1 00:00:17,130 --> 00:00:17,610 Speaker 1: Pushkin. 2 00:00:24,369 --> 00:00:29,249 Speaker 2: This show is not a substitute for professional medical advice, diagnosis, 3 00:00:29,370 --> 00:00:33,849 Speaker 2: or treatment. It is for informational purposes. Please consult your 4 00:00:33,850 --> 00:00:38,850 Speaker 2: healthcare professional with any medical questions. Also in this show, 5 00:00:38,970 --> 00:00:42,930 Speaker 2: we use women as shorthand for people with XX chromosomes. 6 00:00:43,650 --> 00:00:47,610 Speaker 2: We understand sex and gender are more complex and acknowledge 7 00:00:47,650 --> 00:00:51,569 Speaker 2: the experiences we describe reach beyond that word. 8 00:00:52,050 --> 00:00:53,489 Speaker 3: I wanted to let you know as I was in 9 00:00:53,530 --> 00:00:57,330 Speaker 3: the Starbucks preparing for this interview, that's why you were late. 10 00:00:57,610 --> 00:00:59,529 Speaker 3: I kind of while I was on time. Wow, I 11 00:01:00,650 --> 00:01:03,730 Speaker 3: got really emotional actually, and I was the Starbucks. Yeah, 12 00:01:03,770 --> 00:01:05,930 Speaker 3: I did in Starbucks, like little tears were coming into 13 00:01:05,970 --> 00:01:08,810 Speaker 3: my eyes, and I was thinking, why, Well, because I 14 00:01:08,890 --> 00:01:10,690 Speaker 3: was thinking how far we've come. You know, we me 15 00:01:11,250 --> 00:01:12,729 Speaker 3: we met like twenty six years ago. 16 00:01:12,930 --> 00:01:13,330 Speaker 1: We did. 17 00:01:13,570 --> 00:01:16,210 Speaker 3: We were dating around the year two K when we 18 00:01:16,250 --> 00:01:17,890 Speaker 3: thought the world was going to come to an end 19 00:01:17,930 --> 00:01:22,650 Speaker 3: and everything was going to yeah that's okay, And and 20 00:01:22,770 --> 00:01:24,530 Speaker 3: you know, I was thinking, we've come so far. We've 21 00:01:24,610 --> 00:01:26,490 Speaker 3: you know, we've had a family, we met a family, 22 00:01:27,170 --> 00:01:30,890 Speaker 3: We've had careers, an apartment, we bought, had pets, lots 23 00:01:31,010 --> 00:01:33,490 Speaker 3: very important, and so I just want to let you 24 00:01:33,570 --> 00:01:34,050 Speaker 3: know This is. 25 00:01:34,010 --> 00:01:36,130 Speaker 1: Like a really emotionalsery. 26 00:01:36,210 --> 00:01:38,770 Speaker 4: It's like our anniversary, twenty fifth anniversary is coming up. 27 00:01:38,810 --> 00:01:41,690 Speaker 4: Did you know that, Yes, get a gift. 28 00:01:42,170 --> 00:01:44,770 Speaker 3: Yes, this this, This is your gift to be on 29 00:01:44,850 --> 00:01:50,810 Speaker 3: this podcast to help to educate men about menopause and midlife. 30 00:01:50,490 --> 00:01:52,210 Speaker 4: So they call menopause menopause. 31 00:01:54,370 --> 00:01:57,490 Speaker 3: You're listening to Decoding Women's Health. I'm doctor Elizabeth Pointer. 32 00:01:58,690 --> 00:02:01,730 Speaker 3: I was recently on the Ritual podcast talking about hormones 33 00:02:01,730 --> 00:02:04,490 Speaker 3: and menopause, and he asked me a question that really 34 00:02:04,490 --> 00:02:08,770 Speaker 3: stumped me, and I'm not someone who's easily stumped. He 35 00:02:08,889 --> 00:02:12,290 Speaker 3: wanted to know how I advised the partners of women 36 00:02:12,329 --> 00:02:16,850 Speaker 3: going through menopause. This is actually an important topic that 37 00:02:16,889 --> 00:02:21,290 Speaker 3: lots of people, myself included, don't spend enough time talking about. 38 00:02:22,250 --> 00:02:23,610 Speaker 1: Menopause and midlife. 39 00:02:23,649 --> 00:02:28,730 Speaker 3: Hormonal changes have a huge impact on relationships. Since nineteen ninety, 40 00:02:28,929 --> 00:02:31,410 Speaker 3: divorce rates in the United States have gone down for 41 00:02:31,609 --> 00:02:37,410 Speaker 3: every age group except one people over fifty. One survey 42 00:02:37,450 --> 00:02:40,410 Speaker 3: in the United Kingdom found that seven to ten women 43 00:02:40,649 --> 00:02:44,410 Speaker 3: cited perimenopause or menopause as a major factor in their 44 00:02:44,410 --> 00:02:47,810 Speaker 3: divorces seven out of ten seventy percent. 45 00:02:48,769 --> 00:02:50,169 Speaker 1: But it doesn't have to be like that. 46 00:02:50,690 --> 00:02:53,890 Speaker 3: There are ways for couples to navigate these changes, and 47 00:02:54,010 --> 00:02:56,489 Speaker 3: practical advice for those who want to better support their 48 00:02:56,530 --> 00:03:00,810 Speaker 3: partners or friends or loved ones who are experiencing menopause. 49 00:03:01,970 --> 00:03:03,849 Speaker 1: So I thought, who. 50 00:03:03,530 --> 00:03:07,209 Speaker 3: Better to discuss this with than my husband, doctor Richard. 51 00:03:06,889 --> 00:03:09,890 Speaker 4: Shapiro, sometimes called mister Poynter. 52 00:03:10,250 --> 00:03:14,850 Speaker 3: Yep, he's not just mister pointer. He's also a pioneering 53 00:03:14,889 --> 00:03:19,330 Speaker 3: breast cancer and melanoma researcher and surgeon, the very best 54 00:03:19,370 --> 00:03:22,730 Speaker 3: in my opinion. So I invited rich onto the show 55 00:03:22,769 --> 00:03:25,850 Speaker 3: to talk about some common misconceptions around estrogen that he 56 00:03:25,850 --> 00:03:29,970 Speaker 3: hears in his practice and how partners and also frankly, 57 00:03:30,049 --> 00:03:37,250 Speaker 3: clinicians across disciplines can better support women in midlife. Can 58 00:03:37,290 --> 00:03:40,290 Speaker 3: you tell our listeners how we first met? And I'm 59 00:03:40,290 --> 00:03:42,290 Speaker 3: going to jump in with any fat checks if we 60 00:03:42,370 --> 00:03:44,730 Speaker 3: need to have some reality checks and press. 61 00:03:44,810 --> 00:03:49,490 Speaker 4: So I had a colleague at the hospital that came 62 00:03:49,610 --> 00:03:51,730 Speaker 4: up to me one day and asked me if I 63 00:03:51,770 --> 00:03:54,850 Speaker 4: wanted to meet his wife and him for dinner. And 64 00:03:54,890 --> 00:03:57,130 Speaker 4: I said no, and he goes, no, come on, I've 65 00:03:57,130 --> 00:04:00,050 Speaker 4: told my wife a lot about you. It's like all right, 66 00:04:00,210 --> 00:04:02,050 Speaker 4: So we get in a cab. We go first avenue. 67 00:04:02,090 --> 00:04:05,010 Speaker 4: He goes, look, the doors are locked, but my wife 68 00:04:05,050 --> 00:04:08,250 Speaker 4: is setting you up with her closest friend. And if 69 00:04:08,290 --> 00:04:09,850 Speaker 4: I could have gotten out of the car at that 70 00:04:09,930 --> 00:04:12,210 Speaker 4: point on first Avenue, I would have, because I'd been 71 00:04:12,250 --> 00:04:16,089 Speaker 4: through this countless times. Uh. And we went to a 72 00:04:16,130 --> 00:04:21,330 Speaker 4: restaurant and two women walked in and I looked at you, 73 00:04:21,610 --> 00:04:24,610 Speaker 4: and I looked at her, and he said, Elizabeth is 74 00:04:24,650 --> 00:04:27,370 Speaker 4: the taller of the two. And I knew within two 75 00:04:27,409 --> 00:04:31,050 Speaker 4: hours that if you are not the person I've been 76 00:04:31,089 --> 00:04:34,289 Speaker 4: looking for my whole life, that person does not exist. 