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.
“
“
Some of the biggest impacts on our health come from what we put in our mouths. But there’s so much information out there, some of it directly contradictory, so what’s a gal to do?
Team Gennev is pretty much always hungry, and we sometimes struggle to figure out the best solutions to satisfy us” physically and emotionally. We figured if we have questions, no doubt many of our Gennev-ers do too, so we connection with our team of Registered Dietitian Nutritionists, as well as nutrition coach Michelle Cartmel to get some answers.
Think of an Registered Dietitian or health coach as you would any other type of fitness coach or trainer in sports, fitness, etc. At Gennev, our Registered Dietitian Nutritionists coach our patients with not only their nutrition, but other ways to optimize their health and wellness, and thrive in menopause. Their role is to educate, inspire and motivate women to make smart, consistently healthy choices which enable them to reach and continue to maintain their end goal. They create personalized wellness plans based on a client’s goals (weight management, improved energy, better sleep, symptom reduction) and provide the tools, guidance and accountability throughout the journey that can help drive that person’s success. They also offer free texting in between appointments to help their patients stay on track.
When our hormones are “acting up,” we can feel unwell, sometimes enraged and often out of control. Keeping your nutrition in check is paramount to keeping things from spiraling further out of control. The most important thing you can do for yourself is to maintain a well-balanced diet full of whole foods including veggies, fruit, lean protein, legumes, beans, healthy carbs and healthy fats. Minimize or avoid processed foods, sugars and sodium wherever possible because these foods can severely impact brain and gut health and in turn, impact your mood.
Whole foods support your mood, so the best thing you can do to manage hormone symptoms is to create stability through your nutrition. If you know you are prone to succumbing to snack cravings when your hormones affect you, it’s time to be more proactive and have healthy treat substitutes on hand that satiate your desire for unhealthy foods. Some of our Dietitians’ go-to’s are a square of dark chocolate, a tablespoon of nut butter and half a frozen banana, or avocado toast on whole grain bread.
Eating too much sugar. Sugars are hidden in so many of the foods we eat, even the ones that are marketed to us as “healthy,” from yogurt, to salad dressings, green smoothies, specialty coffees and especially bars. According to the Sugar Science, women should consume no more than six teaspoons or 25 grams of added sugars per day. Added sugars are added during the manufacturing process and are not naturally present in the food itself.
Become a food detective and sleuth out sugars by reading labels! It doesn’t take much time for those sneaky little sugar calories to accumulate. Look at your day as a whole and calculate how much sugar you eat on average, then try to determine how to reduce your intake.
First, plan your eating like you plan your workouts. Wake up, think about what your schedule looks like for the day and plan your meals accordingly. That way, you won’t be making decisions on the fly, which can often lead to poor “grab and go” choices and overeating.
Second, if your goal is to get to a healthy weight, exercise portion control. While this may be touch, start with small changes, reducing portion sizes during dinner for one week. Eat from a salad plate so that you stay within a safe zone. Eat slowly and deliberately, savoring each bite, and drink water before and during the meal to create satiety.
Third, stop grazing. When we are constantly nibbling while at work, or while cooking/prepping dinners, kids’ lunches, etc., we can consume a lot of extra food we’re not even entirely aware of eating! Set yourself up for success; if you know your triggers, place things like lemon water, tea or sparkling water at your disposal and make a conscious decision to choose wisely as you’re about to grab for something you shouldn’t.
Proper nutrition is key to warding off disease as we age. If you need guidance on how to incorporate healthy foods into your diet on a regular basis, consider working with our Registered Dietitians who are experts in supporting women in menopause. They will create your personalized plan that will optimize your nutrition and other lifestyle factors, plus provide the support to create healthy habits for the long-term.
“
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.
“
“
Nutrition is a complicated issue, and confusing as even conflicting as information from experts (and would-be experts) doesn’t make it any easier. Nutrition Coach Michelle Cartmel helps us understand our nutritional needs a little better.
Michelle shared that one of the questions that she is most frequently asked by her clients is around protein, particularly: “how much do I need?”
Over the past several years, the word “protein” has become SUCH a common part of our dietary vernacular, we might even say it’s a borderline obsession for some. Blame Atkins, blame the keto craze, blame it on food marketers and what they put on their labels.
All of these messages about protein that we see on social media, on TV, hear from health experts on our favorite morning show as they fuel our curiosity for getting healthy but also create a lot of confusion. There is A LOT of information out there about and it’s difficult to decipher.
Confusion around protein is what led Micelle to write this article, because she wants you to know that it doesn’t have to be confusing. In fact, it’s quite easy to consume adequate protein every day. To help you, she shares three easy protein pointers to live by:
The amount of protein women need is highly dependent on several factors such as body mass, physical activity type and level and overall health status or certain medical conditions. However, most women need approximately 1-1.2 grams per kilogram of body weight. For example, a 150-pound woman would need about 68-82 grams of protein per day.
This sounds like a big number, but trust us, it’s easy to get there, even if you’re a vegetarian. Below is a breakdown of a few of our most common protein go-to’s with respective gram content.
Protein comes from so many sources like poultry, fish, pork and beef, eggs, nuts, Greek yogurt, soy, and beans or lentils, but did you know that some vegetables pack a surprising punch of protein?
We need protein (and calcium during menopause) to support bone health as we age. Women generally understand the importance of a diet rich in calcium to support bone health, but it’s also important to consume adequate protein.
Studies have shown that people who eat an adequate amount of protein each day generally have good bone health, but those who do not can have compromised bone health, as it has been proven that the body absorbs more calcium when the diet is adequate in protein.
The bottom line: do your best to get your proteins from natural sources like the ones listed above.
Be cognizant not to overdo red meat and processed meats as they may lead to an increased risk of heart disease and cancer. If you are tempted to purchase a food product because its label boasts high amounts of protein (and you’ve fallen short that day), read the entire label to see what other items might be hidden inside. Oftentimes products like bars and yogurt may be marketed to us as “healthy” because of their protein composition, but dangerous amounts of sugars might end up sabotaging our good work.
