If your Oooooooos are more Owwwws, you’re not alone. According to Emily Sauer, founder of the Ohnut, painful sex affects up to 75 percent of all women at some point in their lifetime.

Let’s say that again: Up to three-quarters of all women experience painful sex at some point in their lives. For some, the pain is temporary, the result of childbirth or vaginal dryness during certain times in their cycle as for others, it’s chronic. Many women’s pain can be solved with a good vaginal lubricant or intimate moisturizer; some may require a little more help.

Women who have pain or fear pain may start avoiding sex, which can be hard on intimate relationships, and they miss out on all the physical and emotional health benefits of a fulfilling sex life.

Sexual health is part of overall health and well-being, and pleasure during sex or intercourse shouldn’t be considered just a “nice to have.” So why does pain happen, and more importantly, what can we do about it?

What causes pain during sex?

According to pelvic physical therapist Rachel Gelman, “Pain with sex can be due to many factors, and a person usually has several factors at play. They can be anything from hormonal dysfunction to myofascial restrictions. As a pelvic floor physical therapist, I address the musculoskeletal piece that may contribute to pain with sex, but a patient may need other providers on board to address the other elements that may be driving their symptoms. Those providers may include a sex therapist, OBGYN, urologist, naturopath, or acupuncturist. The process can be frustrating but know that there are providers out there who can help!”

So be aware that you may need help both zeroing in on the cause and choosing the right solution.

1. Vaginal dryness is very common among women who are perimenopausal or post-menopausal, breast-feeding, receiving cancer treatment, or taking oral birth control pills, all of which can affect hormone levels. When hormonal changes like estrogen declines, so does vaginal moisture and resiliency. The drier, thinner tissue may tear more easily in penetrative sex or play, causing pain and leaving the vagina more vulnerable to infection. Possible solutions include lubricants and moisturizers, topical estrogen creams or a low-dose vaginal estrogen ring. Or for women who can’t have or don’t want hormones, laser treatments such as the Mona Lisa Touch offer a possible alternative.
2. Vaginal tightness can happen when a woman isn’t feeling relaxed and ready, if she’s nervous or fearful, or if she hasn’t had sex in a while. In many cases, extended foreplay and/or conversation may be all she needs. If the woman is suffering vaginismus, an involuntary tightening of the vaginal muscles, she may need to get outside help from a doctor, pelvic physical therapist, or sex specialist.
3. Vaginal infection or irritation can certainly take the fun out of sex. Yeast infections can cause pain, even without the added friction of penetration, and irritation from contraceptives (foam, “flavored” condoms), lubricants that contain fragrances or “warming” qualities, harsh soaps or detergents, or douching can also make sex uncomfortable. In the case of infections, waiting until the infection is gone is best (and also reduces the risk of transmission); in the case of irritation, identifying and banishing the irritant should take care of the pain.
4. Basic biology. A pain in the lower abdomen could mean your partner is actually bumping up against your cervix, the lower part of your uterus. Or if your uterus is tilted backwards, you can also have pain from too-deep penetration. You can change position to limit thrust; being on top gives the woman greater control. We’re also really excited about the launch of the Ohnut, a customizable wearable that allows you to control penetration depth in any position. Comfortable, interlocking rings placed on the penis determine how far in your fellow can go, so you can relax and enjoy the moment.
5. Endometriosis causes a lot of women a lot of pain, including during sex. In endometriosis, the tissue that should stay inside and line the uterus grows outside as well and can involve the ovaries, Fallopian tubes, and pelvic tissue. When it comes time for the tissue to slough off as it would during a normal menstrual cycle, there’s no exit, and this can cause considerable pain. Treatment for endometriosis may require surgery or pain medication, though some women find relief from hormones such as birth control pills.
6. UTIs. Because urinary tract infections make the area sensitive and painful already, adding intercourse can increase the discomfort. Antibiotics are usually required to clear up a UTI; for recurrent issues, it might be time to consult a urologist or ob/gyn.

Don’t endure painful sex or give up intimacy entirely. Devices like the Ohnut can be part of the fun, if you keep minds and lines of communication open. And introducing a toy or vibrator like the smart Lioness Vibrator sex toy can extend foreplay, help you feel more ready (and thus more relaxed and possibly more lubricated), and bring the fun back to a potentially stressful time.

When should I talk to my doctor about painful sex?

Don’t wait. According to Rachel, “If a person is experiencing pain with sex, they should consult their healthcare provider. I know many people report their providers don’t ask about sexual function, and it can be intimidating or embarrassing to bring up, but no one should have to suffer in silence and there are many treatment options for someone experiencing pelvic pain.”

In short: If it hurts, start talking. If your doc doesn’t ask about your sex life, tell her. Because there are so many possible issues, getting properly diagnosed means identifying the right solution and getting your better sex life back that much faster.

If you need support in managing painful sex, a menopause-certified physician can be helpful. Book a visit with a Gennev doctor.

Have you experienced painful sex? What did you do or are you doing to deal with it? We’d love to hear from you, so please share in the comments below, on Gennev’s Facebook page, or in Midlife & Menopause Solutions, Gennev’s closed Facebook group. 

Unfortunately, given that menopause affects women and people in gender transition, it’s been largely ignored by mainstream medicine. That’s why we recommend you work with a menopause specialist. So doctors receive little to no training specific to the issues of menopause and post-menopause health. This is improving, but the effects of better training are only beginning to be felt and may not have trickled out to your area yet.

In fact, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

Do I really need a menopause doctor specialist?

Yes. Just as you need a specialized doctor for pregnancy and childbirth, you really need a specialized doctor for menopause.

The body changes that come with this time in a person’s life are profound and systemic “” because we have estrogen receptors virtually everywhere in our bodies, when that estrogen dips, flows, and recedes, the impacts are felt everywhere.

So, it’s possible your doctor may not know a lot about menopause. According to the CT Mirror, “One recent survey of obstetrics/gynecology residents found that fewer than one in five polled reported receiving any formal training in the topic.” And those are OB/GYN residents! Now imagine how much training your GP has probably had.

This lack of expertise, coupled with the still-pervasive misinformation from the Women’s Health Initiative on the safety of Hormone Replacement Therapy for hot flashes and other menopause symptoms, means many women just aren’t getting the treatment they need and deserve. Doctors who specialize in menopause are still a bit like unicorns, so you may need to search a bit to find one.

What is a menopause specialist?

While the designation “menopause specialist” isn’t recognized by the American Board of Medical Specialties, there are ways to tell if your doctor has a good understanding of menopause care. We encourage anyone needing medical help with menopause symptoms to interview doctors; anyone can call themselves a “menopause doctor specialist” “” be sure yours really is one.

NAMS, or the North American Menopause Society, is the largest non-profit organization devoted specifically to the health of women in midlife and beyond. Their membership is made up of experts in the field, in medicine, nursing, sociology, psychology, nutrition, epidemiology, and so on.

NAMS offers a training and certification that is generally considered to be excellent and reliable, so if your doctor is an NCMP (NAMS Certified Menopause Practitioner), you can rest assured they have had quality training. If your doctor is not an NCMP, that doesn’t mean they aren’t qualified to deal with menopause issues; you may just want to conduct a bit of your own research.

