Stressed. It has become a common way of describing ourselves these days.
And while you may be aware of what could be causing the stress in your life (work, life events, relationship changes, menopause and other health concerns, fear of the unknown), you may not realize that unmanaged stress can lead to more serious health problems.
Why? Because stress, no matter what the reason, triggers your sympathetic nervous system, or fight or flight response. Stress hormones like adrenaline and cortisol activate, and when (in most cases) your body doesn’t find resolution, it continues to pump out higher levels of stress hormones, resulting in the harmful effects on your body. This chronic stress can lead to heart disease, depression, increased risk of type 2 diabetes, weight management issues and so much more.
Symptoms of stress varies by individual, but the more common and recognizable physical signs include:
You may also notice emotional symptoms of stress, such as:
Much like the various symptoms you may experience, there is no one-size-fits-all or magic pill to remedy stress. The most important thing you can do is be self-aware. Know what may trigger your stress, and become familiar with the signs of stress on your body and mind. Then take action to help reduce stress and support yourself through it.
Build your resiliency – Becoming more resilient can help you manage stress, and managing stress can help you become more resilient. The two are intertwined, which is why some of the strategies to build resilience are similar to ones you might employ to reduce stress. Learn the steps to build your resiliency here.
Eat well – A balanced diet supports the immune system, helping to repair damaged cells and provide the extra energy needed to cope with stressful events. A diet composed of whole and unprocessed foods, specifically healthy unsaturated fats and fiber-rich carbohydrates with lean protein, can support the body’s natural cortisol response. It’s important to avoid skipping meals and eat small, more frequent meals or snacks to stabilize cortisol levels and support an optimal insulin response.
Get some exercise as Exercise helps to lower blood pressure and keep stress hormones in check. Studies show that just”¯20 minutes of aerobic exercise can help reduce cortisol, and get it back to manageable levels. But be cautious about very intense endurance exercise (such as ultrarunning) and be sure to take a rest day between higher intensity workouts. Intense physical activities combined with lack of rest days can cause an increase in cortisol.
Take a joy break as Finding joy in your day can come from the simplest of pleasures. So why not give your pet some play time, eat an ice cream cone, indulge in some funny videos, take a walk outside or find a quiet bench to sit in the sunshine. These found moments will greatly support your emotional health.
Talk about it as most importantly, when stress just won’t quit, talk it out with a friend or family member, or seek the help of your physician or therapist.
While many women feel increased stress, moodiness, anxiety and even symptoms of depression during menopause, don’t just brush it off. Plan a visit with your physician.
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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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Is menopause to blame for increased friction in your relationship? Chances are, you may not be the only one feeling that way. A study among men whose partners were experiencing symptoms of menopause revealed that 56% of them felt that menopause was negatively impacting their relationship. And the symptom that created the most trouble with their partner? Moodiness.
Not everyone will experience menopause the same way, but these symptoms and more may be contributing factors to relationship troubles during menopause:
With so many of us not knowing what to expect in menopause ourselves, it’s unfair to think our partners can even begin to understand. And while this may be a hard pill to swallow, they won’t know one bit about how you are feeling unless you tell them! We’ve gathered below our most popular resources for supporting yourself and your relationships through menopause.
If you have questions about menopause, you can get all your answers in one place. Gennev’s team of OB/GYNS are menopause experts, and will help you understand your symptoms and offer solutions. Book a telehealth visit, and access evidence-based treatments including prescription and natural therapies that cater to your individual needs.
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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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Do you feel like your get up and go has gotten up and left? Low energy is a common concern for women in menopause. In addition to hormone fluctuations impacting our energy at the cellular level, night sweats and sleep disruptions also play a large role in depleting daytime energy.
You may not realize it, but a few tweaks to your morning routine can help increase your energy throughout the day, and support more positive feelings and overall productivity. The key is to stick to a ritual for your first waking hour that nourishes your body and your soul.
Morning Stretch as Stretching in the morning wakes up your body, increasing your blood flow and releasing tension. It also kicks in the parasympathetic nervous system, releasing endorphins which act as a mood booster and prepares you for your day. And as you age, warming yourself up with a morning stretch may”¯help improve balance, maintain mobility and lower your risk of injury.
Meditate as Meditation also activates the parasympathetic nervous system providing a state of relaxation. This will help you relieve anxiety, and enable you to start your day with a clear, intentional mind and be better prepared to counteract stress throughout the day.
Unsure of how to meditate? Try this well-known practice known as the inhale-exhale method. You can begin with just 5 minutes.
You could also try a guided meditation through Insight Timer, Calm or Headspace. These provide a great way to try meditation if you feel intimidated or don’t know where to begin.
Drink a big glass of water – Drinking water first thing in the morning will aid in rehydrating you after sleep and will your boost energy as it replenishes tissues and organs with the necessary fluids. It also aids in getting your metabolism and your digestive system moving. Staying properly hydrated, no matter what time of the day, is vital to supporting your energy, mood and overall health. So, drink up!
Exercise as Exercising in the morning not only has a positive effect on energy levels, but helps you be more alert, and boost your mood long after your workout. Plus, studies show that a”¯morning exercise habit can actually help you sleep better at night. If you like to wake up more gently, walking is one of the most beneficial exercises for improving energy as it increases oxygen flow throughout the body. Usually, the hardest part is just putting on those walking shoes and getting out the door.