Stressed. It has become a common way of describing ourselves these days.
And while you may be aware of what could be causing the stress in your life (work, life events, relationship changes, menopause and other health concerns, fear of the unknown), you may not realize that unmanaged stress can lead to more serious health problems.
Why? Because stress, no matter what the reason, triggers your sympathetic nervous system, or fight or flight response. Stress hormones like adrenaline and cortisol activate, and when (in most cases) your body doesn’t find resolution, it continues to pump out higher levels of stress hormones, resulting in the harmful effects on your body. This chronic stress can lead to heart disease, depression, increased risk of type 2 diabetes, weight management issues and so much more.
Symptoms of stress varies by individual, but the more common and recognizable physical signs include:
You may also notice emotional symptoms of stress, such as:
Much like the various symptoms you may experience, there is no one-size-fits-all or magic pill to remedy stress. The most important thing you can do is be self-aware. Know what may trigger your stress, and become familiar with the signs of stress on your body and mind. Then take action to help reduce stress and support yourself through it.
Build your resiliency – Becoming more resilient can help you manage stress, and managing stress can help you become more resilient. The two are intertwined, which is why some of the strategies to build resilience are similar to ones you might employ to reduce stress. Learn the steps to build your resiliency here.
Eat well – A balanced diet supports the immune system, helping to repair damaged cells and provide the extra energy needed to cope with stressful events. A diet composed of whole and unprocessed foods, specifically healthy unsaturated fats and fiber-rich carbohydrates with lean protein, can support the body’s natural cortisol response. It’s important to avoid skipping meals and eat small, more frequent meals or snacks to stabilize cortisol levels and support an optimal insulin response.
Get some exercise as Exercise helps to lower blood pressure and keep stress hormones in check. Studies show that just”¯20 minutes of aerobic exercise can help reduce cortisol, and get it back to manageable levels. But be cautious about very intense endurance exercise (such as ultrarunning) and be sure to take a rest day between higher intensity workouts. Intense physical activities combined with lack of rest days can cause an increase in cortisol.
Take a joy break as Finding joy in your day can come from the simplest of pleasures. So why not give your pet some play time, eat an ice cream cone, indulge in some funny videos, take a walk outside or find a quiet bench to sit in the sunshine. These found moments will greatly support your emotional health.
Talk about it as most importantly, when stress just won’t quit, talk it out with a friend or family member, or seek the help of your physician or therapist.
While many women feel increased stress, moodiness, anxiety and even symptoms of depression during menopause, don’t just brush it off. Plan a visit with your physician.
“
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.
“
How many women go through menopause?”¯”¯
100% of women go through menopause. 75% of them suffer from debilitating symptoms including weight gain, moodiness and anxiety, hot flashes, night sweats, insomnia, brain fog.
Why don’t more women seek menopause care?”¯
Women typically feel dismissed after going to their regular doctor for menopause symptoms. Primary Care Providers, General Practitioners and Internists receive little to no training for menopause care; often-times symptoms are dismissed, go untreated or are misdiagnosed. OB/GYNs who have had menopause training are best equipped to treat women in menopause.”¯
Why are OB/GYNs best equipped to serve women in menopause?”¯
The study of Gynecology addresses the impacts of hormonal shifts that occur during menopause, including vulvovaginal, vasomotor and sexual wellness changes.”¯ OB/GYNs certified by the North American Menopause Society hold a superior level of education in menopause care. Gennev’s OB/GYN network meets these criteria.”¯
Why don’t more women just go see “their OB/GYN” for care?”¯
There is a growing shortage of OB/GYNs in the U.S. Currently, the ratio is 1 OB/GYN to approximately 86 women in the U.S. This is at the heart of why we have such a lack of access to menopause care for women.”¯
How does telehealth improve access to OB/GYN-led menopause care?”¯
Telehealth enables OB/GYNs to serve more patients, especially in “health care deserts” that are prominent in rural areas.”¯”¯
Is telehealth sufficient for menopause care? When does someone need to see an OB/GYN in person?”¯
75% of menopause care can be managed through a provider/patient conversation. Most menopause symptoms can be diagnosed and treated, even with prescription, through 1:1 consultation between a doctor and a patient. This makes telehealth a viable option for improving access to quality menopause care for women.”¯
In-person care is often required when an in-person exam, lab work or procedure is required for further diagnosis and treatment.”¯
If only 1 in 5 OB/GYNs receive training in menopause, does that mean 100% Unified Women’s Healthcare OB/GYNs are trained in menopause?”¯
Currently 100% of Gennev OB/GYNs are trained in menopause, making Gennev the definitive leader to support the Unified network of 2500 providers. This will establish our combined teams as the largest network of menopause specialists in the U.S.”¯
Who will now have access to my medical records? How can I be assured of privacy and security of my information?
Your Gennev medical record will remain secure within your Gennev account, just as they were before. Your data is not shared in any way across Gennev and Unified providers unless there is a referral and you as the patient has given permission to share the information between physicians.
Can I work with any of the other doctors that are part of the Unified network?
We are working out the process to support women across Gennev and Unified’s network of providers. Stay tuned for updates on how we will support a smooth patient experience that embodies true integrated virtual and in-person care.
Will my Gennev telehealth doctor collaborate on my care with any other physician that I see within the Unified network?
Our intention is to fully support women’s care between Gennev telehealth providers and in-person care providers throughout the Unified network of 2500 providers. Stay tuned for more information on how we will make that a smooth patient experience that embodies true integrated care.
Can I use my Integrated Care Plan from Gennev?
Yes, you can continue to use your Integrated Care Plan (ICP) from Gennev with your Gennev OB/GYN and dietitian. Your ICP is not currently available to use across the Unified network of 2500 providers at this time unfortunately.
Does Gennev’s partnership with Unified mean that my appointments will now be covered by my medical insurance?
