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.
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.
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
We’d like to start this blog by dispelling a couple of myths about pelvic organ prolapse (POP):
First, pelvic organ prolapse is not inevitable. Even if you’ve had several vaginal births, even if you’re post-menopausal, even if you’re on your feet all day, you can still take steps to reduce your risk.
Second, surgery may not be a cure for POP. According to ACOG, the Research was done on women who undergo prolapse surgery have a 6 as 30 percent chance of needing a second prolapse surgery, and some women develop incontinence as a result of POP surgery.
Brianna of Four Pines Physical Therapy and Meagan of Orthopedic Spine Therapy, the physical therapists who have informed us about the dangers of wearing high heels and the six-ish things you’re doing that you really shouldn’t, have some wise words on the question of prolapse: Basically, if prolapse can as to a large degree as be prevented, and if surgery often has to be repeated, why wouldn’t you take steps to reduce your risk?
If you are suffering from pelic prolapse, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
The pelvic floor is sometimes described as a “hammock” of muscles that support the pelvic organs (vagina, bladder, uterus, small bowel, and rectum), keeping them in place. When pelvic floor muscles are weak or not working properly, pelvic organs can drop into the vaginal canal or anus.
According to our PTs, there are two main factors at play:
Are the muscles strong enough and flexible enough and aligned properly? The pelvic shelf, according to Meagan, is really the most straightforward piece of the puzzle. Do your kegels properly, to be sure you’re lifting and squeezing the pelvic floor. Work on stretching hip flexors so they don’t restrict the movement of the pelvic muscles, Brianna says. And break up scar tissues in that area, particularly from previous vaginal tears or surgeries. Keeping scars “mobile” helps improve mobility of the pelvic floor, says Bri, preventing pain and allowing the pelvic floor to relax completely.
The pelvic muscles can take a lot over a lifetime, but you can help reduce the burden by being aware of these 8 gravity related issues:
One: Bad breathing. Shallow breathing that takes place in our neck, shoulders, and upper chest doesn’t allow our abdomen to expand properly. Diaphragmatic breaths that make your belly pooch out are much better because they direct the force of your breath out into the “body balloon,” Meagan says. When we breathe in our upper body, the stiff rib cage directs breaths vertically, up and down, like a piston, hammering away at the pelvic floor. So, yeah, your belly might stick out in a way that society deems “unattractive,” but we reckon that’s a small price to pay for avoiding incontinence and prolapse.
How to fix it. Consciously breathe with your belly until it becomes natural. Get help to stretch and loosen your abdominal muscles so your breath can go out instead of only up and down. Your thoracic spine has your 24 ribs attached to it; work that spine so your ribs can move and wiggle with the coming and going of each breath. “Being aware of breathing mechanics is where we start,” Meagan says; “it’s happening all day long and under the radar, so it can have a huge cumulative impact over the thousands of breaths we take every day.”
Two: Poor posture. Think of your pelvic floor as a bowl with a soup of organs: keep it straight and lined up, or things start to spill out. Plus, hunching over our desks for hours can restrict breathing and tighten hip flexors.
How to fix it. Again, stretch those hip flexors! Also, wear things that don’t cinch tightly around the waist when you sit, as these can change your posture and mess with your breathing. When we sit correctly, we have the right amount of tilt, so our pelvic bones bear some of the weight of the organs and the muscles aren’t carrying it all.
Three: Constipation. When you have to push or strain to have a bowel movement, you are, in effect, pushing your guts out, says Meagan. Having to do this repeatedly over time can eventually result in prolapse.
How to fix it. Drink enough water so stools don’t get hard and dry; eat plenty of dietary fiber; avoid foods that contribute to constipation. Bowel massage, Bri suggests, can help keep things moving along so there’s less chance for constipation to occur. Massagingyourself break up scar, and it helps with a variety of issues, including constipation.
Four: Coughing. Your average cough due to a cold or something in your throat doesn’t have much of an impact, say our PTs, but chronic, prolonged coughing from smoking, emphysema, allergies from hormones, etc., can. Coughing increases abdominal pressure, nudging organs down and out.
