Seriously. This really is the first year I’m celebrating International Women’s Day.

I bet this is true for many people for a couple of reasons”¦.

In the U.S., International Women’s Day (IWD) hasn’t been much of a thing. We put a lot of energy into Mother’s Day as and for all the right reasons as but we haven’t set aside a day to celebrate all women, the way much of the rest of the world does. What I love about IWD is that it truly honors all women, including those who are not mothers. Other countries recognize this day with celebrations, speeches, gifts for menopause, and thanks as and most importantly, with conversation around the important roles women play, the value of their contributions, and the challenges they still face. I think it’s time the U.S. did too.

We’re at a time culturally where many groups of people who feel oppressed as a result of our new administration or other societal changes are rising up to change things. International Women’s Day gives us another platform to make life better for women. By celebrating, we’re choosing not to be victims but to use the momentum and the energy that comes with feeling put-down to actually rise up.

And for me personally, IWD speaks to my inner passion for women’s and girls’ empowerment. That’s what’s behind every bit of effort as the tough and the fun as I put into Gennev.

You see, there’s a special energy that happens when women come together. It’s almost unexplainable. I’ve felt it over the past few weeks in events I’ve been involved with, and in the 1:1s I have with women as sometimes to network, sometimes to chat about Gennev and our mission to be the solution for women heading into menopause, or simply to catch up over coffee or a cocktail.

We’re on the rise, and today is another day to recognize our growing power and influence, and even more importantly, to activate in the things you believe in as adequate healthcare, equal pay, investment in women-owned businesses, having a seat at the boardroom table, and even being an equal parent and at-home partner with your significant other.

I capped off the day with a magical evening at the International Women’s Day Celebration, Seattle. My dear friends Kate Isler and Nickie Smith pulled it together for 500+ women and men in Seattle. And now, as I write this, I’m jamming to Star Anna, who closed the evening with some of the most heartfelt lyrics I’ve heard in a long time.

I celebrate the women who will read this post. I celebrate women supporting women, and I celebrate everyone’s efforts to honor women. Because we need each other, and today is just another reminder of that.

“My deep belief is that with more women living happy, healthy, long lives,
we become a force that changes the world.”
as Laura Boulay, One Million Women Walking

Exercise is good for you. It’s good for your bones, your heart, your muscles and mood. This is not exactly a controversial or surprising piece of information, yet many of us find it difficult to fit regular exercise into our busy days.

We get it: with traffic, parking, changing, showering, it can take a chunk out of your day to hit the gym or pool or get to yoga or spin class. That’s why we’re devoting an entire blog to that simplest and (usually) most accessible of exercises as walking.

A 30-minute walk at least 5 days a week can yield enormous benefits, as Laura Boulay, founder of One Million Women Walking can attest. Team Gennev connected with Laura to talk about how women can incorporate walking into their daily routine and why it may be one of the best decisions they’ll make for their health and well being.

Why walk?

Perhaps a better question would be: Why not walk? We have this notion, Laura says, that exercise has to be painful and punishing to be good for you. In fact, walking may provide the perfect answer to one of our stickiest problems: being too sedentary for too much of the day.

Extended, uninterrupted sitting is really bad for us. Our metabolism slows when we sit too much; sitting is associated with brain changes that may be precursors to cognitive decline; sitting increases your risk of heart disease, diabetes, high cholesterol, high blood pressure, even depression and cancer.

For even more information on the benefits from walking, check out this article on HobbyHelp. 

How we typically exercise may not help. While going for a run or getting in a workout at the gym after work is great, an hour of vigor once a day doesn’t offset the risks of being too sedentary the other 23 hours a day.

Walking, because it’s easy to do in small amounts, could be the perfect remedy. “If you get up every 30 minutes and walk for five minutes, just go to the bathroom or refill your water bottle, you’ve reset your metabolism,” Laura says. (But go ahead and sit in the bathroom, since hovering isn’t good for you either.) You don’t need a gym or special gear besides good walking shoes, Laura reminds us, and you likely won’t need a shower after a brisk 5-minute reset.

How can I make walking a regular part of my day?

A big question that Laura and her organization take on is, “How can we incorporate this into our day, right now?” Laura asks. “We have to make it consumable for busy women.” The best way to tackle making walking a regular (and best of all, frequent) part of your day, says Laura, is to look at the barriers that keep you from it.

So what holds us back?

1. Time. Clearly the more time we’re able to give, the more results we’ll see, but even moving just when you can find time to move has advantages. So, walk while you’re talking on the phone. Walk as you brush your teeth (there’s no shame in using a washcloth as a bib). Sweep more. Park farther from the store or your workplace. Get off the bus a stop early or get on a stop farther on. Still think you need to be at your desk, getting work done? Laura points to a study by Stanford researchers showing that “A person’s creative output increased by an average of 60 percent when walking.” Walking may help you do your job better. Still think you don’t have time?
2. Route. “We’re so overscheduled,” Laura says, “that keeping it simple is important. If you have a go-to route that you don’t have to think about, that’s great. Find a place and a path that make you feel good, then walk it until it feels like home. You know it, you got it, it fits your life, you feel safe and know how long it takes, and that makes it easier to get out the door.”
3. Gear. You don’t need a lot of fancy equipment to walk as that’s one of the best things about it! Do invest in a decent pair of shoes, if you can. “Business appropriate” shoes aren’t necessarily good for our feet, posture, or pelvic floor, so visit a reputable running or walking store and get some expert advice on the shoe that’s right for your purposes, your goals, and your gait. A few good pairs of tech socks can help too, if budget allows.
4. Weather. Bad weather can be a huge deterrent to getting those 30 minutes of walking a day. If you’re loathe to purchase expensive cold- or wet-weather gear, or if it’s just too darn hot to be outside moving around in the middle of the day, the stairs are a great way to boost fitness. As we all know, stairs are much more demanding than walking on a flat sidewalk (or even a hill), so you may want to break up your 30 minutes into smaller increments. Hallways count too, and you might find it easier to get a buddy to join you.
5. Safety. Not everyone has the luxury of a safe space to walk, particularly if heading out alone. Certainly finding ways to get your steps in indoors is one fix, but walking with a group might be an even better solution. Your company’s HR department might have a wellness program for those who exercise, so ask if they can hook you up with another walker or two to provide safety in numbers. (Plus, your org may offer bonuses in the form of money or reductions to insurance premiums for those who meet fitness goals, so a quick chat with HR may be in order anyway.)
6. Motivation. Of all the barriers, motivation may be the toughest nut to crack. How do we get motivated, and even tougher, how do we stay that way, day after day? First, set reasonable expectations for success. If “perfect” is your only definition of success as eg. 30 vigorous minutes every day of the week as you may be setting yourself up to fail. Second, find walking buddies. Knowing your buddy is waiting in the rain for you to get your steps in could be the push you need to face the weather. “Find an accountability partner,” Laura says. “You don’t even need to be in the same city. Text each other in the morning what your intentions are, then send each other a picture at the end of the day. Keep it gentle. Walk for each other. If your friend said her doctor said she had to walk or she’d be in trouble with her health, would you walk for her? Every single woman I’ve asked has said yes. Caring for others is our superpower! So find someone to walk for if you won’t walk for yourself.”