Questions for your ob/gyn or physician:

1. Are you certified by the North American Menopause Society?
2. What percentage of your practice is with women in midlife and menopause?
3. What is your position on hormone replacement and why?
4. What lifestyle changes do you recommend, if any, and why?
5. How do you treat those in menopause and perimenopause differently than premenopausal patients?
6. What kinds of problems and outcomes have you seen for women dealing with menopause issues?
7. On average, how much time do you spend with these patients during a visit?
8. What society recommendations do you follow when providing menopause care? (The North American Menopause Society or NAMS is a good answer. ACOG or the American College of Obstetricians and Gynecologists is another.)
9. Are you willing to earn an NCMP designation? Why or why not?

Finally, listen to your gut. When dealing with such personal, sensitive issues, you want a doctor you feel comfortable with. You may need to be very open about your sex life, your intimate areas, and things we’ve been culturally conditioned to be embarrassed about (periods, hot flashes, aging, libido). Docs, and particularly OB/GYNs, are ready to talk frankly “” you need to be too.

How do I find doctors who treat menopause near me?

If you are looking for doctors who treat menopause near you, sadly, there probably isn’t one physically close to you. The number of OB/GYNs in most industrial nations is declining. We’re already facing a shortage in the US, and we’re losing more to retirement than we’re gaining from medical schools.

And since menopause management doctors are already thin on the ground, those in need of menopause treatment are already finding it difficult to locate the care they need. Searching on “menopause specialist near me” isn’t likely to find you much.

Fortunately, there are resources.

Menopause care via telemedicine

If there isn’t a menopause-focused doctor in your area, you’re not out of luck. The rapid growth of telemedicine during COVID has made it possible for women to access great menopause care, anywhere their internet connection reaches. Gennev offers [telemedicine access ](https://gennev.com/plans)to menopause specialists. Our team of gynecologists serve patients in all 50 states, so you are assured to find a licensed, experience and often-times NAMs-certified practitioner at the click of a button. You can learn more about Gennev’s team of menopause specialists here .

Technology is filling the gap for many women.

For many of us, prior to COVID, the idea of seeing a doctor virtually was nearly unimaginable. How can they diagnose us via a camera?

It’s very possible, says our own Chief Medical Officer, NCMP and gynecologist Dr. Rebecca Dunsmoor-Su. In fact, she says, most menopause care is based around a conversation between patient and practitioner, and this may actually be better via telemedicine.

“When it’s a telemedicine appointment, I generally have lots of information before we even start talking. That means I have the basics and can jump right into the problem/solution part of the conversation,” says Dr. Dunsmoor-Su. “Often women don’t know what’s going on with them, so by asking questions, I can help them figure out where they are in their journey and what menopause treatment options they have. At Gennev, we’re open to any treatment that shows promise and is medically proven to be safe. All women are different and every menopause journey is unique, so we want to be sure women have access to every possible option.”

And because Gennev has a wide network of menopause focused doctors, if a patient needs to be seen in person, Gennev’s telemedicine doctors can make referrals and help women prepare for their appointments.

COVID revealed a need for more telemedicine access, and Gennev took advantage of modified requirements to bring more states on board and staff them with doctors who specialize in menopause. “Prior to COVID, each state had different requirements for a doctor to practice in their state via telemedcine,” says Gennev CEO Jill Angelo. “COVID proved that some states were lagging behind due to unnecessary barriers. Thanks to a reduction in barriers, we’re now able to provide a truly qualified menopause practitioner in every state in the US.”

Find a menopause specialist

A great way is using the “Find a Menopause Practitioner” feature on the NAMS website. All the doctors listed are NAMS members, and those certified by NAMS are designated as such.

Another tool? Each other. If you’re looking for a great doc, ask your friends; if you have one, share!

So, don’t wait until menopause symptoms make your life difficult. If you’re a woman, it’s never too soon or too late to get informed.

If you’re premenopausal, a doctor or menopause-trained health coach can help you understand how to take care of yourself now to feel great and avoid problems in the future. If you’re in perimenopause or if you’re post-menopausal, get the help you need to relieve symptoms and protect your bones, brain, heart, soul, and body for the many years of vibrant life yet to come.

Having the best ob/gyn is important, no matter what stage of life you’re in, but with all the changes and weirdness of midlife likeperimenopause rage and menopause hot flashes, a good gynecologist can be the difference between barely surviving and thriving.

And gynecologists of any kind are getting harder to find. “By 2020, there will be a shortage of OB-GYNs of up to 8,800, according to the American Congress of Obstetricians and Gynecologists. And by 2050, the shortage may grow to 22,000.”

That doesn’t mean you should settle for anything less than the right doctorfor you.

To help you decide if the doc you’ve got is the right OG/GYN for you, we asked the doc who’s perfect for us: Gennev Director of Health and ob/gyn Dr. Rebecca Dunsmoor-Su.

If you are looking for a great OB/GYN, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

How do you know when you’ve found the best OG/GYN for you?

According to Dr. Rebecca, the key to finding a beneficial therapeutic relationship is finding the right balance of some key ingredients:

1. Comfort and relatability as are you able to communicate well together?
2. Their knowledge, experience, and credentials as do they have any special training or interest in menopause?
3. Their ability to treat you appropriately as are they open to all the possibilities?

So, says Dr. Rebecca, since they’ll spend plenty of time assessing you, it’s worth your time to take a moment to assess them.

One: Have a “talking” appointment with the doctor

“Go for an appointment and talk with them about your concerns and issues. If you’re in the US, often they’ll only have 15 as 30 minutes to spend with you (thank you, American medical system), but that may be all you need to decide if you relate to them and them to you. Do their explanations make sense and feel genuine?”

Even if a doctor or specialist for menopause is terrific, he or she may not be right for you. If their style is to be abrupt and you prefer someone a bit more nurturing, then it may not be the best connection. You really want someone you can communicate openly with, about some of the most intimate topics in your life, so keep looking until you find a connection that encourages open and frank discussion.

On a side note, says Dr. Rebecca, “Don’t discount a physician just because they’re telling you something you don’t want to hear. Listen to what they’re saying. Sometimes they’ll have an important warning for you, and you need to hear it.”

Two: Check out their ob/gyn credentials

Are they Board Certified and have they maintained that certification? In the US, you can check that your physician is certified on the American Board of Obstetrics and Gynecology website. Do they belong to national and local ob/gyn societies? “There are good medical school and residency programs all over the country,” Dr. Rebecca says, “but that not the only thing you should judge them on. You want a doctor who keeps up with current research and does her or his due diligence. You can also look for a practitioner who is a member of the North American Menopause Society (NAMS) or who has taken their certified menopause practitioner exam.”

(Here’s a handy list of definitions of credentials, from NAMS.)

Do they have a practice focus on women in midlife and menopause? Ob/gyns tend to “age into” a more menopause-focused practice, Dr. Rebecca says. “As ob/gyns start in practice, they tend to do a lot of obstetrics, as that is how women often come into our care. As we age and our patients age with us, we do more and more midlife and menopause care.” That’s not to say that age (or lack of) is an indicator of ability (or lack of), of course.

Three: ask about menopause treatment options

Menopause has a whole range of symptoms and challenges, and a single therapy may not entirely resolve all the discomforts. You want a doc with both a broad range of information and also an open mind about options for menopause treatment.

“Ask them how they evaluate alternative and complementary therapies and how you should navigate them. Most MD practitioners will not prescribe them, but they should be familiar and able to talk about safe and unsafe options. They should definitely know about possible interactions. If you’re already taking any alternative therapies, never hide them, as they impact your traditional medical care. Even if you’re taking “˜natural’ and “˜harmless’ herbs, they can interact with medications.”

Plus, if you don’t feel you can openly discuss all your treatments with your doctor, that may be a red flag that this isn’t the doctor for you.

