WEBVTT - I Choose...Destigmatizing Menopause with Dr. Mary Claire Haver

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<v Speaker 1>You're listening to I Choose Me with Jenny Garth. Hi, everyone,

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<v Speaker 1>welcome to I Choose Me. This podcast is all about

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<v Speaker 1>the choices we make and where they lead us. So yeah,

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<v Speaker 1>I've talked a little bit about it before, but menopause

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<v Speaker 1>is finally getting its day in the sun. Today I

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<v Speaker 1>choose to get into it. Let's talk about it. There

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<v Speaker 1>is so much to discuss about menopause and all its

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<v Speaker 1>phases and symptoms and side effects. Whether you are going

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<v Speaker 1>through it, or about to go through it, or you

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<v Speaker 1>know someone who's going through it, there's just too much

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<v Speaker 1>stigma about this chapter of life that all of us

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<v Speaker 1>women will eventually go through. My guest today is the

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<v Speaker 1>author of the number one New York Times best selling book,

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<v Speaker 1>The New Menopause. She's a Board certified OBGYN, a certified

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<v Speaker 1>menopause practitioner from the Menopause Society, and a certified culinary

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<v Speaker 1>medicine specialist. She's all about demystifying menopause, which I love.

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<v Speaker 1>She is a leading voice on the topic. Please welcome

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<v Speaker 1>doctor Mary Claire Haver to the Iye Choose Me podcast.

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<v Speaker 1>I'm so so happy to have you with us today.

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<v Speaker 1>I'm so happy to be here.

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<v Speaker 2>This is so fun.

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<v Speaker 1>It's so good. It's so good. Let me just tell

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<v Speaker 1>you something that happened last night. My husband, he thinks

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<v Speaker 1>he's funny. He said, what is going on with this

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<v Speaker 1>menopause stuff? It's more like manopause. I feel like you're

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<v Speaker 1>in your mano pause phase. I was like, that's a

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<v Speaker 1>good one, babe. Have you heard that yet?

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<v Speaker 2>Absolutely all the time, all the time or menopause man

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<v Speaker 2>man no more.

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<v Speaker 1>I know, there's a million things we can do with it.

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<v Speaker 1>Talk to me about like, what happened with you? Why

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<v Speaker 1>did you decide that amplifying this conversation around menopause and

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<v Speaker 1>women's health in this category was so important to you.

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<v Speaker 2>Kind Of my journey was I was a traditional obgyn

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<v Speaker 2>and a big academic institution, I know, taught residents medical students,

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<v Speaker 2>and I had a very robust private practice and I

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<v Speaker 2>was happy, and I really thought I'd do that job

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<v Speaker 2>till I retired, you know, in like twenty more years.

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<v Speaker 2>And then my patients were aging with me because you

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<v Speaker 2>kind of get out and you get all the newly

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<v Speaker 2>pregnant people and I was newly pregnant, so we have

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<v Speaker 2>babies together and then we get old.

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<v Speaker 1>We were all.

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<v Speaker 2>Together, and you know, I was seeing these trends in

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<v Speaker 2>my patients who were aging of you know, these random

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<v Speaker 2>complaints that we couldn't seem to get to the bottom of,

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<v Speaker 2>like joint pain, not sleeping well, libido, weight gain, you know.

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<v Speaker 2>And I was just kind of taught this is what

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<v Speaker 2>happens when women age and get over it. We call

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<v Speaker 2>them whining women in clinic when I was in training,

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<v Speaker 2>you know, meaning she's just whining. This is the time

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<v Speaker 2>of her life, she needs to seck it up.

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<v Speaker 1>There's nothing we can do.

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<v Speaker 2>Never in all of my training was I ever taught

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<v Speaker 2>that this constellation of symptoms might be related to what

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<v Speaker 2>the hell's going on in her ovaries right now.

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<v Speaker 1>Wow.

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<v Speaker 2>So I'm like, something's not right with me, something's not

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<v Speaker 2>right with all my patients. Because I go to church

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<v Speaker 2>with these women, we go out to dinner. It's a

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<v Speaker 2>small town with a big university, right, I know them

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<v Speaker 2>outside of their little complaint list in the office, and

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<v Speaker 2>I know they run marathon, you know, Like, and You're like,

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<v Speaker 2>these are women who this should not be happening to

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<v Speaker 2>in this percentage, right, And they're eating right, they're working out,

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<v Speaker 2>they're doing all the things, and they're like, look, I'm

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<v Speaker 2>falling apart. And so you know, we're testing for a thyroid,

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<v Speaker 2>we're doing all the walk ups and everything's coming back

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<v Speaker 2>normal and they're not fully men apuzzles, so their hormone

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<v Speaker 2>levels really aren't diagnostic at this point. And I'm like,

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<v Speaker 2>we're doing this wrong. Something's wrong. So the main complaint

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<v Speaker 2>was white game. So that's where I started, you know,

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<v Speaker 2>and that's what was happening to me. Suddenly I was

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<v Speaker 2>you know, I'd had then privilege most of my life,

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<v Speaker 2>and then all of a sudden, I had a belly

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<v Speaker 2>and I couldn't get rid of it despite dumbling down

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<v Speaker 2>from Ike. So I called the PhD, you know, nutrition

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<v Speaker 2>scientists at the university. You know, I delivered all their kids,

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<v Speaker 2>and so what the hell is going on with this?

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<v Speaker 2>Like what about women in menopause? Why is this happening?

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<v Speaker 2>This is nearly universal? And they're like, yeah, so there's

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<v Speaker 2>something to do with inflammation. And they just sent me

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<v Speaker 2>down the like PubMed, which is the repository for medical

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<v Speaker 2>data studies, and I started reading all this stuff about

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<v Speaker 2>inflammation and how you know, inflammation and menopause are definitely

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<v Speaker 2>tied and then this weight gain and this new belly

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<v Speaker 2>fat deposition and inflammation is tied. And I start like, well,

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<v Speaker 2>wait a minute, this is happening, and this is happening.

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<v Speaker 2>Menopause and inflammation seems to be a thing. I just

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<v Speaker 2>realized there was such little data there, and no one

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<v Speaker 2>was teaching it to me. I was busy delivering babies

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<v Speaker 2>and pap swears and all the stuff we do. So

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<v Speaker 2>I just went down rabbit hole after rabbit hole, put

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<v Speaker 2>together a nutrition program for my patients and me and

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<v Speaker 2>my girlfriends, and you know, started talking about it on

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<v Speaker 2>social media. I didn't have a Macavelian plan to become

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<v Speaker 2>one of the leading voices in the menopause movement. I

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<v Speaker 2>was a busy mom of two kids, my husband worked overseas.

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<v Speaker 2>You know, I was just trying to stay alive. But

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<v Speaker 2>as I talked more about it and more, people started

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<v Speaker 2>listening and asking me more questions, which would fuel my

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<v Speaker 2>curiosity and I go look up more stuff. So really,

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<v Speaker 2>it wasn't planned. I just started talking about it, started

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<v Speaker 2>validating people's symptoms, telling them that they weren't crazy. This

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<v Speaker 2>is actually a thing, and it just grew and grew

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<v Speaker 2>and grew and the more I would teach and share,

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<v Speaker 2>the more people would join. And now we have got

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<v Speaker 2>almost over four and a half million followers across you know,

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<v Speaker 2>the different channels in.

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<v Speaker 1>Your meno posse. I'm happy to be in your menopasse.

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<v Speaker 2>By the way, it's really, you know, my miniverse is

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<v Speaker 2>I like to call it. It is just a bunch

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<v Speaker 2>of people who are there to help each other out

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<v Speaker 2>and share experiences and make of that crazy.

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<v Speaker 1>Yeah, that sounds like an amazing way of platform, a

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<v Speaker 1>way to develop a platform, and such an incredible way

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<v Speaker 1>for you to reach so many women. It's because you're

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<v Speaker 1>so passionate about it, because it's happening to you.

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<v Speaker 2>I love that I went through it. I'm still going

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<v Speaker 2>through it. I'm you know, I'm still aging and I

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<v Speaker 2>accept that. But you know, I just read a quote

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<v Speaker 2>today from one of my friends who has this program

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<v Speaker 2>called Menopause boot Camp, and she's an incredible personal trainer,

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<v Speaker 2>but she's really focusing on us now. Because forever I

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<v Speaker 2>was a cardio queen, I worked out to be Thinn.

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<v Speaker 2>That was the goal. I had no thoughts of muscles

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<v Speaker 2>or any of that. And you know, our mothers and

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<v Speaker 2>grandmothers just kind of got to our age and were like,

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<v Speaker 2>this is it, and yeah, I am. They end up

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<v Speaker 2>in nursing homes with cognitive deficits and dementia and frailty

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<v Speaker 2>and all this stuff, by and large, you know, not all,

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<v Speaker 2>thank God, But I don't want to accept that, and

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<v Speaker 2>that there's stuff that we can do now to prevent

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<v Speaker 2>that in thirty years.

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<v Speaker 1>I mean there has to be. That's a driving force

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<v Speaker 1>for me too, Like I don't want to go down

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<v Speaker 1>the road that my parents went down as far as

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<v Speaker 1>their health, you know. So that pushes me every day

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<v Speaker 1>to just stay healthy and take better care of myself

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<v Speaker 1>than because I have the knowledge and they didn't.

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<v Speaker 2>Right, right, when I think of the things that came

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<v Speaker 2>out of my mom's mouth about trying to stay healthy,

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<v Speaker 2>like eating olio instead of butter, you know, like that's

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<v Speaker 2>her conception of health, and you know, fighting forever to

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<v Speaker 2>stay thin and not giving herself proper nutrition just so

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<v Speaker 2>that she could be thin. Now she's paying the price, yeah,

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<v Speaker 2>you know, so same same. So when you know, when

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<v Speaker 2>I have patients come into clinic and we take care

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<v Speaker 2>of the acute problems, the joint pain, the brain fog,

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<v Speaker 2>the whatever, you know, we fix all of that. Then

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<v Speaker 2>I'm like, okay, now.

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<v Speaker 1>Let's plan the next thirty years. They're like, what I

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<v Speaker 1>love that, I need you my life.

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<v Speaker 2>What can we do? What path can we put you

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<v Speaker 2>on to avoid ending up? Like And if they come

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<v Speaker 2>in and they're like, my mom's amazing, she's eighty five,

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<v Speaker 2>she's driving around car, she's taking care of herself, Da

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<v Speaker 2>da da da, I'm like, let's do whatever she's doing,

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<v Speaker 2>because that's working. But if they're like, she's can't take

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<v Speaker 2>care of herself, we're looking at home. So we're having

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<v Speaker 2>to disrupt our lives like I want to don't want

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<v Speaker 2>to disrupt my kids lives, you know, as little as possible.

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<v Speaker 2>You know, I don't expect to live for ever, but

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<v Speaker 2>I don't want one of those long, protracted, you know,

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<v Speaker 2>times of infirmity.

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<v Speaker 1>If it can be avoided, it is a big I

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<v Speaker 1>wouldn't say disruptance because I have my mom now, who's

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<v Speaker 1>in her eighties and is getting less and less mobile

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<v Speaker 1>and doesn't want to leave her house, and she spends

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<v Speaker 1>a lot of time reading, and I'm always calling her

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<v Speaker 1>and saying, Mom, how about a walk today? Just let's

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<v Speaker 1>go out, let's get a get a walk in and

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<v Speaker 1>I don't want my kids to have to worry about me.

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<v Speaker 1>Same as you. In your book, you say that every

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<v Speaker 1>organ system in a woman's body is affected by menopause,

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<v Speaker 1>their brain health, their heart, their lungs, and their kidneys.

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<v Speaker 2>Explain this, I think that's you know, forever, we define

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<v Speaker 2>menopause a cessation of period, so the end of your

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<v Speaker 2>cycles and hot flashes, the vasomotor symptoms. But what we're

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<v Speaker 2>now realizing is, my goodness, the cognitive changes, the mental

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<v Speaker 2>health changes. So starting out the brain, you know, palpitations

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<v Speaker 2>are now recognized as a common vasomotor symptom. They're lumped

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<v Speaker 2>in there with hot flashes and night sweats. No very

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<v Speaker 2>few cardiologists know this because they weren't taught this, you know,

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<v Speaker 2>right Like in the lungs, new onset asthma very common

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<v Speaker 2>in menopause, and it tends to be a typical. This

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<v Speaker 2>doesn't happen to men, you know, in their midlife. It

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<v Speaker 2>just happens to women. Autoimmune disease, joint pain, muscle pain.

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<v Speaker 2>Of course, the genital urinary system recurrent UTI is vaginal pain,

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<v Speaker 2>loss of lubrication, on and on and on and so

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<v Speaker 2>what you go through is very different than what I

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<v Speaker 2>go through. Our menopause footprint, you know, our symptom profile

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<v Speaker 2>is as unique as we are, and doctors love a checklist,

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<v Speaker 2>you know, that's how we're trained. Like it looks like

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<v Speaker 2>a duck and walks like duck. It's a duck and

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<v Speaker 2>the duck. For me, it's just outside of your period.

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<v Speaker 2>Stopping and hof flashes can be really hard or can

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<v Speaker 2>overlap with several of the disease states. You know, it's

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<v Speaker 2>hard to tell hypotheridism away from perimenoplaus sometimes, and as.

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<v Speaker 1>It is because you go in and you're wondering what's

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<v Speaker 1>going on with you and you have all these other different,

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<v Speaker 1>weird symptoms and they're not really linked, so everybody's just confused.

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<v Speaker 1>That's was my experience.

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<v Speaker 2>So my goal, you know, besides educating my followers so

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<v Speaker 2>that they can have an informed conversation, is really you know,

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<v Speaker 2>part of our like the doctor menopause, the clinician menopause,

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<v Speaker 2>because we have nurse partitioners and lots of you know,

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<v Speaker 2>psychologists and stuff, is we're now pushing the medical societies

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<v Speaker 2>to recognize these things and start training our clinicians coming

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<v Speaker 2>up in the world so that you know, at least

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<v Speaker 2>the next generation we're going to have to fight.

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<v Speaker 1>I mean, we're all the fighters, but they're going to

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<v Speaker 1>benefit so much from all of your messaging and all

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<v Speaker 1>this data that gathering and this information. Right, it's incredible.

