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Seldom does a podcast recording stick with me like the one I recorded this week with Darcey Steinke.

Author Darcey Steinke is the author of the memoir Easter Everywhere and five novels: Sister Golden Hair, Milk, Jesus Saves, Suicide Blonde, and Up Through the Water.

In her latest book, Flash Count Diary; Menopause and the Vindication of Life, she chronicles her personal journey through menopause.

Our pre-podcast routine started like most of my interviews. Questions are emailed in advance, instructions given for the video-based zoom meeting, and mics readied for recording.

After a few minutes of figuring out the tech, our interview got underway. But not in the sort of formulaic intro I often use to warm up the conversion. We just dove right in. Like I was talking to a friend about her journey through menopause”¦and not just menopause, but life.

I inquired into aspects of the book I found peculiar or even overly assuming with regards to “women’s identity being tied to our fertile selves.”

I, for one, have never birthed a child nor do I long to, so I haven’t thought much about the importance of my fertility. I realize I’m probably in the minority on that one. Nonetheless, I was deeply curious about this departure of identity and how post-menopausal women reported feeling like neither female or male, or in some cases 100% male.

The book stretches from Darcey’s personal menopause stories of experiencing an orb pre-hot flash, to how whales experience menopause, to changing identity, sex, and social acceptance, to a dedicated chapter on anger.

I loved this most about her expression of an angry woman [and I paraphrase], “”¦an angry woman is scary and un-professional, while an angry man is just being a man.”

To say the least, I’m underselling the complexity with which she has researched and documented her spiritual journey through “the change,” and I recommend giving it a listen.

I highly recommend downloading the e-book. Hearing Darcey herself read her account of menopause brings a poetic, intimate feel to the story. It lessens the darkness and emphasizes the human.

In The New York Times review of Flash Count Diary, Jennifer Szalzi comments, “”¦the book still left me wanting more: more voices, more works about this transformation. The subject feels truly fresh and transgressive, while nubility is beginning to seem like, well, old hat.”

I think the conversation around menopause and this transformative part of our lives is just beginning. Thanks to women like Darcey for having the courage to approach it in the fullest expression of themselves.

Jill

P.S. Did you know Gennev has an entire podcast series that highlights interesting people working with women in menopause? Check it out here.

 

Yesterday was the day; my day for experiencing what decades of women have shared, grieved and suffered through for years.

I had my first hot flash.

I was out for a morning run. It was 46 degrees, overcast and windy. I headed up a slight incline. The same path I take every day.

I suddenly burst into a raging sweat, oddly on my back. I felt faint. Thought I was going to pass out, and that my heart was going to explode out of my chest.

I kept running, thinking that I just had to “run it out,” (like most runners, I assume this is an effective means of addressing a bad cold, chest cough, or even a temperature).

But this was different. The flash lingered on for about a block, and just as I was about to stop and take a walk break, it disappeared.

It was sort of like a sweaty, high feeling. I didn’t like it one bit. Fortunately, it was nothing like the topless woman at book club in the latest article on menopause in Oprah’s O Magazine.

But I did feel like I had crossed the chasm. Like I’d earned a right of passage into perimenopause as the thing that I talk about daily in my life as Gennev CEO and founder.

I sort of smiled. Remember when you got your first period? It was an experience you’d likely prepared for. Many young women search and look for the first signs of blood, and when it comes, it’s almost a mark of womanhood. I had to wait till I was 15 years old before I earned my womanly stripes.

And with yesterday’s hot flash moment, I felt like I had reached another milestone. While I’m years from menopause, the hot flash felt slightly epic.

I’m not trying to romance something that so many of you suffer from. I’ve never had a hot flash in front of an audience, a work meeting, or someone I’m trying to impress.

In fact, my virgin experience occurred when I was going to get sweaty anyways”¦on a run, no less.

But it did mark a milestone in my womanhood. And rather than feeling like my sexy was being stripped away, I kind of felt like I was more woman than ever.

The hot flash came at another interesting crossroads at Gennev. We’re starting to produce programs related to the symptoms of menopause, programs that will bring education, solution options and lifestyle behavior recommendations to help women find relief. Think 6-week programs designed to help you manage things like Hot Flashes, Insomnia, Weight and Fatigue.

Our first program is all about Hot Flashes, and we’re currently testing it with a small group of women steeped in hot flash flux.

If you’re interested in being part of a select group of Gennev community members who will receive FREE access to the inaugural Hot Flash program, send an email to info@gennev.com, and we’ll put you on our list for a Nov/Dec launch.

Till then, my hot flash sisters, send me your remedies for managing the flash, and I’ll post up your recommendations in the Gennev community.

Jill Angelo

 

We’re doing some celebrating at Gennev!

This week we announced a major investment in the company from investors who believe women’s health in menopause and the second half of life is worth investing in.

They care. We care. And there is a lot of work to be done to bring real solutions to you.

BlueRun Ventures, Maven Ventures, Startup Health and one awesome angel investor came together to invest $4 million in Gennev to improve how we care for you.

I can’t get the smile off my face as not only because we get to grow the team of people working to deliver better products and services to you as but because women’s health in the second half of life is on the map!

No longer are “post-baby” women assumed to be invisible or irrelevant. Rather, we’re a hot investment “¦ and we matter when it comes to being the best we can be.

However, money only works when you put it to use the right way.

This is where you come in.

Regularly, we’ll be asking you, the Gennev community, direct questions about what you need. If we want to bring trusted experts, products and education to 500,000 women in the next 12 months, we need your involvement to get it right.

With half a million women giving us feedback, we’ll have enough data to bring you more predictive recommendations to head off new symptoms before you’re at a place of suffering.

Here’s what I need from you today: have you taken the Gennev menopause assessment? If you haven’t, please do. Then answer this question: if you had the option to speak with a health coach to review your results and create a plan for the symptoms you’re experiencing, would you do it?

