If your Oooooooos are more Owwwws, you’re not alone. According to Emily Sauer, founder of the Ohnut, painful sex affects up to 75 percent of all women at some point in their lifetime.

Let’s say that again: Up to three-quarters of all women experience painful sex at some point in their lives. For some, the pain is temporary, the result of childbirth or vaginal dryness during certain times in their cycle as for others, it’s chronic. Many women’s pain can be solved with a good vaginal lubricant or intimate moisturizer; some may require a little more help.

Women who have pain or fear pain may start avoiding sex, which can be hard on intimate relationships, and they miss out on all the physical and emotional health benefits of a fulfilling sex life.

Sexual health is part of overall health and well-being, and pleasure during sex or intercourse shouldn’t be considered just a “nice to have.” So why does pain happen, and more importantly, what can we do about it?

What causes pain during sex?

According to pelvic physical therapist Rachel Gelman, “Pain with sex can be due to many factors, and a person usually has several factors at play. They can be anything from hormonal dysfunction to myofascial restrictions. As a pelvic floor physical therapist, I address the musculoskeletal piece that may contribute to pain with sex, but a patient may need other providers on board to address the other elements that may be driving their symptoms. Those providers may include a sex therapist, OBGYN, urologist, naturopath, or acupuncturist. The process can be frustrating but know that there are providers out there who can help!”

So be aware that you may need help both zeroing in on the cause and choosing the right solution.

1. Vaginal dryness is very common among women who are perimenopausal or post-menopausal, breast-feeding, receiving cancer treatment, or taking oral birth control pills, all of which can affect hormone levels. When hormonal changes like estrogen declines, so does vaginal moisture and resiliency. The drier, thinner tissue may tear more easily in penetrative sex or play, causing pain and leaving the vagina more vulnerable to infection. Possible solutions include lubricants and moisturizers, topical estrogen creams or a low-dose vaginal estrogen ring. Or for women who can’t have or don’t want hormones, laser treatments such as the Mona Lisa Touch offer a possible alternative.
2. Vaginal tightness can happen when a woman isn’t feeling relaxed and ready, if she’s nervous or fearful, or if she hasn’t had sex in a while. In many cases, extended foreplay and/or conversation may be all she needs. If the woman is suffering vaginismus, an involuntary tightening of the vaginal muscles, she may need to get outside help from a doctor, pelvic physical therapist, or sex specialist.
3. Vaginal infection or irritation can certainly take the fun out of sex. Yeast infections can cause pain, even without the added friction of penetration, and irritation from contraceptives (foam, “flavored” condoms), lubricants that contain fragrances or “warming” qualities, harsh soaps or detergents, or douching can also make sex uncomfortable. In the case of infections, waiting until the infection is gone is best (and also reduces the risk of transmission); in the case of irritation, identifying and banishing the irritant should take care of the pain.
4. Basic biology. A pain in the lower abdomen could mean your partner is actually bumping up against your cervix, the lower part of your uterus. Or if your uterus is tilted backwards, you can also have pain from too-deep penetration. You can change position to limit thrust; being on top gives the woman greater control. We’re also really excited about the launch of the Ohnut, a customizable wearable that allows you to control penetration depth in any position. Comfortable, interlocking rings placed on the penis determine how far in your fellow can go, so you can relax and enjoy the moment.
5. Endometriosis causes a lot of women a lot of pain, including during sex. In endometriosis, the tissue that should stay inside and line the uterus grows outside as well and can involve the ovaries, Fallopian tubes, and pelvic tissue. When it comes time for the tissue to slough off as it would during a normal menstrual cycle, there’s no exit, and this can cause considerable pain. Treatment for endometriosis may require surgery or pain medication, though some women find relief from hormones such as birth control pills.
6. UTIs. Because urinary tract infections make the area sensitive and painful already, adding intercourse can increase the discomfort. Antibiotics are usually required to clear up a UTI; for recurrent issues, it might be time to consult a urologist or ob/gyn.

Don’t endure painful sex or give up intimacy entirely. Devices like the Ohnut can be part of the fun, if you keep minds and lines of communication open. And introducing a toy or vibrator like the smart Lioness Vibrator sex toy can extend foreplay, help you feel more ready (and thus more relaxed and possibly more lubricated), and bring the fun back to a potentially stressful time.

When should I talk to my doctor about painful sex?

Don’t wait. According to Rachel, “If a person is experiencing pain with sex, they should consult their healthcare provider. I know many people report their providers don’t ask about sexual function, and it can be intimidating or embarrassing to bring up, but no one should have to suffer in silence and there are many treatment options for someone experiencing pelvic pain.”

In short: If it hurts, start talking. If your doc doesn’t ask about your sex life, tell her. Because there are so many possible issues, getting properly diagnosed means identifying the right solution and getting your better sex life back that much faster.

If you need support in managing painful sex, a menopause-certified physician can be helpful. Book a visit with a Gennev doctor.

Have you experienced painful sex? What did you do or are you doing to deal with it? We’d love to hear from you, so please share in the comments below, on Gennev’s Facebook page, or in Midlife & Menopause Solutions, Gennev’s closed Facebook group. 

What do sex and flossing have in common?

Both can increase your life expectancy.

We could all use a little more time in our lives, right? More hours to get more done, more years to experience as much as possible of what life has to offer.

And best of all is if those years are vibrant ones, full of energy, good health, and fistfuls of happiness.

What if you could unlock the secrets of a longer life as beyond the usual stuff most of us already know? Is there more to being healthier, longer than just eating your kale, walking 30 minutes a day, and drinking enough water to float a battleship?

From PRiMEWomen, we bring you six as rather different as ways to increase life expectancy and keep kicking“¦.

As we near the kickoff to the holiday season, we wanted to know how concerned we should really be about the amount of sugar we’re consuming. You hear words like “toxic” and “addiction,” as well as “harmless” and “fun” when it comes to sugar and sugar consumption. So which is it?

The American Heart Association says women should get no more than 25 grams (6 tsp) of added sugar a day, and 36 grams (9 tsp) for men. However, according to SugarScience, a publication from the University of California at San Francisco, the average American gets 82 grams of sugar (19.5 tsp) every day.

We’re eating a lot of it. But when it comes to our health in midlife, is sugar really that bad for us?

