The female reproductive system is an amazing thing, capable of creating, sheltering, and nurturing an entire, tiny human being. Self-regulating and self-cleansing, if left alone to get on with it, a woman’s body will pretty much tick along like a good soldier, and for that, privates, we salute you!
However, there are times when even the most dependable of systems needs a little maintenance to keep running smoothly. Hormonal fluctuations due to perimenopause, menopause, pregnancy, etc. can affect you both above and below the waistline, impacting your quality of life. There are many tests for menopause that let’s you see just how much your hormones are changing. It’s important to understand what’s happening and why, what you can expect, and how you can alleviate the symptoms and get back to your life.
Estrogen is the female hormone that regulates a whole lot of the female reproductive system. Produced by the ovaries, estrogen prompts the development of breasts and body hair, regulates the menstrual cycle, builds bones, rounds hips, and concentrates body fat in the hips and thighs, among many other things. It also helps trigger the female body to produce the slightly acidic, natural lubrication that keeps the vagina clean and healthy.
Estrogen fluctuates throughout a woman’s life, most notably during menstruation, pregnancy, and perimenopause. Subtle (and screamingly obvious) physical and emotional changes are the completely normal result of hormonal fluctuations.
When you’re ready to talk with a doctor about your menopause journey, consider Telemedicine. Discover Telemedicine now.
Pregnancy, as you might expect, causes pretty significant changes in hormone levels, including an estrogen drop off when baby is born to allow lactation to happen. Estrogen is also suppressed while mom is breastfeeding.
Later in life, estrogen levels decline permanently, which can bring about some interesting developments. Because ovaries no longer need to produce eggs, they also stop producing estrogen, causing the stuff we all know about (like hot flashes, that most public of symptoms) but also other effects you may not know to expect.
Different women experience different symptoms and to varying degrees, but there are some typical signals of hormonal changes. The Women’s Health Research Institute at Northwestern University offers a very comprehensive discussion on the effects of estrogen depletion. Breastfeeding, perimenopause and menopause can result in:
“¢ Emotional changes such as mood swings, irritability, anxiety, and depression.
“¢ Cognitive changes including memory loss.
“¢ Physical changes like hot flashes, fatigue, bone loss, reduced skin elasticity, incontinence, and vaginal dryness (the last of which is easily remediable through picking a suitable lubricant).
The good news is, you’ll save a fortune on tampons! Seriously, while this list may seem long and not particularly positive, think of menopause as your body’s invitation to take the best possible care of yourself to reduce the number and severity of menopausal symptoms.
Review HealthFix for support, programs developed by OB/GYNs, and on-demand coaching.
You have choices. There are ways to alleviate many of the symptoms, including our specialty: vaginal dryness.
Some women report discomfort not only during intercourse but even sitting, walking, exercising, or urinating. For younger women, vaginal dryness may only be temporary, and use of a lubricant for sex will get you over, uh, “the hump,” so to speak; for older women, long-term solutions may need to come from outside your body.
While vaginal dryness is usually a normal”if not particularly welcome”part of aging or reproducing, suffering in silence isn’t necessary.
If you’re experiencing vaginal dryness and don’t fit any of these categories, you may be able to solve your problem by discontinuing use of harsh soaps, douches, bubble baths, feminine sprays, certain cold or allergy medications, even your laundry detergent. You can use a lubricant or moisturizer like Gennev Intimate Moisture or Gennev Personal Lubricant to replace your body’s natural moisture until your body returns to normal. If symptoms persist, definitely see your doctor to rule out more serious causes.
Not feeling in the mood lately? You’re not alone”and there’s nothing wrong with you! Low libido in midlife, or diminished sexual desire is a fact of life for up to 87 percent of women as they get older. “For many women, as we age and our relationships age, we just don’t feel spontaneously horny anymore, and that is a completely normal change,” says Laurie Mintz, Ph.D., a professor of psychology at the University of Florida and the author of A Tired Women’s Guide to Passionate Sex. “We think we’re supposed to feel like we did when we were 20 rather than accepting changes as they occur. What might have turned you on at 20 is going to be different than at 40, 50, or 60.” Understanding these changes in libido and how to get help”there are remedies for most sexual issues”could make this the perfect time to reawaken your sexual self and improve your sex life.
“Menopause does not have to be a death sentence to your sex life,” Mintz says. Many people report that the best sex they ever had started at age 50 when they got more comfortable with their bodies and with communicating their needs, according to research by Peggy J. Kleinplatz, Ph.D., a sex therapist and co-author of Magnificent Sex.
Sexual desire isn’t just about lingerie and candlelight. It’s complicated and menopause is only part of the story. Many factors can affect your sex drive:
To further complicate sexual desire, there isn’t a one-size-fits-all definition of low libido. “There’s no criteria,” says Mintz. “It’s so individual.” For one woman, sex once a month may be fine, but anything less than once a week is a problem for another. If you and your partner are satisfied with the frequency of your sexual encounters and level of intimacy, don’t compare yourself to others. However, if your lack of desire, frequency, or quality of your sexual encounters is bothering you, there are ways to improve your love life.
Unfortunately, most women are only aware of one type of desire, the spontaneous kind, where suddenly you feel horny and want to have sex. When this doesn’t happen as often or at all, women feel guilty and think something is wrong with them (even though it’s a normal part of aging). But there is another type of desire, called responsive sexual desire, which is just as important”maybe even more so in midlife.
Responsive sexual desire starts with your brain instead of your genitals. Your brain says sex is a good idea for whatever reason. (According to one study, people gave 237 different reasons for having sex, and being horny was only one of them.) Think of it like reversing the equation; you have sex to get horny. Sexual arousal springs up as a result of stimulation like being touched. “It’s like starting your car in the winter,” says Mintz. “You can still have a pleasant ride, but you have to warm it up first. A lot of times, if you wait to have sex until you’re horny, you’ll never have sex, especially at this stage of life.” And the more sex you have”including with yourself–the more sex you want.
Focusing on responsive desire can improve your sex life, but sometimes you need additional help. If you’re not getting aroused once you and your partner get going or sex hurts, you need to consider underlying conditions. Sometimes it may be as simple as a lubricant to solve the problem, but other times you may need to talk to your doctor.
As estrogen declines during menopause, blood flow to the vagina decreases, and vaginal tissue thins, causing a decrease in arousal and lubrication. These changes can make sex less enjoyable, orgasms harder to achieve, and penetration painful. About half of postmenopausal women experience pain during intercourse, called dyspareunia. It’s one of the most common reasons women shy away from sex. But, there ways to stop the pain. If a lubricant doesn’t help, talk to your doctor about other options. If dryness is causing the pain, a topical estrogen can help. Your doctor can also determine if another condition such as a urinary infection or skin condition is causing the pain and treat it appropriately.
Sex is important for a relationship. Yes, some people are happy in sexless relationships, but that’s probably not you if you’re reading this. Unfortunately, even though we say or think sex is important to us, many of our actions say otherwise. Too tired for sex? But are you staying up late binge-watching your favorite show or scrolling on social media? To get your sex life back on track, here are some steps to take.
Believe sex is important. There are physical, emotional, and relational benefits to having sex. When you’re hugging and touching each other, your body releases the feel-good hormone oxytocin, which reduces stress, anxiety, and irritability. Neurochemicals released during an orgasm can provide pain relief and help you sleep better. You’ll feel more connected with your partner, and you’ll get less annoyed and be less snippy with each other outside of the bedroom. Sex boosts immunity. “This is just the tip of the iceberg,” Mintz says. “There was a 25-page paper written summarizing all the physical, mental, and emotional benefits of sex.”
Make sex a priority. Scheduling sex is one of the most effective therapies that sex therapists prescribe. “I call them trysts rather than scheduled sex because it sounds a little sexier,” says Mintz. “If you look it up in a dictionary, a tryst is a planned meeting between lovers. People think of it related to having affairs, but it can be with your long-term partner as well.” Remember, desire doesn’t have to be spontaneous, and you don’t have to be horny to get it on.
Think about intimacy, not just sex. There’s more to a sexual relationship than just intercourse. Building connections with your partner outside of the bedroom can make your connections in the bedroom more fun and satisfying. Exercising, cooking, holding hands while taking a walk, going on a date, or dancing together can bring you closer. In or outside of the bedroom, hugging, kissing, cuddling, giving or getting massages or foot rubs, even having your hair brushed can enhance intimacy and sensual stimulation. And remember there are lots of ways to pleasure each other, including oral sex, using a vibrator together, or even masturbation. Thinking about sex as a spectrum of activities can help take pressure off of both of you, especially as you get older.
