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Do your jeans irritate you right at the waistband, and not because of the fit? Do you stand at the sink and feel pain or irritation when you lean against the counter?

It could be the scar from that C-section or appendectomy that’s giving you trouble, even if the surgery is years or decades in the past.

Internal and external scars, even long-since healed, can cause sensitivity, pain, and reduced mobility. Knowing the proper way to manage scar tissue can help you reduce or resolve those issues, on any scar, anywhere on your body. Practicing scar massage on new incisions (once healed) can help avoid problem years in the future.

To learn more about “restricted scars” and how to handle them, Gennev turned once again to our fabulous physical therapists, Brianna Droessler-Aschliman PT, DPT, CMTPT and Meagan Peeters-Gebler PT, DPT, CSCS, CMTPT.

How do restricted scars cause problems and why does massage help?

First, it’s important to know a scar is more than just a line on your skin, says Meagan. Our bodies are made of numerous layers, and there may have been several incisions to get to whatever tissue or structure or organ the surgeon was trying to fix. So the “problem” scar may actually lie deep inside.

Second, it helps to understand how scar tissue is formed. “Think of a mud puddle,” Meagan says. “To cover it up, you throw a bunch of straw on it. It covers the hole, but the pieces of straw land every which way and end up lying in different directions. That’s how scars form.”

Plus, says Bri, the cells that form a scar matrix are often tougher and more fibrous. This makes the scar tissue less flexible than the tissue around it.

“Scars can even pull on surrounding skin and tissue and form adhesions,” says Bri. The pain, burning sensation, or restricted movement happens when you try to pull or twist against that adhesion.

Scar massage helps by realigning existing scar tissue so the fibers are neatly organized and running parallel and perpendicular to one another, making the matrix of scar tissue much more flexible and elastic. Second, massage helps break up adhesions, freeing up restricted muscles, organs, and fascia for greater range of motion. Finally, massage can help establish a framework so any new tissue that’s created becomes part of this organized pattern. No more jumbled straw!

How do I know my pain is from a scar?

Restricted scar pain can go undiagnosed for years, since people often don’t associate new pain with an old wound. A doctor or physical therapist will likely be able to feel the restricted scar by pushing on the painful area with their fingertips.

A healthy, well-healed scar should feel and move like the skin around it, according to our PTs. “I shouldn’t feel a barrier, no raised ridge, no wad of tissue or puckering. If I pull it one direction or another, it should move easily, without causing pain,” says Meagan. “If it doesn’t, a restricted scar is where I’ll start.”

“Most people aren’t told about the importance of scar massage,” Bri adds, “so we see this problem pretty often. But it’s really avoidable. People can be taught to start massaging their own scars as carefully as as soon as the incision is healed to keep adhesions from forming in the first place.”

Hands-on healing: how to massage scars

Hang on, before you go diving in: if this is a new incision, is it fully healed? As Meagan says, be sure it’s fully closed, with no draining, oozing or crusting, and no risk of eruption. If you’re not sure, consult with your doc.

Begin by desensitizing the area. Nerves may be flaring and angry from the surgery or injury; you want to calm them so the area can tolerate scar massage a little further down the road. Start the desensitization by rubbing the area lightly with a very smooth, silky fabric. Do that for a few days, then increase the sensory input by moving to cotton, then denim, then wool. Once it can tolerate that level of irritation, you can move on to massage.

According to Bri, most folks are ready for scar massage about 6 weeks after surgery. You’ll want to consult with a physical therapist to learn to do this right. Happily, once you’ve mastered the art of scar massage, you can carry on on your own.

The trick is to find areas of resistance, according to our PTs. When you find one, gently press and hold. You can continue doing this until you feel it start to release. Bri suggests finding a good topical cream to make massage easier and promote healing (oddly, a combination at frankincense and emu oil seems particularly effective, she says).

Fortunately, even very old scars respond to manipulation and massage. And no scars are “off bounds.” Had an episiotomy? Go for it.

Scars and breast cancer awareness month

We wanted to talk about this topic now, in recognition of breast cancer awareness month and the far too many women and men who wear the scars of mastectomies and biopsies.

“Scar massage is really useful for mastectomy and post-radiation healing,” Meagan says. “With mastectomy, women can have challenges with breathing, with rib-cage mobility, arm motion, even just reaching overhead. Plus superficial nerves can get entrapped in scar tissue, and that can cause lots of pain and problems. Knowing how to do scar massage can help avoid a lot of issues later on.”