According to a study from Saarland University in Germany, 25 minutes of brisk walking a day could add as much as seven years to your life. Seven. Years. Regular exercise could potentially repair old, decaying DNA, putting aging on pause. So we’re talking seven good years, seven years of more vigor and better health.

Still need some help to get going and stay in motion? Check out Laura’s “Move More” program designed especially to help busy women overcome their barriers to walking. And join Gennev’s closed Facebook group, Midlife & Menopause Solutions, for support, advice, and a whole lot of women to walk for.

Have you made walking a regular part of your life? How did you get started and what keeps you going? Share with us in the comments, on our Facebook page, or in our closed Facebook group!

For those who go to the doc often, we understand: in this phase of life, your body can be unpredictable, with new as and sometimes alarming as symptoms on a pretty frequent basis. Heart palpitations, ringing ears, insomnia all can be caused by changing hormones, but since we don’t talk about menopause symptoms beyond hot flashes, well “¦ no wonder some women are wearing a path to the doc.

On the other hand, getting to the doctor is often inconvenient, especially if the symptoms don’t feel “serious enough” for medical attention. So many women suffer in silence, believing their symptoms are just “part of aging” or they shouldn’t waste a doctor’s time.

At team Gennev, we think everyone should have the help they need, so we’re building a platform to make connecting with health care easier.

Help when you need it as from a Health Concierge service

No matter which camp you pitch your tent in or if you’re somewhere in-between, we’re guessing most women would agree that having access to expert information and advice is important.

Here’s how we’re making it happen:

Starting in 2018, you’ll be able to schedule appointments with licensed health professionals right here at gennev.com. Spend 15 minutes on a private, secure, video call getting your questions answered, learning next steps, and discussing your options for managing the issues you’re experiencing.

We call it our Gennev Health Concierge service.

Imagine it: concerned about that ringing in your ears, you decide it’s time to get help. Do you “¦ schedule an appointment, survive another week before you can get in, take time off work to fight through traffic to the doc’s office, pay for parking, sit in the waiting room for 20 minutes and in an exam room for another 15, talk to the doctor for the US average time of a whopping 17 minutes, then get a prescription or a recommendation before heading home again?

Or do you “¦ book an appointment at gennev.com and talk to a verified and vetted health professional for 15 minutes while sitting at your kitchen table in your pajamas?

It’s time to live the dream.

Why we are building our Health Concierge service

The longer we’re in the midlife-and-menopause business, the more we hear from women that their needs just aren’t being met. They want advice from health care professionals who are knowledgeable, experienced, and focused on the concerns specific to women in midlife.

As Gennev’s Health Concierge service grows, we’ll add more and more professionals who have relevant expertise and are laser-focused on helping women through this transitional period.

What can the licensed health professional do for you?

Right from the start, our professionals will be able to listen to your concerns and advise you on next steps, whether that’s to consult with a specialist, make diet or lifestyle changes, or try a recommended product. Every adviser will be vetted and verified, so you can trust the information you’re getting.

Midlife can as and should as be some of the best years of our lives. It’s the time when our experience, confidence, and opportunities all line up, and we can do some really exciting things. Feeling healthy and strong is important to taking full advantage of these special years, and team Gennev is here to help you be ready.

If you have questions or thoughts about our Health Concierge service, we’d love to talk with you. Shoot us an email at info@gennev.com, share with us in the comments section below, or join us on our Facebook page or closed Facebook group, Midlife & Menopause Solutions.

“‹

Startups like Gennev, 98point6, and Pandia Health have been working very hard to create a new standard of care for telemedicine. 

Providing constant connectivity to medical advice and prescriptions is what we do. If we can’t rise to the occasion to help keep patients physically out of hospitals and medical offices during this time, then we have failed.

COVID-19 is a painful pop-quiz on the fragility of our nation’s infrastructure. It’s quickly showing its head in Seattle, WA where Gennev is located, which many are calling the epicenter of the U.S. outbreak. 

Northshore School District, one of the largest school districts in the state with nearly 23,000 students, is considering a remote education model. Companies are encouraging people to work from home, causing a 38% jump in the stock price of Zoom, a virtual meeting service. People are shopping online with 27% of Internet users saying they are moving to online shopping and another 58% reporting they will shift from store-front to online shopping to avoid exposure. 

And while the AMA reported a 53% increase in telehealth services last year, the opportunity for it to effectively serve the masses has never been more apparent.

Telemedicine vs the coronovirus

In the grand scheme of our constantly connected way of life, telemedicine is not as familiar to the everyday consumer. We have to change that. Right now, we have to help patients understand what is available in telemedicine and keep them out of the waiting rooms to keep space open for critical patients. 

