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I love hearing from you.

Sometimes you respond to my requests for feedback, and other times I receive articles, media bits and links that speak to my love of caring for women in menopause.

Little did you know that we are taking your input, your shares, and your feedback to heart as we evolve how the Gennev clinic for menopause represents you: a beautifully diverse community of people of varying ages, ethnicity, countries, identities and social views.

With this in mind, we have been working behind the scenes on some exciting changes to Gennev. You’ll come to learn more about those in the months ahead.

For now, I want to share some of the “forwards” that I’ve received over the past few weeks. Thank you for making sure I’m in the know. Seriously, we’re trending.

Thanks to Dawn for sending me the latest from Kristin Scott Thomas in Flea Bag and her monologue on how “”¦menopause is the most wonderful f-ing thing in the world”.

Joanne sent me the latest on CBD and menopause at Ellementa.

And then there’s Deborah Copaken’s entertaining article “Exploring the Link Between Menopause and Alzheimer’s” (it’s more entertaining that the title sounds and it casts a light on our favorite Alzheimer’s researcher and friend Dr. Lisa Mosconi).

In other news, a couple weeks back I asked you, What do we call “women in menopause”?

Here’s a handful of the responses I received. Thank you for being so opinionated.

“I like to be referenced first as a person, second as a leader, and third, if my reproductive organs must shade my entire identity, as a woman.”

“Primetime”

“I am a 55-year-old woman who finds the phrase ‘the change’ so impossibly simplistic, it almost offends me. “¦I like to think of it as a ‘regeneration.'”

“”¦the Shifters, the Transitionals or (my personal favorite) the Sublimes. These would also be great all-female rock band names, but that’s another story.”

“Age-EMBRACING”

“I’m a Gennev-er. Feels easy on my tongue. I’m also a GenXer.”

“As someone who went through menopause at 30, I really hate the terminology ‘midlife’ as it assumes, we are a homogeneous category all of the one age bracket which is clearly not the case. I have no problem with calling myself what I am: ‘menopausal’ or ‘post-menopausal.'”

My takeaway is that we’re women. We’re beautiful and we have some time and experience under our belts, and we know who we are.

Thank you for keeping me current. Thank you for your creative thinking. And thank you for being part of the Gennev tribe.

Keep it coming”¦

genneve CEO Jill Angelo

 

At Gennev, we love to celebrate female entrepreneurs

Melody, we couldn’t agree more.

Everything was perfect: the cozy/cool venue of SIFF Cinema Uptown, that wonderful smell of movie theater popcorn, SIFF’s outstanding staff doling out wit and wine. You know it’s going to be a good night when the laughter starts in the lobby.

Generous sponsors had provided all sorts of goodies, so by the time everyone had filled up their goodie bags and made their way to the theater, the lights were starting to dim.

Jill, CEO and head Gennev-er welcomed everyone as we settled into our seats. Several folks mentioned it later, that you could feel the energy in the air. It wasn’t the excitement of knowing you’re about to see a really great movie, though that was certainly present too. It was the excitement of being on the cusp of something big. Of being a participant in something important and powerful and meaningful.

The Dream, Girl documentary explores the challenges of being a female entrepreneur: difficulties landing investment capital, lack of role models, even the well-intended but not always helpful advice from risk-averse friends and family. The women featured in the film are extraordinary for what they’ve accomplished, but they are also wonderfully, gloriously, human, mistakes and all. And this makes their success seem attainable for anyone willing to work hard and dream big.

As Dream, Girl producer Komal Minhas told me, the best way to experience the film is with a community, so you can talk about it after. So that’s what we did. We brought in a terrific panel of innovators, educators, and entrepreneurs to talk about their trials and triumphs in launching their business or in preparing the next generation of girls to take over the world.

Dream Girl Screening

The crowd asked great questions, including, “What were some of the mistakes you made?” Ally Svenson, co-founder of MOD Pizza, said her biggest mistake was “not having a healthy male ego.” She had a great idea she knew would work, but it took her three-and-a-half years to move forward. “It should have taken three-and-a-half months,” she said. Not having confidence in herself and her idea slowed her down””but it didn’t stop her. That business was hugely successful, and the next time she had a Really Great Idea, she went for it.

Leah Warshawski, producer and director of Big Sonia, admitted she makes mistakes pretty much every single day. “But,” she said, “as long as I learn something from it, I don’t really mind.” The one mistake she did regret, she said, was “not learning Excel sooner”¦”.

Another attendee asked how female entrepreneurs maintained their networks and did they think it was important to do so? The panel overwhelmingly agreed on how critical it is to find support and be support for others. Many female entrepreneurs face resistance and hesitation from well-intended friends and family, and that can be discouraging. Brenda Leaks, Head of Seattle Girls’ School, spoke about how her school makes it a priority to encourage girls to be support networks for one another from the start.

Jill asked the crowd if everyone who considered themselves an entrepreneur would stand. Between a third and half the crowd did, which explained why there was so much head nodding during the film and discussion, you could feel the draft.

And that’s why the atmosphere was so electric. We all understood the problems; we all saw the possibility of moving forward, together, towards solutions. Connections were made, right there and then, between innovators and entrepreneurs, between potential CEOs and someday-investors, among women who are ready for leadership and others ready for “followership,” as Brenda termed it. Our tribe is out there; now we begin the work of gathering and figuring out how we can make this rising tide lift all the boats.

“Loving the girl power.” We couldn’t say it better ourselves.

 

When it comes to health, many people take a piecemeal approach, focusing on one behavior change at a time. That can be a smart move, so you don’t feel overwhelmed with making lots of changes. However, “there’s nothing in our bodies that exists in isolation,” says Gennev health coach, registered dietitian, and exercise physiologist, Stasi Kasianchuk. When you start to change one area, for example, your level of physical activity, it can affect your nutritional needs such as needing more nutrient-dense foods and more fluids. If you’re not meeting these new needs, it can affect the quality of your workouts. Likewise, what you are eating can either support or sabotage your workouts. Here are seven eating habits that may be sabotaging your workouts and how to fix them.

#1 Eating too few calories. Calories are a unit of energy, and the number of calories in food is the amount of energy you can get from eating that food. So, the fewer calories you eat, the less energy you’ll have for your workouts. Unfortunately, at midlife when extra pounds become an all-too-common phenomenon, trying to find the right balance can be challenging. Strategies like skipping meals and cutting out certain foods or food groups can result in eating fewer calories, which in theory should help prevent weight gain, but it can backfire. Depriving yourself can leave you feeling hungry and tired throughout the day, resulting in lackluster workouts and often overeating at night. And when your body feels like it’s being starved, it conserves calories, making it easier to gain weight.

