1
00:00:01,000 --> 00:00:06,000
Speaker 1: This is the most dramatic podcast ever and iHeartRadio podcast.

2
00:00:08,160 --> 00:00:10,240
Speaker 1: Chris Harrison here coming to you from the home office

3
00:00:10,280 --> 00:00:15,040
Speaker 1: in Austin, Texas. I am unbelievably excited about the show today,

4
00:00:15,600 --> 00:00:17,400
Speaker 1: And when I tell you what the subject matter is

5
00:00:17,400 --> 00:00:20,800
Speaker 1: going to be, You're maybe going to be scratching your head.

6
00:00:21,800 --> 00:00:28,720
Speaker 1: But the entire show today is dedicated to menopause, something

7
00:00:28,760 --> 00:00:31,800
Speaker 1: that every woman who walks this earth is going to

8
00:00:31,800 --> 00:00:35,720
Speaker 1: go through. But it's something that as I have kind

9
00:00:35,720 --> 00:00:38,680
Speaker 1: of dove into this, have realized that a lot of

10
00:00:38,720 --> 00:00:40,879
Speaker 1: people don't know a lot about it. They don't know

11
00:00:40,880 --> 00:00:44,760
Speaker 1: what to look for when it's coming, what it means, why,

12
00:00:45,880 --> 00:00:48,159
Speaker 1: And it is kind of astounding to me and shocking

13
00:00:48,200 --> 00:00:51,720
Speaker 1: and terrible that we all don't know more men and women.

14
00:00:52,560 --> 00:00:55,680
Speaker 1: But I know you might be thinking, Chris, you're a

15
00:00:55,680 --> 00:00:59,520
Speaker 1: middle aged man, you're going to be talking about menopause. Yes,

16
00:00:59,640 --> 00:01:03,480
Speaker 1: I am, because I know my audience and I know

17
00:01:04,040 --> 00:01:08,160
Speaker 1: this is an important topic. And there are a lot

18
00:01:08,200 --> 00:01:11,800
Speaker 1: of people that go on social media and they talk

19
00:01:11,920 --> 00:01:15,399
Speaker 1: like they're nutrition experts, they talk as if they know

20
00:01:16,120 --> 00:01:20,280
Speaker 1: and these people kind of get passed off as experts. Well,

21
00:01:20,480 --> 00:01:24,000
Speaker 1: I made sure that we had the foremost expert. This

22
00:01:24,080 --> 00:01:28,600
Speaker 1: woman is active on social media, but she is BORED

23
00:01:29,000 --> 00:01:33,440
Speaker 1: certified obgyn has practiced for many years. She is also

24
00:01:33,560 --> 00:01:38,200
Speaker 1: a mom, also a wife. She is a published author.

25
00:01:39,160 --> 00:01:42,039
Speaker 1: She has an incredible book called The Galveston Diet. I'm

26
00:01:42,040 --> 00:01:47,200
Speaker 1: talking about doctor Mary Claire Haver, and she was nice

27
00:01:47,319 --> 00:01:49,760
Speaker 1: enough to join us so we could dive in and

28
00:01:49,840 --> 00:01:55,480
Speaker 1: allow me to ask everything about menopause, joining me now

29
00:01:55,520 --> 00:01:58,600
Speaker 1: from her home in South Texas, just down the road

30
00:01:58,600 --> 00:02:01,400
Speaker 1: from where I am here in Austin. Doctor Mary Claire

31
00:02:01,400 --> 00:02:03,480
Speaker 1: have thank you so much for joining me.

32
00:02:04,080 --> 00:02:05,360
Speaker 2: Thanks for having me now.

33
00:02:05,400 --> 00:02:07,680
Speaker 1: I know you do a lot of this now between

34
00:02:07,680 --> 00:02:12,679
Speaker 1: social media, TV, you name it. You probably don't sit

35
00:02:12,760 --> 00:02:16,600
Speaker 1: down with a lot of middle aged men to discuss menopause.

36
00:02:17,720 --> 00:02:21,600
Speaker 2: Not very often occasionally, but it's one of the most

37
00:02:21,720 --> 00:02:24,600
Speaker 2: enlightening conversations for me because I really get to see

38
00:02:24,600 --> 00:02:28,880
Speaker 2: it from your perspective and it really helps me guide

39
00:02:29,360 --> 00:02:32,760
Speaker 2: you know, fifty percent of the population, because you are

40
00:02:32,800 --> 00:02:36,640
Speaker 2: affected just as much as we are. Because everything's changing

41
00:02:36,720 --> 00:02:39,080
Speaker 2: in our bodies, in our minds and how we're you know,

42
00:02:39,520 --> 00:02:42,320
Speaker 2: interacting with the world through this menopause process, and that's

43
00:02:42,360 --> 00:02:43,920
Speaker 2: affecting your relationships as well.

44
00:02:44,240 --> 00:02:47,160
Speaker 1: And while I know just enough to be dangerous, I

45
00:02:47,240 --> 00:02:52,120
Speaker 1: will admit that I have cheated because I am engaged

46
00:02:52,120 --> 00:02:54,800
Speaker 1: to a beautiful woman, Lauren Zema, I am raising a

47
00:02:54,840 --> 00:02:58,080
Speaker 1: beautiful woman, Taylor, my daughter. They gave me some very

48
00:02:58,160 --> 00:03:02,160
Speaker 1: important questions that they wanted to ask. And my team

49
00:03:02,240 --> 00:03:04,640
Speaker 1: here at iHeart on the most dramatic podcast ever, is

50
00:03:04,639 --> 00:03:08,360
Speaker 1: probably ninety five percent women, so they had questions. It

51
00:03:08,440 --> 00:03:12,720
Speaker 1: was amazing when we started talking about menopause doctor, how

52
00:03:13,919 --> 00:03:18,160
Speaker 1: many women were lining up that had questions. And it's

53
00:03:18,160 --> 00:03:20,320
Speaker 1: something they're all going to go through. It's something you

54
00:03:20,520 --> 00:03:23,920
Speaker 1: think that we would all, but especially women, would be

55
00:03:24,040 --> 00:03:28,080
Speaker 1: so knowledgeable about, and we're not. Why is that?

56
00:03:29,320 --> 00:03:35,960
Speaker 2: You know, there's several reasons, everything from society, to medical

57
00:03:36,080 --> 00:03:41,080
Speaker 2: education and training to you know, asism, and so if

58
00:03:41,080 --> 00:03:44,560
Speaker 2: you look at in medicine, which is you know what

59
00:03:44,600 --> 00:03:46,280
Speaker 2: I'm an expert in, I can tell you from my

60
00:03:46,400 --> 00:03:50,280
Speaker 2: own obgi N residency training, which was amazing, I've learned

61
00:03:50,280 --> 00:03:52,880
Speaker 2: so many important things. But there was a just a

62
00:03:53,000 --> 00:03:56,320
Speaker 2: sliver of time spent on menopause and I thought nothing

63
00:03:56,320 --> 00:03:59,120
Speaker 2: of it at the time, to be honest, And there's

64
00:03:59,160 --> 00:04:03,880
Speaker 2: also that little bit well a lot of of it's

65
00:04:03,960 --> 00:04:07,280
Speaker 2: kind of in her head. You know, like when a

66
00:04:07,320 --> 00:04:09,880
Speaker 2: woman and a man with the exact same symptoms walk

67
00:04:09,920 --> 00:04:12,119
Speaker 2: into the er, say with chest pain, shortens of breath,

68
00:04:12,240 --> 00:04:15,080
Speaker 2: some classic symptoms of a heart attack, she's much more

69
00:04:15,240 --> 00:04:18,800
Speaker 2: likely to have a delayed diagnosis and to be thought,

70
00:04:19,000 --> 00:04:22,240
Speaker 2: you know, have a mental health diagnosis rather than a

71
00:04:22,279 --> 00:04:25,960
Speaker 2: heart attack. And that is just kind of how we're trained,

72
00:04:26,640 --> 00:04:30,800
Speaker 2: and so that that's a problem. Number Two. We have

73
00:04:30,880 --> 00:04:34,799
Speaker 2: the kind of classically medically recognized symptoms of menopause, hoplaches

74
00:04:34,839 --> 00:04:38,920
Speaker 2: and night sweats, you know, changes in the female anatomy,

75
00:04:38,960 --> 00:04:42,280
Speaker 2: et cetera. But what we're learning now is that there

76
00:04:42,320 --> 00:04:46,280
Speaker 2: are probably forty plus symptoms that can raise their head

77
00:04:46,360 --> 00:04:51,280
Speaker 2: in menopause and they're not recognized as being classically menopausal

78
00:04:51,880 --> 00:04:55,920
Speaker 2: from a society standpoint. You know, look at the Golden Girls.

79
00:04:55,960 --> 00:04:59,440
Speaker 2: They are my age, you know, I love that show.

80
00:04:59,440 --> 00:05:02,440
Speaker 2: They were amaze. I mean, Blanche was still teaching right,

81
00:05:02,560 --> 00:05:06,119
Speaker 2: and it's like they were old ladies in my head,

82
00:05:06,320 --> 00:05:09,680
Speaker 2: you know, the haircut, the outfits and the way they

83
00:05:09,720 --> 00:05:12,440
Speaker 2: approached life and health. I mean, they were wonderful. But

84
00:05:13,240 --> 00:05:15,160
Speaker 2: just this kind of dismissal of this is the end

85
00:05:15,200 --> 00:05:17,320
Speaker 2: of your life when we're going to spend a third

86
00:05:17,480 --> 00:05:20,479
Speaker 2: of our lives a third, we're going to live thirty

87
00:05:20,480 --> 00:05:23,560
Speaker 2: to forty years in this menopausal state, and there's so

88
00:05:23,680 --> 00:05:25,960
Speaker 2: much we can do to improve our lifespan and our

89
00:05:25,960 --> 00:05:27,000
Speaker 2: health span throughout it.