Ask the doc about his or her approach to hormone therapy (HRT) and the alternatives. There’s a lot of confusion among women as and some among docs as  about the efficacy and safety of hormones. Understand this doctor’s position and how they use hormone therapies, says Dr. Rebecca. “Do they use hormones in everyone? In no one? Do they customize treatment to each individual patient?”

Four: assess the doctor’s office

“How do they run their group?” Dr. Rebecca asks. “Will you be seen mostly by the same doctor? If you need a quick appointment, how easy is it to get in? What call system do they have for emergencies? Do they have mid-level providers like nurse practitioners, midwives, or Physician Assistants who help get urgent visits in, and if so, how are they supervised?” You want a clinic or office that is sufficiently staffed, organized, and clean, so don’t be afraid to extend a few questions to the nurses or other staff.

Finally, Dr. Rebecca says, “Approach your visit with an open mind. Just as you don’t feel happy if you’re not heard by your doctor or other practitioner, we also get frustrated when a patient comes in not able to hear what we have to say. In the end, if it’s not a good match, we won’t be hurt if you go elsewhere.”

“But,” Dr. Rebecca adds, “be introspective. Think about what these practitioners are telling you, even if they are telling you something you don’t want to hear. You can always find someone who will give you what you want without question, but please listen to those who question or warn you as they may be providing important, even life-saving information.”

Tell us about your awesome ob/gyn! How did you find him, how long have you been seeing her, what makes them so amazing? Please feel free to comment here, or start a thread in our community forums. You can also reach out to us on Gennev’s public Facebook page or in our closed Facebook group.

When we talk to women about what would have the greatest beneficial impact on their quality of life, there’s one answer that seems to stretch across the entire menopause experience:

Sleep.

It affects everything about our lives “” our mood, our energy levels, our productivity, our confidence, our weight, our physical and mental health in menopause “” for good or ill.

Not enough quality sleep can lead to serious medical conditions like high blood pressure, heart disease, and diabetes. Our immunity can be challenged when our sleep tanks, and that’s especially bad right now.

The occasional sleepless night is uncomfortable but not particularly harmful (unless you doze off while driving “” please don’t do that), but many women we talk to feel like they haven’t had a decent sleep in years. And that takes a real toll on body, mind, and joy.

There are lots of reasons women sleep poorly in this time: hot flashes/night sweats, anxiety, restless leg syndrome, urinary issues, pain”¦. Women in perimenopause and post-menopause have difficulty falling asleep and staying asleep, and they wake up more tired than they were the night before.

Unfortunately, sleep disruption doesn’t usually disappear along with other menopause symptoms. Poor sleep can also be a result of simply getting older. But good news: we can help.

How To Get Better Sleep During Menopause

For many women, a truly effective solution is cannabidiol or CBD. One of many components of the hemp plant, CBD is being studied for a wide range of health benefits, including managing some seizure disorders in children, but also potentially heart disease, some cancers, even dementia.

And while the scientific community is still researching CBD to determine its efficacy, so many women asked us to create a safe, smart supplement, that we jumped into the research with both feet.

Here’s what we learned:

Reported benefits

For many, CBD can help reduce pain, depression, and anxiety and promote relaxation.

How? Well, our bodies already produce endocannabinoids, nuerotransmitters that bind to cannabinoid receptors present in our nervous systems. It’s possible that CBD reduces pain by interacting in that process and reducing inflammation.

And here’s a hint: add a magnesium glycinate capsule to your pre-bed routine for even more natural pain-relief, sleep-promoting assistance.

When it comes to anxiety and depression, CBD may be acting on the brain’s serotonin receptors, imitating the “feel-good” properties of the neurotransmitter. By alleviating pain and worry and promoting relaxation, CBD may be making it a whole lot easier to fall asleep.

Adding melatonin

Our bodies naturally produce the hormone melatonin in the evenings as sunlight diminishes. It helps our bodies and minds relax and prepare for sleep.

However, melatonin production declines with age, making good sleep harder to come by. Adding back some of the lost melatonin may help you fall asleep sooner, stay asleep longer, and get better quality sleep, says the Mayo Clinic

Melatonin may be of particular help if you travel a lot and have to deal with jet lag and time zones, or if your work shift hours dictate sleeping in the day and working through the night.

According to Gennev Naturopathic Physician Dr. Wendy Ellis, 1 mg is typically the amount that provides restorative sleep without the next-day “hangover.”

“You want to mimic normal physiologic doses (the amount the body makes on its own) as much as you can, and most studies say that is 0.3 to 0.8 mg per day. Three milligrams or 5mg is typically too much,” she says.

Legality, side effects, concerns

If you’re concerned about taking CBD, the following information might help.

Cannabidiol (CBD) as which comes from the hemp plant, not from the marijuana plant “” does not have psychoactive properties and is legal in all 50 states in the US. It is considered generally safe. In fact, the World Health Organization says, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential”¦. To date, there is no evidence of public health related problems associated with the use of pure CBD.”

Side effects can include nausea, fatigue, and irritability, says Harvard Health; if you’ve been warned away from grapefruit because of its blood thinning effect, you should avoid CBD products as well.

The greatest concern around CBD for most medical professionals is that it’s unregulated, so it can be difficult to know exactly what you’re getting. Be sure you’re getting CBD from a reliable source.

And of course, we always recommend letting your doctor know you’re adding something new “” just in case there are any concerns the CBD and/or melatonin may interact with medicines you’re taking or health concerns you have.

This transition in your life can be very drying as menopause can cause dry eyes, hair, a dehydrated mouth, itchy skin, dry vagina. As estrogen diminishes, so does the amount of moisture available and our body’s ability to suck it up and retain it.

In none of these places is the dryness really welcome: dry eyes can fog our vision; dry skin itches and wrinkles, and a dry vagina can make penetrative sex unpleasant, even painful.

If you are thinking about a vaginal dilator for painful sex, consult with a specialist. A Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

Menopause Painful Intercourse

The vagina doesn’t just get drier in menopause; it can actually get narrower, shorter, and less flexible. All of these can contribute to pain during sex. And, as we already know, there is no shortage of causes for hurtful sex, especially painful sex after pregnancy or throughout menopause and perimenopause (even intercourse after menopause).

Fortunately, vaginal dilators are a good tool for managing these changes. To get the best results, you’ll need the right equipment, a little training, and some patience. With time, you may be able to increase the width and depth you’re able to tolerate (even enjoy!) and restore some elasticity.

We strongly recommend you start by consulting a pelvic physical therapist, if possible. A pelvic PT can tell you if something else is causing your pain (like pelvic organ prolapse) and advise you on how to proceed with dilators.

A couple of things to make clear: feeling ashamed or as if you’ve somehow failed is neither necessary nor accurate. These changes in the body are normal, though women and their partners don’t have to live with them. Many women don’t get help for vaginal dryness or atrophy because of embarrassment “” they’re even too ashamed to talk with their own doctors.

Women around the world are raving about Gennev’s Intimate Moisture. We designed a lubricant for sex so you can start enjoy yourself again.

You can go down the vaginal dilator path completely on your own, as they don’t require a prescription. But we recommend you talk about it with your ob/gyn or one of ours to eliminate other possible causes and get instructions on how to proceed. 

What are vaginal dilators?

Dilators are generally made of plastic, rubber, silicone, or glass, are tube shaped, and come in a set of 5 to 8 graduated sizes. Inserted in the vagina, they gently stretch the vaginal walls over time.

Dilators range in size from half an inch in circumference for the smallest to just over an inch and a half at the largest. They are smooth-surfaced, rounded at one end, and may come with an interchangeable handle for easier use.

