More and more, experts are recommending a diet heavy in healthy, plant-based foods (vegetables, greens, fruits, nuts, grains, and legumes) and light on animal products (meat, eggs, cheese, milk, and other dairy products) and processed foods to improve health in midlife and beyond.

Every body is different, but there are a few reasons to consider eating more plants and less meat:

• Alzheimer’s disease: Dr. Lisa Mosconi on our advisory board recommends a plant-based diet as a way to reduce your risk of Alzheimer’s disease. 
• Heart disease: cholesterol is a risk factor for cardiovascular disease and is only found in animal products like meat, cheese, eggs, and yogurt. Beans, grains, fruits, vegetables, and other plant-based foods are cholesterol-free. Doctors recommend no more than 300 mg of cholesterol per day for people without risk factors for heart disease and 200 mg for at-risk people; a single egg has 212 mg.
• Breast cancer: grilled, barbecued, and smoked meats may increase your risk of breast and other cancers because of carcinogenic compounds created by burning muscle protein and animal fat.
• Obesity: a plant-based diet can help you lose the weight you gain in midlife. This can be really helpful if you’re concerned about dangerous adipose belly fat.
• Gut health: fiber becomes more and more important as you age, and plant-based diets are full of fiber.
• Longevity: cultures and communities that follow a plant-based lifestyle tend to live longer than others.

Whether your goal is to go fully vegan (consuming no animal products at all, including meat, eggs, and dairy), vegetarian, follow a Mediterranean diet, eat fewer animal products in general, or go meatless once a week (#MeatlessMonday), any new dietary change requires at least a little effort and commitment. 

Here are a few tips for making plant-based modifications stick.

Please note: while we do recommend products and books, none of this content is sponsored. These are resources we’ve found helpful and think may help you. Talk to your doctor (or one of our menopause practitioners) before making any dietary changes.

1. Remember: veggies are part of any healthy diet

Many people approach vegetarianism with the idea that you will be eating more produce (and hence, more kitchen prep time) than you did before, but they forget that fruits and vegetables should be a part of any healthy diet: 50% of your plate should be leafy greens and veggies.

If you think about it this way, you’re really just swapping out the protein. That’s not so hard, is it?

2. But don’t just eat vegetables

Plant-based doesn’t mean only eating fruits and vegetables; you still need protein (see below for more info on this), healthy fats, and carbs. You’ll become fatigued and hungry quickly if you remove animal products and don’t replace them with their nutritional equivalent: not a recipe for long-term success!

3. “Vegan” does not always mean “healthy”

Vegan donuts, cookies, cakes, ice cream, pizza, and burgers may not have cholesterol but are highly processed treats to be eaten in moderation. 

Still, a good vegan cupcake can be life-changing: plant-based eating doesn’t have to mean deprivation!

4. Educate yourself on nutrition

A healthy plant-based diet will give you almost all of the nutrients you need. The one exception is vitamin B-12, which is mainly found in animal products like meat, eggs, and dairy. When you’re limiting your consumption of animal products, consider shopping for a good quality supplement or research and eat some vitamin-fortified foods.  

“Wait,” you may ask, “I’m not going to get everything I need from the food I eat?” You may be surprised that many of your favorite nutritional powerhouses, like milk and bread, are actually fortified with minerals like iron or vitamins.

Educate yourself a bit on nutrition and, again, talk to your doctor before making any dietary changes. 

5. “Where do you get your protein?”

You may have been told your whole life that you need meat to get enough protein, but a healthy plant-based diet provides more than an adequate supply.

Beans and other legumes, grains, nuts and seeds, tofu, and even many vegetables are excellent sources of plant-based protein.

You’ve probably heard that to get a complete plant-based protein, you need to eat beans or tofu with rice or some other grain. While most plant-based protein sources are missing one or more of the nine amino acids that form a complete protein, your liver stores amino acids for later use, so as long as you’re getting everything you need in a 24-hour period, you don’t need to be militant about pairing complementary amino acids.

6. Say yes to soy in midlife

Soy sometimes gets a bad rap, but experts at Harvard University say that soy has either a beneficial or neutral effect in the body, especially as estrogen levels decline. 

The phytoestrogens in soy called isoflavones can mimic the protective effects of estrogen in the body, potentially helping with hot flashes, type 2 diabetes, depression, bone loss, cardiovascular disease, breast cancer, and dementia.

As with many nutrients, phytoestrogens are best when consumed through the diet; the American Cancer Society recommends against soy supplements. 

A note on tofu: Plain, raw tofu can be unappealing, but so is unseasoned chicken. It’s all about the flavor and texture: play around with marinades, sauces, and preparation methods, like pressing, frying, and grilling it.

7. Branch out and try new dishes at your favorite restaurants 

Chinese, Ethiopian, Indian, and Thai are just a few of the global cuisines with a focus on vegetables and are easily made without meat. Keep in mind that many Indian dishes are often cooked with clarified butter (ghee) and Thai curries generally have fish sauce, but most restaurants will be more than happy to work with your needs.

8. Dine at a few vegan restaurants

Who does plant-based food better than plant-based chefs? Vegan restaurants are popping up all over the country, and not just in big West Coast cities: Omaha, Nebraska is home to one of the top-rated vegan restaurants in the U.S.

A quick search on Google or HappyCow can help you find options in your area.

9. Cook like the pros

Try one of these cookbooks:

• How to Cook Everything Vegetarian by Mark Bittman: if you want to really learn how to cook or just how to make beans, roast vegetables, or even make your own pasta, reach for this tome.
• The Moosewood Cookbook by Mollie Katzen: a classic vegetarian cookbook for 45 years.
• Veganomicon by Isa Chandra Moskowitz and Terry Hope Romero: an all-around solid vegan cookbook.
• The Homemade Vegan Pantry by Miyoko Schionner: plant-based cheese, butter, and other pantry staples can be expensive, but making your own can be both easy and delicious.
• Vegan Soul Kitchen by Bryant Terry: low-fat soul food to show you that plant-based isn’t deprivation. 
• Vegan For Her: The Woman’s Guide to Being Healthy and Fit on a Plant-Based Diet by Ginny Messina and JL Fields: written by a registered dietitian and a midlife vegan coach, this book includes recipes and advice tailored towards women.
• Fresh from the Vegan Slow-Cooker by Robin Robertson: explore the slow cooking world. Many of the recipes in this book are gluten-free, soy-free, or low in fat. 

Your local library will have these or other options for you to explore with no financial commitment. And, of course, you can always search for recipes online for whatever you’re craving.

If you don’t even know where to start, a plant-based meal service (like Purple Carrot), online or offline cooking classes (like Rouxbe), or YouTube videos can give you the confidence you need.

10. Many of your favorite dishes are already plant-based (or close to it)

You don’t need to venture too far out of your comfort zone! Think about all the things you eat that are naturally plant-based or could easily be modified: hearty green salads, fruit salad, spaghetti and marinara sauce, vegetable or lentil soup, curries, falafel, burritos, banana bread, and even a good ol’ PB&J.

When you’re on the run, Burger King and White Castle offer the Impossible burger, and Chipotle and Taco Bell have many great options for vegetarians and vegans. Bonus: if you hold the meat in your Chipotle burrito, guac is free. #score

11. Keep it simple

Any transition is stressful enough, so stick with cooking easy meals: stir-fried veggies and tofu, smoothies, bean-based chili, pasta, tacos, kebabs with tofu and veggies, soups, and steel-cut oatmeal are approachable weekday options.

If you still don’t know where to start, fill your plate with salad and veggies.

12. Recreate your favorite dishes

Craving lasagna? Scalloped potatoes? With a few substitutions, almost anything you already love to cook can be made plant-based: mashed banana or egg replacer fill in for eggs in baked goods, tofu or a store-bought substitute like Beyond Meat can stand up against meat in many dishes, and a non-dairy milk like soy, almond, or oat subs for cow’s milk.

Look for a recipe online if you can’t convert one from a favorite cookbook.

13. Take it at your own pace

Some people change their diet cold turkey and never look back, while others prefer to gradually make the switch. 

Some people find that swapping out a beef patty for an Impossible burger is something they can stick to right away, while others prefer to start with whole foods that don’t imitate the meat or dairy they crave.

Over time, you’ll find it to be easier and easier to manage.

14. Plant-based diets have a reputation for being expensive, but they don’t have to be

Veggie meat and non-dairy options are better than they have ever been. There’s more variety, better quality, and you don’t even have to go to the “granola” grocery store to find them.

Still, processed foods are expensive and not always healthy. Save money by buying nuts, dry beans, and other staples in bulk and sticking to whole foods. 

And what’s cheaper than rice and beans? If this sounds punitive, you just haven’t had good rice and beans.

15. You may need to swap more than just the food

You and your partner used to love date night at the local steakhouse, but your only plant-based option there now is a sad garden salad.

If date night is really just about the meat, you’re out of luck (in many ways), but happy couples really just want to spend time together. 

Switch it up! Swap a food-date for an activity- or adventure-date. Explore new restaurants, go for a hike, play pool at the local dive, or find other ways the two of you can share a special connection.

16. Don’t restrict yourself

If you want to eat something that’s not plant-based, eat it. If date night needs steak, eat steak. If your mother will be upset if you don’t eat her famous lasagna “” and you want her famous lasagna “” then eat lasagna.

Restricting yourself too much will make you resentful. If you’re doing this for your health, you have the motivation to keep it up; a few missteps won’t hurt and could even improve your long-term approach.

