Does using birth control delay menopause? Does it increase the risk of breast cancer or heart disease in menopausal or perimenopausal women? After many years on the Pill, how will I know it’s safe to go off it?

Birth control and menopause: what do we need to know?

For answers to our birth-control-and-menopause questions, we turned to Dr. Sherry Ross, award-winning OBGYN and author of the book >She-ology, a look into women’s health beyond the doctor’s office.

Dr. Sherry Ross

For those in perimenopause, should we stop taking the Pill?

“First,” Dr. Sherry told us, “be sure you understand this: until you’ve had no periods for a year, you can still get pregnant.

“Part of the confusion is around definitions: The true definition of “˜menopause’ is when you don’t have a period for one full year, but many women suffer from disruptive symptoms for a few years leading up to full cessation of periods””that’s called “˜perimenopause.’ As I said, until you are officially in menopause””meaning no periods for a full year””you can potentially get pregnant, so be sure to use some form of contraception. If you are single and dating while in menopause, you may not have to worry about getting pregnant, but you do have to protect yourself against sexually transmitted infections, so make sure your partner wears a condom.”

So, re: birth control, keep on keeping on until one year with no periods, and re: condoms, always always always outside of committed, monogamous relationships. Check.

Do birth control pills or using a hormonal IUD help with perimenopause?

” Oral contraceptives and an IUD like Mirenacan mask some of the symptoms of perimenopause and menopause,” Dr. Sherry told us. “That’s one of the benefits. Women on the Pill may have fewer, less-intense hot flashes, more “˜normal’ periods when other women are all over the menstrual map, and they might have more modulated emotional swings, which can be a huge benefit in their personal and professional lives. That’s why many doctors””myself included””prescribe low-estrogen birth control pills women having a rough menopause and don’t smoke or to make the transition into menopause easier.”

Does birth control delay menopause?

Short answer: No. Here’s why:

“Menopause is a time when your ovaries stop producing estrogen and your female hormone reserves are depleted. Known factors that can affect what age you enter menopause include your genetic predisposition, knowing when your mom went through the change, chromosomal abnormalities such as Turner Syndrome, very thin or obese women, long smoking history, needing chemotherapy or radiation therapy, those with autoimmune diseases and epilepsy.

“It’s clear that short- and long-term stress, such as extreme weight loss and weight gain, can offset your hormones, causing irregular periods. The extent this type of significant stress has on your endocrine system, causing hormone adrenal depletion and possibly affecting menopause, is not as clear.

“There is an association between extreme and long-standing exercising causing weight loss which can offset your hormones and cause early menopause. Excessive exercising creates a hormonal imbalance, causing irregular ovulations. It’s less likely short-term exercising mixed in with months of not exercising could cause a cascade of events leading to an early hormonal depletion.

“So there are some things that can bring on early menopause, but being on the birth control pill does not affect when you begin menopause. The Pill can mask the symptoms of menopause and, as I said, many women depend on it to help ease the transition into menopause.”

If we’ve been taking oral contraceptives for 20+ years, how will we know if perimenopause has started?

“The best way to know if you are in menopause while taking the birth control pill is to check your hormonal levels at the end of the pill-free week. Some women may even notice hot flashes during the pill-free/placebo week since they are not taking estrogen that’s normally in the active pills. Your doctor can conduct a simple blood menopause test that determines if your follicle-stimulating hormone level (FSH) has reached menopausal levels.”

If you need a trusted opinion, determine if medication is right for you, and possible prescription support. Book an appointment with one our Gennev menopause-certified gynecologist doctors here.

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Are there health risks to continuing to take the Pill?

Says Dr. Sherry: “As long as you’re not a smoker over the age of 35, and you don’t have any contraindications of being on the Pill (high blood pressure, a history of blood clots, liver disease, breast or uterine cancer, strokes or migraine headaches), there are no health risks to taking the Pill during the first couple of years of menopause. The birth control pill stabilizes your hormones and keeps you physically and mentally balanced.”

And, according to Dr. Sherry, there’s even more good news.

Wait. There’s good news? About menopause?

“There’s evidence that taking birth control pills reduces the risk the risk of ovarian and uterine cancers. It may also help with rheumatoid arthritis.”

OK, that’s all terrific, but there have to be drawbacks.

What are the risks?

Said Dr. Sherry: “As I said, hormonal birth control is not for women who smoke, particularly if they’re 35 or older. Birth control pills may increase your risk of strokes and blood clots, and that risk is exponentially higher for smokers over 35. Yet another reason to quit!”

We completely agree. Anything else?

“Studies are still being conducted into hormonal birth control and breast cancer. But unless a woman has a history of breast cancer or other factors that make her high risk, she should feel comfortable taking low-dose birth control pills to control perimenopausal or menopausal symptoms,” Dr. Sherry told us.

“The best first step is to have a frank and open discussion with your menopause doctor. And don’t be embarrassed or shy””I can tell you from personal experience that almost nothing shocks a doc! Menopause is a normal, natural process and part of life, though women may experience it differently. Your doctor is here to help you understand what’s happening and alleviate symptoms that are interfering with your quality of life. There are solutions. You can feel better. And that’s the best news of all.”

Sheryl A. Ross, M.D., “Dr. Sherry,” is an award-winning OBGYN, author, entrepreneur and women’s health expert. The Hollywood Reporter named her as one of the best doctors in Los Angeles, Castle Connolly named her as a Top Doctor in the specialty of Obstetrics & Gynecology, and she was selected as a 2017 Southern California Super Doctor. Dr. Sherry continues the conversation of women’s health and wellness in her monthly newsletters and on DrSherry.com.  

Dr. Sherry Ross blogs for Huffington Post, Maria Shriver, Greatist, SheKnows, HelloFlo, Today Show, All Things Menopause, and Gurl, and we are thrilled to welcome her to the Gennev community!

We can help you get your questions answered about menopause

• Meet with a Gennev board-certified gynecologist who is a menopause specialist – they are used to having frank and open discussions about menopause, and can offer a trusted opinion, determine if medication is right for you, and provide prescription support.  
• Try Vitality, our #1 daily multi-vitamin supplement is packed with nutrients that support your whole body including mood, energy, stress response, immune health, joint pain, and inflammation. 96% of women report having more energy after just 2-weeks with Vitality.

 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.

Gout? Isn’t that something men suffer from? Do woman get gout? 

It is. And more and more women are getting diagnosed with gout as well.

In the last 20 years, cases of women with gout have more than doubled. According to the Arthritis Foundation, “…Two million women as and 6 million men as in the U.S. have this inflammatory form of arthritis that causes joint swelling and telltale pain at the base of the big toe.”

What is gout?

Gout is, as noted, a form of arthritis. Gout occurs when high levels of uric acid increase in the blood and form needle-shaped urate crystals in the joints or a joint’s surrounding tissue.

How does uric acid get produced? 

When your body breaks down purines “” naturally-occurring substances in your body and in some foods “” uric acid is produced. The normal function includes this uric acid being dissolved in the blood, transferring to the kidneys, and then getting eliminated through your urine.

The body could be out of balance and develop gout by producing too much uric acid, or by excreting too little of it in the urine.

What does gout feel like?

