Speaker 1: What do you do when life doesn't go according to
Speaker 1: plan that moment you lose a job, or a loved one,
Speaker 1: or even a piece of yourself. I'm Brookshields and this
Speaker 1: is now What, a podcast about pivotal moments as told
Speaker 1: by people who lived them. Each week, I sit down
Speaker 1: with a guest to talk about the times they were
Speaker 1: knocked off course and what they did to move forward.
Speaker 1: Some stories are funny, others are gut wrenching, but all
Speaker 1: are unapologetically human and remind us that every success and
Speaker 1: every setback is accompanied by a choice, and that choice
Speaker 1: answers one question, now what. I just was looking at
Speaker 1: the what to expect when you're expecting books, but I
Speaker 1: was looking at the journey of them. Yeah, the drawing,
Speaker 1: yeah yeah, yeah yeah, it's unabelievable. I'm writing about all this,
Speaker 1: and so it's just it's so fascinating to me because
Speaker 1: I was like, look, how miserable this person looks, Yeah,
Speaker 1: rocking chair with like sensible shoes. I'm like, what is happening?
Speaker 1: But you know they have no concept also of the
Speaker 1: mental health struggles and so rough, your nipples hurt, you
Speaker 1: can't poop, you haven't slept, you feel disgusting. You're sweaty.
Speaker 1: Did you shower this week? I mean, nothing works. You're
Speaker 1: so freaking tired, you want to die, and you're supposed
Speaker 1: to keep another human alive. I mean that is a
Speaker 1: disaster area. And I had everything going for me, so
Speaker 1: I don't even know how people do it. My guest
Speaker 1: today is doctor Susanne Gilberg Lens. Doctor Suzanne is a gynecologist,
Speaker 1: a woman's health expert and advocate, and an authority on
Speaker 1: one of the biggest now what moments in many of
Speaker 1: our lives, menopause. She literally wrote the book on it
Speaker 1: and created a program called Menopause boot Camp to help
Speaker 1: women better understand the transition. She worked with women of
Speaker 1: all ages for more than two decades, and I reached
Speaker 1: out to her because I wanted to talk about what
Speaker 1: she's observed during that time and how all of us,
Speaker 1: regardless of our age, can be better advocates for our
Speaker 1: physical and mental health. I'm thrill that she agreed to
Speaker 1: do this show, and I'm grateful to be able to
Speaker 1: share her wisdom with you all. Here is doctor Susanne
Speaker 1: Gilberg Lenz. Hi, there, it is so nice to meet too. Oh,
Speaker 1: thank you so much. It's such an honor for me.
Speaker 1: It's so important, and I love having these conversations. Thank you,
Speaker 1: Thank you for having me on. I've been wanting to
Speaker 1: do an episode just that is focused on women's health
Speaker 1: for a while now. I mean, I've talked about my
Speaker 1: own health issues and STRUG in my books, but something
Speaker 1: that struck me in preparing for this interview was the
Speaker 1: general lack of knowledge on women's health. Why do you
Speaker 1: think it's remained practically taboo. I'm going to use this
Speaker 1: word because the patriarchy and menopause specifically, is I like
Speaker 1: to say, is you know, misogyny and agism had a
Speaker 1: baby and they called it menopause. You know, I'm full
Speaker 1: of these little aphorisms, but I will tell you that
Speaker 1: during medical school, I came in thinking I was interested
Speaker 1: in women's health, and I really tried to convince myself
Speaker 1: otherwise because I felt like obstetrics was probably going to
Speaker 1: be hard, and I was right, But I couldn't convince
Speaker 1: myself otherwise. So why did I love it? I loved
Speaker 1: the opportunity to get to know people over the course
Speaker 1: of their lives. I loved development and physiology and normal
Speaker 1: stuff and how to help people through these transitions in
Speaker 1: these crisis. Yes, I love medicine. I love the operating
Speaker 1: room I get to operate, and delivering babies has been magical.