90
00:05:27,160 --> 00:05:29,479
Speaker 1: Well, what I found interesting is you mentioned going through

91
00:05:29,480 --> 00:05:32,760
Speaker 1: med school, and you are a board certified obgyn. You

92
00:05:32,800 --> 00:05:37,159
Speaker 1: have practiced for many many years, worked with women, delivered babies,

93
00:05:37,160 --> 00:05:40,600
Speaker 1: you name it. But from what I understand of your story,

94
00:05:40,640 --> 00:05:43,720
Speaker 1: it wasn't until you went through menopause that you realize

95
00:05:43,760 --> 00:05:46,200
Speaker 1: that the advice that you had been giving all those

96
00:05:46,240 --> 00:05:49,440
Speaker 1: many years probably not the best. Is that fair?

97
00:05:50,080 --> 00:05:54,400
Speaker 2: That is very fair. If someone came in with severe

98
00:05:54,440 --> 00:05:58,680
Speaker 2: hot flashes, I knew what to do, okay, format, therapy, conversation,

99
00:05:58,800 --> 00:06:02,360
Speaker 2: et cetera. But most of the patients, the number one

100
00:06:02,400 --> 00:06:04,280
Speaker 2: complaint that they had in my office, and when I

101
00:06:04,400 --> 00:06:06,839
Speaker 2: talked to other menopause specialists and looked at, you know,

102
00:06:06,960 --> 00:06:09,920
Speaker 2: thousands of years of patient data, the number one complaint

103
00:06:09,960 --> 00:06:13,120
Speaker 2: really is weight gain and body composition changes like new

104
00:06:13,120 --> 00:06:15,000
Speaker 2: weight gain in places you never had it before, and

105
00:06:15,000 --> 00:06:17,440
Speaker 2: you really haven't changed your diet and exercise. So the

106
00:06:17,520 --> 00:06:19,640
Speaker 2: advice that I'd been taught to give, that I gave

107
00:06:19,720 --> 00:06:23,279
Speaker 2: for years was work out more weight less. We slowed

108
00:06:23,360 --> 00:06:25,080
Speaker 2: down a little as we get older. I mean I

109
00:06:25,200 --> 00:06:27,280
Speaker 2: cringe when I think of the things that came out

110
00:06:27,279 --> 00:06:32,080
Speaker 2: of my mouth, and then it happened to me so embarrassingly. Yes,

111
00:06:32,520 --> 00:06:35,760
Speaker 2: my entry into this menopause world, into doing more research

112
00:06:35,800 --> 00:06:37,719
Speaker 2: and trying to understand what's going on and why do

113
00:06:37,760 --> 00:06:40,640
Speaker 2: I have such a gap in my education was around

114
00:06:40,960 --> 00:06:44,919
Speaker 2: pretty cosmetic reasons of just some unwanted weight gain that

115
00:06:45,000 --> 00:06:47,919
Speaker 2: was making me unhappy. But what I didn't realize, I

116
00:06:47,920 --> 00:06:49,400
Speaker 2: mean it was just the tip of the iceberg. And

117
00:06:49,440 --> 00:06:51,320
Speaker 2: when I when I you know, cracked over in the

118
00:06:51,320 --> 00:06:54,200
Speaker 2: top and started, you know, ice diving, I was like,

119
00:06:54,320 --> 00:06:58,000
Speaker 2: wait a minute, there's so many things here, cardiovascular disease risk,

120
00:06:58,120 --> 00:07:02,680
Speaker 2: you know, neurodegenerator these like Alzheimer's and dementia, and hip pain,

121
00:07:02,760 --> 00:07:05,520
Speaker 2: bone pain, joint pain, every organ system and our bodies

122
00:07:05,560 --> 00:07:06,279
Speaker 2: affected by this.

123
00:07:07,000 --> 00:07:09,480
Speaker 1: I mean, it makes sense. It makes sense that we are,

124
00:07:09,600 --> 00:07:11,760
Speaker 1: you know, one kind of living organism and everything is

125
00:07:11,800 --> 00:07:14,920
Speaker 1: tied together in our bodies. Of course it's going to

126
00:07:15,000 --> 00:07:16,920
Speaker 1: all be affected. I mean, it would be crazy not

127
00:07:16,960 --> 00:07:18,840
Speaker 1: to and it's going to affect people in different ways.

128
00:07:18,880 --> 00:07:22,480
Speaker 1: And so I'm right. I'm glad that not only you

129
00:07:22,600 --> 00:07:26,120
Speaker 1: had this awakening, but now that there is And don't

130
00:07:26,160 --> 00:07:28,280
Speaker 1: get me started on social media. There's plenty of bad

131
00:07:28,320 --> 00:07:32,000
Speaker 1: things out there, but people like yourself that are knowledgeable,

132
00:07:32,240 --> 00:07:35,960
Speaker 1: that can now speak out and just normalize this conversation

133
00:07:36,040 --> 00:07:36,720
Speaker 1: that we're having.

134
00:07:37,600 --> 00:07:40,160
Speaker 2: I feel like the biggest contribution I've made to this

135
00:07:40,240 --> 00:07:44,640
Speaker 2: menopause conversation is trying to normalize it and just validating people.

136
00:07:45,000 --> 00:07:48,320
Speaker 2: My DMS just blow up with and I can't give

137
00:07:48,360 --> 00:07:50,440
Speaker 2: personal medical advice, you know, it's against the law. I

138
00:07:50,520 --> 00:07:53,320
Speaker 2: mean to practice medicine in another state, and so but

139
00:07:53,360 --> 00:07:55,560
Speaker 2: I'm just trying to calm people down, like, yes, this

140
00:07:55,680 --> 00:07:58,280
Speaker 2: absolutely could be could be related to your menopause. Here's

141
00:07:58,280 --> 00:08:00,760
Speaker 2: the questions you can ask your health care, here's the

142
00:08:01,160 --> 00:08:03,240
Speaker 2: you know, medications you might want to think about. Here's

143
00:08:03,280 --> 00:08:05,720
Speaker 2: some supplements that might help, you know. Just trying to

144
00:08:05,760 --> 00:08:08,160
Speaker 2: get everybody on an equal playing field so that they

145
00:08:08,200 --> 00:08:09,560
Speaker 2: can make an informed choice.

146
00:08:09,600 --> 00:08:11,200
Speaker 1: I was looking at I was trying to find because

147
00:08:11,200 --> 00:08:13,000
Speaker 1: I wrote it down, I can't remember where it was.

148
00:08:13,200 --> 00:08:16,360
Speaker 1: The quote you just posted on your social media about

149
00:08:16,640 --> 00:08:19,200
Speaker 1: the validation of what you're going through, if you're going

150
00:08:19,240 --> 00:08:23,120
Speaker 1: through menopause, having those symptoms validated, And I love the

151
00:08:23,200 --> 00:08:24,360
Speaker 1: quote that you put up.

152
00:08:25,040 --> 00:08:28,960
Speaker 2: Like every woman deserves to have validation of what she's

153
00:08:28,960 --> 00:08:31,840
Speaker 2: going through is real. And then in a decision whether

154
00:08:31,880 --> 00:08:35,000
Speaker 2: she chooses or not to pursue certain pharmaceutical options, that's

155
00:08:35,080 --> 00:08:37,760
Speaker 2: that's up to her. But you know, so much of

156
00:08:37,800 --> 00:08:40,839
Speaker 2: that's being taken off the table for so many women

157
00:08:40,920 --> 00:08:42,600
Speaker 2: for at least the last twenty years.

158
00:08:42,880 --> 00:08:46,200
Speaker 1: So what I'm going to do today is think of

159
00:08:46,240 --> 00:08:50,480
Speaker 1: me as the arbitrary voice for all the amazing women

160
00:08:50,520 --> 00:08:54,480
Speaker 1: in my life. And so they lined up, I mean,

161
00:08:54,559 --> 00:08:57,240
Speaker 1: pages of questions. So I'm going to jump in with

162
00:08:57,320 --> 00:09:00,320
Speaker 1: the most important women in my life, vers all my

163
00:09:00,360 --> 00:09:07,760
Speaker 1: beautiful fiance Lauren Zema. She asked, what is para menopause?

164
00:09:08,240 --> 00:09:11,400
Speaker 2: That's a wonderful question. So most, you know, most people

165
00:09:11,520 --> 00:09:14,560
Speaker 2: women men will understand that menopause represents kind of the

166
00:09:14,600 --> 00:09:17,040
Speaker 2: end of your fertility. You're not gonna have periods anymore,

167
00:09:17,520 --> 00:09:20,760
Speaker 2: and you're something about hormones might stop functioning like they

168
00:09:20,880 --> 00:09:24,880
Speaker 2: used to. So when in actuality what happens. There are

169
00:09:24,880 --> 00:09:29,120
Speaker 2: three kind of phases of this menopause journey. We have perimenopause,

170
00:09:29,559 --> 00:09:32,440
Speaker 2: we have menopause, and then we have post menopause, and

171
00:09:32,480 --> 00:09:36,079
Speaker 2: I'll well, let me define those for your followers. So

172
00:09:36,640 --> 00:09:39,079
Speaker 2: menopause is really just one day in your life. It's

173
00:09:39,160 --> 00:09:41,520
Speaker 2: kind of that you go up and then you go down.

174
00:09:41,760 --> 00:09:46,680
Speaker 2: And so menopause represents the last day that your ovaries

175
00:09:46,720 --> 00:09:49,560
Speaker 2: will ever function. There's no more estrogen to be produced.