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<v Speaker 2>So yeah, we're not men with breasts, you know, where

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<v Speaker 2>we're gender help on that.

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<v Speaker 1>So our skin too, though, that's another organ that is

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<v Speaker 1>incredibly affected by medicine.

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<v Speaker 2>So wound healing besides the obvious cosmetic things, which you

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<v Speaker 2>know which are It's shocking because in five years, Jenny,

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<v Speaker 2>we lose thirty to fifty percent of for college.

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<v Speaker 1>Oh my god, where'd it go?

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<v Speaker 2>Like, I feel like overnight? You know? Now, definitely, you know,

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<v Speaker 2>hormon therapy helps. You can do very safe topical hormone

0:11:35.040 --> 0:11:37.520
<v Speaker 2>therapy that works beautifully. Of course, all the cosmetic treatments

0:11:37.520 --> 0:11:40.960
<v Speaker 2>and stuff, but I don't know a woman who goes

0:11:41.000 --> 0:11:43.160
<v Speaker 2>through it who like wakes up every day and is like,

0:11:43.200 --> 0:11:46.320
<v Speaker 2>what happened to dudes, not saying what happened to my skin.

0:11:47.200 --> 0:11:51.000
<v Speaker 2>It's a cosmetic stuff, you know, wound healing and you know,

0:11:51.120 --> 0:11:53.360
<v Speaker 2>just the health of your skin. The trends to epidermal

0:11:53.400 --> 0:11:56.239
<v Speaker 2>water loss, you know, We're much more likely to become dehydrated,

0:11:56.679 --> 0:11:59.199
<v Speaker 2>you know, because our skin becomes so thin and we're

0:11:59.240 --> 0:12:02.360
<v Speaker 2>just blowing off, you know, plus the hot slashes you know,

0:12:02.400 --> 0:12:03.000
<v Speaker 2>in sweatings.

0:12:03.040 --> 0:12:05.640
<v Speaker 1>So it's just crazy how it affects us all. It's

0:12:05.679 --> 0:12:08.400
<v Speaker 1>like a massive cyclone that comes into your life and

0:12:08.480 --> 0:12:10.880
<v Speaker 1>just does all kinds of destruction and then it's like

0:12:11.000 --> 0:12:16.200
<v Speaker 1>bye bye, and I'll take all that with me. Explain

0:12:16.240 --> 0:12:19.400
<v Speaker 1>the difference for those that don't know, because I definitely

0:12:19.400 --> 0:12:21.880
<v Speaker 1>did not know when I didn't know when I was

0:12:21.920 --> 0:12:26.040
<v Speaker 1>in perimenopause. I didn't know what perimenopause was. I didn't

0:12:26.080 --> 0:12:29.040
<v Speaker 1>know the definition of menopause being twelve months after your

0:12:29.080 --> 0:12:31.520
<v Speaker 1>last period, which I learned once I was twelve months

0:12:31.520 --> 0:12:34.760
<v Speaker 1>after my last period. So can you explain the difference

0:12:34.840 --> 0:12:37.600
<v Speaker 1>for people like paris meno and then postal.

0:12:38.040 --> 0:12:42.120
<v Speaker 2>Okay, so we'll do a little baby lesson in endochronology. Okay,

0:12:42.120 --> 0:12:46.160
<v Speaker 2>perfect to educate your listeners. This is this is so critical,

0:12:46.360 --> 0:12:49.480
<v Speaker 2>so big difference between females and males. We have lots

0:12:49.480 --> 0:12:51.760
<v Speaker 2>of differences, but as far as our gonads go, so

0:12:51.880 --> 0:12:56.280
<v Speaker 2>overs and testicles, men make their genetic material, their sperm

0:12:56.360 --> 0:13:01.280
<v Speaker 2>fresh every day Okay. Women are born with a limited

0:13:01.280 --> 0:13:05.000
<v Speaker 2>egg supply. They form when we're still in our mother's uteruses, right,

0:13:05.600 --> 0:13:08.000
<v Speaker 2>and then we're born with one to two million eggs.

0:13:08.400 --> 0:13:10.560
<v Speaker 2>By the time we're thirty, we're down to ten percent.

0:13:10.600 --> 0:13:12.560
<v Speaker 2>By the time we're forty, we're down to three percent.

0:13:12.840 --> 0:13:17.000
<v Speaker 2>Menopause really represents you've run out of eggs. Okay, So

0:13:17.040 --> 0:13:19.199
<v Speaker 2>now let's go to your normal, your twenty five year

0:13:19.200 --> 0:13:22.199
<v Speaker 2>old self for ninety percent of as of normal regular cycles,

0:13:22.280 --> 0:13:23.720
<v Speaker 2>very predictable if you're healthy.

0:13:23.840 --> 0:13:24.160
<v Speaker 1>Okay.

0:13:24.880 --> 0:13:27.840
<v Speaker 2>What happens why we ovulate, is that the hypothalmus, which

0:13:27.880 --> 0:13:30.680
<v Speaker 2>is a gland in our brain, is constantly sampling our

0:13:30.679 --> 0:13:34.080
<v Speaker 2>blood supply for estrogen estra dial, and when the levels

0:13:34.080 --> 0:13:36.200
<v Speaker 2>get low, as they do towards the end of the cycle,

0:13:36.520 --> 0:13:39.080
<v Speaker 2>it sends a signal to the pituitary gland, another gland

0:13:39.080 --> 0:13:42.960
<v Speaker 2>to make stimulating hormones. That will say, ovary, let's get

0:13:43.000 --> 0:13:45.720
<v Speaker 2>an egg out and ovulate, so that'll begin the production

0:13:45.800 --> 0:13:49.160
<v Speaker 2>of estra dial through the ovulation process. What happened, and

0:13:49.160 --> 0:13:52.560
<v Speaker 2>that goes a very ekg like, very predictable rise and

0:13:52.600 --> 0:13:56.040
<v Speaker 2>fall of our hormones month after month after month in

0:13:56.080 --> 0:13:59.720
<v Speaker 2>a healthy woman. Okay, Okay, it happens in perimenopause. So

0:14:00.080 --> 0:14:03.280
<v Speaker 2>menopause by definition is the transition between what I just

0:14:03.320 --> 0:14:08.560
<v Speaker 2>talked about, normal reproducible cycles to no more cycles. The

0:14:08.640 --> 0:14:11.440
<v Speaker 2>chaos zone in the middle is perimenopause. Now what happens

0:14:11.440 --> 0:14:17.079
<v Speaker 2>here reach a critical egg threshold level where the same

0:14:17.240 --> 0:14:21.120
<v Speaker 2>signals that we're sending down each month stop working because

0:14:21.120 --> 0:14:23.600
<v Speaker 2>we don't have enough eggs. We don't have enough follicles

0:14:23.680 --> 0:14:28.080
<v Speaker 2>left to respond. So the hypothalamus is like, hey, where's

0:14:28.080 --> 0:14:29.040
<v Speaker 2>my xtra diol?

0:14:29.800 --> 0:14:31.280
<v Speaker 1>The tutory is like I.

0:14:31.200 --> 0:14:33.880
<v Speaker 2>Sent the signal and is like send more. So we

0:14:34.000 --> 0:14:36.720
<v Speaker 2>end up getting much higher levels of the stimulating hormones

0:14:36.760 --> 0:14:39.800
<v Speaker 2>from the pituitary, but you don't have the same temporals.

0:14:39.840 --> 0:14:42.240
<v Speaker 2>So what used to look like this now is delayed

0:14:42.240 --> 0:14:44.040
<v Speaker 2>because it took a while for the signals to go

0:14:44.080 --> 0:14:46.160
<v Speaker 2>back and forth. Then you get a much higher surge

0:14:46.160 --> 0:14:50.080
<v Speaker 2>of that FSH and then you get much lower drops.

0:14:50.400 --> 0:14:52.880
<v Speaker 2>And so what used to look like in EKG now

0:14:52.920 --> 0:14:57.040
<v Speaker 2>becomes chaotic month after month, and it's not predictable at all.

0:14:57.520 --> 0:15:00.800
<v Speaker 2>And so in that chaos zone, percent of us will

0:15:00.800 --> 0:15:04.240
<v Speaker 2>have abnormal uterine bleeding heavy periods like periods no periods

0:15:04.280 --> 0:15:08.160
<v Speaker 2>too many, too frequent, too few, to craziness. Only about

0:15:08.200 --> 0:15:09.720
<v Speaker 2>ten percent will just wake up and not have a

0:15:09.720 --> 0:15:14.080
<v Speaker 2>period again. There's usually a calling card, hot flashing and

0:15:14.120 --> 0:15:16.800
<v Speaker 2>the night sweats, the joint pain that you know, the symptoms.

0:15:16.960 --> 0:15:22.040
<v Speaker 2>But most importantly, the brain hates chaos. It loves predictability.

0:15:22.680 --> 0:15:26.040
<v Speaker 2>And when our estrogen and progesterone and testosterone levels start

0:15:26.080 --> 0:15:29.280
<v Speaker 2>going haywire in perimenopause is when we see the biggest

0:15:29.760 --> 0:15:32.480
<v Speaker 2>changes in the brain both mental health. We have a

0:15:32.520 --> 0:15:37.480
<v Speaker 2>forty percent increase of depression anxiety across the perimenopause transition.

0:15:37.880 --> 0:15:40.600
<v Speaker 2>So you were living your best life, nothing has changed,

0:15:40.640 --> 0:15:43.360
<v Speaker 2>no stressors have changed, and all of a sudden you've

0:15:43.360 --> 0:15:48.840
<v Speaker 2>lost your resilience. You're cranky or depressed or snappy, or

0:15:49.000 --> 0:15:52.280
<v Speaker 2>the things that used to bother you or now bothering.

0:15:51.680 --> 0:15:54.160
<v Speaker 1>You, you know, and a lot more, uh huh.

0:15:54.320 --> 0:15:59.880
<v Speaker 2>And so also our cognitive ability, so our ability. Think

0:16:00.280 --> 0:16:03.400
<v Speaker 2>you're forgetting names, you can't remember, your job is suddenly

0:16:03.400 --> 0:16:05.720
<v Speaker 2>becoming harder. You're you've got something that took your tongue

0:16:05.720 --> 0:16:07.920
<v Speaker 2>and you can't you know, And like that all happens

0:16:07.920 --> 0:16:09.440
<v Speaker 2>to us every once in a while. But this is

0:16:09.480 --> 0:16:12.080
<v Speaker 2>like a consistent pattern. This is a hallmark of the

0:16:12.120 --> 0:16:13.840
<v Speaker 2>cognitive changes in perimenopause.

0:16:14.120 --> 0:16:16.520
<v Speaker 1>And then you have this crazy fluctuation.

0:16:16.720 --> 0:16:21.560
<v Speaker 2>Busy time turns into full menopause. Now bottomed out, there

0:16:21.640 --> 0:16:24.200
<v Speaker 2>are no eggs left, and now you have no estrogen.

0:16:25.120 --> 0:16:27.600
<v Speaker 1>Oh, then the fun. You know. When I was in Perry,

0:16:27.640 --> 0:16:29.840
<v Speaker 1>I was like, all right, let's get this over with

0:16:30.120 --> 0:16:33.280
<v Speaker 1>enough already, just stop already, period so that I can

0:16:33.320 --> 0:16:35.160
<v Speaker 1>be done with this. And I was kind of like

0:16:35.240 --> 0:16:37.840
<v Speaker 1>hoping for it. And now that I'm in it, I'm like, wait,

0:16:38.120 --> 0:16:40.200
<v Speaker 1>I gotta miss it. Yeah.

0:16:40.320 --> 0:16:43.560
<v Speaker 2>I mean a lot of women are grateful, thankful that,

0:16:43.840 --> 0:16:47.360
<v Speaker 2>especially if they had horrible periods or just ems or

0:16:47.480 --> 0:16:49.880
<v Speaker 2>menstrual migraines, that is over and they can get on

0:16:50.000 --> 0:16:53.160
<v Speaker 2>with their lives. But there are benefits to estrogen in

0:16:53.200 --> 0:16:57.040
<v Speaker 2>our body, especially in the brain and the joints, you know,

0:16:57.280 --> 0:16:59.680
<v Speaker 2>and our gut microbiome, all of it's affected.

0:17:00.400 --> 0:17:02.520
<v Speaker 1>Yeah, And that no one has ever taught us this

0:17:02.560 --> 0:17:04.360
<v Speaker 1>as bonkers to me.

0:17:04.720 --> 0:17:07.760
<v Speaker 2>Right that I just saw a study where ninety percent

0:17:07.800 --> 0:17:10.760
<v Speaker 2>of you know, girls were never taught about menopause in school,

0:17:10.800 --> 0:17:13.439
<v Speaker 2>like nothing like in their health class, Like that there

0:17:13.480 --> 0:17:15.439
<v Speaker 2>would ever be even if it's just like the end

0:17:15.480 --> 0:17:18.480
<v Speaker 2>of your fertility. You know, it's just like this vague

0:17:18.640 --> 0:17:19.120
<v Speaker 2>kind of.

0:17:19.920 --> 0:17:23.360
<v Speaker 1>Something your grandma deals with, right, Yeah.

0:17:23.119 --> 0:17:26.040
<v Speaker 2>And so, and I really had a negative connotation about

0:17:26.040 --> 0:17:29.320
<v Speaker 2>menopause myself, and I just know that's the same for people.

0:17:29.400 --> 0:17:31.439
<v Speaker 2>I remember thinking I hate menopause, like I don't want

0:17:31.480 --> 0:17:32.960
<v Speaker 2>to take care of people at menopause. And now that's

0:17:32.960 --> 0:17:36.120
<v Speaker 2>all I do. And God, you know, I am living

0:17:36.119 --> 0:17:40.840
<v Speaker 2>my best life. I am happier, healthier, better relationships, better boundaries.