Speaker 1: Why do I think we don't know about it? I
Speaker 1: think that the way our medical training system grew up,
Speaker 1: it grew up in an era where women were like
Speaker 1: considered other small men with ovaries. I don't know, like
Speaker 1: they just women are not thought of as our own entity.
Speaker 1: And you know, we have some magical powers, or appear
Speaker 1: to because they are mysterious. They are scary rather than
Speaker 1: being seen for what they are, which is like an
Speaker 1: amazing gift, just like men have amazing gifts. Human beings
Speaker 1: have amazing gifts whatever their gender is. But physiologically we
Speaker 1: are able to carry babies and deliver them out into
Speaker 1: the world and keep them fed yep, and keep them alive.
Speaker 1: And in keeping with what we're talking about, society itself
Speaker 1: has normalized female pain. Oh yeah, they don't tell us
Speaker 1: that you know IVF will pain or do you know
Speaker 1: gynecological procedures could be painful? That all of these things happen?
Speaker 1: You know? So how do you how do you with
Speaker 1: your patients approach like pain? And discomfort in your own practice.
Speaker 1: How do you talk about such a good question? And
Speaker 1: I will tell you that it is definitely one of
Speaker 1: the questions of the moments right now on social media,
Speaker 1: such an interesting and complicated thing, because I will say
Speaker 1: that I also feel that there's been sort of this
Speaker 1: uh celebration of pain around birth, as if it's some
Speaker 1: kind of badge of honor, like as if growing that
Speaker 1: fetus and you know, birthing a baby isn't enough. And
Speaker 1: I'm not saying that nature isn't a miracle, and I'm
Speaker 1: not saying that physiologic, unmedicated birth isn't an option for
Speaker 1: a person who wants it. And I support people's desires
Speaker 1: to do things the way they want while understanding that
Speaker 1: they don't really always know what's going to happen. I mean,
Speaker 1: that's part of the beauty of birth, by the way,
Speaker 1: is that the surrender into it, right, you don't know
Speaker 1: what's going to happen, forget it, and you forget it, well, yes,
Speaker 1: if you're lucky. So having said that, I think there's
Speaker 1: a weird dichotomy there. I got to tell you to me,
Speaker 1: this idea that women don't experience pain when they're having
Speaker 1: a biopsy, when they're having an IUD and inter uterine
Speaker 1: device placed into their uters. Whatever it is that we're
Speaker 1: doing is so cruel and weird. So what I always
Speaker 1: discuss with my patients, I do it differently. I've learned
Speaker 1: over the years. I learn from my patients. I tell them, Okay,
Speaker 1: here's the thing that we need to do, where you
Speaker 1: want to do, and here are the options. Pain management
Speaker 1: is always an option in my office. We use either nitronox,
Speaker 1: which is like nitrosoxide, like old school dentist stuff. We
Speaker 1: can do a cervical block, which, by the way, in
Speaker 1: and of itself, the injection to the cervix is unpleasant.
Speaker 1: We can use sedation, whether they take adavan orally by
Speaker 1: mouth and have a ride. I find that when I
Speaker 1: talk to the patients in advance, and I always do,
Speaker 1: and I advise them here are your options, that right
Speaker 1: there makes all the difference because they feel heard and
Speaker 1: they feel that they're in a space that is going
Speaker 1: to respect what their needs may be. You've given them
Speaker 1: a choice, which gives them a certain amount of power.
Speaker 1: And I think some of what I've experienced gynecologically, I
Speaker 1: was never informed about anything that was happening. So I
Speaker 1: didn't know about HPV and I had to have this
Speaker 1: extensive cone biopsy. I was never told what that was
Speaker 1: going to feel like. A It was a man, a
Speaker 1: great doctor, great surgeon, but I don't know if a
Speaker 1: female would have done it that aggressively. Yes, he got
Speaker 1: all the cancer, but by the same token, it made
Speaker 1: it impossible for me to get pregnant. Yeah, naturally, I
Speaker 1: think some of that. I want to be careful about
Speaker 1: some of this because this is your experience, and I
Speaker 1: think the experience you named it, you didn't have information.
Speaker 1: I mean, you didn't really have information in a conversation.