Currently your Gennev appointments will still be paid out of pocket. Remember to secure your receipt/superbill to submit to your insurance for reimbursement. We are working on in-network coverage, so stay tuned.
How do I get in touch with a Unified doctor?
You can call a Gennev patient coordinator at 206.895.4292 and they will help direct you.
“
“
“My uterus went to the Dark Side.”
That’s how Ann-Marie Archer described life before discovering she had fibroids. “It was horrendous,” she told us: period flow so heavy, she had to plan around it, vaginal pain, incontinence.
And the worst of it was not knowing what was going on or if her experience was normal. Her doctor kept brushing off her concerns as “just menopause,” and searching the Web didn’t really help as there just wasn’t much information out there. But when she twice bled hard enough to soak her surroundings, she knew she had to push for answers.
It turns out she had uterine fibroids. Fortunately, the vast majority of fibroids are benign (not cancerous), and many women don’t even know they have them. However, even the benign ones can cause unpleasant and sometimes debilitating symptoms, depending on location and size, so if you have them, it may be worthwhile to investigate your options.
To get more information on fibroids, their causes and treatments and what to look out for, we talked with Dr. Suzanne Gilberg-Lenz, ob/gyn, integrative medical doctor, and Clinical Ayurvedic Specialist.
Womenshealth.gov describes uterine fibroids as “muscular tumors [i.e. made up of muscle cells] that grow in the wall of the uterus.” A woman may have one or many, and they range in size from apple-seed small to grapefruit, though in rare cases, they can grow much larger.
For women like Ann-Marie, the symptoms are extreme enough to prompt further testing. Other symptoms include heavier, longer, more painful periods, pain during intercourse, incontinence, constipation, pelvic, back, and leg pain, and fertility issues, so women experiencing these should talk with their doctor.
For women with lesser symptoms or no symptoms at all, fibroids may initially be discovered (or suspected) when a gynecologist detects an enlarged or irregular contour of the uterus during a routine pelvic exam. Often an ultrasound will then be used to confirm, map, and measure the fibroids.
According to Dr. Suzanne, they are the most common benign tumor in women. Prevalence rates vary from 5-25 percent, with a lifetime risk of 70 percent for women. However, fibroids are approximately three times more common in African American women than white women.
Dr. Suzanne tells us there does seem to be a familial inheritance pattern and some racial differences. Based on those tendencies, newer research is focusing on possible genetics as a target for therapies, but the exact cause of fibroids remains elusive.
The treatment depends on the symptoms, says Dr. Suzanne, as well as on the location, size, rapidity of growth, and number of lesions.
For instance, a large fibroid in the anterior wall of the uterus may put pressure on the bladder and cause urinary symptoms; fibroids growing into the uterine lining can cause irregular or very heavy vaginal bleeding. In these cases, women may opt for a hysterectomy. And indeed, fibroids are the number one reason for hysterectomies. However, Dr. Suzanne says, you should talk with your doctor about all your options: minimally invasive outpatient surgical options like myomectomy (removal of only the fibroids) are available and an excellent option for many women, especially if fertility preservation is important.
Although cancer in a fibroid is rare, says Dr. Suzanne, occurring in approximately one in a thousand fibroids, rapidly growing fibroids in post-menopausal women should be managed by hysterectomy, as the risk of cancer increases substantially in that situation.
Uterine fibroid embolization (UFE) is a procedure done by an interventional radiologist in which the blood supply to the fibroids is blocked resulting in shrinkage. The recovery time is shorter than with surgery.
For women experiencing heavy bleeding, there are hormonal options such as birth control pills or progestin-containing IUD. Other medical options, both injectable and oral, may be used for up to two years to shrink fibroids. The primary indication for these medications is to shrink fibroids preoperatively since they tend to regrow after medication is stopped.
When it comes to using power morcellators to break up fibroids, Womenshealth.gov cautions against their use as they could spread cancer. And, according to Dr. Suzanne, the American College of Obstetricians and Gynecologists (ACOG) and other professional guidelines at this time do not recommend the use of power morcellators. However, she adds, “I think that in the hands of skilled and experienced laparoscopic gynecologic surgeon, the morcellator with a bag attached is an option. If you have already had the procedure, and the pathology on your tumors was benign, there is nothing to worry about. For added peace of mind, you could consult with a gynecological expert in fibroids or a gynecological oncologist.”
“Yes,” says Dr. Suzanne, “especially if you are pre-menopausal. Fibroids are notorious for re-growing, and there are often tiny seedlings that we cannot see or feel at the time of surgery deep in the uterine wall that can grow over time.”
There are no proven strategies that prevent fibroids from growing or returning, Dr. Suzanne says; many lifestyle studies have been conducted, and none have demonstrated any efficacy from abstaining from alcohol, changing diet, increasing exercise, and so on.
If fibroids are not symptomatic or rapidly growing, they really don’t need any treatment, Dr. Suzanne reassures us. “Watchful waiting is a reasonable strategy; as we pass through menopause, they often shrink, and symptoms disappear or diminish,” she says.
Fibroids are quite common, often problematic, rarely dangerous. If you suspect you may have fibroids, especially if you’re experiencing symptoms and you have a family history, mention it to your gynecologist. While the chances are high any fibroids discovered will be harmless, they can still cause discomfort and annoyance. Plus, you will have some peace of mind.
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.
“
This nutrient-packed recipe uses avocado oil for a healthy monounsaturated fat source. The soup is loaded with collagen-rich protein from the chicken bone broth and plant-based white beans. The leafy greens are particularly great for bone health since they contain both calcium and vitamin K, known to reduce osteoporosis risk in menopausal women.
Try this heart healthy dietitian-recommended recipe for a nutritious lunch, or dinner tonight.
Serves 4
From Monika Jacobson, RDN
Monika Jacobson is a Registered Dietitian Nutritionist (RDN) with over 15 years of experience coaching people through their health and wellness journeys, and is the owner of Eat Move Thrive Spokane.
