Hormone Balance: what you need to know about your hormones and your weight
Our hormones change throughout our lifespan and this can significantly affect how we feel. Estrogen levels starts to change in general in your 40s. This can lead to irregular periods, mood swings, sleep problems and weight gain. Our testosterone levels start to decline in our late 20s, and early 30s, leading to fatigue, low libido and a decrease in muscle mass. Getting your hormones in balance can help with these symptoms.
ACSM Certified Personal Trainer Rachael Lewis interviews Dr. Becky Lynn, gynecologist and menopause specialist on hormonal balance, how hormones affect your metabolism leading to weight gain.
Rachael: Hi Dr. Becky, we are so excited to learn more about your business, Evora! Can you briefly explain your background?
Dr. Lynn: Yes! I am a board certified gynecologist and a specialist in menopause and female sexual health with over 20 years in practice. I am also a North American Menopause Society(NAMS) certified physician and a certified sexual counselor.
Rachael: What do you specialize in?
Dr. Lynn: I specialize in menopause and sexual health and these commonly go hand in hand. Menopause encompasses everything from preventative care and cancer screening, to treatment of hot flashes, weight gain, mood swings, brain fog and sleep disorders. When it comes to sexual health, we treat low libido, painful sex, orgasm and arousal difficulties in women of all ages. Couples counseling is another service I provide as often patients need help explaining the process to their partner, discussing sexual concerns, and maybe working through difficulties or communication issues in their relationship. Because weight gain is so common in menopause, I also offer a weight management program. I help women lose weight in conjunction with you and our nutritionist Katie. We have had many happy customers.
Rachael: How are our hormones affected as we age?
Dr. Lynn: Our hormones change throughout our lifespan and this can significantly affect how we feel. Estrogen levels starts to change in general in your 40s. This can lead to irregular periods, mood swings, sleep problems and weight gain. Our testosterone levels start to decline in our late 20s, and early 30s, leading to fatigue, low libido and a decrease in muscle mass. Getting your hormones in balance can help with these symptoms.
Rachael: Why are so many women today at younger ages already experiencing hormone imbalance symptoms?
Dr. Lynn: We always think of menopause happening at age 50 but the symptoms can start in your early 40s and for some women it starts even earlier.
Rachael: How does diet and lifestyle relate to hormone imbalance?
Diet and exercise can sometimes help rebalance certain hormone levels. For example, some women have polycystic ovarian syndrome(PCOS). Their ovaries may make too much testosterone and estrogen not enough progesterone if/when they don’t ovulate. People with PCOS are more likely to have insulin resistance, meaning your pancreas has to put out more insulin to get glucose into your cells. Insulin makes you deposit fat and gain weight. When you gain weight, you become more insulin resistant and you fall into a vicious cycle of more weight gain. Lifestyle changes, like a healthy, protein-based diet and exercise can help break the cycle. Many times, when women with PCOS lose weight, their hormones go back into balance.
Rachael: Is there a relationship you find between metabolic rate (ability to burn calories/expend energy) and Hormone Balance?
Dr. Lynn: Absolutely! This is so important to menopausal women because when you go through menopause your ovaries stop making estrogen. Low estrogen levels lead to insulin resistance. Similar to PCOS, insulin resistance leads to your body making more insulin which makes you gain weight. Hormone replacement therapy in women has been shown to improve insulin resistance, which is so important to a healthy body weight.
Also, when estrogen levels decline, women’s bodies tend to be less muscular and more fat than when their hormones were at normal levels. This leads to a lower metabolic rate than previously, making it harder to lose weight or making it so you have to eat fewer calories to maintain your weight.
Lastly, after menopause, women tend to deposit more fat around their middle and less on their hips and bust. This leads to a higher risk of cardiometabolic diseases, like diabetes and high blood pressure.
Rachael: What do you wish all women knew related to our health or hormones specifically?
Dr. Lynn: I feel like there is still so much misinformation concerning hormone therapy out there. Women don’t know who to trust or what to believe. I want women to know that hormones have incredible benefits to your health. Like all medicines, they have side effects and risks too and they aren’t the answer for everything or everybody.
This is why it is so important to find a physician who is a hormone specialist and a NAMS certified one!
Rachael: What made you decide to start your own business?
