Skip to main content

Gennev is covered by insurance companies. Check if you are in network now.

The fact that blood clots is a good thing. It’s what allows us to think of minor, ordinary cuts, scrapes, and bruises as trivial rather than life-threatening.

However, blood clots become much more serious when they’re travelling around your insides, potentially blocking blood flow to your brain (stroke) or (heart attack in women), or when deep venous thromboembolism (DVT) moves up from your legs to your lungs (pulmonary embolism).

According to the US Surgeon General, pulmonary embolism from DVTs cause at least 100,000 deaths each year. And because we become more likely to suffer a blood clot as we age, it’s important we understand what they are, why does estrogen cause blood clots, and what we need to do to minimize our risk.

Menopause and Perimenopause Blood Clots

The link between hormones, menopause and blood clots in women is complicated and not entirely understood. Understandably, many women are concerned about their risk of blood clots if they decide to take birth control for menopause or use HRT to manage hot flashes as well as other perimenopause and menopause symptoms.

To get some answers, we turned to Dr. Emily Larmore Cooper, MD, of Sound Medicine and Wellness.*

How do blood clots in women form?

Dr. Emily: Blood clots form because the blood slows down or stops moving. Anything that prevents your blood from moving can make you more prone to developing a blood clot. Common examples include: genetic factors; personal history of a blood clot; immobility either from surgery, chronic illness or even travel; age, smoking, obesity and hormones all increase your risk of developing a blood clot.

Why Does Estrogen Cause Blood Clots?

Dr. Emily: The risk of developing a blood clot increases with age, particularly after the age of 40. Taking hormones also causes a small but increased risk of developing a blood clot. Together, the two combine to increase your risk. However, smoking alone increases your risk of a blood clot by 8.8 times.

Yes, you still need regular Pap tests, even after menopause. Learn why. 

There is a dose-dependent risk and lower doses of estrogen carry less risk. The risk of developing a blood clot is increased in the first 6-12 months of starting hormones. Hormones and blood clots do not increase with the length of time that someone it. Your risk is eliminated when you stop the hormones. There does not appear to be an increased risk with progesterone-only formulations.

Are blood clots more likely in perimenopause or menopause?

Dr. Emily: Women are at the highest risk of a blood clot during pregnancy and in the post-partum period. This is an even higher risk than women taking contraceptives.

“There is a small but significant increased risk of blood clot in
women taking hormone therapy,
but for healthy postmenopausal women,
the absolute risk is very low.”

In the Women’s Health Initiative study, a 2-fold increase in blood clot was found in women taking HRT. The risk was highest within the first year of taking the hormone replacement. Age is an independent risk factor for blood clots. The risk may vary with the type/dose and route of estrogen, but at this time, there is insufficient evidence to recommend one type of hormone replacement over another. There is a small but significant increased risk of blood clots in women taking hormone therapy, but for healthy postmenopausal women the absolute risk is very low.

If I have a personal or family history of blood clots, does that mean no hormones, like HRT?

Dr. Emily: A family history of blood clots could indicate that you have an inherited risk of blood clots. You should speak with your doctor about whether you should undergo genetic testing. If you have a genetic predisposition toward clotting, then you should have a discussion with your physician about the best options for you. Since pregnancy is an even higher risk condition for a blood clot than hormones, you should definitely discuss the risks and benefits.

If you need a professional opinion about blood clots for you, a Gennev menopause-certified gynecologist can give you a trusted evaluation, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

What can I do to minimize my risk, both in terms of medications to use or avoid and in lifestyle choices?

Dr. Emily: The biggest lifestyle measures are to be active, stop smoking and lose weight if you are overweight. Get up and move around when traveling long distances. Don’t cross your legs when you are seated. If you can’t get up, you can pump your calves by lifting up on your toes to keep the blood flowing in your calves. Discuss any medication questions with your doctor.

If you want a personalized lifestyle plan to tackle your blood clots, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

What are the signs that I might have a blood clot?

Dr. Emily: Pain, swelling, redness and warmth in a leg are all symptoms of a blood clot. It tends to be unilateral and it’s uncommon to have symptoms in both legs.

Fuzzy vision may be dry eye in menopause, or it may be menopause cataracts. Learn the difference and what to do next.

If I suspect a blood clot, should I head to the ER? When is my situation serious?

