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.

The physical and emotional changes that come with menopause can complicate intimacy or sexual health.

Sexual intercourse can become painful due to the thinning and drying of intimate tissue; libido may wane as hormones decrease and menopause symptoms increase.

But because sexuality, and in particular women’s sexuality, is such a taboo subject in American culture, we don’t talk about it. And what doesn’t get discussed, generally doesn’t get solved.

But times and attitudes are changing: there are more platforms now for women to get information and solutions and engage in conversation about the very real, very natural changes happening in their bodies.

Two companies helping women regain sexual health in menopause are Gennev and MiddlesexMD.

In this conversation, the CEOs of each company “” Jill Angelo and Dr. Barb De Pree, respectively “” and menopause-specialist OB/GYN Dr. Rebecca Dunsmoor-Su, talk about the importance of open conversation around women’s sexuality and health, the challenges of starting a business in a stigmatized niche, and the ways their companies are helping women enjoy the second half of their lives.

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Transcript

Jill Angelo, Gennev CEO

All right. Well, with us today is Dr. Barb De Pree. She’s a physician and a gynecologist, and she’s been in women’s health for over 30 years, with a specialty in menopause for the last 10 years. In 2013, she was named by the North American Menopause Society as certified menopause practitioner of the year for her exceptional contributions to menopausal care, which is just an incredible feat. And so we’re, we’re so honored to have her here with us today.

Since then and even before then she has been really recognized for her outreach and communication and education of women through menopause through her women’s health platform and website called Middlesex MD and her work as the director of women’s midlife health services at Holland Hospital in Michigan. So welcome Dr. De Pree.

As well with me today is Gennev’s own chief medical officer and OB GYN Dr. Rebecca Dunsmoor-Su. So I get both of them here. She also holds a certification from the North American Menopause Society. And so I’ve got two menopause specialists with me. Welcome ladies.

Dr. Barb De Pree of Middlesex MD

Thank you for having me.

Dr. Rebecca Dunsmoor-Su, Gennev’s Chief Medical Officer

I’m glad to be here, Jill.

Jill

Good to have you both. First and foremost, thank you for what you do for women everywhere. And you know, we, we need, we need expertise in this area and it’s such a shortage as I think we all know, otherwise we wouldn’t be doing what we’re doing. So thank you. Today’s conversation, we’re going to talk about menopause. We’re going to talk about the business of supporting women in menopause. And we’re also going to talk about how women can find the resources that they need, because there is a lot of innovation happening, there’s websites like Middlesex MD, in addition to clinic settings, there’s platforms like Gennev.

And so we just want to kind of, I wanted to bring together experts who are doing this new work for women and menopause and just, and talk about it. And Rebecca is going to kind of help me drive the interview too. So you’re going to hear her asking some questions but, but with that, I’m going to just start off with with a general. Barb or Dr. De Pree, please just kind of help us understand your background and, and really what led you into the work that you’re doing today.

Dr. Barb

Yeah. Thank you, Jill, please call me Barb. So I’m a trained obstetrician gynecologist and probably about 14 or 15 years ago that organization I work with recognized that there was a need for addressing menopausal women’s health in our community, which really when you think about it is a little bit of a vision that not many places were having that many years ago. So I joined a task force, you know, they call people into joint task force, like organizations do to study the issue and find out maybe what could be be done about addressing menopausal women’s health. And so, as I learned about it, I didn’t really know at the time myself, that there were people who specialized in menopause. So it was really an interesting journey for me to understand the unmet need both. I understood that it wasn’t being met in my community. And and I was part of the problem, you know, I wasn’t well trained in menopause at the time. I was a general OB gen and generally a lot of our time and focus is on obstetrics and just, you know, spending a lot of time with OB patients and just well-women, contraception.

But so I took an acute interest in it myself. So I, after deciding yes, the community could benefit. I said, why don’t I be the person to do some additional training? So the hospital supported me in doing some training, which included the North American Menopause Society or NAMS. They do a certified program, a NCMP NAMS-certified menopause provider. So I, I did that. So it became sort of a recognized resource in the community, both a resource for patients, but other providers. I think what we’ve really recognized is that interestingly, even though a hundred percent of women will have this journey through menopause become post-menopausal, it really isn’t that much time is spent on it addressing it in a healthcare setting and internists typically aren’t that interested in it and are, you know, working on other chronic health conditions with patients, primary care, busy doing so many other things with their patients that it tended to, you know, I recognize just get kind of pushed to the side as not that important to addreess. So at any rate, I pivoted my practice away from surgical practice and OB practice, and I really have just a dedicated perimenopause menopause sexual health practice now. So primarily I’m seeing women many ages, but probably the majority of my patient population is over 40 and seeking answers.

Jill

Yeah. So many women I think are but don’t know even to ask or they’re afraid to ask. You know you know, Rebecca, why don’t you share a little bit as well, your journey into specializing into menopause too, because you know, Barb, unlike you, I think you saw a need and you started from a place as an OB GYN. I know Rebecca, you did as well.

Dr. Rebecca

I did, you know, it’s interesting. I was very lucky in that the residency where I trained had had gynecologists who did specialize in menopause. So I had some exposure to it as a specialty, and we had a very strong reproductive endocrinology department that actually still focused on endocrinology, which is the, the hormones of the female body. So I had some exposure, but as, as Barb says, you know, when you’re training in OB GYN, like there’s so much focus on OB and so much focus on surgical skill. And for the first part of my career, it was not the biggest part of my career thinking about menopause and perimenopause. I was very lucky in that my first faculty job, I, the, I was working with a vulva vaginal or, you know, that specialists who, who focused on the vulva and the vagina and disorders of the vulva and vagina.

So I gained those skills. And then as I grew in my practice, it just became obvious that this was how, how I wanted to focus my practice, basically. I feel like, you know, there are many fantastic OB GYNs who do OB and gynecology and some menopause as well. But that, for me, I felt like I could provide a service for women who maybe had slightly more complex menopause or just needed someone who had a few more tools in their toolkit. And then they could come and see me and have a place to go. It’s very much the same reason I started working with Gennev is that I wanted there to be more tools in that toolkit for women. And I was going to say, Barb, it seems like that’s probably a very much, the reason you started the website you did is adding tools to that toolkit.

Dr. Barb

The most important tools we offer patients is time and, and listening. For so many women, it’s a matter of being acknowledged that, Oh yeah, these symptoms do belong under a category of menopause and they’ve been frustrated and searching and at a loss. So I think part of the skill set of being a menopause provider is, is listening and helping women kind of understand how to bring it all together. And then obviously the treatment regimen is, is tailored to whatever those symptoms might be. But through this journey, I have an eight page intake that I have patients fill out in advance and about eight to 10 questions were around sexual health. And it was pretty astonishing to me that nearly every woman had some sexual health related concern. And for some women, it was all eight questions were, you know, somewhat bothersome to them. So and then I, as I asked more about it you know, it’s interesting when you actually ask people questions about it, you will begin to learn more about what you, what really matters to them. And what’s important for them to address and, and sexual health really came to the top of the list soon into my menopausal practice.

And then recognizing also that women didn’t recognize that there were actual expected changes that happen when they go through menopause. I think that’s not widely known. Hot flashes, I think mood, we’re understanding more about that”¦ memory, we’re hearing more about that, but sexual health still, there was a disconnect between what might help happen to them in menopause and sexual health.

So I created this website. I was also going through a master’s program at the time. I’m a masters of medical management and I’m challenged to think about a business and new business and what could you create and what was an unmet need. And for me, it was sexual health tools, devices, solutions. I didn’t have a website. I felt women could go to and have it feel like it was sort of clinically based with integrity. So I created Middlesex MD to help women have a conversation around sexual changes that occur as a result of menopause or aging or any number of things, maybe, you know, side effects of other medications, and then a small selection of things like a vibrator.

How can a vibrator actually be a helpful clinical tool? Most people aren’t thinking of it in those terms. So also want to just elevate the language around sexual health not just sex, but sexual health and how important it is that we help our patients address maintaining or attaining sexual health. And it might be something as simple as selecting the right lubricant or using a vaginal moisturizer or again, using a vibrator.

We, I sometimes will use the analogy, you know, when you turned 42 and you lost your near vision, you didn’t stop reading. You went and you got readers, so you could read. Well, if you can’t have an orgasm, does that mean you just stop? Well, no, maybe you get a device or a tool that helps you address that. So really trying to normalize the conversation around sexual health and making some simple things available to women in a, in a clinical way, was my goal with starting the website, Middlesex MD.

Dr. Rebecca

I’m glad you started to talk about how we as clinicians can help women with their their sexuality. And those changes in sexuality that come with menopause. I find that for my patients, it’s always been a really taboo subject. That there’s a lot of fear and silence and shaming, even around sexuality and the changes that can be very normal and natural as a woman moves into menopause. How do you start that conversation with women, obviously outside of the form that you have them sort of fill out, how do you have that conversation? How do you lead them down a pathway of saying this is not shameful? This is not something to be you know, this is something we should talk about.

Dr. Barb

Well, I think we have the unique opportunity of being healthcare providers and women’s health gynecologists, that it is a forum that women might expect that conversation comes up. So I think we, you know, we have the advantage of really expecting our patients to be able to dialogue about that. And it’s, it’s somewhat of a difficult conversation to have on a first encounter. So I will often recognize that, you know, patients acknowledge some concerns around sexual health and try to get a sense of how willing they are to address it at that first visit. Sometimes it really takes a couple of visits to kind of get a rapport and some trust to have it. But I, I use and emphasize the word sexual health and remind women that, you know, we care about physical health, emotional health, spiritual health, and sexual health is one of those areas that we should care about.

And we need to have language around it. We need to be able to help women understand that some of the anatomy physiology that might be interfering or causing some obstacles to enjoy sexual health and, you know, normalize it. As, you know, menopause providers, obviously we can expect most women are going to have some sexual consequences of becoming menopausal and the, what we now call genital urinary cinema menopause. And so I also, before women are menopausal and what to expect at some point, intercourse may become uncomfortable and you know, we’ll need to address that. And hopefully you’re comfortable in bringing it up. And yeah, so it’s, it’s really just repeating the message, I think about the importance of sexual health. And then I had to get the pulse of each individual as to what their comfort level is and exploring that further.

I can’t, I don’t talk about the vibrator with all of my patients on their first visit, but a lot of times, you know, you get a sense of how open somebody is and can go there right away.

Jill

By establishing Middlesex, MD and that’s M as in mouse, as in doctor. Do you find that when you do make recommendations that your patients are more apt to follow up, to try a vibrator or a lubricant or a product that you’ve recommended because you’ve also got a safe resource for them to go to and I’ll ask that question of Barb, but then Rebecca, I’d love for you to as well offer your perspective. Cause I know you’re also recommending solutions to women and how do you make them comfortable with that? So Barb, you want to start?

Barb

Yes. And I do think most women recognize the value of maintaining sexual health. And, and I put it this way if, especially in the context, now that we’re talking about menopause, we understand that natural atrophy painful sex while it’s not all atrophy, there are good reasons to have a good vulval/vaginal exam. And there are other, you know, diagnoses we have to parse out, but let’s say it is vulval atrophy. You know, the conversation is this is chronic and progressive. So I use the fork in the road. So here we are at a fork in the road and intercourse will continue to be more challenging, more painful, more difficult, or we address it, we treat it and we try some new approaches to this, whether it’s the moisturizer, the vibrator and women, while generally may have, they may have experienced some loss of drive or desire. Most women don’t want to abandon sex. They want to remain intimate within their relationship.

