Casey, age 53, woke up chilled. At 4 am this morning.
Had she actually slept through a hot flash? Miracle of miracles, she could only hope.
Still groggy, she managed to register some gratitude and relief that it wasn’t 1 am, which it had been for the last several weeks. She sighed, turned to her other side, and touched her cheek down to a fresher spot on her pillow. Another sigh.
She counted 6.5 hours of glorious, uninterrupted, deep sleep. “At last,” she thought, “Maybe I’m getting the hang of”¦ wait. What was that?” A warm liquid flood released with her new sleep position. She tentatively touched the mattress behind her back, and the backside of her underwear and sure enough. Evidence”¦ bold, red, and wet was there. “Noooo”¦ no, no, no”¦ I thought I was done with periods.”
It had been 6 months since her last cycle”¦ and there was no mistake that she was having one now.
Not sure where you are in the menopause transition? Take our Menopause Assessment.
If you haven’t experienced skipped (or extra) periods in perimenopause, allow us to assure you, it can be a normal (and annoying) part of the process.
As hormone levels change, menstrual cycles may go from reliable and familiar to whose-period-is-this? Changes may include:
In order to illustrate, let’s do a comparison of what goes on during a regular period and a perimenopausal irregular period.
An egg matures in the ovaries during a period with the help of an increased level of FSH (follicle-stimulating hormone). It’s the follicles that produce estrogen, and the estrogen, in turn, causes the lining of the uterus (the endometrium) to thicken, to prepare to receive a fertilized egg.
Ovulation, the release of the mature egg, creates progesterone. Most eggs aren’t fertilized. What happens next is, the progesterone goes away and the endometrium is sloughed off. This is what we know as a period.
During perimenopause periods, there aren’t as many follicles to stimulate, so the body really increases the FSH, resulting in more estrogen being created. More estrogen means the uterine lining becomes even thicker as causing heavier bleeding and perimenopause periods lasting longer. This whole process can take longer, too, resulting in longer gaps between periods.
Yes, indeed it can happen more often than not. In some cycles, the endometrium continues to thicken until it has to be shed as resulting in a very heavy flow.
During a cycle that has a heavier flow than you’re familiar with, it can feel surprising, baffling, even a little scary to see more blood and clots than you are used to.
Bear in mind, you may experience feelings of disappointment, exasperation, weariness, all in addition to increased or intensified cycle symptoms. Be easy on yourself and ramp your self-care if you can. Your body and mind are going through a significant transformation.
This being said, a regular period can release between 2 tablespoons over the course of 4-6 days, or more, for more days or fewer. We’ve also seen reports of regular or normal period bleeding as being 2-3 tablespoons over 3-5 days.
Abnormal bleeding, specifically may look like very heavy bleeding or bleeding that:
In order to really dial into your own health and body, consider a check-in with one of our Telemedicine doctors. This is for assurance, guidance, support, and it will keep your files noted with new data and insights.
No, not hyper-vigilance. Just simple awareness. Here are a few ways to be and stay prepared for an unexpected period:
When was your last period? How many months have you gone without a cycle?
Menstrual cup, tampons, or pads, have something on-hand until you’re sure you’ve gone 12 months without a period. Desk, car, bag, duffel, wherever. And it doesn’t have to be a lot of supplies, just the right one for you to get you through a few hours.
If you’re experiencing multiple perimenopause symptoms, it’ll make more sense and may feel more normal to have irregular periods at this time. Journal about them, keep a record on Post-it notes at your bedside, record them in a notes-application on your mobile device. They may prove useful and paint a bigger picture when you”¦
Let your doctor or professional know what’s going on with you and your body. Support, education, and care will really help you navigate through perimenopause to menopause by making informed choices about your options.
We have no idea when or which one our last period is. There’s no indicator that we’re on the final countdown, tallying 12 full months of no menstrual cycle to achieve and unlock the menopause level.
Best you can do is to be aware, consult your doctor (or speak with one of ours), practice some extra self-care, and know that this could be the last or at least one of the last, periods you’ll go through. You’ll be closer, if not finished. Regardless, transformation is, indeed, happening.
What have you experienced around irregular periods in perimenopause? And”¦ what are your questions about period reoccurrence during perimenopause? Check-in and chat in our Gennev Community Forums.
Endometriosis affects up to 10 percent of women—possibly more. For some, endometriosis can be a real nightmare, with crippling cramps during periods, heavy period flows, infertility, chronic bloating problems or gastrointestinal discomfort, and women begin to dream of sex without pain.
Other women may notice no symptoms at all.
For women who do experience symptoms, there are ways to manage the disease, once it’s been diagnosed—though it takes on average of about 7 years to get that diagnosis.
There are also some misunderstandings around endometriosis, including that hysterectomy, pregnancy, or menopause will end the pain. That’s not always the case, and we want women to have the information they need to make good choices for their health and futures.
Endometriosis is when endometrial tissue (similar to what grows in the uterus and is shed during a period) grows where it shouldn’t—inside the abdominal cavity and on the outside of organs such as the uterus, bladder, bowel, and ovaries, among others.
Building up over the month, this tissue responds to the body’s signals to shed during the monthly period—but there’s nowhere for it to go. Trapped, it begins to form adhesions which can bind organs together and pull them out of their normal shapes and places. It’s little wonder that women with “endo” describe the pain of their monthly cramps as debilitating.
