Many women in midlife suffer from trouble falling asleep, staying asleep, and low energy during daytime hours. As we age our sleep patterns change. A key contributing factor to quality sleep is our level of melatonin. Melatonin is a hormone made in the pineal gland that helps to regulate our sleep-wake cycles. Melatonin is well-known to promote sleep, maintain sleep, reset the circadian clock and improve sleep quality in general. And as you may have guessed, our melatonin production declines as we get older.
A great place to start in improving sleep quality is practicing good sleep hygiene:
Before turning to a sleep aid, you should consider all the things you may or may not be doing that influence your sleep. Sleep troubles can be attributed to your diet, exercise habits, stress management, alcohol and caffeine intake, medications, underlying medical conditions, hormone fluctuations (hello hot flashes!) room temperature, room darkness, and more.
And when good sleep hygiene is simply not enough, there’s now Gennev Sleep.
We asked Naturopathic Physician, Dr. Wendy Ellis, to formulate a sleep supplement that would support women in menopause. She chose these ingredients for our sleep formula based on her 20 years of clinical experience with various sleep products and single ingredients. She shared, “I love this combination as it helps with falling asleep, but also staying asleep, with the added benefit of reducing anxiety and inflammation.”
Sleep’s proprietary formula provides the following benefits:
Sleep is a proprietary blend of Melatonin, 5HTP, L-theanine, and Magnolia.
“Melatonin as Sleep includes only 1mg of melatonin to help you fall asleep. Peak concentration is within one hour of taking melatonin, but the effects begin as soon as 20 minutes after taking it, and it stays in your system for 4-5 hours. We kept the dosage of melatonin in Sleep to this low dose, as too much melatonin can contribute to nightmares, waking after 3-4 hours, and may leave you feeling groggy in the morning.
5HTP as is an amino acid. It is the precursor for serotonin and melatonin, thus it influences mood and sleep in a positive way. By providing 5HTP to the body before bed, you’re providing more of a foundation for your body to produce serotonin and melatonin.
L-theanine – is a unique amino acid that is naturally found in tea plants. It is one of Dr. Ellis’ favorite amino acids for treatment of menopausal sleep issues because it also has anti-anxiety properties. Amino acids such as 5HTP and L-theanine are a very safe, effective way to treat mood and sleep disturbances. It’s sedating without creating daytime drowsiness, helps slow down the ruminating women often feel at the end of a long day, as well as improving the quality of sleep.
Magnolia – This very safe botanical was added due to the effects it has on our “calming” neurotransmitter, GABA. It helps to create a relaxed mood that allows women to fall asleep more quickly, as well as improve the quality of sleep, without negative side effects.
Take only 1 capsule of sleep per day, approximately 15 min before you want to fall asleep.
Talk with your physician before taking Sleep to avoid interactions with other medications, and especially antidepressants (SSRI/SNRI).
Most sleep issues are behavioral, meaning it’s better to figure out the root cause of insomnia, instead of taking a sleep aid every night. That being said, sometimes you may need to take it for a few nights, weeks or even months in stressful periods, and this is absolutely fine!
Safety:
Dr. Ellis shares, “The formula for Sleep not only helps you fall asleep, but stay asleep, with the added benefit of not feeling “hung over” in the morning. Sleep is a non-addictive formula and has a great safety profile.”
If you continue to have sleep issues, consider seeing a board-certified sleep specialist or a behavioral sleep specialist. They can provide cognitive behavioral therapy, which has been shown to be effective for chronic sleep problems. Always check with your doctor before taking any new supplements or medicines.
When you notice a change in sleep pattern that may be associated with the menopause transition, especially if body temperature instability is part of the problem, consider an appointment with a Gennev doctor to address the role that hormonal shifts can play in your trouble sleeping.
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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.
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Joanna Wasmuth has always juggled a variety of roles and responsibilities, producing impressive results in her career while lovingly taking care of family and friends. Like so many women, Joanna has spent so much time and attention on others that she neglected herself – until now. Joanna has taken her strong work ethic, care, compassion, and business savvy and applied it to a new, and probably the most important job of her life”CEO of her health. “I need to be responsible for my own health,” Joanna says. “Your doctor doesn’t live in your shoes. While they’re wise and have great input, we also have to trust our intuition.” And with all the varying symptoms that accompany menopause, advocating for yourself and seeking the care you deserve is more important than ever.
Today, Joanna’s prioritizing herself, her health, and finding peace and joy. But just a few years ago, she was driven to produce, often putting herself last. Joanna was on a plane several times a week, flying around the world for her job as a strategy consultant, commuting between her home in Miami and office in New York City. She was also making cross-country trips to Seattle to care for her mom and sister, who were both ill. There were early mornings, late nights, and lots of stress. “I was running myself into the ground,” she says.
Everything changed when, at age 44, Joanna had a hysterectomy that included the removal of her ovaries. “I was told that I’d just be put on an estrogen patch, and life would be normal, no big deal,” she recalls. Four day slater, Joanna had three life-threatening pulmonary emboli (blood clots in the lungs) and landed in the ICU. She not only faced months of recovery from that emergency, but she was plunged into surgical menopause with intense symptoms like debilitating joint pain, hot flashes that felt like she was “claustrophobic, suffocating, and burning from the inside out,” sleep problems, weight gain, and memory issues. And because of the pulmonary emboli, hormone replacement therapy was no longer an option.
“I realized that now my body is different, and I couldn’t just keep doing the things I used to do,” says the now-46-year-old. Thanks in part to the pandemic, she’s doing more Zoom meetings and traveling less, which has reduced her stress. “I’ve been given a second chance at life, and having beautiful moments every day is what I’m looking for now.”
As the CEO of her health, Joanna has employed some of her business systems and management skills, starting with a spreadsheet of non-negotiables. “What gets measured gets done,” she explained as she shared her list of 28 “things that I do to be well.” Some are daily practices like drinking 100 ounces of water, walking four miles (she uses the Conqueror virtual challenges to stay motivated and keep it fun), cooking plant-based meals, painting, and meditation using sound bowls (“It’s just a few minutes of peace and resets my energy”). Others are weekly rituals, for instance, meeting with her Gennev health coach to stay on track, sessions in an infrared sauna, sound and light therapy, and strength training (three times a week). And monthly, she gets a massage, has acupuncture, and meets with a Gennev menopause-certified doctor. She marks off each goal in the spreadsheet as she goes, to help her stay on track.
She’s also adjusted her day to have breaks between meetings instead of scheduling them back-to-back. And when she has a stressful presentation or appointment, she rejuvenates by doing something that brings her joy, like walking on the beach or spending time in a favorite place. “As we do hard things, we can do them in a way that supports our wellness and our health,” Joanna says.
