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Many of us still believe heart disease is more a problem for men than women: that just isn’t true.

Heart disease is the leading killer of women in the United States.

According to Go Red For Women, “Cardiovascular diseases and stroke cause 1 in 3 women’s deaths each year, killing approximately one woman every 80 seconds.”

Heart disease risk after menopause

Ten years or so past menopause, a woman’s risk of heart disease equals a man’s. As estrogen declines, it takes a great many protections with it, including keeping blood vessels within artery walls flexible so blood can flow freely. And, post-menopause, cholesterol levels can change: good (HDL) cholesterol may decline, while the bad stuff (LDL) starts to rise.

Not enough HDL or too much LDL can allow plaque to build up in arteries, restricting blood flow.

To better your chances of avoiding or surviving heart disease, it’s a really REALLY good idea to know your numbers and your risk.

Cholesterol: screen at home?

Several screen-at-home tests for cholesterol have hit the market in recent years; what do you need to know about DIY cholesterol testing?

Check out this article in PRiME Women for more information on at-home cholesterol screenings and other facts to protect your heart health.

While you’re at it, be sure you know the symptoms of heart attack in women (which can look very different from men’s), and when what you’re experiencing is more likely to be menopause-related, non-life-threatening heart palpitations.

The information in this article is never intended to replace advice from a medical professional. If you feel you may be experiencing heart problems, get help right away. 

Do you have experience with heart disease? How are you managing it? We’d love to hear how you’re protecting your heart, whether you’re high-risk or low. Please share in the comments below, on Gennev’s Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.

 

Gut health might seem like the latest fad, but this “fad” is for real, and it has major implications on your wellness as especially for women in midlife and menopause.

Beneficial bacteria in our gut microbiome do a whole lot of very useful things, including helping to make many nutrients in our food available for our bodies to use. They keep our intestines intact to prevent “leaky gut,” they help regulate our immune system, they impact brain health, emotions, even reproduction.

It pays to keep your microbiome well-fed and happy.

Gut health for women over 40

There’s a special pocket of gut flora called the “estrobolome” which helps metabolize estrogens in our body. When these are disrupted or die off, we are at higher risk of heart disease, osteoporosis, and obesity. In turn, estrogen in the body helps these flora “¦ flourish! Obviously, these bacteria are at greater risk when we hit perimenopause and estrogen levels begin to drop.

How to protect our gut health

Fortunately, there are ways to optimize the care and feeding of your gut biome to prevent dysbiosis, or the die-off of beneficial bacteria. Check out “Gut Check: How to Increase Beneficial Bacteria” on Prime Women for the full scoop on maintaining a healthy gut and reaping the benefits.

What do you do to protect and nourish all those helpful bacteria in your belly? Share with us in the comments below!

Check out our other articles in cooperation with Prime Women, including How to get good sleep and the effects of low-dose birth control in menopause.

 

Things your doctor wants you to know about your middle-aged body

So the fact that your body at 40 or 50 is a bit different from your body at 25 probably comes as a surprise to exactly nobody.

As bodies change with age, the way we behave in them needs to change as well. So what do your docs as and in particular, your ob/gyn as want you to know and do now that you’re 40 or more?

Board -certified ob/gyn, NAMS-certified menopause practitioner, owner of RENUvaGYN, and Gennev Director of Health Dr. Rebecca Dunsmoor-Su filled me in on all the details for the Care and Feeding of Your Over-40 Body.

The Big 3 Screens: Breast, Cervix, Colon

Once you reach middle age, your risk of certain kinds of cancer increases. So it’s important to get regular screenings, says Dr. Rebecca.

However, what constitutes “regular” differs according to your risk factors. If you’re healthy and have no family history of any of these cancers, you can screen less frequently.

Breast: mammograms every year or two through your 40s.

Colon: screenings now start at age 45, which is younger than previously recommended. You should have a colonoscopy every 10 years up through age 75. There are other, stool-based tests that you can opt for, though they need to be done more regularly: the FIT and gFOBT are annual; a stool DNA test (MT-sDNA) is every 3 years.

Cervix: Pap smear done every 1 to 5 years. Talk with your doc about your HPV status and other risk factors to determine the right interval. Even if you’re menopausal, you still need this exam.

STDs

In fact, thanks to the prevalence of erectile dysfunction meds (and other factors), the rate of STD infections is on the rise among Americans 45 or older.

Menopause does not protect against STDs; in fact, the thinning of vaginal tissue caused by a decrease in estrogen can actually make it easier to be infected as the tissue can more easily tear or abrade during intercourse. As long as you’re having sex, says Dr. Rebecca, you should be using condoms.

Pregnancy risk

Even if your periods are wonky, as long as you’re still having them, you can still get pregnant. Menopause is officially defined as a full calendar year since your last period, so until you pass your “meno-versary,” you should be using contraception.

Eating and fitness

“This is a great time to address eating and fitness habits,” Dr. Rebecca says, “because as you head into menopause, weight tends to rise a bit, naturally and fitness becomes harder to achieve.” During our busy 20s and 30s, you could get away with more, but now it’s time to focus on you and your health.

Walk half an hour or 45 minutes a day. The rule that’s “out there” is 10 minutes a day minimum, but Dr. Rebecca recommends at least 30 minutes. “A 30-minute walk can be incredibly relaxing as well as good exercise,” she says. “It’s a chance to clear your head and reduce your stress, so take advantage of all the benefits.”

As far as diet, now is the time to capitalize on the good habits you already have and slowly erode the bad ones. Some things to bear in mind:

Cholesterol, diabetes, thyroid, and blood count

Most of us understand the need to check cholesterol levels, especially if we have a personal or family history of heart disease, but a blood count can also be a useful tool for other health concerns.

