The more consistently you walk, the more benefits you’ll reap. That’s why it’s so important to minimize your risk for injury and make walking as comfortable and enjoyable as possible. Since walking is low-impact, it’s already a low-risk activity, but how you walk, and what you do when you’re walking, can raise or lower your risk of getting hurt or developing aches and pains. Here are seven dos and don’ts that will help keep you on your feet and walking strong.
Don’t walk with weights. The thinking is that you’ll burn more calories by swinging dumbbells as you walk. In theory, it seems reasonable. The heavier you are the more calories you burn. But when researchers put this strategy to the test, walking with three-pound weights didn’t increase calorie burn compared to walking at the same speed without weights. The only thing it upped was the effort, according to the study in the Journal of Exercise Rehabilitation. In addition, swinging a weight could set you up for wrist, elbow, shoulder, or even neck problems. Instead, leave the weights at home and pick up your pace. You’ll burn more calories as well as improve your heart function. If you’re carrying weights in hopes of toning your arms, you’ll get more definition by using heavier weights before or after your walk. Bottom line: there are more risks than benefits of walking with weights.
Do warm up. This may seem obvious, but when your time is limited, it’s all too easy to immediately kick it into high gear. The result can be burning muscles, gasping breaths, and possibly even an injury. Instead, start at a slower pace to feel better and prepare your body for activity. Muscles get warm and more pliable so you’re less likely to strain them. More nutrient-rich, oxygenated blood is pumped to working muscles to fuel them for better performance. More lubricants are produced in your joints, so they move more freely and have a greater range of motion. In a review of 32 studies, 80 percent of the studies found that warming up first improved performance.
Don’t bounce. Up and down movement is common when you bound off of the ground while running. But, when you’re walking, you want to think about directing all of your energy forward for a speedier, more efficient stride. Ask a friend to watch you while you walk (or have them videotape you). If you’re bouncing, your head will be going up and down, and all that vertical motion increases impact on your joints. Instead, you want your head to stay level as you walk, which will minimize impact on your joints even as you walk faster. To do that, keep your front leg straight, but not locked, as you land and until your foot is under your body. Also, avoid landing flat-footed, and instead roll from your heel to the ball of your foot and toes.
Do posture checks while walking. Maintaining good posture allows your arms and legs to swing more smoothly, your chest to open up so you can take deeper breaths, and your vertebrae to be properly stacked which can prevent backaches. A great way to realign your posture mid-walk is by doing a shirt pull, an exercise I learned from walking coach Suki Munsell, Ph.D. Cross your wrists in front of you as if you’re getting ready to take off your shirt. Raise your arms as if you’re pulling a shirt up and off (but don’t actually do it). As you reach up, lengthen your spine. Then let your arms float down to your sides as your shoulders drop away from your ears. Repeat every 10 minutes or so, or anytime you feel like you’re slouching or notice any aches or stiffness.
Don’t walk the same way all the time. You may not notice the slight variations in roads and sidewalks that can alter body mechanics. For example, many are sloped to allow for water runoff which means one leg may be slightly higher than the other. Or you may always turn your head to the same side to talk with a friend as you walk. Over time, little alterations like these may make you more prone to injuries or problems because of muscle tension or imbalances. Instead, occasionally change direction, take different routes, and alter positions as you walk. This can help to keep you more physically balanced and prevent mental boredom.
Do stretch after a walk. This is when your body is primed for traditional static stretching, the kind where you hold the stretch. Stretching when your muscles are warmed up and your joints are loose after a walk helps to keep you flexible and increase your range of motion. It’s also a relaxing way to wind down after a vigorous walk.
Don’t ignore aches and pains. The sooner you address any issue the less likely you’ll end up being sidelined. Some discomfort like muscle fatigue or a little post-workout stiffness or muscle soreness is normal, but in general, exercise should not hurt. Feel a blister starting? Apply moleskin or a bandage to prevent it. Notice rubbing under your arms or between your thighs? Apply petroleum jelly or a lubricant like BodyGlide to prevent chafing. Achy low back? Check your posture. For more persistent problems, talk to an appropriate doctor: podiatrists for foot problems, orthopedists for joint issues, or physiatrists (also known as physical medicine and rehabilitation doctors) for any issues impairing your activity level. The sooner you remedy problems the quicker you’ll be back to walking regularly, and the stronger you’ll be.
Join the Get Moving Walking Program for Women to receive two 30-day walking programs designed by women for women, support from certified fitness instructors and health coaches, special offers and incentives. Always check with your physician before beginning any new exercise program.
Partner with a Gennev Dietitian for actionable solutions and the support you need to keep moving in midlife and menopause. Learn how to get started with a walking program, the nutrition and supplements your body needs, how to maximize your sleep routine, manage symptoms with actionable lifestyle changes and more.
Meet with a Gennev Doctor – our board-certified physicians are menopause specialists. They will listen to understand your symptoms, answer your questions and develop a treatment plan that is personalized for you.
Pelvic pain during sex, pain from the pelvic region generally, incontinence, prolapse as these do NOT have to be your “new normal.” There are treatments out there to help you manage, even solve, many of the issues related to pelvic floor dysfunction.
One solution might mean taking a long look at your choice of birth control “¦.
Rachel Gelman DPT is a clinical specialist and branch director at the Pelvic Health and Rehabilitation Center in San Francisco. She specializes in the physical therapy management of numerous pelvic pain disorders, including bowel, bladder and sexual dysfunction. We talked with her about some of the sources of pelvic pain, including the surprising news that hormonal birth control may be part of the problem.
If you have pelvic pain, 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.
Rachel says she deals with pain from the “ribcage to the knees,” specifically focusing on the internal muscles of the pelvic floor. We asked her exactly what that meant. The list is surprisingly long as clearly this part of the body is responsible for a heck of a lot and needs proper care and attention.
Rachel also focuses a lot on the impact of hormones on that part of the body. Given that midlife and menopause are a time of enormous hormonal changes, we wanted to understand that better. Rachel explained to us how the sensitive tissue of the vagina and surrounding area are affected by estrogen, progesterone, and testosterone.
