In our first CHASIcast of the year we welcome back Dr. Iris Lesser, who is joined by her Kinesiology colleague Amber Johnston, MSc, to discuss their unique course — KIN499: Women’s Health and Physical Activity. Through this course and their teaching, they aim to fill crucial gaps in understandings of women’s health, particularly around menopause and perimenopause.
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Transcript
CHASIcast voice-over
Coming up on the CHASIcast..
Iris Lesser
They were seeing the need for self compassionate physical activity, not just physical activity, for esthetics, for weight loss. A lot of the things we see with women, which is we use exercise to beat ourselves up. We don’t use it to support a good quality of life,
CHASIcast voice-over
Two UFV professors’ new course on women’s health and physical activity is filling in crucial gaps in understanding of menopause and perimenopause.
Amber Johnston
The lack of research, the lack of awareness, but also the stigma around it, and reducing that stigma and creating more empowerment and education around it.
CHASIcast voice-over
From UFV’s Community Health and Social Innovation Hub. This is the CHASIcast, a program dedicated to bringing experts and insights to the issues that shape our lives because words have to matter. Now here is your host, CHASI director, Dr, Martha Dow…
Martha Dow
I’d like to welcome both of you here today onto the CHASIcast. Thanks so much for taking time today. I’m with Amber Johnston and Dr Iris lesser, and we’re here to talk about women’s health and physical activity and some of the amazing collaborative work that you both continue to do. Iris, you’ve been here before. So thanks for coming back and welcome, Amber. Perhaps we could just start if you could each sort of talk about what you do, what your work, your area, what your passions are, that would be great. Iris, do you want to start or Amber? Yeah?
Amber Johnston
Me?
Iris Lesser
Go for it.
Amber Johnston
Yeah. I’ve been at the University now for, I think going on, to 22 years in the kinesiology program, and spent a lot of time looking at cardiovascular health, metabolic issues, chronic disease, focusing on sort of where exercise and management play a role and behavior change, and really trying to stress the importance of those things and prevention. And then I’d say, over the last probably five to ten years, a bit of a shift in focus, and focusing a bit more on women’s health and just even my own experiences personally and how that can shift into the need for more information and education on that. And so Iris and I have collaborated over the last little while on developing this course and and trying to bring women’s health to the forefront.
Iris Lesser
Yeah, that was a great introduction, and I would just add that my own work has really stemmed from research in the area of topics that are really under discussed and underserved in women’s health. So been on here before, talking about the challenges postpartum and the need for additional support with physical activity. And in developing this course with Amber, really sort of gained an interest in also that, you know, perimenopausal transition, where we see a lot of the same challenges that women face postpartum with, how do we manage, you know, physical activity and implementation and adherence during times of duress, where you’re either challenged with caring for another person, or you’re challenged with your own symptomology and in health changes that make physical activity much more challenging than people like to talk about.
Martha Dow
Can you talk a bit more about the course?
Amber Johnston
Sure, we we started talking about this a few years ago, and really put it into play last year when it was offered for the first time. From a curriculum perspective and a program perspective, it’s really hard to fit these things into certain aspects of courses. You know, I teach anatomy and physiology, and we don’t often get to reproduction and we don’t get to reproductive physiology. Spend a very little time on immunology and things like that, so understanding kind of the role of our body systems and what happens when we look at, you know, prenatal, postnatal care, perimenopause, menopause, and what we go through.
Amber Johnston
And so we started to really collaborate and build the course, and we decided to work on it together and to co-teach the course so that we can have those two perspectives to spend some time looking at reproductive anatomy and physiology, understand hormones, understand what’s happening from menstruation to menopause and everything in between, and then stem into physical activity, the importance of behaviour management and behaviour change and looking at everything that kind of feeds into that through that process or across all these different stages of life.
Iris Lesser
In addition to, you know, the curriculum and not really finding that students are getting enough understanding of physiology, that’s sex based, broadly we’re seeing in society, a real shift in recognizing that we have largely ignored women’s health. And so when it comes to funding, or to research based studies and where we’re really putting energy and effort. I mean, we’ve been working with a male focused, health based research plan for many, many years, and many Obstetricians and Gynecologists and researchers in this area talk about how, you know, we’re a century behind when it comes to women’s health research.
Iris Lesser
And while we’re seeing more funding allocation to those targeted areas, specifically when we look at sort of postpartum, perimenopause, menopause, it is a minute piece of the research budget, and these women are really being left with more questions than answers with a lack of support, and even, you know, through the workplace, not being recognized as having additional challenges or things that really may impact their ability to function and have a good quality of life.