To find out, we called up Dr. Anna Garrett, who talked to us before on getting your mojo back in midlife. Dr. Anna is a certified coach and Doctor of Pharmacy, and her mission in life is helping women get their hormones as and their lives! as back in balance.

Here’s what we learned:

1:17 Can you really get addicted to sugar?

“Sugar actually works on the same centers in the brain as cocaine and nicotine.” So, yeah. Addictive and dangerous. Find out the process of addiction in your brain.

2:23 Is giving up sugar a fad?

Fat used to be the demonized ingredient when it came to obesity and poor health. But did the Big Sugar lobby play fast and loose with the facts to make it appear like fat was the bad guy?

4:25 Does sugar affect hormonal health?

Sugar disrupts insulin, creating chaos with your hormones and possibly contributing to estrogen dominance. And that’s just not good.

5:42 What about heart health?

Sugar wreaks havoc here too, increasing the risk of cardiovascular disease. Dr. Anna explains.

6:40 How the heck do I give up sugar?

Cutting out sugar is tricky. Dr. Anna gives her recommendations on going “cold turkey” versus “cutting back.” HINT: sugary drinks should probably be first to go.

7:37 Ok, fill me in on the drinks”¦?

Some drinks, like milk, have natural sugars. Avoid the ones with added sugars like agave or syrups. And bad news, y’all: wine is a problem.

8:40 Where does sugar hide in food?

Sugar is super sneaky, so even capable label readers may miss a few. Dr. Anna tells us what to be on the lookout for.

9:20 Artificial sweeteners: OK or no?

I’ll give you one guess. Yep. Not good. Dr. Anna tells us why artificial sweeteners may actually sabotage your good intentions. But there are ways to make it less bad for you “¦.

10:45 Withdrawal. What do we have to expect?

There are definitely withdrawal symptoms, just like with other addictions. Dr. Anna gives us the info on how we’ll feel, how long it’ll last, and how to manage it best.

11:58 How long does it take to break free?

If you’re truly serious, you can get to great in 7 as 10 days, says Dr. Anna. She tells us how to go about a sugar “detox” the best way.

13:10 What do you eat, if not sugar?

Dr. Anna gives us insight into her healthy diet. We’ve decided we want to be her when we grow up.

14:02 After the detox, can I bring some sweetness back?

Starchy veggies like beets or sweet potatoes and healthy carbs can be invited back, but for those folks for whom sugar is an “avalanche” food (ie, triggers binge eating), refined sugars should probably be eliminated entirely and permanently.

15:17 Halloween sugar-avoidance tips?

The holidays are coming and most of us are about to be awash in sugary treats. How do we handle it? Dr. Anna has some great ideas on how to be thoughtful about what we’re eating. Autopilot is only good for airplanes, folks; never for food.

17:36 How do you get your family on the bandwagon?

It’s tough to do this right: you don’t want to be the “anti-fun committee,” so explain why you’re doing what you’re doing, include the family in meal planning and prep, and start training taste buds early!

Are you ready to reduce your sugar intake? It can be a tough road, so consider getting help from a coach like Dr. Anna. We’d love to hear how it goes for you! Please share your successes and setbacks with us in the comments  or on Gennev’s Facebook page or Midlife & Menopause Solutions, our closed Facebook group.

According to US Cardiology Review, only 31 percent of women know that menopause is linked to heart disease””the same percentage of healthcare professionals who understand that women are at equal or greater risk of cardiovascular disease (CVD) than men.

And yet, heart disease kills more women than men, and a woman’s risk of heart disease is equal to a man’s, just 10 years later. Because of a fundamental misunderstanding of women’s risk, says the Review, “the extent of the problem in women is frequently underestimated and, compared with men, women are less likely to be offered interventions, are less likely to be represented in clinical trials and have a worse prognosis.”

So that’s the bad news. The good news is, once women are aware of their risks, they can take steps to minimize their chances of developing CVD and to manage it if it does occur.

Why does cardiovascular disease happen to women?

More women die from heart attack and stroke than the next five causes of death combined, and that includes breast cancer. Clearly CVD is a real danger.

Why? Well, the timing gives it away: about 10 years after menopause, a woman’s risk has increased dramatically. That’s because when her estrogen level begins dropping in perimenopause, the protective effects of estrogen on heart health go with it.

Couple loss of estrogen protection with the increase in menopause belly fat, poor sleep, fatigue that can result in less regular or vigorous exercise, and the stresses of middle age, and we can start to understand the increased risk.

The issue we’d like to discuss in this article is cholesterol. A well-known risk factor for CVD, levels generally rise post-menopause. There is an increase in the low-density lipoprotein (LDL as the “bad” kind of cholesterol) and triglycerides, and a decrease in high-density lipoprotein (HDL as the “good” kind). According to the Review, cholesterol levels peak in women at around ages 55 to 65 as about 10 years past menopause.

To make matters worse, many existing cholesterol medications were designed for men (remember that “less likely to be represented in clinical trials”? This is why representation matters!) and don’t work as well in women.

As cholesterol is such a large factor in CVD, we have tips to help you manage your cholesterol levels. The first thing you should do is talk with a doctor and get your levels checked so you can establish where you are and how urgent your situation might be.

Second, we recommend working with our Registered Dietitians who can help you learn lifestyle behaviors that can be very effective at helping reduce risk of CVD.

Protect yourself against rising cholesterol after menopause

According to the Review, just a 10 percent reduction in LDL cholesterol can reduce risk of CVD up to 20 percent. So how do we get that LDL down?

The Review suggests looking for foods that have some key properties: namely plant sterols/stanols, beta-glucan, and soy protein.

Eat these for healthy cholesterol

Plant sterols/stanols

One of the most effective food-based measures you can take are eating foods with plant sterols or stanols. These active ingredients block absorption of cholesterol during digestion of your food, and block re-absorption of cholesterol from the liver. Just 2 as 2.5 grams of plant sterols daily may lower LDL by an average of 10 percent in less than a month. When added to a healthy lifestyle, LDL may decline by a further 5 percent. These have no effect on HDL, and they do not interfere with lipid-lowering medications such as statins.

So, where does one get plant sterols/stanols?

