I can make you believe there’s nothing wrong with me by the way I look and act, but in reality, there’s a raging battle inside my body that I’m constantly fighting. – Richelle

Menopause can be challenging all by itself. Pair it with a chronic condition like multiple sclerosis (MS), and the challenges can seem overwhelming.

Part of the problem is that so few studies have been done on how menopause affects women with MS, so women dont know what to expect. And because many of the symptoms of menopause are so similar to those of MS, it can be difficult to know exactly whats happening.

Women like Richelle already deal with so much uncertainty about their bodies. The menopause clinic team at Gennev wants to help women with MS be better prepared to understand and manage their menopause.

Richelles story of MS and menopause

Diagnosed with MS in 2009, Richelle believes she’s now in perimenopause, but like many women, she’s finding it hard to identify where she is in the journey. “I believe I’m in perimenopause. I don’t know for sure,” Richelle says. “I have night sweats, hot flashes, and cramps occasionally but I have a Mirena IUD, so it’s hard to know. I have had sporadic spotting while using Mirena but no real periods.”

MS only complicates and adds to the confusion so many women feel as they enter perimenopause earlier than they thought, and with symptoms they didn’t know to expect.I had never been someone who sweats very much so suddenly having night sweats was strange to me. “I’ve mentioned to my doctors that I believe I am entering menopause. I asked if they could test my hormone levels but the VA doesn’t provide hormone tests,” she says. But she has noticed an intensifying of the brain fog and fatigue that MS already causes.

Like most of us, she finally self-diagnosed perimenopause, based on what information she could gather. I just realized how hot I would get but still believed it was too early for menopause.At the moment, Richelle hasn’t made lifestyle changes or added prescriptions to help combat menopause symptoms. But her MS does make perimenopause physically harder on her.

Her advice to other women in the same situation?

Rest.

Rest when your body tells you to. If you need to lay down in the middle of the day, give yourself permission; you’re not lazy. Buy a fan…or five.

The more information we can provide women all women the better well be able to make the choices that impact our health and quality of life. So, what do we know? Unsurprisingly, the answer is: not enough.

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Does menopause worsen MS symptoms?

So little research has been done that this is a difficult question to answer. However, MS is more common in women and MS symptoms tend to first appear in the mid-reproductive years. And because both the first period and postpartum period can trigger relapses, it seems likely theres a connection between womens reproductive hormones and MS.

One small study seemed to indicate some reduction in relapse rate but that disability progression didn’t change after menopause.

A small study on MS and menopause from 1992 showed slightly more than half the subjects reported a worsening of MS symptoms, about a third noticed no change, and a small percentage reported an improvement. Of those who noticed improvement, three-quarters had received HRT.

While this may show some promise for HRT in women with MS, the study of 30 women is too small to draw conclusions. Sadly, the alarms raised by the largely erroneous WHI study of HRT means even fewer women have been placed on HRT, and that means fewer women to study.

Other, larger studies have also reported mixed results: in some, women reported that hot flashes caused MS symptoms to flare up. Because those with MS are more sensitive to heat and the neurologic symptoms of MS worsen temporarily when the body is overheated (Uhthoffs phenomenon), controlling vasomotor symptoms such as hot flashes and night sweats may be more urgent for women with MS to retain quality of life. Women who have had surgical menopause in particular notice a worsening of multiple sclerosis symptoms, possibly because the fall off of hormones tends to be much more dramatic and sudden.

In a study published in 2016, researchers found the impact of menopause on MS was statistically significant (meaning there is a likely correlation) but that the effect of menopause on the progression of MS was modest (approximately 1 Expanded Disability Status Scale point over 10 years).

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How to manage menopause and multiple sclerosis

MS and menopause symptoms can overlap, making it difficult to distinguish typical menopause symptoms from a flare up of MS.

Symptoms they have in common include fatigue, bladder issues, depression, waning libido, vaginal dryness, brain fog, and mood swings. If you’re unsure whether what you’re experiencing is a perimenopause or MS, you should consult your doctor. Tracking your periods to note irregularity may help you determine whats happening in your body.

For the most part, according to a study on MS medications and menopause, MS doesn’t change the age of onset of menopause. Women taking the medications methylprednisolone and beta interferons (IFNs) may enter the transition earlier, though the studies aren’t yet large enough to determine correlation.

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HRT

Once you’ve determined you’re experiencing peri/menopausal symptoms, you can begin to take steps to manage those symptoms. Because HRT may have some protective effects when it comes to neurological issues, its worth having an in-depth discussion with your doctor, ob/gyn, and any other medical support on your team.

Additionally, HRT may help with reducing hot flashes and maintaining bone density, both of which are particular concerns for women with MS.

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Lifestyle changes

Managing menopause with MS is much the same as managing without, says the UK-based MS Trust:

– wear removable layers and keep a cold drink nearby for hot flashes.

– Keep your bedroom cool and have a cooling towel by your bed for night sweats.

– Exercise regularly, practice good sleep hygieneto get as much quality sleep as you can.

– Consider yoga and meditation for relaxation and reducing anxiety.

= Take the best possible care of your body and spirit as you can.

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In addition, many women find their symptoms are lessened when they reduce caffeine, alcohol, and sugar. Definitely quit smoking if you possibly can.

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MS taking over your life?

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

As a society, we dont’ really discuss menopause, so many if not most women are caught off guard by perimenopause symptoms. We often dont expect the hormonal fluctuations in our early or mid-40s, nor are we aware of the symptoms that can occur just about anywhere on our bodies and arent just limited to hot flashes and irritability.

Unexpected and unexplained symptoms are a concern for anyone, but it can be much more alarming for those who may experience similar symptoms for another reason such as an MS flare-up. So its even more important for women with MS to understand the symptoms of perimenopause, when they might occur, and how to manage them.

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Are you dealing with MS or another chronic illness? How has it impacted your menopausal transition? How do you manage both? Please share your story with the Gennev community via our Community Forum.

Our recent podcast on COVID 19 was so popular, we decided to do a deeper dive into the particular risks women face and how we can best protect ourselves and those we care about.

Webinar With Lauren Leedy, Stasi Kasianchuk & Dr. Swapna Vaidya and Jill Angelo

In this webinar/podcast, Gennev CEO Jill Angelo talks to Dr. Rebecca Dunsmoor-Su, Chief Medical Officer and director of the Gennev Telemedicine program, Lauren Leedy and Stasi Kasianchuk from the Gennev Dietitian team, and Dr. Swapna Vaidya, psychiatrist, on ways we can stay physically and emotionally healthy in this very unusual, very unpredictable time.

You can also view the webinar video on YouTube. A list of mentioned resources and the full transcript are below.

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Resources mentioned in the video:

1. Fitness:
2. Barre3
3. DownDog
4. Peloton
5. Class Pass
6. Meal Delivery:
7. Thistle
8. Splendid Spoon
9. Sun Basket
10. Grocery Delivery:
11. Amazon Fresh
12. Whole Foods
13. General information:
14. Centers for Disease Control
15. Harvard Health
16. Coronavirus tracker
17. Mental Health and Coping resource
18. Coronavirus Masterlist of resources for psychological health

Transcript:

Gennev CEO Jill Angelo:

All right. Well we’re three minutes past. I’m kind of prompt, we have a lot to cover today, so let’s go ahead and get started. First of all welcome to everybody. This is a special, a special edition of a webinar that we’ve really never done before around coronavirus and the relationship of it as women with menopause stress and the risks that we are experiencing during this kind of unprecedented time in history. I want to welcome you. We have a number of presenters today. We’re going to jump right into it here rather quickly. But just kind of to level set the, the basis and kind of the reason why we’re hosting this webinar today is very much around we as women are having to go through a lot of adjustment right now.

Our kids are home from school for those of you, those of you who have kids at home. Our businesses might be struggling. We’re working from home, we’re trying to balance childcare with, with work. And in some cases our immune systems could be compromised if we’re older or have other conditions that compromise that. And we just wanted to bring together our team of experts to really talk about how we might be compromised from a health perspective but also mental health and then finally what we can actually do to strengthen our immune systems and even some life hacks to try to manage through this part of history. So I’m Jill Angelo. I didn’t introduce myself, but I’m Jill Angelo. I’m the co founder and CEO of Gennev and with me today you can see the faces and we’re going to move live to everybody here in just a moment, but Swapna Vaidya is an MD and psychiatrist focused on behavioral health and women’s health in particular.

