Gennev Chief Medical Officer, Dr. Rebecca Dunsmoor-Su was recently interviewed by David Stewart, host of the SuperAge podcast. The podcast episode “HRT, Estrogen and Menopause, New Scientific Findings with Dr. Rebecca Dunsmoor-Su” is packed with valuable information on HRT and women’s long-term health.
In part one of five transcripts from the session, Dr. Rebecca provides a thorough view of a woman’s hormonal journey, and offers insight on why hormone testing is not always necessary. Please listen to the full podcast by visiting SuperAge.com.
David: Take me through a woman’s hormonal journey.
Dr.Rebecca: Well, I think, it’s good to frame how we talk about women’s hormones with a background of what are they for. So, this is nota value judgment but our hormonal journey is based on reproduction. We are after all biological animals. So, the transitions that the ovary goes through is all based on reproduction and reproductive potential. When you are born, you’re born with all the eggs you will ever have. In fact, they start to die off immediately. So, in utero, there are millions of eggs. By the time you’re born, they’re hundreds of thousands of eggs. By the time, you get to puberty, they’re about 10,000 viable eggs. At puberty, you start to cycle and release those eggs one by one, and a woman will release approximately three to 500 eggs over her lifetime before they’re all gone, and she starts to go through menopause.
How do hormones play into that? As you start to go through puberty, the brain starts to pulsate with pre-hormones that signal the ovary to develop eggs. Those pulsations tell the ovary to make estrogen, which makes an egg grow and mature, and then, mid-cycle when that egg is matured, and it starts to put out hormones of its own. Then the brain has a pulse of what we call luteinizing hormone, which tells you to release that egg and then, progesterone spikes. So, throughout a woman’s cycling years, she’s getting in the first half of her cycle or the first approximate two weeks getting a sort of a buildup of estrogen, and then, the second two weeks, a build of progesterone, and if she does not fertilize that egg and implant it then, everything drops off at the end, and we get a bleed. So, the drop of estrogen, progesterone at the end of the cycle causes a woman to menstruate.
For the first 20 years or so that a woman is cycling, those eggs are good, they’re viable, they respond to the brain, the hormones are nice, and even for most women, there are conditions where they aren’t. But in general, that’s a nice even cycle. Then, we get to generally, woman’s 40s. This can happen earlier in some women and later in others. The eggs that are being recruited just aren’t discrete, as we like to say. They’re a little older. They don’t listen as well. So, the brain has to pulsate more.The hormone spikes have to be higher to get that egg out. What we often see int his time, which we call perimenopause is that, women are still cycling and having bleeding, but it might not happen exactly right on time. Or, she might have a lot more symptoms surrounding it because the hormone spikes are so much. bigger. And then, as we run out of eggs, once there are no more viable eggs to respond to that brain signaling, then, our hormone stopped being produced by the ovary, progesterone and estrogen that is, and our periods stop. And that’s called menopause.
It’d be nice if that all just happened very smoothly. Of course, it doesn’t. The last couple of years of perimenopause can be very erratic. In terms of bleeding, women can have periods every three to six months, they can be very heavy because of these huge spikes of hormone, and then we label it menopause or the end of cycling when you’ve been 12 months without a period or 12 months without those hormones. What I typically tell my patients is that while your estrogen and progesterone go down with menopause and you’re no longer making those from the ovary, you do continue to make testosterone at the same rate. That does not go down with menopause. Both for women and for men, our testosterone slowly decreases over the course of our lifetime from a peak in our 20s until our 80s. But there’s no sudden change in testosterone at menopause. If anything in fact, we see a little bit more of it as women. That’s why we start to get chin hairs and acne. In the menopausal transition, we’re seeing a little more of our testosterone and that’s because one of the things that having circulating estrogen does is, it makes a molecule in our blood called sex hormone binding globulin go up, and that holds estrogen and testosterone bound in our blood so we can’t read it. When the estrogen goes down, so does the sex hormone binding globulin, but the testosterone doesn’t. So, we actually see more of our testosterone.
David: Okay, and then going forward, these levels stay the same in post menopause for the duration of one’s life?
Dr.Rebecca: Yes. After menopause, basically, there’s a little bit of estrogen floating around because there are other things besides the ovary that make a little bit. So, our fat cells make a little estrogen and our adrenal glands make a little estrogen. We basically have no progesterone after the menopause because there’s no use for it. The whole role of progesterone in a cycling woman is to stabilize the uterine lining to inflate the pregnancy. So, that’s not happening anymore. And then, like I said, the ovaries and the adrenal glands continue to make testosterone at a low level through our menopause.
David: Why would someone go into something like hormone replacement theory? Actually, let’s start with what is HRT?
Dr.Rebecca: Hormone replacement therapy is the replacing of the endocrine factors, the estrogen and progesterone that have gone missing from a woman’s body. What I tell all my patients is that there’s a lot of chatter around hormone replacement therapy. A lot of fear mongering, a lot of only I can do this for you the right way. In reality, hormone replacement therapy can be done very safely for most women with your physician, and it should always involve FDA regulated products because that way we know exactly what dose we’re giving you and can adjust appropriately.
David: Well, let’s talk about dosing. So, are you doing like hormone levels and like somewhere you want to match? How do you do this?
Dr.Rebecca: The answer is no. When a woman comes to me in menopause and she’s symptomatic, I don’t need to do a hormone level test because I know what it is. It’s very, very low. There’s nothing that a blood test is going to tell me that her symptoms don’t tell me. A thorough history and exam is much more cost effective than a whole bunch of lab draws that aren’t going to tell me anything different. So, we treat based on symptoms. We don’t titrate hormone levels to a particular lab draw because for example, in a normally cycling woman who’s pre-menopausal, the normal range of estrogen is between about 12 and 200.
David: Whoa.
Dr.Rebecca: I don’t know where to aim in their replacement. I don’t know when she’s going to feel better. Some women feel better at estrogen of 20 and some people it takes to 100. So, doing a level doesn’t tell me if she’s better. She tells me if she’s better. And that’s how we adjust hormone therapy.
David: Let’s say, for instance, I was a woman and you did a hormone draw on me at 30, and then, I come to you at 48, I’m symptomatic and would having this dot in this data point saying like, “Here, everything was happy at this level,” would that be something you’d aim for?
Dr.Rebecca: No. So, here’s the nifty thing because you’re saying, I got a blood drawn you at 30. But did I get it in the first week of your cycle- –the second week of your cycle, the third week of your cycle, and the fourth week of your cycle? All of which have different hormone levels for women. All of those are different estrogen levels. So, we feel fine throughout it. So, women feel fine in it within a huge range of estrogen.
David: If I have a low vitamin D, I mean, I know like what my vitamin D level is, I know what it should be, and I know how to change it. I got a data point,I got a target, I know what to do. How do you do this?
Dr.Rebecca: I talk to women. I talk to them and ask them how they’re feeling and we treat their symptoms. Because that’s really the only marker of when we’ve gotten to the point where a woman feels better – the marker of us using enough estrogen.