Send your response to jill@gennev.com. I want to hear your opinions on how best we can deliver to you a personal plan for mastering your menopause.

You’re going to see some amazing improvements from us in the months to come, so now is the time to forward this email to two women you care about.

We’re doing something completely new and it’s going to take women everywhere to make the changes we need!

 

We at Gennev get a lot of questions about testosterone levels in menopause and testosterone therapy. Women are (rightfully) confused as some providers tout it as the missing link, and others are giving them dire warnings. Is the truth somewhere in between?

Yes and no. First, I think it helps to know a bit about testosterone in menopause and what happens. And as I often counsel patients to “know your sources” when it comes to health information I will tell you who my sources are:

Why do I tell you this? Because these organizations have huge panels of research along with physicians who analyze all of the available data to make recommendations. They have no vested interest and make no money from their recommendations.

First, physiology: What happens to testosterone in women? It is an important hormone, but is at a relatively low level compared to men. In women and men testosterone gets lower over time at a slow steady pace. There is no sudden change in testosterone at menopause. We know this by testing and because we see a big drop in testosterone if women have their ovaries removed, even after menopause. It is also good to know that testosterone is made by ovaries, but also the adrenals, and some is made in the “target tissues” such as the vulva and breasts.

It is also important to know that the general testosterone levels sent to a lab are not sensitive enough or reliable enough at female levels to be useful. They may show no testosterone. This isn’t diagnostic and is unrelated to wellbeing or sexual function. There are much more sensitive tests, but most doctors don’t know to send them and they are hard to find.

Many people advertise testosterone therapy as a “fountain of youth” or “great for weight loss”, “improve your sex drive”. Testosterone is an anabolic steroid. It is banned in sports. Why? It does temporarily increase performance, but you require more and more to maintain effect and as the levels go up it has cardiovascular harm.  What other side effects do women see with too much T?

Is there a role for T in women? Yes, sometimes. There are small studies showing short term low dose T with careful monitoring can improve sexual function in postmenopausal women. It showed an increase from 2 to 3 sexually satisfying encounters per month.

As there is no safe and FDA regulated women’s dose T in the US, this has to be done in person with an experienced provider using male products or compounds (not our favorite at Gennev) with every 3-6 month blood levels to be safe. T is also a controlled substance so you need a local doctor with a DEA license to prescribe it. The biggest bang for the buck in terms of sexual function is to use books such as A tired woman’s guide to passionate sex by Dr Laurie Mintz and apps like our friends at Rosy to work on the underlying issues behind the loss of desire.

The last caution I would give is to stay far, far away from pellets for T (or any hormone). These are unregulated compounds with a lot of problems and reported cancers, which the FDA has warned against using. The levels of T from they tend to be very high and we see a lot of side effects. The people who sell them promote them as safe and effective, but really all they are is a money maker.

I hope that helps to explain testosterone in women. We are always happy to talk about it at Gennev, but it would be inappropriate to prescribe this via telemedicine. If you think you might need testosterone therapy, the NAMS physician finder can help you find a local NAMS certified physician to discuss it with.

We can help you find menopause therapies that are right for you

 

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.

With the lack of clinics for menopause, many women already face inadequate or difficult-to-access care for their transition issues. And for women in much of the US, that OB/GYN shortage problem is only going to increase.

An Ob/GYN Shortage in the U.S.

The US could face a shortage of 8,800 ob/gyns in 2020. Because the current population of ob/gyns is older (16 percent below the age of 40; 36 percent over 55), and ob/gyns tend to retire younger than other docs (at age 59, on average), the problem is likely to get worse.

In this podcast, Gennev CEO Jill Angelo and Gennev Director of Health ob/gyn Dr. Rebecca Dunsmoor-Su talk about the potential impacts of the shortage on women’s health, and how it disproportionately affects women in menopause.

If you need an OB/GYN’s help, 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.

Filling the health care gap for women in menopause

Enter technology, innovation, and passion for women’s health: led by Jill and Dr. Rebecca, Gennev is helping fill the health care gap via our new telehealth service. Affordable, private, convenient video and text conferencing will give many more women access to healthcare practitioners who specialize in helping women manage menopause symptoms.

 

 

We’d love to know your thoughts about our telehealth offering. Are you excited about the possibility of having focused conversation with a menopause specialist? Eager to start getting answers via telehealth? Concerned about privacy?

Share your questions and concerns with us in the comments below, in our g forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group. 

Transcript

Jill: A June 2018 article in Fortune claims that by 2020, the US will be short 8800 OB-GYNs. Why is that a problem?

Dr. Rebecca: So I think that’s a problem for a couple of reasons. OB-GYN training is focused specifically on women’s health and it’s focused on all aspects of women’s health from really adolescence through to old age. And there is no other specialty where women’s health is the primary focus, where that is all we learn.

So for women, OB-GYNs are key during the years of puberty. They’re key for birth control provision. They’re key for childbirth and they’re key for managing GYN concerns through adulthood and through menopause. And really menopause is a key time in the life of a woman and OB-GYNs are the ones best trained to help a woman through that time of life whether it be with advice or whether it be with medication, whatever that is.

So it’s a problem that a good portion of women in this country really won’t have access to these women’s health specialists. I know that primary care doctors do provide some of this care for women, and they do a good job within what they can do. But they have so many other things that they need to focus on, and I feel like there are times when you just need a specialist and women deserve to have a specialist just like men deserve to have a specialist.

You know, nobody is talking about not needing urologists in this world for men. You know, women need a specialist physician who can care for the things that are very particularly female.

Jill: You know, on the topic of as you brought up general practitioners because I think that’s probably where women have the greatest access is to the general practitioner. Can you talk a little bit about the amount of education that they actually get on this part of women’s health or the lack thereof?