Swapna has been an incredible partner with us in working with women in midlife and so we’re really excited to have Swapna with us today. Dr. Rebecca Dunsmoor-Su is an MD. She’s an OB GYN. She’s certified by the North American Menopause Society. She’s also the chief medical officer at Gennev. And is my partner in crime. She’s runs the health practice of this company and it’s just really awesome, always, to have her taking the helm on, on this topic.

Stasi Kasianchuk is a registered dietitian nutritionist. She’s also a physiologist. She’s one of our health coaches at Gennev. In November last year we started a new offering called HealthFix. It’s a membership for women who want to manage more lifestyle approaches to menopause care and to even just strengthening their own immune system in the second half of life. And Stasi is one of our health coaches.

And then Lauren Leedy is our director of health coaching. She leads our health coaching team. She’s also a registered dietitian nutritionist and has just a rich background. Both of them have worked both on the data side of health, but also with women in midlife. So brought them on board. We’re going to talk nutrition, exercise, lifestyle, stress, sleep, all those things.

So without further ado, I will move us on. But before, if, if any of you are new to Gennev, just to give you a quick little overview of who we are, we’re an online clinic for women in menopause. Specifically we offer telemedicine services via doctors specifically OB GYNs. We also have a chat and video access to our health coaches and registered dietitians through our HealthFix membership. And then we also offer over the counter health and wellness products such as dietary supplements, lubricants and hygiene products, all formulated for women’s health and menopause. And finally, we are a platform for free education and community.

This is the place for women to come if you want to really manage your health in the second half of life. And so we’re thrilled that you joined us today. So with that I’m going to stop sharing slides. We’re going to get to actually the people. And so all of our presenters some of you are muted. I’ll remind you if you start talking to unmute. But what we’re going to do is we’re going to start by just, I’m going to plant some questions and we’re going to go over some content a little bit more from an overview perspective, and then I will open it up for live questions in the last 20 minutes or so of our hour together. And so if you do have questions along the way, you can always pop them into chat. Again, chat is on the bottom menu here in your zoom window. So with that, let’s go ahead and kick it off. And I’m going to direct the first question to Rebecca. Just to talk a little bit about COVID 19 and coronavirus and our susceptibility as women in midlife and menopause. Do we have to worry? Do we have any extra worries? Can you just kind of give us a little bit of an overview and what you’ve seen so far?

Dr. Rebecca Dunsmoor-Su:

I’m happy to go and hopefully I remembered to unmute myself to do so. Hi everyone. I’m glad you could all join us either on the Zoom or on Facebook live or any of our other platforms. I think it’s important to talk about this with a special focus on women’s health because the more we learn about this virus, the more we find that it affects different populations, differently. Currently, I’m at last, last I looked to the who and the CDC for their data, it looks like the biggest risk factors with this virus are age and preexisting conditions. So what we’re seeing is that as we get older, the risk of serious illness and even death does increase. The highest risk group obviously being in their eighties and nineties. Some of that is due to preexisting conditions, but some of that is simply just age and immune system as it, as it ages, it’s less effective.

The preexisting conditions that seem to be the most concerning are things that reduce immunity. So obviously cancer treatment medications that you might be taking to reduce your immune system such as steroids or biologics. But the other, the conditions that are, seem to be very concerning are underlying heart disease and lung disease. So people who perhaps feel who perhaps have heart failure at baseline or who have baseline COPD or asthma might be at slightly higher risk if they catch this virus. That being said, it does not necessarily spare anyone. You know, we’re seeing healthy 40 year olds go, go into the ICU. So I tell everybody, you can’t assume because you’re on the younger side and you’re relatively healthy, that it won’t impact you. We all need to be cautious. And in terms of women and women in menopause, women do not seem to be at, at baseline higher risk from this.

It, if anything is equal risk to men and women if not slightly higher risk in men from what we’re seeing. That may also just be who it’s affected so far and who’s been tested. It’s really hard to know. We haven’t tested extensively enough to really know that. But really menopause itself is not necessarily a risk.

Where I see risk coming in is that menopause can have huge impacts on our immune system because of stress and sleep disturbances. And so really addressing those issues of menopause are key in making sure that we keep ourselves healthy and able to combat this virus.

Jill Angelo:

That’s great. Thank you. Rebecca. One thing I just want to come back to you on for one second. You had talked about medications that people might be on that might make you more, is it susceptible or weakened, our systems. What are those, can you just call those out again?

Dr. Rebecca Dunsmoor-Su:

So the ones that we all think of are steroids. So a lot of people need to be on chronic steroids for a variety of reasons. The medications that we tend to call biologics, they typically end with AB or MAB MABs. And those are usually used for things like rheumatoid arthritis or psoriasis or psoriatic arthritis. Any chronic rheumatologic conditions, we tend to suppress the immune system somewhat because the immune system is the thing on the attack in those conditions. And then the other medications we worry about are things like chemotherapy medications that attack the immune system, attack cancer cells. But also the immune system. So those are sort of the big categories. I would think about.

Jill Angelo:

I saw Swapna was nodding her head, Dr. Vaidya. And I want to direct the next question to you. So you’re working right now with, with patients with mental health challenges and, and maybe stress in dealing with, with coronavirus. Can you talk a little bit about what you’re seeing so far?

Dr. Swapna Vaidya:

Yes. thank you, Jill. And thank you for the opportunity to, you know, talk to all of you and to sort of share some of the situations that we’re seeing right now. And one of the things that I’m seeing is a lot of uncertainty and anxiety regarding the situation as it’s evolving. I’m certain that we are all also feeling it because this is a very new novel situation for all of us. At this point in time, what we are trying to focus on is to stay calm the most that we can and to actually make sure that our patients are being informed that there are dynamic things that are happening and changing, but at the same time, it’s so important to take care of yourselves. One of my very good psychiatrist friends actually sort of jotted down a few very simple things.

One of this is that we’re all in this together. There are simple things we can do. Wash hands, you know, maintain social distancing, listen, be patient. This too shall pass. But at this point in time, the wealth of information that’s coming and it’s very overwhelming. I think it’s very important to channelize what you’re trying to learn from the media and elsewhere. I think it’s so important to take care of each other. I think one of the things that we as women have to remember is that we are the pillar of a family, I mean as it is a woman is struggling all the time, she has to multitask. And this situation has even now driven it 10 to 20 times more intense. Now if you’re talking about families being cooped up together, now you’re talking about dynamics. How are we coping with our relationships?

How are the anxieties coming around? Are we taking care of each other? What about the older population that is living with us? So these are the questions that are coming up a lot and a lot of answers that I have to say to them is that, which is as I’m telling myself, is to take care of each other. Facetime is good, really social distancing. A lot of people are coming and asking me, but why can’t I just go and play and have a play date? And I really feel it’s very important at this point in time to understand the situation of flattening the curve. So as much as you know, engage in self care, you know, follow a good diet, exercise, follow daily routine. It’s okay to go for walks. Meditate, take deep breaths and just simple things as I would say.

You know one of my patients was sort of saying, can you just come up with a simple routine? What should I do? How can I make sure this doesn’t happen? It’s, it just jot it down, right? Like, I mean, okay, what, what do you need? Right? So just kind of make a list. How are you coping? You have one coat, use that coat to go out. Use one bag, you know, simplified your life. And collectively, if we all look into this together, I think we can get through this. You know there have been pandemics and there have been natural disasters and you know, the one thing that I’ve learned, I was actually in New York when 911 did happen and what I really saw was the community come together and collectively address this and you know, things were evolving and even then we didn’t know what was going to happen, but it did pass. And I think this shall pass too, this is my advice to myself and to everybody else, you know, meditate daily breaths. We’re all going to be in this together. We’re going to pass this.

Jill Angelo:

Thank you. I think that’s so reassuring, Swapna. Like it’s, it’s a positive message and we need to hear positivity during this time. Just to kind of go in a little bit deeper around I saw one interesting tweet this weekend around, you know, think about others versus yourself. Even if you are out having dinner or something like that, it’s about the others in your home, whether you’re living with elderly parents or people who are more susceptible to this than you are. That kind of notion of being unselfish and, or caring for the others. I think oftentimes women go to the far right or left on that spectrum. I see women locking down their households right and left. We’re in that kind of the hub of it all here in Seattle. Can you share a little bit more about how, you know, in terms of that thinking of others how we as women can encourage, you know, grown kids or others in our family, in our household that do just want to get out and be with their friends or go out to dinner, that they’ve got to think about others beyond just themselves, who they feel even if they feel very healthy.