Healing old wounds (and not just old scars)

For many of us, just looking at a scar is difficult, much less touching or massaging it.

This is where working with a PT can really help. “Often we’re the first to touch a new scar, even before the patient,” says Bri. “They want to know that it’s OK to touch it, that they won’t open it or cause themselves more pain. We can show them how to touch it, when it’s OK; we tell them, this is what it’s supposed to feel like, this is what you can expect, this is how it should move. Once they know all that, it’s easier to be open to the massage and to taking over their healing themselves.”

“It makes sense that it’s hard,” says Meagan. “We associate that mark on our body with a traumatic event. Even if it happened during the happy birth of a child, scars change our body and how we view it. But think of it a different way: a scar is proof that your body is healing, and that’s good. When you can’t bring yourself to touch your scar, it’s like you’re an open circuit, and all that good energy is being lost. Once you can touch it, you complete the circuit, allowing the energy to flow through your body. That’s what healing is.”

Have you practiced scar massage, and did it work for you? Tell us EVERYTHING.  Share with the community in the comments below, or fill us in on Gennev’s Facebook page or Midlife & Menopause Solutions, Gennev’s closed Facebook group.

Want more from Meagan and Bri? Well, of course you do, they’re awesome. Check out if you’re peeing normally and what to do if you’re not. Here are some steps to take to improve your sex life (and how to orgasm better! – like, a lot). And learn why  why your sleep is screwy. Discover why you need good sleep and how to get it. And be sure to read Brianna’s article on “Managing Scar Tissue“ for Nature’s Pathways magazine.

 

When hormone levels change, it seems like your whole body changes, doesn’t it?

This is especially true for women with diabetes who are entering the beginning stages of menopause, perimenopause. True still and again for pre-diabetic women entering the same life transition. Hormones have a whole lot to do with both menopause and diabetes, and it’s baffling at times to navigate new symptoms and identify what they are in your body, in addition to living your busy, awesome life.

A concern for the undiagnosed

In 2015, of the 30.3 million adults who had diabetes, 23.1 million were diagnosed, and the remaining 7.2 million were undiagnosed. 

What will serve you through this is your awareness and attention to what is going on in your body.

If a new diagnosis of diabetes coincides with the onset of menopause, you may be navigating some similar symptoms. For instance, you may experience a symptom of foggy thinking both menopausally and diabetically. The element to zoom in on might be to determine if and/or when there is a difference in it being a diabetic symptom vs a menopause symptom. So much is new, and not much is fun. 

Still, staying informed and aware of symptoms and changes in your body is where your power lies in making good choices and taking good care of yourself. We do recommend talking with your doctor and getting your blood sugar levels checked, especially if your risk is higher for diabetes.

A few of the main symptoms in common

 

What else will help?

Whether you’ve been diagnosed with pre-diabetes, diabetes, or menopause (or not), there are a few things you can do to help your overall health until you talk with your doctor or check in with our telemed team (but please, do talk with a doc. Soon). What can you do? Self-care, support, processing, and testing.

Your health journey is a precious and vibrant part of your life (and quality of life). The attention and care you take to feel better will serve you in both the long and short run. 

We’d love to hear your experience – both the good and the challenging – around diabetes, pre-diabetes, menopause”¦ life!

Join us in the Community for shared knowledge, wisdom, and support.

 

What if you could relax more easily, decrease anxiety, symptoms of depression, fall asleep easily, improve the quality of your sleep, even signal increased anti-inflammatory and self-regulatory body responses at will? We can.

And…bonus! It’s free and easy to do. 

We almost don’t have to think about it to get the benefits.

While scientific research and verification are still underway, it might be worth attempting to activate the vagus nerve regularly with simple breathing exercises in order to engage the parasympathetic nervous system. This will begin to take us into a “rest and digest” mode, and out of the sympathetic system’s “fight, flight or freeze”.

Chances are good you’re more familiar with your sympathetic nervous system. This system is the one that boosts the body’s heart rate, directs blood flow to key systems and organs, and increases alertness, via rapid hormone release. All of this is in order to prepare the body for the fight, flight, or freeze response in a dangerous or stressful situation. 