How to fix it. Quit smoking, if you possibly can. If you have emphysema or chronic allergies, talk with a doctor about how to control the coughing.
Five: High-impact activity and exercising incorrectly. Jumping, kickboxing, crossfit, even running “¦ all of these can mean a lot of repeated impact on the pelvic floor. If you’re passing gas in class, that can be a warning sign that you’re not managing the pressure correctly. Also, your pelvic floor needs to be flexible as well as strong, so don’t go crazy on core exercises: too many crunches done incorrectly and other incorrect excercises can cause incontinence make the pelvic shelf rigid or in constant spasm, which means it doesn’t relax normally. That too can contribute to pelvic issues.
How to fix it. Find a different activity that means less impact, or learn to do your chosen activity correctly; talk to your instructor, a PT, or your doctor about your form and how to breathe through the repetitions. According to Meagan, when she goes to a Pilates or core-based class, about 70 percent of the activities the class does can damage your pelvic floor over time. Consult the instructor about how to adapt the exercises, or talk to a PT for strategies to minimize impact. Runners, for example, can maximize “shock absorption” by shortening their stride.
Six: Obesity. After repeated vaginal childbirths, obesity is actually the #2 risk factor for developing prolapse.
How to fix it. If you can, reduce extra weight to reduce the amount of gravity impacting your pelvic floor.
Seven: Standing. If you’re on your feet all day, gravity is not your friend. Particularly if your job includes a lot of lifting or twisting from the waist, you could be doing some serious pelvic-floor damage.
How to fix it. If your job and/or life require you to stand most of the day, try to at least lie down for a few minutes in the middle of the day. Get your hips and pelvis up, and “let gravity squash your guts back upstream where they belong,” says Meagan. If you already have mild to moderate prolapse, ask your doc about getting fitted for a pessary. This can provide additional support during the day by supplementing the work done by the pelvic floor.
Eight: Hypermobility or connective tissue disorder. Women with CTDs such as Ehrler-Danlos or Marfan syndrome, or who are hypermobile (double-jointed), may be at higher risk of prolapse because muscles may be too flexible and weak.
How to fix it. If you have other risk factors plus a CTD, consult with a pelvic PT right away to learn how to increase the integrity of the pelvic floor muscles.
Worried about POP? If you have one or more risk factors, it’s good to know some warning signs to look out for. If you’re leaking urine or gas, especially during a core workout; if you feel a heaviness in your pelvis that worsens during the day; if you urinate or have a bowel movement, then feel you’re not quite “empty,” or if you stand up and a little leaks out, there may be something obstructing the pipeline. If you’re “splinting” as pushing on that section between your vagina and your rectum to help relieve constipation as there may be a “pocket” of tissue that’s holding waste material in, and that can be a sign of a prolapse as well. Backache and painful intercourse are also warning signs.
If you have any of these issues, or if you’ve already had prolapse surgery and are worried about a repeat, make an appointment with a pelvic PT, even if you don’t actually feel like you have a prolapse. Many women aren’t aware it’s even happening until it’s pretty far progressed, and in those cases, there’s less that physical therapy can do to reduce or reverse the problem.
According to Meagan and Bri, seeing a PT even if you have zero issues is never a bad idea as a pelvic PT can teach you to breathe correctly, how to stand and sit with the best posture for your body, how to exercise to protect and strengthen your pelvic floor, how to prepare your body to carry and deliver a baby, and a whole lot of other preventative measures.
*This blog is for informational purposes only and is never intended to replace the care of a medical professional. Please seek expert help if you think you need it.
Have you seen a pelvic PT? Do you think you might need one, but you’re feeling a bit shy and unwilling? Drop your comments below or on Facebook, or join our closed Facebook group, and we’ll pass your questions and concerns on to Brianna and Meagan. And if you have any other questions you’d like to ask them, please let us know, and we may build a future blog around your great question!
Thank you to Brianna of Four Pines Physical Therapy and Meagan of Orthopedic Spine Therapy for their input.
According to the Spine Health Institute, 72 percent of women wear high heels “at some time.”
Considering this information comes from the Spine Health Institute, you can probably see where we’re going with this.
