Darcey Steinke has written a wholly original book about menopause. And it's wonderful.
She starts with her own experience, then leads us on a journey that explores the biological, sociological, and cultural realities women have faced and continue facing during this part of their lives.
And how it's time those "realities" underwent some real scrutiny.
Darcey argues that menopause can and should be transformative – a unique opportunity to embrace a new, rich, potentially very altered self.
Once genneve CEO Jill Angelo heard Darcey on NPR's All Things Considered, she was eager to meet the woman who spoke so openly and honestly about the changes menopause can have on bodies, sex, relationships, and our own identities as women.
When she learned Darcey was coming to Seattle (home to genneve HQ) to speak about her book, Jill reached out.
What follows is an incredibly lively, fun, and inspiring conversation. We hope you enjoy it, and if you're able to attend Darcey's show in Seattle, we'll see you there!
Many women aren't familiar with the term "perimenopause," even though it could explain their suddenly unpredictable periods, night sweats, and even crappier PMS.
Doctor of Pharmacy Dr. Anna Garrett is on a mission to help women better understand their bodies – and help us all better understand the hormonal journey women travel throughout their lives.
In this podcast with genneve CEO Jill Angelo, Dr. Anna discusses why 35 isn't "too early" to start talking about and preparing for perimenopause and menopause, how these two phases of a woman's life differ, and why it's so important to all women's health to have open conversations about hormones.
Have a listen, then check out Dr. Anna's book, Perimenopause: The Savvy Sister's Guide to Hormone Harmony.
In 2002, the Women's Health Initiative released the results of its study, claiming use of Hormone Replacement Therapy (HRT) increased a woman's risk of breast cancer.
Almost overnight, use plummeted, leaving a great many women without a good alternative for managing their menopause symptoms.
In their book Estrogen Matters, Dr. Avrum Bluming and Dr. Carol Tavris take a deep and detailed look at the WHI study and its conclusions.
Not only, they argue, did the WHI unnecessarily frighten women and leave them suffering with very real symptoms, they may also have prevented women from taking a life-changing, even life-prolonging treatment.
In this podcast with genneve CEO Jill Angelo and genneve Director of Health ob/gyn Dr. Rebecca Dunsmoor-Su, Drs. Tavris and Bluming take us through their research and make a compelling case for the safety and effectiveness of HRT.
If you're in or approaching menopause, this podcast and the book Estrogen Matters can help you better understand HRT, its true risks, and the very real benefits it can offer.
Learn more and find the full transcript at genneve.com.
If you're a woman with a personal or family history of heart disease, don't assume your heart health is completely out of your hands.
And don't assume you "don't need to worry about heart disease" because you're a woman with no family or personal history.
In this podcast, genneve Director of Health, ob/gyn Dr. Rebecca Dunsmoor-Su, interviews one of Seattle's leading cardiologists, Dr. Sarah Speck, on ways to improve your heart health, starting right now, today.
Know your risk factors (preeclampsia can be a risk factor for future heart disease – who knew?) and how to manage them (losing 10% of your body weight if you're overweight can substantially reduce impacts on heart health).
Also, if you're considering HRT to manage perimenopause and menopause symptoms, what are the implications for your heart?
Take 15 minutes to listen; it could change your life.
It's tough enough to start a second career at age 46 – but what if that new career involves wearing a bathing suit and getting your picture taken?
Rachel Peru did it, beautifully.
Volunteering to be in a friend's fashion show led to an entirely new career and, even better, a new confidence in her beauty, power, and resilience.
Now a model, Rachel has embraced her silver hair, her body's natural curves, and is flipping the idea that "women are invisible after 40" on its head.
If this is what 40+ looks like, we say, bring it on!
Photographer Matt Brown @mattsphoto
There's already a shortage of ob/gyns in the US, making it even more difficult for women to find a menopause specialist.
According to Fortune Magazine, "By 2020, there will be a shortage of up to 8,800 OB-GYNs, according to the American Congress of Obstetricians and Gynecologists. And by 2050, the shortage may grow to 22,000."
What are the consequences to women's health if there aren't enough ob/gyns to fill the need?
genneve CEO Jill Angelo talked with genneve Director of Health, ob/gyn and menopause specialist Dr. Rebecca Dunsmoor-Su, about the strain this puts on women, on physicians, and on the health care system as a whole.
They also discussed how genneve's telehealth is an excellent way to help fill the care gap for women in midlife and menopause.
Learn more about genneve and our telehealth service, and read the full transcript of this conversation, at genneve.com.
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.
Join us at genneve.com, the one-stop shop for an easier menopause, to learn more.
Sonya dreamed she was drowning and woke up choking and gasping for air.
She was tired all the time, grabbing quick cat naps in the middle of the day when she could to try and shake off the lethargy and brain fog.
Once a sound sleeper, Sonya just couldn’t make it through the night, sometimes getting up hourly to go to the bathroom. What was going on?
Sleep apnea was going on.
She took an at-home sleep test and was diagnosed with mild-to-moderate sleep apnea, meaning her body was waking multiple times an hour to start breathing again.
Sleep apnea is dangerous – heart disease, stroke, dementia, diabetes are all associated with sleep apnea – and women in menopause are particularly vulnerable.