Focus on you. Take time to take care of yourself. All types of exercise can improve sleep and reduce stress, two factors affecting your sex drive. Working out, especially strength training, may also help with body image issues that can come up when your body is changing. Eating a healthy diet can boost your energy and improve your mood. Pleasuring yourself by masturbating can also be a vital part of self-care. It can help you relax, and getting in touch with your body enables you to direct your partner for more satisfying encounters for both of you.
Use your brain. “Most of us need genital stimulation, but it doesn’t matter how you’re being touched; if your brain isn’t in the game, it’s not going to happen,” says Mintz. For the best sex, you want your mind to be present in your body, not worrying about how you look or thinking about your to-do list. One of the best ways to learn to be more present in the bedroom is to practice meditation or mindfulness outside of the bedroom. Yoga can also help you become more mindful, and the flexibility you can gain from the practice can be an asset in the bedroom. One study even found that women who do yoga are more orgasmic. Another way to use your brain is to fantasize about sex even when you’re not doing it. Fantasizing can be like a form of foreplay, and doing it during sex can help keep distracting thoughts out of your head.
Be adventurous. Reminisce about how fun sex was and look for ways to spice it up now. Try different positions, read erotic books, or watch woman-centric erotica. Sex toys like vibrators offer a whole new element. Even something as simple as a blindfold or feather can enhance your experience. Or try role-playing or book a hotel room to change things up.
Talk about sex. “You can’t solve a problem, sexual or otherwise, without talking about it,” says Mintz. Let your partner know what’s going on. They’ll be much more supportive knowing that it’s the hot flashes or discomfort that’s turning you off and not them. If your partner is part of the problem, you should talk to a therapist who can help you address the topic. It can also help if you speak with your doctor about sexual issues. Don’t be embarrassed because they’ve probably heard it before. “We used to die before we hit menopause,” says Dr. Mintz. “Now, we are outliving our uterus. We are outliving our estrogen. If we’re going to have a healthy sex life after our estrogen has decreased, we need assistance from knowledgeable health care providers.” As one of Dr. Mintz’s patients summed it up, “Communication is the bedrock to make your bed rock.”
Have you experienced changes in your libido? Wonder if what you are feeling is normal? Speak with a Gennev board-certified Ob/Gyn to get your questions answered and learn about proven treatments that can help manage changes in your libido.
Listen to Dr. Mintz in the Gennev podcast where she talks about Sex, Midlife and Menopause
Check out Sex After Menopause: It is really good for you to learn about the benefits of a healthy sex life.
Are mood swings getting in the way of romance? Learn more with Menopause, Marriage and Mood Swings
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.
Do a quick online search for the resources available specifically for menopause help for husbands? Seriously, go ahead. We’ll wait.
Well? I’m guessing you found information about lackluster libidos and vaginal dryness remedies. Which tells you a lot about what our society thinks men are interested in. Now try looking for info about the menopause divorce rate. Uh huh.
If you have a partner going through midlife changes, I’m betting it impacts more than just your sex life. And I bet you’d love to make it easier on her, if only you knew how. “Menopausal rage” might be a thing, but menopause and anger toward husbands don’t have to go together.
We talked to several men who’ve been through midlife with their partners, making them qualified to offer ideas on menopause help for men. This is for all the you out there who are now or one day may be sharing a life with a woman in menopause. Spoiler alert: You’re going to need patience, love, and some courage. You’ve got this!
No, your menopausal wife doesn’t hate you. Remember that her hormones are fluctuating. A lot. And hormones control so much of how the human body works. The result? For some, menopausal mood swings, weight gain, painful sex, anxiety, and night sweats. And for others? Depression, loss of libido, hot flashes, and lower back pain in menopause. And for still others? All of the above and more. This can all add up to extreme fatigue (and we’re never our nicest when we’re tired) and loss of patience with someone (you) who doesn’t understand what a midlife woman is going through. How does this manifest? Rage directed at the ones we love the most (you). Your wife doesn’t want to be angry, but when you consider all of the above, it’s easy to understand why she might be. No, you’re not going to be able to fully get where she’s coming from, but trying to is a good place to start–and shows your wife that you not only want to help, but will stick around and see things through.
Menopause is still such a taboo subject that it can be hard to talk about, even between intimate, long-term partners. As this husband of 28 years said, “Don’t take it personally if she doesn’t want to share the details with you. What happened to her that day might be really embarrassing, like maybe she had a hot flash while training some 22-year-old intern. Be open to hearing it, but also be open to not hearing it. And it can depend on the day, too; one day it’s humiliating, the next day it’s hilarious. Just try to go with it.”
“Dude,” one man told us. “be ready. You are going to hear some stuff. Discharge, heavy flow, boobs always sore, soaking through her pajamas with night sweats. For us guys, it can be hard to hear. But you gotta listen. As hard as it is for us to hear it, she’s actually living it, and that’s a whole lot harder.”
Listening when she needs to complain or just be frank about what’s happening is often the very best thing you can do. As someone who watches hospital shows with one hand over her face, I understand squeamish, but reacting negatively to her horrible menopause stories of heavy flow only embarrasses her and continues the stigma around women’s bodies and their natural functions.
“It’s not a disease as it’s biology,” one wise man said. “You’re not going to catch menopause like the flu. The more you listen, the more she’ll tell, and the more you’ll understand. And that makes it easier on both of you.”
The stereotype is for men to just keep their heads down and wait for the storm to blow over. But the hormone fluctuations of perimenopause and menopause can last for years. “Know yourself and play to your strengths,” one man suggested. “If you’re an open-and-empathetic guy, then really listen. If you’re more of a fix-it guy like me, ask her for actual things you can do to help, then do those. Research hormone therapy, put ceiling fans in every room of the house, be ready to leave the party early if she sweats through her clothes (maybe it’s time to buy somemenopause clothes). Just don’t give advice, and don’t ignore the problem and hope it goes away.”
All our guys agreed on one thing: learn stuff. (You’re off to an excellent start right here at Gennev.) Check out the Menopause Goddess blog and do some reading. Good information is out there, but you may have to do a little digging. There are even men’s menopause support groups in many cities, which can be a serious resource.
But understand first and foremost, “It’s different for every woman. I watched my mom, my sisters, and now my wife go through it, and the experiences are not the same, the way they deal with the symptoms is not the same. My mom and my sisters took HRT, but my wife’s family has a history of breast cancer, so that’s not an option for her. It makes a huge difference. What if I didn’t know that, and I accused my wife of being overdramatic or as heaven help me as hysterical because her symptoms were so much worse than those other women?”
There is nothing more attractive than a man who doesn’t just say he cares as he shows it. By being present. By hanging in. “I want to support the women I love,” one man told us. “My wife, my friends”¦ you know, my sister just turned 50. So I read stuff I’ll never completely understand, like I did when my wife was pregnant. I just learned thatDr. Sarah Speck says women have a higher risk of heart disease after menopause, but the symptoms of a heart attack look different in women. Seems like an important thing to know.”
But being present and engaged is often easier said than done. There’s no doubt that menopause has impacts on the men in the relationship, and guys are often left without good solutions for what they’re going through. As one man put it, “Sometimes it’s annoying feeling like you can’t complain because your wife has it so much worse.” But if you end up resenting it, that’s not good either, he said, so, “Walk away when you have to. Tell her you need 30 minutes or an hour or an afternoon. Go do something “guy,’ if you want. Then come back when you said you would.”
So, partners, we’d love to hear from you how you’re helping the women in your life manage menopause. What resources are your go-to’s, what information is missing? With menopause still so taboo, are you even able to have conversations with women on the subject? Please share your thoughts in the comments below or on Facebook or Twitter. (Yes, share in public forums “¦ remember that bit about not continuing the stigma?) And by the way, guys? Thanks.
For more ideas on making her menopause easier, check out our post, “go away come here go away: 10 tips to support someone through menopause“
One of the thornier aspects of hormonal change during menopause, PMS, pregnancy, etc., is mood and the regulation thereof. In the course of researching this blog and talking to women heading into menopause, I came across story after story from women who found it difficult to “control” their anger. “Menopause anger attacks” don’t affect everyone in the same way, but many women report some sense of elevated anger during menopause.
In truth, I learned that it’s less about controlling menopause anger and more about respecting why it’s there and channeling the truth behind it in more productive ways. It’s not so much finding a menopausal anger treatment as recognizing why the anger is there in the first place.
Time and again I heard women’s “confessionals” of how they felt trapped and helpless in the cycle of rage > regret > rage. The middle-aged woman’s mantra has become “I snapped, I shouted, I apologized.” Menopausal outbursts are much the same.