Joanna’s return on her investment has surpassed expectations, as her doctors frequently express amazement with how well she’s recovering. She’s a perfect example that no matter how bad the symptoms are, you can find a way to thrive. “This is a season of life where it’s not the end, it’s a new chapter,” Joanna says. “And it can be an exciting one.”
If you connected with Joanna’s story, and need support in taking charge of your own health in menopause, book a virtual visit with a Gennev menopause specialist.
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The information on the Gennev site is never meant to replace the care of aqualified medical professional. Hormonalshifts throughout menopause can prompt a lot of changes in your body, andsimply assuming something is “just menopause” can leave you vulnerable to otherpossible causes. Always consult with your physician or schedule an appointmentwith one of Gennev’stelemedicine doctors before beginning any new treatment or therapy.
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The Mediterranean diet is more of an eating style than a diet. It incorporates a variety of whole, nutrient-rich foods that provide the nourishment important for promoting heart health, reducing inflammation, stabilizing blood sugar, managing weight, and more. There are no strict rules for the Mediterranean diet, as it is based on the traditional foods and eating style that people eat in countries bordering the Mediterranean Sea (including France, Spain, Greece, and Italy). Since many people find themselves unsure of how to get started with the Mediterranean diet, we’ve broken down the basics below. One key to keep in mind is that the less processed and more whole a food is, the more likely it is to fit into the Mediterranean style of eating.
Create a colorful plate. Brightly colored vegetables and fruits provide many of the benefits found in the Mediterranean diet. We also eat with our eyes, so see what you can do to have at least five bright colors as the main part of your meal.
Choose fish more often as your animal protein source. Chicken, turkey, eggs, cheese and yogurt are also excellent sources of lean protein, but most of us don’t consume an optimal amount of omega-3s from our food which is what fish can provide. .
Include plant-based proteins. Lentils and beans are fabulous sources of protein and fiber. Enjoy hummus made from chickpeas or a lentil soup a few times per week.
Prioritize healthy fats. Unsaturated fats from fresh salmon, nuts, and seeds provide nutrients that can support the body’s ability to manage inflammation. In addition, these foods are also a good protein source. Olive oil is a main staple in the Mediterranean diet. Use this to prepare salad dressings, marinades, and to cook with.
Go for whole grain. Whole grains such as quinoa and brown rice provide more nutrients, fiber, and protein compared to simple and refined grains. These can also be prepared easily in a large batch and added to meals throughout the week such as a salad for lunch to bring to work or a way to round out a dinner.
Don’t skimp on flavor. Use fresh herbs, garlic, lemon juice, salt, and pepper for flavor. These simple, fresh, and nutrient-rich ingredients can really pack a pop of flavor and offer anti-inflammatory benefits that often go unrecognized.
Vegetables and Fruits as Aim for half of your plate to be filled with fruits and vegetables
Whole Grainsas ¼ of your plate should consists of whole grains
Lean Proteins (animal or plant) as ¼ of your plate should consist of healthy protein
Animal Protein as strive to eat fish or seafood at least twice per week, and include a protein source with all meals and snacks
Plant protein
Healthy fats as add the following as a condiment to meals as or as part of the preparation
Dairy as if tolerable, aim for 2-3 servings per day
Healthy snack options
You can start eating Mediterranean by swapping in foods that better align with this pattern for foods that don’t with your meals each day, and before you know it, it will become a healthy way of life.
Remember to drink plenty of water throughout the day (aim for half your body weight in ounces). And while red wine is an acceptable part of the Mediterranean diet (only one glass per day), we recommend considering imbibing less frequently.
The Mediterranean diet offers a no-nonsense way to nourish your body as well as protect your health for the long-term. And best of all, once you know the principles of the Mediterranean diet, you can modify your eating in a way that works for you, and focus on the foods you love.
Creating healthy eating habits can seem daunting. But don’t let that stop you. Access the expertise of our integrated care team who are specially trained to help you make lifestyle modifications that support your body in menopause. They will create a personalized wellness plan based upon your needs, as well as be your companion on following through.
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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.
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Many women in menopause find their standard eat-and-exercise routine no longer works for maintaining weight. The reality is, in menopause, you’ve probably lost some muscle mass, and with it the higher metabolism that burns more calories faster. On average, midlife women gain 1.5 pounds (0.7 kg) per year. Managing your weight in menopause is simply more difficult.
Body fat produces estrogen, so a little extra of the former means more of the latter to ease your transition and help protect your bones, brain, and heart. That said, menopause also directs your body to put more of the excess weight on your belly, rather than it landing on your hips, thighs, and buttocks, as it did in your reproductive years. Belly fat is more problematic, because it can contribute to heart disease and metabolic syndrome. So, if you find you’re gaining more than you’re comfortable with, there are things you can do to re-rev metabolism and maintain a healthy weight.
A smart first step we always recommend is talking with a doctor or a Registered Dietitian to find out what is truly a healthy weight for you. Talk about any risk factors you have for exercise and ask if any of your medications may be contributing to weight gain and could be safely swapped out for another without that side effect. Generally, doctors won’t prescribe medications or procedures for moderate weight gain, as better lifestyle choices and acceptance of your post-menopausal body are the healthiest paths (hard as we know those can be!) A weight gain of 10-15 pounds during the menopause transition is typical. And if you are lean going into post-menopause, weight gain may actually be protective.
At this stage of life, your body requires fewer calories to function – so if you eat the same amount that you did in pre-menopause, you’re likely to gain weight. Also, perimenopause can suppress leptin (the satiety hormone), and ramp up ghrelin (the hunger hormone), making you feel hungrier. We’ve rounded up the eight lifestyle changes that have proven effective in supporting weight management for the Gennev community.
Embrace your changing body. The biggest lifestyle tip we suggest is to embrace and accept your changing body. It may be a little softer and rounder in spots, and that’s perfectly normal and OK. It’s important to first focus on health. Looking good is great; feeling good is even better.
Optimize your diet. Obviously, this is a biggie. Now is the time to really pay attention to nutrients first and foremost to support brain, bone, and heart health in the years ahead. Fortunately, good food and beverage choices for those tend also to be good choices for minimizing menopause symptoms, including weight gain. Not so much a “diet” as an eating pattern, the Mediterranean diet is the most healthful for women in menopause. It focuses on lots of veggies, plus fruits, whole grains and lean proteins. This style emphasizes eating things closer to their natural state (minimally processed) for the highest nutrient density and ease/efficiency of absorption.
The DASH diet has similar advantages to your body; in fact, it was devised specifically to help treat or prevent hypertension. In addition to many of the same foods advocated under the Mediterranean diet, DASH also advocates limiting salt. Protein, healthy fats, and fiber are how your body reaches satiation and stays there longer, so be sure you include enough of each.
