ConceiveOnline.com, August 17, 2010

“Jill Blakeway changed my life. It’s a bold but true statement. I am – or was – what she considers a typical “pressure cooker” case, making my insides mangled, my mood swing and DH desperate for a solution. Jill is, simply put, the best & kindest acupuncturist in Manhattan.”

culinistannouchka.com  August 12, 2010

More Magazine / 2010

CNN.com / June 24, 2010

culinistannouchka.com May 20, 2010

Inspired by these patients I have started to talk to my patients in their forties about training for menopause. It’s a bit like getting ready to run a marathon. If you know what’s ahead you can train your body to avoid some obvious pitfalls. So today I offer 5 tips for those of us who are (and I hate this word) peri-menopausal, designed to get us in peak shape now so that we’ll be fit and healthy in our fifties.

1. Eat less but make sure that what you do it is high in nutrients.

My teenage daughter can eat empty calories and get away with it. I can’t. It’s not fair but there it is. It’s a fact. As we age our metabolism gets slower and we need fewer calories but we also need to eat food that supports our health. Because your risk of osteoporosis and heart disease increases after menopause, it makes sense to adopt some healthy eating habits in the years before.  Aim for a low-fat, high-fiber diet that’s rich in fruits, vegetables and whole grains and calcium-rich foods like low fat yogurt, tofu and leafy greens to give your bones the nutrition they need.

Being at a healthy weight makes menopause much easier and cuts your risk of high cholesterol, high blood pressure, heart disease and stroke. There’s also evidence that weight gain after menopause increases breast cancer risk. Women who gain in excess of 20 pounds after menopause increase their breast cancer risk by nearly 20 percent so it makes sense adapt to a slower metabolism in peri-menopause by cutting calories  to avoid the risks of being overweight post menopause.

2. Get moving

Not only does exercise help boost your metabolism and stop weight gain but it also helps combat fatigue, reduces stress, strengthens bones and helps with sleep. Aim for 30 minutes of exercise a day. If you hate the gym try walking, cycling, swimming, gardening or dancing.

3. Practice a relaxation technique

Find a stress reduction technique that works for you. Mood swings are one of the symptoms my menopausal patients hate the most. Some women tell me that they feel volatile and out of control. Stress can make hot flashes worse too so combat this by finding a way to relax both your body and mind. Learn yoga, take a meditation class, study tai chi or qi gong. Take time to walk in nature or to read a book for pleasure. It doesn’t matter what you choose, but it’s a great idea to make this a habit in the years leading up to menopause so that when you need to find a way to calm down you’ll have the skills at your disposal.

4. Drop some bad habits

Many of my patients tell me that the older they get the less alcohol they’re able to drink. This has certainly been true for me as I’ve entered my mid forties. These days if I have more than one glass of wine, I have a bit of a hangover the next day. That’s my body telling me that it can’t metabolize alcohol like it used to. There’s no point in arguing! The only option is to cut back. At the YinOva Center here in New York we advise our patients who are forty and above to limit alcohol to one drink a day and make at least two days a week alcohol free.

As we age our livers get sludgy and work less well. An over-taxed liver does not metabolize hormones well leading to hormone imbalances. In Chinese medicine drinking too much alcohol is said to lead to liver heat and thus exacerbate symptoms such as night sweats and hot flashes. There is also evidence that excess alcohol post-menopause can increase the risk or both breast cancer and osteoporosis.

While we’re on the subject of bad habits it’s worth talking about caffeine and cigarettes too. Menopausal women will tell you that caffeine makes their symptoms worse so it makes sense to start to cut back on coffee in the years leading up to menopause. Caffeine causes heat and stagnation in Chinese medicine and there is evidence that not only does it make hot flashes worse but it can also increase the risk of fibrocystic changes in breast tissue.

Smoking is obviously never a great idea, but as we age we’re less able to get away with abusing our bodies. In clinical research women who smoke typically experience menopause 1 1/2 years earlier than women who don’t smoke. If you’re in your forties and you smoke it’s time to consider quitting. Acupuncture can help so ask us for support. We’d be delighted to get behind you as you quit.

5. Take Herbs and Supplements and consider regular acupuncture

From 1997 to 1999 Dr. Susan Cohen, D.S.N., APRN, associate professor of the University of Pittsburgh conducted one of the first studies in the United States to explore the effectiveness of acupuncture in alleviating hot flashes, insomnia and nervousness. She found that during the course of acupuncture treatments, hot flashes decreased by 35% and insomnia decreased by 50%. A follow-up study showed that hot flashes significantly decreased in those receiving acupuncture, compared to those receiving other types of care. At YinOva NYC we have found that our patients who have regular acupuncture during peri- menopause often have less unpleasant symptoms when they reach menopause. This is because we have been able to spot minor problems and head them off before they became more complex.

A specifically targeted herbal formula can help support you in peri-menopause and head off a difficult menopause. Often when a patient comes to me for help with a difficult menopause and I start to take a history I realize that there were warning signs for many years leading up to these symptoms.

