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There are no words that capture the weight of 2020. But what I can share after hearing from countless women throughout the year is: You. Are. Amazing!

Most of all, you did something. You took charge versus your menopause taking charge of you.

And then there is this from one of our HealthFix members, who shared it with her Gennev health coach this week…

Gennev-health-fix-customer

 

Menopause is hard, but living is in the journey.

When women commit to caring for themselves, and seeking help, they become a force that no one can hold back.

I know because I’m one of them. Like you, many members of our team are in peri/post menopause and we’re building Gennev for you from the vantage point of menopausal women”¦and we love it!

We challenge you to take care of you in the new year as however big or small that may be as you’ve got this, and we’ve got you.

Happy New Year!

Jill

Best of 2020 in Menopause

These are the 5 most read/listened to resources of the year. Enjoy!

10 Important Vitamins for Menopause Relief

Some basics of nutrition really don’t change: veggies are great, you need fat, and eating the rainbow is still a good idea. We updated our list of nutrients that are good for women in perimenopause and menopause, but the basics remain the same.

Thriving Through Menopocalypse With Amanda Thebe (podcast)

Amanda Thebe was a lifelong athlete and fitness enthusiast, but when she hit perimenopause at 43, things went … awry. Fatigue set in, and she found her previously boundless reserves of energy were drying up. And, like so many of us, she didn’t realize right away that the issues she was having were hormonal.

Supplement Savvy With Dr Wendy Ellis

We’re all looking for ways to optimize our health and especially our immunity “” things we tend to take for granted when we’re feeling good and there isn’t a pandemic going on. 

Gut Health, Immunity, COVID-19, And Menopause (podcast)

One of the most unknown and underrated ways to strengthen your immune response is gut health. Science is only beginning to understand the importance of a healthy gut, including what all the gut does (a lot) and how best to protect and feed it.

Joint Pain and Menopause: Please Pass The Blueberries

Aching fingers, tight hips, sore knees “¦ joint pain is one of the most common symptoms of menopause. If you’re feeling a bit stiff and sore, especiall

The new year has arrived. And whether you consider yourself a “healthy” person or not, January represents an opportunity for new behaviors…or reestablishing old best practices.

Let’s kick off the year with the best of intentions…and actually do them! The team and I at Gennev are doing the same: smarter snacking, revitalize life fitness, dry January…and most of all, booking necessary health & wellness appointments.

Here is the 2021 healthy woman’s checklist…

To your health!

Jill

1. Create a budget

Consider what your health and wellness budget is for 2021. Are you budgeting for self-care? Do you have FSA/HSA coverage through your employer?

If you have FSA/HSA coverage, check to see what it covers in terms of health provider services and products. With a letter of medical necessity from Gennev providers, you can get coverage for appointments, supplements and lubricants on most plans. Here’s a resource for what qualifies for FSA coverage.

2. Book medical appointments

Are you in the practice of annual exams? If not, start now. Book with your physician or with a Gennev doctor.

Have you scheduled your mammogram? If you’re over 45, consider a colonoscopy if you have risk factors in your family. Whatever you do, don’t put the essentials off; talk to a women’s health specialist today.

3. Plan for necessary lifestyle change

Whether you’re in perimenopause or post-menopause, lifestyle behavior change is a must for managing weight, hot flashes, anxiety, sleep, fatigue and joint pain. We know it’s hard, so build a plan for achievable and sustainable change…even if that means baby steps.

Gennev registered dietitians/health coaches work with women of varying levels of discipline, so don’t overthink it, just start doing something. Book an appointment to build a plan for 2021. We believe this will be your best-spent $45 dollars of the year. We want you to thrive!

4. Check your supplement intake

Are you taking the right supplements for your age or stage of menopause? As women, it’s good for us to annually check-in on the supplements we’re consuming “” whether we have the right combination and whether we’re taking them at the right time of day.

If you’re not 100% confident of your routine, start by watching Gennev Director of Health Coaching Stasi Kasianchuk, RDN interview Dr Wendy Ellis about Supplement Savvy. Or – skip to speaking directly with Stasi and her team by booking an appointment with a dietitian (specify that you want a supplement audit).

5. Get the Menopause Guide

We built the Guide to Menopause from the collective expertise of our team of 25 OB/GYNs, naturopathic doctors, registered dietitians and health coaches. It’s a 60-page collection of evidence-based medical, lifestyle and herbal recommendations for every symptom of peri and post menopause. And it’s free. You can’t go wrong.

 

Fast Company cares about women’s hormonal health!

