Speaker 1: You're listening to I Choose Me with Jenny Garth. Hi, everyone,
Speaker 1: welcome to I Choose Me. This podcast is all about
Speaker 1: the choices we make and where they lead us. So yeah,
Speaker 1: I've talked a little bit about it before, but menopause
Speaker 1: is finally getting its day in the sun. Today I
Speaker 1: choose to get into it. Let's talk about it. There
Speaker 1: is so much to discuss about menopause and all its
Speaker 1: phases and symptoms and side effects. Whether you are going
Speaker 1: through it, or about to go through it, or you
Speaker 1: know someone who's going through it, there's just too much
Speaker 1: stigma about this chapter of life that all of us
Speaker 1: women will eventually go through. My guest today is the
Speaker 1: author of the number one New York Times best selling book,
Speaker 1: The New Menopause. She's a Board certified OBGYN, a certified
Speaker 1: menopause practitioner from the Menopause Society, and a certified culinary
Speaker 1: medicine specialist. She's all about demystifying menopause, which I love.
Speaker 1: She is a leading voice on the topic. Please welcome
Speaker 1: doctor Mary Claire Haver to the Iye Choose Me podcast.
Speaker 1: I'm so so happy to have you with us today.
Speaker 1: I'm so happy to be here.
Speaker 2: This is so fun.
Speaker 1: It's so good. It's so good. Let me just tell
Speaker 1: you something that happened last night. My husband, he thinks
Speaker 1: he's funny. He said, what is going on with this
Speaker 1: menopause stuff? It's more like manopause. I feel like you're
Speaker 1: in your mano pause phase. I was like, that's a
Speaker 1: good one, babe. Have you heard that yet?
Speaker 2: Absolutely all the time, all the time or menopause man
Speaker 2: man no more.
Speaker 1: I know, there's a million things we can do with it.
Speaker 1: Talk to me about like, what happened with you? Why
Speaker 1: did you decide that amplifying this conversation around menopause and
Speaker 1: women's health in this category was so important to you.
Speaker 2: Kind Of my journey was I was a traditional obgyn
Speaker 2: and a big academic institution, I know, taught residents medical students,
Speaker 2: and I had a very robust private practice and I
Speaker 2: was happy, and I really thought I'd do that job
Speaker 2: till I retired, you know, in like twenty more years.
Speaker 2: And then my patients were aging with me because you
Speaker 2: kind of get out and you get all the newly
Speaker 2: pregnant people and I was newly pregnant, so we have
Speaker 2: babies together and then we get old.
Speaker 1: We were all.
Speaker 2: Together, and you know, I was seeing these trends in
Speaker 2: my patients who were aging of you know, these random
Speaker 2: complaints that we couldn't seem to get to the bottom of,
Speaker 2: like joint pain, not sleeping well, libido, weight gain, you know.
Speaker 2: And I was just kind of taught this is what
Speaker 2: happens when women age and get over it. We call
Speaker 2: them whining women in clinic when I was in training,
Speaker 2: you know, meaning she's just whining. This is the time
Speaker 2: of her life, she needs to seck it up.
Speaker 1: There's nothing we can do.
Speaker 2: Never in all of my training was I ever taught
Speaker 2: that this constellation of symptoms might be related to what
Speaker 2: the hell's going on in her ovaries right now.
Speaker 1: Wow.
Speaker 2: So I'm like, something's not right with me, something's not
Speaker 2: right with all my patients. Because I go to church
Speaker 2: with these women, we go out to dinner. It's a
Speaker 2: small town with a big university, right, I know them
Speaker 2: outside of their little complaint list in the office, and
Speaker 2: I know they run marathon, you know, Like, and You're like,
Speaker 2: these are women who this should not be happening to
Speaker 2: in this percentage, right, And they're eating right, they're working out,
Speaker 2: they're doing all the things, and they're like, look, I'm
Speaker 2: falling apart. And so you know, we're testing for a thyroid,
Speaker 2: we're doing all the walk ups and everything's coming back
Speaker 2: normal and they're not fully men apuzzles, so their hormone
Speaker 2: levels really aren't diagnostic at this point. And I'm like,
Speaker 2: we're doing this wrong. Something's wrong. So the main complaint
Speaker 2: was white game. So that's where I started, you know,
Speaker 2: and that's what was happening to me. Suddenly I was
Speaker 2: you know, I'd had then privilege most of my life,
Speaker 2: and then all of a sudden, I had a belly
Speaker 2: and I couldn't get rid of it despite dumbling down
Speaker 2: from Ike. So I called the PhD, you know, nutrition
Speaker 2: scientists at the university. You know, I delivered all their kids,
Speaker 2: and so what the hell is going on with this?
Speaker 2: Like what about women in menopause? Why is this happening?
Speaker 2: This is nearly universal? And they're like, yeah, so there's
Speaker 2: something to do with inflammation. And they just sent me
Speaker 2: down the like PubMed, which is the repository for medical
Speaker 2: data studies, and I started reading all this stuff about
Speaker 2: inflammation and how you know, inflammation and menopause are definitely
Speaker 2: tied and then this weight gain and this new belly
Speaker 2: fat deposition and inflammation is tied. And I start like, well,
Speaker 2: wait a minute, this is happening, and this is happening.
Speaker 2: Menopause and inflammation seems to be a thing. I just
Speaker 2: realized there was such little data there, and no one
Speaker 2: was teaching it to me. I was busy delivering babies
Speaker 2: and pap swears and all the stuff we do. So
Speaker 2: I just went down rabbit hole after rabbit hole, put
Speaker 2: together a nutrition program for my patients and me and
Speaker 2: my girlfriends, and you know, started talking about it on
Speaker 2: social media. I didn't have a Macavelian plan to become
Speaker 2: one of the leading voices in the menopause movement. I
Speaker 2: was a busy mom of two kids, my husband worked overseas.
Speaker 2: You know, I was just trying to stay alive. But
Speaker 2: as I talked more about it and more, people started
Speaker 2: listening and asking me more questions, which would fuel my
Speaker 2: curiosity and I go look up more stuff. So really,
Speaker 2: it wasn't planned. I just started talking about it, started
Speaker 2: validating people's symptoms, telling them that they weren't crazy. This
Speaker 2: is actually a thing, and it just grew and grew
Speaker 2: and grew and the more I would teach and share,
Speaker 2: the more people would join. And now we have got
Speaker 2: almost over four and a half million followers across you know,
Speaker 2: the different channels in.
Speaker 1: Your meno posse. I'm happy to be in your menopasse.
Speaker 2: By the way, it's really, you know, my miniverse is
Speaker 2: I like to call it. It is just a bunch
Speaker 2: of people who are there to help each other out
Speaker 2: and share experiences and make of that crazy.
Speaker 1: Yeah, that sounds like an amazing way of platform, a
Speaker 1: way to develop a platform, and such an incredible way
Speaker 1: for you to reach so many women. It's because you're
Speaker 1: so passionate about it, because it's happening to you.
Speaker 2: I love that I went through it. I'm still going
Speaker 2: through it. I'm you know, I'm still aging and I
Speaker 2: accept that. But you know, I just read a quote
Speaker 2: today from one of my friends who has this program
Speaker 2: called Menopause boot Camp, and she's an incredible personal trainer,
Speaker 2: but she's really focusing on us now. Because forever I
Speaker 2: was a cardio queen, I worked out to be Thinn.
Speaker 2: That was the goal. I had no thoughts of muscles
Speaker 2: or any of that. And you know, our mothers and
Speaker 2: grandmothers just kind of got to our age and were like,
Speaker 2: this is it, and yeah, I am. They end up
Speaker 2: in nursing homes with cognitive deficits and dementia and frailty
Speaker 2: and all this stuff, by and large, you know, not all,
Speaker 2: thank God, But I don't want to accept that, and
Speaker 2: that there's stuff that we can do now to prevent
Speaker 2: that in thirty years.
Speaker 1: I mean there has to be. That's a driving force
Speaker 1: for me too, Like I don't want to go down
Speaker 1: the road that my parents went down as far as
Speaker 1: their health, you know. So that pushes me every day
Speaker 1: to just stay healthy and take better care of myself
Speaker 1: than because I have the knowledge and they didn't.