0:17:42.119 --> 0:17:45.320
<v Speaker 2>I'm guiltless, I have no shame. I am just you know,

0:17:45.440 --> 0:17:49.000
<v Speaker 2>I feel like I'm helping people, I'm teaching. But if

0:17:49.040 --> 0:17:53.159
<v Speaker 2>I had not overhauled everything I think about health and

0:17:53.200 --> 0:17:55.840
<v Speaker 2>how I'm going to age and learn how to prioritize

0:17:55.840 --> 0:17:58.200
<v Speaker 2>myself and stop putting everybody's needs in front of mine,

0:17:58.800 --> 0:18:01.159
<v Speaker 2>I would not be here today. And all I want

0:18:01.760 --> 0:18:05.040
<v Speaker 2>is for what I feel, for everyone to have that chance. Oh.

0:18:05.080 --> 0:18:07.600
<v Speaker 1>I love that, and you. I feel it from you

0:18:07.640 --> 0:18:09.840
<v Speaker 1>when I look at you, when I read your book.

0:18:10.200 --> 0:18:12.400
<v Speaker 1>By the way, your book, I have it right here

0:18:12.640 --> 0:18:15.840
<v Speaker 1>the New Men of oz. Oh, it's really great. Thank

0:18:15.880 --> 0:18:19.760
<v Speaker 1>you for writing that, because it's conversations that we haven't

0:18:19.760 --> 0:18:22.359
<v Speaker 1>had before, and we need to have. I agree you

0:18:22.440 --> 0:18:26.680
<v Speaker 1>are inspiring women our age to go for their best life,

0:18:27.080 --> 0:18:36.120
<v Speaker 1>and I love that about you. What about birth control.

0:18:36.359 --> 0:18:38.600
<v Speaker 1>I've been on and off birth control my whole life.

0:18:39.400 --> 0:18:42.640
<v Speaker 1>Does that affect the onset any perry?

0:18:42.920 --> 0:18:47.080
<v Speaker 2>Yeah, so we need more studies. But we have lots

0:18:47.119 --> 0:18:48.760
<v Speaker 2>of women who are birth control, and I was on

0:18:48.760 --> 0:18:51.400
<v Speaker 2>one of them. I was on it god thirty years

0:18:51.920 --> 0:18:55.240
<v Speaker 2>too well contraception, but also for treatment of my PC

0:18:55.440 --> 0:18:59.080
<v Speaker 2>or you know, covering the symptoms of my pcos. And

0:18:59.119 --> 0:19:01.359
<v Speaker 2>I was happy on them, did great on them, no problem.

0:19:01.800 --> 0:19:05.919
<v Speaker 2>We know that because we suppress ovulation with birth control pills,

0:19:06.160 --> 0:19:08.760
<v Speaker 2>women who are the longer you're on them, you tend.

0:19:08.520 --> 0:19:11.600
<v Speaker 1>To get an extra year or so.

0:19:12.119 --> 0:19:14.320
<v Speaker 2>You know, if you're on like long term ten plus years,

0:19:14.359 --> 0:19:16.240
<v Speaker 2>you might get an extra year or so out of

0:19:16.280 --> 0:19:18.920
<v Speaker 2>the shelf life of your ovaries because we suppressed ovulation.

0:19:19.320 --> 0:19:22.280
<v Speaker 2>We lose about eleven thousand eggs each month with the

0:19:22.280 --> 0:19:27.320
<v Speaker 2>ovulatory process. So so a little bit not hugely clinically significant,

0:19:27.359 --> 0:19:29.520
<v Speaker 2>but there is a little bit, you know, I worry

0:19:29.560 --> 0:19:31.879
<v Speaker 2>about and probably what happened to me was, you know,

0:19:32.520 --> 0:19:34.679
<v Speaker 2>when we're on long term birth control, and for me,

0:19:34.720 --> 0:19:37.000
<v Speaker 2>it was medically treating something that I was happy with.

0:19:37.080 --> 0:19:38.480
<v Speaker 2>You know, what did that do to my bone and

0:19:38.560 --> 0:19:42.000
<v Speaker 2>muscle strength? You know, not having those normal levels of

0:19:42.000 --> 0:19:43.480
<v Speaker 2>tasosterone and estrogen.

0:19:44.080 --> 0:19:46.640
<v Speaker 1>It's just always something scary when when you're like, well,

0:19:46.680 --> 0:19:47.640
<v Speaker 1>I hope this goes well.

0:19:48.040 --> 0:19:50.399
<v Speaker 2>Yeah, you know, and I was happy to be treated

0:19:50.480 --> 0:19:52.840
<v Speaker 2>because I have PCOS and what it did to me.

0:19:53.320 --> 0:19:55.480
<v Speaker 2>You know, there's trade offs, there's were sympnefits for everything.

0:19:55.480 --> 0:19:58.280
<v Speaker 2>But nobody sat me down and was like, okay, listen,

0:19:58.480 --> 0:20:02.680
<v Speaker 2>you know, this is is a bigger conversation than we thought,

0:20:02.720 --> 0:20:04.439
<v Speaker 2>and we do need to have more studies, but this,

0:20:04.600 --> 0:20:06.639
<v Speaker 2>you know, you probably should be doing more weight lifting

0:20:06.680 --> 0:20:08.360
<v Speaker 2>in the gym to hang on to your muscle mass

0:20:08.600 --> 0:20:11.399
<v Speaker 2>because we're going to be suppressing your natural disosterone as

0:20:11.440 --> 0:20:11.840
<v Speaker 2>well with this.

0:20:13.400 --> 0:20:16.239
<v Speaker 1>Our symptoms change according to what phase we're in.

0:20:16.320 --> 0:20:20.119
<v Speaker 2>Right in a menstrual cycle, yeah, so if you're you know,

0:20:20.240 --> 0:20:25.280
<v Speaker 2>pre minstrel, your estrogen levels are rising. So the first

0:20:25.480 --> 0:20:30.280
<v Speaker 2>halfier cycle, progesterone is zero almost very very low. Disascone

0:20:30.640 --> 0:20:32.880
<v Speaker 2>does e and flow, but not nearly as much as estrogen,

0:20:32.920 --> 0:20:35.520
<v Speaker 2>but it's fairly steady state compared to the others, and

0:20:35.560 --> 0:20:38.399
<v Speaker 2>then we have a rise in estrogen mid cycle, and

0:20:38.440 --> 0:20:40.439
<v Speaker 2>then it kind of goes down right after, and then

0:20:40.440 --> 0:20:41.720
<v Speaker 2>we have a little bit more of a rise and

0:20:41.760 --> 0:20:44.439
<v Speaker 2>then it plummets in a healthy menstrual cycle.

0:20:44.640 --> 0:20:47.240
<v Speaker 1>Imperimental policy, we even know, ye, there's no way to

0:20:48.800 --> 0:20:51.880
<v Speaker 1>We need more studies, we need more more data we do.

0:20:52.040 --> 0:20:55.280
<v Speaker 2>Let me, let me give you this, Okay. PubMed is

0:20:55.359 --> 0:20:58.239
<v Speaker 2>like where I go. It's like Google for doctors or

0:20:58.280 --> 0:21:01.520
<v Speaker 2>Google for clinicians to look up vetted medical journal articles,

0:21:01.560 --> 0:21:04.600
<v Speaker 2>like you know. Everything in there's pretty upfront. And I

0:21:04.640 --> 0:21:07.440
<v Speaker 2>just type in the word pregnancy. I get one point

0:21:07.480 --> 0:21:12.119
<v Speaker 2>one million articles. Amazing, right, that's great. We need healthy pregnancies.

0:21:12.160 --> 0:21:13.919
<v Speaker 2>I've had two of them. Then I type in the

0:21:13.920 --> 0:21:17.800
<v Speaker 2>word in menopause. There's ninety seven thousand articles, so ten

0:21:17.880 --> 0:21:21.639
<v Speaker 2>to one difference, uh huh on one roughly a little

0:21:21.720 --> 0:21:24.480
<v Speaker 2>less thanton one. I'm like, am I ninety percent less

0:21:24.480 --> 0:21:26.080
<v Speaker 2>important in this phase of my life than I was

0:21:26.119 --> 0:21:26.920
<v Speaker 2>when I was pregnant?

0:21:27.400 --> 0:21:29.679
<v Speaker 1>And that's what they want us to believe, That's what

0:21:29.720 --> 0:21:30.879
<v Speaker 1>we've been led to believe.

0:21:31.119 --> 0:21:33.439
<v Speaker 2>Wait, so I type in the word perimenopause. I just

0:21:33.480 --> 0:21:36.400
<v Speaker 2>did this, and there's six thousand, seven hundred articles.

0:21:36.840 --> 0:21:39.520
<v Speaker 1>WHOA, Yeah, we got work to do. People don't know

0:21:39.560 --> 0:21:43.000
<v Speaker 1>that there are stages, that there are different symptoms, that

0:21:43.080 --> 0:21:46.840
<v Speaker 1>everybody's different. It's a real mystery to so many people,

0:21:46.880 --> 0:21:48.040
<v Speaker 1>and definitely to men.

0:21:49.200 --> 0:21:51.919
<v Speaker 2>Right now here, you are a partner trying to support

0:21:51.960 --> 0:21:52.840
<v Speaker 2>a loved one through this.

0:21:53.880 --> 0:21:54.800
<v Speaker 1>You she.

0:21:56.280 --> 0:21:59.119
<v Speaker 2>So the best appointments I have are when the partners come,

0:22:00.080 --> 0:22:02.840
<v Speaker 2>usually coming for a place of support and understanding, and

0:22:02.920 --> 0:22:05.959
<v Speaker 2>I just love talking you know about all these things

0:22:06.160 --> 0:22:09.280
<v Speaker 2>for them and they need it really helps.

0:22:09.119 --> 0:22:11.720
<v Speaker 1>It really does, because they're so in the dark. They're

0:22:11.760 --> 0:22:14.920
<v Speaker 1>so in the dark. So why but why is that?

0:22:15.880 --> 0:22:19.879
<v Speaker 1>Historically speaking? Why are we as women so underserved from.

0:22:19.760 --> 0:22:23.560
<v Speaker 2>A medical standpoint when you look at where how women

0:22:23.560 --> 0:22:26.680
<v Speaker 2>have been treated, You know, so much of women's health

0:22:26.720 --> 0:22:30.800
<v Speaker 2>has been you know, how a woman expresses certain diseases

0:22:30.920 --> 0:22:33.760
<v Speaker 2>has been compared to how a man does it. So

0:22:33.800 --> 0:22:37.199
<v Speaker 2>like atypical chest pain is female chest pain. You know,

0:22:37.520 --> 0:22:39.520
<v Speaker 2>a woman is much more likely to die if she

0:22:39.560 --> 0:22:41.720
<v Speaker 2>comes into the er with a heart attack than a man.

0:22:41.880 --> 0:22:45.280
<v Speaker 2>Because everything's based off of how the average white male. Sorry,

0:22:45.320 --> 0:22:48.800
<v Speaker 2>that's just how the US medical system developed acts and

0:22:48.840 --> 0:22:52.040
<v Speaker 2>how drugs affect him. They didn't even study female rats

0:22:52.080 --> 0:22:54.399
<v Speaker 2>in all the animal models. It was always males because

0:22:54.400 --> 0:22:58.960
<v Speaker 2>women are harder. Females are harder because we have psychic fluctuations,

0:22:59.000 --> 0:23:01.880
<v Speaker 2>and so being excluded from all these studies. So that's

0:23:01.920 --> 0:23:04.120
<v Speaker 2>one thing, it's all in her head is another thing.

0:23:04.480 --> 0:23:05.159
<v Speaker 2>It is real.

0:23:05.320 --> 0:23:05.879
<v Speaker 1>It's taught.

0:23:06.000 --> 0:23:11.760
<v Speaker 2>I was taught that a woman tends to tomaticize psychological issues.

0:23:11.560 --> 0:23:13.200
<v Speaker 1>Right, and then you're gas lit.

0:23:13.840 --> 0:23:17.600
<v Speaker 2>Yeah, so yeah, and so instead of believing a woman

0:23:17.680 --> 0:23:19.880
<v Speaker 2>and what she's saying is true, we.

0:23:19.640 --> 0:23:20.640
<v Speaker 1>Were taught.

0:23:21.880 --> 0:23:24.600
<v Speaker 2>You know, is she having a bad day? Is does

0:23:24.600 --> 0:23:27.199
<v Speaker 2>she need some rest? Do you need her vacation? Does

0:23:27.240 --> 0:23:30.320
<v Speaker 2>she need some wine? You know, give her nanny depressant,

0:23:30.440 --> 0:23:32.680
<v Speaker 2>she'll be fine. Yeah.

0:23:33.160 --> 0:23:36.080
<v Speaker 1>Yeah, This is this is why I don't even understand

0:23:36.080 --> 0:23:39.800
<v Speaker 1>what a hot flash is, like why that happens.

0:23:40.600 --> 0:23:45.720
<v Speaker 2>So there is a thermoregulatory center in our brain that

0:23:46.000 --> 0:23:50.080
<v Speaker 2>controls our body temperature. So everybody has head of fever, right,

0:23:50.240 --> 0:23:51.399
<v Speaker 2>and you know what that feels like.

0:23:52.080 --> 0:23:52.920
<v Speaker 1>You are hot.

0:23:52.960 --> 0:23:55.600
<v Speaker 2>You can't figure out why you start sweating, you know,

0:23:55.680 --> 0:23:57.159
<v Speaker 2>especially if you have the flu and you have a

0:23:57.200 --> 0:24:01.159
<v Speaker 2>really bad that's kind of a hot flash. So mine

0:24:01.200 --> 0:24:04.199
<v Speaker 2>and the way most are it feels like so the

0:24:04.200 --> 0:24:07.600
<v Speaker 2>therma regulatory center becomes unstable from the loss of estrogen,

0:24:07.680 --> 0:24:11.040
<v Speaker 2>we think, and you just start profusely sweating for no

0:24:11.160 --> 0:24:13.280
<v Speaker 2>reason without a trigger. So I could just be sitting

0:24:13.359 --> 0:24:14.960
<v Speaker 2>here and all of a sudden, I'd feel something in

0:24:15.000 --> 0:24:16.480
<v Speaker 2>my chest and then it would I would just feel

0:24:16.480 --> 0:24:18.119
<v Speaker 2>this heat wave come up my neck and head, and

0:24:18.160 --> 0:24:20.440
<v Speaker 2>like for me, the back of my head starts sweating

0:24:20.440 --> 0:24:22.480
<v Speaker 2>and it would just drip down my back and my

0:24:22.640 --> 0:24:25.480
<v Speaker 2>chest would be sweating. And at night it would wake

0:24:25.520 --> 0:24:27.960
<v Speaker 2>me up, you know when that would happen because I'm

0:24:28.080 --> 0:24:29.919
<v Speaker 2>hot and then I throw the covers off and I'm

0:24:29.960 --> 0:24:32.480
<v Speaker 2>soaking wet, and then I'm freezing exactly.