Barbara Gordon, RDN, LD, of the American Dietetic Association (ADA) recommends foods such as vegetable oils (olive, canola, sunflower, safflower), nuts (especially walnuts), seeds (ground flaxseed), and whole grains. Also, foods may be fortified with sterols/stanols, so check orange juice, cereals, and breakfast bars.

Beta-glucan and fiber

The ingredient beta-glucan in foods can lower LDL from 2 to 5 percent when 3 to 5 grams is eaten daily. This soluble fiber is usually found in oats, which is why oatmeal is so often recommended for heart health. Oat bran is also a great source.

Soluble fiber generally is good for heart health, so go for asparagus, Brussels sprouts, sweet potatoes, turnips, apricots, mangoes and oranges, says Gordon. Beans, lentils, whole forms of produce (apples, not apple juice or applesauce). Remember: as you increase fiber, you should also drink more water. Fiber can be constipating, and with constipation already an issue in menopause, let’s not make matters worse.

Soy products

Soy protein as part of a low-fat diet can help pull down LDL by 3 to 5 percent, says the Review, with 25 grams of daily consumption. Tofu, soy nuts, edamame, miso as all good ways to bump up your soy. And bonus, soy foods may help reduce menopause symptoms, and there’s no evidence to suggest it’s a danger for women with estrogen-positive breast cancer risk. We recommend against taking isoflavone supplements or soy supplements, as that can provide a very concentrated dose and may therefore be a risk.

Understand that eating cholesterol-healthy foods is NOT a license to eat more cholesterol-unhealthy foods. Soy, oats, and plant sterols are effective as part of a healthy diet, not despite an unhealthy one.

Avoid for healthy cholesterol

Saturated and trans fats

Meats and whole-fat dairy are particularly problematic for saturated fat. Eat these in moderation and swap them out for skim or no-fat dairy or dairy substitutes. A couple of times a week (or more), consider salmon instead of steak.

Trans fats are often added to processed foods. Often called “hydrogenated” fats on ingredient labels, this is often considered the “worst” fat you can eat, says the Mayo Clinic. Not only do trans fats raise LDL, they can also lower HDL, making them a double danger. “Partially hydrogenated” oils contain less trans fat, but because we consume so much of this in the US, they should still be avoided.

You’ll find these wicked trans fats in pre-made baked goods like cakes, pie crusts, and crackers; snacks like potato chips and even microwaved popcorn; fried foods like fried chicken, fries, and donuts; pre-made dough for biscuits, cinnamon rolls, and pizza crusts; margarine and coffee creamer can also contain sneaky trans fats, says the Mayo Clinic.

How much is “safe”? The FDA says none. Even partially hydrogenated vegetable oil is no longer considered “safe” and is being phased out of use.

Additional risk factors

What else can increase risk of high cholesterol? According to Barbara Gordon of the ADA, in addition to estrogen loss, genetics, age, some medications, being overweight, eating saturated and trans fats, not moving enough, and smoking (particularly for women!) can all raise cholesterol levels. If any or all of these describe you, you should pay particular attention to your cholesterol levels and get checked more frequently.

So what is an OK amount of cholesterol?

Twenty to thirty percent of your total daily calories should come from fat, says the Mayo Clinic. Keep saturated fat at less than 10 percent. Choose monounsaturated fats instead: nuts, fish, olive oil and foods with good omega 3 fatty acids (fatty fish).

February is heart health month. It’s also the month of Valentine’s Day. So do something for those you love the most (and that should include yourself) by taking some steps to preserve your healthy heart for the many years ahead.

Ready to get started on better health? Access the evidence-based lifestyle recommendations of our menopause specialists. Book a virtual visit today.

Have you dealt with heart-health issues? How are you managing? We’d love to hear your tips or heart-friendly recipes, so share in our Gennev community forums!

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The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.

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It started with 24 women submitting their menopause stories through selfie videos for what we were calling our ” anthem video”.

Each of them answered a brief script of questions about how they were experiencing perimenopause symptoms, post-menopause, or somewhere in between.

Two months later, our editors wove together their stories into what is now the #IAmTheChange video. Please pause for a moment and watch it now”¦but first, promise me that you will come back to read the rest of this email. It’s critical that you do.

Women Around The World Sharing Their Horrible Menopause Stories

Now that you’ve watched the video, how do you feel? Do you feel emboldened? A little less alone during this time of life? Moved by hearing women talk about a change that you’re going through too?

The #IAmThe Change video is a call to arms for women to speak up about how they’re transforming during their time of menopause. No more shushing women into isolation; this video is meant to help us all feel a little more normal; a little more in control of this miraculous and sometimes challenging transition we’re in; and a little less lonely when the stress, sleeplessness, or relationship strain gets heavy.

We didn’t quite know where the women’s’ stories would take us; but we knew that it takes voices coming together to create change. The kind of change that materially changes how women will experience this menopause transition so many of us manage on a daily basis.

With #IAmTheChange, we believe that talking about our time in menopause will make it less daunting, isolating and stigmatizing for all women.

And it’s not about the hashtag; it’s about the conversation we ignite. It’s the perception we change of a 50-year-old woman. It’s the workplace we help make more inclusive for women experiencing brain fog, fatigue, and hot flashes.

Alicia Garza, the co-founder of the Black Lives Matter movement said, “You don’t turn a hashtag into a movement – people turn things into a movement.”

#IAmTheChange is a conversation-starter. It’s the ice-breaker for real meaningful conversation about this incredible transformation we as women get to go through.

I’m not trying to candy-coat the night sweats, mood swings, weight gain, or mysterious symptoms that come with the change; but I am trying to make them less daunting with a supportive community who can openly express how they’re feeling.

Feel compelled to share your menopause story and be part of a movement to change the way society views women in transition?

Submit your #IAmTheChange story. It takes 5 minutes to write a few things about your experience. You can add your name and photo, or leave it anonymous. Every story helps, because you never know who might read your story and connect, given the immense feeling of relief that comes with knowing that you’re not the only one.

Because it starts with one person, I’m sharing my story below. Please read it and share yours.

Every woman has a story. We want to hear yours.

Here is mine…

Name: Jill Angelo

Age: 47

Menopause phase: Perimenopause

What did you know about menopause before starting your own journey?

I didn’t know much about it. I thought it was a time in life when women got hot flashes and they’re moody. All negatives, nothing positive.

What has been the most surprising aspect of menopause?