176
00:09:49,559 --> 00:09:51,680
Speaker 2: There you've run through all of the eggs that you

177
00:09:51,720 --> 00:09:55,600
Speaker 2: were born with and there's you know, nothing. Everything after

178
00:09:55,679 --> 00:10:00,760
Speaker 2: that point is postmenopause, got it. Menopause represents a seven

179
00:10:00,800 --> 00:10:04,760
Speaker 2: to ten year time period when that function doesn't just

180
00:10:04,800 --> 00:10:07,920
Speaker 2: shut down overnight. It is kind of a degradation. So

181
00:10:08,040 --> 00:10:11,640
Speaker 2: we're born with all of our eggs, right you guys,

182
00:10:11,679 --> 00:10:14,920
Speaker 2: aren't you know? If you're born with the opposite gonads,

183
00:10:15,040 --> 00:10:17,160
Speaker 2: you make your stuff fresh every day. Good for you?

184
00:10:17,280 --> 00:10:20,400
Speaker 1: Yeah, ask Robert de Niro, who's still making babies at

185
00:10:20,400 --> 00:10:21,280
Speaker 1: a one hundred and four.

186
00:10:21,400 --> 00:10:24,959
Speaker 2: Yeah. And we are born with all of our our

187
00:10:25,000 --> 00:10:28,040
Speaker 2: gonads are set. We're done, locked and loaded, ready to go,

188
00:10:28,400 --> 00:10:31,840
Speaker 2: and we start losing eggs at about five months in utero,

189
00:10:32,280 --> 00:10:34,560
Speaker 2: so we start, you know, So we're born with a

190
00:10:34,559 --> 00:10:37,000
Speaker 2: certain amount. By the time we're thirty, we're down to

191
00:10:37,040 --> 00:10:39,080
Speaker 2: about ten percent of what we were born with, and

192
00:10:39,080 --> 00:10:41,400
Speaker 2: then when we're forty, we're down to about three percent.

193
00:10:41,880 --> 00:10:47,839
Speaker 2: And those germ cells represent the ovarian production of estrogen, progesterone,

194
00:10:47,960 --> 00:10:52,480
Speaker 2: and some testosterone as well. And so perimenopause is when

195
00:10:52,520 --> 00:10:56,720
Speaker 2: you become symptomatic from this choo choo train that's getting

196
00:10:56,720 --> 00:10:59,000
Speaker 2: harder and harder to chug to get those last few

197
00:10:59,000 --> 00:11:01,679
Speaker 2: eggs you know, on market, so to speak. And the

198
00:11:01,760 --> 00:11:04,480
Speaker 2: quality of those eggs is decreasing as well, which is

199
00:11:04,480 --> 00:11:07,800
Speaker 2: why we see more down syndrome and other chromosome latinormalities

200
00:11:07,840 --> 00:11:11,400
Speaker 2: as a one gets older and has children. So perimenopause,

201
00:11:11,559 --> 00:11:13,360
Speaker 2: you know, if the average age of menopause in the

202
00:11:13,480 --> 00:11:17,640
Speaker 2: US is somewhere around fifty one, okay, but it's still

203
00:11:17,760 --> 00:11:21,160
Speaker 2: very normal between forty five to fifty five fifty six

204
00:11:21,720 --> 00:11:23,720
Speaker 2: two for that to be normal, And then you do

205
00:11:23,800 --> 00:11:26,600
Speaker 2: the math backing that seven to ten years back. So

206
00:11:26,760 --> 00:11:30,200
Speaker 2: somewhere between thirty five and forty five, a woman will

207
00:11:30,240 --> 00:11:32,720
Speaker 2: probably start noticing. She may not put her finger on

208
00:11:32,800 --> 00:11:36,120
Speaker 2: it or recognize it as perrymenopause, but something is changing

209
00:11:36,160 --> 00:11:40,560
Speaker 2: in her body without any rule, increase in stress, no nutrition, diet,

210
00:11:40,760 --> 00:11:43,280
Speaker 2: you know, like everything's going, She's living her best life.

211
00:11:43,280 --> 00:11:47,160
Speaker 2: And then you know, outside of just aging, which does

212
00:11:47,200 --> 00:11:48,640
Speaker 2: its own magic to us, you know.

213
00:11:49,440 --> 00:11:54,719
Speaker 1: That it does. So this Laura and I very much

214
00:11:54,760 --> 00:11:57,480
Speaker 1: believe in kind of preventive medicine. Have taken care of yourself,

215
00:11:57,880 --> 00:12:00,679
Speaker 1: your diet, gut health, et cetera. And I had this

216
00:12:00,760 --> 00:12:03,800
Speaker 1: question a couple of times from not only Lauren, but

217
00:12:04,120 --> 00:12:06,960
Speaker 1: my young producer Kendall, who's on the line with us

218
00:12:07,000 --> 00:12:09,320
Speaker 1: right now, and they both kind of ask the same

219
00:12:09,400 --> 00:12:11,760
Speaker 1: question of what do I need to be doing for

220
00:12:11,880 --> 00:12:14,679
Speaker 1: my hormones while I am in my mid twenties, while

221
00:12:14,720 --> 00:12:17,280
Speaker 1: I am in my young thirties. Are there things I

222
00:12:17,320 --> 00:12:20,600
Speaker 1: can do that will help alleviate or just help me

223
00:12:20,600 --> 00:12:21,800
Speaker 1: get through menopause later?

224
00:12:22,360 --> 00:12:26,760
Speaker 2: Sure, so, how you show up in perimenopause, your baseline

225
00:12:26,760 --> 00:12:29,760
Speaker 2: health status, those habits that you are locking in the place,

226
00:12:30,280 --> 00:12:34,160
Speaker 2: is going to determine for most women, how much, how

227
00:12:34,200 --> 00:12:36,959
Speaker 2: many symptoms you have, how serious your menopause is, how

228
00:12:37,000 --> 00:12:40,480
Speaker 2: life disruptive it is, as well as attenuate some of

229
00:12:40,520 --> 00:12:44,559
Speaker 2: those cardiovascular risks that seem to accelerate and neurodegenitive risks

230
00:12:44,559 --> 00:12:47,000
Speaker 2: as we get older. So for my children, you know,

231
00:12:47,080 --> 00:12:50,560
Speaker 2: my girls are nineteen and twenty two. They live and

232
00:12:50,600 --> 00:12:53,920
Speaker 2: breed this stuff unfortunately because they're you know, my kids,

233
00:12:54,360 --> 00:12:58,440
Speaker 2: but they understand that they need to lock these health

234
00:12:58,480 --> 00:13:02,400
Speaker 2: habits and now so that it's much easier, they'll have

235
00:13:02,440 --> 00:13:06,319
Speaker 2: an easier menopause. We can't. We haven't figured out yet

236
00:13:06,360 --> 00:13:08,720
Speaker 2: how to prolong the shelf life of the ovaries, like

237
00:13:08,760 --> 00:13:11,280
Speaker 2: if when that happens, and there's some research being done

238
00:13:11,320 --> 00:13:12,840
Speaker 2: for that to delay menopause.

239
00:13:12,960 --> 00:13:15,720
Speaker 1: Interesting, that's probably.

240
00:13:15,280 --> 00:13:18,120
Speaker 2: The thing that will improve quality of life, lifespan and

241
00:13:18,120 --> 00:13:21,160
Speaker 2: health span and a female more than anything else, is

242
00:13:21,200 --> 00:13:23,400
Speaker 2: if we can delay menopause.

243
00:13:23,520 --> 00:13:25,880
Speaker 1: You're already outlasting us anyway. How much longer do you

244
00:13:25,920 --> 00:13:26,960
Speaker 1: want to be exactly?

245
00:13:27,640 --> 00:13:31,120
Speaker 2: You know for evolutionists or life maybe this happened so

246
00:13:31,160 --> 00:13:35,080
Speaker 2: that we didn't outlive men for so long. You know,

247
00:13:35,120 --> 00:13:38,920
Speaker 2: we already outlived five to seven years, but take away menopause,

248
00:13:39,240 --> 00:13:40,679
Speaker 2: we'll live forever.

249
00:13:41,120 --> 00:13:45,199
Speaker 1: But I don't doubt that. Okay, So the last question

250
00:13:45,240 --> 00:13:48,199
Speaker 1: from l Z and again remember where this is coming from.

251
00:13:48,280 --> 00:13:51,760
Speaker 1: I'm going to read it in her voice. Doctor, I'm

252
00:13:51,800 --> 00:13:55,400
Speaker 1: afraid is my vagina going to dry up? Will I

253
00:13:55,520 --> 00:13:58,880
Speaker 1: be vadryina?

254
00:13:59,320 --> 00:14:00,000
Speaker 2: That's awesome.

255
00:14:00,160 --> 00:14:03,600
Speaker 1: That is a medical term that LZ invented by vagarina.

