Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
A woman's health needs continue to evolve from her teen years through her golden years. Being active, eating well, and getting your recommended health screenings are the foundation for good health at any age.
Midlife is a time when you will be making important decisions about your health. It is important to be aware that you are at a greater risk now than in the past for serious health conditions like breast cancer, heart disease, osteoporosis, and others. A healthy diet and an active lifestyle can help prevent or postpone many of these conditions. In addition, we recommend that you make regular screenings an essential part of your health routine:
Research shows that a balanced diet and an active lifestyle can improve your overall health and prevent some of the most common illnesses among women.
As women get older, they experience an increase in body fat and a decrease in the rate at which they burn calories. Unchecked, this combination is a recipe for weight gain. Good nutrition reduces your risk of developing:
Studies have shown that small weight losses of 8 to 10 pounds can significantly improve some medical conditions. For peak health, the most recent studies on women's nutrition suggest the following guidelines:
Make small changes over time. For instance, add 1 serving of fruits or vegetables to any of your meals. Or try having fruit as a snack. Avoid fad diets or big changes in what you eat.
Control portion sizes and choose leaner meat or fish. Choose smaller portions of lean meat (such as tenderloin or bottom round). A healthy portion size is about the size of your palm or of a deck of cards. Try skinless white meats such as turkey or chicken or add some fish to your diet.
Realize that simple changes add up. Switching from whole milk to low-fat milk (1 or 2 percent), or even nonfat milk, can make a difference in your daily intake of calories. Try cutting back on sugar by limiting the amount of soda you drink and switching to sugar-free soda. Use small amounts of healthy oils such as olive or canola oil and try lower fat salad dressings. Drink plenty of water – at least 6 to 8 glasses every day – it is good for the body, and it helps you feel full. Try to eat more slowly. It takes your stomach 20 minutes to signal your brain that it is full.
Avoid temptation. If it is not in your cupboard, you will not be tempted to eat it. Make a grocery list to help you buy healthier foods and stay away from junk food. Substitute lower fat choices (such as popcorn or reduced fat crackers) for foods with lots of fat and sugar. Read labels. Plan your grocery trips so that you do not end up shopping when you are hungry.
If you are in or approaching midlife, this may be the most important time for you to be active. A healthy routine of activity:
Reach or maintain a healthy weight. As you grow older, your body slows down. Your metabolism, the rate at which your body burns calories, naturally decreases. Regular exercise reverses this trend. It increases your metabolism and is one of the best things you can do for your health. Not only will you burn calories while exercising, but your body will continue to burn calories at an increased rate for several hours afterward.
Maintain bone strength. After menopause, women lose strength and density in their bones. Bone loss is a major reason for falls and fractures in older women. These injuries decrease mobility and lead to a lower quality of life. Exercise, particularly weight-bearing exercise, is the best way to maintain bone strength. It can be even more effective than hormone therapy.
Build or maintain muscle mass. After menopause, your weight may shift around your body – usually moving toward the stomach and midsection. You may also lose muscle, which supports bones and joints and keeps your body looking firm. Exercise can help strengthen and tone your muscles, improve your balance, and lift your mood.
Look for ways to be more active during the day. It is best to try to be physically active for 30 to 60 minutes on most days. Here are some tips to help you get there:
Mix up your activities to strengthen different body parts and avoid boredom with your routine. Try walking on Monday, aerobics on Tuesday, lifting weights and stretching on Wednesday, etc. Or go out dancing with friends for a change of pace.
Here are some other ideas for keeping it interesting:
For many women, midlife is a wake-up call to leading a healthier, more reflective life. For others, it seems to heighten emotional and mental challenges, such as:
Antidepressants are prescription medications that may treat menopause symptoms (including hot flashes and night sweats) in addition to treating depression. Certain types can be used as an alternative to hormone therapy for some women.
Drugs called SSRIs/SSNRIs (selective serotonin or norepinephrine reuptake inhibitors) and other types of antidepressants can also be prescribed to treat irritability, anxiety, depression, insomnia, and moodiness. We can discuss whether antidepressants may be useful or recommended for you.