Endometriosis can be a bit tricky to diagnose. If cysts have formed, your doc may be able to feel them during a pelvic exam. An abdominal or vaginal ultrasound may be able to detect cysts. Docs might suggest an MRI to identify endometrial growths. Laparoscopy, where a small cut is made in the abdomen so a thin viewing tube can be inserted for the doctor to have a look at internal organs, is considered by many to be the “gold standard” diagnostic tool. With planning, laparoscopy can also be used to surgically treat the disease at the same time.
Periods may be more frequent and heavier during the years leading up to full menopause, meaning women with endometriosis may find symptoms occur more often and are worse during this time. Many women find relief with hormonal birth control pills or an IUD like the Mirena.
For cases that aren’t controlled by birth control, laparoscopic surgery to remove the lesions and excess tissue can help, though there’s a chance the surgery may need to be repeated if new lesions form.
Severe cases may be treated with hysterectomy. However, the long-term health ramifications of early menopause usually mean this is reserved for cases that have no other resolution.
According to Gennev Medical Director and OBGYN Dr. Rebecca Dunsmoor-Su, endometriosis is estrogen-dependent, so when estrogen is gone, so is the disease. However, this does not mean every woman suddenly finds herself pain-free at menopause. Chronic pelvic pain may continue, and we’ll tackle that very important condition in a future blog.
Whether symptoms abate or not, after menopause, conversations about endometriosis may need to include some additional concerns:
Osteoporosis: According to Harvard Women’s Health Watch, women who have been controlling endo symptoms by taking medications that reduce estrogen (GNrH meds such as Lupron, Synarel, or Zoladex) may be at higher risk of osteoporosis (weakened bones). The publication recommends women ask about osteoporosis medications like bisphosphonate drugs and “be diligent about bone density testing, bone-healthy habits, and follow-up with their clinicians.”
Auto-immune disorders: Endometriosis is not considered an autoimmune disease, but it does appear that women who have endo are at higher risk of such diseases, including lupus, Sjogren’s syndrome, MS, arthritis, IBS, and coeliac disease, as well as allergies and asthma. Women should be vigilant about their health, and if they start to develop new symptoms should consult with a doctor right away.
Cancer: Though some sources might claim a higher cancer risk for women with endometriosis, this hasn’t really proven true, according to the MD Anderson Cancer Center. Harvard Women’s Health Watch says women with endometriosis may face a slightly higher risk of ovarian cancer (though still low), and because the symptoms can mimic those of endo, women should pay attention if symptoms worsen or return. Vigilance beyond normal tests and screenings probably isn’t necessary unless you have other risk factors.
Answer: it might. Says Dr. Rebecca, “HRT may or may not bring symptoms back, as it is lower dose than menstrual hormones. Many women do just fine if they wait a year or so to start.” Hormones that are applied topically may also have less chance of reviving endometriosis.
Every woman needs to have a thorough conversation with a doctor about the pros and cons of taking HRT for menopause symptoms, especially if they have a condition like endometriosis.
Not all pelvic pain is endometriosis, and not every woman with endo experiences symptoms. If you’re having pain during your period, and you’re not sure if it’s just really bad period cramps or something else, talk with a doctor. You are not “overreacting,” you don’t need to just “suck it up.” Pain is your body’s way of communicating a problem, so get help.
Need an doctor’s evaluation of your health? 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.
Have you been diagnosed with endometriosis? We’d love to know how you’re doing, so please share your experience with the Gennev community by commenting below, posting in our community forums, sharing with us on our Facebook page, or joining Midlife & Menopause Solutions, our closed Facebook group.
April is Financial Literacy Month as because who doesn’t get a jolt of reality every year when Tax Day rolls by (or over) us?
Women learning to manage money is especially important as they tend to outlive male partners and spend more years in retirement. And women generally have less to retire on (called “superannuation”), because of the pay gap between men and women, because more women than men take time out of their careers to care for children or aging parents, and because more women will take lower-paying jobs or work for employers who don’t offer retirement plans.
Money management may seem a little off-topic for a menopause site, but your financial health has direct impacts on your quality of life. We’re all about whole-woman wellness at Gennev, and you can’t be at your fabulous best if you’re stressed about your economic wellbeing.
So what can you do to prepare for your financial future? First, take a deep breath. Hold it. Little longer. Little longer”¦. There. Let it out. You can do this.
According to a 2016 Fidelity study, only 37% of women are confident in planning for retirement. But likely close to 100% of us want to be financially secure in our golden years, so let’s review four steps to get us started.
Tackling your finances can be a daunting task as and, quite frankly, a potentially dull one. But with more of us living longer, it’s never been more important to secure our financial futures. Here’s to your long, healthy, happy life!
Team Gennev is lucky. We get to hear from you.
You call us to place an order. You email us your thoughts on our products. Sometimes we have the very real pleasure of talking to you in person.
You share your problems and your pain, what gives you joy and your reasons for hope. You ask us questions, and you give us answers. And every time we talk with you, we learn something new.
Sometimes you share your story with the rest of the Gennev community, like when Michelle went through menopause and almost missed it, or when Anne rediscovered herself after her hysterectomy. But you have so much more to share.
So we’ve created a Facebook group, Midlife and Menopause Solutions, as a place for you to meet each other, talk, share ideas, ask for and receive the support you need.
Because we want women to feel comfortable discussing intimate topics, it is closed group, meaning only those who are approved to join can post or see others’ posts.
There are some community guidelines we ask everyone to follow so conversations stay relevant, thoughtful, and polite. You’ll find those under “description” to the right of the page.
Come in, kick off your shoes, and curl up on the couch with us. We can’t wait to hear what you have to say!