Speaker 2: Right, right, when I think of the things that came
Speaker 2: out of my mom's mouth about trying to stay healthy,
Speaker 2: like eating olio instead of butter, you know, like that's
Speaker 2: her conception of health, and you know, fighting forever to
Speaker 2: stay thin and not giving herself proper nutrition just so
Speaker 2: that she could be thin. Now she's paying the price, yeah,
Speaker 2: you know, so same same. So when you know, when
Speaker 2: I have patients come into clinic and we take care
Speaker 2: of the acute problems, the joint pain, the brain fog,
Speaker 2: the whatever, you know, we fix all of that. Then
Speaker 2: I'm like, okay, now.
Speaker 1: Let's plan the next thirty years. They're like, what I
Speaker 1: love that, I need you my life.
Speaker 2: What can we do? What path can we put you
Speaker 2: on to avoid ending up? Like And if they come
Speaker 2: in and they're like, my mom's amazing, she's eighty five,
Speaker 2: she's driving around car, she's taking care of herself, Da
Speaker 2: da da da, I'm like, let's do whatever she's doing,
Speaker 2: because that's working. But if they're like, she's can't take
Speaker 2: care of herself, we're looking at home. So we're having
Speaker 2: to disrupt our lives like I want to don't want
Speaker 2: to disrupt my kids lives, you know, as little as possible.
Speaker 2: You know, I don't expect to live for ever, but
Speaker 2: I don't want one of those long, protracted, you know,
Speaker 2: times of infirmity.
Speaker 1: If it can be avoided, it is a big I
Speaker 1: wouldn't say disruptance because I have my mom now, who's
Speaker 1: in her eighties and is getting less and less mobile
Speaker 1: and doesn't want to leave her house, and she spends
Speaker 1: a lot of time reading, and I'm always calling her
Speaker 1: and saying, Mom, how about a walk today? Just let's
Speaker 1: go out, let's get a get a walk in and
Speaker 1: I don't want my kids to have to worry about me.
Speaker 1: Same as you. In your book, you say that every
Speaker 1: organ system in a woman's body is affected by menopause,
Speaker 1: their brain health, their heart, their lungs, and their kidneys.
Speaker 2: Explain this, I think that's you know, forever, we define
Speaker 2: menopause a cessation of period, so the end of your
Speaker 2: cycles and hot flashes, the vasomotor symptoms. But what we're
Speaker 2: now realizing is, my goodness, the cognitive changes, the mental
Speaker 2: health changes. So starting out the brain, you know, palpitations
Speaker 2: are now recognized as a common vasomotor symptom. They're lumped
Speaker 2: in there with hot flashes and night sweats. No very
Speaker 2: few cardiologists know this because they weren't taught this, you know,
Speaker 2: right Like in the lungs, new onset asthma very common
Speaker 2: in menopause, and it tends to be a typical. This
Speaker 2: doesn't happen to men, you know, in their midlife. It
Speaker 2: just happens to women. Autoimmune disease, joint pain, muscle pain.
Speaker 2: Of course, the genital urinary system recurrent UTI is vaginal pain,
Speaker 2: loss of lubrication, on and on and on and so
Speaker 2: what you go through is very different than what I
Speaker 2: go through. Our menopause footprint, you know, our symptom profile
Speaker 2: is as unique as we are, and doctors love a checklist,
Speaker 2: you know, that's how we're trained. Like it looks like
Speaker 2: a duck and walks like duck. It's a duck and
Speaker 2: the duck. For me, it's just outside of your period.
Speaker 2: Stopping and hof flashes can be really hard or can
Speaker 2: overlap with several of the disease states. You know, it's
Speaker 2: hard to tell hypotheridism away from perimenoplaus sometimes, and as.
Speaker 1: It is because you go in and you're wondering what's
Speaker 1: going on with you and you have all these other different,
Speaker 1: weird symptoms and they're not really linked, so everybody's just confused.
Speaker 1: That's was my experience.
Speaker 2: So my goal, you know, besides educating my followers so
Speaker 2: that they can have an informed conversation, is really you know,
Speaker 2: part of our like the doctor menopause, the clinician menopause,
Speaker 2: because we have nurse partitioners and lots of you know,
Speaker 2: psychologists and stuff, is we're now pushing the medical societies
Speaker 2: to recognize these things and start training our clinicians coming
Speaker 2: up in the world so that you know, at least
Speaker 2: the next generation we're going to have to fight.
Speaker 1: I mean, we're all the fighters, but they're going to
Speaker 1: benefit so much from all of your messaging and all
Speaker 1: this data that gathering and this information. Right, it's incredible.
Speaker 2: So yeah, we're not men with breasts, you know, where
Speaker 2: we're gender help on that.
Speaker 1: So our skin too, though, that's another organ that is
Speaker 1: incredibly affected by medicine.
Speaker 2: So wound healing besides the obvious cosmetic things, which you
Speaker 2: know which are It's shocking because in five years, Jenny,
Speaker 2: we lose thirty to fifty percent of for college.
Speaker 1: Oh my god, where'd it go?
Speaker 2: Like, I feel like overnight? You know? Now, definitely, you know,
Speaker 2: hormon therapy helps. You can do very safe topical hormone
Speaker 2: therapy that works beautifully. Of course, all the cosmetic treatments
Speaker 2: and stuff, but I don't know a woman who goes
Speaker 2: through it who like wakes up every day and is like,
Speaker 2: what happened to dudes, not saying what happened to my skin.
Speaker 2: It's a cosmetic stuff, you know, wound healing and you know,
Speaker 2: just the health of your skin. The trends to epidermal
Speaker 2: water loss, you know, We're much more likely to become dehydrated,
Speaker 2: you know, because our skin becomes so thin and we're
Speaker 2: just blowing off, you know, plus the hot slashes you know,
Speaker 2: in sweatings.
Speaker 1: So it's just crazy how it affects us all. It's
Speaker 1: like a massive cyclone that comes into your life and
Speaker 1: just does all kinds of destruction and then it's like
Speaker 1: bye bye, and I'll take all that with me. Explain
Speaker 1: the difference for those that don't know, because I definitely
Speaker 1: did not know when I didn't know when I was
Speaker 1: in perimenopause. I didn't know what perimenopause was. I didn't
Speaker 1: know the definition of menopause being twelve months after your
Speaker 1: last period, which I learned once I was twelve months
Speaker 1: after my last period. So can you explain the difference
Speaker 1: for people like paris meno and then postal.
Speaker 2: Okay, so we'll do a little baby lesson in endochronology. Okay,
Speaker 2: perfect to educate your listeners. This is this is so critical,
Speaker 2: so big difference between females and males. We have lots
Speaker 2: of differences, but as far as our gonads go, so
Speaker 2: overs and testicles, men make their genetic material, their sperm
Speaker 2: fresh every day Okay. Women are born with a limited
Speaker 2: egg supply. They form when we're still in our mother's uteruses, right,
Speaker 2: and then we're born with one to two million eggs.
Speaker 2: By the time we're thirty, we're down to ten percent.
Speaker 2: By the time we're forty, we're down to three percent.
Speaker 2: Menopause really represents you've run out of eggs. Okay, So
Speaker 2: now let's go to your normal, your twenty five year
Speaker 2: old self for ninety percent of as of normal regular cycles,
Speaker 2: very predictable if you're healthy.
Speaker 1: Okay.
Speaker 2: What happens why we ovulate, is that the hypothalmus, which
Speaker 2: is a gland in our brain, is constantly sampling our
Speaker 2: blood supply for estrogen estra dial, and when the levels
Speaker 2: get low, as they do towards the end of the cycle,
Speaker 2: it sends a signal to the pituitary gland, another gland
Speaker 2: to make stimulating hormones. That will say, ovary, let's get
Speaker 2: an egg out and ovulate, so that'll begin the production
Speaker 2: of estra dial through the ovulation process. What happened, and
Speaker 2: that goes a very ekg like, very predictable rise and
Speaker 2: fall of our hormones month after month after month in
Speaker 2: a healthy woman. Okay, Okay, it happens in perimenopause. So
Speaker 2: menopause by definition is the transition between what I just
Speaker 2: talked about, normal reproducible cycles to no more cycles. The
Speaker 2: chaos zone in the middle is perimenopause. Now what happens
Speaker 2: here reach a critical egg threshold level where the same
Speaker 2: signals that we're sending down each month stop working because
Speaker 2: we don't have enough eggs. We don't have enough follicles
Speaker 2: left to respond. So the hypothalamus is like, hey, where's
Speaker 2: my xtra diol?