Amber Johnston
And even in the healthcare field, and the training behind that, is there is small pieces throughout people’s professional training; your doctor, your gynecologist or your OB, that have very little time that’s actually spent on talking about menopause or postpartum and care and what’s happening. So we’re seeing a shift in that as well, where, I think it’s the focus is starting to come on, increasing that knowledge and awareness and then making sure that you are seeking out a professional who has that background and has that knowledge as well,
Martha Dow
We think so often, the public must assume that they have that knowledge right. We go into that thinking. I’m curious. In sociology, one of the places we’ve talked about sort of gender is that, instead of having no gender courses, because you tend to get the people in the room that are like highly motivated, highly engaged, we have to think about more critically about how to get it across the curriculum. As you were both talking, I was struck by it sort of an add on, or there’s not quite enough time to get it to it. In kin, what does that conversation look like in terms of it not being particular course, well being particular courses, but in addition to much more attention to kind of address that bias that you spoke of.
Amber Johnston
I think we’re starting to see again, movement towards the not just the need, but the want to have it in the program. And I see that across a lot of kinesiology and related programs in BC, the interest for these specialized topics often are, you know, cardio respiratory exercise response to this. And now we do see Women’s Health and Aging and things like that coming into play, because really this is the population that these graduates are going to be working with. You know, 50% of our population menstruates and is going to experience menopause to some extent, and you look at childbearing and things like that, let alone the aging process. And so I think aging, inflammation and then women’s health are pretty key things that we’ll see increase. And it’s being recognized, and I think more courses are being developed. It’s just finding the place of where you can plug and play them.
Iris Lesser
If we go based on what we got from student feedback in the first run through of this course. I mean, we definitely went into it being like we find this really interesting. I mean, we’re older than our average students. We’re mothers. You know, maybe it’s just us, and this is not going to really sit well with that sort of 20 to 25 year old population. You know, the course filled. There was also many males who took the course. And the feedback was really, I mean, not to toot our own horn, but it was fantastic. I mean, they said it. It changed their life. It changed their mindset. It changed the way they thought about their own future health, as well as their mothers, their grandmothers, they were engaging with women in their lives differently.
Iris Lesser
They were seeing the need for self compassionate physical activity, not just physical activity, for esthetics, for weight loss. A lot of the things we see with women, which is we use exercise to beat ourselves up. We don’t use it to support a good quality of life. And to be perfectly honest, I didn’t think they would get it to that depth. I didn’t think maybe they were old enough, experienced enough. I know for myself, I didn’t learn a lot of this until I had children, and I feel like they’re a decade ahead of me and how they’re going to be able to approach and handle and really take care of their own health.
Amber Johnston
And it’s a good it’s a good age to expose them to that information, because they may not think, okay, I’m 20 years out from this or something, but I think having that preventative education will help to kind of arm them with that information for later, not only with clients, but with family like Iris was saying a lot related to their mothers and their grandmothers and what they sort of saw their mothers and grandmothers going through. I think the males that took the course developed a bit of empathy and understanding that, you know, a lot of these things maybe weren’t known. It was, yeah, it was received very well.
Martha Dow
I was interested. We had a bit of a chat about this the other day, Iris, but this idea that of what exercise looks like, why women are engaged, why women should be and I was really struck by that conversation. Went home, actually, quite frankly, feeling a bit better about, you know, when you’re supposed to be doing things and you don’t. It’s kind of a, you know, zero sum game. Okay, so I got to start again from zero so that, what are the kinds of things there’s this course, but what are the other kinds of movements you’re seeing in society, or how your disciplines can contribute to this dialog, where we really shift how we understand that, particularly for women.
Amber Johnston
I think it’s a any movement is better than no movement and not beating ourselves up about it, not having a competition, not going on your Instagram reels and feeling like this is what you need to look like, and this is where this information is, you know, coming from, it’s any movement, small bits of movement, any bits that we can understand to increase our strength and to understand sort of how that’s going to impact, you know, dealing with aging and dealing with other physiological things that come across us as we age. That’s been a really key thing that we’ve stressed, and I think that’s really important.
Amber Johnston
So, you know, we’re going to have chronic disease, we’re going to have aging, we’re going to have inflammation, and we’re going to have, you know, also very healthy people, but also that inside, outside perspective, you know, you you may be doing everything that you can possibly to be healthy, and you still have that inside component that might not share the same as far as the view and having that awareness on it that, yeah, do what we can, but don’t feel bad, and if we need to reset the next day, then that’s exactly what we do, small steps and really behavior change and modification.