Nourish as Starting your day off with a healthy breakfast kick starts your metabolism, fuels your energy stores and also aids in improving concentration and memory. Many individuals tend to stick to the same breakfast routine to keep things simple as which is perfectly fine – as long as it contains the key nutrients your body craves:
Morning Mango Green Smoothie
While low energy and fatigue is a common symptom of menopause, it can also signal other medical conditions. If your fatigue just won’t quit, be sure to speak with your doctor to be sure it’s nothing more serious.
Many effects of menopause cannot be solved through medication alone. It requires changing one’s lifestyle to address nutritional gaps, weight changes, sleep problems, fatigue, anxiety and so much more. Gennev’s integrated menopause care delivers the medical expertise of board-certified OB/GYNs, along with the knowledgeable guidance of Registered Dietitians to treat the whole you. Book a virtual visit today.
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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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How was this past year a big year for you? Maybe you experienced your first hot flash while you continued to kick butt and take names. Perhaps you’ve achieved some real wins in your career or on the family-front while experiencing less sleep, or a few other common perimenopause or menopause symptoms. It is a big deal. Women are no longer just surviving in midlife”we’re thriving.
Menopause marks the start of a new and exciting chapter in life, giving you an extra reason to celebrate. New year, new you”¦ in a new way.
Let’s finish the year in celebration!
Whatever. You. Want.
We’ll say it loudly for the women in the back: celebrate your body, no matter your age or size. New Year’s Eve isn’t the time to be shy! However, we know that changing bodies sometimes lead to lowered confidence or an evolving approach to clothes, as old favorites just don’t fit the same.
New Year’s Eve is a time to celebrate, so don’t pressure yourself to hold back just because you’re in menopause. After all, you’ve achieved a lot this year, and you did it while sweating through hot flashes and mood swings.
However, the alcoholic beverages we raise to toast the new year can be high in calories, trigger hot flashes, and we know that alcohol use can contribute to risk of chronic disease. We have a few suggestions if you’re planning on being mindful of what you drink.
If it’s not New Year’s Eve without a champagne toast, good news: champagne (or Cava, Prosecco, or generic supermarket sparkles) has fewer calories than red or white wine and may even reduce your risk of dementia. Plus, fizz (in general) encourages you to pace your sips (though if you want to relive your youth or impress your adult kids, there is a solution for slow champagne consumption).
Look for “Ultra brut,“ “brut natural,” and “extra brut” on the label. These varieties have little-to-no added sugar, which your body will thank you for on New Year’s Day.
If you’re looking to have a good time without going overboard, consider one of these lower alcohol sparkling options”in a champagne flute, of course.
You don’t need alcohol to have fun! You could stick with water, or you could treat your tastebuds to something fancy, like one of these mocktails:
Your liver doesn’t realize that age is just a number. Hangovers do get worse when we hit our 40s and 50s, and one reason may be that the water content in our bodies decreases as we get older. Stay hydrated on NYE: alternate alcoholic drinks with a glass or two of water.
DVR the Rose Parade, hit snooze a few times, turn on a college bowl game, and enjoy a few new”and old”traditions.
While working out may be the last thing you want to do after a late (and boozy) night, moving your body produces mood-enhancing endorphins and improves blood flow to the brain. Stick to gentle exercise like stretching, yoga, or a short walk or jog; strenuous activity will dehydrate you further, and you’re more prone to accident or injury with a hungover head.
It’s a tradition (and superstition) in the American South to eat black-eyed peas and collard greens on New Year’s Day for good luck and financial prosperity in the new year. These nutritious foods are also packed with fiber, which is essential as your digestion slows in midlife.
Don’t fret if your friends leave a few fallen soldiers at the end of the night. That half-full bottle of Veuve Clicquot (or Cook’s) still serves a purpose: as a facial toner!
Like all wines, champagne has resveratrol, an antioxidant with anti-aging benefits. Chill your leftover bottles and then apply the wine as you would any other toner in your skincare regimen.
Alcohol can dry your skin, however, so don’t worry about using up the whole bottle; a few applications are all you need.
Do you make resolutions or set intentions?
If you’re looking for something to work towards in the new year, we have a few ideas for midlife health”feel free to pick one, or all, of ours!
How do you plan to celebrate New Year’s Eve? Let us know in our Community forums.
Do you go to bed only to find yourself staring at the ceiling with what seems like a million things running through your head? Sometimes it can feel like negative thoughts and worries are on repeat.
Rumination (repetitive thinking) is usually associated with anxiety and stress. You may find yourself worrying obsessively about something in particular during your waking hours to the point where it affects other aspects of your life and possibly your relationships. And when it occurs when you are settling in for sleep, it is also considered a symptom of insomnia.
Why does rumination occur?
Build your resiliency to counteract stress and its adverse effects. Start with learning what stress feels like in your body. Practicing a body scan can help you become more in touch with your body, noticing areas of tension, and then working on releasing them.