What to do: To minimize weight gain while ensuring that you have enough fuel to power your workouts, focus on eating nutrient-packed, fiber-rich calories like lean meats, fish, poultry, whole grains, fruits, vegetables, and healthy fats. These foods will fill you up faster and keep you satisfied longer so you don’t overeat. They’ll also fight fatigue, so you have more energy for your workouts. You should also make sure that you’re eating throughout the day, about every three to four hours, recommends Kasianchuk. Skipping meals and loading up on empty calories like those in highly processed foods such as baked goods, chips, cookies, and sugary drinks can tip the scales in favor of weight gain and leave you feeling tired all the time. These strategies should help you to balance your energy needs without having to count calories. Calorie requirements vary based on several factors such as age and activity level, but a general guideline for women in midlife is 1,600 to 2,200 calories a day, according to the Dietary Guidelines for Americans.

#2 Being dehydrated. As estrogen levels decline in midlife, your body doesn’t store as much water as it used to, so it’s even more important to make sure you’re drinking enough water. Fluids support your body’s metabolic processes that produce energy. When your fluid levels are low, it can slow those processes and leave you feeling sluggish. And who wants to exercise when they’re feeling fatigued? Hydration also plays an important role in regulating your body temperature. As you exercise your body temperature rises. If you’re not properly hydrated, it’s harder to keep yourself cool and comfortable as you work out.

What to do: Aim to consume about half of your body weight in ounces of water. So, if you weigh 150 pounds, you should drink 75 ounces of water a day. This includes herbal or decaffeinated teas, calorie-free seltzers, and infused waters like those with lemon or strawberries and mint. Caffeinated beverages like coffee and colas can contribute to your overall fluid intake, but they don’t have the same hydration benefits as water, so aim to make water your primary beverage choice.

You also want to spread your intake throughout the day. “Your kidneys are the size of your fists,” says Kasianchuk. “Chugging a large amount of water at once can overwhelm the kidneys. Smaller amounts consumed throughout the day allow your kidneys to process and utilize the hydration more efficiently.”

#3 Skimping on carbs. Carbohydrates have gotten a bad rap lately, causing many women to cut them out of their diets. But that can negatively impact your workouts. “When you start restricting carbohydrates, you lose fuel that’s so important for any exercise,” says Kasianchuk. “That can lead to low energy and feeling fatigued prior to and during exercise, which is going to make the workout feel harder. If it feels harder, returning for subsequent sessions is going to feel even more challenging.”

What to do: Not all carbs are created equal, so you want to make sure that you’re choosing the right ones to fuel your workouts. Instead of refined carbs like white bread, pasta, rice, crackers, and baked goods, choose whole-grain options which have more fiber and nutrients and provide longer-lasting fuel. Refined carbs are broken down quickly, resulting in a spike in blood sugar and burst of energy, but it doesn’t last and can leave you feeling even more wiped out afterward. A better option is to eat more vegetables, beans, and fruits which are high-fiber carbs. Aim to get about 25 grams of fiber a day. In addition to fueling your workouts, carbs also boost levels of serotonin, a feel-good hormone. That combo can make it easier to start exercising, give you the lift you need to push yourself to go a little farther or faster, and leave you feeling more invigorated after your workout.

#4 Not getting enough protein. This nutrient is one of the building blocks of your body and is involved in both growth and repair, especially for muscles. As you age though, you lose muscle mass and strength, which can make exercise and even everyday activities feel more challenging. Your body also requires more repair as you get older. If you’re not getting enough protein, you may not be able to recover from your workouts as well. “You may notice more soreness which may hinder you from getting back out there,” says Kasianchuk. Most women in midlife are not meeting their protein needs.

What to do: Eat some protein at every meal, including snacks. In addition, to giving your body the protein it needs for repair, this practice also provides more sustained energy. “When women incorporate more protein, they’ve told me that they feel more energized throughout the day, especially in that late afternoon slump,” says Kasianchuk. “That’s going to work in your favor if you’re an afternoon walker.”

To ensure you’re energized anytime you walk and have an adequate amount of protein for recovery, spread your protein intake throughout the day by including a protein source with all meals and snacks. Aim to eat at least 20 grams of protein with each of your three meals. This can be a palm-size piece of animal protein, a combination of nuts, hemp seeds, and soy milk in oatmeal, or ½ cup beans with quinoa. For snacks, worry less about the exact grams of protein and just focus on making sure to include a protein source. Have some cottage cheese or peanut butter with fruit, bean dip or hummus with veggies or on whole-grain crackers, yogurt with fruit, or tuna or chicken with mixed greens.

#5 Starting on empty. If you haven’t eaten in about two to three hours, you might find it harder to get yourself moving and less inclined to push your intensity while you’re working out. While you’re still getting benefits from any activity at any intensity that you do, if you are looking for a higher intensity workout, you’ll do better if you fuel beforehand.

What to do: Have a small carb snack with a little bit of protein 30 to 60 minutes before exercising.  Good choices include half an apple or banana with nut butter, yogurt, whole-grain crackers with bean dip, or carrots with hummus. You want to keep it small, so you don’t feel full when you’re exercising. The combination of protein and healthy carbs stabilizes blood sugar levels, fuels you with less, and provides more sustained energy.

#6 Too much sugar. Even if you’re avoiding things like cookies and candy, you may still be getting more sugar than you think. There are lots of hidden sources of sugar, such as cereals (even the healthy-looking ones), yogurt, condiments, energy bars, coffee drinks, and other beverages. These added sugars, not the natural kinds that are in fruits and vegetables, may worsen some menopause symptoms like fatigue, weight gain, and hot flashes””all issues that can disrupt your workouts. Sugar also increases inflammation in the body which may increase joint pain, especially if you have arthritis.

What to do: Read labels and limit the amount of “added sugars” to five teaspoons or 20 grams a day. In the past, it was difficult to separate “added sugars” from naturally occurring ones in foods, but nutrition labels now distinguish between the two, making it easier to track your intake. If a label doesn’t specify the amount of added sugar, check the ingredient list for one of the many aliases that sugar uses, such as ingredients ending in -ose, agave nectar, barley malt, brown rice syrup, dextrin, and malt syrup. The higher up the ingredient list it is, the more sugar is included in that food. Curbing your sugar intake should help prevent dips in your energy, keep off pounds, and may ease hot flashes and joint pain, making exercise more enjoyable.

