December 13, 2017

Marla Ahlgrimm | Hot Flashes – What You Should Know

Marla Ahlgrimm

Marla Ahlgrimm

Women in perimenopause should eat well and get enough sleep, says pharmacist Marla Ahlgrimm, but there are several other ways to head off hot flashes before you feel the heat. Here, Marla Ahlgrimm, the pharmacist who taught the world about PMS in the 1970s, answers questions about hot flashes, flushes, and fending them off.

Q. What is a hot flash?

Marla Ahlgrimm, R.Ph.: It’s a temporary feeling of heat all over the body. It may be accompanied by sweating and facial flushing.

Q. How long do they last?

Marla Ahlgrimm, R.Ph.: Some women have hot flashes from before menopause that last forever. However, some women may never experience them.

Q. What causes hot flashes?

Marla Ahlgrimm, R.Ph.: Doctors do not completely understand what causes them but many speculate that it has something to do with hormonal changes and their effects on the hypothalamus.

Q. Do hot flashes happen during the day or at night?

Marla Ahlgrimm, R.Ph.: Both, in fact, some women report only experiencing hot flashes at night while others have them spontaneously around the clock.

Q. What causes flushing?

Marla Ahlgrimm, R.Ph.: Blood vessels in the skin dilating to help the body cool.

Q. How can I avoid hot flashes altogether?

Marla Ahlgrimm, R.Ph.: There is no guaranteed way to prevent hot flashes.

Q. Can stress trigger a hot flash?

Marla Ahlgrimm, R.Ph.: It definitely can; many women report having more frequent occurrences during times of elevated stress.

Q. Can I still drink coffee, tea, and other hot beverages while fighting hot flashes?

Marla Ahlgrimm, R.Ph.: Yes, but be aware that the heat from the liquid could be a trigger. As well, caffeine and other stimulants, including alcohol, may aggravate your symptoms.

Q. How should I dress to reduce the warmth of a hot flash?

Marla Ahlgrimm, R.Ph.: Layers are a must for women experiencing frequent flashes and cotton is highly recommended.

Q. What about night sweats? How can I combat these when they often interrupt my sleep?

Marla Ahlgrimm, R.Ph.: Use a lighter blanket and remove any mattress covers or feather tops from your bed and run a fan to keep cool air circulating throughout the night.

Q. Is exercise causing my hot flashes?

Marla Ahlgrimm, R.Ph.: Not likely as keeping active is known to help lower the severity of hot flashes in most women.

Q. What about hormone replacement therapy?

Marla Ahlgrimm, R.Ph.: A short-term course of HRT may help reduce or eliminate hot flashes and many other symptoms of menopause. Consult with your physician for more information.

Q. Do the foods I eat affect my tendency to experience hot flashes?

Marla Ahlgrimm, R.Ph.: Yes, they can, and certain foods, such as Indian, Tai, and Mexican cuisine, should be consumed in moderation during peak flash times.

Q. I’ve heard that there are botanical treatments for hot flashes and other menopause symptoms. Is that true?

Marla Ahlgrimm, R.Ph.: There are a number of plant based supplements including Evening Primrose Oil, black cohosh, and Dong quai but these should only be considered after medical consultation.

Q. Is estrogen still used in HRT therapy?

Marla Ahlgrimm, R.Ph.:  Yes, natural estrogen is still the most common hormone therapy for severe or disruptive hot flashes.

Q. What about hydration; do I need to drink more water during menopause/perimenopause?

Marla Ahlgrimm, R.Ph.: Yes, it can be helpful since the body needs water to regulate.

Q. Should I alter my outdoor activities during this time?

Marla Ahlgrimm, R.Ph.: You should avoid strenuous activities if you have been having hot flashes. As well, you should limit your time in the sun and shy away from the hot tub and sauna.

Q. What’s the best way to reduce the effect of hot flashes on my daily life?

Marla Ahlgrimm, R.Ph.: Stay as healthy as possible. If you eat the right foods, get ample sleep, and exercise regularly, your hot flashes should be less intense. Plus, you’ll feel better overall.

 

For more information about Marla Ahlgrimm including links to published works and current blog entries, visit her personal website at marlaahlgrimm.com. Marla Ahlgrimm is a registered pharmacist and member of the Pharmacy Society of Wisconsin, the Langer Society of the Arts, and the UW School of Pharmacy Board of Visitors.  A renowned public speaker, Marla Ahlgrimm has been a featured presenter at TEMPO, the Women’s Sexual Health Physician Symposium, and the Washington Business Group of Health, among others. In addition to her civic and professional associations, Marla Ahlgrimm is the author of The HRT Solution – Optimizing Your Hormone Potential and Self-Help for Premenstrual Syndrome. 

Personal Case Prompts Pharmacist to Start Madison Pharmacy Associates

Madison Pharmacy Associates

Madison Pharmacy Associates

While working at a local Madison pharmacy in the late 70s, Marla Ahlgrimm and one of her pharmacist colleagues identified a syndrome of symptoms that affected several of their female patients severely.  These symptoms occurred regularly, every month from day 14 or ovulation, to  day 28 or the onset of menstruation. At the time, there was no known cause or treatment options  to successfully manage these symptoms. Although Ahlgrimm would eventually identify the symptoms as premenstrual syndrome (PMS), it would still be years before the term “PMS” became widely used in the United States. In the meantime, Marla Ahlgrimm co-founded Madison Pharmacy Associates in 1982, a Madison, Wisconsin based practice where they counseled women on health issues and dispensed customized, natural hormone prescriptions for women.