256
00:14:04,400 --> 00:14:08,680
Speaker 2: More than likely, yes, so, but it's absolutely preventative. I mean,

257
00:14:08,720 --> 00:14:14,240
Speaker 2: it's preventable, preventable. So we we have our vagina, our vulva,

258
00:14:14,440 --> 00:14:16,720
Speaker 2: our all of our you know, bladder, all that tissue

259
00:14:16,840 --> 00:14:18,800
Speaker 2: you know, basically from the pubic bone to the to

260
00:14:18,840 --> 00:14:22,120
Speaker 2: the spinal cord is all super estrogenized. And when our

261
00:14:22,200 --> 00:14:25,520
Speaker 2: estrogen levels began declining in perimenopause, some more than others,

262
00:14:26,040 --> 00:14:28,480
Speaker 2: we will see a decrease in the amount of mucus

263
00:14:28,480 --> 00:14:31,640
Speaker 2: we produce, the amount of mucus we produce with relations,

264
00:14:32,080 --> 00:14:35,200
Speaker 2: as well as loss of elasticity. The tissue gets really

265
00:14:35,200 --> 00:14:38,040
Speaker 2: thin and really irritated, and for a lot of women,

266
00:14:38,040 --> 00:14:42,040
Speaker 2: probably forty to fifty percent, you will have severe atrophy

267
00:14:42,200 --> 00:14:46,359
Speaker 2: with you know, dramatic pain and being uncomfortable with relations

268
00:14:46,400 --> 00:14:49,320
Speaker 2: to the point where libido goes out the window because

269
00:14:49,360 --> 00:14:51,960
Speaker 2: it hurts and you don't want to do it. Fortunately,

270
00:14:52,320 --> 00:14:56,240
Speaker 2: there are safe, efficacious, and reasonably priced medication that can

271
00:14:56,280 --> 00:15:00,640
Speaker 2: absolutely prevent that, and that is vaginal estrogen. And so

272
00:15:00,720 --> 00:15:02,840
Speaker 2: we just put we'll give you back the water you

273
00:15:02,880 --> 00:15:05,280
Speaker 2: were drinking, and we put it in the vagina where

274
00:15:05,280 --> 00:15:08,120
Speaker 2: you need it. And there's no that's the one. There's

275
00:15:08,200 --> 00:15:11,160
Speaker 2: no increased versus of blood clots breast cancer at People

276
00:15:11,280 --> 00:15:14,760
Speaker 2: with a blood clot with breast cancer can absolutely safely

277
00:15:14,880 --> 00:15:18,840
Speaker 2: use this formulation of estrogen to keep that area healthy.

278
00:15:18,880 --> 00:15:22,240
Speaker 2: It's the number one most effective treatment for recurrent bladder

279
00:15:22,280 --> 00:15:26,360
Speaker 2: infections in menopause, not antibiotics, vaginal estrogen.

280
00:15:27,280 --> 00:15:31,160
Speaker 1: Probably because of Hollywood and you know, just the old

281
00:15:31,800 --> 00:15:34,360
Speaker 1: you know scene we've seen, whether it was Golden Girls

282
00:15:34,440 --> 00:15:38,880
Speaker 1: or every movie with middle aged women. You think hot

283
00:15:38,920 --> 00:15:42,200
Speaker 1: flashes and menopause. So I want to dive into this

284
00:15:42,200 --> 00:15:45,120
Speaker 1: a little bit because my daughter, actually Taylor, who's nineteen,

285
00:15:45,160 --> 00:15:47,920
Speaker 1: had a very interesting question. She's heard about hot flashes,

286
00:15:48,200 --> 00:15:51,400
Speaker 1: but how much does your body temperature actually rise?

287
00:15:51,840 --> 00:15:55,480
Speaker 2: Oh that's such a good question, Thank you, Taylor. Okay,

288
00:15:55,680 --> 00:15:58,880
Speaker 2: so it's about one to three degrees okay, like fever.

289
00:15:59,440 --> 00:16:01,400
Speaker 2: So you know, think about it. We're ninety eight point

290
00:16:01,480 --> 00:16:04,280
Speaker 2: six is the average, you know, tent right, and then

291
00:16:04,400 --> 00:16:05,960
Speaker 2: if we get up to one hundred, one hundred, one

292
00:16:06,000 --> 00:16:08,240
Speaker 2: hundred and one, one hundred point six is a fever.

293
00:16:08,360 --> 00:16:10,000
Speaker 1: Yeah, that's a solid fever. If you're at one hundred

294
00:16:10,080 --> 00:16:11,320
Speaker 1: hundred one, basically have.

295
00:16:11,240 --> 00:16:14,080
Speaker 2: A short term fever, and then your body, in an

296
00:16:14,120 --> 00:16:17,160
Speaker 2: effort to cool itself, will dilate all the blood vessels

297
00:16:17,160 --> 00:16:20,240
Speaker 2: of the skin, usually in a hot flash scent, typically

298
00:16:20,240 --> 00:16:24,240
Speaker 2: the central area, so the head, the next, shoulders, chest, back, groin,

299
00:16:25,000 --> 00:16:28,040
Speaker 2: and dilate those blood vessels, which just drives the heat

300
00:16:28,040 --> 00:16:30,800
Speaker 2: out and you just sweat like crazy, and then you're

301
00:16:30,840 --> 00:16:33,280
Speaker 2: freezing because you're so wet. You know, your temperature goes

302
00:16:33,320 --> 00:16:35,840
Speaker 2: back to normal, but you're soaking wet. So yeah, it's

303
00:16:35,880 --> 00:16:37,040
Speaker 2: about one to three degrees.

304
00:16:37,840 --> 00:16:42,280
Speaker 1: Danielle an amazing woman who works with me. Why does

305
00:16:42,320 --> 00:16:45,600
Speaker 1: your body go through this? Why are you having hot

306
00:16:45,640 --> 00:16:47,880
Speaker 1: flashes with menopause? What's actually happening?

307
00:16:48,000 --> 00:16:52,160
Speaker 2: Yeah, So there's a thermoregulatory center in our brain that

308
00:16:52,280 --> 00:16:56,320
Speaker 2: controls our body temperature, and that's the mechanism by which

309
00:16:56,400 --> 00:16:59,000
Speaker 2: we have a fever, which is a physiologic response to

310
00:16:59,040 --> 00:17:03,440
Speaker 2: an infection or medication, you know, adverse reaction whatever. We

311
00:17:03,520 --> 00:17:07,639
Speaker 2: don't know exactly how it happens, but there's something to

312
00:17:07,720 --> 00:17:12,080
Speaker 2: do with declining estrogen levels. Estrogen kind of stabilizes that

313
00:17:12,280 --> 00:17:16,600
Speaker 2: temperature center, and when you take that estrogen away that

314
00:17:16,760 --> 00:17:19,280
Speaker 2: it just becomes erratic and starts going off on its

315
00:17:19,280 --> 00:17:21,400
Speaker 2: own without the usual chemical signal.

316
00:17:21,760 --> 00:17:24,639
Speaker 1: I saw in your social media. Sorry to be uh,

317
00:17:24,960 --> 00:17:27,399
Speaker 1: you know, peeping on you, but you were talking about

318
00:17:27,400 --> 00:17:31,280
Speaker 1: this nightgown that you created because your hot flashes have stopped.

319
00:17:31,680 --> 00:17:33,200
Speaker 2: Yeah, but I'm still hot.

320
00:17:33,320 --> 00:17:35,479
Speaker 1: Your body's still hot. So is that something you have

321
00:17:35,520 --> 00:17:38,879
Speaker 1: to worry about? Once the hot flashes stop, your your

322
00:17:38,880 --> 00:17:41,480
Speaker 1: body temperatures is still like cooked.

323
00:17:41,720 --> 00:17:44,000
Speaker 2: So you're inspiring me for my next TikTok, Like, here

324
00:17:44,040 --> 00:17:47,320
Speaker 2: are the things that hormone therapy did not help me with? Okay,

325
00:17:47,359 --> 00:17:50,760
Speaker 2: And definitely my hot flashes, the ones that woke me

326
00:17:50,840 --> 00:17:52,679
Speaker 2: up at night, that pulled me out of a meeting

327
00:17:52,800 --> 00:17:55,879
Speaker 2: that you know, embarrassed me in public, are gone. But

328
00:17:55,960 --> 00:18:00,040
Speaker 2: I'm just in general hotter all the time, And so

329
00:18:00,080 --> 00:18:03,040
Speaker 2: I was always freezing, freezing, bundled up under the covers,

330
00:18:03,160 --> 00:18:05,280
Speaker 2: going to bed with sweatpants. My husband's very excited. I'm

331
00:18:05,280 --> 00:18:08,439
Speaker 2: not wearing a sweatpants to bed anymore. And that I

332
00:18:08,560 --> 00:18:10,919
Speaker 2: like have this great nightgown I've worn for years, and

333
00:18:10,960 --> 00:18:13,400
Speaker 2: I just cut the arms out of it, like wear

334
00:18:13,400 --> 00:18:18,040
Speaker 2: it like a trucker because I was so hot at night. Still, so,

335
00:18:18,240 --> 00:18:21,040
Speaker 2: hormon replacement therapy can do so many wonderful things for

336
00:18:21,080 --> 00:18:23,160
Speaker 2: our bodies, but it's not I can't give you back

337
00:18:23,200 --> 00:18:25,440
Speaker 2: your twenty five year old ovaries, right, you know that,

338
00:18:25,960 --> 00:18:27,840
Speaker 2: And that's okay. I think most women are fine with that.

339
00:18:27,880 --> 00:18:29,720
Speaker 2: They're not expecting that, but they just want to be

340
00:18:29,760 --> 00:18:36,119
Speaker 2: able to sleep and get on with their lives.

341
00:18:43,560 --> 00:18:47,400
Speaker 1: Hannah asked, how do you know when you are actually

342
00:18:47,560 --> 00:18:48,520
Speaker 1: in menopause?

343
00:18:49,080 --> 00:18:53,560
Speaker 2: That's a really good question. So if you were a normal,

344
00:18:53,720 --> 00:18:58,720
Speaker 2: regularly menstruating person, Okay, yeah, period every month and suddenly

345
00:18:58,760 --> 00:19:00,960
Speaker 2: that stops. If you're over the age of forty five

346
00:19:01,400 --> 00:19:03,119
Speaker 2: and you have not had a cycle when it was

347
00:19:03,160 --> 00:19:07,440
Speaker 2: regular before for a year, that is the definition of menopause.