If you need guidance on how to incorporate healthy recipes like this and others into your diet on a regular basis, consider working with Gennev’s integrated care team who are experts in supporting women in menopause.
“
Pelvic pain can be a frustrating issue at any time in life, but the pain and frustration can escalate during perimenopause. In one survey, abdominal pain, which encompasses pelvic pain, was one of the three most troubling menopause symptoms adversely impacting women’s quality of life. The pain can be so bad that it’s responsible for 11 percent of all emergency room visits each year. Yet many women grin and bear it.
“A lot of women think it’s a natural part of aging and that nothing can be done,” says Dr. Yashika Dooley, an OB/GYN who specializes in Urogynecology, Female Pelvic Medicine and Reconstructive Surgery. “There are lots of women who don’t have pelvic pain. Just because you’re in your 50s, 60s, or 70s, it doesn’t mean you have to give up your favorite activities or the life you want to live. This is a prime time of your life. You should be traveling, hanging out with your significant other, not suffering.”
Unlike some menopause symptoms that you can try to self-treat, pelvic pain is best managed in collaboration with your doctor or healthcare provider. You may be experiencing pelvic pain for many reasons, and treatment varies depending on the cause. Your doctor can quickly treat some causes like urinary tract infections, constipation, and sexually transmitted diseases. Depending on what’s causing your pain though, some remedies could make it worse. For example, Kegels are a popular recommendation for problems down there, but they can worsen some conditions. Working with your doctor or healthcare provider will enable you to get the most effective treatment more quickly for pelvic pain.
Pelvic pain is a complex problem because it has many causes and presents differently from one woman to the next. “The pain can range from a sharp, stabbing pain to a dull ache,” says Dr. Dooley. “It can be in the lower abdomen, going into the groin. It can be a deep, throbbing pain that’s felt more in the vagina. Some women feel it in their rectal area and have pain with bowel movements or while sitting on the toilet. Everybody describes it a little differently.” According to the North American Menopause Society, pelvic pain can be in the pelvis, front of the abdomen, lower back, or even the buttocks, and it can be hard to distinguish from other medical conditions.
Chronic pelvic pain affects about 15 to 20 percent of women ages 18 to 50. While pelvic pain or conditions that cause it doesn’t tend to increase with age, women in perimenopause and postmenopausal women aren’t immune to it. Some problems that cause abdominal pain, like diverticulitis, are more common as you age. Even worse, pelvic pain during this stage of life is often more debilitating. “In menopause, you may experience pain as being more severe,” says Dr. Dooley. “Because hormones are changing and tissues and muscles aren’t as pliable, the level of pain you may experience can be so much worse.” For example, women who have had irritable bowel syndrome (IBS) report a worsening in the severity of their pain in menopause. Research shows that estrogen reduces pain severity. Hence, as estrogen levels decrease, your pain, whether due to a new or existing condition, may increase.
Acute conditions like infections or gastrointestinal issues can result in pelvic pain. And just like IBS, conditions you may have had for years, such as endometriosis or fibroids, can still cause pain, possibly even worse during menopause. Sometimes it’s due to cramping even if you’re not getting your period. A common cause, especially if you notice pain during intercourse, can be vaginal atrophy, which results in changes in the lining of your vagina due to a lack of estrogen.
Trauma, sometimes that you don’t even notice, or overuse can cause pelvic pain. One of Dr. Dooley’s patients developed pelvic pain after a bike trip. “She was sitting on a bike for two weeks, and when she got back, she had problems,” she says. “Your muscles can get into a spasm because you’re doing something they’re not used to doing.” A fall or an injury like a sprain that causes you to change your gait can also lead to spasms. Intercourse can also be a trigger.
Often, pelvic pain can be a combination of things, and the fastest way to unravel the mystery is with the help of your doctor. They’ll usually start by getting a complete history, asking you lots of questions about the pain and your lifestyle, and doing a physical exam. Based on all of that information, your doctor may also order diagnostic tests such as lab work, blood tests, an ultrasound, or other imaging tests such as an MRI or CT. Here’s what you can do to help.
Keep a pain diary. Be specific about when and where the pain occurs and any activities, situations, or foods that trigger it. This is valuable information that can help your doctor get to the root cause of your pain more quickly.
Stop doing what makes it hurt. Some women find that the pain worsens with specific activities, such as exercise or intercourse. “If you notice a trigger causing the pain, it’s best to stop doing that until you see your doctor,” says Dr. Dooley. “If you’re constantly irritating and retraumatizing it, the pain will get worse.”
Skip the Kegels. Kegels strengthen the pelvic floor muscles and can be an effective therapy for urinary incontinence. However, if muscle spasms are causing your pain, the last thing you want to do is contract those muscles. “If you have a spasm in your back or get a Charlie horse in your leg, you don’t go to the gym and work out,” says Dr. Dooley. “You massage or stretch it. You want to relax the muscles. You need to do the same in the vagina, but it’s hard to relax them on your own. That’s when a pelvic floor physical therapist can help.”
Curb stress and anxiety. We know it’s tough to escape the pressure, especially during this stage of life. But the effort may be worth it. Research shows that when you’re stressed out or anxious, pain increases, and when you relax, it decreases. Stress may influence some types of pain more than hormone levels do. The good news: There are many ways to relax. Some take just a few minutes, like deep breathing. Others”like dancing to your favorite tunes, petting your dog or cat, or walking in nature”can be enjoyable. There’s no right way to relax, so find what works for you and do it regularly.
Sometimes pelvic or abdominal pain requires immediate attention. If your pain is accompanied by unintentional weight loss, changes in your bowel habits, nausea or vomiting, blood in your urine or feces, abdominal swelling, or painful sex, talk to your doctor or healthcare provider as soon as possible. If you experience sudden, severe pain on the lower right side of your abdomen, it could be appendicitis and needs immediate attention. If there is any chance you could be pregnant (it can happen in perimenopause), pain could be a sign of an ectopic pregnancy and needs immediate attention. The pain associated with an ectopic pregnancy is sudden, severe, and on the lower right or left side of your abdomen.
