Authored by Gennev Chief Medical Officer, ob/gyn Dr. Rebecca Dunsmoor-Su.

“There’s been yet another round of lay-press headlines about how estrogen plus progesterone hormone replacement may increase the breast cancer risk,” says OB/GYN Dr. Rebecca Dunsmoor-Su. 

Headlines don’t tell the full story, and Dr. Dunsmoor-Su, who is an epidemiologist as well as an OB/GYN, helps us separate fact from fiction in this podcast.

If you’re dealing with menopause symptoms and are worried about taking HRT to manage them, you’ll want to give this a listen.

TRANSCRIPT:

Hi, this is Dr Rebecca Dunsmore-Su, the Chief Medical Officer here at Gennev. I wanted to put together a podcast today about hormone replacement therapy [HRT] and breast cancer. 

I’m addressing this again because there’s been yet another round of lay-press headlines about how estrogen plus progesterone hormone replacement may increase the breast cancer risk. And that’s because of some data presented at a breast conference recently. 

It’s important to note that this data is not new data. It is the same data from the Women’s Health Initiative that we’ve been talking about for many, many years. And the data from that study has been analyzed multiple times by multiple other investigators, and they all note that the data does not really show an increase of breast cancer in this population. 

When you actually parse the data out and look at the women who started estrogen and progesterone and have had never seen hormone before and therefore likely younger and more close to the time of transition of menopause, there is no difference in breast cancer rate between them and people given a sugar pill in the same group.

Importantly, the only group in which they found a difference between them and the sugar pill is in women who had taken hormones before and stopped. 

Two big issues with that: One, that’s not how we use hormones, and two, the group given a sugar pill in that subgroup actually had a much lower than average rate of breast cancer. So in comparing those two groups, you’re actually comparing to the wrong comparative group. 

If you look at that group of women given estrogen plus progesterone, they really actually don’t have a higher rate of breast cancer than any other E plus P group that we’re not calling significant. 

That’s a lot of statistics talk for saying if you work with your data enough, you can make something look like it causes harm. But really when you look at how we use hormones, estrogen plus progesterone really does not increase the risk of breast cancer.

But again, some studies say it does. Some studies say it doesn’t. Some big studies say it does. Some big studies say it doesn’t. And why are we seeing this back and forth? Why don’t we know the answer by now? 

I think there are two real reasons why that’s true. The first reason is, in anything that may have a very small or no impact, if you do studies you’re going to see studies give you false data on both sides of that true estimate. It’s why we do large studies. It’s a statistical anomaly and so what we’re getting is all of these studies on either side sort of telling us, well maybe the reality is somewhere in the middle or somewhere around zero.

The second reason is probably genetic. Not all women are the same and we know from some studies that there are gene products that probably make it an increased risk to take hormones and with breast cancer and we know from other studies that there are women for whom taking hormones can be protective against breast cancer.

The problem is we just don’t know all of the genes that can impact this yet and so you’re going to see different responses from different women to hormone replacement therapy. The one thing I do know is that no matter which side of that genetic line you fall on, the actual overall impact of hormones on breast cancer is probably exceedingly low. 

So what, you may ask, does that mean for you? Well, here’s how I approach hormone replacement therapy. I approach it by saying, well, what is it good for, and what could the risks be, and how do I balance those for my particular patient? 

Benefits of hormone replacement therapy

So first of all, what is hormone replacement therapy good for? 

Number one, it’s good for symptoms. If you are suffering significantly from hot flashes or night sweats or vaginal dryness or any of those symptoms, hormone replacement therapy is actually very a effective medication for that, and only you know how big the impact of those symptoms are on your life and how much you would value taking a medication that can make them go away.

The second thing we know it’s very good for is your bones. It’s one of the best medicines for preserving bone strength. We don’t typically use it just for that, but we certainly as providers understand that it does one of the best jobs with the least risk for protecting bones. 

The third thing I’ll talk about with people is cardiovascular protection from hormone replacement therapy. The answer to that is very complicated and again, women are genetically very different. So there’s no one answer for each woman. But we do know that women who have estrogen have a different lipid profile and a different cardiac risk in terms of heart attack than women who are menopausal. 

And so there is probably some protective effect from that perspective. But depending on how you use the hormone, it can also be dangerous because if a woman has already developed atherosclerotic plaques in her arteries, adding estrogen back can cause blood clots to form on top of those and could probably increase her heart attack or stroke risk.

So when you’re talking to a doctor about hormone replacement therapy and cardiac risk, you need to be having a very complex discussion about whether it might be beneficial or harmful for you. 

The next thing that we sometimes use hormones for is mood, and in some women it really can be quite beneficial in balancing mood, especially in the perimenopausal time. However, we don’t have great evidence that it helps all women. And again, this is likely because women respond differently both to hormone and have different reasons for having mood symptoms. 

And the last things women often ask me about are more what we typically think of as superficial things like their skin, their hair, their nails, and their weight gain. Hormones can be somewhat beneficial for those things, but I certainly don’t start women on it just for that because really its impact is quite low in those things and there are other things that are safer that we can use for that.

Risks of hormone replacement therapy

So if those are the things hormone replacement therapy can be good for, what are the risks? In my mind, the biggest risk is actually for blood clotting. 

So we know that estrogen increases the risk of forming a blood clot in the body. We know that women who are pregnant have a higher risk of that. We know that women before menopause have a higher risk of that. It is a known risk of estrogen. It is not a huge risk. 

The baseline risk of forming a blood clot if you don’t have a predisposition is quite low and the increase is relatively small from adding estrogen. But we do talk about it because it can be an important risk, especially in people who might be at higher risk of stroke. So it’s important to think about that risk and whether it applies to you.

The second thing we talk about when I counsel patients is breast cancer, and I tell my patients honestly I don’t think that estrogen really, on the whole, increases your risk of breast cancer. I think there are certain people for whom that might be true and there are certain people for whom it’s protective. But on the whole, for most women, it’s probably not a big risk. 

The important thing to keep in mind also is one of the things they show in the Women’s Health Initiative that we don’t talk about a whole lot and in some of these other large studies is that when women do get breast cancer on hormone replacement therapy, it’s often a lower grade or earlier-stage cancer and easier to cure. 

The last thing I always talk to my patients about is that one in eight women will get breast cancer in their lifetime. That’s your baseline risk, so it can be really hard to tell if something is actually increasing that risk when the risk is so common. And while breast cancer is very scary to us as women, we think a lot about it, in reality, it kills very few of us, and those of us who are at highest risk of dying from breast cancer and breast cancer complications or those of us getting it at earlier ages, and there’s a lot of genetic interplay with that. 

The sort of breast cancer that we see as women age that contributes to the large portion of this one-in-eight risk is generally caught fairly early stage — if you’re getting adequate screening — and is curable. 

Many, many, many more women will die of cardiovascular disease and many, many more women will die of hip-fracture related complications. So we need to be thinking and talking much more about cardiovascular disease and bone health in women in menopause.

Taking HRT safely

So I just gave you my counseling session that I give to women in my office for hormone replacement, and many of them after that counseling session say, well, what would you do? Or what should I do? 

And I tell my patients that if you’re going to use hormone replacement therapy, which I often recommend, you need to be using it safely, and the most important thing you can do is know what you are taking. 

I see many women in my office who have been told by other providers that they can be given a special, compounded, just-for-them hormone replacement, that will be better than anything made by an evil pharmaceutical company. 

This is not true. 

First myth: there is no “natural” hormone replacement. Estradiol and progesterone are synthetically made. If you get it compounded, it’s still synthetically made in the same pharmaceutical company that made the pills that I would prescribe you or the patches that I would prescribe you.