For more information, we talked to Dr. Katharine Christian, dentist and specialist in dental sleep medicine. She is the Dental Director of the Seattle Snoring and Sleep Apnea Center and Board Certified by the American Academy of Dental Sleep Medicine, and thanks to her, Sonya is finally able to get a good night’s sleep.
To get more information on sleep apnea and Dr. Christian and to read a full transcript of our conversation, visit genneve.com.
You wear your skin every day, so it's a good idea to take care of it. Best way to do that? According to Dr. Keira Barr, board-certified dermatologist and Chief Wellness Officer of Resilient Health Institute, "get naked."
You need to inspect your skin, top to toe, every nook and cranny, Dr. Keira told us. But that's just the beginning.
Dr. Keira shared with us the five things to look for and the three most important things you can do for your skin.
Your skin is your largest organ and a window into your overall health, so listen up and find out how to take the best possible care of it.
Get more information about Dr. Keira and the full transcript of this interview at genneve.com.
In Part 1 of our conversation with neuroscientist Dr. Lisa Mosconi, we learned more about the connection between estrogen, menopause, and Alzheimer's.
In short, in perimenopause and menopause, as estrogen declines, women lose some of the neuroprotective advantages of the hormone, making them more vulnerable to Alzheimer's disease.
Make sure to listen to Part 1 to get grounded in the science. In Part 2, Dr. Mosconi lets us in on how we can protect our brains from the cognitive decline of Alzheimer's. Food, exercise, intellectual stimulation all have a part to play, so you're going to want to hear what Dr. Mosconi has to say. (Bonus: a lot of these same tips can help men age better, too.)
Learn more about Dr. Mosconi, the Alzheimer’s Prevention Clinic, and how you might participate in their research. If you want to start nourishing your brain against age-related decline (“eating for retirement,” as Dr. Mosconi puts it), get your hands on a copy of her fascinating and very readable book, Brain Food: the Surprising Science of Eating for Cognitive Power.
“In the next three minutes, 3 people will develop Alzheimer’s. Two of them will be women.”
As neuroscientist Dr. Lisa Mosconi says in her article, “Alzheimer’s and Women’s Health, an Urgent Call,” while women account for two-thirds of Alzheimer’s cases, little is being done to understand why simply being a woman significantly increases your risk of developing the disease.
Dr. Mosconi is Associate Director of the Weill Cornell Alzheimer’s Prevention Clinic, where she and her colleagues are working to understand this critical – and critically overlooked – piece of women’s healthcare.
Team genneve came across this story because Dr. Mosconi and others have linked Alzheimer’s disease with menopause. They postulate that as estrogen levels subside in a woman’s body as she ages, so do its neurological protections.
As Dr. Mosconi puts it: “In straight talk: menopause causes metabolic changes in the brain that seem to increase the risk of Alzheimer’s disease.”
“In straight talk: menopause causes metabolic changes in the brain that seem to increase the risk of Alzheimer’s disease.”
Fortunately, as Dr. Mosconi has helped identify the problem, she has also helped point to some powerful solutions. Exercise and nutrition, she says, can play a significant role in preventing cognitive decline.
In Part 1 of her podcast with genneve CEO Jill Angelo, Dr. Mosconi explains the mechanism behind menopause and Alzheimer’s risk. Come back for Part 2, where she discusses how women can protect their brains as they age.
Learn more about Dr. Mosconi, the Alzheimer’s Prevention Clinic, and how you might participate in their research. If you want to start nourishing your brain (“eating for retirement,” as Dr. Mosconi puts it), get your hands on a copy of her fascinating and very readable book, Brain Food: the Surprising Science of Eating for Cognitive Power.
For a full transcript of this conversation, join us at genneve.com.
“I’ve been dressing myself since I was four. Why is it suddenly so hard to do?”
Changing bodies, changing priorities, outdated notions of what’s “acceptable” to wear after 40 can all make it feel surprisingly difficult to dress yourself. And whether we like it or not, people do judge us on our appearance.
We can use that very human habit to our advantage, says Mellicia Marx, personal stylist and founder of the very cool Poplin Style Directions. Our clothes can be a tool to express ourselves and project the image we want to the world. You just have to know what that image is and how to achieve it.
Mellicia asks her clients for the three words they aspire to in their style – “confident, edgy, and feminine” or “boho, earthy, and relaxed,” whatever they may be – and from there they can build a closet that’s like a “boutique curated just for you.”
Sound good? Listen in to Mellicia's ideas about fashion, body image, staying on budget, and feeling good enough to take on the world.
Join us at genneve.com for more information about Mellicia and a full transcript of this conversation.
Author, brand strategist, speaker, and motivator Juju Hook is on a mission to rebrand "midlife." It's crap, she says, and she's not wrong.
Why a rebrand?
What do you think of when you hear "midlife woman"? Wrong! We've been sold a bill of goods, Juju says, and she is ready to help every woman embrace her power and glory and step into PrimeTime.
Get more information and read the full transcript of our conversation with Juju Hook on genneve.com.
Did you know that after menopause, women lose many of the heart protections that helped them prevent heart disease? With the loss of estrogen, we lose elasticity in our blood vessels, making the build up of plaque easier.
February is heart health month, and since heart disease is the #1 killer of women and men in the US, we wanted to share some information with you on how to protect yourself.