And when they hear that, I now need to invest in myself in some way to make this possible. Most women are going to opt in and start at that, you know, choosing the right lubricant, introducing a moisturizer. So starting at the beginning. And I think there is a lot of buy in, at least the patients I see there is a lot of buy in and you know, one of the reasons I think Rebecca, we do what we do is the reward is so, you know, people are so grateful for the successes they enjoy when they’re properly treated.

Dr. Rebecca

I completely agree. I find that I’m giving my patients permission to explore sometimes is a huge thing. You know many people were raised with some hesitance about sexuality or some hesitance about exploring their own sexuality and just saying, this is a normal and natural thing that women should do to maintain themselves and their health. Going forward is really helpful. Sometimes I also find that, you know, being able to point at resources that are not frightening, you know, a lot of pornography or, you know, sex shop type things are not designed by women for women. So really being able to say, look, here are a few places you can look that are not, that are not frightening, that are not from a male perspective. They’re actually from a female perspective, it makes a huge difference. And you know, always sort of taking that time to say, you know, these are things that I think are helpful and that I’ve looked into in think believe are actually functional and are helpful is also a really great thing to be able to give to patients.

Dr. Barb

Yeah, I and that was really my primary motivation was to create that space for women because a dozen years ago when I watched the site or so I didn’t know about a safe place to send women. So, but I do think, you know, there are so many smart, intelligent, creative women who have added immensely to this conversation now and who are making more and more resources available. So they don’t have to live in your town or my town to access. We’ve got we’ve, we’ve got a platform to all women can begin to access resources and to learn about it and find solutions.

Dr. Rebecca

Yeah, I think that’s been one of the great things I’ve seen happen over the last 10 or so years is just how the Internet has started to serve this population and how their platforms for sex therapy, their platforms for sexual aids, their platform, all there are now platforms for woman focused, dirty stories and things like that. All the things that can help with sexuality that are much more comfortable to a female population.

Dr. Barb

But it’s still, you know, still run into some obstacles in trying to market and promote the site. You know, there are certain words or statements, so we’ve, some of the social media has had to be a little bit softer, more lifestyle-related conversations rather than sexual health related, which is a little sad that you can’t use proper terms in what would seemingly be the proper context of this message. But, you know, there are still some weird standards out there that are preventing us from really getting the real message out to the, you know, our, our audiences.

Dr. Rebecca

Right. And if we’re, if we’re honest, it’s not just weird standards, it’s double standards. Cause I don’t think they’ve had much trouble promoting Viagra.

Jill

Unfortunately not, you know I was gonna kinda go there a little bit around what, how do you both drive like curiosity or in your patients? Both in clinic or if you’re doing telehealth appointments around this topic, like, you know, Barb, you said you probably don’t bring up a vibrator in every conversation right away, or you know, their relationship matters, but then also in that face to face, but then also what women are searching for you know, online for resources matters too, how do you help women be comfortable and also what would be your guidance to women who might suspect they want or need some help in this, in, in overall their sexual health as part of menopause.

Dr. Barb

That’s a really good question. And I think I’d like to think that most women have a provider in their healthcare team, that they would be comfortable asking specifically that question and could have an answer to that. A lot of the marketing I’ve done with my website has been to providers. We, so we recognize that in this space being a menopausal care provider, it it’s, you know, we’re not doing surgeries and delivering babies. It’s not a high revenue area and these conversations really take time and investment. And so a lot of providers, well, it’s not that they don’t care about it or don’t want to help their patients. They just don’t have time to. So a lot of what I’ve marketed my website is to other providers. So we know that you care about sexual health, here’s a safe place to send your patients.

So I would like to think that providers could be a resource for their patient, but of course we recognize some patients aren’t going to ever bring it up with their provider. Maybe, maybe they’re not comfortable. So it it’s been a journey of trying to be discovered and found in this space, I would say that it’s always a continual journey trying to understand. And I think it’s, it’s conversations like these that, you know, we can reach more people who say, gosh, these women sounded like really, you know, people I could relate to and they made this recommendation about this, you know, Gennev or this product. I’m going to look into that. So I think it’s just telling the story over and over and over again from trusted sources.

Dr. Rebecca

I really do agree with you. I, you know, I think in my clinic, it’s it, people are coming to me because they know I have experience and expertise in this, and that I can, I can walk this path with them. But I think there are a lot of women we found, especially at Gennev in rural situations who just aren’t have access to that provider. And that’s a lot of what drove us to put telemedicine together and to, you know, start to do this free education because we feel like, you know, there are a lot of women who just don’t have that touchstone within their community. And there are ways for us to bring the information and the help to them as well. And I think I completely agree with you that the more we promote each other, you know, I think at Gennev, we always say all boats rise. You know, if someone is doing something great, we want them to succeed. And if they succeed, we will, should only succeed more. Like this is not a competition. We really need to be helping people we think are doing something fabulous. Get that word out.

Dr. Barb

So our understanding is that every day, 6,000 women become menopausal and that there are 50 million menopausal women in America. So I think there’s enough to go around for everybody to be serving this population. And yeah, so absolutely, you know, echoing what you say, we need more providers and we need more access for patients to navigate this because you know, the impact to, to women in menopause around brain health and bone health and heart health and sexual health is enormous. I’ve been working on a project trying to help understand the economic impact of menopause and, you know, people don’t think of it in those terms. It’s more kind of a nuisance, Oh yeah. Too bad. You don’t sleep great. Well, yeah, too bad translates to how well I do my job to my, or my ability to, you know, consider promotion or my willingness to do a presentation because I know I’m not going to find the word I need when I’m in public.

I mean, this is real impact to women and their day to day function. And every woman deserves to try to address this and you know, in a safe and effective manner. And we have answers for those women. We have solutions for them, but they need an opportunity to engage.

Dr. Rebecca

Right. And I think the nice thing about there being many of us in this space who are genuinely trying to bring evidence-based information and solutions to women, is that we all have slightly different styles and every woman can find that place or that style that really works for her. And so, you know, the more of us are out there, the better who are, as long as it’s genuine evidence-based information.

What, what I owe more, I wrote a piece I think, gosh, probably about a year or so ago now called “œInternet hygiene” on how do you use internet hygiene? You know, just helping women to understand, not everything on the internet is safe or verified. And it can sometimes be extremely hard to figure out which is which, but just sort of looking to see if the same information appears somewhere else where it’s not being sold or, you know, things like just their little great keys that we can give women and say, you know, that there’s a lot of great information on the internet. There’s a lot of not great information on the internet and you sorta have to, to navigate your way through, but working with people like you, we can say, okay, you trust us. Here’s another person you can trust that we feel like is doing the right thing and, and trying to bring you evidence based solutions.

Dr. Barb

You know, interestingly, I have a number of men who reach out and ask questions on my website. So there’s an opportunity for some Q and a on the website. And you know, I think the unique thing about sexual health is it involves somebody else. And so I think in healthcare we’ve to a certain extent, maybe miss the mark by not bringing along the other important people to educate them on this journey too. And so I’m always hurting to, when I get questions from men, asking really on behalf of their partner or, you know, their partner, isn’t willing to seek the answers. And I think if we can continue to engage just, you know, others who intersect with that woman we’ll, we’ll do a better job as well, and we’ll be more successful. When they’ve got the support of somebody else alongside them.

Jill

I think you know, I, I do think that is such a relevant point around the support system for women and, and Barb, I especially love that you’re doing additional work around the economic impact of not better supporting women whether it’s in the workplace or whether it’s us as consumers or it’s us as moms, or, you know, there’s, there is an economic impact of not supporting women in menopause and the research and the work’s never been done there. I know as a company who serves them, we often look at you know, how much, how much do they seek out in terms of care every year, you know, and how can we better support that? And I think that we don’t even know to what extent women are spending on trial and error, different kinds of solutions and services to try to get the help they need.

And I think Rebecca, to your point, that’s where they end up in some non evidence-based options that aren’t really helpful. They’re just something that someone has tried and either they’re trying to make a business of it or it worked for them. How, how do you both address women when they bring to you solutions? Because they’re all doing, we’re all doing our research and our diligence around areas of suffering in our lives. If they bring something to you that you might not support or agree with, or it doesn’t align, like how do you, how do you help them through that? Because we, we get it a lot at Gennev. And and I just think it’s something that, you know, we don’t want to make women feel uncomfortable in their due diligence and research either. And yet we want to get them to the right solution.

Dr. Barb

So I was at a meeting that was put on by Mayo clinic probably about a year and a half ago now. And they had an integrative physician presenting on the topic and it was it was around it was actually a breast cancer meeting and addressing, but it was around wellness and prevention and talking about, you know, mindfulness and acupuncture and yoga. And so I asked a question, I went to the podium and asked a question about a specific supplement that a number of my patients were asking me about it was, you know, kind of the latest, greatest Facebook, you know, buy this and it’ll do that for you. And I asked this woman about it. And her comment to me, which I have repeated over and over again, is there are over 800,000 nutritional supplements in the United States right now that people have access to and virtually none of them have much evidence to suggest that they do what the label says it’s gonna do.

And as providers, we just can’t begin to wrap our head around that. We can’t know all of those. So, you know, people bring in their bags and, you know, bring up their labels. Oh, you know, you probably have heard of this. It’s like, no, I’ve not heard of any of that because I don’t have a memory that can keep the 800,000 supplements that are out there. So I usually say, you know, this is a real area that opportunistic people look for an opportunity to sell there wares; we don’t have much evidence on a, B or C, just because it’s not required. So I don’t have evidence to say it’s harmful either. And I typically encourage people to do supplements and, you know, if it works great our placebo effect in, in healthcare is around 30%. So I’m supporting women to try things.

Again, I don’t think we see many of them as harmful. I just, I use the analogy that you know, the reason you’re having multiple symptoms typically in my day, it’s, it’s a hormonal issue. So when there are six bothersome symptoms that result from menopause or the absence of hormones, the thing that most often is going to restore your quality of life is probably going to be around hormones. On the other hand, I do think we need to take this opportunity to talk, talk to women about lifestyle and stress management and sleep and nutrition and diet. But I just try to say, you know, it, it’s a really, really vast industry of looking for alternative solutions. And I don’t want to say that they don’t work. Did it work for you and most people who are seeking my care are there because whatever they’ve tried, hasn’t worked and they’re looking for additional solutions.

So I can’t say that’s a hard conversation to have, but I also don’t want to feel like I’ve got a corner on all knowledge and that there is nothing out there that might not help them, because I don’t believe that. I think there are things out there that certainly can help individuals. And I’m not gonna necessarily deny them that possibility of having a successful treatment option that I may be not aware of.

Dr. Rebecca

I think Jill knows how I feel about the subject. We talk about it a lot at Gennev and we approach it very much the same way you do. We can’t possibly know about everything. And a lot of the alternative supplements and herbals and acupuncture just aren’t studied in the same way that we expect evidence for a medication. So you’re right. We can’t say that we know whether or not it works.

