicated Menopause Program at the University of Massachusetts Medical School and is founder of Health Rock, a health education program that uses music to make learning a fun experience. Thank you for joining me today on It’s All About Food.
Dr. Seibel: Our pleasure.
Karen Giblin: Thank you very much. We’re going to talk about a very hot topic and ways to deal with it.
Caryn Hartglass: Okay, great. Now did I pronounce your name correctly?
Karen Giblin: (States her name.)
Caryn Hartglass: And Dr. Seibel?
Dr. Seibel: Yes. (States his name.)
Caryn Hartglass: Great. I got it right! I got it right! Okay. Well, this is a very hot topic, and we don’t talk about it enough, and I think a lot of medical practitioners don’t talk about it enough or don’t know enough about it, at least not many of the ones that I have spoken to.
Dr. Seibel: It takes a lot of time to talk about menopause and that’s one of the issues, because it is something that we have to educate women about and talk to them about it, and because it does take time, there often isn’t enough time in a typical visit.
Caryn Hartglass: Well, especially not with our healthcare situation the way it is today, where patients have to get in and out quickly.
Dr. Seibel: Exactly.
Caryn Hartglass: Yeah. But that’s one great thing about some of the things that you’re doing, because you both have great websites and lots of wonderful information. I was just looking at your site, Dr. Seibel, and there are so many great little videos up here. This is doctorseibel.com, that’s spelled out d-o-c-t-o-r-s-e-i-b-e-l dot com, and lots of really helpful informative stuff, and it doesn’t cost anything.
Dr. Seibel: Thank you. Yeah, it’s a lot of information and because–
Caryn Hartglass: How come you’re so good?
Dr. Seibel: My whole motto is it’s better to stay well than to get well.
Caryn Hartglass: Yeah.
Dr. Seibel: The only way people can do that is with education.
Caryn Hartglass: And I also quickly want to mention the other site, redhotmamas.org, and that’s Karen Giblin’s site, and again, there’s lots of great information there. But let’s just touch on a few things. Certainly we don’t have a lot of time, but just to get people a little hot about this topic.
Dr. Seibel: No pun intended.
Caryn Hartglass: I can’t help myself. Okay. Now, so I have a question: Is it true that there are other places in the world where the women don’t experience the extreme symptoms that some of us experience here in the United States?
Dr. Seibel: Well, some menopausal symptoms are universal. Some of them, such as hot flashes, do have some cultural aspects to it. The women in Asia, for instance, are less likely to complain of hot flashes, possibly because they eat a lot of soy and other kinds of phytoestrogens, but they do complain about that particular symptom less.
Caryn Hartglass: Mmm hmm. Well, that’s important, and that’s sort of a clue to the rest of us who don’t enjoy these hot flashes.
Karen Giblin: You’re right. I want to mention to you that about 75% of women will experience hot flashes, so there’s many of us out there that are getting the hot flashes not only in the daytime, but at night, and it’s certainly disturbing our sleep and making us cranky the next day, irritable, and often puts us at certain risk of developing diseases. So it’s important, if a woman does experience hot flashes, that she speak to her healthcare provider.
Dr. Seibel: That’s one of the disadvantages of loss of estrogen, because [the loss of] estrogen does diminish the REM sleep, or the rapid-eye-movement sleep, and that does leave a woman feeling very much more tired. And also, the REM sleep is a time during the night that people incorporate or process all of the complex thinking and issues that are emotionally related. That time of sleep is when we process that, so the lower estrogen causes a loss of that time of sleep.
Caryn Hartglass: Now I remember reading somewhere, and I don’t remember where it was–and it was a long time ago–but, those that have higher estrogen levels before menopause than those that have lower estrogen levels will experience more symptoms after menopause because of the greater difference in the drop of estrogen. Am I making any sense here?
Dr. Seibel: Well, it’s kind of, if you have a large differential. In other words, if your estrogen levels abruptly get lower, for instance with the surgical menopause when the ovaries are removed in a woman before she’s actually old enough to go through menopause, she’s going to have a lot of really significant symptoms, and the more that the person’s estrogen levels drop, the greater the delta, the more difference the change between her earlier estrogen level and the level she now has, and she well may be more symptomatic.
Caryn Hartglass: And are there things that one can do? I’m asking personally, because I did go through that. I had advanced ovarian cancer five years ago, and fortunately I am exceptionally healthy right now, but I did go through…
Dr. Seibel: Well, congratulations to you!
