“Where has my sex drive gone?”
“What are menopause and perimenopause?”
“I’m a grown-up. Why is my skin breaking out?”
Women tend to have lots of questions about their health — especially as they age. An all-female audience of more than 150 gathered at Sunningdale Country Club on Oct. 24 to have their concerns demystified. The event, “What the Heck Is Happening To My Body?!” was billed as a candid conversation with health experts for women entering their late 30s, 40s, 50s and 60s. Proceeds benefited White Plains Hospital.
Five respected panelists stood ready to answer questions: Preya Ananthakrishnan, M.D., a breast surgeon at White Plains Hospital; Athena Kaporis, M.D., a dermatologist with White Plains Hospital Physician Associates; Kay Lovig, M.D., who specializes in endocrinology, diabetes and metabolism at White Plains Hospital Physician Associates; Jacqueline Bavaro, M.D., an obstetrician and gynecologist with White Plains Hospital Physician Associates; and Melissa Ferrara, MS, FNP-BC, a nurse practitioner at Maze Women’s Sexual Health.
Organizer and moderator Dara Gruenberg reassured the audience that “none of us is alone in our questions — look around the room. There’s solidarity in numbers.”
With that, she began reading some of the 60-plus questions submitted anonymously by attendees. “I’m in my mid-40s and I feel like I’m going through puberty again. I’m moody, I’m breaking out, my period is all over the map… Why is this?” read one question card. Drs. Bavaro and Lovig jumped in, explaining the difference between menopause (having no period for a year) and perimenopause (the interval leading up to that year and a little bit thereafter, and all the hormonal changes that happen during that time, including irregular ovulation, hot flashes and moodiness).
“The arc is different with every person. Some people, their period just stops and they never have a symptom, and for some people it can go on for five years or so,” Bavaro said.
Lovig offered her own take on this time of life: “When you go through puberty, your endocrine system is getting your estrogen and progesterone and your brain is firing rapidly to get you into that cycle of your estrogen and progesterone … it’s a ramp-up and oftentimes you have many symptoms, or you see it in your children, because it’s a drastic change. Your body is going from one level to another and it takes a few years to go through. And as you approach the other end of the spectrum with menopause, as you become perimenopausal, similarly to puberty, your body doesn’t go from having that natural cycle to just stopping all of a sudden. It kind of starts to go through a natural, gradual decline until your ovaries are no longer firing that estrogen and progesterone and that’s when your periods will start to stop.
“I think similarly your body doesn’t understand what’s happening, that you’re losing this hormone, and it wreaks havoc on your brain and your body. Your brain is actually trying to yell to your ovaries to keep making estrogen and progesterone because it does not understand what’s happening, and so that’s kind of where a lot of those symptoms come from.”
Another question elicited sympathetic chuckles from the audience: “As I’ve gotten older, I’ve started to break out more, including butt acne. By the way, WTH? Why does this happen and what can I do to prevent it?” The answer, from Dr. Kaporis: “As you get older you sweat more, and maybe you’re working out to maintain your weight and feel healthier, and that can cause the butt acne, actually.” She suggested trying an over-the-counter acne wash containing benzoyl peroxide, and seeking medical treatment if it’s not enough. “It probably has to do with sweating and friction,” she said.
Many people asked how to prevent breast cancer, and Dr. Ananthakrishnan responded. “There’s really no magic,” she admitted. “It’s really just eating well — there’s no one specific diet that’s better than another diet. We talk about eating food in its natural form more … staying away from fried foods and fatty foods, and as far as alcohol goes, limiting alcohol by staying under four to seven drinks a week.”
Ananthakrishnan also stressed the importance of taking vitamin D if needed: “You only get it from being out in the sun,” she explained. “You can’t really get it from food, so most people are vitamin D deficient. Your primary care doctor can check your vitamin D levels.” Regular exercise is a must as well, she added, citing the American Cancer Society’s recommendation of 40 minutes of exercise three times a week. “So all these things are basic things that keep you healthy; they help you as you age and they also decrease breast cancer risk,” she concluded.
Shifting gears, moderator Gruenberg moved on to a painfully honest question submitted anonymously: “The only way I can convince myself to have sex with my husband is that it is good exercise,” she read, eliciting laughter from the crowd. “I have no libido and it upsets me greatly. What can I do?”
Nurse practitioner Ferrara explained that as women age, their levels of estrogen, progesterone and testosterone drop. In fact, testosterone, which is seen as the primary force behind libido and desire, decreases by roughly half between a woman’s 20s and her mid-40s. “Here we are, with this question, it’s like, ‘I know it’s good for me, I know it’s good for my relationship, I know I need to be having sex,’” Ferrara said. “What you say is ‘I can get myself to do it because I can convince myself enough that it’s important,’ and that’s true and that’s really great. But at some point it’s sometimes not enough. And that’s where medical intervention can sometimes be helpful.”
A live audience Q&,A followed the presentation, with questions on topics including vitamins, laser vaginal rejuvenation and the use of Retin-A for wrinkles. The hour ended all too quickly, yet much ground had been covered. It was a good conversation, benefiting a great cause.