77 00:04:34,450 --> 00:04:36,049 Speaker 4: So I knew that not I was going to marry you. 78 00:04:36,930 --> 00:04:37,730 Speaker 1: That's pretty cool. 79 00:04:37,810 --> 00:04:42,050 Speaker 4: I think you may but that is absolutely true. 80 00:04:42,170 --> 00:04:45,690 Speaker 3: But you may have reconsidered that at some point, because. 81 00:04:45,330 --> 00:04:47,770 Speaker 4: We have, and we all reconsidered it, but. 82 00:04:47,890 --> 00:04:49,930 Speaker 3: We were It's also really important to note for our 83 00:04:49,930 --> 00:04:53,690 Speaker 3: listeners because this is a midlife women's health podcast. 84 00:04:53,810 --> 00:04:53,970 Speaker 1: Right. 85 00:04:54,529 --> 00:04:57,890 Speaker 3: I realized in prepping for this conversation that when we met, 86 00:04:58,050 --> 00:05:01,050 Speaker 3: you know, it was midlife for me actually, and you right, 87 00:05:01,529 --> 00:05:04,929 Speaker 3: you know, we got married quickly after we after we met. 88 00:05:05,289 --> 00:05:09,289 Speaker 3: We had to because I was old and uhuh yeah, okay, 89 00:05:09,490 --> 00:05:11,969 Speaker 3: and we had her son. We did, and then all 90 00:05:11,969 --> 00:05:14,570 Speaker 3: of a sudden, I had some menopause stuff go on, right, 91 00:05:14,690 --> 00:05:18,770 Speaker 3: I know, depression, like yeah, like severe depression and anxiety. 92 00:05:19,130 --> 00:05:21,010 Speaker 3: Not I don't think it was postpartum depression is more 93 00:05:21,050 --> 00:05:24,570 Speaker 3: related to menopause. But you were super supportive. And you know, 94 00:05:24,610 --> 00:05:27,529 Speaker 3: you're a doctor. You're a breast cancer surgeon, right, so 95 00:05:27,570 --> 00:05:30,490 Speaker 3: you obviously take care of a lot of women. You 96 00:05:30,610 --> 00:05:34,770 Speaker 3: knew probably a few things about hormonal changes, especially being 97 00:05:34,890 --> 00:05:37,650 Speaker 3: breast cancer surgeon with women who can't take estrogen. 98 00:05:38,490 --> 00:05:39,369 Speaker 1: What were your. 99 00:05:39,409 --> 00:05:42,890 Speaker 3: Initial thoughts about what menopause would be like did you. 100 00:05:42,810 --> 00:05:43,770 Speaker 1: Think about it at all? 101 00:05:43,849 --> 00:05:45,890 Speaker 3: Like when I was going through this depression, did that 102 00:05:45,930 --> 00:05:48,130 Speaker 3: come into your mind or what were you thinking? 103 00:05:48,730 --> 00:05:52,969 Speaker 4: I mean, you know, I think that most men don't 104 00:05:53,289 --> 00:05:57,090 Speaker 4: look at it as a medical I don't want to 105 00:05:57,170 --> 00:06:01,570 Speaker 4: use the word condition. But it's a biochemical change. So 106 00:06:01,770 --> 00:06:07,210 Speaker 4: it can be very easy for a man to look 107 00:06:07,250 --> 00:06:12,849 Speaker 4: at a woman going through these changes as being depressed 108 00:06:13,570 --> 00:06:18,409 Speaker 4: or unsatisfied with their life and not realize that it's 109 00:06:18,450 --> 00:06:22,490 Speaker 4: the withdrawal of hormonal support that's really having somebody feel 110 00:06:22,529 --> 00:06:26,609 Speaker 4: this way. And it's very easy to get frustrated and 111 00:06:26,690 --> 00:06:29,530 Speaker 4: to take it personally and to get angry about it. 112 00:06:29,849 --> 00:06:32,489 Speaker 4: You know, when you have a substance in your body 113 00:06:32,529 --> 00:06:36,690 Speaker 4: that is being diminished and your body's reacting to that 114 00:06:36,849 --> 00:06:40,810 Speaker 4: withdrawing from that. You know, most people don't think about that. 115 00:06:40,890 --> 00:06:42,370 Speaker 4: Most men don't think about that at all. 116 00:06:42,770 --> 00:06:46,169 Speaker 3: So when did you first start to notice or when 117 00:06:46,170 --> 00:06:48,570 Speaker 3: did it come into your mind? Because it came into 118 00:06:48,650 --> 00:06:51,570 Speaker 3: my mind really late that I was in perimenopause. Did 119 00:06:51,610 --> 00:06:53,610 Speaker 3: it come into your mind at all? Or was it 120 00:06:53,650 --> 00:06:56,010 Speaker 3: after I said, wait a minute, I just took this Estertonpatt. 121 00:06:56,170 --> 00:06:57,170 Speaker 1: I feel so much better. 122 00:06:57,370 --> 00:07:00,969 Speaker 4: You're not a complainer, and you're someone that always pushes forward, 123 00:07:01,810 --> 00:07:05,489 Speaker 4: and so I think that I really, like most men, 124 00:07:05,890 --> 00:07:09,690 Speaker 4: I think only realized it when you brought up pot flashes, 125 00:07:10,330 --> 00:07:13,850 Speaker 4: because that's the thing that every man will recognize as 126 00:07:14,050 --> 00:07:17,450 Speaker 4: women going through menopause hot flashes. But I think most 127 00:07:17,490 --> 00:07:20,809 Speaker 4: men don't think about all the other things that happen 128 00:07:20,930 --> 00:07:23,650 Speaker 4: to women when they go into this phase of life 129 00:07:23,730 --> 00:07:24,890 Speaker 4: or through this phase of life. 130 00:07:25,490 --> 00:07:28,210 Speaker 3: I have to pause here and say, I hear this 131 00:07:28,330 --> 00:07:31,410 Speaker 3: all the time from my patients that their partners are 132 00:07:31,450 --> 00:07:35,810 Speaker 3: just so confused, if not downright unkind sometimes because their 133 00:07:35,810 --> 00:07:39,690 Speaker 3: partners just don't understand and I've been impressed by Rich's 134 00:07:39,770 --> 00:07:43,530 Speaker 3: journey of learning about hormones. He's a big advocate now, 135 00:07:43,890 --> 00:07:47,850 Speaker 3: but it wasn't always this way. Treatment options for breast 136 00:07:47,850 --> 00:07:50,330 Speaker 3: cancer have improved dramatically in just the last ten to 137 00:07:50,370 --> 00:07:54,370 Speaker 3: fifteen years, but those options often come with side effects. 138 00:07:55,010 --> 00:07:58,570 Speaker 3: Some can even trigger early menopause. So it's important for 139 00:07:58,650 --> 00:08:01,929 Speaker 3: women and their doctors to have an open dialogue about 140 00:08:01,930 --> 00:08:05,090 Speaker 3: the impact of these treatments so we can think through 141 00:08:05,130 --> 00:08:09,370 Speaker 3: the best course of action for each individual patient. As 142 00:08:09,410 --> 00:08:12,130 Speaker 3: I've mentioned before on this show, I believe estrogen can 143 00:08:12,170 --> 00:08:14,490 Speaker 3: really help many women in this chapter of their lives. 