Perimenopause is a period of years before full menopause when periods start to get a bit irregular and other strange and new things start happening, thanks to fluctuations in hormone levels.

Women may experience hot flashes, night sweats, heart palpitations, heavy period flow, and parasthesia as this time of life is hallmarked, women say, by discomfort and frustrating unpredictability.

signs of change

Many women may not realize they’re in perimenopause, or even if they do, they may treat the signs separately: this medication for  headaches, that remedy for hot flashes, giving up this or that food to manage joint pain, ditching coffee and wine in hope of a decent night’s sleep.

One way many women manage the signs of perimenopause is through low-dose hormonal birth control. By evening out estrogen levels, birth control can help women manage many perimenopause signs all at once.

weighing pros and cons

While birth control can be an effective way to lessen the impact of perimenopause, it’s not without risks: blood clots, intense headaches due to hormonal changes, migraines, possibly an increased risk of breast cancer. It’s important to work with a doctor to understand the possible costs versus the benefits to your health.

For more information, check out this recently published article on PRiME Women about the pros and cons of low-dose birth control.

Cold showers before bed. Collagen supplements. Cutting out nightshade vegetables. Adding in hormone replacement therapy. We’ve all likely tried a long list of possible solutions in order to reduce menopause symptoms with varying degrees of success. And while many women prefer to stick with Western medicine techniques–which is totally up to you–others are willing to venture farther afield to give acupuncture for menopause a try. Specifically, the natural alternatives to be found in Traditional Chinese medicine (TCM), which is based upon the complex system of energy circuits throughout the body, called meridians.

On Acupuncture For Menopause

Energy moves through the body along these meridians in much the same way that electrical energy moves through our houses along wires. If energy traveling via the wires servicing our homes is blocked, such as when a circuit is broken, the lights won’t work, or the TV screen goes fuzzy. A simplified look at a complex medicinal process, for sure, but it illustrates the basic premise behind what might be causing your menopause symptoms.

When it comes to humans, physical or emotional pain in our bodies or minds indicates that there is a disruption or blockage of the flow of our energy, also known as Qi. Fascia treatments or acupressure for meno , and tapping are tools used to relieve the imbalance and restore the flow of our Qi. When this is accomplished, followers of TCM have reported many beneficial outcomes, including a lessening in frequency and severity of multiple common medical complaints–and a number of perimenopausal and menopausal symptoms. Here, we’ll take a look at three of the most prominent TCM techniques. 

But before we do, please remember that it’s important to consult your doctor before embarking on any new treatment plan, even natural alternatives. 

Need menopause treatment advice? 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.

Acupuncture: Don’t Focus on the Needles, Focus on the Feels

Let’s start by clearing up one concern that we’ve heard from a number of women. Yes, acupuncture requires the use of needles. But trust licensed acupuncturist Jennifer Mason when she says the needles are “as thin as kitten whiskers.” These are not industrial-size sewing needles used to stitch up denim. Instead, they are small, thin ones that many acupuncture enthusiasts say they don’t even feel (or feel very little) when inserted.

Acupuncture Points For Menopause

Now for the thought process behind the needles. Acupuncture is a staple of TCM that, depending on who you talk to, got its start somewhere between the first century BC and the first century AD. Used to restore the flow of Qi, there are more than 400 acupuncture points on the human body, each one associated with an anatomical landmark. What happens when the needle is inserted? That’s open to debate. Practitioners of TCM will tell you the needle removes the blockage and helps to restore balance. Neuroscientists suspect acupuncture points are places where nerves, muscles, and connective tissue meet and the needles stimulate all three, producing better blood flow and activating the body’s natural pain killers.

Either way, there are many in the midst of perimenopause or menopause who claim acupuncture relieves joint pain, night sweats, hot flashes, sleep disturbances, and mood issues.

The Ins and Outs of Acupressure

Often used in conjunction with acupuncture, acupressure is an ancient form of massage that’s been in use for more than 2,000 years. Believed to relieve the imbalance in one’s Yin and Yang, acupressure helps to restore an optimal flow of Qi. It’s also used to stimulate muscles and aid in relaxation. Many studies conducted using acupressure to relieve perimenopausal and menopausal symptoms showed it’s possible to achieve a significant decrease in both the number and severity of hot flashes, episodes of insomnia, night sweats, and incidents of anxiety. 

A qualified practitioner of acupressure uses their thumbs and fingers (and maybe an elbow) to apply pressure to specific body points. The points differ depending on the symptoms you’re trying to address. They may hold the pressure for anywhere from several seconds to minutes, and the movements they use include circular motions and pushing the acupoint in and out.

While there are plenty of people who would encourage practicing some acupressure on yourself, we strongly urge you to forego self-treatment and seek out a qualified practitioner. With hundreds of points located along the major meridians, a novice is bound to make mistakes. Besides, an acupressure session conducted under the guidance of a professional should be a gentle, positive experience–and when you’re in the hands of an expert? Even better.  

EFT or Emotional Freedom Technique

Based on psychologist Dr. Roger Callahan’s Thought Field Therapy work in the 1980s and the Emotional Freedom Technique (EFT) developed in the 1990s by Gary Craig, many practitioners since have embraced an entire field of study under the name “tapping.”

Craig simplified the process by creating a sequence of tapping certain points (called “The Recipe”) after stating a phrase that identifies or describes the problem. He determined that this process could be used to address any and all problems, emotional or physical.

EFT practitioners serve clients who are experiencing anxiety, menopause foggy brain, or lack of clarity about intention. And for those facing the many challenges presented by perimenopause and menopause, irritability, inability to focus, anxiety, depressed mood, and tearfulness, as well as many of the physical symptoms that women endure are popular targets for the treatment.

Barbara Mark , PhD, an elite leadership, career and life strategies coach and advisor to senior executive women, believes so strongly in the power of tapping that she encourages every woman to “add EFT to her “˜managing perimenopause’ toolkit, along with meditation tohelp with menopause moodswings, yoga, diet, exercise, and western medical treatment.”*

Next Steps

Interested in learning more about acupuncture, acupressure, and/or tapping for the relief of perimenopause and menopausal symptoms? First, talk to your doctor. Current medications you’re taking, diseases you’re fighting, and even allergies are just a few of the items that should be considered before trying anything new treatment-wise. Second, find a qualified TCM practitioner. 

If you’ve tried acupuncture, acupressure, or tapping for menopause symptoms, we’d love to know how it worked for you! Leave a comment below, or talk to us on our Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.

*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.

**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.

Have you taken our menopause assessment? Join over 100,000 women to learn more about your symptoms and where you are in the menopause journey.

Aging parents, teenagers in the house, job responsibilities, menopause: Learn how to manage menopause midlife crisis issues from the transition. 

Change the fear of the unknown to the excitement of the yet undiscovered

Breast Cancer Awareness Month may be over, but the fight against the disease continues. In honor of those impacted, we’re sharing the story of one of our own community. Diagnosed in 2005, Joanne went into research mode. She found lots of information about breast cancer on the Internet, but she wasn’t able to find what she wanted most””stories to give her hope. In this final piece of her three-part series, Joanne shares what gave her hope then and inspires her still. Click to read part one and part two.

Being ready when the help ends

One of the things you have to be conscious of, Joanne says, is that you can feel emotionally really good during the process because you’re so cared for and get so much attention. But you should be careful because once you’re done with treatment, the cards stop coming, the flowers stop coming, and people go on with their lives. And that’s when you can start to feel alone.

Having resources lined up for that eventuality””in Joanne’s case, continuing therapy with the psychiatrist””can get you over that hump. And Joanne found hope in setting milestones: she gave herself time to grieve all she’d been through and set a deadline for when that grief would end and she’d get on with the life ahead. She didn’t meet that deadline, but just having it was a way of setting limits and taking back control.

Finding hope step 4: reclaiming your life

“I think I went into a state of depression when it was over. I had been so goal-focused during the treatment, following the steps to get though the process, keeping to the timeline”¦.and then you get there. And it’s done, it’s over, and you’re like”¦.OK”¦.now what? You get on with life. And in time, I did.”