Quality menopause care begins with a conversation between the provider and patient. Gennev’s board-certified OB/GYNs initiate care of their patients with a 30-minute consultation, dedicated to listening and learning about your menopause symptoms and experiences, as well as offering medical guidance. Book a virtual visit today.
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.
“
What foods come to mind when you think carbs? Cookies? Pasta? Potatoes? Bread? Donuts? Fruit? If you take a trip down fad-dieting memory lane, you may see that the diet industry has, for the most part, demonized carbs and instilled an intense phobia around carbohydrates in general (Atkin’s, Keto, South Beach, Paleo, Whole30 to name a few). The fear around carbs is comparable to the 1990’s when the world feared eating fat. Remember the low-fat and non-fat everything? Thank goodness we have learned from this. However, fatphobia has now been replaced with carbophobia.
All foods are composed of three macronutrients-protein, fat and carbohydrates. We have three macronutrients for a reason and they all serve important functions in the body. Protein helps to repair and build muscle; fat helps with hormone production and nutrient absorption and carbohydrates provide us with the quickest and most readily available form of energy. Gennev Dietitians agree that carbohydrates serve many key purposes in our body and certainly during all stages of menopause, when you may really benefit from the much-needed energy that carbohydrate-rich foods can provide. And, when you are restricting carbs, you may tend to crave more of them. Is this sounding familiar? This is the body’s normal and natural response to scream out for what it wants and needs (hello 4 pm sugar cravings).
Another common problem many women encounter is undereating early in the day and then feeling sluggish, tired, irritable and hangry by the afternoon. That’s when we want to eat ALL THE CARBS! If you can relate to this, you’re not alone.
We have an unnecessary fear of eating carbs, but they are important for energy, satiety and digestion. Strict low-carb diets like many of the recent fads are not sustainable for most people. We need carbs every day, and the amount of carbs is going to vary person to person. This may be related to genetics, activity and your own biochemistry. Eating a balanced diet of all 3 macronutrients (protein, fat and carbohydrates) is crucial for maintaining good health and Gennev Dietitians advise on the importance of balanced fiber-rich carbs with healthy fats and lean protein. This balanced plate approach aligns well with the Mediterranean Diet which includes carbohydrates such as vegetables, fruit, legumes and some whole grains. So, enjoy those whole grain breads, potatoes, carrots, fruit and any other fiber-rich carbs that have unfortunately been painted in a bad light. And enjoy the chocolate and cupcakes too – but save them for a special treat.
If you need support putting these tips into action, book a virtual visit with a menopause specialist to help you optimize your health and nutrition. Our board-certified OB/GYNs and Registered Dietitians can offer you a wellness plan that is unique to your individual needs.
“
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.
“
Weight changes through the perimenopause and menopause transition are so common they may feel inevitable. And a little bit of hormonal weight gain isn’t a bad thing as it can even be protective.
However, how much our weight changes and where new gain is deposited as fat can have impacts on our health. During the menopause transition, weight begins to settle in the abdominal area rather than on hips and thighs, and that can lead to health problems.
In a study in the UK, researchers discovered that women who carried more weight around their middle had a 10% to 20% greater risk of heart attack than women who were just heavier overall. And, excess belly fat may pose a greater danger to women than to men.
Clearly, managing weight is important. It’s also really hard. So, we asked Gennev’s Monika Jacobson who is a Registered Dietitian Nutritionist, and Nicole Negron who is Functional Nutritionist, to help us understand how hormones are related to weight gain, and how to manage our weight for better health.
Monika explains, “As women age, metabolism naturally slows down and this is partially due to a decline in estrogen. Additionally, stress (both physical and mental/emotional stress) causes a release of cortisol into the body which can lead to an increase in food cravings, difficulty sleeping and often resulting in weight gain. It’s also common for fat to accumulate around the abdomen during menopause when previously fat settled into other parts of the body. This is all very normal and natural although it can make some women uncomfortable with these changes.”
Hormones begin to fluctuate in women 35 and over. This is a very normal and natural physiological transition of the body. These hormonal fluctuations have an impact on how the body utilizes energy which in turn, may affect the way body fat is stored. The functional approach is to change your food, lifestyle, and fitness routines to accommodate for this change in hormones. What once worked before menopause may require some adjusting to see changes.
Nicole shares, “It’s important to recognize that weight gain is sometimes a warning sign of a deeper hormonal imbalance. When a woman gains weight, this may be a sign that her blood sugar and insulin levels are unstable, affecting her other fat-burning hormones of thyroid, testosterone, estrogen, and cortisol.”
Nicole shares that there is no one-size-fits-all approach. But as a general guideline, during the menopausal transition, she encourages her clients to eat more, not less. The name of the game is FAT, FIBER, and PROTEIN at every meal.
“Plan to eat meals a little closer together (like every 3-4 hours) to stabilize blood sugar and prevent overeating later in the day,” says Monika. “A balanced plate consisting of ½ plate vegetables, ¼ plate fiber-rich carbohydrates and ¼ plate lean or plant-based protein with some healthy fat, is the best approach for sustainable nutrition.
And when sleep is insufficient or not restful, this can lead to increased cortisol which can result in food cravings, making it harder to maintain weight. It’s also more difficult to exercise when feeling tired and fatigued. Since not getting enough sleep can be a risk factor for weight gain, you really want to be sure you’re doing everything you can to get quality sleep.
Gennev Dietitian Tip: If you suspect caffeine or alcohol may be impacting your sleep quality, consider a trial of cutting back or eliminating these and see what happens.
You may also want to consider speaking with a Gennev menopause specialist to address other ways hormones may be impacting your sleep, and lifestyle approaches that can help you get quality rest.