Dr. Swapna Vaidya:

You know, I’m Jill, I’m glad that you brought this up and this is such an important time and this is what I was talking about, having a collective consciousness because this is not so much about each one of us individually, but it’s about that vulnerable population. It’s about your grandparents. It’s about that you know, those sector of people who are older with comorbid medical conditions that you as a healthy adult, you may go out and you probably might have a milder version, but here you are at the risk of probably perpetuating it and giving it to somebody in your family who might have a very, very drastic reaction. So I think it’s important to sort of like reinforce this behavior and how would you do it? By promoting this yourself, you know, by pulling up facts, by teaching your kids, but involving your kids.

And I think having age-appropriate discussions with the kids. You know, I have a five-year-old, so I think I kind of like having made some rhymes with him about hand washing with Humpty Dumpty or Happy Birthday, he selects one or the other. Involving them and actually educating them because even if he’s five or 10 or 15 or what have you, education and having a clarity about it really helps.

And I know I keep going back to, we are all in this together, but that’s really the mantra that I keep coming back to. We also as a society have to be collectively conscious. I do have patients asking people, why do I need to be quarantined? I”™m healthy. I mean I need to go out. I’m anxious, I’m cooped up. And I know it’s a difficult time, but it’s so important for us as a society to understand that we really are in this together so that we can help flatten the curve and we can actually protect the vulnerable people around us.

And at the same time, self care is very important. So one thing I would like to add, Jill, is that as women, we tend to not care about ourselves. It’s always about the other person first, whether it’s your husband or your kids or your mother-in-law. But it’s important to look at what your needs are and it’s okay to be anxious and it’s okay to not know and it’s okay to say, Hey, you know, I don’t have the answers. Can we, you know, sort of like I need help sometimes. So self-care, understanding, you know, when to kind of put your own oxygen mask, as I say, I know that analogy, it’s so important. So as much as we can do to promote healthy active behaviors involving our kids in healthy active initiatives. And you know I’m sure everyone is involved in Facebook and WhatsApp and what have you. But to kind of promote it to create a healthy platform to share healthy coping mechanisms. I mean we have great people on our panel right now, you know, for the nutrition as well as the other health coaches. And I’m also excited to hear more about for myself as to what I can do during this time. But I think that those kinds of things and those kinds of tips would help so much as we all go through this together.

Dr. Rebecca Dunsmoor-Su:

I just, before you jump in, Jill, wanted to add Swapna brings up a really, really important point, which is that most of us will do just fine with this virus and we’re going to be fine. We probably won’t even require hospitalization, but some proportion of us will. And really the goal of the social distancing is so that as people get this and do require hospitalization, ICU care, and even ventilators, we do it one at a time rather than all at once. Because we will run out of space, we will run out of supplies, and we will run out of healthcare providers, if all of us get it all at once. So really what you’re doing is protecting others, even though you might come through it OK. We need to make sure that this happens slowly and gently across sort of this whole nation. We’re all going to get this. None of us is immune, but if we can do it slowly and carefully, we might just make it through this.

Jill Angelo:

I think that’s a really important point. Thanks Rebecca. And thank you, Swapna you know, I can hear you’re, you’re you’re, you’re a mom and action right now doing your job as well as managing family at home. So you’re, you’re an example for sure. So thank you.

Let’s let’s then pop to nutrition. I’m Lauren, I’m going to go to you next. Lauren is our director of health coaching at Gennev: registered dietitian, nutritionist, and I know your husband as well is one of those on the front lines in the healthcare system right now. So to Rebecca’s point around everyone’s gotta be thinking about others and their health and able to care for others. You’re, you’re, you’re doing that in your household. Can you talk a little bit about immune response? Because we all want to keep our immune systems really strong and a lot of that comes, it starts with what we put in our bodies. So talk a little bit about how you’re, you’re coaching your clients right now and thinking through that.

Coach Lauren Leedy:

Thanks, Jill. And yes, it’s a really challenging time. And I too am a mom and this is, this is hard, you know, to, to balance everything. And at the same time to Swapna”™s point to take care of yourself. Like it’s so hard as women to put yourself first. So I’m hoping that women still at this time continue to nourish their bodies well. To support an immune response, the big thing is to load your body full of nutrients from whole foods. I’m not talking about going and taking certain supplements. There’s going to be a lot of, lot out there, a lot of people capitalizing on the fact that people are trying to boost their immune system right now and promote supplements. The best thing you can do is load your body full of nutritious whole foods and make sure you’re getting adequate fluids.

Coach Lauren Leedy:

So that’s going to do the, the best to prepare your body for actually attacking or getting rid of this virus. And I know what complicates things right now is the fact that our supply is limited and a lot of us are trying to avoid places like the grocery store and getting food or maybe we have kids at home and we just can’t take the time to go out and get that food. So I’m really recommending to my clients that they use this time at home to try out some new techniques they might have always wanted to try. For example, there’s a lot of amazing meal delivery services out there that you can sign up and have cooking kits or fully prepared meals sent to your home. It’s a really great way to involve your kids too if you do have kids at home to prepare some of these different cooking kits.

Another idea too with fluids, a lot of us struggle with getting enough fluids. One simple technique I wanted to share that, you know, women could try to do while they’re at home is the rubber band method. So a lot of people love this technique. Figuring out how many bottles of water you need to drink in a day, and putting that number of rubber bands around the water bottle. Every time you finish it, you take off a rubber band. So the goal is to get them all off by the end of the day. And, and it’s amazing what just nourishing your body and giving yourself enough fluid can do. The other thing I might add just because as women you’re probably got your hands full right now, that this doesn’t have to be elaborate. You don’t have to feel like you”™re cooking all the time. Some time saving tips, you know, use the package foods that are out there and dress them up.

This doesn’t have to be perfect eating, you know, add veggies to a frozen pizza that you have. Throw some extra veggies in a soup or a smoothie, make simple modifications or batch cook once and freeze. So you have multiple meals to work off of. So that’s, you know, it really doesn’t have to be more complicated than what we generally promote.

Jill Angelo:

And how about how about in terms of foods that really boost the immune system? Just call those out. I know we kind of read about it all the time, but, but why don’t you just call those out? What are some specific ones.

Coach Lauren Leedy:

So really fresh fruits and vegetables that are going to be rich in antioxidants. Those are going to the best thing. So the brighter in color they are the better, but you really can’t go wrong with fresh fruits and vegetables. Just a whole foods based diet, not singling out one nutrient or one food in particular. Those are going to be your best bets.

Jill Angelo:

I know in Instagram posts, I think last week you posted a number of these food delivery options. So we should go ahead and include those in our followup on notes for this webinar. But also are, is there any overall guide that you’re watching? Because I know every business is vulnerable during this time. Are any of these delivery services like curbing delivery because they also don’t want to put their staff at risk? Or any, have you heard anything there yet? Are they all functioning?

Coach Lauren Leedy:

Yeah. So I did try to do a grocery delivery service this weekend myself and it was definitely delayed. So another tip I have too, if you need something right away, our local businesses right now, like you said, small businesses, they’re really vulnerable and they’re hurting and we we don’t, you know, want them to, to crash and we want to support them, but at the same time, there’s recommendations to not go to restaurants. Many of them are still open for delivery, takeout. So please use those businesses and maybe try out a new restaurant but get a delivery or get a go pick up your order as another quick strategy. The other thing I wanted to highlight that at Gennev I think is health coaches. You know, put us to the test, use your health coach. Let us know what’s in your pantry right now. And we are more than happy to help you put together a healthy, nutritious meal. So this doesn’t have to be starting from scratch. Like you tell one of us exactly what you have. And we love doing this. We’d love to help you come up with a creative easy throw together meal.

Jill Angelo:

That’s awesome. That’s great. It’s kind of like having someone come over and take a look at your closet and put together like outfits for you.

Coach Lauren Leedy:

It”™s our own chopped challenge.

Jill Angelo:

Yeah. Yeah. That’s great. That’s awesome. That’s awesome. Well then on that note I’m going to move to Stasi. Stasi, your colleague on the coaching side of Gennev. And Stasi you focus a lot on just managing kind of exercise and activity and how even that can help manage the stress and/or sleep challenges that we might be feeling during this time. Can you talk a little bit about more about you know, immune response measures that women can take and that you’ve been talking to women about? As we’re all cooped up, can’t go to the gym, you know.