Practice Mindfulness. Mindfulness is defined as a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations. For busy, stressed people, this may seem impossible to achieve. But even just a few minutes during the day or before you go to bed, taking several deep, intentional breaths can have a very positive effect on helping you find your calm, control repetitive thoughts, and fall asleep. If you are unsure how to get started, there are many apps like InsightTimer and Headspace that can help you begin your mindfulness practice.
Try yoga nidra. Yoga nidra means “yogic sleep“, and is a deep relaxation technique and a form of meditation. In this practice, the body is completely relaxed and your awareness is turned inward by listening to a set of instructions (much like a guided meditation).
Start a bedtime journal. The practice of writing down your thoughts and feelings from the day can help to lower stress. Research suggests that journaling can help us accept rather than judge our mental experiences, resulting in fewer negative emotions in response to stressors.
Set yourself up for a good night’s sleep. Get started by getting some exercise during the day, be consistent with the time you go to bed, avoid caffeine and alcohol in the hours leading up to going to sleep, turn off screens at bedtime, and keep your room cool and dark.
If your repetitive thoughts at bedtime just won’t quit, you may consider visiting with your doctor or therapist for support. Dr. Rebecca Dunsmoor Su, Gennev’s Chief Medical Officer shares, “We often recommend cognitive behavioral therapy for insomnia.“ Cognitive behavioral therapy is a style of therapy that identifies negative behaviors, and works to manage them in amore effective way. Cognitive behavioral therapy for insomnia very specifically tracks behaviors around sleep, such as 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, as well as what you do when you wake in the morning. Ultimately the therapy will work to adjust those habits to improve your sleep.”
You may also try working with a menopause specialist to learn about prescription and natural treatments, optimize your wellness (nutrition, movement, mindfulness) and identify lifestyle modifications (such as a new sleep ritual) that will support better sleep.
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.
Having a healthy gut is integral to overall wellness. Gut health is linked to not only your digestive system, but also plays a role in metabolism, glucose tolerance, insulin sensitivity, the nervous system, endocrine system, and more. The gut microbiome is made up of trillions of bacterial cells, fungi and other microbes, and is as unique to you as your fingerprint. Your unique microbiome began development in utero, and is influenced by many factors including but not limited to genetics, a vaginal or cesarean birth, breastfeeding, the environment, exercise and sleep habits, hormones and nutrition. The bacteria in the gut serves as a communicator to other systems in the body. Changes in the bacteria in the gut microbiome can disrupt the messaging function and put you at an increased risk of many systemic conditions including cardiovascular disease, irritable bowel syndrome, type 2 diabetes, mental health concerns, and auto-immune disease.
There is evidence that suggests hormone fluctuations and specifically the decrease in estrogen, influences the microbiome by altering the bacteria that is present in the gut. We also know that estrogen receptors are located in the intestines, brain, bones and adipose tissue (commonly known as body fat). While it is too soon in the research to know if there is a direct relationship between hormone mediated changes in the gut and menopausal symptoms, it is hypothesized that the microbiome may play a mediating factor in body fat increases, cardiovascular disease, and cognitive decline.
Many women suffer from digestive issues in menopause. This may be attributed to the decrease in estrogen slowing down the motility of the digestive tract, which commonly leads to bloating, gas, and constipation. The hormonal shifts contributing to a change in the bacterial make-up of the gut may also result in poor digestion. The increased stress experienced by many women during menopause can also impact the gut microbiome. The bacteria in the gut communicates with the brain bi-directionally through the gut-brain axis. So if you are experiencing intestinal or digestive distress, it can be the cause — or the result –of anxiety, stress, or depression.
It’s probably not surprising that the lack of sleep common with menopause can also impact the gut microbiome. Add in the increased stress from multiple nights of poor sleep combined with all of the above and you have a perfect storm for a less resilient, less diverse microbiome. There are, however, ways to support your gut health and mitigate these effects.
A diverse gut is a resilient gut. With an increase in bacterial diversity in the gut, the body becomes more resistant to illness, cardio-respiratory fitness and metabolic health are optimized, and exercise performance is elevated. So how do you create a diverse, healthy gut?
When it comes to gut-healthy foods, keep it real, and a little dirty. Eat more plants that are organic or locally grown if you can. And when you are washing your veggies and fruit, a light rinse with water and a rub will suffice. No need to use soap or vigorously scrub as you may lose some of the beneficial bacteria.
Most importantly, have fun in the kitchen! As you transition your meals to include more plants, see how many you can tally in a day. Small additions can add up quickly as you diversify your diet. Smoothies are a great way to load on beneficial ingredients. And try acai bowls, or grain or salad bowls, where you can layer on beneficial ingredients and gain gut health rewards.
In high amounts, these tend to decrease the diversity of the gut microbiome. While it is near impossible to eliminate these all together, it is recommended to limit your intake and prioritize what to add more of. If possible, limit the use of pain medications, NSAIDs and PPIs as they similarly can decrease diversity of the microbiome. Speak with your physician before changing anything to your prescribed routine as the benefits of these medications may outweigh the impact on your microbiome.