17. One bad plant-based meal or product doesn’t mean that all plant-based food is bad

If you go to a bad burger joint, you don’t think that all burgers are bad. You just had a bad meal.

The same goes for plant-based dining and products. You may need to try different foods or, say, different brands of vegan cheese until you find what you like.

18. Your family doesn’t need to be on board (though it helps!)

If you’re the cook in the family, you know that it’s already hard enough to feed a picky teenager or spouse without adding another complication.

If you’re tempted to cook separate meals for yourself, opt instead for a la carte: serve meat, cheese, or dressing on the side with pasta or salad or put together a taco, burrito, or baked potato bar so that everyone can add what they want.

19. Find community

Everything is easier with a support network. You are going to have questions, question your commitment, and maybe even encounter a few other issues. If you don’t know anyone else who is trying to cut down on meat, eggs, and dairy, search for online communities on Facebook, Meet-up, or YouTube. And definitely join our Community too.

20. Remember why you’re doing this

You’re changing your diet so that you can see all the places you want to see in retirement. You’re doing it to take up that hobby you’re always wanted to try. You’re doing it to keep up with your grandchildren. You’re doing it to feel better and live longer. Remember this when the going gets tough. Feeling better and living better is worth it.

Are you ready to adopt and activate any of these tips toward eating a more plant-based diet? Share your favorites, and your progress in our Community. We’d love to cheer you on, too!

Her older sisters told her that her symptoms were just part of perimenopause. 

But she knew her excessive nighttime sweating, severe fatigue, and especially her unexplained weight loss were signs of something more serious. She felt these were not just warning signs of menopause. She persisted and eventually received a diagnosis: a rare form of cancer. 

After several rounds of chemo and a stem cell transplant, she’s back to thriving””because she knew her body and her symptoms.

Midlife can be as confusing and full of changes as adolescence. Your body is going to do things that don’t feel normal to you but are a natural part of perimenopause and menopause. 

Unless they aren’t.

Chances are, what you’re experiencing is due to hormonal changes in perimenopause/menopause or to aging. But you know your body best, and if something feels more urgent, don’t hesitate to take it to a qualified medical professional. Pay attention to what and how you’re feeling; you may want to take extra precautions with some menopause symptoms if you have a personal or family history of certain conditions or symptoms that come with other discomforts.

If you are experiencing unbearable symptoms, a Gennev board-certified OB/GYN can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

Talk to your doctor if you notice any of these red flag warning signs for menopause

1. Fractures before menopause.  If you’ve broken a few bones, or even just one, after age 50 and before menopause, you’re at greater risk for  osteoporotic fractures after menopause, even after all other reasons for osteoporotic fractures (like maternal fracture history, bone mineral density, diet, and drug use) are ruled out. Talk to your doctor about preventative measures.
2. Post-menopausal bleeding or discharge. Irregular, inconsistent bleeding or unusual or foul-smelling discharge should raise a red flag for people with uteruses at any point in their lives, but any bleeding or discharge after your periods stop in menopause is a major red flag; it could be a sign of uterine cancer. Your doctor may order some testing for you, including an ultrasound and biopsy.
3. Weight gain, brain fog, fatigue, temperature regulation, and irregular periods if you have an autoimmune disease or family history of thyroid problems. Many of the symptoms of hypothyroidism can mimic the symptoms of perimenopause. The most common cause of hypothyroidism is Hashimoto’s disease, an autoimmune disorder that attacks the thyroid, which is why people with Type 1 diabetes or celiac disease especially should rule out Hashimoto’s. And, of course, if hypothyroidism runs in your family, you might want to talk to your doctor.
4. You’ve had a major depressive episode prior to perimenopause. Fluctuating estrogen is enough to make anyone in menopause moody. But if you’ve had a major depressive episode in the past, you are 59% more likely to have another as you enter perimenopause. And if you haven’t, but are experiencing fatigue, headache, and a sense of prevailing sadness now that you’re in midlife, you may be depressed and not even realize it. Mental illness is no joke; talk to your doctor about your options before your mental health takes a downturn. There’s no shame in it, and no shame in seeking help.
5. Excessive sweating. Hot flashes are a normal part of menopause, but excessive sweating, especially nighttime sweating, can be a sign of something more serious, along the lines of heart attack or lymphoma. If you’re soaking through the bed sheets every night, especially if you also have unexpected and unintended weight loss, and/or a lump in your armpit, neck, or groin, talk to your doctor.
6. Incontinence. 30-40% of women experience midlife incontinence, but feeling pressure on your bladder or sudden urges to urinate when you haven’t had them before could be a sign of ovarian cancer. Ovarian cancer in its early stages has few to no symptoms, and in the later stages can easily be mistaken for menopause symptoms. If you have just incontinence, chances are you’re experiencing the normal issue that comes with estrogen withdrawal. However, if you’re also experiencing bloating, quickly feeling full when eating, unintended weight loss, pelvic pain, changes in elimination (like constipation), and incontinence, make an appointment with your doctor. 
7. Cognitive challenges that go beyond brain fog. Menopause and brain fog is a normal combination or symptom. Mood fluctuations are a normal part of menopause. It’s not uncommon to forget where you put your keys every now and again or have a word right on the tip of your tongue. However, if you have trouble maintaining a conversation, regularly forget the month, year, or where you are, or can’t remember how to pay the bills, or if your friends and family begin to notice changes in your personality, see a doctor. It could be a sign of something more serious such as early-onset Alzheimer’s or dementia. 
8. Headaches. If you’re someone who regularly suffers from headaches, the good news is that the prevalence of headaches tends to decrease in your 40s. The bad news is that headaches after menopause could be a sign of something more serious. If you didn’t have headaches before menopause or your headache is accompanied by fevers, chills, muscle aches, nausea, or weight loss, gets progressively worse, or hurts more when you stand up, call your doctor. But don’t let this stress you out: migraines and tension headaches are still the most common form of headache in midlife and beyond.
9. Back pain. Pain is never a good thing, though we often see back pain as a normal part of getting older. Sitting too much, poor posture during exercise, and even your mattress can all contribute to spinal aches. But when the pain is localized or acute, you might want to get it checked out, especially if you have osteoporosis or a family history of cancer. If your pain gets worse at night, while you lie in bed, or when you take a deep breath, or occurs without activity, talk to your doctor””especially if you have a cough, unexplained weight loss, fatigue, or begin to cough up blood. 25% of lung cancer patients report mid to upper back pain before being diagnosed. Lower back pain, when combined with constipation, bloating, pelvic pain, loss of appetite or urinary issues, can be a warning sign of ovarian cancer. Best to talk to your doctor and get yourself checked out.
10. Your doctor dismisses your concerns. If you can’t have an open conversation with your OB/GYN about your menopause symptoms or feel like he or she dismisses your concerns, find a new doctor. Seriously. Here’s more on what to look for when selecting an OB/GYN in menopause.

Know what’s normal and what isn’t.

Read up on what to expect in perimenopause and menopause.  

And always trust your gut. Talk to your doctor or one of ours if you have any concerns about your health, your body, and your journey through menopause.

Life is nothing if not the opportunity to continuously learn about, well, anything you’re interested in, especially yourself. In our ongoing quest to help answer questions around the hormonal journey, we thought it would be fun to test your menopause knowledge. A fun test? Absolutely, because this one provides helpful clarification around some of the common questions you might have. And, afterall, knowledge is power.

Get ready. Get set. Let’s take the Gennev team’s 10 Question Menopause Quiz!

If you are dealing with unbearable symptoms, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

The 10 Question Quiz For Menopause

1. Should you continue to use birth control even if the frequency of your periods decreases?
2. Does the arrival of perimenopause mean no more PMS?
3. What’s the average age for menopause to begin?
4. Could smoking bring menopause on sooner? 
5. Is it true that soy products may help alleviate some menopause symptoms?
6. Are there any mammals that experience menopause?
7. Is there a test that will confirm the onset of perimenopause?
8. “Manopause.” Does it exist?
9. Are there natural medicinal alternatives that may help with perimenopause and menopausal symptoms?
10. Will menopause spell the end of my sex life?

