COMING SOON: Archives of the Vagina: A Journey through Time

by Dr. Margaret Aranda

For my Caring Friends, here's a preview of my newest book, written before the doctor dropped me on the floor in March, 2013. I wrote this book (many of you will understand) because I'm not sure if I'll live long enough to see my daughter live through all the stages of womanhood: the maiden, the mother, and the crone.

                                   Book Cover Photo. Archives of the Vagina: A Journey through Time.

The book starts with my first period, and is very tongue-in-cheek humorous, because we all know where we were when we started our first period. Then I go through history, sociology, anatomy, and the endocrinology of the ovaries.

I discuss what Aristotle thought of menstruation and menopause, how William T. Stead is a hero we never hear about for rescuing children out of prostitution in London's brothels. This book is filled with the sociology of menstruation, including whether women on their periods can fly a plane, and whether women who are camping on their periods attract bear attacks that lead to death.

One of the most surprising statistics that I learned in my research and interviews of women is that in the USA, in women over 45 years old, 40% have had a hysterectomy. Of these, nearly 50% have had normal ovaries removed without proper Informed Consent. I dedicate an entire chapter to "Ovarian Conservation" (i.e., keeping your ovaries), and give you all the risk factors you need to know so you can put yourself on the Chart to see if you are at risk for ovarian cancer, and hence should get them removed. So my next book will be Hysterectomy can be Hell. I hope to get an Army behind me on this one, because it will take a Movement to change our culture. And changing a culture always means that people won't like you. Believe me. I've been there before.

I discuss the HPV vaccination for girls aged 11-12, starting your period, how to put in a tampon, and introduce what most women don't know: the menstrual cup, and the nondisposable pad. I promote a certain program that helps girls in Africa obtain menstrual pads so they don't have to miss school, be drop-outs, get pregnant, contract HIV, attain a lower socioeconomic status, and die earlier than the girls that are more educated. So expect a Movement there, too, ladies and girls.

I go through the Women's Health Initiative and basically tear it to shreds, because it had, in my opinion, no application to women in menopause suffering symptoms of vaginal dryness and hot flashes. I let you skip a very medical chapter if you would like, but I also put it in there for medical personnel to evaluate it for themselves. I dissect menopause and give the man's perspective, too, hopefully leading men to more self-discovery and compassionate understanding. Pretty funny stories there, too, my friend.

The last half of the book is dedicated to such things as Invisible Diseases, the Low Glycemic Diet, Immunonutrition and Fish Oil, Telemeres, Living for not only Health & Wellness but also for Quality of Life, Caregiving (and the effects on women, by ethnicity), Long-Term care, and death and dying. I empower you to ask questions, eat Spoon by Spoon, and Don't Fall when you are elderly. I tired of seeing women come into the Operating Room for hip fractures from a fall. You need to know your bone density, and take your Vitamin D or Calcium. The role of an Endocrinologist in your care can not be underestimated. I also believe that Cenegenics has an excellent program for Concierge Medicine, private pay by cash, that is mostly utilized by Presidents and CEOs of companies. They are mostly men. This needs to change, because there are plenty of millionaire women out there. And women need to stop spending all their time nurturing others, and start spending some time nurturing themselves. So I took all this knowledge in my head and told it to you before my traumatic brain injury and DI occurred; and I thank God that I did it.

There. I said it. My opinion rings throughout this book, and it is backed up by over 200 Stanford-quality references that are NIH-funded. I list them all for you, and many of them are dated in 2012 and 2013. Nothing but the best for you, my friends. Nothing but the best. Be prepared to learn, to grow, and to  ROCK your WORLD. You can PRE-ORDER the book (February launch date perhaps) on The Aranda MD Shoppe. My official site is Coming Soon....and I hope you like it. 

God Bless You in all that you do.

MENOPAUSE

In 2000, the average American woman went into menopause at 51.4 years of age. Menopause is a diagnosis of retrospect. By definition, we don’t know we had it or were in it, until it’s been officially one whole year without a period. Until then, we may have hot flashes, difficulty sleeping, insomnia, depression, mood swings, and well, just hormone fluctuations that wreak a little havoc on our bodies. And we didn’t know it was menopause, unless we guess or someone tells us about it.

At Medi-Baskets™, we put together some items for you. These are items that we wish we would have had when we were going through “the change”. We have educational information, websites you can visit, books you can buy, and most importantly, we have items you may use. Items that you can peruse in the privacy of your own home, items that are there when you need them.

