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Continuing our conversation with Dr. Erika La Vella, in this month’s Microbiome Series, we’re asking the doc about how food affects our microbiome for good or ill, how we can eat to protect beneficial gut flora, and substances that may impact our gut.

The gut microbiome is sometimes referred to as “the second brain.” Why? Because what happens in the gut does NOT stay in the gut. As science explores gut flora, we’re discovering more and more how microbiome health impacts so many other systems and organs of the body.

That means taking care of the gut is pretty critical to feeling good and being healthy. And like every other organism, beneficial bacteria rely on the right food sources for optimal health.

So what do they eat? They eat what we eat, for better or worse. Fortunately, people like Dr. Erika La Vella have a good handle on what food our good gut bacteria thrive on, and she shared that information with us.

Hint: As our bodies change in perimenopause and menopause, so does our digestion and our gut. Even if you’ve been eating “gut healthy” for years, you may notice differences in how your body reacts to food. If that’s the case, it might be time to reevaluate your diet and if it’s truly suited “” still “” for optimal gut health.

 

TRANSCRIPT TO FOLLOW

Banana bread and your biological clock

Nicky, aka “Boredom Baker” here! Why is it that, as we age, recommended recipes seem to get more and more boring? I remember when I was a kid, sitting on the trampoline enjoying a delightfully chocolatey ice cream without a care in the world.

Nowadays as a mid-twenty-something, I’m constantly reminded of eating for the health of my relentlessly ticking “˜biological clock.’ Despite what Instagram says, raw grass clippings just aren’t delicious!

As a recreational baker, it has been my mission to bake both the sinfully delicious and the desserts that are good for you and surprisingly yummy as well. It was for this very reason that I did some digging and revamped a plain old gluten-free banana bread recipe into something you’ll actually look forward to.

So no matter where the hands are pointing on your biological clock, today’s recipe will be great for you. This banana bread is an excellent source of Vitamin E, Omega-3s and Vitamin B. These vitamins and minerals are ideal for remedying dry skin, reducing mood swings, and protecting bone density””all-too-familiar symptoms of menopause. So it’s true what they say; cake really IS the key to happiness!

Ingredients:

Directions:

Will keep tightly sealed at room temperature for up to a week.

Serves 11.

Nutritional info:

Calories (per slice): 251

Carbs: 20g Protein: 7.2g Fat: 17.7g Fiber: 4g Sugar: 11g

Vitamins (Based on an average adult’s daily recommended intake)

For more wonderful stuff from Nicky, follow her on Instagram: @BoredomBaker

Did you try the recipe? Post a pic and tag @mygennev on Instagram or Facebook! We’d love to hear what you think of our recipes, so leave us a comment below, or give us a shout on Facebook or Twitter.

 

Gennev Director of Health, ob/gyn Dr. Rebecca Dunsmoor-Su, offers her thoughts on a recent study linking HRT to increased risk of Alzheimer’s disease.

There has been a lot of press lately about the study by Savolainen-Peltonen and associates published in the British Medical Journal that links HRT use to increased incidence of Alzheimer’s disease.

This is a complex area, and clearly we don’t have the full answer yet; however, as an ob/gyn and a bio-statician, this study does not increase my worry about prescribing HRT to my patients.

Let me explain:

The increased risk is small. First and foremost, if this study is correct (and there are good reasons to question its findings as see below) the real increase was 9-18 more women per 10,000 developed Alzheimer’s when using systemic HRT than in the general population.

The increase involved a narrow subset of women taking HRT. There was zero increase in Alzheimer’s risk in women using vaginal estrogen, and in fact, this strong of an association of Alzheimer’s and HRT appeared only in women using hormones for 10 years or longer.

And, as I said earlier, there are good reasons to question conclusions that have been drawn from this study:

Missing information

This is a large study, which is generally good; however, they used a national database and therefore do not have information on health history, family history, or why these women started hormones.

Missing this important information can lead to significant bias in the data. For example, when they started the study in 1994, we thought that HRT could be protective for mental function, so it was sometimes prescribed specifically for women who were having memory issues. It might also have been prescribed as a preventative measure for women with a family history of Alzheimer’s.

 

 

If a mental function issue was the reason for starting HRT, then those patient factors alone could be responsible for the increase in Alzheimer’s the study found in women who took HRT as not the hormones themselves.

These types of retrospective studies are not meant to tell us how to practice medicine but rather to help us design more definitive studies to answer questions.

More accurate studies; different conclusions

Several smaller, previously published studies as which rely on more credible randomized, controlled trials as do not show this association.

Studies that randomize patients tend to introduce fewer biases from factors like family history or current symptoms. We trust the results of these studies more, because they more accurately tell us the effect of the drug itself.

Of course, any study can be done in a biased way (think about the problems with the Women’s Health Initiative), but randomized, controlled trials are less biased by nature.

When we see different results from a randomized trial than we saw from retrospective trials, then we really must ask ourselves, what could be the source of bias? I think we will see larger, randomized, controlled trial results coming out in the future that will help to answer this question.

So, what is the take away?

We should continue to use HRT for the symptoms of menopause where appropriate and for the shortest time needed.

We have not used HRT to improve memory or cognition in years, and we still shouldn’t. If a woman is concerned about Alzheimer’s because of a strong family history, we should discuss if HRT is best for her and minimize the amount of time she uses it.

As we already knew from previous data, women who start HRT right at menopause, and use it for a limited time, respond differently to hormones and seem to have fewer risks from them. This has not changed.

If you’re concerned about HRT or would like to know more, we encourage you to join the discussion on our community forums. 

 

Regular guest contributor Barbara Mark, PhD, takes us through the challenges (and learning opportunities) of perimenopausal rage. What’s really going on here?

Some of the most challenging aspects of perimenopause in the workplace are hot flashes, foggy brain, fatigue, and memory loss.

But the most potentially career derailing is the out-of-the-blue, white-hot, I’m-going-to-rip your-face-off rage. It is incredible and seems to come out of nowhere!

You don’t like it, your colleagues and direct reports are frightened of it, and your boss may want to fire you because of it. Not to mention that your usual sources of support as your spouse, kids, friends as are wondering where their you went. It is time to get a handle on it!

Why does perimenopausal rage happen?

