1 00:00:04,120 --> 00:00:06,080 Speaker 1: What do you do when life doesn't go according to 2 00:00:06,200 --> 00:00:09,760 Speaker 1: plan that moment you lose a job, or a loved one, 3 00:00:10,280 --> 00:00:14,080 Speaker 1: or even a piece of yourself. I'm Brookshields and this 4 00:00:14,560 --> 00:00:18,759 Speaker 1: is now What, a podcast about pivotal moments as told 5 00:00:18,760 --> 00:00:21,600 Speaker 1: by people who lived them. Each week, I sit down 6 00:00:21,600 --> 00:00:23,840 Speaker 1: with a guest to talk about the times they were 7 00:00:23,920 --> 00:00:26,920 Speaker 1: knocked off course and what they did to move forward. 8 00:00:27,880 --> 00:00:33,080 Speaker 1: Some stories are funny, others are gut wrenching, but all 9 00:00:33,360 --> 00:00:38,320 Speaker 1: are unapologetically human and remind us that every success and 10 00:00:38,479 --> 00:00:42,800 Speaker 1: every setback is accompanied by a choice, and that choice 11 00:00:43,000 --> 00:00:51,080 Speaker 1: answers one question, now what. I just was looking at 12 00:00:51,680 --> 00:00:54,640 Speaker 1: the what to expect when you're expecting books, but I 13 00:00:54,680 --> 00:00:57,760 Speaker 1: was looking at the journey of them. Yeah, the drawing, 14 00:00:57,840 --> 00:01:03,640 Speaker 1: yeah yeah, yeah yeah, it's unabelievable. I'm writing about all this, 15 00:01:03,760 --> 00:01:06,119 Speaker 1: and so it's just it's so fascinating to me because 16 00:01:06,160 --> 00:01:09,160 Speaker 1: I was like, look, how miserable this person looks, Yeah, 17 00:01:09,640 --> 00:01:14,160 Speaker 1: rocking chair with like sensible shoes. I'm like, what is happening? 18 00:01:14,200 --> 00:01:16,480 Speaker 1: But you know they have no concept also of the 19 00:01:16,560 --> 00:01:20,640 Speaker 1: mental health struggles and so rough, your nipples hurt, you 20 00:01:20,680 --> 00:01:25,360 Speaker 1: can't poop, you haven't slept, you feel disgusting. You're sweaty. 21 00:01:25,440 --> 00:01:28,840 Speaker 1: Did you shower this week? I mean, nothing works. You're 22 00:01:28,959 --> 00:01:32,080 Speaker 1: so freaking tired, you want to die, and you're supposed 23 00:01:32,080 --> 00:01:34,520 Speaker 1: to keep another human alive. I mean that is a 24 00:01:34,560 --> 00:01:38,080 Speaker 1: disaster area. And I had everything going for me, so 25 00:01:38,240 --> 00:01:43,440 Speaker 1: I don't even know how people do it. My guest 26 00:01:43,480 --> 00:01:49,520 Speaker 1: today is doctor Susanne Gilberg Lens. Doctor Suzanne is a gynecologist, 27 00:01:49,600 --> 00:01:53,840 Speaker 1: a woman's health expert and advocate, and an authority on 28 00:01:53,840 --> 00:01:57,720 Speaker 1: one of the biggest now what moments in many of 29 00:01:57,720 --> 00:02:02,400 Speaker 1: our lives, menopause. She literally wrote the book on it 30 00:02:02,720 --> 00:02:06,600 Speaker 1: and created a program called Menopause boot Camp to help 31 00:02:06,640 --> 00:02:10,320 Speaker 1: women better understand the transition. She worked with women of 32 00:02:10,400 --> 00:02:13,280 Speaker 1: all ages for more than two decades, and I reached 33 00:02:13,320 --> 00:02:15,840 Speaker 1: out to her because I wanted to talk about what 34 00:02:16,000 --> 00:02:19,200 Speaker 1: she's observed during that time and how all of us, 35 00:02:19,240 --> 00:02:22,880 Speaker 1: regardless of our age, can be better advocates for our 36 00:02:23,160 --> 00:02:27,200 Speaker 1: physical and mental health. I'm thrill that she agreed to 37 00:02:27,240 --> 00:02:29,680 Speaker 1: do this show, and I'm grateful to be able to 38 00:02:29,680 --> 00:02:33,640 Speaker 1: share her wisdom with you all. Here is doctor Susanne 39 00:02:33,800 --> 00:02:42,320 Speaker 1: Gilberg Lenz. Hi, there, it is so nice to meet too. Oh, 40 00:02:42,800 --> 00:02:44,680 Speaker 1: thank you so much. It's such an honor for me. 41 00:02:44,960 --> 00:02:48,280 Speaker 1: It's so important, and I love having these conversations. Thank you, 42 00:02:48,520 --> 00:02:51,680 Speaker 1: Thank you for having me on. I've been wanting to 43 00:02:51,760 --> 00:02:54,919 Speaker 1: do an episode just that is focused on women's health 44 00:02:55,320 --> 00:02:57,880 Speaker 1: for a while now. I mean, I've talked about my 45 00:02:58,000 --> 00:03:02,320 Speaker 1: own health issues and STRUG in my books, but something 46 00:03:02,360 --> 00:03:04,640 Speaker 1: that struck me in preparing for this interview was the 47 00:03:04,760 --> 00:03:09,520 Speaker 1: general lack of knowledge on women's health. Why do you 48 00:03:09,560 --> 00:03:13,240 Speaker 1: think it's remained practically taboo. I'm going to use this 49 00:03:13,360 --> 00:03:18,880 Speaker 1: word because the patriarchy and menopause specifically, is I like 50 00:03:18,960 --> 00:03:21,480 Speaker 1: to say, is you know, misogyny and agism had a 51 00:03:21,520 --> 00:03:24,799 Speaker 1: baby and they called it menopause. You know, I'm full 52 00:03:24,840 --> 00:03:27,359 Speaker 1: of these little aphorisms, but I will tell you that 53 00:03:27,639 --> 00:03:31,640 Speaker 1: during medical school, I came in thinking I was interested 54 00:03:31,680 --> 00:03:35,560 Speaker 1: in women's health, and I really tried to convince myself 55 00:03:35,600 --> 00:03:38,280 Speaker 1: otherwise because I felt like obstetrics was probably going to 56 00:03:38,320 --> 00:03:40,320 Speaker 1: be hard, and I was right, But I couldn't convince 57 00:03:40,360 --> 00:03:44,200 Speaker 1: myself otherwise. So why did I love it? I loved 58 00:03:44,920 --> 00:03:47,400 Speaker 1: the opportunity to get to know people over the course 59 00:03:47,440 --> 00:03:51,400 Speaker 1: of their lives. I loved development and physiology and normal 60 00:03:51,440 --> 00:03:54,280 Speaker 1: stuff and how to help people through these transitions in 61 00:03:54,360 --> 00:03:57,840 Speaker 1: these crisis. Yes, I love medicine. I love the operating 62 00:03:57,920 --> 00:04:00,960 Speaker 1: room I get to operate, and delivering babies has been magical. 63 00:04:01,800 --> 00:04:03,720 Speaker 1: Why do I think we don't know about it? I 64 00:04:03,760 --> 00:04:08,160 Speaker 1: think that the way our medical training system grew up, 65 00:04:08,280 --> 00:04:10,640 Speaker 1: it grew up in an era where women were like 66 00:04:11,160 --> 00:04:15,720 Speaker 1: considered other small men with ovaries. I don't know, like 67 00:04:15,880 --> 00:04:20,000 Speaker 1: they just women are not thought of as our own entity. 