I’m most surprised about how freeing it feels. I care less about what others think of me. I have a new respect for what my body is capable of as it transforms into what it needs to become for the next 40 years. I’m also surprised at how others so willingly open up when I share what’s working for my symptom relief.

How do you control your menopause symptoms?

I struggle most with bad irregular periods, night sweats and trouble sleeping. As a result, I am getting an IUD to manage my periods. I have an incredible gynecologist who is helping me. For the sleep and night sweats issue, I limit hard to digest foods; I time my alcohol consumption before 9 p.m.; and I use the Gennev Sleep Premium CBD Tincture to manage my stress and help me fall asleep faster.

What’s your advice to younger women about what to expect in menopause?

Don’t be dismissive of random symptoms that may pop up. I started having night sweats when I was 34. I didn’t dive into educating myself about menopause just then, but I did seek to understand what was causing them and then changed my behaviors to put them in check so I could get a good nights’ sleep. Menopause is not an “old woman’s thing”. It’s a natural change in your hormone patterns that always track to your age.

What happens when women realize their stress, anxiety, and mood swings are different than they have ever experienced before, and in some cases may lead to rage and even panic?  Unfortunately, many end up keeping it to themselves.

In Gennev’s annual women and menopause report, 92% of women reported more stress on top of menopause-related anxiety in the past year.  And 45% of women surveyed revealed they were struggling more than they ever had. 

Being in touch every day with women who are dealing with the many symptoms and impacts of menopause, the Gennev health team knew they needed to respond with a solution to help those dealing with challenges in their emotional wellbeing. Jill Angelo, Gennev CEO shared, “We consistently hear that women in menopause struggle with emotional health, but in the last year, women were requesting referrals to therapists. In response, we designed a program that offers a 360-degree solution for helping women manage their emotional health, complete with therapists, doctors and health coaches”.

“Our participants often feel like there is no one who understands what they are experiencing, or worse, they don’t even know how to begin to ask for help.”  That is what Stasi Kasianchuk, Gennev’s Director of Health Coaching, hears from many women in Gennev’s Menopause and Emotional Wellness program where ten women meet each week in a group session designed to provide education, support and guidance.  “In each of the group programs we have held this year, women have shared their relief in knowing they are not the only ones who have been experiencing these feelings as feelings that are often difficult to admit.”

Gennev’s Menopause and Emotional Wellness Program offers women three key things that are proving to make a difference in the outcomes of participants:

• Reputable information as Education on the symptoms and impact of menopause from experts. Women get their questions answered and feel heard.
• Group support as Sharing and learning from other women in the same shoes is validating.
• Accessible strategies as Women are guided with new ways to manage menopause symptoms effectively.

The program offers a safe space to participate in discussion about uncomfortable topics. While being uncomfortable is part of the process of learning, women don’t need to go it alone.  The education  presented helps women understand what they are experiencing is often a result of the normal hormonal changes that occur during menopause, not them losing their minds. With recognition that these are real changes there are also strategies provided to mitigate the impact.

“The most surprising outcome from each of the programs has been the meaningful connections these women are making.  They find common ground in the first session where each participant shares what they are struggling with most, and the comradery grows from there.  We have had many women planning to meet in person or stay connected via phone once the program ends,” says Stasi, “it’s heartening to know that this sense of belonging can be found with a Zoom meet up.” “Women are grateful for the learning and the clarity the program offers.  They are building confidence in what they are going through, knowing it’s a transition and not a destination.  I believe they have been searching for information to make sense of what they are experiencing and have found the solution in a group setting with the added support of women whose experiences are familiar to them.”

Are you ready to feel better?

Emotional wellness support is critical at every stage of life, and especially now.  If you feel like you don’t know where to begin in finding the support you need, or even what to ask, Gennev can help you.  Join an upcoming Menopause and Emotional Wellness group program for education and connections, or speak one-on-one with a Gennev Health Coach to help you identify the solutions that are best suited for you.

If you have a question about participating in a Gennev Menopause and Emotional Wellness program, please feel free to reach out to Stasi at Stasi@Gennev.com.

At Gennev, our mission is to connect women with the very best menopause resources available to manage their health in midlife. We’re working hard to gather up medical and wellness professionals with expertise on the changes in women’s bodies; vendors offering truly effective solutions; and the very best, most accurate and complete information we can supply.

Why?

Because Ann-Marie Archer.

Because there’s so little information and conversation, even an informed woman who takes good care of herself didn’t know what, who, or even if to ask for help when her body did some pretty frightening stuff.

“I don’t want to scare anyone, but “¦”

At 51, Ann-Marie still wasn’t menopausal or even close. Her periods were erratic and had been for a while, but she wasn’t having hot flashes and her blood tests showed no indication of menopause, so she and her doctor assumed things were fine, if delayed.

Things weren’t fine.

Her periods were extremely heavy as sheet-changing heavy, taking-an-extra-bag-full-of-tampons-when-traveling heavy as but hey, no hot flashes, and that’s how you know it’s menopause, right?

Ann-Marie Archer

“My doctor never said, “˜We should do something about this,'” Ann-Marie says. So they didn’t.

“I’m an informed woman,” Ann-Marie says. “I felt ridiculous asking my doctor if this was “˜normal,’ because I should know if it’s normal. But how can anyone know what’s normal if no one talks about it?”

Two events finally convinced her that it was time to push for more help.

“I was in the office of the business my partner and I owned at the time. It was summer, and I was wearing a sundress. I was 51 or 52, I was having my period, but it was no big deal. I stood up to go the restroom, and suddenly, I was bleeding so badly that it was all over the floor, everything just came out, it was horrifying. Fortunately, the only other person in the office with me was another woman, and she was able to help me. “

With her help, Ann-Marie was able to make it home and change into completely new clothes. Then she went back to work.

“That should have clued me in that something was very wrong. Something wasn’t normal. But I thought, well, that’s just what menopause is.”

“That should have clued me in that something was very wrong. Something wasn’t normal. But I thought, well, that’s just what menopause is.”

She did talk to her doctor, but she didn’t get any satisfying answers. Tests once again seemed to indicate there wasn’t really a “problem” as just “menopause stuff.”

“It was horrendous,” she says. “There were no good options. The doctor said she could put in an IUD or she’d prescribe the Pill, but that just didn’t feel right. There was no discussion of ablation or other possibilities as only choices I didn’t want.”

