If you’ve ever found yourself wondering how you can support your cognitive function, you’re not alone. Maintaining our cognitive health as we age is key to quality of life, and considering that around the globe, 55 million people are living with Alzheimer’s or other forms of dementia, this topic hits home for many. In honor of Alzheimer’s and Brain Awareness month, Gennev’s Registered Dietitians share their 10 tips to help boost your brain health.
One of the most vital nutrients for our brain’s health is omega 3 fatty acids, as it may slow age-related mental decline and support prevention of Alzheimer’s disease. This healthy fat source cannot be made in the body and must come from dietary sources. If you enjoy seafood, aim for two 3 oz. servings of cold-water fish per week to meet your omega 3 needs. Fish can be easy to prepare from scratch – try this salmon veggie sheet pan recipe. You can also stock up on quality canned salmon or tuna (Wild Planet and Safe Catch are recommended brands due to their high quality and sustainability standards) to pair with veggies and crackers for a quick and easy lunch. And of course, supplementation is an option. Gennev’s Glow supplement is an easy way to get in your omega 3’s throughout the week.
If you don’t eat seafood and supplements aren’t for you, aim for plant-based sources such as ground flax, chia seeds or walnuts on a regular basis. These can be added to oatmeal, smoothies or sprinkled on salads.
Building and maintaining strong social bonds is supportive for our overall brain health. And, studies have shown that loneliness may increase the risk of cognitive decline in older adults. Those who stay engaged with others appear to exercise their neural pathways in a way that protects them against cognitive decline with aging. Staying socially connected can look different for everyone – it may involve close friendships, romantic relationships, or being part of a group with a shared interest. Looking to increase your social connectedness? Consider becoming part of a walking group, starting a weekly get-together at a local coffee shop with friends, or joining a book club.
Prioritizing sleep is key for brain health, and most adults need between 7 to 8 hours a night to maintain optimal cognitive function. This can be challenging if sleep is a struggle due to stress, hormonal changes or other factors. Gennev’s Women’s Guide to a Good Night’s Sleep in Menopause offers insight on how you can find solutions for optimizing sleep despite hormonal changes.
A core principle of the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay diet) is to include vegetables throughout the day. This diet was designed to reduce the risk of dementia and loss of brain function as you age. Get started by challenging yourself to make ½ of your plate veggies that you enjoy at mealtime.
Individuals who possess an optimistic mindset, positive attitude, life satisfaction and increased purpose in life are at a reduced risk of developing dementia. Keeping a mindfulness practice such gratitude journaling can support boosting optimism and increase sense of well-being. This can be practiced by writing down a few things you are grateful for each day. Other ideas to boost optimism include positive self-talk, spending time with positive people (positivity is contagious!), and making sure to laugh on a regular basis.
Research shows that exercise increases our levels of BDNF (Brain Derived Neurotropic Factor), the compound that promotes the formation of new neural networks. Focus on what exercise you enjoy most, and don’t be afraid to start small. Walking, biking and swimming are all great choices. Get creative and go for a walk as you explore a new part of a local town or city you live in or visit a new park or hiking trail to include the added benefit of spending time in nature, which also is supportive of our cognitive function. Other ideas include trying a rock-climbing gym or even going snow shoeing if you live in a cold environment. Any type of increased movement is helpful- this could even be as simple as taking the stairs at work, or parking further away at the grocery store.
Even mild dehydration can affect our cognitive function. In her book Brain Food, neuroscientist Dr. Lisa Mosconi states that even mild dehydration can trigger cognitive issues such as brain fog. Water helps to increase blood flow to the brain, and therefore supports cognition. We recommend consuming half your body weight in ounces of water each day. And if you are sweating often from hot flashes, exercise, or being in a warm climate, you may need even more water.
Think of cognitively stimulating activities as exercise for the brain. When we keep our brain stimulated on a regular basis, we are supporting a reduced risk of cognitive impairment as we age. Research shows that board games, crossword puzzles or brain games online, when practiced consistently, are supportive for optimizing cognitive function. Staying cognitively stimulated doesn’t have to be limited to games. It can also include reading, learning new things, painting, drawing or playing musical instruments -just to name a few.
These days, so many of us experience a high level of stress on a regular basis. Menopause itself can be stressful! Stressors will happen, but it’s the chronic, long-term stress that can have a major impact on cognition. Evaluate ways to minimize your daily stressors as much as possible. This will look different for everyone, as each person’s situation is unique. Ideas include limiting phone use and screen time, practicing self-care activities such as stretching before bed, getting a massage, pursuing a hobby or reading a good book, and creating boundaries- learn to say “no’ as appropriate. If this is a significant struggle for you, seek help from your physician, or a mental health provider for additional support.
Choline is an essential nutrient that is crucial for memory formation. Its deficiency is associated with memory deficit, making it important to prioritize this nutrient. Research has found that those with adequate choline intake have greater performance on cognitive tests assessing sensory motor speed, perceptual speed, executive function and global cognition. Sources of choline include eggs, seafood, liver, and certain vegetables such as broccoli and Brussels sprouts. Boost your choline in your daily meals by enjoying an egg scramble, include roasted broccoli with your dinner meal, or enjoy salmon on a salad at lunch time.
A healthy lifestyle is key to supporting your body and mind as you age. If you need guidance to optimize your daily habits and support brain health, visit with a Gennev Registered Dietitian to create your personalized wellness plan.
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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.
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Whether you were an athlete or a not-the-workout type when you were younger, now appears to be the most crucial time of your life to work out. Exercise may be one of your best defenses against unwelcome changes that occur with menopause, including weight gain and belly fat. But exercise’s most significant impact isn’t a slimmer waistline or firmer arms. In fact, one of exercise’s greatest benefits may go unnoticed as the positive impact it has on your metabolic health.
“Often people think of exercise as only a way to burn calories for weight loss,” says Stasi Kasianchuk, a registered dietitian, exercise physiologist, and Gennev’s director of lifestyle care. “Then they give up on exercise if the number on the scale doesn’t meet expectations. They don’t realize the physiological benefits movement provides to the body even without the desired amount of weight loss.”
Exercise improves cell metabolism, blood vessel health, blood sugar control, and brain health, but you can’t easily see or measure these changes. Despite that, they offer long-term benefits for metabolic health, which can translate to better quality of life, fewer menopausal symptoms, and less weight gain.
Metabolic health is the ability of the body to process and utilize energy by metabolizing macronutrients, such as carbohydrates, protein, and fat, and micronutrients, such as vitamins and minerals. “Essentially, the mitochondria, the powerhouses of every cell in the body, are working efficiently and effectively,” says Kasianchuk. When you’re metabolically healthy, your risk of developing chronic disease, such as heart disease, diabetes, and stroke decreases.