Wired, but tired

Feeling wired-but-tired may be an indicator that your sympathetic nervous system is working harder than it needs to, especially if you’ve got that feeling in non-stressful, non-emergency situations. Perhaps you’ve felt it while watching television, or while trying to fall asleep in the comfort and safety of your home. Or maybe you find it challenging to rest or get to a state of relaxation in general.

You’re not alone

Dr. Deepak Chopra, notes that “Our society is on sympatheic overdrive.” Meaning, many of us are in a constant or chronic state of high alert. What else does this mean for our bodies to be in an almost constant state of emergency alert? 

It increases our risks for high blood pressure, inflammation throughout the body, heart disease, cardiac arrhythmias. Getting out of the sympathetic nervous system and into the parasympathetic system takes little effort, and we’re all halfway there by breathing all the time anyway. With a tiny bit of modification, we may reap the benefits of improved health and wellbeing, reduce our risks for heart disease, symptoms of anxiety, and depression.

Fun facts about the vagus nerve

Which is the longest nerve in your body, with a path to almost every organ? It’s the 10th cranial nerve in the body and it wanders from above the mid-brain throughout your body, all the way down to your colon: the vagus nerve. Ta-da!

As a part of the parasympathetic nervous system in our bodies, the vagus nerve influences lung, heart, gut, and diaphragm activity, not to mention facial expressions, speaking and swallowing functions. And it’s possible to activate, support, and bring balance into our bodies regularly by engaging and activating the vagus nerve.

Vagus nerve breathing exercises for engagement

Breathing slowly and deeply is the path to engaging the vagus nerve and improving what’s known as vagal tone. 

Breathing in and out through your nose, inhaling and exhaling to the count of 4. Spend 2-ish minutes and breathe 10 breaths of inhale and exhale at the count of 4 for each, and see how you feel.

Play with it. Perhaps you can slow your number of inhales and exhales per minute even more by inhaling to a count of 5 and then exhaling to a count of 6 or 8 for another series of 10 breaths.

What does this do? 

It provides a balancing effect on your nervous system. When you practice this type of breathing, and other non-invasive methods to activate your vagus nerve, improve your heart rate variability (HRV), so your body can relax faster and easier after a period of stress. This breathing exercise can also help you to relax and fall asleep.

Vagus nerve stimulation

There are medical procedures and devices that have been adopted to stimulate the vagus nerve in order to treat epilepsy and mental health including depression. There was a study done in 2016 for those suffering from rheumatoid arthritis as well. 

Ongoing research is currently underway for inflammatory diseases such as Crohn’s, Parkinson’s, Alzheimer’s, as well as rapid cycling bipolar and anxiety disorders.

More support, not less

How to incorporate a new practice that may ease menopause symptoms, and even help to decrease inflammation, reduce the risk of heart disease? Maybe all you need are a few suggestions to prompt you to engage your parasympathetic nervous system during the day? You could begin to breathe slowly and deeply when you: 

Where else, and what else, might prompt you to take a more conscious, deeper breath?

But wait, there’s more

Additional ways to engage your vagus nerve and your parasympathetic nervous system:

Coaching and additional support may be of help as you navigate through your menopause transition. Make a simple start by slowing and deepening your breathing. The hardest thing about this suggestion may be remembering to do it. 

 

What did you discover when you tried to engage your parasympathetic nervous system via your vagus nerve? We’d love to hear what you’ve experienced in our Community forums. Join, and share.

 

“You get about 15 minutes between pimples and wrinkles. Enjoy it.” as my mom

Turns out, mom was wrong. While we all expect wrinkles with aging, menopause acne can occur or recur for the first time since our teens. Sigh.

Whether it’s prom night or project presentation day, pimples can suck your self-confidence, and no one’s got time for that. So, what’s going on and what do we do about it?

I talked with Dr. David Lortscher, MD, board-certified dermatologist, and creator of Curology. While Dr. Lortscher focuses on individually tailored treatments for acne, he shared with us some information on lifestyle choices that can help women in menopause handle changes in their skin.

Why does acne return in menopause?

As estrogen declines in midlife, so do collagen and elastin, meaning your skin may become thinner, drier, and looser than before. Hence, wrinkles. But estrogen decline also takes with it our skin’s ability to ward off acne, sometimes leading to acne during and even after menopause.