When it happened a second time, this time during a massage, it scared Ann-Marie badly enough that she convinced her doctor to run some additional tests. And there it was: pre-cancerous cells in her uterus. She had a hysterectomy in December of 2016 after, she says, “years and years of suffering vaginal pain and excessive bleeding. Because I didn’t have enough information.”

The surgery revealed enormous fibroids that hadn’t shown up on any of the previous tests, including an ultrasound. “How could they not know?” Ann-Marie asks. “They were so big, my uterus was two-thirds again its normal size. Turns out my swollen uterus was pushing on my bladder, which explained the incontinence I’d been complaining about. I’m a weight lifter, but I could barely sneeze without wetting my pants. The surgery took two hours longer than they expected because of the giant fibroids no one knew were there.”

Women need menopause education

Silence and shame are their own kinds of cancer, Ann-Marie says, but they can be just as deadly.

“If I had known more, if I had more to read, people to ask, if there was more menopause education, I would never have let it go on this long. When I talked to the oncologist about the hysterectomy, I said I assumed they’d leave my ovaries. She advised against it, saying there are no warning signs for ovarian cancer. The crazy bleeding was my body’s warning of the uterine cancer, she told me. Who knew? If I’d known that, I would have demanded tests a lot sooner.

“Women aren’t useless after 50 just because we’re no longer having babies. At 55, I still hadn’t gone through menopause, and my doctor just sort of shrugged it off. If I can’t get information there, how can I possibly know how serious it is? Something’s missing, for women.”

What’s missing, Ann-Marie says, is information. Information on the limits of “normal.” Information on the body’s signals and signs when something’s wrong, and information about all the options to fix it.

“Don’t just talk about hot flashes as if that’s all menopause is. Women manifest symptoms in so many ways, we need to share information and get educated. Let’s talk about “˜here’s what perimenopause is, here’s what menopause is, here’s where normal ends.’ We need to know when everything’s OK and when we’re heading for trouble.”

And it’s not just the bad stuff we need to know, according to Ann-Marie. Education can fill us in on the positives to come as well. For example, Ann-Marie had no idea how much better she’d feel after her hysterectomy.

“My uterus went to the Dark Side,” she says, laughing. “Once I got it out, I was happier than a pig in sh*t. My naturopath put me on naturally occurring hormones [BHRT] as it took about six months to get the balance figured out as but I’m right as rain now. I just wish I’d done it years ago.”

Her BHRT includes a tiny amount of testosterone, which has also had an unexpected impact: “I always had a healthy libido, but now you can’t keep me out of the bedroom. Who knew that was going to happen?”

Educate yourself

Ann-Marie’s advice to others experiencing dramatic symptoms? “Educate yourself. Find whatever information you can, then go to your doctor and push until you know all the options, all the risks and benefits. Don’t settle if none of the choices seem right for you or your body.

“And all of us need to talk, no matter what our experience has been. Talk with your mom, your daughter, colleagues, friends, other women. Keep talking until we figure out what’s normal and not, what’s to be expected, what the signs are that you need medical help. The more we talk, the more we learn, and the better we understand where the edges of “˜normal’ are.”

The more we know, the better our understanding of menopause and midlife. If you have a story to share, please share on Gennev’s Facebook page or in Midlife & Menopause Solutions, Gennev’s closed Facebook group. And, as always, if your symptoms don’t feel normal, or even if they’re just impacting your quality of life, please talk with your doctor.

hormonal birth control and its affects on women’s health

“It’s the only time I’ve ever actually wanted to die. I had one migraine that was so bad, I thought, “˜I could kill myself right now. I could really just die.’ It was that bad.”

Most women have experienced headache pain, but for women like Kara, the agony of a migraine can be a whole lot worse. As in, leave-work-and-spend-a-couple-of-days-in-bed-trying-not-to-throw-up worse. And they were frequent, tearing days out of her life at least once a month.

When she was 38, Kara and her husband Edwin decided they wanted a baby. “We had a great life: good jobs, lots of travel””we weren’t sure we wanted to disrupt that. But we talked about it and decided we didn’t want to get to 50 and have this huge regret.”

But for women who suffer from migraines, opting for parenthood comes with a whole different set of risks. Kara, a microbiologist and research biochemist, is a self-proclaimed “giant nerd,” and she researched the concerns of pregnancy and migraines like the scientist (and nerd!) she is.

“The worst thing,” according to Kara, “is all the conflicting information. Migraines are such a mystery, but we throw medications and chemicals and hormones at women without really understanding what causes the pain, how to treat it, how your body will react to the medications, or even what your triggers are. Honestly, no one has a frickin’ clue.

“And when you’re a woman with migraines who’s considering having a baby, what you usually get told, and what my doctor told me, was that many pregnant women don’t have migraines while they’re pregnant. Sounds great, right? But then I started looking through the stats, and I found that yes, some women don’t have migraines”¦and some women have a migraine that lasts for the entire duration of their pregnancy. Nine months of a horrible, debilitating headache. That was a serious gamble that my doctor didn’t tell me I could be taking; I had to find out on my own.”

Kara decided it was worth the risk, and she went off the Pill for the first time since she was 22. Shortly thereafter, she had the second-worst migraine of her life. However, during her next cycle, when she would normally experience a migraine, she had a mild headache”¦and that was all.

Daughter Anna was born in September; Kara had few migraines during the pregnancy and has had none at all since late July.

There’s a strong genetic component to migraines; people are more likely to have them if a parent does. However, except for recently, Kara has suffered from migraines since early adulthood, despite migraines not running in her family.

“All of this tells me it was the hormones I was taking that were causing the problem, yet no medical professional was willing to explore that possibility with me.

“I’ve dealt with this for years,” Kara says. “I’ve had MRIs of my brain, X-rays of my neck and spinal cord, I tried everything. With my previous ob/gyn, I told him, I think it’s caused by the hormones because they’re like clockwork. I ovulate, I have my period, and I get migraines. His response? “˜Oh, no, no, let’s try you out on a different kind of birth control. This one will make you mildly crazy and angry, but it might help you control the migraines.’ How is that an option??