144 00:08:15,170 --> 00:08:18,610 Speaker 3: So it might surprise you to learn my husband hasn't 145 00:08:18,690 --> 00:08:22,050 Speaker 3: always been on the same page. There's two things that 146 00:08:22,170 --> 00:08:24,090 Speaker 3: I really want to bring up that you said to me. 147 00:08:24,210 --> 00:08:25,090 Speaker 1: The first was. 148 00:08:27,090 --> 00:08:29,370 Speaker 3: You know you're not going to take estrogen. You said 149 00:08:29,370 --> 00:08:32,449 Speaker 3: that to me early on. And then the second thing 150 00:08:32,490 --> 00:08:35,449 Speaker 3: that you said to me, which really is resonating right 151 00:08:35,450 --> 00:08:39,090 Speaker 3: now with this conversation, is that this menopause stuff is 152 00:08:39,130 --> 00:08:42,890 Speaker 3: real you but I don't think you, like, did you 153 00:08:43,050 --> 00:08:46,850 Speaker 3: know anything before I went through this? Did you know 154 00:08:46,929 --> 00:08:51,090 Speaker 3: anything about this? Did it from your mother? From you know, friends, wives, 155 00:08:51,170 --> 00:08:52,329 Speaker 3: from I mean. 156 00:08:52,090 --> 00:08:55,250 Speaker 4: The joke, the hot flashes, the way gain she's going 157 00:08:55,250 --> 00:08:59,089 Speaker 4: through menopause. She's impossible to deal with. She does want 158 00:08:59,130 --> 00:09:03,690 Speaker 4: to do anything. She's depressed. But I really didn't think 159 00:09:03,809 --> 00:09:09,450 Speaker 4: much of it until I started putting patients into menopause 160 00:09:09,650 --> 00:09:12,530 Speaker 4: with the medical treatment for breast cancer. Sh right, But 161 00:09:12,850 --> 00:09:16,690 Speaker 4: so kind of when that started to happen, and you 162 00:09:16,970 --> 00:09:19,330 Speaker 4: it's very you know, it's very easy to see that. 163 00:09:19,569 --> 00:09:22,089 Speaker 4: I think sometimes it's very hard to see something up close, right, 164 00:09:22,170 --> 00:09:25,650 Speaker 4: So I would see something at work and then realize that, 165 00:09:25,689 --> 00:09:28,770 Speaker 4: you know, hey, we gave this woman this medication and 166 00:09:28,850 --> 00:09:32,530 Speaker 4: now they're different or they're having problems that they didn't 167 00:09:32,569 --> 00:09:35,410 Speaker 4: have before. So it's really a cause and effect thing. 168 00:09:36,490 --> 00:09:40,370 Speaker 4: So I thought for me to see that at work 169 00:09:40,569 --> 00:09:45,850 Speaker 4: or professionally or from a distance objectively was much easier 170 00:09:45,929 --> 00:09:50,570 Speaker 4: than actually noticing what's happening in front of it. So 171 00:09:51,330 --> 00:09:55,050 Speaker 4: that's when I really started to become aware. And that's 172 00:09:55,050 --> 00:09:58,410 Speaker 4: when I got to be much better at noticing subtle 173 00:09:58,569 --> 00:10:03,010 Speaker 4: or sometimes not so subtle changes in someone's behavior that 174 00:10:03,050 --> 00:10:04,849 Speaker 4: we can maybe attribute to menopause. 175 00:10:05,530 --> 00:10:08,810 Speaker 3: Yeah, and you actually have done something really important. I 176 00:10:08,929 --> 00:10:12,370 Speaker 3: was for our listeners. We you know, we share patients. 177 00:10:12,410 --> 00:10:17,329 Speaker 3: We talk about patients we've operated together, and you were 178 00:10:18,010 --> 00:10:20,330 Speaker 3: sharing with me a patient the other day that you 179 00:10:20,370 --> 00:10:24,010 Speaker 3: were telling me about who was on some estrogen, but 180 00:10:24,090 --> 00:10:26,810 Speaker 3: you thought her estrogen can be adjusted a little bit better. 181 00:10:26,929 --> 00:10:29,890 Speaker 3: And I was so proud. I was like, oh my gosh, 182 00:10:29,970 --> 00:10:34,930 Speaker 3: he's gone from not knowing anything about this, having conversations 183 00:10:34,970 --> 00:10:39,050 Speaker 3: with me and observing me, and then now applying that 184 00:10:39,290 --> 00:10:40,209 Speaker 3: to helping women. 185 00:10:40,410 --> 00:10:47,329 Speaker 4: There's an incredible fear among doctors that if you give 186 00:10:47,530 --> 00:10:52,450 Speaker 4: women estrogen, they will get breast cancer. And there's a 187 00:10:52,490 --> 00:10:56,210 Speaker 4: lot of kind of ignorance about that, and there's a 188 00:10:56,210 --> 00:10:59,610 Speaker 4: lot of concern medical legally, right because we live in 189 00:10:59,650 --> 00:11:02,650 Speaker 4: that kind of world, and so if a woman develops 190 00:11:02,689 --> 00:11:06,210 Speaker 4: breast cancer and she's on estrogen, there are people that 191 00:11:06,290 --> 00:11:09,130 Speaker 4: would say that you caused that cancer, which you did not, 192 00:11:10,090 --> 00:11:13,010 Speaker 4: and it could be a ton of medical literature to 193 00:11:13,050 --> 00:11:17,410 Speaker 4: refute that. But legally it's always an issue. So a 194 00:11:17,450 --> 00:11:19,450 Speaker 4: lot of people say they want nothing to do with it, 195 00:11:19,850 --> 00:11:25,090 Speaker 4: absolute no. And so I never really thought that, and 196 00:11:25,370 --> 00:11:27,929 Speaker 4: it's a constant battle. It's a battle with many of 197 00:11:27,970 --> 00:11:29,329 Speaker 4: our oncologists as well. 198 00:11:29,650 --> 00:11:31,410 Speaker 3: And you guys got to realize that this guy is 199 00:11:31,410 --> 00:11:34,970 Speaker 3: a research person too, like Shapiro is a rich as 200 00:11:35,050 --> 00:11:38,850 Speaker 3: a real, real hardcore researcher. But you forwarded to me 201 00:11:38,929 --> 00:11:41,290 Speaker 3: the other day from the San Antonio Breast Cancer Conference, 202 00:11:41,290 --> 00:11:43,850 Speaker 3: which is the large breast cancer conference. You know yet 203 00:11:43,890 --> 00:11:46,770 Speaker 3: another study that showed that in the highest risk individuals 204 00:11:46,770 --> 00:11:50,890 Speaker 3: who have Braka one mutations, that estrogen doesn't cause breast cancer. 205 00:11:50,929 --> 00:11:54,090 Speaker 3: So why do you think despite all this data, why 206 00:11:54,130 --> 00:11:57,810 Speaker 3: do you think that medical oncologists and surgical oncologists too, 207 00:11:57,850 --> 00:12:01,329 Speaker 3: not yourself included, but many just are so hesitant to 208 00:12:02,970 --> 00:12:06,370 Speaker 3: grasp onto the estrogen doesn't cause breast cancer. 209 00:12:06,530 --> 00:12:10,730 Speaker 4: I would say the communication all habits die hard. I 210 00:12:10,770 --> 00:12:13,690 Speaker 4: will constantly have arguments with some of my colleagues about this. 211 00:12:14,410 --> 00:12:18,250 Speaker 4: You know, a woman has significant menipausal symptoms, They've tried 212 00:12:18,330 --> 00:12:19,929 Speaker 4: a lot of other things, and there are a lot 213 00:12:19,970 --> 00:12:24,489 Speaker 4: of ways to treat symptoms with things other than hormones. 214 00:12:25,170 --> 00:12:28,690 Speaker 4: So I think that's number one. But if you need 215 00:12:28,730 --> 00:12:33,810 Speaker 4: to have that hormonal support, I mean short, I think 216 00:12:33,809 --> 00:12:36,210 Speaker 4: a lot of doctors are moving into that, but no 217 00:12:36,250 --> 00:12:39,170 Speaker 4: one is really sure because no one had any education. 