Food journaling. If you eat the same amount that you did in pre-menopause, you’re likely to gain weight. When we’re stressed or our hormones are doing strange things, it can be difficult to have a real idea of what we’ve consumed during a day. Keeping a journal helps us get a clearer picture of our eating (and snacking) habits. BONUS: Journaling may also be a way to uncover food sensitivities that didn’t exist previously and that cause other issues like gas or inflammation.
Hydration. Believe it or not, what we think is hunger is often dehydration. Remember, you should be drinking half your body weight (in ounces) every day, so before you have a snack or seconds, drink some water and see if you’re still hungry. If you are, eat! Hydration is so good for us, and you may need more of it if you’re dealing with night sweats and hot flashes.
Sleep. There is a very strong association between not getting enough sleep and weight gain. And yes, sleep is a bear to get during perimenopause and menopause, so do the very best you can to practice smart sleep hygiene and maximize your chances of a good night’s sleep.
Exercise. Even if you’ve been a dedicated exerciser, you may find that your usual routine no longer has the effects it once did when it comes to controlling weight. Changing up the balance of cardio vs strength training can help in lots of ways, to help you manage weight, sleep better, manage stress, and put some healthy demands on your bones. It’s important to keep moving in menopause and beyond for both the emotional as well as physical health benefits.
Mindfulness. “Mindfulness” is the art and science of being fully present and in the moment, and when it applies to eating, it can really help you eat better and less. Being mindful when menu planning and grocery shopping adds to the bounty of goodness this practice delivers because you won’t get home to discover some bags of empty calories, salt, sugar, chemicals, and saturated fat mysteriously ended up in your cart. Mindful eating means not doing other things while eating” no TV, no Internet, no phone calls or emails. Instead, be aware of the now:the smell of your food, the colors, the sizzle of heat, the shine of glaze. As you eat, note not just the taste but the mouthfeel and texture. Try to experience the component flavors: is there a hint of thyme? The more aware you are, the slower you’ll eat and the better you’ll recognize when you’re satiated.
Try Green Tea. Green tea has helped many women with menopause symptoms, including weight gain. Possibly the catechins in green tea accelerate metabolism ever-so-slightly or boost the burning of calories. There isn’t sufficient research to say how or even if green tea works its magic, but it might be worth adding a cup to the early half of your day (it’s caffeinated, so maybe drink before noon and stick to no more than one or two cups per day).
If weight gain continues to trouble you, it’s important to speak with your doctor before it becomes a serious health risk. They can advise of medical interventions that may be right for you based upon your individual weight management goals.
Gennev recognizes that the body weight and shape changes which occur with aging and the menopause transition often leave women feeling uncomfortable in their bodies and concerned for their long-term health. Based on current research we know diets work, but with caveats. Most diets leave most women feeling deprived and frustrated to only gain back the weight they lost (and sometimes more). Through our team’s experience working with countless women and accounting for the physiological and metabolic changes that occur during menopause, we have developed the following approach to address these three important components.
Start with YOU – understanding you as the individual, your place in the menopause transition, your current habits, concerns, and goals is our starting point. Our Integrated Care team meets you where you are and supports you along the way to feeling better in your body:
Cater to menopause physiology – the changing hormones during peri and post menopause result in a physiological and metabolic state which is different from pre-menopause. Strategies that work with rather than against these changes offer greater benefit and long-term sustainability. They include:
Activate the Gennev menopause mindset – a proprietary combination of cognitive behavioral therapy, abundance mindset, and motivational interviewing that supports women in embracing what can be rather than wishing for what was.
With this approach some women will lose weight, and some women will find that they are exactly where they are supposed to be. All women will gain the health benefits of implementing habits supportive of metabolic and physical health as this stage of life.
We understand how frustrating it feels to not get the results you want when you have been working so hard. We invite you to try a different approach and learn how Gennev’s Integrated Care Team can support you with your weight loss goals.
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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.
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Perimenopause (the time leading up to menopause) typically begins for women sometime in their 40s. This is when you may begin noticing menopause symptoms including hot flashes, interrupted sleep, lower energy, and mood swings. And as women arrive at menopause (defined as when a woman has gone 12 consecutive months without a period), they may also be affect by a slowing metabolism. Menopause brings with it many bodily changes, but a well-balanced diet and nutrition can help support you on your journey.
Through the menopause transition, hormones (primarily estrogen and progesterone) are fluctuating as they slowly decline. These changes create a new physiological environment for the body which has metabolic effects that influence how the body metabolizes food. Consuming a well-balanced diet is key for optimizing health throughout all stages of life, but during menopause it becomes even more important.
“The changing hormones of the menopause transition create stress on the body, albeit a normal natural stress, it is stress nonetheless. Being intentional about optimizing your nutrition during this time can support your body through managing the stress of the hormone changes. By giving your body this support, a reduction in symptoms can occur in the short-term and overall health can be supported in the long-term.” –Stasi Kasianchuk, Registered Dietitian Nutritionist, Exercise Physiologist, and Certified Specialist in Sports Dietetics
Stasi Kasianchuk, a Registered Dietitian Nutritionist, and Gennev’s Senior Director of Lifestyle Care, shared with us key nutrition recommendations for women in menopause that will support the body through the transition and optimize health outcomes now and into the future. Stasi suggests that first, it’s necessary to examine our relationship with food. “At times in our life when our bodies change in ways that feel outside of our control it can be tempting to see food as the enemy and want to restrict or limit your intake.” Stasi recommends, “During the menopause transition, when your body is already managing the stress of changing hormones, restricting calories can further exacerbate the stress response resulting in undesirable consequences. Establishing a positive relationship with food by focusing on nourishment and support, can be helpful to get the most out of the following recommendations.”
Rather than low carb or no carb, focus on strategic carb. Estrogen influences carbohydrate metabolism, so as estrogen levels change during the menopause transition, so does the way the body uses carbohydrates. The body’s ability to respond to insulin secreted in response to carbohydrates consumed also decreases and can lead to increased blood sugar levels. This does not mean you need to eliminate all carbohydrates, in fact that will have the opposite effect and typically exacerbates undesirable blood sugar spikes. Strategically approaching your carbohydrate intake, with the majority of these coming from fruits, vegetables, and wholegrain sources, can help to meet your carbohydrate needs and support an optimal blood sugar response. Refined or simple carbohydrates can certainly be enjoyed, as this is part of having a positive relationship with food, and also make a great fuel source prior to exercise, especially high intensity training.
Prioritize protein. Most women are not aware that protein needs increase during peri- and post-menopause. Having adequate protein from food is important to provide the body with the building blocks to support muscle mass which naturally declines during this phase of life. Aiming for 20-25g of protein with each meal and especially after resistance training and high intensity interval training (HIIT) can help to mitigate muscle loss. While all foods containing protein are beneficial, protein foods which contain the amino acid leucine are particularly helpful for stimulating muscle growth. These foods include eggs, beans, legumes, chicken, salmon, brown rice, and chia seeds.