#7 Lack of variety. Another effect of restricting what you’re eating is that you tend to eat the same things. Different foods provide different nutrients. So, for example, a restrictive diet is going to limit your intake of antioxidants and anti-inflammatory nutrients, which can help combat joint pain, says Kasianchuk.

What to do: Don’t limit natural, whole foods, especially fruits and vegetables. The more colorful your diet is the more vitamins and other phytochemicals you’ll be getting. “Making sure that you get a variety of nutrients from a variety of foods can help to increase anti-inflammatory nutrients that can support joint health and decrease joint pain,” Kasianchuk says. If you’re going to limit anything, it should be highly processed foods with lots of added fat and sugar.

The next time you’re not feeling up for a workout either because you’re feeling tired or your joints are achy, think about what you’ve been eating. “Movement and what we eat have a synergistic relationship. Most people feel better if they’re moving and nourishing their bodies,” Kasianchuk says. A few simple changes in your diet may improve your workout performance””and perhaps more importantly, how you feel overall in midlife and on your menopause journey.

 

We can help you maximize your health in midlife

 

Egg freezing is still a relatively new fertility planning option for women and couples wanting to delay pregnancy for a few years.

We wanted to know more about this fascinating procedure that younger women are opting for to freeze their eggs, then have babies, safely, at a later date.

So we sat down with Dr. Lorna Marshall of Pacific NW Fertility. Dr. Marshall, practicing specialist in Reproductive Endocrinology & Infertility, co-founded the clinic back in 2005 and has been helping couples start or build their families ever since.

In the first part of our conversation with Dr. Marshall, we learned more about the science and history of in vitro fertilization (IVF), fertility medicine, and her own path to reproductive medicine. In part 2, we talked about the cultural changes that come with women and couples having more family planning power.

1:07 as vacation days, corner office, egg freezing: fertility planning as benefit

The number of women seeking family planning options has “shot up through the roof,” Dr. Marshall says, at least in part because some large companies are offering egg freezing as a benefit of employment. How has that changed the demographic of women who are coming in to ask about egg freezing?

2:08 as I’m 43, what do I do now?

Dr. Marshall tells us about the realities of egg freezing. Big one: ya gotta do it when you’re young.

3:29 as It only happens in the movies

Or to movie stars. Dr. Marshall says not to be confused by celebrities having babies in their late 40s or even early 50s; chances are they used donated eggs, not their own. It’s important to understand the realities of science and bodies, including their limitations.

4:05 as I’m here; what’s next?

When  woman comes to the clinic, what happens? Dr. Marshall talks about testing, gives us the egg supply explanation, and details the options women have when the results are in.

7:19 as Answering patients’ questions about fertility planning

When it comes to fertility, it’s critical to manage expectations. Doctors may not be able to give a woman an answer to the question, “Will I be able to have a baby with my own eggs?” as there are often too many factors. Find out what impacts fertility and how docs work with women to best reach their goals.

9:19 as Have my eggs been frozen too long?

Because the science of vitrification of eggs is still so new, Dr. Marshall says, some things just aren’t known yet, like, do frozen eggs have as for want of a better term as an “implant by” date? What stresses the egg? How long are vitrified eggs viable, and does the faster-freeze process put eggs at risk?

11:14 as Egg storage: what does it look like, how does it work?

Big tanks hold racks and racks of eggs, sperm, and embryos at the Pacific NW Fertility clinic, Dr. Marshall says. Some fertility clinics don’t store on site, but Dr. Marshall’s clinic has chosen to.

12:25 as The nitty gritty: how much does it cost?

As you can imagine, egg freezing isn’t cheap. And many insurance companies won’t cover “elective” egg freezing. With egg retrieval and the medications it takes to do the process, women can expect to pay $14 as 15,000 for a single cycle. That’s not the cost of establishing a pregnancy, Dr. Marshall reminds us; just the process of freezing.

14:07 as Not a decision to be made lightly “¦

The best age for freezing eggs may be a woman’s 20s, which is not usually when women have the money to have their eggs frozen. The cost may be changing for cancer patients, at least, Dr. Marshall says, with some state legislatures working to require insurance companies cover fertility preservation. Will insurance ever cover truly elective fertility preservation?

17:08 as Making babies: what do you love most?

We wanted to know what made Dr. Marshall want to come back to work every day. Her biggest reason probably won’t surprise you, but, she tells us, the growth and changes in the field have also kept her engaged in her work. “I’m in the heart of society, doing this,” she says.

19:15 as Egg freezing is still in its (wait for it) infancy, so do your homework

Because this procedure is still so new, it’s important to work with a clinic that’s actually made some babies from frozen eggs, Dr. Marshall says. There are lots of clinics that simply haven’t gotten to the “thawing eggs and making babies” part yet. She lists some questions women should ask before choosing their clinic.

22:00 as By the numbers: your chances of making egg freezing work

Like much about a woman’s body, her chances of making a baby may be wildly different from another woman’s chances, even at the same age, says Dr. Marshall. She shares with us some estimates of the chances of success based on age of mom and number of eggs retrieved.

Would you consider freezing your eggs in order to delay pregnancy? Why or why not? We’d love to hear your thoughts; please share in the comments section, email us at info@gennev.com, or let us know on Gennev’s Facebook page or in Midlife & Menopause Solutions, Gennev’s closed Facebook group.

Be sure to stay tuned to Gennev.com for that conversation, or subscribe to Gennev on iTunes, Stitcher, or Google Play, so you never miss an episode.

 

I’m a sucker for the Oscars.

In fact, I prepare for the night of the film awards ceremony and its role in amplifying stories that increasingly shape social views on topics like sexual abuse, racism and inclusion.

I watch the nominated films. I read up on the talent. I even make an awesome dinner and open a bottle of wine with my husband to take the show in.

What I loved most about this year’s awards was the winner of the documentary short category, Period. End of Sentence.

It’s a story about improving access to hygienic menstrual pads in developing markets as part of a non-profit titled The Pad Project. Their tagline: a period should end a sentence, not a girl’s education.

The filmmaker’s acceptance speech started with, “I’m not crying because I’m on my period or anything, I’m crying because a film about menstruation just won an Oscar.”

She said period and menstruation on live television. At the Oscars, no less!

It’s sad that I’m excited about such a small victory, but women of all ages, especially those in the menopause phase of life, suffering in silence because of the stigmas associated with their bodies gets to me.