When your gut microbiome feels off, you may be tempted to try the next new thing that comes your way. From probiotics and other supplements, to microbiome testing, there are plenty of new products hitting the market to tempt you. We suggest using a food-first approach as your foundation for a healthy gut. A diverse diet with a variety of foods is key “ even with probiotics. And most importantly, with microbiome testing – always check-in with your body. This area of study is still quite new, so approach with curiosity and keep an open mind. And be critical about the results to be sure they fit with what your gut is telling you.
If you need support in managing your digestive health, Gennev’s integrated care team can help you create a personalized plan designed to meet your wellness goals. Our dietitians have specific microbiome training to help you diversify and optimize your gut health.
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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 five, the final transcript in our 5-part series featuring Dr. Rebecca Dunsmoor-Su’s interview with David Steward on the SuperAge podcast, “HRT, Estrogen and Menopause, New Scientific Findings”, we’ll learn Dr. Rebecca’s take on whether intermittent fasting is beneficial, why strength training is key for women, and why it’s so important to support your bones starting in your 30s. Plus, Dr. Rebecca shares what she wants every patient to know about hormone replacement therapy. You can listen to the full podcast by visiting SuperAge.com.
David: I’ve had some questions from some of the people in our community about intermittent fasting, stress, and women, how they may react differently to this. And then, does that change with changes in estrogen levels or do we not know anything about that?
Dr.Rebecca: We do have some data on that. Remember, when we were talking about sleep and that metabolic rate change? Part of that discussion was that, when you’re not sleeping and your cortisol is not dropping to its lowest point in the middle of the night like it’s supposed to, then you end up putting yourself into a state of somewhat insulin resistance. So, not fully pre-diabetic, but there’s just a little more insulin resistance, which means you don’t process sugar as well. So, we know that happens. Step one is not so much hormone therapy directly changing that resistance, although, there is probably some interaction between estrogen and cortisol that we don’t fully understand, and so that is contributing, so estrogen can help. But the biggest thing is, when I start someone on hormone therapy and they start sleeping again, then we’re improving their metabolism. Does it mean that when we start hormone therapy and the weight drops off? No. Unfortunately, not. One thing we know from all of our studies is that, women who are perimenopausal or menopausal can lose weight, but it takes a lot longer and a lot more work. Unfortunately, some of these metabolic changes that occur are permanent.
I think intermittent fasting can be very helpful for people who are insulin resistant. For some women in menopause, intermittent fasting is a structure that can work for them. What I tell all of my patients however is what you need to do long term is make changes that you’re going to be able to sustain. So, if this is something that feels good to you, and natural, and normal, and it’s something you can sustain long term, great. That’s a great thing to try. But if you are struggling through each morning to not eat until 11, then, this is probably not the right pathway for you. There’s another way for you and everybody is different, as there is no one diet plan that works for everybody. People need to find what works for their body, and their lifestyle, and their system, and understand the underpinnings of their eating. A lot of what I do in my clinical practice is talk to them about this. What are you eating and why are you eating? Is this emotional eating? Is this bored eating? What are the things that we need to maybe think about and how do we substitute those things out?
David: I just want to go back to that the relationship between the cortisol question. So, does intermittent fasting in women cause a cortisol response that doesn’t happen in men?
Dr.Rebecca: We don’t know – that is my answer. I don’t know. I think, we haven’t studied it well enough yet to really understand how that might differ between women and men. I think that a lot more depends on other impacts on cortisol. So, whether it be sleep or the drop in estrogen, which also impacts cortisol levels, probably, more than the intermittent fasting itself.
The thing is cortisol is not a simple thing. The way our whole endocrine system is interrelated is very complex and not always all that well understood. We think of the endocrine system as multiple different systems. Think of the thyroid, the adrenals, the ovaries, but these are one big system that all interrelates in a way that we haven’t fully defined.
David: I’m a big proponent of strength training. But especially for women, there seems to be this delusion that they’re going to turn ArnoldSchwarzenegger without anabolics. I don’t think that’s going to happen.
Dr.Rebecca: No. Although, if you get testosterone pellets that may.
David: Yeah, that’s an anabolic. Right. If you’re not doing that, so talk tome about is there any counter indication to strength training for women?
Dr.Rebecca: No. Strength training is key for women for a multitude of reasons. One of the things that the drop in estrogen also does is it makes it harder for women to maintain their lean muscle mass. As we all know, lean muscle mass burns calories. So, you have to build that muscle mass back. Even if we put you on estrogen, you still have to build it back and maintain it. That’s just basic health. The second reason is strength training in the big muscles supports your bone. So, as women go through menopause, and they head towards osteoporosis, strength training in the core muscles, the upper body, the lower body, it’s key for maintaining bone health and bone strength and it also helps with balance and strength long term, so that even if you do get into a region of osteopenia or osteoporosis, if you have strong muscles and good balance, you’re going to be better off and less likely to fall unbreakable.
David: Are you having your patients do bone density scans, DEXA scans?
Dr.Rebecca: Oh, yes. In my patients, I do DEXA scans. The current national recommendations are to do a DEXA at 65. I often do it much earlier than that because I feel like by 65, they kind of miss the boat. So, I often will use them in my newly menopausal women who have a strong family history and who want to use that information to help them decide about hormone replacement therapy. So, that’s a good point to do it. I certainly use it anytime someone has fragility fracture, so, like a wrist fracture or refraction. And then, in general, I tend to get one somewhere in a woman’s 50s, just so we know where she is in the pathway to osteoporosis, and so she can start to make excellent changes early on. The recommendation to do it at 65 is really more about the medications, so the bisphosphonates and the MADs, and the medications that can rebuild them, but if we can prevent that bone loss, even better.
