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Speaker 1: First, let me give a little context, shall I, because

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Speaker 1: this one's out of left field unless you really know

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Speaker 1: me and my goals for this show, and then it

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Speaker 1: makes absolute sense. So my mom passed September nineteenth, you

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Speaker 1: know that, and my dad was there and we had

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Speaker 1: we had caretakers around the clock, but he was there

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Speaker 1: by himself, and my brother's not there anymore to swing

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Speaker 1: behind and check on him. He's a very, very severe diabetic.

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Speaker 1: His blood sugar can get really low, he can end

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Speaker 1: up in the hospital. He has over the years. So

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Speaker 1: we made the decision to bring him in Houston, and

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Speaker 1: we found a great institution. We looked everywhere, we talked

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Speaker 1: to everybody, and boy, did ever turn out to be

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Speaker 1: the right choice for us. But you worry, And it

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Speaker 1: also happens to be walking distance from where I live,

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Speaker 1: so I can stop in on him all day every day.

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Speaker 1: Why is he not at my house? Why would you

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Speaker 1: put your dad in a facility? Well, a couple of reasons,

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Speaker 1: but most importantly because they have twenty four hour care

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Speaker 1: and we couldn't provide that travel a lot. So it's

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Speaker 1: turned out to be great. He's happy, I'm happy. But

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Speaker 1: we had all these doctors that he had in the

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Speaker 1: Golden Triangle. For those of you who don't know where

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Speaker 1: that the Golden Triangle was Orange Beaumont, Port Arthur. It's

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Speaker 1: southeast Texas on the Louisiana border. So we needed to

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Speaker 1: find doctors in Houston. And that's kind of my specialty

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Speaker 1: is I like to find good doctors and reward them

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Speaker 1: with lots of referrals. So I called around various doctors

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Speaker 1: and I asked for suggestions, and one of them that

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Speaker 1: was suggested to me was by my cardiologist, Dan Dukman.

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Speaker 1: He said, Hey, I got a guy that I know

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Speaker 1: named Jay Davis. He's a concierge doctor. I wanted a

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Speaker 1: conciers doctor, but he said, he's a concierge doctor. But

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Speaker 1: he's got a partner in his practice. Her name is

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Speaker 1: Andrew Davis Anu, it's an Indian name. He's got a

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Speaker 1: partner named ONUW. Davis. And she's great and your dad

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Speaker 1: would love it and you would love her. So we

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Speaker 1: tried her out, and I told you the story. My

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Speaker 1: wife took him for the appointment. Now she comes to

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Speaker 1: his old folks home. She will come to the old

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Speaker 1: folks home. She'll make house visits, she's now one of

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Speaker 1: my wife's many doctors. So anyway, she walks in and

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Speaker 1: she's sitting on her butt Indian style, appropriately remonte. She's

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Speaker 1: sitting on her butt. She takes off his socks and

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Speaker 1: she's rubbing his feet. If you know anything about diabetes,

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Speaker 1: you know that you don't get circulation to your toes

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Speaker 1: and you end up losing your toes. She is looking

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Speaker 1: for sores. She's talking about his feet, but she's lovingly

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Speaker 1: caressing his feet. If you don't think that I wasn't

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Speaker 1: locked in, send me whatever bill you want. Lady, you

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Speaker 1: are touching my dad's feet and loving on him, and

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Speaker 1: he's eighty five. You have won my heart, right, so

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Speaker 1: we really like him. We were like her. Concierge's medicine

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Speaker 1: is very different than the traditional medicine you're used to.

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Speaker 1: You can call these doctors that you have their cell

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Speaker 1: phone number, and so my dad does, Hey, I call

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Speaker 1: doctor Davis. I'm like, Dad, don't call her too much.

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Speaker 1: You know, she's got other patients. So we have a

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Speaker 1: dinner party, and at the dinner party, I put myself

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Speaker 1: right next to her because I still haven't met her

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Speaker 1: through all this, but we've had text conversations and phone conversations,

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Speaker 1: and I put our boyfriend on the other end of

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Speaker 1: the of the table and my wife next to him,

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Speaker 1: and then we had some other friends in between. But

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Speaker 1: I'm focused on her. I want to know about her practice,

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Speaker 1: what she does. I'm fascinated by this stuff. And at

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Speaker 1: some point I said, you know, how did you get

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Speaker 1: into diabetes. What's your passion for diabetes? She said, My

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Speaker 1: passion is for diabetes, and I love treating diabetes. But

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Speaker 1: if you were to ask me what number one passion,

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Speaker 1: and I can have several, it is menopause. And we

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Speaker 1: started talking about as an endocrinologist, the glands you know,

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Speaker 1: thyroid and a dream or you don't know your glands

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Speaker 1: are mown. You need to learn all your glands because

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Speaker 1: otherwise you can't have a dinner party with her. And

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Speaker 1: we started talking about women's hormones. So I'm fascinated by

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Speaker 1: all this because I just like to learn about everything

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Speaker 1: I possibly can from people who know things. So we're

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Speaker 1: laying in bed and my wife said the next morning,

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Speaker 1: she says, I don't know if you noticed what happened

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Speaker 1: at the party last night, But when ANU started talking

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Speaker 1: about menopause. Every woman leaned forward, and all of our

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Speaker 1: other conversation stopped, whereupon the men leaned forward and they

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Speaker 1: started listening about menopause. And I said, no, I didn't.