Women in midlife and menopause may be at higher risk of developing diabetes, so if you have risk factors, you can include this screen in your blood work as well. If you are 45 or older and have no other risk factors or family history of diabetes, you should be screened every three years, says the American Diabetes Association.

Additionally, you should probably have your thyroid function screened every year or two, says Dr. Rebecca; again, family or personal history of thyroid disease may change the recommended frequency.

With the blood count, the doc is looking to see if you may be anemic. Some medications can reduce your absorption of iron, so it’s good to keep an eye on this. Your doc may also look at the blood work to check that you’re getting enough nutrients.

Heart disease

Unless you have a specific concern, Dr. Rebecca says you probably don’t need what’s called a “stress test” or “stress EKG” where they wire you up and put you on a treadmill to check how your heart is working. Generally this test is reserved for people who already have symptoms or history of heart disease or other risk factors such as diabetes.

What she does want you to know is that heart attacks can look very different in women and men. Women may have jaw pain, shoulder pain, nausea, excessive sweating; the crushing pain under the sternum that we classically associate with heart attack is more common in men and may not be present in women.

Also, many of us still regard heart issues as primarily affecting men. Not true: about 10 years after menopause a woman’s risk is equal that of a man’s. Heart disease is the #1 killer of all genders, so it’s important to pay attention to your heart.

Ob/gyn stuff

Incontinence: If you’re having any leaking, Kegels, Kegels, Kegels, says Dr. Rebecca. Make them an everyday part of your exercise regimen, because continence issues don’t solve themselves. In fact, don’t wait until you have a problem; any woman can and should be doing pelvic exercises to strengthen the pelvic floor. Bonus: better orgasms. However, you might want to get some guidance on how to do the exercises properly, since a too-engaged pelvic floor can also be problematic. Check out a pelvic physical therapist for great, expert advice.

Vaginal tissues: Please talk with your doc. Don’t self-diagnose, don’t self-medicate, don’t clean it with products, and really truly consult with an ob/gyn if you have concerns or questions about any product that’s advertised (or rumored) for use intra-vaginally. Just because someone’s a celebrity doesn’t mean they’re fully informed on vaginal atrophy or pelvic health.

Infections: If you’re getting frequent infections, check with your doctor. Frequent UTIs can indicate menopause; frequent yeast infections can be an early warning sign of type-2 diabetes.

Sex: Use lubes. Always, every time, says Dr. Rebecca. Make it part of the fun. Lubes can protect the tissue from the friction and reduce the risk of infection.

How to talk with your doc

Finally, Dr. Rebecca urges all women to be very direct with their doctors.

Many women feel unheard or dismissed by docs, she acknowledges, so it’s important to be as clear and upfront as you can. Let the doctor know what you’re experiencing, but if you have a specific concern, let him or her know that too. The doc may be able to explain why they don’t share that concern, or she may follow you on that path to see if it’s a factor.

Be direct, and if you don’t feel heard, you’re perfectly within your rights to find a doctor who you trust. However, Dr. Rebecca adds, just because the doctor isn’t saying what you want to hear doesn’t mean she isn’t listening.

Aging and menopause are your body’s way of saying “Take care of YOU.” You’ve likely spent a good chunk of your life caring for kids, taking care of your career, your home, friends, family, etc, and that’s great. But to age well may mean diverting some of your attention back to you, to habits and behaviors that not only keep you healthy but also give you joy.

This article has been reprinted with permission from PRiME WOMEN. 

 

Inviting people into your home

 

Having people to your home is the ultimate personal exposure.

It’s where you sleep, eat, poo, get sick, have sex, watch mindless TV.

It’s the place where you are the real you.

In the past month, more people have witnessed my basement makeshift office than ever before. It’s decorated with a retro, mother-in-law kitchen complete with an olive-colored fridge. Here’s a photo of me at my desk, no make-up, day-old hair, with our beloved 1960s beer fridge as my backdrop. (insert photo)

Before COVID-19, I made sure that my computer camera was perfectly set up at our dining table with a pleasant background of natural wood, art or stone.

How 4 weeks has changed me and my ability to present the real me! I kind of like it.

I have to wonder if this pandemic era will bring out a new level of authenticity in all of us.

I watch John Krasinski’s SGN (Some Good News) and The Tonight Show with Jimmy Fallon and I LOVE the authenticity of their homes, their hair, and their “this is me” experience.

Women everywhere are doing their best to be authentic and make the best of the situation for their families and for themselves.

Two of my favorites in the past week came from friends who got creative about Spring Break. Considering that they weren’t going anywhere, they created an experience for their families in a retro beach scene and in old-town Mexico. (insert photos with names)

We know there were likely tears and moans behind these photos from their kids or spouses. But these moms took one for the team, they got creative, and they adapted to a new normal.

What I love most is that they were bold enough to invite us into their homes with raw honesty on how they’re doing their best in uncertain times.

We’re all trying our best, but we’re also getting comfortable with less polish and more honesty. Less expectation and more understanding. Fewer apologies and more giving ourselves permission to just be and do what we feel.

Stasi Kasianchuk, Registered Dietitian Nutritionist (RDN) who leads Gennev’s HealthFix membership for telehealth-based coaching, said it best in our weekly 1:1 when she said, “The majority of my clients right now just need to be listened to. They need to know that it’s OK to give themselves permission for needing a nap or not working out or just feeling blah.”