(Here’s a fun way to increase pelvic health: get yourself an Elvie)
So, what does that mean for women who take hormonal birth control? Especially women who’ve been on the Pill for a long time? Rachel says there’s no truly perfect birth control; oral contraceptives are effective, but it increases sex hormone binding globulen. The take away: the Pill can negatively impact some very sensitive tissue, so if you have a choice, consider carefully when choosing it as your contraceptive method.
So, what exactly is vestibular tissue, and why is it so impactful if this area is inflamed or otherwise unhealthy? Rachel gives us a sort of private-area map and explains the consequences of hormone imbalance here and what can be done about it.
So, we asked, how do you know when pain is caused by hormonal imbalance as opposed to some other concern? You have to look at all the puzzle pieces, Rachel says; she takes us through how she puts them together to figure out what’s going on and how to fix it.
How do patients find you? Is it mostly by referral? She gets a lot of referrals, Rachel says, from ob/gyns, urologists, etc., but a lot of patients simply find her on the Internet. So, shortcut Dr. Internet: if you’re having a particular problem and not getting a solution from the doctor you’re seeing, ask for a referral to a specialist.
Do you see more older women, or do you see these patients more often? Her practice is pretty evenly distributed, Rachel says, because pelvic issues aren’t limited to age, but yeah, no surprise: age does have impacts as hormones change. So if you’re getting older and have never seen a pelvic specialist, it might be time: avoid problems in the future by being proactive!
What kind of self-care should women be doing between visits to a specialist like Rachel? It depends on where you are, Rachel says; are you already in pain and need help relaxing or releasing? She gives her patients things to do between visits to help them learn to treat themselves, and that’s a Very Good Thing.
“We as humans were not meant to sit on the toilet to have a bowel movement.” Ooooookkaaaaaay. Not giving it up. Just sayin’. Fortunately, says Rachel, there are ways to adopt the optimal BM position without resorting to squatting in the woods. Phew! She explains why not excreting correctly can actually be pretty bad for you.
(speaking of toilets, do you know how much urination is normal for you?)
“Kegels are not the answer to everything,” Rachel says. They can be good for you, but they don’t solve every issue. Best not to self-diagnose a kegel deficiency as if you’re having problems with painful sex, incontinence, bowel dysfunction, there’s help, there are resources. Seek them out and get your standard of living back.
If you’ve had issues with pelvic pain or other issues related to pelvic dysfunction, would you share with us how you managed it? Let us know in the comments below, or hit us up on Gennev’s Facebook page or Midlife & Menopause Solutions, Gennev’s Facebook group.
More about Dr. Rachel Gelman: Rachel is a Bay Area native who received her bachelor’s degree in Biology from the University of Washington in Seattle and her Doctorate in Physical Therapy from Samuel Merritt University. As you heard in the podcast, she’s passionate about women’s and men’s health and strives to promote quality education regarding pelvic health both in the clinic and in the community. We appreciate her sharing her wisdom and expertise with us!
You can follow Rachel directly @RachelgDPT on Twitter.
“Hit Play Not Pause,” podcast is hosted by Selene Yeager, and we think the name is perfect.
While middle age and menopause mean changes in our bodies, aging doesn’t mean physical activity “ even at a competitive level “ is behind us.
In this episode, Gennev CEO Jill Angelo talks with Selene about how post-menopausal women can continue to perform at a high level “ or just be fit and feel good in their bodies, if that’s the goal.
Selene Yeager manages content for Feisty Menopause. She is also a top-selling professional health and fitness writer who lives what she writes as an NASM certified personal trainer, USA Cycling licensed coach, Pn1 certified nutrition coach, pro licensed off-road racer, and former All-American Ironman triathlete.
Learn more about Selene and hear the podcast at FeistyMenopause.com.
“Fatigue” does not equal “tired.” menopause fatigue is something else, and it can be exponentially worse. It isn’t solved with “just get more sleep,” and day after day of it can really wear you down.
Fatigue “ real fatigue “ is a common symptom of menopause. Symptoms makes work hard, exercise impossible, even thinking straight can feel like it takes all your resources.
The kind of fatigue we’re talking about can be a result of less estrogen to “feed” your brain. If you have some menopause brain fog, forgetfulness, are easily distracted and occasionally confused, it’s all part of the same process: your brain is trying to adapt to less estrogen.
While this part of perimenopause and menopause is temporary, it can last a year or two or longer. And if you don’t know what’s happening, it can be frightening. We hear from women all the time that they were terrified they were developing early onset dementia or that they’d been to a round of doctors to deal with “chronic fatigue.” Finding out it’s likely a (temporary) result of menopause is a huge relief.
Even worse than the symptom itself is that often, no one even mentions the culprit could be diminishing hormones, leading women to get expensive hormone level tests, waste time on incorrect diagnoses, and live in fear over a totally normal process. Thankfully, there are other more reliable tests for menopause diagnosis.
There are things you can do to fight the fatigue: the right nutrition and exercise are powerful tools, and there are medications that can help while your brain and body adjust to the new normal.
In this podcast, we hear from Gennev Director of Health Coaching, Registered Dietitian Nutritionist and Exercise Physiologist Stasi Kasianchuk and Naturopathic Physician Dr. Wendy Ellis on how to handle menopause fatigue.
What do you do to combat fatigue, and is it working? Or did you just have to wait it out? We’d love to hear how you handled it, so join the conversation in the Gennev community forums!
It’s week four of Global Menopause Awareness Month, and we’re continuing our journey through the phases of the menopause transition with Gennev’s Menopause Types.
As we learn more from resources like our Menopause Assessment, we’re discovering there are consistencies in what many women experience. That’s how Gennev was able to develop the five Menopause Types. And women are loving having a tool that helps them understand their bodies better and be more prepared for what may be coming next.
Type 4s, that light you see actually IS the end of the tunnel, though at times you might still feel like you’re getting hit by the train. Now several years past your last period, you’re almost ready to throw away that last box of tampons under the bathroom sink, right?
As you move through the Type 4 phase, it’s time to really focus on maintaining your good health for the many happy years ahead. While your body has in many ways adapted to the lack of estrogen, there are long-term effects that require attention.