Question: how many of you have avoided sharing menopause stories or the real reason you’re calling in sick for work or canceling an evening with friends because of a menopause-related symptom?

Is it that heavy menstrual flow that bounds you to the house; hot flashes that spring up in meetings; incontinence that keeps you from outings with your family; or brain fog that makes you feel like you’ve lost your edge?

Three years ago when we started Gennev, we surveyed 1500 women and asked what they needed in menopause. Their response was to “start the conversation” with the goal of lifting the stigma that’s tainted it since before our mothers’ generation.

It’s time we get informed. If you’ve got a symptom that’s nagging you, search on it and learn about what’s happening and what you can do to feel better. If you can’t find what you’re looking for, send us an email.

It’s time we see midlife and menopause as the start of the second half of life. This story about activist Michaela Angela Davis and how she looks at life at age 54 caught my attention as a feisty mindset that’s only possible with midlife confidence.

It’s time we arm men with how they can support the women they love.

It’s time we make it safe to talk about what we’re going through. Forward this email to one or two friends who may be curious about perimenopause or are struggling through it.

It’s time you take care of yourself. If you’ve got questions and feel a sense of concern in your gut, respect it. Take 15 minutes out of our day, book an appointment with a Gennev practitioner as or as join our community.

And maybe it’s time for a documentary on menopause….or maybe I should just stick with serving the women of Gennev.

Jill

P.S. If you see a topic you want me to respond to relative to women 40+ and our health and well-being, email me at jill@gennev.com.

 

Sometimes it’s extra hard to feel grateful for your life. And that “sometimes,” could include tough days dealing with menopause symptoms. Especially when you’re having a brutal hot flash, or series of hot flashes (ugh!).

Luckily, the season of giving is almost upon us, when it’s easiest to experience a sense of gratitude and then also enjoy the benefits of those positive feelings. 

The good news is that you don’t need to stop the gratitude party when you’re at a loss for stuff to feel happy about. In fact, that’s the best time to start feeling warm and cozy about things you didn’t even know you could feel grateful for.

Benefits of gratitude practices

The benefits of gratitude range from emotional to psychological to physical. Starting this type of practice can help you deal with your own sea of emotions as well as navigate the emotions of others. 

Pause any self-pity

When you’re in the thick of things (especially “bad” things), it’s easy to start believing your own negative narrative. 

Why did they do this to me? Why do bad things always happen to me? I wonder if I deserve this?

We’ve all been there, and we all still fall into it from time to time. 

More good news is that it’s pretty much impossible to feel sorry for yourself and grateful for something simultaneously. Don’t ignore your pain. But don’t get stuck in it either. 

How? Acknowledge it, and move on to positive thoughts (perhaps about other things, initially), such as gratitude.

You’ll feel better during menopause

Another one of the benefits of gratitude is that it can even help your body feel better! Studies show that people who practice gratitude daily show fewer signs of stress and anxiety. They sleep better, make better choices, and fewer suffer from depression. 

What does this all mean scientifically? 

Reduced stress and anxiety means reduced cortisol levels. Cortisol is that hormone that can turn your body into a butter churn of stress, which is why it’s called the “stress hormone.” 

One of the best ways to reduce your cortisol? Develop a loving-kindness practice. One such practice is to start writing out what you’re grateful for in a gratitude journal.

You’ll get happier

When you’re grateful for something (or someone), happiness almost always follows. In fact, studies show that patients who take note of happiness triggers feel more optimistic than subjects who were encouraged to journal their stressors. 

Gratitude can even make the recipient of your “thank yous” a little happier. Studies prove that the simple act of gratitude can make your workplace happier and your employees more productive. Better relationships, a happy demeanor, and increased productivity? Let’s do it!

You’ll gain a better understanding of others (and yourself)

Gratitude can even give you some insight into the actions of others, otherwise known as empathy. When you’re grateful for everything in your life, you suddenly start opening your eyes to the lives of others. 

Let’s say you notice that you’re grateful for your morning coffee, and you acknowledge it every day. The beans, the aroma, the extras like cream, milk, sugar, or honey you have and get to enjoy. You love your hand-thrown ceramic mug, and you especially adore that first rich, warm sip of your first cup of the day.

After a time, you may start noticing all things coffee-related, especially if someone is asking for spare change on a cold day to try to buy a hot beverage. You might then just realize that the freedom to buy a cup of coffee every day really is a lot to be thankful for.

You’ll increase your emotional IQ

All of this empathy begets more empathy. Feeling happy, understanding others, and getting healthy can get you in the right mindset to start seeing what changes you can make in the world. 

Emotional intelligence is the ability to navigate emotional relationships with empathy and self-control. It can help you strengthen your current relationships and build new ones. 

How to start a gratitude practice

The good news is that there are no set rules on how to start a gratitude practice. That being said, we’ve put together a few suggestions to guide you in building your own practice and starting to enjoy the benefits. Take a look:

Start small

You’re more likely to stick to a new habit if you don’t go all out in the beginning. Instead of asking yourself to make a list of 20 things to be grateful for each day, just start with one. 

Set a timer on your phone for the same time every day. When the timer goes off, write down one thing you’re grateful for. Easy.

If you’re in a rut, you can always keep a few writing prompts in your pocket. Some of our favorite things to be grateful for include:

Just start writing down stuff you love and why you’re grateful it’s in your life. Or, don’t write it down at all. Make a list in your head on your morning commute or on your lunch break”¦ or while you’re on hold on a call.

Keep a gratitude journal

If you really want to get fancy, you can start writing down your gratitude lists in your journal. Or, buy a special journal or notebook just for this practice. One of the benefits of gratitude journals is that you can go back and remember the good stuff during the rough times. 

A couple of our least-favorite parts in going through menopause are hormonal fluctuations and depression. And as we all know, depression lies. When you’re starting to feel like there was never a time you were happy, crack open your gratitude journal to find the proof you left for yourself.

The important thing is to get really specific about what you are grateful for and also why you’re grateful for it. 

Instead of writing, I’m grateful for my husband, Ted, expound. I’m grateful for my husband, especially when he takes out the trash because he knows how much I hate going out to the cold garage at night. 

Do you see the difference? Writing the why triggers emotional responses in your brain. As you write out your why, all you can think is, “Dang it! I love that Ted. He really goes out of his way for me.”

Find a way to be thankful for the challenging stuff

Let’s face it: it’s easier to be grateful for the good stuff than the bad stuff. We assume right now you’re rolling your eyes at us and saying, “What the hormone is this? How can I be grateful for the crap that’s going on?”