218 00:12:39,770 --> 00:12:41,890 Speaker 4: It's been a while since I've been in med school, 219 00:12:42,010 --> 00:12:45,730 Speaker 4: but I think that there certainly when I was in 220 00:12:45,770 --> 00:12:51,410 Speaker 4: medical school, there was virtually no instruction or education on 221 00:12:51,610 --> 00:12:53,330 Speaker 4: menopause at all. 222 00:12:53,450 --> 00:12:55,730 Speaker 3: You know, you actually bring up a really important point 223 00:12:55,809 --> 00:13:01,930 Speaker 3: because we talk about educating women's health providers right, more 224 00:13:01,970 --> 00:13:06,930 Speaker 3: from the primary care OBGI in setting group, right. But 225 00:13:07,050 --> 00:13:11,490 Speaker 3: here you are operating on women who have a breast cancer, right, 226 00:13:11,890 --> 00:13:14,490 Speaker 3: who have the stress of a cancer and then are 227 00:13:14,490 --> 00:13:19,010 Speaker 3: put into menopause with their treatments many times, or have antiestrogens, 228 00:13:19,050 --> 00:13:20,650 Speaker 3: and you had no education. 229 00:13:20,370 --> 00:13:25,010 Speaker 4: As zero, no education. So it's all anecdotal, and there 230 00:13:25,050 --> 00:13:27,810 Speaker 4: are a lot of naysayers when you want to do 231 00:13:27,890 --> 00:13:31,250 Speaker 4: something to go absolutely not, I'm like, why, well, you know, 232 00:13:31,970 --> 00:13:33,929 Speaker 4: and you know, there is a lot of good data 233 00:13:33,929 --> 00:13:37,170 Speaker 4: coming out now that it is really saying that estrogen 234 00:13:38,370 --> 00:13:44,890 Speaker 4: in many situations is totally safe. But you know, unfortunately, 235 00:13:45,050 --> 00:13:49,530 Speaker 4: any any article that comes out on breast cancer, especially 236 00:13:49,530 --> 00:13:54,130 Speaker 4: those that hit the popular press, are highlighted, and it 237 00:13:54,210 --> 00:13:56,490 Speaker 4: seems like every two months the data is going back 238 00:13:56,530 --> 00:13:58,929 Speaker 4: and forth when it really isn't and so it can 239 00:13:58,970 --> 00:14:01,050 Speaker 4: be very hard, you know, when you have all this 240 00:14:01,130 --> 00:14:04,570 Speaker 4: information thrown at you from ten different directions to really know. 241 00:14:04,890 --> 00:14:08,650 Speaker 4: And another big question is who in the care of 242 00:14:08,650 --> 00:14:11,929 Speaker 4: the patient is responsible for this? Is it the oncologist? 243 00:14:12,130 --> 00:14:14,930 Speaker 4: Is it the surgeon? Is it the gynecologist? Is it 244 00:14:15,010 --> 00:14:18,690 Speaker 4: the endochronologist? You know, people tend to have ten doctors now, 245 00:14:19,090 --> 00:14:22,010 Speaker 4: so who is going to be the one that is 246 00:14:22,090 --> 00:14:27,450 Speaker 4: going to write that prescription and help moderate any type 247 00:14:27,490 --> 00:14:31,729 Speaker 4: of symptoms or lack thereof that the patient's having from it? Like, 248 00:14:31,770 --> 00:14:34,890 Speaker 4: who's going to be responsible? You know, most of us 249 00:14:34,930 --> 00:14:37,330 Speaker 4: are very siloed, and so I know that you are 250 00:14:37,930 --> 00:14:41,010 Speaker 4: once in a while coming up against you know, when 251 00:14:41,010 --> 00:14:43,810 Speaker 4: you're in a multidisciplinary team, it sounds great to treat 252 00:14:43,850 --> 00:14:46,890 Speaker 4: patients that way, but when you have four people that 253 00:14:46,970 --> 00:14:49,610 Speaker 4: have four different opinions about something like this, it can 254 00:14:49,650 --> 00:14:53,050 Speaker 4: be very frustrating, not only for the patient but for us. 255 00:14:53,530 --> 00:14:55,450 Speaker 3: Yeah, and I think that, I mean, you've just said 256 00:14:55,450 --> 00:14:58,090 Speaker 3: that that siloed was the key word, right, and we 257 00:14:58,170 --> 00:15:00,290 Speaker 3: need to take this out of siloce But I think 258 00:15:00,370 --> 00:15:03,650 Speaker 3: that's why we really need to redefine who the women's 259 00:15:03,690 --> 00:15:07,050 Speaker 3: health specialist is to quarterback all this. Who understands oncology, 260 00:15:07,050 --> 00:15:11,810 Speaker 3: who understands cancer, who understands anti hormone therapy, hormon therapy, 261 00:15:12,130 --> 00:15:16,130 Speaker 3: cardiac disease, metabolic disease. We need that oversweeping holistic view. 262 00:15:19,050 --> 00:15:19,610 Speaker 1: Coming up. 263 00:15:19,930 --> 00:15:22,570 Speaker 3: Rich and I talk about the different impacts menopause can 264 00:15:22,610 --> 00:15:37,570 Speaker 3: have on relationships, including sex and libido. So let's go 265 00:15:37,690 --> 00:15:41,730 Speaker 3: back to menopause and how it can impact a relationship 266 00:15:41,730 --> 00:15:46,170 Speaker 3: and then get back to the partner view on menopause 267 00:15:46,210 --> 00:15:48,690 Speaker 3: and how to help a partner going through these changes. 268 00:15:49,610 --> 00:15:53,570 Speaker 3: Let's talk about sex. How do you advise patients partners 269 00:15:53,850 --> 00:15:57,570 Speaker 3: about what to expect with libido sex, how to navigate that. 270 00:15:58,130 --> 00:16:00,490 Speaker 4: You know, as I'm a male doctor, I think that 271 00:16:00,770 --> 00:16:05,250 Speaker 4: a lot of female patients may not be comfortable talking 272 00:16:05,290 --> 00:16:06,330 Speaker 4: about that with a man. 273 00:16:06,450 --> 00:16:07,130 Speaker 1: Do you bring it up? 274 00:16:08,530 --> 00:16:10,850 Speaker 4: I bring it up to them when we talk about 275 00:16:10,890 --> 00:16:15,730 Speaker 4: the possible side effects of some of the anti hormonal 276 00:16:15,770 --> 00:16:19,370 Speaker 4: treatments we're going to prescribe with breast cancer. But I'm 277 00:16:19,410 --> 00:16:23,930 Speaker 4: not the quote expert on it, and so that usually 278 00:16:23,930 --> 00:16:25,970 Speaker 4: falls in the way I work and where I work 279 00:16:26,250 --> 00:16:29,370 Speaker 4: to the medical oncologist that's prescribing that drug to talk 280 00:16:29,850 --> 00:16:32,930 Speaker 4: to them about that. I like to set things up 281 00:16:32,970 --> 00:16:36,130 Speaker 4: so they're not blindsided about it. So I do bring 282 00:16:36,170 --> 00:16:39,290 Speaker 4: it up. But yeah, I would say. 283 00:16:39,170 --> 00:16:40,850 Speaker 3: Do bring it up, and then when you're talking to 284 00:16:41,490 --> 00:16:44,370 Speaker 3: you know your friends and confidants. Do you guys talk 285 00:16:44,410 --> 00:16:46,810 Speaker 3: because guys, right, so I can say, guys, it's a 286 00:16:46,850 --> 00:16:49,890 Speaker 3: guy thing, so heteronormalize it. 287 00:16:49,970 --> 00:16:53,130 Speaker 4: But to send their wives to you and you'll fix 288 00:16:53,170 --> 00:16:55,770 Speaker 4: that right exactly, Yes, with pills and positions. 