Dr. Emily: If you suspect you have a blood clot, you should seek immediate medical attention. Call your doctor and let them know you are concerned about a blood clot. You should be seen right away, but you don’t necessarily need to go to the Emergency room. If you can’t get into your doctor, you should go to the ER. If you are experiencing shortness of breath, chest pain or a racing heart, you should go to the ER as this can indicate that you have a pulmonary embolism.

If I have had a blood clot, will I have another? Should I never fly again?

Dr. Emily: You are definitely at higher risk to have a blood clot if you have previously had a blood clot. In fact, the biggest risk factor for having a blood clot is the history of a prior blood clot. However, this doesn’t have to cramp your travel plans. Speak with your doctor about ways to minimize your risk.

If I have a blood clot, what can my doctor and/or I do about it?

Dr. Emily: Blood clots are treated with blood thinners. Newer medications have made this much simpler in recent years. In the past, you would be hospitalized for initial treatment and then continued on blood thinners that required frequent monitoring with blood tests. Some patients can take oral medications while others require injectable medications. New medications are available that can be given orally and do not require frequent blood tests.

Your doctor will advise the best treatment for you. Typically, treatment lasts between 3-6 months.

So, what is your takeaway from all this? Well, blood clots are not something to be taken lightly. If you have a history, personally or in your family, make sure your doc knows and it’s a part of your conversation. But if you are a healthy, non-smoking, postmenopausal woman who’s never had a blood clot, the benefits of HRT may well outweigh the risks. Be sure to explore all your options ““ types of HRT, doses, and delivery systems ““ with your doc.

MORE ABOUT THE DOC: Dr. Cooper is a board-certified internal medicine physician who has practiced in Seattle since 2004. She is passionate about developing lifelong relationships with her patients. She recently launched her own clinic, Sound Medicine and Wellness.

Have you ever had a blood clot or is this a concern for you? Our team of menopause specialists would love to hear how you’re thinking about it, so please feel free to share with the community by leaving us a comment below, or talking to us on our Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.

 

Americas future surrounding women’s empowerment and the new presidency

This morning I watched Kate McKinnon’s performance (as Hillary Clinton) of Leonard Cohen’s “Hallelujah”.

And I finally cried.

It’s taken me a while to process last week’s election. As a woman, let alone a CEO of a women-focused business, I knew that I needed to make a statement. Take a stand. Be part of the solution. Not be a victim.

And yet, I couldn’t sift through the disbelief, the anger, the sadness, and the understanding and empathy for the millions of people who believe the outcome is right for them.

So I took some time and just buried myself in life with the reassurance that I indeed will process the outcome and share how I see it with you””women who aspire to be the best versions of themselves.

We started Gennev with the profound belief that women should feel fabulous in their bodies. No matter their age. That comes with taking care of the symptoms life’s aging and processing throws our way. The vast majority of Gennev-ers that we reach everyday with our articles and our healthy products are in the most vibrant years of their lives. They’re at an age where they’ve got confidence, they know what they want in life, they’re financially OK, their kids are relatively self-sufficient, their careers are in a good place, and their relationships are well-grounded or becoming more clear.

For many of us, the outcome of this election threatens the path for women’s empowerment and feeling fabulous. And for others, their lives are not threatened. They either believe that the new president will not impact their day-to-day, because they frankly don’t stand for many of the womanly things that a women-led, democratic administration would have stood for. OR, they’ve risen above it to say, “I’m the boss of me” and are taking action to sustain the path of success, confidence-building and support for other women they believe in.

I’m in the latter camp.

I grew up in North Dakota on a cattle ranch and farm. It was awesome, because there was beauty, peace, fun things to do every day, hard work (which I didn’t mind), and family. The days where we gathered, dirty and tired in the house at 10 p.m. after a long hard day of work for a drink and a late-night snack were blissful. It was a very conservative culture””both morally and politically. I understand it well, because I grew up in it. I don’t share the same conservative views today, but I certainly have empathy and love for the culture of people who do. Conservatives don’t represent all the bad parts of the incoming president””in fact, many have love and compassion for all types of people. But, in this election, many of those people didn’t have a better choice, and when needing to select a candidate that most closely represented what they stood for, Trump was their person. For others filled with hate and anger, I simply don’t understand them and only hope there is a uniting force that brings our country together in a way that I cannot see at this point.

I voted for Hillary. I was with her and still am. Am I ready to band together and work through our differences? I don’t genuinely feel that way””like a kid who’s been instructed to say they’re sorry when indeed they’re not. And yet, I know it’s the right thing to do, and I’ll get there. At my own pace.