What is going on here? Starting sometime in your late thirties to your mid-forties, your hormones start to fluctuate wildly. Specifically, your estrogen levels are going nuts and your progesterone level is declining. Progesterone is a natural antidepressant and also prevents anxiety. When your estrogen drops, so do your serotonin and other mood- and stress-moderating brain chemicals. This dance can continue for a while until your hormones stop the wild fluctuations and your body gets used to your new chemistry.

As a result, irritations, annoyances, frustrations can escalate to rage in an instant. This is further complicated by the above-mentioned hot flashes in menopause, fatigue, etc.

Brain chemicals called “neurotransmitters” (serotonin, dopamine, epinephrine, aka adrenaline) are chemical messengers that allow brain cells to talk to one another. They are all involved in the development of perimenopausal rage.

When you have high levels of dopamine and serotonin, your emotions and reactions to events are more positive, and you are able to let things go more easily.

When levels are low, and you encounter an event that spikes your adrenaline and triggers your fight-or-flight response, you are much more likely to fly into a rage. So, when a team member fails to deliver, or your boss is demanding that your performance be better, or you are threatened by a peer, instant rage can take hold of you.

What to do, oh, what to do about hormonal rage?

In the short term as like in the moment that you are ready to fly into attack mode as stop and breathe.

Stopping and taking a few deep breaths can give you a moment to gather your wits, calm you down, and let you say “I need a moment” in whatever way is most comfortable you in a given situation.

(Need a moment? Check out our rage checklist for tips on how to get your chill back.)

In general, you can manage your brain chemistry by making a few good choices:

Need assistance to manage your perimenopause rage? A menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

What was THAT about?

When you are in a calmer state of mind, it’s time to look at what you may be angry about. Rarely are we truly angry about the thing that’s happening when the flash of rage occurs.

The issues that women tackle at midlife are challenging and can cause a woman to question herself, her choices, her identity, and her possible future. Experiencing sex after menopause as well as during are big and deeply rooted issues around energy levels, sexuality, attractiveness, mental acuity, ability to compete with younger colleagues, and perceived opinions of others.

However, women are discouraged from expressing negative emotions, especially in the work environment. This is related to the “likeability bind” that women are in. So, rage is waaaaaay out of the continuum of options! As a result, women repress a lot of feelings of frustration, disappointment, irritatability, sadness and confusion as only to have them erupt later, when they’re in a “safe” place for their rage.

Midlife can also resurface unresolved issues from other aspects of your life as issues with family, relationships, career, and friendships as that keep your vulnerabilities alive and ready to pounce.

You can reel in the rage

Know this: You can reclaim control! Take the time to face and deal with any underlying issues and resolve them, because when a difficult situation catches you off-guard and triggers your emotions, your hormonal “party” can light your fuse in an instant. Whether you snuff it out or blow up is (mostly) up to you.

 

“Sleep is the battery of your body.”
“” Jovanka Ciares

Sooooooo, how’s that battery working for you? Fully charged, 100%, ready to take on the demands of the day? Or in-the-red, cranky, nervous, and self-medicating with caffeine?

Poor sleep and increased anxiety are two of the most frequent issues we hear about from women who are in or approaching menopause. Estrogen levels decline, but cortisol may not, putting your fight-or-flight response in high gear waaaay more often than circumstances require.

 Being amped up 24/7 makes it difficult to wind down for sleep; exhaustion and sleep-deprivation make you even more anxious, and ta da! You’re caught in a cycle of wide-eyed staring at darkness at night, and dropping off at your desk during the day.

Like so many symptoms of menopause, sleeplessness can be managed. To get some help for this thorny issue, we turned to Wellness expert Jovanka Ciares. Jovanka is a former entertainment executive turned master herbalist, detox specialist, nutrition educator, and author.  She  studied nutrition with best-selling author Dr. T. Colin Campbell at Cornell University and life/wellness coaching at the Spencer Institute.

After years of suffering from IBS, ulcers and fibroids, Jovanka embraced alternative therapies like Ayurveda, Chinese Medicine and herbalism. Her journey towards self-healing, peace and happiness became her motivation to inspire and support hundreds of others to do the same. She created a series of videos for , Gennev and we couldn’t be more thrilled to bring her expertise to Gennev-ers. Click the image to watch her video on herbs and sleeplessness.

Poor sleep isn’t the only issue women in midlife face in the bedroom; many women also experience a decline in sexual desire. If you’re looking for solutions to regain your libido, Jovanka offers help for that too. Download her free ebook, 12 Libido-Enhancing Herbs, and discover even more reasons to go to bed early.

Jovanka is a featured expert at People Magazine, Entertainment Tonight, Whole Foods, Veria Living, Fox News LA, NPR and CBS Radio. She’s also a regular contributor in Spanish-language media outlets like Telemundo and is a contributing guest expert at The Huffington Post, MindBodyGreen, BlogHer and PositivelyPositive. Jovanka gave her first TEDx talk on “Rethinking Failure” in November 2013. Want more Jovanka (and who doesn’t, frankly)? Check out her creation: the Wellness Smackdown , an online wellness & learning community for healthy living, which was featured on the first season of ABC’s “My Diet Is Better Than Yours.” Jovanka also offers lectures, workshops and wellness coaching in both English and Spanish.

 

Women can be awfully good at getting in their own way.

We have the skills, the knowledge, the drive, we’re ready to realize our dreams “¦ and yet. We flail, we stall, or worse, we sabotage the success we so desperately want. How can we identify what we’re doing wrong and get on the path towards achieving our goals? Sometimes we just need a partner.

We found that partner in Lara Dalch. Lara is a health and lifestyle coach to “women on the rise” as women who crave practical tools for feeling healthy, confident, and powerful again so they can have the career and life they really want.

Talking About Health With Lara Dalch

As a former entertainment marketing executive and busy female entrepreneur, Lara understands the challenges of balancing good health with a busy schedule and is passionate about helping women harness the power of good health to fuel their lives through a practical, “whole life” approach to health.

A regular contributor to popular health and wellness website MindBodyGreen, Lara has been a featured speaker at Microsoft, Flywheel Sports, Orangetheory Fitness, the University of Virginia, and the University of California, Berkeley. She holds a B.A. in Psychology from the University of Virginia, is a Certified Pilates Instructor, and received her training to practice health coaching via the State University of New York and the Institute for Integrative Nutrition.

1:26
Lara has had a very colorful and non-traditional career path. We asked her, how do you go from working at Comedy Central to health and lifestyle coaching? Perhaps not surprisingly, her own hectic lifestyle was the inspiration behind helping others get control of theirs.

“I stopped falling asleep at my desk!”