Answers

1. True! Until you’ve gone a full year with no periods (which is the definition of “menopause”), you may still be fertile, so continue using birth control because you may still get pregnant until your one-year meno-versary (and yes, we just made that term up). Also, you should probably check in with your doctor if your periods are changing in any way.*
2. Wouldn’t that be awesome? But it’s false. The onset of perimenopause may actually make PMS symptoms worse for a while. Irregular ovulation, fluctuating hormones–even perhaps our lessening ability to deal with PMS because of perimenopausal symptoms–all contribute to this fact. Talk to your doctor* about treatments that can help relieve some of the symptoms of PMS.
3. The average age of menopause is 51 for women in the US. If you chose 42, that’s probably because it’s the answer to life, the universe, and everything. It’s just not the answer to this question. It is important to note, though, that this is just an average. We’re all individuals, and our hormonal journeys will be unique to us.
4. Smoking can cause menopause to start as much as two years sooner. While two extra period-free years may sound like a bonus, it’s important to remember that estrogen protects us from many health concerns. Two extra years of no periods can also mean two years of increased bone loss and increased risk of heart disease, Alzheimer’s, diabetes, and some kinds of cancer.
5. Soy lovers rejoice: It’s true! Certain plants such as soy contain phytoestrogens which can mimic some of the behavior of women’s natural estrogen. Eating tofu, edamame, miso, and tempeh may help reduce hot flashes and other menopausal symptoms. However, there are potential drawbacks to over-consumption of soy. Soy can lead to a possible higher risk of breast cancer, so, as always, talk to your doctor.*
6. Orcas also experience menopause, and we think the ocean sounds like the perfect place to be during a hot flash, frankly. Scientists theorize one reason orcas and human women cease reproduction relatively early in their lives is because the community benefits more from their wisdom than their reproduction. We think society can benefit from women’s wisdom any time in their lives. Probably pods, too.
7. While most women assume menopause is the reason for their symptoms and don’t get a formal diagnosis, it is possible to determine onset of menopause by taking a test. A blood test can determine if FSH””the follicle stimulating hormone””is at menopausal levels. Women with a history of thyroid issues may want to be tested to be sure the issues they’re experiencing are menopause or perimenopause and not due to thyroid malfunction.
8. “Manopause” (OK, it’s actually “andropause” but come on, “manopause” is much funnier) is actually a decrease in the male sexual hormone testosterone. Defined as “a syndrome associated with a decrease in sexual satisfaction or a decline in a feeling of general well-being with low levels of testosterone in older men,” this hormonal decline happens much more gradually than the drop off in estrogen in women, and therefore symptoms are usually less dramatic. So yes, it’s true that men experience hormonal changes, too–though we’re not willing to go so far as to say their experience is on par with what a woman goes through in menopause.
9. Very true! Many women report great success in managing a variety of menopausal symptoms through the use of natural medicine. You may lower menopause symptoms through acupuncture, herbal supplements, and meditation. And it’s entirely possible that one of the above or many of the options not mentioned will help you. As always, though, check with your doctor before exploring any options outside of what you’re currently using to manage your perimenopausal or menopausal symptoms.*
10. False, though you’re going to have to work a bit harder to keep sex fun, easy, and something you’re just as interested in as you were before menopause. Don’t settle for a sexless marriage in menopause. Changes in hormones can make for painful sex, so you’ll be investigating various lubes, sex toys (we recommend you try the Lionness Vibrator), and such to see what helps. Also, your desire for sex may wane, so more homework may be required to identify erotic options that stimulate both your mind and your body. Honestly, though, can tht even be called homework? We think not.

How did you do?

8 as 10 correct: You are a Hot Flash! (in a good way)

Menopause holds few mysteries for you. Go forth and spread your wisdom to the uneducated masses. You probably give menopausal colleagues tiny fans for their desks and bring your special, hot-flash-relieving soy-slaw to every office picnic. You are adored. Bask in your awesomeness.

4 – 7 correct: Congratulations, Menomaven!

Your knowledge of menopause, while not perfect, exceeds most folks’, and for that you should be proud. We’re guessing what you don’t know, you’re always willing to learn and share, and you are probably the office go-to for resources. You don’t shy away from hormone conversations and can say the word “vaginal” in public. Celebrate your greatness.

1 – 3 correct: So, just FYI, “menarche” is not the queen of England.

(It’s actually the onset of periods.) So, you’ve got a few gaps. Who doesn’t? Having the facts on menopause and women’s hormonal journeys generally can increase understanding, empathy, and all manner of good things. You’re here on this blog, taking this quiz, so we can only believe you know that and are bumping up your meno-smarts as we speak. And for that, we thank you.

*It is not Gennev’s intention to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Gennev urges you to consult with a qualified physician for diagnosis and for answers to your personal questions.

Looking to learn more from your peers? We’d love to hear about your experience, so please share in our  community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group

Have you taken our menopause assessment? Join over 100,000 women to learn more about your symptoms and where you are in the menopause journey.

Interested in finding a doctor who specializes in menopause? Didn’t even know they existed? Read our article on not only how to find the best menopause specialist near you.

Two years ago I got acquainted with Lori McKenna, a rising singer-songwriter in the folk and country music scene. My husband, one of my best gal pals, and I bought tickets for Sundance Mountain Resort’s summer Bluebird Café Songwriter Series, where they feature the songwriters behind some of the biggest hits.

I love a good story, but I love even more knowing where it came from. When I learned the Grammy award-winning song Girl Crush was co-written by a middle-aged mother of five, I was intrigued and in love. I love unexpected people doing the unexpected.

McKenna went on to share stories of how songs come to her while carpooling kids to soccer, school, doctors’ appointments and everything in between. She writes at her dining room table. And when she needs a boost of gal-pal power, she hops a plane from her Boston suburban home for Nashville to co-write with 2 other women songwriters. All of them in their midlife, having fun and shaking up the country music scene.

Then, this past week, I was watching CBS’s Sunday Morning as yes, I watch the morning news show that’s written for my parent’s generation as and lo and behold, they did a feature of Lori McKenna. And, once again, my girl-crush on her was fueled with admiration, inspiration and a real motivation for my own pursuits. Being able to see myself in others whom I see paving a cool path in life and making it all work fuels me.

Ironically the song Girl Crush, is a sad story about the “other woman.” It’s not at all what moves me about the song. What moves me is the person who wrote the song, her life, and how she is living it to its fullest. I’ve got a different kind of girl crush that speaks to the admiration and appreciation for the women in my life that are my tribe. They get me. They listen. They challenge me, and laugh at and with me when the moment calls for it.

On this Valentine’s Day, I want to celebrate the notion of those in our lives that we have my kind of “girl crush” on. Women need women. We need friendship, emotional support, and most of all, we need trusted peeps that help us through the highs and lows of life.

Consider your girl crushes, send them a quick email, text or pick up the phone, and thank them. Tell them you love them, and honor them on this day of hearts. Doing so will bring as much warmth to you as it will to them.

Happy Galentine’s Day!

Check out the video!

The experience of menopause differs from woman to woman, but in our conversations with women, one thing seems nearly universal: the more information a woman has, the more in-control she feels over her body and her transition.

Midlife Mojo with Dr. Anna Garrett

The problem? Because menopause is still so taboo, many women struggle to ask questions and get answers.

Dr. Anna Garrett has been a clinical pharmacist for over 20 years, working in a variety of practice settings. Happily for us, she discovered along the way that working with women in midlife is her true passion. Dr. Anna offers her clients a variety of services including hormone balancing, weight loss, and GeneSNP testing. Her health coaching is designed to help women in perimenopause and menopause escape from hormone hell and feel amazing in their bodies so they can rock their mojo through midlife and beyond.

Dr. Anna is a Doctor of Pharmacy and Board Certified Pharmacotherapy Specialist. She is also a Certified Intrinsic Coach , and has studied through the American Academy of Anti-Aging Medicine.

Clearly, Dr. Anna has answers on midlife and menopause. So we asked her some questions.

(We suggest listening to the whole thing, start to finish, then using the time stamps to go back and listen again to those parts that apply most to you.)

1:25
We asked Dr. Anna how she got started on the path of working with women in midlife and menopause. Dr. Anna shared with us how seeing women floundering and not living life to the fullest prompted her to go into practice helping women reclaim their bodies, lives, and selves.

3:40
What do we mean by “hormones,” “hormonal” and “hormone management”? These are kind of important terms to a woman in or approaching menopause, yet most of us are a little unclear on what they really mean. Dr. Anna educates us on hormones, their interactions, and the impacts when they’re out of balance.

6:05
We wanted to understand the difference between traditional HRT (hormone replacement therapy) and B-HRT (bioidentical HRT). So we asked. Dr. Anna tells us what they are, how they differ, when they’re called for, and the “laundry list” of lifestyle changes women should consider first before you go down the HRT road.

8:50
In this part, we asked Dr. Anna to take a little deeper dive into the differences between HRT and B-HRT. She gives us some great details on the risks and benefits and some of the factors to consider if a woman decides to pursue hormone replacement.

11:30
OTC progesterone is available and does have some benefits, but Dr. Anna schools us on the risks of self-medicating without the oversight of a health care professional.

13:12
How do you know if seeing a professional coach/consultant like Dr. Anna could help you? She explains the profile of an “ideal client” as eg someone who is dealing with hormone challenges and is ready to “do the work” necessary to feel better.

14:55
You’re ready to consult someone like Dr. Anna as how do you go about it? What’s that first appointment like, what expectations should you have? Dr. Anna has a range of possible paths to feeling better in your body, depending on where a woman is in her journey, what symptoms she’s experiencing, her financial circumstances and so on.

18:10
Women may not even know that they’re in perimenopause or menopause, and when symptoms are gradual, they may not even realize how poorly they’re feeling compared to how they could feel. Dr. Anna speaks to the issues women face in getting properly diagnosed and treated and offers suggestions how a woman can prepare in the years before midlife to be their own best advocate. Don’t have the joy sucked out of your life when what you’re experiencing can be solved, she advises. Oh, and don’t rely on your Facebook group for an accurate diagnosis and treatment plan.

21:48
Dr. Anna shares stories of women in menopause who got their midlife mojo back.” When hot flashes and body image issues threatened their quality of life, Dr. Anna helped them get balance and perspective back.

24:14
I’m sold, let’s work together as so what does that look like? Dr. Anna talks about why she thinks six months is the right amount of time to do the serious work of getting your body balance as and your mojo as back on track. And because hormone fluctuations know no borders, Dr. Anna talks a little bit about how and why she set up her business to be able to help women globally.

27:00
Dr. Anna takes on the issue of shame surrounding menopause and aging. “It’s not like anyone gets to opt out of this!” she says; don’t suffer needlessly, don’t be ashamed, enjoy the wisdom you’ve earned and celebrate this special time of life.