Coach Stasi Kasianchuk:

Yeah, absolutely. And exercise definitely is a passion of mine. Something I’m right now, especially I’m navigating how do I continue to move my body to be able to be my best self as well as we look to manage this. And exercise I love to similar to nutrition is that there’s a lot of varieties. There’s not a one size fits all approach. And so that gives you a lot of opportunity to try something that’s going to find to find something that’s gonna work best for you. And during this time I think it’s important to come back to, again, all of the messages we’ve heard here. Swapna had some great points on, you know, routine. How can you keep a routine or maintain a routine?

A lot of the women that I work with around menopause, it’s a different, it’s a new time of their life, so they are trying to establish a new routine and I encourage now you might have an extra challenge in finding that routine, but incorporating your family. If you have kids at home, kids need to move too, it can help them get some energy out. So maintaining or establishing a movement routine throughout your day. Now if you’re someone who has more been used to having your exercise time in the morning, maybe that’s changed up a little bit, especially if you can’t go to your gym. But still designate that time. So if you can keep the morning time, great. Maybe it has to move to the afternoon or you can still get benefits from spreading it out. So if you don’t have that hour but you can spread out 15, 20 minute blocks throughout the day, bring the kids along. You know, maybe you’re, if it’s safe, if you are not a high risk population and it’s safe for you to go outside and remain social distance that is definitely an option.

I think the fresh air and sunshine if it’s available to you is really good for us right now. Just remembering to maintain those public health recommendations around where you are outside. So I think that’s establishing that routine and incorporating the family is a great way to keep moving and really help to manage that stress when we are in that one place for too long and not moving our body. We know that sedentary behavior is not supportive of our health, so how we can fit that in right now is going to be important.

Jill Angelo:

That’s great. I know I noticed this morning on my, my morning run, every time I’d meet someone on the sidewalk, like the other person would either go to the street, like we totally like avoided each other even on the sidewalk, which was interesting. So yeah, it’s very real.

Coach Stasi Kasianchuk

I have that experience too. Yesterday and it was interesting feeling that it was all of a sudden it was a sign of respect to do that. So interesting times right now, but accepting that, OK, that”™s your side of the sidewalk. I have no problem going to the other side. No offense. We’re doing it for each other.

Jill Angelo:

Yeah. You know, one thing I hear you talk about, Stasi, a lot is journaling and and again, this notion of routine and maybe it changing or whatever. Is there comfort in journaling too? You know, I might feel like, Oh God, it’s going to like push it in my face, all the things I’m doing wrong, you know, and be another stress. Or is it comforting and healthy? Like talk a little bit about just even documenting what we’re doing on a daily basis.

Coach Stasi Kasianchuk:

Absolutely. Yeah. Journaling is really helpful for women during menopause because so many things are changing and rapidly it can be difficult to remember what happened yesterday, let alone last week or last month. And because we’re trying to see what patterns are happening to then best put together a toolbox to support women during this time. So every, what I, when I’m working with clients, I want them to establish a toolbox so they have the tools to pull out when certain symptoms come up and they feel prepared for that. Doing the journaling can allow you to see what’s happening over time. And so a lot of women will notice patterns. Oh wow, this happened, this did happen last month. I have it documented. Okay, this might start happening every four or five weeks. So what can I do ahead of that curve to best prepare myself for these situations?

And I think this is relative right now too because this is an added stress. How can you reflect on what’s going on, what you really need right now.Aand Swapna you know talked about jotting things down of what do you need in this present moment. I think journaling can be helpful for that as well. I think as women we not to get into the genetics of it, cause I don’t know, I’m not an expert in that area, but I honestly think women tend to hold things in their head more and we let things and Swapna, feel free to jump in, but it feels like it’s a, a, a storm in our head. And so that first step of journaling I find, I talked to a client on Friday where she was actually working more on journaling related to perfectionistic thoughts. And how those perfectionistic thoughts were taking over.

And by journaling those, she was able to identify it. And in reviewing her journaling, she was able to identify areas where she wanted to focus on this week moving forward. So then it, it pulled out a focus point rather than having to focus on everything. So I think journaling can be really helpful as that step. Could also be a step of where do I need to have a conversation about this versus, okay, this is the

If you’re in or around menopause and struggling with issues such as weight management, sleep, stress, nutrition, bone health, appropriate exercise and more, a health coach could be just what you need. In this podcast, Dr. Rebecca Dunsmoor-Su, Gennev Chief Medical Officer, and Lauren Leedy, Registered Dietitian and Director of Health Coaching at Gennev, talk about what Gennev health coaches do, how they work with our physicians, how they’re specially trained to help women in menopause, and why the Gennev model is such a great value for the money. Want to know where you are in your menopause journey?

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First, take our Menopause Assessment.

Then, make an appointment with a Gennev health coach to learn more about the changes your body is going through, and put together a plan to help you relieve symptoms now and stay healthier in the many years ahead. If you had virtually unlimited access to a health coach, what would you ask? If you’ve worked with a Gennev health coach, tell us about your experience in the Gennev community forums!

Its been about 4 years since Ive had a mammogram. Shame on me.

I stopped after I went through the repeated 6-month ultra-sound monitoring required for suspect spots, common with dense breasts.

Yes, I have dense breasts.

If youre like me, I dread a mammogram for so many reasons. It hurts. My boobs dont like to be flattened, and while my pain tolerance is rather high, breast pain hurts so bad!Its also inconvenient. Im not great about booking scheduled appointments that are a necessary in life. Its not that Im fearful. Rather, Im loathe to do something that feels required compared to pumping out a fun new marketing campaign or an email like this one.

Im certainly not practicing what I preach when it comes to women taking control of their health.

So, Im writing this Friday email as a reminder to book a mammogram during this month of Breast Cancer Awareness for me, as much as it is a reminder for you.

Beyond life getting in the way, mammograms have become something to be feared, mostly due to journalistic hype or new schemes for securing a profit.

Gennev’s Chief Medical Officer, Dr Rebecca Dunsmoor-Su, penned a bold and transparent article on the Myths About Breast Cancer Screening.

In it, she debunks the notion that practitioners earn anything from recommending mammograms. She takes on scare tactics about the levels of radiation used in mammograms (which is less than what youre exposed to in two months of living on our planet).

Its a 45-second read that is your best defense during this month of breast cancer awareness. Most of all, I love her call-to-action to donate to breast cancer services for more women. If you have the means, I urge you to do the same, so all women have access to breast cancer screening.

Some options to consider are the American Cancer Association, Susan G. Komen, Planned Parenthood or a similar organization. More than ever, I urge you to do two things:

– Book a screening if you havent had one in the past year

– Reach out to a loved one who has survived to let her know that you care about her

If you care to share how you reflect, engage in, or respond to Breast Cancer Awareness Month, please shoot me an email at jill@gennev.com. Id love to hear from you.

Jill

As Gennev’s Chief Medical Officer, I help write or edit some of the content you see on our site, but you don’t always hear my thoughts in my own voice. In honor of Breast Cancer Awareness, I want to talk seriously about breast health in midlife, cancer, and screening.

Truth: Breast cancer, caught early, is curable

First, I want to emphasize two important points:1 in 8 women in this country will get breast cancer over the course of their lifetimes.

If you catch it early, it is curable (90% of women with breast cancer will be completely cured).If you are worried about breast cancer, a Gennev menopause-certified gynecologist can give you a trusted opinion. Book an appointment with a doctor here.

4 Myths about breast cancer screening

The second point is why I am writing today. I want to dispel myths about breast cancer screening. I am a full-time practicing clinician in Seattle and will often hear these myths and fears in my practice. It worries and upsets me when women get incorrect or even dangerous information.

Myth 1: Screening kickbacks.

This is the idea that your doctor orders screening tests, labs, vaccines, etc. because they get a kickback or make money on it. The fact is, there are specific laws against kickbacks that we are trained on every year. Doctors can lose our licenses or even go to prison for making money through referrals.

Myth 2: Mammograms are radiation and over time will cause breast cancer.

No, for the most part this is not true. While mammograms do use radiation, they use very little equivalent to about 2 months of the background radiation that you get from living in the world. What is true is that the minor risk of this exposure is completely outweighed by the ability to pick up earlier stage breast cancer, so on balance mammograms overwhelmingly save lives.

Myth 3: I dont need a mammogram as I do breast self-exam and will feel a lump early.

No. I would never discourage self-exams, but they cant take the place of a mammogram. This idea is false because the average size of a lump picked up by regular mammogram is about 1 cm, whereas the size picked up by regular breast self-exam is approximately 3 cm. There is a great graphic produced by the Susan B Komen foundation that shows this.

Myth 4: Thermography is as good as mammography at detecting cancer with no risk.