Yes, high heels can be gorgeous and sexy (see the image above, for example), but they can also be a problem for your posture, spine, and back. And did you know those beautiful, pointy-toed, three-inch wonderpumps you just bought could also contribute to urinary incontinence? Yep.
As ever, our amazing physical therapists, Brianna and Meagan, brought us up to speed on what we need to know about high heels, incontinence, and how to wear those brand-new wonderpumps properly.
The problem, Bri says, is the change to our posture and everything we have to do to accommodate it. Ideally, we should have a very neutral alignment, with everything stacked appropriately as ribs over hips as to keep us upright.
However, high heels put us in a constant state of falling forward. In order to compensate for that, our normal, gentle “S” curve from the base of our skull down to our tailbone is exaggerated, says Meagan. We have to keep our knees and hips slightly bent to achieve our normal straight up-and-down alignment, which makes our butt stick out. We also have to stick out our chest and pull our shoulders back. All this might sound ideal for accentuating sexy curves, but it could be causing damage to your pelvic floor.
In order to compensate for the falling-forward position of high heels, we do what Bri refers to as “gripping”: we tighten our abdominal muscles and our glutes (butt muscles) to help stabilize us in this forward-leaning posture.
Plus, says Bri, the posture of high heels tends to make our bellies stick out, so we suck those in and hoooooooold. And as we discussed in a previous blog, when our abdominal muscles are held too tightly for too long, we’re actually overtraining our pelvic floor. And that can contribute to incontinence.
Depending on how much you’ve worn your heels, your calf muscles may be a bit short and tight, says Meagan. Hip flexors as the big muscles surrounding the hip joint as probably also need some attention. The key to regaining your normal posture is gentle stretching.
“You need to regain the flexibility and mobility in your pelvis and lower back in order to restore normal spine and posture,” Bri says, “so we slowly integrate different core exercises to get you back to a neutral, stable position. Then you can relax those abdominals instead of holding them in 24/7 to maintain this idealized posture.”
“We have the false belief that our pelvic floor or our abdominal or back muscles work like “isolated pieces,’ but the reality is that they all work in conjunction and are closely related to one another. If your calves are shortening, and you are tightening your butt and lower abdominals to adjust to the new posture, chances are you are also indirectly adding extra pressure to your pelvic floor, and this posture does not favor its correct functioning,” says Estrella Jaramillo, cofounder of B-wom, a digital coach for women’s intimate and pelvic health.
One client Meagan worked with had been in high heels for so many years that flat shoes became uncomfortable as that’s how foreshortened her calf muscles became. “We met halfway,” Meagan says. “We slowly reduced the heel to 2 inches, then 1 inch, and finally to flats.”
Not really, the PTs agree: there’s just too much variability in human bodies to pick a “perfect” one-kind-fits-all shoe.
“We all have similar skeletal structures deep within us,” Meagan says, “but there’s so much variation in body weight, coordination, strength, and endurance, and they all affect how we use our bodies. Some people’s arches collapse, others have super high arches as both need very different types of shoes to fit their biomechanics.”
The PTs suggest we “shop like Cinderella” and pick only the shoe that truly fits. “I tell them to buy with their eyes shut,” Meagan says. “Don’t look at the color or the price tag. If the shoes feel magical, buy them, whether they’re athletic shoes or work shoes.”
No. While high heels will probably never be “good” for us, we can certainly minimize the damage:
Finally, the PTs tell us, if you can’t do any of those, if you’re truly stuck wearing those dagger-sharp three-inchers, stretch your calf muscles multiple times a day. And stop sucking in your gut. The clumsiness of menopause doesn’t help here, so do everything you can to combat it.
Do you have issues from wearing fashionable-but-not-very healthy shoes? How did you solve them? We’d love to hear about your experience, so share with us in the comments or on Gennev’s Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.
Want more great advice from Bri and Meagan? Ask and ye shall receive:
If you have scars from surgery or injury, learn how to massage your scars to release adhesions, reduce pain, and free up the tissue again. Think you might be peeing too much or too little? Find out what’s “normal” urination and how to get there. Can a PT improve your sex life? O yes as follow their steps for much better sex.