For many years after, Joanne didn’t share her story much, didn’t participate in breast cancer awareness events, though she appreciates those who do. “We all have things that happen to us, and I couldn’t understand why my story would be of interest to anyone. I struggled even with deciding to be featured on the g-spot. But I realized in my own research that there just aren’t good, positive stories out there, not of dealing with the process, and not of life post-cancer treatment. It was a craving, like for food or alcohol: just give me the good stories, give me some hope! But those stories just don’t exist.

“My hypothesis is you don’t hear of the positive stories because those women””and men””have moved on with their lives. They aren’t dwelling on the negatives, they’re seeing the future and what they have to live for, how wonderful life can be.”

There’s plenty of reason for hope and there are lots of positive stories””which is why Joanne ultimately agreed to share her story with us.

“It doesn’t have to be a death sentence. There is life after cancer.

“At some point during the cancer treatment process, someone, I don’t recall who, shared with me a phrase which has come to define how I view and pursue all challenges I’ve faced since that time.

“‘Change the fear of the unknown to the excitement of the yet undiscovered.’ Doesn’t that sound so full of hope for the future? It’s such a simple phrase, but when you think about it, fear controls so many of our actions and emotions and prevents us from really living life. Embracing this phrase enabled me to move forward with big life decisions which I otherwise would have shied away from. I don’t know who said it; I wish I did.

“I’ve talked with friends going through the same experience, and I think I can offer them some of the hope I was looking for. I’ve been where they are, and now I’m in a good, healthy, happy place with a great, meaningful life still ahead of me, with plenty of excitement about the yet undiscovered still to come. And they can get there too.”

You’ve likely heard that there are 34(ish) menopause symptoms. Surprise! There’s actually more than 40. Don’t worry, though. It’s rare that a woman would experience them all. However, given how little society has talked about perimenopause and menopause in the past, women may not know that what they’re experiencing is due to normal hormonal fluctuations.

40+ Common Menopause Symptoms to Know

The symptoms you experience often depend on where you are in the menopause transition, though every woman’s “constellation” of symptoms is unique.

At Gennev we’ve developed “menopause types“ based on what each stage tends to look like. Perimenopause is a Type 2, and many of these symptoms first appear there. However, menopause symptoms can come and go at different times, some even showing up as a symptom after menopause. No matter where you are in your transition, this information can be helpful.

Quickly review the list or bookmark so you can come back as new symptoms appear. This is your comprehensive perimenopausal symptoms list.

If you are really struggling with symptoms, 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.

Perimenopause starts earlier than most of us realize (as early as the mid-30s for some), and symptoms may not be what we expect, so often women are well into perimenopause before they even realize the transition has begun. Too many women begin this natural process in a state of confusion and fear because there’s not enough education about what can happen as our hormone levels change.

Let’s change that. The more informed we are about what to expect, the better we cam manage symptoms as they come.  

Know more about your body in menopause: take the Gennev Menopause Assessment

A proactive stance for menopause could include: putting out a BOLO (be on the lookout) for these symptoms in your body and mind. This list may prove especially helpful if you are approaching 40, or if you’re curious about perimenopause indicators.

Of course, call your doctor or ours if you suspect something is off or concerning. AND review this list… just so you know better what to expect at the onset of perimenopause.

*Note: This is not a checklist, though it is a comprehensive line up.

Menopausal And Perimenopausal Symptoms List

Again, symptoms are experienced differently for each woman: some may have hot flashes for a month or several months, some women may never experience heart palpitations, spotting, or an itchy vagina. This list is about arming and empowering yourself with knowledge so you can make the best decisions for yourself and your health.

All about the vagina

• Vaginal Dryness – Thinning and drying of vaginal tissue can make sex painful. Don’t despair, your days of bedroom frolics aren’t over as just be sure to keep your favorite lubricant handy, and use it liberally and often.
• Itching – You can blame vaginal dryness for this one, too, as the vaginal walls thin and dry out, causing, yes, you guessed it, itchiness down there.
• Painful sex – The vagina may become shorter, narrower, and less flexible during menopause, leading to pain during intercourse. We recommend vaginal dilators for atrophy.
• Irregular bleeding – Irregular periods is often a woman’s first clear signal of the onset of perimenopause. Periods may be farther apart and occasionally skipped altogether, then heavy periods when they come. Note: “heavy” does not mean “flooding.” If you’re having truly heavy periods where you feel unsafe leaving your house, please check with your ob/gyn to be sure fibroids or other issues aren’t causing the problem. (Hint: Birth control pills or Mirena IUD can be helpful here.)

More support

Painful sex webinar with panel of experts

Vaginal issues in menopause: q & A with an ob/gyn

Birth control and menopause: what do we need to know?

Skin & body

• Dry skin texture and hair- Drying and thinning skin and hair are possible. Decreasing estrogen causes not only our skin to become thinner, but our hair, too. Double whammy. Here are some skincare tips for menopausal skin.
• Body odor changes – Yes, even your body odor can change in menopause. You’ll probably be much more sensitive to it than anyone around you. Whether it’s hormonal changes or higher levels of anxiety (normal during perimenopause and menopause), you may sweat more and your body scent may change.
• Acne– Oh, estrogen. As it declines during menopause and you experience a relative predominance of androgens (male-type hormones that stimulate oil production), acne takes the opportunity to make an appearance.
• Hormonal weight gain and body weight redistribution– When you’re younger, estradiol keeps you lean. Guess what happens when you hit menopause? Bingo! Estradiol decreases and estrone takes over–a hormone produced in your fat cells and adrenal glands that stores fat in new, uncomfortable places, like your belly.
• Dry eyes and dry mouth – These can be unpleasant. Be sure you drink enough water, blink frequently (studies show we don’t blink often enough when staring at screens), and for your mouth, see your dentist regularly. Dry mouth can mean more cavities. Your taste can also change, making you less interested in your formerly favorite foods.
• Foot pain – There are many culprits to consider here, including a decrease in the production of collagen, lower bone density, and weight gain, just to name a few.
• Nausea – Though the research is scarce, there’s no denying that nausea can be a symptom for some during menopause. Low blood sugar, progesterone deficiency, and dehydration are all possible causes.
• Joint pain – Joint pain is the one that makes a lot of us feel old overnight. One thing to know: for many women, this gets better. Don’t stop exercising, and go easy on the ibuprofen, which can cause stomach upset. (Hint: manage weight and take magnesium glycinate.)
• Gas / Bloating – Feel like a Macy’s parade balloon with enough natural gas in you to energize a mid-sized city? This can be normal during menopause. Really. Excess air and/or water may contribute to this symptom, as can stress, diet, gut flora, and slowing digestion.
• Constipation – Strictly speaking, if you’re not having at least three bowel movements a week, you’re constipated. It may suddenly seem like no food is “safe.” Don’t panic. Just increase fiber (slowly) and track symptoms. Many women become more sensitive to dairy or grains in this time, so you may be able to identify foods that cause more trouble than others.
• Urination frequency changes due to urinary system changes, even incontinence – Gotta go, gotta go, gotta go? Unfortunately, this is not surprising. Blame our old friend decreasing estrogen, who starts to fall down on its job related to the bladder during menopause. Pee-rfect! A pelvic physical trainer is your best defense here. Even if you’re not having issues (yet), you can avoid a lot of problems by learning how to strengthen your pelvic floor (but not too much). Do not dehydrate yourself, assuming you won’t have to pee as often. (Hint: pelvic PT, tracking food and drinks that irritate your bladder)
• Sense of taste may change – Many women report foods simply don’t taste the same during menopause–and some even experience a constant metallic taste in their mouths. You’d think this would aid in losing the newly deposited belly fat. And yet…
• Heart palpitations– Your heart may race, skip a beat, flutter. These are perfectly normal “” usually. Since we don’t like to leave heart things to chance, check in with your doc or ours, explain what you’re experiencing, and follow instructions. If ever you feel the symptoms of a heart attack, however, get help immediately.
• Numb or tingling fingers (paresthesia) – (tingling or burning sensation in your fingers, hands, feet, etc.) Some women even feel they have insects crawling under their skin. Again, it’s annoying as heck, but it’s not life threatening, you’re not crazy, and it’ll likely reduce as you get further past menopause.
• Ringing ears or tinnitus– Experiencing a roaring or ringing in your ears? Could be tinnitus, yet another super annoying menopause symptom. There’s really not a good treatment for it. It does tend to subside over time, however.