The word is getting out that women’s hormonal health shouldn’t be a taboo, but instead we should feel fabulous in our bodies.

I sat down recently with Fast Company to talk about Gennev’s mission for women to feel empowered and confident in their bodies”¦starting with their vaginal health. Listen in and then tell us what you hope Gennev takes on in our quest for open dialogue, helpful information, and healthy bodies.

see the original article on Fast Company

We hear it a lot, and it’s a legitimate concern: science and medicine aren’t doing enough to help women, particularly women in midlife and menopause.

Well, times are changing.

Innovation around menopause care is happening, often at organizations led by women.

We’re truly excited to tell you that Gennev is partnering with one such innovative organization as MiraKind. Their research into the intersection of genetics, development of cancer, and menopause has revealed an exciting path for exploration and hope for women at high risk of certain kinds of cancer.

We talked with Dr. Joanne Weidhaas, MD, PhD and founder of non-profit MiraKind, about the KRAS variant she discovered, what her research means for women, and how she’s achieving her desire to bring doctors, patients, and scientists together for the benefit of all.

Can you explain what MiraKind is and what you do?

Dr. Joanne: MiraKind was founded in 2013, as a spin out from MiraDx, a company built on the discovery of a very new kind of cancer-associated genetic mutation. The purpose of MiraKind has been to share information about these mutations to the people they can help the most. Right now that is for women, as their first mutation, the KRAS-variant, predicts an increased risk of cancer.

Another priority of MiraKind is to help find prevention strategies for patients with the mutations they have discovered. For patients with the KRAS-variant, this strategy is to avoid estrogen withdrawal.

On your website, it says you engage in “patient-centric research.” What is that?

Dr. Joanne: At MiraKind, working hand-in-hand with the patient through direct patient contact and input is really a cornerstone of our philosophy. We want to learn from the patient as much as we want to educate them about our mutations and what they mean. We can’t find answers without them. And our goal is to find answers for them. Thus, it is really a two-way street!

So tell us about KRAS as what is it?

Dr. Joanne: Well, KRAS is a protein, and it is really important in cancer development, and treatment resistance. The KRAS-variant is the mutation that we discovered, which is basically the control knob for the KRAS protein. In people with the KRAS-variant, they do not control KRAS like other people. The communication between the regulators in the cell (micro RNA’s) and KRAS is flawed. So when non-KRAS-variant people lose estrogen, their cells stop growing; in those with the KRAS variant, cells start to grow, for example.

In some aspects of life, this probably makes them stronger, but, in certain situations, like hormone withdrawal, there is a miscommunication because of this different control knob, and they can develop cancer. The KRAS-variant is the very first example of a mutation of its kind in cancer. It is fundamentally different than other mutations associated with cancer, as we think we really can control it!

Should everyone get tested for it?

Dr. Joanne: Gosh, yes. we certainly think so! Absolutely all women when they become peri-menopausal at a minimum. It is so easy to be tested, and it is such important information to have when you are going through decisions about your health, from hormone replacement therapy, to screening! Because you can inherit the KRAS-variant from your dad, and cancer happens later, you do not need a strong family history of cancer to have the KRAS-variant.

Why is it particularly useful for women to get tested?

Dr. Joanne: As mentioned earlier, women are at a higher risk of developing cancer than men with the KRAS-variant. We have found that declining estrogen levels seem to be a main trigger for their cancer; thus, maintaining hormone levels is a really easy option to help prevent it.

 

 

How can I get tested?

Dr. Joanne: You can get tested by visiting our website at MiraKind.org,  selecting the KRAS-variant test, and placing your order. We will send you a simple at-home cheek swab to obtain your KRAS-variant results, which we can share through a doctor of your choice, and ideally through the network at Gennev! The cost of testing is $295. You can also join a study through MiraKind.org and get a discount.

If I test positive for the variant, what’s my next step?

Dr. Joanne: The most important thing is to team up with a doctor who understands the KRAS-variant and is there to support you. The general recommendation is to continue estrogen and have that carefully managed. Also to get routine screenings, especially of the breasts and the ovaries.

What is the role for HRT in this conversation?

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

Does HRT help prevent ovarian or lung cancer as well?

Dr. Joanne: We believe it will protect against all cancers in KRAS-variant women.

Why am I just now hearing about this very important research?

