“It was a sad day for me as a patient in Dr. Smith’s OB/GYN practice when she informed me she would be leaving her practice to start a new endeavor called the Midlife Wellness Center. It’s hard to find a caring, thorough doctor who is easy to relate to and I knew I would miss her. As they say, every cloud has a silver lining and as my needs changed, I soon became a patient of hers once again. The same qualities I experienced in the past, she brings to this very specialized field. I consider her expertise an indispensable part of remaining healthy. Professionalism, accessibility and a storehouse of knowledge rolled into one. We’re fortunate to have a practice such as this in Kansas City.”

Judi J.

In 1993 I was the first physician in Kansas City to begin prescribing bioidentical hormone replacement therapy (BHRT). Working with BHRT for 23 years with thousands of women has taught me a lot. Let me pass on some of the important principles about BHRT that I have learned.

What is considered midlife for a woman? Some might say they’re at a mid-point in life because their menstrual cycles have ended. But according to Brenda Smith, MD, a board-certified obstetrician/gynecologist and owner of Midlife Wellness Center in Kansas City, Missouri, midlife for a woman is actually a huge segment of time, in fact, many years representing a new and exciting phase for females to fully enjoy. However, the time to plan for a successful transition into and through this time frame requires a solid foundation of good mental and physical health that begins well before entering this phase of life.

Dr. Brenda Smith:

As a woman, a mother of two daughters and a physician who treats only women, Dr. Brenda Smith, board-certified OB/GYN, has an intense interest in fighting breast cancer.

She notes that the majority of women who develop breast cancer have no family history of the disease. “The informal statistic that has made the biggest impression on me is that it seems we all know someone impacted by breast cancer,” stated Dr. Smith. “Even though we’re aware of breast cancer, most women don’t understand what they can do to reduce their risk of this dreaded disease.”

RISK FACTORS ARE INTERCONNECTED.

Dr. Smith has counseled women for many years with expertise in hormonal systems, nutrition, metabolism, brain neurotransmitters, immune and preventative health. She opened the Midlife Wellness Center in 2005 to provide the time and individual attention needed for women at midlife. Dr. Smith says that damaging your cellular DNA, constantly stimulating cells to divide and depressing the immune system are conditions conducive to cancer. For women there are four primary risk factors for breast cancer: genetic, hormonal, nutritional and environmental.

“The body is complex and interconnected, so all of these risk factors overlap and can influence each other,” she revealed. “You may have a genetic risk, but if you control the other factors, your overall risk can be diminished.” She offers the following guidelines to help you increase your awareness of breast cancer and increase your odds of preventing it.

Arm yourself with the facts to identify your risk factors. 

“Don’t just stand in line for a mammogram once a year. You want to have a plan for prevention, so start gathering information,” advised Dr. Smith. “Read What Your Doctor May Not Tell You about Breast Cancer by John R. Lee, MD, David Zava, PhD and Virginia Hopkins, and go tobcpinstitute.organdbreastcancer.orgto learn the risks.”

Discuss your risks and your prevention plan with a health care provider.

Knowing how to conduct a breast self-exam is critical to your healthcare strategy. In addition, talk with your provider about when to begin breast screening and how often to have screenings, and then determine which type is best for your body–mammograms, ultrasounds, thermography or MRIs.

Seek genetic counseling if you are high risk.

All women need a breast cancer prevention plan, but for women who have a family history of breast cancer, the stakes can be even higher. If you have a family history of breast cancer, get counseling at a specialized center to learn how to best manage your risks.

Realize that hormone imbalance can be a breast cancer risk.

Hormone imbalance is not just inconvenient. Suspect hormone imbalance if you’re having symptoms such as breast tenderness, heavy cycles or severe PMS. This could indicate estrogen dominance, which increases your risk of breast cancer. “I would also advise you not to ‘dabble’ in hormone therapy,” she stated. “Hormones are powerful messengers in the body and should be used wisely. If you need hormone therapy, get advice from someone who’s knowledgeable and has actual clinical experience using hormones. Some hormone therapies elevate risk while others can reduce it.”

Nutrition is a powerful tool to lower risk.

Being overweight and consuming alcohol increase your risk of breast cancer. Also, choose meat and dairy products with no added hormones. Use soy only in moderation from natural food sources and increase your consumption of cruciferous vegetables and flaxseed.

Reduce exposure to toxic chemicals.

Evaluate your environment for substances threatening the balance of your body and reduce your exposure to them. Chemicals often increase cellular damage, lead to hormone imbalance and depress the immune system. Women should reduce their exposure to the chemicals applied to their bodies. Choose safer bath and beauty products such as those onsafecosmetics.org. Strive to reduce your exposure to pesticides by avoiding the “dirty dozen” fruits and vegetables fromewg.org. Avoid storing or heating food in plastic containers because chemicals can leach into foods and mimic estrogens in the body.

Exercise your body and mind.

When you exercise, blood is pumped into tissues, delivering nutrients and taking toxins away. The lymph tissue is pumped by the muscles to expel the toxins it has collected; and energy is channeled through your body.

Limit other exposures.