Dr. Rebecca: Sure. It varies very significantly depending on where they trained and whether they’re trained as internal medicine physicians or as family practitioners. Family practitioners probably receive a little more focus on women’s health, and some of them can even do a women’s health specialization. However that’s within the structure of a residency that also covers pediatrics and male health and a lot of other things.

In terms of internal medicine, it’s a three-year residency. But again they focus on adult medicine and all aspects of adult medicine. They have to manage hypertension. They have to manage diabetes. They manage a lot of things. So while they will have some training in women’s health, it is not the sole focus of the training that they get, and when you’re talking about an OB-GYN physician, we spend four years in residency focusing exclusively on women’s health and we do rotations that vary from obviously obstetrics and delivering babies and high risk obstetrics and we do women’s oncology. So GYN oncology which is ovarian cancer and uterine cancer.

We do breast clinic time. We do regular GYN time. We do office hours and a lot of us even get some exposure to adolescent medicine. We do a lot of time worrying about and thinking about birth control and how to best manage that in all types of women and more high risk women and that’s the only thing we focus on during the entirety of our residency over four years.

So while primary care can do a lot of basic women’s healthcare, they are not the specialized provider for that.

Jill: What population of women or what women are most impacted by the shortage of OB-GYNs in your opinion?

Dr. Rebecca: I would say rural women are most impacted. OB-GYNs tend to congregate in larger metropolitan areas and the reason for that is complex. You know, a lot of us do enjoy living in cities. That’s part of it. A lot of it is financial. OB-GYN is one of the poorest reimbursed specialties there is. I’m not going to go into the whole politics of women’s healthcare and why we get paid so badly. That’s a topic for another podcast.

But let’s just say that what we do is not paid well and the thing that is most profitable for OB-GYNs although it is not particularly profitable, it is probably the most reliable is obstetrics, so the delivery of babies. So for OB-GYNs to maintain a practice that is financially viable, they need to deliver a certain number of babies a year and you can’t do that in a rural practice. Often there just aren’t as many obstetric patients in that area.

I think there are a lot of great OB-GYNs who practice in rural areas and they do it for the love of the specialty and a lot of them do it in federally qualified health centers or other ways that they can perhaps make it financially viable. But there’s a certain proportion of patients and deliveries that you need in order to make it worthwhile to be an OB-GYN somewhere. So really rural women are the ones who are going to pay the price.

Jill: This shortage obviously has to impact OB-GYNs as well. What are the impacts that you feel as I’m sure you’re feeling overtaxed. Generally these specialists are busy. Like give it to us from the perspective of an OB-GYN.

Dr. Rebecca: So I think from my perspective, the key things that I feel with this deficit are that I spend a lot of time taking transfers in from as for our rural areas being in the Pacific Northwest. We do have a lot of rural areas and these are patients being transferred in because there is no OB-GYN accessible to them. So their primary care has attempted to do what they can for them but realizes that they need a higher level of care. So we’re spending money on ambulance, helicopter and air flights for these women to get to an OB-GYN. I think that’s a big impact and a waste of healthcare dollars that if we just were able to support OB-GYNs and provide enough, might not need to happen.

I find that women, when they get to me, are frustrated because they’ve been through so many providers who tried to do their best for them. It’s not that these providers are bad at what they do or not doing their best. It’s just they don’t have the same level of expertise and so they’ve been told multiple things and tried multiple things and by the time they get to me, they’re frustrated because they feel either there’s no answer for them or that they’re getting different answers. It takes a lot longer for me to explain that it’s not that the answers they’ve gotten previously are wrong. They were just first steps and that we now need to move to a more specialized level of care and it just takes a lot longer in that situation to care properly for a woman.

Jill: So let’s switch to then solution. We’ve kind of delved into the notion that there’s a real shortage for so many women. Why is telehealth a great answer to this shortage of specialists?

Dr. Rebecca: I think telehealth holds promise for a couple of reasons. I think one of the biggest issues is just you can talk to an OB-GYN specialist who is knowledgeable about the thing that you need to talk about. You can as a lot of what we do is face to face counseling. It’s not reliant on an exam. It’s not reliant on prescription even. It’s just that women need to talk to somebody who understands what they’re going through and can walk them through the process, give them reassurance where needed, talk to them about what things need to be followed up and a lot of that can be done just face to face over the computer.

There are times at which a prescription is needed or exam or even a biopsy type thing might be needed. But that can be referred out or at least a woman then knows that she needs to go find the specialist who may not be available in her community and it might be worth the trip in to see the specialist because she knows that these are the things that need to be done.

Jill: Yeah. Well, and especially for women in perimenopause and menopause, that notion of a conversation is so important. Talk a little bit about that and how video just really makes that an option for so many more women in terms of access.

Dr. Rebecca: Right. So in the perimenopause and menopause itself, a lot of what women are experiencing is natural and normal but it can be frightening if you don’t understand what’s going on and why it’s happening. So a lot of the work I do as a menopause provider is counseling. It’s just talking through symptoms and why they’re happening and how long they may last and if there’s anything that needs to be done about them.

A lot of women just really need reassurance as they’re going through this process. The biggest thing we reassure women about is that this process will end. You know, the perimenopause is not lifelong. It is a transitional time. It can be very crazy. It can be wacky for some women. When your hormones are fluctuating wildly, it can feel very, very different but that that will end.

You will go into a new normal which is different than the old normal and I can talk to them about natural remedies they might want to try. I can talk to them about diet and exercise and how those play into how a woman feels during this time. None of that requires an in-person visit.

If a woman is really struggling and might need to consider hormone therapy, then it’s worthwhile going to see an OB-GYN and she goes in armed with the knowledge that she has tried some of these other things and they’re just not sufficient and she might need hormonal intervention.