Boredom Baker here! What if I told you that today you can, nay, should eat dessert? Today is the greatest day of the year: It’s National Dessert Day! It would be almost criminal if we didn’t celebrate, right?
Now, I know what you’re thinking. Eating copious amounts of sugary deliciousness is just not good for my hormonal health! And that might be true, which is why I went ahead and adapted my all-time favorite dessert, chocolate mousse, and made it just a tad healthier. In fact, this recipe is a great source of calcium for bone density, tryptophan for a mood lift, and manganese to help fight off osteoporosis.
Bon appetit!
Ingredients:
Directions:
Serves: 4
Calories: 150
Carbs: 12g Protein: 6.7g Fat: 8g Fiber: 0.5g Sugar: 5.6g
Manganese: 50%, Calcium: 11%, Copper: 3%
When we talk to women about what would have the greatest beneficial impact on their quality of life, there’s one answer that seems to stretch across the entire menopause experience:
Sleep.
It affects everything about our lives “ our mood, our energy levels, our productivity, our confidence, our weight, our physical and mental health in menopause “ for good or ill.
Not enough quality sleep can lead to serious medical conditions like high blood pressure, heart disease, and diabetes. Our immunity can be challenged when our sleep tanks, and that’s especially bad right now.
The occasional sleepless night is uncomfortable but not particularly harmful (unless you doze off while driving “ please don’t do that), but many women we talk to feel like they haven’t had a decent sleep in years. And that takes a real toll on body, mind, and joy.
There are lots of reasons women sleep poorly in this time: hot flashes/night sweats, anxiety, restless leg syndrome, urinary issues, pain”¦. Women in perimenopause and post-menopause have difficulty falling asleep and staying asleep, and they wake up more tired than they were the night before.
Unfortunately, sleep disruption doesn’t usually disappear along with other menopause symptoms. Poor sleep can also be a result of simply getting older. But good news: we can help.
For many women, a truly effective solution is cannabidiol or CBD. One of many components of the hemp plant, CBD is being studied for a wide range of health benefits, including managing some seizure disorders in children, but also potentially heart disease, some cancers, even dementia.
And while the scientific community is still researching CBD to determine its efficacy, so many women asked us to create a safe, smart supplement, that we jumped into the research with both feet.
Here’s what we learned:
For many, CBD can help reduce pain, depression, and anxiety and promote relaxation.
How? Well, our bodies already produce endocannabinoids, nuerotransmitters that bind to cannabinoid receptors present in our nervous systems. It’s possible that CBD reduces pain by interacting in that process and reducing inflammation.
And here’s a hint: add a magnesium glycinate capsule to your pre-bed routine for even more natural pain-relief, sleep-promoting assistance.
When it comes to anxiety and depression, CBD may be acting on the brain’s serotonin receptors, imitating the “feel-good” properties of the neurotransmitter. By alleviating pain and worry and promoting relaxation, CBD may be making it a whole lot easier to fall asleep.
Our bodies naturally produce the hormone melatonin in the evenings as sunlight diminishes. It helps our bodies and minds relax and prepare for sleep.
However, melatonin production declines with age, making good sleep harder to come by. Adding back some of the lost melatonin may help you fall asleep sooner, stay asleep longer, and get better quality sleep, says the Mayo Clinic
Melatonin may be of particular help if you travel a lot and have to deal with jet lag and time zones, or if your work shift hours dictate sleeping in the day and working through the night.
According to Gennev Naturopathic Physician Dr. Wendy Ellis, 1 mg is typically the amount that provides restorative sleep without the next-day “hangover.”
“You want to mimic normal physiologic doses (the amount the body makes on its own) as much as you can, and most studies say that is 0.3 to 0.8 mg per day. Three milligrams or 5mg is typically too much,” she says.
If you’re concerned about taking CBD, the following information might help.
Cannabidiol (CBD) as which comes from the hemp plant, not from the marijuana plant “ does not have psychoactive properties and is legal in all 50 states in the US. It is considered generally safe. In fact, the World Health Organization says, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential”¦. To date, there is no evidence of public health related problems associated with the use of pure CBD.”
Side effects can include nausea, fatigue, and irritability, says Harvard Health; if you’ve been warned away from grapefruit because of its blood thinning effect, you should avoid CBD products as well.
The greatest concern around CBD for most medical professionals is that it’s unregulated, so it can be difficult to know exactly what you’re getting. Be sure you’re getting CBD from a reliable source.
And of course, we always recommend letting your doctor know you’re adding something new “ just in case there are any concerns the CBD and/or melatonin may interact with medicines you’re taking or health concerns you have.
Remember the Freshmen 10? Now meet the dreaded Menopause 15 as the typical 12-15 pounds many women gain when they hit midlife and menopause.
We’ve heard a lot about “intermittent fasting” as a regimen of eating and fasting within time limits as and because menopause weight gain is a thing, we wanted to know if intermittent fasting is (a) good for us, and (b) effective. Here’s what we learned about intermittent fasting and menopause”¦
Weight gain in women over 40 is extremely common, though the exact cause and effect is still under debate. Lower estrogen levels may mean a lower metabolic rate, which can result in weight gain even when our diet hasn’t changed. We may be less able to utilize starches and sugars due to increased insulin resistance. Or it’s those two enzymes that store and synthesize fat, which are more active in postmenopausal women contributing to menopause weight gain. Or it’s the loss of muscle mass causing us to burn fewer calories, even at rest. Frustratingly, many women deal with an increase in ghrelin, the hunger hormone, and/or a decrease in leptin, the hormone that alerts us when we’re sated.
