Our telemedicine doctors and coaches have been getting a lot of questions about the COVID vaccine, so Gennev CEO Jill Angelo asked me to share my thoughts on the safety and efficacy of the vaccines which are rolling out.
Normally, vaccines take years to develop; this one took a matter of months, and I know many of you have questions, given how fast these have become available. Let me give you some reassurance on that front.
Yes. For the vast majority of us, the vaccines are perfectly safe, and certainly a great deal safer than risking catching the COVID 19 coronavirus. Here are the facts, to help ease your concerns:
In terms of efficacy (how well it does the job), we have data on the two mRNA vaccines already, the one from Pfizer and the other from Moderna:
Regarding side effects, some that have been reported include arm pain, fatigue, and headache. Apparently the second dose hits some people a little harder, with more reporting flu-like symptoms of muscle aches and feeling a bit feverish. This generally lasts 24-48 hours.
Note that these side effects are mild, much more tolerable and short-term than the disease itself, and are actually evidence that the vaccine is working! Your body has recognized a foreign invader and raised its defenses to fight it. That way, if and when it ever sees the “real thing,” it’ll be ready.
If you’ve had COVID or got passive antibodies in the last 90 days, it is not recommended that you get the vaccine. Studies are showing that having contracted the disease provides protection against reinfection for three months. However, after 90 days have passed, yes, get in line. Having had COVID does not guarantee immunity; there are cases of people who’ve survived COVID contracting it a second time.
The vaccine itself is free, here in the United States, even for those who have no insurance. However, vaccination providers are allowed to charge a fee for administering the shots, so it might be worthwhile to “comparison shop” administrators. You can find more information on costs and reimbursement on the US government’s Health and Human Services website.
There are no known interactions with other medications, though it’s always good to check with your doctor to be sure no new information has come to light. If you are immune-compromised, your body may not have as robust a response from the vaccine, but you’ll still get some protection and you should definitely take the opportunity to get the shots.
One thing to understand is this vaccine is not “attenuated,” meaning there is NO live, weakened virus in it. This virus cannot give you COVID, only the antibodies to fight it. There is NO live virus in either the Pfizer or the Moderna vaccines.
For those with allergies, if you have severe anaphylactic responses to multiple things (medications or other), tell the doctor when you get the shot. You should be observed for at least 15 minutes after the administration of the vaccine.
Having the vaccine isn’t a get-out-of-quarantine-free card. We still don’t know if those who have been vaccinated can be passive carriers of the disease, we just don’t have enough data yet. So continue to exercise safe practices, and wave at grandma through the window or over Zoom. It’s not ideal, but it does keep you both safer.
YES! In fact, I stood in a very long line of medical health professionals to get my first shot on Friday. This vaccine, plus continuing to wash hands and wear masks, is how we defeat this terrible and deadly virus and get back to normal life.
And it IS deadly; we are losing over 3000 Americans EVERY DAY currently. I HIGHLY recommend getting the vaccine and have no qualms about that recommendation.
Sincerely,
Dr Rebecca
COVID-19. It’s everywhere in the news, and so many of us, even the experts, seem uncertain how serious the risk actually is, especially for otherwise healthy adults.
No matter what, the risk of contagion is high, even for healthy adults, so we brought together our Chief Medical Officer, Dr. Rebecca Dunsmoor-Su, and Gennev Menopause Coach, Sports Dietitian, Exercise Physiologist Stasi Kasianchuk, to talk about the risks and the best ways to minimize them.
One good practice is to minimize your exposure, so Gennev is stepping up its HealthFix and Telemedicine programs to better accommodate the demand. If you have questions about how menopause changes your risks, or if you take medications or have health conditions that concern you, or you need to renew an HRT prescription, you may want to make an appointment with one of our physicians.
For detailed information on how to reduce menopause symptoms and boost your immune system with nutrition, exercise, stress management, sleep hygiene, and supplementation, check out our HealthFix program. Talk with a Menopause Coach to create your personalized plan for better health during the coronavirus outbreak and well beyond.
Watch the video of this COVID-19 and menopause conversation on YouTube.
Read the full transcript:
Gennev:
Welcome to the Gennev podcast. In this series we talk with the experts about women’s lives and health and menopause. Our mission is to empower you with information that puts you in control of your health. We’re glad you’ve joined us. Let’s get started.
Dr. Rebecca Dunsmoor-Su
Hi, this is Dr. Rebecca Dunsmoor-Su. I’m the Chief Medical Officer here at Gennev, and we’re doing a podcast today to talk a little bit about a coronavirus and what populations we need to take special care in. I’m here today with Stasi. Stasi, you want to introduce yourself?
Coach Stasi
Yes. Hi, I’m Stasi Kasianchuk and I am a menopause coach at Gennev and also a registered dietitian nutritionist and exercise physiologist. So I will also bring some insight in terms of lifestyle recommendations that we can do to support our immune system during this time.
Dr. Rebecca
Excellent. So we wanted to put this podcast together today to talk a little bit about people for whom this virus and this infection is a bit more of a risk. We’ve all seen lots of blogs and podcasts, even from us, about how to protect yourself and how to wash your hands, things like that. And all those things are great and really applicable to the general public, but there are certain aspects of the public for whom that’s just not enough of a precaution. And who really need to think about themselves as being at slightly higher risk and might need to take additional precautions. So in my mind, and the reason I wanted to do this on Gennev, is that one of the things we know about this virus is that it increasingly is more difficult to handle for your body and for your immune system as we age.
And what we’re seeing from the WHO is that, you know, the death rate in children is exceedingly low if not zero under a certain age. And the death rate is very low as far as we can tell up through middle age. But as we get into late midlife and even older, the death rate starts to climb. And some of that is just that as we age, we have more comorbid conditions. So people with over “¦ who already have cardiovascular disease, people who already have respiratory disease are at higher risk. But there may also be something to do just with how the immune system responds as we age because it does become less robust as we age. But also, you know, this is a population in whom there may be many reasons why the immune system is not as strong. So when I’m talking to my patients, the things that I think about are women especially who are on biologics.
Women are more at risk for rheumatologic disease, for autoimmune diseases, which means they’re much more likely to be on those medications that suppress the immune system. And so, you know, you may feel great and feel great in your life and you know, your biologic medication is keeping you very healthy, but it is suppressing your immune system and that puts you at higher risk. I think about women getting cancer treatment. I think about women who are, who’ve just had surgery and their immune system is busy dealing with that and may not be up to the task of also combating this virus. So it’s certainly something that we need to think about if you’re at higher risk. And I think these are the populations where we need to really address social isolation or quarantining yourself. These people should not be going on vacation right now, not be getting on an airplane right now and really trying to avoid public places as much as possible.
None of us have immunity to this virus. So as it starts to spread through the community, everybody’s going to get it and they’re going to transmit it. So what we’re trying to do as a public health community is not prevent people from getting the virus. Eventually people are most likely going to get the virus unless we managed to invent a vaccine before you get it. What we’re trying to do is make sure we get it in very small staggered stages so we can take good care of those people who get sick when they get sick. What we’re seeing right now in Italy is an overwhelming of the medical system. It’s the same thing that we think we saw in Wu Han, China. So many people got sick all at once. And so many people got so sick, there weren’t the resources or the physicians or the nurses. In Italy, they’re talking even about running out of ventilators for people. There’s just not the resources there to take care of them. So if we, if we practice good social isolation, hopefully we can spread out the spread of this disease such that we can care for you if you do get sick. And then Stasi’s here because we really want to talk about, okay, now those are some risk factors, but what are some things can we do as a general population, even those who might be slightly less immune, to really boost our immunity during this time? And I think you have some great recommendations for that.
Stasi
Awesome. Thank you, Dr. Rebecca for the, the insight you have there. I think it’s helpful to have reputable information right now. There’s a lot of information out there and I think it’s important that we’re giving information to our listeners and to the women that we work with through Gennev that they can trust. And that’s something that we pride ourselves in doing. So I appreciate you clarifying. And providing evidence-based scientific information around that. So I think from some of the standpoints, you know, going back to the immune system, there’s a lot of things we can do in our life to support our immune system day to day.