Jill: Well, let’s talk a little bit about prescription. How comfortable are you in terms of prescribing medication via telehealth? We see more and more of that happening and especially for women in perimenopause and menopause. We’re talking hormone replacement therapy.

Dr. Rebecca: So I think the ability to prescribe via telehealth is very much dependent on what we are prescribing. In terms of hormone replacement therapy, a lot of the conversations surrounding prescribing hormone replacement therapy relies on history and a woman’s symptoms. It doesn’t really rely that much on physical exam and I am certainly comfortable prescribing a hormone to a woman who I feel I have a complete medical history on, who is getting regular and routine exams by her primary care physician. I don’t need to do a specialized exam for that.

The one thing that a woman would need to understand before getting hormones prescribed online is that there are side effects of hormones and if any of these come up, she will need to see an OB-GYN perhaps for a biopsy. But that’s pretty rare and if she’s using the hormones correctly, it really shouldn’t become a big issue.

So I think this is one area where telehealth prescribing is actually very beneficial and we see that in other areas of telehealth where people are being prescribed birth control or things like that.

I think the area where it’s not as good is things like antibiotics for infections because that does require more of a physical exam which you can’t do via video camera. So I think there are areas where it makes a lot of sense and this is one of them and there are areas where it really doesn’t make sense and you still need to be seeing a physician.

Jill: You know, obviously many women and people in general but women are understandably nervous about entrusting their care to a video appointment. What would you say to a woman who’s uncertain about telehealth?

Dr. Rebecca: Well, I think the biggest point in establishing that level of trust is the conversation you have with a woman. If you’re involved in conversing with her, if you’ve read her history forms, if you understand the problem that she’s coming to you with and if you listen, then they will feel comfortable and certainly women who think that this is a bad method of healthcare don’t need to use it. They can go and find a physical physician to see. But that’s not an option for a lot of women and I think just having the resource and being able to try it and feel comfortable with it reassures a lot of women.

I think that Gennev, when we do our telehealth, one of the things that we do very well is we ask a lot of questions upfront. They fill out a good health history form so that we know what we’re dealing with and then I explore that with them when we’re face to face on the video camera. So I understand as you know, do they have any risk factors? Do they have medical problems I need to take into account? I think they feel very reassured that I’ve read about them before I come into the phone call and that we can discuss their issues face to face.

It really does feel like a face to face conversation. It’s almost easier than when you go into the office because a lot of times in the office, we’re having to chart while we do things or write prescriptions or do all sorts of different things and we’re not necessarily looking at your face whereas on telehealth, really all we’re doing is looking at you and talking.

Jill: Yeah, that’s true and it’s a private conversation. You’ve obviously been conducting appointments. Talk a little bit about privacy and how a woman as it is a one-on-one exchange but talk a little bit about privacy because that’s probably the most kind of scary aspect of a video appointment.

Dr. Rebecca: Right, and I think the key thing for women to understand is that these video appointments and all the paperwork that goes with them does need to remain HIPAA-compliant. So we have systems in place to keep these conversations private. They’re not recorded and then any documentation or paperwork that we send back and forth between each other is also protected, so that it is kept private between me and the patient. It’s not shared with a bunch of different people and that’s really key in terms of maintaining that compliance for healthcare affordability.

I think women are worried that this is going out to lots of people. It’s not. I’m the only one seeing what they say. They’re the only ones seeing what I’m saying and we do not record these visits for the future. We just as it’s a one-on-one conversation just like you would have in the office.

Jill: Now as Gennev’s Director of Health, you’ve kind of truly been the visionary for establishing a telehealth practice specialized around menopausal care. Talk a little bit about that vision. It has been a dream of yours. You’ve been doing it brick and mortar for a while locally. Talk a little bit about that vision and it’s finally really launching.

Dr. Rebecca: Yeah. I think the vision as from my perspective, I have been an OB-GYN practitioner in the Seattle area since 2005 and I was in Philadelphia before that and I love talking with women and over the years, what has really become a passion of mine is menopause and perimenopausal care and I think it has become a passion of mine because as my patients have aged, I’ve seen that that is the area where they have the least information.

We’re very good at educating women about childbirth. We do a lot of education surrounding birth control because it’s very important. But then we get into the perimenopause and there’s just less out there. It’s a non-reproductive time of life and for a lot of medicine’s history, that’s an unimportant time of life to the medical establishment. I think it’s a very important time of life. Women have a lot more life to live in the perimenopause and the menopause and properly approaching those times of life and those changes and understanding them completely helps a woman to live her best life through that time.

I love doing this face to face with my patients in clinic but there are a lot more patients who need this education and who need providers who are specifically trained in menopause care and there are very few of us in the country.

Many of us have gone through the North American Menopause Society’s certification program and you can find those on their website. But the likelihood of having someone with that certification near you is probably pretty low. It’s just there aren’t that many of us out there. So being able to provide this to women all through the country is just an amazing opportunity.

I know I’ve been doing the telehealth in our alpha testing and one of the women I’ve been speaking with is from a very rural area of Washington and there just isn’t anybody out there who can answer these questions and she’s a little bit more medically complex. Perfect. This system is perfect for her because she can ask questions.

None of them required a prescription. None of them required any testing. She just wanted to talk through some of the things she’s going through and telehealth is perfect for that. I feel like being able to do that kind of good for women all over the country is just an amazing opportunity.

Jill: In that circumstance, what would she typically do in the traditional healthcare system?

Dr. Rebecca: So every area of the country is very different. In Washington, often what we see is these patients need to make appointments in Seattle and so they need to drive three or four or five hours for each appointment and each appointment is maybe 15 or 20 minutes and then if they have more questions, they have to drive back three or four hours in three or four weeks whereas this patient was able to talk to me three times from the comfort of her home and get 45 minutes worth of counselling and not have to go anywhere.