Who are dilators good for?

Most women use dilators to enable them to enjoy vaginal sex again, though they may also be used to prevent or reverse atrophy due to lichen sclerosis flare ups or menopause. Women who have a fear of pain due to cystitis or other factors may also find dilators help them relax, as it puts them in control of the level, pace, and timing of penetration.

Additionally, women who have had cancer may find changes in the vagina beginning as a result of treatments or surgery; starting with dilators as soon as possible may help avoid vaginal atrophy from developing or worsening.

How To Use Vaginal Dilators For Atrophy

You want to ensure maximum relaxation, so be sure you have plenty of time and privacy. Using vaginal dilators for atrophy generally takes between 10 and 15 minutes. 

Our ob/gyn Director of Health, Dr. Rebecca Dunsmoor-Su, says women in perimenopause and menopause should always always use a lubricant when inserting anything into the vagina. As long as your dilator isn’t made of silicone, a silicone-based lubricant is best, as silicone stays slippery longer. If your dilator is made of silicone, stick to water-based lubes like our Personal Lubricant to avoid damaging the dilator’s surface.

Unless a pelvic PT tells you otherwise, it’s usually best to start with the smallest dilator in your set. Lube it up, then lie on your back with your knees bent, feet flat, and insert the dilator as you would a tampon. But go slowly, applying gentle pressure. If you feel any pain, stop. You should feel pressure only as never pain. If you don’t feel much of anything, you may need to try the next size up.

The Memorial Sloan Kettering Cancer Center suggests doing Kegels to help you insert the dilator, as these exercises can help relax your pelvic floor muscles. You can also do Kegels during the process, as it may allow you to go in a little farther.

Once inserted, you can push in and pull back on the dilator to gently stretch the length of your vagina. Soft circles can help with increasing width. Feel free to add more lubricant as needed to keep things comfortably moist. About 10 minutes is all you need at one time. Sloan Kettering advises using moisturizers in the intimate area every night before bedtime to keep things pliable.

Once you’ve finished, remove the dilator, wash with warm, soapy water, and store according to your dilator’s instructions.

Advice differs on how often to use the dilators, but at least 4 times a week seems like a good average. If there’s no pain or irritation, you can probably do more, though too many days in a row isn’t advised. Be patient. Use each size for several weeks until the next size up causes no discomfort. It may take several months to achieve the results you want. 

You may have some bleeding after using dilators; this is normal. An amount of blood easily handled by a panty liner is normal. Enough blood to soak a pad or bleeding that lasts longer than one day are flags. Please talk with a doctor immediately if you notice excessive blood or bleeding that lasts too long.

How do you choose them?

Like so many things, there are a dizzying array of options. We suggest you find a good site that offers not just products, but good information and advice. Dr. Rebecca really likes Seattle-based Babeland for its very no-nonsense, informed approach to healthy sexuality.

Dr. Rebecca also suggests sets that come with a vibrating wand that cam help with relaxation, even add pleasure. Babeland offers the Intimate Basics Dilator set, which is on Dr. Rebecca’s list of good options.

If you’ve used a dilator, we’d love to hear how it worked for you. Feel free to tell us about it in the comments below, find us on Facebook or in Midlife & Menopause Solutions, our Facebook group.

Grip strength: it’s not just about handshakes and pickle jars. The strength of your hands and forearms is actually a pretty decent predictor of future health.

Grip strength defined

According to Ruth Litchfield of Iowa State University, “Grip strength is a measure of muscular strength or the maximum force/tension generated by one’s forearm muscles.”

If you have your grip strength tested by your PT or doc, chances are they’ll hand you a device called a dynamometer. Squeeze the device three times, as hard as you can, and your result is the average of those three squeezes.

A good result for women over 40, according to a 2010 article in the Journal of the American Geriatric Society, was at least 44 pounds of squeezing strength. (For comparison, human gecko free climber Alex Honnold squeezed over twice that at the Oscars).

Be aware that conditions such as carpal tunnel syndrome and arthritis can impact grip strength, so if you have either or both of those conditions, your numbers may well be lower.

Why do we care about grip strength and longevity?

Turns out, grip strength is cheap, quick, and pretty accurate predictor of future health.

A study done in the UK from 2007 to 2010 followed over half a million participants to see how well grip strength did as a measure of overall health and wellness. Participants ranged in age from 40 to 69 at the outset, were 54% female, and included a range of ethnicities, body mass indices, socioeconomic statuses, pre-existing conditions, and lifestyle behaviors such as smoking, physical activity, and diet.

Translation: it was a pretty good as though not perfect as sampling of the general population.

The aim of the study was to see if there was a correlation between grip strength and mortality and disease. Researchers wanted to determine if poor grip strength was associated with higher risk of cardiovascular disease, respiratory disease, COPD, all cancers as and in particular breast, prostate, colorectal, and lung cancers as and mortality overall.

Turns out, as a predictive measure, grip strength is pretty accurate. For both men and women, they found, a lower grip strength of 5 kg (11 pounds) “was associated with a higher hazard for all cause mortality and incidence of and mortality from cardiovascular disease, all respiratory disease, chronic obstructive pulmonary disease, all cancer, and colorectal, lung, and breast cancer.”

The association between grip and wellness declines a bit with age, perhaps because other factors can weaken muscles as we age, not just illness.

Why does this measure work?

It’s probably not the strength of hands and forearms that determine longevity; instead, it’s that grip strength is a good stand-in for overall health and wellness. Retaining muscle strength overall often leads to better health outcomes.

As Darryl Leong of McMaster University told The Washington Post, “Muscle strength is an indicator of your ability to withstand diseases. When you are stronger and you become ill, you have reserves that you can draw on to help fight the disease. Without muscle strength, your odds are significantly poorer.”

I struggle with pickle jars. Am I doomed?

Of course not, unless you depend on pickles for survival.

There are lots of factors that can impact grip strength. It has a strong hereditary component, according to the authors of the UK study (about 52%), but grip strength may also be a reflection of lifestyle.

So if a go at the dynamometer shows you have sub-optimal grip strength, there are things you can do to improve your overall health. (Just an FYI, though; simply improving grip strength probably won’t change your risk of developing certain diseases.)

Get at least 10-15 minutes of physical activity a day. Cardiovascular workouts such as swimming, biking, running, and walking are great, but try to add in some weight and resistance training. Not only is exercise good for muscles mass, it’s good for your bones, weight, and mood, all of which can increase longevity.

Improve core strength and balance. Falls and injuries due to falls are one of the leading causes of death among older Americans.

Eat a healthy diet. Older adults may need to keep an eye on their protein intake to be sure they’re getting enough protein to maintain muscle mass.

Don’t smoke. In addition to all the other negative impacts, smoking also affects strength. Even if you exercise, you’ll retain less muscle or add muscle more slowly if you’re a smoker.

Sitting around squeezing a stress ball to increase hand strength probably won’t help you live longer if you’re not also eating well, sleeping sufficiently, and exercising. (Though if it actually relieves stress, keep it up!)

The truth is, crashing fatigue, busy lives, mood issues such as depression, or menopause symptoms can all lead us to give up on those truly healthy lifestyle choices, like getting out for a walk or cooking our own meals. If you need a little encouragement, testing hand strength might be a good incentive, since you can actually see progress over time.

The next time you see your doc or PT, ask if you can take a grip test. Write down your numbers, left and right hand. In 3 months, test it again: have all those good, healthy changes you’ve made shifted the needle?