David: What’s the delta, what’s the change? That’s important thing, right?
Dr.Rebecca: Right, exactly. I tell my patients that I don’t care what your bone mass is, you should be taking vitamin D and getting enough calcium in your diet or between diet and supplement – and magnesium. Support those bones, we should be starting that in our 30s, because women build bone until they’re 30s, and then they start to lose.
When the Women’s Health Initiative came out in 2002 and everybody got scared away from hormones, it left this huge vacuum in the market where all of us physicians were saying, “Nope, we don’t do that anymore.” So, people stepped up and stepped into the breach, and started promoting things they called safer, or better, or more natural compounds, what they call bioidenticals. These are not safer, they’re not more natural, they’re made from the same synthetic hormone from the same pharmaceutical companies, just ground up and mixed into new bases that are unregulated. Therefore, unregulated in dose. This is not a safe pathway.
Please come talk to us. There are plenty of us out there who are North American Menopause Certified. We will happily talk to you about hormones. We were not afraid of them. But we use FDA regulated products which are safe and body identical.
The more we can get information out to women that this is a pathway they can explore safely with their physician, the better. A lot of physicians are still stuck back in 2002. They don’t understand all the data that’s come since. Find yourself a doctor who has actually read it all.
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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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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Women are on the cover of People magazine!
OK, we get that ordinarily, that’s not exactly stop-the-presses news, but there’s something special about their People of the Year cover.
First, there are actually four People of the Year covers for 2019. Second, three of them feature women 50 and older: Jennifer Aniston (50), Jennifer Lopez (50), and Michelle Obama (55). (The fourth is Taylor Swift, who is a bit young for this discussion, but we cannot WAIT to see her at 50!)
When People magazine, a publication known for the many youthful faces gracing its covers over the years, recognizes the power, strength, influence, and beauty of women over 50, you know that midlife has truly arrived.
“You don’t have the power anymore”¦.”We are doing this my way.” Voiced by Jennifer Aniston’s character to a roomful of men in The Morning Show, this could be women’s motto for 2019. Women are taking on the attitudes that have held them back, stepping into their power, and proving that gender, age, or a combination of both are sources of strength as not limitations on it.
Once, women over a “certain age” couldn’t get cast in shows; now they’re owning the screens, large and small. From daytime talk shows (Kelly Rippa turns 50 next year; Behar and Goldberg on The View are 77 and 64, respectively; Ellen DeGeneres is 61) to big-screen blockbusters, with 53-year-old Robin Wright’s fierce Antiope in Wonder Woman to extremely popular series such as The Morning Show, featuring Jennifer Aniston’s Alex Levy.
They’re beating back middle-aged-woman stereotypes in other realms as well: Michelle Obama’s book Becoming is on track to be the biggest-selling memoir in history. Jennifer Lopez’s new film Hustlers earned $33.2M at opening and she appears to be on her way to an Oscar nomination.
Turning 50 hasn’t slowed Gwen Stefani, who continues to tour and draw huge, fanatic audiences of all ages.
It’s not just entertainment where midlife women are thriving. Though she’s perhaps not as well known as Obama or Stefani, Mary Winston‘s accomplishments are no less impressive: at 57, she’s taken over the reins as Interim CEO at Bed Bath & Beyond. One of the first African American women to lead a Fortune 500 company, she brings a resume chock-full of experience and accomplishment.
What’s more, a larger-than-ever percentage of those women who are crushing it in life are doing it while contending with menopause. Hot flashes, irritability that can tip over into rage, interrupted sleep, brain fog; confidence-crushers like hair loss, weight gain or redistribution, acne, and wrinkles; unpredictable and often extremely heavy periods in the perimenopausal years leading up to menopause; depression and anxiety, and so much more.
Despite all those things, women are clearly still thriving in the second chapter of life. Imagine what they could do with the right support and with safe, effective solutions to help them manage the challenges of menopause.
Great, you say. Women are doing better. I guess we’re done here.
Uh”¦ no.
Despite women’s many accomplishments, there’s a long way to go. Women are still far more likely to be judged on their appearance. They receive far less investment capital when starting a business (a measly 2.3% of venture capital finds its way to women-led start-ups). Women’s “likeability” still matters much too much in elections and promotions.
Ageism hits women particularly hard: a woman’s earning potential tops out at age 40 (and has been trailing behind her male colleagues’ all along, particularly if the woman is of color), where a man’s will likely continue to rise until he hits 49. And women at 65 earn 25% less than men on average, potentially drastically limiting their retirement options and security.
The People magazine covers matter because representation matters: Women in this age group just haven’t traditionally been represented accurately as or at all.
Look for images of mature women (as I do, writing frequent articles about women in midlife), for example. There are a nearly infinite number of pictures of young women, doing all sorts of awesome things, and that’s terrific. Look for images of a woman 45+, and you’ll get a few women fanning themselves. That doesn’t represent me. It doesn’t represent the vital, active, ambitious, intelligent women I know and work with and see all around me. In midlife, women disappear and don’t return until they are “interesting again” as seniors.