0:24:32.760 --> 0:24:35.960
<v Speaker 1>It's the hot cold for me. You get so hot

0:24:36.040 --> 0:24:39.119
<v Speaker 1>that you sweat and then you're freezing because you're basically

0:24:39.160 --> 0:24:41.280
<v Speaker 1>naked in a Yeah, you're wet.

0:24:42.040 --> 0:24:45.400
<v Speaker 2>So and that you know, and then when you disrupt.

0:24:45.680 --> 0:24:48.320
<v Speaker 2>I mean, there is one of the top menopause researchers.

0:24:48.359 --> 0:24:50.920
<v Speaker 2>She's much older in the US, and I just read

0:24:50.920 --> 0:24:52.359
<v Speaker 2>a quote from her and I wanted to roll my

0:24:52.359 --> 0:24:54.840
<v Speaker 2>eyes so hard. I mean, there's the old school menopause,

0:24:54.840 --> 0:24:57.120
<v Speaker 2>the old guard I'm probably going to get in trouble

0:24:57.160 --> 0:24:59.919
<v Speaker 2>for saying this. But the people who kind of, you know,

0:25:00.040 --> 0:25:02.000
<v Speaker 2>and God bless them, they did great research back in

0:25:02.040 --> 0:25:05.080
<v Speaker 2>the day, but they kind of are really reluctant to

0:25:05.560 --> 0:25:09.080
<v Speaker 2>accept that other organ systems can be affected by menopause.

0:25:09.359 --> 0:25:11.640
<v Speaker 2>And she's like, no, no, no, no. The reason why

0:25:11.640 --> 0:25:13.840
<v Speaker 2>you're having brain fog is because your hot splashes are

0:25:13.880 --> 0:25:14.520
<v Speaker 2>waking you up.

0:25:14.400 --> 0:25:15.960
<v Speaker 1>At night and you're losing sleep.

0:25:16.160 --> 0:25:20.600
<v Speaker 2>Despite multiple medical journal articles coming out showing pet scans

0:25:20.640 --> 0:25:23.719
<v Speaker 2>all the brain going through menopause.

0:25:23.760 --> 0:25:28.960
<v Speaker 1>Oh that I mean, it's just that kind of mis knowledge,

0:25:29.280 --> 0:25:32.560
<v Speaker 1>I think, and people talking about that as much as they.

0:25:32.440 --> 0:25:36.080
<v Speaker 2>Have, I thought it a narrative that they have that like, listen,

0:25:36.560 --> 0:25:40.399
<v Speaker 2>women are just And then she similar researcher out of

0:25:40.400 --> 0:25:43.680
<v Speaker 2>Australia is like, it's just tough to be a midlife woman.

0:25:43.800 --> 0:25:45.800
<v Speaker 2>It has nothing to do with menopause. This is just

0:25:45.840 --> 0:25:47.080
<v Speaker 2>what women go through at this stage.

0:25:47.119 --> 0:25:49.080
<v Speaker 1>I'm like, no, that's not good enough.

0:25:49.480 --> 0:25:53.919
<v Speaker 2>I was living my I was perfectly fine until I

0:25:53.960 --> 0:25:57.200
<v Speaker 2>hit a certain age. I changed nothing, no stressors, no.

0:25:57.240 --> 0:25:59.879
<v Speaker 1>Diet, no exercise. My body completely changed.

0:26:00.240 --> 0:26:01.600
<v Speaker 2>My brain has to completely check.

0:26:01.680 --> 0:26:03.800
<v Speaker 1>I'm not a doctor. I didn't go to med school.

0:26:04.040 --> 0:26:07.080
<v Speaker 1>It makes sense to me, and so I don't understand

0:26:07.119 --> 0:26:09.840
<v Speaker 1>how it couldn't make sense to much more intelligent people.

0:26:10.280 --> 0:26:14.119
<v Speaker 2>And I started hormone therapy and I got ninety percent better.

0:26:14.520 --> 0:26:14.840
<v Speaker 1>Yep.

0:26:15.400 --> 0:26:18.040
<v Speaker 2>I just gave my body back what I used to have,

0:26:18.600 --> 0:26:21.280
<v Speaker 2>and turns out all those things kind of went away.

0:26:21.760 --> 0:26:25.280
<v Speaker 1>Let's talk about it then, hormone replacement therapy.

0:26:25.760 --> 0:26:31.159
<v Speaker 2>So I look at it as if I had hypothyroidism.

0:26:31.200 --> 0:26:36.320
<v Speaker 2>So if every woman's thyroid tanked at fifty and you

0:26:36.400 --> 0:26:39.240
<v Speaker 2>were born with, you know, all of your thyroid globulin

0:26:39.280 --> 0:26:42.080
<v Speaker 2>cells and they started deteriorating, you know, and then all

0:26:42.080 --> 0:26:44.560
<v Speaker 2>of a sudden at fifty they were gone, no one

0:26:44.600 --> 0:26:47.840
<v Speaker 2>would question you going on thyroid hormones for the rest

0:26:47.880 --> 0:26:50.080
<v Speaker 2>of your life, you know. And why do we do

0:26:50.119 --> 0:26:55.280
<v Speaker 2>this to women? And so menopause hormone therapy is basically

0:26:55.359 --> 0:26:59.960
<v Speaker 2>just giving your body back estrogen, progesterone, and sometimes testosterone

0:27:00.359 --> 0:27:02.840
<v Speaker 2>in levels that were similar to what you would have

0:27:02.880 --> 0:27:06.560
<v Speaker 2>gotten in your pre you know, in your pre menopause years.

0:27:06.840 --> 0:27:09.680
<v Speaker 2>And for me, it's like basically telling my body functions

0:27:09.720 --> 0:27:12.959
<v Speaker 2>to just operate at their usual level because the loss

0:27:12.960 --> 0:27:17.000
<v Speaker 2>of estrogen and tastosterone leads to dysfunction.

0:27:17.200 --> 0:27:19.879
<v Speaker 1>Well it makes sense, but why why did it get

0:27:19.920 --> 0:27:20.639
<v Speaker 1>such a bad wrap?

0:27:20.920 --> 0:27:24.720
<v Speaker 2>Well, okay, so scared in the eighties and nineties, probably

0:27:25.040 --> 0:27:27.000
<v Speaker 2>you know, depending on the numbers, forty to forty four

0:27:27.040 --> 0:27:29.639
<v Speaker 2>percent of women, it was recommended all women should be

0:27:29.680 --> 0:27:32.280
<v Speaker 2>on HRT. Okay, so about forty four percent of women

0:27:32.359 --> 0:27:34.760
<v Speaker 2>chose to be on it. Now, some had hoflashes, some didn't.

0:27:34.920 --> 0:27:38.119
<v Speaker 2>And what they knew from observational data was that women

0:27:38.160 --> 0:27:40.640
<v Speaker 2>tended to have less heart attacks and less death from

0:27:40.640 --> 0:27:44.680
<v Speaker 2>cardiovascular disease or at later ages than women who weren't

0:27:44.720 --> 0:27:47.600
<v Speaker 2>taking HRT that were age matched. But that was an

0:27:47.640 --> 0:27:50.680
<v Speaker 2>observational study. That's not proof. That's just like, hm, why

0:27:50.720 --> 0:27:54.440
<v Speaker 2>is this happening now? The theory was that, well, women

0:27:54.560 --> 0:27:56.960
<v Speaker 2>on HRT tend to be healthier and wealthier because they

0:27:57.000 --> 0:28:00.199
<v Speaker 2>have access to you know, medical doctors more often, and

0:28:00.240 --> 0:28:03.160
<v Speaker 2>maybe it's just an artifact of the healthier, wealthy patient population.

0:28:03.240 --> 0:28:06.159
<v Speaker 2>So let's do this large, randomized controlled study to see

0:28:06.200 --> 0:28:09.200
<v Speaker 2>if hormone therapy will decrease, truly decrease the risk of

0:28:09.240 --> 0:28:11.640
<v Speaker 2>party of vascular disease. So that was the Women's Health

0:28:11.640 --> 0:28:14.879
<v Speaker 2>Initiative billion dollar study thirty seven thousand patients enroll. They

0:28:14.880 --> 0:28:17.520
<v Speaker 2>have two arms, so it was placebo controlled. This is

0:28:17.560 --> 0:28:20.280
<v Speaker 2>like the gold standard study. So at the time, the

0:28:20.320 --> 0:28:24.200
<v Speaker 2>top two prescriptions given were premarent and prempro. Not really

0:28:24.200 --> 0:28:26.240
<v Speaker 2>what we give now, so that that's one caveat the

0:28:26.320 --> 0:28:29.199
<v Speaker 2>only tested one formulation. If you had a uterist, you

0:28:29.240 --> 0:28:31.960
<v Speaker 2>have to have a progestogen, So they gave premaran, which

0:28:32.000 --> 0:28:35.119
<v Speaker 2>is conjugated decoin estrogen and metroxy progesterine estate. Lots of

0:28:35.119 --> 0:28:37.359
<v Speaker 2>big words to say primpro, and then the women who

0:28:37.400 --> 0:28:40.080
<v Speaker 2>had had hysterectomies got premro because you don't need the

0:28:40.080 --> 0:28:41.080
<v Speaker 2>extra progesterone.

0:28:41.160 --> 0:28:42.280
<v Speaker 1>So off they go.

0:28:42.480 --> 0:28:44.959
<v Speaker 2>They see after a couple of years in the estrogen

0:28:45.000 --> 0:28:49.240
<v Speaker 2>plus progestogen arm that the women had a very slight

0:28:49.320 --> 0:28:52.320
<v Speaker 2>increased risk of breast cancer over the placebo group. Okay,

0:28:52.360 --> 0:28:56.560
<v Speaker 2>so it went from h four out of ten thousand

0:28:56.560 --> 0:28:58.600
<v Speaker 2>per year to like seven out of ten thousand per year,

0:28:58.680 --> 0:29:01.760
<v Speaker 2>which so there's relative risk and absolute risk relative risks.

0:29:01.800 --> 0:29:03.920
<v Speaker 2>That was like a twenty five percent increase in relative risk,

0:29:04.000 --> 0:29:06.000
<v Speaker 2>different than the absolute risk which was less than one

0:29:06.040 --> 0:29:08.760
<v Speaker 2>percent per year. Okay, just it depends on how you

0:29:08.800 --> 0:29:09.840
<v Speaker 2>skew the statistics.

0:29:10.280 --> 0:29:11.120
<v Speaker 1>So they halt the.

0:29:11.080 --> 0:29:14.160
<v Speaker 2>Study for that arm. They called press conference, don't release

0:29:14.200 --> 0:29:16.120
<v Speaker 2>the data, don't let any of the doctors review it,

0:29:16.280 --> 0:29:20.120
<v Speaker 2>you know, and say at this press conference, estrogen causes

0:29:20.160 --> 0:29:23.080
<v Speaker 2>breast cancer. We've stopped the study. This is horrible, Okay.

0:29:23.840 --> 0:29:27.640
<v Speaker 2>Every newspaper, every news show was before social media. Front

0:29:27.680 --> 0:29:30.160
<v Speaker 2>page cover was the number one new medical news story

0:29:30.200 --> 0:29:31.800
<v Speaker 2>of two thousand and two. It was my last year

0:29:31.800 --> 0:29:34.080
<v Speaker 2>of training, by the way, I'll never forget this. And

0:29:34.360 --> 0:29:36.920
<v Speaker 2>eighty percent went through their stuff in the trash, stopped

0:29:36.920 --> 0:29:38.840
<v Speaker 2>taking it. I don't want to die, blah blah, blah,

0:29:38.840 --> 0:29:43.920
<v Speaker 2>blah blah. Antidepressants went up four times, sleeping medications went

0:29:44.000 --> 0:29:47.800
<v Speaker 2>up three times, blood pressure medication, cholesterol, all that statins.

0:29:48.440 --> 0:29:48.640
<v Speaker 1>You know.

0:29:48.720 --> 0:29:50.960
<v Speaker 2>The loss of hormone therapy, women had to go on

0:29:51.040 --> 0:29:54.240
<v Speaker 2>polypharmacy to get everything control that hormones used to control.

0:29:54.520 --> 0:29:57.640
<v Speaker 2>The estrogen only arm continued for a couple more years,

0:29:57.760 --> 0:30:00.560
<v Speaker 2>and they did see an increased risk slightly of stroke,

0:30:00.600 --> 0:30:03.240
<v Speaker 2>which we knew. We knew, okay that after the age

0:30:03.280 --> 0:30:05.320
<v Speaker 2>of sixty, if you're on hormone therapy, your risk of

0:30:05.360 --> 0:30:07.120
<v Speaker 2>stroke goes up a little bit. Like, oh my god,

0:30:07.160 --> 0:30:09.720
<v Speaker 2>it caused a stroke. They did not see an improvement

0:30:09.720 --> 0:30:13.760
<v Speaker 2>in cardiovascular disease risk, no improvement. So now the average

0:30:13.760 --> 0:30:17.840
<v Speaker 2>age was sixty three because they're looking for cardiovascular disease

0:30:17.880 --> 0:30:21.160
<v Speaker 2>as an outcome, okay, which is reasonable if you're looking

0:30:21.160 --> 0:30:23.760
<v Speaker 2>for heart disease. Get it takes time to develop it,

0:30:24.320 --> 0:30:29.520
<v Speaker 2>so much older population than would have really started h RT,

0:30:29.680 --> 0:30:31.840
<v Speaker 2>usually at fifty to fifty one, forty nine, you know,

0:30:32.040 --> 0:30:35.280
<v Speaker 2>somewhere in that age. And they excluded everyone with hot

0:30:35.320 --> 0:30:39.520
<v Speaker 2>flashes because you would know if you had placebo jaw

0:30:39.600 --> 0:30:43.959
<v Speaker 2>flashes get better. So women with hot flashes tend to

0:30:44.000 --> 0:30:48.080
<v Speaker 2>have the you know, really really bad disease. And so

0:30:48.840 --> 0:30:50.680
<v Speaker 2>when with se of your hot flashes, are higher risks

0:30:50.680 --> 0:30:53.760
<v Speaker 2>for other conditions later on. So it was a really

0:30:53.840 --> 0:30:57.400
<v Speaker 2>kind of skewed study. And when they've gone back and

0:30:57.440 --> 0:30:59.680
<v Speaker 2>looked at it the women, they had younger women in

0:30:59.720 --> 0:31:01.640
<v Speaker 2>the st ST. So when they looked at the patients

0:31:01.680 --> 0:31:04.880
<v Speaker 2>who started HRT within ten years of their menopause, they

0:31:04.920 --> 0:31:08.000
<v Speaker 2>did have decreased risk of cardiovascular disease. It was just

0:31:08.040 --> 0:31:11.360
<v Speaker 2>the older patients. So estrogens that turns out, is better

0:31:11.400 --> 0:31:15.840
<v Speaker 2>at prevention than cure. It's very stabilizing to the blood vessels.