Second, no one can match it to the hormones that you had before menopause because those hormones are gone. We can’t predict what those were. So anyone who’s saying they’re making a blend especially for you really isn’t. They’re just making a blend that they’ve been taught to make. 

And the third big thing that I tell people is when you are getting things mixed into creams or rubbing them on your skin, you do not know what dose you are taking. While they try to do their best to get it evenly mixed throughout that compounded cream or lotion or base, it is not evenly mixed and we know it’s not. And when the Lin tests have been done on these products, the variation in the amount of hormone actually in any given dose is quite wide. If you’re going to take something that might have a risk, you need to be taking something where you know what dose you’re getting.

And so I tell my patients, I only use the pharmaceutically generated and regulated products such as estradiol pills, estradiol patches, and progesterone pills and things like that. And that’s just for safety’s sake. If there might be a risk associated with this thing, I at least want to know what I’m giving you. 

The second thing you can do is get your breast screening, get your mammograms, get your breast exams at the doctor. People don’t enjoy getting mammograms. Trust me, I don’t enjoy getting them either, but they are our best method of screening for early-stage cancer, and if we catch breast cancer early, it can be cured. 

The third thing you can do is when these articles come out in the lay press, read them with a critical eye. Many headlines are generated to scare so that you’ll read the article. So just be aware there may be no new data behind this. They may just be rehashing the same data that we’ve heard over and over again, trying to get a new article out of it. 

The fourth thing I tell people is, help us to understand better how genetics play into breast cancer risk and hormone. Go to an organization like MiraKind.org, and there’ll be a link on our website for this. That is a nonprofit organization that’s doing genetic research on how different gene factors play into the breast cancer risk in women. And it’d be great to sign up for one of their studies if you qualify. 

And finally, when you’re thinking about using hormone replacement, find someone with genuine credentials, find a physician who has some training in menopause and really understands the issues behind this and doesn’t automatically do the same thing for every woman. 

This should always be a discussion between you and your doctor and they should have a good understanding of the risks and benefits of hormones and be able to explain that to you and make a tailored decision for you. 

Thank you so much for listening. I know this is a constant question and issue for us here at Gennev. And our goal, as always, is to give you the best, medically valid and evidence-based information we can find.

Join the conversation that continues on about HRT, breast cancer, all things midlife and menopause, and more in our Community forums. You are always invited.

The experience of menopause differs from woman to woman, but in our conversations with women, one thing seems nearly universal: the more information a woman has, the more in-control she feels over her body and her transition.

Midlife Mojo with Dr. Anna Garrett

The problem? Because menopause is still so taboo, many women struggle to ask questions and get answers.

Dr. Anna Garrett has been a clinical pharmacist for over 20 years, working in a variety of practice settings. Happily for us, she discovered along the way that working with women in midlife is her true passion. Dr. Anna offers her clients a variety of services including hormone balancing, weight loss, and GeneSNP testing. Her health coaching is designed to help women in perimenopause and menopause escape from hormone hell and feel amazing in their bodies so they can rock their mojo through midlife and beyond.

Dr. Anna is a Doctor of Pharmacy and Board Certified Pharmacotherapy Specialist. She is also a Certified Intrinsic Coach , and has studied through the American Academy of Anti-Aging Medicine.

Clearly, Dr. Anna has answers on midlife and menopause. So we asked her some questions.

(We suggest listening to the whole thing, start to finish, then using the time stamps to go back and listen again to those parts that apply most to you.)

1:25
We asked Dr. Anna how she got started on the path of working with women in midlife and menopause. Dr. Anna shared with us how seeing women floundering and not living life to the fullest prompted her to go into practice helping women reclaim their bodies, lives, and selves.

3:40
What do we mean by “hormones,” “hormonal” and “hormone management”? These are kind of important terms to a woman in or approaching menopause, yet most of us are a little unclear on what they really mean. Dr. Anna educates us on hormones, their interactions, and the impacts when they’re out of balance.

6:05
We wanted to understand the difference between traditional HRT (hormone replacement therapy) and B-HRT (bioidentical HRT). So we asked. Dr. Anna tells us what they are, how they differ, when they’re called for, and the “laundry list” of lifestyle changes women should consider first before you go down the HRT road.

8:50
In this part, we asked Dr. Anna to take a little deeper dive into the differences between HRT and B-HRT. She gives us some great details on the risks and benefits and some of the factors to consider if a woman decides to pursue hormone replacement.

11:30
OTC progesterone is available and does have some benefits, but Dr. Anna schools us on the risks of self-medicating without the oversight of a health care professional.

13:12
How do you know if seeing a professional coach/consultant like Dr. Anna could help you? She explains the profile of an “ideal client” as eg someone who is dealing with hormone challenges and is ready to “do the work” necessary to feel better.

14:55
You’re ready to consult someone like Dr. Anna as how do you go about it? What’s that first appointment like, what expectations should you have? Dr. Anna has a range of possible paths to feeling better in your body, depending on where a woman is in her journey, what symptoms she’s experiencing, her financial circumstances and so on.

18:10
Women may not even know that they’re in perimenopause or menopause, and when symptoms are gradual, they may not even realize how poorly they’re feeling compared to how they could feel. Dr. Anna speaks to the issues women face in getting properly diagnosed and treated and offers suggestions how a woman can prepare in the years before midlife to be their own best advocate. Don’t have the joy sucked out of your life when what you’re experiencing can be solved, she advises. Oh, and don’t rely on your Facebook group for an accurate diagnosis and treatment plan.

21:48
Dr. Anna shares stories of women in menopause who got their midlife mojo back.” When hot flashes and body image issues threatened their quality of life, Dr. Anna helped them get balance and perspective back.

24:14
I’m sold, let’s work together as so what does that look like? Dr. Anna talks about why she thinks six months is the right amount of time to do the serious work of getting your body balance as and your mojo as back on track. And because hormone fluctuations know no borders, Dr. Anna talks a little bit about how and why she set up her business to be able to help women globally.

27:00
Dr. Anna takes on the issue of shame surrounding menopause and aging. “It’s not like anyone gets to opt out of this!” she says; don’t suffer needlessly, don’t be ashamed, enjoy the wisdom you’ve earned and celebrate this special time of life.

28:36
One piece of advice for listeners? Find someone to reach out to, Dr. Anna says. Your problems can be solved, so don’t suffer them needlessly.

To learn more about as and from! as Dr. Anna, check out her website at drannagarrett.com.

Let’s face it: the female reproductive system has a lot of parts. And because our society is a bit squeamish when it comes to discussing sexual organs “” particularly women’s “” the names may be familiar, but we don’t always know which bits are which or what they do.

In keeping with our mission of putting women in control of their health, we’d like to present: your body.

Obviously, the more you know about your body, the better you’re able to monitor your health and stay on top of changes. However, because virtually everything about our reproduction is hidden up inside, it can be tricky to know what’s going on in there.

With the help of our Chief Medical Officer, OB/GYN Dr. Rebecca Dunsmoor-Su, we’ll take you through the parts, where they are, what they do, how they fit into your body and wellness as a whole, and how the choices and decisions you make affect them.

Looking to understand your body better? Take Gennev’s OB/GYN-designed Menopause Assessment

Your cervix

The cervix is a short tube that connects the lower uterus to the upper vagina. There are a couple of parts to it: the ectocervix, the bit that’s exterior enough to be seen in a pelvic exam, and the endocervix, the canal that leads from the opening of the cervix (the “external os”) through to the uterus. The border between ecto and endo overlaps and is known as the “transformation zone” or “transition zone.”

The cervix is narrow and produces mucus to protect the uterus from harm like bacteria; it expands to allow blood and babies out.

The “glandular” cells that line the tube are known as the endocervical cells. They are a different type of cell than the tougher, “squamous” cells that make up the outside of the cervix. There is a line where the external cells give way to the internal ones, and this transitional zone is the most vulnerable to HPV.