Jill: Yeah, and that’s pretty amazing, the transition or the transformation I think that will have for women like her.

Dr. Rebecca: Yeah, exactly.

Jill: That’s great.

Dr. Rebecca: And it’s not useless to women in cities either. Even though people live in Seattle, there may be plenty of OB-GYNs around. Sometimes you just have a quick 10-minute question that you want to ask an OB-GYN about the perimenopause and your OB’s office is perfectly happy to see you but it’s going to take three or four weeks or you just don’t feel like it’s enough that you want to leave their house and go into the office and do all that.

You can just call into a telehealth service and ask the question and have it answered and if they say, “You know what? You really need to see your OB-GYN about this,” then you go in. If they say, “Nope, your question is answered. You’re good,” then you don’t have to do that.

So there’s a great deal of usefulness for women everywhere in the country. I tend to focus on the rural areas because I’m in an area that’s very under-served up here in the Pacific Northwest but there are a lot of areas where this is helpful.

Jill: Well, that’s I think super encouraging and obviously as a big believer in what Gennev is doing, I’m really excited about the notion of truly being this first ever online clinic for menopause care that makes it affordable to every woman and gives her the care and the access that she needs.

So thanks for being my partner in it, Dr. Rebecca and for bringing your expertise. I just am really excited what this can bring to so many more women and the practitioners who are looking for alternative work opportunities.

Dr. Rebecca: I agree. A lot of the people who will be doing this type of telehealth are people who practice in the traditional office setting. I’m one of those people and it just allows me to reach more women during off hours and times when maybe the office wouldn’t be open or on post-call days when I’m at home anyway and it gives me an opportunity to talk to all sorts of women all over the state of Washington which is really exciting for me.

Jill: Well, good. Well, for more information, women can come to gennev.com. We will be launching telehealth services state by state and we will continue to add more states to our listing. So if your state is not in the states that we report today, sign up to our wait list. Be part of that so that as soon as we do have a practitioner in your region, we can get the word out to you and you can get on to a healthier life.

So with that, thank you, Dr. Rebecca. Here we go. Here we go in launching the first ever clinic for women in menopause.

Dr. Rebecca: Thank you.

 

As a nutrition coach, I frequently field questions from my clients who are concerned about whether or not they are getting adequate amounts of protein in their diets.

While I think the concern is valid, I do believe that the hyper-focus on this food group is a byproduct of a trend that I like to call “Labelmania.” Everyone is talking about what their nutrition label is these days, and many of the labels du jour have a protein-centric approach, from Paleo and Atkins to Ketosis. I feel like I can’t go to a social outing anymore without people asking me what or how I eat!

Pushing protein

Speaking of labels, another culprit fueling the protein phenomenon is food marketers who overpromote our need for protein on their packaging. It’s hard to walk down a grocery and avoid being drawn to these colorful, impactful labels.

Power Bar is a perfect example of this. Their Chocolate Peanut Butter Protein Plus Bar boasts a whopping 20-30 grams of protein. Sounds great, right? What they don’t promote on the label is the 12 grams of sugar in the bar and the nearly 20 ingredients it contains, most of which are impossible to pronounce.

These labels and messages around protein are everywhere, from TV commercials to social media. It’s so much information, and it can be completely confusing.

I’m here to help, because I want you to know that this whole protein thing doesn’t need to be complicated. I’ve created a list of four protein pointers that will help you get the protein you need without the stress. They’re easy to follow and will help you cut through the marketing and Labelmania clutter.

1. Know how much protein you really need

It’s easy to make your protein quota! Did you know that the average woman needs approximately 46 grams of protein each day?

It doesn’t take much effort to get to 46 grams; even if you’re a vegetarian. For example, if you consume a 3.5 oz serving of salmon (25 grams) + 2 eggs (12 grams) + 23 almonds (6 grams) + 1/2 cup quinoa (11 grams), you’re at about 54 grams of protein for the day. That’s pretty easy to attain and you didn’t even have to eat a bar!

2. Get protein power from plants

Put plant-based proteins in your portfolio. Protein doesn’t need to mean meat, meat, meat. There are so many nutrient-dense, plant-based proteins to fill your plate with AND satiate your appetite.

Some of my favorite plant proteins are lentils, chickpeas, quinoa, almonds, kale, tofu and broccoli. Animal-based proteins are an important part of your diet, but it’s important to be cognizant that excessive amounts can be detrimental to your health.

Experts agree that if you eat more protein than your body requires, it will simply convert most of those calories to sugar and then fat. Increased blood sugar levels can also feed pathogenic bacteria and yeast, such as Candida albicans (candidiasis), as well as fueling cancer cell growth.

3. Go protein au naturel

Reduce your intake of man-made proteins. I get it, you’re busy, and it’s way easier to grab a bar than it is a piece of chicken breast when you’re starving and on the go.

If you are truly concerned about your health and what you are putting in your tank, then remember the Power Bar I told you about earlier. Sure, you might be getting protein, but you’re also getting a whole lot of other fake ingredients that detract from any “good” you’re doing.

I’m not asking you to quit bars cold turkey, but reduce your intake of on-the-go wrapped protein options, and find some other smart, on-the-go solutions.

Starbucks is doing a great job with their Mercato products; from their sous vide egg bites to their protein boxes with hard boiled eggs and hummus. If you’re going to do a bar, I’m a fan of Kind and RXBAR bars, as they have minimal ingredients.

4. Time it right

On workout days, timing is everything! If you have an intense workout, time your protein intake correctly pre and post workout to avoid the hangries. This is important at any age, but it is especially crucial now when hormones can play such a key role in our moods.