Let’s define terms from the get-go. Many women experience what they call “irritability” which is a fully understandable reaction to being wide awake at 3 am, soaked in sweat and buzzing with anxiety, while your partner is sound asleep next to you, deep in blissful oblivion.
But irritability, as grindingly awful as it can be, isn’t the subject for today. Instead, I’m talking about the towering, frothing fury many women feel around menopause. It’s about red-hot rage: why you feel it, and what you can do with it.
Let’s start with the “what the hell is happening here?” stuff. Estrogen and serotonin may sound like characters straight out of The Lord of the Rings, but they’re definitely the good fairies of mood regulation.
Serotonin is a neurotransmitter that helps control mood and impulse control. Because the hormone estrogen plays a part in the production of serotonin, when estrogen levels decline (with PMS, menopause, etc.), serotonin levels can tank too, taking mood control with it.
Lack of serotonin makes it far more difficult to cope with the menopause insomnia, hot flashes, short attention span, and all the other symptoms that can make menopause a challenge
Let it out: Absence of serotonin itself doesn’t necessarily make you angry; it may make it harder for you to manage (translation: hide, swallow, underplay) your anger. There are times when we’re fully entitled not just to the anger but also to the expression of that anger”¦provided we wield it effectively, proportionately, and at the right recipient. All those years of holding in the truths you wanted to speak? Let “em out, and feel the rush of being honest, open, and real in ways you’ve never known. There is no better “menopausal rage” treatment.
Give up the guilt: Yes, you’re probably going to fly off the handle from time to time, but now more than ever you need to give yourself a little slack. Be as open as possible with family and friends about what you’re going through, and limit collateral damage as much as you can. Be ready to apologize when apology is clearly called for, then forgive yourself and move on.
Channel the energy: Anger is a big, powerful emotion, and you can use that energy to drive solutions. The great thing about being 40+ is you’ve spent at least 40 years developing nerves of steel, marshaling your arguments, and building a history that demands respect. Use them. Remember the movie Liar Liar? Imagine you’ve taken that truth serum, and use it for good. Take as many deep breaths as you need, open your mouth, and speak your truth.
Nurture yourself: Yeah, when you’re feeling ragey, the last thing you want to do is head out for a jog, but exercise can boost serotonin levels, helping you regain your cool. When going all Xena Warrior Princess is uncalled for or unwise, a few laps around the track or rounds with a non-sentient punching bag can bring you back to earth. And eat, for crying out loud. If you’re going to go all truth-teller, you’re going to need good fuel or nutrition for your hormones to do it right.
Meditate: If you’re just not the loud-mouth, get-it-all-out type, meditation, visualization, and practicing thankfulness can be effective. I do a sort of bio-feedback that was suggested to me by a friend as I explain to myself why I’m angry as if I were telling my mom. Lots of details, and no “f-bombs” that keep me in the anger loop.
Get creative: You’ve got all this adrenaline bouncing around your body or menopausal zest give it something constructive to do. Invent a new dance, grab your journal and start scribbling, cook up some chili spicy enough to be its own revenge. You are humming with energy, and you will feel better when that energy’s released, especially if you have something positive to show for it rather than another apology to make.
Please understand that I am not a doctor prescribing treatments, nor am I endorsing any sort of impetuous action you’ll regret later. But after reading article after article on “how women can quash anger,” or how to suppress or avoid it in the first place, I found myself seeking out solutions that started with understanding the anger and finding value in it”¦and what that could mean for my newly confident self. You are entitled to your emotions, hormone-heightened or not. Suppression, guilt, and avoidance prevent you from expressing your emotions”¦and from getting the relief of letting them go.
“You should be angry”¦. use that anger. You write it. You paint it. You dance it. You march it. You vote it. You do everything about it. You talk it. Never stop talking it.”
“ Maya Angelou, Iconoclasts, 2006
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.
We know what you’re thinking. Isn’t it enough that perimenopause and menopause bring on a whole host of less than appealing symptoms and bodily changes? Do we really have to add a link between menopause and sexless marriage issues? Well, yes. But it’s not hopeless! Disparate expectations, increased physical pain during sex, differing levels of desire, reduced ability–all of these symptoms are frustratingly common in middle age, and allthey can make intimacysex difficult. According to therapist and author (Sex Without Stress) Jessa Zimmerman*, about 20 percent of people are in “sexless” marriages, meaning they have sex fewer than 10 times per year. Of the remaining couples, about 25% have sex less than once a week.
Pause and take a deep breath. You don’t have to settle for a sexless marriage. And once you understand what’s causing the issues getting in the way of your sex life, you’ll know how to move forward with confidence and control.
Struggling with a sexless marriage? A menopause-certified health coach can be helpful. We can provide a personalized plan to revitalize your marriage’s sex. Book 30 minutes for your personal consultation with a health coach.
Couples who don’t have sex are missing out on that physical connection in their relationship. There’s a correlation between divorce and menopause due to lack of sex.
As you probably already know (but it bears repeating) estrogen and testosterone levels drop during perimenopause and menopause. This can cause thinning and drying of the vagina of the vaginal tissue–the vagina may even become shorter, narrower, and less flexible during menopause. Put this all together and you’ve got painful sex. Not to mention you’ll still have these same struggles with sex after menopause. First, talk to your doctor.** There are all sorts of options available to try, including lubricant, topical estrogen, a clinical therapy device (used to increase blood flow to the vagina), and even drugs–though there are some serious side effects that come with these medications, so, not to sound like a broken record, but talk to your doctor.
Another sexual side effect caused by lowered estrogen and testosterone is a lagging labido. The one-two estrogen/testosterone punch can lessen your sensitivity to touch. Throw in some of the other distracting symptoms such as menopausal depression,sleep disturbances, anxiety, and stress, and it’s pretty easy to understand why sex might not be at the top of your to-do list. What can be done? Well, it might be time to try something a bit outside your box. Look for inspiration in erotic films and books. Put a new foreplay plan in place by adding sensual massage or extended oral sex. Play with new sexual positions, especially ones that allow for you to control the depth of penetration. First and foremost, have fun! And please, remember to communicate with your partner. If something isn’t working for you, they need to know.
There’s sex, and then there’s intimacy. They’re inexorably linked, and both are vital to a healthy marriage. Sex is exciting, pleasurable, a mood booster, stress reliever, and can even strengthen your immune system. Intimacy, on the other hand, is the closeness that builds between two people over time in a loving relationship. Does sex increase intimacy? You bet. Do the two work as a team to make you and your partner feel fulfilled in your relationship? Yep. Which is why it’s important when talking about menopause’s impacts on your sex life that we address what it can do to your level of intimacy, too.
So we asked Jessa about how couples can navigate the rocky terrain of sexual and intimacy issues in a relationship. What can couples do to keep the closeness and intimacy if sex is complicated? This is a big part of her couples therapy, Jessa says, and it begins by widening our definition of “sex.” It doesn’t have to be limited to penetration to “count.”
“My definition of sex is that it’s the physical expression of our innate drives for love, intimacy, and pleasure. That means any pleasurable physical intimacy between partners counts as sex. I encourage people to find ways to touch and be touched that each find pleasing. If one person wants sexual stimulation and the other wants their hair brushed or their feet rubbed, they can participate in pleasure with each other. It is so important to open up your idea of what sex is and what it’s for; it takes the pressure off the couple and allows them to find intimacy and pleasure in new, flexible ways.”
So, let’s say you’re happy, you’re satisfied, you’re compatible sexually, and in your approach to midlife. How do you keep this going as menopause starts to throw hurdles in your way?
If your relationship is happy and has been for a number of years, chances are you’re already doing what you need to do. But even good relationships take work, so Jessa gives us three tips to be sure your happy partnership stays that way.
“Marriage is like a garden; it needs tending,” Jessa explains. “Continue to spend quality time together. Make sex and intimacy a priority. Don’t let yourself get so comfortable you don’t water and weed the garden, letting it fall into disrepair.”
This can be a tough one, Jessa acknowledges: “When things are going well, it can be hard to bring negativity into the relationship. People avoid talking about difficult things because they don’t want to spoil the good feelings they’ve been having with their partner. But it’s crucial that a couple maintain open and honest communication, especially about the hard things. If you stop talking and start hiding things that are bothering you, resentment and distance will grow.”
A healthy, supportive partnership is worth celebrating! Jessa underscores. “Recognize that you have something special. Enjoy every moment. Don’t take it for granted because life brings changes, one way or another. Be grateful for what you have and express that to each other.”