So one of the first things to realize it that weight gain in this time of life (or any time, for that matter) is not “failure” or lack of will power. Hormones exercise a much greater power over our emotions and actions than we give them credit for, and fluctuations in estrogen, followed by a decline in estrogen levels can make weight management a whole lot harder. Beating yourself up over it not only isn’t accurate, it also doesn’t burn calories, so please don’t.
Where women gain the weight also shifts, from hips and thighs to belly and waist, making the gain more noticeable when your jeans no longer button comfortably. The menopausal weight gain around the stomach and belly doesn’t just strain your jeans, though. Weight gain can impact your health: extra belly fat is tied to a higher risk of heart disease, type 2 diabetes, cholesterol, high blood pressure as even certain cancers.
Sudden perimenopause weight gain can catch women off guard, and be hard to combat once it’s there. There are many purported menopause weight gain remedies and supplements, but be leery of the plethora of snake oil pushed upon the menopause crowd touted as a miracle cure.
Depending on the regimen you follow, intermittent fasting (IF) can be a pattern of eating normally most days of the week, and severely restricting calories or not eating at all on the other days. It can mean eating only in a window of a few hours a day (say, fasting for 16 hours, getting all your meals in in 8), or fasting every other day.
The idea is that fasting mildly stresses the body’s cells, making them stronger and better able to defend against damage. Advocates say IF can extend life, prevent disease, and regulate weight. There has been some success in studies with rats, and many who practice IF say it’s helped them feel more energized and boosted their metabolism.
There are some very famous (and very fit) proponents of intermittent fasting, including The Wolverine‘s Hugh Jackman. However, the jury is still very much out on the effectiveness of intermittent fasting for the public at large, and more studies with humans need to be conducted to thoroughly understand the benefits and risks.
If you want to try IF, do your research first. Registered dietitian and food peace activist Julie Duffy Dillon says, as with all radical changes to diet, it’s best to proceed with caution and check with your doctor first.
“Intermittent fasting has not been shown to keep weight off long term (2+ years). There is absolutely no data on its capability to keep weight off. Plus, most of the research was done on mice and done for a very short time, just six weeks,” says Julie. “For most people, it’s just not sustainable long term or when they’re under stress.”
But even more, Julie is concerned about intermittent fasting triggering unhealthy, disordered eating. “Women with a history of disordered eating or sensitivity to estrogen changes would be setting themselves up for a massive binge/restrict/binge cycle or other disordered eating patterns mimicking anorexia nervosa or bulimia nervosa. I’d expect binge eating behaviors even for those not connected to eating disorders in their past following a restricting day.”
[see Julie’s thoughts on the links between Eating disorders, midlife, and menopause]
There are lots of ways to get to a healthy body, and for some, intermittent fasting may work. Just be sure to watch for warning signs of disordered eating and get help at the first signs that your diet has taken an unhealthy turn. Exercise for menopause weight gain is a less radical option, or can be used in conjunction with intermittent fasting (very carefully).
If you want to get healthy in a sustainable way, one really smart path is to work with a health coach who understands nutrition. Working with a good health coach can help you avoid the dangers of falling into disordered or just unhealthy eating patterns. Food isn’t evil, it isn’t the enemy in a battle with your will power “ it’s a tool to fuel your body and lifestyle.
A health coach can help you identify the foods you need for the right balance of nutrients and how to introduce more movement into your day. At Gennev, our clinic for menopause has health coaches “ who are also Registered Dietitian Nutritionists “ focus on health rather than weight loss, but losing some sizes and gaining some muscle generally come with a healthier eating plan!
Finally, Gennev health coaches receive special training in menopause issues and menopause care, so they can help you not only understand what your body is doing, they can help get menopause symptom relief and improve the quality of your life overall.
*This article is for educational purposes and is not intended to replace the advice of a health care professional. If you think you may be experiencing disordered eating, please seek help immediately.
Sleep is elusive enough for many women in menopause. You’re exhausted, desperate to get just a few hours of uninterrupted REM, you start to drift off at last, when suddenly your leg starts “¦ tingling. Then pins-and-needles, then throbbing, then an overwhelming urge to move your leg, which brings relief, for maybe a minute, until the whole thing starts again.
According to the National Institutes of Health, Restless Leg Syndrome (RLS) affects up to 10 percent of adults in the US, and it’s more common in women than men. It’s also more common in older people, meaning a lot of sufferers are women in menopause.
While RLS may not be directly caused by menopause, it’s certainly a common complaint among women in midlife and menopause, so we’re making it our Symptom of the Month.
If you are having a hard time dealing with restless leg syndrome, 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.
RLS sufferers generally report unpleasant sensations in the leg as tingling, symptoms of too much electricity in the body, itching, crawling, throbbing as plus an irresistible urge to move. It may affect both legs or just one. It may move from one leg to the other, and for up to 80 percent of RLS sufferers, it’s accompanied by the jerking or twitching of legs and arms known as PLMS: periodic limb movement of sleep.
RLS is classified as a “sleep disorder” because symptoms generally start in the evening and worsen through the night. Obviously, restless leg syndrome can have a huge impact on quality and quantity of sleep.
Moving generally relieves the symptoms temporarily, meaning someone with RLS may feel compelled to shift positions constantly or even get up and walk around. Many find that symptoms disappear for a time in the very early morning, allowing for at least a little sleep as that is, if you don’t have other issues keeping you awake.
Like so many neurological disorders, the exact cause isn’t well understood. It can be genetic, though in most cases the symptoms show up before age 40 when there’s a genetic component.