A flare-up can swell the joints making it painful to walk or move, and can increase stress and frustration levels, which may then exacerbate other menopause symptoms like insomnia, night sweats, hot flashes, etc. Definitely not the direction to head in if you can possibly avoid it.

Joints may also swell, radiate heat, and flush red in color as well. A gout flare-up may also feel as though a joint is on “on fire,” like a joint-specific, localized hot flash of sorts.

If left untreated, gout pain may worsen and joint damage could ensue. Best to get it checked.

Is gout hereditary? If your family history includes gout, The Mayo Clinic notes you’re more likely to develop this disease. 

In men, gout is often described as a sudden, severe attack, usually in the night, with intense pain in one of the joints, commonly the big toe. But this isn’t always the case with women.

In women, it can be a sudden attack, but it may also develop more slowly over time and in multiple joints. Brian F. Mandell, MD, a rheumatologist at the Cleveland Clinic in Ohio and board member of The Gout & Uric Acid Education Society, shares:

“In women, it seems there is a greater prevalence of the initial episode of gout being in multiple joints. It may not always be the typical swollen great toe. In the hands, this is often misdiagnosed as inflammatory osteoarthritis when it may actually be attacks of gout.”

Women frequently experience gout in the ends of their fingers, wrists, knees, and toes and are more prone to gout after menopause.

Ready to focus on your health in midlife and menopause? Work with a Gennev Menopause Health Coach.

Gout in women. What’s estrogen got to do with gout?

Estrogen in premenopausal women and those on estrogen replacement therapy helps to flush the uric acid out of the system, according to the Arthritis Foundation. After menopause, uric acid levels tend to rise. 

If a person with a uterus develops gout before going through menopause, it’s usually due to other conditions such as having a history of taking diuretics, high blood pressure, diabetes, kidney disease, and obesity.

What about nutrition? Can diet manage gout and minimize flare-ups?

When it comes to diet, gout, and overall health, definitely get into your doctor’s office to talk about your health specifically. Especially if you have other health conditions.

Foods to avoid, limit, or moderate regarding gout

Some of the foods recommended to moderate or minimize may have health benefits that outweigh the risk for gout (like the omega 3s in sardines may be more important to brain health than sardines’ risk of gout). Knowing your levels, getting screenings, and having regular conversations about your health with your doctor or nutritionist will be your best way forward.

• Avoid gland or organ meats such as liver, kidney, and sweetbreads.
• Limit serving sizes of beef, lamb, and pork.
• Note and understand that some seafood including anchovies, shellfish, sardines, and tuna do have higher purine levels than other kinds of seafood.
• Limit or avoid sugar-sweetened foods (cereals, baked goods, candies, even some salad dressings), and limit the consumption of naturally-sweetened juices, like fresh-squeezed fruit juices.

On alcohol and gout

The topic offoods to avoid in menopause like alcohol comes up regularly in our content since it can spike the intensity and frequency of symptoms such as”¦ hot flashes, headaches or migraines, and mood swings (well, rage, really). It’s especially important to note for those prone to developing or who are actively managing gout.

Researchers out of the Boston University School of Medicine examined data on 2,476 female and 1,951 male participants in the ongoing Framingham Heart Study, which has followed residents of Framingham, Massachusetts, since the late 1940s. Over an average of three decades of follow-up, 304 cases of gout were reported, with one-third of those cases occurring in women.

Further reporting from the Framingham Heart Study shared that:

“Drinking 7 or more ounces of spirits a week — roughly five drinks — doubled the gout risk in men and tripled it in women. Heavy beer drinking was associated with a doubling of risk among men and a sevenfold increase in risk among women.” [emphasis ours]

Foods to include

We recommend weight loss,if you need it, for healthy menopause weight management. “Being overweight increases the risk of developing gout, and losing weight lowers the risk of it. Research suggests that reducing the number of calories and losing weight “” even without a purine-restricted diet “” lower uric acid levels and reduce the number of gout attacks. Losing weight also lessens the overall stress on joints.”

Recommended eats & drinks:

• Complex carbs. Eat more fruits, vegetables, and whole grains. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices.
• Water. Stay well-hydrated in menopause by drinking water.
• Fats. Skip or cut back on saturated fats from red meat, fatty poultry, and high-fat dairy products.
• Proteins. Focus on lean meat and poultry, low-fat dairy, and lentils as sources of protein.

Talk with your doctor, or one of our doctors, and your menopause health coach, about specific concerns about gout, joint pain, and other forms of arthritis. Talk with them sooner rather than later if obesity, high blood pressure, diabetes figures into your current state of health and well being.

Your health, mobility, and well being are worth it.

Join the Gennev Community Forums to weigh in on this topic, ask questions, and understand more about menopause with others on the path.

I’ve been thinking about community a lot lately.

How much do we need it? As women, most all of us thrive on connection.

And when we’re going through life’s transitions, connecting with others going through the same thing kind of makes it more palatable.

Personally, I’ve got my community of women to whom I go to with the most personal of things. I’ve got a very small handful of friends (like 3-5 max) that I share life’s ups and downs. Things about my marriage, my family, even shameful mistakes that I’ve made. I’ve learned that I feel better when I share with others that I trust”¦even if there is no amount of advice that can help me recover”¦quickly.

But how about going through menopause? Is it something that you want to share with others?

For menopause and health topics, I broaden my net. I’m willing to share my experiences with other women of all levels of closeness to me, because women’s health is a “sisterhood” type of topic that creates a common bond, even when a personal relationship doesn’t exist.

Menopause levels the playing field. We’re all going to go through it.

I commonly find that my role with Gennev makes me a safe place for women to share all types of gnarly health symptoms including mood swings, painful sex, vaginal dryness, and the all-too-common insomnia that especially nails women in the workplace.

One woman even went so far to call me “the vagina whisperer.”

I’m struggling to land on what our Gennev community needs to be as we grow beyond the thousands of women we serve today. Is it a support group or health Q&A forum?

Do you find comfort in sharing/listening in a closed Facebook group, like the one Gennev hosts called Midlife & Menopause Solutions?

Or would you rather browse a general menopause FAQ forum to seek out questions and answers from health practitioners and like-minded women?

And is a menopause community something you want to bring your friends into, or something that you want to do anonymously?

I want to hear what you want your community to be. Is it simply a place to connect with like-minded women? Or a place to get answers and solutions for feeling better in your body?

Email me at jill@gennev.com

Have a great weekend!

JIll

When hormone levels change, it seems like your whole body changes, doesn’t it?

This is especially true for women with diabetes who are entering the beginning stages of menopause, perimenopause. True still and again for pre-diabetic women entering the same life transition. Hormones have a whole lot to do with both menopause and diabetes, and it’s baffling at times to navigate new symptoms and identify what they are in your body, in addition to living your busy, awesome life.

A concern for the undiagnosed

In 2015, of the 30.3 million adults who had diabetes, 23.1 million were diagnosed, and the remaining 7.2 million were undiagnosed. 

What will serve you through this is your awareness and attention to what is going on in your body.

If a new diagnosis of diabetes coincides with the onset of menopause, you may be navigating some similar symptoms. For instance, you may experience a symptom of foggy thinking both menopausally and diabetically. The element to zoom in on might be to determine if and/or when there is a difference in it being a diabetic symptom vs a menopause symptom. So much is new, and not much is fun. 