And putting a slightly silver lining, positive spin to coronavirus, I’d like to say that it’s highlighting and even some of the women I’m working with are paying more attention to things that, Oh, I should be doing these things. Nothing new. Washing hands, a great example. We know that that works and that’s something that didn’t just come up for a Coronavirus. This is something we should be doing all the time, washing our hands regularly. So that’s a basic one obviously, but looking at things that can really support the immune system’s function, especially from a nutrition standpoint, exercise, stress, I’d like to touch on some of those.
So first, from the nutrition standpoint, this is a great time to focus on how you can increase the nutrient density of your nutrition. So thinking about brightly colored fruits, vegetables, more whole foods, this doesn’t mean, and even increasing these in small amounts can make a difference. Think about every bite that you take with meals that you have as an opportunity to support your immune system. So focusing on incorporating more of these foods into your day, into your week in a way that is convenient for you and realistic for you is a great start to provide additional support.
Another one is exercise. Now this the, this can be a little bit interesting during the coronavirus. I’m working with a lot of women, especially in the Seattle area where they go to group exercise classes. That has actually been something where some of them have decided, I”m not going to do group exercise class right now. It’s a lot of people, a lot of sweating going on. So maybe I’m not going to go to my group exercise class, but I’m going to go outside. I’m going to get some fresh air. I’m going to walk in a place that maybe there’s not a large crowd, a lot of people. But moving your body and especially if you’re someone that doesn’t need to be in isolation right now, taking advantage of that time to move your body can actually help your immune system. So exercise is something “¦ regular exercise that supports the immune system.
Dr. Rebecca
And I want to just break in here and say that I 100% support that. I find that regular exercise not only itself supports your immune system, but it decreases stress, especially in a time that’s so stressful for us. Getting out of the house and away from the TV and the news and hearing about every new case of coronavirus is huge for supporting the immune system.
Stasi
Yeah, that’s a great dovetail into just stress management. I think we forget. You know, we live stressful lives. So a lot of times our baseline level of stress might be already elevated. So our body is used to fighting all the time and we don’t want to. And in a situation day to day when there’s not a coronavirus apparent, our immune system may do just fine fighting things we’ve been exposed to. But as you mentioned, none of us are immune to the COVID-19 virus. And so now if your immune system is stressed from day to day family, life, work, and now it’s stressed because you’re concerned about getting the Coronavirus, that can put another, it’s just more taxing. It’s more work for your immune system to do. So taking a deep breath, deep breathing, getting some exercise. And even, you know, meditation apps or mindfulness techniques, taking five minutes, 10 minutes to you know, remind yourself that what it control what you can. I that you can speak more to the statistics right now, Becca. But you know, like you said, most people are not dying from this. It’s unfortunate that there have been some deaths, but we are “¦ generally healthy individuals are able to fight this. Correct?
Dr. Rebecca
Yes. Generally healthy individuals will fight this off. But even some proportion of generally healthy individuals do get very sick. So certainly being able to support your immune system helps to prevent you from becoming one of those people. Most of us who are healthy and don’t have other underlying conditions are probably going to experience it as a fever and a cough that lasts for a while. Some we’re seeing some nausea, some muscle aching. So very much like a flu, but even in 20, 30, 40 year olds who we consider underlying healthy, we are seeing some people get to the point where they need to be hospitalized and/or even in intensive care. And what the difference between those people is we don’t always know. Some of its underlying conditions, but some of it could very well just be the level of stress they”re under regularly or the state of their immune system. What I will say is, you know, in 60, 70 and 80 year olds, the numbers are much higher for those who get very sick and get critically ill. So really as you work your way up that age spectrum, you need to be thinking more and more about how to avoid a lot of contact right now. Because it’s, you’re at higher risk of getting very sick and therefore at higher risk of dying.
Stasi
Yeah, that”s a good point. And for those people too, when you’re thinking, you know, I talked about nutrition being very important and if you’re isolated in your home, it can be hard to find those. But certainly meal deliveries could be options. So things like Sun Basket is a great one that does have a lot of whole foods, fruits, vegetables, colorful antioxidants of immune fighting nutrients. That’s one that I do recommend to clients working on that. But even something like, Hello Fresh, Blue Apron, they all have vegetables. And that’s a way to get those nutrients delivered to you so you don’t have to necessarily go out to the grocery store or areas with a lot of people.
Dr. Rebecca
And you know, you know, we’re in, we’re in Seattle, which is the hub of everything electronic and delivery. However, you know, I’ve noticed that our local grocery store does delivery service. Whole Foods does delivery service, Amazon Fresh does delivery service. There are ways to get ingredients so that you can eat healthy during this. In most places. We totally understand that some people just don’t have access to those services and you’re going to have to go out. But definitely focusing when you do take those times out on getting the best and most healthy food you can is the best option.
Stasi
Yeah, that’s a great point. And then the other piece you know, looking at sleep, that’s another thing coming to for supporting our body’s immune system. Immune system function. When we’re sleeping, our body gets to reset and rest, rejuvenate so that it can take on everything we face throughout the day. So that’s something too I work with a lot of clients on. And during menopause it can be hard because those changing hormones change the sleep cycles. With added stress, certainly that can alter things. So working to develop a sleep routine especially, you know, before getting sick so that you can support your body in that and that might have you know, chamomile tea, sleepy time tea is something that really works for a lot of women as a part of their wind-down routine. Also helps with getting more nutrients to you from the, the teas and then also more fluids. So that’s something. And then the meditation apps, a mindfulness practice, those can be helpful for falling asleep, especially for, you know, when you lie down, all you can think about is the coronavirus, maybe having something that’s a little bit distracting but soothing can help to calm things down for you before going to bed so you can get the most out of the sleep as possible.
Dr. Rebecca
Yeah. I’ve also found that there’s an app called Deep Sleep, which tends to be very helpful for people who really struggle to both get to sleep or get back to sleep in the middle of the night. You know, a lot of these things you can find online and they’re not tremendously expensive. Some are free, some are, you know, a few dollars but definitely can be very helpful. The other thing I find is very stress relieving and helps both with relieving stress, supporting the immune system, and sleep, is making sure that while we are not seeing each other face to face, that we’re still having social interaction. So having a conversation with your friends via FaceTime. It’s important not just to talk on the phone. It’s actually important to see people’s faces and look them in the eyes even if it’s online. So if you have access to FaceTime or Zoom or any of those things, make base with your friends and talk with them, you have tea together, you don’t have to be in the same room. Social interaction can be very supportive and really help us to de-stress.
Stasi
Excellent. Yes, there is such an importance to that around being able to see each other and reassure each other that even if we can’t interact, cause maybe that’s not the safest thing. Hey, I’m okay. Are you okay? That could also bring peace of mind to help decrease that stress. And then like you said, the benefit of the social interaction.
Dr. Rebecca
Yeah. The one thing I do want to address with you and I want to put out there is that, you know, in times like this, there will always be people who take advantage and want to sell you something new and special and the best, newest, immune-supporting drug, supplement, you know, whatever they want to call it. What I typically tell my patients is if you are eating a well-balanced diet, there are very few supplements that you need. And certainly in terms of immune support you know, there are things, there are herbals out there that claim to be immune supporting. I don’t know how much data we truly have on those. I think there’s some things that are considered harmless such as echinacea, chamomile can be good. But definitely, you know, take any of the recommendations you see right now with a grain of salt.