By timing our protein intake around workouts, we can manage through the hangries and the roller coaster effect of feeling food-deprived. On workout days, eat a 3- or 4-to-1 ratio of carbohydrate to protein one hour before and after exercise to ensure your muscles are fueled and replenished. By pairing proteins and carbs, you can slow sugar absorption and help stave off food cravings.

The bottom line is this: protein is a powerhouse that has many powerful effects on your body and mind, but your focus should be a well-rounded diet that also includes lots of vegetables, fruits and healthy carbohydrates.

Try to follow my pointers and try not to get too caught up in Labelmania. It really doesn’t matter what label you’re wearing, it’s how you go about wearing it.

Cheers to your health!
Michelle

More from Michelle:

The holidays are coming round again (canyoubelieveit?). Be ready for the stress “” and the stress eating. Looking for a better way to feed yourself and your family? Be sure to check out how to shop your Farmers’ Market and buy from the bulk aisle!

How are you feeding yourself for optimal health? We’d love to know. Share with the community in the comments below, or hit us up on Gennev’s Facebook page or Midlife & Menopause Solutions, Gennev’s closed Facebook group.

 

Can you touch your tongue to the tip of your nose? Bend your thumb to your wrist?

If you are (or used to be) “double-jointed,” get compliments on your soft skin, and experience joint pains, there’s a chance you could have a rare disease and not know it. 

Fans of RuPaul’s Drag Race know that Season 11 winner Yvie Oddly wowed viewers with her fierce looks and jaw-dropping contortions. For many people, this was their first exposure to Ehlers-Danlos Syndrome (EDS).

The disease is rare, so we don’t know a lot about how it works. But there are some interesting ties to perimenopause and beyond.

What is Ehlers-Danlos Syndrome?

EDS is a group of rare disorders affecting the skin, blood vessels, bones, tendons, ligaments, and other connective tissues; faulty collagen, the protein that adds elasticity to this tissue, is to blame. One or two people out of every 10,000 have EDS, though some doctors think this number is actually higher.

There are 13 types of EDS but the two most common (if you can call a rare disease “common”) are the classical type and hypermobility type (hEDS).

Soft, velvety, and extremely stretchy skin that bruises and scars easily is the hallmark of classical EDS.

hEDS symptoms include joint hypermobility, dysautonomia, and musculoskeletal pain, though there’s some overlap: velvety-soft skin, easy bruising, and the ability to extend joints beyond the normal range of motion are present in most types. 

Tiredness, digestive disorders, easy bruising and bleeding due to weaker capillary walls, and anxiety risks can be present in both forms as well. 

Basically, wherever there is connective tissue, you’re more likely to have issues.

Hypermobility leads to hyperextension, dislocation, subluxations (partial dislocation), and overall pain. For many sufferers, this pain can be debilitating, requiring braces, crutches, or even a wheelchair, all while looking “normal.”

EDS, and especially hEDS, often go undiagnosed; most doctors receive very little training on the disorder, even those who specialize in joint and skin conditions. 

Need a trained doctor’s opinion about hEDS? 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.

There’s no genetic test for hEDS, so diagnosis is dependent on clinical criteria, including the Beighton Scoring System (try it yourself!) to assess joint flexibility and self-reported pain. 

The lack of knowledge and diagnostic tests can lead to years of frustration for sufferers, as doctors ignore their issues, tell them it’s all in their heads, or recognize that there’s something wrong but just don’t know enough about EDS to be effective.

The hypermobility-estrogen connection

Women experience hEDS at a much higher rate than men, and the current theory is that estrogen plays a role. 

Estrogen overall has an effect on connective tissue. Women, in general, have looser ligaments than men and people with higher testosterone, which leaves us more prone to joint injury.

Estradiol receptors, proteins in cells activated by estrogen, are present in skin, cartilage, and other connective tissues. Estrogens help regulate the metabolism of these cells.

Research done on a normal population shows that tendon injury is more common in pre-menopausal women, with the highest risk being when estrogen in the menstrual cycle is at its lowest after ovulation.

This hormonal link to loose joints shouldn’t come as a surprise: ligaments relax in pregnancy to allow the birth canal to expand to fit a baby.

Puberty is often the onset of hEDS symptoms, and those who previously had symptoms notice that they worsen after their periods start.

Women with hEDS often have gynecologic difficulties like heavy periods, heavy cramps, and pain with sex, and report more hEDS symptoms with their menstrual cycle. Combined hormonal contraceptives (CHC) and Progestin-only contraceptives (POP) can help symptoms and reduce fatigue in some patients with hEDS.

What does this mean for menopause?

Well”¦ there isn’t a lot of solid scientific information out there about how menopause specifically impacts people with hEDS. Anecdotally in Facebook groups and online forums, many women with EDS report early menopause, but research does not support this. 

However, because of the hormonal involvement, menopause certainly has an impact on hEDS. For starters, connective tissue in the general population changes post-menopause and skin collagen decreases 1-2% each year after menopause.

Joints stiffen with age for all of us, which can be a good thing for people with hEDS, as less supple joints are less prone to overextension. In a study of 386 women with hEDS, 22% of the post-menopausal women reported that their symptoms decrease after menopause. 

However, more than one-third of participants experienced a worsening of symptoms before their periods while in perimenopause. The most rapid shifts in hormone levels happen during this transition, which is why it’s not surprising that the time just before menopause can be when hEDS is first diagnosed. 

As we previously mentioned, women with hEDS have more gynecologic concerns than the rest of the population. They’re more likely to experience incontinence, vaginal dryness, and how to do sex without pain, concerns that increase for all people with uteruses in menopause.

Some studies have found that people with EDS tend to have lower bone density than the regular population, pre-menopause, which makes them more prone to osteoporosis later in life. While this may be because people with EDS limit bone-strengthening exercise due to pain and mobility issues instead of a structural cause, the implications for bone health are the same. 