It’s never too soon or too late to be informed about menopause symptoms and treatments. And finding a physician who specializes in menopause can help you find relief as well as identify strategies to protect your bones, brain, heart, and body.
Continue to part 2, and learn about the benefits of estrogen, and if HRT is right for you.
Listen to the full podcast episode at SuperAge.com.
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Just as injury causes inflammation, eating the wrong foods can irritate our bodies and cause oxidative stress and chronic inflammation. Inflammation in our bodies can show up as joint pain, muscle aches, skin irritation and more. And chronic inflammation plays a role in nearly every major illness, including cancer, heart disease, Alzheimer’s disease and depression.
One of the most powerful ways to fight chronic inflammation is by following an anti-inflammatory style of eating. By eating anti-inflammatory foods, you may help reduce inflammation and improve symptoms of some common health conditions.
An anti-inflammatory diet is not a specific diet you will follow. Instead, it’s a way of eating that emphasizes plants for their fiber, vitamins, minerals, and phytochemicals and encourages foods that are closer to their natural state (not processed).
Making even small changes to you diet that you know you will stick to, and building from there will go a long way to helping you practice an anti-inflammatory style of eating.
When you practice an anti-inflammatory lifestyle, you will know it’s paying off when you start feeling better. There are many ways your body may respond, but you may begin by noticing:
Eating a healthy diet supports your body against inflammation and disease as you age. If you need some guidance on how to incorporate these foods into your diet on a regular basis, consider working with our integrated care team who are experts in supporting women in menopause. They will help you create a personalized plan that will optimize your nutrition and other lifestyle factors, as well as offer the support to create healthy habits for the long-term.
What foods should you eat in menopause? This is a common question we get here at Gennev- and for good reason! Let’s face it, nutrition can be confusing. We all come across many different opinions and news from so many sources, so our team of health experts has done some digging for you, and offers our targeted recommendations.
Protein: Our protein needs go up in mid-life as extra support is needed to maintain muscle mass, mobility, metabolism, and our immune system. How much protein should you include each day? This can vary from person to person, but a general guideline is to aim for 20 to 25 grams per meal and 10 to 15 grams per snack.
Chicken, turkey, and fish are all good sources of lean protein, or you may choose legumes, grains and even spinach. Plus, we like Greek yogurt for a high protein breakfast or snack option that has the added benefit of being high in calcium. When selecting Greek yogurt, choose a product that is lower in fat and added sugars. You can add in your own berries for flavor.
Prebiotics & Probiotics: Research is finding that our gut health extends beyond digestion to other areas of our health and wellness including metabolism, nervous system regulation, and endocrine system function. The hormonal changes that occur during menopause have even been found to change the bacterial make-up of the gut microbiome. These shifts make it important to include prebiotic and probiotic foods to support having a diversity of beneficial bacteria within your gut.
You are already adding pre-biotics to your diet when you include more fruits, vegetables such as bananas, onions, garlic, leeks, asparagus, artichokes, beans and whole-grain foods to your meals. And including fermented dairy foods like yogurt, kefir and certain cheeses, often contain live cultures which may act as probiotics. Other fermented foods that may provide benefit (but more studies are needed) include sauerkraut, kimchi, miso and tempeh.
Phytoestrogens: Phytoestrogens, found in flaxseeds and soy-containing foods, may have the potential to support a reduction in menopausal symptoms for some women. However, all women can benefit from the plant-based protein and fiber these foods contain as a way to support heart health, which is an important focus point in menopause as estrogen naturally declines. Aim for 2 to 3 servings of high quality soy foods such as tofu, tempeh, or soy milk and 1 to 2 tbsp. of ground flaxseeds daily: consider adding flax to cereal or yogurt or blending in a smoothie.
Anti-inflammatory foods: An anti-inflammatory diet emphasizes plants for their fiber, vitamins, minerals, and phytochemicals and includes foods that are closer to their natural state (not processed).
To get started with an anti-inflammatory diet, the simplest way is to include a rainbow of colorful fruits and vegetables each day for antioxidant support and protection. You may be surprised that you can find one or two creative ways to get those fruits and veggies into your meals such as adding spinach to your scrambled eggs or kale to a smoothie. You can also try adding cauliflower rice to your regular rice for an added boost of nutrients and fiber.
Calcium-rich foods: Bone health is very important to consider in menopause, and calcium will help protect your bones. The recommendation is to aim for 1200 mg per day, which can sometimes be hard to do through food alone. When you think of calcium-rich foods, dairy products like milk, cheese and yogurt are top choices. Also high in calcium are fortified orange juice, dark leafy greens like kale and spinach, broccoli, soy foods , sardines and trout.
Proper nutrition is key to warding off disease as we age. If you need some guidance on how to incorporate these foods into your diet on a regular basis, consider working with our integrated care team of board certified OB/GYNs and Registered Dietitians who are experts in supporting women in menopause. They can create a personalized plan that addresses your symptoms, optimizes your nutrition and other lifestyle factors, as well as offers the support to create healthy habits for the long-term.
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Hello! I’m Jill Angelo, CEO of Gennev. When I started this company in 2016, my number one goal was to solve women’s health pains in menopause. Sleep, weight, hot flashes, sex, depression, fatigue, brain fog – the list of health pains is long and it’s robbing women of their quality of life and productivity at work. If you’re reading this, you likely identify with that.
As the CEO of Gennev, I love knowing that 89% of our patients feel relief from their menopause symptoms. But the more important issue weighing on my mind, is that there are so many more women not seeking care. In November 2021, we surveyed Gennev patients and learned that 85% of them regretted not seeking menopause care sooner.
Considering there are 50 million women in the U.S. alone in menopause, and less than 7% seek care, that leaves 47 million women not seeking the care they need. Are you one of them?
What concerns me is that the solution is so simple: get a menopause check-up. It’s as easy as taking the free assessment (2 minutes), and then speaking with a doctor from the comfort of your own home (30 minutes). Internally, we affectionately call this the “M-check”.
In the past 12 months, over 4K women have had the full M-check (assessment + doctor). And over 200,000 women have taken the assessment.
If you’ve taken the assessment, you’re 50% of the way there. You’re informed about where you’re at in the menopause journey and have access to some great education. The remaining 50% of the effort results in relief from sleepless nights, answers to mysterious weight gain, remedies for brain fog, uncomfortable sex, and unexplainable fatigue. Who doesn’t want to feel better from all of that?
As a leader in women’s health, I feel the responsibility to get the 47M women not seeking care, the care they need.
Starting at the age of 45, women need to get their menopause check-up. Just like a mammogram, pap exam, or colonoscopy leads to awareness and treatment, the M-check answers the health pains of menopause and assesses a woman’s risks for rising cholesterol, depression, and self-doubt when it comes to sexual satisfaction. And, with 75% of women in menopause struggling with hypertension, 30% with osteoporosis, and 10% with depression, the menopause check-up addresses that too.
