Meditation for Anxiety and Stress: What You Need to Know
These days, life moves too quickly.
Stress and anxiety have become so common that we often accept them as normal. When we do, we face dire consequences at work, in our personal relationships, and in our mental and physical well-being.
You don’t need to endure constant stress. There are solutions out there. Meditation for anxiety and stress is a great place to start.
Meditation Over Medication
One of the most effective solutions to chronic stress isn’t a quick fix, and it isn’t pharmaceutical. It involves a lifestyle change.
Meditation for anxiety and stress has proven effective for millions of people. Beyond lower stress levels, benefits include:
- Lower resting heart rate
- Lower blood pressure
- Better sleep quality
- Better immunity (especially if you have a disease affected by stress)
- Lower anxiety and depression
I can’t discount the emotional benefits of meditation, either. It improves patience and tolerance of others and boosts creativity and imagination.
How to Begin Meditation for Anxiety and Stress
Each type of meditation has a different goal: calming the mind, clarifying thoughts, finding emotional peace, creating connections, etc. Meditation was once a strictly spiritual practice, but today, it’s used more pragmatically.
Whichever type you decide to practice, the benefits are real. Decide on your goal, and match that with the type of meditation that’ll best help you reach your goal. These include:
- Mindfulness
- Transcendental Meditation
- Movement Meditation (Tai Chi or Yoga)
- Buddhist Meditation
For people with anxiety and depression, meditation that calms the mind may be challenging. Start with a meditation style that focuses on the heart rather than the mind.
For example, the following heart-focused meditation is often helpful for people with chronic anxiety who have trouble calming down:
Picture the inside of your heart as an egg. Imagine there’s a light inside that radiates through your body. The egg shatters, and the light of love and goodness extends to all the people you love. Then to all the people you know. Then to all people.
A heart-centered meditation for anxiety and stress can lead to deep inner peace.
First Steps
When you meditate, follow these best practices:
- Get as comfortable as possible. Remember, you’ll be in one position for some time.
- Maintain peaceful quiet. You don’t have to remain still — you can meditate while walking.
- Don’t “start small.” Meditate as often as possible to build a habit.
Two Calming Techniques to Try Today
There are two meditative practices you can start right away: autogenic training and box breathing.
Autogenic Training
I learned this in med school and still use it today. You’ll find it on most guided meditation apps.
It’s a remarkable technique my teacher combined with Pavlovian classical conditioning, and 30 years later, I still respond to the signals. Simply pinch your earlobe or press two fingers together when you listen to the guided meditation.
After enough repetitions, an unconscious association forms between that pinch and the relaxation the meditation accomplishes. Just like Pavlov’s dog and the bell, you’ll relax by simply pinching your earlobe.
Box Breathing
Practice box breathing when you’re feeling anxious. It activates your parasympathetic nervous system and curbs your vagal response. Soldiers even use it in combat.
Simple and effective, you breathe in four-second increments. Inhale, hold your breath, exhale, hold your breath, and repeat.
Final Thoughts on Meditation for Anxiety and Stress
Mental illness’s grip on society tightens each day. Meditation for anxiety and stress has helped people find peace for millennia. Try it yourself.
If you’re struggling, talk to your doctor or contact us at Banner Peak Health so we can tailor a solution for you.
7 Things to Do Before Traveling Internationally
Four of my cousins operate a charity hospital in India. Whenever I visit to help out, I take prophylactic malaria medication on Sunday mornings.
One Saturday night, I started shaking, had a 103-degree fever, felt my liver and spleen, and thought, “Oh, great, I have malaria.” I took the pill I would’ve taken in the morning that night, and by the morning, I was well.
Even though I’m a doctor and prepared for everything, I still got sick, which could’ve been disastrous. That’s why taking certain steps to minimize your risk of illness when traveling abroad is critical.
Specifically, there are seven things to do before traveling internationally to ensure you have a healthy trip.
1. Visit the CDC’s Website for Specific Guidelines
The first thing to do before traveling internationally is something you should do as soon as you pick your destination.
The Centers for Disease Control and Prevention (CDC) has a fantastic international travel resource. Choose your destination from their digital list and review the recommended vaccines. You’ll also find information on diseases not preventable by vaccine, such as malaria.
2. Make a Doctor’s Appointment in Advance
The second thing to do before traveling internationally is to see your primary care physician at least four to six weeks before you leave for your trip.