We talked with Dr. Sarah Speck, medical director of the cardiac wellness and rehabilitation programs at the Swedish Heart and Vascular Institute in Seattle and co-founder of POTENTRx, a medical fitness company, about what we can do to stay heart healthy as we age.
Learn more about heart disease, Dr. Speck, and how you can put the wisdom behind the training of elite athletes to work for your heart health: genneve.com.
Quick quiz: menopause or thyroid problem?
Actually, it's kind of a trick question: all of these symptoms can be caused by menopause OR thyroid dysfunction.
Because menopause and thyroid disease can look a lot alike, all too often women who are dealing with thyroid problems like hypo- or hyperthyroidism are told "it's just menopause" or "you're just getting older." To make matters even more complicated, women in midlife are more prone to thyroid disease, increasing the chances that "it's just menopause" is actually "just an incomplete diagnosis."
Yes, it might be "just menopause." But what if it's not?
Thyroid disease can have serious and lasting health impacts if left untreated. So we asked Dr. Kate Kass, a functional medicine physician who specializes in hormonal health, to talk about the differences in symptoms, how to test for thyroid disease, and what we can do to optimize our health under any circumstances.
Get more information on Dr. Kass and see the entire transcript at genneve.com.
Do you ever feel like there ought to be … I don’t know … more? You’re a high-achieving woman – great at your job and “successful” by modern measures – but you still feel like something’s missing, there’s something you haven’t accomplished yet.
Welcome to midlife.
Women in their 40s and beyond often experience a pretty fundamental shift: it’s time to stop worrying what others think of me and concentrate on how I feel about myself, my place, my work, my creative side, my spiritual soul.
Great! Also … dangerous. Frustration with finding yourself where you don’t want to be can lead to impulsive decisions.
How do you honor that part of yourself that’s ready for new challenges and new horizons without disrupting everything you’ve worked so hard to achieve?
Dr. Barbara Mark has some very good ideas for you. Dr. Mark is an elite leadership, career, and life strategies coach, advisor, and confidant to senior executive women. Trained in clinical psychology, Dr. Mark has great insights into human thought and how thought translates into action (or inaction). She focuses on working women in midlife, helping her clients find clarity during an often very challenging time.
We had a few questions for her.
Join us at genneve.com for the full scoop on midlife, "me" time, and Dr. Marks.
If you like beer – especially craft beer created and brewed by experts who love what they do – you’re really going to enjoy this podcast.
If you’re dealing with menopause symptoms, you’re going to love it.
The Portsmouth Brewery is the kind of place where you want to become a regular: amazing beer, great food, the kind of social atmosphere that’s perfect for spending time with friends and unwinding after work or on a weekend. (Hint: go on Tuesdays, and you can take part in “wooden token” day.)
Lately, they’ve been in the press a lot. A LOT.
They’ve created a beer called Libeeration, a gruit designed, as their website says, “specifically for women experiencing menopausal symptoms and to celebrate the liberating aspects of this stage of life.”
That sounded awfully good to us, so we gave them a call. And they agreed to tell us all about it. So if you’ve got some time, pour yourself a glass of your favorite brew and join us.
Come to genneve.com for more information.
As we near the kickoff to the holiday season, we wanted to know how concerned we should really be about the amount of sugar we’re consuming. You hear words like “toxic” and “addiction,” as well as “harmless” and “fun” when it comes to sugar and sugar consumption. So which is it?
The American Heart Association says women should get no more than 25 grams (6 tsp) of added sugar a day, and 36 grams (9 tsp) for men. However, according to SugarScience, a publication from the University of California at San Francisco, the average American gets 82 grams of sugar (19.5 tsp) every day.
We’re eating a lot of it. But when it comes to our health in midlife, is sugar really that bad for us?
To find out, we called up Dr. Anna Garrett, who talked to us before on getting your mojo back in midlife. Dr. Anna is a certified coach and Doctor of Pharmacy, and her mission in life is helping women get their hormones – and their lives! – back in balance.
Here’s what we learned:
“Sugar actually works on the same centers in the brain as cocaine and nicotine.” So, yeah. Addictive and dangerous. Find out the process of addiction in your brain.
Fat used to be the demonized ingredient when it came to obesity and poor health. But did the Big Sugar lobby play fast and loose with the facts to make it appear like fat was the bad guy?
Sugar disrupts insulin, creating chaos with your hormones and possibly contributing to estrogen dominance. And that’s just not good.
Sugar wreaks havoc here too, increasing the risk of cardiovascular disease. Dr. Anna explains.
Cutting out sugar is tricky. Dr. Anna gives her recommendations on going “cold turkey” versus “cutting back.” HINT: sugary drinks should probably be first to go.
Some drinks, like milk, have natural sugars. Avoid the ones with added sugars like agave or syrups. And bad news, y’all: wine is a problem.
Sugar is super sneaky, so even capable label readers may miss a few. Dr. Anna tells us what to be on the lookout for.
I’ll give you one guess. Yep. Not good. Dr. Anna tells us why artificial sweeteners may actually sabotage your good intentions. But there are ways to make it less bad for you ….
There are definitely withdrawal symptoms, just like with other addictions. Dr. Anna gives us the info on how we’ll feel, how long it’ll last, and how to manage it best.
If you’re truly serious, you can get to great in 7 – 10 days, says Dr. Anna. She tells us how to go about a sugar “detox” the best way.
Dr. Anna gives us insight into her healthy diet. We’ve decided we want to be her when we grow up.