There are five markers of optimal metabolic health for women and men:
If your levels for any of these markers fall outside the listed range, we encourage you to take steps to improve your metabolic health. (About 88 percent of American adults have at least one of these risk factors.) Left untreated, things are likely to get worse as you transition into post-menopause. If your numbers are off for three or more of these markers, you have what’s known as metabolic syndrome. Research has found that metabolic syndrome increases a woman’s risk of heart disease six-fold and their risk of diabetes five-fold. It may even increase the risk of breast cancer.
Women who had gestational diabetes or preeclampsia when they were pregnant are also at a higher risk of metabolic problems as they get older. But these problems aren’t inevitable. Exercise and other lifestyle changes can protect your metabolic health.
Menopause and the accompanying decline in estrogen appear to accelerate changes that contribute to poorer metabolic health and an increased risk of metabolic syndrome, heart disease, diabetes, dementia, and even cancer. Increases in belly fat, blood sugar, and cholesterol are common during menopause, along with declines in muscle mass, and affect metabolic health.
Typically, your metabolism is highly efficient. Your body breaks down carbohydrates into glucose (a simple sugar), a primary energy source for your body. In response to glucose in the bloodstream, your pancreas releases insulin, a hormone that signals cells to absorb the glucose. Mitochondria, the powerhouses of cells, process some of the glucose into energy that cells can use. Muscles and the liver store excess glucose as glycogen for later use. Even fat cells can store glucose as energy once it’s converted into triglycerides, a type of fat. When your body needs energy, whether to fuel a workout, your brain and other organs, or body processes like breathing or fighting an infection, it taps into these resources for glucose.
But when estrogen declines during menopause, this process is impacted. The body becomes less sensitive to insulin, so cells aren’t absorbing as much glucose from the bloodstream. In addition, muscle loss accelerates as you age, and the less muscle you have, the less assistance muscle cells can offer to remove glucose from the bloodstream. Higher blood glucose levels place more stress on the pancreas to secrete more insulin. Chronically high levels can lead to diabetes, requiring medications to bring glucose levels back within a normal range.
Estrogen’s anti-inflammatory properties also protect women from heart disease. When it decreases, LDL cholesterol can rise, HDL cholesterol can drop, and blood vessels become more rigid, setting the stage for plaque formation, heart disease, and metabolic dysfunction. The changes in blood vessels may also contribute to rises in blood pressure, another marker of metabolic health. The increase in weight and particularly belly fat that often occurs during menopause is yet another impactor of metabolic health.
The good news: Being physically active can minimize or even counteract some of these negative changes.
Physical activity has a positive effect on metabolic health by mitigating some of the effects of menopause and directly impacting some of the markers of metabolic health.Regular exercise improves insulin sensitivity, so your body can manage glucose more effectively. It reduces bad LDL cholesterol and triglycerides and raises good HDL cholesterol, reducing your heart disease and stroke risk. Combined with a healthy diet, exercise can also help you lose weight or prevent weight gain. But even if the number on the scale isn’t budging, you improve your metabolic health every time you get up and move.
Exercise also improves your body composition. Resistance training, in particular, is beneficial for preserving and building muscle mass. And as estrogen is waning, resistance training may provide an estrogen-mimicking effect to muscle cells to support metabolic health. All types of exercise help burn fat, especially the deep belly fat that contributes to many chronic diseases.
Being active also has a ripple effect on other behaviors that affect metabolic health. Research shows that women who are more active during menopause eat healthier. Exercise has also been found to improve sleep, which is vital to metabolic health.
“Any movement on a regular basis supports metabolic health,” says Kasianchuk. “That said, during the menopause transition, resistance training and high-intensity interval training offer more bang for the buck when it comes to metabolic health.”
Resistance or strength training counteracts the muscle loss that started in your 30s and accelerates during menopause. Declines in muscle cause metabolism to slow, which encourages weight gain. Resistance training can slow the loss and even rebuild muscle, which can help prevent weight gain and make weight loss easier. Muscle is also integral in utilizing glucose. Strength training using dumbbells, exercise machines, elastic resistance bands, or your own body weight provides resistance to challenge muscles so their mass increases. The more muscle cells you have, the better your body will be at managing blood glucose to improve your metabolic health and reduce your risk of diabetes.
High-intensity interval training involves alternating short bouts of vigorous aerobic exercise with recovery bouts of low- to moderate-intensity aerobic exercise. So instead of walking, running, riding a bike, or swimming at the same steady pace for your entire workout, you speed up and slow down. The repeated faster, higher intensity bouts raise your heart rate higher, boosting cardio fitness faster than one-speed workouts. It also trains your body to more effectively utilize fuel to produce energy and improves your body’s ability to regulate glucose, thus enhancing your metabolic health.
You don’t have to spend hours at the gym or follow complicated routines to reap the benefits of exercise in midlife. “Simplicity and enjoyment within the movement you choose is key to building consistency,” says Kasianchuk. Here’s how to maximize exercise’s benefits.
Aim for 150 minutes of aerobic exercise a week. That’s 30 minutes five days a week or 21.5 minutes a day. And you can break it up any way you want during the day. For example, do 10 minutes first thing in the morning, another 10 at lunchtime, and 10 more after dinner. It all adds up and counts. Walking is an easy way to start exercising, and Gennev’s free walking programs can help you stick with it.
Do intervals on two or three days. Instead of doing steady-paced cardio every time you exercise, make some of those workouts intervals by speeding up and slowing down instead of maintaining one speed. This is part of the 150 minutes of aerobic exercise that you’re aiming to do. A simple way to start interval training is with 30-second speed or high-intensity intervals and 60-second slower, recovery intervals. Since interval workouts are higher intensity, you should do this type of workout on nonconsecutive days to give your body time to recover. You can still do moderate-intensity, steady pace exercise in between.
Add one, two, or three days of strength training. Aim to challenge the major muscles in your body. A single set of eight to 12 reps is enough to see improvements as long as you’re using a weight or resistance that makes your last few reps difficult to complete. Plan your strength workouts on nonconsecutive days to allow your muscles time to recover.
“You don’t have to do it perfectly,” says Kasianchuk. “It’s more important to just start. Do what you can and find what movement brings you joy. Any movement is better than none at all.””¯
When you make some key lifestyle choices in menopause, it can have a lasting effect on your health as well as help to relieve symptoms. Gennev’s virtual menopause clinic provides access to experts in menopause lifestyle change management. Our dietitians will help you optimize your health through evidence-based nutrition, fitness and mindfulness practices. Schedule a one-on-one virtual visit to get started with your personalized wellness plan.
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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.
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A smoothie is often a well-intended way to consume something healthy. It can be a perfect opportunity to eat more fruits and vegetables (something we all know we need), add some protein and have a “balanced” meal or snack all in one cup. Sipping a nutritionally balanced smoothie allows for an on-the-go, convenient way to eat in today’s busy world.