Still, staying informed and aware of symptoms and changes in your body is where your power lies in making good choices and taking good care of yourself. We do recommend talking with your doctor and getting your blood sugar levels checked, especially if your risk is higher for diabetes.

A few of the main symptoms in common

• Frequent urination: In menopause the frequency for the need to pee can increase. Same with diabetes but for different reasons, mostly having to do with kidney function not being able to reabsorb the glucose normally when blood sugar is up. Instead, more urine is made, thirst increases, and so, more frequent peeing.
• Night sweats: Another common experience in menopause is night sweats. Ugh. In diabetes night sweats may be caused by low blood sugar levels, while in menopause a decline in estrogen to the hypothalamus in the brain can bring those suckers on and wake you up from your sweet sleep. 
• Anxiety, mood swings, depression: Women are twice as likely as men to experience depression, more during menopause, and still more likely for those women with diabetes. The hormone changes and pressures in life a woman experiences are just plain different from men. You deserve good care, excellent attention, and helpful, reliable information.
• Itchy dry skin: As estrogen levels drop in a woman’s body, so does the moisture content in the skin. Here comes the itchy, dry skin. In diabetes, dry skin is often attributed to high blood sugar and/or poor circulation. As skin is the largest organ of the body, it’s significant when it’s uncomfortable: from crackly, crusted feet to rough hands, to that most intimate, delicate vaginal tissue, moisture replenishment yields comfort.
• Urinary tract and vaginal infections: High blood sugar levels (yes, even pre-menopause) can contribute to UTI and vaginal infections. But wait, there’s more”¦ a decline in estrogen makes it easier for bacteria and yeast (yep) to thrive in the vagina and/or urinary tract.

What else will help?

Whether you’ve been diagnosed with pre-diabetes, diabetes, or menopause (or not), there are a few things you can do to help your overall health until you talk with your doctor or check in with our telemed team (but please, do talk with a doc. Soon). What can you do? Self-care, support, processing, and testing.

• Circulate – Some increased blood flow and endorphins from mild exercise can make a world of difference in your blood sugar levels, improve your health and mindset, and aid in managing hot flashes, depression, or anxiety. Even a little regular movement will help you feel better”¦ maybe even good. But don’t take our word for it”¦ give it a go and see.
• Eat the good stuff – Nutrition is a big topic and the fuel you choose has a lot to do with regulating blood sugar, managing symptoms, even sleeping well when it comes to both menopause and diabetes. Where might you make even better choices around refined sugar, alcohol, and processed foods? When are you more willing to drink a little more water? It’ll make a difference.
• Levels? Check! – If your weight is changing, your symptoms are increasing in intensity or frequency, and you’re at a higher risk level for diabetes, it might be time to get blood sugar, cholesterol, and other levels checked with your doctor. Ask also about whether or not an adjustment to any existing medication levels might be needed.

• Menopausal support – Talk with trusted friends, family, and community about what’s going on in your body. What you’re experiencing is real and talking about it can really support you and help you make sense of all the changes. Another option, sign up for some specific menopause coaching support with a Health Coach who is a Registered Dietitian and a menopause expert. It’s a thing.

Your health journey is a precious and vibrant part of your life (and quality of life). The attention and care you take to feel better will serve you in both the long and short run. 

We’d love to hear your experience – both the good and the challenging – around diabetes, pre-diabetes, menopause”¦ life!

Join us in the Community for shared knowledge, wisdom, and support.

What if you could relax more easily, decrease anxiety, symptoms of depression, fall asleep easily, improve the quality of your sleep, even signal increased anti-inflammatory and self-regulatory body responses at will? We can.

And…bonus! It’s free and easy to do. 

We almost don’t have to think about it to get the benefits.

While scientific research and verification are still underway, it might be worth attempting to activate the vagus nerve regularly with simple breathing exercises in order to engage the parasympathetic nervous system. This will begin to take us into a “rest and digest” mode, and out of the sympathetic system’s “fight, flight or freeze”.

Chances are good you’re more familiar with your sympathetic nervous system. This system is the one that boosts the body’s heart rate, directs blood flow to key systems and organs, and increases alertness, via rapid hormone release. All of this is in order to prepare the body for the fight, flight, or freeze response in a dangerous or stressful situation. 

Wired, but tired

Feeling wired-but-tired may be an indicator that your sympathetic nervous system is working harder than it needs to, especially if you’ve got that feeling in non-stressful, non-emergency situations. Perhaps you’ve felt it while watching television, or while trying to fall asleep in the comfort and safety of your home. Or maybe you find it challenging to rest or get to a state of relaxation in general.

You’re not alone

Dr. Deepak Chopra, notes that “Our society is on sympatheic overdrive.” Meaning, many of us are in a constant or chronic state of high alert. What else does this mean for our bodies to be in an almost constant state of emergency alert? 

It increases our risks for high blood pressure, inflammation throughout the body, heart disease, cardiac arrhythmias. Getting out of the sympathetic nervous system and into the parasympathetic system takes little effort, and we’re all halfway there by breathing all the time anyway. With a tiny bit of modification, we may reap the benefits of improved health and wellbeing, reduce our risks for heart disease, symptoms of anxiety, and depression.

Fun facts about the vagus nerve

Which is the longest nerve in your body, with a path to almost every organ? It’s the 10th cranial nerve in the body and it wanders from above the mid-brain throughout your body, all the way down to your colon: the vagus nerve. Ta-da!

As a part of the parasympathetic nervous system in our bodies, the vagus nerve influences lung, heart, gut, and diaphragm activity, not to mention facial expressions, speaking and swallowing functions. And it’s possible to activate, support, and bring balance into our bodies regularly by engaging and activating the vagus nerve.

Vagus nerve breathing exercises for engagement

Breathing slowly and deeply is the path to engaging the vagus nerve and improving what’s known as vagal tone. 

Breathing in and out through your nose, inhaling and exhaling to the count of 4. Spend 2-ish minutes and breathe 10 breaths of inhale and exhale at the count of 4 for each, and see how you feel.

Play with it. Perhaps you can slow your number of inhales and exhales per minute even more by inhaling to a count of 5 and then exhaling to a count of 6 or 8 for another series of 10 breaths.

What does this do? 

It provides a balancing effect on your nervous system. When you practice this type of breathing, and other non-invasive methods to activate your vagus nerve, improve your heart rate variability (HRV), so your body can relax faster and easier after a period of stress. This breathing exercise can also help you to relax and fall asleep.

Vagus nerve stimulation

There are medical procedures and devices that have been adopted to stimulate the vagus nerve in order to treat epilepsy and mental health including depression. There was a study done in 2016 for those suffering from rheumatoid arthritis as well. 

Ongoing research is currently underway for inflammatory diseases such as Crohn’s, Parkinson’s, Alzheimer’s, as well as rapid cycling bipolar and anxiety disorders.

More support, not less

How to incorporate a new practice that may ease menopause symptoms, and even help to decrease inflammation, reduce the risk of heart disease? Maybe all you need are a few suggestions to prompt you to engage your parasympathetic nervous system during the day? You could begin to breathe slowly and deeply when you: 

• Unlock your mobile phone
• Open the fridge or pantry
• Open your email
• Hear a bell, chime, or ding of any kind
• Stop at a stoplight in your car, or at every stop on the bus route
• Hear a reminder you’ve set for yourself for the purpose

Where else, and what else, might prompt you to take a more conscious, deeper breath?