More support

Skincare tips for menopausal women

The mindful approach to weight management at menopause

Hot flashes: Your internal volcano is now active

• Hot flashes– In an era of COVID, we’ve had lots of women ask if they’re experiencing hot flashes or a fever. Hot flashes are generally pretty short in duration, are often felt first in the chest, neck, and face, and may come with accelerated heart beat. (Hint: hydrate! Drink lots of cool water to help reduce it. Better: talk with your doctor about hormone replacement therapy for hot flashes.)
• Flushing – When a sudden feeling of heat comes from nowhere and spreads throughout the body”¦ It isn’t uncommon to start sweating, palpitations and flushing of the face.
• Night sweats… even day sweating too

More support

Four ways to get rid of hot flashes

Menopause cold flashes: yes, that’s a thing– cold flashes can be caused by menopause or perimenopause. These are pretty unpleasant and can last a long time. Further, they tend to happen at night and are resistant to blankets and fleece pajamas. If you get these, try taking magnesium glycinate at night before bed, and when they happen, warm from the inside out by drinking warm water.

I think I had my first hot flash

Brain and mood

• Fast, and intense, mood changes – Though we’re not precisely certain of its cause (most likely a mix of declining estrogen, physical changes, and external factors), there’s no denying that menopause brings on unwanted mood changes.
• Rage – When your estrogen levels are wildly fluctuating and progesterone (a natural antidepressant and anxiety reliever) seriously declines, your serotonin and other mood- and stress-moderating brain chemicals take a big hit.
• Brain fog / memory lapses or concentration difficulties – Suddenly you lose a word, or a name, or just don’t feel as sharp as usual. While many women worry about early onset dementia, chances are, it’s perimenopause. Talk to a doc if you’re not comfortable, absolutely, but this isn’t cause for panic. (Hint: Omega 3 supplements can help here.)
• Increased clumsiness – Yes, becoming more clumsier is a thing. Why? Well, when your estrogen levels drop, it can be harder to concentrate and also hold onto things comfortably. On top of that, the blurred visions, cataracts, and dizziness can make it harder to be coordinated.
• Tiredness/fatigue – This isn’t due to sleepless nights, this is tired that literally starts with a tired brain. As estrogen decreases, the brain loses its “master regulator,” and you feel fatigue that is bone deep. Again, this will likely recede with time. (Hint: Omega 3s, lowered expectations, self-care)
• Sleep disturbances as aside from night sweats – You know the expression, “I slept like a baby”? Well, this is the reality: waking up every two hours, wanting to cry. Now is the time to start being truly dedicated to good sleep hygiene. (Hint: Sleep hygiene, meditation, CBD, and magnesium glycinate.)
• Restless leg syndrome (RLS) – Experiencing sensations of tingling, electric shock, itching, crawling, throbbing–plus an irresistible urge to move–in one leg or both, especially when you’re falling asleep? Welcome to RLS, where the cause isn’t certain, but the symptoms sure are!
• Stress – We’re not going to define stress here, because we understand you’d like to finish this article at some point. Just know that during menopause, your stress levels might go up. And with everything going on during this life transition, both internally and externally, it’s easy to understand why.

More support

Menopause and mental health: finding yourself in isolation

Depression in perimenopause: we really need to talk

How to get good sleep

What about your regular, cycle-sparked PMS symptoms?

The truth is, every woman’s experience is different. So, it could be that your regular cycle’s symptoms show up and intensify (going from PMS into PMDD), or not. You might also experience new PMS symptoms (yeah, sorry), or not.

Our best suggestion is to be on the lookout so you can quickly identify, accept, and act to diminish discomfort and stress.

• Breast tenderness – Our breasts are capable of great things, like providing vital nutrients to our children. They’re also heavily influenced by hormones, so when menopause throws everything out of whack, your breasts can get in on the action, becoming more tender and sensitive.
• Migraines – More intense than your average headache, migraines might hit you during menopause whether you have a history of them or not.
• Light or sound sensitivity – Did you know that estrogen plays an important role in how the brain processes sound? And that fluctuating hormones may cause eye changes? You know where I’m going with this, right?
• Water retention – Not to sound like a broken record, but those wild and crazy hormones of yours might lead to unwanted water retention.
• Cramps – The pain associated with cramps might intensify during perimenopause–even months when you skip a period. We know what you’re thinking and yes, this is really not fair.
• Mood swings – As we mentioned earlier, mood swings, whether mild or fierce, may become part of your day-to-day. Getting mad easily and feelings of sadness are the most common emotional symptoms of menopause.
• Anxiety and depression – If you have a history of emotionally challenging PMS, post-natal depression, PMDD, anxiety, depression, or other hormonally related emotional issues, be aware that these can come back and be even more severe in perimenopause. If you’ve never had these concerns, they can still erupt during peri, so be aware of the possibility and get help if you need it. (Calming apps and exercise will help with mild cases; seek help for the more serious.)
• Lower back pain – Yes, hormones can play a role in lower back pain. So can a whole host of other issues, including incorrect exercise form, poor stability, and even poor breathing.
• Heavier flow periods – Occurring most commonly during perimenopause, heavier flow periods are typically defined by twelve to sixteen or more soaked sanitary products during a period.

Red flags

Consider talking with your doctor about these if they appear:

• Bleeding after menopause – If you’ve been period-free for a year, then suddenly experience post-menopausal bleeding, it’s time to talk to your doc. Possible causes include tearing of the vaginal tissue and fibroids–concerning, but less scary than a third possible cause, cancer of the lining of the uterus.
• Newly inverted nipples – Apparently, this is somewhat commonplace and can run in families. Still, another possibility is cancer, so don’t ignore the nipples!
• Unintended weight loss – We know this one might feel more like something to celebrate, but when the cause could be infection, hyperthyroidism, depression, and even cancer, it’s best to consult an expert.
• Skin breaks – A drop in estrogen causes dryness, age spots, or a tendency for the skin to bruise. The drop in estrogen can also prompt acne breakouts.

Less-known symptoms of menopause

You may hear about the common menopause symptoms from women in your friend circle who are of similar age, but less-common (or at least, not-as-well-known) symptoms are the ones driving women to the ER or their psychiatrist.

Know that menopause is very different for every woman, so if your transition looks different than your friends’ or your sister’s, that’s OK. Symptoms vary in appearance, frequency, and intensity, but all can be “normal.”

There are a LOT of menopause symptoms, and chances are, if you’re the right age, that bizarre tummy rumble or tingling finger is hormonal. However, there are other possible causes, some serious, so you don’t want to assume it’s menopause. We always recommend you check in with a doctor (preferably a menopause specialist) to verify. And if symptoms are severe, sudden, overly painful, or interfering with your life, please see a medical health professional ASAP.

And please, do your buddies a favor. Pass this article along. No woman needs to lie awake at night, scared she’s having a heart attack but reluctant to do anything about it because she’s been dismissed before. Every woman who lives long enough will go through this, so let’s help each other have the easiest, healthiest transition possible.

I’m only 40; why do I need to know the common symptoms of menopause?

However, given how little our society has talked about perimenopause and menopause in the past, women may not know that what they’re experiencing is due to normal hormonal fluctuations. It’s not just hot flashes.

First, some definitions: symptoms usually start in perimenopause, the years before menopause when hormones first start fluctuating (menopause is just one day as the one-year anniversary of your last period; everything after that day is post-menopause). Some women may experience few or mild or no symptoms early in perimenopause or assume they’re due to stress, bad PMS, or other factors.

Perimenopause can start as early as the mid- to late-30s but commonly becomes noticeable in mid-40s. Poor sleep, mood changes, irregular periods, heart palpitations, and more can occur during this time, and we hear from a lot of women that it took several doc visits and possibly even a trip to the ER before anyone diagnosed them correctly.

Given that perfectly normal symptoms can cause a lot of fear and anxiety (and expense!), we would like everyone who may be experiencing or who will experience menopause to know what could be coming.

By the way, you’ll see the words “talk with your doctor“ a lot in this article. We highly recommend you get a menopause specialist OB/GYN in your life, as you’ll maximize your chances of getting the most complete information.

More aware, better care

Looking ahead, this is a time for more self-care and self-support, not less. Improving your comfort and managing these symptoms with excellent self-care (eating good, healthy foods; hydrating, making sleep and fitness bigger priorities, quitting smoking or vaping) will actually improve your health, inside and out.