Dr. Joanne: There are a couple of reasons. First, this important research is really very new, and is such a paradigm shift. We now know that there are mutations that are control knobs, that they can be triggered (and thus managed), by external factors like estrogen, and that they can be as common as the KRAS-variant is. It’s very new, so we’ve chosen to develop this slowly and responsibly. Also, we wanted to find solutions, and not just scare people. We have chosen to do this through a non-profit model because we want to partner with patients to find prevention strategies. For us, prevention is the ultimate goal.

Where can I learn more?

Dr. Joanne: Visit us at our website at MiraKind.org or follow us on Facebook or Twitter @Mira_Kind. You can also just email me at joanne@mirakind.org!

Are you working on other genetic research?

Dr. Joanne: We have spent the last 10 years proving that the KRAS-variant is the incredibly powerful mutation that it is and finding other mutations like it. We now know exactly how to treat people with the KRAS-variant if they do develop cancer. We also can predict which patients will have toxicity to certain cancer treatments, like immune therapy, and radiation therapy. While the work on directing cancer treatment is done through our sister CLIA lab, MiraDx, the common theme to all of our work is to improve how we care for people and patients.

What is your role now, as head of MiraKind? What’s next for you and your organization?

Dr. Joanne: I also work as a radiation oncologist and vice-chair at UCLA, where I see breast cancer patients and run an R01 funded laboratory. I oversee the work that is done at MiraDx. I have always felt that MiraKind is where the heart of it all is. The ultimate goal for me is to empower people to get the necessary information to protect themselves from ever developing cancer. So the next steps are for us to find like-minded partners to help us do this!

At Gennev, we’re very excited to be able to help Dr. Joanne and MiraKind spread the word and get more women tested. If you think you may be a good candidate for the test or to help MiraKind in their research, we urge you to go to the MiraKind website to learn more and get started.

Have you been tested? Would you consider it? We’d love to know your thoughts on testing for genetic risk factors such as the KRAS variant. Please share with us in the comments below, join our community forums, tell us on Facebook, or join our closed Facebook group, Midlife & Menopause Solutions.

 

That thing you’re doing that’s “good” for you? It’s not. Stoppit.

There’s so much information out there, from so many sources, it’s difficult to know what’s true and what’s false when it comes to taking care of our health.

So”¦we talked with our awesome physical therapists, Brianna and Meagan, to find out what things women are doing in an attempt to be healthier, and why they really shouldn’t. Turns out, some very “normal” things really aren’t good for you.

#1. You don’t have to pee it if you didn’t drink it.

The problem: incontinence or urgency. One of Brianna’s clients was suffering from urgency as needing to urinate very badly and occasionally not making it to the bathroom in time. She assumed she was simply drinking too much water.

The wrong solution: intentional dehydration. To fix the problem, she pretty much stopped drinking water and other fluids while at work. The problem with doing this, says Bri, is it means the small amount of urine she is producing is much more concentrated, increasing her risk of urinary tract infections, for example.

The right solution: water. It turned out that her problem wasn’t caused by drinking too much water; she was actually drinking too little, and her bladder was constantly irritated. Bri worked with her to slowly and properly increase her fluids, ending the irritation and getting her back to walking to the bathroom instead of sprinting.

#2. Baths are for the outside.

The problem: pain during intercourse. Meagan’s client was experiencing pain during sex as well as overall vaginal irritation.

The wrong solution: douching. Meagan explained to her client that the vagina has its own balanced system to keep it clean, and that the douching was only causing more irritation. “She was doing it more out of hypervigilance. She believed she could smell something,” Meagan tells us. “I examined her, and there was nothing abnormal or to be concerned about. Douching is not something we encourage. You’re messing with the delicate balance of the vaginal tissues, and you’re risking infection both on the outside and deeper within the vagina.”

The right solution: promote and protect healthy tissue. Sometimes the issue with painful intercourse is the tissues around the vulva are thin and delicate due to too little blood flow to the area. Pelvic floor exercises, Kegels, vibration and massage helped make the vaginal tissue healthy and more durable. Once that was resolved, the client no longer felt she had unusual discharge or sloughing of tissue, the issues which had led to her deciding to douche in the first place.

Irritation can also be resolved often by simply switching to cotton underwear, using a fragrance-free detergent, using the right intimate soap, and ditching the thongs, Bri adds. PS: this applies to steam cleaning of the vagina, according to Meagan as not necessary and potentially damaging to sensitive tissue.

#3. Clenching the core as nope.

The problem: wanting six-pack abs. While there’s nothing wrong with six-pack abs, a lot of us damage our bodies in the quest to get them.