But wait, there’s more

Additional ways to engage your vagus nerve and your parasympathetic nervous system:

• Cold water “” stimulus splashing cold water on your face can also stimulate your vagus nerve.
• Singing, chanting, or using mantras “” turn up the volume in your car
• Meditation “” an easy access point to slow and deepen your breathing, and to also quiet your mind
• Positive social interaction “” spending time with people who inspire feelings of warmth, love, and compassion
• Laughter “” it feels great, is fun, and promotes general well being
• Exercise “” another excellent reason to move and stay active
• Massage or reflexology “” relaxing and restorative, you can have a professional massage, or practice gentle massage on yourself

Coaching and additional support may be of help as you navigate through your menopause transition. Make a simple start by slowing and deepening your breathing. The hardest thing about this suggestion may be remembering to do it. 

What did you discover when you tried to engage your parasympathetic nervous system via your vagus nerve? We’d love to hear what you’ve experienced in our Community forums. Join, and share.

“You get about 15 minutes between pimples and wrinkles. Enjoy it.” as my mom

Turns out, mom was wrong. While we all expect wrinkles with aging, menopause acne can occur or recur for the first time since our teens. Sigh.

Whether it’s prom night or project presentation day, pimples can suck your self-confidence, and no one’s got time for that. So, what’s going on and what do we do about it?

I talked with Dr. David Lortscher, MD, board-certified dermatologist, and creator of Curology. While Dr. Lortscher focuses on individually tailored treatments for acne, he shared with us some information on lifestyle choices that can help women in menopause handle changes in their skin.

Why does acne return in menopause?

As estrogen declines in midlife, so do collagen and elastin, meaning your skin may become thinner, drier, and looser than before. Hence, wrinkles. But estrogen decline also takes with it our skin’s ability to ward off acne, sometimes leading to acne during and even after menopause.

According to Dr. Lortscher, “As women transition into menopause, as at puberty, a relative predominance of androgens (male-type hormones that all women have) is responsible for acne breakouts in some. In general, androgens stimulate oil production and can worsen acne, while estrogens counter that effect.”

What can we do to treat menopausal acne?

As with all things menopausal, there are a variety of treatments ranging from lifestyle changes to over-the-counter or prescription medications, to more significant medical interventions. But many women can control breakouts by making simple changes to diet, getting more sleep, and dealing differently with stress.

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

Ending menopause acne with lifestyle changes

1. Consider reducing or eliminating dairy. Says Dr. Lortscher, “Milk contains precursors to testosterone and other androgens, which influence the hormone receptors in the skin to turn on the process that causes acne. The association with acne is more marked with skim milk than with whole milk, and in those consuming more than 3 portions per week. It is possible that cheese, ice cream, and yogurt may be associated with acne, but the link appears to be stronger with milk. Not everyone responds to avoiding dairy, but it is something to consider.” Dr. Lortscher warns that soy milk may also aggravate breakouts, so it may be a matter of trial and error to find what works best for you.
2. Add spearmint tea. For hormonal acne, you might want to try some tea! According to Dr. Lortscher, “Although not proven, there is some convincing evidence that drinking two cups of spearmint tea per day can reduce blood levels of circulating androgens.” However, he cautions tea enthusiasts to stick to just two cups per day, as drinking too much tea can be harmful.
3. Boost phytoestrogens. These are the foods that mimic our body’s natural hormone, estrogen, only weaker. Commonly found in soy, seeds, nuts and nut butters, these are good for your collagen, skin, and mood. However, if you have a personal or family history of breast cancer, proceed with caution and check with a doc.
4. Reduce the sugar. Just like when you were a teen, cutting back on sugar (particularly the processed kind) will help with breakouts. Bonus: being aware of your hormones and nutrition can help. Reducing processed sugar helps with many other menopausal issues as well.
5. Supplement. Consider increasing Vitamins B (folic acid, specifically), C, D, biotin, iodine, and Omega 3 supplements for women.

Other remedies are ones you’ve heard before: sleep more. Stress less. Stop smoking. Hydrate. By doing a combination of all of the above, you have a strong chance of reducing or eliminating midlife acne, and you will certainly be doing good things for your overall health. Plus, spearmint tea tastes really nice. 

For those whose acne doesn’t yield to lifestyle changes, you may also want to consider adding over-the-counter remedies to your menopause skin-care regimen: look for creams that include benzoyl peroxide (but use sparingly, as this can further dry your skin) or salicylic acid to unclog pores. Or go another step to a personalized treatment plan. Sometimes hormonal acne treatments can be effective, but do not work for everyone and should be carefully evaluated before going that route. Acne after menopause is often treated in this manner, but to varying results.

Thank you to board-certified dermatologist Dr. David Lortscher, MD and creator of Curology.

 We can help you

• Meet with a Gennev Doctor – Looking for prescription menopause acne treatment? A Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and provide prescription support.
• Vitality is our most popular daily nutrient-packed multi-vitamin supplement for women in menopause. It supports inflammation and joint pain, mood, energy, stress response and immune health.
• Be sure to get your Omega-3s – Gennev’s Heart & Brain Premium Omega-3 for Women offers care for your heart and brain as well as helps to relieve dry eyes and dry skin.

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 haven’t heard of the documentary Dream, Girl, you soon will! Team Gennev, in association with Seattle International Film Festival (SIFF) is bringing Dream, Girl to Seattle for its premiere public screening on Thursday, January 19, followed by a panel discussion/Q&A with local women educators, innovators, and entrepreneurs. We hope you’ll join us for an evening of conversation and inspiration around the challenges entrepreneurial women face and how to overcome them. Learn more about our panel and then purchase your tickets directly from SIFF.

Dream, Girl: showcasing and celebrating female entrepreneurs

What do you need to start living your dreams? For would-be entrepreneurs, the challenges of starting a business can seem overwhelming. And for women”” particularly women of color””the barriers to business ownership can be even greater.

When team Gennev first watched the trailer for the documentary Dream, Girl, we knew we had to bring it to Seattle. The film showcases several female entrepreneurs, exploring their aspirations, challenges, setbacks, and triumphs. For us, it spoke to so many things we’re experiencing as a startup organization: the learning we need, the responsibility we carry, but also the exhilaration, the camaraderie, and the importance of celebrating every success, big and small.

what do you need to start living your dreams?

Happily, we had the opportunity to talk with one of the leaders of the Dream, Girl team: co-producer and co-founder Komal Minhas. Film producer, writer, investor, and entrepreneur, Komal started her business, KoMedia, at just 23 years old, so she knows a thing or two about flying by the seat of one’s pants.

Komal joined the team after viewing a Kickstarter campaign launched by creator Erin Bagwell. In her video, Erin spoke openly of quitting her job after having been sexually harassed at her workplace.

“When I saw that Kickstarter campaign,” says Komal, “I knew that I had to stop everything I was doing and come and help her amplify that message and bring it to the world.”

And what is the message that inspired Komal to sign on to Erin’s dream?

It’s right there in the title: Dream, Girl. With everything that that implies: Be hopeful. Take risks. Work hard. Support others in pursuit of their dreams and allow them to support you as you push towards yours.