By now, hopefully your hot flashes are either gone or clearly going. Your metabolism has likely settled into a new normal, and your weight has, more or less (no pun intended), stabilized. Anxiety, depression, irritability, rage “ those are retreating, and isn’t life more glorious because of it?
It’s good the truly acute symptoms are retreating, so now you can focus on the long-term effects estrogen withdrawal has on sexuality, bones, brain, and heart.
For many women, vaginal symptoms of dryness and thin, vulnerable tissue can persist for their rest of their lives. Vaginal atrophy can make it hard to want or enjoy intimacy.
Gennev’s solutions: A really good daily moisturizer and intimate lubricant can help tissues stay moister and more pliable. For women wanting to re-engage in sex who find penetration too painful, a series of vaginal dilators or sexual toys can be a huge help.
We also suggest an open dialogue with your intimate partner. Sexual problems can be very damaging to a relationship. Sexless marriage during menopause is common. So, honest conversation, perhaps with professional help, is critical.
While men do have more heart concerns than women prior to menopause, about 10 years post-menopause, a woman’s risk of heart disease is equal to a man’s. And because we don’t always recognize the symptoms of a heart attack in a woman, her chance of dying of it is greater.
Heart disease remains the #1 killer of women, but it doesn’t have to be. A healthy lifestyle, plus medical intervention when needed, can go a long way to managing and preventing heart disease.
Gennev’s solution: Good nutrition is vital. There are places on earth marked as “blue zones” where people live longer, healthier lives, and centenarians aren’t unusual! Most of those places eat a Mediterranean-style diet, with its emphasis on leafy greens, healthy fats, and lean proteins. Gennev’s Health Coaches are all registered dietitian nutritionists; sign up to get more information on how to eat the way spry 100-year-olds eat!
Exercise, hydration, and social time are also very important. Get your heart rate up just thirty minutes, five days a week. Drink plenty of water. And spend time with friends and family. That’s tough now, with COVID, but studies show those who maintain social relationships as they age just live longer.
Finally, consider a pet. They do the heart and body good “ taking the dog for walks, even just petting and talking to a comfy kitty can reduce stress and increase oxytocin (the “love hormone”).
If you looked at that subhead a couple of times and thought, “Who’s Brian?” don’t panic! Brain fog is still common in Type 4, but you should be coming to the end of it soon.
All kidding aside, women do account for two out of every three diagnoses for Alzheimer’s disease, and as Dr. Lisa Mosconi and her team at Weill Cornell Alzheimer’s Prevention Clinic discovered, there does appear to be a connection between menopause, estrogen withdrawal, and development of dementia-related brain plaque.
Gennev’s solution: So how do we protect our brains? Nutrition! As Dr. Mosconi told us in our podcasts with her, nutrition is key: make sure you’re getting plenty of omega 3s (fatty fish”Dr. Mosconi particularly favors caviar), as well as fresh vegetables and fruits, healthy, unrefined oils, good glucose (not just sugar), and plenty of water. Hydration is key, says Dr. Mosconi, as 80 percent of the brain is water! Steeply reduce processed and deep-fried foods, minimize animal products, and stay well away from trans-saturated fats.
If you’re not sure you’re getting enough of any of the good nutrients (and O3s can be particularly challenging if you don’t eat fish), check out Gennev’s Vitality supplement to fill in any gaps you may have in your nutrition.
Osteoporosis is extremely common and very dangerous. For one thing, most people don’t know they have bone loss until they experience their first fracture. And since complications from hip fractures kill more post-menopausal women than breast cancer, it’s a real concern.
Gennev’s solution: Obviously, nutrition is huge (again as are you seeing a theme here?) and fortunately, the same things that are good for your brain and heart are also good (or at least not damaging) to your bones: leafy greens, lean proteins, choosing whole foods over processed. Make sure you head to our store to grab vitamin D and Omega 3s and calcium.
Weight-bearing exercise is good for bones, so walking, running, dancing, anything that pits you against gravity is good. And while biking and swimming are great cardio exercises, they don’t help your bones, so try to get some of both. Watch your posture as well! Your body is meant to “stack” so the weight is on your skeleton (which is good for you) and not pulling muscles this way and that (which hurts).
Yes, the years after that final hot flash fades still have challenges, but being proactive and maintaining healthy lifestyle habits can go a very long way. Make an appointment to talk with one of our doctors, and get on the path to thriving through menopause and beyond!.
Some of the best years of your life are ahead of you as enjoy!
Are you a Type 4, or is there a special Type 4 woman in your life? Come join the conversation about All Things Menopause in our Community forums!
So many people suffer back pain as they get older, we’ve come to think of it as a “normal” result of aging. Perimenopause aches and pains are nothing new, so it follows that they could be even worse in full fledged meno. Right?
Well, pain may be common, but it’s not “normal.” It’s the body’s signal that something is wrong, and as spoiler alert as quite often, things that are wrong can be fixed.
As with many things going wonky at this time in our lives, the estrogen depletion of menopause may be playing a role in your back pain. A study done in China in 2017 looked at the spines of 1,566 women and 1,382 men of the same age.
Results? In the 15 years after menopause, women’s lumbar discs degenerated much more quickly. So if you’re feeling back pain, it’s important to act right away to protect your spine and your active future.
If you are suffering from constant lower back pain, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.
When it comes to bodies and dealing with arthritis or other pains, we turn, as we often do, to our fabulous physical therapists, Meagan and Brianna.
According to Meagan and Bri, there are lots of possible causes, including muscular pain or strain, herniated disc, problems with the SI joint (stay tuned for more on that in an upcoming blog), kidney stones, and issues with your bone density.
For women in midlife and menopause, additional common issues might be postural changes resulting from pregnancy, changes in exercise form and technique, poor stability, poor activation of your core, and poor breathing. Menopause and joint pain are often spoken in the same sentence, but many of the above factors can be mitigated through intention.
Also, a surprisingly big culprit? “Doing YouTube exercises that are inappropriate for their ability are a huge problem,” Brianna says. “Please don’t do that.”