The wrong solution: over-exercising our core and pelvic muscles. We hold our stomachs in, do too many crunches, over-exert our core muscles and basically put our pelvic muscles in a state of constant spasm. This can actually cause pain, incontinence, and urgency issues. “Hold weights over your head for 30 minutes, then tell me your arms don’t hurt,” Meagan says. “It’s the same with your pelvic floor as muscles need to clench and relax in order to become stronger.”

The right solution: exercise your core properly. Learn how to exercise your abdominals properly. Consult with your doctor or a pelvic floor specialist if you’re not sure.

#4. Is it over yet?

The problem: painful intercourse. Pain during intercourse can happen for a number of reasons: vaginal dryness due to hormonal change, birth control, or medical procedures; pelvic floor issues such as spasms, etc.

The wrong solution: endure. “Too many women think painful sex is normal and they should just “˜grin and bear it’,” Bri says. “They go somewhere else mentally and just endure it, but it really ends up hurting them, hurting the relationship.”

The right solution: education, openness, and lubricants! Painful intercourse doesn’t have to be your new normal after menopause or for any other reason. “Gals feel like they should be able to have intercourse without any supplemental lubrication,” Meagan says, “and they’re ticked off that their bodies don’t make what they need. They don’t want to deal with using lube, reapplying lube”¦ The problem is they’re causing all these micro tears in that tissue, and pain, increasing risk of infection. Just use a lube!”

#4.2: Amendment to #4 as “Use the RIGHT lube!”

The problem: painful intercourse, coupled (ha ha) with a desire to use “natural” lubricants.

The wrong solution: olive oil. Olive oil has exfoliating properties, meaning it causes the skin to slough off dead cells. This is not a part of the body one should exfoliate, Meagan says; nature has already taken care of that. Bonus info: jojoba isn’t the best choice either, as it’s wax based, and the small amount of wax can build up internally.

The right solution: do your research. If you prefer to go the natural route, there are choices that may well work for you. Just be sure you read research from credible sources, test any substance on another body part first, start small to test for a reaction, and report any unexpected or unwanted reactions to your doctor right away.

[Choose a lube that fits your needs and your lifestyle. Check out this lubricant info sheet from A Woman’s Touch]

#5: Hovering is for helicopters and hummingbirds

The problem: yucky public toilets. Few of us are completely comfortable trusting our bare bottoms to a public toilet seat or outhouse, no matter how picturesque. We’ve all heard horror stories of people picking up strange diseases or at least sitting in something suspiciously moist.

The wrong solution: hover. To keep our tushies safe, we hover above the seat when it’s time to urinate. Not a good idea, say our PTs. “If you’re not in a relaxed, sitting posture or full-on squat position, the muscles through your hips and pelvis aren’t relaxing. This means you’re having to generate extra abdominal pressure to push and force the pee out,” says Meagan. “This recruits the wrong muscles and totally messes with how normal peeing should happen.”

WHO KNEW???

The right solution: sit, Ubu, sit. Layers of TP on the rim. Know that if you don’t have an open sore at a contact point, the chances of contracting anything are pretty minimal. You’ll be fine. Or you can squirt some hand sanitizer on a piece of TP and give the seat a quick cleanse (but wait for the surface to dry to avoid skin irritation). Just don’t hover.

#6: Sunning it where the sun don’t shine.

The problem: lack of Vitamin D in the nether region. Apparently women feel their vaginas aren’t getting enough Vitamin D.

The wrong solution: exposing one’s genitals to sunlight or tanning beds. The real problem? THIS ISN’T A PROBLEM. This part of the body is hidden and shaded for a reason as nature intended it that way. A burn in that area can be extremely painful and damaging to very delicate tissue over the long term.

The right solution: get enough Vitamin D in the usual ways. Exposing the skin to sunlight is good, when done carefully to avoid damage. But maybe bare only the skin that nature and culture have deemed reasonable. ?

 

April is Financial Literacy Month as because who doesn’t get a jolt of reality every year when Tax Day rolls by (or over) us?

Women learning to manage money is especially important as they tend to outlive male partners and spend more years in retirement. And women generally have less to retire on (called “superannuation”), because of the pay gap between men and women, because more women than men take time out of their careers to care for children or aging parents, and because more women will take lower-paying jobs or work for employers who don’t offer retirement plans.

Money management may seem a little off-topic for a menopause site, but your financial health has direct impacts on your quality of life. We’re all about whole-woman wellness at Gennev, and you can’t be at your fabulous best if you’re stressed about your economic wellbeing.

So what can you do to prepare for your financial future? First, take a deep breath. Hold it. Little longer. Little longer”¦. There. Let it out. You can do this.