3:01
Lara gives us a few more details on how her own improved life was her lightbulb moment. “I stopped falling asleep at my desk!” Now she helps others be fully present as and awake as in their lives and work.

5:18
We wanted to know, how do clients know it’s time to seek help? If you’re saying things like, “I’m exhausted all the time,” or “My food is a disaster,” or if you feel like you’re just not “showing up” in work and life the way you want, you might need a Lara.

7:17
Lots of women (and men) undoubtedly fit the criteria of needing a Lara. What keeps us from getting the support we need? Lara says, “They’re afraid they’re not going to show up for themselves.” Hmmmm”¦ having a great idea, getting all excited and prepped, then just not moving forward. Sound familiar?

20:00
Asking for help is often seen as a sign of weakness in modern times. But Lara says it’s one of the most courageous things a high-achiever can do. Lara takes us through the many ways we show we need support and the benefits of getting it.

21:30
On the surface, we should be getting healthier: we have more knowledge, more health care and treatment options”¦so why are we feeling so bloody awful? First, there is such a thing as “too much information” as Lara tells us how to stop looking outside your body when the answers lie within.

23:40
Lara sees herself as a “partner” in achieving optimal health and wellness as a partner to the client but also to the network of other supports in a woman’s life. Often we have tons of advice from lots of expert sources, but we’re missing the implementation piece. It’s great to have a nutrition plan; even better if you know how to follow it.

25:00
Women over 40 have different challenges than their younger sisters, and they often seem much less doable in our 40s than they did in our 20s. According to Lara, there’s no reason to think you can no longer achieve your goals just because you’re older. The magic pixie dust that’ll get you there? Time.

27:02
Lara really enjoys working with women in the 40s and 50s. She gives us the low down on the special gifts women in midlife bring to the table.

27:58
We all know it’s true, even if we can’t seem to make it happen: women who are successful are those who are focused on integrating self-care into their lives. In her talk on the Five Powerful Habits of Women on the Rise, Lara details what successful women have in common. Here’s the good news: it’s all stuff you can have too. Lara shares the details.

30:52
Finally, we asked Lara what a woman should do if she’s considering finding herself a coach. “Be open to going a little out of your comfort zone,” Lara tells us. Openness to experimenting, tuning into your body in a new way, making the decision to move forward toward your goals, those are the beginning to your healthier, more fulfilled future.

Want more Lara? Get her free guide to discover your unique way of getting in your own way when it comes to eating healthier, exercising more, getting more sleep, and kicking the habits that have gotten you out of shape and out of sorts.

 

Thank you to The Riveter for lending us the space to record today’s podcast! The Riveter is a new collaborative workspace built by and for women. The doors of the first location opened on May 1, 2017 with more to come. A community that amplifies women’s big ideas through shared resources and innovative connections, The Riveter offers dynamic programming in beautiful, light-filled spaces and invites members to focus on self-care with daily yoga and meditation. In a culture that embraces the glorification of busy and ignores self-care, The Riveter is a new way to work. If you’re in Seattle, be sure to check it out!

Looking into age-related menopause and eyesight diseases for Healthy Vision Month… (Hey! Happy Healthy Vision Month to YOU!)

We wanted to see if there were any connections between macular degeneration and menopause, specifically. 

Starting with the 3 whats

What is age-related macular degeneration (AMD)?

Affecting more than 10 million Americans, AMD is one of the leading causes of vision loss, pertaining mostly to the deterioration of the central part of the light-sensitive retina, known as the macula. AMD can occur in either or both eyes and at this time is considered incurable”¦ but is preventable and stoppable to some extent when caught in time.

What happens… and what does it look like?

When a person has AMD, their vision blurs or blacks out from the center and moving outward to the sides and periphery. It’s the central part of their vision that is used for myriad daily tasks including reading and driving. Fine details are the domain of the macula, and when it’s deteriorating, fine details in their vision are either blurred or blacked out.

Consider this animation of the loss of central vision and how it can change during AMD. Scary, isn’t it?

 

Subscribe to HealthFix for more support and care.

 

Wet or dry?

There are two types of AMD: wet and dry. 

It’s the dry type of macular degeneration that is known as age-related. The macula actually thins over time “” as part of the aging process “” and this thinning is the cause of blurring of that central vision, generally in both eyes.

The wet type of AMD? This type has more to do with an abnormal blood vessel beginning to grow behind a retina. Wet AMD vision loss happens more quickly due to damage from these vessels.

What about menopause and vision health?

We found a study of nearly 4,400 postmenopausal women, focused on the Association Between Reproductive Factors and Age-Related Macular Degeneration in Postmenopausal Women“¦ yes, a total score of info on this topic. 

The conclusion shares that “… a longer duration of lactation appeared to protect against the development of late AMD. A longer duration of oral contraceptive pill use (aka birth control pills) was associated with a higher risk of late AMD.”

In both cases, weigh in the term “might”, as neither finding of “association” or “appearance” is definitive. If you’ve taken hormonal birth control for many years, you’re not doomed to macular degeneration, but you might want to be more proactive in getting regular check ups.

Let’s turn to proactive and preventative actions

Preserving your vision and preventing AMD has a lot to do with maintaining your best general health. Nothing new, complicated, or special needs to be incorporated into your routine in order to impact and keep your best eye health. Good news, right? 

Take a look at the general choices of recommended health actions and see which ones are already activated. Then take another scan for the one/s that might be improved. It’s good stuff”¦ some of it might even be fun!

Actions for eye and vision health

Regular eye exams: Critical for catching and heading off AMD and other vision illnesses and impairments. There are several age-related eye and vision conditions, including cataracts and glaucoma.

“Regular exercise, quitting smoking, and eating a nutritious diet rich in green, leafy vegetables are good not only for your eyes, but (also) for your overall health status,” explains Dr. Jeffrey Heier, clinical instructor in ophthalmology at the Harvard-affiliated Massachusetts Eye and Ear Infirmary and director of the Retina Service at Ophthalmic Consultants of Boston.

Eye vitamins for dry AMD?

As mentioned above, a nutritious rich in green, leafy veg is awesome. You may have already jumped to the question, “Are there nutritional supplements that might aid in preventing AMD?”

Treatment to slow or stop dry AMD, caught at the intermediate stage, may include “…a cocktail of high-dose “˜eye vitamins.’ The recipe includes vitamins A, C, and E, plus zinc and copper. “Eye vitamins will help to slow or prevent progression in about 25% of people,” Dr. Heier says. “The exam can determine if you will benefit from vitamins.”