What makes a smoothie “healthy”? Smoothies can include anything and everything from fresh fruit, berries, seeds, nuts, powders, elixirs, milks and even ice cream. It can be confusing to sort through all these ingredient options and to understand what is nutritionally optimal, so we broke it down for you. Read on to learn how to build a healthy smoothie.
Gennev Dietitians teach our patients about eating balanced meals that align with our Menopause Healthy Plate method. This means most meals are composed of healthy unsaturated fats, lean or plant-based protein, and fiber-rich carbohydrates. When a smoothie contains all three (fat, protein and carbs), it will satiate the appetite (fill you up), support healthy blood sugar levels and provide other nutritional perks such as antioxidants, naturally anti-inflammatory foods, and fiber for good digestion. Our approach is that nutritional needs can be met with whole foods as opposed to relying on processed powders, added “boosts” or other mixes.
The following are our go-to foods that fit the building blocks of a healthy whole foods smoothie:
*Remember you can swap out different protein/fat/carb options and tweak these recipes to your liking!
Recipes created by: Monika Jacobson, RDN
Protein: ¾ cup plain, unsweetened Greek yogurt
Fat: 1 Tablespoon almond butter + 1 teaspoon unsweetened, shredded coconut (optional)
Fiber-rich carbs: ½ small banana + ½ cup frozen mango chunks + 1 cup spinach
Protein: ¾ cup plain, unsweetened kefir
Fat: 3 tablespoons avocado
Fiber-rich carbs: ½ small banana + 1 cup mixed frozen berries
Protein: ¾ cup silken tofu
Fat: 1 Tablespoon peanut butter
Fiber-rich carbs: 1 small frozen banana + ½ cup shredded kale
Other: 2 teaspoons unsweetened dark cocoa powder
Balanced nutrition from whole foods is key to warding off disease in menopause and beyond. If you need guidance on how to incorporate healthy recipes like this and others into your diet on a regular basis, consider working with our integrated care team who are experts in supporting women in menopause. Our RDNs will create your personalized plan that optimizes your nutrition and other lifestyle factors, plus provides one-on-one support to create healthy habits for the long-term.
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When our bodies change in menopause, our desire for sex often changes as well. With declines in estrogen, many women experience a lower sex drive, vaginal dryness and painful sex. But all too often, they are ashamed to share with their partners why sex has become less appealing, and this can lead to relationship issues.
Whether you are paired up or unpartnered, having regular sex is good for you. According to the North American Menopause Society, regular vaginal sexual activity is important for vaginal health after menopause because it stimulates blood flow, helps keep your vaginal muscles toned, and maintains your vagina’s length and stretchiness. And other studies have shown it can even help boost the immune system.
Yes, sex is good for you. But how can you even think about having sex when your libido is at an all-time low, and intercourse is accompanied by pain and discomfort? Dr. Rebecca Dunsmoor-Su, board-certified OB/GYN and Gennev’s Chief Medical Officer, gets this question from many of her patients. She shared three tips she frequently discusses with her menopause patients.
In midlife, shifting from spontaneous desire to responsive sexual desire is key for aiding arousal. Responsive sexual desire starts with your brain instead of your genitals. Responsive desire can be triggered with touching, kissing, and other forms of intimacy. And by establishing a schedule (like Tuesdays at 9pm) for when intimacy and sex are welcomed, couples can restart the desire cycle by making intimacy a priority, and ensure both partners are open to where it may lead.
Painful sex in menopause is very common but is also very fixable. There is no need to suffer when there are evidence-based treatments that can relieve your symptoms. From vaginal estrogen to pelvic floor therapy, there are medical interventions that can help treat the underlying cause.
Your changing body is likely hard for you to fully understand, so it is very unlikely your partner will realize the impact menopause is having on you. Share with your partner what gives you pleasure as well as what doesn’t feel good. And remember, whatever works for you both is completely fine – whether it’s sexual intercourse, clitoral stimulation or just cuddling.
Book a virtual visit with a Gennev doctor today to learn about the evidence-based treatments that will help relieve vaginal dryness, painful sex and support your libido. Our team of menopause-trained, board-certified OB/GYNs will discuss your symptoms and help you determine the therapies that are right for you.
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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.
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Menopause is the permanent cessation of menstruation and a natural part of a woman’s life. However, for some women, menopause doesn’t happen naturally. Surgical menopause is the removal of a woman’s ovaries, which results in immediate menopause. Though symptoms of menopause are similar whether it occurs naturally or surgically, the experience is often more difficult following surgical menopause”but there are ways to make it more manageable.
Menopause typically happens gradually, with hormones fluctuating and symptoms waxing and waning. It’s a transition that can take anywhere from about four to ten years and begins with perimenopause. During this time, estrogen and progesterone, the primary reproductive hormones, are declining, which causes irregular periods, one of the first signs of perimenopause. Other common symptoms include hot flashes, trouble sleeping, mood swings, and brain fog.
Surgical menopause occurs when both of a woman’s ovaries are removed, a procedure known as an oophorectomy. “There are some very good reasons to remove both ovaries,” says Dr. Lisa Savage, board-certified OB/GYN, and Gennev clinician. The most common are a cancer diagnosis, a high risk for cancer, and endometriosis. Removing both ovaries is a bilateral oophorectomy and can be lifesaving for some women with cancer or a high risk of developing it, or in the case of endometriosis, it could significantly improve a woman’s quality of life. (The removal of only one ovary is a unilateral oophorectomy.)
The ovaries produce estrogen and progesterone, so when they are removed, these hormones are gone, too. “Surgical menopause is this abrupt cessation of those ovarian hormones, whereas naturally-occurring menopause is more of a transition,” says Dr. Savage. “The transition may not be a picnic, but an abrupt cessation can be more intense, especially in younger women.”
After the removal of your ovaries, you may experience more symptoms that appear immediately following surgery and are more severe, compared to perimenopause, where symptoms ebb and flow over a longer time period. So instead of your body being gradually weaned off of estrogen and progesterone, it’s like going cold turkey. The withdrawal can be tough. Suddenly, you could be hit with hot flashes, sleeplessness nights, mood swings, and low libido all at once or some combination on top of recovering from your surgery. And the intensity of these symptoms may be higher than if you gradually entered menopause. Like natural menopause, though, the types of symptoms and their severity vary from woman to woman.
Surgical menopause also has long-term effects that differ from natural menopause. When you go through menopause, you lose the protective effects of estrogen that particularly benefit your heart, bones, and brain. Heart disease risk increases. Bone loss may be accelerated. Cognitive function can be affected, and your risk of dementia and Alzheimer’s may rise. The average age of natural menopause is 51, and it’s after menopause that these problems tend to arise. If you have surgical menopause at an earlier age, things happen sooner.
“It’s double jeopardy if you lose your ovaries at a young age,” says Dr. Savage. “You have more years to live without estrogen and more time to develop those problems. More time of estrogen deficiency is worse than less time of estrogen deficiency.”