Dr. Lynn: I love taking care of patients, especially women in midlife. There are many important topics to cover during a visit that are important to your overall health, well-being and quality of life. I feel strongly that women need more than a 10 minute visit with their doctor in order to meet their health needs. I found that I could not do this as an employed physician working in a large practice. My schedule was always over booked and I would be running behind. Starting my own business has allowed me to limit the number of patients that I see and give my patients all the time, information, and discussion that they need during a visit. At Evora, we never rush. We listen, evaluate the issues and then come up with a plan personalized just for you.
Rachael: How does your service differ from a traditional doctor office visit?
Dr. Lynn: We differ from traditional medicine in numerous ways:
1. My practice focuses on your overall health and well-being, not just your symptoms.
2. We spend an hour with you on the first visit so we can address both prevention and all of your concerns. We always give you the time that you need.
3. We devote all of our time directly to you. Because of this, we do not accept insurance for doctor visits. You can still use your insurance for any testing or imaging that we order. You can always submit to your own insurance for reimbursement or you can use a health savings account or flexible spending account to pay for services. We give you all of the documentation that you need to submit. This way all of our resources are devoted to you, not to collecting from insurance.
Rachael: Last one, what is your favorite thing to do when you’re not at the office treating patients?
Running! I love running. It takes me to my happy place, not to mention exercise is so good for your moods and it keeps my weight in check. My family knows, early in the mornings if mom is not home, she is out running!
Dr. Becky Kaufman Lynn is a gynecologist and the founder of the Evora Women’s Health. She is a North American Menopause Society Certified Physician who has been treating menopausal women for over 20 years. Her practice is located in Chesterfield just outside of St. Louis, Missouri. Dr. Lynn offers a comprehensive midlife wellness program helping women lead healthy lives. Go to evorawomen.com for more information about her practice or to schedule an appointment or send us an email at info@evorawomen.com
Rachael Lewis is a fitness professional who has touched the lives of countless women - helping them move forward in their health and wellness. Rachael currently is an American College of Sports Medicine Certified Personal Trainer who has worked for ten years in multiple sports, corporate and community settings. Rachael believes that every body adapts and responds to exercise differently. Her goal is to create a sustainable exercise regimen that you are able to maintain through the rest of your life. Rachael is the founder of A Perfect Fit, a concierge culinary service. Offering in home cooking and personal grocery shopping, A Perfect Fit allows you to stop stressing over preparing whole meals for you or your family. A Perfect Fit takes care of it for you!
5 facts about (peri)-menopause you didn’t know!
We aren’t taught much about what happens during menopause and the few years before. Read on for some things you didn’t know were related to the loss of estrogen that your ovaries used to make!
We aren’t taught much about what happens during menopause and the few years before.
Read on for some things you didn’t know were related to the loss of estrogen that your ovaries used to make!
1. Vaginal dryness may be due to menopause!
You may not realize that dryness is related to the loss of estrogen. You may not get aroused as easily during sex. You may not be able to reach orgasm; orgasms are not as strong, or it takes too long and too much work to get there. Sex may even become painful. No worries, low dose vaginal hormones help treat all of these, (and you are normal if this is happening to you)! Giving back the estrogen helps the vagina lubricate. It also makes the vagina stretchy, with good blood flow, and more nerves going to it, which makes sex feel better! The good news is that vaginal hormones don’t have the same risks that go along with other hormone use. They do not increase your risk of breast cancer, heart attack, or stroke.
2. Menopause makes it harder to lose weight.
It is not that you are lazy or crazy. During menopause women become more insulin resistant. This means your body needs to pump out more insulin to get the same amount of glucose into the cells. Insulin makes your body deposit fat, which is not good for your waistline. Menopause leads to fat deposition around your middle instead of your hips and bust. This “apple” shape, as opposed to the typical female “pear” shape, leads to an increased risk of cardiovascular diseases like heart attack or stroke. Diet and exercise are the first step to losing weight and making your body less resistant to insulin. Some women may need the help of some of the medicines that are available to help you lose weight.
3. Anxiety, depression and mood swings may worsen around the time of menopause.
Typically, hormone levels become erratic before periods stop. Women may feel like they are on a roller coaster ride of emotions. Also, this is the time the kids leave the home and women may be dealing with an empty nest or a lost identity. They may also be taking care of aging parents or have financial stressors. There are plenty of ways to manage anxiety, stress, or depression. Some are with appropriately chosen medicines, other times yoga or soothing apps like CALM may be all you need.
4. Word finding difficulties, forgetfulness happens.
This can be incredibly scary for menopausal women. You can’t seem to remember why you walked into the kitchen or what task you were supposed to complete today. The good news is that brain exercise helps. Learn a new language or learn how to play an instrument. Exercise and diet also keep the brain “fresh”. Be sure to eat a healthy diet, including omega 3 fatty acids which are found in oily fish like salmon or tuna. A healthy lifestyle lowers your risk of Alzheimer’s Disease and delays the progression of Parkinson’s Disease.