Speaker 1: The tutory is like I.
Speaker 2: Sent the signal and is like send more. So we
Speaker 2: end up getting much higher levels of the stimulating hormones
Speaker 2: from the pituitary, but you don't have the same temporals.
Speaker 2: So what used to look like this now is delayed
Speaker 2: because it took a while for the signals to go
Speaker 2: back and forth. Then you get a much higher surge
Speaker 2: of that FSH and then you get much lower drops.
Speaker 2: And so what used to look like in EKG now
Speaker 2: becomes chaotic month after month, and it's not predictable at all.
Speaker 2: And so in that chaos zone, percent of us will
Speaker 2: have abnormal uterine bleeding heavy periods like periods no periods
Speaker 2: too many, too frequent, too few, to craziness. Only about
Speaker 2: ten percent will just wake up and not have a
Speaker 2: period again. There's usually a calling card, hot flashing and
Speaker 2: the night sweats, the joint pain that you know, the symptoms.
Speaker 2: But most importantly, the brain hates chaos. It loves predictability.
Speaker 2: And when our estrogen and progesterone and testosterone levels start
Speaker 2: going haywire in perimenopause is when we see the biggest
Speaker 2: changes in the brain both mental health. We have a
Speaker 2: forty percent increase of depression anxiety across the perimenopause transition.
Speaker 2: So you were living your best life, nothing has changed,
Speaker 2: no stressors have changed, and all of a sudden you've
Speaker 2: lost your resilience. You're cranky or depressed or snappy, or
Speaker 2: the things that used to bother you or now bothering.
Speaker 1: You, you know, and a lot more, uh huh.
Speaker 2: And so also our cognitive ability, so our ability. Think
Speaker 2: you're forgetting names, you can't remember, your job is suddenly
Speaker 2: becoming harder. You're you've got something that took your tongue
Speaker 2: and you can't you know, And like that all happens
Speaker 2: to us every once in a while. But this is
Speaker 2: like a consistent pattern. This is a hallmark of the
Speaker 2: cognitive changes in perimenopause.
Speaker 1: And then you have this crazy fluctuation.
Speaker 2: Busy time turns into full menopause. Now bottomed out, there
Speaker 2: are no eggs left, and now you have no estrogen.
Speaker 1: Oh, then the fun. You know. When I was in Perry,
Speaker 1: I was like, all right, let's get this over with
Speaker 1: enough already, just stop already, period so that I can
Speaker 1: be done with this. And I was kind of like
Speaker 1: hoping for it. And now that I'm in it, I'm like, wait,
Speaker 1: I gotta miss it. Yeah.
Speaker 2: I mean a lot of women are grateful, thankful that,
Speaker 2: especially if they had horrible periods or just ems or
Speaker 2: menstrual migraines, that is over and they can get on
Speaker 2: with their lives. But there are benefits to estrogen in
Speaker 2: our body, especially in the brain and the joints, you know,
Speaker 2: and our gut microbiome, all of it's affected.
Speaker 1: Yeah, And that no one has ever taught us this
Speaker 1: as bonkers to me.
Speaker 2: Right that I just saw a study where ninety percent
Speaker 2: of you know, girls were never taught about menopause in school,
Speaker 2: like nothing like in their health class, Like that there
Speaker 2: would ever be even if it's just like the end
Speaker 2: of your fertility. You know, it's just like this vague
Speaker 2: kind of.
Speaker 1: Something your grandma deals with, right, Yeah.
Speaker 2: And so, and I really had a negative connotation about
Speaker 2: menopause myself, and I just know that's the same for people.
Speaker 2: I remember thinking I hate menopause, like I don't want
Speaker 2: to take care of people at menopause. And now that's
Speaker 2: all I do. And God, you know, I am living
Speaker 2: my best life. I am happier, healthier, better relationships, better boundaries.
Speaker 2: I'm guiltless, I have no shame. I am just you know,
Speaker 2: I feel like I'm helping people, I'm teaching. But if
Speaker 2: I had not overhauled everything I think about health and
Speaker 2: how I'm going to age and learn how to prioritize
Speaker 2: myself and stop putting everybody's needs in front of mine,
Speaker 2: I would not be here today. And all I want
Speaker 2: is for what I feel, for everyone to have that chance. Oh.
Speaker 1: I love that, and you. I feel it from you
Speaker 1: when I look at you, when I read your book.
Speaker 1: By the way, your book, I have it right here
Speaker 1: the New Men of oz. Oh, it's really great. Thank
Speaker 1: you for writing that, because it's conversations that we haven't
Speaker 1: had before, and we need to have. I agree you
Speaker 1: are inspiring women our age to go for their best life,
Speaker 1: and I love that about you. What about birth control.
Speaker 1: I've been on and off birth control my whole life.
Speaker 1: Does that affect the onset any perry?
Speaker 2: Yeah, so we need more studies. But we have lots
Speaker 2: of women who are birth control, and I was on
Speaker 2: one of them. I was on it god thirty years
Speaker 2: too well contraception, but also for treatment of my PC
Speaker 2: or you know, covering the symptoms of my pcos. And
Speaker 2: I was happy on them, did great on them, no problem.
Speaker 2: We know that because we suppress ovulation with birth control pills,
Speaker 2: women who are the longer you're on them, you tend.
Speaker 1: To get an extra year or so.
Speaker 2: You know, if you're on like long term ten plus years,
Speaker 2: you might get an extra year or so out of
Speaker 2: the shelf life of your ovaries because we suppressed ovulation.
Speaker 2: We lose about eleven thousand eggs each month with the
Speaker 2: ovulatory process. So so a little bit not hugely clinically significant,
Speaker 2: but there is a little bit, you know, I worry
Speaker 2: about and probably what happened to me was, you know,
Speaker 2: when we're on long term birth control, and for me,
Speaker 2: it was medically treating something that I was happy with.
Speaker 2: You know, what did that do to my bone and
Speaker 2: muscle strength? You know, not having those normal levels of
Speaker 2: tasosterone and estrogen.
Speaker 1: It's just always something scary when when you're like, well,
Speaker 1: I hope this goes well.
Speaker 2: Yeah, you know, and I was happy to be treated
Speaker 2: because I have PCOS and what it did to me.
Speaker 2: You know, there's trade offs, there's were sympnefits for everything.
Speaker 2: But nobody sat me down and was like, okay, listen,
Speaker 2: you know, this is is a bigger conversation than we thought,
Speaker 2: and we do need to have more studies, but this,
Speaker 2: you know, you probably should be doing more weight lifting
Speaker 2: in the gym to hang on to your muscle mass
Speaker 2: because we're going to be suppressing your natural disosterone as
Speaker 2: well with this.
Speaker 1: Our symptoms change according to what phase we're in.
Speaker 2: Right in a menstrual cycle, yeah, so if you're you know,
Speaker 2: pre minstrel, your estrogen levels are rising. So the first
Speaker 2: halfier cycle, progesterone is zero almost very very low. Disascone
Speaker 2: does e and flow, but not nearly as much as estrogen,
Speaker 2: but it's fairly steady state compared to the others, and
Speaker 2: then we have a rise in estrogen mid cycle, and
Speaker 2: then it kind of goes down right after, and then
Speaker 2: we have a little bit more of a rise and
Speaker 2: then it plummets in a healthy menstrual cycle.
Speaker 1: Imperimental policy, we even know, ye, there's no way to
Speaker 1: We need more studies, we need more more data we do.
Speaker 2: Let me, let me give you this, Okay. PubMed is
Speaker 2: like where I go. It's like Google for doctors or
Speaker 2: Google for clinicians to look up vetted medical journal articles,
Speaker 2: like you know. Everything in there's pretty upfront. And I
Speaker 2: just type in the word pregnancy. I get one point
Speaker 2: one million articles. Amazing, right, that's great. We need healthy pregnancies.
Speaker 2: I've had two of them. Then I type in the
Speaker 2: word in menopause. There's ninety seven thousand articles, so ten
Speaker 2: to one difference, uh huh on one roughly a little
Speaker 2: less thanton one. I'm like, am I ninety percent less
Speaker 2: important in this phase of my life than I was
Speaker 2: when I was pregnant?