It’s been thought that hormone replacement therapy (HRT), selective estrogen receptor modulators (SERM), and oral contraceptives could improve diseases of connective tissues. Unfortunately, the amount of estrogen in HRT is not enough to protect joints, and higher doses may increase the risk of breast and other reproductive cancers.

If you’re a woman in midlife who thinks that you might have the hypermobile form of EDS, talk to your doctor or one of ours; because the disorder is so rare, you may need to be persistent and detailed about your symptoms to get the help you need. 

More research clearly needs to be done on how to help women with EDS in menopause, but awareness of the condition “” and better reporting, so we have a better idea of actual numbers “” can help bring greater attention to the issue.

Sign up and chime in about your path in menopause on the Gennev Community Forum. Come join the conversation.

 

Feeling stiff or achy when you get up in the morning or after sitting for an extended period of time? Do you have sore knees? Tight hips? Achy fingers?  Back pain?  Joint pain is one of those symptoms that can make you feel old overnight, and unfortunately it strikes more than half of women during menopause. In fact, a study of more than 100,000 middle-aged female veterans found that going through menopause raised their risk of experiencing chronic pain by 85 percent. But you don’t have to suffer and feel older than you are. There are a variety of ways to get relief from menopausal joint pain.

What’s happening when you experience joint pain

Though the precise cause-and-effect of menopause and joint pain hasn’t yet been established, there’s evidence that there is one. Pain, swelling, and inflammation in the joints is often a signal of osteoarthritis (OA), the wearing down of protective tissue between bones. Since OA disproportionately affects women in menopause, it is likely that hormone changes may contribute to arthritis symptoms.  Beyond hormones, carrying excess weight, leading a sedentary lifestyle, dehydration, poor diet, smoking and stress can all trigger or worsen joint pain.

Because estrogen is a natural anti-inflammatory, one possibility is that when it dips and ebbs, inflammation can occur more easily. Plus, estrogen regulates fluid levels throughout the body, so just as your skin is drier and less elastic, the tissue of your joints may be, too. Another theory is that estrogen reduces pain perception so when levels decline, you’re more sensitive to pain.

What to do to relieve joint pain

Unlike many signs of menopause, joint pain may not diminish when hormones level out after menopause. But there are many lifestyle changes that can help ease the pain and prevent it from getting worse.

Fill up on anti-inflammatory foods. Some foods tamp down inflammation while others spur it on. For the right balance, eat more of these inflammation fighters: berries, broccoli, avocado, tomatoes, green leafy vegetables like spinach and kale, citrus fruits, cherries, fatty fish like salmon, olive oil, nuts, dark chocolate (in moderation), olive oil, green tea, turmeric, and ginger. And avoid foods that contribute to inflammation such as refined carbs like white bread and cake, fried foods, red meat and processed meats like hot dogs, soda and other sugary beverages, and foods with trans fatty acids like margarine.

Get some exercise. Regular movement keeps joints lubricated so they flex and extend more easily and with less pain. Low-impact activities like yoga, walking, swimming, and cycling are gentler on the joints than high-impact sports like running.

Keep tabs on your weight Excess weight puts stress on your joints as you move, so losing even a few pounds (weight loss is tough during the menopause transition) can mean exponential relief for weight bearing joints like hips and knees. 

Lift some weights. Strengthening the supporting muscles around a joint provide stability. When joints are stable, they function better, and you have less risk of damage or an injury.

Stay hydrated. Drink plenty of water to keep tissues moist and supple. In menopause, your body doesn’t retain water as well as it used to, so it’s important to replace the lost moisture. Water””not sports drinks, sodas, or coffee””is your best choice. If you need variety, add a few pieces of fruit for flavor. 

Build in stretch breaks. Too much sitting? Too much computer time? At regular intervals, for instance every 20 or 30 minutes, stop what you’re doing and move. On a computer, stretch your forearms, do some wrist circles, or squeeze a soft ball. Get up from your desk and march in place and then stretch your legs and hips. The motion will help to keep your joint lubricated and minimize stiffness and pain.

Strengthen your core. Your body is one long chain of joints and muscles, and weakness at one part affects others. When the core muscles in your abdomen, back, hips, and buttocks are strong, it can help to take pressure off your knees and ankles.

Destress. We know, we probably sound like a broken record, but when it comes to joint pain, stress is especially problematic. Stress raises cortisol levels, and cortisol can cause additional inflammation in joints. Do what you can to keep stress in check. If stressed, consider taking a walk “” in nature is best for a triple crown of stress- and joint-pain relief: nature, time away, and moderate exercise.

Consider supplements. Magnesium may help. According to the Arthritis Foundation, “Magnesium strengthens bones; maintains nerve and muscle function; regulates heart rhythm and blood sugar levels; and helps maintain joint cartilage.” Other good options are glucosamine and chondroitin.

Apply ice and/or heat. Which you choose may be a personal preference. Generally, ice helps when there’s obvious inflammation (swelling, redness). It may also ease achiness after exercise, or you might simply find that it numbs your pain anytime. Heat loosens muscles, enhances flexibility, and increases circulation. For these reasons, heat (heating pad, warm shower, paraffin wax) may be helpful when used before exercise. Apply either for no more than 20 minutes at a time, and protect your skin by having something like a thin towel between your body and the ice pack or heating pad.

Rub on relief. Topical pain relievers like Arnicare and Biofreeze can tame the pain. In addition, simply touching and massaging the area, even with regular lotion, may help desensitize you to the pain. 

When to get help for your joint pain

If you’re not getting relief, the pain worsens, or you have other symptoms such as swelling, redness, rashes, fever, fatigue, dry eyes and mouth, or painful urination, you should see your doctor. There are other causes of joint pain that can be more serious than a drop in estrogen, such as Lupus, Lyme disease, gout, septic arthritis, gonococcal arthritis, thyroid problems, and rheumatoid arthritis (RA and Lupus are autoimmune disorders that affect women more than men; they differ from OA, which is more closely related to aging and wear).