68 00:04:20,360 --> 00:04:24,960 Speaker 1: And you know, we have some magical powers, or appear 69 00:04:25,040 --> 00:04:30,040 Speaker 1: to because they are mysterious. They are scary rather than 70 00:04:30,120 --> 00:04:32,960 Speaker 1: being seen for what they are, which is like an 71 00:04:33,000 --> 00:04:37,080 Speaker 1: amazing gift, just like men have amazing gifts. Human beings 72 00:04:37,279 --> 00:04:41,520 Speaker 1: have amazing gifts whatever their gender is. But physiologically we 73 00:04:41,760 --> 00:04:46,159 Speaker 1: are able to carry babies and deliver them out into 74 00:04:46,160 --> 00:04:49,880 Speaker 1: the world and keep them fed yep, and keep them alive. 75 00:04:50,120 --> 00:04:53,800 Speaker 1: And in keeping with what we're talking about, society itself 76 00:04:53,839 --> 00:04:58,239 Speaker 1: has normalized female pain. Oh yeah, they don't tell us 77 00:04:58,400 --> 00:05:01,240 Speaker 1: that you know IVF will pain or do you know 78 00:05:01,279 --> 00:05:05,559 Speaker 1: gynecological procedures could be painful? That all of these things happen? 79 00:05:05,640 --> 00:05:07,839 Speaker 1: You know? So how do you how do you with 80 00:05:07,920 --> 00:05:11,680 Speaker 1: your patients approach like pain? And discomfort in your own practice. 81 00:05:11,680 --> 00:05:14,240 Speaker 1: How do you talk about such a good question? And 82 00:05:14,279 --> 00:05:16,080 Speaker 1: I will tell you that it is definitely one of 83 00:05:16,080 --> 00:05:18,279 Speaker 1: the questions of the moments right now on social media, 84 00:05:18,760 --> 00:05:21,560 Speaker 1: such an interesting and complicated thing, because I will say 85 00:05:21,600 --> 00:05:24,440 Speaker 1: that I also feel that there's been sort of this 86 00:05:24,800 --> 00:05:27,719 Speaker 1: uh celebration of pain around birth, as if it's some 87 00:05:27,839 --> 00:05:32,320 Speaker 1: kind of badge of honor, like as if growing that 88 00:05:32,360 --> 00:05:35,240 Speaker 1: fetus and you know, birthing a baby isn't enough. And 89 00:05:35,320 --> 00:05:37,360 Speaker 1: I'm not saying that nature isn't a miracle, and I'm 90 00:05:37,400 --> 00:05:40,680 Speaker 1: not saying that physiologic, unmedicated birth isn't an option for 91 00:05:40,760 --> 00:05:44,280 Speaker 1: a person who wants it. And I support people's desires 92 00:05:44,320 --> 00:05:47,480 Speaker 1: to do things the way they want while understanding that 93 00:05:47,520 --> 00:05:49,760 Speaker 1: they don't really always know what's going to happen. I mean, 94 00:05:49,800 --> 00:05:52,120 Speaker 1: that's part of the beauty of birth, by the way, 95 00:05:52,160 --> 00:05:54,960 Speaker 1: is that the surrender into it, right, you don't know 96 00:05:54,960 --> 00:05:57,560 Speaker 1: what's going to happen, forget it, and you forget it, well, yes, 97 00:05:57,640 --> 00:06:00,159 Speaker 1: if you're lucky. So having said that, I think there's 98 00:06:00,160 --> 00:06:03,680 Speaker 1: a weird dichotomy there. I got to tell you to me, 99 00:06:04,240 --> 00:06:06,960 Speaker 1: this idea that women don't experience pain when they're having 100 00:06:07,000 --> 00:06:09,479 Speaker 1: a biopsy, when they're having an IUD and inter uterine 101 00:06:09,480 --> 00:06:11,920 Speaker 1: device placed into their uters. Whatever it is that we're 102 00:06:11,960 --> 00:06:16,800 Speaker 1: doing is so cruel and weird. So what I always 103 00:06:16,839 --> 00:06:19,320 Speaker 1: discuss with my patients, I do it differently. I've learned 104 00:06:19,320 --> 00:06:22,360 Speaker 1: over the years. I learn from my patients. I tell them, Okay, 105 00:06:22,440 --> 00:06:24,479 Speaker 1: here's the thing that we need to do, where you 106 00:06:24,560 --> 00:06:27,159 Speaker 1: want to do, and here are the options. Pain management 107 00:06:27,200 --> 00:06:30,640 Speaker 1: is always an option in my office. We use either nitronox, 108 00:06:30,640 --> 00:06:34,120 Speaker 1: which is like nitrosoxide, like old school dentist stuff. We 109 00:06:34,160 --> 00:06:36,200 Speaker 1: can do a cervical block, which, by the way, in 110 00:06:36,240 --> 00:06:38,960 Speaker 1: and of itself, the injection to the cervix is unpleasant. 111 00:06:40,080 --> 00:06:44,039 Speaker 1: We can use sedation, whether they take adavan orally by 112 00:06:44,040 --> 00:06:46,599 Speaker 1: mouth and have a ride. I find that when I 113 00:06:46,760 --> 00:06:49,240 Speaker 1: talk to the patients in advance, and I always do, 114 00:06:49,640 --> 00:06:52,400 Speaker 1: and I advise them here are your options, that right 115 00:06:52,440 --> 00:06:55,320 Speaker 1: there makes all the difference because they feel heard and 116 00:06:55,320 --> 00:06:57,159 Speaker 1: they feel that they're in a space that is going 117 00:06:57,160 --> 00:07:00,760 Speaker 1: to respect what their needs may be. You've given them 118 00:07:00,800 --> 00:07:03,560 Speaker 1: a choice, which gives them a certain amount of power. 119 00:07:03,600 --> 00:07:08,320 Speaker 1: And I think some of what I've experienced gynecologically, I 120 00:07:08,600 --> 00:07:12,200 Speaker 1: was never informed about anything that was happening. So I 121 00:07:12,240 --> 00:07:15,440 Speaker 1: didn't know about HPV and I had to have this 122 00:07:15,720 --> 00:07:21,800 Speaker 1: extensive cone biopsy. I was never told what that was 123 00:07:21,880 --> 00:07:24,440 Speaker 1: going to feel like. A It was a man, a 124 00:07:24,480 --> 00:07:27,840 Speaker 1: great doctor, great surgeon, but I don't know if a 125 00:07:27,880 --> 00:07:30,920 Speaker 1: female would have done it that aggressively. Yes, he got 126 00:07:30,920 --> 00:07:35,040 Speaker 1: all the cancer, but by the same token, it made 127 00:07:35,040 --> 00:07:40,320 Speaker 1: it impossible for me to get pregnant. Yeah, naturally, I 128 00:07:40,360 --> 00:07:42,960 Speaker 1: think some of that. I want to be careful about 129 00:07:43,000 --> 00:07:45,160 Speaker 1: some of this because this is your experience, and I 130 00:07:45,160 --> 00:07:49,600 Speaker 1: think the experience you named it, you didn't have information. 131 00:07:49,920 --> 00:07:52,880 Speaker 1: I mean, you didn't really have information in a conversation. 132 00:07:53,000 --> 00:07:55,160 Speaker 1: And I have to say over the years that I've 133 00:07:55,200 --> 00:07:59,880 Speaker 1: seen just as many female physicians perpetrate that as male physicians. 