This lack of representation repeats, rather more importantly, in a lack of research into mature women’s health issues, a huge gap in access to health care professionals who are versed in mature women’s challenges, a terrible dearth of information women can access to understand what they’re going through and solutions to manage it.
Seeing older women, acknowledging their existence, hearing their voices, learning about their triumphs and their struggles matters because what stays secret rarely gets solved.
Granted, Aniston, Lopez, and Obama may not be truly representative of the “average” woman, but I’d say they’re closer to us than we’ve been allowed to believe in the past.
Women over 50 are natural leaders. They have built up a lifetime of experience and insight. They are, often, less willing to brook the bulls**t of others. Women have spending power: 27% of consumer spending, or $15 trillion is in the hands of older women in the US. And mature women in power are bringing other women along. When there’s at least one female senior executive, women are three times more likely to be promoted to the same rank than when all the positions are held by men.
Menopause, despite its numerous and often-serious challenges, doesn’t have to be a limiting factor. Gennev exists to support women through midlife hormonal challenges because women have so much to do and so much to offer, and with just a little appropriate support, could have even richer, fuller, more vibrant lives.
How are you dominating midlife? We’d love to hear about your amazing accomplishments despite menopause symptoms, ageism, sexism, and so on. Share your triumphs and challenges in our community forums! And if you’re ready to start conquering the world, get your plan in order with a Gennev Health Coach.
A diagnosis of breast cancer can be terrifying, disrupting life, plans, even your sense of hope for your future. In honor of those who have been impacted by this disease, we’d like to offer a story of one woman’s journey from diagnosis through treatment and on to health and hope.
Joanne was diagnosed with breast cancer in 2005. That diagnosis, and the journey it took her on, required all her strength, focus, and resources. But one thing she really needed was surprisingly hard to find: reasons for hope.
“When I was diagnosed, I was lucky”I had friends, family, good medical care, and good information. But the one thing I couldn’t find was hope. I scoured the Internet for stories like mine, but it was all so negative. I wanted stories of people who had overcome this and moved on, but you don’t hear those, you hear the worst-case scenarios.
“I’ll never forget the day I walked out of the hospital after I was done with radiation. That was the final day of a journey that started with the diagnosis, the lumpectomy, the chemo, and finished with radiation. I felt like literally the weight of the world had been lifted off my shoulders. I was done. I just wanted to run forward and live for the future, for what’s out there. There is hope, there are lots of reasons to be optimistic, even with this diagnosis.”
So, if you can’t find a story of hope, become one. Here’s how Joanne did it.
In early 2005, Joanne was living in Chicago and had just finished her MBA. After two challenging years of full-time work and full-time school, she was ready to enjoy a bit of a break. In August, she got a dog (Molly) for her birthday; in September, she went in for a routine mammogram”all just life as normal.
Except the 45-minute appointment turned into four hours when doctors “found something.” Ultrasounds revealed a small tumor in her left breast, and the decision was made to remove the lump as quickly as possible. In October, Joanne underwent a lumpectomy.
“They removed the tumor, and then they wanted to do both chemo and radiation. I wasn’t gung-ho on doing chemo. Radiation is very specific, very focused on a certain area. Chemo goes through your whole body, it kills everything, both the bad and the good cells, to make sure cancer isn’t lingering somewhere else in your body.”
For a relatively small tumor, this was a pretty aggressive form of treatment. But because Joanne was only in her early 40s and pre-menopausal, her doctors wanted to ensure she’d have the 40 or 50 more years she still had coming to her.
The chemo lasted for two months, with treatments every other week. “After the second treatment, that’s when you lose your hair,” Joanne says. “The irony is, the main reason I didn’t want to do chemo is I didn’t want to lose my hair. I went and got a second opinion, I had additional testing, just because I didn’t want to lose my hair. After I had my surgery in October, they wanted to start the chemo right away, but I postponed because I wanted hair for the holidays. It seems so stupid now, but it was really important then.”
“One of the things I learned was, I had to do this”all of this”at my pace. People are pushing you, constantly, from all different directions, but I felt very strongly that I needed to do this my way to feel comfortable with the choices I made.”
Making decisions for herself, even if those decisions were limited to when she lost her hair rather than if, was a source of strength.
“I decided to start chemo in January. I was living in Chicago at the time, but I came home to Seattle in December, and my very dear friends gave me a great gift: as only two gay men can do, they took me wig shopping. We went for a spa day and then to find wigs. In the gay transvestite community, it’s all about celebrating the feminine in the best way, and we had the most fun shopping for wigs. I ended up with two: one we dubbed my “Nicole Kidman’ look, and the other was my “Meg Ryan’ look.”
While truly fabulous, Meg and Nicole weren’t suitable for work, so Joanne bought a more expensive wig and got it styled by a woman who specialized in adapting wigs for chemo patients. In the meantime, she got her hair cut short so when it did start to fall out, it would be less traumatic.
