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One of the many reasons we love walking for exercise in midlife and menopause is because it is an easy, accessible way for most women to stay active and get outdoors. But what do you do when hot and humid, cold and rainy, or snowy and icy weather keeps you inside?  Don’t use it as an excuse to skip your workout!

Keep Moving With An Indoor Walking Workout 

Most days, you can make some adjustments, dress appropriately, and weather the storm or the heat. For the days when it’s unsafe or impractical to walk outside, turn to our three indoor workouts that will boost your mood, fight belly fat, give you more energy, and help ease those menopause symptoms. The change of pace will also challenge your body in new ways and add variety to your usual routine. Plus, consistency is the key to seeing results from your exercise efforts.

These three workouts can be done in the comfort of your home (or at the gym) no matter what the weather may be.

Workout 1:  The 30-Minute Treadmill Trio

One of the great things about walking on a treadmill is that you’re in command. You control the climate. You can easily walk a precise distance and track your progress. You can add hills when you want them and get rid of them when you don’t. You can multitask while you walk, watching TV, talking on the phone, scrolling social media, or checking your email. Or you can get focused and crank out a heart-pumping, calorie-blasting walk like this one. Adding speed and incline intervals will rev up the fat-burning power of your walk.

Warm-up (easy to moderate intensity)

Part 1: Steady pace (moderate intensity)

Part 2: Speed intervals (moderate to hard intensity)

Part 3: Hill climb burst (moderate to very hard intensity)

Cool-down (moderate to easy intensity)

Workout 2:  15-minute High-Energy Indoor Workout

You don’t need any equipment or a lot of space to get an indoor, energy-boosting walk. Unlike walking outdoors, you can safely change the direction and ways your moving””going side-to-side and forward and backward and adding moves like kicks and knee lifts””to work more muscles, which prevents muscle imbalances and boosts your calorie burn. So, turn up your favorite tunes and get moving.

Warm-up

1 minute: march in place

Part 1: Fancy Footwork

30 seconds: walk on your heels with your toes off the floor

30 seconds: walk on your toes with your heels off the floor

Repeat Part 1 one more time

Part 2: Fast Feet

1 minute: speed walk around your house, exploring as many rooms as possible

Repeat Part 2 one more time

Part 3: Multi-direction Moves

1 minute: climb stairs (no stairs? Step up and down on a single step, exercise step bench, or sturdy low bench, or speed walk around your house again)

Repeat Part 3 one more time

Cool-down

1 minute: march in place

Workout 3:  Add 5 Moves for Total-Body Toning

Add these moves to either the 30-minute Treadmill Trio or 15-minute High Energy Indoor Workout. You can turn either of those previous walking workouts into a total body, toning workout by adding our strength moves for walkers. These multi-muscle exercises will build strength to protect your joints, preserve muscle to keep you active, and improve your balance.

Here’s how to do it: After each part of the workouts above, including the warm-ups and cool-downs, do one of the moves in our strength moves for walkers video, completing 10 to 12 reps of each.

For example:

Want to get more from your walks? Join the Get Moving Walking Program for Women to receive two 30-day walking programs designed by women for women, support from certified fitness instructors and Gennev menopause specialists, as well as special offers and incentives.

Always check with your physician before beginning any new exercise program.  

 

Waking up with perimenopause anxiety in the morning is a common experience for women in midlife. For women who have dealt with it before, it can come roaring back. For women who’ve never experienced it, it can show up for the first time. From annoying to downright debilitating, anxiety can persist for months or years. But anxiety can be treated and managed so you don’t have to live with the swirling brain, pounding heart, and interrupted sleep.

Studies show more than half of women aged 40 to 55 report occasional anxiety (or “nervousness”) and as many as a quarter of women report frequent anxiety.

Researchers haven’t spent much time looking at the relationship between anxiety and perimenopause and menopause, because depression, which can come on the heels of many age-related conditions, has absorbed the lion’s share of time and funds.

Dr Swapna Vaidya

However, with such a large number of people in the perimenopause > menopause transition suffering from disruptive anxiety, we thought it was time to talk with an expert. We asked psychiatrist Swapna Vaidya, MD and Executive Medical Director in the MultiCare Health System, for some answers on hormones, anxiety, and how to stay mentally healthy in a difficult time.

Why does anxiety happen or get worse in perimenopause and menopause?

Dr. Vaidya: Anxiety can occur due to the estrogen and progesterone imbalance that occurs during perimenopause/menopause. When this hormonal system gets out of balance, symptoms of anxiety, depression, irritability, mood swings, foggy brain, tense muscles, and sleep disturbances can all occur. In the brain, reproductive hormones such as estrogen act via steroid receptors. They also have an effect on different neurotransmitters such as serotonin (a mood regulator), dopamine (active in pleasure and reward centers of the brain), etc. Additionally, studies show estrogen can influence brain areas that regulate mood, behavior, and cognitive abilities. So when estrogen declines, we lose its regulating effect on our brain and central nervous system (CNS).

Who is at the most risk of having more anxiety at perimenopause and menopause?

According to Dr. Vaidya, women with a history of depression or premenstrual dysphoric disorder (PMDD), women with significant caretaking responsibilities, those who experience loss or who have chronic fatigue or other health problems are at a greater risk of anxiety. However, even women without risk factors may develop anxiety during this time of hormonal disruption and fluctuation.

Those who already experience anxiety or have a previous experience with anxiety, depression, PTSD, or panic disorder are also at greater risk of developing more severe symptoms of anxiety during the perimenopause to menopause transition.

What does this sort of anxiety feel like? What signs can tell me it’s probably hormonal (at least in part)?

Says Dr. Vaidya, if you’re experiencing hot flashes followed by sweating and panic, body aches, sexual changes, and/or memory issues as well, your anxiety is likely more a sign of hormonal imbalance than a new case of anxiety or panic disorder.

Will anxiety get worse?

It may for a while, says Dr. Vaidya: Studies of mood and anxiety during menopause have generally revealed an increased risk of depression during perimenopause with a decrease in risk during postmenopausal years. The Penn Ovarian Aging Study, a cohort study, showed depressive symptoms increased during the menopausal transition and decreased after menopause. (“Cohort” studies follow a group of individuals who share a common characteristic over time.)

My anxiety is worst in the mornings. Is that normal? Why does it work that way?

Early morning anxiety is typically seen in the perimenopause-to-menopause period, says Dr. Vaidya. Estrogen helps regulate cortisol production; cortisol is your body’s main stress hormone, responsible for your “fight or flight” response. Decreases in estrogen can cause increases in cortisol levels which can stimulate the nervous system, leading to early morning anxiety.

How do I explain to my partner, children, colleagues, boss, etc., what’s happening to me?

Telling people you’re dealing with perimenopause or menopause symptoms can be really tough in our society, and telling people you’re dealing with mental and emotional symptoms as a result risks a double stigma. Hopefully, as menopause and women’s health issues generally become more normalized, we’ll be able to talk more openly and easily.

As Dr. Vaidya says, “Communication and being transparent with your colleagues and loved ones about the experience of menopause and change, whether physical or emotional, would be the first step.” Telling those around you that your responses may sometimes be influenced by unruly hormones may help them have greater understanding and prompt them to do more to accommodate and support you.

What can others do to help?