My big criteria that I give to patients are, do you know, it’s not harmful? Because if it’s not harmful, there’s no harm in trying it and it might work for you. I completely agree with the placebo effect and it’s, and as I tell my patients, the placebo effect works, even if you know, it’s a placebo and that’s great because if you feel better, I don’t care if it’s a placebo. Great. You’re better. So criteria number one is, is it not harmful. I say, you know, if you’re trying to evaluate for yourself whether or not this might work, what do they claim it does? Does it cure everything? Cause nothing cures, everything, you know? So if it’s supposed to fix everything at once, it’s probably not really going to do that. And like you said, yeah. And I talked to them about the fact that, you know, they’re, they’re dealing with a hormonal issue and many of my patients choose to take hormones, but many can’t for whatever reason.

And then we really explore all these other options. And I said, look, there are all these things out there. Why don’t you look around and see what seems to make sense to you and come back and talk to me about it. I can tell you if I know of any harm and we’ll go from there.

Many experience menopause as a time of grief and loss: loss of youth, of reproduction, of a body that looked different, behaved in predictable ways, and seemed easier to control.

To feel some sense of grief at change is totally normal and understandable. But at Gennev, we feel the menopause transition can also be a very positive time to embrace a new you “” changed body, changed attitude, new freedoms, and all.

To help us understand and navigate this transition, Gennev Health Coach Katie Linville talked with Kathleen Putnam, an expert in grief, loss, and transition.

Kathleen gave us new ways of thinking about change and aging, and new strategies to celebrate the new us on the other side of the symptoms.

Listen to the podcast, then come over to Gennev.com to learn more about how to manage menopause to have an easier, better, healthier transition.

Prefer to watch the webinar? You can see it on the Gennev YouTube channel. Be sure to subscribe so you don’t miss upcoming webinars and podcasts!

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TRANSCRIPT

Katie Linville, Gennev Coach

Kathleen Putnam, Health Coach

Katie

Just a quick introduction, I’m Katie Linville, one of the new coaches at Gennev excited to be on board. And I worked with Stacy who you hear a lot in these webinars series and also Jessica as well. And I’m excited to have Kathleen with us today, Kathleen Putnam, a fellow registered dietician and health coach does so many things. We’ve worked together at a previous position. And it’s just so great to connect again today. So Kathleen, I’d love for you to just introduce yourself, give us a bit of your background.

Kathleen

Sure. Thanks for having me. It’s really fun to be reconnected here. And yeah, so I am a registered dietician, a health and a parent coach, and I’ve been in private practice here in Seattle, Washington for over 17 years and now it’s all gone virtual, but I’ve had mostly a specialty in dealing with women’s health with areas around weight disorder to eating emotional and stress eating parent coaching as well as dealing with chronic disease, like heart disease and diabetes.

And in, in addition to coaching just recently completed a training as a life coach focused on grief and loss and death. And also became certified as a end of life, death doula, and a holding space consultant with the Institute of birth breadth and death. And so as a result, my coaching practice is expanding.

Katie

Yeah, that’s amazing. I’d love to hear more about that. So really the topic for today is grief loss and transition in menopause and relating it to that. What inspired you to focus on that area of loss and grief?

Kathleen

Yeah, you know, well, as, you know, as a coach, we’re always working with life transitions and especially working with the emotional stress impacts of those transitions and losses as it pertains to our health and our body changes and a lot of pain and anxiety can come up for people as well as not really having a great way to navigate it.

And so after taking a deep dive into the study of grief and transition and loss, I see that I’ve always been speaking to grief and loss as a dietician. We’re always addressing it as a coaches.  And I think that my background and the awesome opportunities that I’ve had, I was able to work with dr. Dean Ornish for reversing heart disease and with Laura Mellon’s program as an emotional brain trainer at a UCSF and both of those really, really dove into the holistic view of stress and emotions as being a big part of our lifestyle management. And I think that feelings come up that we don’t necessarily recognize as grief. And now it’s just really clear that I wasn’t necessarily recognizing him. I was getting training and I was addressing them, but now it feels a lot more clear that it was a lot about grief and loss and the need to let go of what was through changes in life.

Katie

Yeah, that’s a good point. So grief can come up in so many different areas of life. And how would you really, how would you define grief?

Kathleen

So grief really is the emotional part of loss. It’s, it’s the feeling part of loss. Mourning is actually allowing yourself to go through those feelings. I think one of the big things and I know it’s getting a lot of attention because of COVID and black lives matter. I feel like grief is being discussed more. But a big problem is, is experiencing that loss and grief, but not really allowing yourself to feel it and not really being supported culturally or within our family systems or community systems too,

Be able to grieve.

Katie

Yeah, that’s a good point. And I think maybe sometimes some of us may feel like shameful of our grief or just, why am I feeling this way? Should I be feeling this way, not wanting to open up about it. But I do want to call out, you know, especially I’m thinking of menopause specifically, it’s such a normal experience to feel grief, feelings of loss during any time of transition in your life. But, you know, specifically during this time, whenever you’re trying to navigate, you know, what, what is going on here is this normal? And I will say so once again, it’s completely normal to have feelings such as those as you’re transitioning through menopause. And so whenever I think about this, I wonder, you know, what could be some science, people may not know that they’re going through grief or loss, what would be some signs that someone may be experiencing these feelings and what should they do next after they realize that?

Kathleen

Yeah, you know, I appreciate you bringing up shame an isolation and shutting down and self judgment around this, because that does feel similar to the work with disordered eating and other transitions in life as a coach. A lot of people aren’t openly talking about what it feels like to be in their body and, and they’re beating themselves up and they feel like they need to have the answer themselves. So so some of the signs in particular can be a sense of loss of feeling like themselves in menopause. Like their body doesn’t feel the same. They don’t feel right. But they list feel less attractive more irritable, more moody. There can be an acknowledgement of a loss of usefulness or beauty, which we have a cultural standard about our value as a woman that way. And I think we don’t necessarily look at it as a Rite of passage that we’re all going through and we support one another. So that’s why I just my hats off to the program, because I think that a lot of women are supposed to navigate through and do find themselves isolated not understood and alone with those feelings.

Katie

Right. Absolutely. We had a chat come through mentioning, I recently realized that I was grieving the loss of the old normal due to the pandemic, as well as the loss of how I used to feel during due to perimenopause.

Kathleen

Yeah, exactly. So it’s this, and one thing that’s really a norm about grief is this idea of expectation either externally or internally, that we’re going to end up where we used to be and that we’re getting, but really in a lot of people are talking about this with COVID is the new norm is now I’m getting to a place. One of the stages of grief is to get to a place of acceptance. And then a sixth stage was actually added by David Kessler is then to find meaning to go through a grief process and derive new meaning out of it. And then, so now who am I now inside of menopause, or while I’m going through menopause.

Katie

I like that. So finding meaning through it all, what, you know, how could this be beneficial to me? How can I get to a place of acceptance with it all? And is that something as you know, working as a coach that you really work to help someone find?

Kathleen

Yeah, I think that really establishing what’s most important to the person right here and right now, and what is it that they have control over? We don’t have control over aging. And I know there’s all kinds of products that tell us that there’s, that they can help control with our beauty and our age. And, but we are going to age the years are going at the time is passing. And so really what’s most meaningful. How do I want to go through this? What needs attention and acclimation where maybe it didn’t need attention before? One thing I know that I hear a lot as a coach is what used to work doesn’t work for me anymore.

This used to help you sleep. My body would get back to normal. If I did this, I used to be able to bounce back to exercise. And so really letting go and feeling that loss of what you used to know to be true and reestablishing what you need now to be true so that you’re focusing on what’s most important to you right now.

Katie

That’s true. And I think we all enjoy finding what does work for us. It’s like, Oh, this situation comes up. Here’s what I do about it. Right. I have my go tos. So that can feel really uncomfortable and bother, bother us whenever we realize, well, shoot, I used to have this strategy for stress management or whatever it might be. And now I’m finding this isn’t working. So what do I do? And people may even have moments of, of a panic or, you know what now? So I think that’s a really good point shifting through our different life phases and learning what works for us in this time in our lives is a good point.

You know, it just made me think about how my situation, you know, I am, I am premenopausal having a baby last year experiencing my own feelings of grief and loss during that time. I mean, it was the amazing time, love my baby, all of that. But at the same time, it was like, wow, this whole new life, right. That I’ve never experienced before. I’ve never been a mom until then. And some, you know, re relearning who I identified with as my sense of self and my norm. Right. And just, you know, and not of course body changes. And we talk about how the media really focuses on body image a lot and how frustrating that is. But yeah, that just brings to mind my experience with that. I mean, looking back you know, a year later I feel like I have found my new normal and what works, but in the moment last July, 2019, it was like, wow, what did I, what did I get myself into here with this huge change? Right. So perhaps, you know, many of us can relate to this, whether it be a slow, gradual change that you may experience or a drastic life change that comes on all of a sudden.

Kathleen

And I listened to your other podcast about grief and some of the words of wisdom around resiliency. And I think people who have had children and who have gone through that change and we’ve all gone through adolescents and to be able to remember that not feeling like we were ourselves and our bodies were not our own. I remember constantly saying, I felt like an alien had taken over my body and then she came out and then she was on my body sense of like not being separate. And really now realizing, you know, now that she’s 17 is just, all of the process has been letting go. And there’s a lot that resiliency, if you could look back and say, Oh, I made it through that. I remember thinking I wasn’t gonna be able to make it through that. And then also drawing from other people who have gone through it and finding some mentors and role models who have gone before you, I think is also really, really powerful.

Katie

That’s so true. I remember a lot of friends who were managed really reaching out to me during that time and that made a world of difference and meant a lot to me because it was like, you get it right. You know, how hard this is. And I didn’t know how hard, how hard this was until now, but wow. You know, having that community support system is, is very helpful. And that’s what I love that we’re doing here at Gennev with, with menopause, really making it normalized and making this community, having it accessible here. I mean, I think that’s, that’s crucial. We’re all gonna go through menopause at one point or the other just as women. And so, you know, how can we really focus on that time in our life and make the most of it rather than having this fearful, I don’t know what to do or who to talk to during this time, you know?

Kathleen

Yeah. I think a couple other things is it’s also a time in life that people are experiencing changes in their work life. Yeah, no, maybe not being as satisfied or driven like they remember being earlier in life. There’s a lot of talk about historically about the sandwich generation. A lot of times people wait to have kids. So when they’re going through menopause, they still have kids in the house and they have aging parents. And so they have a lot more needs as far as caregiving goes. When going through this and potentially even, you know, adult children that can’t leave home because of the circumstances right now. And I think that, I think that those, those elements of how modern day life is right now also are taking a toll on people are physically and emotionally going through this hormonal.

Katie

Yeah. Speaking of that, what are your thoughts on grief and loss being intensified by menopause and menopausal symptoms?