28:36
One piece of advice for listeners? Find someone to reach out to, Dr. Anna says. Your problems can be solved, so don’t suffer them needlessly.

To learn more about as and from! as Dr. Anna, check out her website at drannagarrett.com.

Let’s face it: the female reproductive system has a lot of parts. And because our society is a bit squeamish when it comes to discussing sexual organs “” particularly women’s “” the names may be familiar, but we don’t always know which bits are which or what they do.

In keeping with our mission of putting women in control of their health, we’d like to present: your body.

Obviously, the more you know about your body, the better you’re able to monitor your health and stay on top of changes. However, because virtually everything about our reproduction is hidden up inside, it can be tricky to know what’s going on in there.

With the help of our Chief Medical Officer, OB/GYN Dr. Rebecca Dunsmoor-Su, we’ll take you through the parts, where they are, what they do, how they fit into your body and wellness as a whole, and how the choices and decisions you make affect them.

Looking to understand your body better? Take Gennev’s OB/GYN-designed Menopause Assessment

Your cervix

The cervix is a short tube that connects the lower uterus to the upper vagina. There are a couple of parts to it: the ectocervix, the bit that’s exterior enough to be seen in a pelvic exam, and the endocervix, the canal that leads from the opening of the cervix (the “external os”) through to the uterus. The border between ecto and endo overlaps and is known as the “transformation zone” or “transition zone.”

The cervix is narrow and produces mucus to protect the uterus from harm like bacteria; it expands to allow blood and babies out.

The “glandular” cells that line the tube are known as the endocervical cells. They are a different type of cell than the tougher, “squamous” cells that make up the outside of the cervix. There is a line where the external cells give way to the internal ones, and this transitional zone is the most vulnerable to HPV.

In younger women, the transitional zone is larger and more exposed. As a woman ages, that zone shrinks and climbs up into the cervix, making it less vulnerable. HPV tends to live in the transitional zone and/or the endocervical cells, which is why that’s the area your OB/GYN tests in a pap smear.

HPV, cervical cancer, and pap tests

With the cervix, the biggest concern is cervical cancer.

All cervical cancer is caused by the human papilloma virus (HPV), though not all strains of HPV cause cancer. There are hundreds of types of HPV, some which cause warts on different parts of the body, and some which cause warts on the genitals. There are also versions that are higher risk for becoming cancerous.

In the past, many if not most women contracted HPV at some point in their lives, and for many, their immune system was able to clear it. However, sometimes that HPV can lead to HPV disease in which cells become pre-cancerous, ultimately causing cancer if not treated.

A problem with HPV is that many women can have it and show zero symptoms. It can be “sitting in your cervix and doing absolutely nothing you would ever notice,” says Dr. Dunsmoor-Su, “but we can pick it up on a pap smear when we test for HPV.”

Take control of your menopause with your Personalized Menopause Plan. Talk with a Gennev Menopause Coach.

Decisions you need to make regarding your cervix

Depending on your age, you may want to consider the HPV vaccine. Now approved for women up to age 47, the HPV vaccine may help protect you against some kinds of high-risk HPV. (It may be worth getting the jab for women older than age 47, says our Doc, but as it hasn’t been studied in older women, it hasn’t been approved and thus may not be covered by insurance.)

Pap tests. According to Dr. Dunsmoor-Su, the recommendation is that women of perimenopause and menopause age be tested for HPV during their pap test. To clarify: a pap test looks for abnormal cells that could indicate cervical cancer or that could become cervical cancer. The HPV test tests for the presence of HPV as these are not the same thing. If both tests come up negative, a woman is good for five years.

Why only every five years? Well, because of the age-related changes to the external cervix, and because older women generally have fewer partners, the chances of a woman contracting HPV and of it developing into something more serious within that five years are low. There is a particularly aggressive cancer that can invade the glandular cells, called cervical adenocarcinoma, but it’s fairly uncommon. Of course, if a woman of any age has persistent HPV or other changes in the cells, her doc might recommend she be tested more often.

Younger women are tested more often, says Dr. Dunsmoor-Su, because there are two distinct “waves” of cervical cancer: it is most common in younger women in their 20s and 30s, then again in older women in their 50s and 60s.

Younger women may develop cervical cancer more because they tend to have more sexual partners, but also because that transitional zone we spoke about earlier is larger and more exposed. Older women may have had asymptomatic HPV for years, only to have it develop into cancer later.

Pelvic exam vs pap test

We’d like to take a slight detour here to talk about the difference between a pelvic exam and a pap test. These are often done at the same visit, but they aren’t the same thing. The pap, which tests for abnormal cervical cells (and can include an HPV test), is done when the doc inserts a paddle and scrapes a few cervical cells for testing.

A pelvic exam is when the doc inserts their fingers, places a hand on the abdomen, and feels the uterus and ovaries. This should be done every year, says Dr. Dunsmoor-Su, as this is the best test we currently have for ovarian cancer. The doc is feeling for abnormalities, like an ovarian tumor or nodules, and for flexibility in the pelvis (the uterus should be able to move when the doc moves it). Regardless of age or HPV status, women in menopause should continue to get an annual pelvic exam, ideally with the same doc.

What if your doc discovers something concerning?

A pap test tells the doc what the individual cells scraped from the cervix look like, that’s its purpose. “We’re looking at the form of the cell.” If there’s something of concern, your doc will likely call you back in for a test called a colposcopy. This is a scope of the upper vagina. The test consists of the doc placing the speculum, painting the upper vagina with white vinegar (abnormal cells pick up the vinegar and turn white very quickly), and looking at the area with a high-powered microscope. It’s much like having a really long pap test. “If I see anything of concern at that point,” says Dr. Dunsmoor-Su, “that’s when I’ll take a biopsy.” (Pro tip: If you have to have a biopsy, ask your doc to give you a countdown, then cough when it happens. You may well not feel anything, says our doc, though you should let your doc know what you’re planning.)

The biopsy looks at the cells in situ (in its original context), to determine what proportion of cells are abnormal, how deep the abnormality goes, and how much change there’s been to the tissue structure. The results are graded as 1 as 3. If a woman’s cells rate a “1,” it’s a “come back next year; let’s keep an eye on it” situation. Two and three are more concerning, as it can mean the abnormality has gone deeper into the cervix.

LEEP and cone biopsies. In the LEEP procedure (Loop Electrosurgical Excision Procedure) “” hang on, this is going to sound worse than it is “” the cervix is numbed, and the doc takes a wire loop, turns on some electricity, and basically removes the transition zone of the cervix. This can function as a larger biopsy, taking the whole “concerning” part of the cervix out. A pathologist can then look to see if there’s been further invasion, or if this was pre-cancerous vs cancer. A cone biopsy is done with a scalpel and takes a deeper sample. Both of these biopsies can also be effective treatments. As long as the lesion or concerning cells don’t extend beyond the area removed, these biopsies can actually be curative, taking all the cells and HPV along with them.

If these procedures don’t address the issues completely, or if the abnormalities recur, a woman may be offered a hysterectomy. “We don’t need to take the ovaries,” says Dr. Dunsmoor-Su. “Those have a separate blood supply, so we leave them because they may still be hormonally active. Even in menopause, they can still be producing testosterone, and many women just feel better if they’re left in. If there’s no medical reason to remove them, we generally don’t.”

So, your takeaways:

1. Always wear a condom, even after menopause. Condoms aren’t 100 percent effective against HPV because other body parts also carry HPV and aren’t covered by the condom, but they’re still pretty darn good and definitely better than nothing.
2. Get the HPV vaccine, unless your doctor advises against it.
3. Get annual pelvic exams and pap tests on the schedule your doc recommends.

Women in perimenopause and menopause are not immune to HPV disease and cervical cancer, even if they’re not currently sexually active. While women’s bodies generally pass HPV out and “clear” it, they may not always be able to, and HPV that’s hung out for years doing nothing harmful can suddenly turn harmful.

Knowing your body, knowing how to keep it healthy and what to do when problems arise are powerful ways of taking control of your health. Stay tuned for more information on the female body, in all its complicated, sometimes challenging, glory.

What about your body would you like to understand better? If this is helpful to you, or you’d like to suggest what part we discuss next, we’d love to hear from you. Drop your suggestions and any other thoughts into our community forum.

Little ruins a run faster than some unexpected moisture. And we don’t mean rain.

As an almost-49-year-old wanting to qualify for the Boston Marathon this year, I’m looking at a whole lot of miles on my feet in 2017. So when this topic came up in a team Gennev brainstorming session, I jumped. Here’s why:

According to Runners’ World, as high as 40 percent of female runners likely suffer from leaking urine.

But I’m healthy! You cry. Why me??? (Believe me, I’m right there with you, gal.)

as high as 40 percent of female runners likely suffer from leaking urine

Running is a great way to stay fit. It’s also a high-impact exercise: you hit the ground with a force equal to several times your body weight with each foot strike.

There’s been lots of research into how that pounding affects our knees and feet, but for women in particular, the impact has other”¦ well, impacts. That’s a lot of pressure being exerted downwards on your pelvic floor””the network of muscles and ligaments that support your bowel, bladder, and uterus.

According to Physiotherapist Michelle Kenway, if those muscles aren’t fit and strong, running can stretch and weaken them further, and argh! The Dreaded Shpritz.

A weak pelvic floor can cause incontinence when running

Pelvic floor weakness is very common among women generally. Menopause, pregnancy and vaginal births, hysterectomy, obesity: all of these can cause the muscles to weaken and make it harder to control our bodies’ elimination of waste.