We get it. It is tough. 

But have you ever had something really crummy happen (you lost your job, broke up with a significant other, or ruined your favorite sweater) only to find out that losing that job was just the kick in the pants you needed to start your own company? (Let’s not even get started on that sweater… it was sooo 1994.) 

You weren’t grateful for losing those things in the moment, of course. But when you reflect on the situation now, you may realize that the tough and crummy stuff were necessary evils in order to get you onto the current path to financial, and fashion, enlightenment. 

It’s a very tall order, some days. And as humans, we may not be grateful every single day. We go through some really hard stuff, including menopause.

So, if you can, be thankful and be specific.

Why a gratitude practice works

Don’t just take our word for it. This information isn’t just anecdotal, it’s also quantifiable. 

When we are grateful for something, our hypothalamus and ventral tegmental area are activated. The hypothalamus manages stress, and the ventral tegmental area is our brain’s “pleasure center.” 

That means that the same areas that are affected during sex and eating chocolate cookies are also activated by feelings of gratitude. And while chocolate cookies might give you a greater boost in the beginning, their return on investment diminishes over time as we start to feel the negative effects of weight gain, sugar crashes, and depression.

Ultimately, gratitude practices can transform our bodies and minds, inside and out. But don’t take our word for it: give gratitude a chance yourself. You’ll be so grateful you did.

If depression or anxiety are especially tough to walk through, we encourage and support you in talking it over with your doc (or ours) or bring it to our community forums. It’s important to feel as good, and as well, as you can during this important change in your body and life.

 

Hands up, who is experiencing some (additional, worsening) achiness or pains in their joints since beginning to shelter in place? 

Schedules have turned on a dime, and so have a few roles and responsibilities over the last few weeks with the outbreak of coronavirus, COVID-19. Amid changes around the kids’ schedules, work logistics, or even being lately laid-off, there can be a tendency for people to shut down on some level, not only emotionally, but physically. 

 

If you are struggling with aching joints, 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.

Do any of these menopause symptoms for aching joints apply to what you’re going through?

You may be sitting for longer-than-usual periods of time, and feeling stiff or painful when you get up to run errands, prep or make the next meal, or take a bio-break. 

You may be working longer hours in a chair or even at a standing desk. And while we affirm that there are definitely a few benefits to the Netflix&Chill movement, we’re also firm proponents of experiencing (and enjoying) some varied tasks each day. 

 

Gennev is telemedicine for women. Online healthcare & support at home is here.

 

Incorporating a little more movement to prevent stiffening or aching joints or weight gain  can likely help brain and body balance as well. Shake up your day a little bit; variety in the schedule is a good thing!

 

What else could be causing pain or aches in my joints now?

It could very well be perimenopause or the onset of menopause. Review the Big List of common menopause symptoms or take our initial online assessment. 

So, what’s the connection between aching joints/joint pain and menopause? A handful of studies have been conducted, and more are needed. In a clinical research led by psychologist Carolyn Gibson, Ph.D. with the San Francisco VA Medical Center, she shared that women with menopause symptoms are nearly twice as likely to have chronic pain diagnoses, such as fibromyalgia, migraine headaches, and lower back pain.

When it comes to science and studies, observations are noted, but testing and specific findings have not been done. The observations that were documented:

“(Menopausal) Arthralgia is experienced by more than half of the women around the time of menopause. The causes of joint pain in postmenopausal women can be difficult to determine as the period of menopause coincides with rising incidence of chronic rheumatic conditions such as osteoarthritis. Nevertheless, prevalence of arthralgia does appear to increase in women with menopausal transition and is thought to result from reduction in oestrogen levels.” “” M. Magliano

Plus,

“Chronic musculoskeletal pain represents an enormous health burden, affecting over 50% of adult populations. Common sites of pain are the spine, knee, hand, hip and shoulder.1,2 There is a female preponderance irrespective of the cause of the pain.1,3,4 At the time of menopause, musculoskeletal pain is reported by more than half of women.5 Presentation with joint pain in women is greatest between 45 and 55 years of age.6 Although this appears to implicate the menopause and estrogen deficiency, direct causal evidence of a role for menopause is lacking, partly because musculoskeletal pain is so common throughout life.” “” Fiona E. Watt

The above study also notes that it is difficult to assess whether musculoskeletal pain is caused by arthritis or arthralgia due to the way previous epidemiological studies have reported on joint pain.

 

First things first

Talk with your doctor. This is a great topic to talk about and try out our doctor for women telemedicine at the same time. 

Safe movement is key here, so discussing best exercise options with one of our Gennev primary care specialists (or your doctor) online can support your physical, mental, and emotional health while minimizing exposure risk to COVID-19.

While you’re on the call, ask about nutrition, supplementation (specifically, magnesium glycinate for joint pain and as a sleep aid), best forms of exercise, and stress management. 

Movement is a helper, now more than ever, for physical, mental, and emotional health. We’ve got a short, browsable list of recommendations:

 

Movement resources 

 

More regular movement can support your whole body in myriad ways. If the topic of productivity feels like one of your pressures right now, a little time invested in exercise can assist in minimizing worries and maximizing your ability to sleep, stemming menopause symptoms, lubricating your joints and muscles to alleviate pain, and releasing needed endorphins. 

Balance out your schedule, engage in fantastic self-care, and feel better with a little more safe, regular movement.

 

What types of exercise are you considering right now? We’d love to hear about what’s working for you in the Gennev Community Forums. Join us.

 

It was a Tuesday, she remembers, and she was walking down the carpeted steps of her home to the kitchen on the ground floor. She miscalculated as there was one more step where she expected none, and her feet slipped out from under her. Just that quickly, it went from a normal Tuesday to the last normal day she’d see in a long time, as that misstep cost her two broken ankles.

Osteopenia and osteoporosis

Osteoporosis is a condition in which bones lose density, becoming weak, brittle, and less able to withstand impacts. Worldwide, one in three women and one in five men are at risk of an osteoporotic fracture, and the older we are, the higher our risk can be.

Most of our bones’ mass is created in our youth, and we reach peak bone density in our early 20s. After that, bone formation slows. In some, bone loss can outpace replacement, making bones porous and vulnerable.

When bone density is less severely compromised, it’s called osteopenia; when bone mass is even more reduced and risk of fracture is higher, it’s osteoporosis.

While neither condition can be cured, there are lifestyle and exercise modifications you can take to prevent osteopenia from becoming osteoporosis (or slow down the process) or to manage osteoporosis to reduce your risk of breaking a bone.