Dreaming big works, as the film itself demonstrates. Dream, Girl has been screened at the White House, it showed to a sell-out crowd at NYC’s historic Paris Theatre, and last year, Erin and Komal were named to Oprah Winfrey’s SuperSoul100 list.

“people are so happy we have a range of voices and stories
that we don’t traditionally get to see on screen and all together”

Like us, audiences have found a lot to love about this buoyant, inspirational, often funny documentary and the utterly charming women it showcases.

what has made Dream, Girl so popular?

“Some of the feedback we get is that people are so happy we have a range of voices and stories that we don’t traditionally get to see on screen and all together,” Komal told us. “People tell us they feel connected to these diverse and amazing women. And we cover a real breadth of topics””from lack of mandated paid parental leave in the US, to sexual harassment in the workplace, to pausing your dreams to build a strong relationship elsewhere, to finding funding for your project, to what it’s like to be a mom in the workplace””there are so many different topic areas that connect for people.”

At every screening they attend, Komal says, there are moments that make all the effort worth it. For example, during a post-screening discussion at a major firm, a young female employee said she felt she was not being seen at the company as much as her male colleagues were. A senior-level exec was also at that screening, and he stood up and made a promise to remedy the situation, take time with her, and figure out steps forward. Witnessing this sort of genuine progress helps keep Team Dream energized and moving forward.

However, Komal says, perhaps their biggest success has been in finding and supporting each other through the journey and in “strategically and thoughtfully” building a community around the film and its message.

building community: the unique distribution model of Dream, Girl

Speaking of building community, the Dream, Girl team have been very intentional in their distribution model, choosing to push the film through community screenings such as Gennev’s first, before pursuing digital channels. Why?

Because, Komal says, “We have been told time and again that our hosts, our audience members love seeing this film in person. You don’t want to see it alone, you want to see it as a collective and you want to talk about it and really get into the topics. We’ll eventually go digital with our film””that’s a future goal of ours so we can get the word out there as much as we can””but we find that right now, community screenings really give our audience the space they need to take it in.”

Komal and Erin do want their message to reach a larger audience, and they had a taste of what that could look like after the US presidential election. Deeply unsettled by the result of the election, the team made the unique””and uniquely generous””decision to allow people to view the film for free over the Internet. In four days, Dream, Girl was viewed more than 12,000 times. Clearly, people really crave the film’s positive, hopeful message.

“Listen, be kind, and be thoughtful about inclusiveness in the workplace.”

We asked Komal what companies like Gennev can do to take that positive message forward. Given today’s political climate, she told us, the onus is more and more on corporations to recognize and nurture female talent. “If we can make more inclusive workspaces, and help more people feel safe in the places where they spend the majority of their time, that’s the greatest thing companies can do. Listen, be kind, and be thoughtful about inclusiveness in the workplace.”

We never end a conversation without asking for that One Big Piece of Advice””this time for would-be female entrepreneurs. Her answer? “Take care of your health. As millennial women, we get so caught up in the hustle, needing to achieve, needing to accomplish so much by X date and being on the Forbes 30 Under 30 list”¦. Just take care. We have so much more time than we think we do. Clara in the film didn’t start her business until she was 50 years old. It’s important to prioritize your health above all else: your company needs it, the world needs it, and your employees need you.”

More information is available on our Facebook event page, so take a look, then get your ticket while there’s time!

Would you characterize yourself as a do-it-yourself type of person when it comes to your health and wellness? If you’re like me, you’ve maxed out your free article options on Medium and The New York Times in an attempt to soak in every suggested treatment or women’s story that will help normalize what you’re going through.

Or, are you the type of person who wants to rely on the knowledge and care of a coach, a trainer or a very hands-on doctor? Someone who can walk you through understanding why you’re feeling lousy, then hold your hand through the behavior changes required to get on the other side of it?

I’m a DIYer. I’m super disciplined about what I need to do to adjust a lifestyle behavior for better health, and then I just do it. Some call it Type A. It comes with its pluses and minuses for sure. Sometimes I can be a little impatient and I’m not always coachable”¦not things that I’m proud to admit.

What type are you?

With the way the health coaching industry is booming, I’d guess that there are a lot of women who want an approach to getting healthy where you don’t have to go it alone. You’ve got a coach, a trainer or a concierge doctor who is there for you when you need someone to keep you accountable and who helps with wellness adherence.

A menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

Or are you a combo?

You start DIY in the early days but flip to a much-needed relationship (coach, trainer, doctor) to give you  a plan and see you through it?

While I’m typically a DIY when it comes to perimenopause (at this point!), I took the combo approach to running. For my first marathon, I skillfully ripped out the Less is More training from Runners World. And with every marathon thereafter, I would try another plan.

Then I hit a wall. I was super tired and had been diagnosed with Celiac (for a carb-loading runner, hearing that you could not eat pasta or bread prior to a race 10 years ago was sock in the stomach”¦but then eating pasta and bread was a sock in my stomach, literally).

I knew I had an uphill battle to qualify for the Boston marathon so I enlisted my first running coach. He pushed me to the limits; it was painful, and I dreaded the weekly run I had to do with him, because he’d know if I’d been accountable to the plan.

But I got faster. I got healthier. I hit my goals. And I learned to trust the plan.

There isn’t “a plan” for menopause, but I believe there could be a personalized plan for every woman based on her needs.

Do you agree?

How many of you have a plan related to your menopause symptoms or something similar for weight, strength, mental health or even sleep management? And are you working with a coach, a trainer, or a menopause doctor specialist who is keeping you accountable?

I’m intrigued by the idea of taking the idea of a “running plan and/or coach” and applying it to women’s health in menopause.

If it sounds like something you’re already doing or you’ve seen something like it in the glossy world of menopause solutions, send it my way. jill@gennev.com

Casey, age 53, woke up chilled. At 4 am this morning. 

Had she actually slept through a hot flash? Miracle of miracles, she could only hope. 

Still groggy, she managed to register some gratitude and relief that it wasn’t 1 am, which it had been for the last several weeks. She sighed, turned to her other side, and touched her cheek down to a fresher spot on her pillow. Another sigh. 

She counted 6.5 hours of glorious, uninterrupted, deep sleep. “At last,” she thought, “Maybe I’m getting the hang of”¦ wait. What was that?” A warm liquid flood released with her new sleep position. She tentatively touched the mattress behind her back, and the backside of her underwear and sure enough. Evidence”¦ bold, red, and wet was there. “Noooo”¦ no, no, no”¦ I thought I was done with periods.” 

It had been 6 months since her last cycle”¦ and there was no mistake that she was having one now.

Not sure where you are in the menopause transition? Take our Menopause Assessment.

Annoying but normal

If you haven’t experienced skipped (or extra) periods in perimenopause, allow us to assure you, it can be a normal (and annoying) part of the process.

As hormone levels change, menstrual cycles may go from reliable and familiar to whose-period-is-this? Changes may include: 

• Length of your cycle. Have periods been 4-5 days and then gone? They may be longer or sometimes shorter, depending on your body and what it’s going through. 
• Timing of the beginning of a cycle. If you’ve had a reliable routine to the point where you know that your cycles begin in the mornings (or whichever time of day/night), that may change and you may be surprised by the appearance at a different time of day or night. You may also experience monthly periods that have more or fewer days between cycles (e.g. 28 days, the next one is 32 days later, then the next is 29 days after that).
• Unfamiliar or lack of your body’s signals that an egg is gonna drop. If you’ve had regular physical symptoms that you’re body is entering a cycle, such as lower back soreness or cramping, those may change or they may intensify. 
• Flow. These irregular periods could be heavier flow and some could even be lighter. It may switch up from month to month. You may have less (or no) “getting started” hours or days and go straight to heavy flow or menstruation flooding with irregular periods. 