Iris Lesser
Yeah. I mean, we always talk about it as a lifespan approach. So when we think about the fitness industry and the way that exercise is perceived, it’s typically a very kind of acute approach, right? You know, New Year’s resolution, get in the gym, work really hard for 12 weeks, achieve some success. Something goes awry. You know, sickness, something else happens, and you kind of go back to square one. I mean, that’s not physical activity for life. That’s, you know, a blip in time, and it’s not what’s going to change your overall mental well-being and your overall health across the lifespan.
Iris Lesser
So, you know, from my first year courses on, it’s all about, what can we do that we actually enjoy, and that we want to implement, and that we want to do consistently, because doing something for 12 weeks is not going to make you healthier in menopause, you’ve got to figure out a way that works for you and that makes you feel good about yourself and your body and the process, because otherwise we’re just going to keep feeling like we’re failing, and nobody needs to feel like they’re failing. That’s not a health based approach.
Amber Johnston
Yeah, and balance, understanding balance and what works for you as an individual, and it’s almost like a individual self care toolkit. You know the things that work for you to help you strive and thrive.
Martha Dow
I’m curious about social media. It’s been mentioned already. It has, you know, I’m not on it, but I am around enough students.
Iris Lesser
Good for you, don’t get on it.
Martha Dow
So there’s obviously an upside and a downside. Can you talk a little bit about that in terms of the work that you do and how that that shapes up?
Iris Lesser
I mean, as you probably know, the first thing that’s going to jump out to me is specific to that postpartum phase. And we’ve been doing some work around imagery postpartum, and what does realistic look like versus this social media view? And you know, we’ve seen research studies coming out showing that you know when you do hashtag, postpartum body, what you get is not a postpartum body is people that are trying to showcase how to not be normal, how to get ahead of the curve when it comes to what sort of a natural process of needing to recover and find your way back.
Iris Lesser
So I mean, if that is postpartum, you know, add on the challenges through perimenopause and menopause, where we know there’s shifts in body weight and body composition, we know there’s many other factors that are playing in with estrogen and how it’s altering cortisol and the stress process and sleep and all of that’s going to play into being able to achieve that balance. And so if we’re seeing the same thing on social media, you know this is what 50 looks like. This is what 60 looks like, and it’s not showing any of the challenges or realism. We’ve got just as much of a problem when it comes to being able to do that self compassionate physical activity.
Martha Dow
What about with students then? So there’s a challenge you’re having this critical discourse around social media. Obviously we have loads of students that are super savvy around it as well. And we have a lot of students that really suffer, you know, in what they see and how they choose, etc, the Doom scrolling language, etc, thoughts on interventions or how we can engage.
Amber Johnston
I think it’s learning those critical thinking kind of skills and developing those and really trying to it has its pros, like, there definitely are people out there that use that platform in a very positive manner, but it’s finding that and knowing where your information comes from. And I say this to students all the time, is, as kin students, we kind of have a bit of health always. You know that that’s, that’s why they’re in the program, is because they’re, they’re interested in that. But as other students, and just the lay person, is, if they start scrolling, they’re looking these things up. How do we know that this is really evidence based information, and that this information is true, and this is, this is what we need to know, versus what we see, sort of scrolling.
Amber Johnston
So that critical thinking aspect of it, and we sort of incorporate that into the one of the bigger projects that they do in this course is they have to take a lens of social media and talk a little bit about the pros and cons of it with a particular condition that they’re presenting on. And I think they learned a lot, even from the one time run that we’ve done on the two sides of social media, where it has its place, but also where we need to create some awareness and education around, this is actually not reality, and let’s find some better information on it.
Iris Lesser
I mean, I think that’s part of mental health as a whole. I mean, we’ve seen a huge challenge in mental health, particularly since COVID and anxiety and depression with youth that are now entering into university. And you know, that’s probably where we need to start. It’s just, how do we improve mental well being? So that when you are inundated by different messages, and, you know, things that make you feel worse about yourself. What are the coping mechanisms you’ve learned to be able to flip that? Because it doesn’t matter how much education you have. I mean, if you internally process what you’re seeing, then you’re going to be affected by it. And you know, I have a PhD in this area. I know a lot about this. That doesn’t mean that I don’t Doom scroll and compare and wish I look different. And that really comes down to, I think, mental well being and your own self compassion.