So, here’s what’s available to patients with Gennev’s telemedicine service:

Secure scheduling for video-based appointments nationwide,

Medical advice and diagnosis as menopause and more as suited for video-based appointments,

Prescription support called into your local pharmacy. HRT or not, our MDs are prepared to prescribe the most appropriate medications for their patients,

Unlimited follow-ups for all patients who are also members of Gennev HealthFix with unlimited access to Coaches and Registered Dietitians.

For most healthy people, the coronavirus isn’t really a threat to life. However, many of us have elderly parents, or young and vulnerable grandkids, or people in our lives who may be immunocompromised for one reason or another. Maybe we ourselves are at risk of complications beyond the bad-cold symptoms of COVID-19.

Whether we’re concerned about our lives or another’s, or we’d just rather not be sick and quarantined, we’re all taking a bit better care of ourselves. 

Right?

Going to a doctor’s office can feel a bit like heading for the front lines, so why not skip that, save yourself a trip, and relieve a little pressure on our over-burdened medical system: choose telemedicine. 

Stay healthy

Whatever you decide, please continue to practice common-sense precautions to help you stay healthy:

• Wash hands often and well.
• Don’t touch mouth, eyes, or nose.
• Avoid touching communal surfaces as much as possible.
• Keep 3 feet/1 meter between you and any sneezing or coughing person.
• Eat well, sleep well, get exercise, try to minimize stress.
• Limit time around other people.
• Be prepared for an extended stay at home “”
• buy a few extra groceries when you’re at the store (including some treats)
• have enough of your prescription medications,
• stockpile some entertainment.

And help others stay healthy as well. If you’re coughing or sneezing, do so into a tissue (which you then promptly and properly throw away) or the crook of your elbow. Don’t spit in public, and if you’re not feeling well, keep that 3-foot buffer of space around you to avoid contaminating others. 

Are you worried about the coronavirus? Why or why not? Please share your thoughts with us in the Gennev Community Forums!

Regular guest blogger nutrition coach Michelle Cartmel takes on bones and bone health this month. 

Hey Ladies!

May is National Osteoporosis Month which means it’s time to get real about bone health.

Women often overlook the importance of bone health because we can’t actually see our bones, right? We think, I’ll never be that hunched-over older woman; how did that happen to her?

Think again! If you don’t take preventative measures to strengthen your bones with diet and exercise, you might be.

Avoiding fats because you think they’ll make you fat? Well, quit it. Embrace good fats for better health. 

Building bone density is important as you get older. If you need help doing that, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.

How our bones get built

According to Madeline R. Vann, MPH, women reach their peak bone mass at age 18 and continue to build small amounts of bone mass until age 30. After that time, your body will continue to replace old bone cells, but there will be no more increase in bone mass.

After menopause, bone loss becomes even more rapid.  When your body absorbs minerals like calcium from your bones, bone loss occurs. Our bodies need calcium to strengthen our bones and teeth, so when we don’t get enough of it from diet and supplements, it takes it from our bones.

The takeaway: Prevention should start early, and it’s never too late to start. There are two super easy ways to bolster bone strength: fitness and healthy foods.

Strong bones with exercise

With that in mind, I asked certified trainer and owner of Mercer Island Athletic Club Ginny Pietila to share her three favorite, easy-to-follow exercises that support bone health. These moves focus on the hip and spine, two areas that are especially susceptible to breakages as we age.

Ginny and I walk you through the moves in this short video, and the step-by-step instructions for this workout can also be accessed below.

Diet and bone health

As for your diet, most of us understand that calcium supports healthy bones and teeth, but we should know that Vitamin D is an equal hero, as it improves calcium absorption and bone growth.

For most of us, it can be a challenge to consume the recommended daily intake of calcium and Vitamin D, so let’s start with supplements. According to the Mayo Clinic, when it comes to calcium, women 19-50 should have 1,000 mg/day, and women aged 50+ should have 1,200 mg/day. For Vitamin D, women under 70 should have 600 international units per day and 800 after 70.

Calcium isn’t only found in milk and dairy, although these are great go-to’s.  Calcium is in delicious greens like watercress, kale and collards, spinach, bok choy and Chinese cabbage. Tofu and almond butter are also great sources!

As for Vitamin D, look to the sea “¦ a 3 oz. serving of salmon has 100% of the recommended daily dosage and a 3 oz. serving of tuna has about 40% of the recommended daily amount. Fortified milk and cereal contain Vitamin D, and of course, there’s sunlight.

So, what are you waiting for? Join Ginny and me, and let’s get bullish about bone health together.

Cheers to your health!

Michelle

Your Bone Strength Workout 2X/Week

3 exercises, 2 sets of each exercise, 12-15 reps each set

Focus:  Hip, spine and wrist bone density

Squat:

Feet hip distance apart

Keep knees in line with hips and toes, Eyes up, chest up.

Level 1: Bodyweight

Level 2: Weights held down at sides

Level 3: Weights held up at shoulders

Lunge:

Step back lunge, keeping front knee over ankle, back knee 1 inch from the ground.  Eyes up, chest up.

Level 1: Bodyweight alternating right / left each rep

Level 2: Bodyweight 12 on right leg / 12 on left leg

Level 3: Hold weights down at sides

Level 4: Hold weights at shoulder and press up

Step:

Use step height appropriate for your level of strength.

Eyes up, chest up with good posture as you lift your knee.

Level 1: Bodyweight alternating right / left each step

Level 2: Bodyweight 12 on right leg / 12 on left leg

Level 3: Hold weights down at sides

Level 4: Hold weights overhead

We’re all about the whole and healthy YOU at Gennev. Learn more about how to manage your risk of osteoporosis and osteopenia, good supplements to help you stay vibrant in midlife, why walking is great exercise at any fitness level, and how to feed your brain for retirement. Also, it’s a great time to start hitting your local farmers’ market and learning to unlock the nutrition in all those mysterious jars and bins in your grocery store bulk section.

Are you living with osteopenia or osteoporosis or the risk of either? How are you managing your health to stay stronger longer? Share with us in the comments, on our Facebook page, or in our closed Facebook group!

Sami’s period started earlier that day. It had been just two hours since she changed her pad, but it was time to change it already. “That was fast,” she mused as she pulled the stall door closed behind her. It was 8:30 am and she had a meeting starting in a building across her work campus at 9. 