Caryn Hartglass: Yes, I know, I was one of the under 20%. But there are reasons for that. And it’s all about my food. But when you have it forced upon you, what are some of the things that you can do to make up for what you’re lacking?
Dr. Seibel: Karen, you want to talk about it? Would you like me to? I think the most important thing you can do–
Caryn Hartglass: I think we lost Karen and I’m not sure if she’s back yet.
Dr. Seibel: All right. The most important thing you can do is to have a positive attitude. I mean, this is very hard to get, but it’s the most valuable thing in the world. And the thing that can help you to do that is to try and get as much sleep as you can, to get the exercise that you need, to lower your stress and get into stress reduction, and to eat healthily. And these are really the four legs of the stool for good health. And so, women who have hot flashes, if they do exercise in a regular way, if they hydrate – get plenty of water, if they avoid smoking–that’s something they definitely shouldn’t be doing, exercising 30 minutes three to five times a week, and that actually helps retain your cardiac output, because people who don’t exercise between the ages of 30 and 70 have a drop in about 30% of their cardiac output, so their cardiac injection goes way down, and it’s exercise that keeps it going. And then, limiting alcohol to one glass of wine at the most, or one beer or an ounce of spirits daily, and avoiding caffeine. These are all things–limiting salt and soda–these are all things that can help a woman to reduce the hot flashes and experience that she has.
Caryn Hartglass: Well, what I love about hearing all of this is that all of these things you’re recommending are things that are good for all general health. And you can say the same things for lowering your risk for heart disease and diabetes–
Dr. Seibel: High blood pressure. Everything.
Caryn Hartglass: Everything. I love the way nature works that way.
Dr. Seibel: Well I look at health as a continuum. If we look at wellness to illness, if we continue to take poor care of our bodies, then what happens is slowly but surely we start to move toward illness. And so eventually we get to a tipping point, we pass over the middle of the fulcrum and we drop into illness, and then we’ve got to get well. But if we can stay well by simply allowing ourselves to take care of ourselves a day at a time, then it’s much easier to stay well. You cannot cram for life. You’ve got to live life a day at a time. You just can’t go in one day and decide, I’m going to be healthy, and do something really intensively for one day and then expect things to change. We’ve got to be proactive about it. That’s what we try to do with our book. Eat to Defeat Menopause really has a lot, the first 60 pages of the book is just chockfull of health information that’s easy to understand. It talks about menopause; it talks about what you should be eating, and nutritional tips and health information. And then, the rest of the book has 130 recipes or so, both from my kitchen and from Karen’s kitchen, but also from top chefs from around the country. So we went to former White House chefs, we went to people at the top restaurants, and each one gave their favorite recipe or two, and then we had the nutritional department at the University of Massachusetts, where I work, going through it and analyzing it for protein, fats, carbohydrates, how many calories, so you know exactly what you’re eating. And then we have it of course divided into breakfast, into lunch and appetizers, and for dinners, soups and stews and salads, so it’s divided up so you can find what you want. And then, we were fortunate enough, Dean Ornish thought it was a great book, so he wrote the forward for our book; it was a very lovely forward. And throughout it we give some red hot tips, for portion control, or for things that we’ve learned from the yogis, or for different kinds of things that women will find useful as they look through it, and can just say, “Okay, I’m not going to read the whole book, of course, but I’m going to look for a recipe, and while I’m at it, I’m going to find a little red-hot tip that will be helpful for me today.”
Caryn Hartglass: Yeah, that’s all good.
Karen Giblin: Yeah, and the recipes are actually extremely delicious, and we’ve tried most of the recipes ourselves, and we’ve made a lot of them ourselves, and they’re excellent. Excellent. And we deal with a lot of Mediterranean diets and things like that on it. We have tuna and bean salads, pasta, and I know that I’m Italian and you can eat pasta but you have to eat it in a small portion and you won’t gain any weight. And in Italy, the women aren’t heavy because it’s simply, spaghetti and pasta is not weighted down with heavy cheese sauces. So there are ways of eating that are healthy for you.
Caryn Hartglass: Well, there are a lot of interesting recipes here. I’m a vegan, and I promote all the plant foods, and so there are some really interesting ones: watercress salad with fennel–I love watercress, and I’m always encouraging people to eat their greens ’cause there’s so many wonderful things in them, but a lot of great things here. I don’t personally like to encourage dairy or fish foods and I know that they’re in here and I know that a lot of people eat them. I think there are other issues with regard to the environment and some other health issues where I prefer to eat plant foods. But overall, I think this is pretty well balanced.