134 00:08:00,280 --> 00:08:03,640 Speaker 1: Some of it's generational, some of it's generational. Some of 135 00:08:03,680 --> 00:08:06,680 Speaker 1: it is also just how open you are and how 136 00:08:06,720 --> 00:08:09,800 Speaker 1: curious you are as a physician. I think you know, 137 00:08:09,840 --> 00:08:14,080 Speaker 1: the medical training system is very toxic and very military, 138 00:08:14,160 --> 00:08:17,560 Speaker 1: by the way, and so it can breed a lot 139 00:08:17,600 --> 00:08:20,200 Speaker 1: of fear based decision making and a lot of what 140 00:08:20,360 --> 00:08:24,000 Speaker 1: looks on the outside like egotistical kind of authoritarian behavior 141 00:08:24,000 --> 00:08:26,480 Speaker 1: on the part of the physician. You got to understand 142 00:08:26,480 --> 00:08:28,560 Speaker 1: that we grow up in a system that rewards that, 143 00:08:28,680 --> 00:08:32,199 Speaker 1: and that also asks us not to question. I've been 144 00:08:32,480 --> 00:08:35,600 Speaker 1: I've had a reputation, let's say, over the course of 145 00:08:35,640 --> 00:08:37,560 Speaker 1: my career, because I want to do the right thing, 146 00:08:37,600 --> 00:08:40,079 Speaker 1: and I think nobody could ever point a finger and 147 00:08:40,120 --> 00:08:41,880 Speaker 1: say that I don't take great care of my patients 148 00:08:41,920 --> 00:08:44,920 Speaker 1: or that my outcomes are not fantastic. But I question things. 149 00:08:45,120 --> 00:08:47,280 Speaker 1: So I think if you look at like the generation 150 00:08:47,600 --> 00:08:50,400 Speaker 1: of the physician, there's a lot of things I think 151 00:08:50,600 --> 00:08:53,360 Speaker 1: if we don't have what's called I just came back. 152 00:08:53,400 --> 00:08:55,280 Speaker 1: This is tangential, but not I just came back from 153 00:08:55,320 --> 00:08:58,679 Speaker 1: an incredible experience at a place called MEA, the Modern 154 00:08:58,720 --> 00:09:01,720 Speaker 1: Elder Academy. It's un believable and one of the things 155 00:09:01,720 --> 00:09:03,839 Speaker 1: they talk about it's very similar to the stuff you're 156 00:09:03,880 --> 00:09:07,000 Speaker 1: talking about, sort of that new beginning as we get older, 157 00:09:07,280 --> 00:09:09,800 Speaker 1: how do we want to be in our in our lives, 158 00:09:09,800 --> 00:09:12,440 Speaker 1: in our in the community, in the world. For someone 159 00:09:12,480 --> 00:09:16,240 Speaker 1: like me, having a growth mindset has been the key. 160 00:09:16,559 --> 00:09:18,400 Speaker 1: It's why I was able to ask these questions. It's 161 00:09:18,400 --> 00:09:21,600 Speaker 1: why I was able to change course based on my 162 00:09:21,679 --> 00:09:24,839 Speaker 1: training around pain management versus what I do today. It's 163 00:09:24,880 --> 00:09:27,480 Speaker 1: why I was able to say menopause, Well, this is 164 00:09:27,520 --> 00:09:29,959 Speaker 1: really important. We're not learning about it as physicians. We're 165 00:09:30,000 --> 00:09:32,880 Speaker 1: not supporting our patients through the process. How can we 166 00:09:32,880 --> 00:09:37,319 Speaker 1: do things different? When is it time to start bringing 167 00:09:37,360 --> 00:09:40,200 Speaker 1: the alarm bell like pertaining to pain, what do you 168 00:09:40,240 --> 00:09:42,600 Speaker 1: say to your I think again, this is why the 169 00:09:42,640 --> 00:09:45,000 Speaker 1: discussion ahead of time is so important. And so I'm 170 00:09:45,040 --> 00:09:46,960 Speaker 1: so glad we're having this conversation because one of the 171 00:09:47,000 --> 00:09:49,760 Speaker 1: things that people can do at any age is if 172 00:09:49,760 --> 00:09:52,320 Speaker 1: their doctor's not bringing it up, come with questions. You 173 00:09:52,320 --> 00:09:55,160 Speaker 1: know what, be the annoying person whatever. You're the person 174 00:09:55,160 --> 00:09:57,200 Speaker 1: who's receiving care. If they don't like it, maybe that's 175 00:09:57,200 --> 00:10:00,400 Speaker 1: not the right environment for you. If I'm doing something 176 00:10:00,440 --> 00:10:02,800 Speaker 1: with a patient and they can't tolerate it, I'm not 177 00:10:02,840 --> 00:10:05,760 Speaker 1: pushing through. They can come back. We don't have to 178 00:10:05,800 --> 00:10:09,000 Speaker 1: do this today. And when people are anxious, by the way, 179 00:10:09,360 --> 00:10:12,679 Speaker 1: their pain threshold is much lower. So again, if they 180 00:10:12,679 --> 00:10:14,760 Speaker 1: don't feel safe and they don't feel listened to, it's 181 00:10:14,760 --> 00:10:18,080 Speaker 1: going to make your job as a physician harder. So 182 00:10:18,240 --> 00:10:22,679 Speaker 1: it's I think unfortunately. I want your listeners to know 183 00:10:22,720 --> 00:10:27,080 Speaker 1: that their physician may not ask the questions. You come 184 00:10:27,120 --> 00:10:30,840 Speaker 1: with questions prepared. I have in my menopause, Balo Camp, 185 00:10:30,880 --> 00:10:33,800 Speaker 1: I have like two pages of like advocacy questions, not 186 00:10:33,920 --> 00:10:36,839 Speaker 1: to be an a whole and confrontational, but to come 187 00:10:36,840 --> 00:10:38,280 Speaker 1: in and be like, hey, I need to take care 188 00:10:38,280 --> 00:10:40,079 Speaker 1: of myself. How are we going to work together as 189 00:10:40,080 --> 00:10:50,120 Speaker 1: a team. I call this show now What because it's 190 00:10:50,160 --> 00:10:53,160 Speaker 1: really about those times in your personal or professional life 191 00:10:53,160 --> 00:10:56,360 Speaker 1: that surprise you and shape you. What's a now what 192 00:10:56,480 --> 00:10:59,880 Speaker 1: moment that shaped your work as a physician? Oh wow, 193 00:11:00,000 --> 00:11:02,280 Speaker 1: Oh well, there's so many, and I think it depends 194 00:11:02,320 --> 00:11:03,760 Speaker 1: on the person. I'm going to share a couple of 195 00:11:03,760 --> 00:11:07,600 Speaker 1: personal things about myself that really changed the way I 196 00:11:07,720 --> 00:11:11,240 Speaker 1: perceived things in the way I practiced medicine. I had 197 00:11:11,280 --> 00:11:14,880 Speaker 1: my older child, my son, who will be twenty six 198 00:11:14,960 --> 00:11:18,560 Speaker 1: in October, Jaron, while I was the beginning of my 199 00:11:18,679 --> 00:11:21,880 Speaker 1: second year of obg Way in residency. That was pretty brutal, 200 00:11:22,520 --> 00:11:26,320 Speaker 