It’s a tricky question: those who aren’t going through it (and perhaps never will) often struggle to figure out ways to be supportive and helpful. Dr. Vaidya suggests, “One of the best things loved ones can do for you is to listen and to be empathetic. Often people around you may try to give well-meaning but unsolicited advice, but this can come across as pedantic or judgmental.” Discussing a game plan when you’re not currently dealing with anxiety can be helpful, since in the moment, it can be challenging to think and communicate clearly. Now, when you’re clear and calm, is perhaps a better moment to have the discussion.

What are the solutions? Lifestyle choices, naturopathic solutions, medical interventions, apps?

Dr. Vaidya: There are several modalities, interventions, lifestyle changes, and diets that are available out there; however, the most important thing is to create a program that is easy to use and adapt. We know from studies that lifestyle changes such as having a balanced diet and getting good exercise can have real benefits. Cognitive behavioral therapy as well as mindfulness and relaxation techniques have demonstrated significant improvement in symptoms of anxiety. Supportive groups, whether online or in person, are helpful as well; however, it is important not to overwhelm yourself. Approach treatment at your own pace.

When is it bad enough that I should get some sort of help or intervention? What are the red flags that this is likely beyond my control?

If you’re experiencing anxiety or panic that may be hormonal, it may help to talk with a menopause specialist. Remember, hormonal fluctuations can cause symptoms that mimic panic or anxiety disorder, and treatment may depend on the cause of your symptoms. However, regardless of what causes your anxiety, persistent panic attacks and debilitating anxiety that cause significant impairment in functioning or lead to suicidal thoughts or concerns should be addressed immediately.

I know a lot of younger women; should I talk with them about anxiety?

Thanks to continuing social stigma around women’s bodies, many of “Generation X” and older women entered perimenopause with no real understanding of what was happening or what was to come. Moving to normalize perimenopause and menopause can make it so much easier for younger generations of women to have a smoother, healthier transition.

As Dr. Vaidya says, “It’s important to talk about the natural change of life with women in your group. Very often menopause is culturally viewed as an ‘end of reproductive ability or desirability.’ However, opening dialogue and sharing the challenges and treatments would help transform the way menopause is viewed. This can help dissipate fear as well about a normal change in life.” Our anxiety, says Dr. Vaidya, is made worse when we keep menopause a mystery, so talking and educating ourselves and one another is good for us all.

We can help you find relief for anxiety in menopause

Speak with a Gennev Doctor – our menopause specialists can help you understand fluctuations in your hormones as they relate to changes in your moods and anxiety as well as other menopause symptoms you may experience, and provide a personalized treatment plan.

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

As a a consulting psychologist, consultant and executive coach to high-achieving women, guest blogger Barbara Mark, PhD, knows something about the storms of midlife. Here she takes on the six conditions of the perfect midlife storm and tells us how to survive the weather.

“Midlife: when the Universe grabs your shoulders and tells you,
“˜I’m not f***ing around, use the gifts you were given.'” “• Brené Brown

If you are a woman in your late thirties to your late fifties you are entering into, are in the middle of, or are coming out of the perfect storm.

Yes, there’s an “out” to this storm, and you’ll get there. I promise.

Not all women experience this storm with the same intensity, as we are all different with different backgrounds and different communities. Your experience may be that of a squall, or you may find yourself holding on for dear life in a Category 5 hurricane. (If that is the case for you, my heart goes out to you!)

The elements that make up this perfect storm are

  1. The Stages of Adult Development
  2. The Happiness U-Curve
  3. The Social and Economic Realities
  4. Perimenopause
  5. The Sandwich Experience
  6. Cultural Beliefs About Midlife

First of all, it is important to know that you are not alone, you’re in good company. All women are subject to these factors to varying degrees, but we all go through it.

If you need help riding the menopause wave, then 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 Stages of Adult Development

Although it wasn’t until the 1950s, 60s, and 70s that psychologists began to recognize how adults go through stages just as children do, my favorite theorist, Carl Jung, developed his theory of adult development in the 1920s and 30s. Jung experienced a spiritual and intellectual crisis after Freud ended their friendship and professional relationship around 1915. He later identified this time as a spiritual crisis in the middle of life. In 1965, psychologist Elliott Jaques coined the term “mid-life crisis.”

Not everyone experiences a “crisis” as such as it depends on how intense your perfect storm is.

I love this topic and could go on for pages, but let me say simply that the stages of adult psycho/social development that occur in an individual’s 30s, 40s and 50s are the most tumultuous.

Why? Well, we move from a relatively happy young adulthood through deciding that we don’t want to follow anyone else’s rules or meet others’ expectations, to discovering that there is a self to embrace, only then to encounter fears that this self may not be all that our younger self imagined and wanted to be when it grew up. This leaves us feeling, “Is this all there is?” until finally we arrive at a place of self-acceptance in our mid-to-late-50s to mid-60s.

For many women, midlife means an increase in anxiety, depression, and rage. But it is, like adolescence, a transitional (and hormonal!) phase with an ending. The important thing is to find tools (hobbies, exercise, family and friends) that will help you get through to the good stuff on the other side. Trust me as the post-menopausal zest and the last stage of midlife development are awesome! Then adult development goes on to the stages of older adulthood which are pretty cool, too.

The Happiness U-Curve

In the early 2000s, while everyone was looking at happiness, a few theorists developed and evolved the Happiness U-Curve. It is based on a group of longitudinal and multi-cultural studies of life satisfaction, happiness, and contentment. What the results showed was a curve at high levels of happiness in early life that then dives downward to its lowest level in the late 40s, before climbing back up beginning in the late 50s and early 60s.

The nadir of the curve is just at the developmental moment of greatest self-doubt and the search for purpose and meaning. If you’re feeling at the bottom, as unhappy as you can ever remember being, understand that it’s a curve, and there’s an up awaiting you. By this time your hormones have settled down quite a bit and you are feeling the psychological impact of arriving at big self-acceptance!

The Social and Economic Realities

If you are an American woman in your late 30s through your early 50s, you have lived through some difficult times in US history. Many parents’ child rearing practices were pretty hands-off, thus creating a generation of latch-key kids. There were a lot of divorces. The American economy went from OK to boom to bust to OK to a huge recession to a slow recovery. The recession made it more difficult to embrace the typical American Dream of home ownership and wealth-building.

There are big decisions to be made as Marriage? Kids? Kids before or after marriage or without marriage? Intense career development early on and then take time off from work? Try to get back into work or start an entrepreneurial venture? Try to move the Baby Boomers out of the way while dodging the Millennials who are running up behind and past you? And, this is just a cursory review! Wow, I am exhausted just writing this, yet I know that the economy is better and there are lots of resources out there for you.

Perimenopause

While all this is happening, your hormones are having a party at your expense. Many women begin to experience the first stirrings of hormonal fluctuations in their late 30s. This will continue through to menopause, defined as the point at which you have had no period for one year, around 50-52.

The list of perimenopausal symptoms is long and varied. Many women experience hot-flashes, night sweats, insomnia, mind-crushing fatigue, brain fog, anxiety, depression, heart palpitations, migraines, irritability, crying spells, episodes of rage, and lack of impulse control, to name a few.

If you are still young, preparing for this early in your life as your 20s and 30s as will make the transition a whole lot easier. Dedicate yourself to a good diet and lots of exercise. Develop a routine of mindfulness and self-care so that you are not scrambling to create it when you are in the middle of this.

