Casey, age 53, woke up chilled. At 4 am this morning. 

Had she actually slept through a hot flash? Miracle of miracles, she could only hope. 

Still groggy, she managed to register some gratitude and relief that it wasn’t 1 am, which it had been for the last several weeks. She sighed, turned to her other side, and touched her cheek down to a fresher spot on her pillow. Another sigh. 

She counted 6.5 hours of glorious, uninterrupted, deep sleep. “At last,” she thought, “Maybe I’m getting the hang of”¦ wait. What was that?” A warm liquid flood released with her new sleep position. She tentatively touched the mattress behind her back, and the backside of her underwear and sure enough. Evidence”¦ bold, red, and wet was there. “Noooo”¦ no, no, no”¦ I thought I was done with periods.” 

It had been 6 months since her last cycle”¦ and there was no mistake that she was having one now.

Not sure where you are in the menopause transition? Take our Menopause Assessment.

Annoying but normal

If you haven’t experienced skipped (or extra) periods in perimenopause, allow us to assure you, it can be a normal (and annoying) part of the process.

As hormone levels change, menstrual cycles may go from reliable and familiar to whose-period-is-this? Changes may include: 

• Length of your cycle. Have periods been 4-5 days and then gone? They may be longer or sometimes shorter, depending on your body and what it’s going through. 
• Timing of the beginning of a cycle. If you’ve had a reliable routine to the point where you know that your cycles begin in the mornings (or whichever time of day/night), that may change and you may be surprised by the appearance at a different time of day or night. You may also experience monthly periods that have more or fewer days between cycles (e.g. 28 days, the next one is 32 days later, then the next is 29 days after that).
• Unfamiliar or lack of your body’s signals that an egg is gonna drop. If you’ve had regular physical symptoms that you’re body is entering a cycle, such as lower back soreness or cramping, those may change or they may intensify. 
• Flow. These irregular periods could be heavier flow and some could even be lighter. It may switch up from month to month. You may have less (or no) “getting started” hours or days and go straight to heavy flow or menstruation flooding with irregular periods. 

What’s going on? 

In order to illustrate, let’s do a comparison of what goes on during a regular period and a perimenopausal irregular period. 

Most periods until perimenopause

An egg matures in the ovaries during a period with the help of an increased level of FSH (follicle-stimulating hormone). It’s the follicles that produce estrogen, and the estrogen, in turn, causes the lining of the uterus (the endometrium) to thicken, to prepare to receive a fertilized egg. 

Ovulation, the release of the mature egg, creates progesterone. Most eggs aren’t fertilized. What happens next is, the progesterone goes away and the endometrium is sloughed off. This is what we know as a period.

Perimenopause periods

During perimenopause periods, there aren’t as many follicles to stimulate, so the body really increases the FSH, resulting in more estrogen being created. More estrogen means the uterine lining becomes even thicker as causing heavier bleeding and perimenopause periods lasting longer. This whole process can take longer, too, resulting in longer gaps between periods.  

What about ovulation in perimenopause? Is that a thing?

Yes, indeed it can happen more often than not. In some cycles, the endometrium continues to thicken until it has to be shed as resulting in a very heavy flow.

A word about abnormal bleeding

During a cycle that has a heavier flow than you’re familiar with, it can feel surprising, baffling, even a little scary to see more blood and clots than you are used to. 

Bear in mind, you may experience feelings of disappointment, exasperation, weariness, all in addition to increased or intensified cycle symptoms. Be easy on yourself and ramp your self-care if you can. Your body and mind are going through a significant transformation.

This being said, a regular period can release between 2 tablespoons over the course of 4-6 days, or more, for more days or fewer. We’ve also seen reports of regular or normal period bleeding as being 2-3 tablespoons over 3-5 days.

Abnormal bleeding, specifically may look like very heavy bleeding or bleeding that:
 

• Lasts longer than normal
• Occurs more often than every 3 weeks
• Occurs after sex or between periods

In order to really dial into your own health and body, consider a check-in with one of our Telemedicine doctors. This is for assurance, guidance, support, and it will keep your files noted with new data and insights.

Be prepared, stay prepared

No, not hyper-vigilance. Just simple awareness. Here are a few ways to be and stay prepared for an unexpected period:

Keep count.

 When was your last period? How many months have you gone without a cycle?

Bring supplies.

 Menstrual cup, tampons, or pads, have something on-hand until you’re sure you’ve gone 12 months without a period. Desk, car, bag, duffel, wherever. And it doesn’t have to be a lot of supplies, just the right one for you to get you through a few hours.

Practice awareness of body changes and any other symptoms.

If you’re experiencing multiple perimenopause symptoms, it’ll make more sense and may feel more normal to have irregular periods at this time. Journal about them, keep a record on Post-it notes at your bedside, record them in a notes-application on your mobile device. They may prove useful and paint a bigger picture when you”¦

Check-in with your doctor or other health  support systems.

Let your doctor or professional know what’s going on with you and your body. Support, education, and care will really help you navigate through perimenopause to menopause by making informed choices about your options.

Was this one my last one?

We have no idea when or which one our last period is. There’s no indicator that we’re on the final countdown, tallying 12 full months of no menstrual cycle to achieve and unlock the menopause level. 

Best you can do is to be aware, consult your doctor (or speak with one of ours), practice some extra self-care, and know that this could be the last or at least one of the last, periods you’ll go through. You’ll be closer, if not finished. Regardless, transformation is, indeed, happening. 

What have you experienced around irregular periods in perimenopause? And”¦ what are your questions about period reoccurrence during perimenopause? Check-in and chat in our Gennev Community Forums.

At Gennev, we’ve been on something of a quest to find the perfect sleepwear and menopause clothing for women who deal with night sweats and daytime hot flashes (or summer heat, for that matter). We’ve tried several, with mixed results. Then we found Cucumber Clothing. We loved the feel, the moisture wicking, and the cool, flattering cuts and styles. Cooling clothing for menopause, if you’ve been there, might strike you as a fantastic idea. We are inclined to agree.

We loved how it helped us get a better night’s sleep and enjoy cooler days.

Cucumber Clothing’s line, like all the products we bring to our Gennev community, helps you feel and be your best self. And the founders, Eileen and Nancy, are women over 40 who understand the realities of this whole perimenopause to menopause transition. They made the clothes they were searching for, so now the rest of us can (finally!) quit searching.

We asked them to share their story with us; we think a lot of what they told us may sound familiar “¦.

______________________________________

Serious sleeplessness

So here’s the thing, some of us are good at sleeping and some of us are not.

Neither group is well defined as in my lifetime I’ve flitted between the two camps. A sound sleeper as a child, an impossible-to-rouse teenager, a late-night owl in my twenties, and a fretting, nocturnal pattern of wakefulness through the next decade with young children.

Roll on a few years and my circadian rhythms have re-set again. Sleep has become a capricious bed mate, undependable, playing to its own rules, and not to be relied on.

Beyond puffy eyes, foggy head and a general sense of weariness, why is this lack of sleep so important, and why do so many women who may once have felt they owned the holy grail of sleep, now feel they have lost, or at the very least, misplaced it? There are a few things to think about here and not all of them are under our control.

Menopause clothing, hormones, and sleep

We know that as our bodies enter peri-menopause and menopause, our level of hormones begin to fall. One of these, progesterone, helps us sleep, so as the level of progesterone tails off, our ability to have an unbroken, deep sleep does too.

A general fall in hormones can also herald the onset of hot flashes and flushes and the aptly named “˜sweats.’

Just these two factors can mean a swing from a good night’s sleep to an “˜I tossed and turned and sweated and didn’t get a wink’ sort of night, followed by a nightmare sort of day.

We need sleep to refresh ourselves, to reorganize our thoughts and memories, to repair our bodies and to rest our cardiovascular system. So necessary, and yet so frustratingly elusive for some of us.

That’s how Cucumber Clothing was born. Travelling home from a holiday with a bunch of like-minded forty plus year old women, our week-long bonding topics covered everything but the kitchen sink, and most definitely included the menopause.

Why, we wondered, were there so few solutions out there? Busy women all, some of us were suffering from the self-same debilitating double whammy of fractured sleep and sweats, which impacted hugely on the jam-packed days.

Moisture wicking clothing for menopause

We decided then and there to create a beautiful and intelligent range of thermo-regulating nightwear and clothing. One that allowed you to look great and feel great wearing it and that quickly moved any moisture (sweat!) away from the body at speed. One that meant that if you woke up in the night feeling sweaty or even drenched, within a few minutes you would feel dry again. We couldn’t stop you from getting hot, but we could help you get back to sleep comfortably and quickly.