289 00:16:56,130 --> 00:16:59,410 Speaker 1: And do you did do you? 290 00:16:59,610 --> 00:17:02,890 Speaker 3: I mean, do you talk about vaginal dryness and you know, 291 00:17:02,970 --> 00:17:07,330 Speaker 3: like a woman maybe experiencing pain with penetrative sex. 292 00:17:07,570 --> 00:17:10,370 Speaker 4: It's more like, well, they don't want to have sex 293 00:17:10,410 --> 00:17:11,010 Speaker 4: with me anymore. 294 00:17:11,050 --> 00:17:12,490 Speaker 1: Yeah, let's talk about that. So what do you do 295 00:17:12,490 --> 00:17:13,650 Speaker 1: about what do you how do you? 296 00:17:13,770 --> 00:17:16,450 Speaker 4: Guys say? I say, you know, there are a lot 297 00:17:16,450 --> 00:17:19,050 Speaker 4: of things that happen in your menopause. There's vaginal dryness, 298 00:17:19,090 --> 00:17:23,290 Speaker 4: there's lots of libido. You are the first doctor that 299 00:17:23,369 --> 00:17:28,330 Speaker 4: I've come across that also prescribes to stostrone to women. 300 00:17:29,010 --> 00:17:32,410 Speaker 4: People were willing to talk about estrogen and vaginal estrogen 301 00:17:33,050 --> 00:17:38,170 Speaker 4: and support, but no one was on testosterone. I never you. 302 00:17:38,170 --> 00:17:40,490 Speaker 4: You were the first person that kind of opened my 303 00:17:40,490 --> 00:17:42,889 Speaker 4: eyes to like, wow, that makes a lot of sense. 304 00:17:43,090 --> 00:17:46,730 Speaker 3: Yeah, yeah, and that's super helpful with libido. 305 00:17:46,490 --> 00:17:50,370 Speaker 4: And with your muscle tone and I think alertness and 306 00:17:50,570 --> 00:17:56,330 Speaker 4: I can actually you're like my little laboratory, because I 307 00:17:56,369 --> 00:18:00,409 Speaker 4: can tell when we go upstate and you have forgotten 308 00:18:00,930 --> 00:18:05,010 Speaker 4: your estrogen or whatever in the apartment that there's a difference, 309 00:18:05,170 --> 00:18:07,609 Speaker 4: that there's something. You know. I can spot it before 310 00:18:07,650 --> 00:18:14,490 Speaker 4: you can, just in your mood or sometimes you know 311 00:18:14,609 --> 00:18:17,410 Speaker 4: it's a fogginess or and I'll say, you know, did 312 00:18:17,410 --> 00:18:19,330 Speaker 4: you leave your essen in the city, And when you 313 00:18:19,450 --> 00:18:21,970 Speaker 4: yell at me, I know that you have the testosterone 314 00:18:22,010 --> 00:18:24,450 Speaker 4: on board, but the essene isn't. If you don't yell 315 00:18:24,490 --> 00:18:26,330 Speaker 4: at me, I think you're missing both, and they're both 316 00:18:26,330 --> 00:18:30,170 Speaker 4: in the apartment. But I think you can right. It's true, 317 00:18:30,210 --> 00:18:32,689 Speaker 4: And when you get to know someone, you can you 318 00:18:32,730 --> 00:18:35,369 Speaker 4: can really see the difference. I think that probably a 319 00:18:35,410 --> 00:18:40,850 Speaker 4: lot of marriages get into trouble because women go through 320 00:18:40,890 --> 00:18:43,649 Speaker 4: these issues and then the men don't understand it's a 321 00:18:43,690 --> 00:18:46,570 Speaker 4: medical thing. It's not like it's like being angry with 322 00:18:46,609 --> 00:18:50,410 Speaker 4: someone who's blood sugar is low because they're diabetic. It's 323 00:18:50,450 --> 00:18:53,530 Speaker 4: the same thing, but no one really thinks about it. 324 00:18:53,970 --> 00:18:57,570 Speaker 4: So you know, if someone understands that there is a 325 00:18:57,690 --> 00:19:01,129 Speaker 4: you know, men can you know, have erectile dysfunction and 326 00:19:01,170 --> 00:19:04,770 Speaker 4: need a pill for support and that's okay, And people 327 00:19:05,010 --> 00:19:08,330 Speaker 4: understand that or it's becoming okay. But women can have 328 00:19:08,490 --> 00:19:12,170 Speaker 4: a similar problem with lack of hormones and no one 329 00:19:12,170 --> 00:19:12,930 Speaker 4: thinks about it. 330 00:19:13,290 --> 00:19:15,610 Speaker 3: So at the same time that women are going through 331 00:19:15,609 --> 00:19:19,090 Speaker 3: these midlighte hormonal fluctuations, men are going through absolutely their 332 00:19:19,129 --> 00:19:22,050 Speaker 3: team may be dropping off, they may be having career changes, 333 00:19:22,250 --> 00:19:24,609 Speaker 3: identity issues. I mean, we don't really talk about that 334 00:19:24,650 --> 00:19:26,490 Speaker 3: so much, and that could be a perfect storm. 335 00:19:26,570 --> 00:19:30,370 Speaker 4: Unmail, Yes, unmail to think that way. Men go through 336 00:19:30,369 --> 00:19:33,530 Speaker 4: menopause too, in a sense, I mean, this is just ignorance. 337 00:19:33,570 --> 00:19:37,330 Speaker 4: But it seems like the big problem that men seem 338 00:19:37,410 --> 00:19:40,810 Speaker 4: to get is erechtal dysfunction at that time, and that 339 00:19:40,890 --> 00:19:43,690 Speaker 4: can be really fixed or solved with a pill. It's 340 00:19:43,690 --> 00:19:47,690 Speaker 4: an easier fix, it's immediate, and that's not always the problem. 341 00:19:47,810 --> 00:19:50,449 Speaker 4: So there are all those serious health like cardiovascal disease 342 00:19:51,330 --> 00:19:55,970 Speaker 4: manifests sometimes first in erecta dysfunction. So if that happens 343 00:19:56,010 --> 00:20:01,370 Speaker 4: to a man, they need to get their cardiovascosystem. 344 00:20:00,410 --> 00:20:03,010 Speaker 1: Eval diabetes too, right, diet and. 345 00:20:03,129 --> 00:20:05,970 Speaker 4: Blood pressure and all of these things. So you know 346 00:20:06,970 --> 00:20:09,970 Speaker 4: it's different in wake in and everyone's been tabolism changes. Yeah, 347 00:20:10,050 --> 00:20:11,330 Speaker 4: but it happens to men. 348 00:20:11,290 --> 00:20:15,650 Speaker 3: To Yeah, when you give your friends knowledge, right when 349 00:20:15,690 --> 00:20:19,050 Speaker 3: you start talking about sex and libido and testosterone, And 350 00:20:19,690 --> 00:20:21,929 Speaker 3: what are the reactions when they when you give them knowledge. 