Speaker 1: And that's what they want us to believe, That's what
Speaker 1: we've been led to believe.
Speaker 2: Wait, so I type in the word perimenopause. I just
Speaker 2: did this, and there's six thousand, seven hundred articles.
Speaker 1: WHOA, Yeah, we got work to do. People don't know
Speaker 1: that there are stages, that there are different symptoms, that
Speaker 1: everybody's different. It's a real mystery to so many people,
Speaker 1: and definitely to men.
Speaker 2: Right now here, you are a partner trying to support
Speaker 2: a loved one through this.
Speaker 1: You she.
Speaker 2: So the best appointments I have are when the partners come,
Speaker 2: usually coming for a place of support and understanding, and
Speaker 2: I just love talking you know about all these things
Speaker 2: for them and they need it really helps.
Speaker 1: It really does, because they're so in the dark. They're
Speaker 1: so in the dark. So why but why is that?
Speaker 1: Historically speaking? Why are we as women so underserved from.
Speaker 2: A medical standpoint when you look at where how women
Speaker 2: have been treated, You know, so much of women's health
Speaker 2: has been you know, how a woman expresses certain diseases
Speaker 2: has been compared to how a man does it. So
Speaker 2: like atypical chest pain is female chest pain. You know,
Speaker 2: a woman is much more likely to die if she
Speaker 2: comes into the er with a heart attack than a man.
Speaker 2: Because everything's based off of how the average white male. Sorry,
Speaker 2: that's just how the US medical system developed acts and
Speaker 2: how drugs affect him. They didn't even study female rats
Speaker 2: in all the animal models. It was always males because
Speaker 2: women are harder. Females are harder because we have psychic fluctuations,
Speaker 2: and so being excluded from all these studies. So that's
Speaker 2: one thing, it's all in her head is another thing.
Speaker 2: It is real.
Speaker 1: It's taught.
Speaker 2: I was taught that a woman tends to tomaticize psychological issues.
Speaker 1: Right, and then you're gas lit.
Speaker 2: Yeah, so yeah, and so instead of believing a woman
Speaker 2: and what she's saying is true, we.
Speaker 1: Were taught.
Speaker 2: You know, is she having a bad day? Is does
Speaker 2: she need some rest? Do you need her vacation? Does
Speaker 2: she need some wine? You know, give her nanny depressant,
Speaker 2: she'll be fine. Yeah.
Speaker 1: Yeah, This is this is why I don't even understand
Speaker 1: what a hot flash is, like why that happens.
Speaker 2: So there is a thermoregulatory center in our brain that
Speaker 2: controls our body temperature. So everybody has head of fever, right,
Speaker 2: and you know what that feels like.
Speaker 1: You are hot.
Speaker 2: You can't figure out why you start sweating, you know,
Speaker 2: especially if you have the flu and you have a
Speaker 2: really bad that's kind of a hot flash. So mine
Speaker 2: and the way most are it feels like so the
Speaker 2: therma regulatory center becomes unstable from the loss of estrogen,
Speaker 2: we think, and you just start profusely sweating for no
Speaker 2: reason without a trigger. So I could just be sitting
Speaker 2: here and all of a sudden, I'd feel something in
Speaker 2: my chest and then it would I would just feel
Speaker 2: this heat wave come up my neck and head, and
Speaker 2: like for me, the back of my head starts sweating
Speaker 2: and it would just drip down my back and my
Speaker 2: chest would be sweating. And at night it would wake
Speaker 2: me up, you know when that would happen because I'm
Speaker 2: hot and then I throw the covers off and I'm
Speaker 2: soaking wet, and then I'm freezing exactly.
Speaker 1: It's the hot cold for me. You get so hot
Speaker 1: that you sweat and then you're freezing because you're basically
Speaker 1: naked in a Yeah, you're wet.
Speaker 2: So and that you know, and then when you disrupt.
Speaker 2: I mean, there is one of the top menopause researchers.
Speaker 2: She's much older in the US, and I just read
Speaker 2: a quote from her and I wanted to roll my
Speaker 2: eyes so hard. I mean, there's the old school menopause,
Speaker 2: the old guard I'm probably going to get in trouble
Speaker 2: for saying this. But the people who kind of, you know,
Speaker 2: and God bless them, they did great research back in
Speaker 2: the day, but they kind of are really reluctant to
Speaker 2: accept that other organ systems can be affected by menopause.
Speaker 2: And she's like, no, no, no, no. The reason why
Speaker 2: you're having brain fog is because your hot splashes are
Speaker 2: waking you up.
Speaker 1: At night and you're losing sleep.
Speaker 2: Despite multiple medical journal articles coming out showing pet scans
Speaker 2: all the brain going through menopause.
Speaker 1: Oh that I mean, it's just that kind of mis knowledge,
Speaker 1: I think, and people talking about that as much as they.
Speaker 2: Have, I thought it a narrative that they have that like, listen,
Speaker 2: women are just And then she similar researcher out of
Speaker 2: Australia is like, it's just tough to be a midlife woman.
Speaker 2: It has nothing to do with menopause. This is just
Speaker 2: what women go through at this stage.
Speaker 1: I'm like, no, that's not good enough.
Speaker 2: I was living my I was perfectly fine until I
Speaker 2: hit a certain age. I changed nothing, no stressors, no.
Speaker 1: Diet, no exercise. My body completely changed.
Speaker 2: My brain has to completely check.
Speaker 1: I'm not a doctor. I didn't go to med school.
Speaker 1: It makes sense to me, and so I don't understand
Speaker 1: how it couldn't make sense to much more intelligent people.
Speaker 2: And I started hormone therapy and I got ninety percent better.
Speaker 1: Yep.
Speaker 2: I just gave my body back what I used to have,
Speaker 2: and turns out all those things kind of went away.
Speaker 1: Let's talk about it then, hormone replacement therapy.
Speaker 2: So I look at it as if I had hypothyroidism.
Speaker 2: So if every woman's thyroid tanked at fifty and you
Speaker 2: were born with, you know, all of your thyroid globulin
Speaker 2: cells and they started deteriorating, you know, and then all
Speaker 2: of a sudden at fifty they were gone, no one
Speaker 2: would question you going on thyroid hormones for the rest
Speaker 2: of your life, you know. And why do we do
Speaker 2: this to women? And so menopause hormone therapy is basically
Speaker 2: just giving your body back estrogen, progesterone, and sometimes testosterone
Speaker 2: in levels that were similar to what you would have
Speaker 2: gotten in your pre you know, in your pre menopause years.
Speaker 2: And for me, it's like basically telling my body functions
Speaker 2: to just operate at their usual level because the loss
Speaker 2: of estrogen and tastosterone leads to dysfunction.
Speaker 1: Well it makes sense, but why why did it get
Speaker 1: such a bad wrap?
Speaker 2: Well, okay, so scared in the eighties and nineties, probably
Speaker 2: you know, depending on the numbers, forty to forty four
Speaker 2: percent of women, it was recommended all women should be
Speaker 2: on HRT. Okay, so about forty four percent of women
Speaker 2: chose to be on it. Now, some had hoflashes, some didn't.
Speaker 2: And what they knew from observational data was that women
Speaker 2: tended to have less heart attacks and less death from
Speaker 2: cardiovascular disease or at later ages than women who weren't
Speaker 2: taking HRT that were age matched. But that was an
Speaker 2: observational study. That's not proof. That's just like, hm, why
Speaker 2: is this happening now? The theory was that, well, women
Speaker 2: on HRT tend to be healthier and wealthier because they
Speaker 2: have access to you know, medical doctors more often, and
Speaker 2: maybe it's just an artifact of the healthier, wealthy patient population.
Speaker 2: So let's do this large, randomized controlled study to see
Speaker 2: if hormone therapy will decrease, truly decrease the risk of
Speaker 2: party of vascular disease. So that was the Women's Health
Speaker 2: Initiative billion dollar study thirty seven thousand patients enroll. They
Speaker 2: have two arms, so it was placebo controlled. This is
Speaker 2: like the gold standard study. So at the time, the
Speaker 2: top two prescriptions given were premarent and prempro. Not really
Speaker 2: what we give now, so that that's one caveat the
Speaker 2: only tested one formulation. If you had a uterist, you
Speaker 2: have to have a progestogen, So they gave premaran, which
Speaker 2: is conjugated decoin estrogen and metroxy progesterine estate. Lots of
Speaker 2: big words to say primpro, and then the women who
Speaker 2: had had hysterectomies got premro because you don't need the
Speaker 2: extra progesterone.