It takes time for vaccines to work and for your body to build immunity. For example, if you’re traveling to Asia, you’ll want full immunity from typhoid and hepatitis A vaccines, which means getting them four to six weeks in advance.
You’ll also need to get any necessary prescriptions and receive instructions on how to take them. Remember my story about the malaria medication I took? If you’re going somewhere where you’ll need a similar medication, you’ll need to get the drug and ask your doctor how to take it.
3. Be Diligent About Food and Water Precautions
If you’re traveling to a third-world country, be diligent about food and water. Avoid raw foods, including raw vegetables, unless you can wash them in boiled or distilled water.
Also, avoid cooked foods served at room temperature. When cooked meat cools, bacteria multiply. Temperatures of 40–140℉ are dangerous.
Always ensure water is boiled or distilled, and only drink water from sealed bottles. In poor countries, people sometimes refill water bottles with local water to sell to tourists. Do not drink water from a container that’s not properly sealed.
Also, avoid ice. It’s easy to overlook — I forgot once myself and ended up with traveler’s diarrhea because I had a drink made with ice frozen from local water.
Local water can cause waterborne illnesses like typhoid, E. coli, parasites, and traveler’s diarrhea. These are serious, sometimes fatal illnesses, and quality medical care isn’t always available overseas.
4. Take Insect Precautions
If you’ll be camping or spending time in the jungle, treat your clothes and gear with permethrin in advance.
Wear insect repellent and cover exposed skin. There are several effective repellent ingredient options to choose from:
- Deet
- The only ingredient proven effective against ticks, which can transmit Lyme disease
- Concentrations over 50% show no additional protective benefit
- Picaridin
- Repels mosquitoes, biting flies, ticks, fleas, and chiggers
- Needs to be reapplied more often than Deet
- Oil of Lemon Eucalyptus (Paramenthane-3,8-diol)
- Natural botanical that repels mosquitoes
- IR3535
- Repels mosquitoes and black-legged ticks
When wearing both sunscreen and insect repellent, apply sunscreen first, then repellent.
You may need to use a bed net to keep mosquitoes and biting flies at bay while sleeping. Bed nets help prevent malaria, yellow fever, dengue fever, chikungunya fever, and more.
5. Use Caution Around Animals
Americans generally take exceptional care of their pets, but pet owners in other countries don’t always practice the same standards.
Aside from obvious risks like African safaris or swimming with sharks, seemingly “harmless” animals, even pets, can cause rabies. Rabies leads to over 59,000 deaths worldwide annually, with 95% occurring in Asia and Africa. If you get bitten or scratched while traveling, immediately clean the wound with soap and seek medical attention.
Smaller creatures also pose a threat. Watch out for arthropods (insects and arachnids, including spiders, ants, and ticks), scorpions, and snakes. These largely depend on where you’re traveling, but always practice caution.
6. Purchase Travel Insurance
One helpful thing to do before traveling internationally is purchase travel insurance. This includes specific types of insurance, such as medical evacuation insurance, in case you contract a dangerous illness or are seriously injured and local medical care doesn’t meet U.S. standards.
7. Practice Vehicular Safety
Motor vehicle accidents are the number one killer of healthy U.S. citizens on foreign soil. Don’t underestimate how different driving is abroad.
For instance, in India, cars, bikes, rickshaws, buses, and trucks share the same road. It can be chaotic and dangerous if you’re unfamiliar with those conditions.
Choose safe vehicles. Avoid motorbikes. Don’t drink and drive or ride with a driver who’s been drinking. Always wear seatbelts and helmets (if applicable). Avoid driving at night, as the lighting can be poor.
Choose larger aircraft (more than 30 seats) whenever possible when flying. Avoid local or unscheduled aircraft, as those pilots may not meet U.S. standards.
What to Include in a Travel Kit
If you consult us ahead of time, we’re happy to help you prepare a travel kit containing basic items appropriate for your destination, such as:
- Sterile gauze
- Ace wrap
- Alcohol swabs
- Antibacterial ointment
- Tylenol
- Advil
- Benadryl
- Topical steroid
- Imodium
- Dramamine
- Antibiotics (in case of traveler’s diarrhea)
Also include your usual medications (in adequate quantities), an EpiPen if you have a history of anaphylaxis, and an extra pair of contact lenses or eyeglasses.
When you speak with your physician, bring your itinerary. Discuss specific activities and destinations so your doctor can help you fully prepare.
