Thanks, Jane 

I want to join the chorus of reassurance here. I'm 46 too and I've been  feeling like the past 2 years I've been slowly being dismantled,  physically, emotionally and intellectually, by forces beyond my control.  I've always been a bit of a space shot but lately it's been way more than  usual. Keys for instance. Walking into a room and wondering why I've done  that. I'm not on any meds -- it's a natural benefit :). This group has  really helped to reassure me in the month or so that I've finally  realized "aha, menopause," as has the reading that I've done in books recommended at the unofficial website. That might also help you if  you have time to read -- check some of those titles out.

BTW I took Zoloft for a major depression 2 or 3 years ago and although I  had some pernicious side effects from it, memory loss wasn't one of them.

One thing I'm noticing is that every day is different. A month ago I had  so many symptoms I thought I was on Mars. Lately I'm feeling pretty good,  pretty clear, pretty connected. It drives home to me the wisdom of "one  day at a time" which I have as a screen saver on my computer, lest I  forget.
Hang in there, 
Chansonette

If it weren't so disconcerting, it would be funny.  When I was having quite a bit of this one day, I told my son I felt brain-dead.  He laughed and said, "no, Mom, you're dead-brain".  He was making fun of my inability to put two words together in the correct order, which also happens to me when my brain is fogged.  Also, I go around in circles sometimes, and can't remember what I started out to do--it's ridiculous!  But funny too, if you can laugh about it.  My 12 year old son and I are the only two at home anymore, and he is going into puberty as I go into peri, so what a pair we are.  He has many of the same symptoms, and we try to laugh it off and encourage one and other.

You are aging into something very rare and rich, so be kind to yourselves!

Colette
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 No, just being menopausal does not cause gum recession. But hormones can impact existing gum conditions. 

 I posted in the archives many months ago the high points from the American Academy of Periodontology (gums) brochure called Women and Gum Disease. Hormones can have an impact on the gum tissue, but recession is not one of them. Typically one gets an overgrowth of tissue responding primarily to progesterone -produced by the body, especially during pregnancy or taken as a drug. 

 There is a generalized oral tissue complaint known as menopausal stomatitis (mouth tissue disorder) which is rare and badly researched. It may be due to factors other than menopause, but currently it is labeled as such. But again this is not a recession problem. Also many medications (OTC and Rx) have "dry mouth" (and dry vagina) as a very common side effect, so this too is something to watch out for. 

 Recession can have many causes: excessive wear, grinding, bad "bite"  brushing, past orthodontics weakening side bone walls, bone loss from gum disease, bad oral habits and SMOKING.  Depending on the cause, it can either be re-grafted with new tissue and covered over or the underlying disease can be repaired with bone grafts and full gum surgery. But sometimes, if the bone loss is severe, the disease can be cured, but the gum covering can not be re-grown at the former height. 

 I recommend that -everyone- (and yes, I do work for a periodontist)  have a baseline periodontal exam at midlife to be sure there are no early problems that may be overlooked by one's general dentist. I have observed the quality of dental hygiene care for 32 years and it is highly erratic, even when a patient thinks they are getting good care. Be sure you get all of your gum crevices measured at least once a year at your dental cleaning appointment. And if your dentist does not provide that service (competently) then for sure see a periodontist for a general exam.

 In dentistry, an ounce of prevention goes a long way. Stress and some medications can cause bone loss as well, which can lead to visible gum recession sometimes, but not always. Excellent oral hygiene daily is the best and cheapest way to insure a life long healthy mouth. And this means carefully brushing the gum line and cleaning thoroughly in between the teeth with floss, toothpicks or interproximal brushes. 

 Number one good oral health habit: quit smoking. New research is showing a connection between bad gum health and heart disease, low birth weight babies and premature birth and diabetic insulin instability. One can not have a healthy body when the mouth harbors major infection. 

shelly

SACRAMENTO, Calif.--(BW HealthWire)--June 2, 1999-- In a first of its kind survey of more than 100 California women dentists, women professionals cite the biggest oral health problem for women is the onset of periodontal disease, or gum disease, which can strike them at different times than men, due to pregnancy and hormonal changes, particularly during menopause. 
<snip>

Although this oral disease strikes both men and women, women are more susceptible and the disease can become much more severe during pregnancy and again later in life. 