Sex and intimacy are so hard to separate, we often use the latter as a softer “code” word for the former. But the link is real. Physical touch is critical to a healthy relationship, whether that’s foot rubs or foreplay. Ultimately, how a couple defines intimacy and satisfaction is entirely up to them–as long as both parties agree.
So, openly communicate about what gives you pleasure, what you love about your partner, and how important the relationship is to you–it doesn’t get much sexier than that. And if you commit to doing these things, menopause does not have to lead to a sexless marriage.
*We are providing these links for informational purposes only; they do not constitute an endorsement or an approval by Gennev of any of the products, services, or opinions of the corporation, or organization, or individual. Gennev bears no responsibility for the accuracy, legality or content of the external site or for that of subsequent links.
**It is not Gennev’s intention to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Gennev urges you to consult with a qualified physician for diagnosis and for answers to your personal questions.
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Dreaming of a good night’s rest? It can be tricky during menopause, but not impossible. Read this to learn more about what you can do to improve your sleep quality.
Parts of this article were first published on PRiME WOMEN “ a great resource for women to learn more about health, fashion, lifestyle, careers, “second acts” and more.
“In the next three minutes, 3 people will develop Alzheimer’s. Two of them will be women.”
As neuroscientist Dr. Lisa Mosconi says in The Menopause-Alzheimer’s Connection, “ while women account for two-thirds of Alzheimer’s cases, little is being done to understand why simply being a woman significantly increases your risk of developing the disease.
If you are worried about getting alzheimers, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
Dr. Mosconi is Associate Director of the Weill Cornell Alzheimer’s Prevention Clinic, where she and her colleagues are working to understand this critical as and critically overlooked as piece of women’s healthcare.
Team Gennev came across this story because Dr. Mosconi and others have linked Alzheimer’s disease with menopause. They postulate that as estrogen levels subside in a woman’s body as she ages, so do its neurological protections.
As Dr. Mosconi puts it: “In straight talk: menopause causes metabolic changes in the brain that seem to increase the risk of Alzheimer’s disease.”
Fortunately, as Dr. Mosconi has helped identify the problem, she has also helped point to some powerful solutions. Exercise and nutrition, she says, can play a significant role in preventing cognitive decline.
In Part 1 of her podcast with Gennev CEO Jill Angelo, Dr. Mosconi explains the mechanism behind menopause and Alzheimer’s risk. Continue on for where she discusses how women can protect their brains as they age.
If you want to start nourishing your brain against age-related decline (“eating for retirement,” as Dr. Mosconi puts it), get your hands on a copy of her fascinating and very readable book, Brain Food: the Surprising Science of Eating for Cognitive Power.
Know your body better. Take the Gennev Menopause Assessment to help you manage symptoms now and plan for the future
Jill: Well, Lisa, it’s a pleasure to have you with us today. We’re going to talk today about menopause and any correlation it might have to brain health and Alzheimer’s in particular. This topic hits really personal to me, because Alzheimer’s is quite prevalent in my family and I’ve seen its impacts. So, this is a personal conversation for me today and I just deeply appreciate the work that you’re doing. So, welcome!
Dr. Lisa: Thank you. Thank you so much and thank you for having me.
Jill: First and foremost, you’re an expert in brain science. Help us understand what that means and how did you get started in this field?
Dr. Lisa: So brain science is really the study of what happens in the brain. And for me, I was particularly interested in the medical applications of that. So, my background is in neuroscience and nuclear medicine, which is code for brain imaging. So, my work is really focused on detection of whatever goes on inside the brain from a structural, functional and chemical perspective, all of them.
And how I started “¦. My parents are nuclear physicists, both of them. They introduced me to nuclear medicine very early on, because my mother was teaching nuclear physics to medical doctors and to physicists that then transitioned to medicine. So, I started very early on, and pretty much when I started my PhD, my grandmother started showing signs of cognitive decline and cognitive impairment.
Within a matter of years, she just transitioned to full-blown dementia. So, almost by chance, I had started working on Alzheimer’s due to my PhD; I was actually working on the prevention of Alzheimer’s and early detection of Alzheimer’s. And just around the same time, my grandma was pretty much a textbook case of what happens to somebody with dementia and it was terrible, it was terrible to witness not just on her, but on my family as well. And that was really, you know”¦ she had Alzheimer’s, so dementia, probably it was mixed dementia with a strong vascular component. Her sister had exactly the same, and then her younger sister developed it too.
So, like you were saying about your family, you really want to protect your parents at that point. You want to make sure that, in my case, my mother would not have to go through that and that I wouldn’t have to go through that and that my daughter wouldn’t have to go through that. So, prevention has been the main focus of my research ever since I started, and I moved to New York 15 years ago, at this point, to really have the opportunity to do more and better research. Because Italy is Italy as you are lucky if you have any money at all for research. That’s why I moved here and I never left.
So, I started at NYU School of Medicine and now I am working at Weill Cornell Medical Center. And I’m actually the Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell. And this is the first Alzheimer’s prevention clinic in the country.
Jill: Wow, wow! Speaking of Alzheimer’s for a moment, how many Americans or even people worldwide does it affect?
Dr. Lisa: Currently, it’s 46 million Alzheimer’s patients worldwide. And what is even more terrifying, in some ways, is that the number of cases is estimated to increase to 130 million by the year 2050. It’s really an epidemic. We are facing an epidemic, and I think we are not prepared.
Jill: And your work as would you say it’s all around looking at causation or things that cause that; that are going to contribute to that incredible growth in Alzheimer’s?
Dr. Lisa: Yes. Our work is definitely focused on identifying all possible risk factors for Alzheimer’s. All the factors that will make you develop Alzheimer’s. Even if you don’t have a genetic mutation that is causative of Alzheimer’s. And this is really important, because when I started about 15 years ago, most people would think about Alzheimer’s as either an inevitable consequence of getting older, or as a consequence of bad genes in your DNA, or both. And it turns out neither one of these alternatives is really true, in that getting older is not a linear path to dementia, and genes are not your destiny.
In fact, one percent of the population develops Alzheimer’s because of genetic mutations; 1 percent, no more than that. For 99% of us, of course, your genetics play a role on some level: they can put you at risk, they can give you a higher risk, a lower risk, but they are not the entire story. And your lifestyle and your environment play a huge role that was always underestimated until very recently.
“getting older is not a linear path to dementia,
and genes are not your destiny”
So, what we have learned is that 1 in every 3 Alzheimer’s cases could be prevented by addressing lifestyle and medical factors, like factors for cardiovascular risk, but also lifestyle, in terms of exercise, intellectual stimulation, and perhaps, most of all, diet.
Jill: Do you think we’ll ever get to the point where Alzheimer’s is, like, 99% preventable?
Dr. Lisa: Well, I think that’s optimistic, but I think we can probably shoot for 30% to 50%, depending on who’s looking at it. The most conservative estimate is 30%. The most optimistic estimate, at this point, is 50% preventable. And look, it’s great, right? 75 million people, that would be fantastic, I think.
Jill: It sounds like there are so many corollary factors and I think we are going to need another podcast just on all of that, but today let’s talk a little bit about the relationship between Alzheimer’s and menopause. You recently published a piece titled “Alzheimer’s and Women’s Health, an Urgent Call.” To me, that seems alarming. Can you explain a little bit about your findings and what you’ve learned?
Dr. Lisa: Yes, gladly and thank you for the question. As scientists, we have long known that female sex is a major risk factor for Alzheimer’s. The number one risk factor is aging, but the number two, so the second most important risk factor, is actually being a woman. And for many, many years nobody looked into why. This is alarming, because of every 3 Alzheimer’s patients, 2 are women, everywhere in the world, regardless of geography, regardless of cultural background, regardless of a variety of factors. Alzheimer’s affects more women than men.
And people can say, “oh, that’s because women live longer” and they just say, “well, it’s because you guys live longer,” but that is just so not the case. Women outnumber men 2 to 1 in the Alzheimer’s population and this is already accounting for the increased longevity relative to men. You can look at that in any age group; like, if you look at people who are 60 to 70 or 65 to 75, 75 to 85, any age range has exactly the same ratio. Out of every three patients with Alzheimer’s, two are women, one is a man.
Also, if you control for that statistically like we do, with survival analysis, accounting for mortality rates, etc. as it’s exactly the same story. So, it’s not just that we live longer. There is something about just being a woman that puts us at a higher risk for Alzheimer’s as compared to men. And that is really important because it doesn’t happen for other neurological diseases, it’s only for Alzheimer’s. If you look at vascular dementia, it’s not the same rate. If you look at Parkinson’s disease, actually more men suffer than women. So, there’s really a strong connection between female sex and Alzheimer’s, and we just did not know what it was.
