A while back, my co-host Carey Goldberg came to me with her classic buoyant optimism: "I have good news," she chirped. "And arguably less good news."
The good news: She'd been selected to be on the cover of a new women's magazine.
The less good: The magazine was called My Menopause.
Only Carey would agree to write a pro bono piece "sharing how she conquered menopause" with a very large picture of herself, surrounded by greenery, amidst headlines like: "Chinese Medicine Treatments For Menopause," and "What Every Woman Needs To Know About Sexual Dysfunction."
(My Menopause was launched earlier this year by a local doctor, Machelle (Mache) Seibel, a professor at the University of Massachusetts Medical School; he's the kind of guy who sings about health issues, from mammograms and stress incontinence to swine flu and bacterial vaginosis.)
Of course, Carey's piece is excellent. I got weepy when she described aging and the inevitable physical decline, and losing the "yum" of pleasure in her life; no joy for a child's achievements, nor at the prospect of a divine slice of chocolate cake.
Her bottom line, however, is brilliant: the thing that saved her, that saves so many of us, is exercise. Not just when you feel like it and not only when the weather's good, but every day with no excuses, dragging your bum out of the house and letting all those other, far more important things you absolutely must do wait.
For me, exercise has, for decades, helped to preserve my mental health:
through an angry adolescence, eating disorders, depression and a life marked by anxiety. Whether I was dancing, running or more recently, doing hot yoga, exercise is the one constant that can lift a dark mood, allow my heart to fill with gratitude and allow me to keep believing, as time passes inexorably, that what I so often tell my kids is true: it's all going to be OK.
Here's Carey's story:
And a side-phenomenon that I’ve never read about anywhere: I seemed to develop some sort of mild, menopause related autism-spectrum disorder. I let lapse friendships that had lasted decades. I felt as if I were play-acting in many relationships, aware that these ties were worth keeping but unable to feel the underlying affection that had sparked them.
Most of all, I fought fatigue, and the sense that all my cells were simply clogging up with the detritus of half a century.
Hoping to serve up fun bits of information and perform a public service at the same time, my Commonhealth co-host Rachel Zimmerman and I started a regular feature called “Why to Exercise Today.”
It began with my favorite quotation on the brain benefits of exercise, from the psychiatrist John Ratey: “Going for a run is like taking a bit of Prozac — to lighten mood — and a bit of ritalin — to heighten attention.”
In the coming weeks, the new feature spanned a gamut of reasons: Exercise as the best way to improve your chances of a healthy old age. Exercise for short-term appetite suppression. For its laxative effect. To alleviate arthritis. To help prevent stroke. to reduce anxiety. To help survive prostate cancer. To preserve memory. to fight the ill effects of salt.
The more reasons I wrote about, the more I seemed to find. If you know where to watch for them, which journals and websites, you’ll see hundreds of new studies documenting the beneficial effects of exercise coming out each year. I even came upon a poster enumerating 100 reasons to exercise, all in one master list, encompassing virtually every organ, and it still seemed only to scratch the surface.
Now, experts on how to motivate people to change their behavior will tell you that pure, general information is rarely enough. The person has to be ready to change; the person has to see the stakes involved and care about them; the person has to set the right sorts of goals. It’s a whole science.
But I felt the information building, building in my mind. It influenced me to start working out more often, from three times a week to more like six. First, the same old work-outs I’d always done, a half hour or so of step aerobics or running or elliptical. Then, as I learned more, I added in strength training on my gym’s weight machines. And I added high-intensity intervals to my aerobic work.
And I started to notice things. my muscles swelled and I learned to love my arms for the first time in my life. I lost no weight, but my body became somehow shapelier. I was feeling older, but not uglier. Who knows if it was the exercise or merely the passage of time, but my ugly hormonal emotions — or rather, my ugly lack of the usual positive emotions — began to fade.
Most of all, I noticed that on the days when I worked out in the morning, I felt fresh and energized and clean. Younger. And on the days that I didn’t work out, I felt draggy and stale and forgetful — older.
It reminded me of the ominous classic novel “The Picture of Dorian Gray.” All my age-related and menopausal ills could be held in abeyance, channeled away just as Dorian Gray shunted all the outward signs of his debauchery to the portrait he’d hidden in a locked room, remaining youthfully beautiful to the outward world.
On the days I didn’t work out, I felt like Dorian Gray at the end of his gothic tale, suddenly bearing the full consequences of the life he’d lived.
And thus I stumbled on what I believe to be the best of all possible daily workout
motivators: I don’t dare not to. Especially on days when I need to perform well.
Our CommonHealth blog kept churning out “Why To Exercise Today” posts: It lowers blood sugar and helps with Type 2 diabetes. It helps protect bone density. It helps fight age-related muscle loss. It improves pain tolerance. It is linked to better self-image and social life.
Just as exercise seemed able to help with every single organ, it seemed able to help with virtually every menopause-related challenge. I asked Dr. Mache Seibel, editor of this magazine and a specialist on the intersection between menopause and mental health, whether exercise works directly on the hormones involved in menopause, or just does indirect good.
Exercise, he answered, first of all has the broad effect of lowering a person’s overall anxiety and stress, “which is going to make everything a lot better. and it’s going to help you sleep better. Those are things that are going to immediately improve your lifestyle, your life balance...it’s going to help you have better strength, flexibility, and weight control. It can also lessen hot flashes and other symptoms."
In terms of the hormones estrogen and progesterone, Dr. Seibel said, it can lower a woman’s systolic blood pressure during exercise, but “probably there’s not going to be a specific direct impact at the level of exercise most people do.”
So exercise is unlikely to alter the dose for women who take replacement hormones, he said. However, exercise can have a “synergistic effect” with hormone therapy. For example, say you want to avoid osteoporosis. “Estrogen is great for that, but estrogen plus exercise is better,” he said. “Say you want to prevent heart disease. Estrogen will have a favorable effect on blood flow and on your lipids, generally improve your hdl and lower your ldl, and exercise is going to enhance that.”
Estrogen and exercise are such good partners, he figures, “maybe they should call it extrogen.”
I’m not a “pills are our friends” person. And though I cover health day in and day out, I remain confused about the flip-flopping data on hormone replacement therapy. Personally, I’d only opt for hormone therapy if my symptoms were severe, far more severe than they’ve been.
But the data about exercise do not flip flop. Yes, you need to avoid overdoing it and prevent injury, but overall, the findings on exercise improving health are about as consistent and solid as the findings about smoking causing cancer.
And far more of us under-exercise than smoke. The federal recommendations are 150 minutes of moderate exercise a week. That used to seem unimaginably long to me. Now I can’t imagine doing without it.
Sometimes, when I’m writing my umpteenth “Why to Exercise Today” post, I fantasize about writing the headline, “Look. Just take my word for it. Do it.”
This program aired on August 29, 2013. The audio for this program is not available.