If you are in the middle of this, contact a menopause specialist and assess the options that are right for you. Also, exercise and mind your diet. This doesn’t have to be hellish even if you are on the more “hurricane” end of the spectrum!

Trust me as this is not your new normal! This party ends and you’ll celebrate being past this ritual of maturation physically, emotionally, and psychologically.

The Sandwich Experience

Many if not most women are caretakers, and if kids are in the picture and parents are needing help at the same time, life can be a sandwich of competing needs and demands. For many women, travel is involved as more family members live some distance away from each other. Also, women who grew up at this time period are less likely to have many siblings that can pitch in to take care of aging parents, so the burden can fall to just one or two people. This, too, evolves. Give it time and give yourself a lot of self-care!

Cultural Beliefs about Midlife

Last but not least is the social construct that midlife equals “old.” In our youth-obsessed culture we have gendered ageism, meaning “old women” become marginalized and invisible.

As a result, so many women are doing everything they can to deny that they are aging and are not speaking up for what they need or engaging in appropriate self-care. Women are running around exhausted and dripping with sweat, trying to prove to themselves and everyone else that they’ve got it all covered.

We are living longer and healthier, so people no longer feel “old” in their 40s, 50s, 60s and for many even in their 70s! However, we have not updated our concept of what the middle of our lives is. The important thing is to live your midlife, not the one dictated by myths and outdated societal stereotypes.

There is calm after the storm

There is “calm” after the storm, if calm is what you want. But there’s also so much more: excitement, change, growth, confidence, and empowerment.

We now can have a midlife that is a productive, satisfying, full third of our lives book-ended by youth and older-age. I meet so many women who say that being in this middle third of their lives is the most empowered and vibrant time of their lives so far. If you met me in my late forties I would say that I was running out of time to accomplish all that I wanted to in my life. Now in my late sixties I am on top of the world and loving my work and my life.

Take heart, women! This can be a difficult and challenging time, but we have so much more access to information and community support from organizations like Gennev than we’ve ever had. Your hormones will settle down, you will move to a place of self-awareness and integration developmentally, and you will move up the other side of the U-Curve! Yippee!

For more from Barbara, check out her blogs on Middlescence and having fun (yes, fun) in midlife.

Weathering your own perfect storm? We’d love to hear about it. Leave a comment below or on Gennev’s Facebook page, or join Midlife & Menopause Solutions, Gennev’s closed Facebook group!

 

You might find the title of this week’s blog ironic.

Menopause has been around as long as women (and whales!) have been on this earth. What I’m referring to is the growing number of women and brands speaking out on the topic in a modern, no-nonsense sort of way.

Let’s start with Apple, the mothership of all brands. They announced a Women’s Health Study this week in partnership with the Harvard T.H. Chan School of Public Health. Their mission is to study a broad range of women’s gynecological conditions, including menopause. Go Apple! My message to Apple: if you want to work with the experts in menopause, you can find us at https://gennev.com.

Every day, it seems, new products come on the market to relieve or reverse the effects of menopause. Some of my recent favorites are a Cannabis Tea called Kikoko for a range of menopause symptoms (notably insomnia and hot flashes) and Better Not Younger hair care. Beautiful packaging that doesn’t make me feel like I need to look younger.

Women’s voices are ringing out strong in op-ed form, online film, and onscreen drama.

One of my favorite new thought leaders on the topic of menopause at work is Denise Paleothodoros. Her latest piece titled Dear Men, I Hope You Don’t Think My Ask Is Too Big on Behalf of Midlife Women is targeted at men. It strives to help them understand the changes they will experience in the women they care about. And it goes a step further to help them understand how to respond in a modern, sensitive sort of way like only cool men can do.

Filmmaker Lisa Kaselak is releasing a new web series called HelloPause that brings women together to talk openly about perimenopause. Their mission is to “de-mystify, de-stigmatize and de-toxify perimenopause so that ALL women can be prepared for the challenges and joys of a third act well-lived.” They’re on the hunt for new women with new stories. Learn more about future episodes and pay it forward by supporting their GoFundMe campaign.

And for the grand finale, I’m in love with Fleabag. In a cameo appearance, Kristin Scott Thomas lays out a monologue on menopause that will go down in the record books of female definition when she says, “And yes, your entire pelvic floor crumbles and you get f***ing hot and no one cares, but then you’re free, no longer a slave, no longer a machine with parts. You’re just a person.”

Why am I intentionally giving you all these links that take you away from Gennev and all that we’re doing for women in menopause?

Ladies, we’re part of a broader movement. Menopause isn’t just one woman’s voice or one doctor’s point of view, or one product on the market. It is many many women’s stories, bold brands and never-done-before services coming together to serve the massive community that we are.

These brands and influential people are ignoring the long-standing stigma and instead sharing loudly their points of view, their solutions for healthy living, their vibrancy and their struggles.

That’s the community I want to be part of. That’s what I want Gennev to represent. That’s how I hope we, together, can change the face of menopause and women’s health forever.

So, yes, we’re a thing. And we’re just getting started.

At Gennev, our mission is to connect women with the very best menopause resources available to manage their health in midlife. We’re working hard to gather up medical and wellness professionals with expertise on the changes in women’s bodies; vendors offering truly effective solutions; and the very best, most accurate and complete information we can supply.

Why?

Because Ann-Marie Archer.

Because there’s so little information and conversation, even an informed woman who takes good care of herself didn’t know what, who, or even if to ask for help when her body did some pretty frightening stuff.

“I don’t want to scare anyone, but “¦”

At 51, Ann-Marie still wasn’t menopausal or even close. Her periods were erratic and had been for a while, but she wasn’t having hot flashes and her blood tests showed no indication of menopause, so she and her doctor assumed things were fine, if delayed.

Things weren’t fine.

Her periods were extremely heavy as sheet-changing heavy, taking-an-extra-bag-full-of-tampons-when-traveling heavy as but hey, no hot flashes, and that’s how you know it’s menopause, right?

Ann-Marie Archer

“My doctor never said, “˜We should do something about this,'” Ann-Marie says. So they didn’t.

“I’m an informed woman,” Ann-Marie says. “I felt ridiculous asking my doctor if this was “˜normal,’ because I should know if it’s normal. But how can anyone know what’s normal if no one talks about it?”

Two events finally convinced her that it was time to push for more help.

“I was in the office of the business my partner and I owned at the time. It was summer, and I was wearing a sundress. I was 51 or 52, I was having my period, but it was no big deal. I stood up to go the restroom, and suddenly, I was bleeding so badly that it was all over the floor, everything just came out, it was horrifying. Fortunately, the only other person in the office with me was another woman, and she was able to help me. “

With her help, Ann-Marie was able to make it home and change into completely new clothes. Then she went back to work.

“That should have clued me in that something was very wrong. Something wasn’t normal. But I thought, well, that’s just what menopause is.”

“That should have clued me in that something was very wrong. Something wasn’t normal. But I thought, well, that’s just what menopause is.”

She did talk to her doctor, but she didn’t get any satisfying answers. Tests once again seemed to indicate there wasn’t really a “problem” as just “menopause stuff.”

“It was horrendous,” she says. “There were no good options. The doctor said she could put in an IUD or she’d prescribe the Pill, but that just didn’t feel right. There was no discussion of ablation or other possibilities as only choices I didn’t want.”