1: and I was young and thought and I've been, you know, 201 00:11:26,720 --> 00:11:30,199 Speaker 1: doing OB and watching this very high pressured environment in 202 00:11:30,240 --> 00:11:34,640 Speaker 1: which I was training, and I thought to myself, Wow, 203 00:11:34,640 --> 00:11:37,200 Speaker 1: there's a lot of medical interventions going on here. As 204 00:11:37,280 --> 00:11:39,920 Speaker 1: is nineteen ninety seven, I don't think I we need 205 00:11:39,960 --> 00:11:42,400 Speaker 1: all that, and I like on the down low. Brook 206 00:11:42,520 --> 00:11:47,719 Speaker 1: took a Bradley Method natural childbirth course. Okay, nobody in 207 00:11:47,720 --> 00:11:50,240 Speaker 1: the class knew I was an OBIE resident. It was 208 00:11:50,280 --> 00:11:51,719 Speaker 1: a little extreme, but I was like, I'm going to 209 00:11:51,800 --> 00:11:53,800 Speaker 1: take what I like and leave the rest. I came 210 00:11:53,840 --> 00:11:57,199 Speaker 1: in and my labor was going super fast. And despite that, 211 00:11:57,240 --> 00:12:00,000 Speaker 1: my doctor did all this stuff. She broke my water, 212 00:12:00,320 --> 00:12:03,080 Speaker 1: she gave me pitocin, all these things. My husband, I 213 00:12:03,080 --> 00:12:05,679 Speaker 1: didn't know till later, was in the corner trying to advocate, like, 214 00:12:05,720 --> 00:12:07,520 Speaker 1: do you really need to do that. I know Susanna 215 00:12:07,520 --> 00:12:09,000 Speaker 1: doesn't really want you to do that. Do you need 216 00:12:09,040 --> 00:12:10,960 Speaker 1: to do that? I didn't need any of that stuff, 217 00:12:11,000 --> 00:12:14,640 Speaker 1: And it stole my confidence book, and I said to myself, 218 00:12:14,720 --> 00:12:16,960 Speaker 1: I don't think any of that needed to happen, and 219 00:12:17,040 --> 00:12:19,200 Speaker 1: I'm never going to do that to another person. I'm 220 00:12:19,240 --> 00:12:22,400 Speaker 1: never going to do that to a patient. Nothing quote 221 00:12:22,440 --> 00:12:24,720 Speaker 1: bad happened. I was fine, he was fine. You know, 222 00:12:25,000 --> 00:12:27,720 Speaker 1: I'm not crying. I'm just saying it changed my life. 223 00:12:29,120 --> 00:12:35,640 Speaker 1: Then later one of my mentors, who's an internationally renowned 224 00:12:35,679 --> 00:12:39,760 Speaker 1: breast cancer oncologist, she started sending me patients and she 225 00:12:39,840 --> 00:12:43,000 Speaker 1: started sending me a lot of her young breast cancer 226 00:12:43,080 --> 00:12:46,040 Speaker 1: patients and they were rendered menopausal in their thirties. And 227 00:12:46,840 --> 00:12:49,040 Speaker 1: I was like, Filhelmina, I don't know how to treat this. 228 00:12:49,080 --> 00:12:51,000 Speaker 1: She's like, well, you'll figure it out. And this is 229 00:12:51,000 --> 00:12:53,760 Speaker 1: when I realized I didn't understand menopause and I hadn't learned. 230 00:12:54,160 --> 00:12:56,000 Speaker 1: And I taught and taught and taught myself and went 231 00:12:56,040 --> 00:12:58,679 Speaker 1: to conferences and read and worked together with them as 232 00:12:58,679 --> 00:13:02,280 Speaker 1: a team and really helped understand how to restore their 233 00:13:02,320 --> 00:13:05,200 Speaker 1: sense of self, how to feel confident in their body again, 234 00:13:05,480 --> 00:13:08,760 Speaker 1: how to regain their sexuality. Some of them ended up 235 00:13:08,800 --> 00:13:11,120 Speaker 1: getting pregnant after their chemo was done. It was like, 236 00:13:11,200 --> 00:13:14,240 Speaker 1: really miraculous. And I became kind of known as this 237 00:13:14,320 --> 00:13:18,320 Speaker 1: pre menopausal breast cancer gynecologist. And then I got breast 238 00:13:18,320 --> 00:13:21,000 Speaker 1: cancer in my forties, and I was a pre menopausal 239 00:13:21,040 --> 00:13:24,720 Speaker 1: breast cancer patient. So all of these things added up 240 00:13:25,000 --> 00:13:29,440 Speaker 1: to reminding me I'm one of you, you're one of me. 241 00:13:30,400 --> 00:13:32,560 Speaker 1: I was always very open with my patients about my 242 00:13:32,600 --> 00:13:35,720 Speaker 1: own struggles and what I was learning. I had a 243 00:13:35,760 --> 00:13:38,640 Speaker 1: deeper and a wider toolkit because I was doing Iraveda 244 00:13:38,679 --> 00:13:41,240 Speaker 1: and I was doing herbs, and I was doing holistic medicine, 245 00:13:41,240 --> 00:13:44,600 Speaker 1: but also I believed in radiation and surgery, and I 246 00:13:44,679 --> 00:13:51,240 Speaker 1: did it. And I also saw acutely how ignored so 247 00:13:51,400 --> 00:13:55,480 Speaker 1: many of our quote issues were, and I just it. 248 00:13:55,559 --> 00:13:58,960 Speaker 1: Really every step along the way was an AHA for 249 00:13:59,080 --> 00:14:02,160 Speaker 1: me because I said to myself, Okay, so I've learned 250 00:14:02,160 --> 00:14:04,800 Speaker 1: all these tools, and some of these things actually don't 251 00:14:04,840 --> 00:14:08,360 Speaker 1: make sense. Shifting to a more biological now what question, 252 00:14:09,280 --> 00:14:13,360 Speaker 1: what are some of the biological timelines that young women 253 00:14:13,440 --> 00:14:17,520 Speaker 1: really need to just be cognizant of. And then the 254 00:14:17,600 --> 00:14:22,960 Speaker 1: expense of fertility. Yeah, it's costly emotionally, physically, and financially. 255 00:14:23,040 --> 00:14:25,200 Speaker 1: I mean, I think the problem with some of this 256 00:14:25,360 --> 00:14:29,240 Speaker 1: is that some of the data around fertility changes is 257 00:14:29,480 --> 00:14:32,440 Speaker 1: old and it gets get called into question. But the 258 00:14:32,480 --> 00:14:34,840 Speaker 1: reality is that we know that there is a pretty 259 00:14:34,840 --> 00:14:39,640 Speaker 1: big drop off in live births resulting from pregnancies after 260 00:14:39,680 --> 00:14:41,840 Speaker 1: the age of thirty five. So that doesn't mean that 261 00:14:41,880 --> 00:14:43,840 Speaker 1: if you're thirty eight you should go into a panic. 