What’s going on? 

In order to illustrate, let’s do a comparison of what goes on during a regular period and a perimenopausal irregular period. 

Most periods until perimenopause

An egg matures in the ovaries during a period with the help of an increased level of FSH (follicle-stimulating hormone). It’s the follicles that produce estrogen, and the estrogen, in turn, causes the lining of the uterus (the endometrium) to thicken, to prepare to receive a fertilized egg. 

Ovulation, the release of the mature egg, creates progesterone. Most eggs aren’t fertilized. What happens next is, the progesterone goes away and the endometrium is sloughed off. This is what we know as a period.

Perimenopause periods

During perimenopause periods, there aren’t as many follicles to stimulate, so the body really increases the FSH, resulting in more estrogen being created. More estrogen means the uterine lining becomes even thicker as causing heavier bleeding and perimenopause periods lasting longer. This whole process can take longer, too, resulting in longer gaps between periods.  

What about ovulation in perimenopause? Is that a thing?

Yes, indeed it can happen more often than not. In some cycles, the endometrium continues to thicken until it has to be shed as resulting in a very heavy flow.

A word about abnormal bleeding

During a cycle that has a heavier flow than you’re familiar with, it can feel surprising, baffling, even a little scary to see more blood and clots than you are used to. 

Bear in mind, you may experience feelings of disappointment, exasperation, weariness, all in addition to increased or intensified cycle symptoms. Be easy on yourself and ramp your self-care if you can. Your body and mind are going through a significant transformation.

This being said, a regular period can release between 2 tablespoons over the course of 4-6 days, or more, for more days or fewer. We’ve also seen reports of regular or normal period bleeding as being 2-3 tablespoons over 3-5 days.

Abnormal bleeding, specifically may look like very heavy bleeding or bleeding that:
 

• Lasts longer than normal
• Occurs more often than every 3 weeks
• Occurs after sex or between periods

In order to really dial into your own health and body, consider a check-in with one of our Telemedicine doctors. This is for assurance, guidance, support, and it will keep your files noted with new data and insights.

Be prepared, stay prepared

No, not hyper-vigilance. Just simple awareness. Here are a few ways to be and stay prepared for an unexpected period:

Keep count.

 When was your last period? How many months have you gone without a cycle?

Bring supplies.

 Menstrual cup, tampons, or pads, have something on-hand until you’re sure you’ve gone 12 months without a period. Desk, car, bag, duffel, wherever. And it doesn’t have to be a lot of supplies, just the right one for you to get you through a few hours.

Practice awareness of body changes and any other symptoms.

If you’re experiencing multiple perimenopause symptoms, it’ll make more sense and may feel more normal to have irregular periods at this time. Journal about them, keep a record on Post-it notes at your bedside, record them in a notes-application on your mobile device. They may prove useful and paint a bigger picture when you”¦

Check-in with your doctor or other health  support systems.

Let your doctor or professional know what’s going on with you and your body. Support, education, and care will really help you navigate through perimenopause to menopause by making informed choices about your options.

Was this one my last one?

We have no idea when or which one our last period is. There’s no indicator that we’re on the final countdown, tallying 12 full months of no menstrual cycle to achieve and unlock the menopause level. 

Best you can do is to be aware, consult your doctor (or speak with one of ours), practice some extra self-care, and know that this could be the last or at least one of the last, periods you’ll go through. You’ll be closer, if not finished. Regardless, transformation is, indeed, happening. 

What have you experienced around irregular periods in perimenopause? And”¦ what are your questions about period reoccurrence during perimenopause? Check-in and chat in our Gennev Community Forums.

At Gennev, we’ve been on something of a quest to find the perfect sleepwear and menopause clothing for women who deal with night sweats and daytime hot flashes (or summer heat, for that matter). We’ve tried several, with mixed results. Then we found Cucumber Clothing. We loved the feel, the moisture wicking, and the cool, flattering cuts and styles. Cooling clothing for menopause, if you’ve been there, might strike you as a fantastic idea. We are inclined to agree.

We loved how it helped us get a better night’s sleep and enjoy cooler days.

Cucumber Clothing’s line, like all the products we bring to our Gennev community, helps you feel and be your best self. And the founders, Eileen and Nancy, are women over 40 who understand the realities of this whole perimenopause to menopause transition. They made the clothes they were searching for, so now the rest of us can (finally!) quit searching.

We asked them to share their story with us; we think a lot of what they told us may sound familiar “¦.

______________________________________

Serious sleeplessness

So here’s the thing, some of us are good at sleeping and some of us are not.

Neither group is well defined as in my lifetime I’ve flitted between the two camps. A sound sleeper as a child, an impossible-to-rouse teenager, a late-night owl in my twenties, and a fretting, nocturnal pattern of wakefulness through the next decade with young children.

Roll on a few years and my circadian rhythms have re-set again. Sleep has become a capricious bed mate, undependable, playing to its own rules, and not to be relied on.

Beyond puffy eyes, foggy head and a general sense of weariness, why is this lack of sleep so important, and why do so many women who may once have felt they owned the holy grail of sleep, now feel they have lost, or at the very least, misplaced it? There are a few things to think about here and not all of them are under our control.

Menopause clothing, hormones, and sleep

We know that as our bodies enter peri-menopause and menopause, our level of hormones begin to fall. One of these, progesterone, helps us sleep, so as the level of progesterone tails off, our ability to have an unbroken, deep sleep does too.

A general fall in hormones can also herald the onset of hot flashes and flushes and the aptly named “˜sweats.’

Just these two factors can mean a swing from a good night’s sleep to an “˜I tossed and turned and sweated and didn’t get a wink’ sort of night, followed by a nightmare sort of day.

We need sleep to refresh ourselves, to reorganize our thoughts and memories, to repair our bodies and to rest our cardiovascular system. So necessary, and yet so frustratingly elusive for some of us.

That’s how Cucumber Clothing was born. Travelling home from a holiday with a bunch of like-minded forty plus year old women, our week-long bonding topics covered everything but the kitchen sink, and most definitely included the menopause.

Why, we wondered, were there so few solutions out there? Busy women all, some of us were suffering from the self-same debilitating double whammy of fractured sleep and sweats, which impacted hugely on the jam-packed days.

Moisture wicking clothing for menopause

We decided then and there to create a beautiful and intelligent range of thermo-regulating nightwear and clothing. One that allowed you to look great and feel great wearing it and that quickly moved any moisture (sweat!) away from the body at speed. One that meant that if you woke up in the night feeling sweaty or even drenched, within a few minutes you would feel dry again. We couldn’t stop you from getting hot, but we could help you get back to sleep comfortably and quickly.

Cucumber Clothing was launched in September 2017 and, since then, our original range of six simple and elegant jersey pieces in two colors has expanded to include a summer collection in a silk-like fabric (that works just as hard) in three new colours.