In younger women, the transitional zone is larger and more exposed. As a woman ages, that zone shrinks and climbs up into the cervix, making it less vulnerable. HPV tends to live in the transitional zone and/or the endocervical cells, which is why that’s the area your OB/GYN tests in a pap smear.

HPV, cervical cancer, and pap tests

With the cervix, the biggest concern is cervical cancer.

All cervical cancer is caused by the human papilloma virus (HPV), though not all strains of HPV cause cancer. There are hundreds of types of HPV, some which cause warts on different parts of the body, and some which cause warts on the genitals. There are also versions that are higher risk for becoming cancerous.

In the past, many if not most women contracted HPV at some point in their lives, and for many, their immune system was able to clear it. However, sometimes that HPV can lead to HPV disease in which cells become pre-cancerous, ultimately causing cancer if not treated.

A problem with HPV is that many women can have it and show zero symptoms. It can be “sitting in your cervix and doing absolutely nothing you would ever notice,” says Dr. Dunsmoor-Su, “but we can pick it up on a pap smear when we test for HPV.”

Take control of your menopause with your Personalized Menopause Plan. Talk with a Gennev Menopause Coach.

Decisions you need to make regarding your cervix

Depending on your age, you may want to consider the HPV vaccine. Now approved for women up to age 47, the HPV vaccine may help protect you against some kinds of high-risk HPV. (It may be worth getting the jab for women older than age 47, says our Doc, but as it hasn’t been studied in older women, it hasn’t been approved and thus may not be covered by insurance.)

Pap tests. According to Dr. Dunsmoor-Su, the recommendation is that women of perimenopause and menopause age be tested for HPV during their pap test. To clarify: a pap test looks for abnormal cells that could indicate cervical cancer or that could become cervical cancer. The HPV test tests for the presence of HPV as these are not the same thing. If both tests come up negative, a woman is good for five years.

Why only every five years? Well, because of the age-related changes to the external cervix, and because older women generally have fewer partners, the chances of a woman contracting HPV and of it developing into something more serious within that five years are low. There is a particularly aggressive cancer that can invade the glandular cells, called cervical adenocarcinoma, but it’s fairly uncommon. Of course, if a woman of any age has persistent HPV or other changes in the cells, her doc might recommend she be tested more often.

Younger women are tested more often, says Dr. Dunsmoor-Su, because there are two distinct “waves” of cervical cancer: it is most common in younger women in their 20s and 30s, then again in older women in their 50s and 60s.

Younger women may develop cervical cancer more because they tend to have more sexual partners, but also because that transitional zone we spoke about earlier is larger and more exposed. Older women may have had asymptomatic HPV for years, only to have it develop into cancer later.

Pelvic exam vs pap test

We’d like to take a slight detour here to talk about the difference between a pelvic exam and a pap test. These are often done at the same visit, but they aren’t the same thing. The pap, which tests for abnormal cervical cells (and can include an HPV test), is done when the doc inserts a paddle and scrapes a few cervical cells for testing.

A pelvic exam is when the doc inserts their fingers, places a hand on the abdomen, and feels the uterus and ovaries. This should be done every year, says Dr. Dunsmoor-Su, as this is the best test we currently have for ovarian cancer. The doc is feeling for abnormalities, like an ovarian tumor or nodules, and for flexibility in the pelvis (the uterus should be able to move when the doc moves it). Regardless of age or HPV status, women in menopause should continue to get an annual pelvic exam, ideally with the same doc.

What if your doc discovers something concerning?

A pap test tells the doc what the individual cells scraped from the cervix look like, that’s its purpose. “We’re looking at the form of the cell.” If there’s something of concern, your doc will likely call you back in for a test called a colposcopy. This is a scope of the upper vagina. The test consists of the doc placing the speculum, painting the upper vagina with white vinegar (abnormal cells pick up the vinegar and turn white very quickly), and looking at the area with a high-powered microscope. It’s much like having a really long pap test. “If I see anything of concern at that point,” says Dr. Dunsmoor-Su, “that’s when I’ll take a biopsy.” (Pro tip: If you have to have a biopsy, ask your doc to give you a countdown, then cough when it happens. You may well not feel anything, says our doc, though you should let your doc know what you’re planning.)

The biopsy looks at the cells in situ (in its original context), to determine what proportion of cells are abnormal, how deep the abnormality goes, and how much change there’s been to the tissue structure. The results are graded as 1 as 3. If a woman’s cells rate a “1,” it’s a “come back next year; let’s keep an eye on it” situation. Two and three are more concerning, as it can mean the abnormality has gone deeper into the cervix.

LEEP and cone biopsies. In the LEEP procedure (Loop Electrosurgical Excision Procedure) “” hang on, this is going to sound worse than it is “” the cervix is numbed, and the doc takes a wire loop, turns on some electricity, and basically removes the transition zone of the cervix. This can function as a larger biopsy, taking the whole “concerning” part of the cervix out. A pathologist can then look to see if there’s been further invasion, or if this was pre-cancerous vs cancer. A cone biopsy is done with a scalpel and takes a deeper sample. Both of these biopsies can also be effective treatments. As long as the lesion or concerning cells don’t extend beyond the area removed, these biopsies can actually be curative, taking all the cells and HPV along with them.

If these procedures don’t address the issues completely, or if the abnormalities recur, a woman may be offered a hysterectomy. “We don’t need to take the ovaries,” says Dr. Dunsmoor-Su. “Those have a separate blood supply, so we leave them because they may still be hormonally active. Even in menopause, they can still be producing testosterone, and many women just feel better if they’re left in. If there’s no medical reason to remove them, we generally don’t.”

So, your takeaways:

1. Always wear a condom, even after menopause. Condoms aren’t 100 percent effective against HPV because other body parts also carry HPV and aren’t covered by the condom, but they’re still pretty darn good and definitely better than nothing.
2. Get the HPV vaccine, unless your doctor advises against it.
3. Get annual pelvic exams and pap tests on the schedule your doc recommends.

Women in perimenopause and menopause are not immune to HPV disease and cervical cancer, even if they’re not currently sexually active. While women’s bodies generally pass HPV out and “clear” it, they may not always be able to, and HPV that’s hung out for years doing nothing harmful can suddenly turn harmful.

Knowing your body, knowing how to keep it healthy and what to do when problems arise are powerful ways of taking control of your health. Stay tuned for more information on the female body, in all its complicated, sometimes challenging, glory.

What about your body would you like to understand better? If this is helpful to you, or you’d like to suggest what part we discuss next, we’d love to hear from you. Drop your suggestions and any other thoughts into our community forum.

You wake up with a sore throat, and immediately your mind starts to rumble and twist: a post-nasal drip from allergies? Or COVID 19?

You’ve heard you really shouldn’t physically visit your doctor or clinic until symptoms demand it. But when is it time? And what should you do now?

A Gennev Doctor Is Always There For Women

First, don’t panic. Yes, this is a scary time, but late-spring colds and allergies are not new and they’re certainly not uncommon.

Our clinic for menopause, we’re opening up our telemedicine services to help women get medical attention for gynecological or primary care issues without taking the risk of going to their doctor’s office or clinic.

We talked to two of our telemed docs, Dr. Lisa Savage and Dr. Kristen Innes, about the services they offer, both during “normal” times, and now, during the COVID 19 crisis.

1. In “normal” times, what services do you provide via Gennev’s telemedicine services?

According to Dr. Innes, the Gennev doctors, who are all OB/GYNs, generally provide counseling on menopause and perimenopausal issues such as hot flashes, sleep pattern changes, mood and weight concerns, and so on.