262 00:14:43,880 --> 00:14:46,240 Speaker 1: You know, I have patients getting pregnant in their early 263 00:14:46,280 --> 00:14:49,400 Speaker 1: forties all the time. I think, if you think you 264 00:14:49,520 --> 00:14:52,560 Speaker 1: want to have kids, i'd say in you know, your 265 00:14:52,600 --> 00:14:54,960 Speaker 1: early thirties, you should start thinking about what is the 266 00:14:55,000 --> 00:14:57,120 Speaker 1: plan there, because maybe you're not ready for a number 267 00:14:57,160 --> 00:14:58,720 Speaker 1: of reasons to have kids, But I think that's the 268 00:14:58,760 --> 00:15:01,960 Speaker 1: time to start talking to your The issue is that 269 00:15:02,040 --> 00:15:06,000 Speaker 1: the testing that we have available is indirect, and it's 270 00:15:06,120 --> 00:15:07,720 Speaker 1: I don't want I don't think people should be like 271 00:15:07,920 --> 00:15:10,840 Speaker 1: living or dying by the blood tests, like specifically the 272 00:15:10,880 --> 00:15:14,200 Speaker 1: anti malarian hormone which has become very popular. That test 273 00:15:14,200 --> 00:15:16,440 Speaker 1: has really been developed in order to look at who's 274 00:15:16,440 --> 00:15:18,760 Speaker 1: going to be a good responder to in vitro fertilization. 275 00:15:19,400 --> 00:15:22,760 Speaker 1: You know, at least have a conversation so that you 276 00:15:23,000 --> 00:15:26,920 Speaker 1: know what your options are, whether you have the available 277 00:15:27,280 --> 00:15:29,720 Speaker 1: resources to do egg freezing, which by the way, is 278 00:15:29,760 --> 00:15:33,320 Speaker 1: not a guarantee at all, or if you say to yourself, 279 00:15:33,600 --> 00:15:36,720 Speaker 1: maybe we shouldn't, you know, put this off another five years. 280 00:15:37,200 --> 00:15:38,960 Speaker 1: If we really want to have a family, we might 281 00:15:39,040 --> 00:15:41,240 Speaker 1: have to pull the trigger or just be okay with 282 00:15:41,280 --> 00:15:44,080 Speaker 1: the consequences. The conversation I have with my patients is 283 00:15:44,080 --> 00:15:47,440 Speaker 1: that what consequences are you okay with? Including testing? Because 284 00:15:47,480 --> 00:15:48,920 Speaker 1: if we're going to do the test and it's just 285 00:15:48,960 --> 00:15:50,600 Speaker 1: going to freak you out, but you're not going to act. 286 00:15:50,640 --> 00:15:52,160 Speaker 1: I don't know that I want to do this test 287 00:15:52,200 --> 00:15:56,480 Speaker 1: on you. What about new parents, Oh my gosh, given 288 00:15:56,520 --> 00:15:59,360 Speaker 1: any kind of an instruction manual, you know, they have 289 00:15:59,400 --> 00:16:03,240 Speaker 1: no concept. Also of the mental health struggles, it's so rough. 290 00:16:03,440 --> 00:16:05,440 Speaker 1: I remember having a moment with my first and I 291 00:16:05,600 --> 00:16:09,760 Speaker 1: was thirty thirty thirty one with a really supportive partner 292 00:16:09,800 --> 00:16:13,440 Speaker 1: at the time, and I remember having a night where 293 00:16:13,440 --> 00:16:17,360 Speaker 1: I was like, I understand why a teenage mom would 294 00:16:17,480 --> 00:16:19,880 Speaker 1: leave this baby in a trash gown. Okay, And I 295 00:16:19,960 --> 00:16:22,360 Speaker 1: just want you to know that I love that, I 296 00:16:22,440 --> 00:16:25,080 Speaker 1: love this baby so much and I could not. I 297 00:16:25,240 --> 00:16:30,800 Speaker 1: was done. Your nipples hurt, you can't poop, you haven't slept, 298 00:16:31,040 --> 00:16:34,400 Speaker 1: you feel disgusting, you're sweaty. Did you shower this week? 299 00:16:34,960 --> 00:16:38,480 Speaker 1: I mean, nothing works. You're so freaking tired, you want 300 00:16:38,480 --> 00:16:40,920 Speaker 1: to die, and you're supposed to keep another human alive. 301 00:16:41,280 --> 00:16:44,240 Speaker 1: I mean, that is a disaster area. And I had 302 00:16:44,320 --> 00:16:46,880 Speaker 1: everything going for me, So I don't even know how 303 00:16:46,920 --> 00:16:50,040 Speaker 1: people do it. So do you tell your patients that 304 00:16:50,120 --> 00:16:53,480 Speaker 1: without trying to detern them from what I tell them 305 00:16:53,720 --> 00:16:56,200 Speaker 1: is Because here's the thing, especially with the first one, 306 00:16:56,480 --> 00:17:00,120 Speaker 1: they're in such a cloud and they're so excited. Some 307 00:17:00,200 --> 00:17:01,960 Speaker 1: of them are nervous, by the way, and I think 308 00:17:02,360 --> 00:17:05,479 Speaker 1: having a pregnancy in twenty twenty three or you know, 309 00:17:06,160 --> 00:17:09,400 Speaker 1: versus in nineteen ninety six kind of a little different, right, 310 00:17:09,480 --> 00:17:12,200 Speaker 1: Like we were just starting to scratch a service talking 311 00:17:12,200 --> 00:17:14,720 Speaker 1: about stuff like barely right, you know, when you and 312 00:17:14,720 --> 00:17:18,040 Speaker 1: I were having kids. So they have a little more information, 313 00:17:18,119 --> 00:17:21,199 Speaker 1: but in general, they're not in reality. And what I 314 00:17:21,280 --> 00:17:24,280 Speaker 1: try to do for them is not burst their bubble, 315 00:17:24,440 --> 00:17:27,120 Speaker 1: but make sure that again they have information and they 316 00:17:27,160 --> 00:17:30,040 Speaker 1: feel resourced and they know that I'm a safe person 317 00:17:30,080 --> 00:17:32,160 Speaker 1: to come to, that our practice is there for them, 318 00:17:32,560 --> 00:17:34,920 Speaker 1: and leading up to the post, leading up to the birth, 319 00:17:35,000 --> 00:17:38,240 Speaker 1: like as they're starting to get anxious, and reassuring them like, look, 320 00:17:38,280 --> 00:17:41,120 Speaker 1: some of it's going to really fucking suck, and who 321 00:17:41,200 --> 00:17:43,960 Speaker 1: are your people? Who are the people that you're tapping, 322 00:17:44,280 --> 00:17:46,679 Speaker 1: because you need to have that in advance. So my 323 00:17:46,800 --> 00:17:50,119 Speaker 1: patients who come into the pregnancy with mood disorders already 324 00:17:50,400 --> 00:17:53,000 Speaker 1: in a lot of ways, they are in better shape 325 00:17:53,040 --> 00:17:55,679 Speaker 1: because we know they're to increase risk, and so we 326 00:17:55,760 --> 00:17:59,040 Speaker 1: have a plan set up. Okay, the psychiatrist is on board. 