This one makes me the angriest. False, false and more false. Thermography (the idea that breast cancer is hot and can be picked up with a thermal map of the breast) was tested as an alternative to mammography. In the studies done, this screening modality had a 25% false positive rate (claimed to find cancer when there was none) and much more concerning, a 60% false negative rate, meaning 60% of the time when a lump or cancer was present, it was not detected and the study was negative. More modern devices have been tested again and proven to be equally inaccurate.

So why are there thermography centers? Because the device is FDA cleared which means it has been deemed to be safe to use (it wont directly hurt you) but has never been determined to be effective. Any device with FDA clearance can be used in the US. Centers can promote and sell this modality for profit. Some of the providers who promote thermography actually believe it is effective, but they dont have the training to be critical about the source of their information. Some thermography providers believe that mammograms are part of a conspiracy and that they are saving women from this (really). Some just want to make money. Whatever the reason, thermography is not a safe modality to use.

It’s time to dispel the myths of mammography. And in honor of breast cancer awareness, I do not wear pink – but I do I donate to my local Planned Parenthood which is the largest provider of low- and no-cost mammograms in my region. Find out who it is in your region and consider supporting them. And get your mammogram (I do)!

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I’ve never loved the word nipple until now.

In the last week, someone near and dear to me was diagnosed with breast cancer.

How did she know to get her breast health checked? She had a newly inverted nipple.

That’s not common knowledge for most people. And for her who has a history of it in her family, she thought it to be no big deal.

Until her job moved her to research it further”¦and I don’t mean look it up on WebMD, but seriously do some hardcore medical research.

If you are worried about an inverted nipple, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

Breast Cancer After Showing An Inverted Nipple

Her findings turned up that it was an indication of breast cancer.

She made an appointment right away for a mammogram that turned into an ultrasound which became a biopsy which really set some wheels in motion.

For my friend, her newly inverted nipple was not impacting her daily health”¦and in fact, was commonplace in her family. So typically, someone in her shoes would write that off as normal, or as another “women’s bodies are complicated” notion.

Fortunately for her, her job involves researching health and wellness care for women. And, because she happened to be researching breast cancer indications (and came upon the inverted nipple indicator), she consulted with her doctor, the cancer was caught early, and she virtually saved her own life.

I’m sharing this story with you, because it underscores how responsible we are for our own health.

Being aware of our bodies, researching any big or small change and making it a priority to speak with a practitioner as soon as you see it versus feel the impacts of it is serious stuff.

We’re living longer, more vibrant lives than ever, and my hope is that Gennev is a place for answers as whether that be in a DIY sort of way or a reach out and ask for help way as just get curious and don’t waste time thinking you’re needy or wondering if something is “serious enough” to look into.

Is an inverted nipple a sign of breast cancer?

As a response to this new learning of an inverted nipple, you better believe that we’re adding it as a symptom to track within Gennev’s Menopause Assessment. We are publishing an updated version of the assessment in October 2019, so if you’ve taken it already, I highly encourage you to take it again at that time. Don’t worry, I will remind you.

And if you too have an inverted nipple, especially if this has happened recently, please go to see a doctor or specialist. Information is power and taking these scary changes head-on can save your life.

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Mom, menopause and Melinda Gates is a potluck of topics, but theyre on my mind and heres how they come together

In the spirit of Mothers Day, I want to give a shout-out to my mom. And to all moms!

I love my mom. Throughout my life, she was the positive one, the one who let me be me, the one who lifted me up.

Here’s a photo of my mom and me last summer celebrating her and my Dads 50th wedding anniversary. This is us rocking a 6-mile hike up a popular ski mountain in Montana. I love this photo because it shows how spunky mom is.

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I was reminded of her last night when I went to see Melinda Gates on the final night of her book tour.

She recently published her memoir titled The Moment of Lift. Its a warm-hearted book about how Melinda was lifted and supported as a girl and how shes come to learn through her global work, that if you lift up women, you lift up humanity.

Amen!

She went on to state in her talk that we are in a window of lift for women and thats what moved her to write the book she’s been thinking about for some time.It got me thinking about how I was lifted by my mom throughout my life. She was the rock of support in our family. As so many moms are.

Its a woman-skill to be resilient and supportive for those around her, even when she doesn’t feel like it, or when she’s not feeling all that great physically or emotionally.

Here comes the menopause part

I think theres never a better time in a woman’s life than in midlife [and menopause] for women to lift other women up.

We need it. Our bodies, minds and souls are transforming into a better version of ourselves, but the journey makes us vulnerable.

Rather than asking other women around us if they’re having trouble sleeping, having unexplainable mood swings or struggling with sex. We look to our mothers menopause history as the tell-all for what were going through. But, there’s much more that plays into when and how we experience the change.

I challenge you on this Mothers Day weekend to seize this window of lift moment were in, reach out to another woman in your life and give her the boost she needs. It doesn’t have to be a heart-to-heart menopause talk, but relish in the female energy that connects us as women.

It’s amazing what lifting others up does for ones heart. I know for my mom, it was and is, still the thing she does bestand I hope her heart is full.

Happy Mothers Day.

Coughing, watery eyes, maybe wheezing a bit now and again? New food allergies, courtesy of perimenopause? Even menopause-induced hives?*

If these symptoms are new or feel worse than they have in the past, it could be your hormones to blame.

Like so many menopause mysteries, the research is lagging behind, so we don’t yet have definitive answers, but certainly many women report new or worsening symptoms of all of the above. And as women are more prone than men to asthma, and as many women report new allergies in perimenopause and menopause, a link between hormones and allergic disorders seems likely.

Wheezing, coughing, itching and burning skin? It might be time to talk with a menopause specialist. Book an appointment via Gennev telehealth, and get your questions answered.

Estrogen and Allergies / Inflammation

So what’s the link between menopause and allergies and asthma? Estrogen. That’s right, hormone imbalance allergies are a real thing.

As we know, there are estrogen receptors all over the body, including on immunoregulatory cells. And estrogen, it appears, may skew the body’s response toward allergy and inflammation. This is generally held in check by progesterone, but in perimenopause and menopause, when levels of progesterone are low, asthma, allergies, even hay fever may appear or get worse.

A study in Northern Europe included over 2,300 women and tracked their respiratory health from 2000 to 2012. They found the “odds of getting asthma were more than twice as high for women going through the menopausal transition or after menopause, compared to non-menopausal women.” That risk rose further for women who were overweight or obese.

When it comes to asthma specifically, it may actually be the fluctuation of estrogen levels that produce the inflammatory response in a woman’s airways. Many women may have noticed symptoms rising and falling in severity with period cycles or pregnancy, indicating hormones are at least in part responsible.

And we can tell fluctuating hormones play a role in triggering asthma, because often women who have irregular periods for reasons other than perimenopause have worse asthma symptoms than women who are more regular in their cycles.

Menopause And Allergies: So what to do?

Asthma and allergies can be frightening, particularly if they’re new or more dramatic than in the past. But there are things you can do to manage symptoms and catch an attack early.

Know your cycles. Maeve O’Connor, allergist and immunologist from Charlotte, NC, says, “Most hospitalizations for asthma in women occur around the peri-menstrual stage of the menstrual cycle as- right before a woman’s period begins. This is when estrogen levels drop down to almost zero.” When cycles are irregular, as in perimenopause, you may be able to tell if a period is coming by tracking lung power with a peak flow meter. If your lung power has dropped, a period may be on the horizon.

If you experience worsened asthma during your cycle (for those who are still experiencing periods), the medication you’re taking for menstrual pain can also make asthma more severe, so you may want to talk with a doctor about alternative pain relief that doesn’t increase inflammation.

Knowing your cycles can help you understand what’s happening in your body and stay calm when breathing gets more difficult. Tracking cycles can be difficult to do when periods begin to fluctuate along with changing levels of estrogen, however, so we strongly suggest women track as best they can. Keeping detailed records may help you begin to identify physical signals of an approaching period.

Use maintenance medications as prescribed. It’s better for your lungs to manage symptoms rather than treat an attack once it has started.

Know your triggers. And avoid them, obviously. This counts for both asthma and allergies and is especially important if you’re at a stage in your cycle when you may be more vulnerable to triggers.

Reduce exposure to allergens. Clean often. Dust (or get someone to dust for you). Change bedding frequently. Vacuum. Be vigilant about mold. The more you can keep dust and mites (ugh, we know) and other allergens to a minimum, the better.

Manage your weight. Perimenopausal and menopausal women who are overweight have a greater risk of developing respiratory issues, so controlling menopausal belly fat as best you can may help minimize risk.