Remember, the best time to consult your physician is four to six weeks before your trip, so you can cover everything you need to do before traveling internationally. Call Banner Peak Health to schedule an appointment as soon as you finalize your travel plans.
What Is the Relationship Between Stress and Memory?
Stress is a loose concept. It refers to anything that disrupts a person’s homeostasis or to a condition people experience when demands exceed their resources.
It can be external (extreme temperatures or physical discomfort) or internal (anxiety). Your coping skills and how much control you have over your circumstances both contribute to your experience of stress.
For example, if you were in freezing temperatures but had a warm coat, you’d be less stressed than if you were only wearing a T-shirt. Or, if you were in an uncomfortable social situation and unable to leave, you’d experience more stress than if you could exit.
When under stress, your body produces stress chemicals and hormones, including norepinephrine, epinephrine, and cortisol, triggered by the sympathetic nervous system (norepinephrine, epinephrine) and the HPA (hypothalamus-pituitary-adrenal) axis (cortisol). These chemicals and hormones engage your body in “fight or flight” mode, which is why you feel stressed. It’s an evolutionary response to danger.
Stress and Memory
Depending on whether it is acute or chronic, stress affects memory in various ways.
While the human physiologic response to acute stress enhances learning and short-term memory recall, chronic stress is harmful to the acquisition, consolidation, and retrieval of information.
How Does the Brain Respond to Stress?
High cortisol levels particularly affect long-term memory (retrieval) due to cortisol’s harmful effects on the hippocampus, where the brain stores long-term memory.
States of chronic stress often enhance emotional memory recall because the amygdala or primitive brain centers are favored when chronically stressed. This is linked to survival, and explains why facts are often more difficult to recall than feelings when people are in situations where they experience chronic stress.
Our feeling memories and our thinking memories are stored in different parts of the brain depending on how chronically stressed and activated we are.
The Significance
The practical importance of understanding how chronic stress relates to and affects memory is important because it helps us understand the need to return to homeostasis.
Managing stress while learning to maximize memory retention for school, work, and life is crucial. When we begin to see that our memory is suffering as a result of chronic stress, it motivates us to take action to balance our flight-or-flight response with rest, supporting our parasympathetic nervous system. In fact, I would like to introduce a new term: parasympathize.
Some Ways to Parasympathize
- Manage your stress by controlling the controllable.
- Practice recognizing when you’re in “activated” states of stress (i.e., fight or flight).
- Follow stress management best practices:
Following these suggestions will prevent chronically elevated cortisol levels, which is better for your overall health (AKA, homeostasis).
The Connection Between Childhood Trauma and Physical Illness
Would it surprise you to learn that many chronic illnesses — especially ones without a direct physical cause — are linked to childhood trauma?
Childhood trauma causes the nervous system to develop differently. While we’re still learning about this process, it’s clear there are legitimate, debilitating physical effects of childhood trauma in adulthood.
Defining Childhood Trauma
We define childhood trauma using the same criteria the CDC-Kaiser ACE Study put forth. ACE is an acronym for adverse childhood experiences. These equate to traumatic experiences and include three categories: abuse, household dysfunction, and neglect.
- Abuse can be emotional, physical, or sexual.
- Household dysfunction includes substance use disorders, mental illness in the home, parental separation or divorce, and incarceration of a household member.
- Neglect be emotional or physical.
Aside from bearing the effects of childhood trauma in adulthood, adults can experience new trauma, too. For example, the COVID pandemic was a source of trauma for many adults worldwide.
The Mind-Body Connection and How We Process Pain
The brain’s complex design dedicates parts of itself to rational thought and other parts to primitive survival instincts. We sometimes refer to these parts as our “thinking brain” and “feeling brain,” respectively.
Our feeling brain is where our brain perceives threats in our environment and makes instinctual decisions that keep us alive. This is the fight-or-flight center of the brain.
When we talk about repressed memories, this is the part of the brain we’re referring to. Because those memories connect to experiences too overwhelming for the thinking brain, we store them in the feeling brain.
Triggers are a way to access them.
For example, say you had a terrible experience sometime in the past, and during that experience, a certain type of food was cooking.
Later, you smell that food and suddenly feel terrible but don’t know why. That’s your feeling brain accessing your repressed memory as a result of that trigger — the same smell.