Cold packs can be placed over arteries to cool down the body. They can go under the arms or on the carotid arteries of the neck for a quick ‘cool down’. This will undoubtedly alleviate some distraction and bring back that charming, sexy voice you used to have. That you still have inside you. That womanly and sweet voice that sets the tone for the entire home, the car, and trips that you take. You make a difference.

Surgical Menopause seems to be predominant in our culture, and a Second Opinion is not always sought. I believe in Second Opinions on a hysterectomy, because in America, 40% of women over age 45 have had their uterus taken out (i.e., hysterectomy). And the concept and science of Ovarian Conservation is one that is not new.  If you keep your normal ovaries at the time of hysterectomy (assuming you had a 2^nd opinion and normal ovaries without any risk factors), disruption of their blood supply may occur at the time of the hysterectomy anyway, causing you to experience menopausal symptoms.

Symptoms of menopause include hot flashes, vaginal atrophy, night sweats, memory loss, cognitive dysfunction, irritability, mood swings, insomnia, depression, and more. Treatments are available for every symptom, and I know that if you could simply get a good night of sleep, you would feel better. Hormone replacement therapy (HRT) is now freely given to many peri-menopausal women who have few risk factors for endometrial (uterus) or breast cancer. So HRT is an individual decision that a woman makes with her doctor. And plenty of newer studies show that estrogen can save you from dying from a heart attack (#1 killer in America, with 1/4 deaths from heart disease), and progesterone can actually decrease your chance of breast cancer. So learn about it so you can have alternatives to improve your Quality of Life (QoL).

So don’t expect to be the same after a hysterectomy, or after your period stops. Expect changes, especially some tied to your womb, which represents womanhood and fertility. Many women suffer psychologic damage that they didn’t realize they would have, because either they feel they did not receive Informed Consent, or they were told their ovaries would be spared, but instead were taken out. So be careful here. You will require general anesthesia and all the risks that go with that (i.e., sore throat, cracked tooth, lip cuts, heart attack, stroke, aspiration of stomach contents into the lungs, aspiration pneumonia, and death). My opinion is that if it’s not cancerous, don’t take it out. There are plenty of alternatives to menstrual bleeding, cramps, fibromas, and endometriosis.

In my Women’s Health Book that is now being published, I give you and your daughter and your mother, and your sisters, plenty of information (and stories) of being a female. As we look at spending 1/3 of our lives in Menopause, we have to get good at this, right? We have to live with it as best as we can. We can do this.

We bring you unique and personal gifts via Medi-Basket(TM), to help you during this time. And we urge you to consider that there are millions of women worldwide that are going through this with you. And men, too.  We can't forget the men. Andropause needs to be recognized and our guys need to continue to be our best friends. They need us, and we need them. And we are

Women helping women.  We can get good at this.

Medical Disclaimer:  Not intended as medical advice, treatment, or cure. Patients need to be seen by a physician in person, in order to receive an appropriate assessment. Otherwise, generalizations only are made, and are not meant to apply to any one individual. Call 911 in case of Emergency.

REFERENCES:

1. http://aje.oxfordjournals.org/content/153/9/865.long
2. http://www.ncbi.nlm.nih.gov/pubmed/19384117
3. http://www.ourbodiesourselves.org/book/companion.asp?id=26&compID=131
4. http://www.ncbi.nlm.nih.gov/pubmed/12737673

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The History of Menopause

On his Treatise on the History of Animals, Aristotle wrote that menopause occurred in

the fortieth year, but some childbearing up to the fifties was not uncommon.  There is a paucity of writings on menopause in the Greek literature, perhaps because fewer women lived to be of a postmenopausal age. 

The ancient Greeks attributed an “imbalance of humors” to various conditions. Today, we would call it an “imbalance of hormones”.  One of those conditions was the state of infertility due to an inability of an aging woman to have a baby.

The international, social, and biological deficiency state of “imbalance of humors” placed a certain taboo on women worldwide.  Women sought to restore the imbalance, and some of their means were bold.  They placed leeches on their legs, so that the blood-sucking bugs would get rid of the excess blood and create balance. In India, testicular juice was a remedy.  In North America and China, wild yam was used.  There are other extreme measures that women undertook to try to either bring back their periods or alleviate symptoms (see Table).  But these experiments of concoctions proved useful when in the 1950's, the root of the wild yam was harvested for its diosgenin, which is a phytoestrogen. A phytoestrogen is a plant with a hormone that is structurally similar to estrogen.  In the 1960's, based on this chemical conversion of a phytoestrogen to an estrogen, this is how the first birth control was originally formulated.