Karen Giblin: Great.
Dr. Seibel: We tried to have something for everyone.
Caryn Hartglass: Mmm hmm.
Dr. Seibel: What happens is, I think a plant-based diet is just fantastic and I know I primarily eat vegetarian, not exclusively, but that’s a large part of what I eat. But I know that many people are eating other types of food, and so Karen and I incorporated things that would be of value to the people who do choose to eat otherwise.
Caryn Hartglass: Okay, so one of the things that I really like is – there’s so much talk about soy and there’s so much fear about soy and you devoted a good chunk in the book about soy and how good it is and which soy foods are good, so I just want to underline that. I don’t quite understand why there’s been so much fear wrapped around soy foods in this country.
Dr. Seibel: You know, soy gets a really bad rap, and a lot of it has to do with the fact that there was a study that was published that showed that if you take cancer cells, the actual cells, breast cancer, and you put them in culture, depending on how you do the culture, how you do the counting of cells by DNA, there was one study that suggested that soy had some role in cancer production. On the other hand, with that exception, there’s really been no evidence that soy stimulates cancer cells in people that don’t have it. And the fact of the matter is that in China and other Asian countries, where soy is a staple, the incidence of cancer, and breast cancer, is actually lower than in the United States.
Caryn Hartglass: Right.
Karen Giblin: I think one of the issues is when we get involved in taking supplements, a lot of the different supplements. And incorporating soy into our diet is totally different than taking – the consumption of supplements. So what we’ve tried to do is explain carefully the role that soy plays in our diets, and how it can affect hot flashes and other things. But many people are confused about how to incorporate it in our diet.
Caryn Hartglass: Mmm hmm. And that’s where the great recipes come in.
Karen Giblin: Yes.
Caryn Hartglass: What about estrogen replacement? Do you work with patients with that, Dr. Seibel?
Dr. Seibel: Oh, many. Of course.
Caryn Hartglass: And does it help? I’ve heard so many mixed things about it.
Dr. Seibel: Well, I mean there’s no question that in 97% of women, giving estrogen is going to relieve the symptoms that they come for, most typically hot flashes or vaginal dryness, or prevention of bone loss. Estrogen is not a question of if it’s helpful; the question is always weighing the benefits and the risks. And for some women, after the Women’s Health Initiative study, there was a lot of concern about was it more risk than benefit.
Caryn Hartglass: Right.
Dr. Seibel: And most recently, the big bugaboo was in 2001, which is now about ten years ago, when the Women’s Health Initiative study came out showing an increase of cancer of the breast, blood clots and so forth, but in that study, the increased incidence was exactly eight patients per 10,000 increase. In other words, some women who don’t take it get breast cancer and some don’t. But eight more per 10,000 women got breast cancer, which is eight per 10,000, or .8 for 1,000, or .08 per 100, which is less than a tenth of a percent.
Caryn Hartglass: Mmm hmm.
Dr. Seibel: But it was a prevention study. Therefore, the study was discontinued. Now just a few months ago in the Journal of the American Medical Association, another 10,000 women who had their uterus removed and therefore took estrogen only, not progesterone but only estrogen, were followed, and it was found that the women who only took estrogen actually had a 23% reduction of breast cancer risk compared to the women who didn’t get it. So, the data keeps needing to be updated and refined and specified, and every woman needs to talk with her doctor about what’s right for her.
Karen Giblin: And also, the latest findings are shorter-term use of estrogen for moderate to severe symptoms at the time of menopause may be a very effective way in dealing with the menopausal symptoms.
Caryn Hartglass: Okay, that’s good to know. Kind of help your body transition.
Karen Giblin: Yes. But not taking it much later after the onset of menopause. But at the time of menopause, taken for a short duration of time to get over that severe or moderate to severe symptoms is very effective.
Caryn Hartglass: One of the things that I really enjoyed discovering is the music, Dr. Seibel, that you connect with your health practice. And I love the humor. I think music is so important–I’m a singer myself–and I think it’s an effective way to get information out. I really appreciate that you’re doing that and I appreciate the humor.
