Shmirshky

by E

  14 TSH stands for thyroid stimulating hormone. An imbalance in your TSH levels is one of the main indicators of a thyroid condition.

  15 Hashimoto’s disease is also called chronic lymphocytic thyroiditis. The immune system attacks the thyroid gland, which causes inflammation and leads to an underactive thyroid (hypothyroidism).

  16 An endocrinologist is a medical expert specializing in the diseases of the endocrine system (glands and hormones). Thank God for these doctors!

  17 Ultrasound uses high-frequency sound waves to take pictures of the internal systems of the body. There is no exposure to radiation. You don’t feel a thing!

  18 Some shmirshkies find that they do have thyroid cancer, but in many cases it’s a very treatable cancer.

  19 Yep, Maria was a hyper (not a hypo, like me). This means she had an overactive thyroid, which is usually caused by the autoimmune illness called Grave’s disease.

  20 I love my Gay Husbands! This is someone who not only gives you all the love and support of a husband but also enjoys shopping and getting mani-pedis, and knows how to throw a fabulous party.

  21 Who says there can’t be a sexy story in a menopause book?

  22 There are so many books to choose from, and new ones arrive on the market all the time. Sift through the options and find the books that work for you.

  23 HRT is short for hormone replacement therapy. The term HRT is pretty misleading, as no one fully “replaces” all of her hormones. Also called HT (hormone therapy or hormone treatment).

  24 A Pap smear is an examination of cells scraped from the cervix. This sampling is then examined under a microscope by a pathologist to determine if any of the cells are cancerous or precancerous.

  25 A mammogram is an X-ray picture of the breasts. It is used to find tumors and to help tell the difference between noncancerous (benign) and cancerous (malignant) disease. You younger shmirshkies have the wonderful mammogram in your future! Be sure to take advantage of this test! It has caught many precancers and reduced the number of breast cancers in this country. If you can, find a place that has digital mammography, especially if you have dense (bumpy/lumpy) breasts.

  26 You might find that you don’t need all of the tests I’ve listed or that you might need a few tests that aren’t included in this list. More is not necessarily merrier when it comes to medical testing. It’s more important to get accurate results for the tests you need. Always be conscious of false positives and ask your doctor about the accuracy of each test. It is so important to have a clear and accurate diagnosis before you begin any medical treatment.

  27 The suggested normal ranges listed here are for shmirshkies of all ages, except when otherwise specified. These ranges can change from year to year. There are always new advances and discoveries that result in new tests and different standards. There is no one concrete source for suggested number ranges. Different labs, hospitals, and doctors often have different suggested ranges. Be sure to consult with your doctor in order to home in on what range is best for you. All of these ranges and definitions are from the MedlinePlus Medical Encyclopedia, retrieved on October 9, 2010, from http://www.nlm.nih.gov/medlineplus/encyclopedia.html, unless otherwise noted here or in Additional Notes. For more detailed sources, see the corresponding Shmirshky Not-So-Fun Terms on page 136.

  28 Osteoporosis is a medical condition in which the bones become brittle, typically as a result of a hormonal deficiency or reduced calcium or vitamin D levels.

  29 Estrogen is the primary female hormone. Estrogen is responsible for the development and maintenance of female reproductive structures.

  30 T-scores between -1 and -2.5 generally indicate the beginnings of bone loss, also known as osteopenia. T-scores at or below -2.5 typically indicate osteoporosis.

  31 The normal value range for CA-125 varies slightly among different laboratories. Unfortunately, this test can result in false positive results. Be sure to talk with your doctor about the pros and cons of this test.

  32 The suggested ranges for Total cholesterol, HDL, LDL, and Triglycerides are from the American Heart Association. The suggested range for Cholesterol/HDL is from Lab Tests Online.

  33 The FSH suggested ranges are from LabCorp.com. Please make sure you check with your doctor and blood lab about the suggested ranges for your FSH test, as each lab tends to use a different range.

  34 You see, shmirshkies are always getting ready for something! Progesterone is like a hair and makeup person for your uterus: hustling to get you ready for the big event of pregnancy. In fact, the entire menstrual cycle is like getting ready for a ball that you rarely attend. You put on all your makeup, put your hair up all snazzy, and squeeze into a fancy dress. Then once you’re ready to go, you decide, “Nah, let’s just order in.”

  35 T3 and T4 are thyroid hormones that get released into the bloodstream and control the body’s metabolism.

  36 There is a great deal of discrepancy in the medical world regarding the suggested ranges for T3, T4, and TSH. There are many different institutions and doctors with varying opinions. The science seems to be ever evolving. My doctors recommended these ranges to me, but please do not take these ranges as gospel. Be sure to consult with your doctor to determine what range is most appropriate for your body.

  37 Depending on how you feel and your particular medical situation, your endocrinologist may want to keep your TSH lower than 3. Everyone is a little different. I happen to function best when mine is below 1.

  38 The suggested range for Vitamin D3 is from the American Academy of Orthopedic Surgeons.

  39 Hormone replacement therapy; also called HT (hormone therapy or hormone treatment).

  40 The most common bioidentical hormones prescribed for PM&M shmirshkies are estradiol, estrone, estriol, progesterone, and testosterone.

  41 Don’t be fooled by a hormone with two names. Even if one of those names is the name of your body’s hormone, the presence of another name should tip you off that you are NOT dealing with a bioidentical hormone. For example, estradiol is bioidentical, but ethinyl estradiol is NOT.

  42 Defining the terms natural hormone and synthetic hormone can be complicated and confusing. Many different Web sites, books, and journals use conflicting definitions for these terms. For the purposes of this book, I am using very simple and technical definitions as recommended by my doctors. Please note that some experts and resources might use different definitions for these terms, but I am choosing to define them in a way that I believe is the most technically accurate, the least confusing, and the most helpful.