Should you proactively begin taking high doses of these vitamins in order to prevent the onset of AMD? Dr Heier recommends against this and shares that the recommended diet rich in green, leafy veggies and exercise is generally the best course of action. 

This being said, only your eye doctor and your primary care doctor, with your collaboration and insights, can really comment on your personal best next steps, based on the current state of your overall health and vision.

Ask your medical, vision, and coach on your care team about:

Your vision health is close “” so close! “” to your overall health and well being. It’s exciting and your next steps toward feeling even better, with more vitality, are totally in your hands. Onward!

 

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

 

Over the past few weeks, I’ve been spending lots of time with people who want to join Gennev.

We’re growing our team. It’s a team that is doing something few people have the courage and drive to do: re-imagine modern menopause care.

It’s not the sexiest of missions, but it sure pulls at the heart. And there is a HUGE need.

Team Gennev is out to change how the world thinks about menopause. We’re out to change the way women get access to quality care. We’re out to change the way women take control of their health in the second half of life.

This week we welcomed our newest team member as Sarah Ramsay, Vice President of Technology.

As a health and wellness company, you may wonder why we’re not announcing a new doctor, health coach or therapist? Those roles are incredibly vital to bringing you the health and wellness education and services you need, but they rely on Sarah and her team to deliver it to you through systems that reach you no matter where you live.

Sarah has a deep background in building and managing both specialty and women’s health solutions in organizations like Providence Health & Services and Fred Hutch Cancer Research.

She’s also a mom, a wife, a sister, a daughter and a woman who is here to make a big difference in how you find relief. 

Welcome, Sarah!

I want to give you access into the people behind our mission. I want you to know that we’re women (and a few awesome men) who care deeply about women’s health, and our livelihoods are dedicated to bringing you medically backed information, validated products, and experienced practitioners.

Weekly, I get to hear from a handful of you in response to my blogs. Your emails are like an energy pill for team Gennev. I strip out your name and email and then share your thoughts, your feedback (good/bad) with the team, so that we’re more understanding of you.

The Gennev community is incredibly diverse. The more we hear from you, the better we are at our jobs.

If there is information, products, services, or programs you’d like to see us deliver, send me an email (jill@gennev.com).

I can assure you that there are many people who have a passion for re-imagining women’s health. I’ll keep searching for them, but it takes the community of you to make us smarter about what you need.

Have a great weekend!

 

Constipation in menopause affects a whole lot of women. Why?

A couple of possibilities, says Harvard Health: Lack of estrogen may cause the colon to slow. This gives the fecal matter that’s in the system time to dry and harden, making it harder to expel. Or some women may find their pelvic floor is not coordinated, making it less effective for letting the stool out.

How do you solve constipation? You might think of stool softeners or fiber drinks, but there’s another alternative that might help you beat constipation in the long term: a pelvic physical therapist. We asked our two DPTs, Dr. Meagan Peeters-Gebler  and  Dr. Brianna Droessler-Aschliman for advice on handling this much-too-common problem.

Need help with nutrition for constipation or other digestive issues? Connect with a Menopause Coach and registered dietitian. 

What is constipation?

What actually qualifies as constipation? A day where you don’t go? Two? Medically, constipation is fewer than three bowel movements per week. There’s quite a broad range of “normal,” says Meagan: anything from three bowel movements a day to one every three days is considered within a normal, healthy range. Constipation is also usually accompanied by gas and abdominal cramping. 

Why do women get constipated at menopause?

In addition to the lack of estrogen, there are other lifestyle things that affect regularity.

Hydration: Not drinking enough water in menoause can affect the consistency of stools, making them harder to pass, says Bri. Be sure you’re drinking half your body weight in ounces every day; more if you’re constipated or sweating a lot.

Movement: Because of back or hormone joint pains, a lot of menopausal women experience arthritis because they stop moving as much, Meagan says. That means they aren’t rotating their trunk (think about how you swing your arms when you walk) and getting that twisting “massage” of the gut that helps with peristalsis (the movement of matter through the digestive system). Try to get out for a good walk every day, and your legs probably won’t be the only things “moving.”

Diet: Most of us don’t get enough fiber, for one; and in menopause, when our gut may be moving more slowly, we really can’t afford to be without. Try to bump up your intake with high-fiber foods like apples, oatmeal, beans, and broccoli. Don’t go too far, as you could end up with some unpleasant gas, but a slow increase might help you find some relief from constipation, says Bri. Don’t eat as much of the classic stopper-uppers like cheese, red meat, under-ripe bananas, fried foods, and white bread or rice.

Breathing: Poor breathing technique means all the movement is in your chest, not in your belly, says Meagan, which again means your digestive system isn’t getting the advantage of the pumping, massaging action of your breath to keep things moving along. Breathe with your diaphragm, so your belly expands with your breath. OK, it’s not sexy, but is constipation?

Embarrassment: No one wants to be that person at work, and let’s face it, those perfume sprays really don’t make things better. So we ignore the signs that we need to go, potentially causing worse problems. Solution? Find a bathroom on a different floor where no one knows you? Maybe change when you eat dinner or breakfast or have your first cup of coffee so nature calls before you leave home. Or perhaps realize everybody poops and try not to be embarrassed by it.

Fear: This may sound odd, but if going to the bathroom hurts because things are dry and hard, you may be ignoring your body’s signals that it’s time to go. However, ignoring signals only makes things worse, and, our docs say, doing that too consistently will eventually damage your body’s natural receptors, meaning you may not get those early warnings any more. In that case, it takes a lot more matter to alert your body to the need for relief “” and now it’s really painful and dramatic.

Medication: Many medications can slow our system temporarily, Bri says, including narcotics, antidepressants, anesthetics, opioids, even calcium channel blockers for hypertension. If you’re taking iron or calcium supplements, those can be an issue as well. While you’re taking medication that causes constipation, try to balance out those effects with some lifestyle strategies, like increasing water intake, eating high-fiber foods, moving more, or doing the ILU massage.

You’re pooping wrong

What we often call “constipation” may actually be a result of, well, pooping wrong.

Believe it or not, there’s a right and a wrong way to do your twos, our DPTs tell us.