Kathleen

Yeah, I definitely feel like I feel like all of it can be intensified, especially if we’re not attending to it. So if we’re not attending and speaking openly about it, it’s kind of like what you said about having a group of friends. I’m really glad that you had that when you were going through having a baby post-baby because if it’s not talked about openly and we have generations ahead of us that didn’t talk about it openly. And we learned to do that. So I think that having that kind of support so that the key to grieving and the key to emotional regulation is to actually feel it and go through it. And I know many times as a coach and among friends, I’ve been told, you know, if I stop start crying, I think I’m never gonna stop. Or if I start raging or actually expressing my anger, I feel like I’m going to do a lot of damage. So it’s that thing of needing to stifle or not show what it’s really like to go through. And that kind of modeling really shuts down the conversation and the ability to grieve that can be exacerbated by any kind of stress, but there’s a physiological stress that’s going on with menopause that can exacerbate anything that’s not being attended to.

Katie

Oh, that’s so true. I had a question come through. You know, what if something traumatic happens in life are the hormonal shifts I’m experiencing intense intensifying what I’m feeling.

Kathleen

Yeah. I think that there is that potential and that, you know, trauma right now is getting a lot of attention because of so many reasons. And I think attended to past hurts and trauma that again, have not been healed and attended to that. They come to the surface and I think it’s that entering the unknown, not really being sure and not feeling yourself, things that you used to have in your skill, basket and tool basket that used to work for you or not working that, that then all of a sudden there’s a sense of loss. And then and then it’s easy to spiral down and it could be intensified. So getting that support and allowing yourself to have the feelings because feelings don’t, they’re not rational, right. So it’s not about figuring it out. It’s about offering space so that people can feel their feelings, be heard, be understood, feel cared about and then get to the other side. So you can actually access that thinking part of your brain, because when we’re under stress and emotionally driven, we can’t think, and we don’t make good decisions.

Katie

Oh, that’s so true. Stress really takes a toll on our bodies and minds and a lot of different ways. And, you know, we briefly mentioned earlier with COVID this year, the pandemic a lot of people are feeling isolated and losing that routine. Can you talk about grief and loss for women who may be experiencing those feelings losing what’s been normal just even this year with what’s going on?

Kathleen

Yeah, I do think that one that I would say is reaching out and not feeling alone and really, really finding the people that are safe to talk with. And I think that that has been rocked. So people aren’t necessarily in agreement in the same household about how to deal with COVID and what safety majors that household is going to take. So there’s there. And then there’s tension among them neighbors and friends and communities because of black lives matter and that’s being brought to the surface. And so, and then nobody really knows what the future’s going to look like with their job, where they’re gonna live the economy. Are they going to be able to travel? I know you love Disneyland. We had tickets to Disneyland then Disney world it’s like, is that, that was like a routine thing, a tradition and ritual that we had in our family that’s been lost.

And so just to recognize how am I going to be able to adjust those kinds of things. And then also, you know, recognizing that that’s a luxury for so many people to even be thinking that way. So there’s lots to attend to, and I think I’m fine finding a place that is safe and loving and can be a model of uncommon love and acceptance for all these feelings that most of us don’t know how to make sense of this. We don’t know what this is, this time period is going to be called and what it’s going to look like a year from now, you know? So I do think, yeah, I do think it’s really important and I think that’s where a coach can come in because some people say right now, it’s just too hard to be able to do that in their household or with their loved ones, because they’re worried about the emotional balance and stress with their loved ones that they usually lean on.

Katie

That’s a good point. So I was going to ask to you how someone, if they feel like they don’t have anyone, they can reach out to you, how would they find that? And I mean, I think working with a coach, such as you at yourself, you could help them. You could, you know, really personalize it to them and help them find people or places to reach out to for support any other thoughts on that?

Kathleen

Yeah. And I think it’s important to call out if someone really feels like past traumas coming up. I think a therapist, a grief therapist, you know, who’s trained in therapy is appropriate there. And I also think finding communities where people are openly talking about what it is that you’re going through. So I know that there’s some groups. I know that there’s support groups. I know that when I, I went on to your doctor board and format of asking questions and seeing other people answer things, there were a few things where I was like, Oh, this is really great because somebody is calling out a symptom that I never thought was a symptom of menopause.

I just thought I was experiencing this for, I had no idea that other people that this could be related to hormone, disruption or menopause. So I think the normalization is really important and connection. So it would look different for different people. I do think that groups can be really inviting. It helps normalize. What I love about doing group work is that you can learn so much from one another and it can really, really to have someone who has an opposing view or a different view can really broaden your scope of understanding and about what it’s like to be going through grief and loss. And then also to help with finding a deeper meaning when you’re having a hard time, but listening to someone else who’s finding deeper meaning or able to move through and see each other’s progression that can be really helpful if it feels unsafe or you don’t feel like you can really abide by the rules or you feel like you need one on one attention. Then I think one on one coaching is really appropriate.

Katie

Now with the group coaching. I’m curious about that. Is that something, something that you can find out for and other people you don’t know or also in that group? Or is it more of like a friends and family situation?

Kathleen

Yeah. Yeah. It’s you know, it’s an interesting, when I did groups before, I would always try to separate out family. It didn’t always work time-wise and schedule wise for people. And the reason is, is because there’s often pretenses and role play in our relationship. So it’s good not to be in the same. So it usually is people that you don’t know, and it’s not necessarily your friends so that you really can show up authentically and not have to worry about often what happens is it comes from a really good place, but we start taking care of another person, or we’re worried about what we say it’s going to hurt us. So it’s really, it really is an act of self care to separate out and do something just for yourself and really be able to show up authentically and bear those emotions and be able to say hard and difficult things too, I think is important with grief.

Katie

Yeah. Yeah, absolutely. And I’m thinking on some specifics on emotional health, someone had a question, how do I know if I’m raging? It’s a new thing for me.

Katheen

Yeah. I think it’s a thing of so I think it w that container’s always important. So raging is, is really, what’s the impact that I’m going to have on someone else if I’m, if I’m raging. So I think we can, I mean, there’s all kinds of videos that are kind of funny about this with people raging. And I remember at a, at a really young age for my daughter learning you know, just to put up a pillow and ask her to punch it as hard as she wants, like just to get that out of her system and to find ways not to you know, hurt herself potentially, or, or grab the dog, stuff like that. And it’s kind of like, okay, I’m going to start punching things. And I think it’s this thing to realize that emotions don’t stay stagnant, that they actually move through you, if you actually allow them to move to really allow them to.

And so I think it’s important to name it and just say, I’m really angry. This is what anger feels like. This is what rage might feel like. Like, I feel like I want to actually literally rip the door off the wall or something. And you start realizing like, huh, that’s new. That feels really extreme. And that, you know, some pent up anger, which, you know, if you’re angry, if you’re, you know, if hormones are going like this family and had a good night’s sleep, that all that can contribute to that. So I think I think the thing that, that we worry about emotionally is it’s, then you get stuck and you become hostile and it becomes your new normal way that you relate to things. So again, it’s important to feel those feelings so that we don’t kind of get locked in and start labeling and judging ourselves, but that to feel angry, the nice thing about anger that because a lot of women don’t feel like they can be angry or it’s not polite to be angry.

I know my family, it was like, don’t be mad and then it was like don”™t cry. And so when you that down, it it’s like, there’s no way for it to move. So it kind of sneaks out and in a not very visible way. So to be able to say, I’m really angry, I need a break or I need to just, you know get out of the house or I need to do a punching bag moves, or I need to go for a run. And sometimes we’re not really skillful. And I think that also owning that is like all of a sudden I’m in new territory, I’m having feelings and emotions like that. They come on me really quick and it’s out of my mouth and that’s not like me. And I’m really sorry. And again, it requires a safe space to do that, but to be able to acknowledge so that you feel like you’re really, really being seen and heard and you’re addressing it, I think is so important.

Katie

Yeah. That safe space space is crucial. I mean, whenever you open up and share your thoughts and feelings, I mean, having that safe space allows you to feel confident about being able to do that. Talking it through, I mean, it’s huge. I know I have enjoyed journaling, so that’s another thing some people enjoy doing, you know, getting the thoughts out of your head, right.

Especially if you’re a deep thinker and you have a lot on your mind just ways that you can get them out in a productive, helpful manner is crucial.

Kathleen

Yeah. But it’s also okay when we’re in this new norm to screw up. I think that I really want to get that across to like, it’s okay to all of a sudden you’re in this new place and really you can adapt and get new skills. But I think especially if you’re in you know, lifelong relationships, I know I talk with my sisters often about this and it’s like, well, that hasn’t been, you know, we’re not even gonna think that cause that’s not the way you are normally, you know, so it’s, it’s really nice to also get that feedback so that you can get grounded again in it.

Katie

True.

Kathleen

You’re making me think of Francis Weller wrote a book and talks about the five phases of grief. And I think that Gates of grief and he talks about you know, also grieving things that never will be and things that we’ve never recognized in ourselves or ever became.

And I think that I like the word menopause, just the pause. Like it really is a time because of so many things changing, physiologically that you do have to slow down, your body’s not cooperating, it’s not going full force. And I think it is a time that we pause and reflect and grief really can come up. It’s definite Mark, where if you wanted to have children and haven’t had children that grief will come up, your childbearing years are over. And also that sense of being a mom is shifting and changing. And there’s a lot of societal cultural value of being a mom. We get a lot of kudos for being a parent. And so to be able to let that go. So I think attending to, you know, the, the grief that maybe not be so tangible and listened to that, and I think journaling and having some quiet time to be able to reflect on what’s meaningful for you. Some of that stuff will start to come up.

Katie

Yeah, that’s lovely. I had a question come through. You mentioned a poor sleep potentially impacting emotions, mood and grief. When I’m grieving, I often feel tired and have trouble sleeping. Do you have any suggestions on supporting sleep during grief?

Kathleen

I don’t know if you guys have a protocol for sleep cause so feel free to jump in here. I do think that I would let yourself off the hook about that. I do think that asleep schedule’s really, really helpful. So trying to stick to a schedule, even if you’re having difficulty, I think ritual and routine is really key for good sleep and good habit making and feeling your best physically, even going through loss and grief and menopause all alike. So I think having a bedtime and a wake time you stick to and then experimenting with different things. I do think if you find yourself getting to bed I was working with somebody who said she put off getting to bed so much because her husband had passed away. And so she just kept putting it off and putting it off and didn’t want to be in the bedroom.

And so really stepping back and realizing that that needs to be addressed. So if you’re going to bed and you’re overthinking, then you don’t want to stay in bed. You want to get up and actually journal so that you don’t, you don’t want to lay him down, keep ruminating about not being able to fall asleep because then that is not relaxing and comforting. You want it to be super inviting. Like I can’t wait to get to bed. And so how can I turn that around? And then I think grieving, it’s really, really normal to need to sleep and rest and to feel fatigued if you’re grieving, totally normal, really normal. And again everyone’s different. So when you hear, I think one of the tough things about allowing yourself to be open about grieving is that people will say they want to back to the new norm.

People want old Kathleen back, let’s say. And so that there’s this pressure. And so allowing yourself not to put a timetable on your grief and allowing yourself to get the rest when you’re really fatigued and listening to your body. But I do think having a routine and some systematic way of getting on a sleep schedule is really important. Cause it can start wrecking habit with, you know, eating schedules. So schedules, ability to think and process and be really disruptive. And then that leads to, you know a whole beating yourself up saying that can be problematic and mood wise. It’s really difficult. Do you have any recommendations that are, that you want to add to that?