Cucumber Clothing was launched in September 2017 and, since then, our original range of six simple and elegant jersey pieces in two colors has expanded to include a summer collection in a silk-like fabric (that works just as hard) in three new colours.

We’ve broadened the range to include leisurewear pieces that work for the gym (our drawstring trousers are great for Pilates or yoga), to the poolside (throw our ruffle dress over your swimsuit), to work (our v-neck t-shirt looks perfect under a summer jacket with tailored trousers on a hot day). They work for any time you are going to get hot. So now there are cooling clothes for “menopause belly” as well as the gym. 

They are all mix and match, and best of all, after a long day staying cool with Cucumber, you can fall into bed wearing them knowing they will be dry, odor-free (that’s our anti-bacterial nano-technology!) and help keep you cool through then night.

Cucumber’s multi-tasking pieces are ideal for travel as our fabrics don’t crush, are happiest cold-water machine or sink washed and like to hang dry as they dry super fast because of their moisture wicking properties. Remember, don’t iron our jersey pieces, and our “˜silk’ pieces rarely need a light press.

Have you tried Cucumber Clothing? What did you think? Let us know your thoughts in the comments below, on the Gennev Facebook page or by joining Midlife & Menopause Solutions, our closed Facebook group.

While it may not be menopause-related, viruses are certainly a women’s health issue! And with all the concern around the coronavirus outbreak, we wanted to be sure we addressed it with you. 

Unless you’ve been in a very deep cave or lengthy Netflix binge, you’ve likely heard about the coronavirus. There’s been a lot of very scary coverage of the illness, but is it really worth so much intense focus and concern?

We talked with our Chief Medical Officer Dr. Rebecca Dunsmoor-Su, who, in addition to being an OB/GYN, is also an epidemiologist (epidemiology is the study of diseases in given populations). Here’s what she told us.

What is the coronavirus?

Says Dr. Dunsmoor-Su: The coronavirus is basically just a cold virus. There are lots of coronaviruses, actually; “corona” just describes the shape and format of the virus. We’ve known about multiple coronaviruses for a long time; the most recent version is known as 2019-nCoV.

The concern, according to Dr. Dunsmoor-Su, comes with the viruses that jump from animal to human. When we haven’t seen one before, she says, it raises some concerns because we haven’t had a chance to study it and we don’t know much about it.

“We saw the same panic with the SARS and MERS viruses, when they made the jump from animals to humans. These are all just coronaviruses. And the panic around SARS and MERS turned out to be largely unwarranted. There wasn’t the global pandemic some of the more sensational news outlets were speculating about, and it’s very likely this coronavirus will be the same.”

We asked her where the virus came from. In terms of this one, she tells us, “It probably jumped from animal to human in China, where there’s more active, public trading of live animals than we generally see in the west. We’re not sure yet what animal the virus came from. It’s been speculated that the origin may be bats or pangolins, but we don’t know that for sure.”

Don’t live with fear about physical symptoms: talk to one of Gennev’s telemedicine doctors and get back your peace of mind. 

Should we be concerned about coronavirus?

According to Dr. Dunsmoor-Su: No. This coronavirus is highly infectious because it spreads easily. However, it is what is called a “droplet precautions” illness because it can only spread via droplets of spit or mucus from infected people coughing and sneezing. Droplets from the cough land on a surface which you then touch, picking up the virus, and infect yourself by touching your face or eating before you wash your hands. It’s not aerosolized, so you likely can’t be infected from someone breathing on you.

So”¦.as long as you wash your hands frequently and don’t touch your eyes, nose, or mouth, you can likely avoid getting sick.

Not only is it largely preventable with ordinary precautions, there’s not much opportunity to be exposed, outside a specific region in China. The coronavirus hasn’t been seen much in the US as 3 cases initially, and as of February 11, that number has grown to 13.

But a lot of people are sick

True. But most of them have very mild cases. As of February 11, in China, the numbers are 42,700+ cases and just over 1000 deaths. According to Dr. Dunsmoor-Su, those deaths are largely among people who are elderly, medically fragile, immunocompromised patients. For most people, this is a cold that comes with runny nose, maybe a fever, a cough, etc. The reason some die is because the virus turns into a viral pneumonia in medically fragile people, and viral pneumonia is very hard to treat.

What should I do to protect myself?

First, don’t panic. And don’t let sensational headlines urge you into taking unreasonable measures.

For example, don’t take Tamiflu as that won’t help you avoid contracting the illness.

In truth, says Dr. Dunsmoor-Su, the likelihood of coronavirus becoming a widespread pandemic in the US is very small; it’s being monitored, we know when people come in from that region of China, so we can track them. Also the regions where it is an epidemic are being isolated to keep the virus from spreading.

However, for those who are at risk, if you believe you have been exposed, go see your doctor. There is a test that can detect coronavirus, so ask to be tested for it.

If you have it, the procedure now is to provide supportive care as monitoring symptoms, Tylenol for fevers, keeping an eye on you for breathing issues. If you do have respiratory distress, then go to the doctor and get admitted to the hospital for treatment.

What about a mask, we asked: Is wearing a mask a good idea? You can wear a mask, says Dr. Dunsmoor-Su, but frankly washing your hands is more important. If you touch a doorknob that has the virus on it, then touch your eyes, the mask won’t do you any good. Basically, the mask is a good reminder not to touch your mouth or nose without first washing your hands.

How long can the virus survive on a doorknob? We don’t really know, Dr. Dunsmoor-Su tells us. Most viruses don’t survive long outside a body as maybe just an hour or two. But we don’t know yet for this particular virus. So best practices are to wash or sanitize your hands often and don’t touch your face.

Who is most vulnerable?

Are some folks more prone? Not really. Anyone can catch it, but some just get sicker, says Dr. Dunsmoor-Su. Pregnant women are considered medically fragile because their immune system is suppressed. Children are always medically fragile because their immune systems aren’t as robust as they haven’t been exposed to as many contagions, so they haven’t built up an immune “bank.” Anyone on chemotherapy or biologic immunosuppressant drugs for, say, colitis or arthritis/joint pains, can be at greater risk, as can the elderly.

Reduce your risk of all kinds of problems by eating a healthy diet. Our Menopause Health Coaches can help!

Should I go live on an island?

That depends on the reason. Vacation, sure! To escape the coronavirus? Probably a bit extreme.

Yes, the coronavirus sounds very scary, and there’s a lot of hype around it, but honestly, it’s flu season, which is a much deadlier disease: flu has killed 12,000 people so far this year, Dr. Dunsmoor-Su says, so get your flu shot. If you’re medically fragile or have a weak immune system, you’re much more likely to get it, and you’re much more likely to get sick from it. Flu is airborne, so it can be easier to spread and catch because you can breathe it in.

According to Dr. Dunsmoor-Su, the flu shot doesn’t protect against all strains, but it does protect against the most worrisome strains that are circulating. It might not stop you getting sick, but it will minimize the illness, so you’re likely to have a much easier time of it. So, especially if you’re medically fragile, get your flu shot! And of course, take all the usual precautions of washing your hands, not touching your face, etc. as which, bonus, will help protect you against the coronavirus as well.

Your takeaway re: the coronavirus “” Don’t panic

Panic is not warranted at this point. If you’re going to China, take lots of hand sanitizer, and don’t touch your mouth, nose, or eyes (wear a mask, if that helps you remember).

Yes, the number of the infected continues to rise, but the percentage of those who actually die from the disease is going down. Why the change? Because more people are going to the doctor or hospital with symptoms, and more people are getting tested. It’s likely more people were sick with the coronavirus but assumed they had a normal cold and recovered just fine. Only the worst cases were being seen when the outbreak began.

If you’re sick with a “cold,” here’s how to protect others

If you have a legitimate reason to believe you’ve been exposed to the coronavirus, go to a doctor to get tested. (The Centers for Disease Control request you call your doctor first, to let them know of your exposure and that you’re coming in.)

• If you have upper respiratory problems, go to a doctor.
• If your symptoms are clearly not life-threatening, stay home.
• Cough into your elbow, sleeve, handkerchief, something, so you don’t cough onto things and leave droplets.
• Wash your hands regularly and sanitize when you can’t wash, especially before eating.
• Don’t touch your face (particularly the mucus membranes in your mouth, nose, and eyes).
• If you’re not feeling better within 3 as 5 days, talk with a doc.