The tears I finally shed today were a lot for Hillary. I feel so badly for her. In spite of her short-comings (hell, we’ve all got “˜em), she cares deeply for doing what’s right. She’s had to rise up to levels of strength that most of us will never comprehend in our lives. She’s had to fight back amongst highly public humiliations and allegations. And she’s always done so with confidence. She may not have the charisma of people we love to love””like many celebrities (that’s likely part of why they’re so famous)””but we don’t always need to like people in positions of decision, leadership and power. We just have to believe in their ability to lead on our behalf. We have to be able to respect them.

You may have seen the photo of Hillary hiking the leafy paths of Chappaqua, NY last week. I love how human she looked”¦still with a smile on her face. That’s the image we need to be reminded of and replicate when we’re feeling down in the dumps. I hope she gets more time for hiking in the woods in the coming days. I’m going to follow her lead and keep living my life with confidence, grace and a positive outlook”¦but not let go of all the things I stand for when it comes to women’s development, rights, health, and success.

Hallelujah for women like Hillary who dare to take such a bold stand!

 

If adopting one lifestyle change could ease many of your menopause symptoms, would you do it?

What if it were an an easy, painless lifestyle choice for most women to make (though sadly, not all)? Chances are you have it in your house 24/7 and readily accessible most other places.

It’s water.

Drinking more (good) water is the one simple lifestyle change that can possibly improve brain function, make skin, hair, and nails healthier, reduce urinary urgency and bladder irritation, relieve menopause nausea and hot flashes, reduce the intensity and frequency of headaches, and ease menopause cramps.

As we age, our bodies don’t retain moisture as well. In youth, we are 60-70% water; after menopause, women may be only 55% water, which is a substantial drop.

Why so dry?

Estrogen makes it easier for our tissue to retain moisture. As levels of the hormone drop, so does our body moisture.

Dehydration affects your everything.

Let’s start with your brain. According to neuroscientist Dr. Lisa Mosconi, “80% of the brain’s content is actually water. And every single chemical reaction that happens in the brain needs water to occur, including energy production. So, if you don’t have water or you don’t have enough, your brain will just not be able to make energy.”

So not enough water means less energy. But not only that. Dr. Mosconi continues: “Even a minimal loss of water, like 2% reduction, which is not even clinical dehydration, it’s just a very mild dehydration as it can actually cause neurological symptoms, like estrogen brain fog, confusion, fatigue, dizziness and even worse. Brain imaging studies have shown that people who are just mildly dehydrated show brain shrinkage as compared to those who are well-hydrated.”

If brain shrinkage doesn’t send you running to the water fountain, some other issues include drier, more brittle hair and nails, skin that’s flaky, dry, and itchy.Constipation and bloating are common as well as hormonal headaches. Unlubricated joints ache more. Your body thermostat may get (even further) out of whack: Some studies show an increase in hot flashes among women who are chronically under-watered. And drinking more water may help guard against bladder infections, and, somewhat counter-intuitively, incontinence.

How to rehydrate

First of all, not all liquid is created equal. While we’ve been told lots of liquids are actively bad for you, they may not be as bad as all that. Carbonation, it appears, doesn’t affect bone density. >Caffeine isn’t that dehydrating after all (but an FYI on that as the studies most seem to point to involve all men, and we know caffeine affects women differently).

On the other hand, sodas, caffeinated and carbonated drinks, and sugary drinks don’t provide the same benefits you get from plain water. Diet drinks, it seems, may have risks of their own, including an increased risk of stroke as though more research needs to be conducted to verify a link.

What to drink

Staying hydrated in menopause is important. Water contains nutrients, electrolytes, and minerals our brains and bodies need, says Dr. Mosconi, so filtered or otherwise processed water may not contain the same essential nutrients.

Spring water, on the other hand, may be best liquid for your brain and your body, as it contains the most natural assortment of nutrients. Just be sure you’re getting actual “spring” water, which is an FDA-regulated term.  

You should also get hydration from your food, namely fresh fruits and vegetables.

Many liquids can help you hydrate (not alcohol, though, sorry as that is a dehydrator), but they may come with other negatives such as affecting your teeth (fruit juices, sugary soda) or impacting your weight or wallet (fancy coffee drinks).

How much should you drink to help dehydration and menopause symptoms

According to our doctors of physical therapy, Bri and Meagan, divide your body weight in two, and that’s how much liquid you should be consuming in a day. For a 150-pound person, that’s 75 ounces a day. Drinking more water will definitely effect how many times you pee a day.