Amber Johnston
So, yeah, I was just going to say that’s another kind of, one of the reasons that pushed us to do this course too, and we both stated this when we kind of talked to the students in our first week, is nobody’s going to experience menopause in the same way. You’re going to have people that are symptom free or very little symptoms, and you’re going to have people that have all the nasty symptoms and really struggle. Same with, you know, pregnancy, same with postpartum and so the the lack of research, the lack of awareness, but also the stigma around it, and reducing that stigma and creating more empowerment and education around it. And you know, we, both of us, had different pregnancies with both of our kids. We both had different labors and deliveries we but we related also with some of the postpartum things that we both went through. So it’s creating that connection and reducing that stigma, and really trying to empower people and to understand that, yeah, even though everybody might be going through it differently, we’re still going through it. So how can we do this together?
Iris Lesser
Yeah, common humanity is huge, you know, like, Are we alone or are we together? Are we supporting? Are we dividing? And, you know, we’ve even seen some shifts in that common humanity with changes like, you know, ozempic and how much that shifting how we view body positivity versus just wanting to achieve the weight loss. Is it about health? Is it about esthetics? And it’s a really challenging conversation, because you want to be more comfortable within societal norms. What’s right for you, what’s trying to compare? And you know, how do you find your way through that?
Martha Dow
This is always a problem when I’m talking now Iris and now Amber, you’re part of the problem is I want to keep talking forever. There’s so many things that are kind of going up, coming up for me. In sociology, we talk lots about privilege, and certainly exercise and privilege around leisure and that sort of thing. And I wondered your thoughts on that. You know, we talk about community so evident, and yet, obviously our women’s experiences are vastly different based on our socioeconomic status. Thoughts on that?
Iris Lesser
I mean, I’ll pull culture into that a bit. Of course, you know, socioeconomics is huge, and no doubt, education and physical literacy play into comfort level with engagement. But even from a cultural perspective, so much of what we look at and know is from a western view. And it’s individuals who have grown up with that privilege of getting physical education in schools and learning some of that physical literacy and having that ability.
Iris Lesser
I just came out of a meeting last week with The Best for Babies South Asian group, and really looking at how incredibly different that postpartum period looks like when you’re a new immigrant to Canada. When you have a completely different culture that doesn’t even have a word for physical activity within your dominant language. And so when you think about movement, your only choice is exercise or rest, and exercise is not part of the culture. And so if we keep kind of pushing the same mandate around, this is what physical activity or exercise is, regardless of who you are, what you think or what you know, we’re really not going to get far. And so I’m really excited to just see like, how can we support them and their culture and what needs to shift to make physical activity, you know, an option for these other different populations?
Amber Johnston
Yeah, I think that cultural piece is really important to embrace it and to allow for understanding and connection across, you know, individuals, whether it be in the classroom or just that you encounter. And I think also kind of, from a health promotion perspective, is those we come down to these three A’s a lot of time, like affordability, availability and access. So if we can have those things, then it doesn’t have to cost a lot of money to to be active. We can go outside, and we can go for walks, and we can engage with family and other connections and just see the benefits that come along with that, and how, when we learn this earlier, it really does, I think, stem across our lifespan.
Martha Dow
We’ve talked lots about physicians and networking within the healthcare system. Currently, Abbotsford is looking at primary care network, which, obviously in various communities have already activated around that which gives that possibility of many different professionals under the same roof. I wonder if you could talk about, how is this going with physicians? You talked about the research deficit to some extent. We talked about some challenges with social media. General practitioners, where is this dialog out there?
Amber Johnston
Sadly, I think it there’s a need for more. It’s tough because I think we don’t see as many general practitioners to begin with. We see, you know, the model, our healthcare model, and where we can access our physicians, and how we can access physicians and physicians that are not taking new clients or won’t take families. And, you know, that’s a whole other discussion. But I think, really, it’s the support. So from, like, a perimenopause, menopause perspective, is if I go into my doctor’s office, I don’t want to be told, Well, this is, you know, this is just something you have to suck up and go through. I want to know, what are my solutions, what are my options, and how can you support me through this so that I can live a good quality of life, have some enjoyment and not feel like I’m, you know, going down this, this horrible downhill slide as I age.