But there are ways to minimize the effects if it’s necessary to remove both ovaries. Sometimes you can have only one ovary removed (unilateral oophorectomy) or keep them both, based on your personal situation. That’s why it’s essential to talk to all of your doctors about your options and consider getting a second opinion whenever you’re having surgery.
“A hysterectomy does not directly induce menopause,” says Dr. Savage. A hysterectomy is the removal of the uterus. Just because you had a hysterectomy doesn’t mean your ovaries were removed.
In the past, a hysterectomy often included an oophorectomy for women nearing menopause, partly to prevent ovarian cancer. The latest research, however, shows that ovarian cancer more likely originates in the fallopian tubes, and there are benefits to keeping the ovaries. “Now, we may routinely remove the fallopian tubes at the time of a hysterectomy for benign indications but leave the ovaries because they may not be the primary source of “ovarian’ cancer,” says Dr. Savage.
If your uterus is removed, but you still have your ovaries, you’ll stop menstruating, but your ovaries will continue to produce hormones. That means you won’t experience perimenopause until ovarian function declines. For some women, who’ve had a hysterectomy, the decline will follow a similar timeline as women who still have their uterus. However, sometimes it occurs sooner.
“The blood supply to the ovaries can be compromised during a hysterectomy because some of the blood supply is common to the area,” says Dr. Savage. “That doesn’t mean anything was done wrong. It can be a natural consequence of a hysterectomy that ovaries cease functioning earlier than they might have otherwise.”
No matter what type of surgery you’re having, you should understand the procedure, your options, possible side effects, and the recovery process. It is even more critical if your doctor recommends removing your ovaries. “It’s very important that women talk to their surgeons in detail as to exactly why they want to remove the ovaries,” says Dr. Savage. “Make sure there’s a good indication for removing them, and there may be. If not, advocate to keep your ovaries.” You might even want to get a second opinion. “I tell patients if they need a hysterectomy for a benign condition go to the mat to keep their ovaries,” Dr. Savage says. One ovary is usually sufficient to produce enough hormones to prevent you from going into menopause early.
If your ovaries have to go, the conversation with your doctor should shift to managing the impending menopause. “Have a plan in place preoperatively,” says Dr. Savage. “Don’t wait and be reactive. Knowing what to expect ahead of time is so empowering.”
Just like natural menopause, some women who have surgical menopause have an easier time than others. Even if your symptoms are mild, surgical menopause requires management, especially the younger you are. “It’s not just about hot flashes,” says Dr. Savage.
Estrogen plays a role in nearly all your body systems, including your skin, hair, and vaginal tissue. More important is its effect on your heart, brain, and bones. Estrogen protects the heart, fuels brain activity, and strengthens bones.
When you no longer have estrogen, your risk of heart disease increases, cognition may decline, mental health issues like depression and anxiety are more common, and bone loss increases. It can also have a significant impact on your sex life. Vaginal dryness and a loss of libido can be more pronounced following surgical menopause. And the longer you are estrogen deficient, the more problems you can have. “With life expectancy into your 80s, you must take care of those body systems to carry you through,” says Dr. Savage. “You want them working well for the rest of your life.”
Here’s how to manage surgical menopause and stay healthy as you age.
Ask about hormone replacement therapy (HRT). Talk to your doctors to find out if you’re a candidate. The answer will depend upon your individual situation, including the reason for having your ovaries removed. There are some contraindications, for example, if you have estrogen-dependent breast cancer. Discuss your options with all of your doctors. “Any replacement that you take up to the age of 51 is just replacing what you should have had anyway,” says Dr. Savage.
Start HRT quickly. If you are a candidate for hormone therapy, you want to start as soon as is safe following your surgery. “You shouldn’t have to wait to feel terrible to be put on replacement therapy,” says Dr. Savage. “It’s like having your thyroid out and getting replaced quickly.” Dosages might need to be higher in younger patients to achieve physiologic levels of premenopausal estrogen. If you still have your uterus, you’ll also need progesterone to prevent an overgrow of the uterine lining which could become cancerous.
Explore other medications. If you’re not a candidate for hormone therapy, there are other options. Some SSRI (selective serotonin reuptake inhibitors) anti-depressants like Effexor and gabapentin, an anti-epileptic medication, have been shown to help with menopause symptoms, especially hot flashes and night sweats. A new, nonhormonal drug Veozah was recently approved to treat these symptoms. Other medications can reduce your disease risk.
Monitor risk factors. You’ll want to be proactive about disease prevention, so talk to your doctor about prevention strategies and screening tests. You may need cardiac evaluations or bone density tests at an earlier age. If your risk increases, for example, your cholesterol or blood pressure levels rise, or your bone density decreases, quickly addressing those issues will be critical.
Make lifestyle changes. All of the advice that can help with natural menopause, such as exercising, staying hydrated, eating more fiber, taking supplements, and reducing stress also apply to surgical menopause.
Take care of your mental health. Sudden menopause can be more intense psychologically, so seeking helpis essential. Mood swings, anger, and anxiety are common with any type of menopause. With surgical menopause, these symptoms can be more severe, and you may be dealing with other issues like a possible a cancer diagnosis that can add more stress.
Surgical menopause requires management by a trained menopause specialist. Speak with one of Gennev’s board-certified OB/GYNs to learn more about managing symptoms, and stay healthy as you age.
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Feelings of increased anxiety, depression, anger, rage, and panic are not uncommon for women to experience during the peri to post-menopausal transition. Estrogen and progesterone play a role in our brain chemistry, so as these hormones change, there can be downstream effects to the regulation of the brain chemicals which regulate mood and emotions.
While these hormonal changes can absolutely impact mental health status it is important to recognize that they are never the only component playing a role. The hormone changes alone that occur in peri and post-menopause do not by themselves cause anxiety, depression, or other mental health conditions. Rather it is the hormonal shifts which have a tendency to exacerbate underlying symptoms such as anxiety and depression that have existed previously, even if not as intense.
The “convenient” timing of the menopause transition should also not be ignored. This often aligns with a time of life when women have aging parents, teenage children or an empty nest, greater work demands, relationship challenges, or also happen to be living through a Pandemic, just to name a few of the convoluting factors that also impact mental health. To say that the relationship between menopause and mental health is complicated, is an understatement. Given this complexity getting the support needed often takes a collaborative approach involving multiple healthcare providers.
The extremes at which these feelings are experienced exist on a continuum and can vary person to person. Regardless of where someone falls on this continuum, these feelings are real, uncomfortable, and for most women overwhelming, disconcerting, and deserving of getting support.
In cases of severe anxiety, depression, personality disorders, trauma, and derealization, it is important that you are working with a credentialed mental health provider who can provide the specific support you need. If you are experiencing any of the following symptoms, you may need support from a mental health professional:
Finding a therapist that is right for you, and that you can bond with, can have a major impact on your progress. Need help finding a mental health provider?
Many women feel increased moodiness, anxiety, and even symptoms of depression throughout the menopause transition. However, it’s important to not just brush off lingering symptoms to menopause.