Quit smoking. Obviously, smoking is an irritant to your respiratory organs, so quit if you can, reduce if you can’t.

Eat to reduce allergens. Avoid sulfites (preservatives in wine, pickles, dried fruit), eat less salt, and try to get more foods rich with omega 3s (nuts, seeds, cold-water fish). If you eat foods that may be triggering, reduce the amount and don’t exercise directly after when the results may be the worst.

Take vitamin D. According to James T C Li, M.D., Ph.D., “People with more-severe asthma may have low vitamin D levels,” so consider boosting your intake of milk, eggs, and fish such as salmon, and spending a little time outdoors. If you’re concerned you’re not getting enough vitamin D, a supplement can be a great way to boost your levels. Plus, it’s a great mood-booster if low-mood or low-energy are also issues for you.

Consider hormones. If asthma worsens to the point where it’s dangerous or limiting your life, you may want to consider hormone replacement. Again, this is an area where causes and effects are not well understood. In some women, HRT may worsen symptoms, particularly if the asthma is new. For women who have had asthma prior to menopause, HRT may help.

Seriously, if allergies are getting in the way of your life, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

Women with asthma are hospitalized more often than men. Women’s mortality rates from asthma are significantly higher than men’s. But asthma is treatable. If you’re experiencing symptoms that could be asthma or allergies, talk with your doctor right away. Get started on a management plan that will make it easier for you to live your life your way.

And here’s a benefit: for women who suffered with asthma even before menopause, according to the Mayo Clinic, many of them could experience relief from asthma symptoms or severity after menopause.

Do you have hormone-related asthma or allergies? How have you handled your condition? Please share with us by joining the conversation in our community forums.

*This website is not intended to replace a doctor’s professional care. If you’re experiencing symptoms such as difficulty breathing, coughing, wheezing, etc., please consult with your doctor right away.

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“I’ve been dressing myself since I was four. Why is it suddenly so hard to do?”

Changing bodies, changing priorities, outdated notions of what’s “acceptable” to wear after 40 can all make it feel surprisingly difficult to dress yourself. And whether we like it or not, people do judge us on our appearance.

We can use that very human habit to our advantage, says Mellicia Marx, personal stylist and founder of the very cool Poplin Style Direction. Our clothes can be a tool to express ourselves and project the image we want to the world. You just have to know what that image is and how to achieve it.

What do you want your clothes to say about you?

Mellicia asks her clients for the three words they aspire to in their style as “confident, edgy, and feminine” or “boho, earthy, and relaxed,” whatever they may be as and from there they can build a closet that’s like a “boutique curated just for you.”

Sound good? Listen in to Mellicia’s ideas about fashion, body image, staying on budget, and feeling good enough to take on the world.

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For more great information from Mellicia, check out her tips on how to buy a better bra.

Are you comfortable in your clothes, both in fit and in fashion? We’d love to hear about how you make buying decisions. Do you, as Mellicia suggests, buy the dress, then find an event to show it off? Or are you a “dress for what’s next” kind of person? Fill us in on Facebook!

Talking about confidence, style, and fashion over 40

Jill: Mellicia, you’re a personal stylist, and if anyone hasn’t visited your website already, it’s Poplin Style. Explain what you do for your clients.

Mellicia: Yeah, I have an amazing job. I’m very fortunate. Basically, I listen to a woman, and I help her express herself through her clothes, and make sure that she’s communicating what she wants to, and she is seen. That’s really important to me, is really seeing her. We mesh that  with her budget, her body type, her lifestyle, and we put that all together into a strategy for her to help her get ready every day.

Jill: The thing that really pops out for me, in what you say, is you want a woman to be seen. Explain that a little bit more, because I think that’s a really important point, especially as women age.

Am I invisible? Being seen when you’re a 40+ woman

Mellicia: Right, that’s a really important to me, I think, that’s very true, in midlife, but really, kind of at all times in your life. What’s kind of funny, I was thinking about this and thinking about what we were going to talk about today. Really thinking about, you’re younger, and you don’t have the confidence, you’re trying to kind of figure out your body, and who you are, and what’s going on with the world. And you get a little more confidence, then it comes, and goes, and as things keep hitting you, and then at midlife, something happens, and you’re kind of coming and going with the confidence, and it ends up being really challenging for someone to feel like they’re able to communicate who they are, and to have the world see them and hear them, in a way. You know, like you finish a conversation and say, “˜Were you even listening to me?’ You know what I mean? So, being able to have an impact on the conversation without even talking, I think is pretty awesome and powerful, and I find that the better you feel, the more confident you are in what you’re saying.

Jill: I think the essence of fashion, in our clothing, and how we identify, happens at really an early age. When you sit down with a woman for the first time, how do you start to talk about her relationship with her appearance, and her fashion, as a result?

Defining your style

Mellicia: Yeah, that’s a great question. It’s funny, because I have this very in-depth consultation process. We talk for about an hour, and I ask all these different questions. It’s funny, because a lot of the times, it will feel like I’m asking the same question, but I’m asking them in different ways, because it brings up different answers for people. And what’s also funny is sometimes I ask them a question, and I’m like, “˜It’s okay if you don’t have answers,’ but if I don’t ask, I don’t know what your answer is. I find that it’s pretty common for us to have this aspirational view, and it could be, with my client base, it’s not often a celebrity. If I ask them, “˜What celebrity do you identify with,’ they’re like, “˜I don’t know, I don’t follow that.’ But it’s often someone in their office, or a friend that they have, or a friend they say, “˜She always looks amazing, and I just want to look like that.’ It’s not necessarily the same clothes, but projecting the way she projects.

It’s more digging into those visuals to get that sense. You mentioned being younger, and having that how you connect with fashion, and really your presentation. I do find that this doesn’t come up in the initial conversations, but throughout the process, it’s very common that a lot of us have really internalized messages from someone in our life, at some point. I will have women where I’m like, “˜This is your body type,’ and they’re like, “˜No, no, no, I carry my weight here,’ and I’m like, “˜No, you don’t.’ It’s because their mom, or their friend, or their aunt, or someone told them when they were 14, that that’s where they carried their weight, and they can’t see themselves any differently.

I think it’s really important, I find, for us to challenge the assumptions we have about ourselves, and how we look in our bodies, but I also have found that that’s a real life lesson in how powerful our words are when we’re talking to someone else, and these kind of offhand comments can really stick with people for years.

Jill: What do you believe has given you this discerning eye for what works, or what doesn’t work, or the look that a woman wants to achieve? How does that flow into the honest conversation that you have with the women that you work with.

What makes a good stylist?

Mellicia: I have noticed, oftentimes, that when someone works in this industry, “¦ before I started being a stylist, I actually interviewed several women who had worked with stylists. What did you like, and what didn’t you like, and what was that experience, and so on and so forth. A lot of times, it was, “I felt like I couldn’t identify with her, and I have kids, and she came in in these stilettos, and that’s not my life.”

All these things, they were really struggling in that first place. I find that, for me, I have been very fortunate to as my background is actually in philanthropy, and I spent 20 years or more speaking in offices around the world, like, all over the place. I’ve worked in public sector, private sector, nonprofit as I’ve been everywhere. That’s ended up being an incredible strength for me with this job, because whenever I go to meet someone and it’s like, “˜What do you do?’ And they’re kind of mumbling; I say, “˜Oh, I’ve been there. I know what that office culture is like, I know how people interface,’ it’s not like I’ve been hidden away in a retail environment, and am watching the latest trends. Which is not a bad thing, if someone is doing that; it’s just a different need.

For my clients, I’m able to relate to them in that, and also, see what they see. Additionally, I’m not projecting my style onto them, and I think that’s really important. I tell them from the very beginning, I’m not trying to dress you like me; I don’t dress all my clients like one another, so if you look on my site, you will see that they have very different styles. Really, what I’m trying to do, is figure out who you are, what you want to project, and help guide you and give you some filters, so you can do this on your own. I feel that providing filters makes a huge difference.

Essentially, with every client, and women can do this at home, you don’t have to be a client of mine. I say, think of three words, that, when you walk into a room full of strangers, and it should be aspirational, so not what you look like now, not what people would say about you today, but when you’re going to a room full of strangers, you look amazing, you love what you’re wearing, you look great. What kind of words would they use to describe your style? So once you have those words, we have what your body type is, and we use those as filters, every time you go shopping by yourself, every time I do something for you, every time you look at something in your closet, and if you’re trying to say, “˜I’m confident, and a little bit edgy, and feminine,’ and you’re like, “˜Okay, does this say that to you?’ Most of the time, I’m not actually telling them that that doesn’t say that. It’s really, does it say it to you? And they’re like, “˜Well, no.’ Okay, so do you want to have it? That’s really up to them to decide.