According to a 2016 Fidelity study, only 37% of women are confident in planning for retirement. But likely close to 100% of us want to be financially secure in our golden years, so let’s review four steps to get us started.

  1. Build a budget. You can’t make goals for your future until you know where you are now. How much do you really spend in a day, a month, a year? NerdWallet breaks down the popular 50/30/20 budget (50% of income to needs, 30% to wants, 20% to savings and debt repayment) to help you determine how to budget according to your priorities.
  2. Enlist an ally. Financial advisors aren’t just for those with oodles of money. But you want to be sure you find one with your best interests at heart. The Balance has seven steps to help you identify an advisor who will put your needs first. You can also check with WISER, the Women’s Institute for a Secure Retirement, for great advice on saving and investing and planning for retirement.
  3. Be your own best ally. There are some great resources out there to help you wrap your head around how, why, and when to start planning your financial future (spoiler alert: that “when” is now). DailyWorth is a terrific resource for women, so consider joining up for the info they can provide, but also check out their 10 Best Finance Books for Women.
  4. Finally: don’t sacrifice your future. Trying to decide where to put your dollars? Carrie Schwab-Pomerantz (daughter of Charles Schwab and an investment expert in her own right) advised women against doing what women often do: putting themselves last. If it comes down to your retirement or your kid’s college fund, opt to plump up the retirement kitty. Why? There are other ways to finance a college education, and aging parents without sufficient retirement savings can become a burden to their children later on.

Tackling your finances can be a daunting task as and, quite frankly, a potentially dull one. But with more of us living longer, it’s never been more important to secure our financial futures. Here’s to your long, healthy, happy life!

 

I’m struggling right now. It’s the uncertainty of things that really needles me.

You can likely guess how well I’ve been sleeping. Has anyone else been having crazy dreams lately?

Community

My husband and I are embarking on a move in the next two months, but now we can’t go look at possible places. And professionally, I am concerned about the welfare of my team. Are they able to be the parents they need to be right now with all that I’m asking of them? Am I reaching out to them enough to let them know I care?

Gennev is a business as we’re an online clinic for women in menopause, and recently we added gynecology and primary care services too. We see you as “essential workers” in this crisis. In addition to your “day-job”, you’re likely the primary care giver, meal planner and online-learning specialist.

But even more, we’re a community.

We started as a community in 2016. And, it’s still the heart of our organization. Sometimes it gets overshadowed by the telehealth services and the products we offer. But it’s still our core.

There is a reason why Zoom happy hours have become so popular. People need people!

So, I’m dedicating this Friday letter to community and how you can get what you need, when you need it.

Weekly Webinars. These are new. Our healthcare team is hosting specialists to talk through meal-planning, strengthening your immune system, managing isolation and grief, etc. As long as you keep coming and asking for more, we will keep tackling new topics and offering AMAs.

Community forums. These are messaging boards for questions and answers. The cool thing is, they’re moderated by our health care team as AND as they’re safe and confidential. You can ask whatever you feel comfortable, and it won’t show up in your Facebook feed. Our latest forum has begun on COVID-19, which lists all our COVID-19 resources.

COVID-19 Resources. When it comes to women in midlife, we have our own health concerns around COVID-19. We’ve published some helpful podcasts, videos and articles”¦and we’ll keep adding to them over time.

Midlife & Menopause Solutions. This is our private Facebook group for those of you who like daily discussion in a less structured environment. We monitor who joins, so it’s safe. It’s still Facebook, but we do our best to ensure that women who rely on one another for advice are the only ones allowed in. No selling. No trools.

Instagram, Facebook (public), Twitter. These are our public channels. If you like to keep updated on happenings, tips and announcements from Gennev and the women in our community, please follow/join/like. We’ll like you back.

Menopause library. Our trusty library of long-standing, original menopause education is and always will be there. And, like all the other community resources I listed, it’s free”¦and searchable. Use it when you need it. Weekly we publish new articles, podcasts and video.

What kind of community do you need? With us, you have options.

Personally, I’m a lurker on social channels; I’m a consumer of podcast interviews and webinars (where I can multi-task), and from time to time, I like a good forum chat. I don’t need to engage, but I like to know what’s going on.

What’s missing from our approach? Human-to-human contact. You’re going to see more options for small group sessions and forum boards with the Gennev team very soon.

Isolation is real right now. And I think we’re learning that technology isn’t enough. We still need people.

I kind of love how we’re getting back to the essentials of life. It feels more inclusive to me.