Speaker 1: And I have to say over the years that I've
Speaker 1: seen just as many female physicians perpetrate that as male physicians.
Speaker 1: Some of it's generational, some of it's generational. Some of
Speaker 1: it is also just how open you are and how
Speaker 1: curious you are as a physician. I think you know,
Speaker 1: the medical training system is very toxic and very military,
Speaker 1: by the way, and so it can breed a lot
Speaker 1: of fear based decision making and a lot of what
Speaker 1: looks on the outside like egotistical kind of authoritarian behavior
Speaker 1: on the part of the physician. You got to understand
Speaker 1: that we grow up in a system that rewards that,
Speaker 1: and that also asks us not to question. I've been
Speaker 1: I've had a reputation, let's say, over the course of
Speaker 1: my career, because I want to do the right thing,
Speaker 1: and I think nobody could ever point a finger and
Speaker 1: say that I don't take great care of my patients
Speaker 1: or that my outcomes are not fantastic. But I question things.
Speaker 1: So I think if you look at like the generation
Speaker 1: of the physician, there's a lot of things I think
Speaker 1: if we don't have what's called I just came back.
Speaker 1: This is tangential, but not I just came back from
Speaker 1: an incredible experience at a place called MEA, the Modern
Speaker 1: Elder Academy. It's un believable and one of the things
Speaker 1: they talk about it's very similar to the stuff you're
Speaker 1: talking about, sort of that new beginning as we get older,
Speaker 1: how do we want to be in our in our lives,
Speaker 1: in our in the community, in the world. For someone
Speaker 1: like me, having a growth mindset has been the key.
Speaker 1: It's why I was able to ask these questions. It's
Speaker 1: why I was able to change course based on my
Speaker 1: training around pain management versus what I do today. It's
Speaker 1: why I was able to say menopause, Well, this is
Speaker 1: really important. We're not learning about it as physicians. We're
Speaker 1: not supporting our patients through the process. How can we
Speaker 1: do things different? When is it time to start bringing
Speaker 1: the alarm bell like pertaining to pain, what do you
Speaker 1: say to your I think again, this is why the
Speaker 1: discussion ahead of time is so important. And so I'm
Speaker 1: so glad we're having this conversation because one of the
Speaker 1: things that people can do at any age is if
Speaker 1: their doctor's not bringing it up, come with questions. You
Speaker 1: know what, be the annoying person whatever. You're the person
Speaker 1: who's receiving care. If they don't like it, maybe that's
Speaker 1: not the right environment for you. If I'm doing something
Speaker 1: with a patient and they can't tolerate it, I'm not
Speaker 1: pushing through. They can come back. We don't have to
Speaker 1: do this today. And when people are anxious, by the way,
Speaker 1: their pain threshold is much lower. So again, if they
Speaker 1: don't feel safe and they don't feel listened to, it's
Speaker 1: going to make your job as a physician harder. So
Speaker 1: it's I think unfortunately. I want your listeners to know
Speaker 1: that their physician may not ask the questions. You come
Speaker 1: with questions prepared. I have in my menopause, Balo Camp,
Speaker 1: I have like two pages of like advocacy questions, not
Speaker 1: to be an a whole and confrontational, but to come
Speaker 1: in and be like, hey, I need to take care
Speaker 1: of myself. How are we going to work together as
Speaker 1: a team. I call this show now What because it's
Speaker 1: really about those times in your personal or professional life
Speaker 1: that surprise you and shape you. What's a now what
Speaker 1: moment that shaped your work as a physician? Oh wow,
Speaker 1: Oh well, there's so many, and I think it depends
Speaker 1: on the person. I'm going to share a couple of
Speaker 1: personal things about myself that really changed the way I
Speaker 1: perceived things in the way I practiced medicine. I had
Speaker 1: my older child, my son, who will be twenty six