Sometimes, they’ll say, “˜But I love it!’ And then I’ll say, oh, you love it? Let’s talk about that. It’s not edgy or the things you’ve said. Are you telling me that those words actually aren’t accurate, and we want to add in something that’s kind of, boho, because that’s what I’m getting from this? Or, is this nostalgia, or a comfort zone thing? So, let’s look at that.

Really, it’s all driven by the client. I’m sort of just an impartial observer. There’s that about the process.

Where do I get the discerning eye? I have just always been like this. I’ve always been the kind of person that, of course I would know all my friend’s shoe sizes and mail them shoes, like, why wouldn’t I do that? And of course, when I go to a family event, every person there has been dressed by me, like, who doesn’t do that? And, sort of, discovering that, that’s not a standard thing is really helpful.

Jill: It’s a special talent, yeah. Why is it that women need help in finding the clothing that makes them feel the way they want to?

Why do women find personal style difficult to define?

Mellicia: I think there are several different scenarios. One, I think is very common, and speaks to your readers, too, is your body has changed. So, oftentimes, it’s when someone has had a baby, or their weight has changed, or in midlife, I have clients who are going through menopause, and all of a sudden, they’re super busty, and have never been before. They’re just, kinda perplexed. Another thing that happens is when, “˜Oh, I’ve always felt very stylish. I’ve always felt like I know what I’m doing, and then all of a sudden, I feel like I’m too old for those clothes, but I’m too young to wear these clothes, and I don’t know what to do,’ or, “˜I’ve become bored, or uninspired.’ And something I see a lot, because I’m based in Seattle, we have a very educated population, so a lot of the women here have prided themselves on not caring about clothes, and shoes, and handbags. It’s like, “˜I’m serious, I’m getting stuff done, I’m reading, I’m doing all these things,’ and then all of a sudden one day they’re like, “˜It turns out, I do care about how I look, and I never wanted to tell anyone this before, but now I have the means, and I need help, and I’m going to talk to my friends, and it turns out they don’t know how to do it either, because they’re all in the same situation.’

So, it ends up that I’ll style one person, and I’ll end up doing their whole team at work, or a whole group of them, and you see that it’s actually a very common struggle, more than you guessed. It’s also really fun for me, because it shows I don’t dress them all the same. I’ll dress five women working on the same team, and you don’t want to send them all the same jacket, you know what I mean?

Jill: Oftentimes, women in midlife; so you talked about working with groups of women, and their bodies are changing, as they head into midlife through menopause. We often think about, certain clothing isn’t “proper” for that age. How do you address that question; I bet you get that a lot?

What about dressing yourself in midlife?

Mellicia: I do get it a lot, because I get the words that people say, “˜I want to be edgy, confident, whatever,’ and then the word “age appropriate” comes up a lot. So, what does that mean to me? I think about that a lot. I have this amazing client, and she is in her 60s, and she works with rock musicians, she’s a voice coach. As she gets older, things change, and then she’s like, “˜But I’m working with rock stars, I’m not this old person, what do I do?’ So, finding that happy medium”¦. I think, I mean, there are some things that are just inappropriate, but that may be because of age or maybe not, but that’s more inappropriate to the situation. In general, I think the bigger problem is that women, I don’t know if men do this, but I really see it with women, is that there’s this whole obsession with the age appropriateness; “˜Am I too old for this?’ It’s like, we have a long way to go, and if you’re too old at this age, and you’ve got another how-ever-many years, what are you going to wear then?

So I think a lot about this. So, I got my nose pierced a couple weeks ago with my nieces and nephews, because I’m a good role model. But it was a really funny conversation I had with someone after, like, I’m 43 years old, and I’m getting my nose pierced. I think the standard thought on that, is maybe that’s a little too old for something like that. Well, I could be alive another 30-40 years. Am I going to be 60, and wish I had really done that? Kind of like, looking back and saying, “˜I wish I’d had another baby,’ and you can’t do it at some point. I think a lot of times, people “¦ we think we’re too old, or we think we’re too heavy, or we think we’re showing something we shouldn’t be showing. And that’s not the case; it’s all our own conversations. I think something that can be really helpful for an individual woman is to look back at photos of herself, and try, if she keeps a journal or something, to see how she viewed herself at that time. It’s often very flawed, like, “˜I’m a little heavy,’ and you look back and go, “˜Wow, I looked amazing.’ So, you know “¦ embrace it.

Jill: That’s amazing how you look back at something, and when you look at yourself, you think you look so much better than you did at the time. Or you say, “˜What was I thinking with that hair?!’

Mellicia: But you looked awesome, and at that time, you know what I mean? That’s a really key point about style, and I had this conversation with people a lot. They’re like, “˜Classic,’ and I’m like okay, there are more looks that are classic and timeless, but is it so wrong to be of the era you live in? You may decide that you don’t want to be in that, and that’s a totally valid choice, but choose it. Don’t be afraid to embrace whatever it is.

Jill: It also sounds like a lot of your work is all about self expression vs. doing what you think others think you should be doing, or doing what’s “right or wrong.” How do you break that mindset around being confident in your own self expression, and dressing that way, vs. dressing in the way others think you should dress?

Mellicia: Right, I think that’s important, but I think part of that, too, is also being aware of how other people interpret what you’re wearing. You can’t just be like, “˜I love this! Who cares what people think?’ People are making judgements, and that’s happening. You want to be in control of the judgments that they’re making, so if you have the power to influence someone in that way, why wouldn’t you?

Jill: How about you as a professional? Have you ever run into a client that you didn’t feel you were a good fit for? What kind of chemistry do you have to have with the women you work with?

Mellicia: You know what’s funny? That’s only happened twice, in all the years. I do think it’s really important that we connect with each other. You know what’s really funny? I always tell people that the consultation is really just an hour where the woman is trying to decide if she can get naked in front of me. Once she’s comfortable, then we move forward. That’s all it is. [Laughter]

Jill: Your clients probably put so much trust in you, so you have to have some sort of relationship where that trust can exist. What are some specific things that you kind of, tell women, broadly, that they should keep in mind as they shop? Especially if they’re on a budget. Can you go through those?

Mellicia: Yes, of course. To me, the basis of everything I do is those style keywords. Developing those for yourself, either with me, or by yourself. Knowing your body type, and how to dress for that body type. So, once you have those keywords, then every time you walk in, once you know how to dress your body type, every time you walk in a store, things are kind of filtered for you. If it doesn’t communicate any of those words, and it’s not flattering for your body, you don’t even need to pick it up. You just keep on moving. So that will make it so you have significantly fewer things that you try on, in the first place. That’s going to make for a much better experience.

The things I have people do, is I have people think of someone in their professional life, that has an impact on their future and their career. Think of a very specific person, not just “˜somebody.’ Then, I find a lot of times, people will be willing to do more, to go to work, or to go to wherever, but, “˜Oh, this is just at home. This is just this Saturday.’ Whatever. So I say to them, if you got up late on a Sunday, you’re running to the market to get milk, and you happen to run into that person wearing this, how would you feel? And if you’re like, “˜I feel great,’ then it’s fine. So, I think that’s a great Litmus test, and it’s also really helpful to find one piece in your closet that you really love and feel amazing in. Everything you buy needs to make you feel as good as that makes you feel. Why would you buy something new that’s not as great as something you already have?

Jill: That’s a great mindset, especially when you start to fall into this habit of, “˜It’s on sale, it’s a really good deal.’ Let’s talk about money and budget. Do you work as how do you as do you work with clients on an unlimited budget, or how do you help your clients also think about budget?

Fashion on a budget

Mellicia: I definitely work with people with a budget, of all levels. It’s actually really fun for me. I tell people from the very beginning, I am as comfortable at Forever 21 and H&M as I am at Barney’s and Beyond and there’s no judgement here. What matters to me, is that we’re honest with each other, because I never want to send something that makes you feel like, “˜Oh god, I can’t handle that, I can’t afford that,’ because this experience should be fun, and empowering, and make you feel good. If there’s a moment when you start to not feel good, then we’re not in a win. So, we talk very openly about that. I also think it’s really important to as part of being seen is respecting your values. I think it’s really important to respect who you are, and for me to respect who you are. Maybe you’re someone who’s really into minimalism, maybe you don’t believe in buying new things. Maybe you want to focus your money more on your kids’ education; you think that’s more important with your money; that’s great. There are ways to do that.