The olfaction is an association your brain formed during the trauma. That association is a trigger that unlocks the memory, but you’re not conscious of it because it exists in your feeling brain rather than your thinking brain.
It’s a form of classical conditioning similar to Pavlov’s dog.
This phenomenon can happen with physical pain, too. Sometimes, if a child suffers an injury as a result of abuse, they may not experience all the associated physical pain because it would just be too overwhelming.
Their brain locks it away to keep the child safe and alive, but that pain gets triggered later in life because the nervous system remembers it from before. This is one of the many effects of childhood trauma in adulthood.
Effects of Childhood Trauma in Adulthood
When the brain and body know it’s safe, they try to process the physical and emotional pain inflicted years before, but the rational mind doesn’t understand where the pain suddenly comes from. This is why adult victims of childhood trauma often tell their doctor, “I have all these things wrong with me, and I don’t know why.”
Physical effects of childhood trauma in adulthood often include GI symptoms like irritable bowel syndrome (IBS). They can also include overactive bladder, fibromyalgia, and inflammation and muscle pain (muscle knots).
When you better understand the effects of childhood trauma in adulthood, you can begin to process them and begin your journey to recovery.
If you have a history of childhood trauma (as defined above by the CDC-Kaiser study) and experience the symptoms we’ve described, now might be the right time to deal with it.
Those things that were once protective no longer serve you. They kept you alive in environments that weren’t nurturing, but now that you’re safe, they’ve come to the surface for a reason. It’s a sign to address them appropriately.
How to Address the Effects of Childhood Trauma in Adulthood
Ready to address the effects of childhood trauma in adulthood? Here are four steps we recommend to get started.
Step 1: Awareness
Many journeys of recovery begin with a step of admission or acceptance. This one is no different.
You must admit the possibility that what you’re experiencing is real. It’s not just “in your head.” It’s programmed into your nervous system.
Unfortunately, many doctors tell adult victims of childhood trauma that their symptoms are all in their heads or just a result of anxiety or depression. But anxiety is a symptom, not a disease, and it’s likely a reaction to pain that has been inflicted but hasn’t been appropriately processed.
Step 2: Be Kind to Yourself
Understand that your body was and is trying to help you survive — and you did. Your body isn’t against you. It protected you in extraordinary ways.
Trauma is not the event; trauma is the response to the event. Overcoming trauma is not about removing the event. You can’t undo the past.
Trauma is part of our survival response. It’s extraordinary the way the human body stores information with the understanding that it will be processed later, when it’s safe to do so. When we see it this way, we empower ourselves to change our perspective from weakness to strength.
Honor your authentic self. You survived.
Step 3: Try to Identify Harmful Coping Habits
Healing from trauma isn’t easy; sometimes, we reach for things that aren’t in our best interests. Identify unhealthy habits and either reduce, quit, or ask for help to quit.
It can be helpful to find an alternative (healthy) coping mechanism to turn to when you feel triggered or stressed.
Step 4: Make Sure Your Care Team Is Trauma-Informed
As doctors, our standard training does not make us trauma-informed. That leaves the onus on you to find medical professionals who are trauma-informed.
When you’ve experienced the effects of childhood trauma in adulthood or are processing those effects, you need a trauma-informed care team.
If you’d like help finding a trauma-informed care team or want to know more about becoming a member here at Banner Peak Health, reach out. We’d be happy to speak with you.
How to Make Safe Choices With Supplements
For this topic, I’d like to share a few stories about patients I’ve had over the years.
A patient of mine, a young woman in her 30s, was suffering from chronic fatigue and joint pain. This was during COVID, but all her workups were negative. I struggled to determine whether she had a chronic illness.
She began seeing a naturopath, who prescribed a series of supplements — at least 10 to be taken in tandem. A month after she began taking these, she called the naturopath’s office to tell them she felt worse. The naturopath reassured her she was detoxing, and she’d feel worse before feeling better.
Skeptical, she called me, and I asked her to come into the office. She was jaundiced, so I did some lab tests. The results showed she was in liver failure.
She ended up hospitalized and on a liver transplant list. She was young and otherwise healthy, so three or four months after stopping the supplements, her liver fully recovered, and she didn’t need a transplant.
Although it’s difficult to determine which supplement played the biggest role in her liver failure, there’s no doubt the supplements caused her condition. She was extremely lucky to make the recovery she did.