Speaker 1: in October, Jaron, while I was the beginning of my
Speaker 1: second year of obg Way in residency. That was pretty brutal,
Speaker 1: and I was young and thought and I've been, you know,
Speaker 1: doing OB and watching this very high pressured environment in
Speaker 1: which I was training, and I thought to myself, Wow,
Speaker 1: there's a lot of medical interventions going on here. As
Speaker 1: is nineteen ninety seven, I don't think I we need
Speaker 1: all that, and I like on the down low. Brook
Speaker 1: took a Bradley Method natural childbirth course. Okay, nobody in
Speaker 1: the class knew I was an OBIE resident. It was
Speaker 1: a little extreme, but I was like, I'm going to
Speaker 1: take what I like and leave the rest. I came
Speaker 1: in and my labor was going super fast. And despite that,
Speaker 1: my doctor did all this stuff. She broke my water,
Speaker 1: she gave me pitocin, all these things. My husband, I
Speaker 1: didn't know till later, was in the corner trying to advocate, like,
Speaker 1: do you really need to do that. I know Susanna
Speaker 1: doesn't really want you to do that. Do you need
Speaker 1: to do that? I didn't need any of that stuff,
Speaker 1: And it stole my confidence book, and I said to myself,
Speaker 1: I don't think any of that needed to happen, and
Speaker 1: I'm never going to do that to another person. I'm
Speaker 1: never going to do that to a patient. Nothing quote
Speaker 1: bad happened. I was fine, he was fine. You know,
Speaker 1: I'm not crying. I'm just saying it changed my life.
Speaker 1: Then later one of my mentors, who's an internationally renowned
Speaker 1: breast cancer oncologist, she started sending me patients and she
Speaker 1: started sending me a lot of her young breast cancer
Speaker 1: patients and they were rendered menopausal in their thirties. And
Speaker 1: I was like, Filhelmina, I don't know how to treat this.
Speaker 1: She's like, well, you'll figure it out. And this is
Speaker 1: when I realized I didn't understand menopause and I hadn't learned.
Speaker 1: And I taught and taught and taught myself and went
Speaker 1: to conferences and read and worked together with them as
Speaker 1: a team and really helped understand how to restore their
Speaker 1: sense of self, how to feel confident in their body again,
Speaker 1: how to regain their sexuality. Some of them ended up
Speaker 1: getting pregnant after their chemo was done. It was like,
Speaker 1: really miraculous. And I became kind of known as this
Speaker 1: pre menopausal breast cancer gynecologist. And then I got breast
Speaker 1: cancer in my forties, and I was a pre menopausal
Speaker 1: breast cancer patient. So all of these things added up
Speaker 1: to reminding me I'm one of you, you're one of me.
Speaker 1: I was always very open with my patients about my
Speaker 1: own struggles and what I was learning. I had a
Speaker 1: deeper and a wider toolkit because I was doing Iraveda
Speaker 1: and I was doing herbs, and I was doing holistic medicine,
Speaker 1: but also I believed in radiation and surgery, and I
Speaker 1: did it. And I also saw acutely how ignored so
Speaker 1: many of our quote issues were, and I just it.
Speaker 1: Really every step along the way was an AHA for
Speaker 1: me because I said to myself, Okay, so I've learned
Speaker 1: all these tools, and some of these things actually don't
Speaker 1: make sense. Shifting to a more biological now what question,
Speaker 1: what are some of the biological timelines that young women
Speaker 1: really need to just be cognizant of. And then the
Speaker 1: expense of fertility. Yeah, it's costly emotionally, physically, and financially.
Speaker 1: I mean, I think the problem with some of this
Speaker 1: is that some of the data around fertility changes is
Speaker 1: old and it gets get called into question. But the
Speaker 1: reality is that we know that there is a pretty
Speaker 1: big drop off in live births resulting from pregnancies after
Speaker 1: the age of thirty five. So that doesn't mean that
Speaker 1: if you're thirty eight you should go into a panic.