348
00:19:07,480 --> 00:19:11,960
Speaker 2: As far as using clinical symptoms to make the diagnosis, now,

349
00:19:12,040 --> 00:19:14,399
Speaker 2: say you've had a hysterectomy or an ablation or some

350
00:19:14,520 --> 00:19:18,240
Speaker 2: procedure or surgery where you don't have periods anymore. Well,

351
00:19:18,359 --> 00:19:21,080
Speaker 2: sometimes just on the symptoms we can make the diagnosis

352
00:19:21,080 --> 00:19:23,679
Speaker 2: and your age. You know, clinically, there is a blood

353
00:19:23,720 --> 00:19:27,879
Speaker 2: test that we can use to diagnose complete menopause, that

354
00:19:27,920 --> 00:19:34,280
Speaker 2: postmenopausal state but because hormones fluctuate so wildly in pery menopause,

355
00:19:34,600 --> 00:19:37,280
Speaker 2: we don't really have good blood you'urine saliva tests to

356
00:19:37,320 --> 00:19:39,760
Speaker 2: diagnose that. It's a clinical diagnosis. So you need a

357
00:19:39,760 --> 00:19:43,040
Speaker 2: menopause friendly provider who knows what they're doing, who's willing

358
00:19:43,080 --> 00:19:45,920
Speaker 2: to talk to you, help untangle some of the other

359
00:19:46,000 --> 00:19:49,600
Speaker 2: diseases that kind of look like perimenopause, like hypodiroidism or

360
00:19:49,640 --> 00:19:52,440
Speaker 2: an autoimmune disease. You know, when I'm doing blood work,

361
00:19:52,600 --> 00:19:54,439
Speaker 2: hormones is not the first thing I check in a

362
00:19:54,480 --> 00:19:59,040
Speaker 2: perimenopausal woman. It's thyroid, it's nutritional deficiencies. It's a blood

363
00:19:59,040 --> 00:20:00,960
Speaker 2: count to look for a name, you know, based on.

364
00:20:00,920 --> 00:20:05,800
Speaker 1: Her symptoms, you're speaking of a normal period. Blair asked

365
00:20:05,800 --> 00:20:08,520
Speaker 1: a very interesting question. Does the age you get your

366
00:20:08,600 --> 00:20:12,240
Speaker 1: period effect when you start menopause? For example, if you

367
00:20:12,480 --> 00:20:14,800
Speaker 1: started your period very late in life, does that mean

368
00:20:14,840 --> 00:20:16,080
Speaker 1: menopause will come later.

369
00:20:16,520 --> 00:20:21,240
Speaker 2: Yes, it's not a huge contributor, but we do see

370
00:20:21,280 --> 00:20:23,440
Speaker 2: that women who go through and I think it's before

371
00:20:23,480 --> 00:20:27,600
Speaker 2: the age of eleven, tend to have earlier menopause than

372
00:20:27,680 --> 00:20:31,920
Speaker 2: women who don't, and then therefore going through later. Because

373
00:20:31,920 --> 00:20:35,639
Speaker 2: again we're born with the finite amount of eggs, and

374
00:20:35,800 --> 00:20:38,280
Speaker 2: so if you kind of let them sleep for longer,

375
00:20:38,880 --> 00:20:42,160
Speaker 2: you'll have more that'll last you in your mix. Sure

376
00:20:42,920 --> 00:20:45,280
Speaker 2: it's not huge. There's a lot of environmental things that

377
00:20:45,440 --> 00:20:49,360
Speaker 2: go into what you know, genetics, exposure to certain chemicals,

378
00:20:49,400 --> 00:20:51,680
Speaker 2: you know, different things that affect when we go through menopause.

379
00:20:51,720 --> 00:20:53,760
Speaker 1: Well, you talk about that exposure to chemicals and just

380
00:20:53,920 --> 00:20:56,520
Speaker 1: different foods and how our foods have changed. And again

381
00:20:56,520 --> 00:20:58,320
Speaker 1: I'm a big believer in diet and gut health and

382
00:20:58,320 --> 00:21:03,439
Speaker 1: all that young. Can you start menopause and have you

383
00:21:03,520 --> 00:21:06,960
Speaker 1: seen that number change over the years, like, for example,

384
00:21:07,200 --> 00:21:09,479
Speaker 1: I went through this with my daughter. Is like, girls

385
00:21:09,520 --> 00:21:13,200
Speaker 1: are hitting puberty quicker. You know, whether it's the milk,

386
00:21:13,240 --> 00:21:15,440
Speaker 1: whether or whatever you want to say, it is things

387
00:21:15,440 --> 00:21:17,000
Speaker 1: have changed and they're happening faster.

388
00:21:17,640 --> 00:21:21,280
Speaker 2: That's a good question. So we definitely know that women

389
00:21:22,359 --> 00:21:26,280
Speaker 2: girls are going through menarchy or puberty earlier than they

390
00:21:26,280 --> 00:21:28,359
Speaker 2: did one hundred years ago. Isn't that is a fact.

391
00:21:29,160 --> 00:21:31,879
Speaker 2: We think it's improved nutrition actually, so like one hundred

392
00:21:31,920 --> 00:21:34,639
Speaker 2: years ago, you know, the famine and all those things,

393
00:21:35,359 --> 00:21:38,360
Speaker 2: and then they're also have more body fat now and

394
00:21:38,440 --> 00:21:41,600
Speaker 2: that is leading to higher estrogen levels, which is contributing

395
00:21:41,680 --> 00:21:46,480
Speaker 2: to this earlier puberty. So we think on the back end,

396
00:21:46,960 --> 00:21:52,120
Speaker 2: we haven't seen that age of menopause change quite yet.

397
00:21:52,119 --> 00:21:56,399
Speaker 2: They're kind of driven by two different things. So we

398
00:21:56,480 --> 00:21:59,040
Speaker 2: know that smokers go through menopause early. So that's a

399
00:21:59,119 --> 00:22:02,440
Speaker 2: definite something that we know is not good for us

400
00:22:02,440 --> 00:22:03,160
Speaker 2: and attacks our.

401
00:22:03,080 --> 00:22:07,160
Speaker 1: Body reason six thousand, seven ninety two not to smoke, definitely.

402
00:22:07,320 --> 00:22:11,000
Speaker 2: You know, surgery is a risk factor, radiation, chemotherapy, those

403
00:22:11,000 --> 00:22:14,360
Speaker 2: are all risk factors for earlier menopause. I've seen menopause

404
00:22:14,359 --> 00:22:17,640
Speaker 2: in their twenties and it's rare, but you have certain

405
00:22:17,680 --> 00:22:20,399
Speaker 2: autoimmune conditions that will attack the o reason destroy them

406
00:22:20,440 --> 00:22:26,000
Speaker 2: before their time. So premature menopause is before the age

407
00:22:26,000 --> 00:22:28,119
Speaker 2: of forty, and that's about two percent of the population.

408
00:22:28,400 --> 00:22:31,560
Speaker 1: And is that a reason for concern? Is it? Obviously

409
00:22:31,600 --> 00:22:32,480
Speaker 1: you would get it checked out.

410
00:22:32,520 --> 00:22:37,439
Speaker 2: So you know, estrogen is a protective hormone in so

411
00:22:37,520 --> 00:22:40,080
Speaker 2: many organ systems in our bodies. Definitely in our brains

412
00:22:40,080 --> 00:22:42,920
Speaker 2: and our hearts and the blood vessels of the heart

413
00:22:43,119 --> 00:22:46,880
Speaker 2: and our bones, and you know our female organs. When

414
00:22:46,920 --> 00:22:49,600
Speaker 2: you go through menopause earlier and you are not replaced

415
00:22:49,640 --> 00:22:52,640
Speaker 2: with hormone replacement therapy. You have a much higher risk

416
00:22:52,720 --> 00:22:59,520
Speaker 2: of cardiovascular disease, stroke, diabetes, inflammatory conditions, osteoporosis than a

417
00:22:59,560 --> 00:23:03,160
Speaker 2: woman who went through five ten years later. So those

418
00:23:03,480 --> 00:23:06,240
Speaker 2: it's really serious. If any of your listeners have gone

419
00:23:06,240 --> 00:23:09,359
Speaker 2: through premature menopause, they have got to see a physician

420
00:23:09,400 --> 00:23:12,640
Speaker 2: who knows what they're doing and get on hormone replacement therapy.

421
00:23:13,080 --> 00:23:15,360
Speaker 2: You know, there's definitely there's risks of being on any

422
00:23:15,440 --> 00:23:18,240
Speaker 2: medication correct and we've all known about the breast cancer

423
00:23:18,280 --> 00:23:20,280
Speaker 2: risk and that's been walked back. It's a very small

424
00:23:20,359 --> 00:23:22,359
Speaker 2: risk and it's really up to the patient and her

425
00:23:22,400 --> 00:23:26,080
Speaker 2: family history, et cetera. But they're a risk of not

426
00:23:26,760 --> 00:23:29,600
Speaker 2: being on hormone replacement therapy, which is the conversation I'm

427
00:23:29,600 --> 00:23:31,600
Speaker 2: trying to bring to the table interesting.

428
00:23:33,320 --> 00:23:35,800
Speaker 1: Everyone to know does menopause because you hear a lot

429
00:23:35,800 --> 00:23:37,879
Speaker 1: about this. It's right up there with I would say,

430
00:23:38,040 --> 00:23:42,000
Speaker 1: just if hot flashes are one, sex drive would be two.

431
00:23:42,119 --> 00:23:46,399
Speaker 1: That everybody talks about. It's the old cliche, does menopause

432
00:23:46,400 --> 00:23:47,480
Speaker 1: affect your sex drive?