Staying informed about the coronavirus is a good idea. But fear and panic really aren’t warranted, even for those who might be considered “medically fragile.” Take good precautions, eat well, get plenty of sleep, drink plenty of water, get your flu shot, and be well!

If you think chatting with others might help you be more at ease about the coronavirus, join the Gennev community forums!

The day was going great, things were rolling, stuff was getting done… until you got some unexpected negative feedback from your boss.

Instead of taking a few calming breaths and giving yourself some space to reread the email (and discover she didn’t insult your work after all), you just see red. And seethe. Then you try to get back to work, pressing down the feeling so you don’t blow up in the office. Perhaps you further numb your anger over the situation a little later by inhaling a handful of cookies in the breakroom. You don’t remember doing it. But you’re very aware that your fuse to anger is shorter than it’s ever been before.

Let’s face it: our coping strategies for anger in menopause determine our ability to bounce back from unexpected emotional ups and downs. 

It’s easy to let rage consume you. Once you start riding that anger wave, it’s hard to disembark until you’ve reached the beach. Luckily, we’ve got a few tips that’ll help you cut the ripcord before you faceplant in the water.

Why do I seem to be angry all the time?

Increased irritability and anger are common symptoms in perimenopausal, menopausal and post-menopausal women. Yet the reasons for these symptoms can vary greatly from woman to woman.

Just some of the reasons behind unexpected rage include: 

• Unbalanced or fluctuating hormones
• Loss of sleep
• Changes in exercise, nutrition and hormones 
• Dealing with chronic pain or discomfort

It’s also worth noting that not everyone experiences these changes or feels unexpected anger during menopause. So don’t “expect” anger issues just yet. But if you are experiencing these issues, rest assured that this is a common and manageable symptom. 

Unreasonable? Or appropriate?

Have you ever bottled up your feelings for fear others will label you “too emotional”? Many women feel scrutinized and judged for showing too much emotion. We start believing every emotion is unreasonable when really, we deserve to feel our feelings. We even deserve to express them, which can be the real challenge.

Menopausal women in marriages feelings are often cast aside and labeled “hormonal” “” even when they’re completely appropriate to the situation at hand. Our partners, family and friends might write us off as being irrational even when our emotions have nothing to do with hormones. And actually, hormonal changes may not create strong emotions so much as they allow strong emotions to bubble up to the surface. So the emotion is appropriate; now you just need to be sure your response is as well. .

Did a thoughtless driver cut you off in traffic and you are ready to rear-end them? Did someone leave a mini-sip of milk in the fridge at home and you want to decimate the next person unfortunate enough to cross your path? Is your partner’s cereal-eating (namely crunching, slurping, and spoon-scraping, not to mention only leaving a sip’s worth of milk behind) sparking you to feel… murder-y?

Before you unleash your reaction, can you take a breath and ask yourself, is this feeling right-sized for the situation? Or, is this an inappropriate feeling for the circumstance?

Manage hormones through diet and exercise

Diet and exercise play a huge role in our mental health. In fact, there’s a direct link between the body and the mind: doctors believe your gut health is closely related to your emotional health — and we already know that exercise can help get those endorphins (hormones that help boost your mood and relax your mind) moving.

So, move! Not only is physical activity a great way to channel your negative emotions and provide a creative outlet for your stress, but it can increase your happiness hormone levels throughout the day, too.

When it comes to food, everyone is different. Some people can apparently eat nothing but sweets and potato chips all day long and never feel any adverse effects (though, we do demand to know who these people are!). The rest of us might find that we feel better and more in control when our diet supports our physical and emotional health.

So, if you’re feeling a little extra edgy throughout your day, you might want to look at your diet. 

Some of the common hormonal disruptors you need to stop consuming. Reducing sugar in menopause, alcohol and caffeine. If you have an intolerance or allergy to other foods, excluding them from your diet can also help ease tensions and give you more control over your mood. To start, we recommend you:

• Be careful of your caffeine intake — especially first thing in the morning
• Avoid consuming more than the recommended 25 grams of sugar per day
• Limit your alcohol consumption (one serving per day for women)
• Monitor how soy and dairy affect your mood (possible disruptors in some women)
• Avoid dehydration in menopause by drinking plenty of water each day. It will also help flush out the toxins in your system

Develop a meditation/gratitude/yoga practice

One of the most effective ways to curb your stress is by attacking it before it attacks you. Developing a meditation practice can help you sideline anger or mood swings in menopause. 

Mindful meditation allows you to notice your feelings (the good, the bad, and the ugly), accept them, and move on. Instead of shoving them aside or obsessing about them, you can observe them, acknowledge them, and let them go. And it won’t take as much time as you may think it will.

Find an outlet for your stress

Is it a little cliche to take a boxing class to find a creative outlet for your stress? Who cares?! If it works for you, go ahead and give it a shot. 

Sometimes we just need an outlet for our feelings “” whether they’re positive or negative. We can get so caught up in our lives that we forget to take time to really process our emotions. It’s easy to write off feelings of frustration, anger, and self-doubt as “hormonal,” but will that serve us and our relationships? Likely, no.

Having a plan for dealing with adversity can make our reactions more appropriate. Stepping on your daughter’s LEGOs for the umpteenth time really is frustrating! But your hormones can make something like stubbing your toe or stepping on a toy feel 10 times worse. And that can influence how we react, whether we shout at the LEGO-leaver or rub our foot, throw the offending toy into the toy bin, and move on. 

Creative outlets simply allow you to process those feelings in a safe space, and in a safe way. Even if you don’t feel like you’re creatively inclined, you can still channel those emotions into art or physical fitness. Some of our favorite ways to do this include:

• Set a timer for five minutes and write in a journal until the timer dings (or, keep going after time is up if you’re so inclined)
• Blast some music and dance out your problems; we recommend making a playlist full of anthems that you can sing along to and channel your rage
• Cuddle with a furry friend — nothing helps to process your emotions like a support animal
• Go for a run, walk, or bike ride
• Take a spin class
• Get a massage (yes, a massage therapist can help work out those tense muscles)
• Check out our Rage Checklist for coping with anger in the moment. 

The important thing to remember is that there is no “one-size-fits-all” solution for handling unexpected anger and rage. It’s important to listen to your body and do what works for you in the long run. 

Care to share what’s tipping you over your anger-edge lately… and what is working for you in dealing with it? Consider Gennev’s Community Forums as another outlet where women gather and share real experiences about navigating through perimenopause and menopause. Join us. 

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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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!

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 menopause and constipation.

Can menopause cause constipation?

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.

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 during menopause?

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

Hydration: Not drinking enough water in menopause 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 menopause joint pains or back pain, a lot of women stop moving as much in menopause, 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, stretching, and your legs probably won’t be the only things “moving.” to help with arthritis in menopause

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, rice, or take fiber supplements.

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 and to avoid pelvic organ prolapse. Breathe with your diaphragm, so your belly expands with your breath.

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.

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.

Maybe 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 help for your constipation?

If you’re experiencing severe abdominal cramping, 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.

We can help you find relief from constipation

• Meet with a Gennev Doctor – our board-certified gynecologists are menopause specialists who can help you understand how your constipation may be related to menopause, and prescribe a treatment plan to help you find relief.
• Try Vitality, a nutrient-packed multi-vitamin supplement that supports inflammation and joint pain, mood, energy, stress response and immune health.
• Magnesium helps to relieve many symptoms of menopause including 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.

You’ve likely heard that there are 34(ish) menopause symptoms. Surprise! There’s actually more than 40. Don’t worry, though. It’s rare that a woman would experience them all. However, given how little society has talked about perimenopause and menopause in the past, women may not know that what they’re experiencing is due to normal hormonal fluctuations.

40+ Common Menopause Symptoms to Know

The symptoms you experience often depend on where you are in the menopause transition, though every woman’s “constellation” of symptoms is unique.

At Gennev we’ve developed “menopause types“ based on what each stage tends to look like. Perimenopause is a Type 2, and many of these symptoms first appear there. However, menopause symptoms can come and go at different times, some even showing up as a symptom after menopause. No matter where you are in your transition, this information can be helpful.

Quickly review the list or bookmark so you can come back as new symptoms appear. This is your comprehensive perimenopausal symptoms list.

If you are really struggling with 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.

Perimenopause starts earlier than most of us realize (as early as the mid-30s for some), and symptoms may not be what we expect, so often women are well into perimenopause before they even realize the transition has begun. Too many women begin this natural process in a state of confusion and fear because there’s not enough education about what can happen as our hormone levels change.