To understand how we can deal with bone density issues, we talked with our awesome physical therapists, Meagan and Brianna.

I’m a woman over 50; what do I need to know about bone density?

The first thing to understand, according to our PTs, is that there are no outwards signs of osteoporosis or osteopenia. Often the first time someone realizes their risk is when they’ve broken a bone. And while women are at higher risk, a significant number of men suffer bone loss, so everyone can and should take steps to have healthier bones, even if they feel fine.

Second important note from our PTs: a diagnosis of osteoporosis or osteopenia doesn’t mean that your active life is over and it’s time to break out the bubble wrap.

Just the opposite, actually, Bri says. People with bone loss need to be exercising to stay mobile, build strength, restore or maintain good balance, and retain a decent quality of life. Continuing to move is a key factor in staying more independent longer and later in life.

Lifestyle and exercise modifications for bone density

Straighten up! Posture and alignment are really important, say our PTs. Those of us who work at computers especially spend a lot of time in a “kyphotic,” leaning-forward posture, with our backs rounded. The vertebrae are constantly being compressed on one side, which can really put a lot of strain on those bones. As Meagan says, think of your spine as a stack of jelly donuts. If one side of those donuts is constantly being squished, you’re increasing your risk of spinal compression fractures, one of the most common fractures among people with osteoporosis. Exercises can help you maintain a more upright posture, strengthening back, shoulder, and butt (glutes) muscles to pull you out of the hunched posture that makes you more vulnerable for fractures.

Celebrate gravity. Gravity takes a lot of heat for its effects on us as we age, but here’s one time gravity can be a real help. As Meagan says, “bone gets laid down in lines of stress. Our bones are strong in the way we use them, so let gravity assist.” How? Think of your bones, like the long bone of the thigh, the femur. Lengthwise, from knob to knob, the bone is strong, and using it vertically against gravity, like climbing stairs or walking, builds bone. But if you stress it horizontally, it’s like taking an end in each hand and trying to break it across the middle. Introduce force along the length of the bone, the way nature intended; don’t bend, twerk, twist, or rotate along a different axis and risk a break, particularly if you’re already dealing with weakened bones.

Embrace resistance. Using your own body weight (plus our new friend gravity) in impact exercise is a great way to build bone. Squats, lunges as done correctly, these are safe exercises that don’t require twisting and can help with balance. Balance is critical when bones are weakened, since a fall can do a lot more damage than when bones are stronger.

Get lifting. According to Bri, both aerobic and resistance training exercise can provide weight-bearing stimulus to bone, but research indicates that resistance training may have a more profound, site-specific effect than aerobic exercise. Translation: get lifting (but don’t give up running).

While lifting weights is slowly gaining in popularity among young women, Bri says we should all be lifting weights at least a couple of times a week. Previously, many women avoided weights, not wanting to “bulk up,” but strength training can improve BMD (bone mineral density), and therefore improve bone strength. So add it to your exercise regimen, Bri says, but carefully. Free weights of anywhere from one pound to 10 or 15 pounds are probably sufficient for most of us, and weighted lunges or squats or light dead lift can give us the extra resistance. Consider getting professional help to learn how to lift, and how much, she says.

Work from where you are. If you don’t move much, now is the time to get going. But increase gently, especially if you’re already osteopenic or think you might be. Start with a 5 as 10 minute walk, Meagan says. Walk on a treadmill if balance is an issue. Add in stairclimbing or step-ups. Work the back side to improve posture, then walk some more to cool down. Ideally, you should be doing at least 30 minutes of exercise 5 days a week. If you’re doing things like yoga, Pilates, swimming, or biking, those are great, but they don’t generate enough impact to build bone; add in impact exercise such as walking or stairs to get a more fully rounded workout.

Breathe out and in, not up and down. We talked about breathing in the blog on avoiding prolapse, so here’s yet another reason to breathe right. Diaphragmatic breathing (from the belly) and core control help with posture and lung function to maintain mobility in your neck bones (“thoracic spine”) and ribcage. Since the thoracic spine is the biggest victim of spine compression fractures, this is a good place to work on.

Be your body’s best friend. Eat your calcium-rich leafy greens. Ditch cigarettes. Reduce or eliminate caffeine and carbonation. And advocate for yourself as insist on a bone density test. Since osteoporosis and osteopenia have no symptoms, this may be your only way to know if you’re at risk (short of breaking a bone, and let’s not count on that, shall we?). Get tested every other year, starting with this one, so you have a baseline to compare to in future. Eat right, and that includes eating enough calories. Women with a too-low BMI are also at an increased risk of osteoporosis.

Listen to your doctor. We’ve only addressed lifestyle modifications here, but there are medical interventions that can help you manage this condition. If you have osteoporosis or osteopenia, or think you might, seek professional advice before adding exercise or changing your diet to be sure you’re moving forward safely.

Finally, one really great thing you can do is to start educating the younger women in your life. Bone building mostly happens early, so you can do someone a huge favor by helping them maximize those years.

If you have osteoporosis or osteopenia, how are you handling it? We’d love to hear your story, so share in the comments below, on Gennev’s Facebook page, or in our closed Facebook group, Midlife & Menopause Solutions.

 

Talk to a group of women dealing with menopause symptoms, and it won’t take long before someone brings up the question of hormone replacement therapy (HRT) and “bioidentical progesterone cream” or “natural” hormones vs “traditional” or “synthetic” hormones.

Which is best, most effective, safest? Chances are you’ll get nearly as many answers as questions and still not know for sure.

It’s your health, your comfort, and your quality of life that are at stake here, so at Gennev, we want you to have the facts. Our Director of Health, ob/gyn and epidemiologist Dr. Rebecca Dunsmoor-Su, breaks it down for us.

What are bioidentical hormones?

So that we’re all talking the same language, let’s be clear about our terms.

The term “bioidentical“ refers to synthetic hormones that are identical to the ones your body naturally produces. “Natural“ hormones come from plant or animal sources, and while not synthesized in a lab, they still have to be processed in a lab in order to become bioidentical (and usable for the body). “Compounded bioidenticals“ are treatments that have been created in a compounding pharmacy using bioidentical hormones. It’s these compounded bioidenticals that can be problematic.

A lot of people will assert that “bioidenticals” (meaning “compounded bioidenticals”) are safer than those traditionally prescribed in Western medicine. Sadly, not only are compounded bioidenticals no safer than traditional medications, they’re often actively hazardous to a woman’s health.