Speaker 1: You know, I have patients getting pregnant in their early
Speaker 1: forties all the time. I think, if you think you
Speaker 1: want to have kids, i'd say in you know, your
Speaker 1: early thirties, you should start thinking about what is the
Speaker 1: plan there, because maybe you're not ready for a number
Speaker 1: of reasons to have kids, But I think that's the
Speaker 1: time to start talking to your The issue is that
Speaker 1: the testing that we have available is indirect, and it's
Speaker 1: I don't want I don't think people should be like
Speaker 1: living or dying by the blood tests, like specifically the
Speaker 1: anti malarian hormone which has become very popular. That test
Speaker 1: has really been developed in order to look at who's
Speaker 1: going to be a good responder to in vitro fertilization.
Speaker 1: You know, at least have a conversation so that you
Speaker 1: know what your options are, whether you have the available
Speaker 1: resources to do egg freezing, which by the way, is
Speaker 1: not a guarantee at all, or if you say to yourself,
Speaker 1: maybe we shouldn't, you know, put this off another five years.
Speaker 1: If we really want to have a family, we might
Speaker 1: have to pull the trigger or just be okay with
Speaker 1: the consequences. The conversation I have with my patients is
Speaker 1: that what consequences are you okay with? Including testing? Because
Speaker 1: if we're going to do the test and it's just
Speaker 1: going to freak you out, but you're not going to act.
Speaker 1: I don't know that I want to do this test
Speaker 1: on you. What about new parents, Oh my gosh, given
Speaker 1: any kind of an instruction manual, you know, they have
Speaker 1: no concept. Also of the mental health struggles, it's so rough.
Speaker 1: I remember having a moment with my first and I
Speaker 1: was thirty thirty thirty one with a really supportive partner
Speaker 1: at the time, and I remember having a night where
Speaker 1: I was like, I understand why a teenage mom would
Speaker 1: leave this baby in a trash gown. Okay, And I
Speaker 1: just want you to know that I love that, I
Speaker 1: love this baby so much and I could not. I
Speaker 1: was done. Your nipples hurt, you can't poop, you haven't slept,
Speaker 1: you feel disgusting, you're sweaty. Did you shower this week?
Speaker 1: I mean, nothing works. You're so freaking tired, you want
Speaker 1: to die, and you're supposed to keep another human alive.
Speaker 1: I mean, that is a disaster area. And I had
Speaker 1: everything going for me, So I don't even know how
Speaker 1: people do it. So do you tell your patients that
Speaker 1: without trying to detern them from what I tell them
Speaker 1: is Because here's the thing, especially with the first one,
Speaker 1: they're in such a cloud and they're so excited. Some
Speaker 1: of them are nervous, by the way, and I think
Speaker 1: having a pregnancy in twenty twenty three or you know,
Speaker 1: versus in nineteen ninety six kind of a little different, right,
Speaker 1: Like we were just starting to scratch a service talking
Speaker 1: about stuff like barely right, you know, when you and
Speaker 1: I were having kids. So they have a little more information,
Speaker 1: but in general, they're not in reality. And what I
Speaker 1: try to do for them is not burst their bubble,
Speaker 1: but make sure that again they have information and they
Speaker 1: feel resourced and they know that I'm a safe person
Speaker 1: to come to, that our practice is there for them,
Speaker 1: and leading up to the post, leading up to the birth,
Speaker 1: like as they're starting to get anxious, and reassuring them like, look,
Speaker 1: some of it's going to really fucking suck, and who
Speaker 1: are your people? Who are the people that you're tapping,
Speaker 1: because you need to have that in advance. So my
Speaker 1: patients who come into the pregnancy with mood disorders already
Speaker 1: in a lot of ways, they are in better shape
Speaker 1: because we know they're to increase risk, and so we
Speaker 1: have a plan set up. Okay, the psychiatrist is on board.