Let’s change that. The more informed we are about what to expect, the better we cam manage symptoms as they come.  

Know more about your body in menopause: take the Gennev Menopause Assessment

A proactive stance for menopause could include: putting out a BOLO (be on the lookout) for these symptoms in your body and mind. This list may prove especially helpful if you are approaching 40, or if you’re curious about perimenopause indicators.

Of course, call your doctor or ours if you suspect something is off or concerning. AND review this list… just so you know better what to expect at the onset of perimenopause.

*Note: This is not a checklist, though it is a comprehensive line up.

Menopausal And Perimenopausal Symptoms List

Again, symptoms are experienced differently for each woman: some may have hot flashes for a month or several months, some women may never experience heart palpitations, spotting, or an itchy vagina. This list is about arming and empowering yourself with knowledge so you can make the best decisions for yourself and your health.

All about the vagina

• Vaginal Dryness – Thinning and drying of vaginal tissue can make sex painful. Don’t despair, your days of bedroom frolics aren’t over as just be sure to keep your favorite lubricant handy, and use it liberally and often.
• Itching – You can blame vaginal dryness for this one, too, as the vaginal walls thin and dry out, causing, yes, you guessed it, itchiness down there.
• Painful sex – The vagina may become shorter, narrower, and less flexible during menopause, leading to pain during intercourse. We recommend vaginal dilators for atrophy.
• Irregular bleeding – Irregular periods is often a woman’s first clear signal of the onset of perimenopause. Periods may be farther apart and occasionally skipped altogether, then heavy periods when they come. Note: “heavy” does not mean “flooding.” If you’re having truly heavy periods where you feel unsafe leaving your house, please check with your ob/gyn to be sure fibroids or other issues aren’t causing the problem. (Hint: Birth control pills or Mirena IUD can be helpful here.)

More support

Painful sex webinar with panel of experts

Vaginal issues in menopause: q & A with an ob/gyn

Birth control and menopause: what do we need to know?

Skin & body

• Dry skin texture and hair- Drying and thinning skin and hair are possible. Decreasing estrogen causes not only our skin to become thinner, but our hair, too. Double whammy. Here are some skincare tips for menopausal skin.
• Body odor changes – Yes, even your body odor can change in menopause. You’ll probably be much more sensitive to it than anyone around you. Whether it’s hormonal changes or higher levels of anxiety (normal during perimenopause and menopause), you may sweat more and your body scent may change.
• Acne– Oh, estrogen. As it declines during menopause and you experience a relative predominance of androgens (male-type hormones that stimulate oil production), acne takes the opportunity to make an appearance.
• Hormonal weight gain and body weight redistribution– When you’re younger, estradiol keeps you lean. Guess what happens when you hit menopause? Bingo! Estradiol decreases and estrone takes over–a hormone produced in your fat cells and adrenal glands that stores fat in new, uncomfortable places, like your belly.
• Dry eyes and dry mouth – These can be unpleasant. Be sure you drink enough water, blink frequently (studies show we don’t blink often enough when staring at screens), and for your mouth, see your dentist regularly. Dry mouth can mean more cavities. Your taste can also change, making you less interested in your formerly favorite foods.
• Foot pain – There are many culprits to consider here, including a decrease in the production of collagen, lower bone density, and weight gain, just to name a few.
• Nausea – Though the research is scarce, there’s no denying that nausea can be a symptom for some during menopause. Low blood sugar, progesterone deficiency, and dehydration are all possible causes.
• Joint pain – Joint pain is the one that makes a lot of us feel old overnight. One thing to know: for many women, this gets better. Don’t stop exercising, and go easy on the ibuprofen, which can cause stomach upset. (Hint: manage weight and take magnesium glycinate.)
• Gas / Bloating – Feel like a Macy’s parade balloon with enough natural gas in you to energize a mid-sized city? This can be normal during menopause. Really. Excess air and/or water may contribute to this symptom, as can stress, diet, gut flora, and slowing digestion.
• Constipation – Strictly speaking, if you’re not having at least three bowel movements a week, you’re constipated. It may suddenly seem like no food is “safe.” Don’t panic. Just increase fiber (slowly) and track symptoms. Many women become more sensitive to dairy or grains in this time, so you may be able to identify foods that cause more trouble than others.
• Urination frequency changes due to urinary system changes, even incontinence – Gotta go, gotta go, gotta go? Unfortunately, this is not surprising. Blame our old friend decreasing estrogen, who starts to fall down on its job related to the bladder during menopause. Pee-rfect! A pelvic physical trainer is your best defense here. Even if you’re not having issues (yet), you can avoid a lot of problems by learning how to strengthen your pelvic floor (but not too much). Do not dehydrate yourself, assuming you won’t have to pee as often. (Hint: pelvic PT, tracking food and drinks that irritate your bladder)
• Sense of taste may change – Many women report foods simply don’t taste the same during menopause–and some even experience a constant metallic taste in their mouths. You’d think this would aid in losing the newly deposited belly fat. And yet…
• Heart palpitations– Your heart may race, skip a beat, flutter. These are perfectly normal “” usually. Since we don’t like to leave heart things to chance, check in with your doc or ours, explain what you’re experiencing, and follow instructions. If ever you feel the symptoms of a heart attack, however, get help immediately.
• Numb or tingling fingers (paresthesia) – (tingling or burning sensation in your fingers, hands, feet, etc.) Some women even feel they have insects crawling under their skin. Again, it’s annoying as heck, but it’s not life threatening, you’re not crazy, and it’ll likely reduce as you get further past menopause.
• Ringing ears or tinnitus– Experiencing a roaring or ringing in your ears? Could be tinnitus, yet another super annoying menopause symptom. There’s really not a good treatment for it. It does tend to subside over time, however.

More support

Skincare tips for menopausal women

The mindful approach to weight management at menopause

Hot flashes: Your internal volcano is now active

• Hot flashes– In an era of COVID, we’ve had lots of women ask if they’re experiencing hot flashes or a fever. Hot flashes are generally pretty short in duration, are often felt first in the chest, neck, and face, and may come with accelerated heart beat. (Hint: hydrate! Drink lots of cool water to help reduce it. Better: talk with your doctor about hormone replacement therapy for hot flashes.)
• Flushing – When a sudden feeling of heat comes from nowhere and spreads throughout the body”¦ It isn’t uncommon to start sweating, palpitations and flushing of the face.
• Night sweats… even day sweating too

More support

Four ways to get rid of hot flashes

Menopause cold flashes: yes, that’s a thing– cold flashes can be caused by menopause or perimenopause. These are pretty unpleasant and can last a long time. Further, they tend to happen at night and are resistant to blankets and fleece pajamas. If you get these, try taking magnesium glycinate at night before bed, and when they happen, warm from the inside out by drinking warm water.

I think I had my first hot flash

Brain and mood

• Fast, and intense, mood changes – Though we’re not precisely certain of its cause (most likely a mix of declining estrogen, physical changes, and external factors), there’s no denying that menopause brings on unwanted mood changes.
• Rage – When your estrogen levels are wildly fluctuating and progesterone (a natural antidepressant and anxiety reliever) seriously declines, your serotonin and other mood- and stress-moderating brain chemicals take a big hit.
• Brain fog / memory lapses or concentration difficulties – Suddenly you lose a word, or a name, or just don’t feel as sharp as usual. While many women worry about early onset dementia, chances are, it’s perimenopause. Talk to a doc if you’re not comfortable, absolutely, but this isn’t cause for panic. (Hint: Omega 3 supplements can help here.)
• Increased clumsiness – Yes, becoming more clumsier is a thing. Why? Well, when your estrogen levels drop, it can be harder to concentrate and also hold onto things comfortably. On top of that, the blurred visions, cataracts, and dizziness can make it harder to be coordinated.
• Tiredness/fatigue – This isn’t due to sleepless nights, this is tired that literally starts with a tired brain. As estrogen decreases, the brain loses its “master regulator,” and you feel fatigue that is bone deep. Again, this will likely recede with time. (Hint: Omega 3s, lowered expectations, self-care)
• Sleep disturbances as aside from night sweats – You know the expression, “I slept like a baby”? Well, this is the reality: waking up every two hours, wanting to cry. Now is the time to start being truly dedicated to good sleep hygiene. (Hint: Sleep hygiene, meditation, CBD, and magnesium glycinate.)
• Restless leg syndrome (RLS) – Experiencing sensations of tingling, electric shock, itching, crawling, throbbing–plus an irresistible urge to move–in one leg or both, especially when you’re falling asleep? Welcome to RLS, where the cause isn’t certain, but the symptoms sure are!
• Stress – We’re not going to define stress here, because we understand you’d like to finish this article at some point. Just know that during menopause, your stress levels might go up. And with everything going on during this life transition, both internally and externally, it’s easy to understand why.