It’s possible that RLS is caused by the part of the brain that controls movement as the basal ganglia. If that area isn’t able to utilize the brain chemical dopamine properly, the disruption could cause the sensations and involuntary movements of RLS.
Other factors that may contribute to the development of RLS include iron deficiency, renal disease, medications such as anti-nausea, antipsychotic, antidepressants (which are frequently prescribed for women in menopause), even some cold and allergy meds. Pregnancy, especially toward the end, can trigger RLS, though it generally disappears a month or so after delivery. Nerve damage has shown to be related in some cases, and three of the usual suspects for menopause symptoms: smoking, caffeine, and booze.
How could perimenopause or menopause be a factor? Many women in perimenopause who suffer heavy bleeding may have an iron deficiency, so that could contribute. Also, it’s thought estrogen helps muscles relax, so as estrogen declines, we lose that natural relaxant.
Now that you know what it is, how can you treat your restless leg syndrome? First things to look at may be the list of “other factors” above as are you taking any of the medications, are you nearing the end of a pregnancy, are you getting enough iron? When those conditions change, you may find your RLS goes away.
Diabetes is also a related condition that can worsen RLS, so if you have other risk factors for diabetes, you might want to be tested. If you’ve been diagnosed, check with your doctor to be sure it’s being managed correctly.
If none of those are causing your RLS, there are things you can do. As ever, we suggest lifestyle modifications first:
Medications are available that can help, if you do all the above and find you’re still suffering. Requip, Neupro, and Mirapex (dopamine agonists) as possible options. Other medications known as “dopaminergic” drugs (Sinemet) affect the levels of dopamine in your brain. However, there are concerns about the phenomenon known as “augmentation“ as the worsening of RLS symptoms after long-term use of some dopaminergics. Be sure to ask your doctor about the risks versus the benefits.
Other medications that may work are sedatives to help you stay asleep, symptoms or no. Anticonvulsants such as gabapentin have been shown to provide some relief, as have opioids. menopause prescription drugs are very addictive. Medications with opioids may only be prescribed for a short time and for those with extreme symptoms.
There is no “cure” for RLS, and symptoms may worsen with age. However, a combination of good lifestyle choices plus medications if necessary may lessen the symptoms enough to allow you to sleep.
If you are dealing with restless leg syndrome, how are you managing your condition? Please share your experience and wisdom with the Gennev community as leave a comment in the comments section below, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group
Let’s talk brains: We know perimenopause and menopause can impact our brains.
Women report feeling mentally “foggy,” having trouble concentrating, struggling to find the right word or remember if they scheduled that dentist appointment and even get mild-tension menopause headaches. Like the zombies we sometimes feel we’ve become, we just want a fresh brain.
It usually starts in perimenopause, as estrogen levels begin sloping downward. Foggy brain (and some short-term memory impairment, fatigue, and loss of focus) happens because, as neuroscientist Dr. Lisa Mosconi told us, estrogen is a “master-regulator” of our brains. We have lots of widely distributed estrogen receptors in our brains, and when estrogen levels decline, a critical energy source is gone. To put it simply, perimenopause brains are tired.
Fortunately, menopause brain fog is largely temporary. In menopause, women do lose the neuro-protective effects of estrogen, but as our bodies adjust to decreased levels of hormones, so do our brains.
This question comes up a lot at Gennev as women can’t remember where they left their keys; a friend’s name suddenly pops out of their brains; they can’t retrieve the right word in conversation as and they fear they may be experiencing early-onset dementia.
While brain fog is irritating, it’s generally just that as irritating. Dementia is far more likely to disrupt life and normal activities. Have you stopped doing tasks you normally did (household finances, for example) because you feel unable to do them? That might indicate a more serious issue.
If you’re worried your memory lapses may be more serious, there are many signs of Aazheimer’s and a number you can call to speak with an expert about your concerns.
It’s great that menopause brain fog isn’t forever, but the fact is it usually starts in perimenopause and can hang on even into early menopause, meaning women may not feel as sharp or focused for several years. Given that women in their late 40s and early 50s are often at the height of their careers, who can afford to wait?
Roll up your sleeves, because it’s about to get all science-y up in here. The best “natural” remedy for menopausal brain fog might be “¦ thinking. Learning. Using your brain in new ways helps it “learn to learn” again.
Research scientists Denise Park and Gérard Bischof define neuroplasticity as “the brain’s ability to increase capacity in response to sustained experience.” Because the human brain is “plastic,” it’s flexible enough to reorganize itself and form new neural connections. Our plastic might become a bit less malleable with age, but there’s still plenty of opportunity to learn. And it gets easier.
Neuroplasticity typically comes up when the brain has suffered damage from, say, a stroke or accident. When part of the brain is damaged, the function it controls may be lost or impaired: the person may no longer be able to speak or they might lose the ability to walk. Neuroplasticity allows the brain to reroute the function to other, undamaged areas of the brain.
In fact, our brains are constantly reorganizing, like a computer defragmenting to make more space and increase efficiency. And we can take advantage of that fact, even when our brains aren’t damaged by anything more than age.
Hormonal brain fog is frustrating and annoying, and the impact on a woman’s self-confidence can have downstream effects on families and careers. Women are amazingly adept at dealing with the occasional inconveniences of our own reproductive systems as shall we name the ways we’ve discreetly carried a tampon into the ladies’? as but the stress of feeling foggy plus the stigma attached to talking about menopause in the workplace can take their toll over time.