If you’ve tested your grip, or if you want to take us up on the challenge, let us know how it’s going. Please join us in our public forums, leave us a note on the Gennev Facebook page, or join our community in Midlife & Menopause Solutions, our closed Facebook group. 

Healthy eating is an integral part of caring for yourself throughout the menopause journey.  And the same nutritional strategies that support your body through menopause, also support a healthier heart.  The key to eating for your health is to build your meals by balancing nutrients to feel full and satisfied, support blood sugar, as well as lower inflammation and cholesterol.

When you are stretched for time, convenience can interfere with your best intentions for eating well. But a healthy meal doesn’t have to be complicated.  A few key components can help you build a nutritious, balanced lunch that will keep you well-fueled.  Gennev Health Coach and Registered Dietitian Nutritionist, Jessica Gingrich, shared with us the four steps to building a heart healthy salad plate.

• Start with a base of veggies. Lettuce or greens not your thing? That doesn’t matter. Just fill your bowl with the non-starchy veggies you do love as think anything other than potatoes, sweet potatoes, corn, peas and winter squash. Aim for about 1-2 cups. Veggies provide your body with fiber that helps traps and remove cholesterol and antioxidants that reduce inflammation in your blood vessels.
• Next, add on a lean protein. Protein is key for women in peri and post menopause because it is needed to maintain and build muscles, especially if you are strength training. Protein helps keep us full and satisfied, reducing the need to snack more between meals. Include about 3-4 oz of lean animal protein like fish, chicken, or turkey or ½ cup of plant-based protein like beans, lentils, or tofu/tempeh/edamame.
• Keep building with fiber-rich carbohydrates. By adding a carbohydrates source to your salad, you increase the fiber and ensure you won’t be searching out refined carbs later in the day to satisfy a carb craving. Toss on approximately ½ cup of whole grains like quinoa, brown or wild rice, or farro or starchy veggies like potatoes, sweet potatoes, corn, peas or winter squash.
• Top off your salad with healthy fat. That includes mono- and polyunsaturated fat such as nuts, seeds, avocado, olive oil, olives, or cold-water fish like salmon or tuna.

If you hit these four components, you will achieve a satisfying, delicious way to enjoy your lunch break.

Need some inspiration?  Gennev’s Health Coach team shared their personal take on three heart-healthy, menopause-supportive salad plates.

Coach Monika:

The Winter Happiness Salad (appropriately named) is a favorite go-to of mine to prepare a quick and easy lunch for the whole week. Unlike some green salads, this one will not get soggy. It is loaded with monounsaturated fat and fiber to support heart health and satiety too. Not only is it a great lunch option but a wonderful potluck dish or dinner side as well.

• The base of this salad is started with massaged kale (1 bunch). If you haven’t tried massaging your kale yet, I highly recommend it. Kale is a hearty green and this softens the texture while still leaving some bite and the olive oil adds flavor. Parsley (1 bunch) and scallions (about ¼ cup) add variants of green and fresh flavors.
• The chopped apples and raisins or currants (1/3 cup) provide fiber-rich carbohydrates that add a sweet essence to this salad.
• As with many vegetarian meals, the carbohydrate and protein portions of the salad overlap. Here quinoa (3 cups) and chickpeas (15-oz can) make this salad feel heartier and give it more texture. I like to also add toasted almonds for crunch, heart-healthy monounsaturated fats, and a touch of protein and fiber (1/3 cup).
• Dress with Apple Cider Vinaigrette that includes the heart healthy benefit of olive oil and miso to support gut health.

If you are tight on time, you can skip the steps to toast and grind fennel and coriander seed. The salad is still packed with flavor without these additions.

Coach Katie:

My go-to salad is a simple grain bowl, inspired by a local Seattle favorite from Evergreens Salad: the Super Bowl. This salad provides a great mix of nutritious carbs, fats, and proteins to keep you full and satisfied, and support your energy levels throughout the day.

• I build my base with about 1-1 ½ c. kale as I love the crunch and dense nutrient value
• Add ½ cup cherry tomatoes for a pop of color and acidity.
• Top with ½ cup of quinoa – I batch cook this on the weekends to have available all week. Quinoa is a powerhouse with fiber and protein.
• Add 3 oz of turkey or chicken as usually from leftovers from a meal over the weekends as or chickpeas for a plant-based alternative.
• Top with 1 to 2 tbsp. of feta cheese for flavor and a bit of extra protein.
• Drizzle with about 2 tbsp. of a simple homemade red wine vinaigrette as this adds moisture, flavor and healthy fat. Any olive-oil or avocado-based store-bought dressing work well too.

Coach Jessica:

My go-to lunch salad is one of my favorites to duplicate for dinner on those late nights when I am not up for intensive cooking.   

• My base starts with about 1 cup packed arugula for a spicy start. Spinach or shredded and massaged kale would also work well.
• Add about 1 /2 c. (combined) of shredded carrots and pickled beets for added color and flavor.
• I toss in up to 1 cup crispy, roasted chickpeas as these supply a combination of both protein and fiber-rich carbohydrates. My spice combination is usually salt, pepper, garlic powder, smoked paprika and sometimes curry powder. Check out this quick and easy Roasted Chickpea recipe.
• For a protein booster, you can opt for ½ cup of roasted chickpeas plus a sliced hardboiled egg and/or a sprinkle of shredded parmesan cheese.
• Top with olive oil and balsamic vinegar (1-2 tbsp combined) and some avocado slices (1/4 avocado).

Need solutions or support to optimize your health as well as manage menopause symptoms? Schedule a visit with a menopause specialist.  They can help you understand your symptoms and create a personalist treatment plan so you can thrive in midlife and beyond. 

Stress is a fact of life. No matter how hard you wish or even try to live a stress-free life, you can’t escape it, especially now. And midlife and menopause are prime time for stress. While the idea of stress-free living is an illusion, it’s worth the effort to rein in your stress levels. One of the best ways to do that is to learn to roll with the stress by becoming more resilient.

When you think about everything going on during this time of life, it’s not surprising that you’re stressed out. You might be worried about paying for college and saving for retirement or caring for kids and aging parents. Menopause symptoms like mood swings, hot flashes, and sleepless nights add to your stress level and drain your resources to cope with it. You’re also more susceptible to some of life’s biggest stressors like the loss of loved ones, health issues, divorce, moving, or job loss during this stage of life.

How stress affects your body

Stress manifests itself throughout your body in multiple ways””tense muscles, headaches, stomach aches, sleep problems, even chest pain. But these are just the noticeable signs. Deep within your body, stress can damage blood vessels, increase blood pressure, contribute to inflammation, and raise cholesterol and blood sugar levels, which over time can lead to heart disease, diabetes, cognitive decline, obesity, depression, and more. Stress can be so damaging that, in rare cases, a traumatic event like the death of a child has resulted in an immediate heart attack, a condition known as broken heart syndrome.

Stress””whether it’s a looming work deadline, traffic jam, family problems, or natural disaster””triggers your sympathetic nervous system, or fight or flight response, setting off a flood of stress hormones like adrenaline and cortisol. Your body is ready for action. Unfortunately, in most cases, there’s no action or resolution. Instead, your body continues to pump out higher levels of stress hormones, leading to its harmful effects on your body.

Being resilient can help you turn off this stress response and turn on your body’s parasympathetic nervous system, or rest and digest response. In contrast to the sympathetic nervous system, the parasympathetic response calms you down and lowers stress hormones.