Together with LifeStance Health, one of the nation’s largest providers of virtual and in-person outpatient mental healthcare, Gennev offers access to menopause-trained OB/GYNs, psychiatrists, psychologists, licensed therapists, and dietitians who provide guidance, prescription support, and lifestyle therapies for your mind and body through this important stage of life.
“Learn more about how Gennev patients receive integrated care that addresses both the physical and mental health symptoms associated with menopause.
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If your concerns feel too heavy to handle, there is no shame in seeking professional help: Call, text, or chat 988 to reach the National Suicide Prevention Lifeline, and you will be connected to trained counselors that are part of the existing Lifeline network. You can also dial 800-273-8255 or chat via the web at 988lifeline.org/chat/.
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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.
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A new hot flash treatment is on the horizon! The FDA recently approved Veozah (Fezolinetant) for the treatment of hot flashes for women in menopause. This is the first drug treatment of its kind, and represents a viable option for those who are not able to receive hormone therapy.
Hot flashes are one of the most common symptoms of menopause, and can range from mild to severe. In the United States, 70-80% of women experience hot flashes during the menopause transition, and for many of them, they significantly impact their quality of life. “We have known that hormone replacement therapy (HRT) is an excellent treatment for hot flashes, however there are a subset of women who are not appropriate for HRT, or who choose not to use it,” says Dr. Rebecca Dunsmoor-Su, board-certified OB/GYN, and Gennev Chief Medical Officer. “Up until now, in these women we have used other medications such as anti-depressants with minimal to moderate reduction in hot flashes. With the approval of Veozah that changes today!”
According to the FDA statement, Veozah works by targeting and blocking a receptor in the brain which regulates body temperature.
Dr. Dunsmoor-Su shares, “To understand how it works it helps to know how the brain and ovary interact, and why menopause causes hot flashes (or temperature dysregulation). When we are having regular cycles there are neurons in the brain that release a pre-hormone called gonadotropin releasing hormone (GnRH) which stimulate the pituitary to talk with the ovary and develop one or more eggs for ovulation. This GnRH is released in a pulsing pattern, and different pulses signal different parts of the cycle. The pulses are regulated by feedback from the estrogen made by the ovary as it develops eggs. When the ovary runs out of eggs and does not respond to the pituitary, it does not release estrogen, which means the pulses go unregulated and are constant. The KNDY neuron connects this part of the hypothalamus to another part called the “warm sensing neuron”, which regulates what is a normal temperature range for your body. If the pulsing is constant, and constantly being transmitted to the warm sensing neuron, then the range of normal temperatures becomes very small, and any time you sense yourself to be outside that narrow range and you have a hot flash!”
Simply put, when a patient takes Veozah, it blocks one of the transmitters in the KNDY neuron, specifically neurokinin 3 (NK3), which means the body does not tell the warm sensing neuron about what is going on in the GnRH neuron, and the “normal” temperature range does not shrink. Thus, no hot flash is triggered.
Astellas Pharma US, Inc., the company that makes Veozah, did several large-scale studies which looked at effectiveness and safety to the drug. They reported that use of the medication reduced hot flashes by 50% or more over the 12 weeks of use compared to a placebo drug. Patients who continued the medication for a full 12 months saw continued benefits during that time. Because of the effectiveness of Veozah, they showed an improvement in quality of life due to hot flashes. There was also some noted improvement in sleep, though research was inconclusive to the drug’s impact on this symptom.
The most common side effect reported was headache. While there is no significant impact on the liver in the safety trials, because of previous concerns the FDA is recommending liver tests in the first year of use.
“Hormone therapy is still the best medicine for hot flashes,” says Dr. Dunsmoor-Su. “If you are not a good candidate for this medication, we are soon going to have a new medicine that is much more specifically targeting hot flashes with fewer side effects than our previous options. This is an exciting development and is going to be helpful for so many women who have not been able to find relief!”
Veozah is anticipated to be available for patients by early June. A potential downside? According to Astellas, a 30-day supply is expected to cost $550 a month.
Don’t let hot flashes negatively impact your quality of life. Visit with a Gennev doctor to address the role that hormonal shifts play in the symptoms you are experiencing, and access the treatments that are right for you.
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You have likely heard about the practice of mindfulness. Whether it’s in yoga class, on the news or in casual conversation, “be mindful” is a buzz phrase and health tip. While the practice of mindfulness is a growing trend, the origin of mindfulness practice dates back hundreds of years and is rooted in Hinduism and Buddhism. More recently, mindfulness has evolved into a secular practice (for some) and migrated into the Western world. “Being mindful” may sound intimidating if the concept is new to you. But mindfulness can be an approachable and highly effective tool in reducing stress and anxiety, which are two very common symptoms experienced in menopause.
Mindfulness is all about slowing down and making observations about yourself and the things around you. Mindfulness is about being present, here and now. It can greatly optimize mental and emotional wellbeing by being aware of your own internal state and surroundings. When we allow ourselves to be more present, we create space to observe our thoughts without judgement, bring forth curiosity, and be more intentional about our actions and behaviors.
Mindfulness is the opposite of operating on autopilot, or being driven by anxiety and heightened emotions.
Gennev doctors and dietitians often hear from patients how they don’t feel like themselves anymore, or they feel like they are disconnected from their body in menopause. Mindfulness teaches us to be connected to our own bodies once again. When we are mindful, we listen to ourselves and the signals our bodies send us. Menopause can be a season in life where stress and anxiety are amplified, and the busyness of the daily routine can distract us from these signals. By tuning in to our body’s signals, we may notice a need for rest, hydration, movement, seeking food for nourishment, creating boundaries and even saying “no” more often.
“Mindfulness allows us to build awareness and know when our minds and bodies have reached capacity. We all have limits that need to be honored.” – Monika Jacobson, RDN at Gennev
Another way to look at mindfulness is through a neuroscience lens. When a stressful event leaves us feeling anxious, or perhaps you naturally have a nervous or worried demeanor, our sympathetic nervous system is activated. This “fight or flight“ response causes a release of hormones into the body and the accompanying stress can often manifest into physical symptoms. These symptoms may include a racing heart, increased sweating or hot flashes, heightened pain sensations, digestive issues, and difficulty sleeping due to ruminating or racing thoughts (all these are common menopause symptoms too). By practicing mindfulness, we can retrain the brain to find homeostasis, recover, and ultimately spend less time in “fight or flight.”
Here are five practical ways to start practicing mindfulness in your daily life. Remember, it will take some time for the practice of being mindful to become second nature. Be curious and compassionate with yourself, as both are key components of mindfulness.
If you need support in taking the steps to manage the many symptoms of menopause, you are not alone. Together with LifeStance Health, one of the nation’s largest providers of virtual and in-person outpatient mental healthcare, Gennev offers access to menopause-trained OB/GYNs, psychiatrists, psychologists, licensed therapists, and dietitians who provide guidance, prescription support, and lifestyle therapies for your mind and body through this important stage of life. Learn more about how Gennev patients receive integrated care that addresses both the physical and mental health symptoms associated with menopause.