During our weekly COVID webinar <link>, Swapna Vaidya, MD and Psychiatrist mentioned that through telehealth, her patients are “”¦ opening up more in the confines of their home.” Her young patients like to show her their toys and rooms. Women can show her their messy kitchen and the stress they’re feeling about not being able to keep up.

Digital will never replace the need for personal contact, but in this remote-everything world we’re living in, it’s presenting opportunities to be more authentic, even vulnerable.

My social feeds are blowing up with images of friends doing their best, getting vulnerable, showcasing how they’re making the most of a new normal. I love it, because women everywhere are doing their best to rise up and embrace a really tough situation.

And if there are days you don’t feel like rising up, or you fail to cheer up a sad senior graduate who won’t be walking the stage, or you feel like you’re underachieving in all parts of life, give yourself a break. You’re doing the best you can do. You’re doing all that you can do.

From my olive-fridge framed office to yours, here’s to getting comfortable with the real you and letting others see it.

Jill

I’m struggling right now. It’s the uncertainty of things that really needles me.

You can likely guess how well I’ve been sleeping. Has anyone else been having crazy dreams lately?

Community

My husband and I are embarking on a move in the next two months, but now we can’t go look at possible places. And professionally, I am concerned about the welfare of my team. Are they able to be the parents they need to be right now with all that I’m asking of them? Am I reaching out to them enough to let them know I care?

Gennev is a business as we’re an online clinic for women in menopause, and recently we added gynecology and primary care services too. We see you as “essential workers” in this crisis. In addition to your “day-job”, you’re likely the primary care giver, meal planner and online-learning specialist.

But even more, we’re a community.

We started as a community in 2016. And, it’s still the heart of our organization. Sometimes it gets overshadowed by the telehealth services and the products we offer. But it’s still our core.

There is a reason why Zoom happy hours have become so popular. People need people!

So, I’m dedicating this Friday letter to community and how you can get what you need, when you need it.

Weekly Webinars. These are new. Our healthcare team is hosting specialists to talk through meal-planning, strengthening your immune system, managing isolation and grief, etc. As long as you keep coming and asking for more, we will keep tackling new topics and offering AMAs.

Community forums. These are messaging boards for questions and answers. The cool thing is, they’re moderated by our health care team as AND as they’re safe and confidential. You can ask whatever you feel comfortable, and it won’t show up in your Facebook feed. Our latest forum has begun on COVID-19, which lists all our COVID-19 resources.

COVID-19 Resources. When it comes to women in midlife, we have our own health concerns around COVID-19. We’ve published some helpful podcasts, videos and articles”¦and we’ll keep adding to them over time.

Midlife & Menopause Solutions. This is our private Facebook group for those of you who like daily discussion in a less structured environment. We monitor who joins, so it’s safe. It’s still Facebook, but we do our best to ensure that women who rely on one another for advice are the only ones allowed in. No selling. No trools.

Instagram, Facebook (public), Twitter. These are our public channels. If you like to keep updated on happenings, tips and announcements from Gennev and the women in our community, please follow/join/like. We’ll like you back.

Menopause library. Our trusty library of long-standing, original menopause education is and always will be there. And, like all the other community resources I listed, it’s free”¦and searchable. Use it when you need it. Weekly we publish new articles, podcasts and video.

What kind of community do you need? With us, you have options.

Personally, I’m a lurker on social channels; I’m a consumer of podcast interviews and webinars (where I can multi-task), and from time to time, I like a good forum chat. I don’t need to engage, but I like to know what’s going on.

What’s missing from our approach? Human-to-human contact. You’re going to see more options for small group sessions and forum boards with the Gennev team very soon.

Isolation is real right now. And I think we’re learning that technology isn’t enough. We still need people.

I kind of love how we’re getting back to the essentials of life. It feels more inclusive to me.

If there are aspects to how we do community that you’d like to see changed or improved, email me at jill@gennev.com. Yes, that’s my personal email. Human to human.

Be well,

JIll

April is Financial Literacy Month as because who doesn’t get a jolt of reality every year when Tax Day rolls by (or over) us?

Women learning to manage money is especially important as they tend to outlive male partners and spend more years in retirement. And women generally have less to retire on (called “superannuation”), because of the pay gap between men and women, because more women than men take time out of their careers to care for children or aging parents, and because more women will take lower-paying jobs or work for employers who don’t offer retirement plans.

Money management may seem a little off-topic for a menopause site, but your financial health has direct impacts on your quality of life. We’re all about whole-woman wellness at Gennev, and you can’t be at your fabulous best if you’re stressed about your economic wellbeing.

So what can you do to prepare for your financial future? First, take a deep breath. Hold it. Little longer. Little longer”¦. There. Let it out. You can do this.

According to a 2016 Fidelity study, only 37% of women are confident in planning for retirement. But likely close to 100% of us want to be financially secure in our golden years, so let’s review four steps to get us started.

  1. Build a budget. You can’t make goals for your future until you know where you are now. How much do you really spend in a day, a month, a year? NerdWallet breaks down the popular 50/30/20 budget (50% of income to needs, 30% to wants, 20% to savings and debt repayment) to help you determine how to budget according to your priorities.
  2. Enlist an ally. Financial advisors aren’t just for those with oodles of money. But you want to be sure you find one with your best interests at heart. The Balance has seven steps to help you identify an advisor who will put your needs first. You can also check with WISER, the Women’s Institute for a Secure Retirement, for great advice on saving and investing and planning for retirement.
  3. Be your own best ally. There are some great resources out there to help you wrap your head around how, why, and when to start planning your financial future (spoiler alert: that “when” is now). DailyWorth is a terrific resource for women, so consider joining up for the info they can provide, but also check out their 10 Best Finance Books for Women.
  4. Finally: don’t sacrifice your future. Trying to decide where to put your dollars? Carrie Schwab-Pomerantz (daughter of Charles Schwab and an investment expert in her own right) advised women against doing what women often do: putting themselves last. If it comes down to your retirement or your kid’s college fund, opt to plump up the retirement kitty. Why? There are other ways to finance a college education, and aging parents without sufficient retirement savings can become a burden to their children later on.