Anti-depressants, diuretics and anti-allergy medications taken by women can contribute to periodontal disease by decreasing the amount of saliva in the mouth. This creates an optimal environment for disease to flourish. Additionally, the increased use of estrogen replacement therapies and other medications taken by menopausal women can contribute to increased gum disease. 

``I have noticed a profound effect of hormonal and other drugs on the periodontal condition of my female patients. As women begin experiencing menopausal symptoms, they become more aware of their overall health and receive more prescription therapies. They should also become aware of how these drugs may interact with their body's natural system of fighting other diseases,'' said Nicky Hakimi, DDS, a CDA member and practicing Sacramento periodontist. 

Weight gain or loss is a possible side effect of HRT.  Lots of people gain weight in perimenopause (the time, which can be as long as ten years, of hormonal changes leading up to actual menopause).  I was having anovulatory periods, which meant I had plenty of estrogen but no progesterone because my cycle wasn't working.  I gained a fair amount of weight on my own estrogen.  When I took progesterone alone to correct the situation, I lost weight. 

I don't think standard dieting can accomplish anything, and in fact I don't think it ever can; I'm an expert in failed diets.  What your SO might want to concentrate on is eating healthily -- you know, fresh fruits and vegetables, whole grains as the main components of the diet, not leaving out the occasional indulgence if it's comforting -- and on getting some exercise.  My weight, according to various doctors' scales (I gave up weighing myself ten years ago and have never regretted it) didn't change much when I got a great deal of exercise one year in perimenopause, but my clothing sizes changed. 

I snipped a brief discussion in your message about water retention, but that can also happen.  The HRT is going to mask what's going on in her body underneath, but one thing that can happen in perimenopause is lengthened times of PMS, and sometimes getting PMS for the first time. I thought for the past month that I had gained enough weight I should probably get some new bras and jeans, but it was just an ungodly long bout of PMS, including bloating, and now that I'm having one of the worst periods of my entire life (one's body appears to forget how to do this, to work very hard at remembering, and then to become really, really intent on it; geez), everything fits again. 

If she can possibly stop worrying about the numbers on the scale and get some comfortable but beautiful clothes it will help a lot. The reason I only needed new bras and jeans, or thought I did, was that everything else I have is very loose and adjustable. 

Good luck. 
Pamela Dean Dyer Bennett 

These pages aim to provide some helpful tips on how to lose weight. Their emphasis is that small changes can make big differences and that the healthy way to lose weight is gradually. They begin with some general principles on how you might like to start thinking about losing weight. They then summarise the current guidelines for a healthy diet and use these as the basis for some practical tips to help with weight loss. 

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A short, non-technical summary of the body's need for a reasonable amount of "good" fat can be read at http://www.thirdage.com/news/archive/ALT02990623-01.html?hnav

A study reported in the Journal of the American Heart Association this year indicates that, for women, eating a diet extremely low in saturated fat may sharply increase the risk of hemmorhagic stroke. (The URL is too long to copy here, as it would wrap to several lines, but you can read the abstract by going to http://www.ahajournals.org and using their search engine and entering "Stampfer" as author, "stroke" as keyword and choosing February 2001 as the journal date.)

A 1997 study in the New England Journal of Medicine suggests that very low-fat diets may increase the risk of heart attack by lowering HDL ("good" cholesterol").

There are plenty of other references if you're persistent. Medscape (http://www.medscape.com ) is a good place to look; registration is required to access most of the "meat" of the site, but it's free.

The key here is "very low fat," defined as a diet which derives less than 15 percent of its energy (calories) from fat. No one (well, except for a few authors promoting their own fad diets) is suggesting we all go pig out on butter and cream. As is so often the case, the best dietary advice is the boring kind: Balance and moderation - and increased physical activity.

http://www.second-opinions.co.uk/nonsense_diets.html is a pretty good overivew of the biology of eating, including a look at many of the fad diets of the last half-century and why *none* of them work over the long haul. (Caveat: The author is evidently promoting his own diet book, but that stuff's down at the end and you can ignore it if you like.)

Food, in and of itself, is neither poison nor medicine. It's food. We need it to survive, and we ought to derive some pleasure from it. If we all got enough exercise in the course of our daily lives to work off 
some of the excess, I doubt we'd be so obsessed with tinkering with food chemistry in some vain hope of reshaping our middle-aged bodies.

--Pat Kight
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