What we thought was, well, for a really long time, people thought of Alzheimer’s as something that just turns on when we are older. And all my work has always been about early detection. How early on can I catch signs of future Alzheimer’s? Because we are using brain imaging techniques, we can really track development of Alzheimer’s in brain from when people are in their 30s and 40s and 50s. And what we have found as and what other people have found as is that Alzheimer’s is not a disease of old age. It starts in mid-life with changes in the brain when you don’t have cognitive symptoms, you have no clinical symptoms, you have no cognitive decline whatsoever, but it’s already inside your head. And then it takes 20 years before the brain basically gives up and has no more reserve to withstand it, and then people develop symptoms. So there is a twenty years’ gap between the onset of changes in the brain and the onset of clinical symptoms.
And sure enough, what happens only to women and not to men, when they turn 45, 50? They go through menopause.
“Out of every three patients with Alzheimer’s,
two are women, one is a man.”
Jill: When you said, ok, that is the unique thing that women go through and men don’t, you said, “hmm, let’s look at this, let’s look at it “¦ deep”?
Dr. Lisa: Yes. And I was amazed that so little had been done. I mean, it’s such an obvious conclusion to reach, right? And there was so little done to really look into that.
One reason that we thought we should really investigate that is that estrogen is not just involved in fertility. Estrogen plays a huge role in the brain, all the time, throughout our lives as from the minute you’re born to the very last minute of your life, estrogen plays a huge role.
And in particular, it is neuroprotective. So, it literally shields your brain from harm.
So, as you go through menopause, there’s a decline in estrogen levels, and yes, that affects your fertility and your ability to have kids, but at the same time, it gives all sorts of neurological symptoms that are just not thought of as neurological.
So when women suffer from hot flashes, those are not in your ovaries; those start in your brain, right? When you go through menopause and you develop insomnia, depression, confusion, night sweats, memory loss for some women as not loss, but memory decline, memory impairment as that’s not because of your ovaries, that’s because of your brain. There’s something going on in your brain that is not making it function as well as it used to.
And that’s because estrogen plays such a huge role as a neuroprotective agent and also as a stimulant. It literally stimulates certain parts of your brain to be active and to be metabolically engaged.
So, as the estrogen goes down, as women, we lose protection, and that leaves us more vulnerable to brain aging and dementia.
Jill: So, the first question that pops up in my mind is: so what about men? Do they never have that kind of protection? What’s protecting their brain?
Dr. Lisa: Testosterone. Men have more of a balance between estrogen, testosterone, progesterone as they are not as dependent on estrogen as we are. And also, men go through andropause, when they’re, like, 70. So, whatever changes they experience are milder and later on in time. Also, their estrogen levels don’t go down. They start low and just remain whatever”¦ whatever level”¦
We knew from animal studies that the menopause transition has an impact in brain physiology. Now, these are studies in mice. And as a neuroscientist who works with people, I can tell you, whatever happens in mice, does not necessarily happen in people. So, we started with those studies because they’re fantastic, and they were mostly carried out by a wonderful friend of mine, Dr. Roberta Diaz Brinton at the University of Arizona. She is incredible, and she’s such a powerhouse in so many ways, she’s just a fantastic person; such a strong advocate for women’s health.
She actually came up to me when I was giving a talk at some conference, and she said to me, “what do you think about menopause in Alzheimer’s risk”? And I was like, “eh, nothing?” She goes, “well, you should, because we have shown this, this, this and that”¦” And it was such incredible new research, that I was immediately interested, and I said to her”¦ well, what they’re showing is that in female mice”¦ so mice don’t go through menopause naturally, as we do. You have to induce it. And once you induce menopause, their brains, kind of shut down. You can tell, there is a very sudden reduction in brain activity that is related to a suppression of mitochondria function. Mitochondria are little parts, little organelles inside our cells that are responsible for production of energy. So if the mitochondria, kind of, slow down, our ability to produce energy also slows down. This is everywhere in the body and the brain.
So, they showed that menopause really triggers a kind of bio-energetic crisis in the brain of mice. And she said to me, “I would love to see what happens in women.” And so, we did it. We ran one of the very first studies with women. Actually, I think, probably the first one with women prior to menopause.
We studied healthy women without Alzheimer’s, without any cognitive impairment, and they were all 40 to 60 years old. Some were pre-menopausal, meaning they had no symptoms whatsoever, they were doing fantastic. Some were perimenopausal as so they were starting to show signs of menopause. And some were post-menopausal. We also had a group of men of the same age and educational level, so we matched them, they would be, like, our controls.
And we measured a lot of things. We measured”¦ in everybody, we looked at clinical measurements, cognitive performance, lab tests as all sorts of lab tests as cholesterol, homocysteine, vitamin B12s, etc.
But most importantly, we did brain imaging on all of them. So we looked at their brain structure as if their brains showed any sign of atrophy, which is, like, a proxy for neuronal loss. We looked at brain glucose metabolism, which is an indicator of how active their brains are. And also, we looked at Alzheimer’s pathology. We can do brain scans and take a picture of whatever’s in the brain. If you show any Alzheimer’s plaques in your brain, we will see them on the scans and we can quantify how much you have of that pathology.
And we also measured mitochondrial activity. So we had a lot of information, and no matter how you slice it, post-menopausal and perimenopausal women showed on average 45% lower mitochondrial activity than pre-menopausal women. And they showed reduced brain activity by 30%. And the post-menopausal women also showed a lot more amyloid than the pre-menopausal women and men of the same exact age.
If you are worried about altzheimers, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
Jill: Those are big gaps. When you think about that disparity and that difference and the impact, and the vulnerability that we have in our brains to Alzheimer’s, it begs the question, should I be taking hormones? Or, you know, what can I be doing as a woman as and so many women are conflicted about hormone replacement therapy. What’s your point of view on that? Did you have any conclusions around that at this point?
Dr. Lisa: I’ve done research on that, because in 10 years I’ll be perimenopausal, and I want to be prepared. So I looked into that, because that was exactly my question for Dr. Brinton when she contacted me and said, “well, so what do we do?” And my understanding from the media, I guess, was that HRT or estrogen replacement therapy or hormonal therapy increased the risk of breast cancer. And pretty much that’s what everybody thinks. And she got so frustrated, she was like, “aah, another one!” And she said to me, “just figure it out. Just read and then we’ll talk about it.”
Jill: And I’m sorry to interrupt you, but you will hear a lot of OB/GYNs or MDs, really, they’re supportive of hormone replacement therapy in the right way, you know, provided. And so, I can see where her frustration came from.
Dr. Lisa: Yes, I think it was misinformation. Actually, I was talking to the chairman of my department, who’s really supportive of our work and really wants to promote what we’re doing. And he was saying to me, “look, many years ago in 2002 and 2004, there were very big clinical trials that were interrupted almost overnight as the Women’s Health Initiative trials as because they did report that women who were taking the combination therapy as estrogen and progestin as they showed an increased rate of breast cancer and increased incidence of breast cancer. Whereas women who were only taking estrogen, did not. Actually, they showed reduced incidence of breast cancer, but that was enough for the media to basically sound the alarm.
If I understood correctly, a lot of people actually sued the pharmaceutical companies or there was some kind of”¦ upheaval. So, they just interrupted the trials. And I would say those trials were not perfectly designed, because they looked at women who were fairly old. They were 50 to 79, so they were already post-menopausal. Actually, they were not old, I’m sorry, 50 is not old as a terrible thing to say!
Jill: It’s not old anymore, it’s a lot younger than it used to be!
Dr. Lisa: Absolutely, but I meant, you know, endocrinology”¦ well, from an endocrine perspective, 50 is not young. So, they were just post-menopausal. And there is evidence from follow-up studies “¦ also what they showed was an increased risk of cardiovascular events for both groups. So, regardless of whether you were on estrogen-only or estrogen and progestin, they really showed the increased risk of cardiovascular events, and that was also a big concern.
But there’s evidence that if you start therapy prior to menopause, the risk of cardiovascular disease is actually reduced. And even if you start HRT after menopause, but not later than nine years’ post-menopause, there seems to be still benefit.
So, I think what we need is more research, at this point. I think the risk of cancer is scary for everybody. But I think there’s a lot of thought that needs to go into that. If you have a uterus, then estrogen alone is problematic. If you had a hysterectomy, then you can tolerate it without necessarily developing cancer. But it’s also really important, I think, to do genetic testing. And see if you have any genetic risk-factors for ovarian cancer or breast cancer. And that’s something we need to know prior to starting any therapy.