The right way: When you get the “whisper,” heed it. Go to the bathroom. The best position for evacuating is to have your knees above your hips, so get a Squatty Potty, or stack up some books, or turn over a couple of buckets (be careful with this if you’ve recently had a hip replaced). Let your belly go loose and slack, so it’s actually touching your thighs. It’s not the most dignified posture, we get it, but come on”¦ you’re pooping. Vanity really shouldn’t be a factor here.

Let your abdominals be loose so your pelvic floor relaxes. This should allow for your colon to unfold, so  evacuation happens with only gentle pushing from you. Having your knees above your hips allows your colon to unfold into the correct angle so things move more smoothly. Don’t ever force it as if your body isn’t ready, it isn’t ready. Try again when you hear the call.

The wrong way: Ignore your body’s calls of nature repeatedly, then go to the bathroom only when it’s convenient. Push really hard because your body isn’t contracting naturally, and you need to get this done in the next 30 seconds. Strain, hold your breath, push down so that instead of relaxing and opening naturally, the pelvic floor muscles clench tight and “slam the door shut.”

Repeated pushing and straining is especially effective if you’re aiming for hemorrhoids or a “rectocele” (when the the front wall of the rectum bulges against the back wall of the vagina, possibly even drooping into the vaginal canal). A rectocele can form a pouch as it droops into the vagina, and fecal matter can collect there. Depending on the size of the pouch, you may not be able to clear it by pushing.

Take a whole lot of over-the-counter laxatives to counter poor pooping mechanics and try again when your schedule allows. Your body can actually become dependent on OTC laxatives, or they may target the wrong problem (do you need softer stools or increased motility as you really don’t want to get this wrong). Too much softening can cause you to keep your pelvic floor muscles clenched for fear of accidents. That can lead to severe pelvic floor dysfunction, Meagan says, which can make everything a whole lot worse.

Is it time to get professional help for constipation?

If you’re experiencing severe abdominal cramping, menopausal nausea, vomiting, or it’s been more than 3 days, you should definitely get checked out by your doctor or chat with one of ours, according to our DPTs. If it’s only been a couple of days “” or if things are moving, they’re just moving slowly “” you may want to try a few things on your own first.

First, evaluate your lifestyle choices that may be causing the problem. Has anything changed in your life recently that could be throwing your body off its regular pattern?

Are you eating a lot of constipating foods? Are you getting enough fiber in your diet? Are you drinking enough water and moving your body? Did you quit drinking coffee? Have you started a new medication or recently had surgery?

Next, check your pooping mechanics: Do you have your knees above your hips? Are you giving yourself enough time?

Also, Bri and Meagan suggest trying the ILU massage. This self massage involves doing small, circular strokes that follow the path of the large intestine. The gentle stroking massage helps calm an irritated gut and increase the movement of food through your system.

If fixing all the lifestyle options doesn’t help, you need to be sure what you’re dealing with truly is constipation. If you have a rectocele, that may feel like the pressure of constipation, but it really isn’t.

If you haven’t already been evaluated and diagnosed with a rectocele, that’s the first order of business: get to a doc and get checked for that, then follow your doctor’s recommendations.

If you know this is likely to be your issue, our DPTs recommend trying “splinting.” In this case, you use two fingers (wrapped in TP or gloved) to either press against the perineum as that’s the territory between the vaginal opening and the rectal opening as to create a wedge. By pushing gently upward, you don’t allow the rectum to slump and create that pocket, so you should be able to evacuate normally. Some women do this by putting their fingers in the vaginal opening to support the wall between the back of the vagina and the front of the rectum.

Perhaps the best thing of all is to get checked out by your doctor, then ask for a referral to a pelvic PT. They can help you evaluate what else might be contributing to your constipation and give you exercises and lifestyle changes appropriate to your situation.

Thank you our two DPTs, Dr. Meagan Peeters-Gebler and Dr. Brianna Droessler-Aschliman

Have you dealt with constipation? We’d love to know how you managed it, so join the conversation on the Gennev community forums!

 

You wear your skin every day, so it’s a good idea to take care of it. Best way to do that? According to Dr. Keira Barr, board-certified dermatologist and Chief Wellness Officer of Resilient Health Institute: “get naked.”

At team Gennev, we field a lot of questions about skin, and that makes sense, because skin changes as we age””lines, dark spots, melasma are all normal. Most of those changes are entirely normal, if not always welcome.

 

 

But some changes are red flags as “whispers,” says Dr. Keira. Your skin is trying to tell you that something is wrong. If you listen now, while it’s still whispering, fixing the problem will likely be easier than later, when it’s shouting. But you can only hear those whispers if you’re willing to get naked and get to know every nook and cranny of your skin.

Skin Care With Dr. Keira Barr

Dr. Keira talked with Jill about the ways our skin communicates, what it might be trying to tell us, and when it’s time to take concerns to a professional.

Transcript:

Jill: First of all, thanks again for being here with us. Skin is probably one of the hottest topics for any woman because we wear it every day. In your journey in dermatology or into dermatology is a personal one, can you tell us a little bit about that?

Dr. Keira: It’s really interesting because I wasn’t aware of the connection between my childhood experiences and why I wound up choosing my medical career. I thought it was just in medical school I saw pictures of skin, I knew what they were, and I was like “wow, this seems cool.” And dermatology is a beautiful marriage of internal medicine, histology, surgery, all the things that I really enjoyed.

But, looking back, you know, I was born with two birthmarks on my face and, as a kid I didn’t really pay much attention to them until I went to school and kids made fun of them. And they called them “coffee stains.” And they called me “coffee-stain face,” and it was the first time that I became acutely aware that my skin could be such a source of shame and humiliation and embarrassment. So I quickly learned that if I could mask those stains by getting a suntan, it just felt much better to just hide behind that.

Unfortunately, I have very fair skin, my dad’s a redhead, so I would burn before I would tan. Over the years I accumulated tons of sun damage. Fast forward, I become a dermatologist, I learn just how dangerous my behavior was, had tons of atypical moles, and eventually had to diagnose myself with melanoma, which is the most deadly skin cancer there is. So, as a dermatologist, I’d now become my own worst nightmare of a patient.

Getting comfortable in your skin (can save your life)

Jill: Wow, that’s incredible. What a journey, to not only have experienced what you did as a child, but to pay the ramifications of that as an adult. So, you know, you’re a woman now, and you’ve come through that journey, and you’re doing incredible things and, you know, our audience obviously is women in mid-life. And skin is something I know I think about all the time. I look at face every day in the mirror, I look at my body, but one thing you call out a lot is women need to get comfortable looking at their naked bodies. Talk a little bit more about that.