Early Treatments of Menopause	Time Period	Reference
Can be treated with black cohosh, (Cimifuga racemosa), a natural precursor to estrogen	1700’s	eHow 2012
Can be treated with wild yam, Dioscoria villosa	1800’s	Buchanan 2012
Can be treated with testicular juice	1930’s	Singh et al, 2002
Can be treated with crushed ovaries of animals	1930’s	Singh et al, 2002
Devil had a covenant with the woman	Old pagan and religious belief	Body Logic, 2012
‘Usual mixture’ before meals: carbonated soda, opium, vaginal injections of lead acetate, morphine hydrochlorate, distilled water, chloric ether	1855	Foxcroft 2009
Ovarian extracts used to relieve vasomotor symptoms	1897	Speroff, 1999
Herbals, belladonna, cannabis, or opium	1899	Merck
“Ovarlin” flavored powder, dessicated and pulverized cow ovaries	1899	Merck
Women were insane, giving ‘insane interpretations’ of their symptoms.	1903	Savage 1903

 Table.  Descriptions of the early beliefs of menopause through time.  Menopause carries with it a vivid history of remedies to alleviate the 'insanity' of it all.  Today, some hold that hormone imbalance is best treated with bioidentical hormone replacement therapy.

The Ancient Egyptians are credited with the concoction of elixirs that were used for anti-aging purposes (Utian, WH.,  2008).

Trotula of Salerno, who may have been a female physician, wrote in the 13^th Century writing of women in medieval Europe, The Diseases of Women:

 “Since in women not so much heat abounds that is suffices to use up the moistures which daily collect in them, their weakness cannot endure so much exertion as to be able to put forth that moisture to the outside air as in the case of men.

Nature herself, on account of this deficiency, has assigned for them a special purgation namely the menses, commonly called flowers.  Now a purgation of this sort usually befalls women about the 13^th or 14^th year or a little later according to whether heat or cold abounds in them more.  It lasts up to about the 50^th year if she is lean; sometimes up to the 60^th or 65^th year if she is moist; in the moderately fat up to about the 45^th.” 

In 1821, the term ‘menopause’ was coined by Dr. Charles Négrier (1792 – 1862).  It is derived from the Greek; month is ‘men’, and pause is ‘pausis’. 

In the 1800’s, there was much medical interest in menopause, but not the way that you would think.  The average of menopause in England was 45. Consider that you went into menopause in the 1800’s, complaining of depression, hot flashes, and irregular periods.  Doctors were quick to diagnoses these women with “hysteria”, a major term that literally referred to the uterus in Latin.  The Greek 'hysterus' means ‘womb’, and thus the uterus literally caused ‘hysteria’. The uterus was thought to be the organ responsible for physical problems that led to neuroses.

During this time period, it was not uncommon for wives and daughters to be committed to an insane asylum for reasons of “lunacy”.  Women were even “put away” for gong through menopause.  Husbands would put them away, divorce them, then marry a much younger woman.  No one was allowed to visit the woman in the insane asylum, and they were locked up until they died.  Many times, the husbands would simply say that the woman had died.  Women in this situation were subjected to conditions of poor heating, substandard food, unsanitary and unclean conditions, and communicable diseases spread widely in this environment, which sometimes was adjacent to or part of a prison system (Sansone 2012).

In the 1850’s, Edward Tilt, MD determined that “the keystone of mental pathology” was the uterus.  

By 1870, the surgical procedure of hysterectomy was perfected as a quick method to deal with menopausal complaints.  Surgeons took out not only the uterus, but also the ovaries and the cervix.  

It seems that the hysterectomy is still an ultimate alternative to menopause.  Is this a good thing?  In a 2004 study, it was found that Counseling and a Second Opinion physician determined that 98% of hysterectomies were not needed.  Couple that with a 2010 study that estimated that about 500,000 hysterectomies are performed per year in the USA, such that 40% of all women over age 45 do not have a uterus.  How many of these women are offered or are placed on hormone replacement therapy?  