Starchy veggies like beets or sweet potatoes and healthy carbs can be invited back, but for those folks for whom sugar is an “avalanche” food (ie, triggers binge eating), refined sugars should probably be eliminated entirely and permanently.
The holidays are coming and most of us are about to be awash in sugary treats. How do we handle it? Dr. Anna has some great ideas on how to be thoughtful about what we’re eating. Autopilot is only good for airplanes, folks; never for food.
It’s tough to do this right: you don’t want to be the “anti-fun committee,” so explain why you’re doing what you’re doing, include the family in meal planning and prep, and start training taste buds early!
Are you ready to reduce your sugar intake? It can be a tough road, so consider getting help from a coach like Dr. Anna. We’d love to hear how it goes for you! Please share your successes and setbacks with us in the comments or on genneve’s Facebook page or Midlife & Menopause Solutions, our closed Facebook group.
Mona Lisa Touch: You probably haven’t heard of it, but if you’re a woman in midlife, you might want to take a moment to hear about it. This “fractionated CO2 laser,” we hear, can return vaginal tissue to a pre-menopausal state with just a few 3-to-5-minute treatments.
That can mean a return to sex that’s pleasurable instead of painful and an end to mild urinary incontinence.
Because we have no idea what a “fractionated CO2 laser” is, but we wanted to know more, we contacted a provider of the service here in Seattle, Dr. Rebecca Dunsmoor-Su.
Dr. Rebecca maintained her own ob/gyn practice and taught Obstetrics and Gynecology at the University of Washington before decided to take a position with Swedish Medical Center as an OB Hospitalist. In 2016, she opened RenuvaGyn to start offering Mona Lisa Touch to women in menopause.
She knows what this laser is and what it can do for women who are suffering with vaginal atrophy, mild incontinence, and painful sex. Here’s what she told us:
Dr. Rebecca traces her path to Seattle and RenuvaGyn and the Mona Lisa Touch, and why she feels like women deserve to have a robust sex life, even after menopause (shocking!)
Some women can’t use hormones or prefer not to. The MLT gives those women a great option.
Kind of like a photocopy machine with a screen, according to the doc. She explains the process which is nothing at all like making copies.
The laser reawakens cells that start rebuilding and re-hydrating the vaginal area. The thicker layers, rebalanced pH, and returning healthy bacteria bring that bit of the body back to pre-menopause. She also gives us a timeline for when to get going – hint: the sooner, the better.
Yes, it’s good for sex, no question. But it’s also good for the itch and the dryness.
Because it doesn’t go as deeply into the tissue as facial laser treatment or hair removal, it’s less painful than either. A topical numbing cream takes care of any pain that might occur with the procedure. No flaking or peeling, either, woot!
The MLT sounds amazing – why aren’t more women doing it? Cost, says the doctor. It’s not covered by insurance (of course!), so women pay the costs out of pocket.
Cost aside, women are often a little fearful about the procedure, but when it’s done, the usual response is, “that’s it?” Doctor Rebecca goes into what the office visit is like, and it sounds pretty darn easy.
(not all "vaginal rejuvenation" procedures are created equal. read up on why you may not want to keep up with the kardashians)
For mild incontinence, the MLT can be very helpful in a couple of ways. Dr. Rebecca takes us through the advantages. Also good for post-baby women in addition to women over 50, so spread the word!
Mona Lisa Touch (and menopause care generally) doesn’t quite yet pay the bills; Dr. Rebecca is also a OB Hospitalist at Swedish Medical Center, helping with labor, delivery, c-sections, etc. The MLT fulfilled her need to work with women on an ongoing basis. She talks about how doctors are paid and why it doesn’t favor doctors talking with women about menopause issues.
Dr. Rebecca says there’s no physical prep to be done, but it’s good to do some research and know what to expect. One place to look is her own site and blog on renuvagyn.com.
For women who cannot or prefer not to use hormones to treat vaginal dryness and painful sex, the Mona Lisa Touch may provide an excellent, effective, low-risk alternative. You can search for a provider in your area from the Mona Lisa Touch website.
Have you had or would you consider a laser treatment to deal with vaginal atrophy or incontinence? Share with us (anonymously, if you prefer) in the comments on the genneve blog, or you can join the conversation on genneve’s Facebook page or in Midlife & Menopause Solutions, genneve’s closed Facebook group.
Mary Slagle is a SaaS Sales Specialist for MINDBODY, Inc. Working in the field of wellness, and for a company filled with mostly twenty-somethings, Mary was feeling as though she had missed out on the chance to join in on the activities and fun they all enjoyed. With five grown children and four grandchildren, her dream was to be more active and healthy.
While prospecting for new clients, Mary came across Health and Lifestyle Coach Lara Dalch's website and program for a Vibrant Healthy life. She realized it was exactly what she was looking for, in a wholly unexpected way.
In this podcast with Jill, Mary and Lara tell us how they partnered up to help Mary feel balanced and successful in all aspects of her life.
Mary is a high-achieving, got-it-all-together kind of gal. Why would she need a coach? Because being driven and having a full life is terrific, but it can also be stressful. Lara helps her prioritize and spend her time and energy right.
There are lots of coaches and coaching programs out there. We asked Mary how she knew Lara was the right partner for her. According to Mary, The “Get Out of Your Own Way” worksheet, plus the chance to consult with Lara for free, opened her eyes to where she was in life. She was settling, she realized, and that just wasn’t right.