433
00:23:47,960 --> 00:23:54,080
Speaker 2: Yes, we definitely see one of the cardinal symptoms of menopause,

434
00:23:54,200 --> 00:23:56,399
Speaker 2: and it's not for everyone, but it is much more common,

435
00:23:56,600 --> 00:23:59,840
Speaker 2: is less sexual feelings is the way that we kind

436
00:23:59,840 --> 00:24:02,520
Speaker 2: of describe it. So this is probably a topic that

437
00:24:02,600 --> 00:24:05,479
Speaker 2: most of your followers will be interested in. So when

438
00:24:05,480 --> 00:24:09,879
Speaker 2: we talk about sexual function in a woman, there's usually

439
00:24:09,920 --> 00:24:13,920
Speaker 2: five buckets of areas that she is going to have issues,

440
00:24:13,960 --> 00:24:17,280
Speaker 2: and they can overlap. So the first is a relationship issue.

441
00:24:17,640 --> 00:24:20,119
Speaker 2: So if you're not happy, you don't feel supported, you

442
00:24:20,160 --> 00:24:22,919
Speaker 2: feel like whatever, you know, you're not happy with the partner.

443
00:24:23,119 --> 00:24:26,200
Speaker 2: That's normal that you're not going to want to have sex. Okay.

444
00:24:26,800 --> 00:24:29,440
Speaker 2: Then there is pain, if it hurts, we got to

445
00:24:29,480 --> 00:24:31,800
Speaker 2: fix that, you know before we address So then there

446
00:24:31,880 --> 00:24:37,879
Speaker 2: leaves desire, arousal, and orgasm. So desires what happens in

447
00:24:37,880 --> 00:24:42,560
Speaker 2: the brain. Arousal is the physiologic response to a stimulus,

448
00:24:42,600 --> 00:24:44,960
Speaker 2: so all the things that happen in the pelvis to

449
00:24:44,960 --> 00:24:48,080
Speaker 2: get you ready, the things elongate, blood gets engorged, just

450
00:24:48,080 --> 00:24:52,760
Speaker 2: like in a man. And then there is orgasm. So

451
00:24:52,760 --> 00:24:54,359
Speaker 2: so we kind of address each of those. They have

452
00:24:54,400 --> 00:24:57,919
Speaker 2: different treatment options. Most women who are in a nice relationship,

453
00:24:57,920 --> 00:25:00,440
Speaker 2: they love their partner, they want this, you know, they

454
00:25:00,480 --> 00:25:02,720
Speaker 2: miss it. They want to go back to the level

455
00:25:02,760 --> 00:25:05,600
Speaker 2: that they were. They're just feeling really sad about it.

456
00:25:05,760 --> 00:25:08,120
Speaker 2: That's a pure desire issue. And so there's a couple

457
00:25:08,160 --> 00:25:13,040
Speaker 2: of medications that can be helpful. Again, it's a complicated pathway.

458
00:25:13,119 --> 00:25:15,679
Speaker 2: There's some great books out there and great podcasts on

459
00:25:15,720 --> 00:25:19,240
Speaker 2: this whole subject. But Addie and va Lasi. Again I'm

460
00:25:19,240 --> 00:25:21,959
Speaker 2: not paid by these people, but are two medications at

461
00:25:21,960 --> 00:25:26,320
Speaker 2: increase dopamine in the brain. They are FT approved and

462
00:25:26,920 --> 00:25:29,080
Speaker 2: but they are pretty expensive and not covered by insurance.

463
00:25:29,080 --> 00:25:31,520
Speaker 2: But some patients go that route. And then testosterone can

464
00:25:31,560 --> 00:25:34,639
Speaker 2: actually be helpful, especially in postmentopause, for a woman, to

465
00:25:34,720 --> 00:25:38,760
Speaker 2: help her be more reactive to the stimulus that she

466
00:25:38,880 --> 00:25:40,920
Speaker 2: wants and get that part of her life back.

467
00:25:40,960 --> 00:25:44,160
Speaker 1: Because I guess so another one of my I won't

468
00:25:44,160 --> 00:25:45,480
Speaker 1: I won't name her because I don't know if she

469
00:25:45,480 --> 00:25:48,040
Speaker 1: wants her name on this one, but she said, you know,

470
00:25:48,119 --> 00:25:51,800
Speaker 1: it feels like I can't orgasm as easily anymore. And

471
00:25:52,720 --> 00:25:54,720
Speaker 1: obviously this is if you're if you're to that point

472
00:25:54,760 --> 00:25:56,600
Speaker 1: and you're and you know you're just not orgasm and

473
00:25:56,640 --> 00:25:59,840
Speaker 1: clearly you are wanting this, you're stimulated, and you're just

474
00:26:00,280 --> 00:26:02,320
Speaker 1: reaching that right.

475
00:26:02,400 --> 00:26:06,200
Speaker 2: And so that's a whole different class and different medications.

476
00:26:06,240 --> 00:26:08,120
Speaker 2: What happens is a lot of people are like, oh

477
00:26:08,119 --> 00:26:09,680
Speaker 2: my gosh, give me to saucer and I just need

478
00:26:09,680 --> 00:26:12,119
Speaker 2: that to fix me, and that's not going to help

479
00:26:12,440 --> 00:26:15,440
Speaker 2: in certain conditions. So I always have that conversation with

480
00:26:15,440 --> 00:26:18,960
Speaker 2: my patients. And there's a wonderful book called Come as

481
00:26:19,000 --> 00:26:23,800
Speaker 2: You Are by doctor Emily Nagowski, who really does a

482
00:26:23,800 --> 00:26:27,040
Speaker 2: deep dive on this subject. So any person who's struggling

483
00:26:27,080 --> 00:26:30,159
Speaker 2: with this and wants that back in their life and

484
00:26:30,280 --> 00:26:33,120
Speaker 2: is feeling kind of broken, then that's a wonderful book

485
00:26:33,160 --> 00:26:35,000
Speaker 2: to read because it really helps lay out what your

486
00:26:35,000 --> 00:26:37,920
Speaker 2: treatment options are and really makes you feel.

487
00:26:37,720 --> 00:26:40,800
Speaker 1: Like you're not alone. Whatever publicist came up with the

488
00:26:40,800 --> 00:26:45,400
Speaker 1: title of that book's yeah, well done. Come as you Are.

489
00:26:47,280 --> 00:26:51,639
Speaker 1: Diet is so important. So I just went to this

490
00:26:51,720 --> 00:26:54,160
Speaker 1: medical conference. Again I'm a bit of a nerd, and

491
00:26:54,200 --> 00:26:56,520
Speaker 1: I was listening to these doctors who are kind of

492
00:26:56,640 --> 00:27:00,199
Speaker 1: rearranging the way they're thinking about medicine instead of you know,

493
00:27:00,920 --> 00:27:04,280
Speaker 1: you get sick, you do this, you get cancer, you

494
00:27:04,320 --> 00:27:07,080
Speaker 1: do this, trying to look ahead of all this and

495
00:27:07,080 --> 00:27:10,000
Speaker 1: obviously gut health and diet is a huge part of it.

496
00:27:10,200 --> 00:27:12,800
Speaker 1: What I found interesting is what you said about menopause

497
00:27:12,960 --> 00:27:15,920
Speaker 1: and doctors and students only getting about an hour's worth

498
00:27:15,960 --> 00:27:19,440
Speaker 1: of knowledge. They said the same thing about diet.

499
00:27:19,480 --> 00:27:20,480
Speaker 2: Nutrition. Yeah.

500
00:27:20,560 --> 00:27:25,600
Speaker 1: Nutrition shocked me and stunned me that they just back

501
00:27:25,640 --> 00:27:27,919
Speaker 1: in the day and even now maybe are still just

502
00:27:28,000 --> 00:27:31,520
Speaker 1: not spending much time on nutrition and how huge that is.

503
00:27:31,600 --> 00:27:35,480
Speaker 1: And so my question is are there things that women

504
00:27:35,520 --> 00:27:38,800
Speaker 1: could be eating, drinking? What can they be doing that

505
00:27:38,880 --> 00:27:42,280
Speaker 1: will help the inflammatory issues?

506
00:27:42,920 --> 00:27:45,160
Speaker 2: Absolutely? And I wrote a whole book about it.

507
00:27:45,160 --> 00:27:47,720
Speaker 1: It's called The Galveston Diet. Everybody, Just so you know.

508
00:27:48,800 --> 00:27:51,240
Speaker 2: I went back to school. I was so frustrated with

509
00:27:51,280 --> 00:27:54,320
Speaker 2: my lack of knowledge and so hungry from no pun

510
00:27:54,359 --> 00:27:58,040
Speaker 2: intended for more information and wanted to better myself. You know,

511
00:27:58,080 --> 00:28:00,679
Speaker 2: I just felt pulled and drawn to do like on

512
00:28:00,760 --> 00:28:04,639
Speaker 2: my own dime. I found this culinary medicine program at

513
00:28:04,680 --> 00:28:08,959
Speaker 2: Tulane and you know, enrolled and it took about eighteen

514
00:28:09,000 --> 00:28:10,840
Speaker 2: months and I had to like fly around to go

515
00:28:10,880 --> 00:28:13,520
Speaker 2: do different labs and different coursework, and it just was

516
00:28:13,600 --> 00:28:15,560
Speaker 2: the best thing ever. And I was like, gosh, we

517
00:28:15,600 --> 00:28:17,879
Speaker 2: should have taught this at medical school. You know, this

518
00:28:17,920 --> 00:28:19,919
Speaker 2: would really really help, and so much of it is

519
00:28:20,000 --> 00:28:23,120
Speaker 2: preventative and really putting a framework around nutrition. We might

520
00:28:23,240 --> 00:28:27,440
Speaker 2: get an hour of nutrition you know, lectures in our

521
00:28:28,280 --> 00:28:32,600
Speaker 2: medical school and residency training. My daughter started med school

522
00:28:32,640 --> 00:28:35,040
Speaker 2: a couple of weeks ago and her undergrad degree is

523
00:28:35,080 --> 00:28:38,520
Speaker 2: in nutrition science. So like, honey, you're doing it right, you.