This menopause check-up does not exist in health literature or research. While I appreciate research and guidance for Well-Women visits, perimenopause and post-menopause are afterthoughts in the final paragraph with no explanation for what to check in the patient. Women’s post-reproductive health has been largely underserved for decades, but the longer I’m in this business, I’ve come to learn that the status quo is not working. Results from over 200,000 completed assessments remind me of this daily.
What I hope you take away from this article is that women need to start assessing where they are with menopause at age 45. Just like getting a mammogram at the age of 40, and a colonoscopy at 45. It’s that simple.
If you haven’t had your M-check, start by taking the assessment. Then, speak with a doctor and feel better starting now.
If you’re hesitant, I’d love to better understand your concerns. Please take this 2-minute anonymous survey. Hearing from you is the only way we can make a massive change to how women’s health is treated in this country, not to mention the workplace and by insurance providers.
Many of the changes womens bodies go through in menopause can challenge the strength of their immune system. When we are not sleeping well or eating right, stressing more and working out less, we may be more susceptible to illness. However, even small tweaks to your daily routine can make all the difference for maximizing your health.
Why not start right now? Heres your checklist for supporting your body and boosting your immunity in menopause.
When we dont get enough sleep, it can result in a number of negative impacts on our bodies including lowering our immunity, increased inflammation, poor nutrition choices (caffeine, sugary snacks to keep us going), increased risk of disease, stress and anxiety. Try creating a sleep routine including a set bedtime, and stick to it every night. Unwind with meditation or deep breathing, cool down your room, and be sure to make it a device-free zone.
“Staying hydrated supports the lymphatic system which is linked to the immune system. Being properly hydrated helpswith lymphatic drainage and works to clear out toxins and waste materials. Shoot for drinking a minimum of half your body weight in ounces of water or other non-caloric fluids each day. Exercise regularly A 2019 scientific review in the Journal of Sport and Health Science found that exercise can improve your immune response, lower illness risk, and reduce inflammation. It also helps improve your mood, supports weight management, bone health and reduces risk of heart disease and diabetes.Experts recommend 150 minutes of moderate to intense activity per week.
“Vitamin D is one of the most important vitamins for wellbeing in menopause. Like other hormones, vitamin D participates in a whole lot of bodily processes includingmuscle movement;its involved in carrying messages between the brain and body, and its important for fighting off bacteria and viruses. It helps us maintain our bones by supporting the absorption of calcium in menopause, and it plays a role in reducing inflammation. You can get vitamin D through exposure to sunlight, through a supplement, and through your diet in small quantities. Are you getting enough? You can find out your level of vitamin D with a simple blood test done by your doctor.
“Consuming a variety of brightly colored fruits and veggies provides various health benefits. Plant foods are low calorie and include vitamins, minerals and antioxidants we need, and may protect against cancer, heart disease, vision loss, hypertension and other diseases. Try for a total of 4 cups(2 cups veggies/2 cups fruit) a day. This sounds like a lot, but if you plan for two cup servings at each meal, you will quickly crush that goal.
Protein provides amino acids that the body uses to build and repair tissue. Amino acids also form antibodies, which play an important role in immune response. How much protein you need each day depends on how much you weigh. For women over 50, experts recommend1 to 1.5 grams of protein per 2.2 pounds of body weight So, if you weigh 140 pounds, you would need a minimum of 63 grams of protein a day. Be aware that your needs may increase with higher levels of activity. Protein-rich foods include eggs, chicken, lean beef, dairy, nuts and seeds, lentils and legumes, soy.
If you are checking all the boxes to optimize your health, but still feel your energy and wellbeing is lagging, consider speaking with a menopause specialist. They can help you understand how hormone fluctuations may be a contributor, and support you with a personalized treatment plan. 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.
Are you allocating any of your flexible spending account (FSA) funds toward menopause symptom relief? This post is a reminder to set up appointments in order to use all of your benefits before the year turns over. It’ll be the New Year before we know it.
FSA is an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars. Allowed expenses include insurance copayments and deductibles, qualified prescription drugs, insulin, and medical devices. You may have access to a flexible spending account (FSA) through your group health plan such as an HMO or PPO. In most cases, these pre-tax benefits are lost if not used before the start of a new calendar year.
Gina was reviewing her pay stub from work when two things happened: 1. Another hot flash revved and rolled through her body (it had to be the 6th or 7th that day already) and 2. She saw 3 letters jump out at her on her stub…”¯FSA. She blotted her upper chest and neck with a tissue and thought, “Why not use some of my flexible spending account dollars to get some relief from these [expletive] hot flashes?””¯ What a great idea! Put those saved, pre-tax dollars to work especially if you’re experiencing an onslaught of perimenopause symptoms.
Book appointments now (or get referrals) to get in to see new practitioners before the New Year turns over. Use your FSA dollars on the health-related appointments and treatments you need. And if there are a few dollars still in your account that are un-attributed, consider trying a form of care you’ve been curious about.
For now, let’s take a look at some of the alternative, non-invasive types of health care that may be covered in your health care plan.
No more grinning and bearing the symptoms of menopause, book an appointment with Gennev’s integrated menopause care team. Gennev patients find relief from symptoms ranging from vaginal dryness and pain, loss of libido, hot flashes and night sweats, brain fog and moodiness, sleep disruptions, urinary symptoms and more. With a letter of medical necessity from Gennev providers, coverage for appointments, supplements and lubricants are included on most plans.
Spinal alignment with gentle, corrective, chiropractic care can relax the autonomic nerves, which can aid in”¯improving sleep, decreasing”¯stress, and increasing overall vitality. Some find that headaches are also reduced when chiropractic care is conducted.
Relaxing and gentle, a massage can soothe frayed nerves, improve overall well-being, and aid in stress-reduction, while providing some quiet, restful time on the table.
Massage pairs well with other types of care listed here, as well as with more standard Western medicine.
Even if you’re nervous about needles, you might be pleasantly surprised by acupuncture. This kind of care can treat and reduce multiple symptoms at the same time in one session. From anxiety and depression, to hot flashes and sleep trouble, there is evidence acupuncture provides real relief. So be sure to ask HR or your benefits provider about acupuncture and your FSA.
Learn more about how”¯Chinese medicine”¯can balance a menopausal body.
Are you looking for a more holistic approach to supplement your primary care? Consider consulting with a naturopathic physician (ND). Ask about herbal options and/or HRT (hormone replacement therapy) alternatives.
Learn more about naturopathic medicine.
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Separately, or in combination, these alternate health care programs can alleviate menopausal and perimenopausal symptoms. And you may already have the pre-tax dollars saved in your FSA account.
Connect with your insurance provider to be sure that these kinds of care, and their practitioners, will be covered in your plan. You will be glad you did, as this additional me time may balance your stress levels and bolster your self-care through the coming hectic holiday season.
Hint: if a loved one says, I never know what to get you for a gift, massage and acupuncture appointments can make excellent, unique gifts!
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Now that we’ve reminded you of the unused funds in your FSA account, how might you use the money for better menopause care? Share your thoughts with us in”¯our community forums!