If you really want to watch something on YouTube, check out our painful sex webinar.
So, first thing to do is figure out what’s causing the pain.
Best way to do that? See a doctor or a physical therapist and talk about what you might be doing (or not doing) that’s causing the hurt. Here’s a handy list to help you zero in on causes and fixes to help you have that conversation.
Is it your exercise program?
“There are lots of pieces of information you need to tell your doctor or PT,” says Bri. “How long does the pain last? Is it days or hours? Is it just muscle soreness from exercise, and is it triggered by a particular exercise? If it’s specific to an exercise, it may be as simple as changing position or modifying a little: tweak, rotate, breathe, and you may solve the problem.”
Meagan adds, “If you have other joint or muscular pain that’s dull, that happens during exercise, your doc or PT needs to know that. If it warms up and goes away or comes on at the end and is gone soon, that’s probably diffuse muscular pain, that’s just the discomfort of getting in shape. But if it’s localized or increases or is sharp as you need to respect that. The body is designed to use pain as a signal that there’s a problem. But our brains can sometimes override those pain signals, if we really want to get fit or lose weight.
“More often than not, pain should not be pushed through.”
It might be time to update or replace your mattress, Bri says. They’re a pain to replace and they can be expensive, but the wrong mattress or a too-old mattress can set you up for a great deal more pain and expense down the road.
Most of us just aren’t aware enough of our body position when we’re working, says Meagan. We hunch, we lean, we curl forward, all of which can put more strain on your back. A better option is just don’t sit all day, nor stand all day. “Every 5 as 10 minutes, just stand up,” she tells us. “That’s it. Just stand up, then sit down again. Stretch a little, walk around the office if you can. This allows your body to use its natural lubrication on those joints. It’s just unreasonable to sit for 8 hours and assume it won’t have an impact.”
Their thoughts on adjustable desks? If you or your office can afford it, go for it, Bri and Meagan agree. Varying posture during the day is a great way to reduce the load on any one part of your body.
Car seats are designed to be able to fold forward, so the place where we need the most support as the lower back as tends to be a hole instead. If your car seat situates you so your hips are lower than your knees, get a lumbar roll or just roll up a towel to stick behind you to get your butt and hips level with or slightly above your knees.
A lumbar roll that’s easily removed can do double duty with your office chair.
Back pain can have more serious causes that require medical intervention: visceral pain could be from a kidney infection. Pain that’s up high, between the shoulder blades (what Bri calls the “bra strap area“), could indicate a compression fracture. So if you feel pain there as especially if you have osteoporosis, osteopenia, or a family history of either as you need to get to the doc for some x-rays. Here are some steps to prevent osteoperosis.
Sudden back pain can also, rarely, be an indication of certain kinds of cancer, so if the pain is sudden or worsens at night, or you have a personal or family history of cancer, take it seriously and make an appointment.
When we hit midlife and suddenly have some extra pounds (particularly in menopause, when many of us start to put on belly fat), there’s a tendency to go all-out to get back to our younger bodies.
There’s nothing wrong with wanting to get stronger and fitter, and exercise can be very helpful in relieving back pain or avoiding it altogether. But you have to do it right, with good form, while breathing correctly, and after making sure you have the basics in place before you move on to more challenging workouts.
So what are we doing wrong?
Back pain from exercising incorrectly is often the result of poor stabilization, says Meagan. When pelvic floor muscles and the bottom of your core are weak, you don’t have the structural integrity to hold your pelvis, SI joints, and lumbar spine (lower back pain) in good alignment. Then, when you bend or twist, things can shift out of alignment and cause sudden pain. This can be exacerbated in menopause and perimenopause, when aches and pains due to these factors can be triggered more easily and be worse in terms of pain.
This often happens in an exercise classes where moves are difficult and unfamiliar, and you may not have the form, strength, or stability to do the move you’re being asked to do, Bri adds.
If you want to exercise or continue to exercise while still protecting your back, there are ways to do it safely.
Avoid hurting your back by first mastering the basics. A really great way to do this is to see a physical therapist (PT) who can help you identify weaknesses and design a plan to get stronger, wisely.
Most people benefit from a three-dimensional program, Meagan tells us: stabilization to address the central core; flexibility, to address restrictions in your range of motion that you might be compensating for; and cardio, to build up your aerobic capacity. A good PT or coach can help you design a plan that covers all three.
According to Meagan, ramping up slowly is key, especially for those who already experience back pain. “I’d start with breathing, breathing Kegels, getting the pelvic floor and breath working together. You need to get into functional positions right away. Squats, lunges, getting rotation in there, developing movement strategies with appropriate stability and activation of core musculature to allow you to increase difficulty.”
If you don’t have access to a PT, and you’re taking a fitness class, Brianna advises you opt for classes with as few students as possible. If you can, take an individual lesson or attend a class with no more than 3 students per instructor, she says, so you get more personal attention. Learn to do the moves safely before moving on to harder exercises or bigger classes.
Don’t have a PT of your own? We have two, but we’ll share. Here’s what a PT might tell you NOT to do.
When you’re getting ready to launch your new “I’m going to get fit, and this time, I mean it” program (just me?), have actionable, reasonable goals in mind.
What are you hoping to achieve, asks Bri. Do you want to be able to walk longer, are you trying to build strength, are you focusing on cardio or core? There’s no one-size-fits-all exercise program, she warns, because, “We’re all good at hiding our dysfunctions, and we need to tease them out. A gradual, progressive program will address those areas of weakness and allow you to build endurance and stability as you work towards your goals.”
But but but, you say, I feel fine! Nothing hurts!
That may be true, Meagan says, but chances are it just means you aren’t experiencing symptoms yet. “Few of us are perfect,” she says, “and most of us are just getting away with bad habits that will likely catch up to us later. Posture, breathing, proper warm ups and cool downs as because we ignore these, it’s just a matter of time before something is going to hurt or break or get inflamed. The answer is to interrupt the problem now before it becomes apparent.”
“Apparent,” by the way, is PT-speak for “painful.”
When you take a class, you focus entirely on the instructor, following her steps, mimicking her form, and never everchecking out the person next to you who, 45 minutes in, hasn’t yet broken a sweat. Right?
