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Speaker 1: Hey, everyone, it's Sophia. Welcome to Work in Progress. Welcome

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Speaker 1: back to Work in Progress, Whipsmarties. We are back with

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Speaker 1: doctor Mary Claire Haver for a special dive into her

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Speaker 1: new book, The New Perimenopause is officially out in the world.

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Speaker 1: We're thrilled you're here. You're one of the pre eminent

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Speaker 1: authorities on women's health, and you really are making sure

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Speaker 1: women's health stops being a brown paper bag bottomshelf conversation

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Speaker 1: in the American medical system. So thank you. We know

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Speaker 1: that women experience real biological changes, all of us at

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Speaker 1: some point, that medicine has been really slow to recognize

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Speaker 1: or properly treat. And you talk about this in the

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Speaker 1: second chapter of the book, Zone of Chaos. What why

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Speaker 1: for our friends at home? Why has perimenopause remained this

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Speaker 1: blind spot for so long?

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Speaker 2: I well, when we look at women's health funding in general,

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Speaker 2: of in twenty twenty three, the NIH. So when we

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Speaker 2: look at who funds research, right, it's the National Institutes

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Speaker 2: of Health Pharma that get their medications through and private companies. Okay,

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Speaker 2: so right now INIH, you know, things are changing rapidly

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Speaker 2: and I don't know what's going to happen there, it's

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Speaker 2: not prioritized, so you know, so now, but we're also

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Speaker 2: seeing the greatest transfer of wealth to women in the

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Speaker 2: history of the world. And women don't build rockets or

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Speaker 2: buy yachts.

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Speaker 3: They invest in health in other women.

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Speaker 2: Choker Blenda Gates huge one hundred million dollars. You know,

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Speaker 2: we look at the Care Foundation, we look at Mackenzie Scott,

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Speaker 2: you know, like, uh, Missus Walton Alice, I think just

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Speaker 2: built a medical.

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Speaker 3: School for the underserved. So you know, that's what women do.

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Speaker 2: So like I'm very, very very hopeful in that, and

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Speaker 2: like my husband and I just started a foundation to

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Speaker 2: fund women's health you know, like clinically relevant menopause research.

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Speaker 3: So that's what we want to do. We're not in

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Speaker 3: by you know, building a rocket.

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Speaker 2: So so that's exciting, innih. I don't know what's going

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Speaker 2: to happen. It's not looking that great right now. So

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Speaker 2: but in twenty twenty three, we had a forty three

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Speaker 2: billion dollar budget, right, fifteen percent of that went to

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Speaker 2: women's health.

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Speaker 3: The vast majority of that.

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Speaker 2: Went to pregnancy, which is important, but it's not the

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Speaker 2: only thing. And rested in ovarian cancer. Okay, less than

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Speaker 2: one percent of that budget, not of the total budget

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Speaker 2: went to menopause. Okay, So now I'm going to like

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Speaker 2: go to PubMed and put in the word pregnancy. Give

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Speaker 2: me every article ever written of like great medical journals

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Speaker 2: that mention the word pregnancy, and it's about one point

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Speaker 2: two million.

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Speaker 3: Okay.

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Speaker 2: That represents brain power, money, funding, studies, back office staff,

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Speaker 2: you know all the things, patient recruitment. Okay, Now I'm

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Speaker 2: going to type in the word menopause, and right now

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Speaker 2: it's about ninety nine thousand.

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Speaker 3: So twelve to one.

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Speaker 2: Wow, more women will go through menopause than have children. Right, Okay,

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Speaker 2: Perry menopause has nine thousand stop. Not one word mentioned

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Speaker 2: about peri menopause until nineteen seventy seven.

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Speaker 3: It was not a thing.

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Speaker 2: It wasn't even recognized as a transition until nineteen seventy seven.

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Speaker 1: Wow. And so when we spoke last time about how

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Speaker 1: women are often dismissed, Oh she's emotional, Oh she's a

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Speaker 1: little crazy, Oh she has a short fuse. Whatever the

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Speaker 1: idea that this thing that literally happens to all of us.

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Speaker 1: And when I think about the math, okay, hold on, Yes,

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Speaker 1: we got fifteen percent of the NIH budget, but we're

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Speaker 1: fifty one percent of the population. One percent of fifteen

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Speaker 1: percent was dedicated to menopause, even though one hundred percent

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Speaker 1: of fifty one percent of the population will go through it.