Lara’s online worksheet was born from watching women sabotage their lives and their opportunities to live more vibrantly. Check out the ways Lara sees women block their own dreams and futures.
There must have been a moment when you realized you weren’t living the life you wanted. What was it like when your eyes were opened? Mary talks about when she realized she was giving so much to her professional life, it was leaving her powerless in her personal life.
The workshop is a “sliver of hope” that things can change, says Lara; it’s a glimpse into that better, more fulfilling life. Whatever your goals are, there are paths to achieving them – Lara helps her clients realize first, things can be better, and second, here’s how we’ll get you there.
What did the day-to-day work feel like? Lara and Mary talk about the dangers of The Grand Plan and the sanity of setting reasonable goals.
As Lara says, “Feeling well means something different every day.” It’s important for highly driven women to train their brains to notice what’s going well, to celebrate the small steps as much as the big victories. As Lara told us later, there are two critical steps here. Step one: honor how you're feeling and be compassionate with yourself. Step two: redirect your attention to what's going well. Listen to find out how.
We asked Mary about the low points. What were they and how did she get over them? In a house full of food that wasn’t healthy for her body, constant denial was grinding her down. Mary describes how she and Lara developed tools that allowed for some indulgence but kept her choices under her control.
We could all use tools like that! Mary talks about how Lara’s program allows for 24/7 access to the whole history of their journey together through video. Being able to go back to critical touchpoints along the way really helped Mary stay on track.
We asked Lara how she realizes her clients are struggling and what she does when they need a boost. So, what’s “new and good” with you?
“There’s always something” that shifts the client and the coach back into a positive mindset, Lara says. Sometimes they have to talk a while to find the good, but there’s always something.
We asked how the program finishes and Mary is sustaining her progress. The program is designed to be finite, Lara says, though there are options to continue. But high-performing women like Mary tend to get through the material quickly and are ready to fly solo pretty fast. From her side, Mary didn’t want to say goodbye, even though she was “soaring”! So she’s opted to keep Lara in her corner, through check ups and check ins to keep her moving forward. Will she finally join that CrossFit group? Stay tuned!
Life makes it tough to make the right choices sometimes (e.g. a cruise ship full of ice cream and pizza), so negotiations continue. But now, Mary says, she has the tools to make judgement calls and control her own decision-making (like spending candy bar money on better “indulgences”).
“It’s such a pleasure to see her thrive,” Lara says. No surprise there. 😊
If you’re looking to get out of your own way and feel vibrant and fulfilled, take a look at Lara’s website or find a coach near you.
For those who think you should be able to do this on their own, you may well be able to, and that’s great. But also think about all the other times in life when you’re willing to call in expert help – is fixing your future to be more fulfilling less important than fixing your car?
If you’ve utilized the services of a coach for career, fitness, lifestyle changes, nutrition, etc., we’d love to know how you found your coach and how the partnership worked for you. Please feel free to share in the comments on genneve.com. You’re also welcome to join the conversation on genneve’s Facebook page or Midlife & Menopause Solutions, genneve’s closed Facebook group.
Coming up soon on genneve’s podcasts: nixing sugar with Dr. Anna Garrett, just in time for Halloween; brewing up something special for menopause with the Portsmouth Brewery; and learning more about the innovative Mona Lisa Touch with Dr. Rebecca Dunsmoor-Su. Stay tuned or subscribe to us on iTunes, Stitcher or SoundCloud so you never miss an episode!
Pelvic pain during sex, pain from the pelvic region generally, incontinence, prolapse – these do NOT have to be your “new normal.” There are treatments out there to help you manage, even solve, many of the issues related to pelvic floor dysfunction.
One solution might mean taking a long look at your choice of birth control ….
Rachel Gelman DPT is a clinical specialist and branch director at the Pelvic Health and Rehabilitation Center in San Francisco. She specializes in the physical therapy management of numerous pelvic pain disorders, including bowel, bladder and sexual dysfunction. We talked with her about some of the sources of pelvic pain, including the surprising news that hormonal birth control may be part of the problem.
Rachel says she deals with pain from the “ribcage to the knees,” specifically focusing on the internal muscles of the pelvic floor. We asked her exactly what that meant. The list is surprisingly long – clearly this part of the body is responsible for a heck of a lot and needs proper care and attention.
Rachel also focuses a lot on the impact of hormones on that part of the body. Given that midlife and menopause are a time of enormous hormonal changes, we wanted to understand that better. Rachel explained to us how the sensitive tissue of the vagina and surrounding area are affected by estrogen, progesterone, and testosterone.
(here’s a fun way to increase pelvic health: get yourself an Elvie)
So, what does that mean for women who take hormonal birth control? Especially women who’ve been on the Pill for a long time? Rachel says there’s no truly perfect birth control; oral contraceptives are effective, but it increases sex hormone binding globulen. The take away: the Pill can negatively impact some very sensitive tissue, so if you have a choice, consider carefully when choosing it as your contraceptive method.
So, what exactly is vestibular tissue, and why is it so impactful if this area is inflamed or otherwise unhealthy? Rachel gives us a sort of private-area map and explains the consequences of hormone imbalance here and what can be done about it.