I have a lot of clients where we go thrift store shopping, we never go to a new store, and I get the tailor to come over, and we just transform things, and that can save a ton of money, and make you feel amazing.

I also think it’s great to know where you, if your weight fluctuates, if you know where it fluctuates, then to shop accordingly. For instance, it’s very common for women to be, I call it the triangle body shape, or the pear shape where you carry your weight on the bottom. If you carry your weight on the bottom, and your weight goes up and down, that means that your jeans maybe won’t fit next month, that fit now, or throughout the month. Don’t spend all your money on something that is not going to fit in a few weeks. Think about how your body will change, and invest your money in things that are going to work for that.

Jill: What if someone’s not local? Do you work with women that aren’t local?

Mellicia: Yeah, that’s a great question. Actually, it’s kind of this beautiful time that we’re talking about all of this. What’s happened to me, over the years, is that I feel like I discovered how many women really need this more than I think I anticipated at the beginning. I find that I’m sort of maxed out, where I can’t get to all of the people, then I have this big waitlist, then I feel badly, because people are waiting, and I want to help them, and it’s kind of a whole thing. Also, because, as part of my brand, but also me as a person, I believe very strongly in work/life balance. I have a family, and I do a ton of volunteer work. So, finding the way to integrate all of those things means that I can’t be working all the time, regardless of how meaningful that is.

Instead, I’ve shifted the business to have it go toward offering those resources to the masses as opposed to one on one clients locally, which has made a big difference for me. I do a lot on the blog, I have a really strong blog community. Same with my newsletter, so people can engage with me that way. On Pinterest, I have are different boards for their body types, and I have new pieces going up all the time, so they can just shop those. And then, I have books that are going to be coming out in the next couple of months, and there will be a book on each body type, and just this exhaustive description of how to dress for your body type. Then, once you’re understanding what your keywords are, and you know your body type, you have the ability to move forward on your own.

Since the very beginning, I’ve worked very hard to build a community, as opposed to just having clients; I always tell them, “once a client, always a client,” so it’s been really nice for me, I think, and nice for them.

Fashion resources from Mellicia

Jill: You mentioned a couple resources there. How do people find your blog, and I think you also said the Pinterest page. Is it private, or is it public? What parts of private, and what parts are public?

Mellicia: It’s all public, and it’s all “¦ PoplinStyle.com is my website, and then you can get to everything from the website. Pinterest, also, it’s PoplinStyle on Pinterest also, and then the blog is on the website, so it’s all really easy. When people sign up in the first place for the newsletter, they get six weeks of style tips that come directly to their inbox. It kind of kicks you off with a lot of the details; how to shop for shoes, bras, these are the kind of things to take care of, and all that kind of stuff.

Jill: I, for one, have gone out to look at your Instagram, and everything, and it’s beautiful. It’s like a work of art, and so, your eye for fashion and the kinds of women you’re working with, it’s so apparent there. I think, wow, sign up for the newsletter; you get six weeks of tips?

Mellicia: Yep, six weeks to start you off, and I send out a newsletter anyway, so there’s as I try very much to be very respectful of people, so I’m not just sending them stuff all the time. We’re about to launch a giveaway; a $300 gift card for Universal Standard, which is one of my favorite brands; they do size 10 and up, and I love them. I do a lot of giveaways to my readers.

Jill: Is there any question, as we start to wind this down, that I haven’t asked you, that you think every woman should know, or you get a lot from with the women you work around their fashion, their appearance, just projecting the kind of image they want to project?

Mellicia: I think a kind of, part of it, I know it’s uncomfortable, and sometimes it can be scary, but don’t be afraid to admit to yourself, what you wish you looked like, or what you wish you were projecting, and taking steps to get there. I’ve provided a lot of online resources to help you get there, but “¦

I have this client of mine; so beautiful. Her husband had purchased the package as a gift for her, and it took her two years to redeem the package. I know! So, I bumped her ahead of the waitlist; because, well, you paid for it a long time ago! She’s a doctor, and she was in this sort of weird, okay”¦when people get a gift, they’re a bit more tentative; even if they want it, they haven’t gotten to the headspace to be able to say out loud, “˜I want to do this, and it’s something that’s a struggle for me.’ We get to that place, and we do the closet edit, and the closet edit can be a really emotional experience for people. I often as at the beginning I don’t think I realized how intense that is for someone, because you form a bond with your clothes. You remember where you bought them, or how it made you feel. Oftentimes, there’s a lot of baggage there too, you’re putting things on to hide yourself, or because you think it’s appropriate, or you’re afraid that your family won’t approve. There’s all these things tied up in our clothes.

So, to go through that is pretty intense. She was pretty resistant; she was great, but she was resistant, which doesn’t happen that often to me. So, I was kind of like, okay, let’s see how it goes, everybody’s personality is different. Then she sent this beautiful email that night, and she said, “˜This was a really transformational day, and I appreciated your patience,’ but then she said, “˜I always tell my daughters to embrace the growth mindset, and I realize that I need to do that with fashion and style, and I need to be able to do that.’ I think women, especially professional women, we read all these things: the “˜growth mindset’ is the buzzword right now, and if you have kids, that’s something that’s coming up. There’s all these things we apply to all these other aspects of our lives, and we’re willing to put that time into our relationships or our kids, or our career, or with our house, and ways we want to improve, and we’re afraid to look in the mirror and say, “˜what is it I want and how hard is it to get there?’

Going shopping in your own house

Jill: Even if there’s a piece of clothing you always wanted to get back into, so many people keep those around as a motivator. How do you address that?

Mellicia: My general feeling is, everything in your closet, it should fit right now, it should make you feel amazing, it should communicate what your style is, and it should be functional for your life. If it’s not those things, it should not be in your closet. You should lay in bed, you should roll over, you should look at your closet, and it should be like a boutique curated just for you, and everything’s color coordinated, and it makes you so happy, and you just can’t wait to put it on, and you know? If you’re not feeling that way, there are things in there that shouldn’t be in there. Even if you only have 20 things; if they’re all a success, you’re going to feel a whole lot better each day.

The pieces that are too small, but you love them, and they communicate your style, and you can’t wait till someday to wear this again? That’s fine. Put them all together, and put them somewhere else in your house, that you don’t see them, and that’s your too-small pile. Then you have the things you love, and they’re amazing, and you can’t part with them, but they’re too big? That’s fine. You put them somewhere else in your house, and that’s your too-big pile. And let me just tell you, when your weight fluctuates, and you feel like you could fit into those, you go shopping in your other closet, and you find these too small things, it’s a revelation. But, if you find that you’re never going in that closet, then after a while, you get rid of that box and never look in it again.

You don’t want to have that conversation with yourself every day. You don’t ever want to wear something that is digging into your waist, let’s say, because that’s probably where you carry your weight, which is why your jeans, or your tights are digging in. Every day, whenever you adjust that, you’re having this self talk, telling you, “˜I need to lose weight, these haven’t worked out,’ or however your body has changed.

You’re not the problem. The clothes are the problem. Someone’s job is to make clothes for you. If they didn’t make the right clothes, they have failed. You have not failed. This is not on you. So, you want to just be sure that you’re only wearing things that make you feel good, and if something doesn’t fit, and it’s digging into you, it’s not making you feel good. And if you’re looking in your closet every day and seeing something that makes you feel like you failed in some way, that needs to go.

One thing I hear all the time is, “˜I love that,” Someone will go shopping and say, “˜look at that dress, or jumpsuit, but I don’t have anywhere to wear that.’ I feel very strongly about this, that you buy the dress to create the occasion. You do not buy the occasion, like, have the occasion and go find a dress. If you think this is amazing and it’s some crazy formal gown, or a cocktail dress, or something that you have no reason, then you go home, you get on the Internet, and you find somewhere you need to go. If you let that drive your life, things are going to be so much more interesting. You’re going to end up doing things you never thought you’d do, or going places you never thought you’d go, just because of the clothing choices you’ve made. It’s another way to not let fear hold you back, and embrace what you see. If you love it, do it, and find a place that you’re going to feel comfortable wearing it, and also, if you’re going to take any fashion risks, do them in a safe space. Do them with someone you know is going to be supportive of you, and say nice things to you, and don’t start out on a journey going out of your comfort zone in a room full of people that you know are going to criticize you.

Jill: Or, do it in an anonymous place, like, going to New York City, you can kind of reinvent yourself because you’re in amongst a lot of strangers.

Mellicia

Quick menopause quiz: midlife menopause or thyroid problem?