327 00:17:59,080 --> 00:18:01,480 Speaker 1: This is the meds. These are the point people, this 328 00:18:01,520 --> 00:18:04,440 Speaker 1: is what the partner's doing. You know, we have a 329 00:18:04,560 --> 00:18:07,240 Speaker 1: check in plan that's very different than maybe the rest 330 00:18:07,240 --> 00:18:09,560 Speaker 1: of the patients because the reality is you may know 331 00:18:09,640 --> 00:18:12,119 Speaker 1: that like for a lot of people who have a baby, 332 00:18:12,160 --> 00:18:15,440 Speaker 1: they don't even see anybody again for six weeks, which 333 00:18:15,480 --> 00:18:18,800 Speaker 1: is insane. They don't do it like this in other 334 00:18:18,840 --> 00:18:29,520 Speaker 1: countries or other cultures. I want to pivot to menopause, 335 00:18:29,960 --> 00:18:34,720 Speaker 1: specifically the time leading up to menopause, perimenopause, which you've 336 00:18:34,720 --> 00:18:38,400 Speaker 1: gotten on record saying that you what you want to 337 00:18:38,440 --> 00:18:40,960 Speaker 1: do away with that term. Tell me why? Well, I mean, 338 00:18:41,000 --> 00:18:45,200 Speaker 1: here's the thing. I think initially it was a wonderful 339 00:18:45,320 --> 00:18:49,320 Speaker 1: term because it gave people an understanding that it's not 340 00:18:49,440 --> 00:18:52,800 Speaker 1: just like boom menopause, but that there is a period 341 00:18:52,880 --> 00:18:55,320 Speaker 1: of time that could last up to a decade of 342 00:18:55,440 --> 00:18:57,800 Speaker 1: changes in your body, and that they're real. It's not 343 00:18:57,880 --> 00:19:00,480 Speaker 1: you're not being crazy, you're not being difficult, you're not 344 00:19:00,520 --> 00:19:02,800 Speaker 1: making it up. Because your labs are quote normal and 345 00:19:02,840 --> 00:19:05,560 Speaker 1: you still have a regular cycle. There is something going 346 00:19:05,600 --> 00:19:08,239 Speaker 1: on in your body. So I think naming it and 347 00:19:08,359 --> 00:19:11,560 Speaker 1: again giving information was helpful, but turning it into a 348 00:19:11,600 --> 00:19:15,399 Speaker 1: diagnosis that you need to balance, balance your hormones. That 349 00:19:15,520 --> 00:19:18,600 Speaker 1: makes me nuts because it's pathologizing something that is not 350 00:19:18,640 --> 00:19:21,920 Speaker 1: a pathology. As I mentioned earlier, this is a developmental 351 00:19:21,920 --> 00:19:25,600 Speaker 1: physiologic event, puberty of midlife. I would much rather people 352 00:19:25,680 --> 00:19:28,000 Speaker 1: understand there's going to be a process. Your whole life 353 00:19:28,040 --> 00:19:31,159 Speaker 1: is a process. Your cycle is a process. And what 354 00:19:31,200 --> 00:19:34,479 Speaker 1: are the things that they can do to be healthy, 355 00:19:34,600 --> 00:19:37,920 Speaker 1: maintain their health, sustain their health and feel their best 356 00:19:37,920 --> 00:19:40,880 Speaker 1: self as much as possible. How do you know you're 357 00:19:40,960 --> 00:19:43,919 Speaker 1: in menopause? Menopause itself is one day of your life. 358 00:19:44,000 --> 00:19:47,240 Speaker 1: Menopause is the cessation of cycles, so in a person 359 00:19:47,240 --> 00:19:49,480 Speaker 1: who has a uterus, and this is important. When you 360 00:19:49,560 --> 00:19:53,879 Speaker 1: hit twelve months consecutively without a period between the ages 361 00:19:53,920 --> 00:19:57,199 Speaker 1: of forty five and fifty five ish, that's menopause. And 362 00:19:57,240 --> 00:20:00,360 Speaker 1: the menopause is one day. Perimenopause is the time leading 363 00:20:00,400 --> 00:20:02,360 Speaker 1: up to it. It could be three years of noticeable 364 00:20:02,400 --> 00:20:05,480 Speaker 1: changes for you. It could be twelve years. Everything from 365 00:20:05,680 --> 00:20:11,800 Speaker 1: your period quality changing closer together, heavier skipping, sleep changes, 366 00:20:11,920 --> 00:20:17,280 Speaker 1: fatigue changes, intense PMS symptoms. I see a lot of anxiety, yes, 367 00:20:17,440 --> 00:20:22,200 Speaker 1: dry vagina, urinary tract infections, anxiety and panic that comes 368 00:20:22,240 --> 00:20:24,760 Speaker 1: out of the blue, you know, on and on and on. 369 00:20:25,200 --> 00:20:27,919 Speaker 1: How do we not turn this into a death sentence? Though? Like, 370 00:20:28,280 --> 00:20:30,959 Speaker 1: how do we sort of not be filled with dread? 371 00:20:31,600 --> 00:20:35,480 Speaker 1: There's got to be another way to sort of frame 372 00:20:35,560 --> 00:20:40,360 Speaker 1: this or revere it. I don't know. Maybe I'm living 373 00:20:40,440 --> 00:20:42,720 Speaker 1: in the clouds. I don't think you are. I think 374 00:20:42,760 --> 00:20:45,119 Speaker 1: it's tough because the lead up to it is really 375 00:20:45,720 --> 00:20:48,159 Speaker 1: sounds really unpleasant when we list out, you know, the 376 00:20:48,160 --> 00:20:50,600 Speaker 1: thirty four symptoms of menopause or whatever the hell is 377 00:20:51,119 --> 00:20:54,000 Speaker 1: you know online, and then you compound it with this 378 00:20:54,720 --> 00:20:57,159 Speaker 1: cultural narrative, which is that we are used up and 379 00:20:57,320 --> 00:21:00,320 Speaker 1: irrelevant and dried up and no longer wanted. But what 380 00:21:00,400 --> 00:21:04,120 Speaker 1: I really want people to understand is that the reality 381 00:21:04,160 --> 00:21:05,760 Speaker 1: is that for people who go through it in a 382 00:21:05,840 --> 00:21:11,080 Speaker 1: community of other women who are sharing advice and support 383 00:21:11,359 --> 00:21:14,920 Speaker 1: and have tools that are useful and beneficial and validated, 384 00:21:15,600 --> 00:21:18,400 Speaker 1: it's a completely different experience, just like any other experience 385 00:21:18,400 --> 00:21:21,040 Speaker 1: we go through with loved ones and with our girlfriends. Honestly, 386 00:21:21,359 --> 00:21:23,159 Speaker 1: we get through it. We get through the breakups, we 387 00:21:23,200 --> 00:21:25,880 Speaker 1: get through the job losses, we get through the changes 388 00:21:25,880 --> 00:21:29,200 Speaker 1: in our lives. We get through the pregnancies, the lack 389 00:21:29,240 --> 00:21:32,000 Speaker 1: of pregnancies. And when we get to the other side, 390 00:21:32,040 --> 00:21:37,359 Speaker 1: here's the awesome thing. There's this incredible liberation. There's this 391 00:21:37,520 --> 00:21:42,520 Speaker 1: unleashing of creativity, of recognition of our own power and agency. 392 00:21:42,960 --> 00:21:46,480 Speaker 1: And I will tell you that I feel fucking great. Man. 393 00:21:46,880 --> 00:21:51,680 Speaker 1: I'm in a great relationship. My sex life is awesome. Sorry, TMI, 394 00:21:51,920 --> 00:21:54,879 Speaker 1: because I do things to make that work. I have 395 00:21:54,960 --> 00:21:57,480 Speaker 1: a book that I published in my mid to late fifties. 396 00:21:57,520 --> 00:22:00,119 Speaker 1: I'm going to be fifty eight in February. I'm I'm 397 00:22:00,160 --> 00:22:03,160 Speaker 1: living my best life. I'm great. Do you have any 398 00:22:03,200 --> 00:22:06,639 Speaker 1: tips for helping with the side effects I have just metopause? 