So, we asked, how do you know when pain is caused by hormonal imbalance as opposed to some other concern? You have to look at all the puzzle pieces, Rachel says; she takes us through how she puts them together to figure out what’s going on and how to fix it.
How do patients find you? Is it mostly by referral? She gets a lot of referrals, Rachel says, from ob/gyns, urologists, etc., but a lot of patients simply find her on the Internet. So, shortcut Dr. Internet: if you’re having a particular problem and not getting a solution from the doctor you’re seeing, ask for a referral to a specialist.
Do you see more older women, or do you see these patients more often? Her practice is pretty evenly distributed, Rachel says, because pelvic issues aren’t limited to age, but yeah, no surprise: age does have impacts as hormones change. So if you’re getting older and have never seen a pelvic specialist, it might be time: avoid problems in the future by being proactive!
What kind of self-care should women be doing between visits to a specialist like Rachel? It depends on where you are, Rachel says; are you already in pain and need help relaxing or releasing? She gives her patients things to do between visits to help them learn to treat themselves, and that’s a Very Good Thing.
“We as humans were not meant to sit on the toilet to have a bowel movement.” Ooooookkaaaaaay. Not giving it up. Just sayin’. Fortunately, says Rachel, there are ways to adopt the optimal BM position without resorting to squatting in the woods. Phew! She explains why not excreting correctly can actually be pretty bad for you.
(speaking of toilets, do you know how much urination is normal for you?)
“Kegels are not the answer to everything,” Rachel says. They can be good for you, but they don’t solve every issue. Best not to self-diagnose a kegel deficiency – if you’re having problems with painful sex, incontinence, bowel dysfunction, there’s help, there are resources. Seek them out and get your standard of living back.
If you’ve had issues with pelvic pain or other issues related to pelvic dysfunction, would you share with us how you managed it? Let us know in the comments below, or hit us up on genneve’s Facebook page or Midlife & Menopause Solutions, genneve’s Facebook group.
More about Dr. Rachel Gelman: Rachel is a Bay Area native who received her bachelor’s degree in Biology from the University of Washington in Seattle and her Doctorate in Physical Therapy from Samuel Merritt University. As you heard in the podcast, she’s passionate about women’s and men’s health and strives to promote quality education regarding pelvic health both in the clinic and in the community. We appreciate her sharing her wisdom and expertise with us!
So, do you know what fascia is?
We weren’t entirely clear, nor did we know what a big role it plays in movement, flexibility, and stability, and, when inflamed, in joint pain and stiffness. A single, continuous structure from head to toe, the fascia surrounds and wraps all our internal parts. So if it’s hurting, you’re hurting.
Jennifer Mason, owner of Vitamin Chi, knows all about fascia, the care and feeding of. A licensed acupuncturist, Jennifer specializes in neck and shoulder pain and menopausal symptoms. So we grabbed her for a conversation about acupuncture, fascia, trigger points, and using Chinese remedies to bring our bodies back to health.
According to Jennifer, good health is “an everyday thing,” and acupuncture, herbalism, and so forth tend to be a bit esoteric for people. She wants to make Chinese medicine available and accessible for the uninitiated so we can all enjoy the very best of health.
Picture your favorite sandwich meat in a sandwich bag. The meat is your muscle, and the sandwich bag is the fascia, says Jennifer. In the simplest terms, it’s a giant network within your body connecting bits together, and communicating between, so it lends itself well to treatment via acupuncture.
One of the properties of fascia is it remodels itself, says Jennifer. If we don’t move for a while, we need to stretch and move to discourage it from getting too “set.” So if you’re experiencing pain, don’t wait to seek treatment.
The whole body is connected, and while work on fascia is good for joint pain, treating the body as a holistic network is critical. Jennifer takes us through trigger points and why the pain you’re feeling in one point of your body may not have started there.
There are points in the muscle where electrical differences are greatest, and if an acupuncturist can find exactly the right point with the needle, the muscle “resets,” according to Jennifer.
The needle goes right to the “motor point” and communicates up the fascial line to the brain, says Jennifer. Additionally, acupuncture takes into account other important components of chronic pain such as emotion and inflammation. She explains how acupuncture targets all the pain levers to provide relief.
Jennifer admits to us that she “chickened out” of her first acupuncture appointment. But these needles are “as thin as kitten whiskers” she says, and just as effective for making us feel better. She lets us in on how she helps her patients relax into the experience.
This “super-low tech” treatment is great for myofascial release and also Instagram posts, says Jennifer. It feels good and helps relieve pain by pulling inflammation out of the muscle.
This most gentle form of healing comes from Japan and uses the life force of the practitioner, channeled into the patient, to treat chronic pain. “It doesn’t make sense to me,” Jennifer admits, but it changed her life. She tells the story of how she discovered the effectiveness of reiki during a very difficult time.
First, relaxation and readiness, then the practice of channeling the healing energies. Jennifer takes us through how she guides her patients through the experience.
“We all have an innate healing power,” Jennifer says, but we don’t all know how to tap into it and harness it correctly. Learning to be a practitioner takes practice and calm and leaning into the flow.
Jennifer says, women are silently suffering, and if you ask the right questions, you find there’s so much need for help. Chinese medicine approaches the body differently, it’s open to some different ideas about what’s truly happening and how to manage symptoms. “We can get very specific and treat all kinds of things,” Jennifer tells us. “I’m very excited.”