How to take control of stress

You may have heard the term resilience before, but it’s probably not what comes to mind when you’re juggling a work deadline and doctor appointments for your aging mother on top of a sleepless night due to hot flashes. But it can help. Resilience is a trait that is just starting to get talked about because research shows that it’s associated with feeling less depressed and more satisfied with your life. It may even help you to live longer.

You may think of resiliency when you hear stories about someone battling back from a near-fatal car accident or a young mother carrying on after the death of her spouse. Instead of letting the tragedy defeat them, they come out stronger. They’re resilient.

But being resilient isn’t just crucial for the big traumas in life. It can help you through the everyday lows and stress we all encounter, especially during menopause. And the more you use it, the stronger it will become””just like your muscles when you exercise them. Then when a life-altering tragedy hits, you’ll be even better able to handle it.

When you’re resilient, you don’t let stress suck you in. It’s still there, but instead of stewing in it, you acknowledge it, work through your feelings, seek support, and then problem solve and adapt. As a result, you feel more in control, and stress is less threatening to your body and mind.

Build resiliency to counteract stress and its adverse effects

While becoming more resilient can help you manage stress, 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. Here are suggestions from Gingrich to help you manage stress and become more resilient.

Learn what stress feels like in your body. “This is an important part of understanding when stress is present and how to feel it coming on so you can build strategies to reduce it,” says Gingrich. Practicing a body scan can help you become more in touch with your body, noticing areas of tension and then working on releasing them.

Breathe deeply. Slow, rhythmic breathing can quiet your flight or fight response that stress triggers. Research has found that practicing deep breathing before bed improves sleep. Here are two breathing techniques to try. Even just a few deep breaths can be beneficial.

• 1:2 Breathing – Breathe normally through your nose, counting each inhalation and exhalation. Gradually increase your exhalations, so they are twice as long as your inhalations. For example, inhale for four counts and exhale for eight. Choose a length that is comfortable for you.
• Box breathing – This technique is used by Navy Seals to manage stress during dangerous missions. Imagine each step as the side of a box. Breath in through your nose for one to five counts. Hold for one to five counts. Breath out through your nose for one to five counts. Hold for one to five counts, and repeat.

Practice good posture. Roll your shoulders up, back, and down. Lift your head so your chin is parallel to the floor and stand or sit tall. An upright posture can help you feel more confident and boost your mood compared to a slumped posture, according to a study published in the journal Health Psychology.

Get moving. Any exercise, even a 15-minute walk, releases mood-boosting chemicals and counteracts some of the harmful effects of stress like keeping blood vessels flexible, reducing inflammation, and lowering blood pressure, glucose, and cholesterol levels. Vigorous exercise like a run or Spin class can be a great way to work off some stress hormones, bringing your body out of the fight or flight mode. Mind-body exercises like yoga and tai chi can also have effects. A single 90-minute yoga session has been shown to lower levels of cortisol and enhance the parasympathetic nervous system, which is involved in rest and relaxation.

Listen to your favorite tunes. Research has linked listening to music with improved immune function and lower cortisol levels.

Connect with others. Whether you join a book club, grab lunch with a friend, attend religious services, or volunteer, do something with others regularly. “Maintaining social connection is shown again and again to enhance quality of life, health, and stress resiliency,” says Gingrich. “Even small moments of connection””like in the checkout line at the grocery store””are important.” Building connections now can also make it easier to ask for help when you need it””a tough thing for many of us to do.

Increase self-compassion. You’re probably supportive if a friend or loved one has messed up or is going through a tough time. But when you’re in that position, how do you treat yourself with that same love and kindness. Being compassionate toward yourself and others can help diffuse emotional situations. To help build your capacity for compassion, a key component of resiliency, try this Loving Kindness meditation, which has been proven in scientific studies to work.

Turn off the news. Limit or eliminate negative influences such as the news, social media, or even people. The negativity adds to stress levels and can leave you feeling less hopeful. 

Build self-efficacy. Self-efficacy is the belief in your ability to do something. For example, you might have high self-efficacy when it comes to your job but lower self-efficacy when parenting a teen. The higher your self-efficacy is, the more likely you are to succeed in that area. It’s also a key to being resilient. To build your self-efficacy, think about previous moments of resilience and strength. We know you have them. Reminding yourself of your abilities to weather a storm can help you view your current situation more positively.

Go out in nature. Communing with nature or “forest bathing,” as the Japanese call it, has been shown to reduce stress hormones and ease feelings of anxiety, fatigue, and depression, all of which can help build resistance. Even if you simply go out into your backyard or sit in a city park, step away from all your electronics and spend more time outside for a mental health boost.

Experiencing new symptoms and changes to your body that often accompany menopause can add to your stress level.  Meeting with a doctor who specializes in menopause will provide you support through the menopause journey, and will help you devise a personalized plan to start feeling better 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.

The more consistently you walk, the more benefits you’ll reap. That’s why it’s so important to minimize your risk for injury and make walking as comfortable and enjoyable as possible. Since walking is low-impact, it’s already a low-risk activity, but how you walk, and what you do when you’re walking, can raise or lower your risk of getting hurt or developing aches and pains. Here are seven dos and don’ts that will help keep you on your feet and walking strong.

Don’t walk with weights. The thinking is that you’ll burn more calories by swinging dumbbells as you walk. In theory, it seems reasonable. The heavier you are the more calories you burn. But when researchers put this strategy to the test, walking with three-pound weights didn’t increase calorie burn compared to walking at the same speed without weights. The only thing it upped was the effort, according to the study in the Journal of Exercise Rehabilitation. In addition, swinging a weight could set you up for wrist, elbow, shoulder, or even neck problems. Instead, leave the weights at home and pick up your pace. You’ll burn more calories as well as improve your heart function. If you’re carrying weights in hopes of toning your arms, you’ll get more definition by using heavier weights before or after your walk. Bottom line: there are more risks than benefits of walking with weights.

Do warm up. This may seem obvious, but when your time is limited, it’s all too easy to immediately kick it into high gear. The result can be burning muscles, gasping breaths, and possibly even an injury. Instead, start at a slower pace to feel better and prepare your body for activity. Muscles get warm and more pliable so you’re less likely to strain them. More nutrient-rich, oxygenated blood is pumped to working muscles to fuel them for better performance. More lubricants are produced in your joints, so they move more freely and have a greater range of motion. In a review of 32 studies, 80 percent of the studies found that warming up first improved performance.

Don’t bounce. Up and down movement is common when you bound off of the ground while running. But, when you’re walking, you want to think about directing all of your energy forward for a speedier, more efficient stride. Ask a friend to watch you while you walk (or have them videotape you). If you’re bouncing, your head will be going up and down, and all that vertical motion increases impact on your joints. Instead, you want your head to stay level as you walk, which will minimize impact on your joints even as you walk faster. To do that, keep your front leg straight, but not locked, as you land and until your foot is under your body. Also, avoid landing flat-footed, and instead roll from your heel to the ball of your foot and toes.

Do posture checks while walking. Maintaining good posture allows your arms and legs to swing more smoothly, your chest to open up so you can take deeper breaths, and your vertebrae to be properly stacked which can prevent backaches. A great way to realign your posture mid-walk is by doing a shirt pull, an exercise I learned from walking coach Suki Munsell, Ph.D. Cross your wrists in front of you as if you’re getting ready to take off your shirt. Raise your arms as if you’re pulling a shirt up and off (but don’t actually do it). As you reach up, lengthen your spine. Then let your arms float down to your sides as your shoulders drop away from your ears. Repeat every 10 minutes or so, or anytime you feel like you’re slouching or notice any aches or stiffness.