Dr. Keira: Yeah, so, my biggest piece of advice is always “get naked” as for so many reasons.

First of all, your skin is your largest organ and it truly is a window to and reflection of your overall state of health and well-being, so understanding what is your normal, understanding the texture of your hair as is it changing colors or falling out, you know, what’s on your skin as those are clues that will allow you to dig deeper. If there’s more going on inside your body, whether that be a nutritional imbalance, whether you’re not sleeping enough, whether you’re not caring and loving on yourself enough”¦ it all shows up on your skin.

So getting comfortable in your naked body allows you to, number one, feel comfortable in who you are, in your skin, that’s huge. And it was because I didn’t feel comfortable in who I was which is why I tried to hide it with a suntan, so I don’t want that experience for anyone else. But also getting naked to see what’s on your skin, especially with regards to skin cancer prevention and looking for spots that stand out from your crowd, there are certain things that you could look for”¦ and I encourage everyone “¦ Well you get naked every day, but specifically on the date of your birthday, for instance, it’s the same date every month, you are naked before you get in the shower, you look yourself over head to toe, every nook and cranny, and you’re looking for every uninvited guest on your birthday suit, any spot that just stands out from your crowd.

What are we looking for?

Jill: Fascinating. And so when you said there are things to look for, you’re looking for abnormalities, for new things. What else?

Dr. Keira: So, with regards to that, we always talk about knowing your ABCDEs, so especially with regards to melanoma and skin cancer”¦so, a spot on your skin that’s Asymmetric, so if you were to cut it down the middle it’s not the same on both sides, it has a very poorly defined Border, it’s kind of blurred edges, that’s one to bring to your dermatologist’s attention. Something that is varied in Color throughout it or is different in color than any of your other spots. D is for Diameter, that’s a very soft call. We always say larger than a pencil eraser, but I can assure you I’ve seen melanomas that are tiny. E is probably the most important, that is something that is Evolving, changing over time, and also sores that aren’t healing, we take for granted that “oh, it’s just a cut,” as but that sore that just persists”¦pay closer attention to it.

And even if some of your spots meet some of the criteria I was just talking about, it doesn’t automatically mean it’s something to worry about, but it is something to raise a flag and, you know, bring to your dermatologist.

Jill: You know, you talk about the sores that aren’t healing or the sores that even just come back, time and again, is something that I know I’ve witnessed in people”¦

Dr. Keira: Especially a precursor to cancer called an actinic keratosis, it’s a precursor to the type of skin cancer called squamous cell carcinoma and oftentimes it presents on the face or the hands as like a red, gritty, sand-paper like texture, and those are the ones that someone will say “oh, it peels off and it went away,” but it comes back. Those are spots to bring up.

How does skin “communicate”?

Jill: Now you recently published a book titled The Skin Whisperer, which I highly recommend for everybody, we’ll talk a little bit more about that or put up information on the blog of the podcast afterwards. But you talk about, I think, one key thing in the book is you talk about the messages that your skin is sending to you, tell us a little bit more, what do you look for, how do you listen?

Dr. Keira: So, yeah, the title of the book, even though I’ve been called a “Skin Whisperer” because I can see what’s on the skin and give you a diagnosis, the key is to hear the messages your skin is sending you when they are just a whisper. Not shouting at you, which, unfortunately, that was my story, I was deaf to the messages my skin was sending, I was having biopsies of changing lesions on my skin every couple of months, didn’t think anything of it and BOOM, I get skin cancer. It led me down that path because I wasn’t notice of how I was living my life.

So, hearing those messages as what I was saying before: is the texture of your hair changing, are you losing your hair, are you breaking out in new types of rashes, is your skin drier than it normally is, you know, sores that are persistent. These are clues that your body is sending that a dermatologist may be able to look at you and instantaneously give an assessment.

But sometimes it takes more investigative work, so you yourself looking at your own skin, looking for things that are not what they typically are as drier skin, oilier skin, you’re breaking out like crazy, new onset acne in an adult woman, right? as these are things, clues that your body is saying “I need some help here, I need some help. I need either you yourself to kind of take stock of how you’re eating, sleeping, moving, any new products you may be using or hey, get yourself to a board-certified dermatologist who can help you work through these things.”

Is it hormones “¦ or something else?

Jill: So, a couple of the things you called out as dryness, oftentimes they can be linked to hormonal changes in the body, and the adult-onset of hormonal acne in menopause. How does a woman decipher, you know, between the two. Because I bet you get some coming into your office where that’s kind of more the symptom, or don’t you? I guess, is that, how do you help women think about “is this related to hormonal changes or is there something else,” or should you just get it checked out regardless?

Dr. Keira: Well, I think it’s always helpful to get yourself checked out because there may be multi-factorial components like layers of the onion.

I think especially, as we are maturing, there are changes that occur, our skin “¦ collagen production does goes down, skin barrier, you know, the lipids in our skin are decreasing, so we are a little more vulnerable to drier skin, a little more sensitivity.

Products that we’re using because we think we want to fight the aging process, your skin Is naturally slightly acidic, so if you’re using products that are altering that PH, you think you’re doing some good because that’s what the commercial says, but you’re actually disrupting  your normal PH value and disrupting your permeability barrier, you could wind up with a rash, you could cause a flare of your acne.

And then the hormonal component. You know, as we mature, our hormones are going to fluctuate, but especially if you’re stressed, in midlife, we are juggling a lot of things, you’re juggling a career, a relationship, kids, or pets, so many things, and your cortisol levels could be going through the roof. Now that in and of itself is going to set off a cascade of inflammation that can easily exacerbate acne, eczema, psoriasis, any of these other conditions, so it’s kind of taking stock of every facet and seeing where can we get the smallest wins the fastest because sometimes just the smallest shift can make a dramatic difference, and allow you to then as now, what’s the next step as do we even need medication, or suggest “you need to take a breath.”

What can we do for healthier skin?

Jill: Yeah, probably take a breath! You know, I think, what you just talked through, it’s complicated. Where does a woman start, or a man start? And I think one thing you call out a lot is there’s four pillars: lifestyle, nutrition, movement, and mind-set. How do you talk people through those four things? Because I’m assuming for anybody those four things are contributing to the health of their skin.

Dr. Keira: Absolutely. And even though I would love to start with mind-set, because I think all of us could benefit from a little reframe, that’s probably the thing that would come last.