More support

Menopause and mental health: finding yourself in isolation

Depression in perimenopause: we really need to talk

How to get good sleep

What about your regular, cycle-sparked PMS symptoms?

The truth is, every woman’s experience is different. So, it could be that your regular cycle’s symptoms show up and intensify (going from PMS into PMDD), or not. You might also experience new PMS symptoms (yeah, sorry), or not.

Our best suggestion is to be on the lookout so you can quickly identify, accept, and act to diminish discomfort and stress.

• Breast tenderness – Our breasts are capable of great things, like providing vital nutrients to our children. They’re also heavily influenced by hormones, so when menopause throws everything out of whack, your breasts can get in on the action, becoming more tender and sensitive.
• Migraines – More intense than your average headache, migraines might hit you during menopause whether you have a history of them or not.
• Light or sound sensitivity – Did you know that estrogen plays an important role in how the brain processes sound? And that fluctuating hormones may cause eye changes? You know where I’m going with this, right?
• Water retention – Not to sound like a broken record, but those wild and crazy hormones of yours might lead to unwanted water retention.
• Cramps – The pain associated with cramps might intensify during perimenopause–even months when you skip a period. We know what you’re thinking and yes, this is really not fair.
• Mood swings – As we mentioned earlier, mood swings, whether mild or fierce, may become part of your day-to-day. Getting mad easily and feelings of sadness are the most common emotional symptoms of menopause.
• Anxiety and depression – If you have a history of emotionally challenging PMS, post-natal depression, PMDD, anxiety, depression, or other hormonally related emotional issues, be aware that these can come back and be even more severe in perimenopause. If you’ve never had these concerns, they can still erupt during peri, so be aware of the possibility and get help if you need it. (Calming apps and exercise will help with mild cases; seek help for the more serious.)
• Lower back pain – Yes, hormones can play a role in lower back pain. So can a whole host of other issues, including incorrect exercise form, poor stability, and even poor breathing.
• Heavier flow periods – Occurring most commonly during perimenopause, heavier flow periods are typically defined by twelve to sixteen or more soaked sanitary products during a period.

Red flags

Consider talking with your doctor about these if they appear:

• Bleeding after menopause – If you’ve been period-free for a year, then suddenly experience post-menopausal bleeding, it’s time to talk to your doc. Possible causes include tearing of the vaginal tissue and fibroids–concerning, but less scary than a third possible cause, cancer of the lining of the uterus.
• Newly inverted nipples – Apparently, this is somewhat commonplace and can run in families. Still, another possibility is cancer, so don’t ignore the nipples!
• Unintended weight loss – We know this one might feel more like something to celebrate, but when the cause could be infection, hyperthyroidism, depression, and even cancer, it’s best to consult an expert.
• Skin breaks – A drop in estrogen causes dryness, age spots, or a tendency for the skin to bruise. The drop in estrogen can also prompt acne breakouts.

Less-known symptoms of menopause

You may hear about the common menopause symptoms from women in your friend circle who are of similar age, but less-common (or at least, not-as-well-known) symptoms are the ones driving women to the ER or their psychiatrist.

Know that menopause is very different for every woman, so if your transition looks different than your friends’ or your sister’s, that’s OK. Symptoms vary in appearance, frequency, and intensity, but all can be “normal.”

There are a LOT of menopause symptoms, and chances are, if you’re the right age, that bizarre tummy rumble or tingling finger is hormonal. However, there are other possible causes, some serious, so you don’t want to assume it’s menopause. We always recommend you check in with a doctor (preferably a menopause specialist) to verify. And if symptoms are severe, sudden, overly painful, or interfering with your life, please see a medical health professional ASAP.

And please, do your buddies a favor. Pass this article along. No woman needs to lie awake at night, scared she’s having a heart attack but reluctant to do anything about it because she’s been dismissed before. Every woman who lives long enough will go through this, so let’s help each other have the easiest, healthiest transition possible.

I’m only 40; why do I need to know the common symptoms of menopause?

However, given how little our society has talked about perimenopause and menopause in the past, women may not know that what they’re experiencing is due to normal hormonal fluctuations. It’s not just hot flashes.

First, some definitions: symptoms usually start in perimenopause, the years before menopause when hormones first start fluctuating (menopause is just one day as the one-year anniversary of your last period; everything after that day is post-menopause). Some women may experience few or mild or no symptoms early in perimenopause or assume they’re due to stress, bad PMS, or other factors.

Perimenopause can start as early as the mid- to late-30s but commonly becomes noticeable in mid-40s. Poor sleep, mood changes, irregular periods, heart palpitations, and more can occur during this time, and we hear from a lot of women that it took several doc visits and possibly even a trip to the ER before anyone diagnosed them correctly.

Given that perfectly normal symptoms can cause a lot of fear and anxiety (and expense!), we would like everyone who may be experiencing or who will experience menopause to know what could be coming.

By the way, you’ll see the words “talk with your doctor“ a lot in this article. We highly recommend you get a menopause specialist OB/GYN in your life, as you’ll maximize your chances of getting the most complete information.

More aware, better care

Looking ahead, this is a time for more self-care and self-support, not less. Improving your comfort and managing these symptoms with excellent self-care (eating good, healthy foods; hydrating, making sleep and fitness bigger priorities, quitting smoking or vaping) will actually improve your health, inside and out.

Absolutely get into the spirit of research and talk with your doctor (or ours) about best options for hormone management or therapies, alternative health practices for menopause symptom relief (e.g. acupuncture or chiropractic), and even hemp-sourced CBD options. AND! Talk with like-minded new friends on our community forums.

Arm yourself with the information you want and need so you’ll recognize perimenopause indicators when (and if) they show up. Take control of your health and enter this part of your life path with confidence and power.

Are you ready to understand your body better & take control of your health in menopause? Take Gennev’s ob/gyn-created Menopause Assessment now.

While on a birthday trip to Bermuda, Rolonda Wright wasn’t feeling well. VERY not well. Constipation turned to abdominal pain bad enough to send her to the ER for 15 hours.

On her return “” after a vacation that wasn’t at all what she’d hoped for “” she went to her great OB/GYN for tests and discovered she had a uterine fibroid “the size of a four-and-a-half-month pregnancy” or, as Gennev CMO Dr. Rebecca Dunsmoor-Su translated: about a personal-sized watermelon.

Sitting up high, it was actually visible as a bump when Wright was lying down.

“That’s not at all uncommon,” says Dr. Dunsmoor-Su. “So many women come to me with large fibroids thinking they’ve been eating too much bread. It’s not bread! It’s a big ball of muscle.”

“I thought I had to do more sit ups to get that ab down! A doctor a few years ago suggested a hysterectomy for my fibroids, but I didn’t really have any problems: no pain, no problems with sex,” Wright says.  She had heavy periods, but the heavy flow only lasted for a day. “One day I couldn’t leave the house or it would have been a disaster, but the next day it was fine.”

The problem, she says, wasn’t so much the fibroid. It was how little information she had. She came to Gennev to share her journey with us and our readers so that other women would be better informed. You can follow her journey on Facebook, Instagram, TikTok at Rogirll01, or her website.

When you know more, you can act faster, she says. She might have had the fibroid removed when it was much smaller and required less invasive surgery. She might have had a hysterectomy years ago and had a much better time in Bermuda.

Dr. Rebecca Dunsmoor-Su Answers Hysterectomy Questions

Hysterectomy is a big deal, and no one should make the decision to have one without all the information they need and want. So before Wright went in for hers, she came to ask to the questions that should have been answered long ago.

What follows is a very important conversation between Rolonda Wright and OB/GYN and menopause specialist Dr. Rebecca Dunsmoor-Su. Rolonda Wright’s questions are in italics.

How do I prepare for this, both mentally and physically? This housed my child, so it is a little bittersweet. I’m good with it, I’m ready for it, but it’s also a subtle loss.

“It’s a transition,” says Dr. Dunsmoor-Su. “This marks a new stage in your life, and while that’s a good thing, it’s also a loss. You can be happy and sad at the same time.