2. What if I have a problem, like I’m concerned I might have an infection? How do you handle that?

Says Dr. Savage, “If you are concerned about an infection, I can discuss your symptoms and offer advice about whether an exam is needed; usually it is. While we sometimes advise or prescribe without an exam for an infection, the best management for infection includes exam and sometimes culture/tests to establish a diagnosis.” Dr. Innes agrees, adding: “It depends on symptoms; some vaginal infections are easier to treat based on common symptoms. Recurrent infections, lesions and other persistent issues need to be addressed in person with a gynecologist.”

If the problem is severe and urgent, of course, see a medical professional in person immediately. But if you’re just not sure the right next step, a consultation with a Gennev doctor is a good place to start. 

3. What prescriptions can you help me with online?

Obviously, new conditions may well require an in-person visit, but, recurring prescriptions and conditions that don’t require a visit are perfect for telemedicine. Says Dr. Savage, “With telemedicine, I can prescribe menopause hormone replacement therapy and [other, non-hormonal] meds for menopause management, contraceptives, antibiotics/antifungals (rarely) and some other medications. Usually I limit prescriptions for non-gynecologic conditions to short-term refills of stable meds for chronic conditions in the event that a gyn patient is between primary care doctors or otherwise has a reason the prescriber is not available. I always want to be mindful of not fragmenting a patient’s care or stepping away my area of expertise.”

4. How does telemedicine work, if I need a prescription?

It’s actually pretty simple, says Dr. Innes. “When you have your visit, make sure to have your pharmacy information available. If a prescription is needed, we can call the medication in for you to the pharmacy.” We’ll also bill your insurance, as applicable.

5. Tell me how you help women with menopause symptoms?

In “normal” times, Gennev focuses mostly on menopause and the symptoms that can come with it. What does that look like? It’s all about listening to the woman, understanding her current situation and medical history, and tailoring treatment to her body and her needs. That can include medications, lifestyle modifications, naturopathic or alternative therapies, or the perfect blend of all the above.

Says Dr. Savage, “Helping women with menopause symptoms includes assessing whether symptoms  are due to menopause/perimenopause, evaluating symptom severity, educating patients on what to expect and offering solutions, which may include medications in addition to holistic/lifestyle ways to manage any troublesome symptoms or changes.”

Dr. Innes agrees, adding, “There are some supplements that may be helpful in a percentage of women who take them. There are also non-hormonal and hormonal medications that may be helpful for some symptoms. There are many ways to individualize care depending on patients’ wishes as well as medical and family history.”

6. How do you work in cooperation with health coaches?

Hand-in-hand, both of our doctors attest. Women get the most from Gennev when they access all our services, because doctors and coaches can help inform one another’s treatment of a patient, says Dr. Innes, via Gennev’s HealthFix program.

Dr. Savage: “Health coaches can be especially good and have the time available to review lifestyle/holistic management ideas, not only for menopause but for overall health in general. I always read the health coach’s notes if a patient I see has consulted one. I also remind patients about those recommendations and validate them during telemedicine appointments. Health coaches and physicians can learn from each other as well as both contribute to a patient’s overall experience.”

7. Do you have the same privacy standards as an in-person doctor?

“Absolutely,” says Dr. Innes. Because Gennev is so concerned about privacy and security, we often exceed the required security measures.

“I conduct telemedicine appointments in my home study with the door closed, and document the appointment via technology that has all the safeguards one would expect for online medical services,” says Dr. Savage. Patients can be confident their privacy is being scrupulously protected.

8. What happens during a “typical” telemedicine appointment with Gennev?

By now, you might be curious what it’s like to have a telemedicine appointment. We asked our doctors to detail how typical (if anything about menopause can be called “typical”) appointments go.

“During a typical telemedicine appointment, the patient and I “˜connect’ via video chat, or sometimes on the telephone,” says Dr. Savage. “Before each appointment, I have reviewed the intake history a couple of times and read any prior notes, so I’m prepared and can make the most of our time. Preparing ahead of time also gets my diagnostic and therapeutic wheels turning, so I usually already have an idea how to help the patient before we meet. It’s very helpful if patients can be specific when filling out the intake form about what they are concerned about or hoping to achieve.

“When we start the video chat, I conduct the appointment the same way I would in my office. I clarify the history, solicit any additional information needed, listen to the patient describe what she is concerned about, then enter into a conversation about what can be offered to help. Just as in the office, I solicit any questions before concluding. Any prescriptions are then called in to the patient’s pharmacy.

“Our telemedicine visits are documented with notes about what we did and what follow-up is recommended. The patient receives an email with a summary.

“One thing I would add is that for my personal practice style, it is very helpful to have a 30-minute visit for a new patient. Even that goes by fast! I really enjoy a deeper dive and having more time to explain things and answer questions. Fifteen minutes is great for a follow-up. This is not to say that I can’t conduct a new patient visit with the 15-minute option, but having more time with a new patient is very helpful. One complaint that we doctors deserve is that we are “˜rushed’ in the office; being able to have dedicated time and undivided attention is very satisfying.”

9. Gennev has “expanded” its services in the time of COVID 19. What does that mean?

It really pretty simple. The coronavirus is hugely taxing on our medical system, and particularly for women who are medically vulnerable or could spread the illness to vulnerable parents or others, going to the doctor is not a great idea unless the need is urgent.

Says Dr. Innes, “We are seeing more patients for concerns outside of menopause as it may be more difficult for patients to obtain in-person care.” 

Many of Gennev’s doctors are offering primary care assistance; for others, expanded services includes a wider range of gynecological care. Dr. Savage: “‘Expanded’ for me means being able to address gynecology concerns other than menopause, include contraceptive advice/management, menstrual problems, breast issues, etc. This includes helping patients determine when/whether an in-person exam is necessary for complete evaluation.”

10: Why did Gennev think it was necessary to expand services now? Are the doctors qualified to do more?

Absolutely the doctors are qualified. As Dr. Innes says, “Many of us also provide some primary care in our regular practices, so we will provide some basic primary care as well.” 

As to the question “Why expand?” it’s the same reason that underlies every decision at Gennev: to protect women’s health and safety. “Many patients may not have access to in person visits with their physicians due to the COVID 19 pandemic, or they may be uncomfortable leaving their home,” says Dr. Innes. “Telemedicine provides access to a physician in the comfort of a patient’s  home. Expanding our services makes it easier for more patients to receive care regarding their concerns or problems.”

11. Can you help me determine if I have COVID 19?

This question is likely on nearly everyone’s mind. Tests can be hard to come by, and when you have hot flashes, it can be tricky to distinguish them from a fever.

According to Dr. Savage, “Any physician can help determine if your symptoms are consistent with Covid-19.” However, she adds, “To confirm a diagnosis, testing is needed.” If you’re concerned, a call with your doc or ours might be a good next step, but only a test can diagnose you for sure.

12. How will I know when I should go to the doctor and when I should wait?

This is going to be a bit of a judgement call, say our doctors. But if you’re concerned and not feeling confident about your ability to gauge how severe your symptoms are, a telemedicine consult could perhaps put your mind at ease. However, if you are having any difficulty breathing, don’t wait. Seek professional medical help immediately.

Dr. Savage: “At this point in time, I would avoid the doctor’s office unless it’s something that absolutely needs an exam and is acute/urgent. Your annual exam can wait; a raging vaginal infection, extremely heavy bleeding, etc. cannot. Telemedicine can be especially helpful in cases of uncertainty. If you’re not sure about going in vs. waiting, consider a phone call with your local doctor’s office or a telemedicine consult.”

Finally, both say, stay home if you can. Limit your exposure to other people. Eat well, prioritize sleep, manage stress as best you can, and wash your hands.