Reduce your exposure to radiation during medical test such as mammograms, X-rays, CT scans and PET scans.

Spread the Word.

“Let’s be the last generation that willingly accepts toxins into our bodies,” stated Dr. Smith. “Let’s be the last generation that’s ill-informed about our bodies and how they function. If you learn something, pass it on to the other women around you.”  HLM

Midlife Wellness Center is located at 1201 N.W. Briarcliff Parkway, Suite 300, Kansas City, Missouri. See the website at  midlifewellnesscenter.comor call 816 587-7979.

Typical client concerns at the Midlife Wellness Center include hot flashes, low energy, an inability to sleep through the night, weight gain, loss of sex drive and memory loss. Dr. Smith takes a comprehensive approach to her clients’ health, providing guidance on everything from bio-identical hormone replacement therapy, to nutritional assessment, to preventive medicine.

Your evaluation at the Midlife Wellness Center will last approximately 2 1/2 hours and will focus on three areas that typically concern midlife women:

1. Hormonal evaluation and advice. Did you know that your natural hormones can be unbalanced for eight to 10 years before menopause? This often results in a decreased quality of life and increased risk for female cancers. Hormone balance is vital for midlife women and is required for optimal health and well being. During your consultation, we will discuss your family health history, personal risk factors for disease and symptoms you may currently be experiencing, such as hot flashes, inability to sleep, lack of sex drive or stress. If hormone replacement is necessary, bio-identical hormones will be prescribed to bring your hormones into balance.

2. Nutritional education and advice. Nutrition is always important, but as you begin to age, it becomes vital that you provide your body with good fuel. Nutrition even affects how hormones function, or don’t function, in the body. At your consultation we will discuss any concerns you have regarding your weight. We also will develop a strategy to help you maintain a healthy weight, and reduce your risk for weight-related illnesses such as heart disease, diabetes, stroke and cancer.

3. Preventive health advice. It’s a fact that most diseases don’t just suddenly appear. They result from years of neglect and abuse. As you discuss your health, Dr. Smith will help you recognize the early warning signs of disease, and make suggestions for choices that can help you live a healthier midlife.
Following your consultation, any necessary lab work will be ordered to enhance your evaluation.

To schedule a consultation at the Midlife Wellness Center call, 816-587-7979.

The Debate Over Mammograms:

What Should a Woman Do?

Brenda S. Smith, M.D.

The U.S. Preventive Services Task Force (USPSTF) recently completed an evaluation of mammography as a breast cancer screening tool.  The task force recommended reducing the use of mammography due to the risk of radiation exposure and false positive findings that result in unnecessary biopsies and surgery.  The USPSTF recommended that for women who are not at high risk, mammograms begin at age 50 and then recommended mammogram every 2 years instead of yearly until the age of 74.  The USPSF also recommended against self-breast exams again citing false alarms and unneeded biopsies.

The Midlife Wellness Center was designed to offer the extensive health evaluation, as well as intense education, not usually possible at a routine annual medical exam. Brenda S. Smith, M.D., a board-certified obstetrician/gynecologist, will help you explore your health concerns in a relaxed, unhurried environment.

Your visit to the Midlife Wellness Center will last approximately 2 to 2 1/2 hours. Health advice will be developed based upon your unique needs, medical conditions, lifestyle and personal history.

You will maintain your primary doctor as provider of your routine health care and annual gynecological exams. At the Midlife Wellness Center, our goal is to supplement your healthcare by consulting solely on your midlife health needs.

Pulling Back the Curtain – Understanding Your Hormones and Taking Control of Your Health

by Brenda S. Smith, M.D.

Ovaries, Thyroid, Adrenals, Oh My!

For too long how hormones work in a woman’s body has been deemed too complex for a woman to understand or manage. Women have been taught to view their hormones as that mysterious Wizard of Oz behind the curtain turning knobs and manipulating their bodies leaving them little if any control of their bodies. Well ladies, let’s pull back that curtain and learn what is happening in our bodies. Hormones are not to be ignored and tolerated when they misbehave. Learn how to recognize hormone imbalance and correct it, so that your quality of life is enhanced and your risk of disease is reduced.

Every woman should know certain basic facts about hormones and health, but it seems daily in my office I teach women things that they should have been taught at age 12. In the future I hope every woman is properly educated about hormones, but for those of you who have reached adulthood confused about hormones, here are the need-to-know facts.

Demystifying Hormones 101

If I only had more space and time, I could take you on such a fascinating journey through the world of hormones. Instead, I will have to give you some snippets of the hormonal story, followed by some insights I have gained after years of experience treating women and their hormones.