Monika explains, “Time and again, research indicates that a Mediterranean style of eating best supports the health of most people, including women in any stage of menopause. This is due to the natural variety of nutrient-dense whole foods like fiber-rich vegetables and whole grains, healthy unsaturated fats and lean protein while limiting processed foods, high saturated fat and added sugar.”
By following the Mediterranean diet lifestyle, these foods will help optimize health by reducing risk of heart disease, improve or prevent systemic inflammation, lower risk for Type 2 Diabetes and maintain a healthy weight for your body type. Learn how to get started with the Mediterranean Diet with our article How to Eat the Mediterranean Diet Way.
It’s difficult to prioritize exercise when you feel that deep fatigue, especially when you’ve experienced multiple nights of poor sleep. Try setting small, attainable goals around movement instead of going for intense exercise expectations that you may just want to avoid. Try a 20-minute walk at a pace you are comfortable with. Or, try splitting up your exercise into multiple sessions such as a 10-minute stretch in the morning, 15-minute walk at lunch time and a 10-minute strength session with body weight at home in the evening.
Nicole shares, “One of the common things I notice with my clients when they’re transitioning, is they are under enormous stress in menopause as and stress can be exhausting.”
Women in this stage (and in every stage, really) need to focus on reducing stress. We need to take things off our plate to allow healing during times of depletion.
Monika notes, “As menopause-related fatigue improves, you’ll likely have more energy and motivation to move your body again. It’s a bit of a cycle. Better energy leads to higher motivation and likelihood of exercising which can often lead to improved sleep and waking feeling more rested and energized the next day ready to do it again.”
“Not at all!” says Nicole. “Hormones do so much in our bodies that it can seem like they’re in charge, but you’re not “at the mercy” of your hormones if you know what to do.”
Hormones are like plant seeds. For that plant to grow, you need soil, sun and water. So, for the hormones to work optimally they need good exercise, good nutrition, and good sleep. All of these lifestyle interventions help your hormones function optimally.
Alternatively general stress, emotional stress, and physical ailments all affect your hormone levels negatively. The more you know, the more in control you’ll be.
Take control of your health. Your body wants to be healthy, even though right now it might not seem that way. When you work with Gennev’s integrated care team, you will be connected with a Registered Dietitian Nutritionist who can help you identify the foods, exercise, sleep, and supplement regimes that work best for you, so don’t wait to get back in balance and feel better.
“
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.
Hot flashes and sleepless nights may get more attention, but issues “down there” can be more uncomfortable and last longer than other menopause symptoms. Vaginal atrophy, or atrophic vaginitis, is a prime culprit that can result in painful itching and burning. It’s also a common cause of pain during intercourse. Most women will start to experience symptoms in perimenopause when there is a significant decline in estrogen. Up to 60 percent of postmenopausal women experience symptoms of vaginal atrophy, yet only about 30 percent seek treatment, meaning too many women are needlessly suffering.
“Vaginal atrophy really can have a significant impact on a woman’s quality of life. It can prevent her from being able to sit comfortably, exercise, enjoy vaginal intercourse, and put her at increased risk of infections. The constant pain can be annoying and irritating and cause an additional emotional burden of feeling like she is unable to enjoy simple things.” –Dr. Yashika Dooley, M.D.
Many women are embarrassed to talk about issues “down there,” even with their doctors. But here’s the thing, there are lots of treatment options, and unlike other menopause symptoms that tend to dissipate once you’re postmenopausal, vaginal atrophy doesn’t go away. “If you don’t treat it, it’s just going to get worse as you have less estrogen,” says Dr. Yashika Dooley, who has a sub-specialty in urogynecology. “It starts off as a small thing, but then it begins to affect so many areas of your life. It becomes all-encompassing, and you don’t want that.” The sooner you talk to your doctor or healthcare provider, the sooner you can alleviate the pain, stop thinking about your vagina, and get on with enjoying life.
When you hear the word atrophy, you may think of it in the context of muscles. If you don’t work out, your muscles will atrophy”or shrink and weaken. But atrophy doesn’t just apply to muscles. And when it comes to “down there”, vaginal atrophy is about the lining of the vagina.
“Before menopause, estrogen causes the layers in the walls of the vagina to be thick and elastic,” says menopause-certified gynecologist and Gennev Chief Medical Officer Rebecca Dunsmoor-Su, M.D. Ample amounts of collagen give the lining elasticity, and lots of hyaluronic acid and blood vessels bring in moisture. The cells in the walls of the vagina create glycogen. Because of the vaginal wall structure, the top layer of the wall regularly breaks away. This attracts good bacteria like lactobacilli which feed on the glycogen to keep the pH of the vagina low. A low pH creates an acidic environment that keeps away harmful bacteria and yeast and reduces your risk of infections.
Declining estrogen levels with menopause are the primary cause of vaginal atrophy. “All of these things that keep the vagina plump rely on the stimulus of estrogen,” says Dr. Dunsmoor-Su. Just like you may notice that your skin and hair are drier during this stage of life, things down there can get drier, too. The lack of estrogen reduces the production of moisture, collagen, and acid, making vaginal tissue thinner, less elastic, and more fragile. Many women notice increased discomfort or decreased sensation due to these changes, making sex painful and orgasms harder to achieve.
The decrease in estrogen that occurs with menopause leads to decreased blood flow and vaginal lubrication (vaginal atrophy). Vaginal atrophy ultimately leads to changes in the pH of the vagina. Lactobacilli can no longer survive, so other bacteria replace them, and these are sometimes not such “good guys,” increasing your risk of infections. These changes can also cause urinary issues, such as frequent urination, leaks, and infections. That’s why vaginal atrophy is often referred to as genitourinary syndrome of menopause, which encompasses both the vaginal and urinary tract changes that occur as estrogen levels decline.
Since estrogen levels fluctuate during perimenopause, you may not notice symptoms until you’re closer to menopause or postmenopausal when estrogen takes a nosedive. Women who’ve never had a vaginal birth are more likely to develop symptoms than women who have, although the reason why is unknown. Women who’ve entered menopause more abruptly due to surgery or cancer treatments also tend to have worse symptoms.