Further, women are more at risk than men of developing Alzheimer’s disease and dementia: women over 65 stand a 1-in-6 chance of developing Alzheimer’s; for men, the risk is 1 in 11. It’s possible that training our brains early, well before the brain is significantly impaired, allows for a later onset of the disease. Like any muscle, the earlier we start strengthening, the more benefit we’ll see.
While there’s research still to be done to prove it, it does appear that making our brains work harder to learn new things and acquire new skills helps our brains stay plastic and flexible. Repeated demands allow new neural pathways to form. Here are some tips for putting your brain through its paces and supporting brain health in your everyday life.
I have a terrible sense of direction and rely on Waze and similar apps to get me from A to B, even in my own city. This, according to research, is not a good idea. Forcing myself to think through the available choices and decide the best path is a good, challenging mental exercise that can be repeated. Once I’ve mastered the Waze app, on the other hand, there’s really no more learning to do. Take up a musical instrument, if that interests you. Learning a new language is a great idea as the complexities of grammar, the rote memorization of new vocabulary help remind your brain how to retain information and force you to access that new information over and over again.
While the jury is definitely still out on how much you can gain from these games, games designed specifically for improved cognition do appear to “confer some benefit” (scientist speak for “don’t expect to turn into Einstein overnight”). The games should be fun, challenging, and allow you to graduate to harder challenges as you improve. While brain games may not make us smarter or delay onset of dementia, they may make learning new things easier, even as we age.
Do smart stuff with other smart people. You’ll enjoy it more, expand your horizons, and possibly protect your neuroplasticity in the process.
Fish, fish oil, seeds, and nuts all appear to play a role in protecting brain function. Fluid intelligence as our problem-solving smarts as and memory preservation are supported when we have balanced, abundant reserves of Omega fatty acids from our diet.
If you are looking for a convenient way to get your daily fatty acids, try Gennev’s Glow, our omega 3 supplement for women
Vitamin B12 deficiencies might also cause fuzzy thinking, so be sure you’re getting plenty of this nutrient. It can be particularly difficult for vegans to get enough, so consider supplementing if you may be falling short.
Speaking of diet”¦ Calorie restriction (cutting calories by 30%) and intermittent fasting during menopause have been shown to have some protective effects, though both should be done carefully and under the watchful eye of a medical professional.
Exercise increases our levels of BDNF (Brain Derived Neurotropic Factor), the compound that promotes the formation of new neural networks. Just how much exercise is yet to be determined, but combining exercise with Omega 3 and 6 supplements may boost the brain protection ever further.
Mindfulness meditation, positivity, reduced stress, and love, sweet love are all good for our brains (and the rest of our bodies). All reduce internal inflammation which can deteriorate neural pathways. (Find out more about mood swings in menopause here.)
Finally, sleep. Just as your muscles need rest between exertions, so does your gray matter. Chronic lack of sleep causes inflammation that can slow brain recovery and impact”¦ well, pretty much everything: memory, metabolism, attention, function. But everything you don’t need your brain to do should be fine!
Menopausal foggy brain is the result of decreased estrogen, so it stands to reason the best treatment for menopause brain fog is replacing the estrogen.
HRT (hormone replacement therapy) may, in fact, help; hormonal birth control pills in perimenopause can also help by keeping estrogen levels constant. And despite what you’ve likely heard, many if not most women can take HRT safely, provided it’s prescribed correctly and you follow your OB/GYN’s recommendations. HRT is generally not prescribed for cognitive issues alone, but if you’re also experiencing hot flashes and other disruptive symptoms, it may benefit your brain too.
Tons of women in menopause have a hard time with brain fog. If you want to try HRT to reduce brain fog, 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.
For those who can’t or prefer not to take hormonal treatments, the North American Menopause Society did a review of non-hormonal treatments in 2015 and found a low dose of the antidepressant Paxil or the anticonvulsant and pain reliever gabapentin may help relieve the foggy brain feeling of perimenopause and menopause.
The brain’s ability to heal and learn may slow with age, but that doesn’t mean older adults are out of luck when it comes to learning new things. In fact, the very act of engaging in learning probably makes the next effort easier.
So find something that challenges you mentally and that you enjoy and will stick with. Do that challenging thing with friends, while eating nuts and exercising vigorously, and you may find your gorgeous, malleable, plastic brain is fuller, healthier, and happier than ever.
So, you took a menopause test after dealing with various symptoms and you found out you may be indeed going through menopause. What now?
Well, search on the word “menopause” on the Internet, and where once there was mostly silence, crickets chirping, and the distant sound of an eagle’s cry, now there’s “¦ a lot.
Menopause is having its day, and while that is very good and very overdue, it can be hard to wade through the chaos and separate good information on menopause treatments from rumor and hyperbole. We’ll help you cut through the noise and understand the best menopause treatment options available to you.
If you are looking for treatment options, 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.
Menopause is a natural and normal part of a woman’s life, I hear you say. Do we really need treatments for it?
Those lucky few who fly through menopause with nary a hot flash may not need any kind of external support. But many really suffer with menopause vaginal issues, itching, sleepless nights, joint pains, annoying hot flashes, anxiety risks, brain fog, and a host of symptoms that range from disruptive to crippling.
Fortunately, there are treatments and behaviors that can help relieve menopause symptoms, so let’s talk about which menopause treatments work and which don’t, what’s safe and what isn’t.
At Gennev, we’ve found that menopause treatment follows three general tracks: medical intervention (hormone replacement, antidepressants, etc.), lifestyle and behavioral adaptations (diet, exercise, supplements, alternative therapies), or some combination of the two.
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.