351 00:20:21,970 --> 00:20:24,609 Speaker 1: Are they relieved? Did they say thanks rich? 352 00:20:24,970 --> 00:20:27,690 Speaker 4: You know, it's something they didn't think of? Yeah, or 353 00:20:27,730 --> 00:20:30,210 Speaker 4: it's a way out. So a lot of them will 354 00:20:30,210 --> 00:20:33,609 Speaker 4: accept that their wife's going through menopause. But I would 355 00:20:33,650 --> 00:20:37,249 Speaker 4: say the two things that the men complain about, the 356 00:20:37,330 --> 00:20:42,050 Speaker 4: three things the men notice and complain about, is loss 357 00:20:42,050 --> 00:20:45,410 Speaker 4: of libido and the women that the women are constantly 358 00:20:45,450 --> 00:20:48,209 Speaker 4: hot and it's a problem in the car, you know, 359 00:20:48,650 --> 00:20:52,330 Speaker 4: or kind of a snippiness, a shortness. But I think 360 00:20:52,369 --> 00:20:55,890 Speaker 4: that I think that the surprising response from a lot 361 00:20:55,930 --> 00:20:59,010 Speaker 4: of the men that come up to me is that 362 00:20:59,090 --> 00:21:00,330 Speaker 4: I said, you know, there's a lot of things you 363 00:21:00,369 --> 00:21:03,930 Speaker 4: can do that are kind of simple. No one needs 364 00:21:03,970 --> 00:21:07,050 Speaker 4: to be told that they should go get a get 365 00:21:07,090 --> 00:21:09,970 Speaker 4: a different job, or get new hobbies because you're just 366 00:21:10,050 --> 00:21:12,290 Speaker 4: bored and you're sitting home home. You know, no one 367 00:21:12,410 --> 00:21:15,850 Speaker 4: wants to be told that. But if you're telling someone, 368 00:21:15,890 --> 00:21:19,050 Speaker 4: you know, I did some lab tests, and you know 369 00:21:19,090 --> 00:21:21,209 Speaker 4: you need to have some estrogen support, and we're going 370 00:21:21,250 --> 00:21:24,330 Speaker 4: to give you some testosterone as well and X y Z. 371 00:21:25,010 --> 00:21:29,210 Speaker 4: That's that's real stuff. That's not giving someone vitamin supplements, 372 00:21:29,210 --> 00:21:32,490 Speaker 4: which are important, but you know, you're giving someone a prescription. 373 00:21:33,050 --> 00:21:38,290 Speaker 4: And usually prescriptions are evident, hopefully evidence based, and they're 374 00:21:38,369 --> 00:21:39,449 Speaker 4: given for good reason. 375 00:21:40,090 --> 00:21:41,649 Speaker 1: So let's let's talk about that. 376 00:21:41,730 --> 00:21:45,210 Speaker 3: So, you know, we want our partners of women going 377 00:21:45,210 --> 00:21:49,209 Speaker 3: through midlife changes to be supportive, right, And how do 378 00:21:49,290 --> 00:21:54,250 Speaker 3: you be supportive when you see maybe a wife or 379 00:21:55,290 --> 00:21:58,050 Speaker 3: a partner of one of your friends who's not getting 380 00:21:58,290 --> 00:22:01,609 Speaker 3: the right medical care, meaning she's not with somebody who 381 00:22:01,690 --> 00:22:04,609 Speaker 3: can really support her hormonally or lifestyle wise, like a 382 00:22:04,609 --> 00:22:05,929 Speaker 3: lot of docs just ignore it. 383 00:22:06,050 --> 00:22:09,250 Speaker 1: Still, you know, it's really hard. How do them? 384 00:22:09,330 --> 00:22:13,570 Speaker 4: Well, it's hard because you don't wanna If someone has 385 00:22:13,609 --> 00:22:17,290 Speaker 4: a long relationship with their gynecologist to their primary care doctor, 386 00:22:17,970 --> 00:22:20,690 Speaker 4: you don't want to tell them that you know, hey, 387 00:22:20,690 --> 00:22:22,210 Speaker 4: I don't think they're doing the right thing or they're 388 00:22:22,210 --> 00:22:26,369 Speaker 4: not paying attention to you. And so that that's really hard. 389 00:22:27,330 --> 00:22:30,810 Speaker 4: You have to get someone to realize that things are 390 00:22:30,850 --> 00:22:36,290 Speaker 4: not changing or getting better. Yeah, and so in that situation, 391 00:22:37,450 --> 00:22:40,770 Speaker 4: you have to point out to someone that hey, maybe 392 00:22:40,770 --> 00:22:45,209 Speaker 4: we can do something about this. So and maybe you 393 00:22:45,250 --> 00:22:48,850 Speaker 4: know you can get another opinion or a fresh opinion 394 00:22:48,890 --> 00:22:52,090 Speaker 4: on it. So I think it's it's something that you 395 00:22:52,970 --> 00:22:57,290 Speaker 4: can convince people to do. But unfortunately, I think a 396 00:22:57,330 --> 00:22:59,450 Speaker 4: lot of the damage in a relationship is done by 397 00:22:59,450 --> 00:23:02,169 Speaker 4: that point, because you know, it can go on for 398 00:23:02,290 --> 00:23:05,450 Speaker 4: months or years that you know, people are very unhappy 399 00:23:05,530 --> 00:23:08,970 Speaker 4: and very frustrated, and a certain percentage of people going 400 00:23:09,050 --> 00:23:12,129 Speaker 4: to give up or they've had enough, or and it 401 00:23:12,290 --> 00:23:15,450 Speaker 4: just becomes this snowball effect and things start to get worse. 402 00:23:15,770 --> 00:23:18,610 Speaker 4: But I think when you can convince people that there's 403 00:23:18,690 --> 00:23:21,290 Speaker 4: something you can do about this that's not like a 404 00:23:21,369 --> 00:23:24,489 Speaker 4: major intervention, it's not like having surgery, it's not that 405 00:23:24,609 --> 00:23:27,650 Speaker 4: big a deal, give it a chance because a lot 406 00:23:27,650 --> 00:23:30,649 Speaker 4: of people, you know will get a benefit at it, 407 00:23:30,730 --> 00:23:31,490 Speaker 4: or it won't hurt them. 408 00:23:31,810 --> 00:23:34,409 Speaker 3: I think, Yeah, I think I think you really keed 409 00:23:34,450 --> 00:23:37,369 Speaker 3: in on something that if you are not getting better 410 00:23:37,450 --> 00:23:41,530 Speaker 3: and you don't feel well, encourage your partner to get 411 00:23:41,730 --> 00:23:43,970 Speaker 3: new advice or a new strategy. 412 00:23:44,450 --> 00:23:47,929 Speaker 4: Right, let's try something. You try something new, and almost 413 00:23:47,970 --> 00:23:48,850 Speaker 4: everyone and maybe. 414 00:23:48,690 --> 00:23:50,530 Speaker 3: They'll find a new doctor that's going to help them 415 00:23:50,609 --> 00:23:51,850 Speaker 3: or a new situation that's going to. 416 00:23:51,890 --> 00:23:52,770 Speaker 1: But but it's hard. 417 00:23:53,770 --> 00:23:57,490 Speaker 3: It is hard even just to start these conversations. So 418 00:23:57,650 --> 00:24:00,130 Speaker 3: after the break we get into why it feels this way, 419 00:24:00,530 --> 00:24:02,850 Speaker 3: and we talk about some ways that partners can bring 420 00:24:02,930 --> 00:24:18,209 Speaker 3: up menopause. Do you think that men who have female 421 00:24:18,290 --> 00:24:21,090 Speaker 3: partners are scared of menopause or do you think they 422 00:24:21,129 --> 00:24:21,810 Speaker 3: even know about it? 423 00:24:22,090 --> 00:24:25,050 Speaker 4: Make that have female partners are scared of menopause. They 424 00:24:25,810 --> 00:24:28,690 Speaker 4: they only know about it in a way that you 425 00:24:28,730 --> 00:24:32,810 Speaker 4: would see in a TV sitcom that's scary. Almost every 426 00:24:32,890 --> 00:24:35,330 Speaker 4: man I know thinks about men and she's going through 427 00:24:35,330 --> 00:24:40,369 Speaker 4: the change, and so it's it's sort of in every movie, 428 00:24:40,609 --> 00:24:42,970 Speaker 4: there's a there's a there's a woman that is going 429 00:24:43,010 --> 00:24:45,810 Speaker 4: through menopause and she's not fun to be with. But 430 00:24:46,010 --> 00:24:48,330 Speaker 4: and you got to point out people that don't feel 431 00:24:48,410 --> 00:24:50,970 Speaker 4: are not fun to be with, so and and it's 432 00:24:51,050 --> 00:24:54,209 Speaker 4: it's really that you're not feeling well for a biological reason. 