Absolutely get into the spirit of research and talk with your doctor (or ours) about best options for hormone management or therapies, alternative health practices for menopause symptom relief (e.g. acupuncture or chiropractic), and even hemp-sourced CBD options. AND! Talk with like-minded new friends on our community forums.

Arm yourself with the information you want and need so you’ll recognize perimenopause indicators when (and if) they show up. Take control of your health and enter this part of your life path with confidence and power.

Are you ready to understand your body better & take control of your health in menopause? Take Gennev’s ob/gyn-created Menopause Assessment now.

Science is starting to uncover the many ways our gut flora affect our health. While many of us still believe the beneficial bacteria is good for digestion (and it is), it does a whole lot more. 

Dr. Anna Garrett chats about the “Gut-Brain Axis”

In this podcast, metabolic surgeon and gut expert Dr. Erika La Vella talks with Gennev’s Director of Health Coaching Stasi Kasianchuk about the bi-directional relationship between your gut and your brain.

The “Gut-Brain Axis” affects your perception, cognition, your nervous system, your mood, pretty much everything. Given that, and how cattywampus everything can be during menopause anyway, doesn’t it make sense to be sure your gut is getting exactly what it needs?

This is why we bang on about nutrition here at Gennev “” it’s so important to feed yourself well, because it literally affects everything in your body. Good fiber helps the beneficial flora in your gut to thrive so it continues pulling nutrition from the food you eat and sending it where it does the most good. 

Like virtually everything in nature, diversity is best, so eat lots and lots of veggies: 30 different kinds a week, according to Dr. La Vella. The more diverse your vegetable selection, full of vibrant colors and flavors, the better. Because different micronutrients have different functions in the body, “eating the rainbow” really does provide the most comprehensive care.

And if you can’t get them all, supplementation can help fill the gaps, so consider Gennev’s Vitality pack. Thirty veggies is a lot, and if that means you’re bumping up your fiber, you’ll want to take it slowly. While Dr. La Vella assures us that gas is normal and means your gut flora is doing their job, ramping up fiber too fast can cause more than ordinary gas!

TRANSCRIPT TO FOLLOW

Are you taking care of your microbiome? What do you do to keep those good bacteria healthy and thriving? We’d love for you to share your tips for eating the rainbow, getting good probiotics, protecting beneficial gut flora, etc., so please join the conversation on the Gennev Community forums!

Little ruins a run faster than some unexpected moisture. And we don’t mean rain.

As an almost-49-year-old wanting to qualify for the Boston Marathon this year, I’m looking at a whole lot of miles on my feet in 2017. So when this topic came up in a team Gennev brainstorming session, I jumped. Here’s why:

According to Runners’ World, as many as 40 percent of female runners likely suffer from leaking urine.

But I’m healthy! You cry. Why me??? (Believe me, I’m right there with you, gal.)

Running is a high-impact sport

Running is a great way to stay fit. It’s also a high-impact exercise: you hit the ground with a force equal to several times your body weight with each foot strike.

There’s been lots of research into how that pounding affects our knees and feet, but for women in particular, the impact has other, well, impacts. That’s a lot of pressure being exerted downwards on your pelvic floor—the network of muscles and ligaments that support your bowel, bladder, and uterus.

According to Physiotherapist Michelle Kenway, if those muscles aren’t fit and strong, running can stretch and weaken them further, and argh! The Dreaded Shpritz.

A weak pelvic floor can cause incontinence when running

Pelvic floor weakness is very common among women generally. Menopause, pregnancy and vaginal births, hysterectomy, obesity: all of these can cause the muscles to weaken and make it harder to control our bodies’ elimination of waste.

And when pelvic muscles lose strength, not only do you increase your chances of misting your shorts, you also lose some of the deep core strength that makes you a stronger, more injury-resistant runner.

A strong pelvic floor can make you a better runner

Happily, strengthening your pelvic floor brings some serious benefits. You can:

Improve your running. Your pelvic floor is at the deepest part of your core and helps stabilize your body in motion. A strong core helps you maintain proper form, which makes it easier for you to engage all the necessary muscles to propel you forward. Stronger, more efficient, less prone to hip, knee, and back injury—sounds good to me!

Prevent incontinence and prolapse. Along with urinary incontinence, someone with pelvic floor weakness can also suffer fecal incontinence (leaking stools), and pelvic organ prolapse. Prolapse is when a pelvic organ such as the bladder droops and even descends into the vaginal canal or anus. Strengthening pelvic muscles can prevent and may even reverse pelvic prolapse.

Enjoy better sex. According to Women’s Health magazine, strengthening vaginal muscles (which are part of the whole pelvic floor network) can increase pleasure and the possibility of reaching orgasm during intercourse. So, you know—bonus.

Exercises for a strong pelvic floor

Kegels are a common way to strengthen the pelvic floor by squeezing and relaxing the vaginal muscles. If you’ve ever had to interrupt your pee mid-stream, those are the muscles you’re targeting. Contract and hold ’em for a count of 5, then relax. Repeat. Try to get up to 10 sets, a few times a day.

You can also get some very cool smart devices for kegel exercises. These help you target the right muscles and work them correctly by providing feedback to your phone or tablet. Our CEO, Jill, uses the Elvie Kegel and has seen real progress with it. Or you may prefer a non-tech solution such as the Stone Exercise Egg or wearable Kegel balls. With any inserted device, you’ll want to use a non-silicone, water-based lubricant.

If pelvic floor problems persist, or if you experience pelvic pain, please, consult a medical professional.

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.

Friends, I am driven to write this article because of the press release about a large study published in The Lancet, which claims to show that hormone therapy definitively increases the risk of breast cancer.

Having read the study, guidance from the North American Menopause Society, as well as thoughts from Dr. Avrum Bluming, an oncologist and author of Estrogen Matters, I wanted to share with you my concerns about taking these results at face value.

The press loves to put out “scare headlines” even if the results are more complex and muddled than that. This is another example of this type of hype. I have four serious problems with this study and its results:

One: It’s based on observational studies

This is a type of meta-analysis of multiple observational (not randomized) studies run over more than 20 years with different complex regimens. They combine both previously published and some unpublished data (which can not be verified).

For those who do not have a working knowledge of epidemiology, a meta-analysis generally involves taking previously published data and combining it to make a bigger study.

In the epidemiology world, a common joke about meta-analyses is that they represent “garbage in, garbage out.” Unfortunately, this isn’t really a joke. When you bring a bunch of flawed studies together and make the numbers bigger, you magnify their faults.

We have several large randomized trials that, with all their faults, give us better, more reliable data, which do not show an increase in breast cancer on this scale.

Two: It doesn’t reflect current practices

The regimens used in many of the studies that go into this big mash up are, in many cases, higher doses and different types of hormones than are commonly used today.

This mix of past and present practice makes it hard to draw conclusions on what doctors are prescribing today, as different hormones can behave differently in the body.

Three: The study is overly complex

The methodology used to analyze the data from these studies is exceedingly complex and hard to follow, which means it is hard to judge the results.

Dr. Bluming noted in his response to the paper, “In the editorial accompanying this paper, Joanne Katsopoulos, of the Women’s College Research Institute in Toronto, wrote: “˜The complexity of the study design makes it difficult to appraise the results and most of us will take the results on face value.’ What? Meaning: This study is such a mish-mash of complicated analyses that even we professionals can’t make heads or tails of it, and must rely on the investigator’s word of what she found?”

I have to agree with this assessment. I have a master’s degree in epidemiology, and I could not make heads or tails of the study methodology.

Four: It focuses on breast cancer to the exclusion of other concerns

This study does not take into account the balance between length of life and quality of life. Breast cancer is just one risk women face as we age, and is not even the leading cause of death.

Estrogen is one of our best and most studied treatments for osteoporosis and may well protect women from heart disease and those at risk of Alzheimer’s disease.

Most importantly, for women with significant symptoms in menopause, estrogen can be life (and sanity) saving. As always, we need to look at the whole woman when making hormone decisions, as she is more than her breasts.

Professor Michael Baum, a leading breast cancer researcher in London, released a long statement about the study. This is a portion of that response, excerpted from Dr. Bluming’s letter on the subject:

“I think the press release put out by The Lancet is irresponsible and will undoubtedly lead to a drop in the use of HRT/ERT, plunging thousands of women into a life of misery and for all we know shorten the lives of millions around the world. Remember there are more important threats to women’s lives than breast cancer, which is now only 7th in the league whilst those higher up the league might increase as a result of the withdrawal of oestrogen replacement therapy. “˜Statistical significance’ does not always translate into “˜clinical significance.'”