For many women, the safest and most effective menopause treatment is hormone replacement for hot flashes or HRT. While the poorly conducted Women’s Health Initiative trial appeared to indicate that HRT was not safe, the truth is that for most women, if taken correctly, HRT is safe and the best treatment for menopause symptoms.
HRT is the most universally effective treatment for hot flashes and vaginal dryness. In addition, it may provide protection against osteoporosis, heart disease, and even Alzheimer’s disease, so the long-term effects need to be brought in to the risk-benefit analysis.
HRT replaces what your body no longer makes enough of: estrogen. Estrogen does not appear to cause breast cancer (if it did, wouldn’t every woman have it?). However, since it appears to stimulate existant estrogen-sensitive breast cancer, it’s not recommended for women who’ve already had this type of cancer.
Birth control pills and hormonal IUDs help many women with symptoms of perimenopause and menopause. Again, birth control pills or a hormonal IUD like Mirena are not good options for women with a history of estrogen-sensitive cancers, but for many women, the steady release of estrogen can really help balance out hormones during the usually tumultuous perimenopause years.
Antidepressants in low doses can help relieve hot flashes and are generally safe for women regardless of breast cancer risk. The antidepressant dosage recommended for hot flashes is lower than the dose typically used to combat depression.
Moderate vaginal dryness, lichen sclerosus (different than MS), and moderate incontinence can be successfully treated in many women with laser treatments like the Mona Lisa Touch. This is a good, non-hormonal treatment, but it hasn’t been approved by the FDA (though it has been “cleared”). Be sure the practitioner is well-trained in its use and capabilities, and be aware that it is often not covered by insurance.
Bio-identical progesterone creams from a compounding pharmacy are tricky. These are unregulated, so we don’t recommend their use. Additionally, they are no more “natural” than the FDA-regulated medications.
Taking OTC medicines for menopause can be a bit concerning because lack of oversight from the FDA can mean some products can’t be safely verified. Taking ibuprofen for cramps or to reduce heavy bleeding, or fiber supplements for women’s constipation is probably just fine; getting non-regulated bio-identical hormones from a compounding pharmacy or from the Internet may not be. If you’re going with hormones, please get a prescription from your GP or OB/GYN.
Over-the-counter medications are by nature less powerful than their by-prescription siblings, so you may not find complete or sustained relief. If you’re really suffering, there’s no reason not to get in touch with a menopause doctor near you and get a prescription.
If you have any concerns about your medication, OTC or other, check with your GP, OB/GYN or one of our menopause-specialist telemed doctors.
First, it’s important to define “natural.” Some define it as “not from Big Pharma.” We understand why women prefer a more natural alternative, but (1) “natural” is not well-defined by any authoritative, regulating body like the FDA, and (2) “natural” does not mean “safe.” Death cap mushrooms are natural, but I wouldn’t want one in my salad.
There are natural remedies that appear to help women, but not enough studies have been done to verify their efficacy. Our approach is, if it doesn’t hurt, and it might be able to help, it’s worth a try. Check out our thoughts on natural remedies in our article “Hot flashes and alternative therapes: What really works?”
Soy (in food, not concentrated supplements, for hot flashes), black cohosh (for hot flashes), Omega 3 (for brain fog and fatigue), vitamin E (for hot flashes), and magnesium glycinate (joint pain, anxiety, and sleep) are all safe and reasonable things to try for menopause symptoms. And any supplement in the Gennev shop has been tested and made to rigorous standards.
Just remember, if you’re adding any concentrated substance to your diet (and this includes supplements, capsules, analgesics, etc.), please check with a doctor who knows your history and what medications you’re on, just to be sure there’s no concern about interactions.
If you’re uncomfortable with hormones or unable to take them, you’re not out of luck. Behavior changes can take you a long way.
Most of these are things you know or can guess; the difficulty is in sticking with them long enough to see real results.
Hydration is so important and will help you more than you can imagine. Your body holds less water now, so dry skin, dry eyes, headaches, fatigue, and brain fog in menopause can all be helped by drinking more. Check out the book Quench by Dana Cohen, MD, if you need more encouragement to hydrate!
Impact exercise like running and walking can help with bones. Building muscles after forty as well as upper body strength can help with retaining muscle and increasing resting metabolism. Core strength can help with balance, meaning fewer falls. And all of these can help lift mood and invite better sleep.
Diet is another area where a few tweaks can make a significant difference. Now is when you need to increase lean protein and boost healthy greens. The Mediterranean diet is particularly beneficial for women with its emphasis on heart-healthy greens and grains and de-emphasis on red meats. Your brain will benefit, your bones will benefit, and as we age into higher risk of diabetes and heart disease, you’ll have a head start on avoiding long-term illness.
Sleep hygiene is a good idea for everyone, but it’s particularly helpful for peri- and post-menopausal women. Setting a bedtime routine, optimizing your bedroom for sleep, banishing screens two hours before bedtime, going to bed and getting up at the same time every day “ you can start to train your body and mind to understand sleep signals so you can get better rest.
Don’t just say “yeah yeah” and wave vaguely at the piles of laundry, the bulging work email inbox, the kids, the dog, etc. Yes, life is busy and stressful. No, it’s not healthy, and you need to acknowledge when you need help and a lightening of the load. Taking time for self-care isn’t indulgent or decadent “ it’s critical to good mental and physical health.
If you’re challenged or confused about any of these, or just need an accountability partner, we strongly suggest you sign up for Gennev’s Health Fix. You’ll get unlimited access to our Health Coaches, all of whom are Registered Dietitian Nutritionists and have had special training in menopause care.