0:31:15.840 --> 0:31:18.760
<v Speaker 2>That line our carotid arteries and our hearts is where

0:31:18.800 --> 0:31:21.720
<v Speaker 2>strokes come from and where the alproscorotic disease happens.

0:31:22.320 --> 0:31:24.280
<v Speaker 1>And you know, not to say you'll never.

0:31:24.120 --> 0:31:27.000
<v Speaker 2>Develop those diseases, but it can delay the progression. But

0:31:27.120 --> 0:31:29.000
<v Speaker 2>you must start early, early.

0:31:29.040 --> 0:31:31.000
<v Speaker 1>It turns out in the brain.

0:31:31.720 --> 0:31:34.440
<v Speaker 2>Estrogen is a huge, huge, huge.

0:31:34.240 --> 0:31:35.200
<v Speaker 1>Benefit in the brain.

0:31:35.720 --> 0:31:38.000
<v Speaker 2>But you've got to start kind of early in order

0:31:38.000 --> 0:31:40.040
<v Speaker 2>to see those benefits. At least ten years as well.

0:31:40.200 --> 0:31:42.120
<v Speaker 1>Okay, so what's a number early?

0:31:42.640 --> 0:31:46.120
<v Speaker 2>So right now, the quote is to have the cardiovascular

0:31:46.160 --> 0:31:51.360
<v Speaker 2>preventative and cognitive preventative benefits, So within ten years of

0:31:51.400 --> 0:31:53.760
<v Speaker 2>your menopause or before the age sixty.

0:31:54.080 --> 0:31:55.760
<v Speaker 1>Okay, Now that being said.

0:31:55.600 --> 0:31:58.480
<v Speaker 2>I do start patients now, if you've turned sixty and

0:31:58.520 --> 0:32:00.280
<v Speaker 2>you're on HRT and you're doing great, and you have

0:32:00.280 --> 0:32:00.840
<v Speaker 2>no risk.

0:32:00.640 --> 0:32:04.040
<v Speaker 1>Factors, you can keep going. There's no age at which you.

0:32:04.000 --> 0:32:04.480
<v Speaker 2>Have to see.

0:32:04.480 --> 0:32:08.160
<v Speaker 1>You don't have to stop it if you're sixty, no, okay,

0:32:08.640 --> 0:32:10.720
<v Speaker 1>you can continue those preventative benefits.

0:32:10.920 --> 0:32:13.840
<v Speaker 2>But if you already have severe athloskrotic disease, estrogen is

0:32:13.880 --> 0:32:16.640
<v Speaker 2>not going to make it better, okay, And some people

0:32:16.640 --> 0:32:19.120
<v Speaker 2>think it may make it worse. So in my patients

0:32:19.120 --> 0:32:21.640
<v Speaker 2>like above sixty with risk factors, I'm getting a calcium

0:32:21.640 --> 0:32:24.560
<v Speaker 2>cardiac score and like extensive testing to see if they

0:32:24.560 --> 0:32:27.320
<v Speaker 2>have disease. I don't want to add estrogen on top

0:32:27.400 --> 0:32:29.480
<v Speaker 2>for you know, potentially making that disease worse.

0:32:29.920 --> 0:32:39.560
<v Speaker 1>Right, Okay, I heard today. I've known this before a

0:32:39.600 --> 0:32:42.400
<v Speaker 1>friend of mine has a company, but I heard today

0:32:42.400 --> 0:32:44.840
<v Speaker 1>in the news about estrogen in the form of a

0:32:45.280 --> 0:32:48.480
<v Speaker 1>vaginal topical ointment being used.

0:32:48.400 --> 0:32:48.800
<v Speaker 2>On the face.

0:32:49.000 --> 0:32:51.880
<v Speaker 1>This on the face, I think natural about is my friend.

0:32:52.400 --> 0:32:54.280
<v Speaker 2>So I've been using topical estrogen.

0:32:54.520 --> 0:32:56.719
<v Speaker 1>What's it called estra deal how do you say it?

0:32:57.120 --> 0:32:58.600
<v Speaker 1>Estra dial estradiyle sore.

0:32:58.760 --> 0:33:02.840
<v Speaker 2>There's two forms that have been tested. There's estriol, so estrogen.

0:33:02.920 --> 0:33:07.200
<v Speaker 2>Vaginal cream is typically estra dial point zero one percent

0:33:07.440 --> 0:33:09.800
<v Speaker 2>or yeaer point oh one percent vaginal cream.

0:33:09.680 --> 0:33:12.280
<v Speaker 1>And that's something someone's supposed to just rub on their

0:33:12.360 --> 0:33:13.720
<v Speaker 1>vagina and it's to absorb.

0:33:13.800 --> 0:33:16.040
<v Speaker 2>So that's for the treatment of vaginal atrophy and it

0:33:16.080 --> 0:33:19.600
<v Speaker 2>works beautifully. Well, Okay, some people have been putting it

0:33:19.640 --> 0:33:22.400
<v Speaker 2>on their face as well, and they've actually done studies

0:33:22.520 --> 0:33:27.200
<v Speaker 2>with the topical estrogen. This is a very very low dose.

0:33:27.400 --> 0:33:30.000
<v Speaker 2>This is not the estrogen that you would get the

0:33:30.080 --> 0:33:33.000
<v Speaker 2>cream and the sprays and everything for systemic therapy. This

0:33:33.080 --> 0:33:36.800
<v Speaker 2>is a much lower percentage. They tested the blood levels

0:33:36.800 --> 0:33:39.120
<v Speaker 2>of women putting it on their vaginas and on their faces,

0:33:39.120 --> 0:33:42.840
<v Speaker 2>and there's no systemic absorption, so there's no worries about

0:33:42.920 --> 0:33:45.320
<v Speaker 2>block clots or any of that, or endimatoral cancer, none

0:33:45.360 --> 0:33:48.200
<v Speaker 2>of that. Okay, as long as you use that preparation

0:33:48.400 --> 0:33:51.440
<v Speaker 2>meant for the vagina, the low low dose, the low

0:33:51.480 --> 0:33:56.280
<v Speaker 2>low dose and estreol cream, which is another form of estrogen.

0:33:56.280 --> 0:34:00.120
<v Speaker 2>It's actually the estrogen that's created in our placinas when

0:34:00.160 --> 0:34:04.239
<v Speaker 2>we're pregnant, and so they've been able to synthesize that

0:34:04.560 --> 0:34:07.960
<v Speaker 2>and the estray All cream get used on the face

0:34:08.000 --> 0:34:11.680
<v Speaker 2>as well with some similar efficacy, and those are usually compounded.

0:34:12.200 --> 0:34:13.840
<v Speaker 2>So that's the one that I've been using because my

0:34:13.920 --> 0:34:15.680
<v Speaker 2>friend's company made it and I was like, yeah, yeah,

0:34:15.680 --> 0:34:17.640
<v Speaker 2>I'll try it. She sent me one for free. I

0:34:17.719 --> 0:34:19.200
<v Speaker 2>fell in love with it, and of course now I

0:34:19.280 --> 0:34:21.160
<v Speaker 2>just buy it so I can talk about it without

0:34:21.360 --> 0:34:24.760
<v Speaker 2>having to say sponsored no, this is good.

0:34:24.960 --> 0:34:27.520
<v Speaker 1>I mean, it's a conversation that's been going on, but

0:34:27.640 --> 0:34:30.040
<v Speaker 1>now it seems like it's becoming public and I think

0:34:30.160 --> 0:34:31.600
<v Speaker 1>everybody's going to be talking about it.

0:34:31.760 --> 0:34:35.560
<v Speaker 2>Don't skip the vagina if you're you know, people are like, well,

0:34:35.560 --> 0:34:37.920
<v Speaker 2>I'm just trying to down there. I'm like, no, please,

0:34:38.080 --> 0:34:40.680
<v Speaker 2>you know she's staged it down there.

0:34:40.800 --> 0:34:44.399
<v Speaker 1>That's the health part. This is cosmetic. Yes, we talked

0:34:44.400 --> 0:34:47.880
<v Speaker 1>a lot about symptoms. Hot flashes obviously that's like the

0:34:47.920 --> 0:34:53.200
<v Speaker 1>no brainer symptom. But brain fog, you know, it's just

0:34:53.239 --> 0:34:56.520
<v Speaker 1>like when you have postpartum, when you just had your

0:34:56.560 --> 0:34:59.480
<v Speaker 1>baby and your hormones are gone, whack a dooodle. It's

0:34:59.480 --> 0:35:03.719
<v Speaker 1>a silence like misery, and nobody knows what's going on

0:35:03.800 --> 0:35:06.520
<v Speaker 1>in you, but you I feel like the brain fog

0:35:06.719 --> 0:35:11.560
<v Speaker 1>is another just silent struggle that people don't understand because

0:35:11.600 --> 0:35:13.959
<v Speaker 1>I mean, it happens to me at least three times

0:35:13.960 --> 0:35:15.320
<v Speaker 1>a day where I walk into a room and I

0:35:15.400 --> 0:35:18.640
<v Speaker 1>have no idea why I'm in there. That's brain fog.

0:35:19.040 --> 0:35:23.840
<v Speaker 2>M yeah. Or you can't find a word, or you

0:35:23.840 --> 0:35:27.239
<v Speaker 2>you know, can't remember a name or you know, in

0:35:27.320 --> 0:35:29.600
<v Speaker 2>these these things that will happen to us from time

0:35:29.640 --> 0:35:32.200
<v Speaker 2>to time. But when it becomes a pattern and all

0:35:32.200 --> 0:35:34.640
<v Speaker 2>of a sudden, you're questioning your judgment. One in five

0:35:34.680 --> 0:35:37.120
<v Speaker 2>women are quitting their jobs at our age because of this.

0:35:37.400 --> 0:35:41.359
<v Speaker 2>It's so bad, especially since they feel inadequate positions who

0:35:41.440 --> 0:35:45.040
<v Speaker 2>require lots of cognitive ability. You know, our missions are

0:35:45.480 --> 0:35:48.880
<v Speaker 2>they are really struggling and like not and hitting a wall,

0:35:49.160 --> 0:35:50.160
<v Speaker 2>hitting a wall at work.

0:35:50.440 --> 0:35:51.160
<v Speaker 1>It's scary.

0:35:51.680 --> 0:35:55.120
<v Speaker 2>It's so scary, and you know we're losing that. Mckensey

0:35:55.120 --> 0:35:58.600
<v Speaker 2>company just did this incredible report looking at lost economic

0:35:58.880 --> 0:36:01.719
<v Speaker 2>the economic impact of these women who are supposed to

0:36:01.760 --> 0:36:04.640
<v Speaker 2>be leading companies who can't do it. You know, twenty

0:36:04.640 --> 0:36:07.240
<v Speaker 2>percent of women walk away not because of an aging

0:36:07.239 --> 0:36:09.840
<v Speaker 2>payriner stuff. They can't they don't want to be up.

0:36:09.880 --> 0:36:11.400
<v Speaker 2>You know, they can't do their job confidently.

0:36:11.760 --> 0:36:16.560
<v Speaker 1>Is there a correlation between brain fog and early onset dementia?

0:36:18.239 --> 0:36:22.200
<v Speaker 2>Okay, so we all tend to have cognitive decline okay

0:36:22.680 --> 0:36:26.799
<v Speaker 2>in early in perimenopause and early menopause, and then for

0:36:26.880 --> 0:36:31.000
<v Speaker 2>those of us not on the path to dementia, it recovers.

0:36:30.600 --> 0:36:33.440
<v Speaker 1>Okay later, Oh thank goodness.

0:36:33.239 --> 0:36:35.120
<v Speaker 2>It does tend to recover. You will never quite be

0:36:35.120 --> 0:36:38.080
<v Speaker 2>where you were, but it does. The brain rewires, you know,

0:36:38.120 --> 0:36:40.040
<v Speaker 2>from the lack of estrogen, and then you learn how

0:36:40.080 --> 0:36:42.560
<v Speaker 2>to kind of compensate for it. Okay, that brain keeps

0:36:42.560 --> 0:36:46.320
<v Speaker 2>going unless you're on the Alzheimer dementia spectrum, and you

0:36:46.320 --> 0:36:50.359
<v Speaker 2>can keep going down. So, you know, the greatest book

0:36:50.360 --> 0:36:53.040
<v Speaker 2>written on this, and a brand new article just came out.

0:36:53.120 --> 0:36:57.080
<v Speaker 2>Lisa Musconi wrote The Menopause Brain. When she's a neuroscientist

0:36:57.160 --> 0:36:59.319
<v Speaker 2>out of will Cornell and she does pet scan after

0:36:59.360 --> 0:37:02.680
<v Speaker 2>pet scan of women's brains in different levels of menopause

0:37:02.719 --> 0:37:06.520
<v Speaker 2>and it's absolutely fascinating and it's just so validating. You know,

0:37:06.800 --> 0:37:08.440
<v Speaker 2>it's almost like I don't care if it's fixed at

0:37:08.440 --> 0:37:10.640
<v Speaker 2>this point, like at least I know I'm not nuts,

0:37:11.200 --> 0:37:14.760
<v Speaker 2>and you know, but she says, Alzheimer's is a disease

0:37:14.840 --> 0:37:18.560
<v Speaker 2>with symptoms of in old age, but it begins in

0:37:18.600 --> 0:37:22.680
<v Speaker 2>the life and menopause accelerates the deposition of the plex.