Tackling your finances can be a daunting task as and, quite frankly, a potentially dull one. But with more of us living longer, it’s never been more important to secure our financial futures. Here’s to your long, healthy, happy life!

 

That thing you’re doing that’s “good” for you? It’s not. Stoppit.

There’s so much information out there, from so many sources, it’s difficult to know what’s true and what’s false when it comes to taking care of our health.

So”¦we talked with our awesome physical therapists, Brianna and Meagan, to find out what things women are doing in an attempt to be healthier, and why they really shouldn’t. Turns out, some very “normal” things really aren’t good for you.

#1. You don’t have to pee it if you didn’t drink it.

The problem: incontinence or urgency. One of Brianna’s clients was suffering from urgency as needing to urinate very badly and occasionally not making it to the bathroom in time. She assumed she was simply drinking too much water.

The wrong solution: intentional dehydration. To fix the problem, she pretty much stopped drinking water and other fluids while at work. The problem with doing this, says Bri, is it means the small amount of urine she is producing is much more concentrated, increasing her risk of urinary tract infections, for example.

The right solution: water. It turned out that her problem wasn’t caused by drinking too much water; she was actually drinking too little, and her bladder was constantly irritated. Bri worked with her to slowly and properly increase her fluids, ending the irritation and getting her back to walking to the bathroom instead of sprinting.

#2. Baths are for the outside.

The problem: pain during intercourse. Meagan’s client was experiencing pain during sex as well as overall vaginal irritation.

The wrong solution: douching. Meagan explained to her client that the vagina has its own balanced system to keep it clean, and that the douching was only causing more irritation. “She was doing it more out of hypervigilance. She believed she could smell something,” Meagan tells us. “I examined her, and there was nothing abnormal or to be concerned about. Douching is not something we encourage. You’re messing with the delicate balance of the vaginal tissues, and you’re risking infection both on the outside and deeper within the vagina.”

The right solution: promote and protect healthy tissue. Sometimes the issue with painful intercourse is the tissues around the vulva are thin and delicate due to too little blood flow to the area. Pelvic floor exercises, Kegels, vibration and massage helped make the vaginal tissue healthy and more durable. Once that was resolved, the client no longer felt she had unusual discharge or sloughing of tissue, the issues which had led to her deciding to douche in the first place.

Irritation can also be resolved often by simply switching to cotton underwear, using a fragrance-free detergent, using the right intimate soap, and ditching the thongs, Bri adds. PS: this applies to steam cleaning of the vagina, according to Meagan as not necessary and potentially damaging to sensitive tissue.

#3. Clenching the core as nope.

The problem: wanting six-pack abs. While there’s nothing wrong with six-pack abs, a lot of us damage our bodies in the quest to get them.

The wrong solution: over-exercising our core and pelvic muscles. We hold our stomachs in, do too many crunches, over-exert our core muscles and basically put our pelvic muscles in a state of constant spasm. This can actually cause pain, incontinence, and urgency issues. “Hold weights over your head for 30 minutes, then tell me your arms don’t hurt,” Meagan says. “It’s the same with your pelvic floor as muscles need to clench and relax in order to become stronger.”

The right solution: exercise your core properly. Learn how to exercise your abdominals properly. Consult with your doctor or a pelvic floor specialist if you’re not sure.

#4. Is it over yet?

The problem: painful intercourse. Pain during intercourse can happen for a number of reasons: vaginal dryness due to hormonal change, birth control, or medical procedures; pelvic floor issues such as spasms, etc.

The wrong solution: endure. “Too many women think painful sex is normal and they should just “˜grin and bear it’,” Bri says. “They go somewhere else mentally and just endure it, but it really ends up hurting them, hurting the relationship.”

The right solution: education, openness, and lubricants! Painful intercourse doesn’t have to be your new normal after menopause or for any other reason. “Gals feel like they should be able to have intercourse without any supplemental lubrication,” Meagan says, “and they’re ticked off that their bodies don’t make what they need. They don’t want to deal with using lube, reapplying lube”¦ The problem is they’re causing all these micro tears in that tissue, and pain, increasing risk of infection. Just use a lube!”

#4.2: Amendment to #4 as “Use the RIGHT lube!”

The problem: painful intercourse, coupled (ha ha) with a desire to use “natural” lubricants.

The wrong solution: olive oil. Olive oil has exfoliating properties, meaning it causes the skin to slough off dead cells. This is not a part of the body one should exfoliate, Meagan says; nature has already taken care of that. Bonus info: jojoba isn’t the best choice either, as it’s wax based, and the small amount of wax can build up internally.

The right solution: do your research. If you prefer to go the natural route, there are choices that may well work for you. Just be sure you read research from credible sources, test any substance on another body part first, start small to test for a reaction, and report any unexpected or unwanted reactions to your doctor right away.

[Choose a lube that fits your needs and your lifestyle. Check out this lubricant info sheet from A Woman’s Touch]

#5: Hovering is for helicopters and hummingbirds

The problem: yucky public toilets. Few of us are completely comfortable trusting our bare bottoms to a public toilet seat or outhouse, no matter how picturesque. We’ve all heard horror stories of people picking up strange diseases or at least sitting in something suspiciously moist.