“It’s not a selfish act to take care of yourself,” Jennifer says. In fact, when a woman is running on empty, it’s harder on everyone. It’s important to do what’s necessary to heal. And self-care doesn’t have to mean coming to the doc all the time – it may be about recognizing unhealthy patterns and finding tools to correct them.
In addition to being an acupuncturist, Jennifer is a Reiki Master Practitioner and has been using Chinese herbs for health since childhood from her grandparents’ herb shop. Her passion is to help people find healthy solutions in their daily habits, diet, and practices. And tacos. She loves tacos. Find out more about Jennifer Mason and her practice on her company website, Vitamin Chi.
Have you had experience with acupuncture, cupping or reiki? We’d love to hear how it worked for you, so give us a shout in the comments below, on genneve’s Facebook page or in Midlife & Menopause Solutions, genneve's closed Facebook group.
Pelvic floor health impacts your quality of life, whether you know it or not. Actually, when it stops being healthy, you’ll know it.
Peeing, pooping, sexual satisfaction – being successful at these things requires a healthy pelvic floor, and as we age, the muscles that make up that floor can weaken. Because it’s so important to keep this “hammock” of muscles strong and responsive, we talked to physiotherapist Dr. Susie Gronski, “your doc for all things down there.” She gave us the low down on our down-unders: what happens when things are out of whack and how to get them back.
Have a listen to part I of this conversation, “to your pelvic health, our talk with dr. Susie Gronski, part 1.” Then continue on below, where Jill talks to Dr. Susie about pain, the role our pelvic floor plays in our sexual health, and the Big Os:
Experiencing sexual pleasure all the way to orgasm can be more challenging for women, and nearly impossible if there’s pain involved. We asked Dr. Susie how women can relieve the pain and get their desire back. Spoiler alert: help is out there. Dr. Susie fills us in on bringing pleasure and intimacy back into our lives.
In this hands-on (yep), one-on-one course, Dr. Susie teaches students to explore their bodies, interpret what they see and feel, and ultimately, treat and heal themselves. With Dr. Susie’s expert guidance, students learn what the muscles look like, what they do, and how to heal the pain they’re experiencing. Transformation is tough, says Dr. Susie, and everyone should have a support system to get through it.
We wanted to know how the course worked – is it in-person, or can it be done virtually? The six days are in person, Dr. Susie says, because it’s necessary to touch the person, show them how to touch themselves, what to feel for, what they’re feeling when they find it, and so on.
Dr. Susie says, remember, you’re not the only one who leaks in Zumba class! Incontinence and other issues are common, and there’s help. Also, it’s not all about kegels; there’s a network of things happening throughout your body, so it’s important to learn beyond kegels. Finally, Dr. Susie reminds us that we can’t be shy when seeking help. It’s your quality of life on the line – get over your “vagina phobia!”
Here’s to happy private parts!
Thanks again to Dr. Susie for her expert information on how to keep or regain your healthy pelvic floor. You can find more from Dr. Susie on her website.
Have you had professional help and training to regain pelvic floor function? We’d love to hear about it and how it helped you get your quality of life back. Please share with us in the comments below (you’re welcome to comment anonymously), email us at email@example.com, or let us know on genneve’s Facebook page or in Midlife & Menopause Solutions, genneve’s closed Facebook group.
Next up on the genneve podcast calendar, Jill talks with acupuncturist and owner of Vitamin Chi, Jennifer Mason, about your fabulous fascia – what it is and how to keep it happy. Stay tuned!
Do you know how critical your pelvic floor muscles are to your overall health?
Most of us are only aware of our pelvic floor during times of pleasure (contractions in the pelvic floor are what men and women feel in orgasms). But when your pelvic floor is weak, you may suddenly be aware of it for entirely different reasons: pain, incontinence, prolapse, sexual dysfunction, even discomfort just sitting.
Clearly, keeping this area of the body healthy is central to your quality of life.
To learn more about what below-deck problems are possible and how to head them off before they happen, we talked with Dr. Susie Gronski, licensed doctor of physical therapy and a board certified pelvic rehabilitation practitioner. In addition to knowing a lot about your private parts, she’s also a certified health coach. As she says, she’s the doctor for “everything down there” and signs her emails, “In loving wellness for your pelvis™
Here’s what we learned from the “down-there” doctor:
Your nether regions have muscles – they aid in “pooping, peeing, and sex,” says Dr. Susie. She gives us the low down (ha ha) on the pelvic region and how a physiotherapist can help keep all that business functional and healthy.
Your pelvic floor is kind of like the base of a cereal bowl, Dr. Susie tells us, only no cereal bowl in the world does as much as this one. Hear the connections, functions, impacts, and responsibilities of these bits.
Let’s face it: we didn’t grow up talking with our parents about that part of our body once we successfully managed potty training, so we’re a little shy and squeamish. “We don’t focus on any part of our body unless we’re getting signals to focus there,” says Dr. Susie, especially that part of our body. And sadly, those signals are usually negative.
Pain with intercourse, abdominal pain, discomfort or pressure in that region are quite common, and many of us don’t know to associate that pain with pelvic floor health. That’s why it’s important to know the possibilities.
Many problems definitely start in our pelvic region, Dr. Susie says, then spread to other parts of the body as pain. Learn how your body communicates stress or dysfunction – symptoms might show up in one area when the roots of the problem are somewhere else.