We’ve broadened the range to include leisurewear pieces that work for the gym (our drawstring trousers are great for Pilates or yoga), to the poolside (throw our ruffle dress over your swimsuit), to work (our v-neck t-shirt looks perfect under a summer jacket with tailored trousers on a hot day). They work for any time you are going to get hot. So now there are cooling clothes for “menopause belly” as well as the gym. 

They are all mix and match, and best of all, after a long day staying cool with Cucumber, you can fall into bed wearing them knowing they will be dry, odor-free (that’s our anti-bacterial nano-technology!) and help keep you cool through then night.

Cucumber’s multi-tasking pieces are ideal for travel as our fabrics don’t crush, are happiest cold-water machine or sink washed and like to hang dry as they dry super fast because of their moisture wicking properties. Remember, don’t iron our jersey pieces, and our “˜silk’ pieces rarely need a light press.

Have you tried Cucumber Clothing? What did you think? Let us know your thoughts in the comments below, on the Gennev Facebook page or by joining Midlife & Menopause Solutions, our closed Facebook group.

While it may not be menopause-related, viruses are certainly a women’s health issue! And with all the concern around the coronavirus outbreak, we wanted to be sure we addressed it with you. 

Unless you’ve been in a very deep cave or lengthy Netflix binge, you’ve likely heard about the coronavirus. There’s been a lot of very scary coverage of the illness, but is it really worth so much intense focus and concern?

We talked with our Chief Medical Officer Dr. Rebecca Dunsmoor-Su, who, in addition to being an OB/GYN, is also an epidemiologist (epidemiology is the study of diseases in given populations). Here’s what she told us.

What is the coronavirus?

Says Dr. Dunsmoor-Su: The coronavirus is basically just a cold virus. There are lots of coronaviruses, actually; “corona” just describes the shape and format of the virus. We’ve known about multiple coronaviruses for a long time; the most recent version is known as 2019-nCoV.

The concern, according to Dr. Dunsmoor-Su, comes with the viruses that jump from animal to human. When we haven’t seen one before, she says, it raises some concerns because we haven’t had a chance to study it and we don’t know much about it.

“We saw the same panic with the SARS and MERS viruses, when they made the jump from animals to humans. These are all just coronaviruses. And the panic around SARS and MERS turned out to be largely unwarranted. There wasn’t the global pandemic some of the more sensational news outlets were speculating about, and it’s very likely this coronavirus will be the same.”

We asked her where the virus came from. In terms of this one, she tells us, “It probably jumped from animal to human in China, where there’s more active, public trading of live animals than we generally see in the west. We’re not sure yet what animal the virus came from. It’s been speculated that the origin may be bats or pangolins, but we don’t know that for sure.”

Don’t live with fear about physical symptoms: talk to one of Gennev’s telemedicine doctors and get back your peace of mind. 

Should we be concerned about coronavirus?

According to Dr. Dunsmoor-Su: No. This coronavirus is highly infectious because it spreads easily. However, it is what is called a “droplet precautions” illness because it can only spread via droplets of spit or mucus from infected people coughing and sneezing. Droplets from the cough land on a surface which you then touch, picking up the virus, and infect yourself by touching your face or eating before you wash your hands. It’s not aerosolized, so you likely can’t be infected from someone breathing on you.

So”¦.as long as you wash your hands frequently and don’t touch your eyes, nose, or mouth, you can likely avoid getting sick.

Not only is it largely preventable with ordinary precautions, there’s not much opportunity to be exposed, outside a specific region in China. The coronavirus hasn’t been seen much in the US as 3 cases initially, and as of February 11, that number has grown to 13.

But a lot of people are sick

True. But most of them have very mild cases. As of February 11, in China, the numbers are 42,700+ cases and just over 1000 deaths. According to Dr. Dunsmoor-Su, those deaths are largely among people who are elderly, medically fragile, immunocompromised patients. For most people, this is a cold that comes with runny nose, maybe a fever, a cough, etc. The reason some die is because the virus turns into a viral pneumonia in medically fragile people, and viral pneumonia is very hard to treat.

What should I do to protect myself?

First, don’t panic. And don’t let sensational headlines urge you into taking unreasonable measures.

For example, don’t take Tamiflu as that won’t help you avoid contracting the illness.

In truth, says Dr. Dunsmoor-Su, the likelihood of coronavirus becoming a widespread pandemic in the US is very small; it’s being monitored, we know when people come in from that region of China, so we can track them. Also the regions where it is an epidemic are being isolated to keep the virus from spreading.

However, for those who are at risk, if you believe you have been exposed, go see your doctor. There is a test that can detect coronavirus, so ask to be tested for it.

If you have it, the procedure now is to provide supportive care as monitoring symptoms, Tylenol for fevers, keeping an eye on you for breathing issues. If you do have respiratory distress, then go to the doctor and get admitted to the hospital for treatment.

What about a mask, we asked: Is wearing a mask a good idea? You can wear a mask, says Dr. Dunsmoor-Su, but frankly washing your hands is more important. If you touch a doorknob that has the virus on it, then touch your eyes, the mask won’t do you any good. Basically, the mask is a good reminder not to touch your mouth or nose without first washing your hands.

How long can the virus survive on a doorknob? We don’t really know, Dr. Dunsmoor-Su tells us. Most viruses don’t survive long outside a body as maybe just an hour or two. But we don’t know yet for this particular virus. So best practices are to wash or sanitize your hands often and don’t touch your face.

Who is most vulnerable?

Are some folks more prone? Not really. Anyone can catch it, but some just get sicker, says Dr. Dunsmoor-Su. Pregnant women are considered medically fragile because their immune system is suppressed. Children are always medically fragile because their immune systems aren’t as robust as they haven’t been exposed to as many contagions, so they haven’t built up an immune “bank.” Anyone on chemotherapy or biologic immunosuppressant drugs for, say, colitis or arthritis/joint pains, can be at greater risk, as can the elderly.

Reduce your risk of all kinds of problems by eating a healthy diet. Our Menopause Health Coaches can help!

Should I go live on an island?

That depends on the reason. Vacation, sure! To escape the coronavirus? Probably a bit extreme.

Yes, the coronavirus sounds very scary, and there’s a lot of hype around it, but honestly, it’s flu season, which is a much deadlier disease: flu has killed 12,000 people so far this year, Dr. Dunsmoor-Su says, so get your flu shot. If you’re medically fragile or have a weak immune system, you’re much more likely to get it, and you’re much more likely to get sick from it. Flu is airborne, so it can be easier to spread and catch because you can breathe it in.

According to Dr. Dunsmoor-Su, the flu shot doesn’t protect against all strains, but it does protect against the most worrisome strains that are circulating. It might not stop you getting sick, but it will minimize the illness, so you’re likely to have a much easier time of it. So, especially if you’re medically fragile, get your flu shot! And of course, take all the usual precautions of washing your hands, not touching your face, etc. as which, bonus, will help protect you against the coronavirus as well.

Your takeaway re: the coronavirus “” Don’t panic

Panic is not warranted at this point. If you’re going to China, take lots of hand sanitizer, and don’t touch your mouth, nose, or eyes (wear a mask, if that helps you remember).

Yes, the number of the infected continues to rise, but the percentage of those who actually die from the disease is going down. Why the change? Because more people are going to the doctor or hospital with symptoms, and more people are getting tested. It’s likely more people were sick with the coronavirus but assumed they had a normal cold and recovered just fine. Only the worst cases were being seen when the outbreak began.