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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.
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We are proud to announce that Gennev is now in-network with Aetna’s commercial health plans in all 50 states. As the nation’s leading virtual menopause clinic, this allows us to bring more accessible quality menopause care to millions of women across the United States.
Read all about it in our official news release that follows below.
SEATTLE, WA as Gennev, the nation’s leading virtual menopause clinic provider, announced today that it is now in-network for most of Aetna’s commercial health plans in all 50 states and the District of Columbia. Care provided as part of a Gennev integrated menopause treatment plan is available without prior authorization for most Aetna® commercial members and may require a referral within HMO plans.
“One fifth of the U.S. workforce consists of women of menopause age, yet few of them seek treatment for symptoms that impact their quality of life,” said Gennev CEO Jill Angelo. “Gennev providers help women understand where they are in their 7as10-year journey, then they deliver a customized, evidence-based plan to help them feel relief. This agreement with Aetna® will increase access to this menopause care for millions of American women, while helping to reinforce the need for this care with both employers and the women struggling to find solutions.”
A 2023 study by the Mayo Clinic titled, Impact of Menopause Symptoms on Women in the Workplace found that issues stemming from menopause caused approximately one in seven women to miss work, reduce their hours, or quit, retire or be laid off. Most of those same respondents found working during menopause more challenging than other common life changes, yet the majority of them felt uncomfortable talking to supervisors or human resources about their experiences.
Gennev providers have already helped thousands of U.S. women improve their quality of life by prescribing personalized, evidence-based treatment plans and delivering the virtual support needed for those plans to succeed. Integrated treatment plans may include prescription medication, nutrition, fitness, sleep, mindfulness, and behavioral health therapies. Gennev’s team of OB-GYNs and Registered Dietitian Nutritionists serve patients nationwide, and 92% of patients report some symptom relief after their first visit.
Aetna commercial members can book an appointment or take the Gennev menopause assessment at gennev.com, or call the care team at (206) 895-4292 to schedule a visit. The cost of your virtual visit and any necessary prescriptions may vary based on your individual plan. For detailed benefits information, please contact the phone number on the back of your Aetna Member ID card or by visiting Aetna.com
To learn more about our whole-body approach to menopause care, or to book a virtual visit, click here.
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Gennev, the nation’s leading virtual menopause clinic, continues to lead the way in changing the standard of care for women in menopause. Together with LifeStance Health, one of the nation’s largest providers of virtual and in-person outpatient mental healthcare, Gennev now provides integrated care to address both the physical as well as the mental health symptoms of menopause.
During perimenopause and menopause, women may experience impacts to their emotional health, including new or increased symptoms of depression, anxiety and other mental health conditions. And, up to 20% of women will be diagnosed with new onset major depressive disorder (MDD) in midlife.*
Mental health is a critical component of overall well-being, and Gennev clinicians will work closely with LifeStance’s team of psychiatric and psychotherapy clinicians as a collaborative care team to provide evidence-based, comprehensive treatment recommendations that offer a whole-person approach to menopause.
“Gennev is committed to delivering the most comprehensive menopause care for women, and our partnership with LifeStance will empower them to take control of their physical and emotional health needs,” said Jill Angelo, CEO, Gennev.
“Many women struggle with behavioral health symptoms during menopause, but we shouldn’t accept that as the status quo. Research shows that proactively addressing behavioral health conditions during menopause reduces the likelihood of a patient requiring crisis care. The results are improved quality of life and, ideally, a reduction of downstream behavioral health costs,” said Dr. Rebecca Dunsmoor-Su, MD, Chief Medical Officer, Gennev.
“We look forward to partnering with Gennev and bringing LifeStance’s trusted, affordable and personalized mental healthcare to their patients, ensuring they receive integrated treatment that specifically addresses their unique concerns during menopause,” said Dr. Anisha Patel-Dunn, Chief Medical Officer, LifeStance. “By collaborating with Gennev’s clinicians, we can more effectively care for the whole-person health of women experiencing menopause.”
“Learn more about how Gennev patients receive integrated care that addresses both the physical and mental health symptoms associated with menopause.
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* J. T. Bromberger1,2, L. Schott1, H. M. Kravitz3,4, and H. Joffe. Risk factors for major depression during midlife among a community sample of women with and without prior major depression: are they the same or different? Psychol Med. 2015June;45(8):1653as1664
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You are not going crazy! You may feel as if you’re going crazy at times”or most of the time”but you’re not. Whether you’re experiencing more angry outbursts, down-in-the-dump moods, frazzled thinking, or more severe distress, know that it is not just in your head.
“Many women are shocked by the mood swings, anger, and anxiety that can start in the perimenopause,” says gynecologist Rebecca Dunsmoor-Su, M.D., chief medical officer at Gennev.
Instead of simply ignoring a quirky habit that your partner has, like you used to do, you now blow. And then, after a heated argument about something that, in the grand scheme of life, isn’t important, you feel guilty and wonder what’s wrong with you. Or maybe the nervousness you used to have about public speaking now becomes a full-blown panic attack. “It is due to the way the brain responds to the hormone swings that happen naturally during this time, but that does not make you simply hormonal,” says Dr. Dunsmoor-Su. “The symptoms can be even worse if you are someone who has these at baseline.”
Mental health issues are real and common in perimenopause and menopause, but there’s help. You’re not alone. And, you don’t have to suffer through it alone.
In general, women experience mental health problems at a higher rate than men”1 in 5 women compared to 1 in 8 men. The incidence increases during the menopausal years. One in three women, ages 50 to 64, reported needing mental health care in the past two years, according to the 2022 Kaiser Family Foundation Women’s Health Survey.
It’s completely normal to feel more emotional or have a harder time controlling your emotions during this stage of life. Along with the usual life stresses, women’s relationships are often shifting at this time. Their kids are leaving home. Parents may require more care. “All those things are going to impact a woman’s mental health,” says Dr. Dunsmoor-Su.
And then add in a rollercoaster of hormones. “The brain is exquisitely sensitive to estrogen and progesterone,” says Dr. Dunsmoor-Su. “It’s had these hormones in a particular pattern its whole life, and now that pattern is broken. The brain is behaving differently because the pattern is different.” And the pattern keeps changing, resulting in different symptoms as you progress from perimenopause to menopause.
Perimenopause is the two- to 10-year transitional period to menopause when a woman stops menstruating. During perimenopause, though, a woman is still getting her periods, but they may be more erratic. Every month, there is a surge of estrogen in the first half of the cycle and a surge of progesterone in the second half. The ovaries are still producing eggs, but more estrogen is needed to stimulate them. Through the cycle, estrogen levels get higher, progesterone levels increase to match the high estrogen, and then all of the hormones drop. “You get really big spikes of hormones,” says Dr. Dunsmoor-Su. “You get really big troughs of hormones. It’s a roller coaster of hormones, and the brain doesn’t like roller coasters. The brain likes nice, sedate walks on a path.”