524
00:28:38,480 --> 00:28:41,440
Speaker 1: Know, I mean, especially what we know now, I mean,

525
00:28:41,480 --> 00:28:43,440
Speaker 1: I get it. You know. Ten twenty years ago, we

526
00:28:43,480 --> 00:28:45,719
Speaker 1: all thought it was about medicine and pharma and all that.

527
00:28:45,760 --> 00:28:48,520
Speaker 1: But now right now we know it is so linked

528
00:28:48,560 --> 00:28:50,320
Speaker 1: to our nutrition in our gut health.

529
00:28:50,720 --> 00:28:55,600
Speaker 2: Right. So like top tips for someone in perimenopause and

530
00:28:55,640 --> 00:28:58,240
Speaker 2: menopause are look at how much fiber you're getting in

531
00:28:58,280 --> 00:29:01,240
Speaker 2: your diet, you know. And one way to do that,

532
00:29:01,440 --> 00:29:04,520
Speaker 2: and it's pretty effective is download a free nutrition tracker.

533
00:29:04,840 --> 00:29:07,880
Speaker 2: I'm not trying to you know, stress anyone out or

534
00:29:07,920 --> 00:29:10,920
Speaker 2: give them, you know, neurosis about it if this is

535
00:29:10,920 --> 00:29:12,960
Speaker 2: going to trigger something and you don't do it. But

536
00:29:13,840 --> 00:29:15,880
Speaker 2: so many of us it's like using cash instead of

537
00:29:15,920 --> 00:29:17,800
Speaker 2: a credit card. You don't really know what you're eating.

538
00:29:17,840 --> 00:29:19,440
Speaker 2: You think you're eating healthy, and I thought I was

539
00:29:19,480 --> 00:29:21,360
Speaker 2: eating healthy for a long time. It said healthy on

540
00:29:21,400 --> 00:29:26,760
Speaker 2: the bag. So okay, So track your fiber intake, how

541
00:29:26,840 --> 00:29:29,960
Speaker 2: much you really getting through your food. And we should

542
00:29:29,960 --> 00:29:32,160
Speaker 2: be getting at least twenty five grams of fiber in

543
00:29:32,200 --> 00:29:34,120
Speaker 2: our diet per day, and a mix of soluble and

544
00:29:34,160 --> 00:29:37,480
Speaker 2: insoluble fiber. You know, insoluble fiber is what bulks up

545
00:29:37,720 --> 00:29:40,240
Speaker 2: our stool and makes it kind of run through quicker.

546
00:29:40,280 --> 00:29:42,760
Speaker 2: But the soluble fiber is dissolvable, and that's what feeds

547
00:29:42,760 --> 00:29:46,200
Speaker 2: our gout microbiome and keeps it healthy. And so, and

548
00:29:46,240 --> 00:29:50,600
Speaker 2: when you're eating food sources, you know, from various foods,

549
00:29:51,200 --> 00:29:54,640
Speaker 2: then you're getting so many other vitamins, minerals and nutrients

550
00:29:54,720 --> 00:29:58,239
Speaker 2: you know that are part of that fiber package. So

551
00:29:58,400 --> 00:30:00,160
Speaker 2: make sure you're getting twenty five grams of five in

552
00:30:00,160 --> 00:30:03,080
Speaker 2: your diet per day. Number two, watch the added sugars

553
00:30:03,080 --> 00:30:05,440
Speaker 2: and food. So, I know, the whole keto movement kind

554
00:30:05,440 --> 00:30:08,400
Speaker 2: of threw all sugars. All sugars are bad. What fruits

555
00:30:08,400 --> 00:30:12,120
Speaker 2: and vegetables were you know, that's probably, you know, not

556
00:30:12,280 --> 00:30:14,880
Speaker 2: the healthiest way you better option. Sure it's a way

557
00:30:14,880 --> 00:30:18,040
Speaker 2: to lose weight, but at what cost. And so when

558
00:30:18,080 --> 00:30:21,400
Speaker 2: you lose fruits and vegetables, you were losing a tremendous

559
00:30:21,400 --> 00:30:26,720
Speaker 2: amount of nutrients. And so my nutrition professor is like, well,

560
00:30:26,760 --> 00:30:30,400
Speaker 2: Mary Claire, nobody got fat eat and blueberries, you know exactly.

561
00:30:30,840 --> 00:30:34,600
Speaker 2: It's kind of a cowboy. But you know that on

562
00:30:34,800 --> 00:30:37,600
Speaker 2: with me, like why are we demonizing fruits and vegetables

563
00:30:38,840 --> 00:30:42,120
Speaker 2: when we there's so many things in our diets that

564
00:30:42,160 --> 00:30:45,840
Speaker 2: we're eating routinely that could probably be you know, done

565
00:30:45,880 --> 00:30:49,320
Speaker 2: in very much moderation and replacing that with fruits and vegetables.

566
00:30:49,360 --> 00:30:52,760
Speaker 2: So added sugars are the sugars added in cooking and

567
00:30:52,800 --> 00:30:56,520
Speaker 2: processing and alcohol, and so limiting those to twenty five

568
00:30:56,560 --> 00:30:58,720
Speaker 2: grams per day or less. So that's not saying never

569
00:30:58,800 --> 00:31:01,400
Speaker 2: you can't have a cookie or no celebrate birthday or

570
00:31:01,400 --> 00:31:04,720
Speaker 2: however you want to do that. But women who consistently

571
00:31:05,120 --> 00:31:06,880
Speaker 2: less than twenty five grams of out of sugars per

572
00:31:06,920 --> 00:31:11,200
Speaker 2: day have less visceral fat, better menopause symptoms. You know,

573
00:31:11,360 --> 00:31:12,400
Speaker 2: everything is better in there.

574
00:31:12,360 --> 00:31:26,680
Speaker 1: Right two, diabetes, you name it, all of it. This

575
00:31:26,800 --> 00:31:30,360
Speaker 1: next question is kind of specific to their diet. Amy,

576
00:31:30,400 --> 00:31:32,600
Speaker 1: who I do know very well, dear friend of mine.

577
00:31:32,600 --> 00:31:37,040
Speaker 1: She's forty nine, breaking into that fifty club. Clearly going

578
00:31:37,040 --> 00:31:41,680
Speaker 1: through metopause. Eating etamammy salmon and having sex has helped

579
00:31:41,720 --> 00:31:43,680
Speaker 1: my Hot flashes is this normal.

580
00:31:44,560 --> 00:31:50,120
Speaker 2: Absolutely, So the sex is optional and love it, do

581
00:31:50,240 --> 00:31:52,440
Speaker 2: it for sure. It's a great way to stress relief.

582
00:31:53,440 --> 00:31:59,240
Speaker 2: But atamammy is rich in phytoestrogens. And so we've looked

583
00:31:59,280 --> 00:32:03,360
Speaker 2: at women throughout the world and hot flushes specifically, and

584
00:32:03,440 --> 00:32:06,080
Speaker 2: women in Asia have less hot flashes than women who

585
00:32:06,080 --> 00:32:11,280
Speaker 2: are Eurocentric. Interesting, and we think it's because their diets

586
00:32:11,280 --> 00:32:15,440
Speaker 2: are so rich in phytoestrogens. So phyto estrogen is an

587
00:32:15,560 --> 00:32:18,640
Speaker 2: estrogen like compound found in foods, and so the soy

588
00:32:18,720 --> 00:32:21,040
Speaker 2: kind of got a bad rap because of, you know,

589
00:32:21,200 --> 00:32:24,480
Speaker 2: possible links to breast cancer that has never played out. Actually,

590
00:32:24,880 --> 00:32:27,480
Speaker 2: women who have diets rich in natural soy who eat

591
00:32:27,480 --> 00:32:30,600
Speaker 2: out of mammy or soybeans on occasion have lower risk

592
00:32:30,640 --> 00:32:31,120
Speaker 2: of breast.

593
00:32:30,960 --> 00:32:34,920
Speaker 1: Cancer and probably fatty fish with good oils and etcetera, exactly.

594
00:32:34,640 --> 00:32:38,560
Speaker 2: The omega threes. Definitely, the fatty fish with the good

595
00:32:38,640 --> 00:32:41,680
Speaker 2: oils is going to decrease your risk of hot flashes.

596
00:32:42,200 --> 00:32:45,360
Speaker 1: So a couple more symptom questions. Sadie brought this up

597
00:32:45,400 --> 00:32:49,480
Speaker 1: apparently a Beverly Hills housewife fan. She said, Erica Jane,

598
00:32:49,680 --> 00:32:53,760
Speaker 1: a Beverly Hills housewife, claims she lost weight thinks to menopause.

599
00:32:54,400 --> 00:32:57,440
Speaker 1: Is this the truth? And can menopause just as easily

600
00:32:57,440 --> 00:32:58,880
Speaker 1: make you lose weight as gain weight.