Dr. Rebecca
People are out to make money. So my most common warning and you know, I agree with a lot of influencers such as Dr. Jennifer Gunter on this, is don’t buy the thing from the people telling you it works well. Don’t get your advice from the same place that they are selling it. You know, look for your advice elsewhere. They may be telling you the truth. It’s not that they’re necessarily lying to you, but you, they have a vested interest in you purchasing from them. So if you think something might be helpful to you, go somewhere else, look it up, see what the data says, find a reputable source and then maybe go back to it. Yeah. I don’t know if from your nutritionist perspective, or dietitian perspective rather, if there are any things that you generally recommend other than just sort of a well balanced diet and bright, colorful foods in terms of supplements.
Stasi
That’s going to be the I would say the, the nutrition’s going to be the, the foundation. And what I find works best. Individuals that do have a strong immune system, they have a good foundation in those foods. It doesn’t mean they’re perfect, but it means that those foods, the whole foods, fruits and vegetables, we can all, myself included, eat more vegetables. There’s always potential for that. And then limiting those processed foods, I typically see that those individuals have a generally healthier track. You know, some exceptions there, but that’s the trend I see. And we do see that in the research as well. Individuals from that, that maintain that type of nutrition longterm. So I would say that’s the best foundation.
And then again, like, like you mentioned, you know, things like herbal teas may be supportive. Is it the fluid? Is it because it makes people, you know, stay more hydrated? Is it the actual herbals? We don’t know, but it’s probably not going to harm you if you’re having tea form versus supplements. The body deals with supplements different than whole foods. And we have to keep that in mind that a pill will never be the same thing as a colorful plate. And so I think focusing on the food first right now is your best option and being cognizant of who’s promising you those magic pills. If it’s too good to be true, it probably is.
Dr. Rebecca
Very true. The things I often see people using in terms of preventing colds and flus are things like zinc, vitamin C. They’re not harmful. If you take huge high doses of vitamin C, most of it exits via your urine. So you’re just paying for very expensive pee, as we like to say in the medical community. So taking, you know, eating an extra orange a day is probably your better bet than taking a large dose of vitamin C. In terms of zinc, the data’s not bad. It’s not great. I don’t think going to hurt you to take a little extra. But I don’t think it’s, you know, it’s not a cure all. It’s not a protect all. So certainly don’t think if you’re, you know, you’re having three zinc lozenges a day, you can go out and, you know kiss people in the community. It’s not gonna, it’s not going to keep you from catching this thing. So while I don’t think it’s going to hurt you, I don’t think, you know, we can count on that to prevent things.
Gennev
You can now manage your menopause with Gennev. We’ve helped thousands of women take control of their health with our team of doctors, coaches and products. Join our membership program called HealthFix and work with one of our menopause coaches on your personalized menopause plan. Learn more at Gennev.com.
Stasi
Vitamin D may help in certain ways with immune function, but I think there’s again, mixed research on that. It’s hard to distinguish, does vitamin D exactly, you know, especially when it comes to immune function and something like the coronavirus. There’s a lot of things we don’t know about this right now. But certainly that could be something if you have been, had low vitamin D in the past, which a lot of people in the Pacific Northwest have, making sure that you’re sticking to that supplement routine. Whether it was something that your practitioner provided a recommendation for you. That would, that could be something that you know right now is not going to hurt you to meet your Vitamin D requirements. It may not be the the magic pill though.
Dr. Rebecca
Right. Well, there is no magic pill. I think that’s the thing we want to make very clear for everybody. You know, there’s no one thing that”s going to prevent this from happening to you, but doing the right collective things all together to make your immune system as functional as possible is your best protection. I do want to make an important point cause we’ve talked, we’ve talked a little bit about, you know, who is at higher risk in terms of people taking immune modulating medications for a variety of reasons. The one thing I want to make quite clear is I’m not saying that you should stop these medications. You need to continue these medications. They’re important to keeping you healthy longterm. If you have concerns about medications like that or if you think for some reason that it would be better for you to stop, please do not do so.
Go and talk to the doctor who prescribed them and have a genuine conversation or even see if you can talk to them online if, you know, they”re doing video visits now. But those medications are a long-term health benefit. And so in the, in the short term, fear of coronavirus is not a good idea to stop medications that you really do need.
And then the last thing I wanted to ask Stasi to comment on is, okay, so say you are one of those people at higher risk, you’re getting chemo, you’re on a medication that makes your immune system a little bit less strong and you want to exercise for stress relief, but you really feel like going outside is unsafe. What are some things someone can do at home to really get that the blood moving and get themselves healthier?
Stasi
Good question. And that’s where, you know, technology does come in place here. We, there are a lot of app options, so things that I like one of ’em can be done on your app or your computer. It”s called Fitness Blender. It’s a website which has free workout videos and you can do everything from body weight and you can filter through your level of experience. So if you’re just getting started or you’re someone that’s new to exercise, there’s things that are appropriate there, all the way to advanced. So if you have a home gym, you want something new to try out, there could be some different options there. Some other ones that are out there are the Peloton app, you don’t need to have a bike. They have an app that does give you exercises even without the bike or their treadmill. Obviously if you have those resources at home, that can come in handy right now.
Dr. Rebecca:
Yeah, I have to, I have to cut in there cause I actually use that app. I have the bike or the treadmill.
Stasi:
What do you think?
Dr. Rebecca:
I use it actually for outdoor running, because they have audio, outdoor running apps. They have body stretching, they have meditation, they have yoga. I actually think it’s actually a very good app. They have very motivating people on it. And you know, it’s on the more expensive side for some of these apps. But I think they, they do tend to keep up the variety of things. So that is a nice, you can sort of cycle through the variety of different types of exercise. And if you do have a treadmill or even are planning to walk outside, it can be very motivating.
Stasi
Absolutely, yeah. The variety could be key there. And then there is devices that you can use at home, something like the Excy bike where you are able to, and this can work for individuals that may not be either immune compromised or certainly if you’re having chemo treatment this can be a better option where you can, it’s a little bit less intense. You can increase the intensity but there’s a lot more variation there and it can help with keeping limbs moving so you can use it for your upper body, you can segment to your lower body. You don’t have to be doing a full body workout to be able to use this and that might be helpful for blood flow. Or individuals that may be new to exercise or really can’t get outside right now. It needs something where they’re moving more in, in home and don’t have a stationary bike or treadmill option.
Dr. Rebecca
That’s a great point. Anything, I always, well, we used to use it to learn how to tell the size of babies when I was in obstetric training. But I do know that that a bag of sugar is five pounds. That makes a great weight if you don’t have weights in your house.
Stasi:
Yes, exactly. And even walking around with more, well you know, put a backpack on and walk around, that’s going to be a little bit higher intensity than just walking alone so you can get really creative with what you have in your house. An opportunity to just do an exploration exercise. No one said we have to go to gyms to exercise. That just became the thing we did. So doing that as well. And then the other thing right now, if you’re looking for more support in how to, you know, manage menopause and the coronavirus and how to strengthen your immune system, our HealthFix program is a great option. It’s all remote. So they”re calls that you take with a menopause coach like myself. and we can talk about menopause symptoms as well as if you have concerns with strengthening your immune system during this time what strategies are going to be specific to you and what you have available in your lifestyle.
Dr. Rebecca
I think it does and definitely don’t sell yourself short. You can also help people with sleep issues, with stress issues. You guys are very, you’re just incredible resources for women to have. Telemedicine is good at this time and I won’t recommend just us, although I think our telemedicine program is excellent. We do tend to focus on menopause and menopause symptoms, we”re obstetrician-gynecologists with a menopause focus. We can do some basic medical care too, but certainly if you’re worried about your immune system and you’re about to run out of your hormone, please feel free to call us. We’ll happily give you a refill online. But there are other great telemedicine groups as well that do more primary care if you just have a question and don’t want to go into a doctor’s office. Many doctor’s offices are actually adding video visits as well during this time to keep people out of their offices. So there are a lot of great options out there now.
Stasi
Yeah. And, and we collaborate. So my, the menopause coaches and the healthcare providers that we have, the OB/GYNs with Gennev, we work together. So that’s something also that when I’m working with my clients, if I see that working with an OB/GYN is going to help to benefit you to feel better, I will certainly recommend that and vice versa. So a unique opportunity all from the comfort of your home bedroom, living room, wherever you feel most safe right now. Know that you could get support for menopause symptoms as well as if you have questions on how to best support your immune system.