Another patient of mine was taking an off-brand fish oil supplement and suffered from hair loss. We investigated and found she had mercury toxicity. Her mercury levels decreased once she stopped taking the fish oil, and her hair grew back.
Finally, I saw a patient who always presented with high liver enzymes at her routine physicals. Although we did many workups, we struggled to determine the reason.
Eventually, I asked if she took any vitamins. She brought me a huge bag of supplements that contained toxic doses of vitamin A. Mystery solved.
I share these stories to demonstrate a point I often make to my patients: vitamin supplements can provide our bodies with necessary elements they would otherwise lack, but taken without caution and care, these same supplements can do more harm than good.
Not All Supplements Are Safe
In 1994, the Food and Drug Administration (FDA) passed the Dietary Supplement Health and Education Act (DSHEA). It established that “dietary manufacturers” don’t need to adhere to the same regulations as pharmaceutical companies.
This means as long as a product is categorized as a “dietary supplement,” manufacturers don’t need to prove positive results before marketing and selling the product. Instead, the FDA must prove the product is unsafe before issuing a recall, a process which can take years, leaving potentially dangerous products on store shelves in the meantime.
Many products go to market containing poor-quality ingredients, hiding ingredients that aren’t listed on labels, or lacking the ingredients they claim to contain. As such, labels frequently list minimal information regarding ingredients and the amount of each.
For example, several years ago, I saw a patient with high blood pressure and diabetes. She was overweight and had tried many different weight loss plans. One day, she told me she’d lost 12 pounds in three months.
I congratulated her and asked how she did it. She showed me the supplement she’d been taking.
The ingredients confused me, because they were all benign things like cranberries and fruit pectin. When I investigated further, I discovered that the supplement contained Fen-Phen, which was especially dangerous for this patient, who already had high blood pressure.
Not only are there virtually zero quality control measures for supplements, but there’s also a real danger in thinking they’re safe for anyone in any dosage just because you can access them over the counter.
That’s simply not true.
More Is Better, Right?
Wrong.
Companies often take advantage of loose federal regulations. Pair that with the ability to buy online, and we’re left with a huge industry harboring immense potential for disaster.
In America, we tend to believe more is better. If one is good, three will work faster or better. However, that isn’t consistent with what we know about your body’s homeostasis.
The truth is, a little of something might help, but too much might throw other things off.
Throughout the past few years, Americans have been desperate for information and looked to supplements to boost their immune systems during lockdown. At the same time, there’s been mistrust of the medical establishment and the propagation of pseudoscience to desperate people.
We all want to be in control of our health, but we take these supplements without realizing the potential hazards. Often, we don’t even disclose what we’re taking to our doctors. But we should.
Risks Associated With Common Supplements
Below is a list of the most common supplements that carry the highest risks (and what those risks are) when taken in excess or when manufactured poorly. Talk to your doctor before starting or altering any medications or supplements.
Poor Quality Risks — Contamination
- Harmful substances
- Mold — consequence of improper storage or expired ingredients.
- Medication
- Male enhancement supplements (Viagra, Cialis, etc.) — some amounts may contaminate generic or natural supplements produced for male enhancement, which is dangerous for men taking nitrates for their heart.
- Heavy metals
- Mercury — sometimes present in low-quality fish oil.
- Lead and arsenic — Ayurvedic medicine may contain these.
- Allergens
- Shellfish — collagen supplements often contain crustaceans.
Excessive or Unnecessary Dosing
- Vitamin E — can be in a standalone vitamin or multivitamin; taken for heart health; more than 400 IU daily may increase all core causes of mortality, and over 800 IU daily may increase the risk of heart failure.
- Vitamin B6 — excessive doses can increase neuropathy.
- Selenium — taken for prostate health; can increase hemoglobin A1C, risk of melanoma, and all core causes of mortality.
- Vitamin A — can cause birth defects when taken during pregnancy; increases risk for osteoporosis and hip fractures.
- Saw Palmetto — taken to remedy hair loss; can cause birth defects when taken by pregnant women.
- St. John’s Wort — interacts with antidepressants and can cause serotonin syndrome; decreases the effectiveness of birth control.
- Kava Kava — can lead to liver failure.
- Gingko — taken for improved cognition; can increase risk of brain hemorrhage, seizure, and stroke.
- Ephedra — banned in 2004 in the U.S. after dozens of people died as a result of taking it; causes heart attack, stroke, and sudden death.