“One of the issues we see with taking classes,” Bri says, “is you might be standing next to someone who’s been doing this for years. They look great, they make it look easy, and you try to keep up. But they may have core strength you don’t have yet, and you could end up hurting yourself.”
Be OK with modifying some of the moves or simply sitting out portions of the program if you’re not ready. Sure, the gal next to you is 10 years older, but that may just mean she’s been developing her skills and strengthening her core for 10 years longer.
Regular exercise can be enormously beneficial for your body, brain, and mood, but no one benefits from a slipped disc or strained muscle. If you plan to add or increase exercise, consider getting some expert help to do it safely.
If you’ve experienced back pain, what did you do about it? (You did something, right?) We’d love to hear how you managed the pain, so please share what you’ve learned with the class. Tell us your experience in the comments below, or on Gennev’s Facebook page or Midlife & Menopause Solutions, our closed Facebook group.
When it comes to reducing your risk of conditions like osteoporosis, lifestyle changes are usually the first line of defense. They can be effective, are generally very low-risk for side effects, and often have add-on benefits to your health and well-being.
Weight-bearing exercise. Taking vitamin D and calcium together. Maintaining a healthy weight. Not smoking. Eating a healthy, varied (largely Mediterranean) diet. All of these can be helpful in preserving bone health.
However, if these approaches aren’t enough to stop osteopenia from becoming osteoporosis, or if you’ve suffered an osteopenic fracture, it may be time to discuss osteoporosis medications and treatments with your doctor.
The truth of it is, says the International Osteoporosis Foundation, one in ten women aged 60 are affected by osteoporosis. After age 50, a woman’s risk of death from an osteoporosis hip fracture is equivalent to her risk of death from breast cancer. And yet, up to 80 percent of those at the highest risk as those who have already had at least one osteoporotic fracture as have not been identified, nor are they receiving treatment.
Given the potential impact of osteoporosis on longevity and quality of life, we talked to our doctor about it, Gennev Chief Medical Officer Dr. Rebecca Dunsmoor-Su.
If lifestyle options are insufficient to halt the progression of osteoporosis, there are treatments that have proven effective. However, not every treatment works the same for every woman, and all come with at least some risk of side effects, so it’s good to discuss the range of options with your doc.
And, of course, you may find that a combination of lifestyle behaviors and medical interventions offer you the best health protection.
This class of drugs are “anti-resorptive,” Dr. Rebecca tells us, meaning they prevent your body from reabsorbing calcium from your bones and weakening them. Additionally, bisphosphonates can be partly adsorbed onto the bone surface, helping restructure bones to be stronger.
These treatments can be taken orally, by injection, or via an IV, usually on a monthly, bi-annual, or annual basis. For those at low risk of osteoporosis, up to five years of treatments may be necessary. For those at higher risk, particularly those who have already had a fracture, up to 10 years may be necessary.
There are some risks of side effects with bisphosphonates: skin reactions for those receiving injections, stomach upset, heart burn, joint and muscle aches are the most common. For those on high doses, there is an increased risk of osteonecrosis of the jaw (death of bone tissue from lack of blood supply) and atypical femur fractures (the large bone of the thigh). However, the risk is very slight, even among this population.
Long-term studies (up to 10 years) have been done on bisphosphonates and show reduction of bone turnover (less bone loss) without evidence of adverse effects.
Bisphosphonates can be effective in halting the progression of osteoporosis, but not all work the same way or as well for every person taking them, so have a good conversation with your doc and track your progress.
Replacing the body’s hormones to slow, stop, or even reverse the progression of osteoporosis is one way doctors are helping women (and men) keep bones stronger, longer. However, Dr. Rebecca reminds us, no hormone is risk-free, so it’s important to discuss benefits and risks with your doc to decide which (if any) hormonal treatment is appropriate for you.
How does Medicare cover osteoporosis? Find out, with this guide from Texas Medicare Plan.
Some women do get bone benefits from estrogen with systemic hormone replacement therapy, says Dr. Rebecca, potentially even getting some reversal of bone loss. However, given the problematic nature of hormone replacement therapy (possible increased risk of breast cancer and blood clots), most doctors won’t recommend HRT for a single symptom, she tells us.
If a woman is at risk of osteoporosis or has already had a fracture if she doesn’t have a uterus and therefore doesn’t need progesterone (which is associated with breast cancer), and if she has other symptoms such as hot flashes which hormones can help relieve, she may be a good candidate for HRT.
SERMs like Raloxifene (Evista) is a “designer” estrogen which acts like estrogen where bones are concerned (protecting density) but unlike estrogen by not having an effect on the uterine lining (and therefore not causing uterine cancer). You may be familiar with another SERM, Tamoxifen, which is used to prevent the recurrence of breast cancer.
Raloxifene has similar side effects to other hormones, namely a slight but increased risk of blood clots in the leg and lung and increased risk of stroke in women with pre-existing heart disease or risk of heart disease. It can also increase the occurrence of hot flashes.
Duavee is a SERM + conjugated estrogens treatment that can reduce the effects of osteoporosis while also decreasing hot flashes. The estrogens help with vasomotor symptoms (hot flashes/night sweats) and help prevent osteoporosis; the bazedoxifene (BZA) helps protect the uterus from endometrial hyperplasia as a thickening of the uterine lining that can lead to cancer.
A synthetic version of the human parathyroid hormone, Forteo helps regulate the metabolism of calcium. Unlike most of the other treatments which slow down the reabsorption of bone, teriparatide actually promotes the growth of new bone.
However, because Forteo is a relatively new treatment on the market, there’s not a lot known about the long-term safety of the drug, which is administered by self-injection. At the moment, it’s only FDA-approved for two years of use. Possible side effects include skin reactions at the injection site, depression, leg cramps, back pain, and heartburn.
Initially this drug had to be given in an injection because if taken orally, too much was digested in the stomach before it made its way to the blood stream. In response, it was formed into a nasal spray, which is well tolerated by most users. Effectiveness is described as “modest,” but it does seem to increase bone mass, if somewhat less effectively than estrogens and bisphosphonates. However, it does seem to reduce pain from fractures.