Oh, and if you suffer from night sweats and hot flashes, you need even more water to make up for the additional loss. Staying hydrated will also help you lower your other symptoms like fatigue and dizziness in menopause.

But that’s not all the math: two-thirds of that 75 ounces should be water. The remaining third can be “other,” such as coffee, tea, or juice. The PTs recommend getting a reusable water bottle with the ounces marked on the side to help you keep track of your daily hydration.

A study from 2013 found that nearly half of Americans weren’t drinking enough water. And the older we get, the study concluded, the worse we are about water. Our sense of thirst fades as we get older, so it may be time to track your intake if you’re concerned you’re not getting enough.

How much water do you drink in a day? Have you changed the amount lately, and if so, how has it impacted your menopause symptoms? Share your thoughts with the community in our community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.

 

your sexual wellness is in your hands

Or it could be.

Midlife brings a lot of changes, not all of them welcome. Maybe your desire for sex has dropped off, intercourse has become painful, or you’re ready to up your game when it comes to sexual pleasure and the goodness it brings to your body and spirit.

Team Gennev is partnering with Lioness to conduct a study in the latest innovation in sexual health and prepare women for the best sexual fulfillment of their lives. We’re looking for forward-thinking women to participate in a seriously open and frank conversation about age, sex, sexuality, and their impacts on our overall physical and emotional health.*

By completing the survey, you’re agreeing to be considered for our study. Those chosen will be asked to provide requested updates to the Gennev and Lioness teams. We’re going to ask some pretty intimate questions, but we will protect your identity, using only a first name and last initial or a pseudonym.

What’s the study like?

So, what do you think? Ready to help yourself and other women get their sexy back? Complete the survey, and let’s get started!

About our partners: Lioness is a women-led company whose mission is to destigmatize women’s sexual health through knowledge and conversation. Their first product is the Lioness vibrator, a smart vibrator that helps you explore your own, unique sexual response (yes, including your orgasm) and how your sex drive changes over time so you can have the best sex of your life.

*This study is open to residents of the United States only. All online applications must be received by August 4, 2017 at 11:59 PM PT.

A journey from diagnosis, to health and hope

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.

When “life as normal” suddenly isn’t

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.”

Finding hope step 1: Taking control of the process

“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.

What is arthritis?

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.

Is there more than one kind of arthritis?

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. 

Can menopause cause arthritis or make it worse?

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.

Magnesium can be helpful for both bone health and joint pain, so consider adding a magnesium supplement to your day. 

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.

How can I manage my arthritis?

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. 

Does diet affect joint pain?

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! 

When should I talk to a doctor about the pain?

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).

Will I need surgery for my arthritis?

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.

 

Menopause and sexuality is one of the many challenges of midlife that can take a toll on romantic relationships. If libido is not as robust as it used to be (or is non-existent), or sex is painful due to hormonal changes, or your relationship is on the brink of divorce for whatever reason(s), intimacy is suddenly a whole lot less attractive.

And midlife comes with plenty of “reasons”: caring for teenage children and/or aging parents, increased responsibilities at work, concerns about financial security in retirement, health worries “” who has the energy to even think about sex, much less engage in it?

Jessa Zimmerman

But if you want a more active sex life, you should have it. Sex and intimacy are actually really good for physical and mental health. So we engaged Jessa Zimmerman, licensed couples’ counselor and nationally certified sex therapist, to give us some quick tips to help re-engage your sex drive.

And it’s not just about sex. There are lots of ways to have intimate and supportive relationships, so if you’re looking for suggestions to help navigate uncertain relationship waters, we got that too.

But wait. At this point, we often lose those readers who are unpartnered and assume content about sex and love aren’t for them. This is for you, too. Masturbation and self-love “count,” “” YOU count “” so stick with us.

Sexuality and Menopause: Partnered  

It’s Valentime, which means lots and lots of articles about revving up your romance. But what if one (or both) of you is in menopause, and frankly, sex just isn’t all that appealing right now?

First, let’s all agree on one thing: this is not a “shaming” situation. No one should be shamed for wanting sex, for not wanting sex, or for being conflicted on the subject.

Generally, a woman’s sexual response is more complicated than a man’s, and penetrative sex may not be enough as and at this time of life, thanks to the vaginal dryness of estrogen loss, it may actually be quite painful.