As much as the WHI study published in 2017 had flaws in methodology and the conclusions it made, the data from that study are still better and more reliable than the associations made in this more-recent publication.

The WHI, in the end, showed estrogen replacement alone to be protective for breast cancer (even when started late in menopause) and the estrogen and progesterone arm had a slightly higher rate of breast cancer, but not a difference that was statistically significant (which means mathematically it could be a chance or incorrect finding). It is a randomized trial that showed hormones to be overall safe for women if used correctly.

At Gennev we believe every woman has a right to valid data and information when making a personal decision about whether hormones are right for her. We try to provide a balanced interpretation of complex medical studies. We also try to reach out to other experts to see what they have to say.

On balance, this latest publication in The Lancet probably does not add much to the conversation around hormones, except to stoke fear.

Rebecca Dunsmoor-Su, MD MSCE NCMP
Chief Medical Officer, gennev.com

Want to learn more or discuss HRT with other women? Join our community forums and be part of the conversation!

It’s nearly the end of November which means, if you’re like me, you have at least three weeks before you need to start seriously planning and buying holiday gifts.

If you’re one of those folks who likes to give actual gifts (as opposed to handwritten notes saying, “I got you an X; it’ll be here next Tuesday”), we’ve got some suggestions for you to give that wonderful, sexy, midlife someone, whether it’s your wife, girlfriend, best buddy, or self. A menopause care package never hurt anyone! Here are some gifts the team at Gennev recommends.

Our menopause gifts guide

One: Help with menopausal night sweats /hot flashes. One of the worst aspects of hot flashes and night sweats is how they interrupt  sleep. For women who wake at night from the heat, and then lie awake as the anxiety takes over, a weighted blanket made especially to keep her cool can be an amazing and wonderful gift. Check out the Iced Hush weighted blanket.

(Read up on one Gennev-er’s experience with hot flashes and how she handles the heat)

Two: Relief from symptoms. Many women report real relief from menopausal joint pain, hot flashes, anxiety, and interrupted sleep, thanks to acupuncture, so a gift certificate might be a great way to introduce a friend to this ancient practice. You’ll want to set her up with a licensed practitioner, so check to see if your state has a licensing requirement or consult the directory at the National Certification Commission for Acupuncture and Chinese Medicine. Jennifer Mason of Vitamin Chi also suggests checking out websites to find an acupuncturist who specializes in the area your friend needs, whether it’s pain relief, fertility support, perimenopausal insomnia, etc. Acupuncture for menopause symptoms is a great alternative medicine. For another alternative medicine, we recommend you try black cohosh for hot flashes.

(What can fascia Chinese medicine do for you? Find out in this podcast with practitioner Jennifer Mason)

Three: Peace and quiet. Since we ran our story on how Deborah managed the stress of her breast cancer treatment by floating, we’ve heard a lot from other women who have tried it for various reasons. Nearly all reported an improvement in stress levels and sleep. Lying in a silent, dark tank full of warm salt water may sound like an odd way to manage stress, but reports are floating is a slice of sanity, especially in the mad holiday season. Menopause can really hamper peace and quiet, so this is a fantastic option to get some of that back. Single float, $89 at LifeFloat.

Four: Good food. We talk about nutrition again and again in our blogs: kicking sugar, eating healthy in the holidays, and so on because it’s so critical to nourish yourself right in midlife. So how about getting your buddy a gift certificate for the local organic market, or treating yourselves to some healthy cooking classes? And after you’ve cooked and consumed that healthy meal, there’s nothing better than chocolate that’s good for your skin, brain, heart, and hormones, says Nicole Negron, Certified Women’s Health and Nutrition Specialist.

Five: Exercise equipment to build muscle. Starting in our 30s, most of us begin losing muscle mass and function. Healthy muscles help with posture, balance, strength, metabolism, and general quality of life, so help your buddy keep what she’s got and even build more. We like Bintiva dumbbells because the colors make it easy to grab the ones you want quickly, and the hexagon shape keeps them from rolling under the furniture.

Six: Comfort for itchy skin. Midlife skin needs some special treatment to stay hydrated, which means no harsh soaps. Especially when you’re dealing with down-there care, you want to be sure anything that touches sensitive skin is super gentle and free of the sorts of chemicals, fragrances, and other additives that can irritate. Gennev Ultra-Gentle Body Wash and Cleansing Cloths are great for cleaning all of you without irritating any of you. After cleansing, Nicole recommends a probiotic moisturizer. Skin’s pH changes during midlife, Nicole says, and “this product helps retain moisture for improved suppleness and added glow. It also combats free radicals and calms inflammation to safeguard collagen.”

(ditch itchy menopause skin: tips on how to handle one of the most common symptoms)

Seven: Body-loving smarts. Team Gennev believes the book She-ology: The Definitive Guide to Women’s Intimate Health. Period. is a great gift for anyone and everyone. Dr. Sherry Ross is out to educate the world on vaginas, so we can all stop being fearful and embarrassed and start loving this part of our bodies. Ditching the taboos around vaginas and women’s bodies generally can help all women be healthier, and Dr. Sherry gives us a humorous, touching, seriously smart and entertaining way to get answers to those questions we’ve all been too embarrassed to ask.

Eight: Healthy pleasure. Appeal to all parts of your lady friend with the Lioness! This smart vibrator gives pleasure in more than just the “usual” ways as the built-in sensors also speak to her smart phone, giving her all kinds of fascinating information on her sexual response. She can track her orgasms, take notes on what factors might be involved on a given day (food, sleep, mood, cycle), and generally geek out on her O-information. Plus, orgasms are super healthy, so there’s that (here’s our tips on how to orgasm better!). Learn more about the Lioness. $230 at lioness.io.

Nine: Essentials. According to Dr. Arianna Staruch of the Bastyr University School of Naturopathic Medicine, “the safest way to deliver essential oils is through the air in a diffuser. Make sure they are high quality, organic, and if possible, sustainably and ethically harvested. Oils like Sandalwood come from endangered trees. A good all-purpose essential oil is lavender, Lavendula angustifolia. It is one of the very few oils that can be used undiluted on the skin (unless you are allergic). Lavender is helpful to support skin health and is naturally antibacterial. It’s also calming and is great to use in a diffuser at night to promote restful sleep.”

Ten: Hair care. For a lot of women, hair care becomes a whole lot more challenging in midlife. Hair can become drier, more brittle, thinner, and limper. Teadora turns your shower into a rain forest, with all a rain forest’s nourishing, hydrating glory. We love this company because they are so environmentally aware, their products are all-natural, and their products and processes are healthy for women and the planet.

Eleven: Pain relief. Sex after menopause can be harder. Menopause and midlife can come with some extra aches in the joints and some all-over fatigue. Fight both with a potent and ancient pain reliever: hemp. Sagely Naturals has a cooling, non-greasy Relief and Recovery Cream that’s super lightweight and penetrates quickly. We appreciate that it’s made here in the US and isn’t tested on animals. Don’t worry as this is made from hemp, so it’s legal nationwide and won’t affect drug tests or cause you to feel the effects of THC.

Bonus gift: You. One great gift that won’t cost you anything is the gift of your support. Menopause is a challenging time for many women. Understanding the challenges your friend (partner, mom, sister, colleague) is going through and rallying around her when she needs you (and disappearing when she really just doesn’t) might be the best, most valuable gift of all. Thanks for asking.

If you try any of these products or have other suggestions for great gifts for a midlife, menopausal gal, we’d love for you to share. Check in with other women in the same situation on our Community forums!

It’s barely an hour past lunch, and you’re hungry. Again. These days it feels like you could eat everything in your refrigerator at one go without even coming up for air.

What is going on? Why do you suddenly have the appetite of a high school track star?

First of all, there’s nothing wrong with eating. No one should feel ashamed or embarrassed about their appetite. 

But if you’re concerned your appetite, nutrition and hormones may be impacting your health, it may be useful to understand why appetite can ramp up in menopause as and how you can stay within healthy limits.

What hormones makes you hungry?