“I did all of this to be ready, as ready as I could be when you don’t know what’s coming. Everything I read said you have to be proactive, don’t let things happen to you, don’t be a victim. And one of the things you can do is, before you start losing your hair, go get your head shaved.”
Once her hair did start coming out, Joanne decided to take the step. A friend volunteered to go with her, and when they arrived at the salon, they were each given a glass of champagne. The stylist turned Joanne away from the mirror, and her friend kept up a constant stream of gossip from the many celebrity magazines dotted around the place. With all these distractions, Joanne really didn’t pay attention to what was happening.
“When the hair stylist was done, she turned me around to face the mirror. And I was like, huh. That’s not all that bad. I wasn’t in panic mode or anything like that. It just didn’t seem that important. I’d spent three months dealing with the anguish of losing my hair, doing all these things to avoid it, and by the time it came, it wasn’t a huge thing. When we walked out of the salon, my friend asked if I wanted to take my newly bald head out for a drink, and I realized”I can’t. I have a blind date!”
For months, a friend had been trying to set Joanne up with a man she knew, but they’d never managed to get schedules to match. Finally they found a date that worked, but in all that had been happening in Joanne’s life, it had slipped her mind. “I just couldn’t change the meeting again,” Joanne said, so she brought out the very expensive wig and wore it.
“When I tried the wig on before, I had hair, but now I didn’t, so the wig sat further down on my head, and I had to keep blowing my bangs out of my face. And I’d never worn it for more than five minutes, and now, two hours later, it felt like a vice and it itched.“
Neither the date nor the wig was a success, and neither got a second chance with Joanne.
She found cashmere caps at Nordstrom, and in keeping with her plan do this her way, she bought four and banished the wigs to the bedroom closet.
“I was fine,” she says. “The caps kept my head warm, and I liked the way they looked. I was fine.”
She was “fine.” But is being “fine” all there is?
For part 2 of 3, join us Monday, October 31. And if you have a comment or story to share with the community, please join us on our Facebook page.
Aching joints is a very common complaint for more mature folks. But what’s the connection between menopause and arthritis?
And more importantly, what can women do to manage joint and arthritis pain to maintain healthy, happy, active lives?
Dr. Darcy Foral, MD, is a board-certified, fellowship-trained Orthopaedic Surgeon at the Edmonds Orthopedic Center. We squeezed ourselves into her busy scheduled to get a orthopedist’s view of arthritis and other aches and pains.
Dr. Darcy: Arthritis literally means “joint pain.”
The word arthritis is thrown around by doctors and lay people alike to refer to a wide variety of aches and pains, and this creates a lot of confusion.
When my orthopaedic colleagues and I use the word arthritis to describe a condition, we are referring specifically to damage to a joint, significant enough that it is causing pain. We usually see this initially on x-rays or some other form of imaging (MRI or CT scans).
When we diagnose someone with arthritis, we have seen changes to the joint, usually narrowing and the formation of cysts or bone spurs, that indicate this process is happening.
Dr. Darcy: There are many kinds of arthritis.
The most common is osteoarthritis, which is the “wear and tear” type that happens to the majority of people as they age. While there is a genetic component to osteoarthritis, as some families get it worse than others, the science behind that is not yet clearly understood.
Another common form of arthritis is traumatic arthritis. If you had an injury, last year or in childhood, it can lead to damage to a joint that eventually causes that joint to wear out. The timing of the joint wearing out is usually dependent on the severity of the original injury. Repetitive injuries, like multiple ankle sprains from “weak ankles” can also lead to arthritis, even if the injury itself doesn’t seem that severe.
Finally, rheumatoid arthritis, falls into the category of autoimmune diseases and usually has a much worse prognosis. Autoimmune diseases can affect almost every aspect of the human body, but they have the common denominator of your own body attacking itself because your immune system has mistakenly identified one of your own tissues and foreign and something it must get rid of.
In rheumatoid arthritis, your body is attacking the lining of your joints and can cause wide spread destruction. Luckily, in the last 20 years, we have new medications to suppress this, and our treatments have improved significantly.
There is a strong genetic component to autoimmune arthritis and the diagnoses and treatment is also more complicated, usually being managed by a rheumatologist.
If rheumatoid arthritis, lupus, or a similar disease runs in your family and you are starting to have pain or swelling in multiple joints, muscle pain and weakness, or other unexplained symptoms that are sticking around and don’t seem related to activity, you should see your primary care doctor and let them know what you are experiencing sooner rather than later. They should be able to help direct you where to go next in obtaining a diagnosis.
Dr. Darcy: The good news is that menopause does not make your chances of getting any kind of arthritis worse in and of itself, but it can certainly feel that way.
Arthritis and osteoporosis
Most of us know that our bones get weaker with age (osteoporosis), with the maximum density happening before menopause. Once menopause hits and our hormones change, we start to lose bone density if we don’t work hard to prevent it, and sometimes even if we do.
Having poor bone density will not give you arthritis, but it will make you more prone to injury. Let’s say you start to get some compression fractures in your spine due to osteoporosis. As your spine compresses and the shape of it changes, you then develop arthritis in your spine, or narrowing of the joints, causing pinching of the nerves or narrowing of the spinal canal. These changes lead to back pain, nerve pain and weakness, and can be very debilitating as we age.