Madison Pharmacy Associates was the first pharmacy in America to identify and develop treatment options for premenstrual syndrome in the U.S., which is estimated to affect more than 40% of all women between the ages of 14 and 50. With over 150 symptoms reported, PMS includes irritability, anxiety, crying for no reason, cravings for sweets, fluid retention, headaches, depression, and fatigue. Using natural progesterone therapy, Madison Pharmacy Associates was able to help many patients and their doctors manage symptoms without the use of tranquilizers or antidepressants. Progesterone is the most commonly prescribed medication for PMS, according to Madison Pharmacy Associates’ Ahlgrimm. Madison Pharmacy Associates dispensed progesterone in capsule, tablet, suppository, and transdermal cream dosages, individually compounded for each patient.

In addition to customized hormone therapy, the expert staff at Madison Pharmacy Associates counseled patients on self care options including diet, exercise changes and the use of specific nutritional supplements that can make a difference in managing PMS. “65% of patients were able to manage severe symptoms with self care alone, without the need for prescription therapy” Madison Pharmacy Associates co-founder Marla Ahlgrimm says.

Madison Pharmacy Associates provided prescriptions to PMS sufferers throughout the country. Madison Pharmacy Associates offered toll-free 800 lines to field women’s health questions and help them find knowledgeable doctors to work with.

Madison Pharmacy Associates also provided PMS  information and education to any women who called. “It created anonymity, which helps when you’re talking about the menstrual cycle or personal symptoms,” Madison Pharmacy Associates’ Ahlgrimm says.

Madison Pharmacy Associates grew from its original 700-square-foot pharmacy to 17,000 over 30 years but the mission of its co-founder to always put patients first remained the same. Over the years, Madison Pharmacy Associates has helped more than 300,000 women with symptoms related to premenstrual syndrome, perimenopause, and menopause.

The information in this article has been previously published and is provided as a reference resource by Marla Ahlgrimm, R.Ph. The businesses referenced above were sold in 2011. Marla Ahlgrimm is also the co-founder and President of Cyclin Pharmaceuticals, Inc. The company sells proprietary products for the women’s health market as well as ProCycle PMS and ProCycle Gold products. For more information, go online to www.cyclinpharma.com

Pharmacist Marla Ahlgrimm Answers Your Questions

Marla Ahlgrimm

Marla Ahlgrimm

A pioneer in the field of hormone therapy (HT), Marla Ahlgrimm has helped more than 300,000 women manage their symptoms of premenstrual syndrome (PMS), perimenopause, and menopause. Marla Ahlgrimm, founder and CEO of Women’s Health America, receives many questions from women and will answer several of the most common ones.

Q: What is a natural or bioidentical hormone?

Marla Ahlgrimm: When choosing between hormonal medications, a woman and her doctor must select between hormones that are natural or bioidentical and those that are synthetic. A natural or bioidentical hormone is identical – has the same chemical structure – to those hormones naturally produced by a woman. These may include estradiol, estrone, estriol, progesterone, and testosterone. In contrast, synthetic hormones are similar to, but not identical chemically to those produced naturally by a woman. These include oral contraceptives, Provera, Premarin, and Estratest to name a few. A woman doesn’t naturally produce the hormones found in oral contraceptives for example, explains women’s health expert, Marla Ahlgrimm.

“A ‘natural’ hormone does not mean that it is an unregulated, organic product purchased in a health food store either,” Marla Ahlgrimm, co-founder of Madison Pharmacy Associates in Madison, Wisconsin, says. “In fact, ‘natural’ prescription hormones are manufactured by FDA approved pharmaceutical companies.”

Slight chemical differences between natural and synthetic hormones can have substantially different effects in a woman’s body. Pharmacist Marla Ahlgrimm tells her patients, “it‘s more important than ever to understand the differences before beginning hormone therapy”.

Q: What Does Micronized Progesterone Mean?

Marla Ahlgrimm: Progesterone is the hormone of pregnancy and the word means “for gestation.” Progesterone is produced cyclically, 2 weeks out of every month. If pregnancy doesn’t occur, the progesterone level falls and menstruation begins. Micronized describes the size of the particles of progesterone found in pharmaceutical progesterone capsules or tablets. Pharmaceutical companies micronize progesterone particles for better oral absorption. Pharmacists use micronized progesterone powder to formulate customized progesterone dosages for women.

Q: How is Hormone Therapy administered?

Marla Ahlgrimm: Hormones can be administered in a variety of ways. Depending on the hormone, options include transdermal skin patches like Climara or Vivelle for estradiol, transdermal creams, vaginal tablets or creams, oral capsules and sustained release progesterone tablets. Each route of administration is specifically selected by a woman and her physician, according to Marla Ahlgrimm, a licensed pharmacist.

Q: What types of natural estrogen are there?

Marla Ahlgrimm: Estrogen is a general term referring to a category of hormones which include estradiol, estrone, and estriol.   Marla Ahlgrimm has found that many women are surprised to learn there are natural estradiol preparations commercially manufactured and readily available. Brand names include Estrace tablets, Climara, Vivelle patches and Estraderm cream. When hormone therapy is needed, your doctor will likely prescribe a specific hormone or combination that works best for your particular situation, Marla Ahlgrimm, founder of Women’s Health America, concludes.