Fats are your friend. The hormonal shifts during peri- and post-menopause allow the body to better utilize fatty acids. The key here is to prioritize fats from unsaturated sources, especially those containing omega-3s such as salmon, sardines, walnuts, and flax, hemp, and chia seeds. These support brain and heart health and help the body manage inflammation.
Think in color. Focusing on eating a variety of colorful foods typically results in eating more fruits and vegetables which offer fiber and nutrients to help the body better manage inflammation which can increase with the changes in estrogen and progesterone. The hormonal changes during peri- and post-menopause can also influence the gut microbiome. Women may experience changes in digestion as a result. Supporting the gut with a variety of plant sources of fiber not only supports optimal digestion, but also promotes satiety, helps lower levels of blood cholesterol, and stabilizes blood sugar, all of which are also altered when hormone levels start to shift.
Bone support. While dairy foods can certainly support bone health, they aren’t the only foods that provide bone building nutrients at a time when bone formation is no longer occurring. A combination of foods containing calcium, vitamin K, magnesium, vitamin D, and protein synergistically can support maintaining bone. These foods include dairy products, tofu, nuts, seeds, leafy greens, and plant and animal sources of protein. If you have limited exposure to the sun, you may benefit from supplementing with at least 2000 IU of vitamin D per day (check with your doctor to confirm your needs).
Take note of symptom exacerbators. Perimenopausal symptoms such as hot flashes, night sweats, sleep disturbances, anxiety, and mood swings are some of the symptoms that can be exacerbated by certain foods. These include refined carbohydrates/simple sugars, caffeine, and alcohol. Pay attention to your symptoms when you consume these foods or beverages. If you notice your symptoms getting worse it doesn’t mean you have to eliminate these items, but a modification to your intake may help you to feel better.
Implementing these nutritional strategies along with making time for daily physical activity will not only help relieve symptoms, but will support your overall health throughout the menopause transition and beyond. If you need additional guidance in developing a healthy diet in this stage of life, our menopause specialists can be a great resource for creating a personalized plan that supports your body’s changing nutritional needs, relieves symptoms, and optimizes your health for the long term.
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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.
In part four of our five-part series featuring Dr. Rebecca’s interview with David Stewart on the SuperAge podcast, “HRT, Estrogen and Menopause, New Scientific Findings with Dr. Rebecca Dunsmoor-Su”, she shares the three typical usage patterns of hormone replacement therapy, dispels the risks of HRT as they relate to breast cancer and cardiovascular disease and discusses why the risk of Alzheimer’s disease is so much higher for women.
David: Is there a time limit that one can be on HRT, or is it a lifetime?
Dr.Rebecca: Interestingly enough, we talked over the years about risks of HRT. So, a lot of women believe that HRT is going to cause them breast cancer or give them heart attacks. These are the two risks that we tend to talk about. I like to dispel those risks.
First of all, the breast cancer risk. I like to talk about the two hormones separately. Estrogen replacement does not cause breast cancer and I shout that from the rooftops. We have many studies that tell us that estrogen replacement does not cause breast cancer, it does not increase the incidence. The Women’s Health Initiative, that big study that came out in 2002 that scared everybody away from hormones – they continued their estrogen only arm and then they actually published the results of the 18-year follow up last year, and they showed no increased risk in breast cancer in the women taking estrogen alone.
Now, obviously, we talked about the fact that women who have a uterus also need progesterone. The Women’s Health Initiative showed that there was a slight increased incidence of breast cancer in progesterone users as or progestin users. They used Provera and they stopped to study for that. They also followed it up last year, 18 years later, and they can still see that slight incidence bump, and I’m talking slight, one additional cases of breast cancer in about a thousand-woman years which is how we study it, but they saw no increased risk in breast cancer mortality. So, the good news is this is low grade. But again, that was Provera. It’s not what we tend to use now. Nowadays, we tend to use micronized progesterone, which is a little more body identical as we like to call it. I use those words because that separates it from the marketing of bioidentical which is generally the marketing of compounds which are less safe. I talked about body identical, which are estradiol and micronized progesterone, which are the molecules that the body used to make, but FDA regulated.
When we use micronized progesterone, we don’t tend to see that bump in breast cancer risk. We have one big study out of France that has looked at 40,000 women on a micronized progesterone prescription up to five years and they saw no increased risk in breast cancer rates on that particular compound. I tell my patients, I can’t say for sure. It doesn’t increase your breast cancer risk. I think there’s more study to be done on this progesterone, but I certainly don’t think it increases significantly. One in eight women get breast cancer-that’s our baseline rate. Some women on hormone replacement therapy are going to get breast cancer. There’s nothing we do about that. If you get it, you have to stop. But I tell people, there’s a difference between association and causation. I think, we’ve assumed a causation that really isn’t there for many years.
Then, we talk about cardiovascular risk. The Women’s Health Initiative also made us worry about cardiovascular risk of stroke and heart attack. What we know from that in other studies is that, the risks of estrogen and progesterone are based on when you start, not how long you use it. So, if you start within five years of that last period, you can use your hormone replacement fairly indefinitely without increasing your risk. The risk of heart attack, stroke, all those things are based on when you start. And women who start hormone replacement therapy within five years of their last period actually reduce their cardiovascular risk, we talked about that. They also slightly reduce their colon cancer risk and they reduce their all-cause mortality over time. The North American Menopause Society is really clear – there is no set stop date for hormone therapy. You can use it as long as it’s functional for you.
Dr.Rebecca: In my practice, I see three different patterns really. Small group of my patients use it just to manage symptoms rather transition to menopause. Two to five years, they taper off, they feel fine, we’re good. Another subset, use it through the age of retirement. They’re very functional women, they don’t like what it does to their brain when they come off their estrogen, they don’t like the hot flashes in the workplace, they want nothing to do with it, they sleep better on it. So, we use it until they’re 65, 70, 75 and then, we taper off and they do fine. And then, I have a small subset of women who feel better on hormone, and they’re going to die with that hormone in their hands, and that’s fine, too. [laughs] I’m happy to continue that journey with them as long as they don’t have any other risk factors. They haven’t developed breast cancer, they haven’t developed heart disease, or anything else that would mean that they need to come off.
David: Do you have an opinion about why Alzheimer’s risk is so much higher with women than with men?
Dr.Rebecca: I have a lot of opinions. I don’t know how based on science they are. I can tell you what we know from the data and what we suspect. I don’t know if we have the full story yet. We mentioned Dr. Mosconi. She’s working on this at Weill Cornell Medical School, and I think, she’s probably on the pathway of discovering exactly what’s going on in the brain. But I think, there are a couple things about estrogen that we need to think about. Like I said, estrogen is an anti-inflammatory molecule, and it’s anti-inflammatory everywhere including in the brain. So, I think, there’s a certain amount of that anti-inflammatory effect that is beneficial for women.I think that sleep has a lot to do with it. When women are transitioning through menopause, we’re talking about five, ten years of disrupted sleep. That’s a lot of impact in the brain and I think that has a lot to do with it.