“I’m glad you’re doing this and sharing this because women put up with a lot: we endure the pain, the bleeding, the discomfort for such a long time. Partly this may be because it increases slowly and gradually over time. If we went from a normal period to a super heavy period in one month, we’d see a doctor. But because it happens incrementally, we feel like it’s a normal part of aging. So I’m glad you’re bringing this to women’s attention.”

That’s part of the reason I came to you. I’m not even sure what questions I should be asking right now. What do I need to know?

“First, there are multiple kinds of hysterectomy. As physicians, we tend to define it by route of hysterectomy: both by how are we going to do the procedure, and also by what we’re taking and what we’re leaving behind, like ovaries or cervix.

“Fibroids are balls of uterine muscle that grow in the wall of the uterus. They can grow very large. And they are progressive, as they’re estrogen-stimulated. So as long as there’s estrogen in the system, they will continue to grow. We tend to see particularly quick growth through perimenopause when women get these really high spikes of estrogen. So a lot of women end up sort of in that perimenopausal stage, coming in to see us because suddenly this thing has grown quickly.”

Why do Black women have more fibroids than white women?

“Unfortunately, this is one of those things we don’t understand. Black and Asian women tend to have more fibroids; there are thoughts about vitamin D lack and other things, but the research just isn’t sufficient to draw conclusions.

“Not only do Black women have more fibroids, they’re more frequently undiagnosed or misdiagnosed and improperly treated because of systemic racism and sexism in medicine. And because Black women are used to being treated poorly by medical professionals, they may not seek treatment as early. Which is so unfortunate, because the sooner fibroids are caught, the more easily they can be treated.”

I’m a few days prior to surgery. What do I need to be thinking about now?

“In the days prior, you should know how your surgeon is going to do the surgery. It matters because different surgeries have different recovery periods. So if you don’t know, be sure to ask. Also, how are you going to recover? How active can you be, and how quickly? Who’s going to help you out at home, especially in the first couple of days?

“This is even more important now, in the time of COVID, because you need to take extra precautions. Anyone you come in contact with needs to be wearing a mask and washing their hands frequently, and so do you. If they can be tested for COVID and minimize contact with others, that’s best.”

So why have a complete hysterectomy?

“We do hysterectomies because the surgery is much simpler, and generally the women we see are done having children. It’s possible to preserve the uterus for women who are still planning to bear children,  but it is a much more complicated, much more difficult, and much higher blood-loss surgery than just removing the whole uterus. Also, you never have just one fibroid. We usually can see one, but there’s always other fibroids in the wall.

“Additionally, fibroids will continue to grow. So we could do the surgery, take the fibroids out, and in two years you could be right back where you are now. If there’s a need to keep the uterus, then we would do the myomectomy, which is the removal fibroid surgery. But if you’re done having children, the hysterectomy is quicker, safer, and has an easier recovery.”

Should I keep my ovaries and fallopian tubes?

“In most women who are having surgery for fibroids, we don’t remove the ovaries, because there’s no reason to put someone into sudden menopause when really the only problem is the fibroids. We usually take the tubes now because there’s some question about whether they contribute to ovarian cancer rates. However, we usually leave at least one or both ovaries because then you drift into a gradual menopause. Your ovaries also have some roles after menopause in terms of making precursor hormones and testosterone. Those are good, so we want to preserve that function if we can.”

Why do some women elect to have their ovaries removed?

“It’s always a balance of risk/benefit ratio. When I counsel patients, I ask, “˜Do you have a high risk in your family of ovarian cancer or familial breast cancer?’ Familiar ovarian cancer history could mean you’re at higher risk for ovarian cancer, so we might want to consider removing the ovaries.

“Also, if you personally had breast cancer, removing the ovaries can mean reducing the stimulation of the breast tissue with estrogen which can help prevent recurrence.

“But in most women who are just having surgery for something like a fibroid or heavy bleeding, and whose ovaries are not at particularly high risk, there’s a greater benefit to leaving them. Ovarian cancer  doesn’t happen very often, especially in women with few risk factors. Whereas cardiovascular disease and bone fractures and all those things that come with menopause do happen quite often. And so drifting into a more gentle menopause at a later age is just more beneficial for women.”

What are the different methods of hysterectomy, and how do surgeons and women decide which route to take?

“It really depends on the reason for the hysterectomy and what your provider has been trained to use. It’s amazing what we can do without opening your abdomen anymore. Now that we have all these techniques and tricks. Some can be done vaginally, which means we go in through the vagina, grab it, snip it loose and pull it out. In those cases, women don’t even have an incision. And that works when the uterus is small, with no large fibroids. But when you have a larger uterus with large fibroids, we use the laparoscopic camera or the robot, depending on training. We make a couple of centimeter-long holes in your abdomen, and we can get that larger uterus out that way. We disconnect the organ with all the fibroids still in it, put it all into a bag to keep it contained, use a device to turn it into one long strip, then pull it all out. The bag is a precaution because rarely the fibroid can contain cancerous cells that we don’t want spreading throughout the body.

“The beauty of this is that the pain of surgery is generally from the incisions. When incisions can be kept really small, or when you don’t have to make them at all, the pain is much less and the recovery is faster. There will likely be a dull aching in the low pelvis, but women won’t have to struggle to recover nearly as much as previous generations.”

How is the uterus anchored inside the body?

“Generally speaking, it is anchored where the uterus and the cervix meet. If you think of the uterus as a fist, the cervix would be the wrist that hangs out into the vagina. It’s anchored at the connections or the point where the uterus and cervix are joined by two ligaments that go back to your sacrum or tailbone. There are tubes that come off the top of the uterus and sit around the ovaries, but they’re not really connected to the ovaries. There is a little vascular connection between the ovary and the uterus, and that’s pretty simple to disconnect. And then it’s mostly blood vessels.

“At the bottom of the uterus, we take the cervix and close the top of the vagina. Taking the cervix removes cervical cancer concerns, and there’s really no reason to leave it behind. It doesn’t had to do with sexual pleasure, nor does it provide support for the vagina, as was once thought.”

Will I feel any different without a uterus?

“Because your fibroid is quite large, you may feel the lack of the fibroid, but that’s a good thing! You’ll probably feel a bit thinner and less heavy, you’ll have less constipation, possibly less urinary urgency without that big thing putting pressure on your bladder or making constrictions. In terms of sexual pleasure, there shouldn’t be any difference. The center of women’s sexual pleasure is the clitoris, and we don’t remove that ““ it’s very important! If your ovaries are not removed, you won’t have a difference in hormones.”

What should I look out for? Are there concerns after the surgery?

“Of course, every surgery carries risks, so let’s talk about them. There are three main things that I counsel about in terms of risks of any surgery and specifically a hysterectomy risk.”

“Number one is bleeding. Because of the fibroid, you have a big uterus; it’s got big blood vessels to feed it. So we have to tie those off properly. We’re performing the surgery under visualization, so we can see that nothing’s bleeding, but it’s not impossible for a blood vessel to be in spasm and not bleeding and then open up later. So if you suddenly feel dizzy or lightheaded or have severe abdominal pain, those are signs of internal bleeding.

“Number two is infection. We give antibiotics before surgery, and it’s not a big infection risk, but obviously high fevers, chills, and severe abdominal pain can be a sign of infection.

“The last one’s a little more vague. It’s damage to structures around the uterus. There’s bowel all around the uterus, and the bladder in front. Ureters are tubes that carry urine from the kidneys to the bladder, and they go down the side of the uterus and up and over it to get to the bladder. Experienced surgeons will identify them and make sure they’re out of the way and check them at the end, but rarely an unrecognized injury can happen.

“The most common unrecognized injury is actually to the ureter, that tube between the kidney and the bladder. As we’re coming down the side of the uterus to seal off the blood vessels, we’re usually using cautery because it seals the edge of the blood vessel and then we can divide it.

“If the cautery is just a little bit too close to the ureter, even if it wasn’t cut, it could have some localized thermal damage and that can show up a week or two later. That usually ends up presenting as severe abdominal pain, sometimes flank pain. That’s something to look out for as well.

“Again, all of these complications are very rare, but they can happen even to the best surgeon. If there were complications during surgery, your surgeon will let you know about it and tell you what to be on the alert for, but by and large, this is a low-risk surgery.”

What will happen as a result of the surgery? Am I going to gain weight or lose my hair?

“I tell women who are near to the menopause that for about six weeks after a hysterectomy, you may have an upswing in hot flashes. A lot of that’s just inflammation and healing; after all, the ovaries took a little hit! But it usually settles out, and you should drift into a natural menopause like you were before the hysterectomy.