5. Low libido.
Menopause is not all about estrogen. By the time women stop having periods, their testosterone is much lower than it was in their 20s and 30s and this may lead to low or loss of sex drive. Loss of sex drive may significantly impact a women’s relationship, and couples that don’t have sex tend to grow apart. There are plenty of hormonal and non-hormonal ways to improve your sex drive.
Make sure you find a practitioner who is well versed in menopause and sexual health.
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click click here to schedule.
Menopause: 4 things you can do when “down there” feels like sandpaper
Sandpaper. That is what my patients tell me about how their vagina feels during sex after menopause. There’s good news though--you don’t have to live that way. There are several things you can do to reinvigorate “down there”.
Sandpaper. That is what my patients tell me about how their vagina feels during sex after menopause. There’s good news though--you don’t have to live that way. There are several things you can do to reinvigorate “down there”.
What is menopause?
When your ovaries stop releasing eggs each month, you have entered menopause. Without the ovulatory cycle, your ovaries are not making estrogen and progesterone like they used to. Testosterone is also decreasing. These hormones play a large role in sexual function.
Vaginal changes after menopause
We call the changes to the vagina vaginal atrophy which is part of the genitourinary syndrome of menopause (which includes changes to the urinary tract). Vaginal atrophy doesn’t usually appear until about 5 years after the last menstrual period. Many women don’t realize that vaginal dryness is due to menopause. They feel like something is wrong with them when sex hurts. Many times, their partner is concerned because they don’t appear to be lubricated or aroused and the couple is unaware that this is a normal change of menopause.
Lack of estrogen causes some major changes to the vagina. Before menopause, estrogen makes the vaginal walls thick, moist and stretchy. There is good blood flow to the vagina and plenty of nerves (just ask anyone who has had a baby!). There are small folds (rugae) in the vagina that allow the vagina to stretch so a penis can fit into it or a baby can come out of it. All of this leads to pleasurable sex. But after menopause, the vaginal walls become thin and dry. They lose their rugae, stretchiness and they don’t naturally lubricate during sex. This loss of elasticity combined with lack of natural lubrication can lead to painful sex.
4 things you can do about vaginal dryness.
Lubricate: There are several types of vaginal lubricants: water based, silicone based and natural oils like olive oil. If you are menopausal and have vaginal dryness, throw away the water based lubes. Although they sound “natural”, water based lubes pull moisture from the vaginal tissues and make dryness worse. Pick a silicone based lube like Uberlube or Wet Platinum. Water based lubes do not affect the integrity of a condom but some silicone based lubes do. If you are using condoms, the silicone based Uberlube is a good choice because it does not affect the condom. Put some on the outside of the vagina, which is called the vulva, and before sex, put some on your partner too. This will help things glide a lot more smoothly.
Moisturize
Just like you put lotion on your hands, you can also moisturize the vagina. There are a variety of products on the market for this, like Lubrigyn or Hyalo Gyn. I tend to recommend coconut oil (solid) or wait for it. . . .Crisco. You can use as little or as much as you want. You can put some on the vulva morning and night, or every time you pee. You can even freeze chunks in an ice cube tray and then insert them into the vagina with your finger. This does not increase your risk of infection.
Low dose vaginal hormones
Low dose vaginal hormones replace what the vagina is lacking during menopause- estrogen. Before you say no to hormones, remember that low dose vaginal hormones do NOT increase your risk of breast cancer, blood clot, heart attack or stroke. Vaginal hormones restore the elasticity to the vagina, allowing it to stretch without pain and return its ability to lubricate itself again. Sex becomes pleasurable again as there is more blood flowing to the vagina allowing for more sensation and engorgement.
There are some several studies evaluating vaginal laser for the treatment of genitourinary syndrome of menopause. Thus far, they show some promising results. Vaginal laser breaks down old collagen and your body replaces it with new healthy collagen and elastin. After laser, the tissue appears more like premenopausal tissue with more superficial cells and women report less dryness and less pain.
Go ahead, reinvigorate the vagina! No need to have painful sex when there are so many treatment options. You will be so pleased with your results!
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Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click click here to schedule.
Where did my 20 something sex drive go?