There are menopause treatments that really work. It may take some adding, subtracting, tweaking, and testing, but most women find some combination of medical intervention, alternative treatments, and lifestyle change makes them feel a whole lot better.
To find out what route is truly the safest and most effective for you and the menopause symptoms you’re dealing with, talk with a menopause specialist physician. Team up with a Health Coach for ideas and accountability. What’s happening in your body may be frustrating, but it’s normal, and you’re not alone on this journey.
Chris’s morning had been calm so far. Which felt like a gift since she’d been go-go-GO for months since her mom died suddenly and her dad began to need more frequent care.
This morning her partner offered to take both kids to school and to pick up her dad’s new meds from the drug store on the way home. “That is love,” she mused, a smile stealing into her lips. The luxury of time was with her this morning and Chris relished it as she inhaled the deep, roasty aroma of her second cup and enjoyed a sip of coffee at the thought of a slightly longer shower this morning.
Before she was able to swallow, she felt a …flutter”¦ a light, faint beat in her chest. It didn’t hurt, but it definitely called her attention to her heart. “Was that a flutter in my heart?” She set down the cup, put her hand to the middle of her chest, and focused her attention on her heart area.
There it was again. What is that? It felt like there were a couple of caffeinated butterflies trapped in a grapefruit-sized organ. Fluttering. That was definitely a heart flutter. Definitely irregular. Usually, Chris wouldn’t ever think about her heart or how it beats”¦ it just does it, like it has her whole life. Until this morning, this soft, faint beat caught her attention.
Chris is 44. She doesn’t smoke, takes no prescription medicines, walks two miles almost every day, is in pretty good health overall, recently experienced a significant loss, is entering perimenopause, and just experienced a .
An important thing to share first is how hormone estrogen plays a role in heart health. It’s a biggie.
Estrogen’s fluctuation and decline over time, as a person enters perimenopause and moves on to menopause, affects nearly all of the body’s systems in some way: reproductive systems, yes”¦ but also dry eyes, weaker bones (osteoporosis), lungs, and hearts too.
In the heart, specifically the inner layer of the artery wall, estrogen is believed to help keep blood vessels flexible and able to relax and expand to accommodate blood flow. A fluctuation and decrease in estrogen, therefore, may mean less flexibility and less accommodation. Blood pumps through the heart and carries oxygen and nutrients to systems throughout your body. We all want, need and deserve healthy hearts, and menopause is one stage where more attention is needed on the heart than perhaps it was given in previous years.
Heart palpitations are usually harmless, though they can be surprising or even alarming to experience. As mentioned, occasionally, there can be a more serious, underlying cause. But heart palpitations on their own aren’t usually dangerous.
Heart disease, however, is another subject.
Did you know that heart disease is the leading killer of women? So shares the Center for Disease Control and Prevention:
There are a few different ways a heart palpitation can present:
Heart palpitations can draw awareness to your chest, of course, but you may also notice palpitations further up in your throat or neck.
Usually, heart palpitations are harmless and will go away on their own. And there are some cases where a larger issue is underlying or causing heart palpitations.
This can be an alarming symptom in perimenopause and menopause. It’s understandable to want to prevent them from happening at all. Here, we’ll talk about how to stop hormonal heart palpitations.
Before you assume it’s probably stress, or could be perimenopause, check in with your doctor (or get a phone appointment with one of our doctors). If you’re uncomfortable with heart palpitations, it’s worth getting checked out to make sure there’s nothing underlying this new symptom. Your doctor may suggest you have some tests (such as an electrocardiogram (EKG) or echocardiogram, or suggest getting some blood work done (perhaps to check cholesterol and taking safe supplements and other levels).
Some triggers to be mindful of in your daily life may include:
Your ticker is worthy of excellent care and extremely valuable as an ever-pumping muscle in your body. So, let’s talk about you, personally for a moment.
Menopause coaching and support is here for you, right now. Get your HealthFix.
What do you know about your heart health right now?
Consider jotting down some responses in your phone or on paper, plus any questions that may arise as you think about your responses to the above prompts. Talk with your blood relatives if you don’t know your family history, and bring your notes and any additional questions about your heart and your health to your next doctor’s appointment.
Have you ever experienced a rapid heartbeat, heart palpitation, or a heart flutter? Join the Gennev Community Forums and review others’ experiences and share your own. You’re not alone.
How do you discuss a “taboo” topic like menopause on a public forum like a podcast? With humor, insight, wisdom, and patience!
Meet Colleen Ricci Rosenblum and Bridgett Biagi Garratt, the forces behind the hit podcast for midlife women: Hot Flashes & Cool Topics.
A year and 60-or-so episodes out from their launch, and Colleen and Bridgett have a genuine hit on their hands.
They’ve talked about the things you might imagine, given their title: peri/menopause, being empty nesters and relationships with adult children, etc.
But they’ve taken on some tougher topics as well, including Colleen’s daughter’s history with an eating disorder, difficult pregnancies, divorce, and suicide.
Initially, they reached out to Gennev to feature Gennev CEO Jill Angelo on a podcast; they were so delightful and informed and fun, we asked them to return the favor.
What follows is a great conversation about midlife, menopause, the (glacially slow) changing attitudes towards women’s health, and what it’s like to go in the public eye and share intimate information.
TRANSCRIPT TO FOLLOW
What do you think? Is it easier to talk about menopause with friends, family, maybe even at work? Do you agree it’s important that health topics such as menopause be discussed openly? We’d love to know your thoughts, so please join the conversation in the Gennev Community forums.