If there are aspects to how we do community that you’d like to see changed or improved, email me at jill@gennev.com. Yes, that’s my personal email. Human to human.

Be well,

JIll

Inviting people into your home

 

Having people to your home is the ultimate personal exposure.

It’s where you sleep, eat, poo, get sick, have sex, watch mindless TV.

It’s the place where you are the real you.

In the past month, more people have witnessed my basement makeshift office than ever before. It’s decorated with a retro, mother-in-law kitchen complete with an olive-colored fridge. Here’s a photo of me at my desk, no make-up, day-old hair, with our beloved 1960s beer fridge as my backdrop. (insert photo)

Before COVID-19, I made sure that my computer camera was perfectly set up at our dining table with a pleasant background of natural wood, art or stone.

How 4 weeks has changed me and my ability to present the real me! I kind of like it.

I have to wonder if this pandemic era will bring out a new level of authenticity in all of us.

I watch John Krasinski’s SGN (Some Good News) and The Tonight Show with Jimmy Fallon and I LOVE the authenticity of their homes, their hair, and their “this is me” experience.

Women everywhere are doing their best to be authentic and make the best of the situation for their families and for themselves.

Two of my favorites in the past week came from friends who got creative about Spring Break. Considering that they weren’t going anywhere, they created an experience for their families in a retro beach scene and in old-town Mexico. (insert photos with names)

We know there were likely tears and moans behind these photos from their kids or spouses. But these moms took one for the team, they got creative, and they adapted to a new normal.

What I love most is that they were bold enough to invite us into their homes with raw honesty on how they’re doing their best in uncertain times.

We’re all trying our best, but we’re also getting comfortable with less polish and more honesty. Less expectation and more understanding. Fewer apologies and more giving ourselves permission to just be and do what we feel.

Stasi Kasianchuk, Registered Dietitian Nutritionist (RDN) who leads Gennev’s HealthFix membership for telehealth-based coaching, said it best in our weekly 1:1 when she said, “The majority of my clients right now just need to be listened to. They need to know that it’s OK to give themselves permission for needing a nap or not working out or just feeling blah.”

During our weekly COVID webinar <link>, Swapna Vaidya, MD and Psychiatrist mentioned that through telehealth, her patients are “”¦ opening up more in the confines of their home.” Her young patients like to show her their toys and rooms. Women can show her their messy kitchen and the stress they’re feeling about not being able to keep up.

Digital will never replace the need for personal contact, but in this remote-everything world we’re living in, it’s presenting opportunities to be more authentic, even vulnerable.

My social feeds are blowing up with images of friends doing their best, getting vulnerable, showcasing how they’re making the most of a new normal. I love it, because women everywhere are doing their best to rise up and embrace a really tough situation.

And if there are days you don’t feel like rising up, or you fail to cheer up a sad senior graduate who won’t be walking the stage, or you feel like you’re underachieving in all parts of life, give yourself a break. You’re doing the best you can do. You’re doing all that you can do.

From my olive-fridge framed office to yours, here’s to getting comfortable with the real you and letting others see it.

Jill

Things your doctor wants you to know about your middle-aged body

So the fact that your body at 40 or 50 is a bit different from your body at 25 probably comes as a surprise to exactly nobody.

As bodies change with age, the way we behave in them needs to change as well. So what do your docs as and in particular, your ob/gyn as want you to know and do now that you’re 40 or more?

Board -certified ob/gyn, NAMS-certified menopause practitioner, owner of RENUvaGYN, and Gennev Director of Health Dr. Rebecca Dunsmoor-Su filled me in on all the details for the Care and Feeding of Your Over-40 Body.

The Big 3 Screens: Breast, Cervix, Colon

Once you reach middle age, your risk of certain kinds of cancer increases. So it’s important to get regular screenings, says Dr. Rebecca.

However, what constitutes “regular” differs according to your risk factors. If you’re healthy and have no family history of any of these cancers, you can screen less frequently.

Breast: mammograms every year or two through your 40s.

Colon: screenings now start at age 45, which is younger than previously recommended. You should have a colonoscopy every 10 years up through age 75. There are other, stool-based tests that you can opt for, though they need to be done more regularly: the FIT and gFOBT are annual; a stool DNA test (MT-sDNA) is every 3 years.

Cervix: Pap smear done every 1 to 5 years. Talk with your doc about your HPV status and other risk factors to determine the right interval. Even if you’re menopausal, you still need this exam.

STDs

In fact, thanks to the prevalence of erectile dysfunction meds (and other factors), the rate of STD infections is on the rise among Americans 45 or older.