So one of the first places I start is with the nutrition piece and simple things as you know, that was my wake-up call, at the time of my diagnosis I thought I was eating healthy. I was running ultra-marathons, I was wearing sunscreen and protective clothing, all of that, and clearly my body was telling me it was very wrong.

So one of the first places I started was nutrition and just reading labels. I had, I mean, I was like “this is magic!” And it’s the simplest thing, I mean, I worked actually with a nutritionist and she said “let me show you two cartons of chicken broth,” and we just read the labels of each. One had sugar and some stuff I don’t even think I can pronounce and it was like water, vegetables, spices. And I was like “oh, I’ll pick that one.” And it was just that simple, just taking notice of what we are consuming. If it has more than four ingredients, or you can’t decipher an ingredient, put it back on the shelf.

And really, I learned how to cook for the first time. And many women”¦ it’s expected that you cook. But my husband for all of our relationship, he was the chef, “˜cause I thought roasting was something very complicated. I didn’t realize you just turn the stove to 400, a little olive oil, salt, and pepper, and you put in and that’s roasting.

Jill: Not only are you The Skin Whisperer, you’re the culinary you know”¦

Dr. Keira: So you know, it’s just those simple things of like, OK, what is in your pantry, can we clean up your pantry, can we just simplify your life? And chopping vegetables, I found it very therapeutic. Peeling, giving yourself permission to just take that time, you know, and by doing that, by having a wide variety, a colorful array of fruits and veggies, like, you just boosted your antioxidant supply through the charts. Like, little things. And what I found is, “oh, my skin is clearing up,” “oh, I took out dairy for a little bit” or “I cut out gluten” and for some people it does make a big difference.

Three action steps to listen to your skin

Jill: Yeah, you know, I think also what you’re doing is just reminding people of the simpler things, you know what if you were to”¦ OK, complicated space, lots to factor in”¦ if you were to narrow it down at least to three things that a woman can start to take notice of or start to own in terms of listening to her skin and helping it be the most healthy it can be, what are those three?

Dr. Keira: Yeah. With regards to nutrition, it’s not just what you’re eating, but how are you eating as are you actually giving yourself permission to sit down and eat a meal? Because your autonomic nervous system, you’re in that fight or flight mode, so allowing yourself to rest and digest, because if you don’t, your body and your skin is not getting the nourishment and nutrients it needs.

Jill: Not like eat the piece of toast running out the door, like I did this morning

Dr. Keira: Exactly. Sit down so your body can digest it and you can”¦because again, cortisol, stress, it messes with your skin, permeability, inflammation, all of that. The second is how are you sleeping?

And especially as we get older, our sleep cycles can be disrupted, but sleep significantly impacts your skin. Melatonin is what we produce when we sleep, and it has to be very dark for that to switch on. And melatonin is the most potent antioxidant that our body can produce, and it protects you from UV damage, it promotes production of other antioxidants that your body needs to fight environmental stressors.

So how you’re sleeping is important, and taking notice, most importantly, of how you’re loving “¦ most importantly of how you’re loving on yourself. I think most women, especially in midlife, they are so worried about everyone else, other than themselves, and you really need that introspection. And I’m learning this myself on a daily basis. It makes a huge difference, you know. Those bags under your eyes, the dry, flaky skin, it’s the stress of also acknowledging you are just not taking care of yourself, so those would be my three very long, drawn-out, explanations.

What are “breakthrough” sessions?

Jill: Yeah, I think they’re perfect. Your skin is beautiful, Dr. Keira, and it’s apparent that you are listening to your skin and have made this amazing transformation, and you share it in your book. You also”¦ if people go to your website, which is chooseresilience.com, people can book a 20-minute breakthrough session with you. Talk a little bit about that.

Dr. Keira: Yeah, so it’s an opportunity for us to explore, you know “¦ Can I help you, what are your biggest challenges? Because what I’ve learned through this journey and through working with other people is that I can give you tools and strategies, but ultimately the outcome depends on you, the person. Are you willing to put in the work because there is no quick fix, there is no magic lotion-potion, this is work to be done, so really explore that together as is it a good fit.

You know, I really do want everyone to be successful, but that success really is dependent on the person coming to me to seek that out.

Jill: You know, what I’m finding in this conversation is my typical fun about a dermatologist is you book a dermatologist, you see them, but even what you’re talking about so much, especially in your 20-minute breakthrough session, so much of it is a mind-set. You’re almost like a therapist.

And I know for me personally, even if you can’t do those full three things you brought up earlier, or all the tips that you bring forth in your book, if you focus on one, you can make a difference.

When I left my corporate career to start Gennev I was like, “I’m gonna get eight hours of sleep a night.” I always compromised sleep, I would go five or six and think that I could keep going and I’ll catch up on the weekends and even though this job takes it all out of me, I still prioritize sleep, and it’s made an incredible difference. Not only my health, but my skin. So even prioritizing just one of those things, it’s progress.

Knowing your non-negotiables

Dr. Keira: Absolutely, and I mention this in the book too, that whole idea of negotiate your non-negotiables. What are the things that you just absolutely will not negotiate on, what do you stand for, what you and will you not tolerate, and if that’s picking up your kids every day, that’s a priority, or scheduling actual date nights, or scheduling sex, or, you know, a bath. It doesn’t have to be monumental, it has to be something that you can hold firm. When you do this thing for yourself, like, you know, you’re taking a stand for your health and your emotional well-being.

Jill: That’s a perfect way to end. You know, figure out your non-negotiables and go there. Thank you, this has been great. It’s brief, but there’s so much more to learn, I think. The Skin Whisperer, by Dr. Keira Barr as check it out. Any final closing words you wanna share?

Dr. Keira: I think I touched on it earlier, but the most important is get naked. For so many reasons. Have fun with it. Never underestimate a good romp in bed, it’s good for your stress, that’s good for your skin. But also get familiar with your skin. Every nook and cranny of it. Because it’s beautiful, it’s yours, no one’s going to protect it like you can.

Jill: Thank you.

Have you experienced issues with your skin? What did you do? Tell us all about it in the comments below or on Facebook, or join our closed Facebook group. 

Not quite ready to give up podcast-land and join the real world? We’re got more. Our conversation with Dr. Lisa Mosconi on the link between Alzheimer’s and menopause is a fascinating wake-up call to start feeding our brains right: menopause, Alzheimer’s, & eating for retirement, part 1 and more of that same conversation in part 2.