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Speaker 1: Why do you think that was She said, it's a

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Speaker 1: topic nobody will talk about, and everybody's affected by it,

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Speaker 1: and everybody's interested in it. You should have her on

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Speaker 1: the air. I said, well, let's be clear right now.

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Speaker 1: Know your place, woman, You don't tell me what to

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Speaker 1: do on the show. So our guest is doctor Anew Davis,

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Speaker 1: and it is my honor to have her on. I've

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Speaker 1: become a fan. Let's start with this very simple question.

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Speaker 1: And by the way, if you want to look her up,

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Speaker 1: it's river Oaks Doctor's Group. But her name is spelled Anu.

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Speaker 1: She won't be only on New I knew the short

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Speaker 1: for Honorah. That's a very common end the name, but

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Speaker 1: it's Anew Davis. I guarantee it's probably the only one

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Speaker 1: of those. So let's start with a very simple question.

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Speaker 1: What is menopau.

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Speaker 2: So, Michael, thank you for having me on, and I'm

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Speaker 2: excited to talk to you about and answer all your burning

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Speaker 2: menopause questions.

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Speaker 1: So, first, are related to a uti. But that's a

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Speaker 1: whole different question.

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Speaker 2: Okay, well those are different questions, but you're burning menopause questions.

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Speaker 2: You want to know the answers. So the most important

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Speaker 2: first thing is to actually know what menopause is. So

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Speaker 2: menopause is the point at which women stop having cycles

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Speaker 2: and minstrel cycles, that is, and once a woman has

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Speaker 2: not had a minstrel cycle for twelve months, that's when

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Speaker 2: it's she's called in menopause. The big issue with all

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Speaker 2: this is Pete. Women's mintraal cycles can start changing up

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Speaker 2: to ten years before the cycles actually actually stop, so

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Speaker 2: then the whole time before that is called perimenopause. So

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Speaker 2: that's what we tend to be talking about, is perimenopause

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Speaker 2: and menopause.

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Speaker 1: I've heard that I didn't know what it meant. Is

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Speaker 1: that is that about a ten year Is that that

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Speaker 1: happens about ten years before she goes into menopause.

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Speaker 2: Well, sometimes it can be a nice, happy twelve months

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Speaker 2: of stuff. Sometimes it can be up to ten years.

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Speaker 2: So somewhere in the four to ten year range is

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Speaker 2: what perimenopause can be. But up to ten years of

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Speaker 2: fluctuation and transition before the actual pause happens, all right,

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Speaker 2: go ahead, and then menopause is the twenty or thirty

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Speaker 2: years that women live after the cycle stop. Then they're

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Speaker 2: considered to be postmenopausal. And that's the whole. Our job

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Speaker 2: is to maintain health through that twenty or thirty years,

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Speaker 2: so the whole. When people start talking about menopause or perimenopause,

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Speaker 2: the words are often interchangeable. But menopause itself is one

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Speaker 2: of the periods stopped for twelve months.

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Speaker 1: Yeah, and is that just nature's way because we probably

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Speaker 1: weren't meant to live this long, that a woman is

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Speaker 1: beyond her reproductive life, and so there's no need for

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Speaker 1: that cycle. And let me just say before we start,

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Speaker 1: First of all, I'm a dude, so never having gone

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Speaker 1: through that, we all know it's secondhand. I'm trying to

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Speaker 1: I have had a lot of women tell me they

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Speaker 1: are excited to hear what you have to say and

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Speaker 1: to learn more about this, and they're glad that it's

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Speaker 1: being discussed publicly, including some folks, some rather prominent folks

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Speaker 1: that surprised me. They were willing to put their name

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Speaker 1: behind this, but I'm not going to say their names,

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Speaker 1: who were quite interested to learn more but we will

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Speaker 1: talk more to doctor anu A. N You Davis of

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Speaker 1: the river Oaks Doctors Group about Yeah, menopause, that's what

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Speaker 1: we're talking about. I don't care if somebody disrespects you,

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Speaker 1: you can't shoot them. Michael, it's been refolks. I took

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Speaker 1: to more I to introduced because this comes out of

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Speaker 1: left field and I wanted people to understand not going

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Speaker 1: to do that again. Doctor Anew Davis is our guest.

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Speaker 1: She's a menopause expert river Oaks Doctors Group. She's in Houston,

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Speaker 1: and this is something she is passionate about, is treating

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Speaker 1: women with menopause. And my question was do women stop

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Speaker 1: having a menstrual cycle because they are past the age

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Speaker 1: that they should be, or are typically giving birth or

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Speaker 1: is there some other reason.