David: Wow, okay. So, I’m going to paraphrase here and tell me if I got this wrong. But it seems like with HRT, unless you fall into one of these groups where you have a preexisting condition, and you can’t do it – this seems like a really good thing all around. If for nothing else, just the sleep. Like not sleeping for ten years like, oh, my gosh, that’s going to cause all kinds of problems.
Dr.Rebecca: Right. I don’t disagree with you. I think, we have been told a scary story of hormone replacement therapy. Before the Women’sHealth Initiative published, that was not the story we were telling. We were telling women it was great for them. Those of us who’ve been working in this space a long time have gone back to that story for the most part. I think that was the Women’s Health Initiative, and the way it was published, and the way it was recorded was a bit of a blip in that story. The way I’d like to think about it is that, menopause probably had a function when it started. Very few species go through menopause. It’s us and a couple of great whales. That’s pretty much it. There’s a whole sort of grandmother theory about why we would do this. And the theory is that, the grandmothers are the repository of knowledge within these societies, and risking them in childbirth as they age doesn’t make sense, so they stopped being able to reproduce, so they can continue to pass on knowledge. That’s a great theory. There’s no way to prove that. But sounds good. I like it.
But the one thing I do think about is, when menopause is fine and functional, if you’re going to live to be 65, you got 10 years to survive your menopause, you’re going to be okay. We live to 95, 100, 105 now. And that’s a long time. That’s almost half your life without the hormones that sort of keep things going. So, I think that we need to adjust like, I think people have been fed this line that, it’s better to just go through this natural and normal transition. Well, it’s natural normal, but so is dying by 65. We’re in a different place now. So, we need to think about our long-term health, and estrogen may actually help with that long-term health. Not everybody needs it. People do live to 85, 90, 95 without hormone replacement therapy, but it can be beneficial for many women.
David: So, if somebody comes to you and they’re non-symptomatic, they’re not having any of the sort of sleep disorders, mood stuff, weight gain, but they come to you and they say, “Huh, I’ve read this stuff about hormones and long-term brain health. Should I be doing this? Not so much my current status but my longevity, essentially?
Dr.Rebecca: The answer if they’re just talking about brain health is, I don’t know if we know for sure. We have some studies that point at increased exposure to hormone over a woman’s lifetime being protective of her brain and reducing the risk of dementia and Alzheimer’s dementia specifically. In that, we’re talking about a couple of studies. There’s an observational study called The Cache County Study out of Utah, where they just looked at this county and watched everybody age, and one of the publications that they did was they counted up women’s years on estrogen, they counted their pregnancies, their breastfeeding, their hormone use, all those things, and showed that women with more estrogen exposure had a reduced risk of Alzheimer’s disease.
Then, there’s Dr. Mosconi’s study, which was recently published, which looks at women who’ve had exposure to contraceptives, or hormone replacement therapy, things like that, and more exposure showed decreased risk. There are other studies that show that HRT increased the risk of dementia. The Women’s Health Initiative showed an increased risk of dementia. Now, there are some issues with how that study was designed, a lot of those women were 10 or more years into menopause when they were started on hormones, there’s the whole idea of blood clotting and could there be small strokes in the brain, there are a lot of issues. But I have to be honest with these patients and say, there’s data on both sides.
Some data says that, it’s harmful, some data that says, it’s helpful. My take on all that data is, I think, there’s more help than harm if we use it correctly. If you start within five years of that menopause, if you take it continuously, if we use it through the skin rather than orally, because through the skin, there’s a lower risk of blood clots. There are ways that we can do it safely and I am happy to prescribe someone hormone therapy for health benefit as long as they understand that is actually what we consider an off-label use. Hormone therapy is FDA approved to treat hot flashes and protect your bones. That’s it. We know all these other things. So, we can have that conversation and do the prescribing based on that, but definitely, we’re in a somewhat of a gray area.
The menopause journey is different for everyone, but you don’t have to go it alone. Learn more about whether HRT is right for you by tapping into the expertise of our integrated care team. You will access both natural and prescription therapies approved by physicians who specializes in menopause.
Continue to part 5 for Dr. Rebecca’s take on whether intermittent fasting is beneficial, why strength training is key for women, and the importance of supporting your bones starting in your 30s.
Don’t miss the entire series of Dr. Rebecca’s interview with SuperAge on HRT:
And be sure to listen to the full podcast episode at SuperAge.com.
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In part three of five transcripts from Dr.Rebecca Dunsmoor-Su’s interview with David Stewart on the SuperAge podcast, “HRT, Estrogen and Menopause, New Scientific Findings with Dr. Rebecca Dunsmoor-Su”, she reviews the need for quality sleep, and what you need to know about testosterone therapy in menopause. Please listen to the full podcast by visiting SuperAge.com.
David: I know that if you’re not getting deep sleep, your brain’s not being cleared out, and your chances of Alzheimer’s dementia goes through the roof. So, how are you addressing that?
Dr.Rebecca: Sleep is really key for women, especially, as we age. It’s not just the Alzheimer’s dementia risk, which is higher in women as we know. But it’s also the fact that if you’re not getting deep sleep, you’re reducing your basal metabolic rate. All women tend to start gaining weight during this time in this transition. It probably has a lot to do with their lack of sleep. You can lose about 400 kilocalories a day in your basal metabolic rate if you’re not sleeping well. It tends to generate a little bit of an insulin resistance from that lack of deep sleep. Your cortisol never really goes all the way down. You don’t get to that really restful place. So, sleep is really key.
How do we address it? Well, I address it in a couple of different ways. I address it with the one proven therapy for sleep that’s been shown in studies to actually work which is cognitive behavioral therapy for insomnia, either using an app, or an online system, or they can even work in person with someone. But the apps in the online versions are actually quite good, and can really help people track their sleep habits, and make changes that helps them to sleep more deeply. Then, sometimes, I address it with hormone therapy, if that’s one of their big symptoms, and they want to try hormone therapy for it.
David: What is cognitive behavioral sleep therapy?
Dr.Rebecca: Cognitive behavioral therapy is a style of therapy that works on behaviors-recognizing behaviors, and changing them is basically the tenant of cognitive behavioral therapy. There’s a specific subset called cognitive behavioral therapy for insomnia. And what that does is, it very specifically tracks behaviors around sleep, about when you go to bed, what you do when you wake in the middle of the night, what things you include in your bedtime ritual, what do you do when you wake in the morning, all these types of things. And then, it works with you on how to adjust those to improve your sleep. And there’s a great app that people can get for free called CBT-I trainer, I believe. It was made at the VA for veterans with PTSD. So, it’s free to everybody. It’s in your app store. You can just download it and give it a try.