Katie

Well I mean, I think everything you said is spot on we can work, we can go into all the details. I feel like there’s so many things that may be helpful.

They are very individualized. I mean, keeping our room cool. For example, especially if you experience hot flashes. I mean, I think that’s a huge one. I think it was 68 degrees or so. They, that they recommend as being the perfect temperature for our bedroom. Perfect. Whatever that means. But I, I think that the list can go on and on, but I love what you said about, you know, if you’re laying in bed ruminating having me fonts, get up, do something else and work through that.

Kathleen

Right. I do think that, sorry. I would feel really bad not addressing that. I think a lot of people have is just getting off a computer, getting off the phone and getting off the TV because the light really does. And the stimulation really, really does. We live in the light that can have a huge impact giving yourself an hour.

And then because food’s been thrown off, I know caffeine and alcohol to be really disruptive.

Katie

It really can. I know I’m very sensitive to caffeine. I cannot handle more than like a cup a day and it has to be in the morning. It’s ridiculous. So yeah, some people are very sensitive to that, that type of thing. Yeah. And you know, what amidst you sharing all of that. You mentioned that for grief, there’s really no specific time that you can expect for you to be through that, that feeling. Can you speak a little more to that too?

Kathleen

Yeah, I think you know, I think being able to name specifically the loss that you’ve had and the meaning that loss has, has had in your life and what it is that you’ve lost. I think that recognizing, allowing yourself to feel it. And then I think it’s that the idea. In saying that is that all of a sudden, you might think that you’re over it because you’re feeling better. I don’t know if you’ve had this experience with losing a loved one or losing a job or losing a pet. And then all of a sudden that loss comes back to you and it’s out of the blue. It could be that a song came on or I know after losing my dad, it would be food or it would be this memory of something that we did together. And I went to do it and I would have this flood of emotions and I would find myself back with that sense of loss and grief. And I think what’s important is if we have really loved something or loved someone to grief is gonna continue and we get more skilled at managing it, but some of us may feel that intense grief for a really long time, especially when we’re talking about life partners, which is a reality in midlife.

Many women’s partners pass away or they’ve lost their health or an as

Physical health and financial health have a lot of overlap. When one is not optimal, the other can suffer.

How much should you have before you can “safely” retire? Should I be aggressive or conservative in my investments now? How can I invest in companies that represent my interests and principles?

Because women live, on average, a couple of years longer than men, and because women generally come to retirement with less in the bank, retirement planning is really important. Yet many women avoid taking the time to truly plan so they can enjoy a comfortable, stable retirement income.

If you’re like us, just the thought of planning for retirement can bring you out in a sweat.
So when you shower, make sure to use soap gentle enough for your everywhere.

Interview With Jenifer Sapel From Utor Wealth

We asked Jenifer Sapel, CEO of Utor Wealth, to join us for a conversation on how women can protect their financial health “” and independence “” as they age.

Prefer to watch the webinar? You can access it on Gennev’s YouTube channel. Don’t forget to subscribe so you don’t miss a webinar.

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You can find the slides Jenifer referenced here.

RESOURCES REFERENCED:

• https://www.morningstar.com/start-investing/classroom
• https://www.ssa.gov/myaccount/
• https://www.genworth.com/aging-and-you/finances/cost-of-care.html
• https://www.amazon.com/Millionaire-Women-Next-Door-Businesswomen/dp/0740755706
• https://www.amazon.com/Soul-Money-Transforming-Your-Relationship/dp/0393353974/ref=sr_1_2?dchild=1&keywords=soul+of+money&qid=1595545525&s=books&sr=1-2
• https://www.amazon.com/You-Are-Badass-Making-Money/dp/0735222975
• https://mightydeposits.com/
• https://utorwealth.com/
• https://utorwealth.com/pod-cast/

TRANSCRIPT

Jill Angelo, Gennev CEO

All right. Well, welcome to our weekly webinar series. This is the generic weekly webinars series, and I’m excited to be with you today. I’m Jill Angelo, I’m the co-founder and CEO of Gennev, a virtual menopause clinic for women in midlife. And today’s topic is a little bit different. Typically we come to you with specific health related topics around women’s midlife health. And this time we’re going to talk about money because I think financially we all want to be healthy. And I think money stress and or joy plays a lot into our health. And so I’m delighted today to have Jenifer Sapel, the founder and CEO of Luther wealth with us. So welcome Jenifer.

Jenifer Sapel, President & CEO, Utor Wealth

Thank you, Jill. I’m really happy to be here. I love the work that you guys are doing around women’s health.

Jill

Thank you. Well, I think more and more health and wealth, you know, especially as we go into our second half of life they kind of start to merge as topics and because you’re caring about both and you also start to become more intentional about it as a woman and as a man. And I, I just, this is such a huge topic. So a couple of housekeeping items before we jump into the real crux of all of our information today are the meat of the topic is what I was going to say. First and foremost we’re Gennev online clinic for women in menopause. Check us out if you haven’t used our telehealth services, health and wellness products for your symptom relief and or just the education and community, which is what we’re doing here. And throughout this webinar, we will take questions.

So if you’re joining us on zoom on the webinar itself please go ahead and submit them via the chat or the Q &a feature. And if you’re joining us on Facebook live, just put them, put them right in the Facebook live, and we’ll make sure to get your questions answered. I’ve got those coming in to us today. So again I am here with Jenifer Sapel, the founder and CEO of Utor wealth. She has really dedicated her background in wealth management to now helping specifically, I think mostly women manage our wealth in the second half of life. So Jennifer, tell us a little bit about couture and, and what led you to do what you’re doing.

Jenifer

I’m happy to. Yeah, thank you. So I’ve been a financial advisor for 16 years now, and it wasn’t until maybe three or four years ago where I really started to embrace that. Being a woman is different and it’s different in every aspect and it’s different financially. So it’s just been in the last three or four years where I’ve really, really focused in, on being a woman. And I’m a new mother. I have a two year old and a four month old. And so that adds a whole nother kind of layer of complexity. And so founded couture after 14 years of being in the business with a big company, founded couture and Utor is literally Latin for enjoy. And so much of the conversation around money. And I think so much of our anxiety around money is that because it’s finite and because it’s measurable because it’s quantitative because we can actually like keep score with it.

There’s this, there’s this desire or this kind of pressure to feel like there’s something that’s right or wrong. There’s a right or wrong answer. And that’s not really the case. So that’s kind of led this, the shift for me, we are a comprehensive financial planning firm. So what that means is when we engage with a client, our, our objective is to help them be financially organized and give them a framework for financial decisions and give them advice for financial decisions. We also offer services with investment management and then some insurance brokering. So life insurance, longterm care, disability insurance, but the overall objective is to help people use money as a tool in their life to live the life that they enjoy. And all of us define that a little bit differently.

Jill

You know, one thing you mentioned besides I’m totally going to come back to, what’s different about it for women. And I think some of those things are parents, but one thing that you mentioned that really caught my attention was there’s no right or wrong answer. And I know personally in my own wealth management, I’ve wanted someone to just tell me what to do. I want the right or wrong answer versus, well, what kind of life do you want to lead? And we don’t really think about that. Like, how do you pull that out of people? Or how do you address the, know that people who just want guidance or want an answer? They want to be told what to do?

Jenifer

Well, there’s, there’s a couple of things there. Again, if you frame money as a tool, it it’s a tool in your life. So you are the user of the tool. So think about any other tool you have, right. And like you know, your toothbrushes, a tool at some point in your life, it was awkward learning how to use a toothbrush. Right. but you’re the one who, you know, you learn how to do it. You got through that awkward phase and you’re the one who decides ultimately like, well, you know, am I going to brush right when I get up or, you know, like you decide how you’re going to fit it into your overall life, same with any other kind of tool, right? Like your car is a tool. You’re, you know, I like kitchen gadgets. Those are my, you know, when I first, when I first got my, my what’s the new pressure cooker, right.

I was terrified of my Instapot. And the first time I used it. Right. but how I use it is different from how my friend uses it. And it’s just fine because this is like, this is what I want out of it. So this is how I do it. A great example financially is you know, should I pay down my mortgage or not? So the answer to that is if you, if you want to make the ultimate, like if you want your sheet and that’s like, what you’re worth when you compile everything that you own, and you take out everything you own, if you, Oh, if you want your balance sheet number to be as big as possible, if that’s your objective, then the answer is no, you shouldn’t pay off your mortgage. But if your objective is, I want to just feel better about it at night. I want to, like, I want to just know that my house was paid off and that I don’t have a mortgage anymore. And just have that peace of mind and security at night, if that’s your objective, then by all means back your mortgage. So that’s just one of many examples of like, there isn’t really a right answer for anybody. It’s what is the right answer for you? Does that answer your question?

Jill

Totally. Well, and I think your ability to lead someone like me down a path of, you know, what, there’s multiple paths and helping me understand how to think about the paths is just really valuable cause that, that certainly doesn’t come to me intuitively. And that’s, that’s something that, you know, in ways of framing it in terms of different options that’s where I think your role becomes just really, really important with women and men. Well, let’s, let’s get back to that point around. It’s just different. It’s different for women. Share a little bit more about what you, what you mean there.

Jenifer

So like financial principles are the same but how we experience our lives are different. So the, the oversimplified answer to our finance is different for men than they are for women. Particularly around retirement is that most for the, for most women, we arrive at retirement with less money and we live longer. So those are two huge differences and have huge financial implications for, you know, what, what options are available to you and what kind of lifestyle do you want to live. Of course, we get to retirement with less money for many reasons, but the wage gap is one of them. It’s often women who are, are taking career pauses for unpaid work. So if they’re caregiving for children or for aging parents or for anybody else you know, there’s the, the, we don’t necessarily negotiate or ask for more raises.

So those are all contributing factors to arriving at retirement, along with a lot more. We can, we don’t need to talk about all of them today. We can do that. We could have a whole separate webcast just on that. But then living, living longer, you know, and, and as we sit here today, our life expectancy is two and a half years longer than men. That gaps actually shortening and they, the actuaries, the guests there is as women enter the workplace and work that same number of hours and things like that as men, we are seeing that as a detriment to our life expectancy.

Jill

Interesting. That’s fascinating what stress does.

Jenifer

It is well and financial implications distress. You started, you started with that. People who have pensions live longer. So if you have a pension, if you have a retirement source of income, that is a steady paycheck, right. That you can rely on those people live longer than people without pensions. And then people with more means. So if you have if you have more wealth and more means those people also live longer than, than people with less. So there are, I mean, they are, or you started this whole webcast with that. They are completely tied your health and your wealth.

Jill

Yeah. They’re tied together. Oh, that’s well I know Jennifer, you have a couple of slides to share and I think you’ve done a nice job just in terms of showcasing this life, you know, this roadmap of life. And so why don’t you go ahead and share those and talk us through it a little bit because you know, it’s yeah. If you think about lifespan this isn’t always something like, in terms of planning, I don’t naturally go here. But talk a little bit about this in some of the shifts or changes that you’re seeing. Cause you already called out a couple around women’s life expectancy and men’s life expectancy coming closer together. That’s fascinating.