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Speaker 2: No, it's a natural process. Okay, the periods stop because

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Speaker 2: your past reproductive age. The issue is is that we

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Speaker 2: live for another thirty years after that. Right, our life

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Speaker 2: expectancy is seventy five to eighty five, So in that

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Speaker 2: thirty years we want to maintain our health. There has

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Speaker 2: been a lot of issue and discussion about whether these

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Speaker 2: hormones are useful and what happens and how do we

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Speaker 2: maintain women's health in that thirty years because we all

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Speaker 2: want to be upright and functional and thinking straight. So

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Speaker 2: that's the reason that menopause gets so much discussion. And

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Speaker 2: what happens to women's hormones and how do we treat

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Speaker 2: this and what other symptoms and issues come up because

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Speaker 2: of them?

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Speaker 1: And what are these hormones that we're talking about. What

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Speaker 1: do they control? Is this sexual drive? Is it diet?

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Speaker 2: Is it?

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Speaker 1: You know when I was when my mom was forty

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Speaker 1: in nineteen eighty five, she started, I lost my mom

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Speaker 1: and I a crazy woman. Poltrygeisted into her body and

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Speaker 1: she screamed and hollered, and when we would go, Mom,

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Speaker 1: what in the world, And she'd say, I'm going through menopause.

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Speaker 1: I'm having hot flashes. Can you talk through that? Because

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Speaker 1: I can be as clinical and not silly as I

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Speaker 1: want to be, but there's a lot of dudes going,

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Speaker 1: can you explain to me what's going on with my

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Speaker 1: wife right now?

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Speaker 2: Well, so we know that hormones fluctuate all the time,

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Speaker 2: but as the hormones decline, we have realized that there's

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Speaker 2: estrogen receptors everywhere, and so the hot flashes and the

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Speaker 2: night sweats. That's the first thing that we talk about.

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Speaker 2: But the mood can become just mood stability can become

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Speaker 2: a problem, sleep can become a problem. Women start to

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Speaker 2: have joint pain, vaginal dryness, pain with sex. There's up

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Speaker 2: to one hundred different symptoms that can occur once as

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Speaker 2: the hormones are fluctuating and declining. So that's the problem

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Speaker 2: women are suffering and it's making them less functional. So

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Speaker 2: so yeah, so there's lots of different things going on,

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Speaker 2: and the big question is, you know, are is replacing

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Speaker 2: these hormones It it's been taboo for a long time.

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Speaker 2: And part of the reason for that is because there

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Speaker 2: was a big study it came out in two thousand

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Speaker 2: and two that called the Women's Health Initiative. And when

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Speaker 2: that happened. When that study came out, because of the

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Speaker 2: way the study ended, it was publicized that hormone replacement

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Speaker 2: is bad and that hormone replacement causes breast cancer and

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Speaker 2: increases cardiovascular disease. So when that happened, the women who

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Speaker 2: were on hormone replacement at that time for treatment of

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Speaker 2: their menopausal symptoms, the rate of hormone replacement went from

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Speaker 2: forty percent of women postmenopause were taking hormone replacement to

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Speaker 2: something like five to six percent. The guidelines from all

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Speaker 2: the medical societies came out that hormone replacement causes breast cancer.

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Speaker 2: So for twenty years, many women did not receive hormone

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Speaker 2: replacement that they received because the doctors were taught that

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Speaker 2: hormones breast cancer.

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Speaker 1: In your reason, do you think though, that hormone replacement

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Speaker 1: causes breast cancer.

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Speaker 2: Hormone replacement does not cause breast cancer. So the reason

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Speaker 2: some of this has come to light in this last

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Speaker 2: year is because in twenty twenty four last year, they

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Speaker 2: came back and reanalyzed all the data from the Women's

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Speaker 2: Health Initiative. And so now twenty years later, they've come

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Speaker 2: back out and they've started talking about where how the

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Speaker 2: data was analyzed incorrectly, and they've come back out and said, well,

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Speaker 2: women's hormone replacement does not cause cardiovascal disease, it does

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Speaker 2: not cause breast cancer. And for those of us who've

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Speaker 2: been sitting in our corner of the world treating this,

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Speaker 2: we never stopped giving hormone replacement because we know that

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Speaker 2: hormone replacement is important for bone health. It's important for

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Speaker 2: cardiovascar health, it's important for brain health, and it may

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Speaker 2: and so that's why we get hormone replacement.

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Speaker 1: Doctor Davis, I can't help but think the parallel here.