Obviously, if it runs in your family, then you know that you are sensitive to estrogen replacement therapy, you know that. If you carry the Angelina Jolie gene, for instance, then that’s a big red flag; so the BRCA gene, if you are positive for that then, I would say, you should not take estrogens.
But for people who don’t test positive for the genetic markers, then I think we need more research and we need to understand when to initiate therapy or what kind of therapy or what kind of dosage, what’s the source of the estrogens, right? Many formulations are from horses. Is that the best way? Could we take phytoestrogens, for instance, from plants? Would that be more gentle on the body? You know, I think there are so many questions that we’re just not asking, and it’s a pity, because everybody goes through menopause, everybody. It’s insane that there is no relief.
Jill: Whether you experience the symptoms or not, every woman or any person with a uterus goes through menopause.
Dr. Lisa: Yes, absolutely. But also I would say, 80% of women do have symptoms; there’s only about 20% who just breeze through it, like my mom. But 80% is a lot. I think there are 850 million women in the world who are entering menopause or just entered menopause. And we have no ways to help them.
Want to know where you are in your menopause journey? Be sure to take Gennev’s Menopause Assessment. Then subscribe to HealthFix for unlimited access to a Gennev Health Coach for help with managing symptoms. Are you concerned about Alzheimer’s or have you taken steps to reduce your risk? We’d love for you to share your story in our Community forums!
Midlife can feel like a time when we have to drastically reduce or give up so many things we love: sugar, wine, coffee, carbs, sweaters that don’t button down the front, good sleep.
For some women, quitting smoking just feels like one sacrifice too many.
To you we say: add something else back, but please…get rid of cigarettes.
May 31 was World No Tobacco Day, according to the World Health Organization. Part of the Tobacco Free Initiative (TFI), it’s a day of awareness and learning.
Gennev participated, with a webinar with our Director of Health Coaching, Stasi Kasianchuk, hosting Gennev’s Chief Medical Officer, OB/GYN Dr. Rebecca Dunsmoor-Su, and pulmonologist Dr. Anne Lipke.
They spoke not just on the benefits of quitting smoking, but also on the particular reasons women in menopause should quit.
In addition to entering menopause up to a year or two earlier than her body might naturally (and thus losing the protections of estrogen earlier), smoking is hard on the skin, the heart, the brain, the teeth, and just about every part of a woman smoker’s body.
Listen to the podcast for more information on why to quit, how to quit, how to nourish your body after (and avoid weight gain). Then make an appointment to speak with a physician or a health coach to begin your journey to a happier, healthier life!
TRANSCRIPT COMING SOON
Did you quit or are you trying to quit? We’d love to hear whatever magic you used to quit or what didn’t work. Hit us up in the Gennev Community forums!
“Ever heard of perimenopause depression? A woman’s risk of depression doubles or even quadruples during the menopausal transition.”
“Some studies show that one-third of women will experience a major depressive episode in their lifetime.”
Depression can be debilitating as sucking the joy out life, making activities we once enjoyed uninteresting, rendering work impossible, closing us off from those we love. Even more, clinical depression, when untreated, significantly increases a person’s risk of suicide.
In the manner of ripping-off-the-Band-Aid, let’s get the ugly statistics out of the way first.
According to the Centers for Disease Control and Prevention:
Perimenopause and menopause can cause or exacerbate depression. Depression can lead to suicidal ideation, attempt, and completion.
So, with all that said, well, we really need to talk. Openly. Honestly. Often.
Kate Spade’s suicide at 55 was as mystifying as it was devastating to many of us. She was bright, beautiful, wildly successful, and overflowing with talent and creativity. Who could have imagined she would “choose” to end her life? And while no one but Ms. Spade can truly know what was going on in her mind and heart, her suicide has helped lend urgency to an overdue conversation about the link between menopause and depression.
A link that leads, too often, to suicide.
So what’s going on here?
If you are experiencing perimenopause depression, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
We use “depression” as a blanket term to cover a range of emotions, and that’s not only inaccurate, it can be dangerous. Anyone who’s suffered from clinical depression will tell you it’s very different from sadness or grief and needs to be treated accordingly. Depression rises to the level of “clinical” when it lasts for two weeks or longer and comes with other symptoms such as change in appetite, loss of interest or pleasure in things you usually enjoy, changes in sleep patterns (too much or too little), feelings of worthlessness or guilt, increase in “purposeless” activity like pacing, and thoughts of death or suicide. Depression as a symptom of perimenopause is not uncommon, but should be taken seriously.
Rather infuriatingly referred to as the “menopause blues,” depression in perimenopause as the years leading up to menopause as is fairly common, though it should never be regarded as “normal.” Estrogen interacts with certain chemicals in the brain, including those which regulate mood (which explains menopausal anger). In some women, this translates to rage, in others, menopause anxiety symptoms. And in many, depression. Hormonal fluctuations during the perimenopause years seem to make women particularly vulnerable.
The risk is even greater when a woman has experienced depression earlier in her life. Birth control and HRT can cause depression in some women, help alleviate it in others. Pretty clearly, there’s a hormonal component. This is critical to understand because so many women are too ashamed and embarrassed to seek help, feeling as though they’re just being “weak.” They try and tough it out on their own, the way they grit their teeth and get through the hot flashes and headaches.
But we wouldn’t ask someone to simply “tough out” diabetes or leukemia or hypertension, and depression is no different. If your depression lasts longer than two weeks and significantly impacts your day-to-day life, you should seek professional help.
In addition to hormones, the realities of aging may play a role. Realizing you haven’t yet achieved your goals may be tougher at 50 than at 30, particularly in a sexist, ageist society that seems bent on telling women their lives are pretty much done when their ability to reproduce is gone.
There are plenty of pressures outside our heads and hormones that can contribute to depression: Aging parents. Empty nest or wishing it were empty because the kids are in their “challenging” teen years. More responsibility at work, or more competition from younger colleagues. Physical challenges of perimenopause and menopause, including hot flashes, poor sleep, weight gain, headaches. Relationship challenges from a deflated libido and painful sex. Worries over a financial future in retirement.
So now that I’ve scared you and have you rethinking every time you got tearful at a Budweiser commercial (come on, those Super Bowl ones with the Clydesdales have all the feels), here’s the good news:
Depression is among the most treatable of mental disorders. Between 80 percent and 90 percent of people with depression eventually respond well to treatment.
Emerging from depression is not easy. It might mean taking medications you’re not entirely comfortable with, like SSRIs or other antidepressants. It may take time in psychotherapy. Cognitive behavioral therapy (CBT), where you train your brain to problem-solve its way out of negative thought patterns, can be quite effective against depression. Brain stimulation therapies such as ECT can help in more severe cases.
When depression is painful but not “clinical” in intensity or duration, there are many effective things you can do on your own: exercise is a wonderful, natural mood elevator (especially when it’s over), quality sleep, Omega 3s, sunshine, St. John’s wort, strong social connections with family and friends, good work, avoiding sugar, and as we have the science to back it up, self care. It’s true: simply doing more pleasurable activities helps us be more positive generally. Surprise!
And the even better news for women in midlife: rates of depression decline in post-menopausal women once hormones level out and the body and brain adapt to their new normal.
Depression should never be taken lightly. Mild depression can disrupt our ability to enjoy our lives fully. Major depression is dangerous. Life-threateningly dangerous. And it takes far too many women who are truly in their prime.
If you feel you or someone you care about may be suffering from depression, there is help. You can start finding your way back from depression by talking to a doctor or calling the National Suicide Prevention Hotline at 800-273-8255. If you’ve dealt with depression or had thoughts of suicide, how did you recover? We’d love to hear from you. Please feel free to comment here, or start a thread in our community forums. You can also reach out to us on Gennev’s public Facebook page or in our closed Facebook group.
This article was first published on PRiME WOMEN and is republished here with permission.
Ringing, buzzing, whooshing, or clicking sounds in your ear(s) could mean a couple of things:
Let’s talk about tinnitus and menopause.
Tinnitus is the sensation of hearing certain sounds that aren’t present. That roaring, hissing, ringing noise could be caused by damage to your inner ear as or it may be caused by the hormonal changes of menopause.
There are two kinds of tinnitus: subjective, the far more common version where only the sufferer hears the noise, and objective, the very rare kind where some internal function of the sufferer’s body, like blood flow or body movement, is actually audible to others. This is also commonly accompanied by headaches.
Lots of loud. Remember when you trooped off to see Huey Lewis and the News’ Sports tour and your mom told you to wear ear protection or you’d regret it when you were older? No? Just me?