As we age Chinese medicine says that we get more yin deficient and stagnant. Yin describes the body’s ability to moisten, cool, nourish and settle itself, so women who are yin deficient become dry, overheated, malnourished and unsettled. Dryness, hot flashes, night sweats and insomnia are all symptoms of yin deficiency so to avoid these symptoms in menopause it makes sense to nourish yin in the years before. As us to write a formula specially for you or for the sake of convenience you can take an over the counter formula in pull form. I like a formula called liu wei di huang wan for peri-menopausal women because it mildly nourishes yin.

Stagnation of qi and blood in Chinese medicine describes poor circulation leading to irregular menstrual periods and difficult hormone transitions. If you suffer from PMS or irregular menses in peri-menopause it’s worth taking Chinese herbs to correct this ahead of menopause and that way head off more major mood swings and emotional volatility. Again we can write a formula specifically for you or prescribe you a generic formula in pill form such a jia wei xiao yao san.

Other supplements that may be helpful are: -

• Zinc helps increase levels of progesterone and decrease levels of estrogen. In addition, it can help to boost the immune system. Zinc also helps to build strong bones, thereby reducing the risk of osteoporosis.
• Vitamin E can balance volatile hormones
• Flax seed oil lowers cholesterol and helps combat mood swings by smoothing hormonal transitions
• An essential fatty acid supplement like borage oil or evening primrose oil can help moisten tissue and prevent vaginal dryness as well as balance hormones.
• Calcium supplements help build strong bones in the years before menopause to prevent post-menopausal osteoporosis

Anesthesiologist Dr. T.J. Gan, prompted by research that shows acupuncture can stop nausea and decrease pain, decided to give his patients an acupuncture treatment before and during surgery. He uses points that prevent nausea and stimulate the body’s own pain killing chemicals and has found that patients treated in this way have significantly less nausea and reduced post operative pain.

At the YinOva Center this kind of research is of particular interest because it echos our own interest in helping our patients to get the best out of both Eastern and Western medicine.

“What is prenatal massage?”

It is just like a regular massage: it loosens the muscles and joints, improves the circulation to you and your baby, and relieves fatigue.

The difference is prenatal massage is performed by a New York certified prenatal massage specialist who is able to target the unique needs of mothers-to-be in each trimester. These therapists are adept at working with specific conditions that can occur during pregnancy such as pelvic pain, digestive and elimination issues to bring you safe relief.

The length of your prenatal massage can range from sixty minutes to two hours depending on your specific needs. Several techniques are employed such as Swedish massage, myofascial, stretching & range of motion, and other modalities to relax and soothe the body, treat and ease tensions. At the end of the session you are left feeling restored, relaxed and comfortable in your happy body. You will also get tips on how to sleep better, foods that support pregnancy, relaxation techniques and exercise to support you during this time of added stress.

As your pregnancy progresses you will find each trimester will hold it’s own focus for your body’s needs.

“How is prenatal massage different in the first trimester?”

This is when we create the foundation for your pregnancy.

As weight in your belly begins to increases your center of gravity shifts adding stress and strain to weaker areas. This is your opportunity to concentrate on muscles, ligaments, and postural problems to create a stronger structural foundation.

The focus of your first trimester is to address any pre-existing conditions that would include chronic issues: back, neck, shoulder or pelvic pain, sciatica, or other recurring problems. Immediately attending to these issues will support your body’s ability to more easily distribute the added weight as your baby grows. Along with physical support massage at this time also reduces emotional anxieties which are important to a healthy foundation.

“What about the second trimester? Does the massage differ?”

In some ways this is your baby’s first massage

At this stage the pregnancy is settled in and it is time to focus on uterine support. As your uterus increases in size( 4 oz to 13 lb..) it is easy to over stress the 13 ligaments which give it support. Keeping the ligaments toned easily prevents many debilitating symptoms such as pelvic or back pain, premature delivery, and back labor. However, most importantly massage is a wonderful way to connect to your baby. You will be taught your own self care massage for home play.

“And in the third trimester?”

This is when we start to prepare you for labor.

So many internal and external events are taking place in preparation for your labor and birth. As strain to ligaments increase due to weight and increased hormones simple movements can induce pain until the muscles around them are releases. Also uterine pressure to your legs can cause excessive swelling along with blockages to digestion and elimination. Not only does prenatal massage on a regular basis help combat these symptoms but it will also relax your body in preparation for an easier labor, delivery and recovery.

“Should our Yinova Moms still be coming in for massage post-partum?”

Yes indeed. I like to say that we are returning a wandering womb

Your body has been put under tremendous stress. Especially in the abdominal and pelvic area where there are many new physical and emotional demands. These experiences – recovering from your pregnancy, delivery (especially with cesarean section) and now caring for your newborn are all individually major transitions. Postnatal massage supports recovery of all these stages in a gentle and effective way.

One major overlooked problem in postpartum recovery are the uterine ligaments. These ligaments are meant to easily expand to accommodate pregnancy however, recovery can many times create complications. One uterine massage after birth will not usually repair the nine months they have endured under great pressure. Especially if there was some type of trauma during delivery (such back labor, cesarean, extended pushing, improper care). These ligaments have a hard time recovering just like the over stretched elastic in your waist band. If they are not properly healed the uterus can not return to it’s proper positioning and many can complications occur. Some complications are incontinence, uterine, bladder or rectal prolapse, constipation, scar tissue especially with caesarean fallopian tube blockages and future fertility issues.