And when pelvic muscles lose strength, not only do you increase your chances of misting your shorts, you also lose some of the deep core strength that makes you a stronger, more injury-resistant runner.

A strong pelvic floor can make you a better runner

Happily, strengthening your pelvic floor brings some serious benefits. You can”¦

Improve your running. Your pelvic floor is at the deepest part of your core and helps stabilize your body in motion. A strong core helps you maintain proper form, which makes it easier for you to engage all the necessary muscles to propel you forward. Stronger, more efficient, less prone to hip, knee, and back injury””sounds good to me!

Prevent incontinence and prolapse. Along with urinary incontinence, someone with pelvic floor weakness can also suffer fecal incontinence (leaking stools), and pelvic organ prolapse. Prolapse is when a pelvic organ such as the bladder droops and even descends into the vaginal canal or anus. Strengthening pelvic muscles can prevent and may even reverse pelvic prolapse.

Enjoy better sex. According to Women’s Health magazine, strengthening vaginal muscles (which are part of the whole pelvic floor network) can increase pleasure and the possibility of reaching orgasm during intercourse. So, you know”¦ bonus.

Exercises for a strong pelvic floor

Kegels are a common way to strengthen the pelvic floor by squeezing and relaxing the vaginal muscles. If you’ve ever had to interrupt your pee mid-stream, those are the muscles you’re targeting. Contract and hold “˜em for a count of 5, then relax. Repeat. Try to get up to 10 sets, a few times a day.

You can also get some very cool smart devices for kegel exercises. These help you target the right muscles and work them correctly by providing feedback to your phone or tablet. Our CEO, Jill, uses the Elvie Kegel and has seen real progress with it. Or you may prefer a non-tech solution such as the Stone Exercise Egg or wearable Kegel balls. With any inserted device, you’ll want to use a non-silicone, water-based lubricant such as Gennev’s Personal Lubricant.

If pelvic floor problems persist, or if you experience pelvic pain, please, consult a medical professional.

“

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.

Do things just slip through your fingers? Do you continually bump into things, drop things, misplant a foot when descending the stairs or stepping off a curb?  

Remember that gawky awkward phase you went through as you entered puberty, when suddenly your legs were longer, your arms reached farther, and all these new bits of you felt out of your control?   

Well, like the acne, mood swings, and erratic periods, clumsy is back, and menopause may be (in part, at least) to blame. Fortunately, like adolescence, it’s generally temporary on this end too.

The possible link between clumsiness and perimenopause and menopause

Estrogen as particularly estradiol as appears to have a beneficial effect on fine motor skills. It’s why, at certain points in a woman’s cycle, she may feel a bit clumsier or more graceful than at other times.

It’s also why many women in perimenopause and menopause notice a marked difference in their ability to hold onto things and move comfortably through the world.

Drops in estrogen can also make concentration a bit more difficult, and that moment of inattention can be the difference between enjoying a glass of wine and cleaning it off the carpet.

Additionally, blurred vision from dry eye or even cataracts can add to the number of accidents we seem to be having lately.

Finally, some women say slight dizziness or light-headedness during this time also causes a lack of coordination.

What to do about it

Constantly having to clean up messes is annoying, takes time, and can start to drain our already flagging self-confidence, so here are a few tips to get through this second “awkward phase”:

1. Slow down. Cleaning out the dishwasher is a crappy chore, and we all hurry through it, but you can avoid adding extra layers of crappiness by slowing down so things don’t slip through your fingers and break.
2. Do less at once. Not having to make more than one trip from the car is kind of a fun challenge, but where you used to be comfortable balancing 18 boxes and bags in one trembling pile, now you may not. Consider it an opportunity to get a little more exercise, and bring in the groceries in multiple trips.
3. Be mindful. This one is really important for women who may have osteopenia or osteoporosis. Pay attention to the terrain, step carefully off the curb, so you plant your foot soundly. Your depth perception may be a bit challenged right now, so give yourself that extra second to save yourself any risk of a fall.
4. Get your eyes tested. Be sure you’re seeing well. Get drops for dry eyes, check the prescription on your glasses. If you’re knocking things over, you may just not be seeing them clearly and misjudging the distance.
5. Exercise. In menopause particularly, balance and strength are critical to maintain. Balance, strength, and coordination exercises can help you regain more control of your body (think Tai Chi or qigong, or yoga). And bonus, the right exercise regimen can help strengthen muscles and retain more bone density, so it’s basically a win-win-win. Talk with a physical therapist, if possible, about exercises that help with motor control. These activities from wikiHow might help with fine motor skills, hand strength, and hand-eye coordination. My personal favorite tip: learn to juggle. It’s great for hand-eye coordination.
6. Be patient with new things. Everyone is clumsy with unfamiliar tools or activities, and you may need a bit more time to master new skills. But learning new things can be really good for your brain, so give yourself extra time and leeway for making mistakes. Don’t give up or decide not to try something new just because you’re really going to look like the newb you are.

When to seek help

An increased tendency to drop things and bump into furniture during this time is common, but if your “clumsiness” seems very sudden, very extreme, or comes with slurred speech, numbness, headaches, or difficulty swallowing, seek medical help right away.

Of course, if you have any concern that what you’re experiencing is more serious that a dip in estrogen, please talk to your doctor.

And now for the good news

While there’s not much research on this, what there is, plus anecdotes from women I’ve spoken with seem to indicate this is transitional and temporary, and most women regain motor control after their bodies adapt to less estrogen.

Of course, you can help yourself recover more completely by doing strength exercises. The lost muscle mass many women experience doesn’t regenerate without effort, and much of motor control depends on strength.

We can help you feel in control of your menopause

• Meet with a Gennev Doctor – our menopause specialists can help you understand the expected and unexpected symptoms you may be experiencing and devise a personal treatment plan to help you feel better
• Partner with a Health Coach for actionable lifestyle solutions and the support you need to tackle menopause on your own terms
• Vitality as our most popular daily supplement is a nutrient-packed multi-vitamin supports mood, energy, stress response, immune health, joint pain, and inflammation
• Magnesium as Our super-power supplement can help relieve joint pain, muscle cramps, Restless Leg Syndrome, headaches, depression, fatigue, anxiety and supports better sleep.

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.

What do you give a woman who has every menopause symptom? (or so it seems, anyway)

You give her sweet relief. 

If you’re dealing with all the other gifts like hot flashes, anxiety, insomnia during menopause, we have a list for you. Stick it under a loved one’s nose as a not-too-subtle hint or buy “˜em for yourself because you deserve it.*

Self-care for menopause

Teadora

We have two recommendations this year from one of our favorite self-care brands. This is a company that will raise your holiday spirits: woman-led, environmentally aware, super-healthy products that really work.

Wild Acai Canna Cream with CBD: Whether it’s the acai berries or the CBD, we don’t know and we don’t care. It’s totally refreshing and soothing. And it’s CBD, not THC, so it’s legal in all 50 states and non-hallucinogenic.  

Wild Superfood Miracle Shampoo: If your hair is particularly frizzy and temperamental now, this shampoo will tame and calm it. Just a little goes a long way, and it’s gentle enough for daily use.

Gennev founder, CEO, and current Night Sweats Champion Jill Angelo always runs hot (and not just when she’s running). She wears the Birkenstock Arizona sandal pretty much all the time at home. They keep her feet cool and help her be all-over comfortable. 

Exercise is the gift that keeps on giving in menopause: it helps with bone health, retaining muscle, managing weight, and protecting your brain, heart, and emotions. But let’s face it, as the days get shorter, darker, and colder, getting out for a run or to the gym is tough. We love the Excy for exactly all those reasons “” you get a full-body workout in the comfort of your own home.  

Menopause symptom relief gifts

Gennev

We are the source for menopause relief, and two of our favorites are Gennev Magnesium Glycinate for sleep and joint pain (and many women report anxiety relief), and our new Black Cohosh for help with hot flashes and night sweats.

Hush

We love the Iced Hush weighted blanket. Weighted blankets are great for easing the insomnia and anxiety that can plague women in midlife, but who wants more blankets when they’re having hot flashes? Hush has one designed to keep you cool, despite the extra weight. 

Embr

The Embr Wave is the cutting edge of “FemTech” as a very attractive bracelet that will help you regulate body temperature. Too cool? Hit the button from a warm-up. Feeling a hot flash starting? Nip it in the bud. 

Great reads for women in menopause 

Darcy Steinke’s Flash Count Diary is a fantastic read about one woman’s journey into understanding menopause and her own identity in this second half of life. We dare you not to tear up in the whale section.

She may be a neuroscientist, but she’s also an amazing author. We recommended Dr. Lisa Mosconi’s book Brain Food last year; this year it’s The XX Brain: The Groundbreaking Science Empowering Women to Maximize Cognitive Health and Prevent Alzheimer’s Disease. She is making the claim that what we eat has huge effects on our brain health, and it’s an empowering, positive read. 

No, eating sugar won’t give you a yeast infection. Dr. Jen Gunter’s The Vagina Bible clears up so many misconceptions we have about our intimate bits and promotes a truly healthy approach towards women’s bodies and female sexual health.  

Pleasure 

If you’re very close to a woman in midlife and menopause, Dr. Rebecca Dunsmoor-Su, Chief Medical Officer of Gennev, ob/gyn, and expert in women’s sexual health, recommends the Lelo SONA. This sonic clitoral massager may be, quite literally, just what the doctor ordered for a woman struggling with low libido and painful-sex issues. Great for solo play or with a partner, the SONA can help you find new ways of enjoying and expressing sexuality and pleasure.