When it happened a second time, this time during a massage, it scared Ann-Marie badly enough that she convinced her doctor to run some additional tests. And there it was: pre-cancerous cells in her uterus. She had a hysterectomy in December of 2016 after, she says, “years and years of suffering vaginal pain and excessive bleeding. Because I didn’t have enough information.”

The surgery revealed enormous fibroids that hadn’t shown up on any of the previous tests, including an ultrasound. “How could they not know?” Ann-Marie asks. “They were so big, my uterus was two-thirds again its normal size. Turns out my swollen uterus was pushing on my bladder, which explained the incontinence I’d been complaining about. I’m a weight lifter, but I could barely sneeze without wetting my pants. The surgery took two hours longer than they expected because of the giant fibroids no one knew were there.”

Women need menopause education

Silence and shame are their own kinds of cancer, Ann-Marie says, but they can be just as deadly.

“If I had known more, if I had more to read, people to ask, if there was more menopause education, I would never have let it go on this long. When I talked to the oncologist about the hysterectomy, I said I assumed they’d leave my ovaries. She advised against it, saying there are no warning signs for ovarian cancer. The crazy bleeding was my body’s warning of the uterine cancer, she told me. Who knew? If I’d known that, I would have demanded tests a lot sooner.

“Women aren’t useless after 50 just because we’re no longer having babies. At 55, I still hadn’t gone through menopause, and my doctor just sort of shrugged it off. If I can’t get information there, how can I possibly know how serious it is? Something’s missing, for women.”

What’s missing, Ann-Marie says, is information. Information on the limits of “normal.” Information on the body’s signals and signs when something’s wrong, and information about all the options to fix it.

“Don’t just talk about hot flashes as if that’s all menopause is. Women manifest symptoms in so many ways, we need to share information and get educated. Let’s talk about “˜here’s what perimenopause is, here’s what menopause is, here’s where normal ends.’ We need to know when everything’s OK and when we’re heading for trouble.”

And it’s not just the bad stuff we need to know, according to Ann-Marie. Education can fill us in on the positives to come as well. For example, Ann-Marie had no idea how much better she’d feel after her hysterectomy.

“My uterus went to the Dark Side,” she says, laughing. “Once I got it out, I was happier than a pig in sh*t. My naturopath put me on naturally occurring hormones [BHRT] as it took about six months to get the balance figured out as but I’m right as rain now. I just wish I’d done it years ago.”

Her BHRT includes a tiny amount of testosterone, which has also had an unexpected impact: “I always had a healthy libido, but now you can’t keep me out of the bedroom. Who knew that was going to happen?”

Educate yourself

Ann-Marie’s advice to others experiencing dramatic symptoms? “Educate yourself. Find whatever information you can, then go to your doctor and push until you know all the options, all the risks and benefits. Don’t settle if none of the choices seem right for you or your body.

“And all of us need to talk, no matter what our experience has been. Talk with your mom, your daughter, colleagues, friends, other women. Keep talking until we figure out what’s normal and not, what’s to be expected, what the signs are that you need medical help. The more we talk, the more we learn, and the better we understand where the edges of “˜normal’ are.”

The more we know, the better our understanding of menopause and midlife. If you have a story to share, please share on Gennev’s Facebook page or in Midlife & Menopause Solutions, Gennev’s closed Facebook group. And, as always, if your symptoms don’t feel normal, or even if they’re just impacting your quality of life, please talk with your doctor.

Remember that high school gym teacher who told you to “walk it off” when you were hurt? Yeah, well, turns out Coach J may have had the right idea, at least when it comes to mood.

Exercise may be the last thing you want to do when you’re dealing with menopause issues, but it may also be your first line of defense against many of the emotional impacts of this major transition.

Walk it off, run it off, swim it off, lift it off as there is enormous healing power in movement, and we’re going to talk about how to tap (dance) into it.

Menopause exercise and emotional wellness

Research proves it: regular, moderate exercise improves mood. But you have to stick with it.

As a matter of fact, if you need help keeping up with your fitness goals, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

What can exercise do?

Exercise promotes endorphins, the feel-good hormones. These natural mood-boosters are great at combating mild-to-moderate depression of the kind many women report during perimenopause and menopause.

Also, exercise and endorphins suppress cortisol, the stress hormone that can keep us in an elevated state of fight-or-flight during the menopause transition. High, long-term stress and anxiety have all sorts of down-stream effects on our bodies and psyches and can worsen many menopause symptoms. Aerobic exercise, even just 20 minutes of it, can help pull cortisol back to manageable levels.

Regular exercise can also help you sleep better and aid in weight management, both of which can make us feel healthier and happier. Nearly any woman in menopause and midlife will tell you that decent sleep is both rare and gloriously mood-elevating when it happens, so anything we can do to increase our chances is worth a little effort. Just avoid exercising too close to bedtime, as that can bring on night sweats for some women.

More reasons to move: our PTs filled us in on how exercise helps women dealing with osteoporosis. 

Moving more regularly gives us energy. Yes, exercise can wear you out and help you sleep, but paradoxically, it also shores up our energy reserves. Start slowly, if exercise isn’t part of your daily routine now, but over time, your body will adjust to the higher energy demand by producing more and working more efficiently. And having the energy to do what we love (and let’s face it, the stuff we just need to do) is key to emotional wellness.

Exercise can be a social activity. Lots of women in menopause withdraw due to depression, embarrassment over bodily changes like weight gain or incontinence, or low energy. But being with other people is really good for our brains and our spirits. Because social isolation often leads to higher mortality rates, exercise can help save your life in more ways than one!

Does it really work, or is it a lot of hype?

A small study of 23 healthy post-menopausal women showed a clinically significant improvement in anxiety, depression, health worries, and quality of life with exercise. The women, who were not active prior to the study, took on a six-week walking program, completing roughly 15 hours of exercise over the course of the study.

A follow-up of the women showed that benefits continued as long as the women kept walking. At the end of the first six-week period, the women were split into two groups: one kept walking, one stopped. The group that kept it up kept reaping the benefits, while those in the sedentary group made fewer gains or none.

A much larger study of nearly 34,000 Norwegian adults found that not only does exercise help on a day-to-day basis, it can also help inoculate you from depression in the future.

Menopause and exercise. So, how do I start?

Talk with your doc. As ever, if you’re going to add something new to your daily regimen, a quick check-in with the doc is a great place to start, especially if you haven’t been exercising or you have a medical condition.

Ease into it. Ramping up too hard and too fast is a recipe for sore muscles and a quick quit. Start from where you are; do more today than you did yesterday. Adding just 20-30 minutes a day can be enough to see benefits, but if five minutes is what you’ve got in you today, that’s five minutes your body and mind will appreciate.

Find what you love. I know, this makes me laugh every time too, but it is possible that there’s an activity out there you will enjoy. Walking is a great exercise and will do perfectly well, but if you’re looking for something different, there are lots of options. Try something outside your comfort zone: go rock climbing, borrow a buddy’s road or mountain bike, go for a hike, hit the pool, take up fencing or swing dancing. If there’s something you’ve always wanted to try, now’s the time to try it. Groupon has a “fitness classes” section (pole dancing!), so grab a deal, talk some friends into coming along, and do something new. (Nature is a natural mood-elevator, so bonus points for those who can get outside among some trees for their 30 minutes.) Join a group like One Million Women Walking for support, motivation, and tips to get you moving and keep you moving.