According to Dr. Lortscher, “As women transition into menopause, as at puberty, a relative predominance of androgens (male-type hormones that all women have) is responsible for acne breakouts in some. In general, androgens stimulate oil production and can worsen acne, while estrogens counter that effect.”

What can we do to treat menopausal acne?

As with all things menopausal, there are a variety of treatments ranging from lifestyle changes to over-the-counter or prescription medications, to more significant medical interventions. But many women can control breakouts by making simple changes to diet, getting more sleep, and dealing differently with stress.

Looking for prescription menopause acne treatment? 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. 

Ending menopause acne with lifestyle changes

  1. Consider reducing or eliminating dairy. Says Dr. Lortscher, “Milk contains precursors to testosterone and other androgens, which influence the hormone receptors in the skin to turn on the process that causes acne. The association with acne is more marked with skim milk than with whole milk, and in those consuming more than 3 portions per week. It is possible that cheese, ice cream, and yogurt may be associated with acne, but the link appears to be stronger with milk. Not everyone responds to avoiding dairy, but it is something to consider.” Dr. Lortscher warns that soy milk may also aggravate breakouts, so it may be a matter of trial and error to find what works best for you.
  2. Add spearmint tea. For hormonal acne, you might want to try some tea! According to Dr. Lortscher, “Although not proven, there is some convincing evidence that drinking two cups of spearmint tea per day can reduce blood levels of circulating androgens.” However, he cautions tea enthusiasts to stick to just two cups per day, as drinking too much tea can be harmful.
  3. Boost phytoestrogens. These are the foods that mimic our body’s natural hormone, estrogen, only weaker. Commonly found in soy, seeds, nuts and nut butters, these are good for your collagen, skin, and mood. However, if you have a personal or family history of breast cancer, proceed with caution and check with a doc.
  4. Reduce the sugar. Just like when you were a teen, cutting back on sugar (particularly the processed kind) will help with breakouts. Bonus: being aware of your hormones and nutrition can help. Reducing processed sugar helps with many other menopausal issues as well.
  5. Supplement. Consider increasing Vitamins B (folic acid, specifically), C, D, biotin, iodine, and Omega 3 supplements for women.

Other remedies are ones you’ve heard before: sleep more. Stress less. Stop smoking. Hydrate. By doing a combination of all of the above, you have a strong chance of reducing or eliminating midlife acne, and you will certainly be doing good things for your overall health. Plus, spearmint tea tastes really nice. 

For those whose acne doesn’t yield to lifestyle changes, you may also want to consider adding over-the-counter remedies to your menopause skin-care regimen: look for creams that include benzoyl peroxide (but use sparingly, as this can further dry your skin) or salicylic acid to unclog pores. Or go another step to a personalized treatment plan. Sometimes hormonal acne treatments can be effective, but do not work for everyone and should be carefully evaluated before going that route. Acne after menopause is often treated in this manner, but to varying results.

Thank you to board-certified dermatologist Dr. David Lortscher, MD and creator of Curology.

 We can help you

 

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 haven’t heard of the documentary Dream, Girl, you soon will! Team Gennev, in association with Seattle International Film Festival (SIFF) is bringing Dream, Girl to Seattle for its premiere public screening on Thursday, January 19, followed by a panel discussion/Q&A with local women educators, innovators, and entrepreneurs. We hope you’ll join us for an evening of conversation and inspiration around the challenges entrepreneurial women face and how to overcome them. Learn more about our panel and then purchase your tickets directly from SIFF.

 

Dream, Girl: showcasing and celebrating female entrepreneurs

What do you need to start living your dreams? For would-be entrepreneurs, the challenges of starting a business can seem overwhelming. And for women”” particularly women of color””the barriers to business ownership can be even greater.

When team Gennev first watched the trailer for the documentary Dream, Girl, we knew we had to bring it to Seattle. The film showcases several female entrepreneurs, exploring their aspirations, challenges, setbacks, and triumphs. For us, it spoke to so many things we’re experiencing as a startup organization: the learning we need, the responsibility we carry, but also the exhilaration, the camaraderie, and the importance of celebrating every success, big and small.

what do you need to start living your dreams?

Happily, we had the opportunity to talk with one of the leaders of the Dream, Girl team: co-producer and co-founder Komal Minhas. Film producer, writer, investor, and entrepreneur, Komal started her business, KoMedia, at just 23 years old, so she knows a thing or two about flying by the seat of one’s pants.