According to Dr. Rebecca, the truth is, treatments bearing the bioidentical or natural label are made of the same stuff traditional treatments are made of. “There’s only one place to buy estrogen and progesterone,” Dr. Rebecca says, “and that’s from the pharmaceutical industry.”

So the estrogen and progesterone in compounded bioidentical treatments and in traditional treatments start from the same place as as big crystals of hormone which are then turned into treatments.

The difference is in how those base elements are made into the treatment you pay for.

Compounded hormones

First, says Dr. Rebecca, it’s important to understand that hormones are healthy and good and safe when prescribed and used correctly. “I do not want to put down compounding pharmacies in general, they are excellent for many purposes. In fact, I use them myself for topical numbing cream for my clinic. I am warning specifically about compounded hormones.”

So what’s bad about compounded hormones? The problems occur in the preparations.

“Compounders are literally taking the exact same medications I would prescribe as estradiol and micronized progesterone as grinding it up, mixing it in a cream even though the medication may not be designed for systemic absorption, and telling you to rub it on your body,” Dr. Rebecca says.

If it’s the same medication, why is that a problem?

“There are a couple of problems here,” Dr. Rebecca tells us. “You don’t know how much of the hormone you’re getting, that’s a huge problem. These treatments are not FDA-regulated, and there’s no way to tell how high of a dose you’re getting even from day to day. There’s no way to take a pill, grind it up, mix it with cream, and guarantee consistency of dosage. It’s not possible. Plus, that medication wasn’t designed to be used topically, so it may not even absorb into the skin.”

“Women are being told to rub it on their stomach, their arms, their clitoris, insert it in their vaginas, all sorts of places,” she tells us. “Topical estrogen absorbs through skin really well; we know that, which is why we make absorbable versions. And it can absorb in high doses. So I see women who have gotten a very dose of estrogen one day, and maybe a very low one the next day. Because it’s not consistent, her dosage and her experience with the medication can vary wildly from day to day.”

The situation is even worse when it comes to progesterone. For women with a uterus, if they are given estrogen, they must also have progesterone to avoid developing endometrial cancer. Taking estrogen alone, if you have a uterus, is practically a guarantee of endometrial cancer eventually.

Help from compounded progesterone cream

“Women are given progesterone cream by practitioners to prevent cancer as but the cream doesn’t work. Often the progesterone that’s used in these compounded preparations is micronized progestin, because it’s considered “˜bioidentical.’ But micronized progestin is too large, the molecules are too big to be absorbed consistently through the skin. So these women are taking estrogen, rubbing this cream on themselves to prevent cancer, and getting cancer anyway, because the cream doesn’t work. It wasn’t designed to be absorbed.”

There are two forms of progesterone that can be used topically and are typically found in “combined” patches (patches that contain both estrogen and progesterone): norethindrone and levonorgestrel. Even these don’t absorb all that well through surface skin, Dr. Rebecca says, and so the dosage of progesterone has to be quite high.

“Progesterone is absorbed best through the GI tract as so, an oral pill; through the vagina if prepared for that purpose; with a combo patch, though that’s not my favorite, or via an IUD like the Mirena in the uterus. I use these because I know what kind of dosing a woman’s going to get, I know it’s going to be consistent, and I know it’ll be protective against endometrial cancer.”

If you’re given a vaginal cream for your progesterone, be sure it’s not micronized progesterone. “Vaginal progesterone is for pre-term labor prevention and miscarriage prevention as these are the only uses it’s been studied and approved for. We do not have data to support the dosing and use in prevention of endometrial cancer with HRT. The small studies we have are inconclusive, so I would not use it for that reason.”

What about hormone pellets?

Dr. Rebecca is quite adamant in her objection to pellets. Why? Because they can have pretty awful side effects, and once the pellets have been implanted, side effects or no, they can’t come out.

Hormone pellets are tiny pellets no larger than a grain of rice that are surgically implanted under a patient’s skin or in muscle tissue. The pellets are intended to give a slow, continuous release of hormone. DHEA testosterone pellets are particularly popular for women hoping to revive their sexless marriage after menopause.

“The problem with pellets is, again, they’re not FDA-regulated, and we’ve seen that they can give an exceedingly high dose of hormone depending on where and how deeply they were implanted. Many women suffer significant side effects as a result, especially with testosterone. Women think they’ll get their libido back, have more energy, feel younger, and they may “¦ but they may also grow a beard, develop acne, have clitoromegaly, where the clitoris grows and becomes very like a small phallus, and develop a deeper voice. Those last two don’t go away when the testosterone does. The small phallus and the deep voice are forever.”

Frustration with pharma

Given all the risks and dangers, why do women still choose compounded bioidenticals?

According to Dr. Rebecca, often women who come to her to get help with menopause symptoms and side effects of poor treatment tell her they simply weren’t told.

“Whether the person giving her the treatment doesn’t know about the risks or is more interested in the profit, I don’t know,” Dr. Rebecca says, “But they just don’t warn women of the risks they’re taking.”

Another reason may be that women have come to be distrustful of standard Western medicine and doctors.

“I understand, I do. Western medicine has not always done right by women; ob/gyns don’t always listen, they don’t always understand the hormonal journey, they’re not always sympathetic. We haven’t done the research into menopause, we don’t have a lot of solutions. It makes sense that women are frustrated. And the flawed WHI study that convinced everyone that HRT is dangerous just compounded the damage.

“Unfortunately, often the only people offering relief are even less trustworthy, and their treatments are less regulated, less understood, less studied than the ones we have. And women are bearing that risk.”

How to be healthier

Women need to be their own best advocates while science and Western medicine catch up.

“Get a doctor you can truly trust,” Dr. Rebecca says. “We’ve gotten poorer at judging someone’s credentials and knowledge base and approach, so ask the important questions until you’re confident this person knows what they’re talking about.”

One good measure is to see if they’re certified by the North American Menopause Society (NAMS) for menopause care. All of Gennev’s telemedicine ob/gyns are required to have this certification.

And do your own research. Read Estrogen Matters by Drs. Bluming and Tavris to have a more informed understanding of HRT and the WHI study. Browse NAMS’ resource library. And of course, check out the resources right here on Gennev.

“If you have questions, a menopause specialist ob/gyn is probably your very best bet for answers. You’ll find them in Gennev’s telemedicine.”

Are you considering HRT and not feeling confident about the options? We’d love to continue the discussion. Please join us in our public forums, leave us a note on the Gennev Facebook page, or join our community in Midlife & Menopause Solutions, our closed Facebook group. 