“The best way to minimize problems in recovery is to go in healthy and really well nourished. Make sure you’ve got all the nutrients you need for your body to undertake this big healing process. I am not personally a huge supplement taker. I tend to eat a very balanced diet and that’s generally enough, but before my own surgery, I took Gennev’s Vitality product, which is a daily supplement. I used it for the months surrounding my surgery. I knew that I would be barreling through all these nutrients as my body’s trying to heal, so I wanted to do everything I could to help my body do that. Vitality is a very focused supplement for women age 40 and above, and it has the things we need more of like vitamin B and vitamin D and so on.

“Before surgery, I talk to my patients about their health goals, their history, and their risks because all of those should inform their surgery.

“Even though you may not go into menopause because of your surgery, you’re eventually going to go into menopause. How do you want to handle that? What are your fears about this process of menopausal transition? And, you know, what’s most important to you to preserve?

“You know, some women say my biggest fear is weight gain, in which case I say, well, there are a couple of really important things you need to keep in mind: One, you lose muscle mass as you go into menopause. So adding more weight training to your regimen rather than more cardio can help you maintain weight. Two, you need fewer calories as you get older.

“Is fear based around sexual function? In that case, I tell them there are important things they need to do during menopause. One is make sure your relationship and your stressors are under control because probably the most key things in any woman’s libido are stress and relationship stress. Number two, make sure vaginal tissues and happy and healthy and take pleasure from intercourse. We can do that by treating vaginal tissues with local estrogen or other moisturizers and using a really good lubricant. Do it right away, because once you start to experience pain down there, you may start to fear sex and it will drive your libido down.

“For some women, fear centers more around longevity in terms of cardiovascular health and bone health. Maybe they have a strong family history of osteoporosis or heart attacks. Then we talk about hormone replacement. Certainly if someone’s having significant symptoms around menopause, like significant hot flashes, significant sleep disturbances, HRT can really help them transition comfortably and safely.

“For many or most women, we experience menopause in our fifties, when we’re not done at work. We are at the height of our careers. We can’t really afford to be having seven hot flashes a day and not sleeping at night. So we take hormone replacement through our fifties and into our sixties and come off it when we retire. I have patients who use hormone replacement for two years. I have patients who use hormone replacement for 10 years. I have patients who use hormone replacement until they die because they love it and it makes them feel good. And all of those are appropriate responses to menopause.”

Rolonda Wright is sharing her journey with us so other women will have an easier “” and certainly more informed “” journey of their own. While we’re comfortable talking about all kinds of personal things (ask any runner about their digestive system, for example), hysterectomies have long been considered embarrassing and shameful. And that does not help women be healthier.

Our thanks to Rolonda for sharing her experience, asking questions so many women share but are too afraid to ask or have no one to ask. If any of her experience sounds familiar to you, we encourage you to talk to your doctor or ours to learn more. Don’t wait, don’t suffer, don’t be embarrassed. Be healthier and happier instead!

Are you dealing with fibroids or do you suspect you might be? Come ask questions and learn more from the Gennev Community forums!

If you were a child in the 70s or 80s, chances are you’ve heard of or experienced the Clean Plate Club. You know the one, where you are expected to eat every last morsel of food on your plate because there are starving children in the world who have nothing to eat.

My personal version of this was a face-off against ten lonely, shriveled, tasteless lima beans. My parents made me sit at the table for HOURS after dinner ended until I finished every last lick of limas.

I have wonderful parents, but this was such a horrid experience for me that I never let them live it down, AND I definitely don’t raise my two young sons this way.

As a mother and cook, I knew I needed to take a more modernized approach to feeding my family, which I refer to as the Clean Plate Club 2.0. We eat healthy, we eat clean, we don’t eat massive portions just because they are on our plates, and if you don’t like lima beans, by God, you don’t have to eat them!

Clean Plate Club 2.0

This is a great time to introduce the Clean Plate Club 2.0 concept to our followers, as it’s cervical cancer awareness month, which is top of mind for us here at Gennev.

Cervical cancer is highly preventable and treatable, provided that people take the steps to get screened and vaccinated. While the biggest risk factor for cervical cancer is an HPV infection, there are other health-related risk factors, including a diet low in fruits and vegetables and being overweight.

In 431 B.C., Hippocrates, the father of medicine, wisely said, “Let food be thy medicine and medicine be thy food.” We’ve all heard this before, but I always return to this quote as it is a reminder of the medicinal properties wholesome food can have on us. Now remember, in 431 B.C., people didn’t eat food out of boxes or wrappers, they ate fruits, veggies, whole grains and certainly weren’t eating foods that had been genetically modified!

So the Clean Plate Club 2.0 is loosely based on this revolutionary quote. As a nutrition coach, my mission is to educate you on the role that smart nutrition plays in nourishing your mind and body, and preventing illnesses like cancer.

I’m introducing Clean Plate Club 2.0 because studies have shown that you can fight cancer with food, particularly plant-based foods because they contain phytonutrients and other special compounds.

Participating in the Clean Plate Club 2.0 is easy. Here are three basic rules to follow:

One: Make veggies and leafy greens the stars of your plate at lunch and dinner.

Cruciferous vegetables like arugula, kale, cauliflower, Brussels sprouts and broccoli are low in calories, high in nutrients, and have sulfur-containing compounds with cancer-fighting properties. Opt to include two servings of veggies on your dinner plate with a small (optional) serving of whole grains and a small serving (4 oz or less) of lean protein.

Two: Minimize the number of added ingredients in your meals like sugar, dressings and mayonnaise.

Instead, add flavor to your dishes with real ingredients: healthy fats such as olive oil, avocado, Greek yogurt, lemon/lime juice and zest and spices like turmeric, cinnamon, ginger and curcumin, known for their anti-inflammatory properties. For example, make a quick and easy salad dressing with olive oil, lemon juice and curcumin instead of pouring a calorie-dense, preservative-laden bottled dressing onto your next salad.

Three: Reduce the amount of animal fat in your diet.

Meat, cheese, and butter can be rich in saturated fat, which has been linked to obesity “” a big cancer predictor. Look at these products as a treat, and a special accessory to your plate when you have them. If you are going to eat animal fat, splurge on organic, grass-fed meat and butter and sprinkle cheese onto foods sparingly.

The benefits of joining the Clean Plate Club 2.0 are numerous, but like anything else, you need to be consistent 95 percent of the time to see results. In addition to combating cancer, you’ll increase your energy levels, improve digestion and gut health, enjoy a clear complexion and feel lean and strong.

Open enrollment starts today, and I can’t think of a single reason that you shouldn’t join, but the main reason you should: because YOU are worth it.

Cheers to your health,

Michelle

How do you handle nutrition in your house? We’d love to know more as share with the community in the comments below, or hit us up on Facebook  or Midlife & Menopause Solutions, Gennev’s closed Facebook group.

While hot flashes are practically synonymous with perimenopause, some women experience the other extreme: a bone-deep cold that no matter how many blankets you layer on, you just can’t warm up. Or you may be in a warm room and suddenly feel chilled and begin shivering. Sometimes cold flashes come on the heels of a hot flash when damp, sweaty clothes only make them worse. Other times, they come alone and mysteriously. Cold flashes usually pass within a few minutes, but they can last for up to 20 minutes and are more common at night.

Cold flashes are considered an unusual perimenopause symptom, but given the number of women we’ve heard from who are experiencing them, we’re starting to think that cold flashes are more common than doctors realize.

Cold flashes: What’s happening?

Much like hot flashes, cold flashes are likely caused by the hormone havoc going on in your body. As estrogen levels drop, the hypothalamusasthe part of your brain responsible for regulating your body temperatureasgets overly sensitive, and therefore temperature regulation can be unstable.

Cold flashes can also be triggered by a panic attack or anxiety. During a panic attack, your body releases adrenaline and other stress hormones that can affect its ability to regulate body temperature.

Although they’re less common than hot flashes, cold flashes are no less disruptive, especially at night. And given how rare a decent night’s sleep can be during this time of life, learning how to manage cold flashes may give you a shot at some vastly improved rest.

What to do about cold flashes

Here are some steps you can take to help even out your body temperature:

Limit caffeine and alcohol. Not only can they disrupt your sleep, but these substances also influence your body’s temperature regulation system.

Avoid sugar, spicy foods, and nicotine. All can be triggers for cold or hot flashes.