Speaker 1: This is the meds. These are the point people, this
Speaker 1: is what the partner's doing. You know, we have a
Speaker 1: check in plan that's very different than maybe the rest
Speaker 1: of the patients because the reality is you may know
Speaker 1: that like for a lot of people who have a baby,
Speaker 1: they don't even see anybody again for six weeks, which
Speaker 1: is insane. They don't do it like this in other
Speaker 1: countries or other cultures. I want to pivot to menopause,
Speaker 1: specifically the time leading up to menopause, perimenopause, which you've
Speaker 1: gotten on record saying that you what you want to
Speaker 1: do away with that term. Tell me why? Well, I mean,
Speaker 1: here's the thing. I think initially it was a wonderful
Speaker 1: term because it gave people an understanding that it's not
Speaker 1: just like boom menopause, but that there is a period
Speaker 1: of time that could last up to a decade of
Speaker 1: changes in your body, and that they're real. It's not
Speaker 1: you're not being crazy, you're not being difficult, you're not
Speaker 1: making it up. Because your labs are quote normal and
Speaker 1: you still have a regular cycle. There is something going
Speaker 1: on in your body. So I think naming it and
Speaker 1: again giving information was helpful, but turning it into a
Speaker 1: diagnosis that you need to balance, balance your hormones. That
Speaker 1: makes me nuts because it's pathologizing something that is not
Speaker 1: a pathology. As I mentioned earlier, this is a developmental
Speaker 1: physiologic event, puberty of midlife. I would much rather people
Speaker 1: understand there's going to be a process. Your whole life
Speaker 1: is a process. Your cycle is a process. And what
Speaker 1: are the things that they can do to be healthy,
Speaker 1: maintain their health, sustain their health and feel their best
Speaker 1: self as much as possible. How do you know you're
Speaker 1: in menopause? Menopause itself is one day of your life.
Speaker 1: Menopause is the cessation of cycles, so in a person
Speaker 1: who has a uterus, and this is important. When you
Speaker 1: hit twelve months consecutively without a period between the ages
Speaker 1: of forty five and fifty five ish, that's menopause. And
Speaker 1: the menopause is one day. Perimenopause is the time leading
Speaker 1: up to it. It could be three years of noticeable
Speaker 1: changes for you. It could be twelve years. Everything from
Speaker 1: your period quality changing closer together, heavier skipping, sleep changes,
Speaker 1: fatigue changes, intense PMS symptoms. I see a lot of anxiety, yes,
Speaker 1: dry vagina, urinary tract infections, anxiety and panic that comes
Speaker 1: out of the blue, you know, on and on and on.
Speaker 1: How do we not turn this into a death sentence? Though? Like,
Speaker 1: how do we sort of not be filled with dread?
Speaker 1: There's got to be another way to sort of frame
Speaker 1: this or revere it. I don't know. Maybe I'm living
Speaker 1: in the clouds. I don't think you are. I think
Speaker 1: it's tough because the lead up to it is really
Speaker 1: sounds really unpleasant when we list out, you know, the
Speaker 1: thirty four symptoms of menopause or whatever the hell is
Speaker 1: you know online, and then you compound it with this
Speaker 1: cultural narrative, which is that we are used up and
Speaker 1: irrelevant and dried up and no longer wanted. But what
Speaker 1: I really want people to understand is that the reality
Speaker 1: is that for people who go through it in a
Speaker 1: community of other women who are sharing advice and support
Speaker 1: and have tools that are useful and beneficial and validated,
Speaker 1: it's a completely different experience, just like any other experience
Speaker 1: we go through with loved ones and with our girlfriends. Honestly,
Speaker 1: we get through it. We get through the breakups, we
Speaker 1: get through the job losses, we get through the changes
Speaker 1: in our lives. We get through the pregnancies, the lack
Speaker 1: of pregnancies. And when we get to the other side,
Speaker 1: here's the awesome thing. There's this incredible liberation. There's this
Speaker 1: unleashing of creativity, of recognition of our own power and agency.
Speaker 1: And I will tell you that I feel fucking great. Man.
Speaker 1: I'm in a great relationship. My sex life is awesome. Sorry, TMI,
Speaker 1: because I do things to make that work. I have
Speaker 1: a book that I published in my mid to late fifties.
Speaker 1: I'm going to be fifty eight in February. I'm I'm
Speaker 1: living my best life. I'm great. Do you have any
Speaker 1: tips for helping with the side effects I have just metopause?