Amber Johnston
So I think connection and awareness and more information and education and support from physicians, but also specialists. So being able to branch out to, you know, if you if you want to go to somebody who’s more in functional medicine, or a naturopath, or if you have a midwife versus an OBGYN, is making sure that whoever you are working with, that you’re advocating for yourself, that you are using evidence based information, that people that you are working with have the professional, you know, background in that area, and can help support you as best as possible. And I say, sort of interdisciplinary as well. So it’s, you know, you’re going to be probably working with mixed groups of people.
Iris Lesser
Yeah, my only add on to that is that the number of different symptoms that you can experience for perimenopause, and how early you can experience them, like seven to 10 years prior to actually going into menopause. It can mean that when you go see a general practitioner and you’re describing, you know, I’m just so incredibly anxious and I just can’t function, and they treat the anxiety, instead of the hormonal shift, you can end up treating you know seven different symptoms, rather than finding, as Amber talks about, you really, you know a solution for improving your quality of life. One of the big things that you know we bring in this course is we’ve come back to hormone replacement therapy.
Iris Lesser
I mean, there was a study done many years ago, that really curtailed being able to use HRT because of what was assumed to be a higher breast cancer risk that was shown to have fallacy and deficits within it. And it led to, you know, a couple of decades of women having no solution. And now we really see kind of the comeback of HRT, like there are estrogen receptors everywhere in your body. And if you can take something to help you through that process, then you should, and you shouldn’t just be living with that symptomology. And if we’re not up to date enough with that knowledge and with those varied symptoms, it is very easy for a general practitioner to treat a symptom rather than a condition
Amber Johnston
Or dismiss it or so. I mean, those, those estrogen receptors, they’re, yeah, they’re in our brain, they’re in our gut, their liver, our colon, our skin and our reproductive organs. It’s understanding that there’s, you know, there’s over 70 different symptoms that are associated with perimenopause and menopause. And so someone who has frozen shoulders been a really, you know, key term that you’ve heard a lot in podcasts and information on this, but that joint pain that comes with it, and then maybe you are starting to have one or two other symptoms is connecting that. Oh, maybe this is, is, is perimenopause, and this is a hormone shift. And what can I do to best support that. And this hormone therapy is really beneficial for a lot of women, and having access earlier just helps to enhance that quality of life. So instead of being in this perimenopausal period for five to eight years, if I recognize this in the first couple years, then I can live the rest of those, you know, five years in good, positive health and a positive mental state.
Iris Lesser
I mean, I was just going to add on. There is a study that came out of the Women’s Health Research Institute this past month that looks specifically at the health economics of menopause. And this is extremely costly, because women are a huge part of the workforce, and if they’re suffering, so are their positions, their children, and it has a very, very large economic impact. And I think that study is going to be really important in changing sort of that shift around why we need to do more research in this area.
Amber Johnston
And a lot of societies and foundations supporting menopause again, recently, in the last year, this menopause in the workplace document kind of came out and really supporting women through this, they’re working during this time of life. So how can we best support that?
Martha Dow
Clearly, you’re both going to have to come back again, because there’s so much I’m so privileged to be able to listen to this as, you know, as a mom, as a post menopausal, you know, and thinking about all of these issues. So I’m always super appreciative. Would love, though, to if give you both a chance you’ve talked a little bit about what’s next and what you’re excited about. And that’d be a great way to close what’s next for the two of you, your work [or] research.
Iris Lesser
Well, I am too excited about too many things. I mean, I of course, you know, you have your kids, and you feel like, well, postpartum is the most underserved area, like, I need to fix this. And then you get through that, and you’re getting, you know, closer into that perimenopause, you’re like, oh, nothing’s been done here. I need to fix this. And it just keeps going. So I mean, so many different ideas, so many different students who want to do research in this area, want to do community based work. Want to find different ways of engaging in physical activity beyond just you know, that classic exercise prescription model, and I mean, Amber, and I are certainly excited to keep offering this course. We’re going to do it again this spring, and really hope to see it continue on.
Amber Johnston
Yeah, it’s sort of a ditto. So I think just continued research, and I think in the workplace as well. I think, you know, UFV is a perfect example. We probably could have more information on this, surrounding this to support everyone at UFV. But the student interest is large. So I think directed studies and more involvement with this course, more students taking this course, and probably more development of hopefully maybe some future courses as well.
Martha Dow
The name and number of the course, again, is?
Iris Lesser
So it’s a special topic of course, so it’s called KIN 499, but this one we called women’s health and physical activity.
Martha Dow
Fantastic. Thank you both really appreciate it, and we’ll look forward to more conversations in the future.
Amber Johnston
Thank you.