Although you can often take steps to improve your mental and emotional states on your own, sometimes you may need assistance. Clinical depression is much more than just feeling sad. Seek out professional help if you have been depressed for 2 weeks or longer and have had several of the following symptoms:
If you notice any troublesome mental or emotional effects of midlife, consider the following self-help tips:
The amount of estrogen produced by your ovaries slowly decreases during perimenopause and then drops off steeply at menopause. This hormonal change, as well as other physical changes in midlife, can cause shifts in your sexual desire or create challenges in your lovemaking.
Like many other aspects of the transition through menopause, your reaction to these changes will be individual. You might enjoy sex more after menopause, or you may feel a drop in your sex drive during this time.
Sexual desire is the result of a complex interplay between your psychological makeup, social and cultural background, and hormones. Although estrogen affects sexual desire, the amount of testosterone your body produces has a greater influence. Often, women's testosterone levels do not decline as quickly as their estrogen levels. A higher ratio of testosterone to estrogen after menopause may actually lead to an increase in your sexual desire. Having more time with your partner or having more time for intimacy may also boost desire. However, if intercourse becomes painful, or if you are bothered by symptoms of menopause (including hot flashes, insomnia, or irritability), your desire may lessen. We can help you find ways to treat these symptoms.
There are many reasons for a decrease in sexual interest:
There are many ways to overcome sexual difficulties and enjoy a fulfilling sex life. If you are experiencing vaginal changes or decreased desire, try the following self-help measures:
Scientists are just beginning to document the benefits of mind-body and herbal approaches for women in midlife. You can try some complementary and alternative approaches to see if they help reduce symptoms of menopause and improve your sense of well-being.
We recommend that complementary and alternative approaches be combined with a healthy diet and regular exercise routine. Women who make regular exercise a priority and who maintain a normal body weight fare best in regard to midlife changes.
It seems there is a new suggestion at least every week for over-the-counter herbs, supplements, and techniques to control menopausal symptoms and manage midlife changes to your mind and body. Although it can be difficult, it is important to try and await the results of good scientific studies before trying a remedy with unknown risks and uncertain benefits.
Soy. Soy has some positive effects on health. Soybeans and soy products contain isoflavone, which studies have shown to decrease the risk of heart disease by lowering cholesterol. Research results about whether soy can decrease hot flashes are mixed. Some studies show a small decrease in women who take soy protein supplements but not in women who take isoflavone alone in a pill. Research does support consuming a daily serving of soy (25 grams of soy protein) as part of a low-fat, well-balanced diet.
Progesterone cream. Studies have shown that creams containing progesterone may reduce hot flashes. Never use creams in place of prescription progesterone medication.
Bioidentical, natural, or alternative hormones. The term "bioidentical" describes hormones that are chemically identical to those we make naturally in our bodies. These hormones are made from soy and yams. They come as pills, patches, creams, and sprays and act like regular hormones. Here are some things to consider about these products:
Black cohosh. This is the most widely studied herb in menopause treatment. There have been recent reports of liver problems in women taking black cohosh. For this reason we do not recommend this supplement at this time.
Dong quai. The first study on the use of dong quai for hot flashes took place at Kaiser Permanente. It showed that dong quai was no more helpful for hot flashes than a placebo, or sugar pill.
DHEA. This hormone changes into estrogen and testosterone when it enters the body. DHEA can cause acne, voice deepening, and liver problems, and it may decrease HDL (good) cholesterol. Women with high levels of DHEA seem to have more heart attacks. There is no evidence that DHEA is effective in improving well-being or health, and the long-term effects are unknown.
Evening primrose oil. There is no scientific evidence that evening primrose oil can reduce hot flashes.
St. John's wort. Studies have shown that St. John's wort may relieve symptoms of mild depression. However, it is not effective in treating major depression and usually is not recommended beyond 2 years. Side effects may include stomach upset, fatigue, and increased sensitivity to sunlight. It should not be used with anticlotting drugs or with prescription antidepressants.
To help you be your healthiest in midlife, I encourage you to take advantage of the resources we offer for women before, during, and after menopause. Mammograms and routine Ob/Gyn appointments are important to your health in midlife, and they may be booked online or by calling the Appointment and Advice line.
In addition to our online resources, our Health Education center offers:
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.