Make it a habit. Plan your exercise into your day the same way you plan meal prep, board meetings, or kid-activity chauffeuring. To be effective, exercise needs to be frequent and consistent. Wake up earlier in the morning (if you can spare the sleep), use part of your lunch break to walk, if work allows. But make it a non-negotiable priority, five days a week.

Track to see improvement. Positive feedback is a great motivator, so track a metric that will help you see results. Track mood, sleep, measurements, consistency, give yourself a notch for each new thing you try as whatever will help you see the benefits and keep you moving forward. Just remember to measure yourself against “¦ well, yourself. You’re not competing with your superfit friend or that gal training for her 3rd Ironman (unless competition is what revs your engine, in which case, kick butt).

Remember the end goal: to support your emotional well-being through a trying time. How you do that is up to you.

If exercise has helped you overcome emotional difficulty, we’d love to hear what you’re doing, how you got started, how you stuck with it, and how it’s helping. Yes, that’s a lot, but come on, share with us! Leave a comment below, or let us know on Facebook or in Midlife & Menopause Solutions, our closed Facebook group.

 

If you ever get a weird tingling, crawling, numbness, or itching throughout your body, especially in extremities like hands, feet, arms, and legs, you might be surprised to learn that it could be related to menopause.

We all know the pins-and-needles feeling of realizing you’ve been in one position too long and your foot fell asleep, or of toes warming up after an afternoon of sledding. But when the burning or tingling all over your body happens for none of the usual reasons, it can be a little alarming.

Fear not. It’s called paresthesia, it’s not uncommon, and it usually stops when estrogen levels stabilize. Knowing that doesn’t make it any less annoying, so we’re going to talk about what it is and how to get rid of it for our Symptom of the Month.

What causes the tingling in my hands?

Menopause and nerves have a complicated relationship. Surprisingly, declining estrogen levels may be the culprit. Because estrogen levels affect our central nervous system, when those levels start to fluctuate, it can begin to affect our nerves.

The sensations can take a lot of forms: tingling, burning, crawling skin, cold, numbness, the classic pins-and-needles, and increased sensitivity. Women report symptoms from intermittent and mild to lasting and painful, even to the point of waking them from sleep.

What about in the face? Is that paresthesia as well?

This is most likely due to essentially the same cause, but with a different outcome. Most women report menopausal paresthesia of the hands, but it’s not uncommon to experience the same effects in the face. It can be particularly unpleasant, and can cause serious questions about your overall health. If your facial paresthesia is caused by the same declining estrogen levels, then the same treatments and remedies can theoretically be just as effective, which we’ll get to shortly.

Is the tingling sensation dangerous?

Paresthesia due to hormone fluctuation isn’t dangerous on its own, although numbness in the feet can cause women to lose their balance and fall when walking or running. Some women report the numbness or other sensation can make it temporarily difficult to grip or do fine finger movements.

When suffering a bout of paresthesia, it’s important to pay attention to how your body may be affected and adapt to any reduced ability. This can also lead to increased menopausal anxiety, so it’s important to pay close attention without stressing over it too much, or you’ll be doing more harm than good.

And of course, if you’re concerned about the severity of your symptoms, or if the tingling is disrupting your life, work, or hobbies, describe your symptoms to a doctor. If you can find a doctor who is particularly experienced with menopause symptoms and treatments, even better.

What can I do to help with these weird sensations?

As usual, there are lifestyle changes to try first:

  1. Eat well. A balanced diet with plenty of fresh fruits and veggies helps regulate the body and may help ease symptoms.
  2. Regular exercise improves blood flow and reduces tension, both of which can help relieve paresthesia. Stretch. Move.
  3. Get acupuncture and/or massage. Again, improving circulation can really help with paresthesia symptoms. Also, these treatments can be great for reducing stress, and stress often contributes to increased paresthesia symptoms.
  4. Sleep, hydrate, cut back on alcohol and caffeine. You know all these already, and should be doing them for all your menopause symptoms. Give your central nervous system all the support it needs to do its job well. Practice good sleep hygiene to maximize your down time.
  5. If you smoke, quit. Smoking is hard on circulation, restricting blood flow. Plus there are so many reasons to quit smoking at this time of life! If you want to quit but are struggling, talk with a Gennev clinician for tips on how to cut back and finally, quit entirely.
  6. Add supplements. B12 deficiency is a particular cause of paresthesia, and adding iron, magnesium supplements, and vitamins B, C, D, and E might help. If you suspect you may be low on B12, that’s a good time to see a health care professional.

When should I consult a doctor about paresthesia?

If none of these solutions make the paresthesia manageable, or if it’s impacting your sleep or quality of life, talk to a doctor about medical interventions like hormone replacement, topical creams, or a low-dose antidepressant medication for menopause symptom treatment.  While paresthesia related to menopause is considered “chronic” (long lasting or recurring), there are ways to moderate the sensations until estrogen levels reach their new normal and sensations reduce or disappear.

Tingling and burning sensations can be caused by more dangerous conditions such as fibromyalgia or stroke, so if you have any of the following as well as the paresthesia, talk to your doc:

Paresthesia may not be pleasant and it might distract you when it strikes, but it generally isn’t considered painful. The more severe, sometimes more painful version is called dysesthesia and may be related to multiple sclerosis. If your tingling is painful, talk to a doctor right away.

We can help you understand paresthesia

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 conditions. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.

We know what you’re thinking. Isn’t it enough that perimenopause and menopause bring on a whole host of less than appealing symptoms and bodily changes? Do we really have to add a link between menopause and sexless marriage issues? Well, yes. But it’s not hopeless! Disparate expectations, increased physical pain during sex, differing levels of desire, reduced ability–all of these symptoms are frustratingly common in middle age, and allthey can make intimacysex difficult. According to therapist and author (Sex Without Stress) Jessa Zimmerman*, about 20 percent of people are in “sexless” marriages, meaning they have sex fewer than 10 times per year. Of the remaining couples, about 25% have sex less than once a week. 

Pause and take a deep breath. You don’t have to settle for a sexless marriage. And once you understand what’s causing the issues getting in the way of your sex life, you’ll know how to move forward with confidence and control.

Struggling with a sexless marriage? A menopause-certified health coach can be helpful. We can provide a personalized plan to revitalize your marriage’s sex. Book 30 minutes for your personal consultation with a health coach.

Why Do Menopause And Sexless Marriages Happen? Let’s Look at What’s Going On, Down There

Couples who don’t have sex are missing out on that physical connection in their relationship. There’s a correlation between divorce and menopause due to lack of sex.

As you probably already know (but it bears repeating) estrogen and testosterone levels drop during perimenopause and menopause. This can cause thinning and drying of the vagina of the vaginal tissue–the vagina may even become shorter, narrower, and less flexible during menopause. Put this all together and you’ve got painful sex. Not to mention you’ll still have these same struggles with sex after menopause. First, talk to your doctor.** There are all sorts of options available to try, including lubricant, topical estrogen, a clinical therapy device (used to increase blood flow to the vagina), and even drugs–though there are some serious side effects that come with these medications, so, not to sound like a broken record, but talk to your doctor.

Another sexual side effect caused by lowered estrogen and testosterone is a lagging labido. The one-two estrogen/testosterone punch can lessen your sensitivity to touch. Throw in some of the other distracting symptoms such as menopausal depression,sleep disturbances, anxiety, and stress, and it’s pretty easy to understand why sex might not be at the top of your to-do list. What can be done? Well, it might be time to try something a bit outside your box. Look for inspiration in erotic films and books. Put a new foreplay plan in place by adding sensual massage or extended oral sex. Play with new sexual positions, especially ones that allow for you to control the depth of penetration. First and foremost, have fun! And please, remember to communicate with your partner. If something isn’t working for you, they need to know.