Speaker 1: So off they go.
Speaker 2: They see after a couple of years in the estrogen
Speaker 2: plus progestogen arm that the women had a very slight
Speaker 2: increased risk of breast cancer over the placebo group. Okay,
Speaker 2: so it went from h four out of ten thousand
Speaker 2: per year to like seven out of ten thousand per year,
Speaker 2: which so there's relative risk and absolute risk relative risks.
Speaker 2: That was like a twenty five percent increase in relative risk,
Speaker 2: different than the absolute risk which was less than one
Speaker 2: percent per year. Okay, just it depends on how you
Speaker 2: skew the statistics.
Speaker 1: So they halt the.
Speaker 2: Study for that arm. They called press conference, don't release
Speaker 2: the data, don't let any of the doctors review it,
Speaker 2: you know, and say at this press conference, estrogen causes
Speaker 2: breast cancer. We've stopped the study. This is horrible, Okay.
Speaker 2: Every newspaper, every news show was before social media. Front
Speaker 2: page cover was the number one new medical news story
Speaker 2: of two thousand and two. It was my last year
Speaker 2: of training, by the way, I'll never forget this. And
Speaker 2: eighty percent went through their stuff in the trash, stopped
Speaker 2: taking it. I don't want to die, blah blah, blah,
Speaker 2: blah blah. Antidepressants went up four times, sleeping medications went
Speaker 2: up three times, blood pressure medication, cholesterol, all that statins.
Speaker 1: You know.
Speaker 2: The loss of hormone therapy, women had to go on
Speaker 2: polypharmacy to get everything control that hormones used to control.
Speaker 2: The estrogen only arm continued for a couple more years,
Speaker 2: and they did see an increased risk slightly of stroke,
Speaker 2: which we knew. We knew, okay that after the age
Speaker 2: of sixty, if you're on hormone therapy, your risk of
Speaker 2: stroke goes up a little bit. Like, oh my god,
Speaker 2: it caused a stroke. They did not see an improvement
Speaker 2: in cardiovascular disease risk, no improvement. So now the average
Speaker 2: age was sixty three because they're looking for cardiovascular disease
Speaker 2: as an outcome, okay, which is reasonable if you're looking
Speaker 2: for heart disease. Get it takes time to develop it,
Speaker 2: so much older population than would have really started h RT,
Speaker 2: usually at fifty to fifty one, forty nine, you know,
Speaker 2: somewhere in that age. And they excluded everyone with hot
Speaker 2: flashes because you would know if you had placebo jaw
Speaker 2: flashes get better. So women with hot flashes tend to
Speaker 2: have the you know, really really bad disease. And so
Speaker 2: when with se of your hot flashes, are higher risks
Speaker 2: for other conditions later on. So it was a really
Speaker 2: kind of skewed study. And when they've gone back and
Speaker 2: looked at it the women, they had younger women in
Speaker 2: the st ST. So when they looked at the patients
Speaker 2: who started HRT within ten years of their menopause, they
Speaker 2: did have decreased risk of cardiovascular disease. It was just
Speaker 2: the older patients. So estrogens that turns out, is better
Speaker 2: at prevention than cure. It's very stabilizing to the blood vessels.
Speaker 2: That line our carotid arteries and our hearts is where
Speaker 2: strokes come from and where the alproscorotic disease happens.
Speaker 1: And you know, not to say you'll never.
Speaker 2: Develop those diseases, but it can delay the progression. But
Speaker 2: you must start early, early.
Speaker 1: It turns out in the brain.
Speaker 2: Estrogen is a huge, huge, huge.
Speaker 1: Benefit in the brain.
Speaker 2: But you've got to start kind of early in order
Speaker 2: to see those benefits. At least ten years as well.
Speaker 1: Okay, so what's a number early?
Speaker 2: So right now, the quote is to have the cardiovascular
Speaker 2: preventative and cognitive preventative benefits, So within ten years of
Speaker 2: your menopause or before the age sixty.
Speaker 1: Okay, Now that being said.
Speaker 2: I do start patients now, if you've turned sixty and
Speaker 2: you're on HRT and you're doing great, and you have
Speaker 2: no risk.
Speaker 1: Factors, you can keep going. There's no age at which you.
Speaker 2: Have to see.
Speaker 1: You don't have to stop it if you're sixty, no, okay,
Speaker 1: you can continue those preventative benefits.
Speaker 2: But if you already have severe athloskrotic disease, estrogen is
Speaker 2: not going to make it better, okay, And some people
Speaker 2: think it may make it worse. So in my patients
Speaker 2: like above sixty with risk factors, I'm getting a calcium
Speaker 2: cardiac score and like extensive testing to see if they
Speaker 2: have disease. I don't want to add estrogen on top
Speaker 2: for you know, potentially making that disease worse.
Speaker 1: Right, Okay, I heard today. I've known this before a
Speaker 1: friend of mine has a company, but I heard today
Speaker 1: in the news about estrogen in the form of a
Speaker 1: vaginal topical ointment being used.
Speaker 2: On the face.
Speaker 1: This on the face, I think natural about is my friend.
Speaker 2: So I've been using topical estrogen.
Speaker 1: What's it called estra deal how do you say it?
Speaker 1: Estra dial estradiyle sore.
Speaker 2: There's two forms that have been tested. There's estriol, so estrogen.
Speaker 2: Vaginal cream is typically estra dial point zero one percent
Speaker 2: or yeaer point oh one percent vaginal cream.
Speaker 1: And that's something someone's supposed to just rub on their
Speaker 1: vagina and it's to absorb.
Speaker 2: So that's for the treatment of vaginal atrophy and it
Speaker 2: works beautifully. Well, Okay, some people have been putting it
Speaker 2: on their face as well, and they've actually done studies
Speaker 2: with the topical estrogen. This is a very very low dose.
Speaker 2: This is not the estrogen that you would get the
Speaker 2: cream and the sprays and everything for systemic therapy. This
Speaker 2: is a much lower percentage. They tested the blood levels
Speaker 2: of women putting it on their vaginas and on their faces,
Speaker 2: and there's no systemic absorption, so there's no worries about
Speaker 2: block clots or any of that, or endimatoral cancer, none
Speaker 2: of that. Okay, as long as you use that preparation
Speaker 2: meant for the vagina, the low low dose, the low
Speaker 2: low dose and estreol cream, which is another form of estrogen.
Speaker 2: It's actually the estrogen that's created in our placinas when
Speaker 2: we're pregnant, and so they've been able to synthesize that
Speaker 2: and the estray All cream get used on the face
Speaker 2: as well with some similar efficacy, and those are usually compounded.
Speaker 2: So that's the one that I've been using because my
Speaker 2: friend's company made it and I was like, yeah, yeah,
Speaker 2: I'll try it. She sent me one for free. I
Speaker 2: fell in love with it, and of course now I
Speaker 2: just buy it so I can talk about it without
Speaker 2: having to say sponsored no, this is good.
Speaker 1: I mean, it's a conversation that's been going on, but
Speaker 1: now it seems like it's becoming public and I think
Speaker 1: everybody's going to be talking about it.
Speaker 2: Don't skip the vagina if you're you know, people are like, well,
Speaker 2: I'm just trying to down there. I'm like, no, please,
Speaker 2: you know she's staged it down there.
Speaker 1: That's the health part. This is cosmetic. Yes, we talked
Speaker 1: a lot about symptoms. Hot flashes obviously that's like the
Speaker 1: no brainer symptom. But brain fog, you know, it's just
Speaker 1: like when you have postpartum, when you just had your
Speaker 1: baby and your hormones are gone, whack a dooodle. It's
Speaker 1: a silence like misery, and nobody knows what's going on
Speaker 1: in you, but you I feel like the brain fog
Speaker 1: is another just silent struggle that people don't understand because
Speaker 1: I mean, it happens to me at least three times
Speaker 1: a day where I walk into a room and I
Speaker 1: have no idea why I'm in there. That's brain fog.