Jessa’s advice for partners of menopausal women:

  1. Let her “warm up.” Give her time. Quite literally, you need to give her time to get the juices flowing. Extended foreplay is a great idea. Letting her set the pace and determine how far things go is awesome.
  2. Be physically affectionate, even if it doesn’t result in sex. If, for example, every backrub is just a prelude to intercourse, and intercourse is painful, suddenly backrubs aren’t all that pleasant. Be prepared to touch and cuddle without expectations.
  3. Buy lube. She may be embarrassed by the changes in her body, or she may want to have sex but fears the pain, bleeding, even infection from vaginal tearing that can result. Buy some lube for sex, have it handy, check in regularly to see if more is needed. Make it sexy or playful so it’s part of the experience.
  4. Talk. This is a tough topic, even with someone you share a bed with. Talk about sex when you’re not having it, and talk about it when you are as what works or doesn’t, what gets her excited or doesn’t, how you can both find pleasure.
  5. Get educated about a woman’s body and sexual response. Very few women of any age experience orgasm from penetrative sex alone. Learn with the clitoris is and how it works, be open to toys like the lioness vibrator to help her along.

And remember, sex isn’t the only place where your partner needs additional support during this time, says Jessa. Now is the time to be her ally and her cheerleader. If her self-confidence has taken a hit, boost her up. Show interest in her passions. This can be a powerful time of growth in career, second career, creativity or menopausal zest, so be supportive and join in if she makes a space for you.

Support her physical health by joining her or inviting her out for walks or runs or other physical activity. Encourage healthy eating by cooking some good Mediterranean diet recipes. Be sensitive and never downplay or joke about or call out her symptoms unless you know she’s truly OK with it. Listen. Ask her how she’d prefer you deal with her hot flashes or irritability, then try to accommodate.

This doesn’t mean you give up your life, we promise! But some flexibility and extra sensitivity could go a long way to making life easier for you both.

Jessa’s advice for menopausal women

You’re in menopause, and sometimes life is kind of “¦ miserable. Not only that, but you fear you’re making those around you miserable too.

We get it. Chances are you’re not the ogre you think you are, but we’ve got some suggestions for you too.

  1. Talk about sex. Advocate for what you want and need, Jessa says. If you’re getting what you want, you’re likely to want it more often!
  2. Initiate sex sometimes. Drive can become more responsive over time, Jessa says, so don’t just wait until you’re in the mood.
  3. Prioritize intimacy. Make time for undistracted togetherness. Be sure your partner understands this isn’t a guarantee of intercourse (to take the pressure off) and let what happens, happen.
  4. Get professional support or treatment if you’re struggling. Guilt or worry over whether you’re “normal” aren’t helpful or sexy, so see if a professional can help you get back on track.
  5. Embrace erotica. Suggest to your partner that you watch a sexy movie or read a sexy book together. Even if this doesn’t lead to sex, it can help “keep the embers glowing,” Jessa says.

This can and should be a powerful time for you. You’re probably freer from obligation and more independent than you’ve been in a while, maybe ever. Give yourself time to enjoy that, get to know you if that feels right, take control, set goals, live the life you want. If you want, you and your partner can find new hobbies, ventures, projects to do together.

Or, perhaps this is time to branch out on your own to live new experiences, then come back together to share. Being confident and finding pleasure in life can help you find confidence and pleasure in your relationships as well.

Unpartnered

Notice we didn’t say “alone.” You’re not alone, even if you’re currently not in a romantic relationship. The longest and most important relationship you’ll have in your life is with yourself.

And you’re changing. This transitional time can change our spirits and psyches as well as our bodies, so this is a really good time to get to know yourself (again).

Jessa asks: Are you ready to pursue new things, invest in yourself, leverage your new power at work or in your life? Or maybe it’s time to take a bit of a break, rest, re-energize, focus on self-love and self-care before embarking on your Next Big Thing. Whatever’s right for your next step, this is your time to figure it out, then pursue it. Be your own cheerleader!

And while you’re moving forward, don’t neglect your sexuality, Jessa says. The more you engage your body’s sexual response, the easier it becomes, so keep the fires burning. There are lots of great toys and tools for women’s sexual pleasure that don’t require a partner. You may have a new “body map” for pleasure, so get to know your body and responsiveness. It’ll be even more fun to share when you’re able to define exactly what suits you best!

Want more tips from Jessa Zimmerman? Be sure to check out her awesome book: Sex without Stress: A couple’s guide to overcoming disappointment, avoidance, & pressure.

Got thoughts to share on relationships, intimacy, sex, and love? Join in the conversations happening on the Gennev private Facebook group!