- Biotin — taken for hair, skin, and nails; can interfere with the following tests:
- Blood tests for heart injury and heart failure — can throw off the results
- Thyroid testing — can throw off the results
- Urine pregnancy tests — can affect the control line
Today’s Takeaways
- Supplements aren’t inherently bad, but you must be careful about what and how much you take.
- Let food be thy medicine. Don’t take supplements to make up for a terrible diet.
- Talk to your doctor. They can tell you what supplements you really need, check for drug interactions, and educate you on side effects and warning signs. Keep your doctor in the loop and avoid becoming our next horror story.
Perimenopausal Hormone Replacement Therapy — An Updated View
In the 1940s, the medical community introduced the idea of giving menopausal women estrogen to combat their symptoms. Twenty years later, the FDA approved the first estrogen pill.
For the next few decades, supplemental estrogen was generally seen as positive. Observational studies in the 1980s and 90s even suggested a decreased risk of cardiovascular disease in women receiving hormone replacement therapy (HRT). In 1992, a randomized controlled study called the Women’s Health Initiative (WHI) set out to determine once and for all if and how women benefit from HRT.
The WHI planned to follow 27,347 women between the ages of 50–79 over 13 years. The average participant was 63 — a significant limitation, considering the study didn’t take into account a younger population of perimenopausal women.
The results of the WHI shocked the medical community: for the population studied, HRT didn’t protect from heart disease and resulted in an increased risk of breast cancer. Doctors spent the next few decades making recommendations based on this study’s results.
We’re just now beginning to realize how flawed the WHI was. It omitted a significant portion of the population — perimenopausal women, who, as recent investigations suggest, benefit the most from HRT.
The medical community has spent the 2020s reevaluating the benefits of HRT for perimenopausal women.
‘The Change’ and How Hormones Can Help
During perimenopause and menopause, estrogen and progesterone levels in the body drop and cause vasomotor symptoms (hot flashes, night sweats, and sleep disturbances).
Loss of estrogen can cause loss of bone and muscle mass, mood changes, difficulty concentrating, and loss of sexual function and libido. Sleep disturbances in particular create a cycle that increases other health risks, such as cardiovascular disease and diabetes.
Recent investigations show vasomotor symptoms must be treated by HRT within 10 years of onset for the best results and the best chance of preventing osteoporosis.
Types of HRT
There are several types of HRT, and each requires specificity. For example, if you have an intact uterus (i.e., have not had a hysterectomy), you would need to take progesterone in addition to estrogen to minimize the risk of uterine cancer, endometrial hyperplasia, and endometrial cancer.
Years ago, HRT was usually given orally. Since then, technology has developed many convenient and effective ways to deliver hormones.
Depending on their doctor’s recommendations, women can choose from oral pills, topical preparations, implanted subdermal pellets, or transdermal patches. Transdermal patches in particular are gaining popularity because they tend to cause fewer side effects than other methods. Specifically, they don’t tend to raise cholesterol as much as oral pills.
Risks vs. Benefits
Although HRT can effectively reduce the symptoms of perimenopause, it’s not right for everyone. It can cause a risk of venous thromboembolism, gallstones, and stroke, and a very slightly increased risk (0.0009%) of breast cancer. Women who have a family history of blood clots may be encouraged to avoid HRT altogether.
However, for most women, the benefits of HRT far outweigh the potential risks. The most common benefits include bone health, preservation of muscle mass, improved sleep, and increased collagen production. In African American women, HRT may also decrease the risk of precursor lesions to macular degeneration.
For women with diabetes, HRT may lead to better glycemic control — though because of an inherent increased risk of heart disease, women with diabetes must be carefully selected for HRT to avoid unnecessary risk.
The key is treating women early. Once a woman goes through menopause, HRT is no longer effective in treating symptoms or reducing the risks for these conditions. It can even be detrimental.
In one study, women treated with hormone replacement during “mid-life” (avg. 48.7 years) saw their risk for dementia decrease by 26%. However, women given HRT in “later life” (avg. 76 years) increased their risk for dementia by 48%.
In summary, perimenopausal women stand to benefit greatly from HRT and may prevent the worst of symptoms while reducing their risk for more serious issues.
Could HRT Be Right for You?
There’s a lot of pseudoscience out there — saliva and urine home test kits that claim to check hormone levels, for example. Because hormone levels vary from day to day, sometimes hour to hour, according to your monthly cycle, those at-home tests are ridiculously unreliable.