Sex and Intimacy: Different, But the Same

There’s sex, and then there’s intimacy. They’re inexorably linked, and both are vital to a healthy marriage. Sex is exciting, pleasurable, a mood booster, stress reliever, and can even strengthen your immune system. Intimacy, on the other hand, is the closeness that builds between two people over time in a loving relationship. Does sex increase intimacy? You bet. Do the two work as a team to make you and your partner feel fulfilled in your relationship? Yep. Which is why it’s important when talking about menopause’s impacts on your sex life that we address what it can do to your level of intimacy, too.

So we asked Jessa about how couples can navigate the rocky terrain of sexual and intimacy issues in a relationship. What can couples do to keep the closeness and intimacy if sex is complicated? This is a big part of her couples therapy, Jessa says, and it begins by widening our definition of “sex.” It doesn’t have to be limited to penetration to “count.”

“My definition of sex is that it’s the physical expression of our innate drives for love, intimacy, and pleasure. That means any pleasurable physical intimacy between partners counts as sex. I encourage people to find ways to touch and be touched that each find pleasing. If one person wants sexual stimulation and the other wants their hair brushed or their feet rubbed, they can participate in pleasure with each other. It is so important to open up your idea of what sex is and what it’s for; it takes the pressure off the couple and allows them to find intimacy and pleasure in new, flexible ways.”

Incolulating a Healthy Relationship

So, let’s say you’re happy, you’re satisfied, you’re compatible sexually, and in your approach to midlife. How do you keep this going as menopause starts to throw hurdles in your way?

If your relationship is happy and has been for a number of years, chances are you’re already doing what you need to do. But even good relationships take work, so Jessa gives us three tips to be sure your happy partnership stays that way. 

1. Keep investing in the relationship; don’t get complacent

“Marriage is like a garden; it needs tending,” Jessa explains. “Continue to spend quality time together. Make sex and intimacy a priority. Don’t let yourself get so comfortable you don’t water and weed the garden, letting it fall into disrepair.”

2. Maintain open communication; don’t be afraid of rocking the boat

This can be a tough one, Jessa acknowledges: “When things are going well, it can be hard to bring negativity into the relationship. People avoid talking about difficult things because they don’t want to spoil the good feelings they’ve been having with their partner. But it’s crucial that a couple maintain open and honest communication, especially about the hard things. If you stop talking and start hiding things that are bothering you, resentment and distance will grow.”

3. Celebrate

A healthy, supportive partnership is worth celebrating! Jessa underscores. “Recognize that you have something special. Enjoy every moment. Don’t take it for granted because life brings changes, one way or another. Be grateful for what you have and express that to each other.”

Sex and intimacy are so hard to separate, we often use the latter as a softer “code” word for the former. But the link is real. Physical touch is critical to a healthy relationship, whether that’s foot rubs or foreplay. Ultimately, how a couple defines intimacy and satisfaction is entirely up to them–as long as both parties agree.

So, openly communicate about what gives you pleasure, what you love about your partner, and how important the relationship is to you–it doesn’t get much sexier than that. And if you commit to doing these things, menopause does not have to lead to a sexless marriage.

*We are providing these links for informational purposes only; they do not constitute an endorsement or an approval by Gennev of any of the products, services, or opinions of the corporation, or organization, or individual. Gennev bears no responsibility for the accuracy, legality or content of the external site or for that of subsequent links.

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

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

Dreaming of a good night’s rest? It can be tricky during menopause, but not impossible. Read this to learn more about what you can do to improve your sleep quality.

Parts of this article were first published on PRiME WOMEN ““ a great resource for women to learn more about health, fashion, lifestyle, careers, “second acts” and more.

Menopause and sexuality is one of the many challenges of midlife that can take a toll on romantic relationships. If libido is not as robust as it used to be (or is non-existent), or sex is painful due to hormonal changes, or your relationship is on the brink of divorce for whatever reason(s), intimacy is suddenly a whole lot less attractive.

And midlife comes with plenty of “reasons”: caring for teenage children and/or aging parents, increased responsibilities at work, concerns about financial security in retirement, health worries “” who has the energy to even think about sex, much less engage in it?

Jessa Zimmerman

But if you want a more active sex life, you should have it. Sex and intimacy are actually really good for physical and mental health. So we engaged Jessa Zimmerman, licensed couples’ counselor and nationally certified sex therapist, to give us some quick tips to help re-engage your sex drive.

And it’s not just about sex. There are lots of ways to have intimate and supportive relationships, so if you’re looking for suggestions to help navigate uncertain relationship waters, we got that too.

But wait. At this point, we often lose those readers who are unpartnered and assume content about sex and love aren’t for them. This is for you, too. Masturbation and self-love “count,” “” YOU count “” so stick with us.

Sexuality and Menopause: Partnered  

It’s Valentime, which means lots and lots of articles about revving up your romance. But what if one (or both) of you is in menopause, and frankly, sex just isn’t all that appealing right now?

First, let’s all agree on one thing: this is not a “shaming” situation. No one should be shamed for wanting sex, for not wanting sex, or for being conflicted on the subject.

Generally, a woman’s sexual response is more complicated than a man’s, and penetrative sex may not be enough as and at this time of life, thanks to the vaginal dryness of estrogen loss, it may actually be quite painful.

Jessa’s advice for partners of menopausal women:

  1. Let her “warm up.” Give her time. Quite literally, you need to give her time to get the juices flowing. Extended foreplay is a great idea. Letting her set the pace and determine how far things go is awesome.
  2. Be physically affectionate, even if it doesn’t result in sex. If, for example, every backrub is just a prelude to intercourse, and intercourse is painful, suddenly backrubs aren’t all that pleasant. Be prepared to touch and cuddle without expectations.
  3. Buy lube. She may be embarrassed by the changes in her body, or she may want to have sex but fears the pain, bleeding, even infection from vaginal tearing that can result. Buy some lube for sex, have it handy, check in regularly to see if more is needed. Make it sexy or playful so it’s part of the experience.
  4. Talk. This is a tough topic, even with someone you share a bed with. Talk about sex when you’re not having it, and talk about it when you are as what works or doesn’t, what gets her excited or doesn’t, how you can both find pleasure.
  5. Get educated about a woman’s body and sexual response. Very few women of any age experience orgasm from penetrative sex alone. Learn with the clitoris is and how it works, be open to toys like the lioness vibrator to help her along.

And remember, sex isn’t the only place where your partner needs additional support during this time, says Jessa. Now is the time to be her ally and her cheerleader. If her self-confidence has taken a hit, boost her up. Show interest in her passions. This can be a powerful time of growth in career, second career, creativity or menopausal zest, so be supportive and join in if she makes a space for you.

Support her physical health by joining her or inviting her out for walks or runs or other physical activity. Encourage healthy eating by cooking some good Mediterranean diet recipes. Be sensitive and never downplay or joke about or call out her symptoms unless you know she’s truly OK with it. Listen. Ask her how she’d prefer you deal with her hot flashes or irritability, then try to accommodate.

This doesn’t mean you give up your life, we promise! But some flexibility and extra sensitivity could go a long way to making life easier for you both.