• Hormones are messengers in the body that tell your body what to do turning on and turning off cellular functions. When hormones are produced in your body, what makes each hormone unique is its chemical shape. Each hormone works by finding a receptor that matches its chemical shape. Then like a key in a lock, the hormone activates the receptor and a message is delivered to your body. Bio-identical hormones are man made from plants, but are shaped exactly like the corresponding hormone in your body, delivering the exact same message at the receptor. Bio-identical hormones, working as hormones were designed to work in the body, tend to give better results with fewer side effects. I see so many women in my practice who have blindly been using inappropriate hormones and suffering the consequences. Be choosey about any hormone you put in our body – remember its message can be powerful.
• There are many hormones in the body, i.e. ovarian, adrenal & thyroid to name a few and they all communicate with each other. Some hormones like the adrenal hormones are required for life; others like the ovarian hormones are important, but not required for life. It is always important when evaluating hormones to look at the big picture and not focus on one specific hormone. Hormones do not work in isolation. For years doctors diagnosed all hormone problems as ovarian deficiency ignoring the impact thyroid hormones, adrenal hormones and even the hormone insulin can have on a woman’s health. Most women I work with have multiple hormone imbalances that must be addressed to help her achieve optimal health.
• Hormones do not just willy-nilly send messages and do what they want, they are part of a complex communication system in your body designed to help you have quality of life and survive. Hormones act based upon messages they receive from other parts of the body and from the environment. The food you eat affects that message, toxins you are exposed to affect that message, exercise and your mental state affects that message. So don’t expect to be highly stressed, polluting your body with toxins and poor nutrients and have hormones that behave the way you “want” them to. In fact, most of the time hormones don’t just misbehave – we disrupt them by making poor choices. Bottom line – to truly have hormone balance you have to look at what I call “global” health, the many facets of your health that affect your overall well-being. Don’t be misled by clever marketing that claims a simple cream, pill or patch can solve all your health problems. In fact, I would have to tell you that some of the healthiest and attractive women I see have never used hormones – they have achieved their good health by living a healthy, balanced life.
• When hormone imbalance is suspected, careful evaluation and testing is in order. Ignoring what the body is trying to tell you and guessing about hormones is not acceptable. Since 1993 I have been listening very carefully to women because what their body is telling them is important information that I want to know. I have also been testing hormones to help verify the “impression” I have formed after listening to a patient’s story. This combination of listening and testing has proven to be invaluable in coming up with the correct diagnosis. If you suspect hormone problems, get help from a physician trained to diagnose and treat hormone disorders. Don’t let someone with minimal knowledge of your health prescribe hormones. Your hormones are not just pesky problems; they are an important part of your health.
• At every stage and every age of life hormones are required, but the correct recipe for hormonal health changes as we age. The set of hormones that are beneficial at one stage of life can actually be detrimental later in life. The body uses hormones wisely, not indiscriminately. Anabolic hormones that cause cells to divide like estrogen can be a risk for cancer. When we are young and need to reproduce, the advantages of these hormones usually outweigh the risks. As we age, however, continuing to stimulate cells to divide can be a bit riskier. Careful evaluation of each individual’s specific risks & benefits is important before using anabolic hormones. Read What Your Doctor May Not Tell You About Premenopause /Menopause by John Lee, M.D.

 

Action Tips

Set the intention to be actively involved in your health. This means having a basic understanding of hormones and how they work. Read What Your Doctor May Not Tell You About Premenopause/Menopause by John Lee, M.D. Realize that you can achieve balanced hormones by adopting a healthy lifestyle.

Don’t ignore symptoms that warn of hormone imbalance. See an informed physician who will listen and test to determine if a hormone imbalance exists.

Don’t dabble in hormone therapy. It’s important to look carefully at the risks & benefits of hormone therapy before initiating any treatment. When using hormone replacement therapy (HRT), insist on an individualized approach to hormone therapy that is comprehensive and has your safety in mind.

Accept that your health is complex. Don’t blame every health problem on hormones, take responsibility for your diet and lifestyle and don’t expect HRT to work without addressing other health issues.

Why All Calories Are Not Created Equal

by Brenda S. Smith, M.D.

Eyes Wide Open

When it comes to eating correctly, all you have to do is open you eyes. Really look at things and see them for what they are. Look in the mirror - are you satisfied with what you see looking back at you. Look at your dinner plate – is it food from nature that your body was designed to accept and use appropriately. Open your eyes and truthfully evaluate what’s in front of you.

Dear Friend,
Most women want to be healthy--but being healthy is confusing--especially at midlife. You are constantly bombarded by news reports, drug companies, diet gurus, and well-meaning friends who offer you conflicting advice on everything from hormone replacement to botox.

The one thing we can all agree on is that as we age, we begin to experience a decline in our health and well being brought on by unbalanced hormones, poor health habits and years of stress.

That is why after many years in a traditional obstetrical/gynecological medical practice, I am thrilled to be able to offer a unique service to women called the Midlife Wellness Center. It is my passion to help you sort through the endless maze of midlife health questions you have, and find a logical, rational approach to your personal midlife health concerns based on the latest scientific research.

At the Midlife Wellness Center, you won't find the usual distractions of a doctor's office. Instead, we offer a consultative service where we will work with you in a relaxed, pleasant atmosphere. Our mission is simple--to devote the time and attention you deserve to provide high quality, personalized care that meet your needs As a woman in the midst of midlife myself, I know from first-hand experience that if you want to live a full, active life, now is the time to take control of your health, or suffer the consequences. Let's work together to help you achieve a healthier midlife.

Brenda S. Smith, M.D., Founder, Midlife Wellness Center