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If you thought yeast infections were for vaginas only, get ready for your mind to be blown wide open.
Chances are good that you’ve heard of vaginal yeast infections, and perhaps you’ve experienced them firsthand? You wouldn’t be alone as the Centers for Disease Control shared that 75 percent of adult women will experience Vaginal Candidiasis at some point in their lives.
It’s a fungal infection and can occur in places on the body where skin rubs together or touches (also known as intertriginous areas, for the vocabulary, biology, and crossword puzzle fans). Yeast infections aren’t just for adult women, either. Men, kids, even infants can get these funky fungal skin infections.
The strain of fungus is called Candida and more than 150 species exist.
No need for alarm at the word “fungus” though; a small amount of yeast is a normal thing on your skin and in your digestive system. It’s the overgrowth or an imbalance of yeast in or on the body that causes infections and the irritating symptoms that go with them.
The easy answer is commonly where areas of skin touch or rub against another area of skin. So, where does skin touch on the body? At the armpits, in the mouth and at the corners of the mouth, inside or around the navel, between digits, on finger or toenails, and certainly around the groin. Skin folds are another spot where an overgrowth of yeast can happen, such as in the abdominal area as well as underneath pendulous breasts.
Here’s another tip: candida skin infections are called by different names in different places on the body. So, you may have heard of oral thrush or diaper rash without knowing that those are types of candida skin infections. Other common types of candida, or yeast, infections are jock itch, athlete’s foot, and nail fungus.
Talk to a medical menopause practitioner. Book your appointment now.
Warm, moist environments encourage more yeast production, so if you’re living in a warm, humid climate, wear restrictive clothing, or get lax about your hygiene, you may be prompting more risk for this annoying skin infection.
You may have a higher risk of developing a yeast infection if you’re pregnant; work outdoors in wet, warm weather; have diabetes, douche or use vaginal sprays; have a weakened immune system due to certain conditions or medications; or are using hormonal contraceptives, such as birth control pills.
We checked in with Chief Medical Officer, Dr. Rebecca Dunsmoor-Su to see if hormone replacement therapy (HRT) contributed to the overgrowth of yeast. She said, “HRT is actually preventative as it tends to keep vaginal pH correct and prevent yeast overgrowth.” Regarding oral contraceptives, “…(they) are a plus minus, depending on the levels of estrogen and progesterone.” Definitely a few good talking points for your next exam or appointment.
Note: Treatments do vary for each area of the skin, and preparations should only be used as intended where symptoms appear. For instance, a spray may be really convenient for athlete’s foot, but using it for a case of thrush (in your mouth) isn’t a great idea.
Best bet is to
1. Get the right diagnosis with your doctor
2. Take the right medication, as directed.
The most common symptom is a rash or irritated, red skin: it can develop under an abdominal fold of skin, between toes, inside or around a navel, beneath breasts, or on the underside of a penis. Once diagnosed, anti-fungal creams and ointments will generally clear up this symptom, if it is, indeed, a yeast infection. Symptoms won’t improve if the real issue is bacterial instead of fungal”¦ see below for more on that.
Other common symptoms:
Thrush is actually a type of yeast infection that develops in the mouth. It appears as red or white patches of skin, and a medicated mouthwash is often suggested or prescribed to clear it up. Keep an eye on the inside of your mouth as you age, as risks of developing thrush increase with age. Risk increases even more if you wear dentures. Keep brushing and flossing twice daily, plus swishing with mouthwash (as needed) daily for best prevention.
If you’re taking antibiotics for a bacterial infection, you may develop a yeast infection. For women, the balance of the body’s natural production of vaginal yeast can get thrown way off when antibiotics are used to fight off bacteria. Talk with your doctor about replenishing your digestive system’s good gut flora if they prescribe a course of antibiotics.
For vaginal yeast infections, symptoms may include:
If you’re unsure about whether or not you’ve got a yeast infection, make an appointment with your doctor and get it checked out. Usually, a skin sample (such as a swab or a bit of a gentle tissue scraping) and completed test can illuminate what’s going on with your skin.
Feeling alone in your menopause journey? Work with a Menopause Health Coach. Learn more.
Your best health is worth your time and effort. Experience excellent health, not to mention some good, healthy pride and satisfaction in caring for someone really important”¦ YOU!
Yeast infections are a topic worthy of open conversation and one safe place to talk about it is in the Gennev Community Forums. Join the conversation today.
February 4 is World Cancer Day
The C-word is scary. We picture hospitals, hair loss, debilitating treatments, and the worst-case scenario.
Cancer is the second-leading cause of mortality in the United States. The odds are good that someone in your family or someone you know has fought cancer. While there is a hereditary component to some cancers “ as our practitioner Dr. Lisa Savage says, “choose your parents wisely ;)” “ your genes don’t always have the final say.
You can’t change your family tree, but you can make lifestyle decisions that can improve your chances of staying healthy. Here are the best tips from our in-house medical experts:
This is a biggie. Tobacco kills 8 million people worldwide every year, according to the World Health Organization, and is the leading cause of preventable death in the US.
The chemicals in cigarette smoke cause all forms of cancer, not just lung cancer. Seriously: avoid all tobacco products and exposure to secondhand smoke.
Need tips to quit smoking during menopause? We have you covered.
Did you know there’s a link between quality of sleep and cancer? Waking more than twice a night ups your breast cancer risk by 21%. Poor sleep quality can lead to weight gain and diabetes, which itself is a cancer risk.
The National Sleep Foundation recommends seven to nine hours of sleep for adults in midlife. To maximize shut-eye:
And beware: too much sleep may be associated with some types of cancer as well!
Nearly 70% of Americans are considered overweight (having a body mass index, or BMI, of 25 to 29.9) or obese (a BMI of 30 to 39.9).
You’re gorgeous at any size, but being overweight is linked to a number of different types of cancer. Researchers theorize that obesity causes inflammation, excess estrogen in fat tissue, or the body’s ability to regulate insulin, all of which can lead to increased cancer risk.
Maintaining an ideal body weight is easier said than done but can be an important step in prevention. If you’re stuck, try the mindful approach to weight management at menopause.
The American Institute of Cancer Research recommends a diet high in vegetables, fruit, and grains and low in sugar. A plant-based diet full of anti-inflammatory foods, low glycemic starches, and healthy fats is even better. Try the Clean Plate Club 2.0.
Intermittent fasting (consuming all of your daily calories in a specific 8-10 hour window) is another option to reduce your cancer risk.
Alcohol is woven into the fabric of our society but regular consumption increases your risk of cancer. The more you drink over time, the more likely you are to develop an alcohol-related cancer, like liver, esophageal, head, mouth, breast, or colorectal cancer.
Our Dr. Savage advises drinking seven drinks a week or less (though not in one sitting: binge drinking is also dangerous!) Read: how to stop smart and about other foods to avoid in menopause.
Support for self-care during menopause is here.
We all know that the sun is damaging to our skin but may not realize that our risk of skin cancer increases in menopause.