Menopause does not protect against STDs; in fact, the thinning of vaginal tissue caused by a decrease in estrogen can actually make it easier to be infected as the tissue can more easily tear or abrade during intercourse. As long as you’re having sex, says Dr. Rebecca, you should be using condoms.

Pregnancy risk

Even if your periods are wonky, as long as you’re still having them, you can still get pregnant. Menopause is officially defined as a full calendar year since your last period, so until you pass your “meno-versary,” you should be using contraception.

Eating and fitness

“This is a great time to address eating and fitness habits,” Dr. Rebecca says, “because as you head into menopause, weight tends to rise a bit, naturally and fitness becomes harder to achieve.” During our busy 20s and 30s, you could get away with more, but now it’s time to focus on you and your health.

Walk half an hour or 45 minutes a day. The rule that’s “out there” is 10 minutes a day minimum, but Dr. Rebecca recommends at least 30 minutes. “A 30-minute walk can be incredibly relaxing as well as good exercise,” she says. “It’s a chance to clear your head and reduce your stress, so take advantage of all the benefits.”

As far as diet, now is the time to capitalize on the good habits you already have and slowly erode the bad ones. Some things to bear in mind:

Cholesterol, diabetes, thyroid, and blood count

Most of us understand the need to check cholesterol levels, especially if we have a personal or family history of heart disease, but a blood count can also be a useful tool for other health concerns.

Women in midlife and menopause may be at higher risk of developing diabetes, so if you have risk factors, you can include this screen in your blood work as well. If you are 45 or older and have no other risk factors or family history of diabetes, you should be screened every three years, says the American Diabetes Association.

Additionally, you should probably have your thyroid function screened every year or two, says Dr. Rebecca; again, family or personal history of thyroid disease may change the recommended frequency.

With the blood count, the doc is looking to see if you may be anemic. Some medications can reduce your absorption of iron, so it’s good to keep an eye on this. Your doc may also look at the blood work to check that you’re getting enough nutrients.

Heart disease

Unless you have a specific concern, Dr. Rebecca says you probably don’t need what’s called a “stress test” or “stress EKG” where they wire you up and put you on a treadmill to check how your heart is working. Generally this test is reserved for people who already have symptoms or history of heart disease or other risk factors such as diabetes.

What she does want you to know is that heart attacks can look very different in women and men. Women may have jaw pain, shoulder pain, nausea, excessive sweating; the crushing pain under the sternum that we classically associate with heart attack is more common in men and may not be present in women.

Also, many of us still regard heart issues as primarily affecting men. Not true: about 10 years after menopause a woman’s risk is equal that of a man’s. Heart disease is the #1 killer of all genders, so it’s important to pay attention to your heart.

Ob/gyn stuff

Incontinence: If you’re having any leaking, Kegels, Kegels, Kegels, says Dr. Rebecca. Make them an everyday part of your exercise regimen, because continence issues don’t solve themselves. In fact, don’t wait until you have a problem; any woman can and should be doing pelvic exercises to strengthen the pelvic floor. Bonus: better orgasms. However, you might want to get some guidance on how to do the exercises properly, since a too-engaged pelvic floor can also be problematic. Check out a pelvic physical therapist for great, expert advice.

Vaginal tissues: Please talk with your doc. Don’t self-diagnose, don’t self-medicate, don’t clean it with products, and really truly consult with an ob/gyn if you have concerns or questions about any product that’s advertised (or rumored) for use intra-vaginally. Just because someone’s a celebrity doesn’t mean they’re fully informed on vaginal atrophy or pelvic health.

Infections: If you’re getting frequent infections, check with your doctor. Frequent UTIs can indicate menopause; frequent yeast infections can be an early warning sign of type-2 diabetes.

Sex: Use lubes. Always, every time, says Dr. Rebecca. Make it part of the fun. Lubes can protect the tissue from the friction and reduce the risk of infection.

How to talk with your doc

Finally, Dr. Rebecca urges all women to be very direct with their doctors.

Many women feel unheard or dismissed by docs, she acknowledges, so it’s important to be as clear and upfront as you can. Let the doctor know what you’re experiencing, but if you have a specific concern, let him or her know that too. The doc may be able to explain why they don’t share that concern, or she may follow you on that path to see if it’s a factor.

Be direct, and if you don’t feel heard, you’re perfectly within your rights to find a doctor who you trust. However, Dr. Rebecca adds, just because the doctor isn’t saying what you want to hear doesn’t mean she isn’t listening.