“The medical industry just has so little understanding of how hormones trigger migraines and how complicated female biology is, but they just keep handing out hormone pills like “˜hey, the research is done, they’re really effective at preventing pregnancy, mission complete!’ Except hormonal birth control doesn’t work for every woman, and we need more safe, effective choices.

Fortunately, Kara now has a new ob/gyn whom she loves. After baby Anna was born, when it was time to consider birth control, they had a very open conversation about all the options. “I didn’t want to go back on the Pill because I was sure they were causing or at least contributing to my migraines. She listened, and we came to a solution that will work for me and my family.” Kara wants all women to have that experience.

The lack of good information and options affects a lot of women, not just women starting a family, Kara says. When she was on the Pill and having migraines, it was embarrassing to have to explain taking a couple of days off every month.

“Women need more information, and doctors need to be a lot more open about the risks and side effects. A former colleague of mine has terrible migraines, and I suggested she talk to her doctor about her birth control. She said no, they were just going to keep trying different versions until they found one that solved everything. I hope she finds it, but I worry that for some women, hormonal birth control just isn’t an option, but they’re not being educated about that.”

Until we can count on getting the full story from our medical professionals, Kara recommends every woman do her due diligence. “Don’t self-diagnose. Never self-diagnose,” Kara says. “But do your research, be ready with your questions when you talk to your doc, and don’t leave until you’re satisfied. Get a second opinion if you’re not feeling confident about what you’re being told. Be open and advocate for your own health the way you would for your kid or your partner or your parent. Doctors can’t know what we don’t tell them, and sometimes the only way we learn things is to ask.”

Our thanks to Kara for sharing her experience. The more we at Gennev talk with women and hear their stories, the more convinced we are that opening the conversation around women’s hormonal health is critical. If you have a story to share, join us on Facebook, Twitter, or Instagram.

One part of your body that probably isn’t slowing down as you approach menopause is your bladder. You may be noticing an increase in the number of times you have to pee each day, and many of those trips to the bathroom may be pretty urgent. Unfortunately, overactive bladder and urinary incontinence increase as you get older. According to new research published in Menopause, the journal of The North American Menopause Society (NAMS), about one in five women ages 50 to 54 experience these unpleasant conditions. The study included more than 12,000 women, ages 27 to 82.

An overactive bladder generally refers to an urgent and frequent need to urinate. When you experience urine leakage before you can get to the bathroom, that is urge incontinence. The more common type of incontinence is stress incontinence which occurs due to physical pressure. It’s when you leak a little (or a lot) of urine when you laugh, sneeze, or cough, or when you’re exercising or having sex.

What causes bladder problems in midlife and menopause?

Estrogen affects just about every system in your body, including your urinary system. With less estrogen, your bladder that holds urine and your urethra, the tube that carries urine out of your body, weaken, which affects your ability to control your urinary function. Your bladder also loses volume and elasticity as you age which can contribute to problems.

Other contributors to bladder problems may include:

• Weight gain, a common side effect of menopause, is a risk factor for stress incontinence because the extra weight puts pressure on your bladder.
• Medications like antidepressants may affect urinary control.
• Conditions such as diabetes and multiple sclerosis can cause nerve damage that affects bladder control.

How to curb the urge and stop leaks

Since bladder problems can be embarrassing, impact your lifestyle, and worsen with age, the sooner you take action the more relaxed and happier you’ll be. Here are six ways to minimize bathroom visits and leakage.

Drink up. It may seem counterintuitive, but your urinary system””along with the rest of your body””functions best when it’s well hydrated. Restricting fluids cause urine to become very concentrated, which irritates the bladder. It also conditions your bladder to hold smaller amounts of urine, meaning more potty breaks throughout the day. Instead, aim to drink about half of your body weight in ounces a day. If you’re not getting enough fluids, gradually increase the amount you’re drinking by sipping small quantities throughout the day. Dehydration can worsen other menopause symptoms, too, so as you rehydrate you may notice other improvements. If you’re drinking excessive amounts of fluid, you may need to cut back on your intake.

Exercise your pelvic floor. Your pelvic floor is a sling of muscles that stretch from your pubic bone to your tail bone and out to the sides to support your bladder, intestines, and uterus. These muscles are responsible for controlling urination, but hormone changes during menopause can weaken them. Other contributing factors include childbirth, surgery, persistent coughing, and chronic constipation. To strengthen your pelvic floor muscles and regain more control of your bladder, perform Kegel exercises by contracting and releasing the muscles around your vagina and anus. Imagine that you’re trying to stop the flow of urine or trying to avoid passing gas. Aim to do three sets of 10 Kegels daily. If you’re unsure if you’re doing Kegels right, a physical therapist specializing in pelvic health can help. There are also devices like elvie kegels that provide feedback to assist you in engaging the correct muscles in the right way.

Avoid diuretics. Caffeinated beverages like coffee, tea, and soda act like diuretics, increasing urine production, so you must pee more frequently. Caffeine also irritates the bladder, which results in contractions that will send you to the bathroom, typically within five to 45 minutes of consuming caffeinated beverages. Cut back or eliminate these beverages from your diet.

Watch out for other bladder irritants. In addition to caffeine, other beverages and foods that can aggravate urinary problems include alcohol, carbonated drinks, artificial sweeteners, citrus, tomatoes, tomato-based dishes, and spicy foods. Try eliminating these irritants and see if your symptoms improve. Not all foods affect everyone, so you can try reintroducing foods one at a time to see which ones affect you the most.

Get more fiber. Too little fiber in your diet can cause constipation, which puts more pressure on your bladder. Aim to get about 25 grams of fiber a day by eating more vegetables, beans, and fruits. Some good sources include oatmeal, oat cereals, barley, beans, nuts, lentils, peas, apples, blueberries, oranges, Brussel sprouts, and sweet potatoes. Fiber also helps by filling you up with fewer calories to make it easier to keep your weight under control.

Schedule bathroom visits. Start by going every two hours whether or not you have to go. This regularity can help prevent sudden urges. Once you see improvement, gradually increase the amount of time between bathroom visits. This will retrain your bladder to hold more urine.

When to see a doctor about overactive bladder concerns

If frequent urination or leaks are interrupting your life, talk to your doctor. There are medications, hormones, biofeedback, devices, and as a last resort, surgery that can help. Physical therapists who specialize in pelvic floor issues can help you to strengthen pelvic floor muscles and retrain your bladder.