433 00:24:54,650 --> 00:24:57,610 Speaker 4: It's not that you're not feeling well because you're disappointed 434 00:24:57,650 --> 00:25:00,689 Speaker 4: in your life, well, you don't like your partner, or 435 00:25:00,730 --> 00:25:03,490 Speaker 4: you're not you know, you're not attracted to each other anymore. 436 00:25:03,970 --> 00:25:10,850 Speaker 4: So it really hasn't been recognized as a significant medical condition. 437 00:25:11,369 --> 00:25:14,450 Speaker 4: And the only parallel I can come up with. Is 438 00:25:14,530 --> 00:25:17,929 Speaker 4: that I've noticed, as you know, we're old now, is 439 00:25:17,970 --> 00:25:22,690 Speaker 4: that more and more men that I know will take 440 00:25:22,810 --> 00:25:28,010 Speaker 4: cialis or some of these medications because it's normal. Yeah, like, hey, 441 00:25:28,129 --> 00:25:29,770 Speaker 4: I need it, Like I'm going to get it. There's 442 00:25:29,770 --> 00:25:32,249 Speaker 4: no stigma to that anymore. It used to be that 443 00:25:32,290 --> 00:25:35,130 Speaker 4: patients wouldn't even tell me they're on it, or friends 444 00:25:35,129 --> 00:25:37,649 Speaker 4: wouldn't tell you that they were on it, or they 445 00:25:37,650 --> 00:25:40,330 Speaker 4: would ask you sheepeshly, hey, you know, have you ever 446 00:25:41,010 --> 00:25:43,770 Speaker 4: take this to you today? But I don't think women 447 00:25:45,250 --> 00:25:50,650 Speaker 4: think about it the same way. But there's also the 448 00:25:50,770 --> 00:25:54,970 Speaker 4: fear and overlay and ignorance about what estrogen could potentially 449 00:25:55,010 --> 00:26:00,170 Speaker 4: do bad things to you. So a lot of there's 450 00:26:00,210 --> 00:26:03,490 Speaker 4: a lot of ignorance about the pros and content estrogen. 451 00:26:04,129 --> 00:26:04,290 Speaker 4: You know. 452 00:26:04,369 --> 00:26:07,250 Speaker 3: It's interesting because it used to be that men would 453 00:26:07,250 --> 00:26:10,689 Speaker 3: develop ed, women's libido would go down, and then the 454 00:26:10,690 --> 00:26:14,409 Speaker 3: relationship just changed a little bit. Right, And now I 455 00:26:14,410 --> 00:26:16,730 Speaker 3: think the EED drugs have really changed. I mean, they 456 00:26:16,770 --> 00:26:20,530 Speaker 3: they've rocked that, they've really changed. Yeah, right, I. 457 00:26:20,450 --> 00:26:24,930 Speaker 4: Think the fault it's just that it has not been 458 00:26:24,970 --> 00:26:26,729 Speaker 4: I don't want to use the market it, but it 459 00:26:26,810 --> 00:26:31,130 Speaker 4: hasn't been put out there that this is there is help. 460 00:26:31,369 --> 00:26:35,290 Speaker 3: Yeah, it's the biology of midlife women that. 461 00:26:35,210 --> 00:26:36,210 Speaker 1: It can impact. 462 00:26:36,330 --> 00:26:40,250 Speaker 4: It happens to everybody, everybody, everybody to everybody. 463 00:26:40,530 --> 00:26:43,090 Speaker 3: But it's interesting because, I mean, we really do need 464 00:26:43,170 --> 00:26:47,450 Speaker 3: to get the education out there to partners of midlife women. 465 00:26:47,690 --> 00:26:50,970 Speaker 3: Like hot flashes, night sweats, these are symptoms of perimenopause 466 00:26:51,010 --> 00:26:55,250 Speaker 3: or menopause or midlife hormonal fluctuations, sleep disruption, right waking 467 00:26:55,330 --> 00:26:59,210 Speaker 3: up early, right, mood changes, anxiety, depression for me, and 468 00:26:59,210 --> 00:27:01,010 Speaker 3: then our relationship, it was like it was in bed 469 00:27:01,010 --> 00:27:04,930 Speaker 3: all day. Vaginal dryness and sexual discomfort, brain fog, you 470 00:27:05,250 --> 00:27:07,850 Speaker 3: describe that, and me actually being a little fuzzy when 471 00:27:07,850 --> 00:27:10,690 Speaker 3: I don't take my estrogen and my hormones and testosterone. 472 00:27:11,090 --> 00:27:12,970 Speaker 3: How do we educate men? What is the answer in 473 00:27:13,090 --> 00:27:16,409 Speaker 3: terms of educating partners of midlife women. 474 00:27:16,530 --> 00:27:18,530 Speaker 4: It's whose whose responsibility is it? 475 00:27:18,690 --> 00:27:19,090 Speaker 3: Yeah? 476 00:27:19,290 --> 00:27:22,970 Speaker 4: Right, I'm not sure. I think that there has to 477 00:27:23,050 --> 00:27:27,930 Speaker 4: be sort of more of a public awareness of it. Right, 478 00:27:28,530 --> 00:27:32,129 Speaker 4: It's something that needs to get out there, and I 479 00:27:32,129 --> 00:27:34,729 Speaker 4: don't know, I'm not really sure how to do it. 480 00:27:35,690 --> 00:27:40,250 Speaker 4: Hockey games, menopause night like hockey fights, can't I don't know. 481 00:27:40,330 --> 00:27:41,330 Speaker 4: I mean, I don't know. 482 00:27:41,490 --> 00:27:42,730 Speaker 1: I like that Menopause Night at. 483 00:27:42,609 --> 00:27:47,770 Speaker 4: The Hockey Fight metopause, but but yeah, so I'm not 484 00:27:47,810 --> 00:27:51,810 Speaker 4: really sure. I mean, it definitely should start with medical 485 00:27:51,850 --> 00:27:55,410 Speaker 4: students and in nursing schools. I would say that there 486 00:27:55,410 --> 00:28:02,730 Speaker 4: should be some serious educational effort into this, but also. 487 00:28:02,530 --> 00:28:05,490 Speaker 3: Just at the at the lay level, right, I mean, 488 00:28:05,530 --> 00:28:10,570 Speaker 3: we need to educate partners of women. You could actually 489 00:28:10,570 --> 00:28:15,290 Speaker 3: go to Menopause Society website. They list the menopause practitioners there. 490 00:28:16,170 --> 00:28:21,170 Speaker 3: There's also online Menopause Concerns which you can do online 491 00:28:21,170 --> 00:28:24,330 Speaker 3: telehealth with which I think would be beneficial. Also, you know, 492 00:28:24,450 --> 00:28:28,169 Speaker 3: so how would you advise a partner to bring this up? 493 00:28:28,170 --> 00:28:32,690 Speaker 3: So you have a partner that is seeing these changes 494 00:28:32,730 --> 00:28:35,249 Speaker 3: in his partner and she may not realize what's going on, 495 00:28:35,290 --> 00:28:35,770 Speaker 3: how does he. 496 00:28:35,730 --> 00:28:36,129 Speaker 1: Bring it up? 497 00:28:36,170 --> 00:28:38,330 Speaker 4: That's another tribut getting a punched in the face, because 498 00:28:38,370 --> 00:28:43,170 Speaker 4: when you're going through these having these difficulties or issues, 499 00:28:43,570 --> 00:28:46,650 Speaker 4: you can't see it. Yeah, a lot of people can't 500 00:28:46,690 --> 00:28:50,570 Speaker 4: see how their behavior is changed. Or some people are 501 00:28:50,570 --> 00:28:53,250 Speaker 4: self aware, but I think most are not that self aware, 502 00:28:53,810 --> 00:28:57,370 Speaker 4: and so I think that it's hard. I mean, everyone's 503 00:28:57,410 --> 00:29:01,330 Speaker 4: relationship is different, right, But you know, a man are 504 00:29:01,330 --> 00:29:06,130 Speaker 4: sometimes very uncomfortable talking about this kind of thing. 505 00:29:06,490 --> 00:29:10,130 Speaker 3: I think for our relationship, it's about partnership. 