 

That thing you’re doing that’s “good” for you? It’s not. Stoppit.

There’s so much information out there, from so many sources, it’s difficult to know what’s true and what’s false when it comes to taking care of our health.

So”¦we talked with our awesome physical therapists, Brianna and Meagan, to find out what things women are doing in an attempt to be healthier, and why they really shouldn’t. Turns out, some very “normal” things really aren’t good for you.

#1. You don’t have to pee it if you didn’t drink it.

The problem: incontinence or urgency. One of Brianna’s clients was suffering from urgency as needing to urinate very badly and occasionally not making it to the bathroom in time. She assumed she was simply drinking too much water.

The wrong solution: intentional dehydration. To fix the problem, she pretty much stopped drinking water and other fluids while at work. The problem with doing this, says Bri, is it means the small amount of urine she is producing is much more concentrated, increasing her risk of urinary tract infections, for example.

The right solution: water. It turned out that her problem wasn’t caused by drinking too much water; she was actually drinking too little, and her bladder was constantly irritated. Bri worked with her to slowly and properly increase her fluids, ending the irritation and getting her back to walking to the bathroom instead of sprinting.

#2. Baths are for the outside.

The problem: pain during intercourse. Meagan’s client was experiencing pain during sex as well as overall vaginal irritation.

The wrong solution: douching. Meagan explained to her client that the vagina has its own balanced system to keep it clean, and that the douching was only causing more irritation. “She was doing it more out of hypervigilance. She believed she could smell something,” Meagan tells us. “I examined her, and there was nothing abnormal or to be concerned about. Douching is not something we encourage. You’re messing with the delicate balance of the vaginal tissues, and you’re risking infection both on the outside and deeper within the vagina.”

The right solution: promote and protect healthy tissue. Sometimes the issue with painful intercourse is the tissues around the vulva are thin and delicate due to too little blood flow to the area. Pelvic floor exercises, Kegels, vibration and massage helped make the vaginal tissue healthy and more durable. Once that was resolved, the client no longer felt she had unusual discharge or sloughing of tissue, the issues which had led to her deciding to douche in the first place.

Irritation can also be resolved often by simply switching to cotton underwear, using a fragrance-free detergent, using the right intimate soap, and ditching the thongs, Bri adds. PS: this applies to steam cleaning of the vagina, according to Meagan as not necessary and potentially damaging to sensitive tissue.

#3. Clenching the core as nope.

The problem: wanting six-pack abs. While there’s nothing wrong with six-pack abs, a lot of us damage our bodies in the quest to get them.

The wrong solution: over-exercising our core and pelvic muscles. We hold our stomachs in, do too many crunches, over-exert our core muscles and basically put our pelvic muscles in a state of constant spasm. This can actually cause pain, incontinence, and urgency issues. “Hold weights over your head for 30 minutes, then tell me your arms don’t hurt,” Meagan says. “It’s the same with your pelvic floor as muscles need to clench and relax in order to become stronger.”

The right solution: exercise your core properly. Learn how to exercise your abdominals properly. Consult with your doctor or a pelvic floor specialist if you’re not sure.

#4. Is it over yet?

The problem: painful intercourse. Pain during intercourse can happen for a number of reasons: vaginal dryness due to hormonal change, birth control, or medical procedures; pelvic floor issues such as spasms, etc.

The wrong solution: endure. “Too many women think painful sex is normal and they should just “˜grin and bear it’,” Bri says. “They go somewhere else mentally and just endure it, but it really ends up hurting them, hurting the relationship.”

The right solution: education, openness, and lubricants! Painful intercourse doesn’t have to be your new normal after menopause or for any other reason. “Gals feel like they should be able to have intercourse without any supplemental lubrication,” Meagan says, “and they’re ticked off that their bodies don’t make what they need. They don’t want to deal with using lube, reapplying lube”¦ The problem is they’re causing all these micro tears in that tissue, and pain, increasing risk of infection. Just use a lube!”

#4.2: Amendment to #4 as “Use the RIGHT lube!”

The problem: painful intercourse, coupled (ha ha) with a desire to use “natural” lubricants.

The wrong solution: olive oil. Olive oil has exfoliating properties, meaning it causes the skin to slough off dead cells. This is not a part of the body one should exfoliate, Meagan says; nature has already taken care of that. Bonus info: jojoba isn’t the best choice either, as it’s wax based, and the small amount of wax can build up internally.

The right solution: do your research. If you prefer to go the natural route, there are choices that may well work for you. Just be sure you read research from credible sources, test any substance on another body part first, start small to test for a reaction, and report any unexpected or unwanted reactions to your doctor right away.

[Choose a lube that fits your needs and your lifestyle. Check out this lubricant info sheet from A Woman’s Touch]

#5: Hovering is for helicopters and hummingbirds

The problem: yucky public toilets. Few of us are completely comfortable trusting our bare bottoms to a public toilet seat or outhouse, no matter how picturesque. We’ve all heard horror stories of people picking up strange diseases or at least sitting in something suspiciously moist.

The wrong solution: hover. To keep our tushies safe, we hover above the seat when it’s time to urinate. Not a good idea, say our PTs. “If you’re not in a relaxed, sitting posture or full-on squat position, the muscles through your hips and pelvis aren’t relaxing. This means you’re having to generate extra abdominal pressure to push and force the pee out,” says Meagan. “This recruits the wrong muscles and totally messes with how normal peeing should happen.”

WHO KNEW???

The right solution: sit, Ubu, sit. Layers of TP on the rim. Know that if you don’t have an open sore at a contact point, the chances of contracting anything are pretty minimal. You’ll be fine. Or you can squirt some hand sanitizer on a piece of TP and give the seat a quick cleanse (but wait for the surface to dry to avoid skin irritation). Just don’t hover.

#6: Sunning it where the sun don’t shine.

The problem: lack of Vitamin D in the nether region. Apparently women feel their vaginas aren’t getting enough Vitamin D.

The wrong solution: exposing one’s genitals to sunlight or tanning beds. The real problem? THIS ISN’T A PROBLEM. This part of the body is hidden and shaded for a reason as nature intended it that way. A burn in that area can be extremely painful and damaging to very delicate tissue over the long term.

The right solution: get enough Vitamin D in the usual ways. Exposing the skin to sunlight is good, when done carefully to avoid damage. But maybe bare only the skin that nature and culture have deemed reasonable. ?

 

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.