Dr. Rebecca
And one last thing I want to bring up because I think it’s a very fearful time for many people right now and fear is not a bonus to your immune system. So as much as you can try to manage that fear, turn off the news at night. You don’t need to know where the last case ended up. You’ll find out tomorrow. So just take a break from the news every day. Take a break to meditate or read a good book or just not think about what’s going on in the world because you need to let your, your stress response system calm down a little bit. If you’re struggling to manage that fear, if you’re feeling anxious all the time, if you’re feeling panicky, please, please reach out. There are providers online who can help talk you through that. And that is while a maybe perhaps a normal response, something that can actually be dealt with and managed. There are therapists online. There are doctors who can prescribe online if necessary. So please don’t feel like that anxiety you have to live with it. It can be helped.
Stasi
Good point. We have all this technology, might as well take advantage of it. And good thing it’s coronavirus in 2020 not 1920.
Dr. Rebecca:
Yeah. So thank you so much for coming to this podcast and/or video. We really enjoyed talking to you today about how to really boost your immune system and how to protect yourself during this time that is, can be fearful but is also a time that we can all manage.
Stasi:
Yes. Thank you so much for listening. Hopefully this information is helpful for you and of course if you have more questions, we’re here to support you.
Dr. Rebecca:
Yep. We have a community, we have chat, and we have HealthFix where you can talk to wonderful coaches like Stasi.
Stasi:
Or our Telemedicine where you can talk to Becca.
Gennev:
Thank you for listening to this episode of the genetic podcast. Remember, you can subscribe on iTunes, Google Play, Spotify, and just about anywhere you get your podcasts. Gennev is your online destination for menopause, doctors, coaches, products, and education. You can find us at Gennev.com. Thanks for joining.
A jog on a Hawaiian beach was all it took for Jan, a post-menopausal registered nurse, to fracture a bone in her foot. The sand shifted slightly as she took a step, and she felt the pain.
The vacation that Jan and her husband had anticipated for months? Ruined.
Jan always assumed she got enough calcium to keep her bones strong through her healthy diet and didn’t dwell on taking supplements before she entered menopause. Even her nursing training had only briefly touched upon nutrition.
If she had known the full truth, she might have spent more time in Hawaii outside of her hotel room, catching sun rays, instead of in the emergency room, getting x-rays. At Gennev HQ, we’ll show why you need calcium, where to get it, and how much is enough.
Check out our review of the 10 best vitamins for menopause symptoms.
Minerals like calcium are vital to a healthy body. Your bones and teeth are home to 99% of your body’s calcium, while the remaining 1% helps your blood clot, your nervous system relay information, your muscles and blood vessels contract, and performs many other functions.
Your bones are constantly remodeling, breaking down and rebuilding to repair injuries and the daily wear and tear from normal activities.
During bone remodeling, your bones release calcium into the bloodstream and reabsorb it back. If your body doesn’t have enough available calcium, it will use the calcium released into your blood to repair nerves, cells, and muscles instead of reabsorbing it into your skeleton.
In childhood, our bodies build more bone than we lose. This is how we grow. From adolescence until our thirties, our bones are the strongest because they build up and break down at an equal pace.
In our mid-thirties, this changes. We start to lose bone mass faster than we can maintain it.
Bone loss speeds up when your body’s estrogen production decreases during perimenopause and menopause, as estrogen aids calcium absorption from food and reabsorption into bones.
This all can lead to osteoporosis, a condition where bones become porous, brittle, and break easily, and its precursor, osteopenia. Forty percent of post-menopausal women in the US will have an osteoporosis-related fracture at some point in their lives. Some women have even died from osteoporosis hip-fractuces . Our friend Jan is one of these women. If your mother or grandmother had osteoporosis, you are at greater risk of developing it.
The calcium that you consumed as a teen and young adult is what shapes your risk of osteoporosis entering menopause.
“This is great for my daughter,’ you might say, “but how does it help me now?’
You can’t have your teenage body back, including your bones, but keeping adequate levels of calcium in your bloodstream as you enter menopause and beyond can help your bones stay strong.
For more than 20 years, the USDA has defined the recommended daily allowance (RDA) of calcium for American women as 1000mg for women 50 and under and 1200mg for women over 50.
Some nutritionists now suggest that as low as 500mg per day may be enough. However, more research is needed to support this conclusion.
The foods you eat are the most effective sources of calcium. Great sources of dietary calcium include yogurt (310 mg/serving), cheese (up to 210 mg/serving), sardines (325 mg/serving), cow’s milk (300 mg/serving), fortified soy milk or orange juice (300 mg/serving), tofu (205 mg/serving), and leafy greens (up to 360 mg/serving). [Learn more: A Guide to Calcium-Rich Foods]
You can figure out how much calcium you’re getting from your diet by checking food labels or using a calcium calculator. Note: the “DV” (daily value) for calcium on food labels is based on 1000 mg, so “30% of DV” is 300 mg. If you are over 50, this isn’t 30% of your daily need!
Your doctor may also suggest taking a daily calcium supplement. For best absorption, take calcium supplements in doses smaller than 600mg; if you need more calcium than this, space out your supplement several times throughout the day
Calcium carbonate is the more affordable and available form of calcium supplement. You may already have calcium carbonate in your medicine cabinet as an antacid, like Tums or Rolaids. Take it with food, as stomach acid increases absorption.
Calcium citrate is another form of over-the-counter calcium. You can take it with or without food.
Side effects of calcium supplements may include gas, bloating, and constipation. Calcium carbonate tends to have more side effects than calcium citrate, so if you’re experiencing gastro discomfort, consider making the switch.
The amount of calcium that’s right for you may defer from the norm if”¦
Getting more than the RDA value of calcium may increase your risk of kidney stones, heart disease from increased calcification in the arteries, and potentially colon cancer, though more evidence is needed to support these claims.
Preliminary research shows that vitamin K2, which plays an important role in calcium metabolization, can help with heart health if this is a concern for you; be sure to talk to your doctor first.
(Did you know that vitamin K is great for your bones, too? Women who get at least 110 micrograms of vitamin K daily are 30% less likely to break a hip than women who don’t!)
Studies suggest that exceeding the RDA of calcium doesn’t actually increase bone health in patients with osteoporosis but meeting your daily needs now and taking preventative measures will reduce your risk of fracture in the future.
If you are 65+ or have risk factors for osteoporosis before entering menopause, get a bone mineral density test (BMD) to evaluate your bone health before you break something.
And remember that calcium is only part of the equation for strong bones: if you want toprevent osteoporosis, exercise, a healthy diet, and refraining from smoking.
Jan now maintains her bone strength by eating calcium-rich foods, doing yoga with her husband, and walking to the grocery store instead of driving. She can focus her attention on her book club and adult children knowing that she’s doing everything she can to prevent another fracture.
Are you dealing with or at risk of osteoporosis? We’d love to know what you’re doing to manage your health and keep your bones strong. Please share with us in the Gennev Community Forums!
Meet writer Helen Pitlick! A seasoned communicator with a master’s degree in digital media to back it all up, Helen loves to create content that helps women feel more confident at all stages of their lives. When she’s not in front of her laptop, Helen enjoys pottery, pretending to play soccer, and hanging out with her dog.
Can osteoporosis kill you? Osteoporosis is sometimes referred to as a “silent killer” “ “silent” because women may not realize they have a problem until they break a bone, and “killer” because complications from osteoporotic hip fractures kill more women in the US than breast cancer.
Osteoporosis is a thinning of bone, reducing both density and quality and making bone much more fragile. While there are medications that can help prevent osteoporosis, we also know that diet, exercise, and other lifestyle factors can really benefit your bones.