The wrong solution: hover. To keep our tushies safe, we hover above the seat when it’s time to urinate. Not a good idea, say our PTs. “If you’re not in a relaxed, sitting posture or full-on squat position, the muscles through your hips and pelvis aren’t relaxing. This means you’re having to generate extra abdominal pressure to push and force the pee out,” says Meagan. “This recruits the wrong muscles and totally messes with how normal peeing should happen.”

WHO KNEW???

The right solution: sit, Ubu, sit. Layers of TP on the rim. Know that if you don’t have an open sore at a contact point, the chances of contracting anything are pretty minimal. You’ll be fine. Or you can squirt some hand sanitizer on a piece of TP and give the seat a quick cleanse (but wait for the surface to dry to avoid skin irritation). Just don’t hover.

#6: Sunning it where the sun don’t shine.

The problem: lack of Vitamin D in the nether region. Apparently women feel their vaginas aren’t getting enough Vitamin D.

The wrong solution: exposing one’s genitals to sunlight or tanning beds. The real problem? THIS ISN’T A PROBLEM. This part of the body is hidden and shaded for a reason as nature intended it that way. A burn in that area can be extremely painful and damaging to very delicate tissue over the long term.

The right solution: get enough Vitamin D in the usual ways. Exposing the skin to sunlight is good, when done carefully to avoid damage. But maybe bare only the skin that nature and culture have deemed reasonable. ?

 

Science is starting to uncover the many ways our gut flora affect our health. While many of us still believe the beneficial bacteria is good for digestion (and it is), it does a whole lot more. 

Dr. Anna Garrett chats about the “Gut-Brain Axis”

In this podcast, metabolic surgeon and gut expert Dr. Erika La Vella talks with Gennev’s Director of Health Coaching Stasi Kasianchuk about the bi-directional relationship between your gut and your brain.

The “Gut-Brain Axis” affects your perception, cognition, your nervous system, your mood, pretty much everything. Given that, and how cattywampus everything can be during menopause anyway, doesn’t it make sense to be sure your gut is getting exactly what it needs?

This is why we bang on about nutrition here at Gennev “” it’s so important to feed yourself well, because it literally affects everything in your body. Good fiber helps the beneficial flora in your gut to thrive so it continues pulling nutrition from the food you eat and sending it where it does the most good. 

Like virtually everything in nature, diversity is best, so eat lots and lots of veggies: 30 different kinds a week, according to Dr. La Vella. The more diverse your vegetable selection, full of vibrant colors and flavors, the better. Because different micronutrients have different functions in the body, “eating the rainbow” really does provide the most comprehensive care.

And if you can’t get them all, supplementation can help fill the gaps, so consider Gennev’s Vitality pack. Thirty veggies is a lot, and if that means you’re bumping up your fiber, you’ll want to take it slowly. While Dr. La Vella assures us that gas is normal and means your gut flora is doing their job, ramping up fiber too fast can cause more than ordinary gas!

 

TRANSCRIPT TO FOLLOW

Are you taking care of your microbiome? What do you do to keep those good bacteria healthy and thriving? We’d love for you to share your tips for eating the rainbow, getting good probiotics, protecting beneficial gut flora, etc., so please join the conversation on the Gennev Community forums!

 

The red cup is back at Starbucks, and you know what that means: the holidays are just around the corner.

Finding gifts for everyone on your list can be enough to put even the most seasoned shopaholic in a bad mood.

And if you traditionally use Thanksgiving as your cue to start shopping, we have bad news: there are only 26 shopping days between Thanksgiving and Christmas in 2019.

And Hanukkah starts on December 22 this year.

Don’t: stress

Hooray! “˜Tis the season for an extra layer of emotion slathered over everything. It may be your first December without a loved one or the annual reminder of rough times with your ex. Family expectations are high, and your mother-in-law still hasn’t forgiven you for marrying her favorite child.Staying relaxed is easier said than done, but stress is both no fun and a big trigger for hot flashes.

If listening to music calms you, bring your headphones while you shop. Take a break for self-care: get a massage, soak in the tub, or go for a long walk before you start to feel burnout.

Doctor’s orders.

We’re hoping this list helps, as well.

Do: prioritize Cyber Monday over Black Friday

Who really wants to wake up at 4 a.m. to beat the Black Friday (November 29) crowds? Cyber Monday (December 2) has become a solid alternative. You’ll get great deals, save gas, and you can do it in your PJs with a cup of (decaf) coffee.

And you don’t need to wait: many retailers already have their Black Friday discounts listed online. For example, Cnet has curated a few ideas from favorite retailers like Walmart and Amazon, and TechRadar has predictions about upcoming Cyber Monday bargains.

Fear not, procrastinators: even if you snooze on the post-Thanksgiving deals, you can take advantage of Free Shipping Day on December 14.

Do: plan out your brick-and-mortar shopping routes

Online shopping makes it easier than ever to cross off everyone on your holiday list without leaving the house.

But when your partner or kids have prying eyes, you want a one-of-a-kind gift that can only be bought in a brick-and-mortar location, or you’re desperate for a new outfit to wear to the office holiday party, you need to put on your big girl pants and get out there.

Whether you’re hitting the mall or the mom-and-pop shops on Main Street on Small Business Saturday (November 30), write out what you want from each store and in which order to visit them to save time, gas, and stress.

Don’t: forget your comfortable shoes and your FitBit!

Hitting the mall can be a great way to get in your steps. Exercise during menopause is important for bone health, weight management, and to lower your risk of breast cancer. Make shopping work to your advantage!