Should postmenopausal women, including those with Surgical Menopause, take hormones?  For many practicing physicians, this is no longer a professional 'debate', it is a public debate that began with the Women's Health Initiative in 1992.   Today, the issues are clear, as the treatment is individualized.  Stay tuned for more.

As 2013 nears, it is important to understand that menopause is still a taboo subject for many women, in many cultures, and throughout the world.  Women are embarrassed to talk about it, and some clam up when the doctor starts asking questions.  Only after effective rapport is established will some women discuss the subject so that symptoms, time increments, and a proper Medical History can be reported.  Women need to speak freely about the matter, so that the medical field can determine the problem, and work towards a solution for each individual woman.  What is it all about?  Quality of life.  It's a Quality of Life issue.

References:

Body Logic MD. The History of Menopause, 2012. http://www.bodylogicmd.com/hormone-articles/the-history-of-menopause

Buchanan, Paul A.  Wild yam restores sex drive during menopause.  Ezine Articles, 2012. http://ezinearticles.com/?Wild-Yam-Restores-Sex-Drive-During-Menopause&id=7099288

eHow.  How to naturally treat hot flashes and menopausal symptoms, 2012. http://ezinearticles.com/?Wild-Yam-Restores-Sex-Drive-During-Menopause&id=7099288

Foxcroft, L. The mad, mad menopause: Louise Foxcroft charts its fascinating, and sometimes gruesome, history.  April 9, 2009.  http://www.dailymail.co.uk/femail/article-1168710/The-mad-mad-menopause-LOUISE-FOXCROFT-charts-fascinating-gruesome-history-.html#comments

Merck Manual: Diagnosis & Therapy.  New York:  Merck and Co., 1899.

Savage George.  A Lecture on the mental disorders of the climacteric.  The Lancet, 1903.

Singh A., et al.  A historical perspective on menopause and menopausal age.  Bull Indian Inst Hist Med Hyderabad 2002 Jul-Dec; 32(2):121-35.

Speroff L.  Clinical Gynecologic endocrinology and infertility.  6^th Edition. Baltimore, MD: Williams and Wilkins; 1999.

Utian WH, et al.  Effect of raloxifine on quality of life: a prospective study using the Utian Quality of Life (UQOL) scale.  Menopause 2004 Jay-Jun:11(3):275-80.

http://www.ncbi.nlm.nih.gov/pubmed/15167306

From Menarche through Menopause: A Journey through Time

AUTHOR'S NAME: Dr. Margaret Aranda

TITLE OF MANUSCRIPT: From Menses to Menarche: A Journey through Time

GENRE: Adult Non-Fiction

WORD COUNT: 120.000

Query:  

Femininity is equated with passages through the pagan symbolism of the Three Goddesses:  The Maiden, The Mother, and The Crone.   At Menarche, we had our First Talk.  At Motherhood, we didn't really need a formal 'talk'; it just happened over the course of months and years.  At Menopause, we had...we had our...we had our well, nothing.  We never had The Second Talk.  So many of us Baby Boomers are peri-menopausal, and what is a woman to do?  First, estrogens cause uterine cancer and breast cancer, then progesterone makes it better.  And what about testosterone for women?  

From Menses to Menopause starts with menstruation; its history, culture, and conceptions since the time of Aristotle.   Then it accompanies today's Spirited, Fit and Forty Woman's speedy life, fast-forwarded to the here and now.  Let's give you that Second Talk, ripe for today.  You do remember where you were when you started your first period, don't you?  You do remember who gave you The First Talk.  Well, sit right down and get your Mother in this room.  Her journey through The Second Talk is about to begin.

First 150 Words:

My "First Talk" wasn't actually a "talk" talk.  I was 13 years old, and my Mother handed me a red hardcover book.  The Red Book.  I was told to turn to say, the seventh Chapter.  Okay, basic Anatomy.  The vagina was depicted in a large color illustration of the uterus and Fallopian tubes, and there was a small illustration of the penis. 

No preamble, no introduction, no warning.  Initially it was pretty boring.  A couple was sitting on the couch.  A married couple.  They made a big deal about that part.  Horrified, my eyes widened as the penis was inserted into the vagina.  What?  I had to read it over again.  How did that happen so fast?  What?  How did that happen so fast?  How could that happen with their clothes on?  I read it again.  They definitely still had their clothes on.