0:37:24.160 --> 0:37:25.840
<v Speaker 1>Yeah, it's a shame.

0:37:25.920 --> 0:37:30.480
<v Speaker 2>But even with the APO E four gene HRT, like

0:37:30.560 --> 0:37:31.520
<v Speaker 2>women on HRT.

0:37:31.480 --> 0:37:35.279
<v Speaker 1>Have involume better scores and women not what you call

0:37:35.320 --> 0:37:35.800
<v Speaker 1>it the APO.

0:37:36.000 --> 0:37:39.080
<v Speaker 2>So there's a APO E four I think gene which

0:37:39.120 --> 0:37:42.359
<v Speaker 2>is the genetic marker for Alzheimer's, Alzheimer's.

0:37:42.080 --> 0:37:43.280
<v Speaker 1>And even people.

0:37:43.280 --> 0:37:45.120
<v Speaker 2>So they studied that group and there was a few

0:37:45.160 --> 0:37:47.319
<v Speaker 2>of the women who actually got put on HRT for

0:37:47.360 --> 0:37:50.479
<v Speaker 2>hot flashes, and they had bigger brain volumes and better

0:37:50.480 --> 0:37:54.040
<v Speaker 2>cognition scores than their age match women, you know when

0:37:54.080 --> 0:37:56.960
<v Speaker 2>they started young, than the women who never got HRT

0:37:57.640 --> 0:37:59.400
<v Speaker 2>with the genetic predisposition.

0:38:00.120 --> 0:38:04.600
<v Speaker 1>It's so fascinating. Bodies are so crazy facinating. Wow, I

0:38:04.680 --> 0:38:07.760
<v Speaker 1>totally get it. Why you became a doctor. Loss of sleep,

0:38:07.800 --> 0:38:11.520
<v Speaker 1>that's another huge I had a lot of loss of sleep,

0:38:12.560 --> 0:38:16.520
<v Speaker 1>and that is what was the final driving factor. Combined

0:38:16.520 --> 0:38:18.520
<v Speaker 1>with the hot flashes of the marine fog. I guess

0:38:18.560 --> 0:38:21.360
<v Speaker 1>they'll go together. But I said, I can't lose my sleep,

0:38:21.400 --> 0:38:23.879
<v Speaker 1>and I'm not sleeping. I just wake up like five

0:38:23.920 --> 0:38:26.319
<v Speaker 1>times a night, whether it's from a hot flash or

0:38:26.440 --> 0:38:29.600
<v Speaker 1>just because. And that's why I decided to go on estrogen.

0:38:29.960 --> 0:38:32.319
<v Speaker 1>Why are we losing our sleep? Is it because of

0:38:32.360 --> 0:38:35.120
<v Speaker 1>the hot flashes? Few reasons. The hot flashes are just

0:38:35.120 --> 0:38:35.880
<v Speaker 1>sleep disruptive.

0:38:35.880 --> 0:38:38.759
<v Speaker 2>They'll wake you up right right. So, but even though

0:38:38.800 --> 0:38:41.080
<v Speaker 2>we can get those under control, women are still struggling

0:38:41.200 --> 0:38:45.800
<v Speaker 2>to sleep, not as much as before. So with the anxiety,

0:38:46.320 --> 0:38:49.680
<v Speaker 2>if someone is on the spectrum of their anxieties getting

0:38:49.719 --> 0:38:51.279
<v Speaker 2>higher in the racing thoughts at night.

0:38:51.800 --> 0:38:52.720
<v Speaker 1>That's one of the things.

0:38:52.719 --> 0:38:58.160
<v Speaker 2>Progesterone works incredibly well for that, or that three am

0:38:58.200 --> 0:39:00.399
<v Speaker 2>wake up and then you can't shut your ain off

0:39:00.400 --> 0:39:01.240
<v Speaker 2>to go back to sleep.

0:39:02.520 --> 0:39:05.400
<v Speaker 1>Progesterone works for that. The other thing is our bladders

0:39:05.400 --> 0:39:06.120
<v Speaker 1>can wake us up.

0:39:06.200 --> 0:39:09.120
<v Speaker 2>So if you're having irritable bladder or you're having you know,

0:39:09.160 --> 0:39:14.799
<v Speaker 2>incontinence or bladder spasms, then you know, vaginal estrogen can

0:39:14.840 --> 0:39:17.400
<v Speaker 2>do a beautiful job here of calming all that tissue

0:39:17.400 --> 0:39:20.680
<v Speaker 2>down so that you can sleep through that disruption. But

0:39:20.760 --> 0:39:22.759
<v Speaker 2>for my patients who you know, we've gotten the hot

0:39:22.800 --> 0:39:26.319
<v Speaker 2>flashes under control and she's still struggling, you know, with

0:39:26.440 --> 0:39:29.359
<v Speaker 2>the wake ups or the racing thoughts, progesterone we can

0:39:29.440 --> 0:39:30.839
<v Speaker 2>you know, you can go up to three and even

0:39:30.840 --> 0:39:34.600
<v Speaker 2>four hundred milligrams a night for that. The other thing

0:39:34.680 --> 0:39:36.560
<v Speaker 2>is if I choose to drink, and this is most

0:39:36.560 --> 0:39:40.440
<v Speaker 2>of my patients, if I choose alcohol, I am choosing

0:39:40.480 --> 0:39:42.560
<v Speaker 2>not to sleep. There's no way around it for.

0:39:42.520 --> 0:39:45.080
<v Speaker 1>Me, I know, man. And then there's just that's not

0:39:45.120 --> 0:39:47.640
<v Speaker 1>a decision you have to make because I'd rather sleep

0:39:47.680 --> 0:39:50.160
<v Speaker 1>than have a glass of wine. Yeah, I'd rather wake

0:39:50.239 --> 0:39:54.719
<v Speaker 1>up refreshed, yeah, yeah, and I'm sad because I'd love

0:39:54.760 --> 0:39:59.040
<v Speaker 1>to just you know, have wine or drink like my friends.

0:39:59.600 --> 0:40:01.319
<v Speaker 1>But I know how it affects me.

0:40:01.680 --> 0:40:04.960
<v Speaker 2>Yeah, so I have good I have really serious conversations

0:40:05.000 --> 0:40:07.960
<v Speaker 2>with my patients, like I can't fix this. We don't

0:40:07.960 --> 0:40:09.759
<v Speaker 2>know what you know, no one studied this yet. We

0:40:09.800 --> 0:40:12.480
<v Speaker 2>know it's happening, you know. And it could be that

0:40:12.520 --> 0:40:14.520
<v Speaker 2>our body composition is changing and.

0:40:14.760 --> 0:40:17.279
<v Speaker 1>Getting to cut out of your life.

0:40:17.040 --> 0:40:19.399
<v Speaker 2>And there's really no medical benefit to it.

0:40:19.960 --> 0:40:22.920
<v Speaker 1>I mean, it's boyson. We can work on other ways

0:40:22.960 --> 0:40:27.040
<v Speaker 1>to stress release. So yeah, yes, please, let's talk about

0:40:27.200 --> 0:40:33.600
<v Speaker 1>this Hypoactive sexual desire disorder. Yeah probably aka low libido,

0:40:33.880 --> 0:40:37.000
<v Speaker 1>AKA I'm not in the mood. There's many ways, so

0:40:37.040 --> 0:40:38.440
<v Speaker 1>we can sumb that one up.

0:40:38.560 --> 0:40:42.239
<v Speaker 2>Fifty percent of my patients have HSDD and it's it's

0:40:42.360 --> 0:40:45.120
<v Speaker 2>very very common. So hypoactive sexual desires source. So when

0:40:45.120 --> 0:40:47.280
<v Speaker 2>a woman comes in and I screen all my patients

0:40:47.320 --> 0:40:49.200
<v Speaker 2>for this, when they hit the door, my I have

0:40:49.280 --> 0:40:51.839
<v Speaker 2>low libido. There's kind of a medical checklist we have

0:40:51.880 --> 0:40:54.480
<v Speaker 2>to go through. Are you having pain? Okay? So when

0:40:54.520 --> 0:40:56.440
<v Speaker 2>we look at the buckets of why a woman's sexual

0:40:56.440 --> 0:40:59.239
<v Speaker 2>function is not where she wants it to be. One

0:40:59.320 --> 0:41:00.600
<v Speaker 2>is relationship disorder.

0:41:01.880 --> 0:41:02.880
<v Speaker 1>I'm not going to fix.

0:41:02.640 --> 0:41:05.200
<v Speaker 2>That, you know, Yeah, do you have a supportive partner?

0:41:05.360 --> 0:41:08.680
<v Speaker 2>You know, if when you're by yourself you're happy, and

0:41:08.800 --> 0:41:11.640
<v Speaker 2>when you're with this person there's zero interest. That's you know,

0:41:11.800 --> 0:41:14.839
<v Speaker 2>that's a counseling issue or whatever. That's you know here, no, no, no,

0:41:14.880 --> 0:41:16.279
<v Speaker 2>I love him. I w you know.

0:41:16.320 --> 0:41:19.200
<v Speaker 1>Did you ever have a great desire?

0:41:19.280 --> 0:41:21.439
<v Speaker 2>Yes? I used to, and it's just gone. I can't

0:41:21.480 --> 0:41:23.319
<v Speaker 2>seem to make it come back. I'm like, Okay, are

0:41:23.320 --> 0:41:23.959
<v Speaker 2>you having pain?

0:41:24.040 --> 0:41:24.520
<v Speaker 1>Yes or no?

0:41:24.640 --> 0:41:26.200
<v Speaker 2>And we have to fix that, get to the bottom

0:41:26.200 --> 0:41:28.960
<v Speaker 2>of that. Then there's arousal disorders, which are not that

0:41:29.040 --> 0:41:32.120
<v Speaker 2>common in women that they can happen, and orgasmic disorders.

0:41:32.760 --> 0:41:35.640
<v Speaker 2>So arousal disorder is you're struggling to get blood flow

0:41:35.680 --> 0:41:38.240
<v Speaker 2>to the area your brain saying yes, but nothing's happening

0:41:38.239 --> 0:41:41.359
<v Speaker 2>in the pelvis. Okay, that's where female viagra can come

0:41:41.400 --> 0:41:44.080
<v Speaker 2>into play, because that will increase just like in a man.

0:41:44.120 --> 0:41:46.359
<v Speaker 2>It will increase blood flow to the genitalia and kind

0:41:46.360 --> 0:41:48.120
<v Speaker 2>of get things moving in that direction, but it's not

0:41:48.160 --> 0:41:49.200
<v Speaker 2>going to do anything for your brain.

0:41:49.480 --> 0:41:52.360
<v Speaker 1>Wait, what's female viagra? Is it called viagraf.

0:41:52.880 --> 0:41:55.719
<v Speaker 2>Yeah, okay, giving a woman viagra can help with that,

0:41:55.800 --> 0:41:57.800
<v Speaker 2>and sometimes they just put the pill in the vagina

0:41:57.840 --> 0:42:01.080
<v Speaker 2>and let it dissolve and work there. Oh. The other

0:42:01.200 --> 0:42:03.600
<v Speaker 2>is orgasmic disorder, and you know, like ten percent of

0:42:03.640 --> 0:42:07.319
<v Speaker 2>women never ever ever have orgasms and their lives. And

0:42:07.520 --> 0:42:09.560
<v Speaker 2>you know if that was men, wouldn't this be a

0:42:09.640 --> 0:42:10.600
<v Speaker 2>national emergency?

0:42:11.320 --> 0:42:12.399
<v Speaker 1>We would have heard about it.

0:42:12.560 --> 0:42:14.520
<v Speaker 2>And so there's primary and secretary, so you know, we

0:42:14.560 --> 0:42:16.360
<v Speaker 2>get to the bottom of that. Then what's left is

0:42:16.520 --> 0:42:21.399
<v Speaker 2>HSDD hypoactive sexual desire disorder. Basically like love this person, right,

0:42:21.440 --> 0:42:24.520
<v Speaker 2>everything's great in my life. I can't figure out why

0:42:24.560 --> 0:42:27.560
<v Speaker 2>I can't get the signal up here. There's some medications

0:42:27.560 --> 0:42:29.960
<v Speaker 2>that work really well for that. So there's two FDA

0:42:29.960 --> 0:42:32.920
<v Speaker 2>approved medications. One is Addie, which is the pill you

0:42:32.920 --> 0:42:35.360
<v Speaker 2>take every day. It works at the level of neuro receptors.

0:42:35.960 --> 0:42:37.960
<v Speaker 2>Great story on how long it took for them to

0:42:37.960 --> 0:42:40.840
<v Speaker 2>get past the FDA compared to viagra, which took like

0:42:41.120 --> 0:42:42.120
<v Speaker 2>thirty seven minutes.

0:42:42.239 --> 0:42:45.840
<v Speaker 1>Okay, oh my god, story Cindy Ekkerd.

0:42:45.920 --> 0:42:48.040
<v Speaker 2>You have to listen to her. She's amazing. Then there's

0:42:48.200 --> 0:42:51.720
<v Speaker 2>v Lasi, which is an injection that you give yourself

0:42:51.760 --> 0:42:52.800
<v Speaker 2>thirty minutes before.

0:42:53.080 --> 0:42:54.880
<v Speaker 1>But some patients who does.

0:42:54.760 --> 0:42:57.560
<v Speaker 2>Well, they love it. It works on Milana Courton and you know,

0:42:57.640 --> 0:42:59.800
<v Speaker 2>kind of opens up things in the brain there.

0:43:00.000 --> 0:43:01.480
<v Speaker 1>Where do you inject it anywhere?

0:43:01.600 --> 0:43:04.000
<v Speaker 2>Okay, usually an ADAM and most people just grab the

0:43:04.040 --> 0:43:06.080
<v Speaker 2>scin and pop it in and you just wait and

0:43:06.120 --> 0:43:10.920
<v Speaker 2>then you wait thirty minutes. And then there's testosterone which works.