David: In my world, I would call this good sleep hygiene.
Dr. Rebecca: It’s a bit more structured than good sleep hygiene. They’re actually things that it recommends in terms of like, if you wake in the middle of the night, you actually get out of bed, don’t check the time, go to a quiet place and actually sit up. It’s a little bit more, but yeah, it starts with good sleep hygiene.
David: So, let’s talk about this other hormone that you mentioned, testosterone. Is it ever a good idea for a woman to be supplementing testosterone?
Dr.Rebecca: I’m glad you’re bringing it up because there’s a lot of what I like to call predatory practice out there – when people are selling women testosterone as a fountain of youth. Testosterone is anabolic steroid. It will make you feel great – and then, it’ll wear off, and you’ll need more, and then, you’ll feel great for a little while, and it’ll wear off, and you need more. So, we end up seeing as women getting into really high levels of testosterone, basically male levels of testosterone, and getting all the joy that comes with that including facial hair and acne. Their voices can deepen, they can grow an Adam’s apple, they can actually grow a small penis from their clitoris. But also on the inside, they’re getting cardiovascular disease on the level of men.
Testosterone is an important female hormone. As I mentioned before, it doesn’t really go down with menopause. It goes at a slow drift throughout our lifetimes, but you haven’t suddenly lost it. People assume as we go through menopause, and there’s often a change in libido, that its testosterone causing that change. In fact, it’s probably a much more complex thing that has to do with psychological factors, how we feel about our bodies, how we feel about our aging, how we feel about our relationships and all those things that are causing that drift down in libido. But there are some small studies that have shown that replacing testosterone at very low female physiologic levels can give a slight boost to libido in women. So, you can increase their sexual satisfying events by about two per month over time.
David: I know you don’t like to say numbers, but can we put a number on that? What’s the dosage?
Dr.Rebecca: We’re having to use male-dosed products at female levels. Because there is no female-dosed testosterone product available in the US that’s FDA approved. So, we’re just struggling with that as physicians. A lot of people are given like compounds or pellets, these are dangerous, very hard to manage, and you can get really high testosterone levels. Those of us who practice in this space typically take a male-dosed product – it comes in little packets of five milligrams each, and for a man, that five milligrams would be a one daily dose. We have women use 1/10th of that a day. So, about 1/10th of five milligrams, 500 micrograms. We’re taking it down and trying to keep it in the female physiologic range. It’s hard for us to do. It’s something that those of us who work in the sexual function space really struggle with because we think there’s some decent data for this, but it’s really hard to safely replace in women. This is not something that should be routinely replaced in women because it is hard to manage, you have to get blood tests regularly to make sure we’re not bumping you too high to the male range, and it’s just something that has a role, but a very restricted role.
Whether you suffer from sleep issues, hot flashes or changes in sexual function, finding the therapies that fit your needs can seem daunting. Skip the endless searches for information, and tap into the proven therapies of our integrated care team. You will access both evidence-based lifestyle strategies and treatments approved by our CBT-trained health coaches and physicians who specialize in menopause.
Continue to part 4 to learn about the three typical usage patterns of HRT, the risks of HRT, plus why the risk of Alzheimer’s disease is so much higher for women.
Did you miss part 1 of this series? Learn about the hormonal journey and why hormone testing is not always helpful.
“In part 2, you’ll learn about the benefits of estrogen, and why some women are not good candidates for HRT.
And be sure to listen to the full podcast episode at SuperAge.com.
Gennev Chief Medical Officer, Dr. Rebecca Dunsmoor-Su was interviewed by David Stewart of the SuperAge podcast for the women’s health episode “HRT, Estrogen and Menopause, New Scientific Findings.”
In part two of five transcripts from the session, Dr. Rebecca shares estrogen’s impact on heart and brain health, as well as why some women are not good candidates for hormone replacement therapy. If you have wondered if hormone replacement therapy is right for you, read on. And please listen to the full podcast by visiting SuperAge.com.
David: As progesterone goes to zero, estrogen goes very, very low, what are the other effects on the body from this?
Dr.Rebecca: That’s a really good question because I think we have lost sight of talking about the benefits of estrogen for a woman over the years with all the fear mongering around cancer, which we should also discuss separately. But estrogen is actually a really healthy hormone for women. So, we know that estrogen is active in basically every part of the body. It’s active in the brain, in the cardiovascular system, the bones, it’s active in the genital region, obviously. And losing estrogen has significant impacts on women as they age. For example, let’s start with the cardiovascular system. So, we for years knew that women didn’t really start having their heart attacks until after menopause. There were a lot of theories by this was, there was this big Framingham nurses’ study that came out looking at many, many nurses, and we’re tracking their progress over the years, and we were seeing that, those women who started hormones, when they went into menopause were also not getting heart attacks. So, it was obviously protecting their hearts. We asked the question, what’s happening there?
What it seems is that, estrogen is an anti-inflammatory molecule. So, at the cardiovascular system in the blood vessels, it’s increasing pliability, reducing plaque. So, it’s keeping those things healthier and younger in that sense, but it also alters the HDL, LDL ratio a little bit. So, women’s HDL is a little bit higher before they go through menopause and actually goes down, and their LDL rises with menopause. So, we switch our lipid profile a little bit to look a little more masculine when we go through menopause. So, it’s a heart healthy hormone if it’s something you’ve had all along and continued. There is some datas showing that if you go through menopause, and then, wait 10 years, and then start estrogen, it’s actually unhealthy for the heart. So, the big important thing there is that you’ve already been made those cardiovascular changes. Your vessels have become less flexible, you’ve built plaque in your vessels, and then, estrogen has the opposite effect because it also slightly increases blood clot risk. So, you can put clots on top of plaques and actually have strokes and heart attacks.
A lot of the benefit of estrogen is continuous estrogen. It doesn’t work, you can’t start later on. At the bone, estrogen helps us keep calcium in our bones. It helps prevent osteoporosis for women. It’s actually a really, really good bone medicine. It’s actually one of the things that the FDA has approved it for is for maintenance of bone health. In terms of the brain, there are a couple of different pathways to go down with brain health. One is just the general symptoms of menopause. A lot of women experience what we call brain fog. So, they just have some word searching difficulty and some memory changes as they start to transition through menopause, that does not last forever.
David: I want to know, why is that? What’s happening there?
Dr.Rebecca: I don’t know that we fully know. There are actually trackable changes in brain function that you can see. Dr. Lisa Mosconi, who’s the head of the Weill Cornell Alzheimer’s research group did a brain function study, which I think they published in the last year. What they did was, they can actually track brain function changes in women going through menopause. The nice thing is they also checked on them a couple years later, and they recovered those brain functions with or without hormone. So, it’s just something about the brain transitioning how it functions. Estrogen is active in the serotonin system, in the norepinephrine system, in the dopamine system, it’s active in the memory centers, it’s active everywhere in the brain. So, there’s something that’s going on as we transition out of the state. Our brain comes to a new steady state. But there’s definitely a lot of women really noticed that.