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Speaker 1: I'm a big proponent of testosterone and a testosterone replacement,

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Speaker 1: and our mutual friend Moe with Kara is a big

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Speaker 1: boat believer in testosterone replacements. It's done wonders for me,

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Speaker 1: and the same thing. I get people emailing me and say, hey,

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Speaker 1: my general physician who hasn't kept up with developments, and

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Speaker 1: this says I'm going to get prostate cancer if I

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Speaker 1: do it because of one study forever ago that said that,

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Speaker 1: And now most people don't believe it. And it's very

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Speaker 1: frustrating because it seems like there's a strange parallel between this,

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Speaker 1: because I think a lot of women do need hormone

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Speaker 1: replacement for them to be happier and healthier and have

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Speaker 1: healthier marriages. I see a lot of guys divorcing their

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Speaker 1: wives because they think she went crazy. She didn't go crazy.

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Speaker 1: Her body is working against her. Am I right in that.

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Speaker 2: You are correct. So there was even time when obi

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Speaker 2: Jen's were taught that cognitive behavioral therapy would help hot flashes.

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Speaker 2: But if your body is having a physiologic reaction, you

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Speaker 2: can't talk it out of a hot flash. You cannot

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Speaker 2: talk your body out of having a hot flash. So

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Speaker 2: there are there's exactly that that women struggle and suffer

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Speaker 2: with hormone fluctuations that and you know, for a long

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Speaker 2: time they're ignored anyway because they're trying to get pregnant

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Speaker 2: during reproductive age and there's you know, during pregnancy, you

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Speaker 2: just have to deal with that because your focus is

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Speaker 2: on being pregnant and protecting the baby. But post pregnancy,

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Speaker 2: like women are struggling with all these hormonal fluctuations, and

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Speaker 2: because they've been sold that hormone replacement is not good

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Speaker 2: for you or can be harmful to you, many women avoid,

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Speaker 2: they avoid. Not only do they avoid hormone replacement after menopause,

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Speaker 2: it some will actively avoid birth control pills and treatments

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Speaker 2: for their hormone fluctuations, which are really affecting their day

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Speaker 2: to day life. But sometimes this is nuanced, right, like

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Speaker 2: you have to get in there and understand where these

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Speaker 2: hormones can benefit you.

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Speaker 1: Well, it just strikes me that a lot of married

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Speaker 1: couples divorce after they've been through the toughest and maybe

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Speaker 1: most rewarding years of their marriage, that is, their kids

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Speaker 1: leave high school. And the thing I hear men say

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Speaker 1: in the locker room at the cigar lounge at the

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Speaker 1: bar is I just couldn't deal with her moods anymore.

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Speaker 1: And I think, man, you built a life together. It's

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Speaker 1: one thing if he's running off chasing strippers or he's

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Speaker 1: running away with the secretary. But when he can't be

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Speaker 1: in the house with her because of the mood swings

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Speaker 1: and the hot flashes, that's a horrible, horrible thing to

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Speaker 1: lose a marriage over that hold with me, doctor and

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Speaker 1: new Davis, we're talking about menopause coming up with hell.

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Speaker 2: Yes, we're gonna take your ar fifteen eighty opaedo Michael Show, Yes, Yes, yes, yes.

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Speaker 1: Doctor and new Davis is our guest. She is passionate

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Speaker 1: about the treatment of women with menopause. She's a concierge doctor.

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Speaker 1: She's actually my father's doctor. No, he doesn't have menopause,

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Speaker 1: he's eighty five with diabetes. But she's a concierge doctor.

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Speaker 1: That is your general practitioner. That means just your primary

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Speaker 1: that you go to for whatever else. With a specialty

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Speaker 1: into chronology, and that's all your glands and hormones and

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Speaker 1: all those sorts of things. And she handles my dad's

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Speaker 1: diabetes and may I say, masterfully, which is not an

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Speaker 1: easy thing. And she handles and focuses on menopause. And

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Speaker 1: we decided it was time to have that conversation in public.

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Speaker 1: So I want to I guess I'm going into the

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Speaker 1: soft science opposed to the medical science. I want your expertise.

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Speaker 1: One of the things that bothers me a lot, and

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Speaker 1: I will confess this is to watch couples who are

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Speaker 1: fifty three to sixty five. They got the kids through

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Speaker 1: high school, they seemingly had a solid marriage, and then

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Speaker 1: he says I'm done with you, or maybe she thinks

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Speaker 1: she wants out, and then he may go off and remarry,

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Speaker 1: but she's miserable and all of that is lost, and

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Speaker 1: the kids are sad because their innocence and their childhood

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Speaker 1: is lost. They didn't fight all those years. I think

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Speaker 1: it's this hormonal imbalance. Can you speak to that.