Rather than wasting your time and money on those, schedule a serum test with your doctor and rely on them to interpret the results. We guide our patients through this process often, and we consider every individual’s risk-benefit ratio to make the best decision for them.
Hormone replacement therapy is, in general, a great thing — it keeps you young — and we want to remove the stigma based on a flawed, 20-year-old study. Many women should consider HRT for their health and longevity.
If you have more questions about HRT, contact Banner Peak Health. We’d be happy to chat with you.
How Accurate Is Your Apple Watch’s Heart Rate Monitor?
We live in an age of consumer-driven healthcare. COVID accelerated this, and tech companies have jumped on board to meet the public’s demand.
The Apple Watch is part of this trend, and although it sits at the intersection of entertainment and medical technology, we can’t dismiss its usefulness. The hype regarding the Apple Watch’s accuracy as a heart rate monitor isn’t as exaggerated as you might think.
The Apple Watch detects heart rate through photoplethysmography (PPG), a technique in which LEDs illuminate a capillary and read volumetric changes in the blood. It’s quite accurate when used to measure heart rate and blood pressure, and we can expect additional applications of this technology as it improves.
But just how accurate is the Apple Watch heart rate monitor? When I investigated, I found some impressive data.
Real Examples of the Apple Watch Heart Rate Monitor
So, how accurate is the Apple Watch heart rate monitor? Here are a few examples.
I’ve had two patients in their 40s rush to consult me after alarms on their Apple Watches went off, indicating atrial fibrillation (A-fib). A-fib is a condition in which irregular electrical activity at the top of the heart leads to poor blood flow. It’s notorious for causing stroke and heart failure.
After these patients showed me the data from their Apple Watches, I connected them with a cardiologist who treated them. At the time the alarm sounded, they weren’t feeling anything abnormal, but thanks to the Apple Watch, they received treatment and prevented a serious problem.
Note: While the FDA hasn’t approved the Apple Watch for diagnosing A-fib, the device has been cleared for monitoring A-fib.
Beyond personal experience, I’ve read many stories about people whose Apple Watches alerted them to abnormal heart rhythms, which allowed them to receive life-saving treatments.
For example, in 2018, a high school senior’s Apple Watch alerted her of a heart rate of 190 bpm (beats per minute). When she got it checked out, she discovered she was in renal failure. More recently, in 2021, a nurse was alerted that her heart rate was 40 bpm, which led her doctor to find an atrioventricular block.
The Apple Watch also has a “fall detection” setting, which automatically calls 911 if it detects a fall and the wearer doesn’t move for several seconds. This is a potentially life-saving feature for anyone with low blood pressure or a fainting condition, or for older people who might not be able to get up without help.
What Heart Health Data Points Does the Apple Watch Provide?
The Apple Watch can detect more than just your heart rate, but your heart rate alone can reveal much about your health.
For example, a low heart rate can indicate an atrioventricular (AV) block, as in the case we mentioned above. These patients, who are at a greater risk of fainting, often need a pacemaker.
Conversely, a high heart rate can indicate various issues, including pulmonary embolism and pericardial tamponade. A higher-than-normal resting heart rate also puts you at a higher risk of cardiovascular disease. Staying aware of these conditions can help you strategize with your doctor accordingly.
You can also use your Apple Watch to track your heart rate variability, which is a fitness indicator that varies from person to person. Again, discuss any concerns with your doctor.
Believe it or not, your Apple Watch can even record an EKG (electrocardiogram), sometimes also called an ECG. This test detects irregular heart rhythms and can indicate any number of issues, including atrial fibrillation (A-fib). (If you take an EKG with your Apple Watch and the results concern you, consult your doctor immediately.)
In 2019, the New England Journal of medicine published a study that followed 419,297 Apple Watch wearers over eight months. Eighty-four percent of irregular pulse notifications participants received during this time were accurate. That was four years ago.
This technology is constantly progressing. So, what about in 2023? How accurate is the Apple Watch heart rate monitor now?
How Accurate Is My Apple Watch Heart Rate Monitor?
How accurate is the Apple Watch heart rate monitor today? If you’re only checking heart rate, it’s quite accurate.
If you’re looking for other measurements, like certain arrhythmias, take the readings with a grain of salt and rely on your doctor’s advice — especially regarding ventricular arrhythmias, which the Apple Watch doesn’t identify reliably.