If you’re wanting to make some changes to help you maintain bone density, especially coming out of a period of drastic lifestyle changes due to COVID 19, we’ve got help. We chatted with Dr. Meagan Peeters-Gebler about ways to make the best choices for your bones.
Some people are more at risk of weaker bones than others, says Meagan: thin Caucasian women, women generally, women over 50, women in menopause. Underweight women are more at risk than at-weight or overweight women.
Genetics can also play a role, so a family history of osteoporosis may indicate that you are more likely to develop the condition. Women who are currently dealing with or have a history of an eating disorder such as anorexia or bulimia may have thinner bones. Chronic dieters may have missed out on some nutrients over years of food restrictions.
Also, women on steroids or blood thinners, women who smoke or consume excessive caffeine or don’t get enough Vitamin D and/or calcium may have a higher risk; women who take some medications, including some for breast cancer, and women who don’t get enough weight-bearing exercise or has ehlers-danlos syndorme (EDS) are also at higher risk.
If you are in any of these categories “ and especially if you fall into more than one “ making changes to protect your bones now can help you stay healthier in the long run.
From a physical therapist’s perspective, exercise and posture are two of the biggest changes you should make now.
Exercise: It really needs to be weight-bearing and against gravity, says Meagan.
“Being vertical and having gravity go through your long bones is the most important piece. That could mean walking, running, climbing stairs. That’s why swimming and cycling aren’t as helpful for bone strengthening. When we are only swimmers, or only cyclists, we’re not getting gravity going through the length of our bone. We are getting various tugs on tendons and muscle insertions, but we’re not loading the length of the bone.
“When we are vertical and exposed to gravity, your body reacts to that stress by creating more bone. Your body thinks, “Oh, I really need to be good at this. I should create something that’s a little bit more dense with the tools that I have, thus being better able to do that activity, got it. Okay.'”
Another key piece of the osteoporosis puzzle is posture.
As Meagan says, “When we look at the shape of our spine against gravity that you know shape is designed to tolerate loading from above.” But we don’t sit that way most of the time. We bend over keyboards, look down at laptop monitors and phones, and suddenly gravity isn’t working for us anymore.
“The more we start to bend over and get that C shape,” says Meagan, “the more we change which part of the bone has pressure on it. And now you’re no longer loading in the center, you’re loading off to one side, so you create asymmetry in the bone. If that bone is already compromised and not dense, you now are wedging and putting pressure through one half, and it’s kind of like walking on thin ice. You know, you can lie on thin ice “ but you can’t stand on it.
“So you’re loading up where all of that pressure is going through, making it much more vulnerable typically on the front portion of the vertebral bodies because of that rounded C-shape position, and then you end up with vertebral body compression fracture. And then when that fractures, you get more hunched and more hunched and more hunched.”
Possible end result: fractures in the bones of the spine (usually the thoracic or mid/back region).
And it’s not just the neck that’s at risk. When your posture is poor, that asymmetry of pressure translates down your body, into the pelvic bone and femur (thigh bone), and the whole chain is impacted, says Meagan.
Our life is geared toward leaning forward. Think of all the things we do that involve bending forward: working at a desk, picking up a child or your groceries, many of the physical games we play, cooking, driving. Meagan recommends balancing that out by doing some backward bending. Reach up straight above your head. If you carry something, try to keep your back straight rather than hunching forward.
If you already have fractures or are at risk due to osteoporosis or osteopenia, some exercises just aren’t for you, says Meagan.
If you’ve had a compression fracture, sit ups, that forward ab-machine at the gym, crunches, big spinal twists with a medicine ball, bringing your knee up to your shoulder, virtually any exercise where you’re flexing forward Is going to put you at risk.
The better plan, according to Meagan, is to get vertical and strengthen those back muscles. “We want those muscles as strong as possible because they feed into the overall durability of the system. Then you have the structural integrity in the tendons around and attached to the bones to translate the forces and impacts through the whole system more effectively.”
Basically, the idea, Meagan says, is to get your muscles to do more of the active support, so your bones aren’t bearing all the load.
“Have a strengthening regimen that’s well thought-out. Work with a physical therapist who understands your risks and get a plan that strengthens your back muscles like your rhomboids, your low trapezius, your middle trapezius, your back extensors as not just the front muscles that everyone likes to strengthen because they’re visible.”
One thing that can really help you stay healthier, even with some bone loss, is having good balance. “Falls are really the concern with osteoporosis, because so many women suffer hip fractures from a fall. Yes, there are spontaneous fractures from a sneeze or cough, but if you fall, it’s going to be your hip, your wrist, your femur, or your vertebra. Having appropriate balance reactions and balance skills will make you safer.”
So: if you have to sit a lot, have a good chair, stick a pillow behind you to maintain the natural curve of your lower back. Your feet should be flat on the floor. Stack yourself, starting with your “sits bones” (the bony bits of your butt as if you’re not sure where those are, ask a cyclist!).
It may be tough right now to keep up your regular exercise routine, and many of us are still working from home, meaning we may not have the good ergonomic set-up we had at the office.
The key is to do what you can. Get your monitor up to eye level so you’re not looking down. Get a separate keyboard if necessary so your arms stay at the ideal 90-degree angle. Bring in some crates or boxes to give you the option to stand or sit and mix it up a bit.
An easy fix: take a break, go outside, get your [vitamin D](https://shop.gennev.com/collections/basics/products/strong-body-vitamin-d), and walk.
Get a strengthening routine, but first, if you suspect you may be at risk of osteoporosis, get a DEXA scan and share the results with your physical therapist. If you don’t have one, or need one with a specialty in women with bone issues, Meagan suggests consulting the Academy of Pelvic Health.
“I would recommend seeing a PT with this specialty before joining any classes, even a “strong bones’ class, “says Meagan. “You just want to be sure you’re fully informed, know how to move safely, and know what your limitations are.”
Do you have osteoporosis or osteopenia or are you at risk? What are you doing to maintain bone density? We’d love to hear your thoughts, so please join the Gennev Community forums!
We’d like to start this blog by dispelling a couple of myths about pelvic organ prolapse (POP):
First, pelvic organ prolapse is not inevitable. Even if you’ve had several vaginal births, even if you’re post-menopausal, even if you’re on your feet all day, you can still take steps to reduce your risk.
Second, surgery may not be a cure for POP. According to ACOG, the Research was done on women who undergo prolapse surgery have a 6 as 30 percent chance of needing a second prolapse surgery, and some women develop incontinence as a result of POP surgery.
Brianna of Four Pines Physical Therapy and Meagan of Orthopedic Spine Therapy, the physical therapists who have informed us about the dangers of wearing high heels and the six-ish things you’re doing that you really shouldn’t, have some wise words on the question of prolapse: Basically, if prolapse can as to a large degree as be prevented, and if surgery often has to be repeated, why wouldn’t you take steps to reduce your risk?
If you are suffering from pelic prolapse, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
The pelvic floor is sometimes described as a “hammock” of muscles that support the pelvic organs (vagina, bladder, uterus, small bowel, and rectum), keeping them in place. When pelvic floor muscles are weak or not working properly, pelvic organs can drop into the vaginal canal or anus.
According to our PTs, there are two main factors at play:
Are the muscles strong enough and flexible enough and aligned properly? The pelvic shelf, according to Meagan, is really the most straightforward piece of the puzzle. Do your kegels properly, to be sure you’re lifting and squeezing the pelvic floor. Work on stretching hip flexors so they don’t restrict the movement of the pelvic muscles, Brianna says. And break up scar tissues in that area, particularly from previous vaginal tears or surgeries. Keeping scars “mobile” helps improve mobility of the pelvic floor, says Bri, preventing pain and allowing the pelvic floor to relax completely.