In my gynecology and sexual medicine practice, I see women every day who tell me they have lost their sex drive. Some women are desperately missing it. They say they “want to want” again. Others tell me they would be completely happy if they never had to have sex again in their entire life. Some have '“duty sex” just to please their partner. How can women improve and regain their sex drive? Yes, there are ways to improve your sex drive. Read about it here.
I was recently watching the Netflix series “You” which deals with an intensively obsessive 20 something man, falling for a somewhat clueless, innocent, sexy 20 something woman. But it’s not the obsession that struck me(or the unusually nefarious plot), it is the crazy, throw me up against the wall, rip off my clothes and have passionate sex with me that caught my attention. That is because in my gynecology and sexual medicine practice, I see women every day who tell me they have lost their sex drive. Some women are desperately missing it. They say they “want to want” again. Others tell me they would be completely happy if they never had to have sex again in their entire life. Had to have it? Where do our 20 something sex drives go as we age? Why do we lose them and most importantly, how do we get them back?
When does sex drive peak?
Sex drive peaks in women’s early reproductive years. Nature’s drive to find a mate and reproduce is super strong. Over time, we tend to settle down, have children, lead busy lives and our children become our main priority, right? Our spouse or partner, who we know is going to be there at the end of the day, becomes our last priority as we raise our kids and/or try to succeed in our careers. Sex lives become stale, boring, and we succumb to you guessed it-Duty Sex.
What is duty sex?
Duty sex is the sex we have because our partner wants it and we do it to fulfill their needs, not ours. Is it rip-roaring, bed-banging, need you NOW sex? Not at all! It is hurry up and get it over with sex. Our partner has needs right? But what are we, as women, getting out of duty sex? Intimacy and closeness, maybe. Pleasure? Not so much. When it comes to our pleasure during sex play, we say, “oh don’t worry about me”, “you can get me next time” or “I don’t need an orgasm today”. So we skip it, and from our standpoint, the sex is not so great. Next time, we want to do it even less, and the sex is even less great. In fact, it is kind of bad, so we don’t want to have sex the next time and the next time and the next time. You get the point. Our drive tanks because in order to want to have sex, it has to be sex worth wanting!!
Boring sex isn’t the only thing that can lower your sex drive.
Low libido is almost never due to just one thing, like duty sex. When I see my patients, I do a complete and detailed history to uncover anything that might remotely be contributing to low drive. If we only see and treat one thing, drive isn’t going to improve because all of the contributing factors weren’t addressed. I ask about depression, anxiety, medicines, pain during sex, communication and relationship problems, body image, what your family taught you about sex, history of sexual trauma, partner sexual dysfunction like erectile dysfunction or premature ejaculation. (I know I am being heteronormative here, but the majority of my patients are in heterosexual relationships). The list is long.
But is there treatment or should I just give up?
YES! There is treatment. Don’t give up. Women may never get back to that same drive they had in their 20s but yes, they can “want” again. My general approach to treatment is to first educate women about what is normal. Many of us operate under certain assumptions about how sex should be, how we should be and how much sex we should want. What is normal for one relationship is different from what is normal for another. Second, we discuss how to mitigate all the contributing factors. For example, if the antidepressant someone is on is contributing to low libido, we discuss possibly changing it. If the relationship needs some help, maybe some counseling is in order. I generally recommend a good regimen of erotic reading if a patient is open to it. The idea behind erotic reading on a regular basis is to get those neurons in the brain that think sexual thoughts firing again and again and again. Those neurons may be out of shape, so to speak. So go ahead, pick up that smutty novel, and exercise your erotic brain.
There are medicines that are FDA approved to treat low drive in women like Addyi and Vyleesi. There are medicines that are not FDA approved for women, like testosterone, that have been shown in scientific studies to improve low sex drive in women. They work in a variety of ways. Each one has its own set of risks, benefits and side effects. One may work for one woman and not for her sister or best friend. None of them will give a woman the sex drive of a 15 year old boy reliably and usually not at all. But for a percentage of women they work! And a good sex sex life is important to a relationship and to overall well-being. Sexual harmony so to speak!
Stay tuned for my next blog with more information on medicines.
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click here to schedule.
Check out my website today for more information.
Or call 314 934 0551 to make your appointment today!
Why can't I climax anymore?
Menopause can wreak havoc on your sex life. Difficulty with or inability to reach orgasm is just one thing menopausal women face. Great news though there is a way to get back to your normal sexual self again!
Why can’t I climax anymore?