Speaker 2: M yeah. Or you can't find a word, or you
Speaker 2: you know, can't remember a name or you know, in
Speaker 2: these these things that will happen to us from time
Speaker 2: to time. But when it becomes a pattern and all
Speaker 2: of a sudden, you're questioning your judgment. One in five
Speaker 2: women are quitting their jobs at our age because of this.
Speaker 2: It's so bad, especially since they feel inadequate positions who
Speaker 2: require lots of cognitive ability. You know, our missions are
Speaker 2: they are really struggling and like not and hitting a wall,
Speaker 2: hitting a wall at work.
Speaker 1: It's scary.
Speaker 2: It's so scary, and you know we're losing that. Mckensey
Speaker 2: company just did this incredible report looking at lost economic
Speaker 2: the economic impact of these women who are supposed to
Speaker 2: be leading companies who can't do it. You know, twenty
Speaker 2: percent of women walk away not because of an aging
Speaker 2: payriner stuff. They can't they don't want to be up.
Speaker 2: You know, they can't do their job confidently.
Speaker 1: Is there a correlation between brain fog and early onset dementia?
Speaker 2: Okay, so we all tend to have cognitive decline okay
Speaker 2: in early in perimenopause and early menopause, and then for
Speaker 2: those of us not on the path to dementia, it recovers.
Speaker 1: Okay later, Oh thank goodness.
Speaker 2: It does tend to recover. You will never quite be
Speaker 2: where you were, but it does. The brain rewires, you know,
Speaker 2: from the lack of estrogen, and then you learn how
Speaker 2: to kind of compensate for it. Okay, that brain keeps
Speaker 2: going unless you're on the Alzheimer dementia spectrum, and you
Speaker 2: can keep going down. So, you know, the greatest book
Speaker 2: written on this, and a brand new article just came out.
Speaker 2: Lisa Musconi wrote The Menopause Brain. When she's a neuroscientist
Speaker 2: out of will Cornell and she does pet scan after
Speaker 2: pet scan of women's brains in different levels of menopause
Speaker 2: and it's absolutely fascinating and it's just so validating. You know,
Speaker 2: it's almost like I don't care if it's fixed at
Speaker 2: this point, like at least I know I'm not nuts,
Speaker 2: and you know, but she says, Alzheimer's is a disease
Speaker 2: with symptoms of in old age, but it begins in
Speaker 2: the life and menopause accelerates the deposition of the plex.
Speaker 1: Yeah, it's a shame.
Speaker 2: But even with the APO E four gene HRT, like
Speaker 2: women on HRT.
Speaker 1: Have involume better scores and women not what you call
Speaker 1: it the APO.
Speaker 2: So there's a APO E four I think gene which
Speaker 2: is the genetic marker for Alzheimer's, Alzheimer's.
Speaker 1: And even people.
Speaker 2: So they studied that group and there was a few
Speaker 2: of the women who actually got put on HRT for
Speaker 2: hot flashes, and they had bigger brain volumes and better
Speaker 2: cognition scores than their age match women, you know when
Speaker 2: they started young, than the women who never got HRT
Speaker 2: with the genetic predisposition.
Speaker 1: It's so fascinating. Bodies are so crazy facinating. Wow, I
Speaker 1: totally get it. Why you became a doctor. Loss of sleep,
Speaker 1: that's another huge I had a lot of loss of sleep,
Speaker 1: and that is what was the final driving factor. Combined
Speaker 1: with the hot flashes of the marine fog. I guess
Speaker 1: they'll go together. But I said, I can't lose my sleep,
Speaker 1: and I'm not sleeping. I just wake up like five
Speaker 1: times a night, whether it's from a hot flash or
Speaker 1: just because. And that's why I decided to go on estrogen.
Speaker 1: Why are we losing our sleep? Is it because of
Speaker 1: the hot flashes? Few reasons. The hot flashes are just
Speaker 1: sleep disruptive.
Speaker 2: They'll wake you up right right. So, but even though
Speaker 2: we can get those under control, women are still struggling
Speaker 2: to sleep, not as much as before. So with the anxiety,
Speaker 2: if someone is on the spectrum of their anxieties getting
Speaker 2: higher in the racing thoughts at night.
Speaker 1: That's one of the things.
Speaker 2: Progesterone works incredibly well for that, or that three am
Speaker 2: wake up and then you can't shut your ain off
Speaker 2: to go back to sleep.
Speaker 1: Progesterone works for that. The other thing is our bladders
Speaker 1: can wake us up.
Speaker 2: So if you're having irritable bladder or you're having you know,
Speaker 2: incontinence or bladder spasms, then you know, vaginal estrogen can
Speaker 2: do a beautiful job here of calming all that tissue
Speaker 2: down so that you can sleep through that disruption. But
Speaker 2: for my patients who you know, we've gotten the hot
Speaker 2: flashes under control and she's still struggling, you know, with
Speaker 2: the wake ups or the racing thoughts, progesterone we can
Speaker 2: you know, you can go up to three and even
Speaker 2: four hundred milligrams a night for that. The other thing
Speaker 2: is if I choose to drink, and this is most
Speaker 2: of my patients, if I choose alcohol, I am choosing
Speaker 2: not to sleep. There's no way around it for.
Speaker 1: Me, I know, man. And then there's just that's not
Speaker 1: a decision you have to make because I'd rather sleep
Speaker 1: than have a glass of wine. Yeah, I'd rather wake
Speaker 1: up refreshed, yeah, yeah, and I'm sad because I'd love
Speaker 1: to just you know, have wine or drink like my friends.
Speaker 1: But I know how it affects me.
Speaker 2: Yeah, so I have good I have really serious conversations
Speaker 2: with my patients, like I can't fix this. We don't
Speaker 2: know what you know, no one studied this yet. We
Speaker 2: know it's happening, you know. And it could be that
Speaker 2: our body composition is changing and.
Speaker 1: Getting to cut out of your life.
Speaker 2: And there's really no medical benefit to it.
Speaker 1: I mean, it's boyson. We can work on other ways
Speaker 1: to stress release. So yeah, yes, please, let's talk about
Speaker 1: this Hypoactive sexual desire disorder. Yeah probably aka low libido,
Speaker 1: AKA I'm not in the mood. There's many ways, so
Speaker 1: we can sumb that one up.
Speaker 2: Fifty percent of my patients have HSDD and it's it's
Speaker 2: very very common. So hypoactive sexual desires source. So when
Speaker 2: a woman comes in and I screen all my patients
Speaker 2: for this, when they hit the door, my I have
Speaker 2: low libido. There's kind of a medical checklist we have
Speaker 2: to go through. Are you having pain? Okay? So when
Speaker 2: we look at the buckets of why a woman's sexual
Speaker 2: function is not where she wants it to be. One
Speaker 2: is relationship disorder.
Speaker 1: I'm not going to fix.
Speaker 2: That, you know, Yeah, do you have a supportive partner?
Speaker 2: You know, if when you're by yourself you're happy, and
Speaker 2: when you're with this person there's zero interest. That's you know,
Speaker 2: that's a counseling issue or whatever. That's you know here, no, no, no,
Speaker 2: I love him. I w you know.
Speaker 1: Did you ever have a great desire?
Speaker 2: Yes? I used to, and it's just gone. I can't
Speaker 2: seem to make it come back. I'm like, Okay, are
Speaker 2: you having pain?
Speaker 1: Yes or no?
Speaker 2: And we have to fix that, get to the bottom
Speaker 2: of that. Then there's arousal disorders, which are not that
Speaker 2: common in women that they can happen, and orgasmic disorders.
Speaker 2: So arousal disorder is you're struggling to get blood flow
Speaker 2: to the area your brain saying yes, but nothing's happening
Speaker 2: in the pelvis. Okay, that's where female viagra can come
Speaker 2: into play, because that will increase just like in a man.
Speaker 2: It will increase blood flow to the genitalia and kind
Speaker 2: of get things moving in that direction, but it's not
Speaker 2: going to do anything for your brain.
Speaker 1: Wait, what's female viagra? Is it called viagraf.
Speaker 2: Yeah, okay, giving a woman viagra can help with that,
Speaker 2: and sometimes they just put the pill in the vagina
Speaker 2: and let it dissolve and work there. Oh. The other
Speaker 2: is orgasmic disorder, and you know, like ten percent of
Speaker 2: women never ever ever have orgasms and their lives. And
Speaker 2: you know if that was men, wouldn't this be a
Speaker 2: national emergency?