Take the stairs or walk up the escalator. To really get a workout when shopping during the day, park as far from the entrance as you can, or on the opposite end of the side that you’re planning on visiting.

But”¦

Do: be safe

Safety first, always! Law enforcement professionals remind you to park in well-lit areas, keep your hands free and keys and cellphone easily accessible, roll your windows all the way up when parking, store gifts and bags in your trunk, and always lock your car.

Cybersecurity experts remind you to use trusted websites, make sure the site is SSL encrypted (you’ll know because the URL will start with “˜https’ and you’ll see a locked padlock in the address bar), and other best practices when shopping online.

Don’t: shop hungry, and Do: bring water and healthy snacks

Who can resist the alluring smell of Cinnabon? When that cinnamon-sugary aroma wafts across the food court, it can be hard to resist, especially when you’re stressed. Unfortunately, sugar, caffeine, and other mall delights can lead to hot flashes and midlife weight gain.

Stash a few snacks filled with fiber, protein, vitamins, and healthy fats in your bag: nuts, apple slices, dried fruit, hardboiled eggs, a cup of yogurt or cottage cheese, string cheese, or single-serve hummus and carrots are all portable and healthy.

You’ll feel better and make better shopping decisions.

Don’t forget your water bottle!

Thirst has a funny way of sometimes coming across as hunger, and water is good for your brain, body, and holiday spirit. It’s extra important that you stay hydrated in perimenopause, menopause, and beyond.

Do: play sleuth on social media

You can always count on Santa to let you know what the wee ones want. Teenagers and adults, not so much.

Time to do some sleuthing. Your friends and family members’ “Likes” on Facebook or “Hearts” on Instagram can give you insight into what they would like to find under the tree.

We promise this doesn’t make you a stalker. Well, maybe a little bit, but finding a thoughtful, inspired gift that the recipient will cherish makes it cute, not creepy.

Don’t: gift a DNA testing kit (unless you’re positive the recipient wants one)

Many of us in midlife find ourselves wanting to get in touch with our roots or explore our family tree. DNA tests have become a popular gift in recent years, and the most popular services offer deals around the holidays.

These tests can provide amazing genealogic and health insights but may be problematic as unsolicited gifts.

Do: buy gifts that support health

Perhaps your sister is trying to shed a few post-menopausal pounds, or your best friend is getting hit hard by hot flashes. Maybe makeup and nail polish are easy stocking stuffers for your daughter or niece.

We’ve written about how makeup, nail polish, and other cosmetics can be a bummer for breasts. Pick products that are free of parabens, phthalates, phenols, and other potential toxins.

Use this as an opportunity to help your friends swap out bad for better, such as alternatives to plastic (which may be full of cancer-causing chemicals). [A few ideas for reusable gifts]

And browse our gift ideas for women in midlife and menopause or our menopause wish list; from float sessions to cooking classes to smart vibrators (oh my), we’ve got you (and your sister, and your girlfriends) covered.

Don’t: buy gifts at all

What do you get for the person who has everything? Sometimes the answer is nothing””nothing besides memories and experiences.

Sure, you can’t give everyone on your list a vacation or spa day, but there are plenty of experiential options for all budgets, for kids, and for the entire family.

You could also give cold, hard cash, but what’s better than getting $5? Giving $5 to charity. Research shows that the pleasure of receiving money fades, while philanthropic contributions leave a warm and lasting glow. Charity Navigator can help you find reputable non-profits and causes that will resonate with your friends and loved ones’ areas of interest.

And you can’t go wrong with a homemade gift from the heart–even if you aren’t crafty enough to upcycle an apron, you can have a lot of fun putting together a DIY bubble bath set.

Do: get a head start on next year’s shopping

You can score seasonal cheer at a deeply discounted rate after Christmas… while you buy yourself what you really wanted from Santa. If you have the space, stock up on holiday decor and evergreen gifts to save your future self some of the stress you’ve just vanquished.

Don’t: be afraid to say “œno”

While there is some truth behind the idea of retail therapy, don’t shop if you know you aren’t in the right headspace for it. The holidays can be hard, and your mental and physical health needs to come first.

While you’re at it, feel empowered to skip the office holiday party. Unless you found that perfect outfit on your shopping adventures.

If you’ve mastered the art of stress-free holiday shopping, help a buddy out and share it with us in our community forums!

 

Does using birth control delay menopause? Does it increase the risk of breast cancer or heart disease in menopausal or perimenopausal women? After many years on the Pill, how will I know it’s safe to go off it?

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

For answers to our birth-control-and-menopause questions, we turned to Dr. Sherry Ross, award-winning OBGYN and author of the book >She-ology, a look into women’s health beyond the doctor’s office.

talk with Dr Sherry

Dr. Sherry Ross

For those in perimenopause, should we stop taking the Pill?

“First,” Dr. Sherry told us, “be sure you understand this: until you’ve had no periods for a year, you can still get pregnant.

“Part of the confusion is around definitions: The true definition of “˜menopause’ is when you don’t have a period for one full year, but many women suffer from disruptive symptoms for a few years leading up to full cessation of periods””that’s called “˜perimenopause.’ As I said, until you are officially in menopause””meaning no periods for a full year””you can potentially get pregnant, so be sure to use some form of contraception. If you are single and dating while in menopause, you may not have to worry about getting pregnant, but you do have to protect yourself against sexually transmitted infections, so make sure your partner wears a condom.”

So, re: birth control, keep on keeping on until one year with no periods, and re: condoms, always always always outside of committed, monogamous relationships. Check.

Do birth control pills or using a hormonal IUD help with perimenopause?