There are a few possibilities to consider, but note that the jury is still out on exactly how hormones, menopause, and appetite interact. So, as always, talk with your doc before making assumptions about your own situation.

1. Increased ghrelin, decreased leptin. In perimenopause, levels of the hunger-stimulating hormone ghrelin increase, a reason why many women find themselves frequently hungry during this phase. Levels of the hormone leptin, which promotes a sense of fullness, reduce throughout peri- and postmenopause.”
2. Increased cortisol. Persistent stress causes a lot of people to overeat as and often, to make some fairly poor choices of foods (high-fat, high-sugar “comfort” foods). So in perimenopause and menopause, when the cortisol-dampening effects of estrogen are diminished, stress-fueled appetite can increase.
3. Decreased estrogen. Like leptin, estrogen serves to dampen appetite. One form of estrogen, estradiol, helps regulate metabolism and body weight. As estrogen declines in perimenopause and menopause, appetite ramps up.
4. Poor sleep. During perimenopause and menopause, hormone weirdness can impact your sleep ( perimenopause night sweats, for example). Insufficient sleep can further elevate sensations of hunger.

So, since hormonal changes in midlife are inevitable as if they haven’t happened sooner as are we stuck struggling to manage our appetite and weight?

Not necessarily.

Before we get to the advice portion, there’s something we want to point out: Many of the articles we found dealing with menopause and appetite are about losing weight. We want to emphasize that we believe achieving and maintaining a healthy weight is the goal. So, we say to societal standards based on unrealistic (and frankly misogynistic) ideas about the female form, there’s the door.

Maintaining a healthy weight in menopause

When it comes to weight, it’s a jungle out there. Lots of folks want you to believe they have the answer, so be sure to do your research and talk to your doc before making radical changes or introducing new supplements or “diet aids” to your daily routine.

As our Chief Medical Officer, Dr. Rebecca, says, “Research into all of these hormones and neurotransmitters (some function as both) is still at the basic and translation science stage. We don’t know what it means clinically, so while it may be nice to understand to an extent how they may impact menopause and the experience of menopause, no practitioner can alter or ‘treat’ these things. If someone is selling you something to do that, they are selling snake oil as the science is, unfortunately, still years away. The only take away is to reduce your stress as best you can (which you didn’t need the science to tell you!)”

Whatever the role hormones have to play in appetite, one thing that’s quite common is the difficulty of losing weight once gained in menopause.

That may be because of our slowed metabolism, it may be due to menopausal fatigue, stress, the effects of night sweats and restless leg syndrome (RLS) on our ability to get a decent night’s sleep. 

All of which is to say: Be aware that maintaining a healthy weight in midlife may require different strategies and be patient with yourself.

Controlling menopause and food cravings

1. Eat more fiber. Since women in midlife frequently experience constipation, this isn’t a bad idea anyway. And since fiber can make you feel fuller longer, it may help curb your appetite.
2. Eat enough protein. Our protein needs may be less than in previous years, but it’s still important to get enough. Protein helps us feel satisfied, which obviously dampens our enthusiasm for snacking.
3. Load up on veggies. Low-calorie, high-fiber, nutrient-dense veggies are ideal for those looking to maintain a healthy weight. They’ll fill you up for a lot fewer calories, and the fiber may benefit your gut biome, further helping with weight management.
4. As Gloria A. Richard-Davis, MD, FACOG, NCMP wrote for the North American Menopause Society, “learn to cope without food.” A lot of us turn to the reliable pleasure and comfort of food under stress, but taking a break to walk the dog or indulge in some non-edible self-care may be a far better option.
5. Move more. Exercise alone doesn’t do a lot for weight loss, if that’s your goal, but its benefits for heart, lungs, brain, and mood are inarguable. Keeping and building muscle after 40 is essential. Mix it up with cardio and strength training to get the biggest boost, and don’t ignore the benefits and feel-good qualities of really good stretching. Exercise can increase appetite, of course; just make sure you refuel with the right foods.
6. Maximize your chances of getting a good night’s sleep by practicing good sleep hygiene. Some women take CBD or sleep better by eating a small snackor before bed.
7. Drink water.  Althought being hydrated can make you pee more often, water is good for you, good for your brain, good for your body. And it can help you feel full. Humans often mistake thirst for hunger. Tired, lightheaded, unable to focus as sounds like you need food, right? Well, it’s also possible that a glass of water is what your body is actually asking for.
8. Allow yourself the pleasure of food. Here’s what Dr. Anna Garrett says about “Vitamin P,” when we take the time to slow down and take pleasure in our food, we may be more in tune with the satiety signals that tell us it’s time to stop eating.

Clearly weight management is more complicated than “calories in, calories out.” Hormones, the stresses of life, and the unique challenges of midlife can all add layers of complication to the way we eat and the way we feel.

But it’s important to understand that weight gain isn’t personal failure. Your body is extraordinarily complex and amazing; it can also be frustratingly unpredictable. Give yourself room to experiment and learn, and don’t forget to include your doctor in major lifestyle changes.

What are your challenges in maintaining a healthy weight, and what’s worked (or hasn’t)? Please share with us by commenting here, or joining the conversation in our community forums. You can also reach out to us on Gennev’s public Facebook page or in our closed Facebook group.

Many women in midlife report seeing their lives with greater clarity as their desires, their needs, their futures are clearer than ever before. Ironically, it’s also the time when actually seeing becomes more difficult because of hormone dry eyes and because women who are at greater risk of developing menopause cataracts.

Oh, estrogen as we really didn’t know what we had till it was gone, did we? In addition to all the other things it does for a woman, estrogen also protects her eyes from the damage of too much sun exposure and aging.

24.4 million Americans aged 40 and up suffer from cataracts. Thanks to estrogen loss in menopause, women are disproportionately affected with cataracts, accounting for 61 percent of that number.

Since cataracts are common and prevalent, and because correcting cataracts could help you live longer, they are our Symptom of the Month.

If you are worried about cataracts, 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.

What are cataracts?

As we age, the lens of our eyes can get cloudier and yellower, making our vision fuzzy and blurry and making colors appear less vibrant. Night vision can be especially impacted, as cataracts also make us more sensitive to glare.

What causes cataracts and how do I know if I have them?

Cataracts are usually age-related; most of us will develop them, if we live long enough.

There are environmental, lifestyle, health, and genetic factors that increase your risk of developing cataracts or developing them sooner: these include smoking, diabetes, high blood pressure, obesity, use of certain medications (steroids), over-exposure to ultraviolet radiation (usually sunlight but also tanning beds and even light therapy lamps), a family history of cataracts, and injury to the eye. And of course, being a woman in menopause.

Symptoms of cataracts include clouded or blurred vision that doesn’t correct when you blink. Halos around lights. Sensitivity to glare. Needing new prescriptions for your glasses often. Diminished contrast between colors. Difficulty seeing after dark. Double vision in one eye. If you notice any of these, get to an eye doc. And note that cataracts can develop so slowly that often we aren’t aware of the problem as a good reason to see your eye doctor regularly.

OK, my eye doctor says I have cataracts. Now what?

The quality of your vision can have a real impact on the quality of your life. Yet many of us are nervous about messing with our eyes, even if that “messing” can have a substantial positive outcome.

If that describes you, maybe this will help: “The best way I can describe how traumatic the experience can be is to tell you what most patients say to me as they walk in the door after the first procedure”¦. “˜When can I get the other eye done?’ The end result is so good that they cannot wait to get the other eye transformed as well.”  as Dr. Michael Hsu

For more information, we talked to Dr. Michael Hsu, optometrist and owner of Lakeview Vision Clinic in Seattle, about cataracts and what to do if you’ve got ’em.

Are cataracts difficult to treat?

Dr. Michael: Once cataracts become visually significant, surgery is the treatment of choice. There is now a tendency to treat cataracts early before the degrading vision is a problem for the patient. Some patients have difficulty reading, inability to see well in the distance despite updated prescription for glasses, and bothersome glare and reduced acuity with driving. Surgery is performed either in a surgery center associated with the eye surgeon’s office or in a hospital. Surgery without complication takes about 10 minutes.

Are there other treatments available?

Dr. Michael: There is no other good way of treating a cataract once it has become a problem. It is like a dirty window that cannot be cleaned.

What kind of difference can patients expect before and after?