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Speaker 2: I mean, there is a significant amount of dysfunction that happens,

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Speaker 2: right like if you're not able to have, if you're

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Speaker 2: not able to sleep and then you're not able to

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Speaker 2: have conversations, and then sex is painful and you're not

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Speaker 2: able to have those conversations with your partner, then the

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Speaker 2: health of your of your relationship declines, and that from

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Speaker 2: the testosterone side, that that becomes the thing that the

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Speaker 2: whole marriage has to be treated. Right, the sexual health

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Speaker 2: of a marriage has to be treated, but some of

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Speaker 2: that has to be treated. Each person has to individually

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Speaker 2: be healthy. So these women they've been they're they're suffering, right,

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Speaker 2: They're suffering because they they can't think straight, and they

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Speaker 2: can't sleep, and they're you know, sex is painful and

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Speaker 2: they're and they're not able to fix it, and they

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Speaker 2: go see their doctor and their doctors have said, well,

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Speaker 2: I mean, there's not really much we can do, and

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Speaker 2: then they get when they get that answer, they they

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Speaker 2: do feel like they're losing their minds, right, And when

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Speaker 2: that happens, I mean how they aren't able to communicate

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Speaker 2: with their partners, to talk to them. So it is

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Speaker 2: part of it, right, the whole the relationship has to

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Speaker 2: be treated, and that can contribute to them. It's a

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Speaker 2: sad thing to see.

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Speaker 1: You've spoken generally about treatment. What does treatment look like?

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Speaker 1: So give me kind I know there is no standard patient,

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Speaker 1: but lady walks in. Roughly what age is she most

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Speaker 1: likely to be if she walks in? If I'm building

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Speaker 1: a profile, why did she come to you? How did

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Speaker 1: she know she had a problem, What are the tests,

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Speaker 1: what's the diagnosis, and how are you treating her? I

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Speaker 1: got five minutes in this segment.

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Speaker 2: So the average age for menopause, for when the periods

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Speaker 2: actually stop, is about fifty one. I would say most

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Speaker 2: people come to me in their mid forties starting to

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Speaker 2: notice certain symptoms. They start to notice hot flashes and

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Speaker 2: night slits. Everybody's different. Other things people notice are point pain,

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Speaker 2: pain with sex, brain fog. So people come for different

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Speaker 2: reasons and they start to notice some irregularity in their

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Speaker 2: cycles when they show up. The main way of figuring

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Speaker 2: this out is by history. We do do labs to

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Speaker 2: make sure that there isn't something else causing these symptoms.

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Speaker 2: It's and then we start really thinking about you know,

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Speaker 2: and we do history, take a history to learn about

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Speaker 2: how her cycles were before and how things have changed,

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Speaker 2: and you know, all the way through pregnancies, so all

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Speaker 2: that stuff. It makes a difference and helps us prepare

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Speaker 2: for the transition through menopause and determine what the best

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Speaker 2: treatments would be. So in addition to using hormones as treatment,

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Speaker 2: which is which are very useful in treating the hot

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Speaker 2: flashes and some of those symptoms, then we also assess

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Speaker 2: risk for health for the long term. Right, we also

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Speaker 2: want to increase nutrition, and we also want to improve

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Speaker 2: exercise because hormones can do a lot, but they can't

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Speaker 2: fix everything. So in order to help overall health and

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Speaker 2: prevent complications and keep women stronger for those last thirty

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Speaker 2: years of their lives, we spend a lot of time

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Speaker 2: in addition to talking about how hormones may be part

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Speaker 2: of the treatment, but also nutrition and also exercise.

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Speaker 1: Why is nutrition important to menopause, because that's a question

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Speaker 1: I received a lot of emails from listener women fifty

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Speaker 1: to eighty about how does that affect it?

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Speaker 2: Because one of the biggest things that we have to

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Speaker 2: do in the last part part of our life is

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Speaker 2: keep ourselves mobile, and in the most important thing in

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Speaker 2: keeping ourselves mobile is maintaining our muscle mass and preventing fractures. Okay,

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Speaker 2: and hormone replacement can help us with maintaining our bone health.

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Speaker 2: But to maintain our muscle mass, we have to focus

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Speaker 2: on nutrition. We have to focus on nutrition in new

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Speaker 2: ways that maybe we haven't in the years before, and

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Speaker 2: we have to try to make up for what we

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Speaker 2: messed up, you know, way back when, in all the

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Speaker 2: years we weren't that.

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Speaker 1: I was talking to Stan Dukman, our mutual friend, the cardiologist,

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Speaker 1: and we're talking about strategies for good health, especially as

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Speaker 1: you get older. We're talking about my dad's health, and

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Speaker 1: he said, you know, Michael, I can't figure out a

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Speaker 1: good way to say it, but what we want to do.

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Speaker 1: We're all going to get sick, and what we want

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Speaker 1: to do is get the body strong enough that when

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Speaker 1: that sickness hits, we've got some reserves to draw on.

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Speaker 1: We've got good core strength. Yeah, we've got low body fat.

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Speaker 1: We've got good muscle and bone density and these sorts

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Speaker 1: of things. Let me ask you this a minute left

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Speaker 1: in this segment hair loss, And I'm trying to kind

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Speaker 1: of make a compositive question. A lot of questions about

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Speaker 1: hair loss. It sounds like that's typical. What can be

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Speaker 1: done about that in your treatment?