Dr. Seibel: Well, thank you. People who do learn by musical messaging activate more parts of the brain than people who are receiving just the spoken word, so it is a very helpful tool. Just like Schoolhouse Rock, some people will remember was very popular for getting people to remember. “Conjunction Junction” and things like “I’m Just a Bill on Capitol Hill,” [sic] and those songs which are now a part of the culture. The reason they were effective is they taught people ways to remember using different parts of their brain. It just gave them a better recall — the music, the rhythm, etc.
Karen Gilbin: And you know, there is no prescription required to laugh.
Dr. Seibel: That is true.
Karen Giblin: Definitely, and I think of all times, you’ve got to honor your humor at menopause, and keep that twinkle in your wrinkle. Mache is doing a very good job at that with his website. Dr. Seibel, thank you.
Dr. Seibel: Thank you. And you know, Karen has a lot of wonderful content on hers, as well, lots of information. So the listeners can go to either of our websites, either redhotmamas.org or doctorseibel.com, and get lots of information that they can go just through at their leisure.
Caryn Hartglass: Okay. You say you should talk to your doctor for help, but sometimes we can’t find a doctor that has this information. Are there places to go to find doctors that are plugged into the whole nutrition scene and have a more integrative approach?
Karen Giblin: Actually, you can go onto to the North American Menopause Society website, which is menopause.org, and they will have a list of menopause clinicians who are certified. And, on redhotmamas.org and Dr. Seibel’s healthrock.com, you’ll also find some doctors.
Caryn Hartglass: That’s really good to know, because I think more and more doctors are realizing the importance of nutrition, but I’ve talked to far too many that don’t know enough, how helpful simple things can be. And some, unfortunately, believe that their patients don’t want to make changes. I just think it’s important that the doctor promote the importance of healthy diet and lifestyle.
Dr. Seibel: I do think that today we’re having to be more advocates for our own health, and I think people need to understand that prevention is the important thing. That things like this book were inspired to try to help women to have a diet and nutritional information that can help them and they can incorporate into their daily lives, along with exercise and stress reduction and getting enough sleep. These are, as I said earlier, the real cornerstones of good health. And women can talk to their doctors and see if they share these beliefs. And if they don’t, they can look for other people that are more inclined to go along that way.
Caryn Hartglass: Well, there are lots of symptoms that you list here for perimenopause. And some of them, I think, go into menopause: Hot flashes, insomnia, weight gain, vaginal dryness, palpitations, lower sexual desire, depression, and it really is good to know that we have some control over the magnitude of all of these symptoms.
Dr. Seibel: Absolutely. They can all be modified by our behavior. By that I mean the things we’ve been talking about: Our diet and nutrition, our exercise, lowering our stress, sleeping more. If we can get everybody organized to work on these particular things and make little changes over time, they can have a much healthier, longer, vital life.
Caryn Hartglass: I don’t want to include the men out of this discussion, but I do know some men who also have hot flashes. Is it a similar type of phenomenon going on?
Dr. Seibel: Well, most of the men that I know that have hot flashes are generally men who are on different medications that are causing it. I don’t know any men that are having them outside of that.
Caryn Hartglass: Okay. I do. (Laughs)
Dr. Seibel: Maybe there are some. They’re in touch with their feminine side.
Caryn Hartglass: Right. Okay. Well, do you have a little jingle or something that you could give us before we sign off?
Dr. Seibel: I don’t know what to say in a very quick way.
Caryn Hartglass: Well, one of the things that I love watching your little videos is the big smile, and it’s so important, all of this information that you’re giving us, to know that we have the power. We can take control. It’s not hard to do, and it’s easy. It’s friendly. So I thank you for that tone. It’s really important.
Dr. Seibel: Menopause isn’t a disease. It’s a naturally occurring phase of life, not unlike puberty, not unlike the reproductive years. It’s just another phase, and the more we can embrace it and embrace our dietary intake and plan to eat healthy, then I think we can have a much better transition through it.
Caryn Hartglass: Okay. Well, thank you so much Karen Giblin and Dr. Mache Seibel. I really appreciate you coming on to talk about your book, Eat to Defeat Menopause, and I want to repeat our websites. We have redhotmamas.org and doctorseibel.com, spelling out “Doctor Seibel.” And there’s more information there, not just on menopause. Lots of other “stay well” programs, as well.
Karen Giblin: Thank you for having us.
Caryn Hartglass: Thank you so much.
Dr. Seibel: Thank you very much. I enjoyed being with you.
Caryn Hartglass: Yes. Thank you.
Transcribed by TW, 7/28/2014