” Oral contraceptives and an IUD like Mirenacan mask some of the symptoms of perimenopause and menopause,” Dr. Sherry told us. “That’s one of the benefits. Women on the Pill may have fewer, less-intense hot flashes, more “˜normal’ periods when other women are all over the menstrual map, and they might have more modulated emotional swings, which can be a huge benefit in their personal and professional lives. That’s why many doctors””myself included””prescribe low-estrogen birth control pills women having a rough menopause and don’t smoke or to make the transition into menopause easier.”

Does birth control delay menopause?

Short answer: No. Here’s why:

“Menopause is a time when your ovaries stop producing estrogen and your female hormone reserves are depleted. Known factors that can affect what age you enter menopause include your genetic predisposition, knowing when your mom went through the change, chromosomal abnormalities such as Turner Syndrome, very thin or obese women, long smoking history, needing chemotherapy or radiation therapy, those with autoimmune diseases and epilepsy.

“It’s clear that short- and long-term stress, such as extreme weight loss and weight gain, can offset your hormones, causing irregular periods. The extent this type of significant stress has on your endocrine system, causing hormone adrenal depletion and possibly affecting menopause, is not as clear.

“There is an association between extreme and long-standing exercising causing weight loss which can offset your hormones and cause early menopause. Excessive exercising creates a hormonal imbalance, causing irregular ovulations. It’s less likely short-term exercising mixed in with months of not exercising could cause a cascade of events leading to an early hormonal depletion.

“So there are some things that can bring on early menopause, but being on the birth control pill does not affect when you begin menopause. The Pill can mask the symptoms of menopause and, as I said, many women depend on it to help ease the transition into menopause.”

If we’ve been taking oral contraceptives for 20+ years, how will we know if perimenopause has started?

“The best way to know if you are in menopause while taking the birth control pill is to check your hormonal levels at the end of the pill-free week. Some women may even notice hot flashes during the pill-free/placebo week since they are not taking estrogen that’s normally in the active pills. Your doctor can conduct a simple blood menopause test that determines if your follicle-stimulating hormone level (FSH) has reached menopausal levels.”

If you need a trusted opinion, determine if medication is right for you, and possible prescription support. Book an appointment with one our Gennev menopause-certified gynecologist doctors here.

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Are there health risks to continuing to take the Pill?

Says Dr. Sherry: “As long as you’re not a smoker over the age of 35, and you don’t have any contraindications of being on the Pill (high blood pressure, a history of blood clots, liver disease, breast or uterine cancer, strokes or migraine headaches), there are no health risks to taking the Pill during the first couple of years of menopause. The birth control pill stabilizes your hormones and keeps you physically and mentally balanced.”

And, according to Dr. Sherry, there’s even more good news.

Wait. There’s good news? About menopause?

“There’s evidence that taking birth control pills reduces the risk the risk of ovarian and uterine cancers. It may also help with rheumatoid arthritis.”

OK, that’s all terrific, but there have to be drawbacks.

What are the risks?

Said Dr. Sherry: “As I said, hormonal birth control is not for women who smoke, particularly if they’re 35 or older. Birth control pills may increase your risk of strokes and blood clots, and that risk is exponentially higher for smokers over 35. Yet another reason to quit!”

We completely agree. Anything else?

“Studies are still being conducted into hormonal birth control and breast cancer. But unless a woman has a history of breast cancer or other factors that make her high risk, she should feel comfortable taking low-dose birth control pills to control perimenopausal or menopausal symptoms,” Dr. Sherry told us.

“The best first step is to have a frank and open discussion with your menopause doctor. And don’t be embarrassed or shy””I can tell you from personal experience that almost nothing shocks a doc! Menopause is a normal, natural process and part of life, though women may experience it differently. Your doctor is here to help you understand what’s happening and alleviate symptoms that are interfering with your quality of life. There are solutions. You can feel better. And that’s the best news of all.”

Sheryl A. Ross, M.D., “Dr. Sherry,” is an award-winning OBGYN, author, entrepreneur and women’s health expert. The Hollywood Reporter named her as one of the best doctors in Los Angeles, Castle Connolly named her as a Top Doctor in the specialty of Obstetrics & Gynecology, and she was selected as a 2017 Southern California Super Doctor. Dr. Sherry continues the conversation of women’s health and wellness in her monthly newsletters and on DrSherry.com.  

Dr. Sherry Ross blogs for Huffington Post, Maria Shriver, Greatist, SheKnows, HelloFlo, Today Show, All Things Menopause, and Gurl, and we are thrilled to welcome her to the Gennev community!

We can help you get your questions answered about menopause

 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.

Gout? Isn’t that something men suffer from? Do woman get gout? 

It is. And more and more women are getting diagnosed with gout as well.

In the last 20 years, cases of women with gout have more than doubled. According to the Arthritis Foundation, “…Two million women as and 6 million men as in the U.S. have this inflammatory form of arthritis that causes joint swelling and telltale pain at the base of the big toe.”

 

What is gout?

Gout is, as noted, a form of arthritis. Gout occurs when high levels of uric acid increase in the blood and form needle-shaped urate crystals in the joints or a joint’s surrounding tissue.

 

How does uric acid get produced? 

When your body breaks down purines “” naturally-occurring substances in your body and in some foods “” uric acid is produced. The normal function includes this uric acid being dissolved in the blood, transferring to the kidneys, and then getting eliminated through your urine.

The body could be out of balance and develop gout by producing too much uric acid, or by excreting too little of it in the urine.

 

What does gout feel like?

A flare-up can swell the joints making it painful to walk or move, and can increase stress and frustration levels, which may then exacerbate other menopause symptoms like insomnia, night sweats, hot flashes, etc. Definitely not the direction to head in if you can possibly avoid it.