Nourishment

Food at its finest is a glorious balance of nutrition and pleasure. To help you get the most from your food, we turned to our Director of Health Coaching and Registered Dietitian, Lauren Leedy. 

She suggests the Instant Pot pressure cooker for quick, easy weeknight meals or a subscription to a meal delivery service to take the guesswork out of meal planning and food prep.  

Says Lauren, “My top recommendation is Sun Basket for cooking kits and Thistle for fully prepared meals.”

What are you hoping to find under the tree this holiday season? Share your awesome gift ideas with the Gennev community in our forums! 

*Note: Gennev has affiliate relationships with some of the retailers on this list and receives compensation at sale. 

Our environment can be pretty heavy with things that are bad for our health, including endocrine-disrupting substances.

An Important conversation with Mary Purdy

Cleansers, detergents, scrubs, things we use to clean our environments and ourselves may be doing more damage to our health than than they prevent. What about products that go on and in our bodies “” soaps, creams, powders, makeup, body wash, deodorants and anti-perspirants, hair sprays, plastic containers to hold our food in the fridge or microwave. How many products do you come in contact with every day, all days of your life?

And it’s not just the products we use. Disruptive chemicals can be in our clothes or furniture or daily use objects as fire-retardants or easy-clean surfaces. 

Mary Purdy is an expert on helping us minimize our exposure to toxins in our environment and maximize our efficiency in ridding them from our bodies, homes, and workplaces.

TRANSCRIPT TO FOLLOW

Constipation in menopause affects a whole lot of women. Why?

A couple of possibilities, says Harvard Health: Lack of estrogen may cause the colon to slow. This gives the fecal matter that’s in the system time to dry and harden, making it harder to expel. Or some women may find their pelvic floor is not coordinated, making it less effective for letting the stool out.

How do you solve constipation? You might think of stool softeners or fiber drinks, but there’s another alternative that might help you beat constipation in the long term: a pelvic physical therapist. We asked our two DPTs, Dr. Meagan Peeters-Gebler  and  Dr. Brianna Droessler-Aschliman for advice on handling this much-too-common problem.

Need help with nutrition for constipation or other digestive issues? Connect with a Menopause Coach and registered dietitian. 

What is constipation?

What actually qualifies as constipation? A day where you don’t go? Two? Medically, constipation is fewer than three bowel movements per week. There’s quite a broad range of “normal,” says Meagan: anything from three bowel movements a day to one every three days is considered within a normal, healthy range. Constipation is also usually accompanied by gas and abdominal cramping. 

Why do women get constipated at menopause?

In addition to the lack of estrogen, there are other lifestyle things that affect regularity.

Hydration: Not drinking enough water in menoause can affect the consistency of stools, making them harder to pass, says Bri. Be sure you’re drinking half your body weight in ounces every day; more if you’re constipated or sweating a lot.

Movement: Because of back or hormone joint pains, a lot of menopausal women experience arthritis because they stop moving as much, Meagan says. That means they aren’t rotating their trunk (think about how you swing your arms when you walk) and getting that twisting “massage” of the gut that helps with peristalsis (the movement of matter through the digestive system). Try to get out for a good walk every day, and your legs probably won’t be the only things “moving.”

Diet: Most of us don’t get enough fiber, for one; and in menopause, when our gut may be moving more slowly, we really can’t afford to be without. Try to bump up your intake with high-fiber foods like apples, oatmeal, beans, and broccoli. Don’t go too far, as you could end up with some unpleasant gas, but a slow increase might help you find some relief from constipation, says Bri. Don’t eat as much of the classic stopper-uppers like cheese, red meat, under-ripe bananas, fried foods, and white bread or rice.

Breathing: Poor breathing technique means all the movement is in your chest, not in your belly, says Meagan, which again means your digestive system isn’t getting the advantage of the pumping, massaging action of your breath to keep things moving along. Breathe with your diaphragm, so your belly expands with your breath. OK, it’s not sexy, but is constipation?

Embarrassment: No one wants to be that person at work, and let’s face it, those perfume sprays really don’t make things better. So we ignore the signs that we need to go, potentially causing worse problems. Solution? Find a bathroom on a different floor where no one knows you? Maybe change when you eat dinner or breakfast or have your first cup of coffee so nature calls before you leave home. Or perhaps realize everybody poops and try not to be embarrassed by it.

Fear: This may sound odd, but if going to the bathroom hurts because things are dry and hard, you may be ignoring your body’s signals that it’s time to go. However, ignoring signals only makes things worse, and, our docs say, doing that too consistently will eventually damage your body’s natural receptors, meaning you may not get those early warnings any more. In that case, it takes a lot more matter to alert your body to the need for relief “” and now it’s really painful and dramatic.

Medication: Many medications can slow our system temporarily, Bri says, including narcotics, antidepressants, anesthetics, opioids, even calcium channel blockers for hypertension. If you’re taking iron or calcium supplements, those can be an issue as well. While you’re taking medication that causes constipation, try to balance out those effects with some lifestyle strategies, like increasing water intake, eating high-fiber foods, moving more, or doing the ILU massage.

You’re pooping wrong

What we often call “constipation” may actually be a result of, well, pooping wrong.

Believe it or not, there’s a right and a wrong way to do your twos, our DPTs tell us.

The right way: When you get the “whisper,” heed it. Go to the bathroom. The best position for evacuating is to have your knees above your hips, so get a Squatty Potty, or stack up some books, or turn over a couple of buckets (be careful with this if you’ve recently had a hip replaced). Let your belly go loose and slack, so it’s actually touching your thighs. It’s not the most dignified posture, we get it, but come on”¦ you’re pooping. Vanity really shouldn’t be a factor here.

Let your abdominals be loose so your pelvic floor relaxes. This should allow for your colon to unfold, so  evacuation happens with only gentle pushing from you. Having your knees above your hips allows your colon to unfold into the correct angle so things move more smoothly. Don’t ever force it as if your body isn’t ready, it isn’t ready. Try again when you hear the call.

The wrong way: Ignore your body’s calls of nature repeatedly, then go to the bathroom only when it’s convenient. Push really hard because your body isn’t contracting naturally, and you need to get this done in the next 30 seconds. Strain, hold your breath, push down so that instead of relaxing and opening naturally, the pelvic floor muscles clench tight and “slam the door shut.”

Repeated pushing and straining is especially effective if you’re aiming for hemorrhoids or a “rectocele” (when the the front wall of the rectum bulges against the back wall of the vagina, possibly even drooping into the vaginal canal). A rectocele can form a pouch as it droops into the vagina, and fecal matter can collect there. Depending on the size of the pouch, you may not be able to clear it by pushing.

Take a whole lot of over-the-counter laxatives to counter poor pooping mechanics and try again when your schedule allows. Your body can actually become dependent on OTC laxatives, or they may target the wrong problem (do you need softer stools or increased motility as you really don’t want to get this wrong). Too much softening can cause you to keep your pelvic floor muscles clenched for fear of accidents. That can lead to severe pelvic floor dysfunction, Meagan says, which can make everything a whole lot worse.

Is it time to get professional help for constipation?

If you’re experiencing severe abdominal cramping, menopausal nausea, vomiting, or it’s been more than 3 days, you should definitely get checked out by your doctor or chat with one of ours, according to our DPTs. If it’s only been a couple of days “” or if things are moving, they’re just moving slowly “” you may want to try a few things on your own first.

First, evaluate your lifestyle choices that may be causing the problem. Has anything changed in your life recently that could be throwing your body off its regular pattern?

Are you eating a lot of constipating foods? Are you getting enough fiber in your diet? Are you drinking enough water and moving your body? Did you quit drinking coffee? Have you started a new medication or recently had surgery?

Next, check your pooping mechanics: Do you have your knees above your hips? Are you giving yourself enough time?

Also, Bri and Meagan suggest trying the ILU massage. This self massage involves doing small, circular strokes that follow the path of the large intestine. The gentle stroking massage helps calm an irritated gut and increase the movement of food through your system.

If fixing all the lifestyle options doesn’t help, you need to be sure what you’re dealing with truly is constipation. If you have a rectocele, that may feel like the pressure of constipation, but it really isn’t.

If you haven’t already been evaluated and diagnosed with a rectocele, that’s the first order of business: get to a doc and get checked for that, then follow your doctor’s recommendations.

If you know this is likely to be your issue, our DPTs recommend trying “splinting.” In this case, you use two fingers (wrapped in TP or gloved) to either press against the perineum as that’s the territory between the vaginal opening and the rectal opening as to create a wedge. By pushing gently upward, you don’t allow the rectum to slump and create that pocket, so you should be able to evacuate normally. Some women do this by putting their fingers in the vaginal opening to support the wall between the back of the vagina and the front of the rectum.

Perhaps the best thing of all is to get checked out by your doctor, then ask for a referral to a pelvic PT. They can help you evaluate what else might be contributing to your constipation and give you exercises and lifestyle changes appropriate to your situation.

Thank you our two DPTs, Dr. Meagan Peeters-Gebler and Dr. Brianna Droessler-Aschliman

Have you dealt with constipation? We’d love to know how you managed it, so join the conversation on the Gennev community forums!