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Speaker 2: Depend I mean, we do have to dig in to

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Speaker 2: do a little bit of search for what is causing

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Speaker 2: the hair loss. Hair loss is common with menopause. Hair

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Speaker 2: loss can have a genetic component, right if it runs

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Speaker 2: in your family and everyone has that male pattern baldness,

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Speaker 2: there's not as much you can do about it. But

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Speaker 2: nutrition is important. Protein is important, and then there are

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Speaker 2: some other medications and topical treatments that can help.

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Speaker 1: When you talk about these treatments, I'm gonna be up

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Speaker 1: against a break here in just a moment, so I

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Speaker 1: will ask you and we'll address it on the other side.

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Speaker 1: How are these being delivered? Is this a pill regiment?

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Speaker 1: Is it typically one pill a day? And I know

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Speaker 1: that's going to vary, but I mean talk about the composite.

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Speaker 1: Is the shots? How often are those shots? How often

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Speaker 1: does somebody A lot of people I think are afraid

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Speaker 1: to engage in a relationship where it's going to be

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Speaker 1: I'm having to come to the doctor every day or

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Speaker 1: is this a one and done? What does that look like?

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Speaker 1: I'm assuming you have to adjust those. We'll continue that

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Speaker 1: conversation with doctor Anu a n U doctor anew Davis,

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Speaker 1: a Houston concierge, doctor, intochronologist, diabetes expertise, and we're talking

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Speaker 1: menopause what a maroon Michael Very show. So it strikes

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Speaker 1: me that menopause is something that my mother suffered horribly

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Speaker 1: from during my teenage years. And I'll be on it

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Speaker 1: and I've told her this and she's We've had deep conversations.

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Speaker 1: She passed September nineteenth. But I left nothing out and

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Speaker 1: she left nothing out. I resented her. I resented the

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Speaker 1: crazy woman who took over my sweet mother. I adored

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Speaker 1: my mother, and there was this period of time that

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Speaker 1: this awful monster took over my mother my mid teenage years,

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Speaker 1: fifteen to eighteen. And I didn't like that lady. And

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Speaker 1: then at some point that person got bored of her

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Speaker 1: and moved on to the next lady. Maybe it was

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Speaker 1: your mother or wife. But my mother didn't have access

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Speaker 1: to all of the great medical advancements we do today.

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Speaker 1: And an expert like a new Davis, who is our guest,

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Speaker 1: that spelled an u anew Davis, and we're talking about menopause.

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Speaker 1: Let's talk about hair loss, because that was one of

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Speaker 1: the many questions I have in my stack. And by

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Speaker 1: the way, I was shocked how many women reached out

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Speaker 1: and were willing to say yes, I want to know

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Speaker 1: more about menopause upsetting me or my mother, So let's

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00:26:02,920 --> 00:26:03,600
Speaker 1: talk about that.

431
00:26:06,760 --> 00:26:09,520
Speaker 2: Yeah, I mean, the menopause question is is kind of

432
00:26:09,560 --> 00:26:12,960
Speaker 2: a crazy one, right, Like I remember back I was

433
00:26:13,000 --> 00:26:15,640
Speaker 2: a baby doctor and I was doing a house call

434
00:26:16,440 --> 00:26:19,320
Speaker 2: at like maybe like when I first started my practice,

435
00:26:19,320 --> 00:26:21,000
Speaker 2: like ten or fifteen years ago, and I was doing

436
00:26:21,000 --> 00:26:24,600
Speaker 2: this house call on this Saturday morning, and I was

437
00:26:24,600 --> 00:26:26,600
Speaker 2: seeing this little eighty one year old woman and I

438
00:26:26,640 --> 00:26:28,320
Speaker 2: told her I was going to give a talk after

439
00:26:28,560 --> 00:26:31,760
Speaker 2: I finished her house call, and I was going to

440
00:26:31,960 --> 00:26:34,320
Speaker 2: give this talk about menopause. And she's like, you don't

441
00:26:34,400 --> 00:26:38,400
Speaker 2: lie to those people. I was like, that's funny. I

442
00:26:38,440 --> 00:26:40,880
Speaker 2: just can remember her saying, don't lie to them, tell

443
00:26:40,920 --> 00:26:43,960
Speaker 2: them the truth. And I said, okay, well, and you know,

444
00:26:44,040 --> 00:26:47,280
Speaker 2: the truth has changed and we are learning more every

445
00:26:47,359 --> 00:26:52,879
Speaker 2: day and having been able to go having this change

446
00:26:52,880 --> 00:26:54,879
Speaker 2: in the guidelines and this next year is really going

447
00:26:54,960 --> 00:27:00,919
Speaker 2: to help women. Okay. The guy the Menopause Society and

448
00:27:00,960 --> 00:27:05,159
Speaker 2: the UK societies that write about menopause actually changed the

449
00:27:05,200 --> 00:27:10,960
Speaker 2: guidelines in twenty twenty four at and took back all

450
00:27:11,000 --> 00:27:14,600
Speaker 2: the initial recommendations from two thousand and two. So because

451
00:27:14,640 --> 00:27:17,439
Speaker 2: of this, this is why this is so important now

452
00:27:17,560 --> 00:27:22,560
Speaker 2: and why we're trying to do our part to educate.

