Episode 204: Why You Need Vitamin D for Your Mood

In this re-released episode, Dr. Lisa and Dr. Toni are discussing everything you need to know about vitamin D. Vitamin D isn’t just needed for bone health and immune system – could low vitamin D be the cause of your aches, pains, low energy and mood?

Vitamin D deficiency is still underdiagnosed, under prevented and under treated in between 60-90% of the worldwide population. In Canada, over half of the population are vitamin D deficient (below 75 nmol/L). 

Vitamin D is a fat soluble vitamin and is best absorbed as a supplement when taken with food. 

What increases your risk of experiencing vitamin D deficiency?

  • Dark skin
  • Obesity
  • Older age
  • Malabsorption
  • Inflammatory Bowel Disease (due to malabsorption and inflammation)
  • Sunlight overprotection and/or deprivation
  • Chronic use of prednisone and other anti-inflammatory steroid derivatives, anticonvulsant medications (due to upregulation of liver detoxification, promoting excretion of vitamin D and metabolites)

Why should you care about vitamin D?

Vitamin D plays many roles in the body! It’s not just for bone density, which can decrease as estrogen decreases in perimenopause and menopause.

Vitamin D is known as a pro-hormone synthesized in the skin and activated in the liver and kidneys. Cholesterol is its precursor.

Why do you need vitamin D in your body?

  • Reduces cellular growth
  • Improves cell differentiation
  • Regulates and controls genes
  • Reduces inflammation, risk of cancer, autoimmunity
  • Reduces muscle aches/pain, fibromyalgia
  • Improves mood (and energy)
  • Enhances bone health

“The most common manifestations of vitamin D deficiency in adults is:

Depression

Infection

Chronic Pain”

  • Alex Vasquez (vitamin D monograph available at academia.edu)

Low vitamin D status or deficiency can manifest as:

  • Bone and muscle pain 
  • Fatigue
  • Depression
  • Infections/dysbiosis
  • Frequent falls and cognitive impairment
  • Statin intolerance and myalgia
  • Preterm birth 

How does vitamin D support your vagina?

Research shows that vitamin D supports the proliferation of vaginal epithelium in postmenopausal vaginal atrophy. After using a suppository with 1000IU vitamin D over 8 weeks, vaginal pH decreased, while vaginal dryness and pain significantly reduced.

You can think about your skin and mucous membranes (including epithelial cells and immune cells) are like bricks in a wall, with tight junction proteins acting like mortar and weather proofing or waterproofing provided by antimicrobial peptides, as well as lysozyme and secretory IgA, on surfaces. 

Mucous membranes are present in your mouth, digestive tract, genitourinary tract and respiratory tract. Strengthening your exterior barrier defenses prevents infection.

Research shows that people with low vitamin D levels are 27-55% more likely to get an upper respiratory tract infection. Higher doses of vitamin D are more protective, improves lung function and decreases inflammation. 

Synergistic nutrients for vitamin D include:

  • Magnesium – cofactor in the synthesis of vitamin D from both exposure to sunlight and dietary sources
  • Vitamin K2 supports getting calcium into bones and teeth

Vitamin D3 (cholecalciferol) produced in skin and consumed in diet, preferred form for supplementation.

Food sources provide low amounts: fatty wild fish like mackerel, herring, sardines, trout, salmon, cod liver oil, egg yolk, milk, soy milk, fortified foods, beef liver, cheese

Vitamin D2 (ergocalciferol) produced by irradiating fungi and mushrooms, less efficient precursor to biologically active 1, 25 dihydroxyvitamin D (calcitriol), also potentially less effective and more toxic. 

Some examples of research using cod liver oil as a source of vitamin D:

  • study with 10 patients with multiple sclerosis over 2 years, daily supplementation of 1000mg calcium, 600mg magnesium and 5000IU vitamin D (from 20g cod liver oil) reduced number of exacerbations with an absence of adverse effects
  • studies with cod liver oil showed significant reductions of type 1 diabetes, while a study of more than 10,000 infants (less than 1 year of age) and children with 2000IU of vitamin D daily reduced incidence of type 1 diabetes by almost 80%

How do you know if you’re getting enough vitamin D?

Get your blood tested!