Sami, 35, was surprised to have started this morning. She’d skipped a month, (or was it 2?). It happens sometimes, right? Frankly, she hadn’t been that aware she’d missed her period, with work taking off and all. But that surprise was nothing to the shock at the sight of so much blood, and already a clot or two. 

Could she have been pregnant and was now miscarrying? 

Nope. That was definitely not a possibility. There’d been no intimacy in her life for a while.

What else?

“Internal bleeding? Bleeding disorder?” Sami’s mind began to race and her breathing started to follow suit, a little shallower and faster. She did a body scan for pain or other out-of-the-ordinary symptoms. No”¦ nothing else unusual.

She’d been to see her doctor for her annual screenings just a few months prior and had had a clean bill of health. 

“What else? What else could it be?” she asked herself as she took a deeeep breath and a slow exhale. 

Two unexpected words popped into Sami’s head: hormone change.

“I’m too young for that change to be starting.” 

Her mom had been in her late 40’s when she started talking”¦ well, complaining, really”¦ of menopause symptoms. Mainly hot flashes, plus her mood went decidedly sour for about 5 years. Generations up the line on both sides never discussed it, and Sami had never directly asked.

Still. The shock in seeing so much more blood than usual stopped Sami cold. She never bled this much, even on her heaviest days, and this period had just started that morning.

So, what, exactly, was going on here?

Sami could very well be in the wee beginnings of perimenopause, and menorrhagia “” heavy flow periods “” could be a new experience. Time to talk to the doc.

When is it “menorrhagia,” specifically?

CEMCOR, the Centre for Menstrual Cycle and Ovulation Research, states that “menorrhagia, meaning blood loss of 80 ml or 16 soaked regular sanitary products or more per cycle, occurs in 25% of very early perimenopausal or early menopause transition women as well as in fewer adolescents and premenopausal women of any age.”

Some experience radically less blood loss than their “regular” period. If it’s less than 20ml, that may be considered a light period or light flow. 

It’s worth reinforcing that some people experience menorrhagia as part of their normal cycle. For some, very heavy bleeding is familiar and part of their normal courses; it’s been part of their cycles since their periods began. Controlling heavy bleeding may be as simple for some as taking ibuprofen on the heaviest days, and others may opt for an IUD. Both of these options, and any others, are best coming directly from your doctor.

For many, experiencing a very heavy-flow period is a brand new occurrence. And yes, if it’s not your usual, familiar “flow”… it can be a seemingly shocking amount of blood, (not to mention clots) that will pass. Best to get any new change checked out with your doctor, as new-to-you heavy flow may be a symptom of other conditions such as fibroids or polyps, endometriosis. The best idea always is to get it checked. 

Real coaching & support for your menopause journey: It’s time for HealthFix. Review & subscribe.

How well do you know your “normal”?

No one experiences your period like you do. And no one else will know what constitutes “normal” for you, or what is “new” in your body better than you. This is simply a pitch for deeper awareness. You may not love the idea, but it can really help you navigate your perimenopause and menopause path if you cultivate a deeper awareness as new changes occur. It’s helpful to track exactly what, when, how much, and how intense the symptoms or changes are for you. 

Some have tracked periods religiously, others are surprised every time they start. Many fall somewhere in between the two. Whether it’s in a journal, on a tracking app (take your pick of many), or just a red dot on the hanging calendar for each day of your cycle, more awareness is better than less. 

How might you best track your periods?

Consider these few prompts: 

• When did you start having periods?
• Average number of days between cycles?
• How long, on average, does a period last for you?
• Does anything happen prior to your period to tip you off that it’s about to drop? 
• Mood changes, perhaps? How many days before? How intense?
• Perhaps a pinch about where one of your ovaries may be?
• What else feels like a regular period for you? 
• Cramps? How intense? How long do they last? 
• Headaches? How intense? How long do they last? 
• Sore or tender breasts? How sore? Is it more tender prior to a period or during?
• And for all of these, what normally works to treat or soothe these symptoms before and during a regular period for you?

If you’re at a loss at first glance, that’s okay. Perhaps a little context could help: Ask family members what their periods are or were like and see if you can identify what a regular period is, and isn’t, for you in that discussion. 

For example, your regular periods may be radically different from your mom’s or sister’s, or friend’s periods. A little chat about it may unveil a lot of information.

If you’ve captured this, awesome! Why not send it along to your doctor’s office and have them put it in your file? Take a photo of it, have it handy for future appointments. And add to it as time goes on and new changes occur.

A surprising, but practical, thing to share with your doctor

Let’s go back to Sami: what can she do while waiting for a call back from the clinic or doctor? If possible, get as specific as you can about this period. Namely, how much blood are we talking about? Sami might track the number of pads she’s going through in a day, and/or how fast a pad gets saturated. Sami might also note the color of the blood, the increase or decrease of clots as the period continues.

Same again if tampons are used. 

More accuracy for the “how much blood?” question can be gathered if you’re using a menstrual cup, as many have a measuring line. Note it or jot it down, and track the number of times you’ve emptied the cup through the course of your cycle.

Once Sami gets to the doctor and has a candid chat, her doctor may want to run labs, test for FSH levels, and ask for other details about what’s new or different in Sami’s life. The awareness Sami brings can level up the care and collaboration with her doctor.

Just in case

If your doctor dismisses or diminishes your experience of a startling increase or sudden heavy flow, consider whether or not you’re willing to engage with this kind of “care” moving forward. Your health, well being, and awareness are absolutely precious and worth real, good quality, compassionate care, and respectful attention.

What constitutes a “regular” period for you? Does heavy flow figure in? Or no? Read, review, and share in the Gennev Community Forums today.

Modern sexuality is “¦ complicated. And talking about our sexual health, even with a doctor, can be awkward as awkward enough that many of us will avoid it, even when we have a problem that needs solving.

Enter consultants like Bianca Palmisano, owner of Intimate Health Consulting, who’s helping doctors, nurses, and other medical and health care professionals speak openly and non-judgmentally to their patients about issues of sexuality.

Bianca Palmisano On Sexual Positivity

Gennev CEO Jill Angelo talked with Bianca about sex, sexuality, and why it’s so darn hard to have those important conversations.

1:50
“Sex positivity” means understanding sex and sexuality as a normal, healthy part of life with a wide range of modes of expression. We asked Bianca if the notion of sex as a positive part of life is gaining some traction in a culture that has an often unhealthy approach to sex.

3:25
What are the trends out there when it comes to sex positivity and women in midlife? Bianca has good news for us as one, the medical profession is innovating to give women “more options in the toolkit” for treating menopause symptoms that impact intimacy, and two, more sex educators are talking about sex at midlife and helping women understand the physical and emotional changes at menopause.

6:27
So, if it’s a good idea to talk about these things with your doctor, how do we start the conversation? Bianca talks about how she provides both medical professionals and patients with strategies for starting, continuing, and finishing the conversation satisfactorily.

9:16
How can women get educated about healthy sexuality? The problem with a taboo subject is that “¦well, it’s taboo. So, not much info. Except there is. Bianca says you can look beyond your doc if that person isn’t someone you can go to, and she gives some ideas on places to look for answers. (see below as well)

11:22
So what is “sexual health competency” and why do medical professionals need it? “Knowing how to have conversations in a way that puts your baggage on a back shelf,” says Bianca. We all have ideas and opinions on sexuality and what we feel is “right” or even “normal” as Bianca helps doctors understand how and why they should ditch the preconceptions when talking with patients.

13:25
Why is good sex so important? There’s an important dynamic between sex and relationships, according to Bianca. But relationships can get thorny in midlife, given all the life-stage stresses and physical changes, so how do we stay intimately connected to one another?

15:00
But relationships can get thorny. How do women initiate conversations about sex with their partners? Probably not when pulling out the condoms in the 10 minutes before Johnny comes home from soccer practice, Bianca says. Hear her ideas on a better way to bring it up.

16:30
Women in midlife often experience some profound changes in their sexuality. Careers are solid, kids are grown, the house is settled on its foundations “¦ are you? Bianca addresses how some women make important decisions and have major revelations about themselves, their lives, and their sexuality.

Want to learn more about sexual health and sex positivity? Visit Bianca’s website, Intimate Health Consulting, and check out these other sexuality experts: Sex educator, writer, and speaker Walker Thornton; Joan Price, author of The Ultimate Guide to Sex After 50 and Naked at Our Age; Certified Sexuality Educator Melanie Davis, PhD, and Dr. Myrtle, author of the series The Recipe for Ecstasy. 

Bianca Palmisano is a sex educator and medical consultant serving the DC community since 2012. As the owner of Intimate Health Consulting, she specializes in training healthcare providers around issues of sexual health, as well as LGBT, sex worker, and sexual assault survivor competency. She also serves as the Community Outreach Chair for the Metro DC PFLAG Board of Directors.

Palmisano is the primary author of “Safer Sex for Trans Bodies,” an outreach and education guide for the trans community sponsored by Whitman Walker Health and the Human Rights Campaign. She has been a guest lecturer at George Washington University, Johns Hopkins, and University of Chicago.

We see the numbers a lot: estradiol, estrogens, FSH. But what do they mean, and what can they actually tell a woman about where she is in the menopause transition?

Turns out, the team at Gennev found that using a menopause hormone levels chart may be less helpful than we’d like.

While there are uses for having hormone levels tested, pinpointing your place on the perimenopause-to-menopause journey probably isn’t one of them. Hormones just don’t cooperate during this time (which is probably why you’re wanting to get them tested in the first place), and hormone tests can only really offer a limited snapshot of where you are right now as which is probably not where you’ll be tomorrow.

To understand all this better, we had a Q & A with our ob/gyn Chief Medical Officer, Dr. Rebecca Dunsmoor-Su, on to test or not to test.

What is the reason for testing hormone levels?

Dr. Rebecca: Good question. Hormone levels are helpful when we are tracking fertility and ovulation induction [using hormonal therapy to prompt an ovary to release an egg]. Taken several times, they can give a very tentative window into where in the fertility transition a woman is. 

But as and this is a big but as hormone levels are extremely variable throughout the cycle and even more irregular during the perimenopausal transition, so they become much less useful.

Looking At A Menopause Hormone Levels Chart

This graph is of hormone levels in one woman over the course of 1 year in perimenopause. At the bottom you can see the spacing between her periods, which is very irregular. During this year her cycles vary from 99 to 20 days long. In the top graph are measurements of her FSH and LH, but if you look at how varied the FSH is (solid line), you’ll notice that there are several time points where if measured it looks “normal” and several where it looks “post-menopausal” and lots in the middle. This is why it is not reliable. In the bottom chart you can see that her estrogen measurements are similarly irregular and all over the place (the dotted line) but most of the time are within the “normal” range. 

Is it ever useful to check hormone levels for women in perimenopause or menopause?

Dr. Rebecca: In my experience, I almost never check them. If a woman has a uterus, than where she is in menopause or perimenopause is best determined by her cycles, or lack thereof.

If a woman has had a hysterectomy, we go by symptoms. We may check FSH [follicle-stimulating hormone] if these are unclear, but again, because it can be so variable, it may not tell us much.

Fundamentally it feels important to know where you are “in menopause,” but really we need to know if you are symptomatic, and we will treat that. Menopause is a normal and natural transition for women that requires no medication if a woman is not having problematic symptoms. If your symptoms are problematic, then we should treat you, no matter where you are in that transition.

What are these tests testing for?

Dr. Rebecca: If correctly done, they look at the relative levels of FSH, progesterone, and LH (leutenizing hormone) to try to get a window into the hormones at a certain point in a woman’s cycle. They are best understood at the “day 3” point of the cycle, i.e. the 3rd day after the start of your period. This is when we have the most data about what they should look like. Random values of these hormones are not helpful.

What do the numbers mean?

A woman reported her numbers as “Estrodial: 8.2, Estrone: 23.3, Total Estrogens: 31.5″ as what does that tell her or her doc?

Dr. Rebecca: Not much at all. What day of her cycle is she on? What is her FSH? When did she last have a period? What medications is she taking? I can’t interpret these tests without all that information.

Additionally, while there is a range of m=normal estradiol levels for women, they vary over the cycle, and between women. If the patient has symptoms, we should be treating her; if she doesn’t, then there is no need to treat, no matter what the values are. Also, just estradiol is needed, that is the active hormone; testing the rest doesn’t add any information (though it does add cost…). There are much better menopause tests for diagnosis available.

Why do doctors conduct these tests if they’re not truly useful?

Dr. Rebecca: Some physicians do not understand the cycle well and think that these tests help. A lot of these tests can help us talk about fertility, and if a physician is not menopause savvy they may not understand the difference in usefulness.

Some providers are getting some money from the tests in “special labs.” Some use them to prescribe expensive hormones or supplements that are no better than the pharmaceutical ones as in fact, they are probably less safe.

A big red flag I need to point out: if your provider tells you “only they understand” how this works, or only they have the answer and the rest of the medical community is “behind” or “ignorant” or “just doesn’t understand” and only they can sell the exact product you need, run away.

Any well-trained menopause provider should truly understand how hormones work and change in the perimenopause. We all have access to charts like the perimenopausal transition chart and the STRAW staging of menopause, and we can tell by symptoms and periods about where you are. We all know how to prescribe HRT properly and will recommend that you use an FDA-regulated product.

Compounded hormones are no more “bio-identical,” in fact they are generally a pharmaceutical product which is crushed and compounded into a cream. So it’s the same medication I would prescribe, now less reliably absorbed and dosed. 

What are better indicators of where women are in the menopause transition?

The menopause is defined based on menstrual cycle. The most common pattern is that first cycles become just a little shorter (21-25 days instead of 28-32). Then they start to space out, and women will occasionally skip periods (see the perimenopausal transition chart).

During this time, some months the ovaries are working normally, some they are behind, but eventually they’ll recruit an egg. Sometimes they just don’t make it to an ovulation, and the lining of the uterus sheds in a irregular fashion because it got too thick (this is usually a long, heavy period bleed).

During this whole time period, hot flashes and night sweats can be present. Eventually, periods will stop, and after there have been no menses for one year, you are menopausal. 

Is there some way to know (or approximate) when symptoms will begin to lessen and finally end?

Symptoms are very individual. In general, hot flashes and night sweats can start 1-3 years before the last period and last on average between 2-6 years. Some women experience them up to 10 years. Vaginal dryness and vaginal issue symptoms happen in about 50 percent of women, and generally don’t start to be a problem until 1-2 years after the last period. Cardiovascular risks and cholesterol changes, bone changes all start when the periods stop. 

Can women use this information to make decisions like whether to begin HRT?

HRT is generally prescribed for symptoms, and so we would treat based on that. We no longer generally prescribe systemic HRT for bones or heart health (though it can be helpful for those things too).

HRT is not a “fountain of youth,” though there is some evidence that women who use HRT may live longer. However, the studies were not designed to look at that, so we can’t be sure that this isn’t because they weren’t healthier to begin with.

Knowledge is power as and so many women feel powerless during this time. What tools do we have to empower women for real?

Gennev is a wonderful and empowering resource. A NAMS-certified menopause practitioner is also a great resource. Ask your OB/GYN if they are comfortable with menopause care and hormones.  

It would be nice to put an end date on menopausal symptoms, but hormone-level testing probably won’t get you any closer to an answer than a discussion with your doctor will.

If you’re ready to better understand where you are in the perimenopause > menopause transition, take Gennev’s Menopause Assessment. You may be surprised to discover some of the issues you’re having are actually related to hormones. Then, take your results to your doctor as or consult with one of our menopause specialists via Gennev’s telehealth.

We can help you understand where you are in your menopause journey

• Meet with a Gennev board-certified gynecologist who is a menopause specialist – they can give you a trusted opinion, determine if medication is right for you, and provide prescription support.  
• Try Vitality as our nutrient-packed multi-vitamin supplement supports your whole body including mood, energy, stress response, immune health, joint pain, and inflammation. 96% of women report having more energy after just 2-weeks with Vitality.

 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.

Whose belly is this?

This was never how my body looked or felt.

And you’re right, of course. The body you had, knew, loved, and lived in is changing and behaving in a new way due to the change in hormone levels. In this life, so far, you’ve never yet been this age and your body is going through a significant change”¦ sometimes referred to as “THE Change.” 

The Big M and Body Fat Redistribution

During and after menopause, weight redistribution, mostly fat redistribution, occurs in the belly area, rather than the thighs or rear. So whether you’re just entering perimenopause, or you’ve been on the path for a while, a change in hormone levels means change throughout your body: mood, skin, sex drive, body composition, the works.

What’s actually happening with weight redistribution?

The estrogen hormone levels are decreasing in your body. If you’ve experienced premenstrual syndrome (PMS) symptoms, you know mood can change when hormones do. Plus, water retention, migraines or headaches, and cramps. 

Similar in that we’re still talking about hormones (estrogen, specifically), but different in that your body’s estrogen flow is decreasing over time, you may experience a whole new lineup of symptoms. Yeah, sorry about that.

Scientists are still learning about how estrogen affects the body, but allow us to clarify that estrogen is indeed a powerhouse. It’s the hormone that has a lot to do with texture and moisture in your skin; changes in your weight, and indeed, in how and where fat deposits “land” on your body. Hips and thighs pre-menopause; post-menopause, most likely, your belly.

The main health issue for this annoying, yet common, the phenomenon is in how much weight is now part of your new middle. More fat deposits in your belly area may present an increased risk for heart disease in women and metabolic syndrome.

Weight redistribution can be alarming and stressful. A flood of emotions may swell in like frustration, anger (okay, rage), resentment, even grief, and sadness. Some of this change does indeed constitute a loss. The body you had is not the body you are living in now.

Working with, instead of railing against

Though we have no actual say or control over how the body acclimates to the new levels of estrogen, we can, however, embrace and support our bodies with the information we do have and by taking good care of our mental, emotional, and physical health day-to-day. 

We get a lot done in a day as mothers, daughters, caregivers, sisters, leaders, partners or spouses, business owners, workers, and the list go on and on. Our bodies take us through incredibly busy days and have specific needs in order to maintain excellent (or even good) health: drinking clean water; regular movement and stretching; good, nutritious food at regular intervals; and relaxation and downtime.

As busy as we are, it’s a real struggle for many of us to prioritize what we need for self-care. Even taking a few deep breaths seems easily forgettable, though really helpful, in the face of other stresses and tasks. There are small things we can do that will lead to motivation for more self-care. What are they? 

Let’s start with one of those deeeeep breaths and look at an opportunity that can present itself in many places: taking a few stairs. Maybe not even a whole case, but a few.

Self-care inspires more self-care

You may not feel inclined, inspired, or motivated to exercise or build muscle strength. It’s understandable, especially if you’re also navigating your busy life with other new symptoms like hot flashes, insomnia, or anxiety. 

Multiple symptoms can be exhausting. But did you know that a little self-care, including a good stretch, and a few exercises can really help you shift a lot of the negative or tired feelings toward more positive feelings? 

Good feelings will beget more willingness and momentum”¦ and more self-care.

Even if you don’t feel like taking the stairs, you may consider taking them on anyway. Why?

Even this small bit of effort can give you new energy, spark some self-esteem, and give you some inspiration to take even better care of yourself. If you’re winded at the top of the stairs, well, you’re already breathing deeper and taking in more oxygen. You’ve asked more of your muscles (which may be burning). You may also be inspired to take a long drink of water before (or instead of) an afternoon coffee or soda. As the day goes on, the good feelings from that single trip up a few of those stairs could inspire you to roast up and eat some extra veggies at dinner.

Who and what

Your physical body is changing, true. And how about taking a look at what else may support you physically as well as emotionally, mentally, and for some, spiritually as well.

Who might you find?

• Friends on their own meno-path: you’ll be able to share, vent, gripe, ask, and commiserate together.
• Post-menopausal women: friends, relatives, and even those in a community you haven’t met in person: wisdom around what comes next can give some real hope for hanging in there at this time. Also to hear that what you are experiencing is normal.
• Coaching or therapeutic support: depression and anxiety are real symptoms of menopause and help from a trusted coach, counselor, or therapist may help you to move through these changes with more ease, clarity, and support. 
• Your doctor, or ours: check-in for tests, recommendations, and options that may ease your symptoms.

What could you do to build up your inner support system?

Identify a few activities you can accomplish each day that may help build momentum for more self-care:

• Take a few stairs when you find them
• Stretch your legs, arms, middle, and back while you’re waiting for your morning beverage to brew
• Get a few extra sips of water into your beautiful body
• Develop a gratitude practice and take a few moments to enjoy it

Infuse energy into your body and mind:

• Lift something heavy, and do it safely. Some women put a kettlebell near their front door and do a few lifts going in or out when they don’t have anything in their hands. Dance break! Even 30 seconds can feel fun and silly, but that can translate to energy.
• Got a favorite song? Sing the chorus out loud. Yes, really loud! Take some space, fill it with your voice”¦ you’ll feel more energy too.
• Make time for meditation or say your mantras for support and affirmation

If you make it a game and stay curious about what else you can do in these small ways, you’ll always win. And you’ll feel better.

So look for opportunities to keep all forms of your health in good order with tasks along the way. You don’t need an hour for each thing”¦ just a moment in some cases. Celebrate your whole glorious self, menopause belly and all. You are so much more than the changes you are experiencing. 

What do you do to make yourself feel glorious? Because belly fat or no, you are glorious! We’d love to hear more about how you’re supporting yourself through this time of change. Please join the Gennev community forums and share!

The cold and flu season is upon us here in the Northern hemisphere, so the menopause clinic team at Gennev would love to share ideas for staying menopause and immune system despite the viral stew everywhere around us.

Loss of estrogen can mean your immune system is weaker than in the past, so keeping the germs at bay may be even more challenging. However, since you’re taking better care of yourself than ever before (right?), you’ve got a head start on staying healthy.

Menopause’s effects on the immune system

So why do we get sick more easily during this time? A few reasons: First, perimenopause and menopause can ramp up the stress hormone cortisol. When we have too much cortisol for too long, a study at Dartmouth found, it can increase inflammation and weaken our immune system’s ability to fight off infections.

And menopause can have a lot of add-on effects: major night sweats or poor sleep, not enough exercise due to no energy or menopausal fatigue, poor diet, and changes in our gut flora can all increase the possibility of getting sick.

How to stay healthy (or get well faster)

So what can we do to counteract the negative impacts of menopause on our immune system? We can make our immune system as robust and vigorous as possible.

1. Wash your hands. This is probably the single most effective thing you can do to prevent the spread of disease. Soap, water, twenty seconds (singing “Happy Birthday” twice will get you there, though we prefer the first 20 seconds of “Bohemian Rhapsody”), and don’t forget to get under your fingernails and wash your thumbs.
2. Tend to your gut flora. It’s a garden in your gut, and a disease-fighting powerhouse garden at that. Keep your gut flora healthy and happy, and it will do the same for you. Beans are a great pre-biotic, meaning they feed your good gut bacteria. Greek yogurt is a probiotic which can also help your gut fight infections, especially if the yogurt is fortified with Vitamin D.  
3. Speaking of Vitamin D”¦. it’s sort of a big deal. Not only does it play a critical role in our immune defenses, it’s also important in building bone and warding off depression. However, most of us are short on the Big D, so it’s important to be vigilant. If you can’t spend time in the sun as our best source of D as look for foods that are naturally high in D (fatty fish like tuna or salmon, egg yolks, beef liver) or fortified with it (dairy products, soy milk, orange juice, cereal).
4. Guzzle the green tea. The polyphenol catechin in green tea does a lot for our bodies, including helping us fight bacteria and viruses. From better bones and teeth to lower cholesterol and easier weight management, boosting your intake might help you get through the winter better. However, it does contain caffeine, so be aware of that, plus high levels can potentially interfere with iron absorption or interact with other drugs you may be taking, so talk with your doctor or a menopause specialist near you if you have any concerns.
5. Bump up the garlic. Garlic is a powerful healer that’s been used for centuries as a way to ward off illnesses. Just be sure to chop it up fine, as that allows the release of the allicin that does the heavy lifting. If you’re using it in cooking, add it toward the end to preserve its germ-fighting ability.
6. Boost zinc. If taken within 24 hours from the time you first notice symptoms of a cold, zinc may shorten that cold by up to 33 percent. Oysters are a good source of zinc, as are many nuts and beans. And there are zinc lozenges available for a quick uptake when you’re feeling symptomatic.
7. Reduce stress. While this may be at the top of the “easier said than done” category, especially during the holidays, remembers that whole bit about cortisol as without estrogen’s dampening effects, cortisol can be at elevated levels already. You don’t want to add more. Excuse yourself without guilt from things that stress you out. If you can’t, try breathing exercises or calming apps to help you feel better in the moment. Have a bedtime routine that helps you stay grounded and sleep better. Make self-care time non-negotiable, however you define that time. Not only will you get sick less often, but you’re laying the groundwork for a healthier future.
8. Exercise during menopause regularly, sleep well, reduce alcohol, don’t smoke. All of these can help you feel better generally as well as stay healthier during cold and flu season.

Avoiding illness entirely is pretty tough in the modern world, but you can definitely minimize your chances of getting sick and help your body return to wellness faster. Pay attention as if you’re in a public place, try to avoid touching your hands to your face until you’ve had a chance to wash them. Be vigilant about eating foods that increase well-being (fruits and veggies) and only indulging in the others occasionally (hello, sugar). If you’re in a stressful situation, try some mantra for positive thinking to keep cortisol levels from ramping up.  

Menopause can make avoiding illness a bit more challenging, but there’s still plenty that’s within your control. For help in supporting your body through menopause, meet with a menopause specialist.  And if you have suggestions for how to make it easier to stay healthy in cold and flu season (or any time), why not share them on our Facebook page or in Midlife & Menopause Solutions, our private Facebook group.  

When you look your best, it’s easier to feel confident. Unfortunately, midlife seems to conspire against us, at least by today’s cultural standards of “best,” with belly fat or thicker waistlines, more wrinkled skin, and flyaway hair.

One of the first things we notice when we see someone for the first time is their hair “” and this is especially true of women. If our previously shiny, glossy, thick hair is now dry, thinner, and frizzy, we feel we’re not making our best first impression. That can undermine confidence before we even open our mouths.

Sonsoles Gonzalez, founder of Better Not Younger

To help women feel better about their hair, whether it’s to make a better first impression or just have happier moments in front of the mirror, Sonsoles Gonzalez founded Better Not Younger, a haircare brand focused on the changes many women experience as they age.

Better Not Younger isn’t just dedicated to healthier hair, though; it’s also changing the conversation around women and aging. 

As an executive in the haircare industry, Sonsoles noticed that products were always geared toward the “18-44 year old women” market. What happens when a woman turns 45, she asked?

Apparently, as far as the large brands go, 45-year-old women and older pretty much cease to exist. But at 52 or 53, Sonsoles, says, she still felt youthful and attractive “” not ready for invisibility!

So she started her own company that researched the needs of women in this demographic and began providing products that work. 

In this podcast, Better Not Younger CEO Sonsoles Gonzalez and Gennev CEO Jill Angelo talk about providing products for women in midlife and how our culture is slowly shifting to recognize the unique value and beauty of women 40 and over.

TRANSCRIPT TO FOLLOW

Have you noticed changes in your hair? Have you tried Better Not Younger or other solutions you’d like to share? Come join us in the Gennev community forums! 

Dear Gennev-ers,

Thankfulness is a gift when times feel tough.

2016 has been a tough year for many people I care about, including me. The election just seemed to top off a year of anxiousness in a world where many things feel out of control, desperate, mad and filled with such anger and resentment towards one another.

Feel down? Yeah, me too.

But I’m taking this week to reflect on things I appreciate. One thing I’ve noticed is that the thankfulness in my heart goes far deeper than it’s ever gone before. It feels more real and authentic. That’s perhaps because I need it to carry on.

Thankfulness feels so good.

I’m so deeply thankful for my husband who props me up every day. Laughs with me. Loves me.

I’m blessed with family whom I love and who love me back. No tension. Just acceptance.

My friends, oh my gosh my friends! They listen, they laugh, they problem-solve, and they tell me the truth even when I don’t want to hear it.

And then there’s Gennev. At times, she’s an all-time high and other times a stressful low. The mission for women’s health is the steady hand”¦and it’s the part I’m most grateful for.

I get to work with incredible women and men every day to help women feel fabulous in their bodies. Gennev has brought a whole new level of fulfillment through the menopause stories and the impact we’re making on Gennev-ers around the world. I’m deeply thankful for our small yet mighty Gennev-ers team.

I’m healthy and I’m able to run 13 miles when I want to. OK, that’s pretty awesome too!

So, 2016 has had a lot of good in it.

When I stop to reflect and break down the things that matter most, gratitude is running through my veins! And it feels extra warm and peaceful given the many external factors I have no control over.

No doubt, the tough stuff of politics, refugee crises, race tensions, women’s rights issues, lying, anger towards one another isn’t going to stop overnight. But what gives me pause is that I’m still me. And I’m the boss of me. I can face this world of tough-going, because I’m filled with the optimism that gratitude brings to my soul.

On this Thanksgiving, I wish you five minutes to simply find some of the gratitude that will help you move through the challenging times we’re in.

And if you’d like to add your list of thankfuls to my list, please email them to me at jill@gennev.com, and I’ll publish our collective list. Thankful begets thankful, and happy begets happy.

Happy Thanksgiving!