399 00:22:06,880 --> 00:22:08,679 Speaker 1: Oh my gosh, Yes, I mean I have. And the 400 00:22:08,680 --> 00:22:11,040 Speaker 1: book covers not everything, but it covers a lot of 401 00:22:11,040 --> 00:22:14,320 Speaker 1: different categories. So all the lifestyle stuff, whether it's really 402 00:22:14,359 --> 00:22:16,679 Speaker 1: digging into your sleep, like your sleep honestly is the 403 00:22:16,680 --> 00:22:19,119 Speaker 1: most important thing you have to recover your sleep and 404 00:22:19,200 --> 00:22:24,360 Speaker 1: protect your sleep. Exercise, movement, fitness. If you're doing it already, fantastic. 405 00:22:24,440 --> 00:22:26,720 Speaker 1: If you're not doing it, even better, you have something 406 00:22:26,760 --> 00:22:29,520 Speaker 1: you can do. You know, how you eat, when you eat, 407 00:22:29,920 --> 00:22:34,080 Speaker 1: stress management, meditation, stillness. Honestly, a lot of that stuff 408 00:22:34,119 --> 00:22:36,960 Speaker 1: is the most potent medicine that will sustain you through 409 00:22:37,280 --> 00:22:39,359 Speaker 1: not only that process, but the rest of your life. 410 00:22:39,840 --> 00:22:42,800 Speaker 1: Making sure you're looking at your overall general health because 411 00:22:42,800 --> 00:22:46,000 Speaker 1: we know as women, our hearts and our brains are 412 00:22:46,000 --> 00:22:47,760 Speaker 1: going to decline as we get older if we're not 413 00:22:47,800 --> 00:22:51,640 Speaker 1: paying attention to not only our exercise and our lifestyle 414 00:22:51,680 --> 00:22:55,680 Speaker 1: and our stress. Alcohol use, hormones, are they right for you? 415 00:22:57,000 --> 00:23:00,439 Speaker 1: And then specific herbs that have decent data. Never going 416 00:23:00,480 --> 00:23:03,560 Speaker 1: to compare it to pharmaceutical data. That's not happening, Let's 417 00:23:03,560 --> 00:23:07,120 Speaker 1: be honest. But there is data to support some supplement use. 418 00:23:07,800 --> 00:23:10,040 Speaker 1: And then hormone therapy, which can be magical for the 419 00:23:10,119 --> 00:23:13,080 Speaker 1: right person and have many many benefits. There's a lot 420 00:23:13,080 --> 00:23:16,119 Speaker 1: of talk about hormones, Yes, I mean, what is your 421 00:23:16,320 --> 00:23:19,760 Speaker 1: thought on I had a doctor who said, you know what, 422 00:23:20,520 --> 00:23:23,639 Speaker 1: why don't we just help you over the edge so 423 00:23:23,680 --> 00:23:26,840 Speaker 1: that you're not just plummeting off the off the cliff. 424 00:23:27,640 --> 00:23:30,479 Speaker 1: And I got to tell you it's been amazing. I mean, 425 00:23:30,480 --> 00:23:33,000 Speaker 1: there's a lot of talk about you, hormone testing and 426 00:23:33,040 --> 00:23:36,639 Speaker 1: hormone therapy. Do you have a strong opinion about it? 427 00:23:36,760 --> 00:23:39,040 Speaker 1: I have a strong opinion that, like with everything else, 428 00:23:39,080 --> 00:23:42,400 Speaker 1: as long as you're educated and you're getting supported, that 429 00:23:42,480 --> 00:23:44,920 Speaker 1: might be the right decision for you. I am definitely 430 00:23:45,600 --> 00:23:48,679 Speaker 1: in the camp that says hormones should be part of 431 00:23:48,680 --> 00:23:52,040 Speaker 1: the toolkit for a lot of people. There are probably 432 00:23:52,200 --> 00:23:55,200 Speaker 1: some people that can't use it, people who have already 433 00:23:55,200 --> 00:23:58,440 Speaker 1: had a blood clot What about hormone testing for non 434 00:23:58,520 --> 00:24:03,639 Speaker 1: menopausal women. One testing is hogwash. There's no data to 435 00:24:03,640 --> 00:24:06,280 Speaker 1: support it. And for people. First of all, I just 436 00:24:06,320 --> 00:24:10,119 Speaker 1: told you the definition of menopause, so it's a clinical diagnosis. 437 00:24:10,840 --> 00:24:12,439 Speaker 1: I will say if you, let's say you've had a 438 00:24:12,480 --> 00:24:16,480 Speaker 1: hysterectomy or then that's a person that maybe we do 439 00:24:16,520 --> 00:24:19,200 Speaker 1: hormone testing on. But to be honest, we're not treating 440 00:24:19,240 --> 00:24:23,199 Speaker 1: those numbers, unlike blood sugar or thyroid, where we know 441 00:24:23,240 --> 00:24:25,520 Speaker 1: there's a narrow range you have to be between here 442 00:24:25,560 --> 00:24:29,200 Speaker 1: and here. Like I said, menopause is not a disease. 443 00:24:29,480 --> 00:24:32,120 Speaker 1: We don't know. Oh, when your estrogen falls below here, 444 00:24:32,160 --> 00:24:34,120 Speaker 1: that's when you have a hot flash on your progesterones. 445 00:24:34,119 --> 00:24:36,199 Speaker 1: There you feel like you're want to kill your family. 446 00:24:36,480 --> 00:24:40,280 Speaker 1: So we're not treating numbers. We're treating you. So doctors 447 00:24:40,280 --> 00:24:42,920 Speaker 1: and practitioners who are doing tons and tons of tests 448 00:24:43,520 --> 00:24:45,480 Speaker 1: and bringing you back all the time and charging you 449 00:24:45,560 --> 00:24:49,200 Speaker 1: for this. That's a business model that's not evidence based. 450 00:24:49,640 --> 00:24:52,040 Speaker 1: I'm not saying I never test hormones, because I do, 451 00:24:52,880 --> 00:24:56,119 Speaker 1: but I use my brain and I individualize it. So 452 00:24:56,320 --> 00:24:59,480 Speaker 1: I'm not against hormone testing, but the idea that you 453 00:24:59,520 --> 00:25:01,720 Speaker 1: should be tes leading up. It's not going to do 454 00:25:01,760 --> 00:25:04,800 Speaker 1: anything for you. We're going to treat your symptoms. You're 455 00:25:04,800 --> 00:25:09,520 Speaker 1: having hot flashes, you can't sleep, estrogen you know more. 456 00:25:09,680 --> 00:25:12,160 Speaker 1: It's a little more complicated than this because you need 457 00:25:12,200 --> 00:25:15,280 Speaker 1: progesterone as well to protect your users, but also because 458 00:25:15,280 --> 00:25:18,840 Speaker 1: progesterone can help with mood, can help with sleep, so 459 00:25:19,520 --> 00:25:22,679 Speaker 1: there's so much benefit. And that's just for symptoms. The 460 00:25:22,720 --> 00:25:25,760 Speaker 1: reality is that the data is very very clear that 461 00:25:25,840 --> 00:25:31,160 Speaker 1: osteoporosis prevention is a thing. We can decrease the risk 462 00:25:31,359 --> 00:25:36,800 Speaker 1: of bone loss and fractures if we start hormone therapy 463 00:25:36,880 --> 00:25:41,560 Speaker 1: within ten years of menopause before the age of sixty. 