Aging and menopause are your body’s way of saying “Take care of YOU.” You’ve likely spent a good chunk of your life caring for kids, taking care of your career, your home, friends, family, etc, and that’s great. But to age well may mean diverting some of your attention back to you, to habits and behaviors that not only keep you healthy but also give you joy.

This article has been reprinted with permission from PRiME WOMEN. 

 

Gut health might seem like the latest fad, but this “fad” is for real, and it has major implications on your wellness as especially for women in midlife and menopause.

Beneficial bacteria in our gut microbiome do a whole lot of very useful things, including helping to make many nutrients in our food available for our bodies to use. They keep our intestines intact to prevent “leaky gut,” they help regulate our immune system, they impact brain health, emotions, even reproduction.

It pays to keep your microbiome well-fed and happy.

Gut health for women over 40

There’s a special pocket of gut flora called the “estrobolome” which helps metabolize estrogens in our body. When these are disrupted or die off, we are at higher risk of heart disease, osteoporosis, and obesity. In turn, estrogen in the body helps these flora “¦ flourish! Obviously, these bacteria are at greater risk when we hit perimenopause and estrogen levels begin to drop.

How to protect our gut health

Fortunately, there are ways to optimize the care and feeding of your gut biome to prevent dysbiosis, or the die-off of beneficial bacteria. Check out “Gut Check: How to Increase Beneficial Bacteria” on Prime Women for the full scoop on maintaining a healthy gut and reaping the benefits.

What do you do to protect and nourish all those helpful bacteria in your belly? Share with us in the comments below!

Check out our other articles in cooperation with Prime Women, including How to get good sleep and the effects of low-dose birth control in menopause.

 

Many of us still believe heart disease is more a problem for men than women: that just isn’t true.

Heart disease is the leading killer of women in the United States.

According to Go Red For Women, “Cardiovascular diseases and stroke cause 1 in 3 women’s deaths each year, killing approximately one woman every 80 seconds.”

Heart disease risk after menopause

Ten years or so past menopause, a woman’s risk of heart disease equals a man’s. As estrogen declines, it takes a great many protections with it, including keeping blood vessels within artery walls flexible so blood can flow freely. And, post-menopause, cholesterol levels can change: good (HDL) cholesterol may decline, while the bad stuff (LDL) starts to rise.

Not enough HDL or too much LDL can allow plaque to build up in arteries, restricting blood flow.

To better your chances of avoiding or surviving heart disease, it’s a really REALLY good idea to know your numbers and your risk.

Cholesterol: screen at home?

Several screen-at-home tests for cholesterol have hit the market in recent years; what do you need to know about DIY cholesterol testing?

Check out this article in PRiME Women for more information on at-home cholesterol screenings and other facts to protect your heart health.

While you’re at it, be sure you know the symptoms of heart attack in women (which can look very different from men’s), and when what you’re experiencing is more likely to be menopause-related, non-life-threatening heart palpitations.

The information in this article is never intended to replace advice from a medical professional. If you feel you may be experiencing heart problems, get help right away. 

Do you have experience with heart disease? How are you managing it? We’d love to hear how you’re protecting your heart, whether you’re high-risk or low. Please share in the comments below, on Gennev’s Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.

 

Resiliency is our ability to adapt to as and thrive through as times of change.

New job, new spouse, adding babies, subtracting college-bound kids, moving, losing a parent: change, whether happy or sad, adds its own challenges to our lives.

If we’re resilient, we stay focused on the positive, are confident in our ability to get to the outcome we want, and embrace the opportunities change brings.

What do sex and flossing have in common? Increasing our life expectancy. Yep.

Menopause and resiliency

Think about it: who is more immersed in change than a woman in perimenopause / menopause? Our bodies are changing, our emotions change (sometimes from minute to minute); if we’re in midlife when the transition comes, more than likely our lives are undergoing some changes as well.

Any woman going into or out of the menopausal transition is already pretty darn resilient. She has to be. But resiliency is kind of like joy: a little is great. A lot is better. Good news! Even if you were born with only a little resiliency, you can still have a lot.

Evidence suggests that resilient people live longer and experience more satisfaction with their lives. Evidence also suggests that resiliency can be learned, developed, and strengthened. If you’ll live better and longer with a little practice, isn’t that worth the effort?

If you’re ready to become even more resilient, to meet changes with a smile and a strategy, check out this article on PRiME Women about seven ways to build your resiliency.

What’s your experience with change? Do you dread it, celebrate it, grit your teeth and get through it? Let us know how resilient you are and how you deal with changes in your body and world. Share with us in the comments, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group!