Learn more about joint pain

The Facts About Menopausal Arthritis and Movement

Menopause and Aching Joints

Getting to the Bottom of Knee Pain in Women

We can help you find relief for joint pain

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy. 

Are you just not getting the results you want from your exercise program? Maybe it’s time to find a personal trainer who can help you understand your midlife body better so you can reach your fitness goals.

Debra Atkinson

Learn how to pick your perfect training partner from fitness expert, author, and professional speaker Debra Atkinson. Debra is the host of The Flipping 50 Show podcast and Flipping 50 TV show. With more than 30 years experience in the fitness industry, she is also America’s Boomer Babe Fitness Expert. This article by Debra is reposted here with permission from PRiME WOMEN. 

We are going to show you how to choose a personal trainer who’s right for you by asking the right questions. Whether you’ve got goals of a starting line or you need to exercise safely with arthritis or osteoporosis, there’s a trainer for you. When you first meet a trainer, remember you’re interviewing them as much as they may be interviewing you. Here are a few questions you should ask:

Are you certified as a personal trainer and by which agency?

Among the 500 different certifications and certificate programs, there are still only a handful of agencies I would preference even as the National Commission for Certifying Agencies (NCCA) accreditation attempts to create higher standards in fitness certification. Fitness is still a self-governed industry.

Top-tier certifications include American College of Sports Medicine (ACSM), American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), and National Strength and Conditioning Association (NSCA). Within each of these agencies there are certification options. Someone may be certified as a group fitness instructor, for instance, not as a personal trainer, and therefore lack the knowledge to design a custom exercise prescription.

Certified as an NSCA Strength and Conditioning Specialist, a trainer has more specific expertise for sports conditioning. An ACE Medical Exercise Specialist is more focused on designing around the needs for special conditions.

Trainers might reference CPR, AED and First Aid certifications. While this is good, it’s actually mandatory to be currently certified by a national agency. This can tip you off to the fact that they are less experienced and/or are searching for anything to use as a credential.

Is your certification current?

Confirm it. I’ve had mature employees not see value in achieving industry standards by taking an exam once they’ve gone through a training course. Her attitude was “What’s it going to change?” when she was already earning the highest percentage paid and was as full as she wanted to be.

That attitude is poison in the personal training industry. It implies a trainer’s willingness to train a client although they lack the confidence to feel they could pass an exam. That, reader, is backwards. Trainers and clients alike can be guilty of assessing trainer skills by popularity. They must be “the best” if they are the most full.

To remain current with a credible certification, a trainer must take a minimum of Continuing Education credits annually or every two years, depending on the certification. Ask about the most recent continuing education course taken and the content. I would favor a trainer updating their knowledge in a topic area I would benefit from if I were shopping them.

Do you have a degree in Exercise Science?

A unique combination of academics, certifications, years of experience and testimonials will determine whether a trainer is qualified. There may be no degree in exercise science, but a combination of other components might be so great that someone becomes your trainer of choice. Fewer people made the decision to become trainers 20 and 30 years ago when they were in college.

If you discover proof that other forms of preparation allow him or her to make decisions commensurate with those who do have a degree, then you may still feel confident in your choice.

How much experience do you have?

Don’t discount a new trainer, but ideally, age-friendly trainers have at least two years of experience in the industry according to the International Council on Active Aging. I would suggest based on industry standard that a trainer is still a rookie if they’ve worked three or less years.

Remember that they’ve worked with all ages and abilities and probably have not specialized in midlife and older adults. It’s important to ask how many hours a week they’ve worked. Trainers who say they have 4 years of experience of training 10 hours a week don’t have any more experience than a trainer who trained 40 hours a week for a year.

Have you worked with someone with my needs before?

Have you worked with someone my age before? Do you have two or three references I may contact? Age alone shouldn’t be your question. Two 50-year-olds can have very different needs, histories and goals and likewise, with two 80- or 90-year-olds. If your hormones have changed everything, be sure to ask if the trainer is experienced with that.

The response will tell you whether the trainer will relate to you well or not, and you’ll gain insight about the trainer as you talk. When you contact the reference ask open-ended questions and those that pertain to your greatest concerns. “Is there anything else you’d like to add?”

Why are you interested in working with me?

What do you have in mind for me?

Make sure you get an enthusiastic response! Get his or her recommendations. You want to know he or she is confident and hear that he or she has the beginnings of a plan that makes sense to you before you hire.

Which professional organizations do you belong to?

Most certification agencies have a corresponding professional membership group. Similar to other professions, participation in industry associations means your trainer is serious about networking, improvements in the industry, access to recent research and legal aspects of their business.

IDEA Fitness Connect is the largest fitness professional directory, connecting 200,000 fitness professionals verified by 160 certifying and training bodies with consumers. Whether or not your trainer is a member of IDEA, he or she could be listed in this directory.

Together, these questions and your observations of trainer responses can help you determine if a trainer is right for you. Does the trainer listen completely and convey an understanding of what you said? Did you enjoy the trainer’s personality and sense of humor? Can you see yourself spending one to three hours a week with this trainer?

Do you need to choose a personal trainer to watch your repetitions? The internet provides you access to a world of trainers and coaches. You can “meet” via Skype or phone and get weekly plans that meet your needs.

Knowing how to choose a personal trainer is important to the ultimate success of your health and fitness routine. Take the time to find the right one for you.

This post is an excerpt from Navigating Fitness After 50: Your GPS for Choosing Programs and Professionals You Can Trust.

Do you have a personal trainer you adore and can’t live without? How did you find him or her, and what makes your trainer all that and a bag of low-calorie, sustainably sourced, high-protein soy chips? 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.

 

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.

 

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