To keep your skin safe, stay in the shade, wear hats, keep your arms and legs covered, apply sunscreen that is at least SPF 15 or higher and protects against UVA and UVB rays, wear sunglasses that block both UVA and UVB rays, and avoid tanning.
A note on sunscreen: applying two SPF 15 products will not add up to a single SPF 30. And, yes, you can burn through a car window.
If you have new spots or growths, your dermatologist should run tests for you to rule out cancer and remove anything risky. Talk to your doctor about how often you should come for screening.
The American Association for Cancer Research suggests that the combination of exercise and preventing weight gain is important for preventing cancer and increasing overall survival after a diagnosis.
We know it’s hard to drag yourself to the gym after a long day or fit a workout into everything else you have going on, but make fitness a priority for your health.
Read: How to really get fit in midlife.
“In women’s health care, our biggest concern is cervical cancer,” Dr. Connie Mao, director of Harborview Women’s Dysplasia Clinic in Seattle, told us in an interview.
HPV (human papilloma virus) most commonly causes cervical cancer but can also lead to cancers of the vulva, anus, and mouth. More than 12,000 people in the US were diagnosed with cancer of the cervix in 2016.
The vaccine can kill 80-85% of these viruses. While the prime target for the vaccine is boys and ages 9-12, all sexually active adults should consider it, though the more sexual partners you have had in your life, the more likely you are to have been exposed already.
Hepatitis is another virus with a link to cancer. Hepatitis C is the leading cause of liver cancer in the US, while people with chronic hepatitis B have a 25% to 40% risk of developing liver cancer in their lifetime. While there’s currently no vaccine for hepatitis C, more than half of all cases of liver cancer can be prevented with the hepatitis B vaccine.
Talk to your doctor if you haven’t been vaccinated and want to schedule your shots.
You can still get pregnant until your periods stop, but the good news is that The Pill can help in preventing both unintended pregnancies and certain forms of cancer. “Most people don’t know birth control prevents cancer,” says Gennev telemedicine physician Dr. Ghazaleh Moayedi.
While birth control pills with estrogen and progesterone may raise the risk of breast and cervical cancers, people who have ever used oral contraceptives lower their ovarian cancer risk by 30% to 50%, endometrial cancer risk by at least 30%, and colorectal cancer risk by 15-20%. Talk to your doctor, or one of ours, to determine if this is right for you.
Understand where are you in your menopause journey by taking the Gennev Menopause Assessment now.
Screening won’t prevent cancer, but it can catch it early and improve your outcome.
Many cancers are preventable, and the prognosis can be improved by knowing what to look out for.
A wealth of experience is available on the Gennev Community Forums. You are always invited to join, ready, gain insights, and yes, share.
Have you ever gotten a new job and felt”¦ uncertain? Unskilled? Unfamiliar?
Perhaps similar feelings are emerging right now as we come to terms with living and working from home (as much as possible) during this COVID-19 crisis?
Self-care for optimal good health is on deck for all of us as we do our parts to help flatten the curve of exposure and minimize the risk of this coronavirus spreading.
Self-care can look different for each and every person. It’s not all bubble baths and manicures, (though a soak, trim, and paint do sound nice sometimes). The term gets tossed about everywhere, so before we do anything else, let’s clarify.
According to Oxford, self-care is:
“The practice of taking action to preserve or improve one’s own health.”
And it’s also defined as”¦
“The practice of taking an active role in protecting one’s own well-being and happiness, in particular during periods of stress.”
Sounds reasonable, yes?
Especially now? Heck, yes.
This research study followed participants for a 4-month period: 2 months as a “control” period, and the following 2 months participants entered a physical exercise routine. The findings during the 2 months where participants exercised regularly were that “During the regulatory exercise phase, participants also reported significant decreases in perceived stress, emotional distress, smoking, alcohol and caffeine consumption, and an increase in healthy eating, emotional control, maintenance of household chores, attendance to commitments, monitoring of spending, and an improvement in study habits.”
So, exercise can help equip us to manage stress and other self-regulating behaviors better, per this study. Based on the decreased stress and emotional distress noted, an improved outlook seems like it would figure in too. Sign us up!
How are you feeling about your self-care routine now that we’re a few weeks in?
Is it different every day? It might feel like your capacity is different every day.
We’d like to affirm that is this reasonable, especially right now. No one has ever been here or done this before.
We are all learning as we go.
And of course, all this is doubled if you’re experiencing new symptoms of perimenopause or menopause.
It’s time to slow down, even when you don’t want to, or don’t feel skilled at slowing down.
We do have several suggestions for self-care that don’t take a lot of time but really fuel you and can help to ease symptoms like increased hot flashes, anxiety, sleeplessness, and headache.
It’s time for more support, not less. Gennev is your online, women’s health clinic. Learn more.
Getting familiar and feeling confident in new skills takes practice, even around some of what might be considered as the basic self-care activities. Self-care is made up of myriad practices! Break them down and learn them, take your time and give yourself the grace to feel unfamiliar”¦ you won’t feel this way forever.
In fact, with care and attention, you’ll likely feel better.
You ready? Take a look and try these out:
Water, for the win
Dehydration happens when water is not replenished in the body. We need water for every cell in our body so systems, tissues, and organs can do the body’s work of”¦ well, functioning. Continual replenishment of good clean water definitely counts as excellent care.
Move it, move it
Made for motion, our bodies and minds thrive with regular stretching, muscle-building, and exertion to the point of increased heartbeat and even some sweat”¦ cardio, anyone? A little extra or a little different movement can spark momentum and endorphins for better feelings and an improved sense of well being.
Spice up your current movement strategy or exercise plan with a new stretch, or a new component to your regular routine. Jump rope, sketch a chalk hopscotch outline and play, pick up the pace on your run with a few sprints, or tackle a new hill on your walk. Variety can give your body and mind more to work with during your workout or even a gentle stroll.
Afternoon naps for everyone!
What do we mean by, “nap”? Quiet time. Rest. Heck, even sleep, if that comes naturally. What if a daily rest period were a part of your regular routine? Only you can say for how long. And the length of the quiet time, or nap, may be something that changes and flexes day-to-day.
For a few minutes? Yes, this qualifies.
For an hour? Sure, if it makes sense, is needed, and doesn’t disrupt you or your household’s current sleep schedule.
Sleep is not “required” (though it could happen!); quiet and restful time is the intention. Meditation could feel restful if you’re up for practicing. A few stretches at the beginning and at the end might feel really good and help to transition both in and out of this quiet time.
Ease up
A reminder: this is a highly stressful, unprecedented time. Sleep planning, hygiene, and relaxation are part of balance and self-care. You may need a little practice in order to acclimate and begin to feel skilled in this. Who knows, a gentle, flexible resting time during the day may help with your nighttime sleep routine as well.
What have you got to lose in trying more conscious elements of self-care?
Test drive one or all and see how you feel. We’re hoping that “better” is part of your results.