Jessa’s advice for menopausal women

You’re in menopause, and sometimes life is kind of “¦ miserable. Not only that, but you fear you’re making those around you miserable too.

We get it. Chances are you’re not the ogre you think you are, but we’ve got some suggestions for you too.

  1. Talk about sex. Advocate for what you want and need, Jessa says. If you’re getting what you want, you’re likely to want it more often!
  2. Initiate sex sometimes. Drive can become more responsive over time, Jessa says, so don’t just wait until you’re in the mood.
  3. Prioritize intimacy. Make time for undistracted togetherness. Be sure your partner understands this isn’t a guarantee of intercourse (to take the pressure off) and let what happens, happen.
  4. Get professional support or treatment if you’re struggling. Guilt or worry over whether you’re “normal” aren’t helpful or sexy, so see if a professional can help you get back on track.
  5. Embrace erotica. Suggest to your partner that you watch a sexy movie or read a sexy book together. Even if this doesn’t lead to sex, it can help “keep the embers glowing,” Jessa says.

This can and should be a powerful time for you. You’re probably freer from obligation and more independent than you’ve been in a while, maybe ever. Give yourself time to enjoy that, get to know you if that feels right, take control, set goals, live the life you want. If you want, you and your partner can find new hobbies, ventures, projects to do together.

Or, perhaps this is time to branch out on your own to live new experiences, then come back together to share. Being confident and finding pleasure in life can help you find confidence and pleasure in your relationships as well.

Unpartnered

Notice we didn’t say “alone.” You’re not alone, even if you’re currently not in a romantic relationship. The longest and most important relationship you’ll have in your life is with yourself.

And you’re changing. This transitional time can change our spirits and psyches as well as our bodies, so this is a really good time to get to know yourself (again).

Jessa asks: Are you ready to pursue new things, invest in yourself, leverage your new power at work or in your life? Or maybe it’s time to take a bit of a break, rest, re-energize, focus on self-love and self-care before embarking on your Next Big Thing. Whatever’s right for your next step, this is your time to figure it out, then pursue it. Be your own cheerleader!

And while you’re moving forward, don’t neglect your sexuality, Jessa says. The more you engage your body’s sexual response, the easier it becomes, so keep the fires burning. There are lots of great toys and tools for women’s sexual pleasure that don’t require a partner. You may have a new “body map” for pleasure, so get to know your body and responsiveness. It’ll be even more fun to share when you’re able to define exactly what suits you best!

Want more tips from Jessa Zimmerman? Be sure to check out her awesome book: Sex without Stress: A couple’s guide to overcoming disappointment, avoidance, & pressure.

Got thoughts to share on relationships, intimacy, sex, and love? Join in the conversations happening on the Gennev private Facebook group!

 

Maybe it’s been a few months and you were thinking, “oh, yay, finally no more UTIs,” but on your next trip to the bathroom, the burn and ache say otherwise.

Urinary tract infections (UTIs) are incredibly common among women. Some experts say half or more of all women will have at least one in their lifetime. Let’s discuss what you need to know about menopause and UTIs.

What causes UTIs?

The most common UTIs are caused by the bacteria E. coli. Normally found in the gastrointestinal tract, E. coli can migrate from the anus to the vagina, hitching a ride on thong underwear or toilet paper used improperly (translation: wiping back to front).

Normally the urinary system can keep these invaders from getting a foothold, but if they get in in enough numbers, they can start to colonize and travel up the urethra, causing pain and burning, the urge to urinate, cloudy or bloody urine, and pelvic pain.

UTIs are annoying and painful, and having to get a prescription antibiotic isn’t ideal, but most UTIs are relatively simple to solve. The problems really begin when a woman gets rid of one infection, only to have it come back a few months later.

UTI won’t go away…they keep coming back”¦?

Recurrent UTIs as infections that return as are more than just annoying; they can really disrupt your life. If you’re having several UTIs in a year, it might be time to start looking for other causes.

Recurrent UTIs are very common among perimenopausal and post-menopausal women, so we talked to ob/gyn and Gennev Director of Health Dr. Rebecca Dunsmoor-Su about the causes and treatments of the ones that just won’t go away.

What causes recurrent UTIs?

According to Dr. Rebecca, there are two main reasons women experience recurring UTIs: either the vaginal tissue and flora have changed, or there’s an anatomical issue that needs to be addressed. Both of these happen frequently in women in perimenopause and menopause. So let’s take them in turn:

One: UTIs caused by change in vaginal tissue and flora

A normal, healthy vagina is colonized by lactobacilli. They consume the glycogen our bodies no longer need and produce lactic acid which prevents other, harmful bacteria from invading the vagina.

In perimenopause, estrogen levels start declining. This causes the tissue of the vagina to thin and dry and changes the vaginal pH. Because lactobacilli require a very specific pH to survive and thrive, they may die off during this time in a woman’s life, leaving her much more vulnerable to infections.

 

How do you treat them?

If it’s a flora issue, says Dr. Rebecca, she usually counsels patients to consider estrogen or the MonaLisa Touch laser treatment. Both restore homeostasis, returning vaginal tissue to its pre-menopausal pH and allowing lactobacilli to recolonize.

“Estrogen” in this context means the topical ESTRACE cream, Dr. Rebecca says; generally for vaginal complaints, estrogen applied directly to the area in question appears to be more effective than estrogen taken orally. However, the estrogen needs to be at a higher dosage to work, so if you still have your uterus, you’ll need progesterone as well. Vagifem tablets and the Estring ring are low-dose, and while they may work fine for some, they may not provide enough estrogen to combat recurring UTIs in all women.

For those who can’t or prefer not to use hormones, there’s the MonaLisa Touch. The laser can rejuvenate vaginal tissue and increase blood flow to the area, bringing tissues back to their pre-menopausal condition. Once the tissues return to normal, the body’s pH returns, as does the glycogen the lactobacilli need to survive.

Hear our podcast with Dr. Rebecca about how the MonaLisa Touch works and why it’s a good option for many women in menopause.

One of these two treatments is generally necessary to handle the problem. According to Dr. Rebecca, taking a probiotic supplement isn’t particularly effective because the bacteria in the supplement don’t make it to the vaginal canal. Even if they did, the pH still wouldn’t be right for them to survive. Cranberry juice or extract may provide some relief, but more clinical studies need to be done to determine if it really does protect the bladder from bad bacteria.

Two: UTIs caused by anatomical issues

The other UTIs, she says, are due to anatomical problems. Prolapse and weakened bladder muscles may stop the bladder from emptying completely in urination, and that can lead to recurrent UTIs.

As we age, tissue can weaken; if the tissue between the bladder and the vagina weakens, the bladder may bulge into the vagina, causing a prolapse or “cystocele.” If the bladder drops enough, it’s no longer in an ideal position for voiding completely. Bulges may form pockets where urine pools and doesn’t make it out.

If bladder muscles are weak, they don’t contract properly anymore, and again, a woman may not be able to empty her bladder completely.

The urine that isn’t expelled becomes a breeding ground for unhealthy bacteria, enough of the bad bacteria build up to overwhelm the good bacteria, and pretty soon, the woman finds herself with another UTI.

How do you treat them?

First, get a diagnosis from an ob/gyn, Dr. Rebecca says, so you know what’s actually happening. Then, if appropriate, a physical therapist may be able to help strengthen weak bladder and pelvic floor muscles. Medication can help you empty your bladder more completely, and if the problem is a prolapse, surgery might be your best bet.