Arrange a consult with a Gennev physician or health coach if you need help managing menopause symptoms ““ those don’t stop just because there’s a pandemic, and getting symptoms under control can alleviate stress, which can impact your immune system.

if you’re concerned about your health, or need non-urgent medical help, Gennev is here to help.

Just need some community support? Check our our Gennev forums. It’s a great place to ask and answer questions and connect with others who understand exactly what you’re going through!

At Gennev, we’re announcing an expansion of our popular HealthFix subscription service. In this time of the COVID-19 virus, our online services are even more in demand, so we’re making it even easier for women in menopause to access the answers and services they need.

We talked with Gennev co-founder and CEO Jill Angelo about what this new HealthFix program includes and why it’s needed.

What is HealthFix?

Gennev HealthFix is a monthly membership that offers on-demand access to OB/GYNs and Health Coaches for personalized menopause care with nutrition, exercise, sleep, stress management and prescription support.

Why is HealthFix such a great resource for women in menopause?

Gennev has learned that menopause management goes beyond providing prescription support, because not every woman can or wishes to take hormone therapy. To fill the gap, Gennev built the HealthFix membership to offer women both behavioral and medical solutions to menopause symptoms through a team of health coaches, registered dietitians, physiologists, and OB/GYNs.

Gennev’s continued innovation advances the possibilities of telemedicine to give women the physical and mental health support they need online through the entire life cycle of menopause. In addition, because Gennev’s platform is online, at this critical time with COVID-19, Gennev is focused on helping women stay out of waiting rooms to keep space open for critical patients and to follow social distancing protocols.

You’ve recently created a second subscription option as how does it differ from the first?

We originally launched HealthFix to provide only behavioral support for improving nutrition, exercise, sleep, and stress management as they relate to menopause symptoms. Patients worked with Health Coaches who are also Registered Dietitians to create a personalized menopause plan for their care.

More than once we heard from women that they wanted medical care as well. They wanted their Health Coach to be talking directly with their doctor rather than them having to be the go-between. In response, we created a second HealthFix membership which we call HealthFix Premium to include unlimited access to Gennev OB/GYNs, Health Coaches, as well as complimentary Gennev products.

This Premium option includes medical care, including access to MDs who can make diagnoses, prescribe medications, and then connect with the patient’s Health Coach to help keep that patient accountable to nutrition, exercise, sleep, and stress management behaviors for managing their menopause symptoms.

And in a time where social distancing is becoming so important, we see HealthFix as remote care option for women in menopause to get the help they need from the comfort and safety of their homes. This leaves clinics and ERs available for critically ill patients.

How can I decide which HealthFix plan is right for me? Is there an ideal candidate for each?

It really depends on what a patient needs. If a patient wants to try managing their menopause symptoms purely based on nutrition, exercise, sleep and stress lifestyle behaviors, then working with a Gennev Health Coach and accessing Gennev dietary supplements, lubricants, and hygiene products might be the best option for them. These services and products are all available for $25 per month in the HealthFix Basic membership.

If a woman prefers to also have a doctor as part of her menopause care team, then HealthFix Premium at $75 per month is the plan for her. Note that this pricing is less than a telemedicine appointment on Gennev.com, so it’s a great value, not to mention it offers unlimited video and chat access to Health Coaches, quarterly complimentary Gennev products (value of $50), and 10% discount on all Gennev product purchases plus free shipping.

If a woman starts with HealthFix Basic, and she and her coach determine that she should see a doctor, she can upgrade to HealthFix Premium at any time.

We’re working to price healthcare for the everyday woman, rather than having personalized, remote care available only for wealthy people.

How closely do your docs and coaches work together?

HealthFix Premium was created from feedback from women asking for a “team approach” to their menopause care. They wanted doctors and coaches to work hand in hand and remove them as the middle-person always responsible for relaying messages.

With that as our grounding feature of the Premium membership, our doctors and coaches work very closely together, while still respecting the doctor/patient privacy that is expected with quality health care.

Can I use HealthFix if I’m pre- or post-menopausal? What do you have to offer me?

What’s awesome about HealthFix is that it’s personalized to every member. When a woman signs up, her initial conversation is with a Health Coach who creates her personalized menopause plan. This plan aligns to the goals the patient wants to accomplish as whether that be better managing her mood swings, or minimizing fatigue, or helping her sustain nutrition habits that will minimize hot flashes, for example.

Whether a woman is in perimenopause or post-menopause, we all need a healthy way of living. HealthFix is designed to help women achieve that. And, during times like coronavirus, we also need to boost our immune systems, and HealthFix Coaches and Doctors are experts at helping women achieve a strong immune response.

Since you brought it up”¦. I’m worried about the coronavirus. How can HealthFix help me?

Coronavirus most often impacts people with respiratory problems or compromised immune systems. HealthFix and the healthy lifestyle behaviors your Health Coach will work with you to create improve your immune system, not to mention your menopause symptoms.

Plus, having access to quality health care specialized for women through HealthFix can help keep women out of clinics and ERs where more critically ill people may be. Social distancing is becoming the new normal, and HealthFix is making that possible for women everywhere who still need access to health professionals, but from the safety and convenience of their home.

According to Gennev’s Menopause Assessment, I’m a type 3 as does my coach know what that means and how to help me?

Your Gennev Menopause Assessment is secure and accessible only to you, until you release it to your Gennev Health Coach and/or doctor. So, yes, when you provide access to your Menopause Assessment to your health care team, they can help you manage the symptoms you’re experiencing and also help you understand how you will transition through menopause as from Type 2 to Type 3 and beyond .

What is the Personalized Menopause Plan? What does “personalized” mean?

A Personalized Menopause Plan is a care plan that you and your Health Coach design together. It’s created to fit a woman and her needs vs. the typical trial-and-error searching (and money wasting) that women often face when looking for menopause symptom relief.

The Health Coach has a template that she will work with you on to define your health goals (e.g. sleep better, minimize night sweats, improve energy, minimize mood swings). Once your goals are defined, she helps you identify and then modify habits in your nutrition, exercise, sleep patterns, and stress response with different behaviors. Our coaches’ number one goal is to create a sustainable plan for you. They are accountability partners who will check in on women to help them be successful in reaching their goals and feeling better. They can also help women understand what their doctor may be advising, and then be the go-to on a daily, weekly, or monthly basis for check-ins, questions, or simply a listening ear.

So, a Personalized Menopause Plan is personalized to a woman to include what she needs to feel better as both physically and emotionally. It may also include recommended supplements or over-the-counter products or even prescriptions if a woman is subscribed to HealthFix Premium.

Consider HealthFix and our Personalized Menopause Plan as remote concierge medicine that’s affordable to women at various levels. It’s been published that, on average, women spend $2116 per year on menopause care. Our goal at Gennev is affordable health care, and HealthFix and Personalized Menopause Plans are our answer to reaching millions of women, not just the few who can pay a lot of money.

If you’re a HealthFix subscriber, we’d love for you to share your experience. What has it been like working with a Health Coach? What have you been able to put into practice, and how has it helped your quality of life? Tell us in the Gennev Community forums!

So many women ask, Why isn’t there a pill for menopause?

The reason is because menopause is basically estrogen withdrawal. And because we have estrogen receptors all over our bodies, the lack of estrogen shows up as a whole lot of different symptoms.

And even a single symptom, like poor sleep, may have a bunch of different causes, including joint pain, hot flashes, anxiety, and stress.

Sure, one solution can make a difference, but when problems are as challenging and multi-faceted as sleep, energy, or even feminine dryness, Gennev’s Menopause Systems can do a whole lot more.

Based on a deep understanding of how menopause affects bodies, Gennev’s menopause systems are designed to tackle problems from multiple angles, and the products are formulated to work better when used together.