Join the community and ongoing conversations about menopause, midlife, self-care, and balance: Gennev Community Forums. You’re always invited.
If you think about it, nearly a third of your life is spent at work as at least during the week.
So let’s talk about your work space: is it harming you?
As we age, our bodies are less flexible. Joints hurt and muscles grumble sooner and louder than they used to, and bad habits we could shake off before may now be causing incremental but lasting damage.
So this month, DPTs Dr. Meagan Peeters-Gebler and Dr. Brianna Droessler-Aschliman gave me some tips to share on ergonomics and how to make your work space comfortable, functional, and body friendly.
Optimize your chair for the many hours you’ll spend in it and the work you’ll be doing from it. According to Meagan, you should be able to sit so your feet are flat on the floor. Your hips should be slightly higher than your knees and tucked firmly against the back of your chair (no sitting on just the front half or the edge of your seat, no matter how exciting your job may be). A lumbar roll to fill in the gap between the small of your back and your chair is great for support.
Brianna also recommends correcting for monitor placement. If, like most of us, you spend the majority of your day staring at a monitor, you should really be sure it’s at the right height to protect your neck and eyes. So: adjust your monitor so you’re looking ahead and slightly down. If your monitor is too low and not “adjustable,” well, phone books need something to do these days.
If you have two monitors, put the most-used monitor in the center, with the other one slightly off to the side of your dominant eye. To determine which eye is dominant, form a triangle by crossing your hands. Center some object in the middle of the triangle, then close each eye in turn. Whichever eye still sees the object is “dominant.”
Don’t let vanity determine health. Go ahead and bump up the font size on your monitor if it reduces eye strain. Consider an anti-glare screen as well. Your screen should optimally be arms’ length away or about 20″. Get computer glasses if you need “em.
As we have all heard, sitting too much really isn’t great for our bodies. We get tight hip flexors, weak butt muscles, and a whole list of issues up and down the chain from there. Even those who exercise daily may not be able to compensate for the sit.
So, adjustable desks! As Bri says, this does not mean “get a standing desk” or “get an adjustable desk and don’t adjust it.” Standing all day probably isn’t the best either, as most of us will shift our weight from one foot to the other, from one hip to the other, potentially resulting in lumbar and pelvic issues.
An adjustable desk means you sit down, stand up, sit down, stand up, just like the old cheer (minus the “fight, fight, fight”) to even out the stressors on your body.
If you find your joints hurt a lot more often now,
talk to one of our docs about inflammation, diet, exercise, and all things menopause
via Gennev’s telemed services.
We have this unfortunate notion that desks are “one size fits all,” when in fact, not so much. The right desk should allow you to sit with your arms at a 90° bend at the elbow. If your desk is too high, to get the right angle, you have to ratchet up the chair, so now your feet are no longer on the floor.
If you can, work with your HR department to get a desk (and chair!) that’s appropriately sized. If you can’t change desks, a stool for your feet will help.
One way to reduce your risk of carpal tunnel syndrome and other repetitive motion issues is to avoid repeating motions. One way to do that, if you type a lot, is to try to keep your wrists still and in a neutral position. Meagan suggests you find a way to support the meaty base of your hand and let your fingers do the work, not your wrists.
A detached keyboard will help you keep your wrists and arms in the proper position without sacrificing your neck by having to look down at your laptop monitor.
OK, now that we’ve got you nicely aligned and perfectly comfortable, you may want to stay that way. Yeah, don’t do that either. Meagan warns that holding too still for too long can mean you develop trigger points in muscles and joints that aren’t moving enough. Set yourself a reminder to move for 30 or 60 seconds every 10 minutes or so. Roll your head to stretch your shoulders and neck. Stand up and walk around the office (or better, the block).
Fill your water bottle from the water dispenser that’s a floor (and a staircase) away; use the bathroom that you have to hike to, not the one just around the corner. It sounds silly, but these little bits of motion add up to a healthier you.
For those folks who stand a lot, if you stand in one spot, a good mat. Carpet over concrete isn’t enough, Bri says. You need a thicker pad that relieves the strain.
If you move a lot (nurse, teacher), get the good shoes. They may be more expensive, but if you can afford the outlay, they’ll probably save you money. They last longer than cheaper alternatives and can help you prevent costly pain and injury down the road. Keenes, Merrells, Dansko as all provide good support for long days on your feet, Meagan says.
If you take a bus to work, look up from this article and count how many folks are looking down at a device or book or magazine in their lap. Probably most of them (including you), right?
We spend a lot of time with our heads tilted down, which isn’t particularly healthy. As Meagan says, the danger is that you’re asking the natural curve of your spine to stay prolonged in the exact opposite position (forward, down) from where it’s supposed to be (up, looking ahead).
You’re overusing certain segments and under-utilizing the whole chain of your vertebrae. You end up with extra wear and tear at the top and bottom of the chain, which can accelerate degeneration, irritate the discs, pinch nerves, and put extra tension on the muscles, decreasing blood flow to the area. And Bri says, it contributes to a lot of the tension headaches that bring her patients to her door.
If you must look down, vary your head position: tuck your chin in sometimes; extend your neck at others. It’s not ideal, but it does spread the burden out a bit.
Those tension headaches may be caused by a tightening of the muscles between your neck and head. Roll a tennis ball in there to gently release those muscles.
Also, if you spend a lot of time on the phone, get a headset. Squeezing a phone between ear and shoulder as really not good for your body. And considering how slippery most cell phones are, probably not good for your phone either.
Headaches, neck strain, back issues, carpal tunnel, hip and glute problems, eye strain, and probably much more can be avoided or reduced by optimizing your work space to fit your body. When we’re comfortable, we’re more productive and have a more positive attitude, we may require less of our insurance plan, and we’re likely to need fewer sick days.
Talk to your HR department about bringing in an expert to assess work areas but also to teach teams how to work in the healthiest possible ways. Yes, an adjustable desk can really help, but so can knowing how to hydrate, how to stretch, when to move, and how to sit.
Has your employer done something amazing to accommodate employees? We love to hear the good news, so please share about your new adjustable desks, or a quiet room for women dealing with menopause symptoms, or thicker mats or easier flextime. What would you like to see your employer do? What about steps you’ve taken personally to make your space more body friendly? Hit us up with some ideas in the community forums, share with us on Gennev’s Facebook page, join Midlife & Menopause Solutions, our closed Facebook group.
Have you exercised today?
We get it. Women’s fitness motivation is hard. Between getting yourself and your family ready for the day, making breakfast and lunches, walking the dog, checking traffic and weather for your commute, synchronizing schedules, and all the other Workday Wonders, you probably haven’t had time. Yet.
Or maybe you have a health condition that makes standard exercise choices difficult or impossible. Or you live in an area or climate that’s not outdoor-exercise friendly. The gym might be far away or just plain intimidating.
Yes, exercise (both cardio and strength training), helps us maintain our bones, stay strong or get stronger, it improves balance and endurance, helps us maintain our weight, promotes greater heart, brain, and emotional health, and reduces the risk of many diseases”¦ but “¦ it’s hard.