Don’t walk the same way all the time. You may not notice the slight variations in roads and sidewalks that can alter body mechanics. For example, many are sloped to allow for water runoff which means one leg may be slightly higher than the other. Or you may always turn your head to the same side to talk with a friend as you walk. Over time, little alterations like these may make you more prone to injuries or problems because of muscle tension or imbalances. Instead, occasionally change direction, take different routes, and alter positions as you walk. This can help to keep you more physically balanced and prevent mental boredom.

Do stretch after a walk. This is when your body is primed for traditional static stretching, the kind where you hold the stretch. Stretching when your muscles are warmed up and your joints are loose after a walk helps to keep you flexible and increase your range of motion. It’s also a relaxing way to wind down after a vigorous walk.  

Don’t ignore aches and pains. The sooner you address any issue the less likely you’ll end up being sidelined. Some discomfort like muscle fatigue or a little post-workout stiffness or muscle soreness is normal, but in general, exercise should not hurt.  Feel a blister starting? Apply moleskin or a bandage to prevent it. Notice rubbing under your arms or between your thighs? Apply petroleum jelly or a lubricant like BodyGlide to prevent chafing. Achy low back? Check your posture. For more persistent problems, talk to an appropriate doctor: podiatrists for foot problems, orthopedists for joint issues, or physiatrists (also known as physical medicine and rehabilitation doctors) for any issues impairing your activity level. The sooner you remedy problems the quicker you’ll be back to walking regularly, and the stronger you’ll be.

Join Gennev and get moving

Join the Get Moving Walking Program for Women to receive two 30-day walking programs designed by women for women, support from certified fitness instructors and health coaches, special offers and incentives. Always check with your physician before beginning any new exercise program.   

We can help you be your best self

Partner with a Gennev Dietitian for actionable solutions and the support you need to keep moving in midlife and menopause. Learn how to get started with a walking program, the nutrition and supplements your body needs, how to maximize your sleep routine, manage symptoms with actionable lifestyle changes and more. 

Meet with a Gennev Doctor – our board-certified physicians are menopause specialists. They will listen to understand your symptoms, answer your questions and develop a treatment plan that is personalized for you.

Walking is easy, right? Yes and no. The physical act of walking, putting one foot in front of the other, is pretty easy for most. Heck, we’ve been doing it since we were about a year old. But it’s not always easy to get out the door. Even I struggle at times.

Because I’m a walking coach, and I’m always encouraging others to walk more, many people think that I take long walks EVERY DAY. Nope! I am far from perfect, and in fact, it’s not about being perfect. So, let’s not beat ourselves up over it! And instead, let’s celebrate every little step we take in the right direction!

Progress, not perfection, is what we should be focusing on.

There are going to be days when you crush your walks, going faster or farther than you thought you could. And then there are going to be the days””like one of mine recently””where it’s 7 p.m. and the only walks you’ve gotten in have been between the refrigerator and your desk and the bathroom and your desk. Life is messy and your walking program will be at times, too. The good news: you don’t have to follow the Get Moving walking plans to a T to benefit. So if you find yourself missing a day or two, the most important thing to do is to start walking again.

Before I had kids, I always changed into my workout clothes and usually drove to a beautiful park to do my walks. Not anymore! If I arrive at an appointment early, even if I’m wearing jeans or a nice outfit, I’ll take a walk around the block instead of sitting in my car or the waiting room. I keep a pair of sneakers and socks””the only essential pieces of walking gear you need””in my car so I can sneak in a walk whenever an opportunity presents itself. Some walking is better than none, and more walking is better than some.

The right attitude will take you farther than the most expensive pair of sneakers.

Your thoughts and what you say influence how you feel and how you behave. If you’re thinking about and talking about your walks as something you have to do, or they’re one more thing on your to-do list, walking will seem less appealing. I’ve found that little tweaks in how you frame walking can make it more desirable. Instead of thinking of it as a chore, make it your escape, some quiet, stress-free, me-time. Or make it a time to connect, whether you walk side-by-side or via technology with a friend or family member. Even a single word change has helped me get my butt in gear on days when I used to rationalize why I shouldn’t walk, like “I have too much work” or “I need to start dinner.” When I was overloaded, thinking to myself that I had to walk made me feel even more overwhelmed. But when I started to reframe it as “I get to walk,” it made it feel more like a privilege that I shouldn’t take for granted. And when I’ve walked even though I’m feeling overwhelmed, I’ve discovered that those are exactly the times when I need walking the most. I’d come back from my walks feeling refreshed and recharged. I’d be more productive, and I was better able to manage all of my responsibilities. It was like a gift that I gave myself.

Seeing improvements can motivate you to do more.

Whenever I teach a walking class, I start by getting a baseline for each of the participants so they can see the benefits of their efforts. Usually, I time them as they walk a set distance. Then, I teach them techniques to improve their walking. After some practice, we repeat the timed walk, and except for one time, everyone has always been faster””and they’re excited about it. That excitement fuels a desire to keep walking and see how much you can improve.

Speed isn’t the only way to track your progress. You could also track the length of your walks, how often you walk or the number of steps you take. My favorite ways to monitor my walks are with my FitBit and MapMyWalk. My FitBit smartwatch tracks the number of steps I take, the number of stairs I climb, my calorie burn, heart rate, hourly movement and my sleep. Checking my weekly and monthly averages helps to keep me accountable. I also use the MapMyWalk app on my phone when I take a walk. Along with showing me my route, it tells me how far and how fast I walked. It’s so rewarding when I see that I’ve completed a previous route in less time or that I’m averaging a faster minute-per-mile pace. It makes me want to do more, but that’s me. You may be motivated by seeing improvements in other areas.

Remember, I mentioned that one time someone did my timed walking drill, and she wasn’t faster? Marion, who has Parkinson’s disease, might have been slower, but when she finished her loop, she was celebrating. For the first time in five years, she was able to look up at the trees and the sky while she was walking instead of always looking down at her feet. She had developed that habit because of her fear of falling, but the techniques she learned helped her to feel more confident and improve her posture while still being able to spy obstacles in her path.

Decide what’s important to you””it may be getting a better night’s sleep, having more energy, reducing your blood pressure or spending more time with friends (that’s become one of my motivators as I’ve gotten older). Then figure out a way to measure it. It could be as simple as writing down in a journal how you feel each day or keeping tabs of how often you walk with friends by checking off days on your calendar. Keeping track can help you reaffirm your commitment when you’re getting off track (happens to all of us), and looking back and seeing how far you’ve come can be rewarding and motivating.

Now I’d love to hear from you! Please share with the Get Moving Walking Community for Women what works for you.

If you try any of my strategies, or some of your own, please let us all know how it goes.

Michele’s key tips for walking success:

• Focus on making progress, not being perfect.
• Walk in what you’re wearing, no need to change clothes.
• Keep a pair of sneakers and socks in your car for impromptu walks.
• Make walking a desirable activity, savoring it as me-time or sharing it with friends or family.
• Start saying, “I get to walk,” instead of “I have to walk.”
• Track your progress with an activity monitor, app, journal or calendar

Join us and get moving

Join the Get Moving Walking Program for Women to receive two 30-day walking programs designed by women for women, support from certified fitness instructors and health coaches, special offers and incentives.

Be part of our Get Moving Walking Community for Women for daily motivation to keep moving, share your walking experiences, receive encouragement, and have the support of other women.