In addition to working better together, bundling saves you money! When you purchase a system, you save 10 percent off the price of purchasing each item individually.

Gennev AM/PM Daily Menopause Pack

Are you craving the energy you used to have? Taken as part of your morning and bedtime routine, the AM/PM Daily Menopause Pack helps restore energy during the day and brings a peaceful sleep at night.

In the morning, take the Gennev Vitality multi-vitamin between breakfast and lunch to fight afternoon fatigue, regulate mood, and provide whole-body nutrition that can help bones, hair, and nails. Women rave about this new multi-vitamin formulated for women 40+. As one satisfied Gennev Vitality customer said: “I am not a vitamin person…never have been…. Vitality has been amazing. I have been taking them for over a month and I’ve never had an upset stomach – even if I don’t eat much in the morning first. I also don’t like to drink a lot of caffeine but I do feel tired in the afternoon but after taking Vitality I don’t get that afternoon energy slump.”

At night, add the Sleep CBD + Melatonin softgels and Magnesium Glycinate to your bedtime routine to help you get more rest at night. You’ll wake up feeling refreshed and free of morning anxiety. Our bodies naturally make melatonin, but as we age, we make less. Gennev Sleep CBD + Melatonin supplies just the right amount to help you fall asleep fast and stay asleep peacefully. With the natural stress- and pain-relief many get from CBD, the softgels are a powerful sleep aid that do not create dependency or the “boomerang” effect of worsening sleep you can get from OTC sleep aids.   

Each of these products and can be purchased separately, but if taken together, you get the benefits of them working in harmony to help you feel your best. The AM/PM Daily Menopause Pack is priced at $89.95 for a 30-day supply (which equals a 10 percent savings on all products when purchased as a system).

Gennev Sleep System

So. Many. Women are affected by interrupted sleep in perimenopause and menopause. And lack of sleep can make a very challenging time even harder to manage. So the Gennev Sleep System takes on all the reasons women aren’t getting good rest.

Sleep CBD Tincture absorbs quickly through the tongue so you fall asleep faster. Our Tincture is THC-free and can be used safely with kids, pets, and older adults without fear of getting “high.” The organic peppermint essential oil gives it a nice, refreshing flavor.

Magnesium for sleep is another natural aid, but up to 80 percent of us don’t get enough of this powerful nutrient. It can also relieve joint pain and menstrual cramps and relieve the morning anxiety many women experiences.

The Gennev Sleep Challenge addresses many of the other reasons women have trouble sleeping: food and drink choices, hydration, stress, movement, and more. Daily, users receive a text tip to their phone, helping them practice good sleep hygiene for natural sleep improvement.

Purchased together as the Gennev Sleep System, you get the compounding effects of these products working together. And, priced at $56.96 for a 30-day supply, you get a sweet 10 percent discount compared to purchasing the products individually.

Gennev Menopause Dryness Care

Are you craving better sex? Feminine dryness can really ruin the moment. Formulated by OB/GYNs and naturopathic doctors, the Gennev Menopause Dryness Care system soothes vaginal dryness. Gennev’s Ultra-Gentle Body Wash gently cleanses and balances the pH of a woman’s intimate area. Gennev’s Intimate Moisture feels and functions like a woman’s own moisture to relieve feminine dryness instantly, enhance intimacy, and help with painful sex. And the aloe-infused Cleansing Cloths are a fabulous way to freshen up afterwards or on-the-go.

These products used together work more effectively to ensure you feel like your old self down there, and we’ve priced the Gennev Menopause Dryness Care system at $34.95 for a 30-60 day supply, so you get a better value as well!

Why “systems”?

The Gennev systems were created for a number of reasons:

1. Simplicity = consistency. For most menopause solutions, it takes time for your body to adjust and really feel the benefits. If you’re not consistent using the product, that time can be even longer and the benefits more gradual. We want you to feel the goodness as soon as possible, so making sure you have a good supply of everything you need makes that a whole lot simpler. (Hint: a monthly subscription that lets you set it and forget it is even better for helping you stay consistent, not to mention the additional discount.)
2. Evidence-based research. Our systems were created using treatments that truly complement one another, like combining magnesium glycinate and CBD for better sleep. It’s the definition of synergy: combined, the effects of each solution are even greater. We have a whole team of medical professionals weighing in on the best combination of products for symptoms, so you don’t have to do the research!
3. Price/footprint. When we can send products packaged in one shipment, you save money, we save money, and we use less packaging, which helps save the planet’s resources.

As women buy products, we learn what you need, and as women provide feedback on the systems, we’ll continue revising and improving our offerings. Please pass along feedback to info@gennev.com.

So, about that “magic pill” for menopause “¦

For many women, HRT can do a lot to alleviate menopause issues, so explore it as an option if you’re a good candidate. If HRT isn’t right for you, your “magic pill” for menopause might be more of a “magic packet.” But that’s OK. Our systems can help you put a lot of things right and manage your menopause in a new and healthy way.

Join us on the Today Show with Maria Shriver!

Gennev, women’s menopause clinic, is going to be on the Today Show!

On December 10, Gennev co-founder and CEO Jill Angelo is going to take a seat next to Maria Shriver and talk about hot flashes and wonky periods and why every woman deserves a healthy menopause journey.

Menopause isn’t a new topic for Today. They’ve recently talked about “What every woman should know“

and had our favorite neuroscientist, Dr. Lisa Mosconi, on the show to talk about the link between menopause and Alzheimer’s disease.

What’s Jill going to talk about on Today? 

You. You are the modern menopausal woman, and no generation before has been like you.

In our surveys, in our online communities, and in discussions, you’ve told us some important messages that Jill will be passing on:

You want access. You want accessible, affordable care from qualified medical professionals who understand menopause, the complete range of treatments available, and how women can stay healthy well beyond the menopause transition.

You want information. Jill will talk about the thousands of you who have taken our Menopause Assessment because women today want to know where they are on the journey, how to manage the symptoms they’re experiencing, and what may lie ahead.

You want to make menopause normal. It is normal and natural, but try and start a conversation about menopause around the water cooler, right? Research, solutions, understanding as to have these, we have to be talking about menopause openly and frankly.

Ninety-four percent of you in our survey asked for help to make menopause normal, and what better way to do that than talk about our experiences on the Today Show?

We hope you’ll join Jill on the Today Show December 10. Let’s get this conversation going, because modern women have #NoTimeToPause.

Chief Medical Officer, OB/GYN Dr. Rebecca Dunsmoor-Su

explains how Gennev is helping women take control of their health in menopause

Want to know more about menopause? Sign up for our email newsletter to get expert advice, specials, and more!

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!

• 1 million women consumed Gennev podcasts, webinars and articles to learn about symptoms, be supported, and get inspired.
• 100,000 of you completed the Menopause Assessment to learn about your place in the journey.
• 80,000 women joined our community to get informed, work with our menopause team of doctors and dietitians, and use products like Vitality, Magnesium and Sleep CBD to find relief for hot flashes, fatigue, sleeplessness, joint pain, and dryness.

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…

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.

Team Gennev is lucky. We get to hear from you.

You call us to place an order. You email us your thoughts on our products. Sometimes we have the very real pleasure of talking to you in person.

You share your problems and your pain, what gives you joy and your reasons for hope. You ask us questions, and you give us answers. And every time we talk with you, we learn something new.

Join Our Menopause Group

Sometimes you share your story with the rest of the Gennev community, like when Michelle went through menopause and almost missed it, or when Anne rediscovered herself after her hysterectomy. But you have so much more to share.

So we’ve created a Facebook group, Midlife and Menopause Solutions, as a place for you to meet each other, talk, share ideas, ask for and receive the support you need.

Because we want women to feel comfortable discussing intimate topics, it is closed group, meaning only those who are approved to join can post or see others’ posts.