What if”¦ and we know we’re reaching here “¦ what if it weren’t so hard? Why is finding women’s fitness motivation so tough?
Need help staying motivated? A menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.
Exercising regularly is not just a matter of better scheduling or more willpower. It’s accessibility, privacy, convenience, affordability, and a host of other concerns that just make it feel impossible.
One woman who is really lowering the barriers is Michele Mehl of Excy. She’s created a full-body cycling device that is so convenient and effective, the only resistance you’ll feel is coming from the machine.
We asked Michele to explain why fitness is so important, and how she’s helping women achieve their best selves.
According to Michele, “The scientific benefits of exerciseasslower aging, better mood, less chronic pain, preventing diseaseasare real, measurable and almost immediate.” She’s right. When it comes to midlife, studies have shown that midlife fitness may be associated with the compression of morbidity in older age. Translation: motion is lotion for the joint pains in midlife and is instrumental in helping us live with less disease, less pain, and fewer illnesses.
In fact, research shows that regular exercise helps with chronic disease prevention and management, Michele says, even when someone is going through cancer treatment and living with other conditions like Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, and osteoporosis.
“With just over 100 million people having multiple chronic conditions, and 54 million of them being women, we must start talking more about the science of exercise and how it helps the heart, muscles, lungs, bones, and brain.”
[Check out video of Michele and Gennev CEO Jill Angelo exercising together as part of the Founders Fight Cancer campaign for breast cancer awareness month!]
Excy eliminates common fitness barriers of time and space by making quality, full-body cardio, strength training, and rehabilitation exercises safely available to anyone, anywhere, Michele tells us. “Within seconds, Excy can be easily converted into a gym-quality recumbent exercise bike, upper body ergometer, full-body resistance-based gym, desk cycle, or even a peddler to exercise in bed.”
Exercise in bed? Does it get any better? In fact, it does.
“Excy is optimized for efficient cardio and strength training without impacting joints. Millions of women struggle with mobility limitations that make walking, running frequently, climbing stairs, cycling, or getting enough exercise challenging. We open up a world of exercise for them at home, work, or on the go.”
Plus, Excy weighs only 14 pounds and folds up, so you can take your fitness gym and regime with you, wherever you go, and use it in a limited space as like a hotel room. Excy also offers free mobile coaching applications for guided training, including videos from physical therapists.
Like so many innovations, Excy is a product of its creator’s own personal woes that led to a broader desire to help others in similar situations.
“A busy schedule and family history of heart disease got me thinking about a better, more convenient way to exercise for a healthier quality of life. I recruited my co-founder Mike Rector to begin prototyping a portable stationary exercise bike, one that promoted the same quality of exercises offered at a gym or a spin class, but portable enough to use anywhere.
“Just as we were in that phase, I broke my leg. Emergency surgery led to a rod, 10 screws, and a plate to hold it all together, as well as a blood clot. Two additional surgeries followed, leaving me in a boot for five months. To say my morale was low would be an understatement.
“Yet during these non-weight-bearing months, Mike and I both embraced the injury to rapidly innovate our design. I worked with my physical therapist in the clinic to recover, and at home I was able to keep my upper body strong and burn over 450 calories using Excy’s ergometer features. When my insurance would no longer pay for PT, I continued to manage my leg’s rehab with Excy recumbent bike movements at home. I had an entire rehab facility at my disposal!
“After months of physical therapy and relying on caretakers, I got just a small glimpse into the plight of those living with injury, disability, and disease. It was an eye-opening experience that led to a new dialog with potential customers. That inspired us to help those who fall outside of the traditional fitness mold gain unprecedented access to a new way of staying healthy and strong.”
Excy is built on a strong cycling and high-tech foundation. Michele spent more than 20 years working for technology startups innovating around consumer experiences and products. Partner Mike has more than 30 years at the forefront of tech, part of prototyping teams responsible for tablets, simulators, and robotics.
Says Michele, “Mike brings tremendous manufacturing, operations, and product development knowledge to Excy and a lifelong passion for cycling. I’ve had the blessing of leveraging my collegiate athletic background, injuries, and marketing to inform how the machine is built but also how we let women know about it.”
Learn more about Excy at their website.
“Everyone deserves easy access to consistently and safely enjoy the health benefits of strength training and cardio exercise,” Michele says. “We need to start treating exercise like the miracle drug it is. It really is that important. But it’s not good enough to just tell someone they need to exercise more. That’s like handing someone with high blood pressure a bottle of pills for Parkinson’s disease. Not everyone needs the same prescription. You need to find the thing you’ll do and do it.”
How do you keep yourself fit? We’d love to hear about your exercise challenges and triumphs, so please feel free to comment here, or start a thread in our community forums. You can also reach out to us on Gennev’s public Facebook page or in our closed Facebook group.
When you’re worried about your health, your heart is probably not at the top of your list”but it should be! More women die from heart disease and stroke than all cancers combined. It’s the leading killer of women, and your risk of heart disease spikes in midlife and menopause. But the good news is that it’s highly preventable, and you can significantly reduce your risk of having a heart attack or stroke. But don’t wait.
“If you ask the average 40-year-old woman what her biggest health concern is, she’s likely to say breast cancer,” says Sarah Speck, M.D., one of Seattle’s leading cardiologists and co-founder of POTENTRx, a medical fitness facility that combines medicine, exercise, nutrition, and lifestyle coaching. “Yes, you should get your annual mammograms and Pap tests, but you also need to be aware of the risk factors for heart disease because it’s more likely to kill you.”
Heart disease occurs when the lining of blood vessels becomes inflamed. Once inflammation starts, the environment is set for cholesterol-related plaque to form in blood vessels. Heart disease isn’t much of a concern during the first half of your life thanks to estrogen. The anti-inflammatory properties of estrogen help to keep women’s blood vessels flexible, reduce plaque, increase good HDL cholesterol, and keep bad LDL cholesterol in check.
A lack of estrogen is one of the reasons that men are nearly twice as likely to have heart disease as women early in life. At age 45, one in five men has heart disease compared to only one in nine women. As estrogen levels fall during perimenopause and into menopause, women lose estrogen’s heart protective benefits, and by age 65, their risk for heart disease is similar to men’s risk”one in three.
But you don’t have to become one of those statistics. “There’s an incredible window there”20 years”where you can do something if you realize that you’re at risk,” says Dr. Speck. Think of your hot flashes and other perimenopause symptoms like warning lights on your car. You wouldn’t ignore them and keep driving, would you? Probably not. More likely, you’d check your owner’s manual to find out what they mean. Consider this guide to be your owner’s manual for heart disease. If you take the time to discover what warning lights (or risk factors) you may have, you can take steps to reverse them and reduce your risk of having a heart attack or stroke.
The first step to protecting your heart is to know what your personal risk of developing heart disease is as you get older. Some risk factors are uncontrollable, such as age and family history, but knowing if you have any of these uncontrollable risk factors will help you customize your healthy heart plan. While it may seem scary to have uncontrollable risk factors, there are many more risk factors that you have control over and managing those will provide significant protection.