The other thing that happens during this time is because of the effect on the brain is sleep gets disturbed. So, women get disturbed sleep as they transition through menopause. Usually, what they come to me and tell me is not that they can’t fall asleep, they can all fall asleep. But at 2 or 3 o’clock in the morning, they wake up, they’re up for two or three hours, their minds are racing, and they’re just getting this very scattered sleep. We think that has a little bit more to do with progesterone. Progesterone is a bit of a calming hormone level of the brain. But estrogen, too, because when we’re often waking with hot flashes, and then, they’re up, and they can’t get back to sleep. Sleep has tons of downstream complications including brain health, but also weight, and energy, and all sorts of things.Then, I lost bit for a minute there. Oh, yes. We’ve talked about the brain, we’ve talked about the cardiovascular system and the bones. What else is estrogen good for, what’s good for our skin. It’s good for our hair. It keeps our vaginal tissues young and healthy. There’s a lot of just general benefit for the female body.
David: I’ve interviewed people who’ve said, “Well, I’m not a good candidate for HRT,” or, “It doesn’t work for me.” Because everything you’re telling me is, this seems like a really good thing to do. Why not?
Dr.Rebecca: There are a couple of categories of people for whom hormone replacement therapy is not a good choice. Category number one, women who’ve had breast cancer. So, if you’ve had breast cancer, and that breast cancer often is hormone sensitive, then, we are increasing your risk of recurrence by adding estrogen or progesterone back into the system. So, we just don’t do that. Another category is, people who already have cardiovascular disease.So, if you already have known cardiovascular disease, and then we have this blood clot risk that we add on top, we can actually increase your risk of cardiovascular events. Then, the third category are often women who’ve had a clotting disorder, or had a blood clot in the past, or have a strong family history, or a genetic reason why they might clot their blood. We’re very hesitant to add estrogen to that system because it does slightly increase blood clot risk.
David: When you’re doing HRT, are you adding both estrogen and progesterone or just estrogen?
Dr.Rebecca: That depends on whether or not a woman still has a uterus. So, as I said back in the beginning, progesterone’s role in the cycling woman is to stabilize the uterine lining to get ready to implant a pregnancy. In hormone replacement therapy, its role is to keep that uterine lining from growing under the influence of estrogen. If you give estrogen alone to a woman with the uterus, her lining will grow and grow and grow, she’ll have a ton of bleeding, but eventually, will also grow into endometrial cancer or uterine lining cancer. Progesterone stops that from happening. So, if a woman has a uterus, we give both. If a woman doesn’t have a uterus, she doesn’t actually need the progesterone arm. We usually start with just the estrogen. In rare cases, I might add progesterone if sleep is a huge issue for her, and we want to try it to see if it really calms the brain. But in general, we start with estrogen and then see if it’s needed.
To find out if hormone replacement therapy is right for you, speak with a physician who specializes in menopause. Together, they can help you weigh the risk versus the benefits, and prescribe the therapies that are right for you.
Continue to part 3 to learn about the need for quality sleep, and what you need to know about testosterone therapy in menopause.
Did you miss part 1? Learn about the hormonal journey and why hormone testing is not always helpful. And be sure to listen to the full podcast episode at SuperAge.com.
Just as injury causes inflammation, eating the wrong foods can irritate our bodies and cause oxidative stress and chronic inflammation. Inflammation in our bodies can show up as joint pain, muscle aches, skin irritation and more. And chronic inflammation plays a role in nearly every major illness, including cancer, heart disease, Alzheimer’s disease and depression.
One of the most powerful ways to fight chronic inflammation is by following an anti-inflammatory style of eating. By eating anti-inflammatory foods, you may help reduce inflammation and improve symptoms of some common health conditions.
An anti-inflammatory diet is not a specific diet you will follow. Instead, it’s a way of eating that emphasizes plants for their fiber, vitamins, minerals, and phytochemicals and encourages foods that are closer to their natural state (not processed).
Making even small changes to you diet that you know you will stick to, and building from there will go a long way to helping you practice an anti-inflammatory style of eating.
When you practice an anti-inflammatory lifestyle, you will know it’s paying off when you start feeling better. There are many ways your body may respond, but you may begin by noticing:
Eating a healthy diet supports your body against inflammation and disease as you age. If you need some guidance on how to incorporate these foods into your diet on a regular basis, consider working with our integrated care team who are experts in supporting women in menopause. They will help you create a personalized plan that will optimize your nutrition and other lifestyle factors, as well as offer the support to create healthy habits for the long-term.
What foods should you eat in menopause? This is a common question we get here at Gennev- and for good reason! Let’s face it, nutrition can be confusing. We all come across many different opinions and news from so many sources, so our team of health experts has done some digging for you, and offers our targeted recommendations.
Protein: Our protein needs go up in mid-life as extra support is needed to maintain muscle mass, mobility, metabolism, and our immune system. How much protein should you include each day? This can vary from person to person, but a general guideline is to aim for 20 to 25 grams per meal and 10 to 15 grams per snack.
Chicken, turkey, and fish are all good sources of lean protein, or you may choose legumes, grains and even spinach. Plus, we like Greek yogurt for a high protein breakfast or snack option that has the added benefit of being high in calcium. When selecting Greek yogurt, choose a product that is lower in fat and added sugars. You can add in your own berries for flavor.
Prebiotics & Probiotics: Research is finding that our gut health extends beyond digestion to other areas of our health and wellness including metabolism, nervous system regulation, and endocrine system function. The hormonal changes that occur during menopause have even been found to change the bacterial make-up of the gut microbiome. These shifts make it important to include prebiotic and probiotic foods to support having a diversity of beneficial bacteria within your gut.
You are already adding pre-biotics to your diet when you include more fruits, vegetables such as bananas, onions, garlic, leeks, asparagus, artichokes, beans and whole-grain foods to your meals. And including fermented dairy foods like yogurt, kefir and certain cheeses, often contain live cultures which may act as probiotics. Other fermented foods that may provide benefit (but more studies are needed) include sauerkraut, kimchi, miso and tempeh.
Phytoestrogens: Phytoestrogens, found in flaxseeds and soy-containing foods, may have the potential to support a reduction in menopausal symptoms for some women. However, all women can benefit from the plant-based protein and fiber these foods contain as a way to support heart health, which is an important focus point in menopause as estrogen naturally declines. Aim for 2 to 3 servings of high quality soy foods such as tofu, tempeh, or soy milk and 1 to 2 tbsp. of ground flaxseeds daily: consider adding flax to cereal or yogurt or blending in a smoothie.
Anti-inflammatory foods: An anti-inflammatory diet emphasizes plants for their fiber, vitamins, minerals, and phytochemicals and includes foods that are closer to their natural state (not processed).