Clients don’t know what to expect except that someone’s about to “assess their private parts.” Yep, that’s a tough one. Dr. Susie talks about how she communicates with clients to keep them comfortable and feeling safe while dealing with the issue at hand. So to speak.
Depending on the trigger(s), the treatment can take lots of forms, and Dr. Susie looks at all the possible causes. Pain isn’t just about body parts, it’s about the patients’ psyche, social constructs, all the things that weigh in on our lives. The treatment has to take all those factors into account to be effective, she says. Also, butt gripping. Yeah, you need to hear about that.
Nope, says Dr. Susie. Because science (which she explains in a super-friendly lay person way, hoorah). Basically there are lots of ways you can mess yourself up by keeping your abdomen tense, and Dr. Susie gives us the details. Hefty price for a six-pack.
Oh, look at that – we’re out of time. Come back to genneve for part 2, and you’ll get the FAQs on the big O.
Dr. Susie is currently in private practice in Asheville, North Carolina specializing in holistic men’s pelvic health. Dr. Susie is also the author of Pelvic Pain: The Ultimate Cock Block and the creator of a unique hands-on training program to help men with pelvic pain become experts in treating themselves.
Learn more by visiting drsusieg.com.
Egg freezing is still a relatively new option for women and couples wanting to delay pregnancy for a few years.
We wanted to know more about this fascinating procedure that – hopefully – allows younger women to freeze their eggs, then have babies, safely, at a later date.
So we sat down with Dr. Lorna Marshall of Pacific NW Fertility. Dr. Marshall, practicing specialist in Reproductive Endocrinology & Infertility, co-founded the clinic back in 2005 and has been helping couples start or build their families ever since.
In the first part of our conversation with Dr. Marshall, we learned more about the science and history of in vitro fertilization (commonly known as IVF), fertility medicine, and her own path to reproductive medicine. In part 2, we talked about the cultural changes that come with women having more family planning power.
The number of women seeking family planning options has “shot up through the roof,” Dr. Marshall says, at least in part because some large companies are offering egg freezing as a benefit of employment. How has that changed the demographic of women who are coming in to ask about egg freezing?
Dr. Marshall tells us about the realities of egg freezing. Big one: ya gotta do it when you’re young.
Or to movie stars. Dr. Marshall says not to be fooled by celebrities having babies in their late 40s or even early 50s; chances are they used donated eggs, not their own. It’s important to understand the realities of science and bodies, including their limitations.
When woman comes to the clinic, what happens? Dr. Marshall gives us the guided tour from testing to egg supply explanation to talking options when the results are in. Hear the process.
When it comes to fertility, it’s critical to manage expectations. Doctors may not be able to give a woman an answer on if she’ll be able to have a baby – there are just too many factors. Find out what impacts fertility and how docs work with women to best reach their goals.
Because the science of vitrification of eggs is still so new, Dr. Marshall says, some things just aren’t known yet, like, do frozen eggs have a – for want of a better term – “implant by” date? What stresses the egg? How long are vitrified eggs viable, and does the faster-freeze process put the eggs at risk?
Big tanks hold racks and racks of eggs, sperm, and embryos at the Pacific NW Fertility clinic, Dr. Marshall says. Some fertility clinics don’t store on site, but Dr. Marshall’s clinic has chosen to.
As you can imagine, egg freezing isn’t cheap. And many insurance companies won’t cover “elective” egg freezing. With egg retrieval and the medications it takes to do the process, women can expect to pay $14 – 15,000 for a single cycle. That’s not the cost of establishing a pregnancy, Dr. Marshall reminds us; just the process of freezing.
The best age for freezing eggs may be a woman’s 20s, which is not usually when women have the money to have their eggs frozen. The cost may be changing for cancer patients, at least, Dr. Marshall says, with some state legislatures working to make insurance companies cover fertility preservation. Will insurance ever cover truly elective fertility preservation?
We wanted to know what made Dr. Marshall want to come back to work every day. Her biggest reason probably won’t surprise you, but, she tells us, the growth and changes in the field have also kept her engaged in her work. “I’m in the heart of society, doing this,” she says. “Every day I’m successful, and every day I fail or feel like I fail.”
Because this procedure is still so new, it’s important to work with a clinic that’s actually made some babies from frozen eggs, Dr. Marshall says. There are lots of clinics that simply haven’t gotten to the “thawing and making babies” part yet. She lists some questions women should ask before choosing their clinic.
Like much about a woman’s body, her chances of making a baby may be wildly different from another woman’s chances, even at the same age, says Dr. Marshall. She shares with us some numbers of chances of success based on age of mom and number of eggs retrieved.
Would you consider freezing your eggs in order to delay pregnancy? Why or why not? We’d love to hear your thoughts; please share in the comments section, email us at firstname.lastname@example.org, or let us know on genneve’s Facebook page or in Midlife & Menopause Solutions, genneve’s closed Facebook group.
Next up: Dr. Susie Gronski, doctor of physical therapy and certified pelvic rehabilitation practitioner. We talked with Dr. Susie about sexual wellness and enjoying your sex life, even post-menopause. Be sure to stay tuned to genneve.com for that conversation, or subscribe to genneve on iTunes, SoundCloud, Stitcher, or Google Play, so you never miss an episode.