Jenifer

Yeah. So you can see the financial life stages. So what, we’re, what I’m showing here from age zero to two age, 120 this line with this, this line represents is your wealth. So again, that’s a what is your net worth? What’s your, what’s your, what’s your balance sheet, say your personal balance sheet say, and most of us, right. We, we start working out of high school or out of college and some of us, you know, start from zero and some of us start from a heavy debt load from college. But in our working years, over the course of time, we accumulate, right. And we grow assets and we grow wealth. And then you can see there’s this at the top of the Hill, there’s a preservation stage. So if you’re within 10 years of retirement, this is what we call into your preservation stage.

It’s important in this time that you’re doing things that are going to keep your wealth and your net worth relatively safe, right? So you, you have to do some risk management here. And the reason this is a critical time for risk management is that you’re, you still are at a point where you have a long life expectancy ahead of you, right? So there’s still, if you’re, if you’re 50, you still could have 40 years ahead of you or 50 years ahead of you. And you’re at, you know, kind of peak wealth earnings. So this is a time to think about preservation. I think, you know, with, with the work you guys doing, right, your body changes and your, you know, your health and wellness leading up to this time. And what it looks like after this time are very different. Same is true for your financial life. There’s two major, major phases in your financial life. One is accumulating wealth, and then the other is at some point using that wealth to replace your income. And we call that in the financial world, we call that distribution, but now we’re taking the wealth and using it for our living expenses and not necessarily having to work anymore. The answer, your question.

Jill

Yeah, I think that’s great. And I think your, even your corollary to health and wealth you know, like, like we say, on the health side now is we’re kicking off the second half of life, you know, women in midlife. And so what we do now really is risk mitigation too, in terms of future chronic issues or whatever, the more that we take care of ourselves during this menopause timeframe or these hormonal shifts it totally plays out in the long run and, and it’s, it’s so parallel with the financial health of your life as well.

Jenifer

Right. It really is. And you, so you gave kind of a specific example, just a quick example here is, you know, market corrections during these times, we have to remember how the math works on on investments. But if you’re, if you’re, if you have a hundred thousand dollars in the market declined by 25%, so your a hundred thousand dollars drop to $75,000 that’s a 25% decline to get back to a hundred thousand dollars. It isn’t a 25% increase we need to see in the market. It’s a 33% increase we need to see in the market. So that’s why this, this stage, right, this is risk mitigation stage. That’s why you can accept fewer fluctuations during this period of your life. Then you can, you know, if you’ve got another 10 years or so to be invested.

Jill

Yeah. It’s incredible.

Jenifer

Yeah. And then you had mentioned let’s see, I think our next, some kind of critical decision points during this time. So from the age of 50 to 70 and a half the top three on this chart are all regarding social security. So the earliest you are you can draw social security is 62. And if you choose to draw it at 62, you’re going to take a reduced benefit. You’re not going to get as much out of social security as you could, if you were to delay and then you can, you can delay social security until age 70. So you’ll get your maximum amount available to you on a monthly basis. If you wait to take your social security payment until age 70, you can see the big age, 65 kind of in the middle there again, this is where our two worlds intersect.

Medicare becomes available age 65. So if you’re thinking about stopping work before age 65, then part of your plan has to include, am I going to get healthcare coverage? Right? Cause most of us are covered through our employer. And so if we were retired from our employer and we’re not yet eligible for Medicare, then that’s something you need to factor into your, to your expenses. And then the bottom three are around taking withdrawals from, from retirement accounts. So something that I’ll just note here quickly is if you, again, if you plan on being away from work between age 50 and 59 and a half, you could have money in 401ks or 403 B’s depending on what kind of employer you’re you’re with that inside of that plan, they allow you to take money out of it without penalties. If you roll that money into an IRA, an IRA, the TAC, the IRS says you can’t take money out of out of an IRA until you’re 59 and a half. So just be careful that you just kind of caution caution, if you’re planning on 50 55 and 59 and a half, you may have some options inside of your 401k that you won’t have in an IRA.l

Jill

In terms of having flexibility of taking that money out and using it to subsidize your life.

Jenfier

Exactly. Exactly. Yeah.

Jill

Great. That’s great. Well, good. Well, I’m gonna I’ve got one, a couple of questions for you in particular, Jennifer, that I wanna, you know really kind of dive into. And, and so, you know, you talked about the differences for women versus men and how are, you know, the, the rate of earning is different, unfortunately pay instill in an equitable between men and women. But can you also, can you kind of go into, what do we, what are mistakes that women commonly make? What, what do we, what did we get wrong? Whether it’s along the trajectory or, or even in these critical decision points down the road?

Jenifer

Great question. I think two, two that I really, really want to highlight one is that we ignore or defer you know, so that could look like I really should pay more attention to my financial life. I’ll get around to it right next year, right. Or next month, or once this happens or once I get a raise, right? There’s all kinds of conditions as to this is what I’m going to sit down and be serious about my financial life. So if you’re ignoring it, that’s a mistake. If you’re deferring it a hundred percent, this is a huge mistake for women. Most women still and millennials at the same rate as baby boomers and gen Xers are deferring major financial decisions, particularly investing to partners.

Jill

Why is that? Do you know, like what’s the psychology? I do it, I’m guilty of it. So, you know, I’m just put myself out there.

Jenifer

All right. Well, thank you. Thank you for sharing and being vulnerable. I, I, if I had to guess, I I don’t know, and I don’t know if there’s actual science about this, but if I have to guess, I would say it’s for two reasons, one it’s in our socialization. So Starling bank out of the university or not university, a United Kingdom, did a, did a research on media messages for men and for women and media messages for women around money are very, very different than media messages for men. So what they found was 93% of articles geared towards women that had to do with money were telling women how to scrimp and save, right? So like how not to spend so much money. So it’s implying right that our, our w that’s that’s the only area of finance we need help with, right.

Is how to save money, how to clip coupons, that kind of thing. 70% of articles geared towards men talk about investing. So there’s a cultural you know, and social kind of machine, like there’s some conditioning going on where the expectation of us to, you know, to be able to invest or talk about money with confidence. Isn’t the same as for women as it is for men. The other thing is that that women have a time deficit for us, you know, again, caregiving and unpaid work falls disproportionately to women than it does for men. So like when you’re, when you’re at capacity, you’re tired and you’ve got a lot on your plate. Like the last thing you want to do is learn a skill that you don’t particularly have an interest in you know, and add that to your plate. So those would be my guesses. I think they’re pretty good guesses, but those would be my guesses. Do they resonate with you?

Jill

Totally do. Yeah, they do. You know, I am very much a and even you just, when I think about just the, the right things to do, you know, infrastructure of life insurance, you know, paying bills, et cetera I know how to do it. I’m certainly capable, but, you know, my husband just kind of takes charge of it and I run my own business and I do it for my business, but, and I probably even think about it different with my company than I would if I, you know, I dunno, you know, I wonder even when you said you were talking about saving and clipping coupons and being frugal or making your money really stretch I know sometimes I’d put that mindset towards even my company versus thinking big and investing and going for it, you know? And it’s just, yeah, it’s a, it’s a risk, a risk aversion or an aversion to risk or mitigating risk in such a way that I’m sure in some ways it’s healthy and in other ways it holds us back.

Jenifer

Yeah. Yes, you’re right on both of those friends and even if, and even with even if you’re deferring. So I don’t want to say that, you know, that even in your particular situation, that what you guys have going on, isn’t isn’t unhealthy necessarily. You know, we, we, if you’re partnered with somebody, you split household chores, right? I mean, some people do yard work and some people don’t and some people do housework, some people don’t, so that’s perfectly fine. So even if you have a healthy relationship and somebody else is is taking care of, of the financial life, what I will say is it’s critical that at least once a year, if not twice a year, or once a quarter, it doesn’t necessarily have to be any more than that, but at least once a year, you sit down together and audit, right?

So that is where is every account and how is every account invested and pull a credit report. And I say this because I’ve seen it personally, eight out of 10 women at some point will have sole responsibility for their financial life. So even if they are deferring at some point 80% of the time, you will, you will need you will have to take over the reins. So know where all the bank accounts are, have like some kind of rough balance of where they are. And too high of a percentage of women are surprised when that happens. So, you know what I’ve personally seen our surprise, I didn’t know there was a tax lien on the business, right? That it’s still an obligation that I’m going to have to pay. So at least once a year, make sure that you’re taking inventory and that you’re running credit reports, and you’re kind of getting on the same page. And if, for the day to day decisions, if you’re still dividing, dividing the work there that’s okay.

Jill

That’s great. Well, why don’t you go ahead and take the SlideShare down and I’m gonna keep diving into some questions here, Jenifer. And if found any of these questions, it makes sense to show an image. I know you’ve got some additional visuals let’s, let’s definitely go back. But one, one question that came in or that we wanted to address was you know, I don’t have a million dollars in the bank or my 401k will I ever be able to retire comfortably? So let’s talk about, you know, if a person has deferred saving kind of altogether, like you talked about when you hit, like, I think remembering that that bell curve 50 ish, or, you know, you want to start to preserve your wealth. What if you haven’t really been preserving it? What’s your advice for starting to save or think a little bit more, or, or take money that you have saved and actually start investing it, maybe you haven’t invested it much of at all. Cause you have deferred that till a point when you would need to do it.

Jenifer

Yeah. So start, start now and start small. We are better humans. We’re, we’re better at doing if we automate it. So what I would say is like, if you’re behind and you need to, you need to play catch up a little bit, then put it on your calendar where, you know, you’re saving 1% more, right? So 1% of your income and if, and the more you can automate it, the better it is. So if that means you’re doing an uptick in a 401k or four, three B contribution with your employer then great, most of America builds wealth that way because of the automation, right? So if that’s the easiest way to do it, do it that way. If you can set up an automatic transfer, direct deposit into a separate account that isn’t going to go into the checking and ultimately be spent however you can automate it.

Great. And I, you know, take it 1% at a time, if you can increase by 1% every three months, every six months, even every year, you’re going to be better off the only way, right. To, to get yourself in a better position for retirement is ultimately to save and invest more so. And that’s kind of what you just mentioned Jill, right? One is make sure that you’re saving more of your income and investing more of your income. Two is how right, how you’re saving and investing. And that is get, like, you got to get off the sidelines. You’ve gotta be invested in something that’s going to at least keep up with inflation can be sitting in a, in a savings account. And there, there’s not a whole lot of tricks to investing either. You just gotta be in a, in a well diversified portfolio. And there’s, there’s a couple different ways that you can go about finding that.

Jil              l

How about you know, just we’re in interesting times right now, where unemployment’s at a super high rate and, you know, a lot of people have lost their jobs. And you let’s say you have been saving a small, you know, as much as you can. What’s been your advice, if any, to clients who have lost their employment and maybe need to rely on their savings more for a period of time, any guidance around how you dip into that maybe before, when, before you thought you would need to. Cause I think a lot of, lot of people are in that boat right now.

Jenifer

Yeah, yeah. And if you’re in that boat, you’re not alone. A lot of people, a lot of people are in that boat. The first thing I’ll tell you is one of the most empowering things you can do for your financial life, whether you’re in that situation or not like anybody, one of the most empowering things you can do is sit down and review every single expense from last month. You know? So just so take June and review and categorize every single transaction that left your any of your bank accounts. If you haven’t done that in a while, you will find, you will find subscriptions that you forgot that you were subscribed to, you will find like you’re just going to find things that if you haven’t been paying attention to it that are there and available and, and relatively easy ways for you to adjust.