Komal joined the team after viewing a Kickstarter campaign launched by creator Erin Bagwell. In her video, Erin spoke openly of quitting her job after having been sexually harassed at her workplace.

“When I saw that Kickstarter campaign,” says Komal, “I knew that I had to stop everything I was doing and come and help her amplify that message and bring it to the world.”

And what is the message that inspired Komal to sign on to Erin’s dream?

It’s right there in the title: Dream, Girl. With everything that that implies: Be hopeful. Take risks. Work hard. Support others in pursuit of their dreams and allow them to support you as you push towards yours.

Dreaming big works, as the film itself demonstrates. Dream, Girl has been screened at the White House, it showed to a sell-out crowd at NYC’s historic Paris Theatre, and last year, Erin and Komal were named to Oprah Winfrey’s SuperSoul100 list.

screening for Dream Girl at White House

“people are so happy we have a range of voices and stories
that we don’t traditionally get to see on screen and all together”

Like us, audiences have found a lot to love about this buoyant, inspirational, often funny documentary and the utterly charming women it showcases.

what has made Dream, Girl so popular?

“Some of the feedback we get is that people are so happy we have a range of voices and stories that we don’t traditionally get to see on screen and all together,” Komal told us. “People tell us they feel connected to these diverse and amazing women. And we cover a real breadth of topics””from lack of mandated paid parental leave in the US, to sexual harassment in the workplace, to pausing your dreams to build a strong relationship elsewhere, to finding funding for your project, to what it’s like to be a mom in the workplace””there are so many different topic areas that connect for people.”

At every screening they attend, Komal says, there are moments that make all the effort worth it. For example, during a post-screening discussion at a major firm, a young female employee said she felt she was not being seen at the company as much as her male colleagues were. A senior-level exec was also at that screening, and he stood up and made a promise to remedy the situation, take time with her, and figure out steps forward. Witnessing this sort of genuine progress helps keep Team Dream energized and moving forward.

However, Komal says, perhaps their biggest success has been in finding and supporting each other through the journey and in “strategically and thoughtfully” building a community around the film and its message.

building community: the unique distribution model of Dream, Girl

Speaking of building community, the Dream, Girl team have been very intentional in their distribution model, choosing to push the film through community screenings such as Gennev’s first, before pursuing digital channels. Why?

Because, Komal says, “We have been told time and again that our hosts, our audience members love seeing this film in person. You don’t want to see it alone, you want to see it as a collective and you want to talk about it and really get into the topics. We’ll eventually go digital with our film””that’s a future goal of ours so we can get the word out there as much as we can””but we find that right now, community screenings really give our audience the space they need to take it in.”

Komal and Erin do want their message to reach a larger audience, and they had a taste of what that could look like after the US presidential election. Deeply unsettled by the result of the election, the team made the unique””and uniquely generous””decision to allow people to view the film for free over the Internet. In four days, Dream, Girl was viewed more than 12,000 times. Clearly, people really crave the film’s positive, hopeful message.

“Listen, be kind, and be thoughtful about inclusiveness in the workplace.”

We asked Komal what companies like Gennev can do to take that positive message forward. Given today’s political climate, she told us, the onus is more and more on corporations to recognize and nurture female talent. “If we can make more inclusive workspaces, and help more people feel safe in the places where they spend the majority of their time, that’s the greatest thing companies can do. Listen, be kind, and be thoughtful about inclusiveness in the workplace.”

We never end a conversation without asking for that One Big Piece of Advice””this time for would-be female entrepreneurs. Her answer? “Take care of your health. As millennial women, we get so caught up in the hustle, needing to achieve, needing to accomplish so much by X date and being on the Forbes 30 Under 30 list”¦. Just take care. We have so much more time than we think we do. Clara in the film didn’t start her business until she was 50 years old. It’s important to prioritize your health above all else: your company needs it, the world needs it, and your employees need you.”

More information is available on our Facebook event page, so take a look, then get your ticket while there’s time!

 

Would you characterize yourself as a do-it-yourself type of person when it comes to your health and wellness? If you’re like me, you’ve maxed out your free article options on Medium and The New York Times in an attempt to soak in every suggested treatment or women’s story that will help normalize what you’re going through.