453
00:27:23,040 --> 00:27:25,960
Speaker 2: You know, all the internists who have to see patients

454
00:27:26,000 --> 00:27:30,119
Speaker 2: all day long and who want to be able to

455
00:27:30,119 --> 00:27:32,840
Speaker 2: treat their patients well and give them good treatment, but

456
00:27:33,200 --> 00:27:36,480
Speaker 2: didn't have the knowledge up until then. So the way

457
00:27:36,520 --> 00:27:40,960
Speaker 2: that this looks is that the history is the most

458
00:27:41,040 --> 00:27:45,440
Speaker 2: important thing. Right. First, we take a long history and

459
00:27:45,600 --> 00:27:51,800
Speaker 2: we try to understand kind of how each patients has

460
00:27:51,880 --> 00:27:55,760
Speaker 2: done through her cycles, and then how her menopause and

461
00:27:55,800 --> 00:28:00,720
Speaker 2: how the transitions are affecting her, and then we aim

462
00:28:00,800 --> 00:28:07,320
Speaker 2: our treatments specifically at helping her and also preventing disease

463
00:28:07,440 --> 00:28:13,040
Speaker 2: in the long term, keeping her strong and healthy, protecting bones,

464
00:28:13,119 --> 00:28:18,359
Speaker 2: protecting her heart, protecting her brain, and making sure that

465
00:28:20,280 --> 00:28:22,880
Speaker 2: she is feeling in control.

466
00:28:23,520 --> 00:28:27,919
Speaker 1: Let's talk about the bones first. My mom had severe osteoporosis,

467
00:28:28,720 --> 00:28:32,520
Speaker 1: so she was on a pretty heavy calcium treatment. She

468
00:28:32,720 --> 00:28:36,760
Speaker 1: never had She had one fall that messed her back up.

469
00:28:36,840 --> 00:28:38,280
Speaker 1: She had to have a surgery. She got on a

470
00:28:38,400 --> 00:28:42,920
Speaker 1: darn step ladder like they shouldn't be doing. We all know,

471
00:28:43,040 --> 00:28:44,080
Speaker 1: but in any case.

472
00:28:44,080 --> 00:28:46,200
Speaker 2: It happens. Yeah, sure, the.

473
00:28:46,240 --> 00:28:49,760
Speaker 1: Bone strength, I have a trainer Michael Petrow petru in

474
00:28:49,840 --> 00:28:52,360
Speaker 1: home fitness and he trains a lot of elderly folks

475
00:28:52,800 --> 00:28:56,080
Speaker 1: and a big issue there is avoiding falls because you

476
00:28:56,120 --> 00:28:58,400
Speaker 1: know the old you know, you see it happen, You fall,

477
00:28:58,920 --> 00:29:01,800
Speaker 1: you break your hip, you ever really recover And people say,

478
00:29:02,280 --> 00:29:04,800
Speaker 1: you know, the last three years of his life were horrible,

479
00:29:04,960 --> 00:29:10,360
Speaker 1: or her life because of the hip never really fixed.

480
00:29:10,880 --> 00:29:13,840
Speaker 1: How much can you do to fix We're gonna I'm

481
00:29:13,840 --> 00:29:17,200
Speaker 1: asking one by one, the bone strength, the bone density,

482
00:29:17,240 --> 00:29:18,800
Speaker 1: depending on how bad it's degraded.

483
00:29:20,920 --> 00:29:24,000
Speaker 2: So when we see women in their forties, we're able

484
00:29:24,080 --> 00:29:27,640
Speaker 2: to We have medications that help us build bone. We're

485
00:29:27,680 --> 00:29:34,240
Speaker 2: able if we're able to start hormone replacement before before

486
00:29:34,240 --> 00:29:40,000
Speaker 2: we are at menopause. Bone strength, bone density decreases significantly

487
00:29:40,080 --> 00:29:42,760
Speaker 2: in the first thirty six months after menopause. So if

488
00:29:42,760 --> 00:29:47,080
Speaker 2: we're able to start hormone replacement to where they never

489
00:29:47,200 --> 00:29:50,840
Speaker 2: lose any estrogen, we're able to protect the bones that

490
00:29:50,880 --> 00:29:55,120
Speaker 2: they've built up up to that point and we don't

491
00:29:55,160 --> 00:30:01,760
Speaker 2: see that loss, and we're able to early to prevent fracture.