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Speaker 3: Like it just so it's so stupid, Like it's all performative.

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Speaker 2: Right. So the last administration said, oh, we're going to

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Speaker 2: do one hundred million dollars of new funding for women's health. Okay,

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Speaker 2: of forty three billion. Do the math, one hundred million.

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Speaker 2: Everyone comes to the table, indometriosis, Policyscoberian syndrome, all the

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Speaker 2: autos that primarily affect women, rheumatartarrite, you know, and everyone's like,

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Speaker 2: give me a kernel, you know, and it's not enough.

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Speaker 2: And I feel like RBG, like when they're nine, Like

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Speaker 2: until we get all the funding for twenty years and

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Speaker 2: then we'll built them out to men when we feel like.

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Speaker 1: It, Yeah, to catch up, because by the way, they're

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Speaker 1: doing just fine.

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Speaker 2: I mean, there are issues there too, but I only

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Speaker 2: take care of women, so only focus on that, I guess.

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Speaker 3: I guess.

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Speaker 1: I mean, in the balance of the scales, you're crimped.

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Speaker 1: Sometimes I say things very hyperbolically and then people get

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Speaker 1: mad at me, and I'm like isn't it obvious what

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Speaker 1: I think I realized. No, you have to be very

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Speaker 1: specific all time. You know this, you're a doctor. I

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Speaker 1: just am so fascinated by this because the gaps, the

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Speaker 1: chasms in the funding mean there are chasms, and how

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Speaker 1: we're taken care of, and I really appreciated. In the

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Speaker 1: fifth chapter in the book, you talk about how the

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Speaker 1: mental health shifts can come first and when you consider

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Speaker 1: system overwhelmed, like if your computer's doing too many things

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Speaker 1: at once, it'll crash. Right, our brains are not dissimilar.

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Speaker 1: And you talk in the fifth chapter of The New

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Speaker 1: Perimenopause about how perimenopause can actually trigger these mental health

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Speaker 1: experiences like depression, anxiety. So many women will say, I

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Speaker 1: don't know what's wrong with me. I don't feel like myself.

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Speaker 1: All the things I do, I just can't I can't

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Speaker 1: do them anymore. How do you help people identify mood

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Speaker 1: changes and rather than feel like it's some sort of

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Speaker 1: personal failure, understand it's part of their biological evolution.

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Speaker 2: We talk about when's the last time you didn't feel

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Speaker 2: this way? Tell me about that, Mary Claire, you know,

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Speaker 2: tell me about that, Sophia, When did you have all

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Speaker 2: this managed, so like walk me through the transition for

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Speaker 2: where you are to day to where you were, and

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Speaker 2: we try to look for triggers like, you know, did

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Speaker 2: your dad die, did you lose your job? Are you

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Speaker 2: fighting with your spouse or you you know, with your partner,

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Speaker 2: are you are the kids going through you know, their

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Speaker 2: hormone changes at the same time.

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Speaker 3: Which is so unfair, so unfair. So you know, are

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Speaker 3: you in a big sandwich generation?

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Speaker 2: And oftentimes it's let's do a trial of hormone therapy

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Speaker 2: and see if you get better. The data out of

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Speaker 2: Australia is clear if it is new onset anxiety or depression,

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Speaker 2: or she was totally fine before starting her on menopause,

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Speaker 2: hormone therapy In parity, menopause has better outcomes than starting

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Speaker 2: her on an SSRI. If she was on an SSRI

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Speaker 2: and doing great, like she's had a year's long history

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Speaker 2: well managed with her medications, all of a.

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Speaker 3: Sudden she's breaking through. The symptoms are back. Start her, don't.

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Speaker 2: Add a dose or increase yet, try go do a

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Speaker 2: trial of hormone therapy. First wow for these women and

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Speaker 2: it's going to make a huge difference.

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Speaker 3: M Wow.

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Speaker 1: You know you talk about what you wish you'd known

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Speaker 1: at thirty five, and so when you talk about this,

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Speaker 1: that shift because to your point, someone might have been

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Speaker 1: on an SSRI since college and been crushing and then

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Speaker 1: suddenly feel like she's drowning, and I imagine that might

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Speaker 1: happen around thirty five or forty. So, so what would

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Speaker 1: you put on that list for any women in that

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Speaker 1: age range you know who are around thirty five who

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Speaker 1: are listening to talk today, what do you want them

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Speaker 1: to know now so they don't have to learn what

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Speaker 1: they wish they'd known it thirty five at forty five.