Bone removal is, of course, part of the natural process of life, but as we age, bone removal far outpaces replacement, and bones become porous and weaker as a result. Denosumab prevents the development of the cells that remove bone. A Prolia injection every six months has been proven to help some women and men strengthen their bones and reduce their risk of fracture.
Prolia can have immune effects, Dr. Rebecca says, so it’s important to communicate fully with your doctor before starting and during treatment.
The company OsteoStrong has a unique approach to osteoporosis that may well be worth exploring: non-impact osteogenic loading. Osteogenic loading is putting a high load on the bones in order to force bones to strengthen as this is why impact, weight-bearing exercise can help with bone density.
According to Brent Jordan, co-owner of OsteoStrong Mercer Island, OsteoStrong’s equipment simulates that impact without the danger of hitting the ground wrong. Members spend 10 to 15 minutes, three times a week, at an OsteoStrong facility, where there are four different machines to target different fracture-prone areas: arms between the wrist and shoulder, legs between the hips and ankles, core (ribs), and spine. Members pull or push as hard as possible against immovable parts of the machine, putting pressure on the bones and prompting the body’s inherent response as to increase bone density.
Used properly, the machines can also build muscle and improve balance, Jordan says, which can reduce the potential for falling, another benefit for women with osteoporosis.
Information on the effectiveness of OsteoStrong’s machines on bone density is still being gathered, and there is at this point insufficient evidence to recommend it over regular weight-bearing exercise, says Dr. Rebecca. So we suggest that you consult with your doctor before beginning the therapy, just as you would with any other treatment.
Are you dealing with osteopenia or osteoporosis or concerned about your bone density? What are you doing to manage or avoid the condition? We’d love to hear from you! Please share in our Gennev Community forums!
We know, not what you want to hear. While your period will likely be a no-show at times during perimenopause, cramps may still be making an appearance. And for some, the pain may intensify or last longer than normal. Phantom cramps are usually your uterus’ way of letting you know it is still building a lining and another period is somewhere on the horizon. Once you reach menopause that point when you haven’t had a period for 12 months, premenstrual (PMS) symptoms like cramps should be gone, too.
While estrogen levels decrease during perimenopause, it’s not a nice, neat linear decline. There are times”and this is one of them”when estrogen levels surge. As your ovaries struggle to produce mature eggs, your body pumps out more follicle stimulating hormone (FSH), which results in more estrogen being created. More estrogen means the uterine lining becomes even thicker. (The cause of heavier bleeding and longer periods when they do show up.) It also results in higher levels of prostaglandins, hormones responsible for the uterine contractions that open the cervix, expel the built-up uterine lining, and cause painful cramping. While these hormones are on the rise, levels of progesterone, a hormone involved in triggering menstruation, are the first to decline. These erratic hormone patterns are believed to be the reason that some months you may not experience a period, but still have cramps and other PMS symptoms like bloating and sore breasts.
You don’t have to grit your teeth until you’re postmenopausal. Here are simple remedies that can help you feel better right now.
Take a walk. Mild to moderate cardio exercise, such as walking, cycling, jogging, or taking a Zumba class, boosts feel-good chemicals in the body that may block some of the pain signals. It also improves circulation, which can relax constricted blood vessels in the uterus that result from cramping.
Apply heat. Try a heating pad or warm bath. In an analysis of 23 studies, heat was found to be just as effective as analgesics. Heat may help by increasing blood flow to the abdomen and inhibiting pain signals.
Pop a pain reliever. Ibuprofen and naproxen are some of the best medicine for this type of pain and may reduce bleeding. These anti-inflammatories work by blocking the production of prostaglandins.
Stretch it out. Gentle exercise like stretching and yoga may help by lowering stress hormones which then lower prostaglandin levels. In a review of research studies, exercise was found to be more helpful in easing pain than over-the-counter medication.
Increase these nutrients. Fiber and omega 3s may ease cramps by helping to regulate hormones. Good sources of fiber include beans, berries, whole-grain cereals and pasta, chia seeds, artichokes, and Brussel sprouts. You should aim for about 25 grams of fiber a day. For omega 3s, eat more cold-water, fatty fish like salmon and tuna; flaxseeds, chia seeds, walnuts; and plant oils like soybean and canola. Other nutrients that may help include vitamins B and E, magnesium, and zinc.
If cramps are impacting your life, you should see your doctor for alternative treatments and to rule out other causes. Your doctor can prescribe low-dose birth control pills or a progesterone IUD like Mirena, which can reduce bleeding and pain.
If your pain is due to other culprits, such as uterine fibroids, polyps, gastrointestinal problems, or issues with your pelvic floor muscles, your doctor can determine an appropriate treatment plan. You should also see your doctor, if you have gone more than 12 months without a period and then you have bleeding.
Many women are concerned about ovarian cancer when they experience pelvic pain, but that pain is different. First, ovarian cancer is called the “silent killer,” because there isn’t much pain until the disease has progressed. Second, this pain is likely to be more constant and severe and is commonly associated with decreased appetite and severe abdominal bloating.
It’s always good to exercise caution. If you’re concerned about the pain you’re feeling, make an appointment with your doctor”they can help you find relief and peace of mind!
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.
Got a second? Try this: bend down to tie your shoe. When you’re down there, exhale. Were you holding your breath? Yes? Don’t do that.
If you’ve ever taken scuba diving lessons, you know the #1 rule: don’t hold your breath. Turns out, that’s a pretty good rule for life out of the water as well.
Pelvic organ prolapse, when the uterus, rectum, vagina, or bladder drops from its normal position, is an astonishingly common condition, occurring in maybe as many as half of all women worldwide. And holding your breath is one of the risk factors.
Because menopause is another of the major risk factors for this condition, our DPTs Meagan and Brianna filled us in on what we need to know.
Your pelvic floor is a sort of hammock of muscle and tissue helping to keep internal organs such as the vagina, rectum, uterus, and bowels in place. If that muscle becomes too weak or the connective tissue is too stretched, the organs can droop, collapsing or changing the vaginal wall. Pelvic organs can even drop into the vaginal canal and protrude outside the body.