Speaker 1: We would have heard about it.
Speaker 2: And so there's primary and secretary, so you know, we
Speaker 2: get to the bottom of that. Then what's left is
Speaker 2: HSDD hypoactive sexual desire disorder. Basically like love this person, right,
Speaker 2: everything's great in my life. I can't figure out why
Speaker 2: I can't get the signal up here. There's some medications
Speaker 2: that work really well for that. So there's two FDA
Speaker 2: approved medications. One is Addie, which is the pill you
Speaker 2: take every day. It works at the level of neuro receptors.
Speaker 2: Great story on how long it took for them to
Speaker 2: get past the FDA compared to viagra, which took like
Speaker 2: thirty seven minutes.
Speaker 1: Okay, oh my god, story Cindy Ekkerd.
Speaker 2: You have to listen to her. She's amazing. Then there's
Speaker 2: v Lasi, which is an injection that you give yourself
Speaker 2: thirty minutes before.
Speaker 1: But some patients who does.
Speaker 2: Well, they love it. It works on Milana Courton and you know,
Speaker 2: kind of opens up things in the brain there.
Speaker 1: Where do you inject it anywhere?
Speaker 2: Okay, usually an ADAM and most people just grab the
Speaker 2: scin and pop it in and you just wait and
Speaker 2: then you wait thirty minutes. And then there's testosterone which works.
Speaker 2: That's works the best, but unfortunately we don't have an
Speaker 2: FDA proved medication. It works and postmona balls with women beautifully,
Speaker 2: and so probably half of my patients end up on testosterone.
Speaker 2: As long as you give it in physiologic doses, then
Speaker 2: they usually don't have a lot of side effects and
Speaker 2: we're just restoring their levels and they're so happy. It also,
Speaker 2: you know, has very promising research on brain function on
Speaker 2: But there's just a sasterm receptors everywhere. And when my
Speaker 2: patients come in and they are sycopenic because I have
Speaker 2: a body scanner in my office, or they have local density,
Speaker 2: you know, peniostioporosis, I'm using it in their toolkit of
Speaker 2: how are we going to get your bone stronger, you know,
Speaker 2: or keep your bone strong of you know, resistance training, protein,
Speaker 2: the weighted vest, all that plus testosterone. So most of
Speaker 2: my patients when we go through the options, choose testosterone
Speaker 2: because it seems to have multiple benefits.
Speaker 1: And can you be on estrogen, progesterone, and testosterone. Yeah,
Speaker 1: we call it the megapack. That's like a dream come try.
Speaker 1: I'm on all three. Yeah, wow, I got to get
Speaker 1: on that train. I've seen you before with your weighted vest.
Speaker 1: What the heck is happening with that?
Speaker 2: So there's great studies there. You know, women our a
Speaker 2: genteralder are rarely studied. It's really sad, but there are
Speaker 2: actually some really nice studies looking on women and men
Speaker 2: in long term care facilities, measuring muscle and bone strength
Speaker 2: and all the tools that they used. So I call
Speaker 2: it my osteoporsus Prevention pack. And because you know you
Speaker 2: fall and break a head, you dead. Thirty percent of
Speaker 2: us will die even with surgery in a year after
Speaker 2: the age of sixty five.
Speaker 1: That's in nine years for me.
Speaker 2: That's not good.
Speaker 1: That's coming up.
Speaker 2: So you know, I'm doing everything I can. So the
Speaker 2: weighted vest is just a hack. I'm actually going to
Speaker 2: develop one with QVC. I love this. I'm in line
Speaker 2: because I have one and I love it, but it
Speaker 2: doesn't fit over the when women's chests very well. They
Speaker 2: were made for men as per us, and so I
Speaker 2: want to make one where we can kind of slide
Speaker 2: the stuff around and fit around our girl parts.
Speaker 1: So, God, you, I'm so excited for you to come
Speaker 1: to the queue with all your packs, all your things.
Speaker 1: It's going to be really great. So that's just like
Speaker 1: a weighted thing that you do. You wear that like hiking,
Speaker 1: working out.
Speaker 2: Yeah, so I tell my patients. Start wearing it around
Speaker 2: the house, doing housework, walk the dog, you know, until
Speaker 2: you start with about ten percent of your body weight,
Speaker 2: so you know, twelve rounds or fifty nothing crazy. And
Speaker 2: then as you get stronger, you wear it more and more.
Speaker 2: I now wear it when I'm working out, like and
Speaker 2: I also I turn my treadmill into a walking desk
Speaker 2: and so I'll put the desk on an encline, throw
Speaker 2: on my weight to vest and I'm doing research or
Speaker 2: doing zoom calls for work not not a podcast.
Speaker 1: But yeah, you're not doing it right now. No, how
Speaker 1: high are you is your weight up to?
Speaker 2: Oh? Of course my husband got into it. So now
Speaker 2: we have eight which no one wears anymore. We have twelve, fifteen, twenty,
Speaker 2: twenty five, thirty, and thirty five.
Speaker 1: So he wears the heavier ones.
Speaker 2: Every once in a while, I'll put the heavier one
Speaker 2: just to feel, but I'll take it off in like
Speaker 2: thirty minutes.
Speaker 1: So that is great though, What a way to strengthen yourself,
Speaker 1: I mean, just overall.
Speaker 2: So the studies showed improved bondensity and improved muscle strength
Speaker 2: and improved balance.
Speaker 1: So that's so important for us to decrease risk. You
Speaker 1: know what I'm obsessed with right now. Stretching. Yeah, I
Speaker 1: cannot get enough of it. Every night, I lay in
Speaker 1: front of the TV on the floor, I put my
Speaker 1: little yoga mat down and my dogs come around and
Speaker 1: we stretch, and like, I get into every joint because
Speaker 1: I I feel like when you get sedentary and your
Speaker 1: joints lock up, they get rusty, you know.
Speaker 2: I mean, there's there's data showing stretching decreases the risk
Speaker 2: of falls because you're your decreasing motion if you don't stretch.
Speaker 1: Can we go back for one second about the balbido thing.
Speaker 1: How can we get our partners to be understanding or
Speaker 1: compassionate or I don't even know what the right word is.
Speaker 1: But it's a challenge because they don't understand what's happening
Speaker 1: right and we ourselves don't understand exactly what's happening.
Speaker 2: Some of the most impassioned letters I get our DMS
Speaker 2: are from partners. Help me help her how you know,
Speaker 2: And I'm like, educate yourself so that you can understand
Speaker 2: what she's going through. And this is not her fault.
Speaker 2: She is in there and she still loves you more
Speaker 2: than likely, you know, but she isn't likely. She is
Speaker 2: going through a cataclysmic change right now, and none of
Speaker 2: this is your fault. And so here are the ways
Speaker 2: to support her.
Speaker 1: Go with her.
Speaker 2: I mean, the study is showing that when the men
Speaker 2: go with the women to the doctor, they're much more
Speaker 2: likely to be believed and get therapy. Absolutely, then if
Speaker 2: and then help her find a menopause educated provider so
Speaker 2: that you can have you guys can have an informed
Speaker 2: conversation about her healthcare.
Speaker 1: I love that it's just about supporting her. I mean,
Speaker 1: if something were to happen to your spouse physically, you
Speaker 1: would support them automatically. So this is just something that
Speaker 1: needs to be on the partner's radars. For sure, for sure,
Speaker 1: I did want to talk about you are a mother
Speaker 1: of two. I am a mother of three daughters as well,
Speaker 1: and I just want to know, Okay, so our moms
Speaker 1: and grandma's weren't talking about it. Now our daughters are
Speaker 1: starting to hear us talk about it. It's becoming less
Speaker 1: taboo to talk about what can we do to help
Speaker 1: them not be afraid of it, to not be you know,
Speaker 1: to not be so fearful of it.
Speaker 2: So I have this what I would tell myself at
Speaker 2: thirty five. So these are like the tenets I try
Speaker 2: to teach them. But again, they're prone to social media
Speaker 2: and you have societal expectations. My oldest is in medical
Speaker 2: school now, so she's you know a little radicalized for
Speaker 2: menopausecare because of me. And my youngest is twenty in
Speaker 2: college and she's actually interning for a menopause telemedicine company
Speaker 2: this summer. So again, my kids are not the normal.