Mom wasn’t wrong. One of the major causes of tinnitus is long-term exposure to heavy noise. While one bout of Huey and Co. may only result in short-term tinnitus, too many high-decibel concerts, with too much loud MP3 boogie in-between, can result in permanent damage. Because hearing damage can be cumulative, if you have kids, start bugging them early to “turn it down.”
Ear pods. Professor Dean Garstecki of Northwestern University says ear buds that fit directly into the ear can cause more damage than headphones that sit atop the ear “ from 6 to 9 dB more. So if you wear the in-your-ear kind, turn the volume down or save them for quiet places where you don’t need to crank the sound up to compensate for city or road noise.
Ear stuff. A significant build-up of ear wax, congestion, dirt, hair, etc. can irritate the inner ear and cause that unpleasant ringing sound. Get it out quickly, if you can, as long-term irritation can make tinnitus permanent.
Age. Hearing loss is often accompanied by tinnitus, which is why it’s so common in adults over 60.
Head and neck trauma. Injuries that affect blood flow to the area or impact nerves or muscles can result in tinnitus.
[Got itchy skin? Check out this symptom of the month article on four ways to handle itchy skin in menopause.]
Other, less common causes, include TMJ, a disorder of the joint where the jaw attaches to the skull, sinus pressure, injury from barometric trauma (think SCUBA diving), brain injuries such as concussion, and certain medications.
Tinnitus can be a symptom of a more serious medical issue such as hypo- or hyperthyroidism, anemia, Lyme disease, high blood pressure, etc., so if you’re suffering, please consult with a medical professional.*
If you are worried about ringing in your ear, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
The direct cause-and-effect has yet to be established. Because both menopause and tinnitus often happen around the same age, it’s difficult to tell if one causes or worsens the other, or if they’re both just a factor of getting older.
Having said that, many women report increases and decreases in tinnitus that seem to be linked to the rise and fall of their hormone levels. Because women complain of this during pregnancy or around their menstrual periods as well as during perimenopause or menopause, it may not simply be a product of aging.
There is also some evidence to suggest that taking HRT (hormone replacement therapy) or hormonal birth control can worsen tinnitus.
[what causes and how to handle (or not, if you value your life) sore menopause breasts]
First, see a doctor to rule out more serious causes. Next “¦
Tinnitus is fairly common to women in their 40s, 50s, and 60s, but that doesn’t mean it’s simply a result of aging or menopause. Because there can be more serious causes, before you sign up for that tai chi class, please consult a doctor. Then sign up for the tai chi class, because it’s good for you.
If you’ve dealt with tinnitus, we’d love to hear what you did / are doing to combat the ringing. Please share with us in the comments below, on the Gennev Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group!
*Thanks to American Tinnitus Association for information relating to the causes of tinnitus. This information is for education only and should not be used as a replacement for professional medical care. If your ears are ringing, go see your doc, hear me?
If the average American woman hits menopause at 51, she’s likely to have a whole lot of living left.
What will The Change change in your life? Is it time to pursue your passion into a whole new second act?
In her article for PRiME WOMEN, leadership expert and founder of The Perfect Fit Nancy Keene lays out the steps.
Your life may span more years than you think. Best to be proactive, not reactive in designing as and funding as the life you want to lead. Start now to lay the groundwork for your second act.
Be expansive in imagining the possibilities you want to pursue, but do incorporate an underpinning of reality planning. What if an elder parent whom you are supporting lives for another 10 years? What if you become responsible for the lifelong care of a younger sibling as or grandchild? What if you make an investing mistake? A back-up plan is like money in the bank!
Do NOT let your professional licenses expire. They are lifelong assets you’ve worked too hard to earn.
Take the Gallup Strengths Finder assessment. Have your significant other do the same! It will shine a mirror on your core assets and what is important to you. Why not build your second act on your strengths, rather than try to change a lifetime of who you are?
Maybe you have a vision already in place. If not, scope out what others are doing. What looks interesting? What is attainable and within reach? What is a scenario you would be willing to sacrifice for? How are others integrating challenge + enjoyment + revenue continuity? Start researching and networking, either on-line or in-person!
Are you hoping to serve on a public company board? Here is the #1 criteria: previous board experience. Desirable candidates include: public accounting audit partners; public company CEOs, COOs or CFOs; public company line executives with ops/line responsibilities. Does your current company support major non-profit organizations? Could you win a slot representing them on the board? This is a way to gain exposure with other board members who may also be serving on for-profit boards.
A female banker took a separation package in the aftermath of a mega-merger. Instead of retiring, she stayed in the game. She took a business development role for a virtual CFO consultancy as still connected to key banking decision makers. When a new bank entered the market, she was offered a dream role as based on her longstanding experience and current, active client contacts.
As you enter a new stage of life, you may not want the rigor of a 24/7 top executive position. But, you can teach others what you’ve learned. A successful magazine editor pursued a PhD while she was still on the masthead. As the print publication market upheaved, she was able to pursue a follow-on career in academia as also gaining an additional pension revenue stream. She is now partially retired and still teaches an abbreviated schedule of classes.
Earlier in my career, I noticed a number of older tech colleagues and clients moving into the field of retained executive search. They were applying the same principles of client service to a different discipline. The traits of maturity + wisdom + experience were highly-valued in high-level recruiting. Something an earlier career entrant couldn’t instantly osmose. Look for new channels that can deliver career longevity and on-going revenue for your second act.
Another game-changer for me was a consulting assignment in the construction and building materials industry. Many of my clients in the go-go tech and start-up sectors thought I was crazy as like a fox. It was a mature industry with an executive population that skewed older as and male. I could be a fresh young face as for a long time. 20 years later, I still operate successfully in heavy-industry realms.
The pioneering TV newswoman, Linda Ellerbee, saw her network career cut short as management sought younger, less expensive, more glamorous on-camera talent. Ironically, her future was with an even younger demographic than those who replaced her at NBC. She wrapped up a 25 year, award-winning run anchoring Nick News as for kids as on the Nickelodeon channel. Talk about a contrarian move!
As the world of technology evolves at a lightning fast pace, entirely new business disciplines are being spawned. There are high-demand, high-growth opportunities in areas such as coding, social media, SEO and more. And top-ranked business schools are offering highly strategic Digital Marketing executive education programs as a powerful imprimatur that can punctuate your portfolio of offerings and even break the tie if you are in a panel of candidates being evaluated for a senior position, consulting engagement or board slot.
Tracey Jackson had a 20 year run as a successful screenwriter. Then, she turned 50 and hit the brick wall of gender bias in Hollywood. Not to be deterred, she joined forces with Grammy and Oscar-winning songwriter, Paul Williams, to create Gratitude and Trust, a brilliant new book + blog + conference platform as appearing together on Oprah, the New York Times bestseller list, and more! Why go it alone when you can collaborate and trigger some serious synergy?
Direct marketing companies can provide a way to leverage your contacts and business skills. Beauty, fashion, decor and other product categories abound. Research the categories and talk to existing consultants and team leaders. Many successful executive women are adding this to their second act platform to enhance discretionary spending budgets.
In evaluating the future, you may choose to step off the fast track. Enjoy! But remain visible and maintain a re-entry ramp. Stay connected via social media and professional organizations. Be strategic in your non-profit and community service commitments. Maintain your brand, tweak it as or experiment with an entirely new platform!
Have you embarked on your second act? Are you considering a change? How have you laid the groundwork to prepare? We’d love to know the steps you took. Leave us a comment below, or talk to us on our Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.
It can be a conversation-stopper: “I’m CEO of a company that plans to make vaginal dryness a thing of the past. And what do you do?”
Of course that’s not all Gennev is about, but it makes for a hell of an elevator pitch.
Just over a year ago, I was a marketing executive at Microsoft. It was a fantastic job, working with super smart people, helping users discover products that genuinely made their lives easier and more productive, and leading an incredible corporate life. I’d always been in tech, first at an ERP-software company, then venturing to Microsoft via acquisition over 15 years ago. I traveled the world. I launched consumer and enterprise products. I worked with some of the most incredible leaders and pioneers in the tech industry.
But I knew there was something else I was meant to do.
I like tech a lot, but I’ve always been a passionate advocate for women, and not just because I am one! Women are smart, strong, ambitious, and resilient, but often we’re held back from being our best selves. I’m a student of this predicament, so why not figure out a better way?
In my heart of hearts, I want to help women claim their power and place”but that can be hard to do when you don’t even feel comfortable in your own skin. That’s what motivated me to start Gennev.