0:43:10.960 --> 0:43:14.520
<v Speaker 2>That's works the best, but unfortunately we don't have an

0:43:14.560 --> 0:43:18.560
<v Speaker 2>FDA proved medication. It works and postmona balls with women beautifully,

0:43:18.600 --> 0:43:22.640
<v Speaker 2>and so probably half of my patients end up on testosterone.

0:43:23.080 --> 0:43:26.280
<v Speaker 2>As long as you give it in physiologic doses, then

0:43:26.480 --> 0:43:28.400
<v Speaker 2>they usually don't have a lot of side effects and

0:43:28.400 --> 0:43:32.280
<v Speaker 2>we're just restoring their levels and they're so happy. It also,

0:43:33.000 --> 0:43:36.239
<v Speaker 2>you know, has very promising research on brain function on

0:43:36.360 --> 0:43:38.560
<v Speaker 2>But there's just a sasterm receptors everywhere. And when my

0:43:38.600 --> 0:43:40.960
<v Speaker 2>patients come in and they are sycopenic because I have

0:43:41.000 --> 0:43:44.120
<v Speaker 2>a body scanner in my office, or they have local density,

0:43:44.280 --> 0:43:48.480
<v Speaker 2>you know, peniostioporosis, I'm using it in their toolkit of

0:43:48.520 --> 0:43:50.319
<v Speaker 2>how are we going to get your bone stronger, you know,

0:43:50.440 --> 0:43:54.200
<v Speaker 2>or keep your bone strong of you know, resistance training, protein,

0:43:54.239 --> 0:43:58.440
<v Speaker 2>the weighted vest, all that plus testosterone. So most of

0:43:58.480 --> 0:44:01.239
<v Speaker 2>my patients when we go through the options, choose testosterone

0:44:01.239 --> 0:44:03.000
<v Speaker 2>because it seems to have multiple benefits.

0:44:03.040 --> 0:44:06.640
<v Speaker 1>And can you be on estrogen, progesterone, and testosterone. Yeah,

0:44:06.640 --> 0:44:09.879
<v Speaker 1>we call it the megapack. That's like a dream come try.

0:44:09.960 --> 0:44:13.239
<v Speaker 1>I'm on all three. Yeah, wow, I got to get

0:44:13.239 --> 0:44:22.520
<v Speaker 1>on that train. I've seen you before with your weighted vest.

0:44:22.600 --> 0:44:23.839
<v Speaker 1>What the heck is happening with that?

0:44:24.200 --> 0:44:28.640
<v Speaker 2>So there's great studies there. You know, women our a

0:44:28.719 --> 0:44:31.520
<v Speaker 2>genteralder are rarely studied. It's really sad, but there are

0:44:31.560 --> 0:44:35.080
<v Speaker 2>actually some really nice studies looking on women and men

0:44:35.280 --> 0:44:38.280
<v Speaker 2>in long term care facilities, measuring muscle and bone strength

0:44:38.719 --> 0:44:41.279
<v Speaker 2>and all the tools that they used. So I call

0:44:41.320 --> 0:44:44.799
<v Speaker 2>it my osteoporsus Prevention pack. And because you know you

0:44:44.840 --> 0:44:48.120
<v Speaker 2>fall and break a head, you dead. Thirty percent of

0:44:48.160 --> 0:44:50.160
<v Speaker 2>us will die even with surgery in a year after

0:44:50.200 --> 0:44:51.160
<v Speaker 2>the age of sixty five.

0:44:51.960 --> 0:44:53.160
<v Speaker 1>That's in nine years for me.

0:44:53.480 --> 0:44:54.200
<v Speaker 2>That's not good.

0:44:54.280 --> 0:44:55.000
<v Speaker 1>That's coming up.

0:44:55.520 --> 0:44:57.759
<v Speaker 2>So you know, I'm doing everything I can. So the

0:44:57.760 --> 0:45:00.279
<v Speaker 2>weighted vest is just a hack. I'm actually going to

0:45:00.320 --> 0:45:04.360
<v Speaker 2>develop one with QVC. I love this. I'm in line

0:45:04.480 --> 0:45:06.440
<v Speaker 2>because I have one and I love it, but it

0:45:06.480 --> 0:45:09.160
<v Speaker 2>doesn't fit over the when women's chests very well. They

0:45:09.200 --> 0:45:12.120
<v Speaker 2>were made for men as per us, and so I

0:45:12.160 --> 0:45:14.000
<v Speaker 2>want to make one where we can kind of slide

0:45:14.080 --> 0:45:16.360
<v Speaker 2>the stuff around and fit around our girl parts.

0:45:16.880 --> 0:45:19.839
<v Speaker 1>So, God, you, I'm so excited for you to come

0:45:19.880 --> 0:45:23.719
<v Speaker 1>to the queue with all your packs, all your things.

0:45:24.160 --> 0:45:26.719
<v Speaker 1>It's going to be really great. So that's just like

0:45:26.760 --> 0:45:29.160
<v Speaker 1>a weighted thing that you do. You wear that like hiking,

0:45:29.440 --> 0:45:29.960
<v Speaker 1>working out.

0:45:30.080 --> 0:45:32.520
<v Speaker 2>Yeah, so I tell my patients. Start wearing it around

0:45:32.520 --> 0:45:35.759
<v Speaker 2>the house, doing housework, walk the dog, you know, until

0:45:35.800 --> 0:45:37.759
<v Speaker 2>you start with about ten percent of your body weight,

0:45:38.160 --> 0:45:41.680
<v Speaker 2>so you know, twelve rounds or fifty nothing crazy. And

0:45:41.680 --> 0:45:43.399
<v Speaker 2>then as you get stronger, you wear it more and more.

0:45:43.440 --> 0:45:45.440
<v Speaker 2>I now wear it when I'm working out, like and

0:45:45.520 --> 0:45:48.080
<v Speaker 2>I also I turn my treadmill into a walking desk

0:45:48.520 --> 0:45:50.759
<v Speaker 2>and so I'll put the desk on an encline, throw

0:45:50.800 --> 0:45:52.880
<v Speaker 2>on my weight to vest and I'm doing research or

0:45:52.960 --> 0:45:55.080
<v Speaker 2>doing zoom calls for work not not a podcast.

0:45:55.120 --> 0:45:58.480
<v Speaker 1>But yeah, you're not doing it right now. No, how

0:45:58.560 --> 0:45:59.799
<v Speaker 1>high are you is your weight up to?

0:46:00.239 --> 0:46:02.359
<v Speaker 2>Oh? Of course my husband got into it. So now

0:46:02.400 --> 0:46:06.760
<v Speaker 2>we have eight which no one wears anymore. We have twelve, fifteen, twenty,

0:46:06.880 --> 0:46:08.680
<v Speaker 2>twenty five, thirty, and thirty five.

0:46:08.719 --> 0:46:09.919
<v Speaker 1>So he wears the heavier ones.

0:46:09.960 --> 0:46:11.440
<v Speaker 2>Every once in a while, I'll put the heavier one

0:46:11.520 --> 0:46:13.680
<v Speaker 2>just to feel, but I'll take it off in like

0:46:13.719 --> 0:46:14.400
<v Speaker 2>thirty minutes.

0:46:14.880 --> 0:46:18.240
<v Speaker 1>So that is great though, What a way to strengthen yourself,

0:46:19.120 --> 0:46:20.520
<v Speaker 1>I mean, just overall.

0:46:20.239 --> 0:46:23.279
<v Speaker 2>So the studies showed improved bondensity and improved muscle strength

0:46:23.320 --> 0:46:24.200
<v Speaker 2>and improved balance.

0:46:24.880 --> 0:46:28.600
<v Speaker 1>So that's so important for us to decrease risk. You

0:46:28.680 --> 0:46:33.239
<v Speaker 1>know what I'm obsessed with right now. Stretching. Yeah, I

0:46:33.280 --> 0:46:36.040
<v Speaker 1>cannot get enough of it. Every night, I lay in

0:46:36.040 --> 0:46:37.680
<v Speaker 1>front of the TV on the floor, I put my

0:46:37.680 --> 0:46:40.560
<v Speaker 1>little yoga mat down and my dogs come around and

0:46:40.600 --> 0:46:44.280
<v Speaker 1>we stretch, and like, I get into every joint because

0:46:44.400 --> 0:46:48.759
<v Speaker 1>I I feel like when you get sedentary and your

0:46:48.840 --> 0:46:52.120
<v Speaker 1>joints lock up, they get rusty, you know.

0:46:52.560 --> 0:46:56.040
<v Speaker 2>I mean, there's there's data showing stretching decreases the risk

0:46:56.080 --> 0:47:00.200
<v Speaker 2>of falls because you're your decreasing motion if you don't stretch.

0:47:01.440 --> 0:47:03.759
<v Speaker 1>Can we go back for one second about the balbido thing.

0:47:03.920 --> 0:47:08.480
<v Speaker 1>How can we get our partners to be understanding or

0:47:08.520 --> 0:47:12.120
<v Speaker 1>compassionate or I don't even know what the right word is.

0:47:12.160 --> 0:47:16.400
<v Speaker 1>But it's a challenge because they don't understand what's happening

0:47:16.840 --> 0:47:20.240
<v Speaker 1>right and we ourselves don't understand exactly what's happening.

0:47:20.600 --> 0:47:23.920
<v Speaker 2>Some of the most impassioned letters I get our DMS

0:47:23.960 --> 0:47:28.400
<v Speaker 2>are from partners. Help me help her how you know,

0:47:28.680 --> 0:47:32.120
<v Speaker 2>And I'm like, educate yourself so that you can understand

0:47:33.080 --> 0:47:35.120
<v Speaker 2>what she's going through. And this is not her fault.

0:47:35.200 --> 0:47:37.560
<v Speaker 2>She is in there and she still loves you more

0:47:37.560 --> 0:47:40.400
<v Speaker 2>than likely, you know, but she isn't likely. She is

0:47:40.480 --> 0:47:43.600
<v Speaker 2>going through a cataclysmic change right now, and none of

0:47:43.600 --> 0:47:45.680
<v Speaker 2>this is your fault. And so here are the ways

0:47:45.680 --> 0:47:46.319
<v Speaker 2>to support her.

0:47:46.400 --> 0:47:47.240
<v Speaker 1>Go with her.

0:47:47.840 --> 0:47:49.600
<v Speaker 2>I mean, the study is showing that when the men

0:47:49.680 --> 0:47:53.000
<v Speaker 2>go with the women to the doctor, they're much more

0:47:53.120 --> 0:47:57.319
<v Speaker 2>likely to be believed and get therapy. Absolutely, then if

0:47:57.360 --> 0:48:01.279
<v Speaker 2>and then help her find a menopause educated provider so

0:48:01.320 --> 0:48:03.560
<v Speaker 2>that you can have you guys can have an informed

0:48:03.560 --> 0:48:04.960
<v Speaker 2>conversation about her healthcare.

0:48:05.480 --> 0:48:07.719
<v Speaker 1>I love that it's just about supporting her. I mean,

0:48:08.360 --> 0:48:11.799
<v Speaker 1>if something were to happen to your spouse physically, you

0:48:11.800 --> 0:48:14.759
<v Speaker 1>would support them automatically. So this is just something that

0:48:15.280 --> 0:48:20.000
<v Speaker 1>needs to be on the partner's radars. For sure, for sure,

0:48:20.480 --> 0:48:24.520
<v Speaker 1>I did want to talk about you are a mother

0:48:24.640 --> 0:48:29.240
<v Speaker 1>of two. I am a mother of three daughters as well,

0:48:29.280 --> 0:48:32.840
<v Speaker 1>and I just want to know, Okay, so our moms

0:48:33.200 --> 0:48:36.399
<v Speaker 1>and grandma's weren't talking about it. Now our daughters are

0:48:36.719 --> 0:48:40.000
<v Speaker 1>starting to hear us talk about it. It's becoming less

0:48:40.000 --> 0:48:43.319
<v Speaker 1>taboo to talk about what can we do to help

0:48:43.400 --> 0:48:46.640
<v Speaker 1>them not be afraid of it, to not be you know,

0:48:46.880 --> 0:48:48.399
<v Speaker 1>to not be so fearful of it.

0:48:48.960 --> 0:48:51.319
<v Speaker 2>So I have this what I would tell myself at

0:48:51.360 --> 0:48:53.479
<v Speaker 2>thirty five. So these are like the tenets I try

0:48:53.520 --> 0:48:56.920
<v Speaker 2>to teach them. But again, they're prone to social media

0:48:57.360 --> 0:49:01.160
<v Speaker 2>and you have societal expectations. My oldest is in medical

0:49:01.239 --> 0:49:04.480
<v Speaker 2>school now, so she's you know a little radicalized for

0:49:04.640 --> 0:49:08.880
<v Speaker 2>menopausecare because of me. And my youngest is twenty in

0:49:08.960 --> 0:49:13.000
<v Speaker 2>college and she's actually interning for a menopause telemedicine company

0:49:13.400 --> 0:49:16.200
<v Speaker 2>this summer. So again, my kids are not the normal.

0:49:16.640 --> 0:49:19.080
<v Speaker 1>No, they're going to carry on though, they're going to help. No,

0:49:19.360 --> 0:49:20.440
<v Speaker 1>But my daughter what.

0:49:20.440 --> 0:49:22.360
<v Speaker 2>I would tell, you know, what things I would the

0:49:22.400 --> 0:49:24.600
<v Speaker 2>tenants I would try to teach my children, you know,

0:49:24.760 --> 0:49:29.280
<v Speaker 2>or teach the next generation strong over skinny. Okay, yes,

0:49:30.200 --> 0:49:32.040
<v Speaker 2>you know, moving your body to be strong and not

0:49:32.239 --> 0:49:35.520
<v Speaker 2>thin is key here because we're going to you know,

0:49:35.600 --> 0:49:37.239
<v Speaker 2>trying to get that in their head that they're going

0:49:37.280 --> 0:49:40.720
<v Speaker 2>to reach a maximum muscle and moon strength around age thirty,

0:49:40.760 --> 0:49:42.560
<v Speaker 2>and then age is going to start trying to take

0:49:42.600 --> 0:49:45.160
<v Speaker 2>it away from us and aging process, and then that

0:49:45.200 --> 0:49:48.200
<v Speaker 2>accelerates in menopause. So so these habits of getting this

0:49:48.239 --> 0:49:52.359
<v Speaker 2>stuff down now, of moving your body for strength and

0:49:52.600 --> 0:49:54.840
<v Speaker 2>our strong brain and a strong heart and strong muscles

0:49:54.880 --> 0:49:58.040
<v Speaker 2>and strong bones, you can do that now and not

0:49:58.200 --> 0:50:00.880
<v Speaker 2>just focused on cardio to be skinny is going to

0:50:01.000 --> 0:50:02.200
<v Speaker 2>serve you so much better.