Joints may also swell, radiate heat, and flush red in color as well. A gout flare-up may also feel as though a joint is on “on fire,” like a joint-specific, localized hot flash of sorts.

If left untreated, gout pain may worsen and joint damage could ensue. Best to get it checked.

Is gout hereditary? If your family history includes gout, The Mayo Clinic notes you’re more likely to develop this disease. 

In men, gout is often described as a sudden, severe attack, usually in the night, with intense pain in one of the joints, commonly the big toe. But this isn’t always the case with women.

In women, it can be a sudden attack, but it may also develop more slowly over time and in multiple joints. Brian F. Mandell, MD, a rheumatologist at the Cleveland Clinic in Ohio and board member of The Gout & Uric Acid Education Society, shares:

“In women, it seems there is a greater prevalence of the initial episode of gout being in multiple joints. It may not always be the typical swollen great toe. In the hands, this is often misdiagnosed as inflammatory osteoarthritis when it may actually be attacks of gout.”

Women frequently experience gout in the ends of their fingers, wrists, knees, and toes and are more prone to gout after menopause.

 

Ready to focus on your health in midlife and menopause? Work with a Gennev Menopause Health Coach.

 

Gout in women. What’s estrogen got to do with gout?

Estrogen in premenopausal women and those on estrogen replacement therapy helps to flush the uric acid out of the system, according to the Arthritis Foundation. After menopause, uric acid levels tend to rise. 

If a person with a uterus develops gout before going through menopause, it’s usually due to other conditions such as having a history of taking diuretics, high blood pressure, diabetes, kidney disease, and obesity.

 

What about nutrition? Can diet manage gout and minimize flare-ups?

When it comes to diet, gout, and overall health, definitely get into your doctor’s office to talk about your health specifically. Especially if you have other health conditions.

Foods to avoid, limit, or moderate regarding gout

Some of the foods recommended to moderate or minimize may have health benefits that outweigh the risk for gout (like the omega 3s in sardines may be more important to brain health than sardines’ risk of gout). Knowing your levels, getting screenings, and having regular conversations about your health with your doctor or nutritionist will be your best way forward.

 

On alcohol and gout

The topic offoods to avoid in menopause like alcohol comes up regularly in our content since it can spike the intensity and frequency of symptoms such as”¦ hot flashes, headaches or migraines, and mood swings (well, rage, really). It’s especially important to note for those prone to developing or who are actively managing gout.

Researchers out of the Boston University School of Medicine examined data on 2,476 female and 1,951 male participants in the ongoing Framingham Heart Study, which has followed residents of Framingham, Massachusetts, since the late 1940s. Over an average of three decades of follow-up, 304 cases of gout were reported, with one-third of those cases occurring in women.

Further reporting from the Framingham Heart Study shared that:

“Drinking 7 or more ounces of spirits a week — roughly five drinks — doubled the gout risk in men and tripled it in women. Heavy beer drinking was associated with a doubling of risk among men and a sevenfold increase in risk among women.” [emphasis ours]

 

Foods to include

We recommend weight loss,if you need it, for healthy menopause weight management. “Being overweight increases the risk of developing gout, and losing weight lowers the risk of it. Research suggests that reducing the number of calories and losing weight “” even without a purine-restricted diet “” lower uric acid levels and reduce the number of gout attacks. Losing weight also lessens the overall stress on joints.”

Recommended eats & drinks:

Talk with your doctor, or one of our doctors, and your menopause health coach, about specific concerns about gout, joint pain, and other forms of arthritis. Talk with them sooner rather than later if obesity, high blood pressure, diabetes figures into your current state of health and well being.

Your health, mobility, and well being are worth it.

 

Join the Gennev Community Forums to weigh in on this topic, ask questions, and understand more about menopause with others on the path.

 

I’ve been thinking about community a lot lately.

How much do we need it? As women, most all of us thrive on connection.

And when we’re going through life’s transitions, connecting with others going through the same thing kind of makes it more palatable.

Personally, I’ve got my community of women to whom I go to with the most personal of things. I’ve got a very small handful of friends (like 3-5 max) that I share life’s ups and downs. Things about my marriage, my family, even shameful mistakes that I’ve made. I’ve learned that I feel better when I share with others that I trust”¦even if there is no amount of advice that can help me recover”¦quickly.

But how about going through menopause? Is it something that you want to share with others?

 

 

For menopause and health topics, I broaden my net. I’m willing to share my experiences with other women of all levels of closeness to me, because women’s health is a “sisterhood” type of topic that creates a common bond, even when a personal relationship doesn’t exist.

Menopause levels the playing field. We’re all going to go through it.

I commonly find that my role with Gennev makes me a safe place for women to share all types of gnarly health symptoms including mood swings, painful sex, vaginal dryness, and the all-too-common insomnia that especially nails women in the workplace.

One woman even went so far to call me “the vagina whisperer.”

I’m struggling to land on what our Gennev community needs to be as we grow beyond the thousands of women we serve today. Is it a support group or health Q&A forum?

Do you find comfort in sharing/listening in a closed Facebook group, like the one Gennev hosts called Midlife & Menopause Solutions?

Or would you rather browse a general menopause FAQ forum to seek out questions and answers from health practitioners and like-minded women?

And is a menopause community something you want to bring your friends into, or something that you want to do anonymously?

I want to hear what you want your community to be. Is it simply a place to connect with like-minded women? Or a place to get answers and solutions for feeling better in your body?

Email me at jill@gennev.com

Have a great weekend!

JIll