Arthritis and weight management
The other common factor that can lead to joint pain and arthritis is weight gain.
Some of us have to be careful our whole lives to avoid excessive weight gain, but for many women, menopause is the first time in their lives that they see their metabolisms change dramatically. I see so many women who come in for very legitimate musculoskeletal issues, and so many of these issues are either caused or made worse by weight gain.
It’s a delicate topic, because of course no one wants to be overweight, and when your body isn’t working well for you, it’s easy to continue to put on more weight.
We know from many scientific studies on osteoarthritis that extra weight will wear out your joints, especially your weight-bearing joints which are your hips, knees, and ankles.
Dr. Darcy: I think that it is important to remember that many things change as we age, and running five miles over lunch may not be the best choice of exercise for you any more, at least not if you have an injury.
There are so many fun, low-impact options that you can choose to keep active without increasing wear and tear on your joints. Swimming, biking, rowing, and yoga are easy for most people to access if they are motivated.
While many women shy away from weight lifting, keeping your muscle mass up is a great way to keep your metabolism from slowing down, and it also is the single best thing you can do to help keep osteoporosis at bay. Staying strong helps your balance as well; good balance means less risk of falls and fractures and the ability to remain independent well into your 80s and 90s.
Dr. Darcy: In the case of weight gain, yes, it really can, but there is a lot about diet we are learning, specifically the role of foods that cause inflammation, that may affect joint pain.
The make-up of our gut bacteria may also play a role in our disease processes and weight. I do not proclaim to be an expert in this area but I do watch it closely for solid recommendations to help direct patients who are looking for advice, as well as advice for myself!
Dr. Darcy: It is very normal to get a little joint pain here and there. We all get sore and “tweak” a joint lifting something or turning the wrong way. We get excited and over-do it at the gym or on an extra long hike, or if you’re like me, trying to keep up with the kids.
Joint pain or musculoskeletal pain that doesn’t go away with a few days of rest, ice, and ibuprofen should probably be checked out by a doctor. The RICE formula is a good one to keep in mind as your first line of treatment for aches and pains (Rest, Ice, Compression, Elevation).
Orthopaedic surgeons like myself are specifically trained to figure out what is wrong with your musculoskeletal system and direct you to your best treatment course (imaging, lab work, physical therapy, massage, acupuncture, bracing, injections or surgery).
Dr. Darcy: Even though we are surgeons, the vast majority of our patients do not need surgery. My goal is always to try to look at the big picture and find the best course of treatment for my patients, taking their whole lives into account, with surgery as a last option if all else fails.
I encourage all of you to find a doctor you feel respects you, takes your life goals into consideration, and helps make a reasonable plan with you to feel better and stay active and keep moving without daily pain.
I know from being a patient myself, it is not always easy to find and develop that kind of relationship with a doctor, especially if you are in a rural area. Reach out to friends, family, and co-workers to help find a doctor you are comfortable working with. If you can’t, online options might be the next best place to look.
While Dr. Google can be right sometimes, I encourage you to visit a physician if at all possible before you waste precious time and money on bad online recommendations or the wrong diagnosis.
Do you suffer from arthritis or joint pain? What are you doing to manage the condition and the pain? We’d love to hear your story and solutions, so please share with us by commenting here, or starting a thread in our community forums. You can also reach out to us on Gennev’s public Facebook page or in our closed Facebook group.
As vaginal tissue and pH change, more frequent UTIs can become a real problem for many women in perimenopause and menopause.
Many women in perimenopause and menopause find themselves repeatedly at the doctor, getting yet another prescription for yet another antibiotic. The problem is solved for maybe a couple of months, then *boom* “ the UTI is back.
Why? They’re doing everything right: staying hydrated, urinating after intercourse, trying new birth control methods, etc. etc. etc., and yet the stinging and cramping while voiding comes back time and again.
Listen to our podcast to learn more about why it happens and about an innovative new product from Uqora to help women of any age ward off the dreaded UTI.
If you prefer to watch the discussion, you can find it on YouTube. Be sure to subscribe to the Gennev channel, so you never miss a video!
TRANSCRIPT COMING SOON
Sexuality in menopause is tricky. Libido may be less robust than in previous years, or missing altogether.
Vaginal dryness or atrophy can make penetrative sex painful.
Weight gain, digestive issues, hair loss, and dry skin can leave us feeling distinctly unsexy and give our self-esteem a gut punch.
Add to that the challenges of a verrrrrrry long stretch of “us time,” and romance, intimacy, menopause and sex become about as interesting as cleaning out the refrigerator.
So what do you do when menopause and/or COVID 19 derails your love train?
We brought back “sexpert,” psychologist, and author Dr. Laurie Mintz and our own Chief Medical Officer OB/GYN Dr. Rebecca Dunsmoor-Su to talk about how relationships and intimacy can survive and thrive in difficult times.
Watch the video of their conversation on the Gennev YouTube channel, then subscribe so you never miss an episode.
TRANSCRIPT COMING SOON
How is your sex life surviving COVID 19 and menopause? We’d love to know how you’re managing to keep the flame alight. And if you’re struggling, feel free to share that too, in the Gennev Community forums.