Speaker 1: Oh my gosh, Yes, I mean I have. And the
Speaker 1: book covers not everything, but it covers a lot of
Speaker 1: different categories. So all the lifestyle stuff, whether it's really
Speaker 1: digging into your sleep, like your sleep honestly is the
Speaker 1: most important thing you have to recover your sleep and
Speaker 1: protect your sleep. Exercise, movement, fitness. If you're doing it already, fantastic.
Speaker 1: If you're not doing it, even better, you have something
Speaker 1: you can do. You know, how you eat, when you eat,
Speaker 1: stress management, meditation, stillness. Honestly, a lot of that stuff
Speaker 1: is the most potent medicine that will sustain you through
Speaker 1: not only that process, but the rest of your life.
Speaker 1: Making sure you're looking at your overall general health because
Speaker 1: we know as women, our hearts and our brains are
Speaker 1: going to decline as we get older if we're not
Speaker 1: paying attention to not only our exercise and our lifestyle
Speaker 1: and our stress. Alcohol use, hormones, are they right for you?
Speaker 1: And then specific herbs that have decent data. Never going
Speaker 1: to compare it to pharmaceutical data. That's not happening, Let's
Speaker 1: be honest. But there is data to support some supplement use.
Speaker 1: And then hormone therapy, which can be magical for the
Speaker 1: right person and have many many benefits. There's a lot
Speaker 1: of talk about hormones, Yes, I mean, what is your
Speaker 1: thought on I had a doctor who said, you know what,
Speaker 1: why don't we just help you over the edge so
Speaker 1: that you're not just plummeting off the off the cliff.
Speaker 1: And I got to tell you it's been amazing. I mean,
Speaker 1: there's a lot of talk about you, hormone testing and
Speaker 1: hormone therapy. Do you have a strong opinion about it?
Speaker 1: I have a strong opinion that, like with everything else,
Speaker 1: as long as you're educated and you're getting supported, that
Speaker 1: might be the right decision for you. I am definitely
Speaker 1: in the camp that says hormones should be part of
Speaker 1: the toolkit for a lot of people. There are probably
Speaker 1: some people that can't use it, people who have already
Speaker 1: had a blood clot What about hormone testing for non
Speaker 1: menopausal women. One testing is hogwash. There's no data to
Speaker 1: support it. And for people. First of all, I just
Speaker 1: told you the definition of menopause, so it's a clinical diagnosis.
Speaker 1: I will say if you, let's say you've had a
Speaker 1: hysterectomy or then that's a person that maybe we do
Speaker 1: hormone testing on. But to be honest, we're not treating
Speaker 1: those numbers, unlike blood sugar or thyroid, where we know
Speaker 1: there's a narrow range you have to be between here
Speaker 1: and here. Like I said, menopause is not a disease.
Speaker 1: We don't know. Oh, when your estrogen falls below here,
Speaker 1: that's when you have a hot flash on your progesterones.
Speaker 1: There you feel like you're want to kill your family.
Speaker 1: So we're not treating numbers. We're treating you. So doctors
Speaker 1: and practitioners who are doing tons and tons of tests
Speaker 1: and bringing you back all the time and charging you
Speaker 1: for this. That's a business model that's not evidence based.
Speaker 1: I'm not saying I never test hormones, because I do,
Speaker 1: but I use my brain and I individualize it. So
Speaker 1: I'm not against hormone testing, but the idea that you
Speaker 1: should be tes leading up. It's not going to do
Speaker 1: anything for you. We're going to treat your symptoms. You're
Speaker 1: having hot flashes, you can't sleep, estrogen you know more.
Speaker 1: It's a little more complicated than this because you need
Speaker 1: progesterone as well to protect your users, but also because
Speaker 1: progesterone can help with mood, can help with sleep, so
Speaker 1: there's so much benefit. And that's just for symptoms. The
Speaker 1: reality is that the data is very very clear that
Speaker 1: osteoporosis prevention is a thing. We can decrease the risk
Speaker 1: of bone loss and fractures if we start hormone therapy
Speaker 1: within ten years of menopause before the age of sixty.