Getting regular massage and learning to do your own “Self-Care Massage” will assist not only the uterine ligaments and uterus to return to proper place but, will support the harmony of all healing.

You can start Postpartum Massage one week after a normal vaginal delivery, six weeks after a normal cesarean and after release of doctors care from any other complications.

“So how would you sum up the benefits of prenatal massage?”

The health of your uterus and it’s ligaments will assist you in avoiding common complications such as incontinence, prolapse, scar tissue (especially with caesarean) and future fertility issues. Prenatal massage does more than benefit the mother. Everything a pregnant woman does from her diet and fitness to her relaxation and relative state of contentment – also directly affects the child she is carrying. Study after study has proven that calmness in the mother leads to healthier baby development.

According to a study¹ receiving regular prenatal massage benefits labor by:

• 25% shorter delivery time

• 30%reduction in all pain medications

• 50% fewer cesarean births

• 60% less request for epidurals

Prenatal massage:

• promotes relaxation

• reduces edema

• reduces blood pressure & relieves varicose veins

• improves blood circulation & lymph circulation

• facilitates support for respiratory, digestive & elimination

• releases neck, back and and other joint pain

• relieves muscle spasms and cramps

• reduces mental strain, fatigue and depression & anxiety

1.  Touch Study Support for Pregnancy by Marshall Klaus, MD

You don’t have to live with PMS. Learn some easy changes you can make that will banish your PMS symptoms for good.

Many women dread the last week of every cycle because of how irritable and miserable they feel. Chinese medicine has been treating premenstrual symptoms for thousands of years and here at the YinOva Center we have drawn on this traditional wisdom to help modern New Yorkers address their PMS simply and effectively. Many of our patients are surprised and thrilled to find out that PMS can be solved and that they don’t have to put up with feeling moody and uncomfortable every month.

Recently Parents TV came to our center to interview me and talk to one of our patients about using Chinese medicine to treat PMS and below you can see the video

In Chinese medicine uncomfortable symptoms before the period are related to Liver Qi Stagnation and by this we mean that stress and fatigue cause qi and blood to circulate less well and our livers to function sluggishly resulting in hormonal transitions that are not smooth. At the YinOva Center we use a combination of weekly acupuncture to move qi combined with a natural herbal formula to help balance hormones, gently and safely. Your herbs can be specially tailored to suit your particular symptoms so, for instance, if you suffer from breast tenderness we can add qing pi (Tangerine Peel) which can really help. Likewise if  abdominal bloating and gas is a problem we can add mu xiang (Costus Root) to help move qi in your abdomen.

Most of our patients find they need to take the herbs for three months to bring their body back into balance after which we wean them off and, like Suzanne in the interview above, they usually find that their premenstrual symptoms are much more manageable.  Likewise we suggest weekly acupuncture for the first three months followed by a treatment once a month for a further two months and as Suzanne says in the interview this is usually enough to make a permanent change.

There are also plenty of things you can do to help yourself. Here is the advice we give our YinOva patients about tackling their PMS :-

• Get regular exercise. This moves qi and blood and smooths hormonal transitions.
• Eat plenty of vegetables, particularly cruciferous vegetables and leafy greens.
• Prioritize unsaturated fats such as olive oil and whole grains such as brown rice and oatmeal.
• In the week before your period avoid alcohol, coffee, salt and processed foods.
• If you feel irritable take Vitamin B6 (50 – 100 mg)
• If you suffer from breast tenderness take Vitamin E (400mg).
• If you suffer from bloating take take Magnesium (400mg)
• If you feel weepy take Calcium (1200mg)

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A special shout out goes to our YinOva patient Amelia. Amelia, who is 13, has been our patient since she was 5 years old. She heard about our Help for Haiti Month and emailed me and ask if she could join in by holding a bake sale in our office. So last Monday evening she stayed up untill 3am baking an enormous amount of cookies, muffins and cakes. On Tuesday she arrived with her Mom, Joanna, and set out her stall in our waiting room. Many of you met her and bought her cakes, which were delicious. She tended to her stall from 9am until 9pm which was an amazing achievement, especially for someone who had been up so late the night before.

Many of you emailed me to tell me how inspired you were by Amelia’s efforts and on behalf of the whole YinOva community, I’d like to express our appreciation for her hard work and enthusiasm. Way to go, Amelia!

Amelia raised $250 dollars and decided to give the money to Habitat for Humanity a charity that she had researched on the internet and she chose because they had been working in Haiti for over 20 years and so, she felt, they would have the infrastructure in place to be of real benefit to people who were rendered homeless by the earthquake.

One of the many things I love about the YinOva Center is our sense of community. I am thrilled that Amelia felt so at home here that she chose us to host her bake sale and so grateful that you all  supported her, enthusiastically, by buying her cakes and cookies. Thank you.