These drastic fluctuations often predispose women to anxiety, anger, and mood swings. Some women also experience depression or worsening of their symptoms if they already had depression before perimenopause. Those symptoms may also be worse for women who’ve previously experienced premenstrual syndrome (PMS) or its more severe counterpart, premenstrual dysphoric disorder (PMDD). The good news is that these mental health issues tend to be temporary symptoms associated with perimenopause. As your hormone levels decline and fewer fluctuations occur, mood swings and anxiety often lessen. However, depression can be more common after menopause.
Menopause is achieved once you’ve gone 12 months without a period. “In post-menopause, there is very low estrogen and basically no progesterone,” says Dr. Dunsmoor-Su. The decline in hormones tends to level out mood swings, ease anxiety, and tame anger, but can be associated with an increase in depression. In addition to the effect of hormones on your mood, other frequent postmenopausal issues such as hot flashes, poor sleep, body changes, and stress can all contribute to depression. Studies associate increased hot flashes with increased depression. Symptoms are often worse for women who’ve had depression at other times in their lives. And 15 to 20 percent of women may be diagnosed with new-onset depression in midlife.
Unlike anxiety and mood swings, which tend to resolve once you’re postmenopausal, depression may stick around. “If you’re someone who has had depression your whole life, you may get a temporary exacerbation through the menopausal transition, and then it might get somewhat better,” says Dr. Dunsmoor-Su. “These things wax and wane.”
Despite these general patterns in mental health symptoms during midlife, the experience can differ from one woman to the next. “It’s a fluid time,” says Dr. Dunsmoor-Su. “Every woman’s journey is different. They’re going to go through the same hormonal changes, but the way their brain behaves is very different because of the different patterns of estrogen and progesterone receptors in the brain.” And because women’s menopause experiences vary, treatments can vary, too.
Immediately! As women, we tend to take care of everyone else first and often put our needs aside. But this strategy isn’t helpful for anyone over time. Think of it this way, what would be the most effective way of saving your loved ones if you were all in a leaky life raft? You’d wear yourself out and wouldn’t save anyone if you’re madly bailing the water. But if you take the time to patch the leak, you’ll save everyone without sacrificing yourself.
“Menopause is already a stressful time on the body, says Dr. Dunsmoor-Su. “It impacts your long-term health, sense of well-being, cardiovascular health, and longevity. It’s important to care for yourself because this is the beginning of the rest of your life. You’ve got a solid 30 to 40 more years to live, and you want to do it in the healthiest way possible. If you don’t address your sources of stress, mental health being one of them, it can be harder to live a healthy life.”
Now isn’t the time to try to push through it or let the stigma of mental health issues prevent you from seeking help. If you notice that any of these mental, psychological, or emotional issues are impacting your quality of life, you should talk to your doctor or healthcare provider. Common signs that it’s time to take care of your mental health may include feeling less able to manage day-to-day, negative changes in relationships, problems at work, a lack of desire to participate in activities that you used to enjoy, or others noticing a difference in you.
If any of these apply to you, talk to your primary care doctor, gynecologist, or menopause doctor. Let them know that you’ve noticed these changes in your mental health and want to know what resources are available. You can also ask for a referral to a mental health professional.
Sometimes mental health issues can be severe and require immediate attention. According to a European epidemiological study across the reproductive life cycle of women, suicidal ideation increases during the menopause transition. The study showed a 7-fold increase in suicidal ideation in perimenopause versus other women. If you are experiencing any thoughts about hurting yourself or others, seek help right away.
As menopausal mental health problems differ from one woman to another, so do treatments. The course of action often depends on the severity of symptoms and can range from lifestyle interventions or therapy to hormone therapy or medications.
Sometimes treating physical symptoms like hot flashes or sleep problems can improve your mental health without additional treatments. But if you need something more, there are lots of options.
During perimenopause, low-dose birth control pills may be enough to quell mild to moderate anxiety, depression, and mood swings. “There is some good data that in perimenopause hormone therapy is as effective as SSRIs (the most common antidepressants such as Prozac) for managing depressive and anxiety symptoms,” says Dr. Dunsmoor-Su. For postmenopausal women, a combination of estrogen and antidepressants works better than either alone, according to research.
Therapy is another option that may complement other treatments or work on its own. “Having behavioral techniques that you can use when you’re feeling very stressed or anxious can be really helpful during this time,” says Dr. Dunsmoor-Su.
“We have to look at each patient as an individual,” she says. “One patient may need mental health care. One patient may need hormones, and one patient may need both. It’s about taking a holistic look at the patient and her symptoms and figuring out how we can help.”
You deserve the best care for your physical and mental health in menopause. Together with LifeStance Health, one of the nation’s largest providers of virtual and in-person outpatient mental healthcare, Gennev offers access to menopause-trained OB/GYNs, psychiatrists, psychologists, licensed therapists, and dietitians who provide guidance, prescription support, and lifestyle therapies for your mind and body through this important stage of life.
“Learn more about how Gennev patients receive integrated care that addresses both the physical and mental health symptoms associated with menopause.
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If your concerns feel too heavy to handle, there is no shame in seeking professional help: Call, text, or chat 988 to reach the National Suicide Prevention Lifeline, and you will be connected to trained counselors that are part of the existing Lifeline network. You can also dial 800-273-8255 or chat via the web at 988lifeline.org/chat/.
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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.
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When it comes to supplements, magnesium is often overshadowed by more popular nutrients like multivitamins, vitamin D, omega 3s, and calcium, according to the National Center for Health Statistics. But, at Gennev, magnesium is known as a superhero supplement because it’s made a pivotal difference in menopause symptom management for so many women.
“Magnesium was a game changer for me,” says Wendy Y. “It’s helped me to calm my nervous system, get rid of anxiety-ridden thoughts, and sleep better. I used to wake up between 2 a.m. and 4 a.m. and not be able to fall back to sleep. Now, I fall asleep immediately and sleep through the night. I get a deeper, more restorative sleep, so I’m calmer, more productive, and think more clearly during the day. It’s also helped with constipation.”
Magnesium, found in every cell of your body, is essential for the functioning of over 300 enzymes. It’s involved in more than 600 biochemical reactions in your body”everything from energy production and muscle and nerve function to blood sugar and blood pressure regulation and bone formation. Yet, more than half of Americans aren’t getting enough of this valuable mineral. In a study of 171 postmenopausal women, 82 percent were low in magnesium, which can greatly impact menopause symptoms and health as you age.