Uncontrollable risk factors of heart disease
The more uncontrollable risk factors you have, the earlier you should start implementing the preventative strategies below.
Controllable risk factors of heart disease
Now that you know the factors that can increase your risk for heart disease, it’s time to take action.
These steps will help reduce your heart disease risk no matter which risk factors you have. In addition, they’ll help to ease many menopause symptoms, improve your mental health, and lower your risk for other health problems such as diabetes, depression, and cancer.
1. Partner with a health professional you trust. You want someone who listens to you, understands what you’re going through, and will work with you to address your unique needs. A menopause-certified doctor is specially trained to help you manage symptoms during perimenopause and address long-term health risks like heart disease. They will know what types of screenings you need and create personalized health plans to reduce your individual risk for various conditions, including heart disease.
2. Know and follow your numbers. They include weight, waist circumference, blood pressure, blood sugar, LDL (bad) cholesterol, HDL (good) cholesterol, triglycerides. If your numbers are healthy based on the “controllable risk factors” above, you should talk to your doctor about specific steps you can take to improve them. In addition, it is even more critical that you make the healthy lifestyle changes that follow.
3. Get tested. If you’re over the age of 40 and don’t know your numbers listed in #1, find them out now. You’ll need to get a script from your doctor for the cholesterol and blood sugar tests, but the others you can do on your own. You’ll want to start tracking these numbers even earlier if you have any of the uncontrollable risk factors listed above. You should consult with your doctor about the best timing for you. If you don’t have any other risk factors, and these numbers are normal, repeat the blood tests every three to five years. Track your weight, waist measurement, and blood pressure at least annually.
At menopause, or earlier, if you have certain risk factors, there are three additional tests you should get:
4. Avoid all tobacco. This includes e-cigarettes and second-hand smoke. Smoking causes inflammation that contributes to heart diseases. If you smoke, do everything you can to quit. Nicotine gum or patches may help and do not contribute to heart disease.
5. Manage stress and address depression. Just like stress comes from a variety of sources”your job, your family, the news, traffic”the negative impact it has on your heart occurs in a variety of ways. The hormone cortisol is released when you’re stressed, and it can increase cholesterol, triglyceride, blood sugar, and blood pressure levels. It may also contribute to plaque in arteries, impair blood flow to the heart, and make blood stickier and more likely to clot.
In addition, when you’re stressed, it’s harder to practice other healthy behaviors like eating healthy, exercising, and getting to bed early. That’s why it’s so important to find a stress management technique that you can practice consistently. And like there are numerous sources of stress, there are multiple ways to relax, such as walking, meditating, listening to music, taking deep breaths, practicing yoga, and petting your dog or cat. If you still can’t get your stress under control, seek help from your primary care provider, or therapist.
If you’re feeling depressed, get help. Women are two to four times more likely to experience depression during the menopause transition, and being depressed increases your risk for heart trouble.
6. Eat healthy. Based on research, the Mediterranean diet appears to be the best choice for keeping not only your heart healthy, but also your brain. It may also help with hot flashes, prevent breast cancer, boost your mood, and help you live longer. The diet focuses on limiting animal protein to chicken, turkey, and fish, eating two servings of fish a week, eating five servings each of fruits and veggies daily, eating whole grains instead of refined sugars and starches, and consuming heart-healthy olive oil and nuts instead of other fats.
This eating style appears to protect your heart on two fronts. Research has shown that the Mediterranean diet lowers risk for heart disease and heart attacks by up to 30 percent and risk for stroke by up to 17 percent. The diet also influences other risk factors that contribute to heart disease, such as improving cholesterol and blood pressure levels and lowering the risk for diabetes.
7. Move every day. “You don’t have to sweat. You just have to move,” says Dr. Speck. “There’s a 40 percent decrease in cardiovascular risk by just walking three to five hours a week. That is the same reduction in cardiovascular disease risk as taking medication.” You should aim to accumulate 150 minutes of moderate-intensity aerobic activity such as walking, cycling, swimming, or dancing a week. Aerobic, physical activity will also help to boost your mood, keep you mentally sharp, make weight control easier, and reduce your risk for diabetes, hypertension, and other diseases.
Strength training, such as lifting weights, using resistance bands, or doing bodyweight exercises like pushups, provides additional benefits such as keeping you strong, protecting your bones, and easing joint pain. Aim to strength train twice a week.
8. Consider a vitamin D supplement. Vitamin D plays a role in many areas of the body, including bone health, immunity, and mood. It may also help protect your heart by reducing your chances of developing hypertension and diabetes, both risk factors for heart disease. Talk to your doctor about checking your vitamin D levels to see if you might benefit from a supplement. The recommended daily intake of vitamin D is 600 to 1,000 IUs (international units) a day in the form of vitamin D3. Food sources include fatty fish like salmon, tuna, and trout; cremini and portabella mushrooms that have been exposed to sunlight; fortified foods like milk, tofu, yogurt, orange juice, and cereals; and eggs.
9. Familiarize yourself with symptoms of a heart attack and stroke. More women die of heart attacks than men. One reason may be due to women having more subtle signs instead of the classic crushing chest pain or pressure associated with a heart attack. Here are additional symptoms you should pay attention to:
If you experience any of these symptoms, call 9-1-1 immediately. Delaying action may be one of the reasons women are less likely to survive heart attacks. Seconds count, and even subtle symptoms can be deadly.
This advice applies to strokes, too. Stroke is the fourth leading cause of death for women and a cause of serious, long-term disability. A quick way to remember signs of a stroke is to think F-A-S-T:
But like a heart attack, stroke symptoms for women may also be atypical or vague, such as fatigue, confusion, or general weakness instead of weakness on just one side. Pay attention to any sudden changes like a severe headache or loss of function like difficulty walking. Treatment for stroke is time-sensitive, so call 9-1-1 immediately. The ambulance crew can alert the hospital to get you treatment faster.
When it comes to HRT and heart health, it’s complicated. That’s why hormone replacement therapy isn’t a part of our Heart Health Checklist. While natural estrogen protects your heart, synthetic estrogen can be both helpful and harmful. It all depends on the timing and your personal health history. When HRT is prescribed before or within five years of menopause, usually for symptom management, it may reduce your risk for heart disease and improve other risk factors such as cholesterol. So, if you need symptom relief, it is safe to use HRT during this time frame. However, once you are eight to 10 years past menopause, the one-year mark after your last period, taking estrogen replacement may increase your risk for a stroke or heart attack. HRT is also not an option if you’ve already had a heart attack or stroke.
The complexity of HRT is a good example of why it’s essential to work with a menopause-trained doctor. Other decisions like taking supplements and the timing of screening tests can have similar pros and cons based on your symptoms, risk factors, and lifestyle. Menopause specialists are aware of the latest research in areas affecting women in midlife and menopause, can apply those findings to your personal circumstances, and support you in making lifestyle changes to improve your health.
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.