464 00:25:41,680 --> 00:25:45,760 Speaker 1: The information on dementia risk and heart disease is also 465 00:25:45,840 --> 00:25:48,639 Speaker 1: starting to really be more and more robust. I'm a 466 00:25:48,680 --> 00:25:52,600 Speaker 1: believer that for the right person, it is appropriate to 467 00:25:52,720 --> 00:25:56,199 Speaker 1: start you on hormone therapy early and close to the 468 00:25:56,240 --> 00:25:59,760 Speaker 1: time of menopause, even before if you need it for symptoms, 469 00:26:00,160 --> 00:26:02,240 Speaker 1: because I think we're going to decrease your risk of 470 00:26:02,240 --> 00:26:04,480 Speaker 1: heart disease, which is the number one killer of women, 471 00:26:04,600 --> 00:26:07,720 Speaker 1: not breast cancer, even breast cancer survivors. The number one 472 00:26:07,760 --> 00:26:10,560 Speaker 1: killer of breast cancer survivors because most of us are 473 00:26:10,600 --> 00:26:14,960 Speaker 1: early stage, is heart disease. But also, women haven't really 474 00:26:15,040 --> 00:26:18,080 Speaker 1: been taught to know this stuff. Are there any health 475 00:26:18,080 --> 00:26:21,160 Speaker 1: conditions that we as women should look for? Oh? Yeah, well, 476 00:26:21,160 --> 00:26:22,800 Speaker 1: like I said, and this is where it is so 477 00:26:22,840 --> 00:26:27,520 Speaker 1: important for the younger members of the audience to understand 478 00:26:27,520 --> 00:26:30,480 Speaker 1: that your health, just like your health going into a 479 00:26:30,520 --> 00:26:33,080 Speaker 1: pregnancy is going to really affect the pregnancy and beyond, 480 00:26:33,440 --> 00:26:35,760 Speaker 1: your health going into menopause is going to affect your 481 00:26:35,800 --> 00:26:39,600 Speaker 1: menopause and beyond. So when we hit menopause, our hormone 482 00:26:39,640 --> 00:26:43,800 Speaker 1: levels decline and we start seeing a big bump in 483 00:26:43,840 --> 00:26:49,080 Speaker 1: metabolic disorders, so diabetes, pre diabetes, high cholesterol, all of 484 00:26:49,119 --> 00:26:52,280 Speaker 1: these inflammatory issues that are all going to contribute to 485 00:26:52,320 --> 00:26:55,600 Speaker 1: heart disease and to dimension Alzheimer's. Women are two to 486 00:26:55,640 --> 00:27:00,080 Speaker 1: three times more likely to have Alzheimer's than men in 487 00:27:00,119 --> 00:27:05,479 Speaker 1: the same age group. So this is why lifestyle, family history, 488 00:27:05,640 --> 00:27:08,960 Speaker 1: risk factors are really important to understand and to advocate 489 00:27:09,000 --> 00:27:11,240 Speaker 1: for yourself, because if you look at men in the 490 00:27:11,240 --> 00:27:15,360 Speaker 1: same age group, they're getting their cardiac evaluations and are 491 00:27:15,400 --> 00:27:17,480 Speaker 1: we That's another thing you need to go in and 492 00:27:17,520 --> 00:27:20,840 Speaker 1: ask your doctor about. If you're fifty and you haven't 493 00:27:20,880 --> 00:27:24,040 Speaker 1: had a deep dive into your cholesterol and other things, 494 00:27:24,160 --> 00:27:26,280 Speaker 1: you need to ask your doctor about that. And if 495 00:27:26,320 --> 00:27:28,480 Speaker 1: you have a male partner and they've been tested, why 496 00:27:28,520 --> 00:27:31,160 Speaker 1: haven't you. I left my doctor because of this. By 497 00:27:31,200 --> 00:27:35,719 Speaker 1: the way, so fascinating and this is twenty twenty whatever 498 00:27:35,800 --> 00:27:39,040 Speaker 1: when it was, But that's a point. It feels like 499 00:27:39,040 --> 00:27:41,240 Speaker 1: we've come a long way, but we have a long time. 500 00:27:41,320 --> 00:27:44,239 Speaker 1: We have to take responsibility for ourselves. That's why a 501 00:27:44,280 --> 00:27:48,640 Speaker 1: podcast like this is so important. Well, I think you're 502 00:27:48,720 --> 00:27:53,359 Speaker 1: bringing it. You're bringing it into a place where we 503 00:27:53,640 --> 00:27:56,480 Speaker 1: are a community and can discuss it. And there is 504 00:27:56,560 --> 00:28:01,440 Speaker 1: safety in numbers. And I'm adamant in my life about 505 00:28:02,760 --> 00:28:07,040 Speaker 1: owning and being so happy about my age. Why do 506 00:28:07,119 --> 00:28:12,719 Speaker 1: you think aging is a positive thing? Oh my gosh, 507 00:28:12,840 --> 00:28:15,639 Speaker 1: Like I mentioned to me, I know myself so much better. 508 00:28:16,200 --> 00:28:18,560 Speaker 1: One of the big grief moments that I see for 509 00:28:18,640 --> 00:28:21,840 Speaker 1: women is this loss of the period, Like we feel 510 00:28:21,840 --> 00:28:24,280 Speaker 1: so identified with our cycle because we spend so many 511 00:28:24,320 --> 00:28:28,199 Speaker 1: decades in it, avoiding it, managing it, whatever. And then 512 00:28:28,280 --> 00:28:30,680 Speaker 1: it's like, who are we without a cycle? And guess 513 00:28:30,720 --> 00:28:32,520 Speaker 1: what I really like? Who I am without a cycle? 514 00:28:32,560 --> 00:28:35,040 Speaker 1: It turns out I was affected by my hormones and 515 00:28:35,040 --> 00:28:37,040 Speaker 1: ways that I didn't even really realize. And I feel 516 00:28:37,080 --> 00:28:40,200 Speaker 1: just more steady, I feel more like myself. I feel 517 00:28:40,240 --> 00:28:45,600 Speaker 1: more calm. I'm like a pretty intense person, so I'm 518 00:28:45,640 --> 00:28:49,440 Speaker 1: not as emotional in a way that bothers me. And 519 00:28:49,480 --> 00:28:52,160 Speaker 1: I'm just like, like I said, I'm super creative, Like 520 00:28:52,200 --> 00:28:55,240 Speaker 1: I'm digging into that creativity in a whole new way. 521 00:28:55,280 --> 00:29:05,800 Speaker 1: It has been ah amazing. That was doctor Suzanne Gilberg Lenz. 522 00:29:06,360 --> 00:29:09,000 Speaker 1: If you liked our conversation, go pick up a copy 523 00:29:09,040 --> 00:29:12,600 Speaker 1: of our book, Menopause boot Camp. That's it for us today. 524 00:29:13,200 --> 00:29:19,080 Speaker 1: Talk to you next week now. What with Burke Shields 525 00:29:19,360 --> 00:29:23,040 Speaker 1: is a production of iHeartRadio. Our lead producer and wonderful 526 00:29:23,040 --> 00:29:27,480 Speaker 1: showrunner is Julia Weaver. Additional research and editing by Darby 527 00:29:27,520 --> 00:29:32,640 Speaker 1: Masters and Abu Zafar. Our executive producer is Christina Everett. 528 00:29:33,320 --> 00:29:35,520 Speaker 1: The show is mixed by Vahid Fraser