We had the pleasure of recording a menopause goddess podcast with Lynette Sheppard, author of Becoming a Menopause Goddess and “scribe” and moderator of the website and blog by the same name. Lynette and her goddesses are tackling the lack of knowledge and awareness women have when approaching the “Big M.” Lynette spent more than 10 years as a  Nurse-Manager and head of Intensive Care and Coronary Care units in Santa Rosa, California. She knows her way around healing and the human body and is a terrific translator of medical-speak.

We talked with her about where the Menopause Goddesses came from, what she’d learned over the years, and how the blog had changed as and continues to change as so many women’s lives for the better.

JILL: I’m here today with Lynette Sheppard, author of the book Becoming a Menopause Goddess, and moderator of the Menopause Goddess blog and website. She and her team of goddesses decided to take on the lack of knowledge and awareness women generally have when heading in to the big M. She’s a former nurse manager and was the head of Intensive Care and Coronary Care Units in Santa Rosa, CA for about 10 years before deciding to go out on her own as a speaker, author, and expert on all things healing and health.

The Menopause Goddess blog has been named a top menopause blog for the past five years by Health Line magazine, and so we’re extremely excited to have Lynette with us today.

LYNETTE: Absolutely my pleasure, I look forward to talking to your listeners and sharing what I’ve come to know over the past oh-so-many years of menopause.

Becoming a menopause goddess

JILL: How did you come to find this lack of awareness associated with menopause when you started out with Menopause Goddess?

LYNETTE: Honestly it happened because as a nurse I expected fully that menopause would be a simple, easy transition. Maybe I would be hot once in a while but no big deal, and how wonderful not to have to worry about if I could wear white pants or a white skirt anymore, but what happened was so many weird menopause symptoms and so much strangeness occurred that I began to look for information, and there wasn’t much. There was one site called powersurge.com and it was so confusing I couldn’t even figure out how to follow or get more information. It was very chatty and nice but it didn’t have anything for me. There were a couple of big books but they were written by doctors, and they were so hard to tackle, so full of anatomy and physiology, that even as a nurse I didn’t want to read it. What I wanted to know was, was what was happening to me normal? If it was, what could I do about it because my entire life was turned upside down.

JILL: Do you mind sharing how it turned your life upside down?

LYNETTE: Personally, first of all the hot flashes were so overwhelming, it was like heart palpitations, intense heat, and they would last for “¦ they weren’t flashes, they lasted for five, ten minutes, and they were hideous and literally interfered with daily living. They were dreadful. I thankfully did not have any of the emotional symptoms as I did not get depressed, I did get a little angry once in a while. Kind of like a cranky child, when you’re too hot, when you have the flu or something, you get irritable. And you know the other symptoms were just weird things like I got sick a lot, I had shingles for the first time, everything was catty-whampus  and upside down and it made no sense at all. There was vaginal dryness, the libido just said goodbye”¦ so there were so many things that were so disconcerting.. oh, and my hair started falling out. That was horrifying and to have it all happen at once. I was like “either I have some terminal illness or this is menopause and if it this is menopause, why doesn’t everybody talk about this?” I talked to my own mother and she said, “Oh honey I didn’t really notice it.” Well, that generation unfortunately was given hormone pills before they actually would have felt a symptom, I believe, so there was no way she would have felt it. Anyway it was dramatic and it was interfering with my life terribly.

JILL: Was there a moment where you just said “I’m gonna take this on and start not only fact-finding for myself, but publishing”?

LYNETTE: Absolutely there was, my girl friend, my best friend Teresa started menopause around the same time as I did. I was talking with her on the phone one day and I asked her “Do you think this is normal? Do you think we’re normal?” “Do other women go through this?” And we decided to have what we called a “slumber party with a focus.” We were gonna invite some women to spend a weekend where we explored what was going on with us, we women of a certain age and affliction. We had all these icebreaking exercises and stuff which we obviously didn’t need because the minute the 15 women gathered the floodgates opened. Clearly we were all going through dramatic huge upheaval, and there was no place to vent that or to realize that we were not alone so that became the impetus. We began to meet every year, we met for 14 years once a year and kept in touch the rest of the time, just to find out we were not alone, that all of us had been sort of hit upside the head by menopause was a huge relief. And the second part was beginning to realize that it would not last forever, the worst of it was going to be temporary. But we shared what we called “kitchen table wisdom” with one another, the things that worked for us or didn’t. Each of us was different, each of us had different symptoms and each of us responded differently to different remedies, but coming together and being able to share that meant “OK we’re women, we’re tough, we can get through anything if we know what to expect.” But not knowing what to expect threw us over the cliff. We didn’t know what to do. We didn’t know what was wrong with us. If somebody had told us, “hey, it’s normal, and the worst of it will last a year or two” we would’ve said, “fine, good, we’re down with that.” I mean, women can have babies, we can do this! To not know was probably the worst thing possible for us, and basically started the impetus of our goddess group meetings.

“Just to find out that we were not alone, that all of us had been sort of
hit upside the head by menopause, was a huge relief.”

JILL: Lynette, I love the notion of the slumber party with a purpose. Women need women, and the notion that you all took this time and maintained it over the course of 14 years and now have pulled it into something like the blog and your own writings is really remarkable. What are some of the unique remedies or a remedy you’d care to share?

LYNETTE:  If I were to give one remedy and absolutely one, it would be to create your own goddess group and call it whatever you want. Sometimes when you’re in the throes of menopause it’s like, “Oh I can’t possibly do that, it’s too much work,” but we’ve already done the work for everybody. If someone went to our menopause goddess blog and wrote in “creating your own goddess group” in the search box it would come up with all the ways of how to do that and how easy it is. So no reinventing the wheel, all you’d have to do is invite people and it would be simple. But if there’s one remedy we would say, all of us, got us through, instead of just surviving menopause we actually became able to thrive during the transition, it was each other; it was that group. Single most important, every woman said: the single most important remedy they had in their multiple remedies and things that they tried. That one saved their bacon.

JILL: Tell us a little bit about the blog then, how did that group in its very infancy shape the blog? What kind of resources and information do you make available?

The origins of the Menopause Goddess blog and book

LYNETTE: First of all, how it got started was my girlfriend Teresa said, “Not only will we start this group but we’ll write a book about it! There’s not any information out there.” I said “You write a book, I’ve written a book once, it was a lot of work and I said I’d never do it again.” But the things that were shared were so wonderful and so helpful that we couldn’t help but share it. I asked my book agent about starting a blog and she told me it was a good idea. But the blog took on a life of its own oddly enough, so not all the stuff in the book ever made it on the blog because so much information was coming in so fast and furious that I had more than enough stuff to put on the blog for years. Because it’s been around for 15 years, the kinds of information really are partly what women share with each other but also as a nurse I’m pretty well able to sift through the medical information, pull out, and put in plain language, what we really need to know.

I would say that in the last couple years the shift of the blog has been more to what do we do post-menopause to live a vibrant life. I would say to women going to the blog, every symptom, everything you want to know about has been written about at least once, probably five to ten times on the blog. That search box is amazing. Dealing with heavy bleeding? All those posts show up. You can find remedies, you can find information on the blog because it’s been around so long. We’ve gathered that information and that’s why the blog has shifted its focus now so the more recent entries are much more about living our second act. Of course if there’s a new product like yours, I’ll showcase that if it’s worthwhile, or books. I’ll also report on new research and new modalities. Otherwise it’s all there, for the asking and the taking.

How has being a menopause goddess changed you?

JILL: How has managing the blog changed the way you deal with your own life changes associated with menopause and this next chapter? Has the blog made you more conscientious? What would you attribute to the blog that’s changing the way you’re moving through this as a woman?

LYNETTE: I absolutely think the meetings and the blog have made me more open and conscientious, and probably ask ourselves questions we never would have asked ourselves. I think that was really important, knowing that every woman has a different menopause, and what worked for one woman may not work for another, or what worked for me today may not work tomorrow, which is startling but true. So you become much more fluid, open and receptive rather than trying to control everything, if that makes any sense.

JILL: What are some of the lifestyle changes that help with the transition into menopause and also into this second chapter of life?

LYNETTE: I think the lifestyle changes for the second chapter are pretty simple. There’s a nurse who’s also a hospital administrator I know and she summed it up pretty sweet and simple saying “Eat well, move, and love well and if you do that, you’re gonna do great.” And I really think that’s the prescription. That said, when you’re first going through menopause it’s rough, different foods, temperature, things like that can precipitate horrible hot flashes as women will find themselves trying anything. There is a lot of writing out there that says you shouldn’t have chocolate, alcohol, wine, all of those precipitate hot flashes. I basically wrote in the book that I would give up my health care practitioner before I would give up wine and chocolate and coffee. One of the doctors who proofread my book said “absolutely best part of the book.” What that really translates to is you have to be gentle with yourself. If/when you make changes, don’t change everything all at once, you’re already going through so much. If you’re having horrible hot flashes you might try cutting out caffeine or decreasing it, same thing with chocolate and wine, but if those are things that also make you feel happier, then I wouldn’t do it! When we started meeting the refrigerator for the weekend was stuffed with wine, chocolate, and we had coffee and we had a wonderful time. And now there may be one or two bottles and we don’t need to drink it. We don’t feel the need for so much chocolate (probably our serotonin levels are up again.) We all agree there’s only so much you can give up and so much you can do to yourself. And secondarily if you haven’t been super heavy duty in exercise I wouldn’t do 6 days of Pilates. Again, be gentle, be kind to yourself more than you’ve ever been because you really need it at this time of life. Don’t think you can fix it because it doesn’t get fixed. It’s something we have to go through but we can choose how we go through it. If you feel nourished by making lifestyle changes, I think that’s great. If you don’t, if you feel deprived, now is not the time to feel deprived.