What can I do about recurrent UTIs?

Depending on the reason you have recurrent UTIs, there are a few things you can do to reduce your risk: schedule an appointment with a pelvic physical therapist for help with pelvic floor strengthening; stay hydrated so you’re using the bathroom every 2 as 4 hours; empty your bladder as completely as you can; pee immediately after intercourse; if your doc approves it, try Uqora for UTIs, take one dose of antibiotic before engaging in behavior that often triggers a UTI (like intercourse); and since it doesn’t hurt and might help, drink cranberry juice, if you like it, but watch the sugar.

When should I see a doctor?

Most women get a UTI at some point, and often once they’re over, they’re over. But if you’re suddenly having 3 or 4 UTIs in a year, that’s less common, and it might be time to check with your ob/gyn.

Dr. Rebecca advises you to have a culture done so you know what bacteria you’re dealing with. If it keeps coming back, you might have a resistant strain of bacteria that needs a different treatment, or perhaps you’ve just been taking the wrong medication. UTIs don’t go away on their own, so don’t wait to get help from a medical professional.

If you had or have recurrent UTIs, how did you handle it or how are you handling it? Leave a comment below, or let us know on Facebook or in Midlife & Menopause Solutions, our closed Facebook group.

 

Increased risk of diabetes, heart disease, osteoporosis, dementia, autoimmune disorders”¦.

Either menopause is Mother Nature trying to kill us, or it’s her way of signaling that it’s time to start taking really good care of ourselves.

Considering Mother Nature also supplies a lot of nutrition for hormones we need to achieve and maintain good health, we’re going with the latter.

Loss of estrogen does, directly and indirectly, increase our risk of developing type 2 diabetes. And since having diabetes increases our risk of other health conditions, we definitely want to reduce any chance of setting some unhealthy wheels in motion.

What does diabetes do to my body?

Nothing good. Type 2 diabetes increases your risk of heart disease and stroke, it can lead to kidney disease, vision problems like menopause cataracts, nerve issues, and more. Because it affects blood vessels and nerves, diabetes can diabetes can impact any part of your body, though some are more vulnerable to its affects than others.

Diabetes is the #6 killer of women aged 45-54 and #4 of women between 55 and 64, so clearly we need to understand and minimize our risk.

How does menopause contribute to diabetes risk?

Both men and women are more vulnerable to metabolic diseases as we age, but it appears losing estrogen can speed up and intensify the process.

  1. Estrogen may play a role in managing insulin, says Michael J Breus Ph.D. Certainly many women who have diabetes find it more difficult to regulate blood sugar levels during and after the menopause transition, indicating a hormonal impact.
  2. In perimenopause, hunger hormones fluctuate right along with estrogen and progesterone, often causing a spike in the hunger-causing hormone ghrelin and a reduction of the appetite-dampening hormone leptin. Increased appetite can lead to weight gain, which is a risk factor for developing diabetes.
  3. Speaking of weight gain, many women put on more fat around their stomach at this time, and excess abdominal weight can increase diabetes risk.
  4. Menopause is also frequently a time of increased stress, increased fatigue, and decreased quality sleep, all of which can make you more vulnerable to developing diabetes, especially if you exercise less than previously and your diet is not exactly ideal.

Women who enter menopause early (before age 46) or late (after age 55) may have an even higher risk of developing type 2 diabetes, says a study by National Institute of Health, so if you’re in either of those categories, you really need to prioritize healthy choices.

If you need help making life changes to control your diabetes, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

Speaking of healthy choices “¦

So what should you do to minimize your risk?

According to the North American Menopause Society, you should get tested for diabetes every 3 years beginning at age 45. If you have risk factors such as a family history of the disease, blood pressure above 135/80, or if you are overweight, had gestational diabetes during pregnancy, or have PCOS, you may want to test more frequently. Some ethnicities also have a higher rate of the disease, so if you are Hispanic, African American, Native American, Asian, or Pacific Islander, more frequent testing might also be recommended.

In many cases, type 2 diabetes can be prevented, managed or even reversed with some healthy lifestyle choices. A study by the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases found that losing a modest amount of weight (7 percent of body weight was the goal), and improving diet and exercise was the most successful at helping people at high risk avoid developing type 2 diabetes. Those who adopted the Modified Lifestyle Change Program reduced risk by 58 percent. And those over 60 fared best of all, reducing their rate by 71 percent! And change really was modest: eat less fat and fewer calories, get women’s fitness motivation, increase exercise to 150 minutes per week.

If you’re interested in joining a program based on the study, you can find the one nearest you at the Diabetes Prevention Support Center website. You can also check out The Diabetes Diet from HelpGuide.org for suggestions on how to improve your food choices.

If you smoke, stop. Or at least reduce your exposure to nicotine as much as you can. According to the Centers for Disease Control and Prevention, smokers are 30 as 40 percent more likely than non-smokers to develop diabetes, so do what you can to avoid the unnecessary risk. If you already have diabetes, smoking can make the disease harder to control. (Smoking intensifies many menopause symptoms as remember: mother nature is trying to get you to take better care of yourself.) Alcohol can also increase risk, so limit intake to one drink a day or less.

Prioritize sleep. A single night of total sleep deprivation was as detrimental to insulin sensitivity as six months of eating a high-fat diet! While most of us aren’t dealing with “total” sleep deprivation, interrupted or poor sleep can cause weight gain and increased risk of diabetes. Getting better sleep during menopause is often really hard, so give yourself every advantage by practicing good sleep hygiene.

So much feels out of our control during this particular phase of life, but much of your diabetes risk can be managed. Eat better. Don’t smoke. Exercise. Not only will you minimize diabetes risk, you’ll likely also have a healthier heart and brain, a trimmer waistline, and reduced menopause symptoms.

Do you have diabetes or are you at high risk of developing the disease? What do you do to manage your health, and is it working? We’d love to know more. You can comment here, find us on Facebook or in Midlife & Menopause Solutions, our Facebook group. You can also join us, anonymously, if you prefer, on our community forums.   

*Menopause is defined as 12 months without a period.

 

How do you discuss a “taboo” topic like menopause on a public forum like a podcast? With humor, insight, wisdom, and patience!

Meet Colleen Ricci Rosenblum and Bridgett Biagi Garratt, the forces behind the hit podcast for midlife women: Hot Flashes & Cool Topics.

A year and 60-or-so episodes out from their launch, and Colleen and Bridgett have a genuine hit on their hands.

They’ve talked about the things you might imagine, given their title: peri/menopause, being empty nesters and relationships with adult children, etc. 

But they’ve taken on some tougher topics as well, including Colleen’s daughter’s history with an eating disorder, difficult pregnancies, divorce, and suicide.

Initially, they reached out to Gennev to feature Gennev CEO Jill Angelo on a podcast; they were so delightful and informed and fun, we asked them to return the favor.

What follows is a great conversation about midlife, menopause, the (glacially slow) changing attitudes towards women’s health, and what it’s like to go in the public eye and share intimate information.

 

TRANSCRIPT TO FOLLOW

What do you think? Is it easier to talk about menopause with friends, family, maybe even at work? Do you agree it’s important that health topics such as menopause be discussed openly? We’d love to know your thoughts, so please join the conversation in the Gennev Community forums.