0:50:02.520 --> 0:50:03.960
<v Speaker 1>Nutrition over calories, this.

0:50:04.000 --> 0:50:07.359
<v Speaker 2>Obsessive you know, calorie counting, it's not helping us. It's

0:50:07.360 --> 0:50:10.360
<v Speaker 2>not helping you know, still living with you know, incredible

0:50:10.440 --> 0:50:15.279
<v Speaker 2>levels more but obesity, and you know, really looking at

0:50:15.280 --> 0:50:17.880
<v Speaker 2>their nutrition. You know, how much magnesium are you getting,

0:50:17.880 --> 0:50:20.440
<v Speaker 2>how much fiber, how much protein? These are the things

0:50:20.480 --> 0:50:22.680
<v Speaker 2>I talked to my kid about. How much sugar is

0:50:22.680 --> 0:50:24.959
<v Speaker 2>in that are you know, like like trying to fill

0:50:25.000 --> 0:50:27.680
<v Speaker 2>your like trying to eat more instead of being so

0:50:27.760 --> 0:50:31.560
<v Speaker 2>restrictive and then educate learning about this is a natural

0:50:31.560 --> 0:50:33.920
<v Speaker 2>phase of life. Shouldn't be scared of it, but it

0:50:34.000 --> 0:50:35.560
<v Speaker 2>is going to happen, and it can affect you. And

0:50:35.640 --> 0:50:37.920
<v Speaker 2>kind of here's what happened to mom. You know you

0:50:38.000 --> 0:50:40.360
<v Speaker 2>watched me go through it. My older daughter now says,

0:50:40.680 --> 0:50:42.719
<v Speaker 2>I guess it was kind of not fair that I

0:50:42.800 --> 0:50:44.680
<v Speaker 2>was a teenager. I was the teenager I was, and

0:50:44.719 --> 0:50:48.120
<v Speaker 2>you were going through very menopause at the same, right.

0:50:48.040 --> 0:50:50.760
<v Speaker 1>If they only knew, So she knows now.

0:50:51.520 --> 0:50:53.680
<v Speaker 2>And I look back at that, Mary Claire, I'm like,

0:50:53.680 --> 0:50:58.399
<v Speaker 2>oh my god, oh my god. Yeah, who buying off

0:50:58.400 --> 0:50:58.840
<v Speaker 2>the handle?

0:50:59.239 --> 0:51:01.839
<v Speaker 1>Uh huh dark, But look how much better we are now.

0:51:02.040 --> 0:51:02.480
<v Speaker 2>Yeah.

0:51:02.640 --> 0:51:05.400
<v Speaker 1>Yeah, tell me though about that. You are a certified

0:51:05.440 --> 0:51:08.560
<v Speaker 1>culinary medicine specialist, so that goes hand in hand with

0:51:08.640 --> 0:51:10.800
<v Speaker 1>that giving the right nutritional messages.

0:51:11.320 --> 0:51:14.279
<v Speaker 2>So when I decided to like, I was like, I'm

0:51:14.320 --> 0:51:17.920
<v Speaker 2>going to fix this menopause fat problem, weight gain whatever.

0:51:18.080 --> 0:51:20.200
<v Speaker 2>I didn't even know about visceral fat. I just thought

0:51:20.280 --> 0:51:21.000
<v Speaker 2>fat was fat.

0:51:21.440 --> 0:51:22.400
<v Speaker 1>So I enrolled in this.

0:51:22.760 --> 0:51:25.080
<v Speaker 2>I wanted to get a master's in nutrition, and again

0:51:25.120 --> 0:51:27.600
<v Speaker 2>I was at a university and one of the professors

0:51:27.719 --> 0:51:30.280
<v Speaker 2>was like, well, there's this culinary medicine program that's popped

0:51:30.320 --> 0:51:32.400
<v Speaker 2>up and there's a professor at Tulane who's running it.

0:51:32.880 --> 0:51:34.680
<v Speaker 2>You know, you probably could 'en roll in that. It

0:51:34.680 --> 0:51:36.400
<v Speaker 2>looks like it's going to give you all the basics

0:51:36.400 --> 0:51:38.880
<v Speaker 2>you need without having to like enroll in a university

0:51:38.920 --> 0:51:40.480
<v Speaker 2>while you're a teaching professor like that.

0:51:40.680 --> 0:51:41.560
<v Speaker 1>It was too hard.

0:51:41.880 --> 0:51:44.680
<v Speaker 2>Yeah, Like okay, so I learned so much. We didn't

0:51:44.920 --> 0:51:48.200
<v Speaker 2>learn much nutrition in medical school hardly, like scratch the surface.

0:51:48.680 --> 0:51:51.279
<v Speaker 2>This was like the best thing I ever did about

0:51:51.480 --> 0:51:55.080
<v Speaker 2>you know, the blue zone and Mediterranean and dietary patterns

0:51:55.120 --> 0:51:58.279
<v Speaker 2>and how you know. It was just incredible, and so

0:51:58.360 --> 0:52:00.799
<v Speaker 2>I wrapped up all of that to like create the

0:52:00.840 --> 0:52:03.840
<v Speaker 2>Galveston Diet, my first book for my patients and followers,

0:52:03.880 --> 0:52:05.359
<v Speaker 2>and then it turned into a book and a thing.

0:52:06.320 --> 0:52:08.880
<v Speaker 2>But quickly as soon as I wrote that, I was

0:52:09.000 --> 0:52:11.560
<v Speaker 2>you know, sharing on social media about it, and people

0:52:11.560 --> 0:52:13.960
<v Speaker 2>were asking me more and more menopause questions in general.

0:52:14.280 --> 0:52:15.880
<v Speaker 2>So then I, you know, I'm curious, so I just

0:52:15.960 --> 0:52:19.120
<v Speaker 2>keep researching, and that's how Pause came about.

0:52:19.440 --> 0:52:22.360
<v Speaker 1>Yeah, I mean, the connection with food and the sugar

0:52:22.600 --> 0:52:25.399
<v Speaker 1>and the like what you were saying right now, I'm

0:52:25.440 --> 0:52:27.960
<v Speaker 1>just it's all about for me, protein intake and fiber

0:52:28.040 --> 0:52:29.000
<v Speaker 1>intake same.

0:52:29.480 --> 0:52:32.520
<v Speaker 2>I look at my plate and it's like protein plants,

0:52:32.960 --> 0:52:33.319
<v Speaker 2>you know, and.

0:52:33.280 --> 0:52:34.280
<v Speaker 1>How much of that is fiber?

0:52:34.920 --> 0:52:38.200
<v Speaker 2>So right, I just made a huge smat of like

0:52:38.280 --> 0:52:40.719
<v Speaker 2>beans with ground turkey, and that's like our meal prep

0:52:41.160 --> 0:52:43.760
<v Speaker 2>for the week. You know, we can munch on it whenever,

0:52:43.840 --> 0:52:47.520
<v Speaker 2>and I know I'm going on hand and my fiber exactly.

0:52:48.280 --> 0:52:51.320
<v Speaker 1>Well, I feel like we've talked about so many great things.

0:52:51.520 --> 0:52:54.680
<v Speaker 1>You have been doing the circuit, talking so much about

0:52:55.160 --> 0:52:59.239
<v Speaker 1>menopause and your new book, and you've just been doing

0:52:59.239 --> 0:53:01.439
<v Speaker 1>such a great jobs. Is there anything that you ever

0:53:01.520 --> 0:53:03.879
<v Speaker 1>would think like, Oh, I wish we could just talk

0:53:03.880 --> 0:53:04.799
<v Speaker 1>a little bit about that.

0:53:05.040 --> 0:53:09.239
<v Speaker 2>You know, just menopause is inevitable, but suffering is not.

0:53:09.920 --> 0:53:13.360
<v Speaker 2>And the more we normalize this and talk about it

0:53:13.400 --> 0:53:16.720
<v Speaker 2>in our own unique experiences, and the more the world's

0:53:16.760 --> 0:53:19.680
<v Speaker 2>going to pay attention, because I think they're paying attention now.

0:53:19.880 --> 0:53:20.720
<v Speaker 1>They are now.

0:53:20.760 --> 0:53:25.000
<v Speaker 2>It's like getting our legislators and our you know, government agencies,

0:53:25.040 --> 0:53:27.120
<v Speaker 2>and our medical schools and stuff.

0:53:26.840 --> 0:53:28.520
<v Speaker 1>To like get on board.

0:53:29.280 --> 0:53:33.239
<v Speaker 2>We're probably twenty years away from like our daughters being

0:53:33.239 --> 0:53:36.240
<v Speaker 2>able to confidently walk into a clinician's office and discuss

0:53:36.280 --> 0:53:39.520
<v Speaker 2>their menopause and have adequate care. So it's it's just,

0:53:39.640 --> 0:53:41.440
<v Speaker 2>you know, we have to fill in the gaps for now.

0:53:41.440 --> 0:53:43.279
<v Speaker 1>Oh my god. It just makes me so excited, though.

0:53:43.280 --> 0:53:45.680
<v Speaker 1>I have to throw my cards up because the work

0:53:45.719 --> 0:53:49.840
<v Speaker 1>you're doing is so important to our generation, our daughters,

0:53:50.320 --> 0:53:54.560
<v Speaker 1>our granddaughters. I just I'm so motivated by you and inspired,

0:53:54.719 --> 0:53:56.800
<v Speaker 1>and I'm glad that we met at the Q fifty.

0:53:57.120 --> 0:53:58.160
<v Speaker 2>Yeah, that was awesome.

0:53:58.239 --> 0:54:00.920
<v Speaker 1>Before we go, I want to ask you, what was

0:54:01.160 --> 0:54:03.120
<v Speaker 1>your last I choose me moment?

0:54:04.000 --> 0:54:10.080
<v Speaker 2>You know, I've had to put up boundaries in relationships

0:54:10.840 --> 0:54:14.240
<v Speaker 2>and it's okay. I have to put my own mental

0:54:14.280 --> 0:54:17.480
<v Speaker 2>health first. And you know, it doesn't mean I don't

0:54:17.520 --> 0:54:21.560
<v Speaker 2>love someone or whatever, but in order to live my

0:54:21.680 --> 0:54:24.480
<v Speaker 2>best life and be the person I want to be,

0:54:25.280 --> 0:54:28.520
<v Speaker 2>sometimes I have to say no and put up a

0:54:28.560 --> 0:54:31.279
<v Speaker 2>boundary where I'm not going to let this affect me

0:54:31.400 --> 0:54:33.560
<v Speaker 2>or I'm not going to get involved in that drama.

0:54:33.840 --> 0:54:35.719
<v Speaker 2>And that is one of the most powerful things of

0:54:35.719 --> 0:54:38.680
<v Speaker 2>my metopause, is just having no guilt or shame about that.

0:54:39.040 --> 0:54:42.160
<v Speaker 1>I love that. Well, thank you, doctor Haber, You're welcome.

0:54:45.560 --> 0:54:49.479
<v Speaker 1>Oh how I love her. That conversation with doctor Mary

0:54:49.520 --> 0:54:53.120
<v Speaker 1>Claire Haveer was so interesting. And honestly, it just gives

0:54:53.160 --> 0:54:56.879
<v Speaker 1>me so much hope. I feel inspired and I feel heard.

0:54:57.360 --> 0:54:59.279
<v Speaker 1>I'm just I'm so grateful that she came on the

0:54:59.320 --> 0:55:03.640
<v Speaker 1>podcast and gave us all this information. Menopause is something

0:55:03.680 --> 0:55:06.279
<v Speaker 1>that half the population is going to go through, and

0:55:06.360 --> 0:55:08.759
<v Speaker 1>I'm just really happy to be a part of the

0:55:08.760 --> 0:55:12.600
<v Speaker 1>conversation and to use my platform to destigmatize this because

0:55:13.000 --> 0:55:16.400
<v Speaker 1>it's something as women we shouldn't be ashamed to talk about.

0:55:16.840 --> 0:55:21.240
<v Speaker 1>So as we continue to choose ourselves each week, this week,

0:55:21.600 --> 0:55:25.040
<v Speaker 1>I want to encourage you to have a conversation with

0:55:25.239 --> 0:55:28.560
<v Speaker 1>another woman in your life, your mother, your best friend,

0:55:28.680 --> 0:55:33.719
<v Speaker 1>your sister, your partner, about menopause. What do they know

0:55:33.840 --> 0:55:37.359
<v Speaker 1>about it? Are they in it? How was it, what

0:55:37.520 --> 0:55:41.960
<v Speaker 1>was their experience? Did they feel alone? How did they

0:55:42.000 --> 0:55:44.680
<v Speaker 1>handle it? As women, we talk about a lot of

0:55:44.760 --> 0:55:47.480
<v Speaker 1>things we go through, So why don't we talk about

0:55:47.480 --> 0:55:51.319
<v Speaker 1>the menopause chapter. Let's just all do our part to

0:55:51.560 --> 0:55:55.520
<v Speaker 1>amplify this topic, and it starts right here by talking

0:55:55.600 --> 0:55:58.440
<v Speaker 1>about it with each other. I love you, Thanks for

0:55:58.520 --> 0:56:00.960
<v Speaker 1>listening to I Choose Me. You can check out all

0:56:01.000 --> 0:56:04.400
<v Speaker 1>our social links and doctor Mary Claire Haver's info in

0:56:04.480 --> 0:56:07.600
<v Speaker 1>our show notes. Make sure to follow, rate, and review

0:56:07.640 --> 0:56:11.160
<v Speaker 1>the podcast, and use the hashtag I Choose Me. I'll

0:56:11.200 --> 0:56:13.600
<v Speaker 1>be right here next week, and I hope you choose

0:56:13.680 --> 0:56:14.359
<v Speaker 1>to be here too,