“I just have to work sooooo hard to reach orgasm nowadays”, said my patient. My husband thinks it is him and it’s not. “I just don’t know what is wrong with me”. I hear this from my menopausal patients day in and day out. They feel bad, they are worried something is wrong with them, it is causing concern in the relationship.
You can blame menopause.
Difficulty reaching orgasm or inability to orgasm is super common during menopause. During menopause your ovaries pretty much stop making estrogen and by this time they aren’t making much testosterone either. Both the vagina and the clitoris need these hormones to function normally. So, reaching orgasm requires a lot more work, for some women. Some women then decide to forgo that elusive orgasm (or they fake it). “oh, don’t worry about taking care of me” my patient says to her partner. “You can get me next time”.
The problem with this scenario is that for the woman, the sex isn’t always that great when she doesn’t get that pleasure release of orgasm. When a woman reaches orgasm, she gets a flood of dopamine in her brain. Dopamine is that feel good hormone, it is the one that is released if you do heroin or cocaine that keeps you coming back for more. (NO, don’t do heroin or cocaine). After orgasm, your body releases oxytocin, the cuddle hormone, that makes you want to curl up next to your partner. A good orgasm is an important part of good sex. When sex starts to become not so good, sex drive decreases too. In order to want to have sex, it has to be sex worth wanting.
We just don’t learn about this stuff!!
Did anyone tell you this was going to happen during menopause? Heck, no!! Women’s sexual pleasure is a bit hush in our culture. Well, it shouldn’t be. All women should know that there is treatment for difficulty with orgasm due to lack of necessary hormones. Low dose vaginal hormones can be used and these do NOT increase your risk of breast cancer, stroke, heart attack or blood clot. I repeat, no increased risk when used vaginally. Low dose vaginal hormones bring the healthy blood flow back to the vagina. They allow the vagina to make the cells that make moisture and they allow the vagina to be stretchy again, so sex is much less likely to hurt- another menopausal trouble, to be discussed in another blog.
I have to mention that there are a variety of other things that can affect a woman’s ability to orgasm and the list is long. If you are having trouble, see your doctor. No let me change that, see your sexual medicine doctor!
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed in Missouri, Tennessee and Illinois. Call today to schedule your appointment. (314) 934-0551 or Click here to schedule an appointment.. If you are not located in Missouri, Tennessee or Illinois, Dr. Lynn offers an E Health. Click here to learn more about E Health and meet with Dr. Lynn today!
Check out our website today for more information.
Imagine Concierge Care from Your Gynecologist
Concierge care is better quality care. Dr. Becky Lynn explains how she improves the patient physician relationship leading to better care leading to better outcomes and a happier you.
How to stop the long waits in the doctors office
Have you ever waited hours in the doctor’s office to see your doctor for all of 5 minutes? Has it taken a month to get your test results back? Or no one would call you back for days and when someone did, it wasn’t the doctor. All of these things will drive a patient crazy. Concierge care came out of frustration with the current system, where doctors carry a load of about 4000 patients and on average spend about 7 minutes with you. After a hello and how is the family, that is really only 5 minutes of medical care!
As a physician, this system really weighed on me. I realized that I didn’t really know my patients like I used to. I didn’t have time to call people back when they needed information and I didn’t have time to follow up on the tests I had run in a timely manner. Not good for patients! It wasn’t so great for doctors either. After a day of seeing as many patients as my hospital system could put on my schedule, I would go home and do charting all night.
I care deeply about my patients
I care deeply about my patients. So I am making the jump into concierge medicine. This means I limit the number of patients in my practice and charge a fee, either a membership fee or a fee for service. I don’t accept insurance. I can then spend time with my patients, taking care of all their needs in one visit. I can spend up to an hour or more with a patient. Unheard of! I can really get to know people, so I can take care of the whole person. I am so excited to go back to the patient physician relationship like it should be!
Can I afford Concierge Care?
If you think not everyone can afford concierge care, well, think again. I offer an affordable, monthly plan. Also, health savings accounts and flexible spending accounts can be used to pay for care. Or you can submit your visit to your insurance company for reimbursement unless you have medicaid or medicare.
Giving Back to the Community
On the second Tuesday of every month, I provide concierge care to anyone and everyone who needs me, free of charge. Or they can contribute whatever they can afford, because everyone deserves quality care. And 7 minutes with your doctor is, plain and simple, not quality.
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click here to schedule.
Check out my website today for more information.
Or call 314 934 0551 to make your appointment today!
Listen to my radio show
I talked about the benefits of concierge care with Michael Kelley and John Hancock on KMOX on December 27th. You can listen to it here: