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When you think of someone with an eating disorder, what does that person look like? If you’re like most of us, you think of eating disorders as happening primarily among young, white, thin women and girls. That misconception can be dangerous.

Eating disorders affect a much wider range of people, including up to 13 percent of women in midlife. Hormonal shifts, major changes in our lives, and societal pressures can all contribute to women over 40 engaging in unhealthy behaviors around eating, exercising, and occupying their own bodies.

Disordered eating has the highest fatality rate of all mental health issues, so it’s important to understand where this disease comes from, what it looks like, and how to combat it to get or stay healthy. To learn more, we turned to nutrition therapist and eating disorder specialist Julie Duffy Dillon.

 

 

What does an eating disorder look like?

There are several kinds of eating disorders, including anorexia nervosa, in which people restrict their calories and the types of food they eat and may engage in excessive exercise; bulimia, which is characterized by binging on large amounts of food then purging via self-induced vomiting or other methods; and, by far the most common among women in midlife, binge eating disorder (BED). Sufferers of BED generally eat large volumes of food, rapidly, to the point of discomfort, even when they’re not hungry. Feelings of self-disgust, shame, guilt and embarrassment are common.

But according to Julie, disordered eating doesn’t have to mean eating to the point of sickness multiple times a week to be a concern and bad for our health. Often, the beginning stages are marked by withdrawal as something as small as not attending the Friday family pizza and game night because we don’t trust ourselves around pizza.

If, says Julie, concerns about eating and body image are keeping us from taking part in activities we enjoy, if we’re starting to “check out” of our normal lives, then there’s a problem we need to address.

Why are eating disorders common at midlife?

According to Julie, there are a few reasons women in midlife are particularly vulnerable.

Hormonal shifts. As estrogen and serotonin decline in our bodies around menopause, women who are sensitive to the shifts in levels become more susceptible to binge eating, in particular. This estrogen sensitivity pre-dates any eating disorder behavior, meaning women who had issues with eating disorders in the hormonal chaos of adolescence may find themselves confronting the problem again in midlife.

Life changes. According to Julie, if you’re susceptible to disordered eating, times of transition are the most vulnerable periods of our lives. Midlife is marked by huge transitions: in addition to the hormonal shifts of menopause, women are often contending with a newly empty nest, aging parents, divorce, etc. Being constantly under stress can drown out our body’s natural signals that help us eat healthfully.

Societal pressures. Our culture values thinness (not necessarily healthiness, mind you: thinness), and women over 40 feel the pressure every bit as much as their younger sisters. But during menopause, research shows most women gain around 15 pounds, much of it in “central adiposity” (belly fat). That’s just part of the natural process. But most of us feel the pressure to be thin, to have a flat tummy regardless of age or child bearing. Raise your hand if you’ve heard someone say of a mature woman that “she’s let herself go.” Argh argh argh.

Fighting our body’s natural inclination during this transition is counter-productive, Julie says, because fat, particularly in the midsection, holds on to estrogen. Even when a woman is no longer ovulating and producing regular estrogen, that fat allows the body to have a release of estrogen that can help alleviate menopause symptoms.

“So many women I know are seeking out ways to help with symptoms
and side effects, but if they weren’t fighting their bodies so hard,
their bodies could take care of some of it, or maybe even all of it!”

It’s a kind of cultural toxicity, Julie says. We’re told that to be seen, to get a promotion, to keep a romantic partner’s interest, we have to be thin and trim. That pressure ends up being a far greater risk factor for disordered eating than are estrogen and serotonin sensitivity as and they affect a far greater number of women.

Poor information. The idea that gaining weight, particularly in the midsection, can be beneficial, seems radical, Julie says, but it’s true. We’re told that belly fat increases inflammation, leads to higher risk of heart disease, etc., but we really need to look deeper. There’s a weight bias at work in our culture that limits our access to information such as the protective qualities of some belly fat gain.

How do we get back to healthful eating?

It really is “getting back” to healthful eating, Julie says. We’re all born with an innate knowledge of how to feed ourselves and move our bodies for optimal health. But we’re taught to distrust our own instincts as starting as far back as when a parent demands we clean our plate or only take one helping, for example. But we can relearn how to read our body’s signals “¦ and trust them.

This “Food Peace Journey,” as Julie calls it,
is an untangling of the societal and cultural cues about how we “should” eat
and what we “should” look like, and reconnect with our bodies.

“Every woman is expert on her own body,” says Julie. “She’s the only one that’s been there the whole time! We know metabolism starts to slow down, and we shouldn’t be scared of that or fight it. When we stay in our bodies, our bodies let us know what to do. Hunger and fullness cues are still reliable during this transition, just as they were in our 20s or 30s or 40s. For women who have learned not to trust their bodies, it can take some time to learn the cues. But all the information is there and can be trusted. When you tune in, you realize eating certain foods makes you feel more energized while others make you sluggish. If we stay connected, our bodies will lead us to make choices that are health promoting.”

So what’s a woman in midlife to do?

From Julie: Don’t fight your body. That fight is distancing you from the healthy body you’re craving. Yes, society is going to send you mixed messages, like a grocery store full of food that shunts you through an alley of magazines of glamorous women at the checkout. But the key is to reshape the messages for yourself: acknowledge that the food in your cart is there to nourish you, that you’re making the choices that are right for you. Respect your body; enjoy your autonomy; do and eat what makes you feel good and energized. Learn the skills to hear your body’s messages and then make informed decisions about your food.

To get more great information from Julie, visit her website, check out her blog, take a listen to her podcast. Then stay tuned, because we’re going to host Julie on our podcast! So if you have questions for her, please add them to the comments below, or give us a shout on Facebook or Twitter.

 

Want to be healthy in midlife? Eat your veggies. Wear sunscreen. Drink enough water. Have sex (use lube!).

Wait”¦.Have sex?

Yep. Not to give cheesy pick-up artists one more line to use in a bar, but having sex after is actually really good for you.

How sex improves your overall health

“Sex is an important part of our health and well-being,” Madeleine Castellanos, MD, physician, sex therapist, and author of Wanting to Want: What kills your sex life and how to keep it alive told us.

“Consider that we are created with all these different systems that are interrelated. Our cardiovascular system is intimately related to our immune system, which is related to our neurological system. Human beings are designed to respond to physical contact, to eye-to-eye contact; it’s what makes us thrive as babies and as adults.

“We know that people who have strong interpersonal connections live longer lives. One extension of that is sex. It helps support a healthy balance of our hormones and a healthy balance of our neurotransmitters, it helps us feel pleasure and triggers our relaxation response.

“People who have regular sexual activity have better blood pressure, they handle stress better, they have less depression, they’re protected against dementia, they have better cognitive functioning, better memory, better eyesight. Sex improves blood flow “¦ basically, if you want to live longer and better, make sure you get enough lovey-dovey time!”

Recent research certainly supports Dr. Castellanos’ enthusiasm for regular sexual activity. Studies show orgasms help us sleep, thanks to a release of sleep-supporting (and stress-killing) hormones. If your heart is healthy enough for sexual activity, the aerobic nature of sex can actually promote heart health. Sex can relieve pain and even keep you looking younger.

That’s great, but I’m really not interested in sex after menopause anymore

Midlife can make sex seem less sexy. Reduced libido, vaginal dryness in women, erectile dysfunction in men, plus our cultural attitude that sexuality is for young people can all contribute to us turning off and tuning out when we hit a certain age.

It’s understandable to feel that way, says Dr. Castellanos, because our bodies become so unpredictable in midlife. In perimenopause, we experience estrogen dominance, she tells us. “Your brain gets the message that no egg is being produced because progesterone levels are low. So it starts pumping out estrogen, but there’s no progesterone to balance that surge of estrogen. So you get tender breasts, moodiness, irregular periods, and the up and down, up and down of emotions. In menopause, when estrogen drops off significantly, you get the hot flashes, which are caused by estrogen withdrawal, and vaginal dryness. It’s no wonder so many women get discouraged and give up.”

Brains can get a little unpredictable too. Some women blossom in midlife, embracing their freedom from periods and pregnancy scares, while other women get caught in negativity, Dr. Castellanos tells us. “They think, “˜I’m older, my skin is sagging, no one’s really going to want me.’ That affects their behavior and their response to their partners, and pretty soon all those negative thoughts start to create negativity in real life.”

How can we get our sexy back?

Celebrate! It is possible to get your sex drive back, with a little effort (fun, sexy effort!) How?

  1. Have sex. “Both your brain and your body operate on the principle of “˜use it or lose it.'” Dr. Castellanos told us. “The number one way to deal with lack of desire is to continue to have regular sexual activity. That regular contact with your partner reinforces psychological pathways from your brain to your genitals as by way of your heart, incidentally, which is awesome. And your body supports this, increasing the flow of blood and nutrients to the area to make sex easier and more pleasurable.”
  2. Vibrate. No partner? No problem! says Dr. Castellanos. “When women are on their own, I recommend they find a hard-plastic vibrator as which you can safely use with a water-based lube, which is nicer for women with dryness as insert it into the vagina and leave it there, buzzing away for 5-10 minutes. The vibration increases blood flow and creates a mild muscle-contraction response that supports healthy tissue. Masturbate, or read the newspaper, do your nails, whatever, just do it!” When your body is more able to experience sexual pleasure, your brain will be less resistant.
  3. Daydream. As Dr. Castellanos put it, “Practice positive neuroplasticity in favor of your sexuality.” Before you run out and get that printed on a t-shirt, it means to take advantage of your brain’s ability to grow new pathways. If sex has a negative vibe for you right now, create positive associations that will override the bad stuff. “Think about sex, in private, and concentrate on what you really like. It can be a great memory, a fantasy, simple or complex; the key is you really want to get into it. Focus on reliving the experience, asking yourself, why did I like that? How did my body respond? Why was that erotic and exciting for me? Remember the joy, the excitement, the laughter. Just soak in that feeling for two or three minutes a day, and you’ll increase your brain’s ability to think positively about sex.” Try to avoid using pornography for this purpose and use your own creative memory instead. “Pornography is too passive, and it hijacks the visual cortex of your brain,” says Dr. Castellanos. “You want to engage all your senses so the emotional part of your brain is more involved.”
  4. Embrace down time. “It used to be that when the theme song to Johnny Carson came on, it was a sort of Pavlovian cue to have sex. There was nothing else to watch! But now, people can watch cable TV 24/7, and sex just isn’t on their radar. Sex therapists like me are trying to give people insight and permission to see their own patterns and how they may be messing up their sex lives without even realizing it.”

Ultimately, Dr. Castellanos says, sex and sexuality are highly personal, and there’s no shame or guilt in simply being uninterested. But if not having sex or intimacy is making you unhappy, stressing your relationship, and reducing your quality of life, there are ways to improve the situation AND get all the healthy benefits of regular sexual activity.

We’d love to hear what you’re doing to revitalize your sex life. Share your tips and tricks on Gennev’s Facebook page. Want to talk to other women about what they’re experiencing? Join our closed Facebook group for frank, safe, open conversation.

 

I’m a straight, cisgender woman. A million miles away from anything “transgender.” Chaz Bono, Title VII, Laverne Cox as all good, but they have nothing to do with me. For a long time, that’s what I thought.

Today, I think differently. Today, I believe that when we accept the differences we see in others, we accept something within ourselves.

This is how the transgender movement changed me.

dead-end vagina: part 1

I struggled to understand “transgender” as how someone could be a woman trapped in a man’s body or a man trapped in a women’s body. It made no sense to me. If you had male genitalia, an X-chromosome, male hormones, and male genes, you were a man. How could you be anything else? I believed that gender was biology, and your body defined who you were.

Then I watched the Amazon series Transparent, and Maura Pfefferman’s struggle to live as a man and then as a transgender women captivated me. As I followed her journey, I put aside whatever confusion I had about bodies and gender. In fact, I found myself not thinking about whether her story made sense to me; instead, I became wholly wrapped up in her safety, comfort, and happiness. I came to believe Maura knew who she was, and the tragedy of her situation wasn’t just that her identity was at odds with her body. It was also that it was at odds with what people around her expected, needed, and demanded her to be.

I may be a million miles away from transgender, but struggling to live as the person you know yourself to be? I know that story. I’ve lived that story. Most people have.

And when I finally understood Maura’s struggle as a journey of identity, of claiming the person she knew herself to be, I could let go of my biological hang-ups, my physiological “yeah, but.” I embraced the idea that, while your identity is partly informed by your body, it doesn’t depend on it. Regardless of your chromosomes, identity is something you know, something you figure out on your own, based on how you experience the world.

I still don’t understand why gender doesn’t always line up with genitalia or why the body doesn’t always reveal who we are. But Transgender has taught me to trust in other people’s knowledge of themselves, to believe in their own sense of identity. And the same goes for me. I have to trust myself to know who I truly am.

So, now, when someone tells me they identify as a woman as or a man or as neither as I don’t add my own analysis to that claim. I don’t look for physical evidence to support it. I just accept it to be true.

We all know who we are. Because we just do.

dead-end vagina: part 2

Look up the word “vagina” and you’ll see in the definition “tube,” “passage,” “canal.” The vagina serves as the channel between a woman’s uterus and the outside world. And that makes sense, because the uterus is where we incubate life, and it’s through the vagina that we transport the future.

In more pedestrian terms, the vagina takes semen in and carries babies/unused ovum/menstrual fluids/assorted-other-stuff out.

I’d never really thought much about all this until recently; after undergoing surgery to remove a basketball-sized cyst, I also lost my cervix, uterus, fallopian tubes, ovaries and appendix. Having never spent the night in a hospital or even gone through a major illness, as the anesthesiologist approached my hospital bed, I had only one thought:  I want to wake up. I was terrified of being put to sleep and cut open, terrified of what the oncologist would find when she looked inside me. As I lay in the hospital after the surgery, my brain was empty. I slept, learned to roll out of bed, and lifted my gown as each nurse came on duty, to show him or her my incision.

But when I got home, I began to wonder what my body had become. I could see the 9-inch vertical cut that arced around my belly button, forcing puckers at the curve, evidence that I was changed.

But what had I become inside?

I did some research and discovered that my vagina is now a road to nowhere. A cul-de-sac. Stitched together at the top, it no longer acts as a passageway, a channel, something dynamic, action-packed, and poised to change the world. It’s a site where buildings have been condemned, then torn down, and the approaching avenue closed off forever.

When I try to talk about my new body, people usually remind me that I’m lucky the oncologist didn’t find cancer. I am. Very lucky. Lucky that what was wrong with me could be fixed. Lucky that I woke up. Lucky to have friends and family who helped me.

All that luck, though, doesn’t change the fact that my vagina has been sewn up, and beyond its new wall is nothing. Just a dead-end.

dead-end vagina: part 3

I have friends who’ve gone through similar experiences, having their entire reproductive systems removed. About two months after my surgery, a few of us got together for lunch and talked about the worst things that come with losing your ovaries and uterus. I, of course, made jokes about my dead-end vagina.

I also shared my new theory of reptilian-ness.

“I can’t maintain a steady body temperature anymore,” I said. “It’s hot, cold, hot, cold, hot, cold all day long. I mean, constant body temperature is one of the hallmarks of being a mammal. If I can’t maintain my body temperature, doesn’t that make me kind of like a lizard?”

My friends stared at me, as though they wondered if I was serious, if I really believed I was no longer mammal. Then one of my friends said, “Well, it does change you. I mean, I don’t even feel like a woman anymore.”

“Really? Why?” I asked.

“Because everything inside me that distinguished me as a woman is gone. I can’t have children. I can’t serve my purpose.”

There was some sad nodding around the table, and another woman said she felt the same. Then the conversation moved to other things, challenges at work, those stubborn extra pounds no one can seem to lose, but in my head, I stayed on that, thinking about how the surgery had changed me, about the male nurse at the hospital who’d looked at my incision and said, “I guess your bikini days are over.” I told him I wasn’t convinced that they were. I’m still not.

Yes, physically, I have a dead-end vagina. And I spent about a week after my surgery obsessively rolling that idea around in my head and trying to come to terms with my new road to nowhere. But even as I was breathlessly interrogating a friend of a friend as a gynecologist as about what was going on at the top of my vagina and what that meant for sex, I never questioned my identity, never doubted it. Losing my ovaries tossed me over the fence into sudden menopause and cursed me with some wicked hot flashes, but it didn’t change how I felt about myself. Or, rather, it didn’t make me feel like less. If anything, I felt like more. Because now I had battle scars, physical evidence that I’d been through something terrifying “¦ and I’d survived.

Every time I look at my scar, I think, “That’s pretty ugly.” And then I think, “It’s also pretty badass.”

I wonder, though, if I could have gotten through all this with my sense of self intact if there’d been no Maura, no Transparent, no transgender movement. Would I still wake up every day feeling like a woman and knowing that, regardless of what my body reveals, that is who I am?

I suspect the answer is “no,” that only by hearing the stories of brave people, like Chaz Bono and Laverne Cox, am I able to know with certainty that while the experience of being cut open has changed me as made me stronger, wiser and kinder as the scars left behind have not.

 

This week I participated in the Women’s Brain Initiative led by Dr. Lisa Mosconi at Weill Cornell Medicine in New York City. She’s a neuroscientist with a passion for brain health, nutrition and women’s well-being.

The Initiative is a multi-year research study to understand why women are more susceptible to Alzheimer’s than men. Dr Mosconi’s thesis is that there is a correlation between menopause and Alzheimer’s. You can read more about it in her 2018 New York Times op-ed, The Menopause-Alzheimer’s Connection.

With a history of Alzheimer’s in my family, the experience was a personal one. I’m bringing you along the journey with me, because there may be some insight that you can glean from my learning.

On Tuesday, I checked in for the first day of blood work, cognitive testing and MRI scans.

The blood work was standard. Six vials will give them the information they need to establish whether I have the Alzheimer’s genetic marker or not.

The cognitive testing involved a series of memory tests. An instructor listed words that I had to recite back to her, in order, reverse order, and then in whatever order they came to me 10 minutes later. There’s nothing more humbling than memorization exercises.

The final exercise of the day involved a 70-minute MRI scan of my brain. If you’ve ever had an MRI, you know how loud it can be. If you haven’t, the only way I can describe the loud clanking noises is to correlate it to something out of 2001 Space Odyssey. Thankfully, I was able to sleep through a large portion of the scan. The photo at the top of this blog is me before my 70-minute nap in the machine. 

The MRI results will show the health of my brain, which is hydrated by estrogen flowing through my body. As estrogen declines, gray matter can recede, which makes women more vulnerable to brain diseases.

Day 2 was 100% dedicated to a brain imaging technique called PET. I fasted the night before, so they could inject a tracer into my bloodstream.

Watch this short video where Dr. Lisa Mosconi explains the purpose of the tracer and what she hopes to learn from this part of the study.

Next steps are for Dr. Mosconi and her team to analyze the results over the duration of the study, which will last another year.

What can you do to prepare yourself while we await the results?

For one, you can read Dr. Lisa Mosconi’s book, Brain Food: The Surprising Science of Eating for Cognitive Power.

I also recommend downloading the 2-part podcast I recorded with Dr. Mosconi titled, “Menopause, Alzheimer’s and Eating for Retirement.” In addition to reading “Out of focus: getting your concentration back in menopause.”

Finally, if you’re interested in participating in the study, send me an email at jill@gennev.com. I believe they still have room for more participants.

Here’s to our brain health!

 

When it comes to menopause symptoms, most of us know about them because we’re either dreading them or living them.

But what if we could look forward to life after menopause instead of feeling apprehensive of it? What if we could anticipate the time when the symptomatic phase of menopause is over and we can just relish the benefits of post-menopausal life? What if there were more than grieving the finality of our reproductive lives? 

Life after menopause symptoms

If you’re currently suffering through the symptoms of menopause or perimenopause (or simply dreading the idea of it), read on and discover the true benefits of this new phase of your life.

Here’s a sneak peek at post-menopausal life.

Increased intuition 

Many of us have been conditioned to only look at the negative side of growing older, and with that, we often forget that aging is a natural part of life. Whenever something in our lives ends, it’s a natural fact that a new phase is waiting for us.

According to Dr. Christiane Northrup, author of The Secret Pleasures of Menopause, your brain continues to change after menopause, especially in the temporal lobes, which control intuition.

Dr. Northrup is so certain that menopause isn’t something to fear or to “wait out” that this doctor (who once made a career of shepherding patients through their negative symptoms) now invites women to embrace the upsides of menopause. 

Increased resilience and self-awareness

Many women don’t find their true voices until they get older. As a society, we’ve been trained to believe that we must know everything about a subject before we can be considered an expert in it. As mature women, we know better.

While we at Gennev do believe that age begets wisdom, we also realize that, with age, our confidence levels and resiliance increase when it comes to certain subjects. 

The older we get, the wiser and stronger we become. We can look back at our lives and reflect, “I went through a lot…and I made it.”

This being said, some adults do begin backtracking when it comes to confidence later in life, and menopause symptoms can make confidence even slipperier to hold on to. If support is needed, seek it out and use it to build the feelings of accomplishment you’ve earned and have a right to enjoy.

Our mindset? Lean into your next phase with the strength, wisdom, and experience you’ve gathered.

Increased confidence and focus

As we get older, we better understand the immediacy in life. We say yes to what we want and no to what we don’t. Post-menopause is a great, and natural, time to say, “I don’t have to put up with this,” as well as, “I am so ready for that.”

We’ve been through the fire; we know what we can and can’t do. In fact, a 2018 study concluded that confidence peaks in your 60s. The study also found that there was only a slight drop in confidence once you hit your 70s and 80s.  

Increased sexual pleasure

While many see menopause as a time of waning sexual interest and pleasure, it really doesn’t have to be that way. Did you know you can rewire your brain to make your body feel sexy? According to Dr. Northup, the trick is keeping an eye on your nitric oxide levels, an important factor in arousal. She recommends taking vitamins, eating well, and keeping active to reduce stress, even when the menopause transition is over.

Northrup also advises menopausal and post-menopausal women to take control of their pleasure by learning to love themselves, getting massages, and exploring their own bodies. 

Finding focus

Other changes you can expect in this area of the brain? Increased focus. 

This means you needn’t get too distraught if you’re in the thick of menopause, complete with menopause foggy brain. When menopause is over, not only will you likely get your attention span back, it might just be better than ever.

Fewer periods … and ultimately no periods

One of the biggest hurrah moments of menopause? Saying goodbye to PMS and periods. 

Over 80 percent of women report experiencing painful periods. And before the period? Don’t even get us started. According to the Office of Women’s Health, 3 out of every 4 women suffer from PMS symptoms, including headaches, bloating, and irritability. 

When you’re post-menopausal, bring on the white pants. Oh, and by the way, fewer periods can often mean more pain-free sex for many women. And of course there’s lube, if vaginal dryness remedies become a must.

It also means no more worrying about unwanted pregnancies. After the transition to post-menopause is over, it’s a great time to consider transforming your passions into a second career without the worry of children.

Self-aware = self-care

Don’t just take it from us that post-meno can be a fabulous time. There’s plenty of anecdotal information from women going through perimenopause, menopause, and fully in post-menopause to inspire you “” there’s plenty to enjoy, if you have the right mindset.

Jordan Rosenfeld is one of those women. When she started perimenopause early (age 41), she made a beeline for her doctor’s office. She’d been experiencing increased irritability and low energy or menopause fatigue. She was also starting to worry about getting older.

Professor of medical psychology and OB-GYN at Columbia University Irving Medical Center Catherine Monk suggested she take a different approach. Instead of trying to “solve” her irritability, Monk suggested that maybe she had stifled her frustrations too often before her symptoms got out of control. 

Monk also suggested that her fatigue might be just her body’s way of telling her to take a break.

Understanding what your body is going through “” and giving yourself space and time to adapt to the changes “” is an important kind of self-care.

Relief from depression

Women with depression or sucicidal thoughts experience fewer symptoms after menopause. Most of the women who found relief didn’t start experiencing symptoms of depression until the start of menopause. 

Ellen Freeman, Ph.D., who oversaw the study, found: “Among women who first experienced depressive symptoms approaching menopause, the risk of depressive symptoms declined after the FMP [final menstrual period], with a significantly lower risk the second year after menopause.” 

While many women choose to undergo hormone replacement therapy (HRT), others find that increasing their daily amount of exercise and managing stress to be just as effective. 

Is there life after menopause?

No matter what you’ve been told, not all women experience the symptoms of menopause in the same way, or sometimes even at all! Check your expectations at the door and you might just enjoy this new chapter of your life. When all else fails, don’t forget: menopausal symptoms aren’t forever.

We’d love to hear what you are looking forward to in this second chapter of your life. Chime in with your post-meno visions in our Community.

 

Sports Dietitian, Exercise Physiologist and Gennev Health Coach, Stasi Kasianchuk has updated some favorite recipes to accommodate the realities of menopause symptoms. You don’t have to give up or miss out when you can modify it! 

It’s the holidays, and the indulgences of the season are part of the fun! But when you’re dealing with menopause symptoms, you might be better off setting yourself some limits.

Reducing sugar and alcohol intake during menopause can help you manage symptoms such as hot flashes, disrupted sleep, headaches, and irritability. However, the time from Thanksgiving to New Year’s is not the easiest time of the year to forego sugar and alcohol; attempting to eliminate them entirely can quickly tip you into frustration and, ironically, over-indulgence. 

The holiday season tends to mean an increase in foods and beverages that are higher in calories, fat, sugar, and alcohol. While all of these ingredients can fit, excessive amounts can have consequences, especially during menopause. 

Instead of limiting your holiday fun, check out the following recipes which help to modify the amount of sugar and alcohol. Sharing these at your next holiday gathering can set you up for sustainable success when it comes to nutrition during the holidays. 

Festive Green Sauce

Make this a day ahead of time and enjoy with whole-grain crackers, raw veggies, or veggie chips. Increase the oil to ¾ cup to thin the sauce for a salad dressing or topping for chicken breast, salmon, or tofu. 

Ingredients 

Instructions

Pulse all ingredients as except nuts as in a food processor until incorporated. Add nuts and pulse until mostly smooth. Ingredients*Adapted from Pinch of Yum 5 Minute Magic Green Sauce

Cheers to Fruits and Veggies Holiday Cocktail

Nutritionally enhance your cocktails with fruits and veggies for flavor without the added sugar. 

Mix ingredients and serve straight up or on the rocks. 

Alcohol can be omitted for a fancy bubbly mocktail.

Nutty Chocolate Berry Balls

These can be made several days ahead of time and stored in the fridge. They are packed with anti-inflammatory nutrients and can be put out with the holiday cookies or enjoyed as a quick snack when you’re on the go!

Ingredients

Instructions

Adapted from Super Food Snacks-Chocolate Cherry Goji Bars by Julie Morris

Our recent blog post “Holiday Nutrition Tips for Women and Menopause“ provides additional practical strategies to keep your nutrition optimal during the holidays. 

Have you adapted some holiday favorites? Or do you throw caution to the wind at this time of year? Whatever you do, we’d love to hear about it on our community forums, so won’t you join the conversation?

 

There are nearly 37 million menopausal women in the U.S. today. We’re gen-Xers, baby boomers and if you’re a cancer survivor or you’ve had a hysterectomy, you may even be a millennial.

We’re at the height of our careers, our families are becoming more independent and our parents more dependent.

We’ve also got more spending power than any other audience and we influence 85% of all household spending.

We’re a force. I like us. I like being part of this tribe of real, bold women who are getting honest with our bodies, our hearts and our souls.

Speaking to women in menopause

Everywhere I look lately, companies and brands are trying to find ways to speak to us.  In the Groove and Ageist are two examples that represent a new approach. For decades we were invisible, but I feel a real social change happening.

It might be too early to declare victory against the stigma of menopause or aging, but we’re certainly game on.

What’s interesting to me is, what do we call ourselves?

Are we women in midlife? Women of a certain age? Menopausal women? Wise women? Maturing women? Age-defying women?

I don’t like any of those references. And yet, we’re a demographic with power and influence, and I want us to claim it. I don’t have the answer.

Brands are struggling with how they reference us in their marketing. Here’s a fine example of a new line of hot flash and beauty products that are struggling with terms like “menopause-age” and “anti-aging.”

We’ve struggled with this same challenge at Gennev. As we consider new products that take on menopause symptoms including insomnia, anxiety and hot flashes, we’ve tussled with how to positively reflect their role in empowering you to feel your best.

How do you want to be referenced? I’d love to hear what you think on this topic. Together, we get to redefine a new generation of women. We get to redefine how society sees us. We get to take back control even when menopause can make us feel out of control.

Email me at jill@gennev.com with your perspectives on this redefinition and I’ll publish them in a follow-up to this group.

Let’s do some work together for us and for generations ahead!

Sleep may seem more elusive during midlife and menopause than any other time of life – even after having a new baby. Ninety-six percent of women in midlife say that poor sleep is one of their top three symptoms of menopause, according to a recent Gennev survey. To make matters worse, it seems like every day there’s another health problem attributed to a lack of sleep””weight gain, memory problems, decreased immunity, and increased risk of diabetes, heart disease, stroke, and even cancer. No wonder you can’t sleep!

“When sleep becomes a constant concern that a person is preoccupied by, that in itself can make it difficult to become a good sleeper,” says Sound Sleep Guru Meredith Broderick, M.D., who is board certified in sleep medicine and neurology.

So, the first step to better sleep is to stop worrying so much about your sleep. We know, easier said than done. That’s why we’ve created this guide to help you to stop obsessing about your sleep and start enjoying a good night’s rest. You may be surprised to find out that some of the most effective strategies are pretty simple. And even if you’re sleep isn’t perfect, there are things you can do to mitigate the negative effects of poor sleep on your health.

Why is a good night’s sleep so important?

Sleep is your body’s rest and repair time. You may think you’re busy during the day, but a lot is going on inside your body at night. Cells are regenerating. Hormones are regulating. Memories are being stored. Your immune system is reinforcing itself. Muscles are getting stronger. Nerve cell connections are being made. All in an effort so you can perform at your best the next day.

To make all of this happen, your body cycles through two types of sleep throughout the night. If you use a sleep tracker like a Fitbit or Apple watch, you may be familiar with some of this. The first type is non-rapid eye movement sleep (non-REM), which includes light and deep sleep. The latter is a crucial time for growth and repair, and if you awaken during this stage, you’ll often feel groggy and disoriented for a while. The second type is rapid eye movement sleep (REM sleep), which involves more brain activity than non-REM. This type of sleep is essential for the processing and storing of information, including memories, in your brain. Overnight you cycle through the various stages, with each cycle lasting about 90 minutes and the REM stage getting longer the more you sleep.

How menopause interrupts sleep at night

There are lots of reasons women sleep poorly during midlife. Hot flashes. Worries. Night sweats. Restless leg syndrome. Pain. A never-ending to-do list. Urinary issues. Sleep apnea. Even if you don’t have trouble falling asleep, you may find yourself waking up more often throughout the night and having a harder time falling back to sleep. Unfortunately, sleep problems don’t usually disappear along with other menopause symptoms.

But a good night’s sleep doesn’t have to be a dream. Often, when you address underlying issues such as urinary problems or joint pain, you’ll sleep better. Treating menopause symptoms like night sweats and anxiety can also help. That’s why your first step should be to see a doctor with experience treating women in menopause. They will understand what you’re going through and have the most options for helping you. A serious sleep robber that needs immediate attention is sleep apnea. If your partner notices that you’re snoring or appear to stop breathing while you sleep, talk to your doctor about getting checked for sleep apnea. As estrogen levels decline, you’re more likely to snore and even experience sleep apnea, a serious condition that disrupts your breathing. Like other underlying conditions, treating sleep apnea will help you sleep better and wake up feeling rested.

What’s more important: quantity of sleep or quality?

As you’re trying to improve your sleep, you may get fixated on the number of hours you’re snoozing. If you wear a sleep tracker, you might obsess about how much deep versus REM sleep you’re getting. While both quantity and quality are important, Dr. Broderick says the most valuable endpoint is feeling rested throughout the day. “If you feel good, the numbers aren’t as important,” she says. “Feeling good and functioning well during the day are what I care about the most.”

And getting a good night’s sleep, so you wake up feeling rested, starts long before you turn in for the night. “What you do with the time you are awake and the quality of your waking hours has a dramatic impact on your sleep quality,” Dr. Broderick explains. “Being active, engaged, having a purpose, and connection are reasons why you get out of bed in the morning. They also keep you busy and help your body generate the need for deep, uninterrupted sleep.”

8 steps to getting a good night’s sleep

While you address any underlying causes that may be keeping you up at night, here are additional steps you can take to set your body up for a good night’s sleep. Some may even help with conditions like anxiety, joint pain, and hot flashes that can rob you of sleep.

  1. Be active. The latest research shows that exercise can protect against the adverse health effects of poor sleep. All activity levels provide some benefit, and the more you do, the more protection you get. Exercise has also been shown to improve sleep so it’s a win-win.
  2. Adopt a plant-based diet. A healthy diet is even more essential when you’re not sleeping well. A new Stanford University Medical School study found that when you incorporate more plant-based foods into your diet, the decrease in saturated fats and sugar minimized the side effects of sleep deprivation, such as brain fog, poor concentration, fatigue, and irritability. Other research suggests that high-carbohydrate diets may promote better sleep than high-fat diets, and foods like fish, fruits, vegetables, and milk products may also help.
  3. Get out in the sun. Sunlight is one of the most potent ways to reset your body’s internal clock, your circadian rhythms, that dictate your sleep-wake cycle. It tells your body to stop producing melatonin, a hormone that promotes sleep. That’s why it’s best to get a dose of sunlight early in the day. A morning walk is a great way to do this and get some exercise for a double-dose of sleep medicine.
  4. Wake up at the same time every day. It’s best if you have a consistent bedtime and wake-up time, even on weekends, to train your body and brain to know when it’s sleep time. If you can’t be consistent with both, at least keep a consistent wake-up time, which may make it easier to fall asleep at night than if you sleep in the prior morning.
  5. Curb caffeine. You don’t have to cut it out entirely but cut off your caffeine consumption (coffee, tea, soda, chocolate) at least five hours before bedtime. The earlier, the better. Caffeine can stick around in your system for 12 hours or more. And even if you think it doesn’t affect your sleep, research shows that it can shorten valuable deep sleep time.
  6. Pick up some weights. Cardio like walking, running, cycling, or swimming tend to be the go-to types of exercise. But a new study suggests that strength training may have an edge in promoting sleep. Because strength training can be more taxing to muscles and requires more recovery than cardio, it may make your body crave sleep, so you sleep more soundly.
  7. Limit night lights. Bright artificial light and blue light from screens can disrupt your sleep hormones, making good quality sleep harder to get. Turn down overhead lights and limit screen time in the evening to signal to your body that bedtime is coming. Avoid screens for at least 30 minutes before hitting the hay.
  8. Trade in your nightcap. A glass of wine or other alcoholic beverages may make you sleepy, but they can cause you to wake up more and get less deep sleep. Instead, sip golden milk or 100-percent tart cherry juice about 30 minutes before bed, recommends Gennev Health Coach Stasi Kasianchuk.

If you continue to have sleep issues, consider seeing a board-certified sleep specialist or a behavioral sleep specialist. They can provide cognitive behavioral therapy, which has been shown to be effective for chronic sleep problems.

When you notice a change in sleep pattern that may be associated with the menopause transition, especially if body temperature instability is part of the problem, consider an appointment with a Gennev doctor to address the role that hormonal shifts can play in your trouble sleeping.

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.

It’s 3.30 AM, and you’re wide awake. Again. Maybe you’re drenched in sweat, or your heart is racing, or your head is spinning, or maybe you’re experiencing all of the above, but whatever sensations you’re feeling right now, “sleepy” isn’t one of them.

“I sleep like a baby,” one perimenopausal woman told us.
“I wake up every two hours and cry.”

We hear from women all the time that interrupted sleep is one of the most frustrating symptoms of menopause. Even women who generally sleep well find their rest interrupted with night sweats and the resulting pajama and bedding changes.

So what’s the big deal over some lost zzzzzzs?

Not enough sleep is really, REALLY bad for us. Poor-quality sleep can exacerbate other menopause symptoms like mood swings, anxiety, depression, weight gain, and digestive issues. As a woman in perimenopause or menopause, you may have a weakened immune system which is further compromised when you don’t get good sleep. Even worse, being in menopause raises a woman’s risk of hypertension, heart disease and stroke; sleep deprivation can increase that risk.

What’s a woman to do?

May is Better Sleep Month, and to help you have better nights, we’re sharing some information on how to boost your snooze time.*

Sleep issue #1: night sweats

First of all, what’s happening? Well, one theory is that the hypothalamus as the part of your brain that regulates body temperature as gets confused by fluctuating estrogen levels into thinking the body is overheating. It opens up the body’s blood vessels and promotes sweating in an attempt to release excess heat, and voila! Night sweats.

How to handle it? Definitely a cool bedroom, light bedding and pajamas (wicking sheets and cool clothing can help you stay dry), no spicy food, coffee or alcohol in the hours before bedtime. And don’t smoke. Smoking can increase the severity of menopause symptoms. Exercise daily, but earlier in the day to avoid raising your body temperature too close to bedtime.

Some women have good results with natural remedies such as black cohosh, evening primrose oil, acupuncture for menopause symptoms or meditation; others may find relief with supplements like Estroven or Macafem. However, before adding any supplement, be sure to talk with your doctor; even natural remedies can interfere with medications you may be taking or have side effects.

There are menopause prescription remedies as hormone replacement therapy (HRT), low-dose depression medications, even a blood pressure medication as that may help with night sweats, but as always, talk to your doctor about benefits and risks.

Sleep issue #2: depression and anxiety

What’s happening? Without estrogen’s calming influence on our cortisol, our stress response can get a little wonky, ramping up stress and anxiety. Depression can also be prompted or worsened by changes in hormone levels.

How to handle it? Lifestyle changes can go a long way to helping women reduce stress and sleep better. Eating a healthy diet with less sugar, caffeine, and alcohol can help. Many women report balancing their stress levels by taking a magnesium glycinate supplement at bedtime or taking up yoga or meditation. There are prescription treatments, but lifestyle changes are often less invasive and should be considered first.

Sleep issue #3: sleep apnea

What’s happening? If you’ve ever woken up feeling like you’re choking or gasping, you may be experiencing sleep apnea in menopause. Disordered breathing during sleep often worsens in women during and post-menopause. Estrogen and progesterone help maintain muscle tone, and, according to The National Institute of Health, that includes the muscles around our airways. When those hormone levels drop, airways can partially collapse during sleep, causing increased snoring and the interrupted breathing of sleep apnea.

Sleep apnea may not even entirely awaken you, but the quality of your sleep can be reduced by these gaps and pauses in ordinary breathing.

How to handle it? Sleep apnea can be a real health risk, so if you’re experiencing apnea symptoms, or if your partner reports a notable increase in snoring, you should consult a doctor or sleep specialist. Apnea can be worsened by excess weight, so managing your weight can be a significant help. HRT has been shown to help some women with sleep issues, including apnea, or your doctor or specialist for menopause may recommend a continuous positive airway pressure (CPAP) machine to help you breathe more regularly.

We all know that little can beat the restorative power of a really good night’s sleep. It regulates our mood, controls our appetite, gives us energy, helps us ward off disease, and is just so darn comfy and cozy. Protect your zzzzzs by making some healthy lifestyle changes and talking with your doctor about risks and options.

*The information contained in this blog is not intended to replace expert advice from a medical professional.

Are you getting decent sleep? If you’re getting all the zzzs you need, could you share how you’re doing it? Let us know in the comments, or join the Gennev community and tell us more.

 

If there’s one thing we can thank the Kardashians for, it’s bringing awkward topics into the light for conversation.

“Vaginal rejuvenation” is one of those awkward topics. Apparently, at least two of the sisters have undergone treatment to “tighten” their vaginas after childbirth.

While we’re not suggesting you play Keep Up with the Kardashians, some vaginal treatments can give women relief from menopausal symptoms, and that’s worth exploring.

If you are interested in vaginal rejuvenation for yourself, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if treatment is right for you, and they can provide support. Book an appointment with a doctor here.

Vaginal rejuvenation meaning…

Just like other parts of the body, the vagina ages over time thinning, drying, loosening, shrinking and it may change due to vaginal births. Vaginal rejuvenation therapies are intended to help women regain the moisture, tightness, and elasticity of their younger, pre-childbirth parts. Treatments generally fall into two categories: cosmetic and reparative.

Cosmetic surgeries include labiaplasty, which changes the appearance of a woman’s vagina by reducing the size of the labia as the interior and exterior “lips” of the vulva that protect the clitoris and vaginal opening.

Some cosmetic surgeries change a woman’s sensations during sex: vaginoplasty tightens the vaginal walls which can get stretched in childbirth; or there’s clitoral hood reduction, intended to expose more of the clitoris for greater sensation.

Other options include ” revirgination,” surgery intended to return the hymen to its “virginal” state, and ” G-spot amplification” wherein collagen is pumped behind the vaginal wall to make the G-spot thicker, more sensitive, and easier to “¦ uh “¦reach.

Reparative vaginal treatments are intended to do exactly that: repair. Surgical procedures can treat prolapse, for example, where pelvic organs such as the uterus “droop” into the vaginal canal, or they may be able to help with urinary incontinence.

Also, as vaginal walls thin and dry with age, intercourse can become painful; some treatments may make vaginal tissue healthier and more resilient and restore the body’s natural moisture.

Today’s discussion is about reparative vaginal treatments, but if you are considering any type of surgery on your lady parts, please be sure you’re familiar with the risks of vaginal surgery.*

An alternative to vagy rejuvenation surgery as the Mona Lisa Touch

When it comes to ways to combat vaginal dryness associated with menopause, there are also non-surgical options. For many women, lubricants such as genneve’s Personal Lubricant for menopause dryness or Intimate Moisture: Lubricant For Sex get the job done very nicely, thank you. But for those who also suffer incontinence or atrophic vaginitis, the Mona Lisa Touch (MLT) might be worth investigating.

Dr. Rebecca Dunsmoor-Su

A relatively new technology, the Mona Lisa Touch received FDA approval and has been available in the US since 2014. To better understand how (and if) it works, we talked with Dr. Rebecca Dunsmoor-Su MD, MSCE, FACOG, a Seattle-based doctor, medical researcher, and educator who offers MLT treatment to patients  in Seattle.

What is the Mona Lisa Touch and how does it work?

During and after perimenopause and menopause, lack of estrogen can make vaginal walls thin, dry, fragile, and easily damaged. Women can experience pain during intercourse (or exercise, or even just daily activity like walking and sitting) and an uptick in the number of urinary tract infections.

Uh “¦ no.

The Mona Lisa Touch, according to Dr. Dunsmoor-Su, is a “fractionated CO2 laser” that works by making pinhole-size “injuries” in the vaginal walls. While this may not sound any better than the dryness, these micro-injuries actually prompt the body to send in immune cells to repair the damage. Cells called fibroblasts awaken and pump up the volume of moisture, collagen returns, the pH returns to normal, and healthy vaginal bacteria come back as all Very Good Things.

“Biopsy studies show the Mona Lisa Touch can return the vagina to its pre-menopausal state,” says Dr. Dunsmoor-Su.

Even better, the MLT uses no hormones, making it an excellent option for women with a personal or family history of breast cancer.

“About 50% of my patients are breast cancer survivors,” says Dr. Dunsmoor-Su, “but the Mona Lisa Touch is a great option for any woman who prefers a non-hormonal solution to menopausal symptoms.”

Should I try it?

Studies demonstrate high levels of success with the Mona Lisa Touch. In one Italian study of 20 women, 17 of those women who were not sexually active due to pain “regained a normal sexual life at the 12-week follow-up.” Dr. Dunsmoor-Su cites rates as high as 85-92% for improvement in dryness, burning, irritation and frequent infections, and 50-75% success rate for women with mild-to-moderate incontinence.

Drawbacks to laser treatment?

  1. Cost. Because insurance doesn’t cover the cost of treatments, which average around $2,400, many doctors will recommend that patients exhaust other, covered treatments first, such as HRT.
  2. Commitment. This is pretty minimal, but those considering MLT should be aware that laser treatments can take more than one visit. Dr. Dunsmoor-Su’s patients get three treatments done six weeks apart, and then an annual “touch-up.”

For such high success rates, the drawbacks and risks are extremely low.

So about those “extremely low risks” “¦

According to Dr. Dunsmoor-Su, the MLT is pretty much risk-free: there’s no hormone exposure, and the laser doesn’t penetrate deeply enough to cause real injury: “For my patients who have treatments on the external vulva, where most of the nerve endings are, they say they have 24 hours of feeling like they have a sunburn down there. We treat it with ice and numbing cream. That’s really it.”

The only other risk might be that the treatment simply doesn’t work. Some women are simply too far past menopause for the fibroblasts to be awakened, or if a woman has had radiation in the area, there may not be any cells remaining to recruit. It’s always worth trying, the doctor says, so she offers the first treatment at a reduced price for women in these categories. If there’s no improvement, they stop.

What is treatment like, and what should I expect?

The treatment is delivered via a thin probe inserted vaginally. The process takes about 3-5 minutes.

How soon do things start to improve?  Almost immediately, says Dr. Dunsmoor-Su. “There’s improvement after the first session,” she says, “with the peak benefits coming after the second. The third gives the treatment longevity so patients don’t have to return for the maintenance for at least a year.”

High success rates, low risk, long-term benefit: For women looking for relief from vaginal issues like incontinence and painful sex, the Mona Lisa Touch is definitely worth investigating. We’ll be talking more with Dr. Dunsmoor-Su in an upcoming podcast, so stay tuned for that. 

If you’ve received Mona Lisa Touch treatment (or any treatment, really), we’d love to know how it went for you! Let us know on Gennev’s Facebook page or in Midlife & Menopause Solutions, Gennev’s closed Facebook group. 

*As always, the information here is just that as information. It’s not intended to replace the expert advice of your doctor, so if you think you need professional help, please go get it. 

 

Like many women, Lauren Chiren had a rough transition to menopause. During a particularly bad 18-month stretch, her brain fog and short-term memory got so bad, she quit her high-powered senior role, concerned she was developing early onset dementia.

When she learned she was actually dealing with menopause and there were ways to manage her symptoms, she decided to commit herself to helping women so no one would go through what she did.

Now as Founder and Director of Women of a Certain Stage, Lauren coaches executive women, helping them make the lifestyle changes that allow them to continue to perform during perimenopause and menopause. And she educates organizations on how to best support this very valuable workforce of women.

 

What do you think a “menopause optimized” workplace should look like? Do you have one? If not, how can we start the conversation to make workplaces friendlier for women managing the menopause transition?  What is your workplace doing right or wrong, and do you feel comfortable and supported? Is it worth the risk for women to admit they’re in menopause and try to make some changes? (Yes, we know, it shouldn’t be a “risk” at all, but that’s the often-sexist and ageist world we live in, no?) 

We’d love to hear your ideas, so please share! Comment below, or find us on Facebook or in Midlife & Menopause Solutions, our Facebook group. You can also join us, anonymously, if you prefer, on our community forums.

 

 

https://podcasts.google.com/feed/aHR0cHM6Ly9nZW5uZXZlLmxpYnN5bi5jb20vcnNz/episode/YjBjZjllN2MtODNiOC00NThjLWJiZjQtNzRjYzQ0OTk1NWNl https://open.spotify.com/episode/5lhEmU9XGNt4emsmKU3WMf?si=57KV6YiMQtmmf6dpZfLB_Q https://open.spotify.com/episode/5lhEmU9XGNt4emsmKU3WMf?si=57KV6YiMQtmmf6dpZfLB_Q