While you can’t stop the decline of estrogen, you can control two common risk factors: smoking and a lack of sexual activity. Smoking can inhibit the effects of any estrogen that you still have. It also affects circulation, decreasing the flow of nourishing nutrients and oxygen to that area. Likewise, a lack of sex can have a similar effect. Sexual activity, with or without a partner, stimulates blood flow and can keep your vagina more elastic.
You can also take steps to avoid aggravating symptoms.
Ditch tight clothing. The restriction can make burning, itching, and pain worse. You also get less airflow, which can increase your risk of infections.
Wear cotton underwear. It’s more breathable to keep you drier and reduce your chance of an infection.
Skip scents. If you use any products down there, stick to unscented varieties. Perfumes, fragrances, and other chemicals can make symptoms worse. The fewer and the more natural the products you use in your vaginal area, the better. And look for products that are pH balanced.
Don’t douche. It can further dry out your vagina and increase your risk of infection.
Sleep au naturel. When you sleep without underwear, there’s no rubbing, and the area can air out. “Having nothing irritating it for six to seven hours at night gives the tissues time to heal,” says Dr. Dooley.
Retire sanitary pads. If you need protection from urinary leaks, use incontinence liners. They wick away moisture and form a barrier to keep the skin drier than menstrual pads. Constant moisture against your skin can irritate like a baby’s diaper rash.
Eat more soy. Soybeans, tofu, soy milk, and flaxseeds are high in phytoestrogens, plant compounds that act like estrogen. Some research shows that eating foods high in phytoestrogens reduces vaginal dryness. Eating more soy may also help with other menopause symptoms like hot flashes.
The strategies above can help ease some of the burning, itching, and pain associated with vaginal atrophy,and for some women, that will be enough to manage their symptoms. However, lifestyle changes don’t address the underlying structural and functional changes in the vagina as estrogen declines. Some women will need to address those issues to get relief. Here are some options your doctor or healthcare provider can offer you.
Moisturizers and lubricants
“Depending upon the severity of your symptoms, using a combination of a vaginal moisturizer during the day and a lubricant when you’re having sex may solve the problem for some women. Here’s what to look for in these products.
If you find products that work for you, use them like hand lotion, putting them on throughout the day. “If you have dry skin, you don’t just put lotion on once a day,'” says Dr. Dooley. “Whenever you notice the dryness, you put on more lotion. It’s not a big deal.” If your vagina is irritated, use moisturizer or lubricant anytime during the day. Do not use petroleum jelly inside of the vagina because it can increase your chances of a yeast infection.
Moisturizers and lubricants are only treating the symptoms, though. They don’t change the tissue in the vagina. So, if they aren’t providing enough relief or stop working, see your doctor or healthcare provider STAT! “It’s easy for doctors to fix, and there are lots of ways we can fix it,” says Dr. Dooley.
Hormone therapy
“Topical estrogen is an effective treatment for many women and comes in various forms. “In terms of hormones, in my experience, treating the vagina directly is key to getting a good response,” says Dr. Dunsmoor-Su. Creams, suppositories, or vaginal tablets are used daily for a few weeks and then one to three times a week to maintain estrogen levels and manage symptoms. There’s also a vaginal ring that your doctor places in your vagina. All you have to do is have it replaced every three months. If other menopausal symptoms are also disrupting your life, your doctor or healthcare provider may suggest oral estrogen or an estrogen patch, depending on your medical history.
Laser therapy
“There are several devices on the market, but the one with the most evidence to support it is the Mona Lisa Touch device. The theory behind the laser is that it stimulates cells in the vagina to start rebuilding and rehydrating the area. It’s like turning back the clock. The tissues become thicker. The pH is rebalanced so healthy bacteria can thrive. In studies that track patient outcomes (but don’t provide comparisons) they show up to 90% symptom relief, however comparative studies are less positive, and there is some question about effectiveness of this therapy. Laser therapy may also help with incontinence and pain during intercourse. Three initial treatments spaced six weeks apart are required, followed by annual maintenance treatments. Unfortunately, insurance doesn’t cover laser therapy for vaginal atrophy. The cost is usually between $600 and $1,000 per treatment. If you choose to try laser therapy, there are a few important warnings:
Like so many menopause symptoms, the severity of vaginal atrophy can vary from one woman to the next. These changes can also affect you both physically, mentally, and emotionally, especially when you consider all the other changes going on in your body while you’re trying to juggle a busy life. The right doctor or healthcare provider”one who is menopause-trained“can help.
Gennev’s board-certified OB/GYNS are menopause specialists, and can offer more solutions for the menopause symptoms you’re experiencing. They’ll make it easier for you to talk about embarrassing problems like vaginal atrophy. With the right help, support, and treatment, you’ll feel more comfortable, and more confident. Book your virtual visit now!
“
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.
We all need to “reset” our nutrition habits every once in a while. Most often, we may feel like we need to reset after a vacation or the holiday season. Or maybe certain eating behaviors have led to less than ideal nutrition, and you’re seeking a bit of focused structure with your meals again. By the way, this is all very normal, and “resetting” can be a good way to reboot, support your body, and feel your best – especially throughout menopause.
At Gennev, we educate and support our patients on finding a sustainable way of eating that doesn’t focus on restriction. Research shows that weight loss diets can work, but many of the benefits are short-term versus for the long-haul. And they can leave women feeling deprived and frustrated to only gain back the weight they lost (and sometimes more). By approaching instead with a nutrition reset that modifies one focused behavior at a time, we are much more likely to be successful in the long term. And you may find that just a couple days of being intentional with what you are eating can lead to feeling more confident and comfortable in your body. You may also experience less bloating, better energy and even a boost in mood!