 

Like most nights recently, Cheryl woke up at 4 AM, heart pounding, mind racing, soaked in sweat. Her night’s sleep was probably over, though the alarm wouldn’t ring for another two hours. She tried to calm her heart rate, her breathing, her desperation and out-of-control thoughts and go back to sleep, but all she could hear was the sound of her own anxiety, buzzing like a bee hive inside her head.

“Cheryl” isn’t a real person; but she’s very real, in that she’s based on dozens of stories we’ve heard from women going through the very real experience of perimenopause and menopause.

Menopause and anxiety are common. Increases in anxiety, depression, and rage are some of the most common and debilitating concerns we hear about from women, and the treatments available for midlife women as usually HRT or antidepressants as come with their own concerns.

Playing around with anxiety

Team Gennev was fascinated to hear about controlling anxiety and other mental health problems in menopause with gaming: calming the anxious mind through online games and apps based on brain science and “cognitive training.” A treatment that doesn’t require a lot of time, doesn’t depend on taking medications, is safe, effective, private, and probably already in our pockets? Tell us everything!

To learn more, we spoke with Tracy Dennis-Tiwary, Ph.D., professor of Psychology and Neuroscience at The City University of New York, and Director of both the Stress, Anxiety, and Resilience Research Center and the Interdisciplinary Center for Health Technology and Wellness. Dr. Tracy is also the founder of Personal Zen, one of the companies leading the digital mental health revolution to put wellness back in people’s hands.

As Dr. Tracy says, there are treatments already out there for anxiety- and stress-related disorders. However, these treatments may only help 30 as 50 percent of sufferers over the long term. And they can be expensive, time-consuming, and stigmatizing. Even more, 89.3 million Americans live in federally-designated Mental Health Professional Shortage Areas, meaning they have to travel four or more hours to get help.

These concerns about existing barriers to treatment inspired Dr. Tracy to take the research she was doing on anxiety and create Personal Zen.

Threat bias and its effect on the anxious brain

Dr. Tracy’s research focuses on anxiety, on trying to understand what’s actually happening as neurologically as when someone experiences anxiety. This knowledge, Dr. Tracy says, can directly inform intervention development. Simply put, once we know where anxiety comes from in the brain, science can target those specific areas, slowing or stopping the processes that cause it.

Personal Zen leverages the knowledge that most people, when anxious and stressed, engage in what’s known as threat bias.

According to Dr. Tracy, threat bias is a habit of paying attention only to what’s negative in our environment and being hyper-vigilant about every potential threat. It sucks up all our attention, and we miss opportunities to notice positives that could offer safety and comfort because we’re focused exclusively on real or perceived threats.

It’s a vicious cycle that can be hard to break: as your attention narrows to the negative, you perceive more threats, which makes you more anxious, causing even more focus on the bad to the exclusion of the good. Once you start loosening up patterns of attention, Dr. Tracy tells us, you can disrupt the cycle as and that’s the promise of these kinds of cognitive training techniques.

Threat bias, says Dr. Tracy, is common across many if not all anxiety disorders (like social anxiety, phobias, panic disorder, etc.) and across stress- and trauma-related disorders like PTSD. It may even be related to other emotional disorders such as depression, making treatments targeted at alleviating threat bias potentially very powerful.

We have to be aware of potential threats, of course; we wouldn’t survive long otherwise. But, Dr. Tracy says, “the problem with threat bias is the focus on threat becomes too rigid, too consistent, and too strong, and we need to increase flexibility.” By disengaging our attention from the negative, we’re able to regain awareness of and benefit from the positive.

How Personal Zen works

Personal Zen directly targets threat bias, rewarding players for focusing on positive images. Two sprites, one smiling, one frowning, tunnel around in tall grass. Players trace the path of the happy sprite, earning purple and gold jewels as they get faster and more accurate at following.

It sounds simple as and it is as but the goal isn’t collecting lots of jewels; instead, you get better at following the more you’re able to ignore the negative sprite and focus on the positive. Within minutes, players report feeling less anxious and more ready to cope with the world.

Even better, that calm lingers. In a study Dr. Tracy conducted with pregnant women, just 10 minutes of Personal Zen a day, a few days a week for one month resulted in less of the stress hormone cortisol. It’s actually possible to build resilience against anxiety, and less cortisol could mean far fewer sleepless nights.

Does it work for older as and menopausal as brains?

One question we had for Dr. Tracy was if threat bias becomes so habitual over time that it’s more deeply entrenched in those of us over 40. “Habits are supported by neural circuitry that becomes activated over time,” she told us, “so there’s a readiness to activate.” But, she reassured us, there’s still plenty of flexibility in mature brains and therefore plenty of reason for hope.

For women dealing with the additional emotional challenges of menopause, apps like Personal Zen can be a huge help. The hyper-focus on the negative that characterizes anxiety is also present in rage and depression, making Personal Zen a hat trick for women in midlife.

Getting your Zen on

Personal Zen and other cognitive training apps and games can be used alone or as an adjunct to medication, therapy, etc. Dr. Tracy doesn’t advocate ditching your shrink (her term!) for an app, but, she says, there are “so many ways to get at anxiety. Personal Zen is great because it’s based on science, it’s engaging, and it’s brief. We’ve done four clinical studies that show a few minutes a day, a few days a week can really help.”

Because the app is on your phone, it’s incredibly portable. Waiting for the bus? Take 10 minutes to ease some stress out of your day. Nervous about giving a big presentation or making a speech? Fire up your Personal Zen to calm your nerves before you head in to the conference room. (Bonus: Research has proven that this kind of cognitive training reduces anxiety and can improve your performance at scary tasks like public speaking.)

Mix the app up with exercise (a surprisingly effective intervention for multiple mental health concerns), throw in some mindfulness meditation, Dr. Tracy says, and you have really powerful tools for recalibrating your mood.

Ready to find your Personal Zen? You can download Personal Zen for free at the Apple Store. And stay tuned for the release of the next version, coming soon, with even more environments to explore!

Find out more about Dr. Tracy and the science behind Personal Zen on the Personal Zen website and her blog, Psyche’s Circuitry.

Have you tried online games or apps to deal with anxiety, depression, or other challenges? We’d love to hear how it worked for you, so share with the community in the comments below, or fill us in on Gennev’s Facebook page or Midlife & Menopause Solutions, Gennev’s closed Facebook group.

 

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

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

What is HealthFix?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How closely do your docs and coaches work together?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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