The pelvic muscles can take a lot over a lifetime, but you can help reduce the burden by being aware of these 8 gravity related issues:
One: Bad breathing. Shallow breathing that takes place in our neck, shoulders, and upper chest doesn’t allow our abdomen to expand properly. Diaphragmatic breaths that make your belly pooch out are much better because they direct the force of your breath out into the “body balloon,” Meagan says. When we breathe in our upper body, the stiff rib cage directs breaths vertically, up and down, like a piston, hammering away at the pelvic floor. So, yeah, your belly might stick out in a way that society deems “unattractive,” but we reckon that’s a small price to pay for avoiding incontinence and prolapse.
How to fix it. Consciously breathe with your belly until it becomes natural. Get help to stretch and loosen your abdominal muscles so your breath can go out instead of only up and down. Your thoracic spine has your 24 ribs attached to it; work that spine so your ribs can move and wiggle with the coming and going of each breath. “Being aware of breathing mechanics is where we start,” Meagan says; “it’s happening all day long and under the radar, so it can have a huge cumulative impact over the thousands of breaths we take every day.”
Two: Poor posture. Think of your pelvic floor as a bowl with a soup of organs: keep it straight and lined up, or things start to spill out. Plus, hunching over our desks for hours can restrict breathing and tighten hip flexors.
How to fix it. Again, stretch those hip flexors! Also, wear things that don’t cinch tightly around the waist when you sit, as these can change your posture and mess with your breathing. When we sit correctly, we have the right amount of tilt, so our pelvic bones bear some of the weight of the organs and the muscles aren’t carrying it all.
Three: Constipation. When you have to push or strain to have a bowel movement, you are, in effect, pushing your guts out, says Meagan. Having to do this repeatedly over time can eventually result in prolapse.
How to fix it. Drink enough water so stools don’t get hard and dry; eat plenty of dietary fiber; avoid foods that contribute to constipation. Bowel massage, Bri suggests, can help keep things moving along so there’s less chance for constipation to occur. Massagingyourself break up scar, and it helps with a variety of issues, including constipation.
Four: Coughing. Your average cough due to a cold or something in your throat doesn’t have much of an impact, say our PTs, but chronic, prolonged coughing from smoking, emphysema, allergies from hormones, etc., can. Coughing increases abdominal pressure, nudging organs down and out.
How to fix it. Quit smoking, if you possibly can. If you have emphysema or chronic allergies, talk with a doctor about how to control the coughing.
Five: High-impact activity and exercising incorrectly. Jumping, kickboxing, crossfit, even running “¦ all of these can mean a lot of repeated impact on the pelvic floor. If you’re passing gas in class, that can be a warning sign that you’re not managing the pressure correctly. Also, your pelvic floor needs to be flexible as well as strong, so don’t go crazy on core exercises: too many crunches done incorrectly and other incorrect excercises can cause incontinence make the pelvic shelf rigid or in constant spasm, which means it doesn’t relax normally. That too can contribute to pelvic issues.
How to fix it. Find a different activity that means less impact, or learn to do your chosen activity correctly; talk to your instructor, a PT, or your doctor about your form and how to breathe through the repetitions. According to Meagan, when she goes to a Pilates or core-based class, about 70 percent of the activities the class does can damage your pelvic floor over time. Consult the instructor about how to adapt the exercises, or talk to a PT for strategies to minimize impact. Runners, for example, can maximize “shock absorption” by shortening their stride.
Six: Obesity. After repeated vaginal childbirths, obesity is actually the #2 risk factor for developing prolapse.
How to fix it. If you can, reduce extra weight to reduce the amount of gravity impacting your pelvic floor.
Seven: Standing. If you’re on your feet all day, gravity is not your friend. Particularly if your job includes a lot of lifting or twisting from the waist, you could be doing some serious pelvic-floor damage.
How to fix it. If your job and/or life require you to stand most of the day, try to at least lie down for a few minutes in the middle of the day. Get your hips and pelvis up, and “let gravity squash your guts back upstream where they belong,” says Meagan. If you already have mild to moderate prolapse, ask your doc about getting fitted for a pessary. This can provide additional support during the day by supplementing the work done by the pelvic floor.
Eight: Hypermobility or connective tissue disorder. Women with CTDs such as Ehrler-Danlos or Marfan syndrome, or who are hypermobile (double-jointed), may be at higher risk of prolapse because muscles may be too flexible and weak.
How to fix it. If you have other risk factors plus a CTD, consult with a pelvic PT right away to learn how to increase the integrity of the pelvic floor muscles.
Worried about POP? If you have one or more risk factors, it’s good to know some warning signs to look out for. If you’re leaking urine or gas, especially during a core workout; if you feel a heaviness in your pelvis that worsens during the day; if you urinate or have a bowel movement, then feel you’re not quite “empty,” or if you stand up and a little leaks out, there may be something obstructing the pipeline. If you’re “splinting” as pushing on that section between your vagina and your rectum to help relieve constipation as there may be a “pocket” of tissue that’s holding waste material in, and that can be a sign of a prolapse as well. Backache and painful intercourse are also warning signs.
If you have any of these issues, or if you’ve already had prolapse surgery and are worried about a repeat, make an appointment with a pelvic PT, even if you don’t actually feel like you have a prolapse. Many women aren’t aware it’s even happening until it’s pretty far progressed, and in those cases, there’s less that physical therapy can do to reduce or reverse the problem.
According to Meagan and Bri, seeing a PT even if you have zero issues is never a bad idea as a pelvic PT can teach you to breathe correctly, how to stand and sit with the best posture for your body, how to exercise to protect and strengthen your pelvic floor, how to prepare your body to carry and deliver a baby, and a whole lot of other preventative measures.
*This blog is for informational purposes only and is never intended to replace the care of a medical professional. Please seek expert help if you think you need it.
Have you seen a pelvic PT? Do you think you might need one, but you’re feeling a bit shy and unwilling? Drop your comments below or on Facebook, or join our closed Facebook group, and we’ll pass your questions and concerns on to Brianna and Meagan. And if you have any other questions you’d like to ask them, please let us know, and we may build a future blog around your great question!
Thank you to Brianna of Four Pines Physical Therapy and Meagan of Orthopedic Spine Therapy for their input.
Meet Nickie, 49, who has just about had it with her hot flashes and night sweats.
They have increased in intensity and in frequency to the point where she is changing her tops (and her undies) at work at least once a day. She wakes up several times a night with perimenopause night sweats.
She hasn’t had a period in 8 months, walks 2-3 miles each day, and eats pretty well, though it’s tough for her to fit lunch in with the pressure of her new job. Her health overall is really good, but she is missing her sleep and beginning to worry about how little sleep she is getting “ especially since she just started this job and is still making first impressions.
Yes, she went to her doctor before she moved across the country. They discussed hormone replacement therapy or HRT for hot flashes as an option, but Nickie doesn’t have the money to cover this therapy, plus she’s a little unnerved by the whole HRT topic and wants to keep her care as natural as possible.
What has she tried? Let’s see, sticking her head in a freezer (minimal and very temporary relief), black cohosh supplements (she is using our black cohosh for hot flashes and it worked a bit for her, but symptoms have lately ramped up after the move).
She also tried chiropractic therapy and acupuncture, which work really well for her asthma and help her to relax but aren’t effective for easing hot flashes or waking up due to night sweats.
Nickie is considering trying a CBD (or cannabidiol) product. This has not been suggested by her doctor, but she’s not sure what else to do. There are lots of dispensaries where she now lives (a recent transplant from Idaho to Maine), and cannabis is both legal and decriminalized, but she is also very new to this topic and is absolutely clear that she doesn’t want to get high while using CBD.
She just wants to get some good sleep. Also, since she has asthma, smoking and vaping are out.
She doesn’t know if CBD will work for her. And she doesn’t really know how to get started.
Boy, do we empathize. Missing sleep and being in a seemingly constant state of “heat surge and sweat” can spark additional discomforts. In addition to not getting enough rest, she is worried and anxious about what her lack of sleep may do to her focus and job performance. And additional sugar or caffeine intake to keep mind and body going at her high-pressure job? Uh oh, stress and more caffeine can speed the vicious symptom cycles too.