There are some community guidelines we ask everyone to follow so conversations stay relevant, thoughtful, and polite. You’ll find those under “description” to the right of the page.

Come in, kick off your shoes, and curl up on the couch with us. We can’t wait to hear what you have to say!

Going out for a walk is one of the easiest steps you can take to manage menopause symptoms and feel better””physically, mentally, and emotionally””right now!

When scientists at the University of Alberta looked at what happens when women start walking, they found overwhelmingly positive results. Nearly all of the 77 different walking programs that they studied showed that women felt better and were healthier after walking. Ninety one percent of the programs resulted in improvements in at least one menopause symptom or issue, such as mood, cardiovascular disease risk factors, body weight, self-esteem, and quality of life.

Nearly 7,500 midlife women participated and benefitted. Now it’s your turn to walk away from the trials of menopause and walk into the next stage of life feeling strong, vibrant, and confident.

Here are 50 more reasons to join Gennev’s Get Moving Walking Program for Women and start walking today!

1. Boost your mood. In as little as 10 minutes, walking can lift you up when you’re feeling down.
2. Short-circuit stress. Stress can negatively impact nearly every system in your body from headaches to stomach upset, and it can amp up menopause symptoms. Taking a walk dissipates stress and prevents its negative side effects.
3. Improve sleep. Getting your steps in during the day can affect how well you sleep at night. In one study, midlife women reported sleeping better and longer on days they walked more than on days they did less.
4. Tame anxiety. Within five minutes of starting to walk, your body’s anti-anxiety effects start to kick in to ease worries.
5. Minimize joint pain. Walking increases synovial fluid in joints like your knees and hips which lubricates them and brings more oxygen and nutrients to the cartilage. Exercise also activates genes associated with rebuilding cartilage.
6. Love how you look. After walking three times a week for four months, women ages 45 to 65 were happier with their appearance even if they didn’t lose any weight.
7. Cut your risk of breast cancer. A review of research found that exercise like walking could lower your risk by 20 to 30 percent.
8. Fight belly fat. Fat around your middle is associated with more health problems. But exercise seems particularly adept a targeting deep, dangerous belly fat. Women, whose exercise levels decrease during menopause, tend to have the greatest gains in their waistlines.
9. Avoid a heart attack. Logging 25 minutes a day reduced the risk of dying from a heart attack or heart disease by 35 percent, according to an eight-year Harvard University study of more than 70,000 women ages 40 to 65.
10. Beat fatigue. For a healthier pick-me-up, take a quick jaunt around a block or two instead of reaching for a caffeine- or sugar-boost.
11. Form stronger relationships. Whether it’s with a family member, friend, acquaintance, or coworker, walking together can help you get to know each other better. There’s something about taking a walk that just gets the conversation flowing.
12. Reduce your risk of diabetes. A 15-minute walk after meals improves your body’s ability to regulate blood sugar, which can help stave off the development of diabetes.
13. Burn calories. The faster you walk the more calories you’ll burn, which can help you to maintain a healthy weight.
14. Strengthen bones. Walking is a weight-bearing activity unlike swimming or cycling in which your body weight is supported. Weight-bearing activities stimulate your bones to help keep them strong.
15. Raise cardio fitness. Aerobic exercise like walking conditions your heart and lungs so you’ll have more stamina for activities like climbing stairs and chasing after kids.
16. Fight depression. Walking for 30 minutes three times a week was found to be as effective as antidepressants in one study. (But don’t stop taking any prescribed medications without checking with your doctor.)
17. Short circuit cravings. A 15-minute walk can curb a sweet-tooth and chocolate cravings.
18. Moderate bad genes. A daily brisk walk may inhibit a genetic tendency to be obese. Research on how behaviors like diet and exercise impact genes is just beginning, but it appears that exercise may help you beat a family history of a host of health problems.
19. May ease hot flashes. In one study that followed 438 women in midlife for eight years, those who exercised daily were 49 percent less likely to report having hot flashes than those who exercised less. Women whose exercise frequency decreased during the study, experienced more hot flashes. Research isn’t conclusive, and for some it may trigger hot flashes 
20. Less risk of injury, than higher impact activities like running. The risk is one to five percent for walkers versus 20 to 70 percent for runners.
21. Stay sharp. As you get older, your brain starts to shrink, which may contribute to memory problems. But research shows that logging five to six miles of walking a week can counter the decline.
22. Connect with others. It could be your walking partner or people you see along your route. Maybe you stop to chat with a neighbor. Even a simple “hello” as you pass other walkers counts as a social connection. The more social connections people have the healthier and happier they tend to be, according to research.
23. Protect your heart. Just 21 minutes of walking a day reduces your risk of heart disease by 30 percent.
24. Save money. The more you replace driving with walking the less you’ll spend on gas, and maybe even car repairs.
25. Clear your head. Whether you’re ruminating over a difficult work assignment, a relationship issue, or a bigger problem in your life or the world, stepping outside for a relaxing walk can be a welcome break
26. Ease digestive woes. It can help with bloating and gas.
27. Solve problems more easily. Walking helped people come up with twice as many creative solutions to problems compared to just sitting and stewing, according to a Stanford University study. The effect lasted even after they sat down.
28. Decrease risk for colon cancer, by up to 50 percent. Not only has exercise been shown to protect against this type of cancer, it can also reduce many risk factors for colon cancer such as excess weight, insulin resistance, impaired immune function, and high triglycerides.
29. Feel more satisfied. Three hours of walking a week helped midlife women feel more satisfied with their lives.
30. Slow the effects of osteoarthritis. The joint pain and stiffness from arthritis can impair your functioning. But just 10 minutes of walking a day can prevent disability and keep you active.
31. Rev up your immunity. Workers who walked 20 minutes, five days a week took 43 percent fewer sick days than those who walked once a week or less, during a 12-week study. If the walkers did get sick, their symptoms were milder, and they were back to work sooner.
32. Enhance self-esteem. When you start walking, you start to feel better about yourself.
33. Prevent weight gain. Both aging and hormonal changes during menopause have been implicated in gaining weight and fat. But exercise has been shown to slow the weight creep and, along with dietary changes, may prevent it entirely.
34. Stay strong. A decline in strength has been associated with menopause, however being physically active has been found to be a strong predictor of increased strength during this transition.
35. Pump up your energy. Going for a walk enhances oxygen flow in your body and triggers hormones like epinephrine and norepinephrine that boost energy levels.
36. Relieve cramps. Walking improves circulation that can help relax constricted blood vessels in the uterus that result from cramping. And the feel-good endorphins it produces can block pain signals to offer relief.
37. Be a good role model. Got kids or grandkids? Walking with them can help them learn to enjoy exercise and build a lifelong healthy habit.
38. Remedy constipation. Walking helps to get things moving.
39. Lengthen your life. You may live three years longer ensuring you get 150 minutes of brisk walking in a week. And those years will likely be better quality ones than if you’re sedentary.
40. Boost good HDL cholesterol. In one study, walking an hour five times a week raised HDL levels nearly 10 percent after 24 weeks.
41. Gain a new perspective. You’ll notice more and appreciate the world around you more when you’re walking instead of driving. Even reversing the direction that you walk a typical route changes what you see.
42. Reduces back pain. A research review found walking to be an effective strategy for dealing with back pain.
43. Preserve muscle mass. Your muscles fuel your metabolism, meaning that you burn more calories throughout the day. Unfortunately, muscle mass tends to decrease as you age, and menopause speeds up the loss. While strength training is the best way to maintain muscle, all types of exercise, including walking, may help slow the loss.
44. Lower bad LDL cholesterol. Even leisurely walking has been shown to have a positive impact on this risk factor for heart disease.
45. Turn down anger. Instead of lashing out, take a walk to blow off steam and avoid saying something you might regret later.
46. Lower blood pressure. Research shows that walking improves blood pressure whether you have hypertension or not.
47. Decrease stroke risk. Hit the recommended 150 minutes of moderate-intensity activity like walking a week, and you could cut your chances of having a stroke by 24 percent. Double it (an hour, five days a week), and you’ll slash your risk by nearly half.
48. Protect the environment, if you walk instead of drive. Going 1½ miles on foot instead of in a car reduces the amount of greenhouse gases produce by about 75 percent. Cut out 10 miles of driving each week, and you’ll eliminate roughly 500 pounds of carbon dioxide a year.
49. Reduce your risk of falling. Walking improves lower body strength and balance, factors the will help to keep you more stable.
50. Mitigate a myriad of menopause symptoms. When researchers grouped symptoms into psychological ones (depression, irritability, anxiety), somatic ones (sweating, heart complaints, joint and muscle pain), and urogenital ones (sexual issues, urinary problems, vaginal dryness), they found that walking helped in all areas. In the study, women who started walking with other women for an hour, three times a week, reported fewer symptoms after four months than women who didn’t walk.