Reference ranges for serum 25 (OH) vitamin D3 in adults can vary:

Example:

Deficiency: <20 ng/ml (50 nmol/L) 

Insufficiency: 20-40 ng/ml (50-100 nmol/L)

Proposed optimal: 40-65 ng/ml (100-160 nmol/L)

Excess: >80 ng/ml (200 nmol/L)

Proposed updated ranges:

Depletion: <20 ng/ml (50 nmol/L) 

Insufficiency: <32 ng/ml (80 nmol/L) 

Marginal sufficiency: 30-40 ng/ml (75-100 nmol/L)

Sufficiency: 40-50 ng/ml (100-125 nmol/L) 

Proposed optimal physiologic range: 50-90 ng/ml (125-225 nmol/L) – based on levels found in pregnant rural Africans, lifeguards in USA/Isreal, farmers in Puerto Rico

Supraphysiologic: >100 ng/ml (250 nmol/L)

Potentially toxic: >150 ng/ml (325 nmol/L)

Pharmacologic dosing: 200-300 ng/ml (500-750 nmol/L)

Today’s Mama Must Have:

Dr. Lisa is a big fan of board games for lots of family fun, including Despicable Me Minion Game of Life, Mousetrap and Don’t Make Me Laugh. 

Dr. Toni loves her emulsified vitamin D drops by NFH plus vitamin D/K for the whole family.

Email us or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe and healthy everyone!

Disclaimer: The information provided in this presentation is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.

Episode 173: Genitourinary Syndrome of Menopause with Pharmacist Teresa Isabel Dias

In this re-released episode from 2022, Dr. Lisa talks to pharmacist and Certified Menopause Practitioner (NCMP) Teresa Isabel Dias about how to support vaginal and urinary health in perimenopause and menopause. Genitourinary Syndrome of Menopause (GSM) impacts up to 80% of women and can be an embarrassing result of the hormone fluctuations. It can start in perimenopause causing: vaginal dryness, pain with or without sexual intercourse, burning, irritation, frequent urinary tract infections, urinary urgency and discomfort. Learn how you can address and reverse symptoms of GSM; you don’t have to suffer! 

“Do not let your vagina ruin your marriage” – Teresa Isabel Dias

Teresa Isabel Dias is a registered pharmacist with over 25 years of professional experience in community pharmacy and drug information in Toronto.

In 2013 she became a Certified Menopause Practitioner (NCMP) through the North American Menopause Society (NAMS) and founded MenopausED to help women navigate the change.

Teresa raises awareness about menopause, provides education, and supports women in midlife (40+). She helps women understand what’s going on in their bodies and minds during the menopause transition to decrease fear and anxiety about this natural but sometimes challenging phase of life. She educates women about healthy lifestyles and symptom management options so women can make informed decisions about their care to improve quality of life, relationships, and work.

Teresa has delivered education and training to the Royal Bank of Canada, Maple Leaf Foods, the University of Waterloo, University of Toronto, Brock University, Stantec, Women in Government, and other major employers and associations. I have also written and presented to several pharmacy associations and the Pharmacy Practice + Business magazine.

In this episode, Dr. Lisa and Teresa cover:

  • The importance of awareness and education around symptoms you may experience in perimenopause and menopause
  • How lower levels of estrogen in perimenopause and menopause can change the cells of your vagina and vulva 
  • The role of lubricants and moisturizers to deal with vaginal dryness and pain with sex
  • Why Teresa recommends silicone based lubricants and doesn’t recommend using cooking oil as a lubricant
  • The role of hyaluronic acid and vaginal estrogen to address vaginal estrogen
  • What to look for in a compounding pharmacy when looking for vaginal estrogen products
  • How seeing a pelvic floor physiotherapist can help with vaginal pain and reduce urinary symptoms
  • Why you should not douche!

You can connect with Teresa at https://menopaused.org/ and find the Please Yourself – Six Tips For An Easier Menopause guide. Her IG handle is: @menopausedtid

Today’s Mama Must Have:

Dr. Lisa is a big fan of using red light bulbs and night lights. 

Teresa loves doing at least 5 minutes of stretching before bed to improve sleep.

What else we’re up to:

Join Dr. Lisa’s new Facebook group Wild Woman Adventures Toronto if you want to get out in nature, connect with other women and push yourself out of your comfort zone. Activities include: sunrise/sunset SUP, tree-top trekking, a new moon workshop and more!

Dr. Toni’s next HypnoBirthing class series starting in April – for more info on a free online masterclass to reduce fear and anxiety around birth, go HERE.

Thank you for joining us today!

Email us or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode. You can also support us by visiting our Patreon page.

Please tell your perimenopausal mama friends about us, too!

Stay safe and healthy everyone!

Episode 23: Let’s Talk About Sex – In Conversation with Dr. Trina Read

Today, Dr. Toni is talking all about sex in perimenopause and beyond with Dr. Trina Read, sexologist and CEO of the Business of Sex. They discuss: why you need to “use it or lose it”; the importance of mixing things up in the bedroom, especially during perimenopause; how to feel more sensual; and why libido tanks and what you can do about it.

Dr. Trina has an unique perspective as a sex and relationship expert who has a corporate background in marketing and PR and who is also a perimenopausal mom.

