“A healthy lifestyle is the basis of everything,” Bitner said. “There is no magic pill.”
by Richelle Kimble • photo by Two Eagles Marcus
Dr. Diana Bitner’s desire to help others was always present; in her youth, she loved babysitting, cleaning up, participating and making a difference. She perused nearly every book in the middle school library, and despite seeing most doctors as men, she knew she could be one. She’s always embodied perspicacity, and through years of pivotal drive and education, has earned the wisdom she’s known for in the medical field.
Pursuing women’s health stemmed from the yearning desire to know more; as a physician, she was vexed when women asked specific questions on subjects such as menopause and weight gain. As fervent as she is, Bitner sought answers. She was enlightened at her first women’s health conference.
“All the information about gender-specific treatment and explanations about how women are so different from men began to sink in,” Bitner said. “I wanted to know how to make this information practical to women.”
She now specializes in women’s wellness, and to achieve her desire to impact women’s lives with crucial gender-specific information, she wrote a nationally acclaimed book titled, I Want to Age Like That—Healthy Aging Through Midlife and Menopause. For Bitner, women’s health, education and practice are “labors of love.”
Bitner has reached her 20th year of practicing OB-GYN, and her masterly practice earns her heightened recognition. She’s a certified menopause physician through the North American Menopause Society and was named the 2015 menopause practitioner of the year. She’s completed specialized training with the International Society for the Study of Women’s Sexual Health (ISSWSH) and remains involved in the medical world through impressive efforts including serving on the executive committee for Go Red For Women. Following, Bitner shares knowledge on women-specific health concerns, the link between menopause and heart disease, and effective methods of taking preventative action.
Going to the doctor for a routine checkup may be mundane, and many women arrive with no prepared questions or concerns. Taking the time to focus on self-health is essential to taking preventative action as aging occurs. According to Bitner, women in their 20s or 30s often don’t think about midlife or menopause, but preparing for this stage, which she calls “the perfect storm,” is necessary.
“The better you are and the more healthy you are in terms of preparing for the midlife, or the ‘perfect storm,’ the better you are,” she said.
When visiting the doctor, ask questions. Think ahead, be blunt, ask about personal risk factors, and family history. “We’re all busy, and we don’t think health concerns such as heart disease is going to affect us,” Bitner said. “And then it sneaks up on us.”
The Perfect Storm
According to Bitner, the perfect storm is when hormones start changing—it can be at age 50, 40, or as early as 20s depending on health circumstances. There are two storm fronts: physiology and symptoms.
Bitner describes the physiology storm front as how the body is changing. The big focus is the fluctuation of estrogen levels that occur during early or pre-menopause. This low estrogen can cause a chain of reactions including insulin resistance (which causes higher insulin levels), changes in brain chemicals (which can lead to more irritability, flight or fight mode, fuzzy brain), alterations in sex drive (which can alter self-image and relationships), and more.
Because of the physiological changes such as those listed above, physical symptoms begin to rise, creating the second storm front. For example, the physical result of fluctuating estrogen may be poor sleep due to night sweats (which can lead to a lack of motivation and energy to exercise or eat well, unproduced brain chemicals that regulate mood), increased irritability, and weight gain. “This perfect storm leads to not only decreased quality of life but also increased risk for heart disease,” Bitner said.
The Link Between Menopause and Heart Disease
During the perfect storm, a woman’s body is constantly changing. If women fail to take preventative actions, the above storm fronts may create the ideal state for developing heart disease. Take for example the physiological change of a woman’s metabolism and how she handles fat changes. “This can lead to a rise in bad cholesterol, and when good cholesterol is down, and insulin levels are spiked, endothelial dysfunction may occur,” Bitner said.
If women don’t understand the risk factors for heart disease and how the perfect storm alters body function, then the basic health practices such as eating better and exercising more can be helpful, but perhaps not enough.
The key to tackling the perfect storm is prevention and modifying risk factors. If women were aware of their life stage, which is achieved by asking questions and understanding menopause, then an enhanced everyday lifestyle can more easily be attained. The crucial detail, though, is reaching this before the perfect storm arrives.
“How I think about it is, when you cross over into the threshold of menopause, it’s as good as it gets,” Bitner said. “You’re setting the trajectory for your health for the next 50 years.”
Bitner explained how doctors can nearly time out when a woman will reach heart disease by observing her risk factors, Reynolds score (a gender-specific risk stratification score for heart disease), family history, the timing of menopause, habits and health state.
“If we can get to you before you get to that point of almost no return, we can modify your risk factors,” she said.
Modifying the Risk Factors
Bitner and Spectrum Health developed a reference for women to achieve healthy aging that they call the Seven Seeds. These seeds represent the non-negotiable needs for proper function; mastering these seeds will greatly increase the quality of life and a women’s midlife transition. “A healthy lifestyle is the basis of everything,” Bitner said. “There is no magic pill.” Following are the seven seeds, accompanied by Bitner’s explanation for emphasis.
- Water (eight 10-ounce glasses every day): Water helps with energy, helps avoid the hot flashes and night sweats, and makes our skin look better.
- Sleep (50 hours every week): “Sleep is everything. If we’re sleeping, we’re more likely to exercise, we have better moods, we’ll have more energy to get on the treadmill, and it helps our sugar metabolism,” Bitner said. “If we’re sleep deprived, the body craves sugar. If you eat it, it will go straight to fat.”
- Vitamins (multivitamin, B complex if you exercise, Vitamin D): Bitner stresses the importance of all vitamins, but especially Vitamin D given recent studies that show a link between Vitamin D deficiency and heart disease.
- Fiber (35 grams per day): Fiber is important for good bowel movements, not getting colon cancer, and menopausal and vaginal infections.
- Nutrients (carbohydrates, proteins, smart fats, one treat): “Think of simple carbs as a treat,” Bitner said. “You get one serving per day.”
- Activity: Balance aerobic exercise, strength training, and stretching over a daily commitment of 20-30 minutes.“Big studies show that women who maintain their lean body mass are less likely to have insulin resistance, heart disease, and hot flashes,” Bitner said.
- Mind-body connection (one 5-minute instance each day of metered breathing): Bitner stresses the importance of gratitude, saying, “There’s so much power in gratitude—it helps us not give power to the little stuff, and it helps us sleep, increase sex drive by being focused in the moment, build connections, be present in our bodies, make good decisions, not have addictive tendencies to sugars and caffeine. It helps so much.”
Make the Change
Aging doesn’t have to parallel with health declination. Take control of your health, ask the appropriate questions and do essential research to better understand risk management. After all, there’s a reason doctors like Bitner are so passionate about educating women on health and prevention.
“Find what works for you. Find a way to get in the little things, because the benefits will show,” Bitner said.
When she’s not editing for WLM, Richelle enjoys exploring, traveling, writing, reading, cooking, learning and playing. Follow her for adventure inspiration: @thekleerlife