To get started with an anti-inflammatory diet, the simplest way is to include a rainbow of colorful fruits and vegetables each day for antioxidant support and protection. You may be surprised that you can find one or two creative ways to get those fruits and veggies into your meals such as adding spinach to your scrambled eggs or kale to a smoothie. You can also try adding cauliflower rice to your regular rice for an added boost of nutrients and fiber.
Calcium-rich foods: Bone health is very important to consider in menopause, and calcium will help protect your bones. The recommendation is to aim for 1200 mg per day, which can sometimes be hard to do through food alone. When you think of calcium-rich foods, dairy products like milk, cheese and yogurt are top choices. Also high in calcium are fortified orange juice, dark leafy greens like kale and spinach, broccoli, soy foods , sardines and trout.
Proper nutrition is key to warding off disease as we age. If you need some guidance on how to incorporate these foods into your diet on a regular basis, consider working with our integrated care team of board certified OB/GYNs and Registered Dietitians who are experts in supporting women in menopause. They can create a personalized plan that addresses your symptoms, optimizes your nutrition and other lifestyle factors, as well as offers the support to create healthy habits for the long-term.
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Hello! I’m Jill Angelo, CEO of Gennev. When I started this company in 2016, my number one goal was to solve women’s health pains in menopause. Sleep, weight, hot flashes, sex, depression, fatigue, brain fog – the list of health pains is long and it’s robbing women of their quality of life and productivity at work. If you’re reading this, you likely identify with that.
As the CEO of Gennev, I love knowing that 89% of our patients feel relief from their menopause symptoms. But the more important issue weighing on my mind, is that there are so many more women not seeking care. In November 2021, we surveyed Gennev patients and learned that 85% of them regretted not seeking menopause care sooner.
Considering there are 50 million women in the U.S. alone in menopause, and less than 7% seek care, that leaves 47 million women not seeking the care they need. Are you one of them?
What concerns me is that the solution is so simple: get a menopause check-up. It’s as easy as taking the free assessment (2 minutes), and then speaking with a doctor from the comfort of your own home (30 minutes). Internally, we affectionately call this the “M-check”.
In the past 12 months, over 4K women have had the full M-check (assessment + doctor). And over 200,000 women have taken the assessment.
If you’ve taken the assessment, you’re 50% of the way there. You’re informed about where you’re at in the menopause journey and have access to some great education. The remaining 50% of the effort results in relief from sleepless nights, answers to mysterious weight gain, remedies for brain fog, uncomfortable sex, and unexplainable fatigue. Who doesn’t want to feel better from all of that?
As a leader in women’s health, I feel the responsibility to get the 47M women not seeking care, the care they need.
Starting at the age of 45, women need to get their menopause check-up. Just like a mammogram, pap exam, or colonoscopy leads to awareness and treatment, the M-check answers the health pains of menopause and assesses a woman’s risks for rising cholesterol, depression, and self-doubt when it comes to sexual satisfaction. And, with 75% of women in menopause struggling with hypertension, 30% with osteoporosis, and 10% with depression, the menopause check-up addresses that too.
This menopause check-up does not exist in health literature or research. While I appreciate research and guidance for Well-Women visits, perimenopause and post-menopause are afterthoughts in the final paragraph with no explanation for what to check in the patient. Women’s post-reproductive health has been largely underserved for decades, but the longer I’m in this business, I’ve come to learn that the status quo is not working. Results from over 200,000 completed assessments remind me of this daily.
What I hope you take away from this article is that women need to start assessing where they are with menopause at age 45. Just like getting a mammogram at the age of 40, and a colonoscopy at 45. It’s that simple.
If you haven’t had your M-check, start by taking the assessment. Then, speak with a doctor and feel better starting now.
If you’re hesitant, I’d love to better understand your concerns. Please take this 2-minute anonymous survey. Hearing from you is the only way we can make a massive change to how women’s health is treated in this country, not to mention the workplace and by insurance providers.
Many of the changes womens bodies go through in menopause can challenge the strength of their immune system. When we are not sleeping well or eating right, stressing more and working out less, we may be more susceptible to illness. However, even small tweaks to your daily routine can make all the difference for maximizing your health.
Why not start right now? Heres your checklist for supporting your body and boosting your immunity in menopause.
When we dont get enough sleep, it can result in a number of negative impacts on our bodies including lowering our immunity, increased inflammation, poor nutrition choices (caffeine, sugary snacks to keep us going), increased risk of disease, stress and anxiety. Try creating a sleep routine including a set bedtime, and stick to it every night. Unwind with meditation or deep breathing, cool down your room, and be sure to make it a device-free zone.
“Staying hydrated supports the lymphatic system which is linked to the immune system. Being properly hydrated helpswith lymphatic drainage and works to clear out toxins and waste materials. Shoot for drinking a minimum of half your body weight in ounces of water or other non-caloric fluids each day. Exercise regularly A 2019 scientific review in the Journal of Sport and Health Science found that exercise can improve your immune response, lower illness risk, and reduce inflammation. It also helps improve your mood, supports weight management, bone health and reduces risk of heart disease and diabetes.Experts recommend 150 minutes of moderate to intense activity per week.
“Vitamin D is one of the most important vitamins for wellbeing in menopause. Like other hormones, vitamin D participates in a whole lot of bodily processes includingmuscle movement;its involved in carrying messages between the brain and body, and its important for fighting off bacteria and viruses. It helps us maintain our bones by supporting the absorption of calcium in menopause, and it plays a role in reducing inflammation. You can get vitamin D through exposure to sunlight, through a supplement, and through your diet in small quantities. Are you getting enough? You can find out your level of vitamin D with a simple blood test done by your doctor.
“Consuming a variety of brightly colored fruits and veggies provides various health benefits. Plant foods are low calorie and include vitamins, minerals and antioxidants we need, and may protect against cancer, heart disease, vision loss, hypertension and other diseases. Try for a total of 4 cups(2 cups veggies/2 cups fruit) a day. This sounds like a lot, but if you plan for two cup servings at each meal, you will quickly crush that goal.
Protein provides amino acids that the body uses to build and repair tissue. Amino acids also form antibodies, which play an important role in immune response. How much protein you need each day depends on how much you weigh. For women over 50, experts recommend1 to 1.5 grams of protein per 2.2 pounds of body weight So, if you weigh 140 pounds, you would need a minimum of 63 grams of protein a day. Be aware that your needs may increase with higher levels of activity. Protein-rich foods include eggs, chicken, lean beef, dairy, nuts and seeds, lentils and legumes, soy.
If you are checking all the boxes to optimize your health, but still feel your energy and wellbeing is lagging, consider speaking with a menopause specialist. They can help you understand how hormone fluctuations may be a contributor, and support you with a personalized treatment plan. 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.