Speaker 1: No, they're going to carry on though, they're going to help. No,
Speaker 1: But my daughter what.
Speaker 2: I would tell, you know, what things I would the
Speaker 2: tenants I would try to teach my children, you know,
Speaker 2: or teach the next generation strong over skinny. Okay, yes,
Speaker 2: you know, moving your body to be strong and not
Speaker 2: thin is key here because we're going to you know,
Speaker 2: trying to get that in their head that they're going
Speaker 2: to reach a maximum muscle and moon strength around age thirty,
Speaker 2: and then age is going to start trying to take
Speaker 2: it away from us and aging process, and then that
Speaker 2: accelerates in menopause. So so these habits of getting this
Speaker 2: stuff down now, of moving your body for strength and
Speaker 2: our strong brain and a strong heart and strong muscles
Speaker 2: and strong bones, you can do that now and not
Speaker 2: just focused on cardio to be skinny is going to
Speaker 2: serve you so much better.
Speaker 1: Nutrition over calories, this.
Speaker 2: Obsessive you know, calorie counting, it's not helping us. It's
Speaker 2: not helping you know, still living with you know, incredible
Speaker 2: levels more but obesity, and you know, really looking at
Speaker 2: their nutrition. You know, how much magnesium are you getting,
Speaker 2: how much fiber, how much protein? These are the things
Speaker 2: I talked to my kid about. How much sugar is
Speaker 2: in that are you know, like like trying to fill
Speaker 2: your like trying to eat more instead of being so
Speaker 2: restrictive and then educate learning about this is a natural
Speaker 2: phase of life. Shouldn't be scared of it, but it
Speaker 2: is going to happen, and it can affect you. And
Speaker 2: kind of here's what happened to mom. You know you
Speaker 2: watched me go through it. My older daughter now says,
Speaker 2: I guess it was kind of not fair that I
Speaker 2: was a teenager. I was the teenager I was, and
Speaker 2: you were going through very menopause at the same, right.
Speaker 1: If they only knew, So she knows now.
Speaker 2: And I look back at that, Mary Claire, I'm like,
Speaker 2: oh my god, oh my god. Yeah, who buying off
Speaker 2: the handle?
Speaker 1: Uh huh dark, But look how much better we are now.
Speaker 2: Yeah.
Speaker 1: Yeah, tell me though about that. You are a certified
Speaker 1: culinary medicine specialist, so that goes hand in hand with
Speaker 1: that giving the right nutritional messages.
Speaker 2: So when I decided to like, I was like, I'm
Speaker 2: going to fix this menopause fat problem, weight gain whatever.
Speaker 2: I didn't even know about visceral fat. I just thought
Speaker 2: fat was fat.
Speaker 1: So I enrolled in this.
Speaker 2: I wanted to get a master's in nutrition, and again
Speaker 2: I was at a university and one of the professors
Speaker 2: was like, well, there's this culinary medicine program that's popped
Speaker 2: up and there's a professor at Tulane who's running it.
Speaker 2: You know, you probably could 'en roll in that. It
Speaker 2: looks like it's going to give you all the basics
Speaker 2: you need without having to like enroll in a university
Speaker 2: while you're a teaching professor like that.
Speaker 1: It was too hard.
Speaker 2: Yeah, Like okay, so I learned so much. We didn't
Speaker 2: learn much nutrition in medical school hardly, like scratch the surface.
Speaker 2: This was like the best thing I ever did about
Speaker 2: you know, the blue zone and Mediterranean and dietary patterns
Speaker 2: and how you know. It was just incredible, and so
Speaker 2: I wrapped up all of that to like create the
Speaker 2: Galveston Diet, my first book for my patients and followers,
Speaker 2: and then it turned into a book and a thing.
Speaker 2: But quickly as soon as I wrote that, I was
Speaker 2: you know, sharing on social media about it, and people
Speaker 2: were asking me more and more menopause questions in general.
Speaker 2: So then I, you know, I'm curious, so I just
Speaker 2: keep researching, and that's how Pause came about.
Speaker 1: Yeah, I mean, the connection with food and the sugar
Speaker 1: and the like what you were saying right now, I'm
Speaker 1: just it's all about for me, protein intake and fiber
Speaker 1: intake same.
Speaker 2: I look at my plate and it's like protein plants,
Speaker 2: you know, and.
Speaker 1: How much of that is fiber?
Speaker 2: So right, I just made a huge smat of like
Speaker 2: beans with ground turkey, and that's like our meal prep
Speaker 2: for the week. You know, we can munch on it whenever,
Speaker 2: and I know I'm going on hand and my fiber exactly.
Speaker 1: Well, I feel like we've talked about so many great things.
Speaker 1: You have been doing the circuit, talking so much about
Speaker 1: menopause and your new book, and you've just been doing
Speaker 1: such a great jobs. Is there anything that you ever
Speaker 1: would think like, Oh, I wish we could just talk
Speaker 1: a little bit about that.
Speaker 2: You know, just menopause is inevitable, but suffering is not.
Speaker 2: And the more we normalize this and talk about it
Speaker 2: in our own unique experiences, and the more the world's
Speaker 2: going to pay attention, because I think they're paying attention now.
Speaker 1: They are now.
Speaker 2: It's like getting our legislators and our you know, government agencies,
Speaker 2: and our medical schools and stuff.
Speaker 1: To like get on board.
Speaker 2: We're probably twenty years away from like our daughters being
Speaker 2: able to confidently walk into a clinician's office and discuss
Speaker 2: their menopause and have adequate care. So it's it's just,
Speaker 2: you know, we have to fill in the gaps for now.
Speaker 1: Oh my god. It just makes me so excited, though.
Speaker 1: I have to throw my cards up because the work
Speaker 1: you're doing is so important to our generation, our daughters,
Speaker 1: our granddaughters. I just I'm so motivated by you and inspired,
Speaker 1: and I'm glad that we met at the Q fifty.
Speaker 2: Yeah, that was awesome.
Speaker 1: Before we go, I want to ask you, what was
Speaker 1: your last I choose me moment?
Speaker 2: You know, I've had to put up boundaries in relationships
Speaker 2: and it's okay. I have to put my own mental
Speaker 2: health first. And you know, it doesn't mean I don't
Speaker 2: love someone or whatever, but in order to live my
Speaker 2: best life and be the person I want to be,
Speaker 2: sometimes I have to say no and put up a
Speaker 2: boundary where I'm not going to let this affect me
Speaker 2: or I'm not going to get involved in that drama.
Speaker 2: And that is one of the most powerful things of
Speaker 2: my metopause, is just having no guilt or shame about that.
Speaker 1: I love that. Well, thank you, doctor Haber, You're welcome.
Speaker 1: Oh how I love her. That conversation with doctor Mary
Speaker 1: Claire Haveer was so interesting. And honestly, it just gives
Speaker 1: me so much hope. I feel inspired and I feel heard.
Speaker 1: I'm just I'm so grateful that she came on the
Speaker 1: podcast and gave us all this information. Menopause is something
Speaker 1: that half the population is going to go through, and
Speaker 1: I'm just really happy to be a part of the
Speaker 1: conversation and to use my platform to destigmatize this because
Speaker 1: it's something as women we shouldn't be ashamed to talk about.
Speaker 1: So as we continue to choose ourselves each week, this week,
Speaker 1: I want to encourage you to have a conversation with
Speaker 1: another woman in your life, your mother, your best friend,
Speaker 1: your sister, your partner, about menopause. What do they know
Speaker 1: about it? Are they in it? How was it, what
Speaker 1: was their experience? Did they feel alone? How did they
Speaker 1: handle it? As women, we talk about a lot of
Speaker 1: things we go through, So why don't we talk about
Speaker 1: the menopause chapter. Let's just all do our part to
Speaker 1: amplify this topic, and it starts right here by talking
Speaker 1: about it with each other. I love you, Thanks for
Speaker 1: listening to I Choose Me. You can check out all
Speaker 1: our social links and doctor Mary Claire Haver's info in
Speaker 1: our show notes. Make sure to follow, rate, and review
Speaker 1: the podcast, and use the hashtag I Choose Me. I'll
Speaker 1: be right here next week, and I hope you choose
Speaker 1: to be here too,