The two biggest risk factors, according to Bri and Meagan, are menopause and childbirth. Bearing all that extra weight during pregnancy, then delivering vaginally, can weaken the pelvic floor, especially after multiple births.
Menopause or estrogen loss for any reason can also be problematic. The drop in estrogen can affect strength, elasticity, and density of muscles, all of which can result in a weakened pelvic floor.
Having a hysterectomy is another risk factor. The uterus is kind of like the keystone of an arch, Meagan says; all the organs are wedged in there, supporting each other. Once the uterus has been removed, even if the surgeon ties everything back into place, the architecture just isn’t as sound and the structure can start to crumble.
Another risk factor is chronic constipation. If you’re doing a lot of pushing to pass stools, Meagan says, you’re nudging all your pelvic organs that direction as well.
Chronic coughing puts pressure on your pelvic floor, Brianna told us, so smoking, emphysema, even chronic allergies can be concerns.
Genetics plays a role, as with many conditions. Those with connective tissue disorders such as hypermobility should seek help early.
High-impact exercise. If you’re doing a lot of bouncing, like runners do, it’s good to get some advice from a pelvic floor specialist before symptoms arise. Abdominal gripping, like doing too many crunches or other “gotta-have-a-six-pack” exercises, can cause an overstimulated pelvic floor that doesn’t relax naturally. While this is different from having too-weak pelvic muscles, the end result of incontinence during exercise and prolapse can be the same.
Heavy lifting, whether for exercise or work, needs to be done correctly, says Brianna, which brings us to one of the most common factors:
Breath holding. Remember that test of tying your shoe? We hold our breath too much, says Brianna, and often we’re not even aware we’re doing it. But it’s not good: “When you hold your breath, your organs have nowhere to go. There’s all this pressure from above, so they start to move south.”
(Know what else isn’t great for your pelvic floor? Your shoes.)
One of the earliest symptoms, say our PTs, could be trouble with tampons. If they’re just not staying in place or if you can’t keep them in at all, that’s a really important warning sign that something else is occupying that space.
Another sign may come from this simple test: lie flat on your back and bend your knees. Put a pillow under your hips. If you feel some relief from pressure down there, that could be an indication that things are happening that shouldn’t. (Bonus: this is also just a good preventative measure to do every day.)
Other symptoms include feelings of pressure or fullness in the vagina or rectum or both; urinary or fecal incontinence; low back pain; urinary retention, which is the feeling that you can’t quite empty your bladder entirely or you have to go twice; feeling a bulge or something actually protruding; painful sex.
(How many times should you pee a day normally? Answers from our PTs on pees.)
Definitely make an appointment with your ob/gyn and ask that they do a standing test. When you’re on your back and the doctor’s speculum is actually holding things in place, it may be harder to gauge the presence or severity of prolapse. Since, as Meagan says, “most of us live in a vertical world,” a standing test with gravity doing its thing may make diagnosis easier.
If you have any concern that you have or may be at risk for prolapse, ask for a reference to a pelvic PT. If you have mild prolapse, your PT can help you keep the condition from worsening; if your condition is more developed, you can get educated about all your options, like surgery or non-surgical options such as a pessary. If you have no symptoms of prolapse, great! Celebrate and then find out how to stay that way.
If you’ve had prolapse surgery, you definitely want to work with a pelvic PT as one in three women who’ve had surgery need it again because they haven’t fixed the behaviors that caused or contributed to the problem.
For some women, Kegels are great. Their pelvic muscles are weak, and Kegels can help strengthen them. But these aren’t for everyone, and alone, they may not be enough. Here are other things you can do to manage your risk of pelvic organ prolapse:
A pelvic PT like Brianna or Meagan can help you learn toileting posture, breathing strategies, lifting strategies, etc. You don’t have to give up your job or your exercise routine, but you should learn how to do things properly to minimize risk. Not willing to do any of this? Well, Meagan says, you can always become a mermaid or move to the moon!
Having children as or any of the other risk factors as doesn’t guarantee prolapse is in your future. Equally important to know: never having children as nor any of the other risk factors as doesn’t mean you’re guaranteed to stay free from prolapse.
Best thing you can do to minimize your risk? Go see a pelvic PT. Get an assessment. Learn strategies that allow you to do the things you want to do without negatively impacting your health. Share the knowledge with friends, colleagues, other women in your Mommy and Me group, your menopause Facebook group, etc. There’s a lot you can do beyond (or instead of) Kegels, so get educated, and get going!
Have you dealt with incontinence or prolapse? We’d love to hear how you’re managing it. You can leave a comment below, shoot us an email at info@gennev.com, or talk to us on Facebook or in our closed Facebook group.
Eight percent. Eight. That’s how many of us actually accomplish our New Year’s resolutions, according to Forbes. You have a far greater probability of being speared by a narwhal.*
But it doesn’t have to be that way.
Team Gennev did a little searching to find some of the unique ways others make resolutions “stick””so next year we can look back on a 2017 full of accomplishments and “to do’s” that became “ta da’s!”
Here’s what we found:
Make your goal into a puzzle that your brain will inherently want to solveasby turning it into a question. Wilding gives us three prompts she says will help us fire up our creativity and curiosity.
My goal for 2017 is to finally train and run a marathon that will qualify me for Boston. So, using her prompts, I created my questolutions and answers:
How might I”¦.
“¦stick to a training schedule? (I can hire a coach or join a group that’s focused on Boston.)
What if I”¦.
“¦improved my eating habits? (I can work with Health Coach Michelle to improve nutrition.)
What do I need/want”¦.
“¦to help me stay engaged in the training for 6-8 long months? (I can find a training partner or group.)
I think I have my answer: don’t go it alone! I’ll let you know as the year progresses if my resolution “sticks.” So”¦ anyone want to go for a run?
We can only imagine that a place called “Gymsource” is very familiar with the cycle of resolution-to-resignation that many of us fall into. Rewards can be powerful motivators, but as Gymsource warns, find a reward that aligns with your goal rather than working against it. In my case, a really flash pair of running tights from INKnBURN is probably a better reward than a box of donuts.