So that’s, you know, number one a lot of people avoid doing that because they think they have to judge every single transaction, good or bad, like, Oh, I did good here. I did bad here. And I’d say like throw judgment out the window. This is a treat for yourself. This is you empowering yourself and gaining knowledge over your situation. So resist the urge to judge good or bad, just kind of categorize, just kind of take inventory. The second thing is if you’re having to draw from accounts, if it’s a savings account, you know, again, you’re controlling your expenses is really the most empowering thing you can do. But if it’s the same account, I wouldn’t so much worry about you know, how to take it or when to take it. Things like that. The mistake that I see people making is if they’re having to take out of retirement accounts, so a 401k or an IRA or things like that I’ll hear things like, you know, well, I have this old 401k from a job three jobs ago and there’s $15,000 in it.

So I’m just going to cash it out and stick it in my bank account, you know, and in case I need it over the course of the next couple months, don’t do that instead, just take out every month, just the amount you need every month, right? Because if you’re taking money out of those accounts early, you’re gonna have to pay taxes on all of that money. If it’s money, you haven’t paid taxes on, I’m already under normal circumstances, you pay a 10% penalty that the cares act gives you some relief there. But even with that relief, if something changes next month, if you know, if a vaccine comes out next month, you know, none of us know we’re all in kind of unchartered territory. And you’re back to work or you’re able to pivot, or, or you find a different opportunity a month or two earlier than you thought, then you were foregoing. Any of the growth that account could have, could have achieved for you by just like cashing it all out at once. So take what you need, just take what you need to get by each month as you need it to get by.

Jill

Hmm. That’s great. That’s you know, I that’s, it’s when you break things down into like little bits like that, it’s much more, I don’t know, achievable, or you feel like you have a little bit more control over it, otherwise it can be just really be overwhelming, you know, especially when you think about saving or how much should I be living on or whatever. It’s amazing how just the little steps can just make it more comfortable and like, yep. I can do this and you break it down and you start working at it. So, yeah. How about this question? What if I’ve already retired? Is it too late to plan now or to change the plan?

Jenifer

Never, it’s never too late. Never, ever, ever. No. So the, so, you know, ultimately there’s there for, in a financial world there’s really only kind of two major components. One is your balance sheet. So that’s just kind of like, what do you own and where is it and how is it, how is it situated and how is it invested? And the other is cashflow and cashflow is how much you bringing in on a monthly basis and how much is going out on a monthly basis. We think about these things, right? Jill, you were saying earlier, you think about them in terms of business. But we hardly ever apply those same principles to our personal financial life. But if you’re sitting here retired today, you still have there’s,

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Last week I received a call from Dr. Joanne Weidhaas, M.D. PhD, founder of MiraKind. Her mission is to study the KRAS-variant genetic marker found in breast, ovarian and lung cancer.

She told me I tested positive.

The KRAS genetic marker is a contributor to 20% of all breast cancer cases, 20% of ovarian cases and 25% of all lung cancer cases.

According to Dr Weidhaas, Since we have found that declining estrogen levels trigger cancer in KRAS-variant positive women, we know that estrogen is protective for them. We support HRT, particularly in women with the KRAS-variant, as it helps protect them against their cancer risk.

Thankfully, Gennev’s Chief Medical Officer, Dr. Rebecca Dunsmoor-Su, happened to be sitting next to me in our office when I received the news.

I immediately asked her if I should go on hormone therapy.

She responded with a question, Are you still getting your period?

Yes, I still have my period.

Well then your body is still making estrogen. You dont need estrogen when your body is still making it.

I was relieved, but my next question was, What if I want to go on the Mirena IUD to regulate my period? My period is still monthly, but sometimes its more frequent, heavy, painful and downright unpredictable in terms of flow.

Too much TMI? Welcome to us getting more comfortable with our health.

Dr. Dunsmoor-Su recommended that I forgo the Mirena IUD or any form of birth control that could mask whether I was still menstruating, so that I can more closely monitor when my estrogen levels will sharply declineaka menopause.

At that point, I will likely turn to supplemental hormone therapy to manage my cancer risk in accordance with my KRAS test results.

People have asked me, Do you really want to know if you have a gene for this or that? My answer is yes! Knowledge is power. With my test results, I am empowered to manage my long-term health in an informed way with the help of an evidence-based doctor.

This is what preventative healthcare is. This is me taking control of my health.

I share these personal results with you, because as women we need to be aware of whats happening in our bodies as we enter perimenopause and come out the other side.

If you’re interested in taking the KRAS-variant genetic test, its a simple cheek swab using a mail-order kit that Dr. Weidhaas team carefully ships to you and easily collects with a self-stamped return. Heres what the kit looks like.

Our health cannot be left to online questionnaires or annual visits to a general practitioner. Things are changing in our bodies in our 40s, 50s and 60s, so we need to learn and act. Take the test. Talk to a doctor. And feel empowered about your health in the second half of life.

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April is Financial Literacy Month as because who doesn’t get a jolt of reality every year when Tax Day rolls by (or over) us? Learning to manage money is especially important for women who tend to outlive male partners and [“¦]

If you are one of the many women who has searched online for natural alternatives for managing menopause symptoms, chances are you found suggestions to include soy in your diet.  Studies on soy’s effectiveness in offsetting symptoms (like hot flashes) are mixed, and many individuals may still have concern associated with how much soy is safe to consume. Here, we take a deeper dive on soy, and share five tips about adding soy to your diet in midlife and menopause.

Why soy?

Soy is a nutrient-dense source of plant-based protein that contains isoflavones (plant estrogens) also known as phytoestrogens. Isoflavones differ from the hormone estrogen, but they may provide some benefits of estrogen without the hormone’s sometimes potentially harmful side effects. Soybeans and soy products such as tofu, soymilk, miso and tempeh are the richest sources of isoflavones in the diet. 

Will eating soy reduce my hot flashes?

Although isoflavones have no effect on estrogen levels, eating soy foods on a regular basis may help with menopause symptoms. Results of more than 15 studies conducted mostly in Western countries show that isoflavone supplements can reduce both the number and severity of hot flashes by 50%. We recommend taking a food-first approach here: aim for 2 to 3 servings of soy foods a day.

Will eating soy cause breast cancer?

In Asia, women who eat the most soy foods have a lower risk of breast cancer compared to women who eat little soy. Women with breast cancer who eat soy foods may be less likely to see their cancer return and are less likely to die from their disease. It is the position of the American Cancer Society, Canadian Cancer Society and World Cancer Research Fund International that women with breast cancer can safely consume soy foods.

Does it matter what type of soy foods I eat?

Aim for soy foods that are not heavily processed, as the phytoestrogen content is typically much lower in processed foods. Limit soy-based meat analogs when possible, and aim to have your food sources from foods such as a good quality tofu, edamame, or soy milk. Brands we like include WESTSOY for soy milk and Wildwood Organic for tofu.

How much soy should I eat in a day?

Many studies suggest that aiming for 2 to 3 servings of whole soy foods per day are beneficial.  Suggested serving sizes include:

• Tofu as ½ cup (4 oz.)
• Edamame as ½ cup (cooked)
• Soymilk as 1 cup (8 oz.)

If you need more information about nutritional strategies and natural solutions to help manage your menopause symptoms, schedule a visit with a Gennev menopause specialist. They can support you with a personalized treatment plan designed to meet your specific 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.

If you have ever experienced electric shock sensations, it can be quite scary. Women have described it as feeling like a rubber band snapping on your skin, a zing of electricity shooting through you, or as serious as a jolt likened to a taser. Electric shock sensations, or ESS, aren’t typically attributed to perimenopause. And for most, ESS is generally harmless and short-lived, but for some it has been the signal of an imminent hot flash.

Electric shock sensations: What’s happening?

It’s not exactly clear what’s going on, but these zaps could be related to aging, or possibly fluctuating hormones. Estrogen works with your central nervous system to send messages along nerves to the brain. When your hormones start to go haywire, signals may get crossed, amplified, short-circuited, or otherwise distorted, causing the sensation of a shock or tingling all over your body or elsewhere.

Some medications, particularly those prescribed for hot flashes, may also contribute to the sensations. Anxiety may increase the likelihood and severity of ESS.

While ESS won’t harm you, it may disrupt sleep and increased anxiety, creating a vicious cycle. In some cases, it may be a symptom of a more serious condition.

What to do about electric shock sensations

Since hormones and anxiety seem to be triggers for ESS, reining both in may be your best defense. Here are some options.

Eat more phytoestrogens. These compounds occur naturally in foods like soybeans, tofu, chickpeas, flax seeds, broccoli, berries, wheat bran, and green and black tea, and act like estrogen in the body. The addition of dietary estrogen may level out the hormone dips that are implicated in many perimenopausal symptoms. An analysis of multiple studies found that they can provide some relief from hot flashes and vaginal dryness.

Get stuck. While acupuncture can sometimes cause electric shock sensations, this ancient Chinese practice has been found to help ease anxiety and hot flashes and improve sleep and quality of life for perimenopausal and menopausal women.

Consider hormone replacement therapy (HRT).  If symptoms are disrupting your life, it’s worth talking to your doctor about HRT. The goal is to provide some additional hormones to attenuate the drop in your levels and minimize the accompanying unwanted symptoms.

Get your B vitamin levels checked. Low levels of B12 may actually cause those annoying electric jolts.

Learn to relax. Pick what works for you””yoga, soaking in the bathtub, deep breathing, meditation, a walk in nature. The effect will be less anxiety, which may turn down the voltage on electric shocks.

And, like so many other menopause symptoms, ESS may respond to overall healthy habits, such as:

1. Drinking more water. When you’re properly hydrated, all systems in your body perform better.
2. Getting moving. Exercise boosts your mood to help you cope with the emotional side of perimenopause. It also reduces stress and anxiety, which may help alleviate ESS.
3. Practicing good sleep habits.  A lack of sleep can adversely affect all body systems, increasing your risk for a host of health issues, such as heart disease and obesity, and likely amplifying any perimenopausal symptoms you are experiencing.
4. Curbing caffeine. It stimulates your nervous system which may contribute to ESS.
5. Cutting out alcohol and nicotine. They can lead to nerve damage that may result in ESS.
6. Eating right. Make sure you’re getting the right nutrients in the proper amounts, so your body works right, rests well, and heals correctly. Nutrients like omega 3s found in fish, nuts, seeds, and plant oils such as flaxseed, soy, and canola, and magnesium, found in legumes, nuts, seeds, whole grains, and green leafy vegetables, are important for a healthy functioning nervous system.
7. Considering supplements. If you worry you may not be getting the nutrients you need, a supplement may help reduce ESS and other symptoms and support your overall health.

When to get help with electric shock sensations

As with all new and unexplained symptoms, it’s a good idea to consult with a doctor to rule out other possible causes.

If you have shock sensations down your leg, it could be related to a herniated disc or spinal stenosis. Diabetic peripheral neuropathy can cause shooting pain sensations in the legs and feet. Osteoporosis of the spine increases your risk of experiencing ESS, so you may want to talk with your doctor about a bone density test. Dysesthesia, or abnormal sensations, related to multiple sclerosis can be confused with ESS, but it is usually more painful.