Want some help with eating better? Check out these Three Reasons to Make Friends with Health Fats

JILL : In all of that have you come across any surprises along the way?

LYNETTE: Absolutely. The weirdest one was when a women wrote me on the blog saying she had “burning lip syndrome.” I had never heard about that, I swear, her doctors had said she needed to take heavy duty drugs, like anti-convulsants and had huge side effects to deal with that. It was so painful for her that it made it hard to eat. So I made it my personal mission to learn what I could about Burning Lip Syndrome and I found that weirdly enough there was a way to deal with it that was more natural that worked probably better than the big drugs. It was simply oil with cayenne pepper, controlling a burn with a burn. But it was an eye opener, I thought “Wow, there are symptoms that I never dreamed of that occur with menopause.” So that was shocking to me. It was surprising to me how many women, previously healthy, strong, active women, came down with some serious illness or illnesses during the menopause transitions. It’s not too surprising that your immune system might be affected, but I mean hideously affected. I got my first attack of shingles and when I went online it said I either had lymphoma or something is really wrong with you. But now enough of us, of the Baby Boomers, have had shingles that it says “You’ll probably get shingles for the first time when you’re menopausal because it’s caused by the chicken pox virus which continues to live in your system.” But you can imagine how terrified I was when I thought I had lymphoma.

JILL: That’s one thing you really don’t hear about menopause at all is around that notion of more serious illnesses outside of the traditional symptoms.

LYNETTE: Absolutely, I even wrote to the investigators at the Nurses’ Health Study which is the longest pro-active health study that’s ever been done, and I’m part of it. It started the year before I was in nursing school. They said it was interesting, they were studying rheumatoid arthritis as group and lupus as a group, but they hadn’t considered that this might be because there’s an immune system assault that happens with menopause. Now, have they done anything with it? Not that I know of, but I’m still hopeful that there will be research done. Even if research isn’t done, I would say if you’re coming up on perimenopausal age, now is the time to start boosting up your immune system as much as you can.

The five “forgotten” signs of menopause

JILL: You’ve listed some of the really odd things with menopause along with some of the more common things, but Lynette, what are the five forgotten symptoms of menopause?

LYNETTE: Well I just mentioned one of them which is the immune dysfunction which is just horrifying and horrible and fully half of our group had some huge health problem when they’d never had any health problems their whole life except for normal colds and flus. Each one had a different assault which I think is why it’s not noticed as much.

Secondly the hair loss is getting a little bit more play now, but most of us women define ourselves a little bit as feminine by our hair. If your hair is falling out in big clumps, it’s a real concern. I found this the most disconcerting symptom of all, actually. Thank god I had a lot of hair because I believe I lost fully a third of my hair volume. I was ready to research hats and wigs and then it stopped. If you go to your dermatologist or your hair dresser, you’ll be told it’s just hormonal. That really doesn’t help. It’s horrifying. I don’t think that one gets as much credence as it should, but that’s changing, thankfully.

Brain fog is another one, the fact that suddenly your brain doesn’t work at all. You can’t remember things, you can’t focus or concentrate. One woman wrote me and said, “Oh my god I’m studying for my master’s degree, I started to write my thesis, and menopause came on and I’m afraid I’ll never finish it. I just can’t seem to think.” So if you think about having the flu and your head’s all full and you can’t think and you’re out of it as it’s like that, only every day. It really feels like we’re losing our minds. So to tell someone, “No, you don’t have Alzheimer’s, no, you’re not going crazy, what’s happening is normal, it kinda sucks, but it does get better with time.” But it can be a horrifying symptom too. Most menopausal women laugh it off now but it is difficult to deal with.

Fatigue is almost never addressed I think and there can be almost a bone crushing fatigue that happens with menopause. Just because everything hormonally is in such flux, so you can feel like you have no energy whatsoever. So just the time when you think you oughta be exercising, you can barely drag yourself through the day. It’s exhausting. Certainly insomnia plays a part in that, but even if you’re sleeping well, and I did sleep well after a while, the fatigue would come out of nowhere as didn’t want to do anything, didn’t want to move. Again it was like having the flu all the time.

The fifth symptom I mention is anxiety. People who’ve never been anxious their whole lives suddenly have panic attacks as waking up in the middle of the night worried about everyday things, a constant barrage of worries, and it’s pretty debilitating also. There aren’t a lot of remedies you can use without pretty major side effects. Obviously, if it makes you feel like you can’t leave the house then it should probably be treated, but if you’re feeling just general feelings of worry and doom and gloom, that can be managed with, “This is normal, it’s gonna go away and get better, I’m gonna give myself a reality check. What is happening in this moment? The sky is not falling, nothing has happened, everything is OK in this moment.” To breathe into that sometimes can break the pattern of that. Just knowing it’s normal honestly is such a huge relief to women when they write me and say “I think I’m going out of my mind, I’m scared of everything, I’m nervous,” I write back “it’s totally normal” and they go, “Oh, my god, thank you. And this is not gonna last forever? Fabulous. I can deal.”

Get some herbal help for sleeplessness and anxiety from Jovanka Ciares

Celebrating the good things about menopause

JILL: Are there any uniquely good things that start to happen as we move into the menopause phase of life?

LYNETTE: Oh that’s a very good question, and yes there are. After the initial physical and sometimes emotional onslaught, you kind of come out the other side feeling like “OK, I’m different now. And if I’m different, how is that going to play out in my life?” Oddly enough we all decided that we cared less what people thought in the best possible way. We found menopausal women become extremely creative, the creative urge overwhelming, you can’t wait to create, whether it’s craft or dance or painting or writing or gardening, that creative urge is huge. It’s like we channel the fertility into another type of fertility. Also sort of a willingness to try anything, because we feel like we’ve been through the worst of it, so now it’s like a new life in a sense. So in that new life, you’re not afraid to try new things because the “Oh you didn’t do it good enough” police won’t come and get you. You can fail at something and laugh and then try something else, you can enjoy things more. There’s a settling into your body that happens. I think it’s like an awakening. Menopause is such a sharp transition, I feel sorry for men that they don’t get to go through it. That sharp change makes you question everything and you begin to go “Oh, I see what I want to do with life, I see how I want to live it, I see how I want to enjoy it and how full and rich it could be.” So actually menopause turns out to be a wonderful thing. I always say “menopause will set you free but it will really piss you off first.”

JILL: That’s fantastic, I love that. We typically don’t look at the positive. Often times we celebrate these other milestones in life as women, first period, first baby, but we don’t really celebrate menopause other than “I look forward to not having a period” but it’s such a small bit within the bigger new next chapter that you just talked through from a positivity perspective. What makes your blog so popular amongst your readers?

LYNETTE: I think it’s just the plain talk, and the fact I can sift through the medical information and make it plain and simple. But the straight talk from real women, not just me but all these women, we distilled the wisdom and put it out there. I think that’s what made it popular, trying to demystify things, make things simple and clean and pure and not be afraid to say certain things. Some bloggers are afraid of litigation, but we’re just women sharing wisdom. We’re not gonna hold back, we’re not gonna say we know, we’re just gonna share it. We are there as a broader community of women helping each other.

JILL:  What kind of lasting advice would you give our listeners about how they can take control of this phase of their lives and ultimately feel as fabulous as they possibly can?

LYNETTE: Again, I can’t say how important it is to have a group of like-afflicted, like-minded women. That said, I think just being responsive to your body and to yourself. Again you’re gonna want to exercise and eat well but you also want to be gentle with yourself. I always think of menopause as puberty to the tenth power. When kids are going through puberty we give them lots of space, we understand their moods, we let them go into their room and be quiet and write poetry. Alas that’s not always what happens for a menopausal woman who has to work and take care of a family, and is feeling all those feelings only to the tenth power. I think making that space for yourself and being proactive, saying, “I need this, this is what I need to take care of myself.” And involving family and friends. I think a lot of men read the blog with their wives because if we have no idea what’s going on, it’s even worse for them. It’s like their partner has suddenly turned into someone they don’t know! For them to experience it and to be a help along the way is so healing for both partners. I think those are the kind of things. Be gentle with yourself, gradually incorporate more exercise, eating well, but if you’re suffering from brain fog and a whole bunch of things, be good to yourself. Take time out for yourself.

Resources to help you become a menopause goddess yourself

JILL: That’s wonderful. Especially about involving men. They’re partners in our lives and they’re trying to come along on the same journey and that’s really critical.

Lynette, in a final note, can you share with our audience how to find more of the resources you offer?

LYNETTE: It’s easy to find the blog, it’s menopausegoddessblog.com, and secondly the book Becoming a Menopause Goddess, it’s on Amazon, it’s on all the ebook sites, Barnes and Noble, it’s everywhere. If you’re on the blog just click on the stuff about the book or contact us. We’re more than happy to talk to anybody, just give us a little time to get back to you.

JILL: Thank you, Lynette, and thank you to your whole community that’s gotten you to this point. We appreciate you sharing your time and wisdom with the audience and the Gennev-ers out there listening, we certainly hope to bring you back in the future. I think we T’d off all sorts of deeper dive topics that we could go into and it would be good to have you back.

LYNETTE: It would be my pleasure. Thank you guys for all you are doing to help menopausal women, it’s just so heartening that there are more resources out there now. Like I said, I’m happy to let people know about those resources because all of it’s gonna make our transition easier.

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