Dr. Michael: Having a cataract can cause sensitivity to light especially with bothersome glare. Depending upon the location of the cataract relative to the center of one’s vision, it can be disruptive to reading comfortably or reading the text on a television monitor. I have had patients tell me that they have stopped reading as much as they previously did.

Surgery for cataracts is essentially a replacement of the opacified natural lens of the eye with an artificial lens implant. Cataract surgery has progressed now to where it is tantamount to refractive surgery. In other words, it is not a simple replacement that leaves you stuck with glasses. It is now possible to target the final prescription to what is desired. There are implants that correct astigmatism such that vision without glasses is possible at any desired distance.

Most people will want to have good distance vision and wear reading glasses; others, especially those who are presently nearsighted, may want to keep their innate ability to read up close without the glasses and wear them for distance. Now there are even good multifocal implants which allow for an excellent range of distance and near vision. A thorough discussion with your optometrist or ophthalmologist about desired post-surgical resultant vision is very important now.

Wait as you’re saying my vision can be better, and not just because the cataracts are gone?

Dr. Michael: Yep. That’s why it’s so important now. Being glasses-free is possible for some.

Will the lenses need to be replaced at some point in the future?

Dr. Michael: You’ll only need cataract surgery one time. That implant is good for the rest of your life. There is a secondary opacification that can occur usually some time after the surgery that requires a touch up treatment with a laser. This is nothing to fear, and once the hazy capsule behind the implant is removed, the patient has their clear vision back.

Is there anything I can do to prevent cataracts from developing?

Dr. Michael: Cataracts are thought to progress faster due to oxidative stress effects of free radicals, so eating food high in antioxidants would be useful in prevention. Adding more colorful fruits and vegetables is a simple way to improve your diet. Higher intake of vitamin C has been studied as helpful. Sunlight adds to the oxidative stress, so shielding your eyes by using UV protective sunglasses is also recommended.

There is also some reason to believe hormone replacement therapy could aid in preventing or minimizing cataracts.

Does that ringing in your ears affect your life? Learn more about the different ways to handle noise tinnitus and menopause.

Is it worth getting treatment for cataracts?

If you’re not yet convinced, consider this: treating cataracts can add years to your life. A 20-year study of over 74,000 women 65 and older showed a 60 percent lower risk of death for those who had cataracts removed.

Why? Researchers don’t really know why, exactly, though there are several possibilities: if you can see better, you’re more likely to exercise and be social, especially if cataracts had limited your ability to drive after dark. You’re less likely to trip and fall, meaning fewer broken bones and hospitalizations. You may also be more able to read labels and medicine bottles, meaning better adherence to medical regimens and better diet.

The surgery has a 98 percent success rate with few risks, says The NYT, and recovery usually involves taking some simple precautions for a few weeks after surgery (no heavy lifting, no swimming, antibiotic drops). And many insurance policies will cover the basic surgery, though vision-correcting lenses may cost more out-of-pocket.

One of the most important things you can do to protect your eyes, says Dr. Michael, is see your eye doctor every year after you turn 40. The earlier cataracts are diagnosed, the simpler they are to remove.

For more information on common menopause-related conditions like frozen shoulder, itchy skin, restless leg syndrome, night sweats and more, check out our menopause Symptom of the Month series on Gennev. You may discover that weird thing that’s happening to you (body odor changes? cold flashes??) aren’t just you after all.

Have you been diagnosed with cataracts and decided for or against the surgery? We’d like to hear about your decision and how things turned out for you. Leave us a comment below, or talk to us on our Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.

Whether it’s a tag in the back of your shirt, a merino wool sweater, or even your favorite body wash that gets you scratching, you may be noticing that you feel itchy more often lately. And, yup, you can chalk it up to menopause. Itchy skin is yet another symptom, and the itchiness is usually due to dry skin.

Itchy menopause skin: What’s happening?

Your skin is made up of 64 percent water. One of estrogen’s many responsibilities is to trigger the body’s production of collagen and body oils, which keeps your skin moist. The hormone also makes it easier for your body to retain its natural moisture. As estrogen declines in perimenopause and menopause, so does your body’s moisture, resulting in dry, itchy skin, irritation, small bumps, and occasionally even a rash.

Unlike other menopause symptoms that ease up after menopause, your body never regains its ability to create and retain moisture the way it did in your youth. Fortunately, there are steps you can take to relieve the itch and keep your skin dewy.

What to do about itchy menopause skin

While drinking more water is popular advice for dry skin, it isn’t super helpful in this instance because your skin isn’t retaining moisture like it did when you were younger. The best remedies work from the outside to minimize the amount of water your skin cells are losing. (But keep drinking water; there are lots of other benefits.)

Slather on moisturizer. It comes in lotions, creams, ointments, and oils so pick your favorite. A moisturizer creates an effective barrier to prevent your skin from losing more moisture. Products with the fewest harsh chemicals, like sulfates, and no fragrances, such as petroleum jelly or coconut oil, are usually best tolerated. Or look for natural products with anti-inflammatory properties that are rich in vitamins, antioxidants, oleic acids, and fatty acids. For best results, always apply a moisturizer after a bath or shower while skin is still damp to lock in moisture.

Turn down the temp. A hot, steamy shower or soak in the hot tub may sound or even feel luxurious, but hot water damages skin and can increase dryness. Instead keep the water lukewarm and limit showers to no more than 10 minutes, once a day. And skip the hot tub. Bonus: a cool shower before bed may also reduce night-time hot flashes.

Avoid irritants. Antibacterial and deodorant soaps strip natural oils from your skin, making it drier. Any products with harsh chemicals or fragrances that come in contact with your skin like laundry detergent (it stays in your clothes), makeup, and skin care products can also irritate your skin and increase the itch. If you enjoy swimming, always take a quick, cool shower afterward to remove harsh pool chemicals.

Soak in an oatmeal bath. Oats have been used for centuries to soothe a variety of skin conditions, and dozens of modern-day research studies confirm its effectiveness. It’s even approved as a skin protectant by the Food and Drug Administration. Chemicals in oats called avenanthramides have been found to reduce itching and decrease inflammation and redness. That’s why you see so many products with oatmeal on the market. But you can make your own. Simply grind one cup of oatmeal into a fine powder, add it to a tub of warm water, and soak for 10 to 15 minutes. 

Always wear sunscreen. It may not replace the moisture that’s lost, but it can help protect your skin from further sun damage which dries it out more. Use an SPF 30 or higher on all exposed areas, year-round.

Add moisture to the air. Winter is prime time for dry skin because the air is drier and cranking up the heat dries skin out more. You can counter this by using a humidifier in your home to create a more skin-friendly environment.

Eat more good fats. The good kinds of fats nourish your body and skin. This is one strategy from the inside out that is effective. Eating more essential fatty acids such as olive oil, nuts, salmon, and flaxseeds can help skin cells retain more moisture.

When to get help with itchy menopause skin

Can’t stop scratching? Scratching getting worse? Talk to your doctor. There are prescription products they can offer relief. They can also check to see if another condition may be contributing to your suffering.

If your skin is not only dry, but also has a yellowish tinge and is cold to the touch, you might want to ask your doctor to check your thyroid. If you find you are often too cold or too hot, and you’re experiencing unexplained changes in body weight, these can also be indicators of a thyroid imbalance that may need medical care.

Diabetes and kidney disease can also cause dry, itchy skin. If you have a family history or other risk factors for either disease, or if you’re concerned that you may be experiencing either diabetes or kidney issues, get in touch with a doctor right away. 

We can help you manage itchy menopause skin

• Meet with a Gennev Doctor to help you understand your itchy menopause skin symptoms and their impact on your overall health and wellness

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. 

Bring up menopause in friendly conversation, and the mood is likely to plummet. While you may find comfort in knowing that you’re not alone, talk turns quickly to the miserable experiences of menopause: breaking out in a visible sweat while in an important business meeting, waking up drenched at 3 a.m. and not being able to go back to sleep, gaining weight around your middle despite not changing your eating or exercise habits, or flying off the handle when your partner looks at you the wrong way. And many women continue to suffer since traditional care often leaves huge gaps in providing them the relief they need in menopause.