 

Guest blogger Dr. Barbara Mark weighs in on the parallels between adolescence and “middlescence,” when we get to ride that hormonal roller coaster all over again. 

I imagine many of you have wonderful memories of adolescence: shouting matches with your mother about how she just doesn’t understand you; long, insightful diary entries about your true love; confusing thoughts and feelings about what’s going on with your body; mood swings flinging you from euphoria to the depths of depression and back again.

Well, welcome to “middlescence” as adolescence with life wisdom and life experience as well as many more questions and a lot more responsibilities!

Symptoms of middlescence

Women I work with tell me they feel they are losing their minds. They fear they have serious health issues because of joint pain, heart palpitations, six-week periods, and daily headaches. They might fire every person who reports to them, they tell me, or quit their job altogether because they haven’t slept in weeks and are so depressed they can’t concentrate.

What’s really happening?

In fact, these women are going through significant emotional and psychological changes as normal changes that are part of being at this developmental stage of life.

Yes, just like adolescence, adulthood has stages, some of which seem impossible to navigate. It is a time of great hormonal transition as well as personal awakening to new aspects of yourself. Midlife and menopause are normal for women, and both resolve in time.

Is this happening in your life? The good news is that as just like adolescence as you will grow out of it!

 

Is HRT safe? What can I do about these hot flashes?

Consult with a menopause-specialist physician or nurse practitioner from the comfort of your home with Gennev’s telemed service.

Managing middlescence

While you’re waiting to “grow out of it,” there are things you can do to make the journey a bit more tolerable, even interesting.

First of all, have a good conversation with your doctor. If your doctor doesn’t have much information about perimenopause and midlife development, find a menopause specialist who can support you. Information about what is happening and why will make the experience easier.

Secondly, share information with partners, spouses, and children. No, they don’t need all of the details, but it will help them to understand what is happening to you and why you seem to be a different person than you used to be! This is a good time to find a third party to talk to if things at home are chaotic. A bit of coaching or counseling can go a long way to relieve the strains on a relationship.

Thirdly, develop workplace strategies. We live in a culture that is youth-obsessed. It can be very daunting for a woman to experience the tell-tale signs of perimenopause as like hot flashes as in a work environment. Perimenopause can make a woman feel old, and that can erode your self-confidence.

Most workplaces in the US are not very aware of or supportive of how to accommodate menopause in the workplace. (Countries like the UK and Australia are ahead of us in this regard.) And, because of very valid concerns about ageism, most women in the workplace don’t want to be identified as “middle-aged.” Having a game plan to deal with signs can help you feel confident and continue to be productive.

Let me give you some tips that I share with my clients:

Middlescence at work

OK, so maybe you’re not a teenager anymore, and the option to storm off to your room, slam the door, and write angsty poetry is no longer open to you. And perhaps you’re now on the “mom” side of those teen-mom screaming matches. You survived the hormonal roller coaster once; you’ll survive it this time too. Just be sure your strategies and support network are in place so you can thrive through middlescence.

How have you handled perimenopause symptoms in the work place? Do you have any tips for others? If you have a man in your life, how have you explained what’s going on to him? I would love to hear about your experiences! Please tell me about it in the comments below or on Gennev’s Facebook page, or join me and many women with experience to share in Gennev’s closed Facebook group, Midlife & Menopause Solutions.

 

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.

Covid-19 sexual health in menopause with Dr Laurie Mintz

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.

What is pelvic organ prolapse?*

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.

What causes pelvic organ prolapse?

According to our PTs, there are two main factors at play:

The strength and integrity of the pelvic shelf

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.

Can pelvic prolapse be reversed?

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.

Warning signs of prolapse

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.

How do high heels affect the pelvic floor?

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.

What can you do if you’ve been wearing heels for years?

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.”

Is there a perfect shoe for humans?

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.”

Do we have to throw our high heels away?

No. While high heels will probably never be “good” for us, we can certainly minimize the damage:

  1. Limit the height, the PTs tell us: go for 1 inch over 2 or 2 instead of 3.
  2. Choose a wedge heel over a stiletto for greater stability.
  3. If you’re wearing heels to be taller, find some that are also thicker at the toe, decreasing the difference from heel to toe while still increasing your stature.
  4. Wear them only a few hours instead of all day.
  5. Stay off your feet as much as you can when wearing them.
  6. If you’re walking to work, throw the heels in your bag and wear tennis shoes or stylish flats to cover the distance.

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.