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Speaker 2: Listen, educate yourself as much as possible about this process

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Speaker 2: and all the organ systems that could be affected. Not

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Speaker 2: everything is menopause or perimenopause, but we're missing so much

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Speaker 2: of what is, and women are suffering needlessly when we

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Speaker 2: have multiple ways to support you through this. But you're

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Speaker 2: going to need to find a menopause educated clinician, and

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Speaker 2: they're not easy to find, and so you know it's

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Speaker 2: going to take some hustle. You know, it's going to

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Speaker 2: take some reading, it's going to take some self evaluation,

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Speaker 2: but we've got tools for you, and you do not

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Speaker 2: have to suffer.

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Speaker 3: You can live your best life.

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Speaker 1: Yeah. Now you mentioned in our in our last chat

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Speaker 1: that you analyze everything from you know, your ferretine levels

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Speaker 1: to vitamin D to how active you're being. Are are

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Speaker 1: there things that you think just universally track for women

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Speaker 1: like I've spoken to some other medical professionals who say

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Speaker 1: menting vitamin D and magnesium before bed can be two

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Speaker 1: of the quickest things you can do that'll change your life.

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Speaker 3: I agree.

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Speaker 2: Okay from a you know, mag bisclicinate is great at

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Speaker 2: relaxing the body, so that's why it works so well

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Speaker 2: before bud And like full disclosure, I have a supplement company.

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Speaker 2: We sell a sleep product that contains max so take

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Speaker 2: it with a grain of salt.

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Speaker 3: You can get this stuff anywhere.

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Speaker 2: But we also have elthyanine, which is a natural anti

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Speaker 2: anti anxiety kind of stops those helps to stop the

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Speaker 2: racing thoughts, you know, mixed together. But eighty percent of

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Speaker 2: our patients or vitamin D low or deficient. And you know,

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Speaker 2: optimal is not the same as deficient. And so for

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Speaker 2: a healthy patient, you really wanted to be above sixty

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Speaker 2: to one hundred ish and her vitamin DLA her ceerin,

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Speaker 2: vitamin D level mag If you're going to do a

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Speaker 2: magnesium level, you want an red intracellular like intra red

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Speaker 2: blood cell magnesium that's more of what your stores are

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Speaker 2: rather than what's floating around the blood because that blood

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Speaker 2: that can fluctuate the serum level. If you like, Ferretin

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Speaker 2: is such a great way to see what your iron

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Speaker 2: stores are doing. It's the first thing to go when

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Speaker 2: we're dealing with iron deficiency. So you really want a

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Speaker 2: ferretin level. So but if you're just I'm gonna say, okay,

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Speaker 2: take one thing you can safely take up to four

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Speaker 2: thousand I use a vitamin D a day without worries

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Speaker 2: of toxicity. So start there. Track your nutrition just for

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Speaker 2: a week, don't be crazy about it. How much fiber

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Speaker 2: are you getting, how much vitamin D are you getting,

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Speaker 2: how much magnezim are you getting? So many of us

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Speaker 2: the average American woman is getting ten to twelve grams

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Speaker 2: of fiber and her diet per day. For gut health,

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Speaker 2: it's a minimum of twenty five. For cardiovascular it's thirty five.

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Speaker 2: So that is an easy thing up that fiber in

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Speaker 2: diet's not seeds, lugumes, a fiber supplement, you know, to

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Speaker 2: get you over the hump if you need it.

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Speaker 1: Wow. See little things like that that would probably change

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Speaker 1: the way we all feel in our bodies day that

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Speaker 1: we don't even know to start with.

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Speaker 3: Yeah, so thank you, You're welcome.

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Speaker 1: I'm excited about the fact that your approach is so

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Speaker 1: holistic and frankly that you wrote us a book because

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Speaker 1: you know, you do have a clinic, but you can't

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Speaker 1: see every woman in the world, but every one of

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Speaker 1: us can read the book to be better prepared or

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Speaker 1: to cope with current symptoms of parry or menopause. I'm

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Speaker 1: just thrilled to have been able to have this conversation

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Speaker 1: with you and to get to see your face even

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Speaker 1: though we're not together personally.

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Speaker 3: Friends.

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Speaker 1: The new Peri Menopause by doctor Marie Claire Haveer is

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Speaker 1: out now. Congratulations on another fantastic book, and thank you

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Speaker 1: for writing this for us.

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Speaker 3: Thank you, thanks for having me