506 00:29:09,570 --> 00:29:13,250 Speaker 4: It's about listening to some one. And also, yeah, it's 507 00:29:13,330 --> 00:29:16,930 Speaker 4: really I mean, you gotta there are so many times 508 00:29:17,090 --> 00:29:20,010 Speaker 4: you so many times in my life when I made 509 00:29:20,010 --> 00:29:24,570 Speaker 4: an assumption about a situation and when I actually talked 510 00:29:24,610 --> 00:29:26,890 Speaker 4: about it, I felt that like ninety five percent of 511 00:29:26,890 --> 00:29:29,810 Speaker 4: the time was wrong. So a lot of times I've 512 00:29:29,810 --> 00:29:30,890 Speaker 4: gotten much more direct. 513 00:29:31,690 --> 00:29:33,850 Speaker 3: And when you're going through midlife, it's not and this 514 00:29:33,970 --> 00:29:37,890 Speaker 3: is really I think key, it's not the relationship that changed. 515 00:29:38,050 --> 00:29:42,130 Speaker 3: It's really the hormonal milieu that changed that interferes with 516 00:29:42,170 --> 00:29:43,130 Speaker 3: the relationship. 517 00:29:43,170 --> 00:29:45,130 Speaker 1: And so when you have that target that you can go, 518 00:29:45,290 --> 00:29:45,730 Speaker 1: you don't. 519 00:29:45,530 --> 00:29:48,130 Speaker 4: Play the blame game. It's your fault. Yeah, you know, 520 00:29:48,410 --> 00:29:50,930 Speaker 4: you have to also be willing to listen. But I 521 00:29:50,970 --> 00:29:56,290 Speaker 4: think that again, the recognition that this is actually a 522 00:29:56,530 --> 00:30:02,930 Speaker 4: real health issue that needs to be addressed is the 523 00:30:03,290 --> 00:30:08,850 Speaker 4: you know, and makes it much more understandable or palatable 524 00:30:09,170 --> 00:30:12,250 Speaker 4: for a male partner to say, hey, this is a problem. 525 00:30:12,290 --> 00:30:15,370 Speaker 4: It's like I mean, it's like they have a lump 526 00:30:15,370 --> 00:30:19,130 Speaker 4: in their breast or they have a urological problem. Or 527 00:30:19,530 --> 00:30:21,850 Speaker 4: they you know, I need a hip or plate, whatever 528 00:30:21,890 --> 00:30:25,610 Speaker 4: it is. Menopause is a is a medical phase or 529 00:30:25,610 --> 00:30:28,370 Speaker 4: condition that's as important as all of those things, and 530 00:30:28,450 --> 00:30:31,690 Speaker 4: it's not addressed. So you would never get frustrated with 531 00:30:31,730 --> 00:30:35,570 Speaker 4: your partner because she has a suspicious mamigram and may 532 00:30:35,610 --> 00:30:40,090 Speaker 4: have breast cancer. But if someone isn't behaving the same 533 00:30:40,130 --> 00:30:44,770 Speaker 4: way towards you or your family because they are biochemically 534 00:30:44,890 --> 00:30:48,290 Speaker 4: deficient in substance that they've had their whole life and 535 00:30:48,330 --> 00:30:51,770 Speaker 4: now it's been taken away from them, you know, then 536 00:30:51,930 --> 00:30:55,490 Speaker 4: people would think a little bit differently about the problem. 537 00:30:55,650 --> 00:30:57,130 Speaker 1: That's a really lovely answer. 538 00:30:59,250 --> 00:31:02,570 Speaker 3: Okay, I know he's my husband, but I just have 539 00:31:02,690 --> 00:31:06,050 Speaker 3: to say I was so impressed by Rich's perspective and 540 00:31:06,130 --> 00:31:09,690 Speaker 3: how much he's evolved since I first experienced MIDLFE prmonal changes. 541 00:31:10,730 --> 00:31:13,930 Speaker 3: I hope that any partner or a loved one or 542 00:31:14,090 --> 00:31:18,290 Speaker 3: friend feels like menopause is a little less mysterious and 543 00:31:18,370 --> 00:31:22,890 Speaker 3: a little less daunting after this conversation. If you take 544 00:31:23,010 --> 00:31:25,730 Speaker 3: one thing away from this episode, I hope it's this 545 00:31:26,850 --> 00:31:29,850 Speaker 3: menopause doesn't have to be something you suffer through in silence, 546 00:31:30,250 --> 00:31:32,489 Speaker 3: and it doesn't have to be something that comes between 547 00:31:32,490 --> 00:31:35,450 Speaker 3: you and your partner. There is a way to get 548 00:31:35,450 --> 00:31:38,530 Speaker 3: through this together, and the more open dialogue we have 549 00:31:38,650 --> 00:31:43,450 Speaker 3: between women, their partners, and their doctors, the more options 550 00:31:43,490 --> 00:31:48,010 Speaker 3: we have for remedying symptoms and improving women's quality of life. 551 00:31:48,610 --> 00:31:51,770 Speaker 3: I really love the way Rich framed this. You wouldn't 552 00:31:51,770 --> 00:31:54,170 Speaker 3: get angry with someone for having an outburst when they 553 00:31:54,210 --> 00:31:56,290 Speaker 3: have low blood sugar, or for finding out they have 554 00:31:56,330 --> 00:31:56,890 Speaker 3: a lump. 555 00:31:56,650 --> 00:31:57,570 Speaker 1: In their breast. 556 00:31:58,130 --> 00:32:02,730 Speaker 3: Instead, let's treat menopause as the biologic event that it is. 557 00:32:03,450 --> 00:32:07,210 Speaker 3: It doesn't have to cause a ripped in relationships. Communication 558 00:32:07,410 --> 00:32:10,370 Speaker 3: and education are our best tools for navigating through this 559 00:32:10,530 --> 00:32:15,730 Speaker 3: change together. Coming up on the next episode of Decoding 560 00:32:15,770 --> 00:32:20,690 Speaker 3: Women's Health, Dry January maybe over, but our relationships with 561 00:32:20,770 --> 00:32:23,969 Speaker 3: alcohol are year round. What are the ways for us 562 00:32:24,010 --> 00:32:25,130 Speaker 3: to cut back on alcohol? 563 00:32:26,170 --> 00:32:29,810 Speaker 4: Quite often, health professionals also feel uncomfortable about asking about 564 00:32:29,890 --> 00:32:33,489 Speaker 4: drinking habits and pateants because we kind of assume that 565 00:32:33,530 --> 00:32:35,850 Speaker 4: it's okay when it may not be. 566 00:32:37,210 --> 00:32:40,130 Speaker 3: Decoding Women's Health is a production of Pushkin Industries and 567 00:32:40,170 --> 00:32:44,090 Speaker 3: the Atria Health and Research Institute. This episode was produced 568 00:32:44,130 --> 00:32:47,170 Speaker 3: by Daphne Chen. It was edited by Amy Gaines. 569 00:32:47,250 --> 00:32:47,650 Speaker 1: McQuaid. 570 00:32:48,650 --> 00:32:53,170 Speaker 3: Mastering by Sarah Bruguerer. Our associate producer is Sonya Gerwitt. 571 00:32:53,370 --> 00:32:57,370 Speaker 3: Our executive producer is Alexandra Garreton. Our theme song was 572 00:32:57,370 --> 00:32:58,410 Speaker 3: composed by HANNS. 573 00:32:58,450 --> 00:32:58,770 Speaker 1: Brown. 574 00:32:59,650 --> 00:33:04,530 Speaker 3: Concept creative development and fact checking by Shabon O'Connor. Special 575 00:33:04,570 --> 00:33:09,770 Speaker 3: thanks to Alan Tish, David Saltzman, Sarah Nix, Eric Sandler, 576 00:33:10,330 --> 00:33:16,370 Speaker 3: Morgan rat Owen Miller, Jordan McMillan, and Greta Cone. I'm 577 00:33:16,410 --> 00:33:19,650 Speaker 3: doctor Elizabeth Pointer. Thanks for listening. Until next time.