If you’re sick with a “cold,” here’s how to protect others

If you have a legitimate reason to believe you’ve been exposed to the coronavirus, go to a doctor to get tested. (The Centers for Disease Control request you call your doctor first, to let them know of your exposure and that you’re coming in.)

• If you have upper respiratory problems, go to a doctor.
• If your symptoms are clearly not life-threatening, stay home.
• Cough into your elbow, sleeve, handkerchief, something, so you don’t cough onto things and leave droplets.
• Wash your hands regularly and sanitize when you can’t wash, especially before eating.
• Don’t touch your face (particularly the mucus membranes in your mouth, nose, and eyes).
• If you’re not feeling better within 3 as 5 days, talk with a doc.

Staying informed about the coronavirus is a good idea. But fear and panic really aren’t warranted, even for those who might be considered “medically fragile.” Take good precautions, eat well, get plenty of sleep, drink plenty of water, get your flu shot, and be well!

If you think chatting with others might help you be more at ease about the coronavirus, join the Gennev community forums!

The day was going great, things were rolling, stuff was getting done… until you got some unexpected negative feedback from your boss.

Instead of taking a few calming breaths and giving yourself some space to reread the email (and discover she didn’t insult your work after all), you just see red. And seethe. Then you try to get back to work, pressing down the feeling so you don’t blow up in the office. Perhaps you further numb your anger over the situation a little later by inhaling a handful of cookies in the breakroom. You don’t remember doing it. But you’re very aware that your fuse to anger is shorter than it’s ever been before.

Let’s face it: our coping strategies for anger in menopause determine our ability to bounce back from unexpected emotional ups and downs. 

It’s easy to let rage consume you. Once you start riding that anger wave, it’s hard to disembark until you’ve reached the beach. Luckily, we’ve got a few tips that’ll help you cut the ripcord before you faceplant in the water.

Why do I seem to be angry all the time?

Increased irritability and anger are common symptoms in perimenopausal, menopausal and post-menopausal women. Yet the reasons for these symptoms can vary greatly from woman to woman.

Just some of the reasons behind unexpected rage include: 

• Unbalanced or fluctuating hormones
• Loss of sleep
• Changes in exercise, nutrition and hormones 
• Dealing with chronic pain or discomfort

It’s also worth noting that not everyone experiences these changes or feels unexpected anger during menopause. So don’t “expect” anger issues just yet. But if you are experiencing these issues, rest assured that this is a common and manageable symptom. 

Unreasonable? Or appropriate?

Have you ever bottled up your feelings for fear others will label you “too emotional”? Many women feel scrutinized and judged for showing too much emotion. We start believing every emotion is unreasonable when really, we deserve to feel our feelings. We even deserve to express them, which can be the real challenge.

Menopausal women in marriages feelings are often cast aside and labeled “hormonal” “” even when they’re completely appropriate to the situation at hand. Our partners, family and friends might write us off as being irrational even when our emotions have nothing to do with hormones. And actually, hormonal changes may not create strong emotions so much as they allow strong emotions to bubble up to the surface. So the emotion is appropriate; now you just need to be sure your response is as well. .

Did a thoughtless driver cut you off in traffic and you are ready to rear-end them? Did someone leave a mini-sip of milk in the fridge at home and you want to decimate the next person unfortunate enough to cross your path? Is your partner’s cereal-eating (namely crunching, slurping, and spoon-scraping, not to mention only leaving a sip’s worth of milk behind) sparking you to feel… murder-y?

Before you unleash your reaction, can you take a breath and ask yourself, is this feeling right-sized for the situation? Or, is this an inappropriate feeling for the circumstance?

Manage hormones through diet and exercise

Diet and exercise play a huge role in our mental health. In fact, there’s a direct link between the body and the mind: doctors believe your gut health is closely related to your emotional health — and we already know that exercise can help get those endorphins (hormones that help boost your mood and relax your mind) moving.

So, move! Not only is physical activity a great way to channel your negative emotions and provide a creative outlet for your stress, but it can increase your happiness hormone levels throughout the day, too.

When it comes to food, everyone is different. Some people can apparently eat nothing but sweets and potato chips all day long and never feel any adverse effects (though, we do demand to know who these people are!). The rest of us might find that we feel better and more in control when our diet supports our physical and emotional health.

So, if you’re feeling a little extra edgy throughout your day, you might want to look at your diet. 

Some of the common hormonal disruptors you need to stop consuming. Reducing sugar in menopause, alcohol and caffeine. If you have an intolerance or allergy to other foods, excluding them from your diet can also help ease tensions and give you more control over your mood. To start, we recommend you:

• Be careful of your caffeine intake — especially first thing in the morning
• Avoid consuming more than the recommended 25 grams of sugar per day
• Limit your alcohol consumption (one serving per day for women)
• Monitor how soy and dairy affect your mood (possible disruptors in some women)
• Avoid dehydration in menopause by drinking plenty of water each day. It will also help flush out the toxins in your system

Develop a meditation/gratitude/yoga practice

One of the most effective ways to curb your stress is by attacking it before it attacks you. Developing a meditation practice can help you sideline anger or mood swings in menopause. 

Mindful meditation allows you to notice your feelings (the good, the bad, and the ugly), accept them, and move on. Instead of shoving them aside or obsessing about them, you can observe them, acknowledge them, and let them go. And it won’t take as much time as you may think it will.

Find an outlet for your stress

Is it a little cliche to take a boxing class to find a creative outlet for your stress? Who cares?! If it works for you, go ahead and give it a shot. 

Sometimes we just need an outlet for our feelings “” whether they’re positive or negative. We can get so caught up in our lives that we forget to take time to really process our emotions. It’s easy to write off feelings of frustration, anger, and self-doubt as “hormonal,” but will that serve us and our relationships? Likely, no.

Having a plan for dealing with adversity can make our reactions more appropriate. Stepping on your daughter’s LEGOs for the umpteenth time really is frustrating! But your hormones can make something like stubbing your toe or stepping on a toy feel 10 times worse. And that can influence how we react, whether we shout at the LEGO-leaver or rub our foot, throw the offending toy into the toy bin, and move on. 

Creative outlets simply allow you to process those feelings in a safe space, and in a safe way. Even if you don’t feel like you’re creatively inclined, you can still channel those emotions into art or physical fitness. Some of our favorite ways to do this include:

• Set a timer for five minutes and write in a journal until the timer dings (or, keep going after time is up if you’re so inclined)
• Blast some music and dance out your problems; we recommend making a playlist full of anthems that you can sing along to and channel your rage
• Cuddle with a furry friend — nothing helps to process your emotions like a support animal
• Go for a run, walk, or bike ride
• Take a spin class
• Get a massage (yes, a massage therapist can help work out those tense muscles)
• Check out our Rage Checklist for coping with anger in the moment. 

The important thing to remember is that there is no “one-size-fits-all” solution for handling unexpected anger and rage. It’s important to listen to your body and do what works for you in the long run. 

Care to share what’s tipping you over your anger-edge lately… and what is working for you in dealing with it? Consider Gennev’s Community Forums as another outlet where women gather and share real experiences about navigating through perimenopause and menopause. Join us.