With predominantly negative images surrounding menopause, it may come as a surprise to find out that it’s possible to feel AMAZING during this stage of life. “You don’t have to suck it up and grin and bear it,” says Jill Angelo, founder of Gennev. “Ninety-four percent of our patients report an improvement in their symptoms as a result of working with Gennev providers. Our mission is to improve the standard of care for women in their post reproductive years. This can be a high point in women’s lives. Why allow menopause to hold them back? Let’s catapult them to what’s ahead.”

What is Integrated Menopause Care?

Gennev’s successful standard of care is Integrated Menopause Care, a team approach between you, a medical doctor, and a health coach. “Women need medical care and lifestyle change to manage their menopause,” says Angelo. “There’s no one prescription pill that can do it all. There’s no one vitamin or behavior change that can do it all. It’s the two working together that makes menopause symptoms manageable.”

On the medical care side are Gennev’s doctors, who are board-certified ob/gyns with experience in treating women in menopause. Many are also certified by the North American Menopause Society as menopause practitioners or are working on their certification. They also follow Gennev’s evidence-based protocols for treatment.

To help women make the necessary lifestyle changes that support their health during their post-reproductive years, Gennev has a team of health coaches who are registered dietitians and often use cognitive behavioral therapy approaches when appropriate. They guide women to create plans and set goals in nutrition, fitness, sleep, mindfulness, and stress management. Then, they help them implement those plans and provide accountability and support so women can achieve their goals, feel better, and live longer, healthier lives.  All of the coaches have training and experience working with women in menopause, in addition to following Gennev’s protocols, working in lockstep with Gennev’s doctors.

“It’s truly a care team approach,” says Rebecca Dunsmoor-Su, M.D., the chief medical officer for Gennev. “Every woman’s menopause journey is as unique as she is, so the best treatment for menopause for her will generally require a little experimentation and tweaking to get just the right formula. The care team works together, keeping each other apprised of what’s going on, so a woman doesn’t have to worry about updating her providers.”

What makes Gennev’s Integrated Menopause Care approach different?

Gennev offers a multi-level, in-depth, personal approach compared to traditional menopause care. Most women go to their primary care physician or ob/gyn when menopause symptoms start. Unfortunately, in traditional settings, few doctors are trained in menopause care, and women can end up with multiple medications, general advice, and even misinformation. “Women often leave appointments feeling dismissed and frustrated, as well as with prescriptions that are just addressing the symptoms and not dealing with what’s at the core, which is hormonal change,” says Angelo. Treating the whole person is the only way to improve a woman’s quality of life versus just band-aiding the symptoms.”

This model draws from the broader definition of Integrated Care as defined by the NHS as, “Integrated care is an organizing principle for care delivery with the aim of achieving improved patient care through better coordination of services provided. Integration is the combined set of methods, processes, and models that seek to bring about this improved coordination of care.”

The whole-person approach

Estrogen affects more than just your reproductive system, which is why the symptoms of menopause are so widespread. Estrogen receptors are found throughout a women’s body, causing this hormone to affect nearly every system in the body, from bones and muscles to the heart and brain. “Because of hormonal shifts during menopause, this is the one time in your life when certain things will set off other things,” says Dr. Dunsmoor-Su. “If a woman’s not sleeping well, it also correlates with her gaining weight because you gain weight when you don’t sleep well.” The effects also go beyond physical health. They affect women mentally and emotionally. In addition, how you manage the changes that are happening now impacts your health down the road.

“When you think of a women’s health, post reproductively, it starts with menopause, and menopause frames up your long-term chronic health,” says Angelo. “Until now, women were never educated on how taking care of our menopausal symptoms also has preventive aspects for our long-term chronic care when we’re in our 50s, 60s, 70s, specifically to heart disease, diabetes, osteoporosis, Alzheimer’s disease, and dementia.”

With all of that at stake, it’s even more critical to ensure that you’re receiving integrated menopause care. Unfortunately, even major organizations like the American Medical Association and the American College of Obstetrics and Gynecology provide little support in menopause, making it hard to find this type of care. That’s why Gennev created its telehealth approach so no matter where you live in the United States, you have access to a menopause specialist.

Physical exam not required

Menopause isn’t diagnosed by a physical exam or blood test. Menopause is the point when you’ve gone an entire year without menstruating–the one-year anniversary of your last period. Likewise, there’s no definitive way to determine where you are in perimenopause, the transition to menopause, or how long it will last (typically four to 10 years).

Despite expensive diagnostics, including hormone level tests, or multiple prescription medications, many women continue to suffer. Quality menopause care starts with a conversation. Menopause-trained doctors know the right questions to ask, and at Gennev, our doctors have the time to really listen to you and understand what you’re going through. Unlike traditional doctor appointments, where you get only 10 to 15 minutes with your doctor, your initial appointment with a Gennev doctor will be 30 minutes. And then, your care continues with follow-up visits and recurring appointments with a health coach.

How one woman found relief from menopause symptoms

“Everything started going haywire about a year ago,” says Kristine, 50, a Seattle-based realtor. “I was waking up three to four times a night with night sweats. I was fuzzy during the day. My body started changing shape, and I was gaining weight in my middle area even though I was exercising more. My anxiety was out of control. It was affecting my mental health as well. And the thinning hair and drier skin, I felt like I was aging at a rapid pace.”

Kristine tried all of the usual routes to find relief. Her mom wasn’t any help; she had very few, if any, symptoms. Her much younger doctor, who’s a nurse practitioner and naturopath, had little experience with menopause. While she offered suggestions, including prescribing bio-identical hormones, nothing helped. “I got very frustrated with the whole process,” she says.

When she finally started talking to her girlfriends about her symptoms, one of them suggested Gennev, a company focused on helping women through this transition. “It was the specialty I really needed,” says Kristine, who has had two doctor appointments and two health coach appointments in the time it would have taken her to see her regular doctor.

The next level of care

Kristine’s virtual appointment with one of the Gennev doctors couldn’t have been better. “She was confident that we could get this under control, which was such a relief for me,” she says. “She knew her stuff inside and out.” Even though Kristine prefers to avoid medications in favor of natural remedies, she agreed with the doctor’s recommendation to try an estrogen patch. “My symptoms were so severe that I just couldn’t keep living the way I was,” Kristine says.  “We talked through my concerns, and I felt comfortable going that route.”

Within about a week, all of Kristine’s menopause symptoms were subsiding. “Everything is moving in the right direction,” she says. But her care didn’t stop there. She started to meet regularly with one of Gennev’s health coaches who’s helped her implement healthy new behaviors into her life like meal planning, eating more protein, and lifting weights. “I learned that women lose muscle mass as they get older, so putting on muscle is now my goal,” says Kristine, who is impressed with the quality of care that she’s getting at a price that’s less than what many of her friends pay for coaching. “Recently, we had an appointment on a Thursday and over the weekend my health coach checked in and sent links for meal prep and recipes for high-protein snacks. It feels like she cares and has a vested interest in my success. It feels like it’s the next level of care.”

In the amount of time Kristine would have been suffering, waiting for an appointment with her regular doctor, she thrived. “I’m not waking up at all in the middle of the night. My anxiety is way down. I’m feeling stronger. My clothes are fitting better. It has been life-changing,” she says.

How to get started with Gennev Integrated Menopause Care

While Kristine’s journey to feeling better started with a friend’s referral, you can begin your journey now to finding relief from your menopause.

It starts with a simple intake or quiz we call the Menopause Assessment. It provides you with personal health insights about where you’re at in menopause. It also sets up your initial visit with a Gennev doctor, providing information essential for diagnosis, medical guidance, and prescription support.

The next step is to meet with a Gennev health coach to implement a lifestyle plan based on health concerns you shared in your Menopause Assessment and with your doctor. The plan often includes nutrition, movement, mindfulness and stress-relief tactics, and sleep practices to address your personal situation.

As the weeks go by, you control how often you connect with your health coach””whether via appointment or text messaging. She is there as an accountability partner and supporter for you as long as you need her. And if you need to see the doctor months down the road””to check in on a prescription or to report changes in your symptoms””your coach can help you decide when that moment is right for you.

That’s the power of integrated care, and Gennev is bringing this proven approach to treating menopausal symptoms. “Let’s get you feeling better and improving your quality of life now so that you can function and thrive in life, and at the same time, prevent long-term chronic illness,” Angelo says.

It’s time to experience Gennev’s proven integrated care model for menopause. Get started by scheduling an appointment today.