So, before you chalk it up to menopause, consult with your physician or a Gennev doctor. Our menopause specialists can help you understand electric shock sensations as they may relate to menopause, plus discuss your symptoms and their impact on your overall health and wellness.

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.

Content warning: disordered eating.

If you think you left behind your eating disorder in your teens or made it out of your 20s without worrying about your weight or body image, you might be in for a rude as and dangerous as surprise in midlife.

Do a quick search for “body image in menopause” and you’ll come across comments like the following:

“Half the time I’m feeling bloated and gross and really resenting the weight I’ve gained these past few months. The other half I’m making excuses to have another candy or treat. I knew getting older meant not being able to burn off calories like before, but this is really awful”¦ And yes, I did have an eating disorder as a teen, just typing all this out and I can see that old thinking coming back.”

“I have always been slim, not skinny, and as I’ve aged I’ve had to watch what I eat, etc. If the past had been facing a small challenge to be slim and healthy then the menopause is Mount Everest. No matter how ‘good’ I am I can’t lose a single pound and I put them on so easily I’d win Olympic gold at weight gaining.”

“I feel like in my 20’s I could just stop eating junk food and the pounds came off. now it seems no matter what I do I can’t lose weight and it’s all in my middle :(“

If these statements sound familiar, you’re not alone. And that doesn’t mean this sort of thinking is necessarily healthy.

(Take caution: pro-eating disorder forums or websites (e.g. Pro Ana, referring to Pro Anorexia Nervosa behaviors, and Pro Mia, referring to Pro Bulimia behaviors) are sometimes disguised as support.)

Leslie (not her real name) doesn’t consider herself as having an eating disorder, but she’s no stranger to extreme dieting.

Extreme dieting is considered a type of disordered eating, defined as “a “˜very strict diet’ or “˜hardly eating anything at all’ in order to influence their weight or shape.”

Although Leslie’s mom had diabetes, and three of her siblings have had heart attacks, Leslie’s concern has always been less about health and more about her physical appearance. Before midlife, Leslie was always thin. As a teenager, she led crowds in cheers with her baton and skimpy outfits as a majorette in her high school marching band.

However, after two children and then menopause, she grew more and more self-conscious of the stubborn fat around her midsection. She calls it her “roll.”

To lose the midlife bulge, Leslie followed a plan that restricted food intake to alternating days of consuming around 500 calories worth of dairy or vegetables. To combat hunger pangs, she would rub ball bearings taped behind her ears (“acupressure points”) every hour, on the hour.

While Leslie stopped once she hit her goal weight, she falls back on this method whenever she feels uncomfortable with her “roll.” She calls it “going back on the beads.”

If you need help with eating disorders in midlife, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

What do eating disorders look like in midlife?

Leslie’s story is all too common.

Eating disorders and body dissatisfaction affect up to 13 percent of women aged 50 and older, with risk factors that correlate to eating disorders in younger women as compounded with additional anxiety around the aging process. 

While 13 percent represents the percentage of women in midlife with a diagnosable eating disorder, 60 percent report that their body image has a negative impact on their life, and 70 percent report trying to lose weight or belly fat. 

With such a high percentage of women suffering, you may not need a reminder of the various types of eating disorders, but just to be clear, we’re talking about all of the following here:

• Anorexia Nervosa: Starvation or compulsive exercise to reduce calorie intake, though it can also involve binging and purging (consciously throwing up or taking laxatives)
• Bulimia Nervosa: Binge eating (eating to excess) and then purging.
• Binge Eating Disorder: Eating to the point of feeling sick, without purging, accompanied by feelings of guilt or shame.
• Orthorexia: an obsession with healthy eating to an extent that impacts well-being.
• Other specified feeding or eating disorder (OSFED): eating disorders, like Leslie’s, that don’t meet the diagnostic criteria for the above but still cause significant medical problems.

In midlife, eating disorders generally look like binge eating, bulimia, or other specified feeding or eating disorders. Anorexia rates typically plateau around age 26, but binge eating levels out at age 47, and purging can last until a woman is in her 70s. Women who have never married or had children are more likely to experience anorexia or bulimia in midlife.

Support and care from a Menopause Health Coach: It’s time to subscribe to HealthFix.

Eating disorders are dangerous on their own, representing the highest mortality rate of any mental illness. They bring even more health challenges in midlife, as our bodies are more prone to injury and illness than in adolescence and we feel the effects more strongly. For example, bone density is already a concern as we enter menopause, and eating disorders compound our likelihood of a compound fracture. 

Hospitalizations for eating disorders increased among all age groups between 1999 and 2009, but hospitalizations for the 45-65 demographic rose the most: 88 percent. People over 45 saw the highest increase in purging. 

We’ve written before about why women in midlife are so prone to disordered eating. It comes down to hormonal shifts that lead us to binge eat or fall back into harmful dietary patterns, stressful big life changes (like kids going off to college or taking care of aging parents) that make it harder to eat healthily, and societal pressure to be thin when your body wants to gain and hold on to weight as and sadly, weight discrimination, perceived or otherwise, is prevalent in our society. 

For some women, it’s a new thing. Others relapse into old patterns. And some women finally realize that they’ve had problems with food for decades when their children receive treatment for an eating disorder. 

Get help

Consider this: you owe it to both yourself and the next generation to break the cycle of dieting and self body-shaming. Your children (or grandchildren, nieces, or nephews) are watching your actions and will model their own body image around yours.

If you recognize any of the symptoms of an eating disorder in yourself or feel you have an unhealthy relationship with food or exercise, talk to your doctor or schedule a phone conversation with one of ours. 

Awareness of eating disorders in midlife is increasing, but some women still find that their practitioner of choice will brush off their concerns, believing that only teenagers can have an eating disorder. Consider seeing another provider if this happens to you, particularly one who specializes in eating disorders.

Experts suggest that treatment for perimenopausal and menopausal individuals with eating disorders focus on behavioral and cognitive symptoms. In addition, they advise addressing the specific challenges of midlife, whether they be the physical aspect of aging, reflection upon choices made during reproductive and career-building years, and, for women who have long struggled with their eating disorder, acceptance around relationships and accomplishments that may have turned out otherwise without it.

Don’t fight Mother Nature

Consider focusing on being healthy instead of being thin.  After all, none of us will ever get to (have to) be in our 20s again. 

For most of us, this means that gone are the days of crying at 3 AM after too much tequila, sleeping on a futon because we’re saving up for a real bed, sharing an apartment we can barely afford (despite having a roommate or two), and having our hearts broken by one-night stands. And, hey, even if you can still party until dawn or your back can handle a futon, you’ve at least left behind that pesky late-adolescent angst. 

We’ve left our 20-something mindset in the past; we can leave our 20-something bodies there as well. There’s more to come… let’s get after it!

Your insights and experiences are valuable… and shareable! Click over to the Gennev Community Forums to ask questions, clarify, and process your experience of midlife, menopause, perimenopause, and health. We’d love it if you’d join us.

In the weight-loss world, carbs are the current “bad guy,” but is it necessary to give up carbs? Or is going carb-free actually causing weight loss to stall? We’ll break down the best time to eat carbs

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Throw out our carbs? Maybe when you pry that baguette from our cold, dead hands.

Fortunately, we may not have to. As Debra Atkinson writes for PRiME WOMEN, giving up carbs completely may be the wrong strategy for those hoping to lose weight.
What if you could tie in good sleep, weight loss and renewed energy? Here&rsquo;s the key.&nbsp;Don&rsquo;t ditch carbs completely. The team at <a href=”https://gennev.com/”>Gennev</a>breaks it down with Debra Atkinson.</p>

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Is It Bad To Eat Carbs At Night? When is the best time to eat carbs?

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Include complex low and slow carbohydrates at every meal. Increase the number of carb servings at each meal throughout the day. Start with eating carbs at a lower amount for breakfast and have the most carbs at dinner. Shocked? Here&rsquo;s how to make sense of that
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Cortisol levels ideally peak in the morning and fall throughout the day. When cortisol drops you can become more edgy. If calming carbohydrates increase as cortisol decreases you’ll avoid that hangry feeling.

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Sleep yourself skinny? Recent studies support this dream of getting slim passively. There’s growing evidence that longer sleepers (compared to individuals who don’t sleep nearly as long) are slimmer, with lower body mass index (BMI) levels, and they perform better. In spite of exercise and diets that should result in weight loss, your body could actually conserve your fat, at the expense of your lean muscle, without the right amount of shuteye.

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If you have a hard time getting adequate quality or quantity of sleep, pay special attention when eating carbs. Eating the largest por&shy;tion of carbohydrates at your evening meal will calm you with some serotinin and help you get a better night&rsquo;s sleep. If you’re in the habit of decreasing your carbohydrates at night to help prevent weight gain, and you’re not sleeping well, this small change by itself may improve weight loss. More carbs for weight loss? Who knew?

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All carbs are not the same, however. Choose low and slow. That is, low Glycemic Index (GI) and Glycemic Load (GL) foods that are released slowly. Quinoa, brown rice, legumes, and sweet potatoes are good examples.

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Eat for Sleep

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Nine out of ten women who begin a Flipping 50 program have two things in common.

They have severely reduced carbohydrate consumption at night.
Their rating of sleep quality is 5/10 or less.
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That’s not coincidence. If you are struggling to sleep and lose weight both, there&rsquo;s a chance that the very thing you’re doing to reach your weight loss goal is sabotaging both that and short-sheeting you on sleep.

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Eating carbs boosts your natural production of serotonin. Serotonin is your feel-good hormone. Women have lower levels of it than men. Too little of it can make you feel depressed. The right amount helps keep you calm and will improve your readiness to sleep in the evening.

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Though simple math about carbohydrate storage in the body can make you lose weight quickly by removing carbohydrates, it could sabotage you later. For every one-part carbohydrate stored, three parts water is stored. Eliminate carbs and you’ll lose water weight. After a short time, driving your carb intake too low can disrupt your sleep and cause cravings you can’t out-willpower.

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Dinnertime is a good time to eat more carbohydrates. That is, eat more than you have at previous meals in the day.

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Still with me?
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I know it’s often the exact opposite of what you may be doing. But if you’re both sleepless and weight loss has stalled, what have you got to lose? Women usually come back within a week and tell me they can&rsquo;t believe how much more energy they have, and how much happier they are! We do love eating carbs. The trick is to not go for the breadbasket or the chips to do it.

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Try one or two of these suggestions for a full week and see what happens.
Tonight, have a sweet potato with your dinner. If you prefer, have some brown rice or quinoa. Make a butternut squash soup or have chili made with beans. Finish with a small cup of berries.

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Since sleep affects every aspect of life, it’s important to be aware of the fact that sleep duration not only enhances your weight and your weight loss efforts, it also benefits the quality of your sleep. It’s a two-way street. It may not take a lot to improve your sleep. In fact, as little as 10 minutes of exercise a day can boost self-reports of sleep quality by nearly 30 percent. Couple that with eating carbs at night, and you are on your way to weight loss!

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Have you tried bumping up your healthy carbs to improve sleep and help with weight management? How did it work for you? Talk to us on our Midlife & Menopause Solutions.

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