If you’re taking medications like antidepressants or have other health problems like diabetes, your doctor can help determine if any of these factors are contributing to your bladder issues.

You’ll also want to see a doctor if you have any of these symptoms:

• A change in the color of your urine, such as red, pink, or brown
• Having trouble emptying the bladder completely
• Pain or burning when urinating
• Fever

It could be the sign of an infection or something more serious.

We can help you manage overactive bladder and incontinence

• Meet with a Gennev Doctor -Our board-certified physicians are menopause specialists and can help you narrow down the possible causes of your symptoms and discuss next steps for full evaluation and management.
• Vitality is a proven, daily nutrient-packed supplement for women in menopause, that supports mood, energy, stress response, immune health, joint pain, and inflammation

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy. 

When Team Gennev went looking for the right face to put on our website, we had a good idea what we were looking for: a face that showed the strength, resilience, beauty, and energy of a woman in midlife and menopause.

It can be hard to find images of mature women doing anything besides fanning themselves and looking annoyed.

Happily, we finally found lots of incredible choices on the Ageist website: active women over 50 living their best lives, overcoming challenges, and full of the postmenopausal “zest” Margaret Mead was talking about.

We went a little crazy with the credit card, purchasing the rights to use these wonderful images of real women. 

As Ageist founder David Stewart said in his podcast with Gennev’s Jill Angelo, we just don’t see ourselves in the typical, commercial images of people our age. So when you come across a treasure trove of representative images, you take advantage.

Podcast with Aliza Sherman

One of the images we loved was that of Aliza Sherman “” we loved it so much, she graces Gennev’s home page with her wide-open smile. You can just feel the hum of energy and life flowing through her. 

Not long ago, @AlizaSherman tweeted, “Yes, that’s me. Apparently I’m the happy face of menopause.” Team Gennev had been wanting to reach out and ask her to do a podcast; this was the nudge we needed. What follows is that conversation.

We know there are more “Happy Faces of Menopause” out there “” maybe even your face! Share it with us on our Instagram, and tag @MyGennev and #HappyFaceOfMenopause!

We’d love to know how your menopause is going! Join us in the Gennev Community forums. 

Getting out of bed can get tougher as we get older, and not just because our “to-do” the list is starting to look like a phone book. For the 27 million Americans with osteoarthritis and the 1.3 million with rheumatoid arthritis, getting out of bed can be an exercise in pain. Menopause joint pain fatigue and arthritis and are a real thing for many women, but there are some things that can be done.

Both rheumatoid arthritis (RA) and (OA) can develop or worsen in menopause, indicating that hormone levels play a role. What that role is exactly isn’t yet known as one theory is that estrogen may help reduce perception of pain. Whether or not menopause can actually cause RA or OA is still a matter of debate.

Because the cause(s) of arthritis and any correlation with menopause are still undetermined, there isn’t a cure, and treatment options are limited. However, this is one of those times when the choices we make can have a very big impact on our quality of life. We took the question of arthritis to our doctors of physical therapy, Meagan and Brianna.

I just got a diagnosis of arthritis. Is it time to upgrade my couch?

One of the biggest issues in managing arthritis isn’t the pain, our PTs tell us, it’s the notion that a diagnosis of arthritis means you need to slow down or stop all activity to preserve your joints from further damage.

Nope, says Bri. “Motion is lotion. Even if you have menopause arthritis symptoms, sitting still, not moving, is worse for your body than activity. People who get a diagnosis of arthritis or degenerative disc disease often fear that moving will make things worse. But activity and exercise that keep you stretching and moving are really important for maintaining flexibility and strength.”

But isn’t the arthritis pain telling me to stop?

There isn’t actually a correlation between the severity of the disease and the severity of pain, says Meagan. Someone with only mild degeneration can feel a lot of pain, whereas someone with bone-on-bone arthritis may not feel much at all; it depends on the individual. What that means to you is that even if it hurts, you’re probably not doing additional damage as and you may be doing some real good.

OK, so how do I exercise with arthritis in menopause?

A diagnosis of arthritis is scary, so a visit to a physical therapist might be your best next step. When fear of pain or doing damage means we start limiting ourselves, PTs can help us understand our true limitations and how to exercise safely.

Once you have the diagnosis, it’s time to make some good choices about managing the condition. A PT can help you”¦

Determine the right activity and level of activity. Arthritis presents differently in different people, Bri says, so your choice of activity depends on what works for you. For some, continuing with or even increasing their current activity is fine. For others, switching to non-weight-bearing such as pool or bicycle might be more comfortable.

Learn how to strengthen and stabilize joints. “The more stability a joint has, the less “˜slop and play’ there is in the system,” Meagan says. “That looseness and instability is what could pinch the meniscus in the knee, for example, or the cartilage, and further contribute to tissue break down. If you’ve got good stability and co-contraction when the joint is moving, you won’t have the wiggles and dings that end up causing additional damage. We can help you learn to build the supporting muscle around the joint that provide the stability and flexibility that allow the joint to function.”

Evaluate your true range of motion. “Seeing a PT for a formal evaluation is helpful,” says Meagan, “because a fearful person may start to restrict their range of motion. If the joint should have 90 degrees of range, but you limit that motion to just the middle 45 degrees, you’re overusing that portion of the joint surface. You need to share the load over the entire joint surface, the way it was designed. Wearing away at a portion of the joint can cause more problems over time.” PTs can help you understand not only the restriction you’re dealing with but also how you can begin extending that range safely.

Determine the true cause of pain. According to Bri, a PT can help determine if the pain you’re feeling is truly from the joint itself, or if it’s “referred” from somewhere else. Is it a muscle restriction or tight hip flexor? Or is it maybe a trigger point in a nearby muscle or a pinched nerve in your back? Identifying other sources of pain can be really helpful in determining a treatment plan.

Reduce pain. Ever heard of the “Gate Control Theory” of pain? It goes like this, Meagan says: the brain can really only accept one signal at a time, traveling up the peripheral nervous system from the limbs. Once a signal is received, it temporarily shuts the brain off from getting other messages, effectively “closing the gate.” Pain signals as while it may not seem like it when you stub your toe as travel relatively slowly. So if you can get another signal there first, it can shut the gate to pain, reducing our sensation of hurt. A PT can teach you ways to “wiggle” your joints to both shut the gate to pain but also to spread synovial fluid and lubricate sore joints.