Join Us and Get Moving

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

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

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

“Are you using your butt?”

Menopause coincides with (or contributes to) an uptick in lower back pain and joint pains are common in menopause, and many women find their knees are causing quite a bit of trouble at this time.

At Gennev, we’ve heard from a lot of women that knee pain makes it tough to be motivated to exercise. Since exercise is really important for helping of , heart disease, and dementia; since it helps us control weight as well as endorphins and alleviate menopause depression; since it helps us sleep “¦ well, not being able to move just isn’t an option.

So we turned to our two awesome DPTs, Dr. Brianna Droessler-Aschliman of Four Pines Physical Therapy and Dr. Meagan Peeters-Gebler of Orthopedic & Spine Therapy, for some help.

If you are dealing with knee pain, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

Knee Pain In Women Caused By Their Butts?

If you’re experiencing knee pain and you go to a physical therapist, “Are you using your butt” is one of the first questions you’re likely to hear, says Brianna. “If the pain is not from an obvious injury like a sprain or twist or tear, I start with the glutes.”

Why questions about the butt when it’s the knee that hurts? Well, knee pain is often caused not by a problem with the knee itself, but by tight, weak hips and weak glutes.

“The glutes are both stabilizer and powerhouse,” says Bri. “There are three muscles working together back there: your gluteus maximus, which is the big muscle of your butt cheek that provides a lot of power, and the gluteus medius and minimus, which are stabilizers that run along the sides of your hips. When people come to me with knee pain, I test these first, and often I find that weak glutes are the culprit.”

If you want to test your glutes, lie on your back and raise one leg. Ask a friend to push down against your leg and see if they can force it down. If there’s little resistance from you, chances are you’ve got some weak glutes. (Hint: it’s really best if your “friend” is a qualified PT or coach).

So what’s really going on here?

We spend a lot of the day on our butts, which can cause the hips and the smaller glute muscles (med and min) to tighten. Combine that with weak glutes generally, and you end up relying on the powerful quad muscles in the front of the thigh and the big hamstring in the back to do the power work the glutes should be doing.

The quads and hammies mostly do pretty well, which is why so many of us default to them. The problem is your body mechanics aren’t set up for the quads and hammies to take this much of the load. Your quads insert into your knee in a way that applies extra pressure when that big muscle contracts, compressing the patella into the knee. Glutes do the same job without that compressive kneecap force, Meagan says, so they don’t constantly inflame the knee and cause pain.

Fire up yer glutes!

Strengthening, stretching, and activating your glutes and hips may go a long way toward alleviating your knee pain. Clam shells, side hip raises, side walking, tightening and squeezing your butt while sitting at your desk or standing at the sink to do dishes as these can help you start to strengthen those muscles. Walk up and down stairs, but put your whole foot on the step and push up with your heel rather than your toe.

You can also do a “toes-up bridge” where you lie on your back, knees bent, toes pointed upward. Bring your hips up to form a straight line from shoulders to knees, while squeezing your glutes. Hold at the top for a count of 10, then come back down. Ten reps at a time a few times a week, and you can start to feel the glutes getting stronger.

Oddly, getting those big, powerful muscles to activate is harder than it seems, so for awhile you may have to consciously engage your butt. “Self-talk,” Bri advises. “You have to be intentional about it at first, think about those muscles firing as you walk or run or do a squat. You’ll tire faster than you expect, but that’s OK; you’ll get stronger and eventually you won’t need to concentrate as much.”

Check your posture in midlife as you walk, Meagan says. If you have your butt tucked under, your glutes can’t work as well. Think about leaning slightly forward so your “headlights” enter the room before your pubic bone does, as this forces the glutes to engage to move you forward.

And at the end of the day or after your workout, stretch and roll those big muscles with a foam roller to relieve the tension and relax tightness. Stretch out your quads by bringing your knee gently up to your butt, knee pointed down. Even if you didn’t get to exercise that day, just sitting is hard on your body, so give yourself a little love.

Solving from below: ankle, feet, and knees

Your glutes may not be (entirely) to blame for knee pain in women. As Meagan says, when the middle joint is hurting, it’s probably menopausal arthritis and the problems often start in the joints above as well as below. Tight hips is one issue, but tight ankles and weak feet can also cause problems and pain in the knees.

Protect your knees by keeping your calves stretched out so your ankles stay flexible and have a good range of motion. Be sure the shoes you’re wearing have a decent cushion and good support. If you’re a runner or walker, have shoes fitted at a running store and replace often. Bri suggests over-the-counter orthotics or even prescription orthotics if a doc recommends them. 

How to deal with the pain now

So, you’re pretty sure the pain you’re feeling isn’t due to an injury or accident (you got a doc or PT to figure that out, right? And no, Dr. Internet isn’t good enough). How do you control the pain as you’re working to strengthen your glutes, hips, feet, and ankles?

Consider wearing a compression sleeve made for knee pain. Not only does it take some of the pressure off the knee, it also helps your brain be more aware of what your knee is doing as you move. (Note: do NOT use compression if you have circulation or blood clot issues or a skin sensitivity to the material.)

If you’ve ever seen a pack of distance runners, you may notice one or two have colored tape on their legs. That’s elastic therapeutic tape or kinesiology tape, and it could be well worth exploring. The tape works by lifting the skin off the fascial layer and connective tissue beneath so the body can flush out built-up toxins via the lymphatic system. It also allows in more oxygen and better blood flow for faster healing. With the tape “making room,” the layers of tissue and muscle glide over each other with less friction, and the brain sensory input reteaches your brain the proper movement pattern. The only concern is if you’re sensitive to the glue.

And the advice you knew was coming: “Relative rest,” says Meagan. “That doesn’t mean total inactivity, it just means you choose actions that don’t inflame the knee. If going down stairs hurts, take them one step at a time,” for example. Give the inflammation in the knee time to subside, and stop triggering more pain. “Ride a bike,” says Bri. “Maybe you can’t run a mile right now, but maybe you can bike for five. Just make sure what you’re doing isn’t making it worse.”

But as ever, be aware of limitations, and if something hurts, stop. “Knee pain isn’t something that gets better by pushing through it,” says Meagan. Catching and diagnosing the pain early gives you a great opportunity to fix less-than-ideal body mechanics. Pushing through it is a great way to make a small problem into a much bigger one.

How are your knees holding up? If you’re managing knee pain, we’d love to know how you’re doing it. Give us a shout via comment here, find us on Facebook or in Midlife & Menopause Solutions, our Facebook group. You can also join us, anonymously, if you prefer, on our community forums.