Goodman knows you don't want to hear this, but if you want to weather The Change, he says, make changes. "You need to do the basic work, the building blocks, yourself before medications and other modifications can kick in and help. Good nutrition, sleep and stress management, and exercise all seem to raise serotonin levels (the key), which will help reduce symptoms."
His way of stressing exercise (to be fair, a mainstay of all three books) -- actually got me to the gym. "An important point: Do not look on exercise as fun!" he writes (a huge relief to me). "It's like a job you have to do to put food on the table."
Dummies: As uneven as readers' mental state. Pun alert: Know the "shape urine."
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_____Live Discussion_____
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Marcia Jones will be online Tuesday, Feb. 8, at 2 p.m. ET to take your questions about women's health and the various stages of menopause and how it can affect your body, your emotions, and your libido.
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Goodman's analysis is clear; his treatment suggestions exacting. Is your PMS getting worse as you get older? Among other things, Goodman suggests drinking half-caf coffee most of the time, then going to decaf during PMS week. If you try cutting caffeine just during PMS times, you're likely to get a cold-turkey headache. Although he advises PMS sufferers "if it's a brown liquid, don't drink it," his suggestions acknowledge that giving up caffeine entirely may be unrealistic.
I learned more from this book's two pages on menstrual migraines (a subject I'm all too familiar with) than I have in discussions with half a dozen doctors over the years. One suggestion I've never heard (and will be sure to ask about): "Try a mid-dose estrogen supplementation for approximately one week, beginning plus or minus one day before your expected cyclic 'bad days.'"
There's straightforward information, too, on topics including irregular bleeding (what's normal and what's not), "your pelvic floor and other things that fall out," the difference between hormone pills and patches ("stay away from oral estrogens if your libido's gone south!"), and when "isolated hormone testing makes sense."
Goodman is very clear on the meaning of the Women's Health Initiative study: "There is absolutely no evidence that short-term estrogen supplementation (defined as under 2-3 and probably for 4-5 years) increases in any way a woman's likelihood of succumbing to breast cancer."
He even has a warm spot in his heart for placebos. "The placebo effect is one of the most wonderful (and safest) results of many medical and paramedical therapies," he writes.
Goodman's final chapter on medical treatments on the horizon (more about SERMs) and his view that "there is always a way" actually made me a bit optimistic about my next 10 years. Given my state of midlife colic, that's not easy to do.
Of all three books, "The Midlife Bible" is the shortest, the cheapest and the best. This extremely judgmental moron gives it an A.
Now, if you're serving humble pie, make mine with whole wheat.•
Stefanie Weiss is a regular contributor to the Health section.