Key takeaway: “The more you’ll gain by reaching your goals, the less likely you’ll be to turn away from them.”
When we try to do way too many things at once, we get overwhelmed and ultimately give up. Robert Farrington suggests setting goals by priority. This can help you be more realistic about what you can accomplish in a single year.
While Farrington’s prioritization is for financial goals”emergency fund first, then credit card debt, then student loan, then down payment”this step-by-step approach can make any big thing seem much more manageable.
So break down your Big, Scary Resolution into bite-sized chunks, by priority. For me, my first step is draft up a weekly schedule that makes room for training so I won’t beg off with my worn-out “no time!” excuse.
A year can seem like a gloriously long time, amirite? “It’s only January, I have tons of time to get going on that resolution.” But then it’s suddenly March, and I’ve yet to take those first steps, and then I’ve wasted two whole months, I’m already so far behind my goals, so never mind, maybe next year.
Having check points, Anna Johannson says, “keeps you on pace.” You don’t need 50 new contacts by the end of the year, you need four a month. Four is easier to meet, and if you only get three, stepping it up next month to five still seems doable. Course correction is a whole lot simpler when you’re only slightly off track.
For me, the check points are built in to most training schedules, so I just have to make sure I’m getting quality miles and speed workouts (UGH) done according to plan.
BONUS HINT: You can make those check points even more motivating by adding a financial penalty for failure. Make a pledge to give money to a politician you dislike every time you miss the mark, then see how quickly your commitment increases!
Change is hard. Creating new habits is hard. But with the right mind-set, you (and I!) can belong to The Illustrious Unicorns of the Eight Percent.
We’d love to hear your resolutions and your progress towards a happier, healthier life. One of our big goals at Gennev is to provide a support network for women seeking to live their best lives, and we hope you’ll join us by engaging with us and your fellow Gennev-ers. You can find us on Facebook, Twitter, Instagram, and Medium!
*We totally made this stat up. But narwhals do have big spiky things on their heads, so it’s not completely impossible, that’s all we’re saying.
Women are starting businesses at an astonishing rate. There are 11.3 million women-owned businesses in the US, and nearly a thousand new ones open every day. And yet, women have difficulty finding investment as a female entrepreneur has, on average, only 50% of the startup capital that her male counterpart enjoys.
As a woman-owned, woman-led startup, team Gennev is calling shenanigans on that.
Dream, Girl is a documentary exploring the challenges many female entrepreneurs have faced “¦ and how they’ve triumphed. Created by blogger and film-maker Erin Bagwell and an all-women team, funded mostly through grit and Kickstarter, the film is itself a triumph over obstacles.
We’re planning an amazing evening with you at the center. In addition to this inspiring film, we’re hosting a panel discussion and Q&A with some of Washington’s most innovative and accomplished entrepreneurs, educators, and businesswomen. Come ask your burning questions of execs from local orgs like MOD Pizza, TomboyX, JUJA Active, Seattle Girls School, and Inflatable Film. We’ll also have a few surprises to make this a truly special, memorable event!
Order of events:
6 PM Doors open.
7 as 8:30 PM Screening of Dream, Girl
8:30 as 9:15 PM Panel discussion, Q&A hosted by Gennev CEO, Jill Angelo
There’s no end to what we can accomplish when women and their allies work together and support each other.
Check out our powerhouse panel, with more to come!
Leah Warshawski is a producer/director who works for film, television, branded entertainment and corporations around the world. Her motto is “Live Hard. Work Hard. Give Back,” and when she’s not traveling you can find her day-dreaming about whales and warm beaches.
Erin Simmons is a Seattle transplant via Philadelphia with a passion for Google Analytics, Excel Shortcuts, addictive Spotify playlists, and her dog Eddie. She cut her teeth in the agency world before moving in-house as the Director of Marketing for TomboyX. Erin is an experienced marketer that leverages analytics to develop data-driven stories. She then uses these stories to create measurable digital strategy that works.
Betsy Webb is Head of Marketing and Digital, JUJA Active. She has been an entrepreneur, a marketer, and a strategist during a career that has included 5 years at Sprint and 18 at Microsoft, where she was the business leader for the Office 365 launch and for all the corporation’s advertising/media. Now at JUJA Active, a retail startup, Betsy is building a digital marketing engine from the ground up.
Ally Svenson and her husband, Scott, co-founded MOD Pizza, opening the first MOD in Seattle in 2008. They are currently pursuing an aggressive national and international expansion of the brand, excited by the notion of “Spreading MODness” into new communities. Ally is a Seattle native, graduate of Bellevue High School and honor graduate of Wellesley College. Above all, Ally’s greatest and most sacred role is that of mother to her four amazing boys and as wife to Scott!
Brenda Leaks is Head of School at Seattle Girls’ School. She is passionate about helping middle school students find their voices and live into themselves each day.
Many thanks to our sponsors!
“All of a sudden, all these medical professionals are like, “Have fun with your baby, see ya!’ And the hospital door shuts behind you, and you have no idea what to do.”
This may sound familiar to a lot of first-time parents. The risks are so high, yet many new moms and dads feel like they’re missing vital information that would make adjusting to parenthood easier.
Chris and Josh Gourley had their little girl Michaela 15 months ago. Says Chris, “Having a child”especially a first child”is opening the door to a whole new world where this tiny person hands you grubby things to eat”¦.and you eat them because you want your kid to know it’s good to share. Who knew that was going to happen?!”
“Being a parent is a huge adjustment, especially for women: If you’re a dad, your whole life just changed. If you’re a mom, yep, your life changed, but so did your body, so did your hormones. That has a huge impact. But we don’t talk about it. We talk about pregnancy and the time up to the childbirth, and we talk about going through the birth of the child, but we don’t talk about what comes after. No one prepares you for what’s coming.”
So we asked Chris what she learned that might help others in the transition to parenthood:
Many thanks to Chris for sharing her experience and learnings from her Adventures in Motherhood. What did you have to learn when you became a parent for the first (or second or third) time? Share your expertise with us in the comments below or on our Facebook page.