YOU DOCS

Garden City Telegram

Q: I'm a year past menopause and, for the first time, I have belly fat. I've also gained weight. How can I reverse this trend and lose the fat? - Lanny F., Portland, Oregon

A: You're not alone; almost 75% of women over age 55 in the U.S. are overweight or obese. Combating that is a priority for maximizing length - and most importantly, quality - of life. 

One of the reasons older women gain weight is that blood levels of estradiol, a form of estrogen, decline measurably after menopause. That change in estradiol also changes one of its metabolites, testosterone (yes, women have testosterone) and together they alter how you burn calories and manage fat. Researchers have found, however, that hormone levels aren't the only thing in decline. 

A study in the International Journal of Obesity tracked 158 healthy premenopausal women, age 43 and older, for four years. The researchers found that women who became menopausal were getting half as much physical activity as they had in the four years prior to menopause - and their activity levels remained low. And while everyone in the study added visceral belly fat - post-menopausal women added the most.

That belly fat, accumulating around your internal organs and boosting bodywide inflammation, ups your risk for diabetes, heart disease, dementia, and colorectal and breast cancer - not to mention depression, a lousy sex life and digestive woes. 

What can you do about it? A lot. You can rebuild muscle mass with 20-30 minutes of resistance and strength training two to three times a week and get 150 or more minutes of high-intensity interval training cardio exercise weekly - stoking your metabolism. And you can upgrade your diet by eliminating ultra-processed foods, enriched flours, partially hydrogenated oils, and saturated and trans fats. That reduces fat-storing inflammation.

Need some help? Check out "How To Lose Weight After Menopause," and "Get Rid Of Belly Fat," on DoctorOz.com. Or borrow our book "YOU: Staying Young," revised, from your neighborhood library.

Q: I'm experiencing erectile dysfunction - I'm 45 - and I tried one of the pills they advertise, but it doesn't really help. What's the best treatment? - F.J., Chicago

A: More than 30 million men in the U.S. deal with erectile dysfunction. The causes range from medications, psychological and emotional turmoil, and operations such as a prostatectomy, to low hormone levels, obesity, atherosclerosis and smoking. ED is affecting more young men as the epidemics of sedentary living, diabetes and obesity spread to guys in their 30s and 40s. One 2013 study found that 25% of men seeking medical help for new onset ED were under 40. 

Becoming heart healthy is step No. 1 for long-term improvement of every bodily function, including sexual function. So, eat a healthy plant-based diet, get lots of exercise, adopt good sleep habits and take medications, such as statins, if needed.

There are also medications that promise immediate help. They're PDE5-inhibitors - such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra or Staxyn) and avanafil (Stendra). However, they're not effective for around 30% to 40% of men who take them, according to a study in Therapeutic Advances in Urology. Worse, many generics only deliver 10% to 15% of the active ingredient on their label. 

Now, a study published in JAMA Network says taking a dose of antioxidants, such as L-arginine, along with your PDE5-inhibitor increases the benefits. (You can also get 'em by chewing - very well - spinach or kale.) While the combo is especially helpful for ED associated with low testosterone levels or a prostatectomy, the researchers suggest it should become first-line therapy for all guys. The duo works like this: PDE5-inhibitors tamp down an enzyme that can interfere with blood flow into and out of the penis. The antioxidant raises levels of blood-vessel-relaxing nitric oxide - giving blood flow a second boost. 

One more tip: If there's an emotional component to your ED, talk to a therapist. These medications aren't remedies for psychological obstacles. 

Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer Emeritus at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com.

Distributed by King Features Syndicate, Inc.