What else can I do to manage my arthritis? Does post-menopausal arthritis go away?

Arthritis does seem to run in families. And it disproportionally affects post-menopausal women. Given that, it’s understandable that many women feel they’re likely doomed to decades of increasing pain and decreasing functionality. 

However, say our PTs, there are so many factors that are within your control, that a diagnosis of arthritis doesn’t have to signal the end of your active life.

Stop smoking. Smoking makes arthritis worse. It may accelerate the destruction of cartilage or impede its repair. It reduces the effectiveness of treatments, complicates surgery, and increases mortality risk. If you can stop, do.

Maintain a healthy body weight. Smoking and BMI are tough topics for our PTs to broach with their patients, they tell us, but “I wouldn’t be doing my job well if I didn’t bring it up,” says Meagan. Bodyweight, like smoking, takes a toll on joints. Intermittent fasting during menopause and” losing even one pound can take four or five pounds of pressure off your knees with every step,” Meagan says. “That’s worth celebrating!”

How to keep arthritis from getting worse

Try topical remedies. Arnica, Biofreeze, even just using lotion for arthritis to touch and massage the painful area can help desensitize you to the pain, the PTs tell us. 

Apply heat. Warm water soaks, Epsom salt baths, dipping painful fingers in warm paraffin wax as heat really helps lubricate the joints. “Think of putting maple syrup in the microwave,” Meagan says. “It gets nice and thin and runny and it covers more of your waffle. The same is true of synovial fluid and joints. You want it to coat the whole joint surface so it can lubricate the joint better.”

Stretch and move. “People really overlook the importance of stretching and moving,” says Bri. “If you’ve been on your computer for a while, take five minutes, do some forearm stretching, maybe find a quiet corner and do some foam rolling of hips and shoulders. If your fingers hurt, grab a couple of rubber bands, put them around your fingers, and open and close your hands. Get a soft ball to squeeze. These help build up strength and keep the joints in motion.”

Strengthen your core. This may seem like an odd remedy for pain in the wrist or shoulders or hands, but the stronger your core is, the less work your appendages have to do. “It’s that slop factor again,” Meagan tells us. “If your hips and abdomen and pelvis and lower back are strong, your knees and ankles don’t have to work as hard to correct for the weakness in the chain.” Although somewhat counterintuitive, a large part of the pain caused by a weak core is ultimately felt through pain in the knees for women in menopause.

Get good shock absorbers. Want to keep running? Get good shoes and/or inserts. The right shoes can stabilize and cushion, meaning less shock traveling up from the impact with the road. For cyclists, good gloves with the right padding can minimize impacts on your hands and up the chain from there.

Leverage the power of hydration and diet. It’s more effective than you might think, Bri tells us, you have to avoid a lot of foods in menopause as well as eat and drink the right things. Drink lots of water. Eat turmeric and other vitamins for menopause symptoms. Boost intake of anti-inflammatories and Omega-3s for women.

A diagnosis of arthritis isn’t the end of your active life; for most of us, it’s livable and manageable. “Too many people let a diagnosis of arthritis be an excuse to stop being active,” says Meagan, “but there are ways to have some control over the pain and the progression of the disease. A positive mindset and the decision not to let it victimize you are really powerful tools. Use them.”

Brianna

Meagan

Are you dealing with a diagnosis of arthritis? What are you doing to manage it? Please share what you’re doing and how well it’s working! Leave a comment below, on our Facebook page, or in our private Facebook group Midlife & Menopause Solutions.

On March 8, team Gennev was on hand for “Be Bold: Stand Up for Change,” an event to celebrate International Women’s Day.

The Seattle event was spectacular as starting with the great food by That Brown Girl Cooks, on to the “Bold Women” history lesson from Dr. Devon Atchison, to the insightful panel discussion, through the breathtaking, heartbreaking snippet from the documentary film Girl Rising, and closing with the gorgeous music and lyrics of Star Anna. Hundreds of women attended, and there were many tears, laughs, and pledges to carry the momentum forward.

But that’s the question: how do we keep our enthusiasm from folding up along with the chairs and tables at Town Hall? It’s great to attend events like these, but it’s even greater if we can take that energy forward to make real and lasting change for women, their families, and communities all over the world.

Fortunately, the organizers of the Seattle event, Kate Isler and Nickie Smith, were already way ahead of me.

“How do I re-create the spirit and passion of
International Women’s Day, every day?”

Based on recommendations from the United Nations, here are Kate and Nickie’s suggestions for keeping the momentum of International Women’s Day going:

1. Forge opportunities for women. There are lots of women-owned, women-led companies out there. Find some. They’re in your neighborhood. Ask your friends; start small but start looking for them, and you’ll be pleasantly surprised by what you find. (Shannon: I wasn’t able to locate an app or website that tells you which businesses in your area are woman-owned or woman-led, but there may be one. If you know, please share in the comments!)
2. Challenge bias and inequality. Gender inequality is often so “normal” that it’s nearly invisible until someone points it out. Be that someone. If you see an all-male panel, challenge it; offer to occupy a seat, if appropriate, or help the organizers locate some female experts. Monitor the pay gap, and if you’re responsible for the pay of others, don’t help propagate it. Challenge stereotypes as and by this, we mean all stereotypes, including the “inept father” as well as the “ditzy blonde female.” Support inclusive leadership. Call it out when you see it and reward those who are truly making an effort. Raising awareness as in your community, among family, with friends, every opportunity you get as is key.
3. Campaign against violence. Educate young people on how to have positive, supportive, equal relationships. There’s a lot of female-victim blaming and male-perpetrator excusing behavior out there: don’t engage in it or let it go unchallenged. Report violence if you witness it. Support community groups that help counteract abuse.
4. Champion women’s education. Donate to an organization that educates girls globally, and be a voice for your local schools. Help launch or fund a scholarship that provides educational funds to women or girls. Celebrate women’s accomplishments by talking about them on social media and with friends.

Finally, be an advocate for women in your daily life. Mentor a younger woman or seek out a mentor to help you grow. Connect women who can help one another. Gather women and the men who support them to set goals and find or carve out opportunities for women in your local community.

And take time to celebrate a very important woman in your life who tends to go unappreciated: you.