In this episode, we cover:

  • How to use self care to bring libido back
  • Why you need to know your happy triggers for sex
  • The importance of knowing what you want out of sex and communicating it
  • Why you might want to take intercourse and orgasm off the table for better sex
  • How to have those awkward conversations around sex
  • Why personal lubricant makes all sex better
  • The importance of working your pelvic floor muscles

Where did my libido go?

In perimenopause and in stressful times, you may find your libido is flatlined and don’t feel like sex.

Your body can only produce either cortisol (your stress hormone) or testosterone (your sex drive hormone). If you’re producing cortisol, you can’t produce testosterone.

In situations with great change, it’s important to connect with your partner and look for ways to be together, so that you don’t drift apart. Being proactive and finding pockets of time to be close with your partner helps your relationship, as well as feeling more powerful yourself.

How to feel more sensual and “get in the mood”

You can back into the groove and bring your body back to a place where you feel more centred and sensual by:

  • Taking a bath
  • Listening to your favourite music
  • Giving yourself some me time alone in your bedroom with a vibrator
  • Just making up your mind to connect with your partner (even if it feels forced at first)

The Centre for Menstrual Cycle and Ovulation Research (CeMCOR) was founded at the University of British Columbia (UBC) by endocrinologist Dr. Jerilynn Prior. There is lots of information about their research around menstruation and hormones at https://www.cemcor.ubc.ca/

UBC is also home to the Sexual Health Laboratory run by Dr. Lori Brotto that focuses on research around women’s sexual health. https://brottolab.med.ubc.ca/

Research shows that sexual desire is similar to happiness. For most women, in order to feel sexual desire, you needed to be triggered. You can learn positive triggers around sex and negative triggers around sex. You need to set up your positive triggers for sex.

Unfortunately, you may have been brainwashed to think that only 2 things available for sex is having intercourse and having an orgasm.

Sexual intercourse all the time can be a negative trigger for a lot of women, especially if you feel like it doesn’t quite do it for you.

When you can anticipate doing something that you want to experience, a happy trigger for sex can be created. Working on triggers for sexual desire and increasing your repertoire for sex are important for your sexuality to evolve.

There are studies that prove that meditation improves your sex life!

Self care like meditation, yoga and tai chi lowers stress and cortisol and can increase your libido.

Perimenopause is like reverse adolescence with wild ebbs and flows of estrogen and progesterone that can create mood swings, anxiety, hot flashes and insomnia. No wonder you don’t feel like having sex!

Sex in your 40s and beyond: now is the time be selfish, use lubrication and practice Kegel’s!

Once you hit 40 years of age, you produce less oxytocin. Oxytocin is a bonding hormone. With less oxytocin, you start being more “selfish” and focus on yourself. With more wisdom, self confidence and self care, you can feel more deserving and able to explain to your partner what you want.

This is your opportunity to create something different and better in your sex life! Your partner will be on board with you becoming a more engaged partner…it could result in you actively wanting sex more often.

If you’re experiencing vaginal dryness sometimes or all the time, sex can be painful. Trying out a few different brand of lubricants (silicone based, water based or a combo) can be a game changer for your sex life. Lubricant makes all sex better. You might even want to try a lubricating suppository.

If you don’t use it, you lose it! If you don’t use your vaginal canal, you could experience vaginal atrophy. Exercising your pubococcygeus muscle increases blood flow. Research shows that post-menopausal women who do Kegel exercises have bigger, better orgasms than women who don’t do Kegels. 

Is sex painful? You may have a prolapsed uterus:

Every woman’s uterus will prolapse to a certain extent. Greater levels of prolapse can create painful sex. 

There are options to address uterine prolapse other than surgery:

  • Herbal medicine like black cohosh
  • Pelvic floor physiotherapy
  • Bioidentical hormone replacement therapy
  • Laser rejuvenation

You can slide or decide: slide into painful sex or decide to do something different and exciting.

How to talk to your partner about foreplay and sex:

Too scared to talk to your partner about doing something different and new?

How can you start talking to your partner about sex when you feel awkward and uncomfortable. Dr. Trina’s website http://trinaread.com/ has many different articles you can share with your partner to stimulate conversation around sex and your own sex life.

Connect with Dr. Trina Read on Facebook at https://www.facebook.com/trina.read and Twitter at @DrTrinaRead

Watch for the release of Dr. Trina’s self help fiction book, “Amy Finds Her Sex“!

Today’s Mama Must Have: 

Dr. Toni is a huge fan of her local neighbourhood buy and sell groups on Facebook. These can be a lifesaver for moms on a budget. 

Thank you for joining us today! 

Find the show notes at stephanies48.sg-host.com or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe everyone!