Speaker 1: The information on dementia risk and heart disease is also
Speaker 1: starting to really be more and more robust. I'm a
Speaker 1: believer that for the right person, it is appropriate to
Speaker 1: start you on hormone therapy early and close to the
Speaker 1: time of menopause, even before if you need it for symptoms,
Speaker 1: because I think we're going to decrease your risk of
Speaker 1: heart disease, which is the number one killer of women,
Speaker 1: not breast cancer, even breast cancer survivors. The number one
Speaker 1: killer of breast cancer survivors because most of us are
Speaker 1: early stage, is heart disease. But also, women haven't really
Speaker 1: been taught to know this stuff. Are there any health
Speaker 1: conditions that we as women should look for? Oh? Yeah, well,
Speaker 1: like I said, and this is where it is so
Speaker 1: important for the younger members of the audience to understand
Speaker 1: that your health, just like your health going into a
Speaker 1: pregnancy is going to really affect the pregnancy and beyond,
Speaker 1: your health going into menopause is going to affect your
Speaker 1: menopause and beyond. So when we hit menopause, our hormone
Speaker 1: levels decline and we start seeing a big bump in
Speaker 1: metabolic disorders, so diabetes, pre diabetes, high cholesterol, all of
Speaker 1: these inflammatory issues that are all going to contribute to
Speaker 1: heart disease and to dimension Alzheimer's. Women are two to
Speaker 1: three times more likely to have Alzheimer's than men in
Speaker 1: the same age group. So this is why lifestyle, family history,
Speaker 1: risk factors are really important to understand and to advocate
Speaker 1: for yourself, because if you look at men in the
Speaker 1: same age group, they're getting their cardiac evaluations and are
Speaker 1: we That's another thing you need to go in and
Speaker 1: ask your doctor about. If you're fifty and you haven't
Speaker 1: had a deep dive into your cholesterol and other things,
Speaker 1: you need to ask your doctor about that. And if
Speaker 1: you have a male partner and they've been tested, why
Speaker 1: haven't you. I left my doctor because of this. By
Speaker 1: the way, so fascinating and this is twenty twenty whatever
Speaker 1: when it was, But that's a point. It feels like
Speaker 1: we've come a long way, but we have a long time.
Speaker 1: We have to take responsibility for ourselves. That's why a
Speaker 1: podcast like this is so important. Well, I think you're
Speaker 1: bringing it. You're bringing it into a place where we
Speaker 1: are a community and can discuss it. And there is
Speaker 1: safety in numbers. And I'm adamant in my life about
Speaker 1: owning and being so happy about my age. Why do
Speaker 1: you think aging is a positive thing? Oh my gosh,
Speaker 1: Like I mentioned to me, I know myself so much better.
Speaker 1: One of the big grief moments that I see for
Speaker 1: women is this loss of the period, Like we feel
Speaker 1: so identified with our cycle because we spend so many
Speaker 1: decades in it, avoiding it, managing it, whatever. And then
Speaker 1: it's like, who are we without a cycle? And guess
Speaker 1: what I really like? Who I am without a cycle?
Speaker 1: It turns out I was affected by my hormones and
Speaker 1: ways that I didn't even really realize. And I feel
Speaker 1: just more steady, I feel more like myself. I feel
Speaker 1: more calm. I'm like a pretty intense person, so I'm
Speaker 1: not as emotional in a way that bothers me. And
Speaker 1: I'm just like, like I said, I'm super creative, Like
Speaker 1: I'm digging into that creativity in a whole new way.
Speaker 1: It has been ah amazing. That was doctor Suzanne Gilberg Lenz.
Speaker 1: If you liked our conversation, go pick up a copy
Speaker 1: of our book, Menopause boot Camp. That's it for us today.
Speaker 1: Talk to you next week now. What with Burke Shields
Speaker 1: is a production of iHeartRadio. Our lead producer and wonderful
Speaker 1: showrunner is Julia Weaver. Additional research and editing by Darby
Speaker 1: Masters and Abu Zafar. Our executive producer is Christina Everett.
Speaker 1: The show is mixed by Vahid Fraser