False positives can lead to anxiety and unnecessary ER visits. It’s best to contact your primary care physician and discuss your concerns, if possible, rather than run to the hospital — unless you physically feel that something is wrong. If it’s a true emergency, drop everything and go.
Remember, the Apple Watch, like any over-the-counter technology, has limitations and requires appropriate interpretation.
Today’s Takeaways
- Have your doctor verify and interpret all serious alerts and readings from your Apple Watch. However, the pros of wearing one far outweigh the cons.
- Pay attention to your symptoms and trust your body. If something doesn’t feel right, talk to your doctor, even if your Apple Watch doesn’t identify a problem.
- Monitor your readings over time and discuss them with your doctor. He or she will help you interpret the results.
Common Myths About Women’s Sexual Health You Should Stop Believing
Many of my peri- and postmenopausal patients believe diminishing sexual interest, drive, and enjoyment is a normal part of human aging. In fact, they’ve accepted it — which is why they’re so shocked when I tell them this is nothing more than a myth.
Why do so many women believe sex is only for the young? Well, there are many reasons.
Postmenopausal sex is a taboo subject, and it’s not discussed as much as it deserves to be. There also isn’t nearly enough funding for women’s health research. Women’s Health Initiative was a landmark study, but it fell short of collecting exhaustive data. (More on the shortcomings of the WHI in an upcoming post.)
The sore lack of research and a societal aversion to transparent conversations has led to rampant misinformation about women’s sexual health. It’s something I as a physician strive to change, starting with my individual patients.
The truth is, women can and should have fulfilling sexual lives well into their 60s, 70s, and even 80s. There are many ways we can support our sexual health as we age, and we’ll discuss some of them in this post — but first, we’ll explore the significant health benefits of maintaining your sexual health throughout your healthspan.
The Benefits of Supporting You or Your Partner’s Sexual Health
Social/Emotional
Our relationships do wonders for our overall happiness and quality of life, and a healthy sexual relationship is no different. Physical intimacy solidifies the bond you share with your partner.
Intercourse facilitates the synthesis and release of a cascade of hormones, including oxytocin and DHEA, which play an important role in bonding. It’s a deep feeling that’s difficult to quantify, but one we all recognize.
Mood
Studies have demonstrated that sexually mindful women have better self-esteem and tend to be more satisfied with their relationships.
Pain Relief
Sex releases endorphins, which help with pain reduction. Not only is preexisting physical pain subjectively less intense during intercourse, but the endorphins released via orgasm can reduce stress and alleviate pain.
Sleep
The hormones released during sex have also been shown to improve sleep. When you improve your sleep, other aspects of your health are impacted, such as your immune function, cardiovascular health, and mood.
For example, some studies have shown a 30% increase in IGA antibodies in sexually active people versus the abstinent control group.
Breast Cancer Risk Reduction
There’s even a study that demonstrates a risk reduction for breast cancer in women who had sex once a month versus women who didn’t.
Ways to Support Our Sexual Health as We Age
Generally speaking, women experience a decline in interest, drive, and enjoyment of sex during perimenopause and postmenopause due to estrogen loss. Hormone replacement therapy is the primary way we can address this.
In fact, this was the norm in the early 2000s, when one in four women was receiving hormone replacement therapy. But the medical community has since stopped using this therapy regularly, and today, only about 4% of women are receiving hormone replacement.
We should reconsider using this therapy for individuals who are a good fit. Of course, we need to take factors like clotting disorders and stroke risk into account, but that aside, hormones can generally be a good solution for many women.
Other ways to support women’s sexual health include exercise, diet, and carefully chosen supplements. Regular exercise boosts libido. Fruits such as apples, watermelon, and cacao have been linked to enhanced vascular and sexual health. Soy and low-salt diets also help.
The biggest point I want to drive home today is that, as a woman, you are entitled to a vibrant, fulfilling sexual life no matter your age. While it’s common to experience decreased interest, drive, and enjoyment, it’s not a permanent situation, and you don’t need to resign yourself to it.
Talk to your doctor or therapist about the challenges you’re facing. There are solutions available to you, and we’re here to help.
Today’s Takeaways
- The decline in sexual interest, drive, and enjoyment as you age is due to a natural loss of estrogen — but you don’t have to accept it.
- Depending on your individual risk factors, hormone replacement therapy may be a great option for you.
- Every woman, regardless of life stage, deserves a full, healthy, satisfying sexual life.