Not surprisingly, I get this question a lot. “Why leave an incredible job at Microsoft to launch a start-up dealing with [whispers] vaginal dryness???“
I’d been with Microsoft for more than 15 years when a mutual friend introduced me to Jacqui Brandwynne. Jacqui was the driving force behind building the Neutrogena brand, and she had a line of products for women’s hormonal health. Jacqui wanted someone to take on the business, and I saw an opportunity to make a real difference in women’s lives. I made the decision and, with the support of friends and family, I made the leap.
I knew I wanted to get Jacqui’s products into the hands of more women, because 1 in 3 women suffer from poor vaginal health”namely, vaginal dryness.
I decided a brand refresh was in order, products and packages that reflect women’s new openness about the changes their bodies go through. With the help of a few brand-savvy friends, we decided that Gennev would represent the woman we wanted to serve: feminine, classy, confident, and non-apologetic. She can put a tube of Gennev Intimate Moisture next to her bed or in her shower, no embarrassment or explanation needed.
But healthy products in new packaging wasn’t enough. I asked a bunch of questions of my friends, I surveyed thousands of women, and I came to understand that there’s too much taboo and not enough education, support, and conversation around women’s hormonal health. Until that changes, too many women will still struggle unnecessarily, feeling silenced and alone.
We needed a media platform for women (and men!) to share stories, find information, and have an open conversation about the journey every woman goes through in her lifetime. It wasn’t going to be another academic, hard-to-understand health website, but a platform that carries a real, honest and open voice. As such, the g-spot was born to bring this taboo topic out of the shadows.
At 42, my hormonal journey has been relatively easy so far. I’m in the perimenopausal phase of life, but I haven’t experienced the kinds of symptoms women talk about”¦yet. I don’t have biological children, so I’m learning like crazy from women who are moms about what their bodies go through during and after pregnancy and while breastfeeding.
I wanted to get involved because our approach to women’s hormonal changes is, well, disastrous. Not always, but let’s face it: Women endure a lot, and as a society, we rarely even acknowledge the struggles, much less provide support for the women dealing with them. We need to change that.
Periods, breastfeeding, menopause”¦these are natural things, yet women are taught to be embarrassed and secretive about them. Having healthy, happy vaginas is what we need to be talking about! Going through hormonal changes would be so much easier if we met them with empathy, laughter, open minds, and listening ears. And for those women who experience hormonal change for other reasons”cancer treatments, hysterectomies, prescription medicines, etc.”a community of support and information can be critical.
I’m building a company that’s approachable, trustworthy, and trusted. I try to bring all these traits to every conversation I have with women, and it works. We share, we laugh, we shake our fists, and then we put our heads down and get to work.
“Building a new brand with new products to come AND creating a media platform? You’re taking on too much!” as well-intentioned advisors.
I disagree. The more I listen to women, the more I hear how ready we are to face these issues chins-up and head-on. Women are eager to share their stories, get best tips on handling symptoms, turn their workplaces into safe spaces for all women, educate others, and have healthy, happy bodies!
Is it a lot of work? You bet. But I’ve never done more important work. And I’m not doing it alone. I’m building a team and network of experts, advocates, scientists, educators, storytellers, and frankly, saints, who are willing to share their experiences and expertise for the better of all.
I’m putting out my call right now: I’m calling all women who are fired up about feeling incredible in their bodies, women who want open dialogue, healthy, fabulous relationships, and great sex. No matter where you are in your hormonal journey, there’s a place for you in the Gennev Community. Also, calling all men who have women they love in their lives. We’ve saved seats for you too.
Yes, our products are tried, tested, and trusted, and you can use them with confidence, but Gennev is about more than lubricants and moisturizers. It’s about comfort. It’s about confidence. It’s about enjoying your sexuality. It’s about all the wonderful things that can happen when you take back control of your body and you’re not ashamed to make that happen.
The very best part of my job is hearing your stories. Please send me a personal email at jill@gennev.com.
We’re building something special here. I hope you’ll join us.
Talk with us! Be a part of the movement and the conversation: Leave a comment on our blog and engage with us on Twitter, Facebook, and Pinterest.
Stephanie was asked to put together a presentation at the last minute for an upcoming board meeting. Though it’s a fantastic opportunity, one she has been waiting for, this new responsibility has also added to her stress level and taken a big chunk of time out of her already busy schedule. Sure, she’d had more hot flashes in the past few days, but whatever… she handled it, sweated through it, and moved on in her focus and work.
So the day comes, and Stephanie is ready. Prepared, confident, and ready. 100%. She woke up early, drank a big glass of water before her first cup of coffee and was feeling amazing about the day ahead until”¦
She looked in the mirror and saw a big, red, swollen bump on her chin. A double-take and then a close-up only confirmed her dread and suspicion: a cyst. Painful and hot to the touch, this one was deep”¦ and mad.”Grrreat,” thought Stephanie, “Important day, huge zit right on my face”¦ that I can’t get to and pop. Aghhhh.”
Stephanie is 52.
A couple of years ago, a review of six studies called Emerging Issues in Adult Female Acne was released in The Journal of Clinical and Aesthetic Dermatology. And of course, as science and the medical industry “catch up” to menopause, the results are inconclusive and “more research is needed.”
Despite the fact that middle-aged women have long complained about a resurgence of adolescent acne, the incidence of peri/menopause-plus-acne wasn’t studied specifically. Up until recently (the article was released in 2017) all women over 25 years old who reported an incidence of adult acne were studied together. Further subdivision (women 25-44, and then women 45 and up) for some additional study wasn’t really suggested until a couple of years ago.
Adult acne is more prevalent in women than in men across all age groups. One study also noted that depression was more common in women experiencing adult acne than in men (specifically, 10.6% in women versus 5.3% in men).
It was also noted that women seek treatment for this skin disease across age groups as well.
Does adult acne bring the same embarrassment and self-consciousness it might have done in puberty? The best and fastest thing to do is to check in with yourself about this question. Does this acne affect me on a psychological level? Is my quality of life being affected? If so, how?
A few prompts for reflection: Am I…
Androgens and estrogens are two of the major types of hormones that regulate the sebaceous glands in the skin system. (Any of this ringing any middle-school science class bells?)
In the stages of menopause, we’re fairly familiar with the fact that estrogen levels are decreasing over time, so that is one major hormone that is in a state of change. Check.
The major androgens are testosterone, androstenedione, and dehydroepiandrosterone (DHEA). These are produced in the adrenal glands and the ovaries in women.
According to this study, most of the decrease in the androgen testosterone happens in women between the ages of 20-40 years old. No further decrease happens in menopause, but slight increases may occur. Could this be considered a “fluctuation”? It’s not unreasonable to think so.
Hormone fluctuations, plus stress, may increase the frequency of breakouts in menopause. Speaking of stress…
Would it really surprise you to find that chronic stress is one of the primary aggravating factors in adult acne? Given the levels and intensity of responsibilities that women work with on a daily basis in modern life, it isn’t much of a “revelation,” in our minds.
Continual stress increases hormone levels. Increased hormone levels can lead to increased oil production in the skin, starting in the sebaceous glands.
So what’s the deal with cysts vs. pimples? Cysts are usually buried deep in the dermal tissues, where a pimple is a clogged pore that is closer to the surface of the skin. Many times cysts are reported to be located in the lower third of the face (jawline and chin).
More than a clogged pore, a cyst is often attributed to infected, clogged pores, which then develop bacteria and go deeper into the skin. A cyst can be itchy and painful, and, a gross bonus here, it’s filled with pus. If a cyst bursts, the infection can spread and lead to more breakouts. Ugh.
If you think you may have cystic acne, consider putting a call out to your doctor (or call our Telemed docs) to talk.
What you can do is review 4 major pillars in your life and health: nutrition, hydration, exercise, and stress levels. If you can improve any or all of these foundational aspects, you’ll also be better flushing your system and promoting balance and regularity in all of your body and mind’s systems. That’s a big win.
A few small steps to improvement:
According to the Mayo Clinic:
A decrease in estrogen is a big part of how the skin dries, thins, and changes. Your skin’s moisture-level is an important factor here. So find a good one that your skin and body can just drink in and pat it on to your freshly washed, still-damp skin with pride and pleasure. And sunscreen… don’t forget your sunscreen.
The largest organ of your body is your skin system, and it’s working doing a tremendous amount of work for you day in and day out. Take a moment to find some appreciation for it, see if you can be grateful, and see how you might continue to take good care of your skin.
What else are you noticing in your skin? What’s surprising, maddening, confusing, or even hilarious about your menopause path? Join us in the Gennev Community Forum to share with other women on the same path.