Our 4-week Nutrition RESET is about just that – supporting you in feeling more empowered and confident in your own skin. Each week of the Reset has a focused goal. Aim to work on each reset challenge, one day at a time. After one week, that behavior may start to feel more like a habit. But be compassionate with yourself! It takes more than one week to make sustainable changes stick.
As the 4-week Nutrition Reset Challenge evolves from one week to the next, you will be adding one new behavior change, while continuing with – and building upon -the previous week’s focus. By the end of four weeks, you will have four KEY healthy behaviors in place which will support you in feeling your best. Ideally these new nutrition habits will continue on far beyond the 4-week Reset. But if you should stray off track, use this Reset as a way to “steer your ship back on course”. One thing at a time.
First up in the 4-Week Reset Challenge is all about vegetables! We all know we need more vegetables and most of us still don’t get enough. How many do we really need? Health experts recommend at least 3 cups of vegetables per day and this doesn’t change in menopause. However, we suggest that vegetables are even more important as we age to support our heart health, stabilize our blood sugars, regulate our digestion and provide a healthy gut biome, and deliver the antioxidants that eat up free radicals in our bodies and prevent disease.
The simplest way to put this into action is the make “1/2 your plate veggies” concept. This pattern on your plate is often easiest at lunches and dinners (considering the typical American diet), but including vegetables at breakfast are an added bonus, and you should add them whenever you can!
By planning meals around the vegetables, you will naturally prioritize them too. Sometimes these vegetables are mixed into a recipe and sometimes they stand alone on the side. Nevertheless, they are present and doing their job. Here are some sample ways to add vegetables to each of your meals.
Breakfast
Lunch
Dinner
Week 2 of the Nutrition RESET is all about adding phytoestrogens to your daily meals. These are plant-based compounds that bind to estrogen receptors and mimic the effects of this hormone in our bodies. Phytoestrogens may be particularly beneficial during menopause, as studies show they may help with hormone balance and reducing hot flashes. However, it’s important to be consistent with eating these foods to experience the potential benefits.
There are three different types of phytoestrogens: isoflavones (found in soy and legumes), lignans (in most vegetables, fruits and whole grains), and finally coumestans (found in some beans). The highest levels of phytoestrogens are found in soy, soy products, and flaxseed.
While the research on consuming phytoestrogens for menopausal relief is still limited, Gennev Dietitians agree that people can glean many other health benefits from eating these foods as they are rich in fiber, protein and antioxidants to support overall health. Give this healthy addition a try, and remember consistency is key!
How to add more phytoestrogens into your diet:
Week 3 of the Nutrition Reset challenges you to take a look at your supplements, and determine which ones you really need, and which ones you can ditch (and start saving some dollars). Think of this as a “supplement audit.”
Supplements are intended only to supplement the diet. A diet rich in vegetables, fruits, protein, healthy fats and fiber may not need additional supplemental nutrients. Many individuals take vitamins to help “fill in the gaps” where the diet is lacking, or to address certain symptoms related to menopause. As women age, their nutritional needs change and certain nutrients may be needed in higher amounts than before. Conversely, women may not need the same supplements they were taking during child-bearing years (folic acid for example) and when menstruating on a regular basis (extra iron for some).
What are the common “gaps” where supplements are needed in midlife? And which vitamins help us to fill those gaps?
There are some key supplements that may be more beneficial during the menopausal transition and to help manage symptoms. Remember, every person is different so every woman in menopause will not require the same dietary supplements. Some common gaps in the diet include:
A Registered Dietitian can help you audit your supplements, and take your personalized supplement plan to the next level. They will consider your diet, lifestyle, current medications and menopause symptoms to provide tailored recommendations specifically to you. They will also help you determine if you’re taking the correct dosage, ensure you are using a safe and reputable brand, and identify if there are any contraindications for using it.
It’s important to remember that supplements are regulated by the Food and Drug Administration as food, not as drugs. This means the FDA does not have the authority to approve the labeling, safety or efficacy of dietary supplements before they are on the market. Therefore, it’s crucial to consult with your health care professionals to ensure safety, potential drug interactions and overall potential effectiveness of the supplement.
This final week of the Nutrition Reset is all about hydration. We have all heard it’s important to drink water, but why exactly? And do we need to drink more water in menopause? We sure do! This is due to the declining estrogen making it harder for the body to retain moisture. Drinking adequate water is a fairly simple behavior change that can improve many menopausal symptoms such as dry skin, hair or nails due to estrogen decline, combat bloating or constipation, prevent headaches, reduce bladder urgency and irritation, improve menopause related nausea, ease cramps and even help with maintaining a healthy weight and preventing food cravings. Even mild dehydration can lead to uncomfortable symptoms like dizziness, fatigue and brain fog.
How do I know if I’m dehydrated?
The simplest way to determine if you’re already dehydrated is urine color. A well-hydrated person will have pale, light yellow urine. If it’s beginning to look darker yellow or even slightly orange, that’s likely dehydration. But, be aware some supplements such as multivitamins with high B vitamin concentration can make urine color very bright yellow-like a highlighter.
By drinking water early and consistently in the day, you’re much more likely to maintain adequate hydration. Remember if you tend to sweat a lot with exercise, hot flashes, or hot weather, you are more prone to dehydration. Also, as we age our natural thirst mechanism doesn’t work quite as well, so we may not feel as thirsty as we did earlier in life.
How much water do I need?
The easiest way to approximate your water needs is to aim for half your body weight in ounces. For example, a person weighing 150 pounds would need about 75 ounces of water per day.
Adequate hydration can be met with any unsweetened, non-caffeinated beverages such as plain water, sparkling water, herbal teas or infused water with foods like citrus fruits, berries or fresh herbs.
Tips to increase your water intake:
Proper nutrition is key to warding off disease as we age. If you need guidance on how to incorporate healthy foods into your diet on a regular basis, consider working with our integrated care team who are experts in supporting women in menopause. They will create your personalized plan that will optimize your nutrition and other lifestyle factors, plus provide the support to create healthy habits for the long-term.
“