  43 If this doesn’t make total sense the first time around, don’t feel bad. It took me years to fully understand what all this stuff means. Try reading the last few paragraphs again, this time slower and without grinding your teeth! If you’re still confused, just go to shmirshky.com or e-mail me at e@shmirshky.com and I’ll walk you through it!

  44 Keep in mind that there are many schools of thought on this, and it is up to you to educate yourself and draw your own conclusions about what is best for your body.

  45 The Women’s Health Initiative was created by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health under the U.S. Department of Health and Human Services. The WHI conducted a series of clinical trials and observational studies on postmenopausal shmirshkies.

  46 The Food and Drug Administration is a federal agency that oversees the safety regulations of most types of food, supplements, drugs, vaccines, and medical products.

  47 Whooaaaaa, horsie! Horses are such huge animals. I already feel so big; I don’t need any help in that department. Horses are beautiful, don’t get me wrong, but couldn’t we get urine from something petite and lithe... like a Cover Girl model?

  48 Progesterone gets the uterus ready for pregnancy and the breasts ready for milk production. After ovulation, progesterone helps make the uterus ready for implantation of a fertilized egg. Remember, shmirshkies are always getting ready for something! When your ovaries stop produ
cing progesterone and estrogen, you’re in M, and you don’t have to get ready for the pregnancy party that you usually don’t end up going to each month.

  49 Estradiol is the most important form of estrogen produced in the body.

  50 Estrone is one of the three most common types of estrogen secreted by the ovaries.

  51 Estriol is the weakest of the three main types of estrogen.

  52 Women’s Health Initiative.

  53 Estrogen dominance refers to the situation in which there is too much estrogen relative to the amount of progesterone in a woman’s body. When estrogen dominates, there is a greater risk of heavy menstrual bleeding and other symptoms.

  54 Hot shmirshky!

  55 Lesbian shmirshkies know all about this. Double the shmirshkies, double the PM&M!

  56 Synthroid is one of the medications commonly used to treat hypothyroidism.

  57 A colonoscopy is an examination of the large colon and part of the small bowel with a curious little camera they stick up shmirshky and erlick’s next-door neighbor. Is this more fun than a Pap smear? Have one of each and then decide.

  58 A hysterectomy is an operation in which the uterus is removed.

  59 Estrogen dominance occurs when there’s too much estrogen relative to progesterone in a shmirshky’s body. Heavy bleeding and sometimes even cancer can result from this.

  60 Incontinence refers to the loss of bladder control. For shmirshkies, this can mean anything from mild drips to full-on floods.

  61 Endometriosis occurs when tissues that behave just like the cells that line a shmirshky’s uterus grow in other areas of the body (usually in the pelvic area, outside the uterus, on the ovaries, bowel, rectum, or bladder).

  62 In Darby’s case, her cells were behaving abnormally and could possibly have turned cancerous. Unfortunately, when cells behave badly, you can’t just put them in “time out”; sometimes they need to be removed all together.

  63 Acupuncture is a practice developed in China of inserting fine needles through the skin at specific points to cure disease or relieve pain.

  64 You can find information on each state’s licensing board at http://www.acupuncture.com/statelaws/statelaw.htm.

  65 I dished out $80 for this fabulous experience, but costs will vary depending on the practitioner and length of the session. Be sure to check with your insurance providers, as many carriers cover acupuncture these days.

  66 Type A people are known for their impatience, aggressiveness, and competitiveness. Who, me? Type B folks, by contrast, are known for having a lack of aggressiveness and tension. Sounds glorious!

  67 Aerobic exercise releases endorphins, which make us feel good—even euphoric. I love these endorphins; they are really something! As it turns out, exercise is just as important for your mental and emotional health as it is for your physical health. It can help ward off depression, increase your daily energy, and help you sleep better.

  68 Hormone replacement therapy; also called HT (hormone therapy or hormone treatment).

  69 Women’s Health Initiative

  70 Shmirshky Board

  71 Shmirshky Board

  72 All Web sites in the Shmirshky Not-So-Fun Terms support both the definitions listed in this section as well as the matching definitions in the text and footnotes of the book and were retrieved on October 9, 2010, unless otherwise specified.

  73 Unfortunately, the technical definitions of premature menopause, premenopause, perimenopause, menopause, and postmenopause rarely do justice to the actual PM&M experience. The process takes years and years to go through, and each shmirshky has different symptoms and stories. After reading this book—and living through PM&M—you can write your own definitions!

  74 Compounding pharmacies create medication formulas, specifically designed for a particular individual’s needs.

  75 Information for this section was gathered from http://www.pdr.net and through the help of my pharmacist and doctors. These hormone therapy options were all available as of September 1, 2010. As you know, many new drugs come on the market each day, and some get taken off. Since I am not a doctor, I can’t recommend or suggest any of these drugs. If you choose to try hormone therapy, it is critical to find the right doctor to be your partner and help you make the right choices.

  I’ve indicated which of these hormone therapy options are bioidentical or not for quick and easy reference, but this should by no means be the only factor you consider when going on hormone therapy. If your doctor prescribes HRT, discuss all the different options and learn as much as you can about the medicine that he or she suggests so that you are comfortable with what you put into your body.

  For the purposes of this chart, hormone therapy options that contain a bioidentical hormone as well as a nonbioidentical hormone all wrapped up into the same medicine are classified as nonbioidentical, since you can’t separate the bioidentical hormone from the nonbioidentical hormone before the medicine is administered.

  76 Progestin is a nonbioidentical form of HRT intended to supplement low levels of progesterone in the body.