Nickie’s not alone in her menopause symptoms, for sure. She’s also not alone in her curiosity around non-high-producing CBD use for better sleep and increased relaxation/decreased anxiety.
News and laws around this topic are changing daily. There are lots of opinions and already, a lot of products to choose from. It’s hard to know where to turn or where to start, so we began with our in-house medical expert.
We checked-in with our Chief Medical Officer, Rebecca Dunsmoor-Su, for her perspective. Here’s what she said:
“CBD products made primarily from hemp seem to have limited harm, but there have been almost no real studies on their effectiveness because of the limits that have been placed on studying it. This is slowly changing as laws ease up. But we really don’t have evidence to support the many health claims made about it. Sleep and pain effects seem to be most likely areas where it works (there are anti-seizure effects in particular syndromes that have been shown).
“In terms of true cannabis/THC-containing products, there are no known medical uses as we have had a complete ban on studying it, and technically it is still a scheduled drug federally. We just genuinely don’t know. People make all sorts of claims but there haven’t been studies. I most commonly see my patients use it (I would note it is “legal” in our state) in place of alcohol to help relax and promote sexual desire and function.”
So, studies have baaarely begun due to the laws that govern the study of both hemp and cannabis products, regardless of the allowances (or disallowances) in each state. More will come, but these take time.
Women are talking with their doctors about using CBD and THC-containing products. We definitely encourage you to do the same with your medical provider (or talk with ours). And, if your current doctor isn’t up to (or open to) discussing any topic that you want to talk about, consider shopping around for a better, more supportive fit for yourself and your health.
Dr. Rebecca shared, “As an MD, I always want to have an open conversation, it helps me to know what people are using, especially if there could be interactions with medications I might prescribe but also so I can give them safety parameters as best I can. We don’t judge folks on this, we just need to know.
“Also, a lot of the information out there is advertising. I always caution women not to get their health information from the people selling a product. They have no reason to provide balanced or even genuine information.”
There are lots of ways to consume CBD: oils, smoke or vape, tinctures, edibles, and even suppositories, with more options and varieties being developed and released in abundance. We asked Dr Rebecca about this as well:
“I would warn folks away from vaping (it seems the serious lung disease was primarily from bad THC mixed in vitamin E oil) and also smoking, as this long term can do lung damage. Luckily there are a lot of edibles available now. They can be quite strong, so make sure they know how much to start with, especially if naïve.”
Still, if you’re in the same, or similar, boat as Nickie, and are curious about using a CBD product, we’ve got a couple of initial recommendations:
Regardless of what you choose, or don’t choose, we’re here to support you on your path to feeling good in your body, suffering less, and thriving in perimenopause and menopause. More will be forthcoming on this topic, for sure. Stay tuned to Gennev.
Does Nickie’s situation feel familiar? Are you thinking about using (or actively using) CBD products for pain relief, anxiety reduction, or insomnia? We’d love to hear your experience and insights on the Gennev Community forums. You’re absolutely welcome and invited.
With so many vaginal lubricants for menopause dryness and feminine moisturizers for sex to choose from, it’s no wonder people are a little confused.
The truth is, different types of products serve different purposes, and one product may not fit your every need. And of course, it’s important to use the lubricant properly to ensure you get the full benefit. So, how do you find the best lubricant for women? Here are 10 answers to show you exactly how to pick the right one for your own needs.
If you are looking to reignite your sex life, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.
We put some of your frequently asked questions to our product-formulation team, and here’s what we found out:
You’d be surprised how many products women use for vaginal dryness that aren’t actually approved for intra-vaginal use; they’re only intended for use outside the body. Additionally, lubes with flavors, warming or tingling elements, scents, etc. can cause reactions, and added sugars for flavoring can increase your risk of a yeast infection, so check the label and proceed with caution.
To be sure you’re OK to insert the product vaginally, check that it’s certified for intra-vaginal use, like Gennev Comfort for painful sex and vaginal dryness. Internally safe lubricant can alleviate painful sex experienced after pregnancy, or symptoms often experienced throughout menopause due to estrogen dominance or estrogen loss.
We’re really glad you asked that question! Many women we’ve talked to don’t really get why you need lubrication for solo play. First, to answer your question, yes: If it’s safe for sex, it’s certainly safe for masturbation. But again, check the label if you intend to use it internally.
The bigger question here may be, why use lube when you’re alone? For the same reasons you use it when you’re with a partner: it enhances your pleasure and protects delicate tissue, especially if you’re enjoying sex toys like the Lioness vibrator, etc. It’s common to apply personal lubricant for feminine dryness, and it’s also a great way to discover how much you need, how best to apply it, etc., so you can feel confident when there’s someone there with you as and what’s sexier than that?
As with any other intimate activity, your purpose (yes, you can have more than one) may help you determine the best feminine lubricant to use. If you want to rejuvenate vaginal tissue with some healthy vibration, for example, you may want a silicone-based lubricant that lasts longer.
Note: if your toys, vibrators, etc. are made of silicone, opt for a water-based lubricant as more on that in a moment.
Some women have asked if water is naturally lubricating. It’s not as water will actually wash away your natural moisture, so you’ll definitely want to add a lubricant to your friskier showers. Water-based lubricants may not have much staying power under a direct stream of water; products with silicone will likely hold up better.
And this may sound silly, but we suggest giving your lubricant a test run in the shower on your own a time or two as when the moment arises, you don’t want to be fumbling with an unfamiliar cap! Plus you’ll get a good idea of how long your lubricant lasts before being washed away.
Lubricants must undergo condom compatibility testing to obtain 510k certification, so you can use products with this cert, like Gennev Comfort, with confidence. The general rule is to stay away from oil-based lubricants like petroleum jelly, which can degrade condoms.
Natural lubricants for female dryness, menopausal or not, are an appealing choice, but be cautious also of “natural” oils like olive oil, avocado, or coconut oil, as those can degrade a condom to the point of tearing during intercourse.
Generally, it’s wise to avoid silicone-based lubricants with silicone toys, as the lube can break down the material of the toy. Water-based lubricants like Gennev Intimacy Lubricant are probably the better choice for use with silicone-based toys. Hard plastic toys aren’t vulnerable to silicone-based lubricants, so having an assortment is never a bad idea!
Water alone or soap and water work best, according to our gals, so keep it simple! And certainly personal hygiene wipes like our Cleansing Cloths can be used when soap and water aren’t immediately available.
Check the label or product description for “non-staining,” if you value your sheets and bedspread. Lubricants with colors, flavors, etc. can be messy. Non-staining lubricants and moisturizers like all Gennev products in our shop tend to be healthier for your body anyway, so”¦bonus!
Learning how to apply lubricants for females is often an onus unfairly foisted upon the female partner in the relationship, but it doesn’t hurt to have a good understanding of the process. “Apply generously” got a lot of head nods from our team. While lubricants combat women’s vaginal dryness and the resulting pain, men can suffer from too much friction too; customers have told us that a few drops inside the condom solves the problem nicely.
Don’t want to interrupt to reapply? We get it: it can be a little awkward. However, vaginal tissue is delicate, and extended play without lubrication can damage that tissue. Make it part of the whole sexy experience by applying it one another. Just warm it up in your hands first to avoid chilling the moment.
Everyone’s sensitivity is different, and no vaginal moisturizer or feminine lubricant can guarantee it won’t cause a reaction. However, a product formulated to closely mimic a woman’s natural moisture and osmolality is least likely to trigger a UTI. In lay terms (pun intended), a healthy body has a healthy amount of moisture in tissue cells. The wrong lubricant can, ironically, dry out skin cells, making them more susceptible to infection. Our Intimacy Lubricant is formulated to help the body maintain normal moisture levels, so your most sensitive tissues are protected from damage.
According to our formulation team, concerns about glycerin are overblown. Yes, some people have sensitivities to glycerin, but millions of people use glycerin-based lubricants without issues. It’s important to know your body and respond to its signals. If you want or need to avoid glycerin, there are plenty of good options when it comes to natural cures for female dryness, including Gennev Intimacy Lubricant.