“The changing hormones during the menopause transition can increase risk for low bone mineral density, brain fog, poor sleep, mood shifts, increasing anxiety, increased insulin resistance, and changes in digestion,” says Stasi Kasianchuk, a Registered Dietitian Nutritionist and Gennev’s director of health coaching. “A micronutrient in form, magnesium can have macro effects impacting multiple areas of health for peri and post-menopausal women.”
Gennev customers have shared that they’ve experienced many benefits from taking this supplement consistently, including relief from joint pain, cold flashes, Restless Leg Syndrome, muscle cramps, PMS, anxiety, headaches, disrupted sleep and fatigue.
“Estrogen offers anti-inflammatory benefits and joint lubrication,” says Kasianchuk. “With estrogen levels decreasing over the menopausal transition, inflammation throughout the body can increase, and a low magnesium status may exacerbate this. Addressing the magnesium deficiency can play a role in mitigating inflammation at the joint and help to mitigate pain.”
Here are some of the greatest benefits magnesium offers based on scientific studies.
Keeps bones strong. Calcium and vitamin D tend to be the go-to supplements for bone health, but they may not be enough, especially during menopause. About 60 percent of your body’s magnesium is stored in bones, making it a key player in bone health. In a 2021 review of seven studies on magnesium supplementation, all showed increases in bone density and decreases in fracture risk.
Bones are in a constant state of remodeling, with cells called osteoclasts breaking down bone and cells called osteoblasts rebuilding bone. During your youth, osteoblasts outperformed osteoclasts resulting in more bone building and stronger bones. Their activity evens out during adulthood, and you tend to maintain bone strength and density. But as you age, osteoblasts slow down, and bone density and strength start declining. The loss of estrogen with menopause increases osteoclast activity resulting in more significant bone loss and risk of osteoporosis, low bone density that puts you at risk for fractures, and its precursor osteopenia, borderline losses in bone. Magnesium supplementation has also been shown to decrease this bone turnover in postmenopausal women with osteoporosis.
Low magnesium levels have also been associated with osteoporosis and low vitamin D levels. A study in the journal Nutrient found that improving magnesium levels in postmenopausal women also had a beneficial effect on their vitamin D levels. When 27 healthy postmenopausal women with low magnesium took magnesium supplements for two months, they not only increased their magnesium levels but also raised their vitamin D levels. About 80 percent of the women were low in vitamin D at the start of the study. The improvement is probably due to magnesium’s essential role in the synthesis and activation of vitamin D.
Boosts mood. Magnesium plays a role in the production of serotonin, a neurotransmitter that regulates mood, which may explain why magnesium supplementation has been found to help ease depression and anxiety, common issues during menopause. Low magnesium levels have been associated with a greater risk of depression and more severe symptoms, according to research. In a six-week study of 126 adults, average age 52, and with mild to moderate depression, magnesium supplements alleviated symptoms with improvements noted within the first two weeks. On average, people reported a six-point decline in depression based on a 27-point questionnaire and a four-point reduction in anxiety based on a 21-point questionnaire. Some research has even found improvements in less than a week.
Unlike a sedative or anti-anxiety medication, magnesium is milder, but often effective. Kasianchuk suggests, “it’s like it turns down the volume of racing thoughts, making it feel more manageable.”
Improves sleep. Magnesium impacts bodily functions that can help you get a better night’s sleep. It’s involved in regulating your circadian rhythms, your body’s natural clock, that affects your sleep-wake cycle. It interacts with neurotransmitters that play a critical role in sleep regulations. It appears to increase melatonin, a hormone that regulates your sleep cycle, and magnesium can have a relaxing effect on the body, which helps facilitate sleep. When 23 older adults with insomnia took magnesium supplements for eight weeks, they fell asleep faster, woke up less throughout the night, and slept longer, resulting in an overall better quality of sleep, compared to a control group, according to a study in the Journal of Research in Medical Sciences.
Protects your heart. Magnesium is essential for healthy heart rhythms. Low levels of magnesium have been linked to irregular heartbeats known as arrythmias and atrial fibrillation (afib). This common heart rate disorder that causes the heart’s upper chambers to quiver and increases your risk of stroke and heart attack. In a small study, some postmenopausal women who were consuming a low-magnesium diet experienced afib and heart flutters within two months. Following supplementation, the symptoms quickly resolved. Your risk of heart disease, the leading cause of death in women, also increases if you’re not getting enough magnesium.
Magnesium also impacts key risk factors for heart disease, such as hypertension and diabetes. Based on research, people with adequate levels of magnesium appear to be at a lower risk for these diseases compared to those with low magnesium levels. Along with protecting against these diseases, magnesium supplementation also appears to improve these conditions. Several meta-analysis have found that magnesium can lower systolic blood pressure (the top number) by up to four points and diastolic blood pressure (the bottom number) by up to three points. The improvements were even greater when magnesium was combined with antihypertensive medications, 19 points for systolic and 11 points for diastolic. Magnesium also plays a role in regulating blood sugar. In a review of 18 studies on people with diabetes or people at high risk for diabetes, magnesium supplementation improved blood glucose levels and insulin sensitivity.
The first step to increasing your magnesium and getting all of its amazing benefits is to eat more foods that are high in magnesium. Here are some good choices to make a part of your daily meals.
While magnesium is plentiful in a wide variety of foods, it can be difficult to get enough from diet alone, especially as you age. Only about 30 to 40 percent of the magnesium you get from food is absorbed by your body, which is why it is wise also to supplement. The recommended daily intake for magnesium is 320 mg. While high doses of magnesium, don’t seem to be a problem because your kidneys will excrete any excess, too much could lead to diarrhea, nausea, and cramping. To be on the safe side, keep your intake to no more than 350 mg.
Magnesium supplements come in a variety of forms, so it can be confusing to figure out which one is right for you, and some forms can cause unpleasant side effects. “When I tried magnesium for insomnia and muscle cramps, it worked well, but it wasn’t easy on my sensitive GI tract,” said Tracy P. “I was reluctant to take it every day until my doctor recommended magnesium glycinate. My muscle cramps have subsided. I’m sleeping well, and I don’t have to compromise with an upset stomach to get enough magnesium.”
The forms of magnesium that seem to be best absorbed by the body to raise your magnesium levels with fewer gastrointestinal symptoms like diarrhea include, glycinate, lactate, and malate. Magnesium glycinate seems to have a calming effect, making it particularly helpful for other menopause symptoms including anxiety, depression, stress, and sleep. Magnesium malate may help with symptoms of fibromyalgia and chronic fatigue syndrome, but more research is needed to confirm this. Other well-absorbed types that can have a mild laxative effect are citrate and chloride, which may be helpful if you have constipation.
Magnesium oxide isn’t well absorbed, but it is an effective treatment for constipation and other digestive problems like heartburn and indigestion, and some research shows it may be helpful for migraines.
Whatever type of magnesium supplement you choose, speaking with your doctor or a Gennev Dietitian about your symptoms may reveal additional remedies and evidence-based treatments that will make your menopause transition more manageable.
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.
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