Or, are you the type of person who wants to rely on the knowledge and care of a coach, a trainer or a very hands-on doctor? Someone who can walk you through understanding why you’re feeling lousy, then hold your hand through the behavior changes required to get on the other side of it?

I’m a DIYer. I’m super disciplined about what I need to do to adjust a lifestyle behavior for better health, and then I just do it. Some call it Type A. It comes with its pluses and minuses for sure. Sometimes I can be a little impatient and I’m not always coachable”¦not things that I’m proud to admit.

What type are you?

With the way the health coaching industry is booming, I’d guess that there are a lot of women who want an approach to getting healthy where you don’t have to go it alone. You’ve got a coach, a trainer or a concierge doctor who is there for you when you need someone to keep you accountable and who helps with wellness adherence.

A menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

Or are you a combo?

You start DIY in the early days but flip to a much-needed relationship (coach, trainer, doctor) to give you  a plan and see you through it?

While I’m typically a DIY when it comes to perimenopause (at this point!), I took the combo approach to running. For my first marathon, I skillfully ripped out the Less is More training from Runners World. And with every marathon thereafter, I would try another plan.

Then I hit a wall. I was super tired and had been diagnosed with Celiac (for a carb-loading runner, hearing that you could not eat pasta or bread prior to a race 10 years ago was sock in the stomach”¦but then eating pasta and bread was a sock in my stomach, literally).

I knew I had an uphill battle to qualify for the Boston marathon so I enlisted my first running coach. He pushed me to the limits; it was painful, and I dreaded the weekly run I had to do with him, because he’d know if I’d been accountable to the plan.

But I got faster. I got healthier. I hit my goals. And I learned to trust the plan.

There isn’t “a plan” for menopause, but I believe there could be a personalized plan for every woman based on her needs.

Do you agree?

How many of you have a plan related to your menopause symptoms or something similar for weight, strength, mental health or even sleep management? And are you working with a coach, a trainer, or a menopause doctor specialist who is keeping you accountable?

I’m intrigued by the idea of taking the idea of a “running plan and/or coach” and applying it to women’s health in menopause.

If it sounds like something you’re already doing or you’ve seen something like it in the glossy world of menopause solutions, send it my way. jill@gennev.com

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

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

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

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

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

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

Annoying but normal

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

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

What’s going on? 

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

Most periods until perimenopause

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

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

Perimenopause periods

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

What about ovulation in perimenopause? Is that a thing?

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

A word about abnormal bleeding

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

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

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

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

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

Be prepared, stay prepared

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

Keep count.

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

Bring supplies.

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

Practice awareness of body changes and any other symptoms.

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

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

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

Was this one my last one?

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

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

 

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

 

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

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

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

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

______________________________________

Serious sleeplessness

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

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

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

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

Menopause clothing, hormones, and sleep

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

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

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

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

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

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

Moisture wicking clothing for menopause

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

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

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

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

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

 

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

 

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

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

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

What is the coronavirus?

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

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

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

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

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

Should we be concerned about coronavirus?

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

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

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

But a lot of people are sick

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

What should I do to protect myself?

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

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

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

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

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

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

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

Who is most vulnerable?

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

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

Should I go live on an island?

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

Why do I seem to be angry all the time?

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

Just some of the reasons behind unexpected rage include: 

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

Unreasonable? Or appropriate?

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

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

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

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

Manage hormones through diet and exercise

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

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

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

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

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

Develop a meditation/gratitude/yoga practice

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

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

Find an outlet for your stress

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

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

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

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

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

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

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

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

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

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

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

Becoming a menopause goddess

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

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

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

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

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

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

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

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

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

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

The origins of the Menopause Goddess blog and book

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

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

How has being a menopause goddess changed you?

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

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

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

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

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

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

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

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

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

The five “forgotten” signs of menopause

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

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

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

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

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

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

Get some herbal help for sleeplessness and anxiety from Jovanka Ciares

Celebrating the good things about menopause

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

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

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

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

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

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

Resources to help you become a menopause goddess yourself

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

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

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

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

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

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

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

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

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

What is constipation?

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

Why do women get constipated at menopause?

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

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

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

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

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

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

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

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

You’re pooping wrong

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

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

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

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

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

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

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

Is it time to get professional help for constipation?

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

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

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

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

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

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

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

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

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

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

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