Be prepared. Stash extra clothes at work, in the car, or carry some with you.  You can don another layer when a cold flash strikes. If it’s a hot flash, you can change out of damp clothes, which may reduce the chances of a follow-up cold flash. At night, keep extra blankets handy. Moisture-wicking bedding and pajamas can help, too, and keep a spare pair next to your bed for a quick change if needed.

Get active. When you’re in the throes of a cold flash, hop out of your seat and start moving. This will increase blood flow to help warm you up.

Practice relaxing. Easier said than done, right? Especially if you’re thinking that it means meditating for a half hour or taking an hour-long yoga class. It is easier than that. You can start with just a minute or two. Set a timer for every hour or so and when it goes off, stop and take a few deep breaths. Before each meal, do a few stretches. Or every time you’re in your car alone, close your eyes and pay attention to how your body feels””of course, do this before you start driving or once you reach your destination. Even small steps can help to ease anxiety that may precipitate a number of perimenopausal symptoms.

Slip on socks. If cold flashes haunt you at night, keeping your feet warm may help.

Keep in mind that sometimes the things you do to survive a cold flash may trigger a hot one. If that’s your M.O., proceed with caution. Drink warm beverages instead of hot ones. Pile on one blanket at a time instead of half a dozen. Turn up the thermostat a degree or two, not 10.

When to get help with cold flashes

If you’re having disruptive cold flashes, a trip to the doctor is recommended. Poor blood circulation, thyroid dysfunction, anemia, and low blood sugar can cause cold flashes and can be more serious than a typical hormonal imbalance due to perimenopause. If they are strictly perimenopause related, you and your doctor can discuss hormone replacement therapy (HRT),antidepressants, or low-dose birth control pills, which can offer relief. 

We can help you manage your cold flashes

• Meet with a Menopause-certified Doctor to understand cold flash symptoms, and their impact on your overall health and wellness
• Black Cohosh is a dietary supplement may help relieve hot flashes, cold flashes, night sweats
• Vitality is our nutrient-packed multi-vitamin supplement that that supports, mood, energy, stress response, immune health, joint pain, and inflammation

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.

As I’m writing this, it’s St. Pat’s Day, and several friends on Facebook are passing around a recipe for Irish Coffee. There are a few problems with this, not least of which is it’s not even 8 AM as a trifle early for whiskey, even on a Friday. But the booze and sugar are not the only things to be wary of.

Many of us wouldn’t consider facing a day without at least one sturdy cup of coffee. But hang on a second: before you order that double-tall mocha latte, you might want to read on.

I recently spoke with our fabulous physical therapists, Brianna and Meagan, on a problem they’re seeing more and more in their practice. As PTs who specialize in pelvic floor issues, they see a lot of women as including young women who haven’t had children as with urinary incontinence. These women are going to the bathroom often, sometimes not producing very much, sometimes not even making it in time.

Urgency and leakage are signs of an irritated bladder, says Bri, and one of the biggest culprits? Caffeine.

The low-down on coffee inflammation

The issue lies with the lining of the bladder. When the lining is calm and happy, it can stretch to accommodate larger volumes of fluid without triggering that feeling of urgency, the PTs tell me. Acidic substances like coffee, soda, and even fruit juice irritate the lining, causing muscle spasms that make us think we have to pee, and pee now.

“We hear from women that they’re trying to get their pants unbuttoned, and they’re already leaking, their bladder muscle is contracting. If your pelvic floor isn’t strong enough to overcome the contraction, the bladder wins, and the leak happens,” Meagan says. “Strengthening the pelvic floor can help, but it’s not an arm-wrestling match. You want to retrain your body to inhibit bladder muscle contractions and stop the leakage.”

“The lining of your bladder is mucous membrane, like the inside of your mouth,” Meagan continues. “Imagine holding a mouthful of something acidic like coffee or soda for an hour or two, versus holding a mouthful of water. Which do you think would be more irritating?”

Do you have a pee problem?

So what’s a “normal” amount of times to pee in a day? If you’re not actually leaking or coming close to it, does that mean you don’t have a problem?

“Ideally, you should be able to wait 2-4 hours between trips to the bathroom,” Bri says. “Can you sit through a whole movie? If not, you may need to cut back on the caffeine. Some people are going 15-20 times a day, when 6-8 is probably more normal. And for women, wiping that often can damage delicate tissue, making it more vulnerable to infections.”

Keeping a bladder diary

If you suspect you may have a problem, keeping a bladder diary can help.

“The majority of patients coming in with urgency issues are massive coffee drinkers,” Bri tells me. “Coffee and soda. Most of them didn’t make the connection between their habits and their problem until we told them to keep bladder diaries.”

“We ask them to log what they’re drinking and when,” Meagan explains. “And how often and how much they’re voiding. When they wrote it down, they could see the cause and effect. If you have four sodas before lunchtime, it’s no wonder you go so often!”

A diary will help you keep track of how often you actually go to the bathroom, a number most of us don’t keep a running tally of. If you’re exceeding that 6-8 a day, it might be time to make an appointment with your doc for a referral to a physical therapist who specializes in this area.

Common bladder irritants

Since it’s not just coffee and Coke that cause problems, a bladder diary can also help you identify those foods and drinks that are triggers for you.

Common liquid irritants are acidic juices, including orange, grapefruit, cranberry (yep, cranberry juice as how ironic is that?) and tomato juices. And of course, our favorite liquids, coffee, soda, and alcohol. “Alcohol can be a particular concern,” says Meagan. “It’s both an irritant and a diuretic, meaning it causes the body to produce more urine, which dehydrates you. And people tend to drink less water when they’re drinking alcohol, causing a pretty bladder-unfriendly cycle.”

Among foods, tomatoes themselves can be irritating (“If you leak every time you eat Italian food, that could be your problem!” Bri says.) Spicy foods such as hot peppers and curries can be problematic, so be sure to hydrate when you bump up the heat.

How to calm an irritated bladder: taming the bladder beast

If you have issues with urgency or leakage, and you suspect coffee may be the culprit, it’s time to reevaluate your morning habit. The good news is, you may not have to cut out coffee altogether. To avoid the wee pee, according to Bri and Meagan, there are some alternative strategies that may work. (Hint: these work for the other irritants too; just replace the word “coffee” with whatever your trigger of choice may be.)

“I won’t give up coffee. But I find ways to meet my needs for flavor and caffeine that my body can tolerate.” asMeagan

1. Get the volume down to one serving. And that doesn’t mean one grande venti bucket, Bri warns. One serving is six ounces, like the fine china cups your grandmother has in her cupboard.
2. “The solution to pollution is dilution.” Meagan suggests drinking 6-8 ounces of water first thing in the morning, before you hit the coffee. Why? “The lining of the bladder is affected by what hits and sits, so if the caffeine and acidity get diluted when they hit the bladder, the bladder lining is less likely to be irritated. When it’s irritated, it won’t stretch as much to store liquids, so you end up needing to go more often.”
3. Hydrate properly. Not drinking isn’t a good strategy either. “We see women who restrict fluids, thinking they’ll have to pee less often,” Bri says. “But the problem is, they’re putting less fluid in, which means the pee that’s in there is more concentrated, making it more irritating to the bladder.” Meagan adds, “Also, increasing your water intake teaches your bladder to suppress urgency. Too many irritants can, over time, cause the muscle fibers of the bladder to shorten and lose elasticity, but drinking water can gently stretch the fibers to accommodate the normal volume of fluid again. You can retrain your bladder to go longer, but you want to do it with fluids that don’t irritate. Water’s best.”

Lifestyle changes for a healthier bladder don’t have to be dramatic, but the results can be. Says Meagan, “We had a 16 or 17-year-old patient who was sent by a urologist because of chronic inflammation of the bladder, called interstitial cystitis. Down the road, she could potentially have been facing distentions [medical procedure to stretch the bladder to increase capacity and reduce pain], painful sex, all kinds of medical interventions. We found out she was drinking 5-6 big cups of coffee plus 2-3 sodas a day, and no water. We added water back, cut way back on the caffeine, and she’s fine now. If she stays on track, she’ll stay fine and probably avoid much worse health issues that she already had.”

Even if you don’t have urgency or leakage issues now, being mindful of your habits re: your bladdery bits can help you avoid problems in the future. So put down the coffee, grab a big glass of water and let’s toast as the Irish do: sláinte mhaith, to your very good health!

(However, since moderation is always key, you’ll find that lovely sounding Irish Coffee recipe here.)

As ever, we love hearing what you’re doing to feel fabulous in your body. Please share with the community, in the comments here or on Facebook and Twitter.