492
00:30:01,920 --> 00:30:05,560
Speaker 2: We actually have lots of tools for fracture prevention. But

493
00:30:06,320 --> 00:30:09,760
Speaker 2: if women are able to start hormones to where they

494
00:30:09,800 --> 00:30:14,120
Speaker 2: aren't deprived of these hormones. Because realistically, when we talk

495
00:30:14,120 --> 00:30:18,120
Speaker 2: about hormone replacement therapy, we're replacing something that their body's

496
00:30:18,160 --> 00:30:24,320
Speaker 2: just not making anymore. Taking their body's not making anymore

497
00:30:24,720 --> 00:30:28,400
Speaker 2: doesn't mean they can't they can't benefit from it, right,

498
00:30:29,160 --> 00:30:32,960
Speaker 2: So they benefit from it. Their bodies just stopped making

499
00:30:33,000 --> 00:30:36,040
Speaker 2: it because of you know, where we came from, and

500
00:30:36,160 --> 00:30:39,080
Speaker 2: because before we only lived to fifty five or sixty five,

501
00:30:39,080 --> 00:30:41,960
Speaker 2: and once we were done reproducing, we were finished, right,

502
00:30:43,000 --> 00:30:47,320
Speaker 2: But that's not where we are. We we're replacing something

503
00:30:47,400 --> 00:30:51,240
Speaker 2: our body's not making anymore. So if we do that before,

504
00:30:51,320 --> 00:30:56,959
Speaker 2: the bones feel the depletion of estrogen. So if we

505
00:30:57,040 --> 00:31:01,240
Speaker 2: get that early, then the bones don't deteriorate in that

506
00:31:01,680 --> 00:31:03,440
Speaker 2: initial postmonom puzzle Parian.

507
00:31:05,600 --> 00:31:11,280
Speaker 1: And so when what's the delivery mechanism? Is that a pill?

508
00:31:11,440 --> 00:31:14,160
Speaker 1: Is that a shot? And how soon do women start

509
00:31:14,240 --> 00:31:19,120
Speaker 1: noticing a real change in life from the hot flashes

510
00:31:19,280 --> 00:31:23,200
Speaker 1: to feeling better to a better And I'm assuming most

511
00:31:23,200 --> 00:31:25,480
Speaker 1: of this is estrogen, but can you speak to that?

512
00:31:27,320 --> 00:31:33,720
Speaker 2: Sure? So there's three hormones, The main two are estrogen

513
00:31:33,760 --> 00:31:42,360
Speaker 2: and progesterone. Okay, the estrogen is the one that's responsible

514
00:31:42,440 --> 00:31:46,240
Speaker 2: for protecting the heart and protecting the bones, and probably

515
00:31:46,280 --> 00:31:51,320
Speaker 2: protecting the brain and protecting the colon. And so that's

516
00:31:51,680 --> 00:31:55,000
Speaker 2: the hormon, the main hormone that needs to be replaced.

517
00:31:55,600 --> 00:31:59,640
Speaker 2: If women have a uterus, we give them progesterone also

518
00:32:00,160 --> 00:32:04,800
Speaker 2: to protect their uterus in the in the menopausal time.

519
00:32:06,280 --> 00:32:11,480
Speaker 2: We the medications can be given by pill, they can

520
00:32:11,520 --> 00:32:16,600
Speaker 2: give by patch, they can be given by cream, and

521
00:32:16,640 --> 00:32:21,120
Speaker 2: so some of that is preference, and some of that

522
00:32:21,640 --> 00:32:26,440
Speaker 2: is just kind of what works for people and what

523
00:32:26,520 --> 00:32:30,800
Speaker 2: works for their day to day lives. But the form

524
00:32:30,880 --> 00:32:34,040
Speaker 2: the medications are the same. It's still we're just replacing

525
00:32:34,080 --> 00:32:38,680
Speaker 2: hormon that their bodies aren't making. So the form is

526
00:32:38,840 --> 00:32:41,600
Speaker 2: just a preference issue.

527
00:32:43,320 --> 00:32:47,000
Speaker 1: That brings me to the next question. You said, if

528
00:32:47,000 --> 00:32:50,240
Speaker 1: they have a uterus, meaning of course that if they

529
00:32:50,240 --> 00:32:54,120
Speaker 1: don't have a uterus, they've had a hysterectomy, which my

530
00:32:54,240 --> 00:32:56,600
Speaker 1: mom had. And by the way, if anybody out there

531
00:32:56,640 --> 00:32:58,800
Speaker 1: is wondering, why is he throwing his mom under the

532
00:32:58,800 --> 00:33:02,800
Speaker 1: bus given her medical history. She was interviewed by the

533
00:33:02,920 --> 00:33:06,640
Speaker 1: local news about all of this in Beaumont. She was

534
00:33:06,760 --> 00:33:09,560
Speaker 1: happy to talk about it. She was a little ahead

535
00:33:09,560 --> 00:33:11,520
Speaker 1: of her time in terms of being willing to talk

536
00:33:11,560 --> 00:33:14,520
Speaker 1: about women's issues when other people wouldn't. She was a

537
00:33:14,600 --> 00:33:20,120
Speaker 1: tough woman. But we will talk about post hysterectomy and

538
00:33:20,200 --> 00:33:24,240
Speaker 1: treatments for that. Yeah, we're actually talking menopause with an expert,

539
00:33:24,280 --> 00:33:27,760
Speaker 1: doctor Anu Anu. Doctor Anu Davis went up