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

We can help you be your best self

• Meet with a Gennev Doctor – our board-certified physicians are menopause specialists. They can help you understand your symptoms and develop a treatment plan that is personalized for you.
• Vitality as boost your energy and your walks with a nutrient-packed multi-vitamin supplement that supports your whole body including joint pain and inflammation, mood, stress response, immune health.

Using eastern medicine and traditions to combat period discomfort

If you have difficult periods, you’ve probably searched high and low for real and lasting relief. We talked with acupuncturist and Chinese Medicine practitioner Adam Burrill about remedies that have proven useful for many women for centuries. Turns out, what we eat can have significant effectsasgood and badason how we feel, particularly during our periods or times of hormonal change. Here’s what Adam had to share.

From Adam Burrill, L.Ac., MSOM:

Many women experience difficult periods in their teens, during stressful times, or as they approach menopause.

Symptoms women experience vary widely but can include cramping, irritability, back/hip soreness, headaches, digestive disturbance, fatigue, general discomfort, breast tenderness, sleeplessness and more.

Don’t despair: These symptoms may be avoidable.

If you go to your doctor to complain about symptoms related to your periods, the first thing your doctor is likely to give you is birth control. The birth control pill, and other birth control that contains hormones (like injectable forms or some IUDs), is likely to change your cycle by dominating the hormonal communication that is going on in your body to signal creation of estrogen, progesterone, and other hormones. The logic here is that your body must be regulating your cycle improperly. Sometimes these extra hormones work to relieve undesirable symptoms; sometimes they don’t.

Seeking relief in Chinese Medicine

Chinese Medicine, of which acupuncture is the most famous component, offers some perspective on the menstrual cycle that may be helpful.* Chinese Medicine was developed over many centuries of scientific observation, but uses a different kind of logic than mainstream medicine does today.

In Chinese Medicine, the menstrual cycle is governed by the blood. The healthy state of your blood produces healthy fertility and menses. Those essential things we sometimes neglect””decent sleep, minimal stress and a proper diet, for example””can affect your blood and lead to worse periods. Some things to avoid: excessive alcohol, sugar, caffeine and tobacco.

The four basic patterns of problem periods

There are four basic patterns we see with difficult periods: The healthy state of your blood (from the Chinese Medicine perspective) can be affected by stagnation of circulation, emotional stagnation, lack of nutrients, and high stress levels.

With circulatory or emotional stagnation, you may experience cramps, back soreness and emotional upset, and you may see menstrual blood that is dark red or brown with clots. For relief, eat more spicy foods with herbs like cumin, coriander, cinnamon, oregano, and turmeric in them and increase the amount of exercise you get.

If you’re lacking nutrients, you may observe menstrual blood that is thin and a flow that lasts only one or two days with cramping, hot flashes, and fatigue during and following menses. For relief, eat lots of vegetables, healthy proteins and fats, get lots of rest, and don’t exercise excessively.

If you’re frequently under a lot of stress, you may experience any of the above. Try to reduce your stress and take all of the advice above. You can also go to an acupuncturist; acupuncture and herbs can smooth out your cycle fairly quickly.

*These are general guidelines and are not meant to diagnose or cure any disease. If you have serious problems, please see a licensed practitioner or your doctor.

Adam Burrill, L.Ac., MSOM, is an acupuncturist at Spring and Autumn Acupuncture in Portland, Oregon. Adam specializes in pain conditions and sports medicine and helps patients with stress, anxiety, depression, women’s health concerns, and neurological disorders.

by guest blogger Amanda Giralmo: 

You’ve been hitting snooze on your alarm clock for days now like it’s the Staples Easy Button, but there’s nothing easy about dragging yourself out of bed when you’re feeling exhausted again. You somehow misplaced your keys in the fridge, and you feel overwhelmed by the fact that you should put something in your fridge other than your keys and four days’ worth of take out leftovers.

In short: you feel completely out of balance! But, how do you find this elusive balance that everyone is seeking in today’s always-on, go-go-go world?

Working with my clients as a holistic health coach, I can confirm that the struggle to feel mentally well and nourished physically, while also making sure those around you are cared for, is real!

In my practice, I work with smart, busy people who face this challenge often. My clients want to feel their best but aren’t quite sure how to get there on their own, so I create space and a supportive environment that enables them to articulate and achieve their wellness and lifestyle goals through actionable, bite-sized changes.

How to take care of yourself mentally

One of the tools I use to support my clients, and one of the ways I manage to keep my sanity, is by defining basic, self-care needs.

Self-care is all about nurturing and recharging yourself with the same kindness you provide to your loved ones. I may not complete a single one of my self-care needs in a day, but if a few days go by without including at least one, I feel my balance begin to tip. Here’s some insight into how I identified my self-care needs, so you can establish your own, and how to take care of yourself emotionally and physically.

Remove Guilt

The first step to defining your self-care needs is removing the guilt associated with taking care of yourself. Understanding your basic needs and showing yourself the love, respect and nurturing you deserve will allow you to sustain and find joy in caring for others. Removing guilt will help reduce your menopause anger attacks at yourself and others.

Stop Comparing

“Comparison is the thief of joy.”
“” Teddy Roosevelt

Do you have a case of “keeping up with the Joneses”? Like Teddy Roosevelt said, “Comparison is the thief of joy.” Skip to the beat of your own drum, by getting inquisitive with yourself:

• When do I feel most energized to complete big tasks?
• When and how often do I need quiet time alone?
• When and how often do I need to engage with friends, and how do I like to engage?
• What role does exercise play in my life?

Start designing your day around the answers to your personal Q&A and get your joy back.

I’ve learned that doing intense cardio workouts on a regular basis burns me out, even though I know numerous people who thrive on this type of exercise. I flourish when I have a mix of walking, yoga and strength training; these are a part of my weekly self-care basics. I’ve also found that focusing my social calendar on more intimate events that really allow me to connect with friends energizes me vs. attending large, crowded events. I tend to shy away from larger events, even though many of my friends enjoy them.

Sleep

Sleeping 8-9 hours per night is high up there for me in my basic self-care needs. The amount of sleep individuals need to feel rested can vary; however, most adults need an average of 7-8 hours of sleep per night.

Anyone looking to find balance in their life should get familiar with their sleep needs. Remove all tempting electronics from your bedroom, play around with different bedtimes, try waking up without an alarm clock a few days per week, until you find the good amount of sleep you thrive on.

Stress Busters

Deep belly breathing, meditation, nature walks, taking a technology time-out, calling a friend or loved one, taking a hot bath, watching a funny YouTube video can all help us relax. Play around with some or all of these, and pay attention to other activities that help to lower your stress.

The basic self-care needs that help me break through stress include daily meditation and time in nature (even if it’s just a walk around the block); weekly reiki, yoga and 1:1 time with my partner.

Infuse Delight

Playing is not just for kids; identify activities that bring you true delight! Traveling and experiencing new cultures make me feel like a kid on Christmas morning, so my yearly self-care includes at least two trips to somewhere new! Because I also enjoy new experiences, I’ve included new exercise classes, a guided meditation class, new hikes, dance lessons, and a shark dive at my local aquarium.

Once you have identified your self-care needs and their frequency, write them down, then spend a few minutes visualizing what life will be like when infused with these items. Identify the feelings associated with the visualization as relaxed, peaceful, energized, loving, etc”¦

When life starts to feel unbalanced, review what you wrote down and ask yourself as “when was the last time I did something to show myself love and support my basic needs?”  Then choose one and go do it.

Gennev note: Certain content in this blog was inspired by content developed by Integrative Nutrition Inc. Integrative Nutrition Inc. does not endorse the content of this blog.