It’s best if lubricants are kept at room temperature and out of direct sunlight. You don’t need to refrigerate, but it’s probably best to use it up or replace it when it reaches its expiration date. And again, this may sound silly, but take a look at the packaging your lubricant comes in. You don’t want to be embarrassed to pull it out in front of your partner. Is it classy enough to have on the nightstand, ready when you are?
Knowing your habits, preferences, and sensitivities will make it easier to make the right decision. Do you always use condoms? Do you tend to be sensitive to certain ingredients? Answers to such questions can help you narrow down the array of options.
And if you’re still not certain which vaginal lubricants are right for you, test out several (see? research can be fun!).
If you have other questions to ask or suggestions to make to our product team, please do. You can email them to info@gennev.com. We’ll ask the team and include their answers in a future blog. Meanwhile, let’s hear about your experience with lubricants! Share your stories with us on Facebook, Instagram, Twitter, or in the comments on this blog.
From Gennev CEO, Jill Angelo…
A couple of weeks ago, I wrote to you about Gennev’s position on hormone replacement therapy (HRT).
I heard from many of you about your personal stories of using hormone therapy effectively to combat menopause symptoms. From others, I heard concerns.
And that’s OK.
Our health is not a quick decision. What we do know is that there is no one-size-fits-all for women’s health in midlife.
In the last week, a new observational study hit the wire from Finland about HRT and Alzheimer’s. The researchers looked at outcomes involving nearly 85,000 postmenopausal Finnish women and found that those who had taken hormones long-term (like 10+ years) had a very small increased risk for Alzheimer’s.
Note the word “postmenopausal.” This study was done with women 65 years and older.
Immediately, I reached out to sources I trust most, and here’s what they had to say.
Dr. Rebecca Dunsmoor-Su, M.D. and Gennev’s Director of Health and resident ob/gyn, breaks down the study in terms we can understand. Mind you, she’s also an epidemiologist who is schooled on the virtue of broad observational studies such as the one in Finland versus the randomized approach most medical studies prefer.
In summary Dr Rebecca says, “”¦ this study does not increase my worry about prescribing HRT for my patients.”
Dr. Lisa Mosconi, PhD, Director of the Women’s Brain Initiative and Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College (WCMC)/New York-Presbyterian Hospital, weighed in with a simple comment, “I think this article only confirms what we already knew as initiating HRT after menopause doesn’t work and can actually increase risk of dementia in women who are older than 60, in part because of an increased risk of ischemia (part of your body not getting enough blood and oxygen).”
According to CNN, “The study’s authors say the results cannot show a cause-and-effect relationship between the use of hormones and an increased risk of Alzheimer’s. That’s partly because the study was not able to capture age and other risk factors for comparison, such as genetic risk for Alzheimer’s, diabetes and cardiovascular disease.” And the BBC warns women to “”¦not be alarmed.”
We asked Dr. Lisa Savage, MD and ob/gyn and new guest blogger for Gennev, to give us the 101 on HRT application forms. For me personally, this review grounded me like no other.
We’ve explored HRT for a number of menopause symptoms, for longer-term issues like heart disease, and for as you guessed it as Alzheimer’s and dementia.
We’ve even taken head-on your questions about HRT versus bio-identical hormone replacement therapy (BHRT) in a recorded webinar with Dr. Rebecca Dunsmoor-Su. And we’ve given you a straightforward perspective on testing hormone levels.
Gennev is seeking the truth on HRT, and it’s our intention to bring you credible, tested, and trusted opinions on this topic. With less than 7% of women in menopause getting the help they need to manage symptoms, we believe HRT is a viable option for more women than it serves.
I’ve labored on now twice in the past month about hormone therapy, so I will give it a rest (for awhile).
If you have questions and concerns about whether or not HRT is the right treatment for you, there is no better place than Gennev’s community forum or our private 1:1 practitioner appointments to get your questions answered by experts you can trust.
As always, if you have comments or recommendations for future topics you’d like me to weigh in on, please email me directly at jill@gennev.com.
Have a great weekend!
Jill
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 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?”
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.”
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.
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.
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.)
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.
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.
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.
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.
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.
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.
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!
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:
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.
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.
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.
So, you didn’t sleep so well last night, you’re feeling a little irritable today, lunch left you with the ole’ menopause bloat and you’re seriously eyeing the space under your desk for a little snooze. Want to hit the gym?
Yeah, me neither. But you might want to drag yourself in anyway. Menopause is a time when a lot of women gain weight. That may partly be due to a slowing metabolism as hormone levels decline, but it may also be that at this time we tend to eat more (due to decreased sleep and increased anxiety) and exercise less (thank you, bloating and fatigue).
First, we want to say we think you look terrific. Seriously. And a little extra weight may actually be protective. But if you want to get more fit for health reasons, or just stay in shape for the coming zombie apocalypse, we’re here to help.
Why worry? Comparing apples to pears
Why worry about your weight? It’s a legitimate question. Many women embrace aging as it puts less emphasis on their looks and figure and more on their wisdom and experience. But the truth is, too many extra pounds in midlife can be hard on your health because of the way our bodies accumulate fat as we age. Before menopause, fat tends to be stored on hips, thighs, and buttocks, resulting in a pear shape. During and after menopause, fat is more likely to accumulate in the midsection, turning pears into apples.
And apple shapes are more likely to suffer from heart disease, making it a very good idea indeed to avoid gaining too much weight in midlife.
Finding your weigh
So how much should you weigh? Excellent question to which science has no easy answer. Your weight can vary significantly from day to day depending on hydration, and, if you’re still having periods, on where you are in your cycle. You can use BMI (body mass index) to give you a ballpark figure (ha ha), but BMI doesn’t take into account your fat-to-muscle ratio, and it measures excess weight, not excess fat.
Better indicators of ideal weight may be as simple as gauging how you feel. Are you able to walk and talk comfortably without gasping? Can you climb stairs, garden, chase children or grandchildren? Are your clothes comfortable or snug? Instead of fretting over numbers on a scale, decide as in consultation with a doctor or physical trainer as what your fitness goals are, and shoot for those instead.
PEBGAW
You’ve assessed your fitness level, determined some healthy goals, and you’re ready to shed some unhealthy pounds.
Now what?
You know “now what” as boost the fruit and veggie intake, get your full allotment of sleep, drink plenty of water, reduce low-nutrient foods like white breads and processed foods, cut back on sugar, and exercise. While human bodies are way too complex and variable for the reductive “calories in/calories out” idea, I’m guessing most of us have an idea or two how we can improve our diet and make lifestyle changes.
But here’s the issue: getting it done.
Perhaps it’s different for you, but for me, the problem isn’t necessarily knowing what to do as it’s having the discipline to do it. Tech support folks use the acronym “PEBKAC” (“Problem Exists Between Keyboard And Chair”) for when the issue isn’t the software or hardware, it’s the user. I’m going with “PEBGAW”: Problem Exists Between Goals And Willpower.
Again, the idea of “willpower” is too simplistic as there’s so much more going on than simply strength of will as but let’s concentrate on that portion we can control.
Rethinking the shrinking
Part of the mental and emotional problem of dieting is the notion of subtraction, of doing without, and that can be demoralizing. What if, instead, we focused on adding in, on increasing fullness and richness and variety?
Weight gain in menopause isn’t inevitable. And combating it can actually be a pleasure, with the right ideas and attitude. Most importantly, don’t beat yourself up. Beating yourself up does not burn calories or build muscle, so cut it out (if you can). Perfection is not the goal; taking steps toward feeling better tomorrow than you do today is. Defeat PEBGAW by focusing on adding, not subtracting, and celebrate the victories as they come, whatever size they come in.
We’d love to know what you’re doing to be healthier, so please share triumphs, fails, and everything in between on Facebook and Twitter!