601
00:33:00,360 --> 00:33:04,720
Speaker 2: So here's what we know. Women tend to gain weight

602
00:33:04,760 --> 00:33:07,120
Speaker 2: as we age. It's more to do with getting older

603
00:33:07,240 --> 00:33:10,680
Speaker 2: and loss of muscle mass and replacement of that muscle

604
00:33:10,680 --> 00:33:14,520
Speaker 2: mass with fat. And so I don't talk about what

605
00:33:14,640 --> 00:33:16,160
Speaker 2: I try not to talk about weight in terms of

606
00:33:16,160 --> 00:33:19,120
Speaker 2: the scale. I talk about muscle mass and fat mass

607
00:33:19,480 --> 00:33:23,520
Speaker 2: and visceral fat to be specific. So subcutaneous fat is

608
00:33:23,520 --> 00:33:25,800
Speaker 2: the fat we've known our whole lives. It's under our skin.

609
00:33:25,920 --> 00:33:27,480
Speaker 2: It gives us curve cell you like. We don't like it.

610
00:33:27,480 --> 00:33:30,120
Speaker 2: It's cosmetically distressing, but it's really unless it's a lot,

611
00:33:30,200 --> 00:33:34,720
Speaker 2: it's not that dangerous. Visceral fat starts really expanding in menopause.

612
00:33:34,800 --> 00:33:37,400
Speaker 2: That is the fat inside of our abdomen, our momentum

613
00:33:37,480 --> 00:33:40,400
Speaker 2: rocks around our internal organs, and that fat is pro

614
00:33:40,480 --> 00:33:44,280
Speaker 2: inflammatory and linked to hypertengen, diabetes, stroke and all the

615
00:33:44,360 --> 00:33:47,600
Speaker 2: chronic diseases. It makes you feel terrible and look kind

616
00:33:47,600 --> 00:33:51,080
Speaker 2: of pregnant. And so so many women are seeing an

617
00:33:51,160 --> 00:33:55,360
Speaker 2: increase in their abdominal circumference where they never had it before.

618
00:33:55,680 --> 00:34:01,640
Speaker 2: You know, and that is causing in resistance, increasing inflammation levels.

619
00:34:01,760 --> 00:34:04,240
Speaker 2: And so some of those nutritional things I talked about,

620
00:34:04,280 --> 00:34:08,520
Speaker 2: the added sugars, the fiber, actually, probiotics and tumoric have

621
00:34:08,600 --> 00:34:11,759
Speaker 2: been shown to help bring that visceral fat level down

622
00:34:11,840 --> 00:34:13,360
Speaker 2: and decrease inflammation markers.

623
00:34:13,840 --> 00:34:15,799
Speaker 1: You mentioned something, you just said it right there, and

624
00:34:15,800 --> 00:34:18,279
Speaker 1: you also said this on social media. I found it

625
00:34:18,360 --> 00:34:21,840
Speaker 1: very interesting, again, just kind of being in this world

626
00:34:22,000 --> 00:34:26,080
Speaker 1: and loving this science behind it, especially with women, the

627
00:34:26,239 --> 00:34:34,160
Speaker 1: percentage of muscle you lose as you age, and correct

628
00:34:34,160 --> 00:34:35,680
Speaker 1: me if I'm wrong, But what you were saying is,

629
00:34:36,880 --> 00:34:39,799
Speaker 1: don't just worry about the scale, don't worry about how

630
00:34:39,880 --> 00:34:43,239
Speaker 1: much you weigh, don't just worry about jumping on a treadmill.

631
00:34:43,400 --> 00:34:46,839
Speaker 1: Think about gaining some muscle and keeping that sustaining that

632
00:34:46,920 --> 00:34:48,960
Speaker 1: muscle as you get older. And that is huge for

633
00:34:49,000 --> 00:34:49,400
Speaker 1: a woman.

634
00:34:50,000 --> 00:34:52,439
Speaker 2: That is one of the biggest lessons I've learned through

635
00:34:52,440 --> 00:34:55,240
Speaker 2: this whole journey that I've been on, you know, learning

636
00:34:55,360 --> 00:34:58,640
Speaker 2: nutrition classes, look at talking to other experts, you know,

637
00:34:59,280 --> 00:35:01,760
Speaker 2: figuring out what Peter A. T Is trying to say,

638
00:35:02,000 --> 00:35:05,200
Speaker 2: you know, and applying that to us as females. When

639
00:35:05,200 --> 00:35:09,000
Speaker 2: you add in the endocrine aging through menopause, and what

640
00:35:09,040 --> 00:35:13,200
Speaker 2: we see in menopause is acceleration of the muscle mass loss,

641
00:35:13,400 --> 00:35:16,719
Speaker 2: which is immediately replaced. You know, the scale may be

642
00:35:17,120 --> 00:35:19,759
Speaker 2: you know, whoever the housewife is. She may be like,

643
00:35:19,800 --> 00:35:23,520
Speaker 2: I'm doing great, I'm doing great. But if she's replacing,

644
00:35:23,719 --> 00:35:26,439
Speaker 2: you know, losing muscle mass and replacing it with fat,

645
00:35:26,480 --> 00:35:28,680
Speaker 2: she's not healthier. She won't live as long.

646
00:35:28,560 --> 00:35:30,120
Speaker 1: Because muscle weighs more than fat.

647
00:35:31,239 --> 00:35:35,200
Speaker 2: And so my own workouts have changed. For twenty five years,

648
00:35:35,280 --> 00:35:37,279
Speaker 2: thirty years, I worked out to be thin. That was

649
00:35:37,320 --> 00:35:39,000
Speaker 2: my goal. I wanted to look a certain way. I

650
00:35:39,000 --> 00:35:41,560
Speaker 2: wanted to fit in certain clothes. I had skinny privilege.

651
00:35:42,000 --> 00:35:44,360
Speaker 2: And now if I could do anything like your twenty

652
00:35:44,360 --> 00:35:47,399
Speaker 2: five year olds, your staffers, my kids are much better

653
00:35:47,400 --> 00:35:49,440
Speaker 2: about this than I was at that age. They are

654
00:35:49,440 --> 00:35:51,920
Speaker 2: not so focused on being thin. They know they need

655
00:35:51,960 --> 00:35:55,040
Speaker 2: to be strong. When they work out, they lift weights.

656
00:35:55,080 --> 00:35:57,560
Speaker 2: You know, they're not just running or doing aerobics or

657
00:35:57,600 --> 00:35:59,719
Speaker 2: doing something cardio. They know that that's part of it.

658
00:35:59,760 --> 00:36:02,720
Speaker 2: But they recognize the importance of muscle training and keeping

659
00:36:02,800 --> 00:36:03,279
Speaker 2: it up.

660
00:36:03,480 --> 00:36:05,319
Speaker 1: And ladies don't worry. Everyone says, oh, I don't want

661
00:36:05,320 --> 00:36:08,640
Speaker 1: to bulk up you're not gonna bulk not Arnold Schwarzenegger,

662
00:36:08,680 --> 00:36:10,520
Speaker 1: don't worry about it.

663
00:36:10,640 --> 00:36:13,400
Speaker 2: Well, bulk up. No, it's important.

664
00:36:13,520 --> 00:36:17,279
Speaker 1: Alexandra has a very interesting issue. She says, my hair

665
00:36:17,360 --> 00:36:20,839
Speaker 1: is thinning, but I'm also growing a beard. What's up

666
00:36:20,880 --> 00:36:22,640
Speaker 1: with that?

667
00:36:22,640 --> 00:36:25,080
Speaker 2: That is just one of the most common things that

668
00:36:25,120 --> 00:36:27,600
Speaker 2: I hear in menopause is you're losing hair from places

669
00:36:27,640 --> 00:36:30,160
Speaker 2: you want it, but it's popping up in new places

670
00:36:30,200 --> 00:36:31,080
Speaker 2: where you never had it.

671
00:36:31,120 --> 00:36:33,640
Speaker 1: I will say, this is where men and women are equal.

672
00:36:33,719 --> 00:36:35,640
Speaker 1: We typically I know I have a good head of

673
00:36:35,640 --> 00:36:38,239
Speaker 1: hair thanks to my mom, but typically we lose our

674
00:36:38,280 --> 00:36:40,880
Speaker 1: hair up top pretty early and then it just starts

675
00:36:40,880 --> 00:36:45,840
Speaker 1: going elsewhere back, so we'll talk about.

676
00:36:45,719 --> 00:36:47,759
Speaker 2: The chin hair and the hair the new hair that

677
00:36:47,800 --> 00:36:52,759
Speaker 2: we don't want. That's usually hormonal, and so as our

678
00:36:52,880 --> 00:36:57,200
Speaker 2: estrogen levels decline, our liver stops making something called steroid

679
00:36:57,200 --> 00:37:00,799
Speaker 2: hormone binding globulin. It's basically a protein carries our sex

680
00:37:00,840 --> 00:37:03,480
Speaker 2: hormones around, and when they're bound to the protein, they're

681
00:37:03,520 --> 00:37:06,000
Speaker 2: not active. And so even though your levels might be

682
00:37:06,040 --> 00:37:08,080
Speaker 2: the same, if you don't have as much as that protein,

683
00:37:08,160 --> 00:37:10,200
Speaker 2: the activity of some of those hormones is going to

684
00:37:10,200 --> 00:37:12,680
Speaker 2: be higher, and so we see in this transition, the

685
00:37:12,719 --> 00:37:15,960
Speaker 2: activity of our androgens gets higher, even though are levels

686
00:37:16,080 --> 00:37:19,440
Speaker 2: or maybe lower or the same, and that's leading to

687
00:37:19,960 --> 00:37:22,800
Speaker 2: new fun I have one right here that I always

688
00:37:22,920 --> 00:37:28,640
Speaker 2: do surveillance for on my chin, and so so there. Fortunately,

689
00:37:28,640 --> 00:37:30,640
Speaker 2: we have lots of cosmetic ways to rid ourselves with

690
00:37:30,719 --> 00:37:33,080
Speaker 2: those peskiers and or just pluck them and get on

691
00:37:33,120 --> 00:37:35,320
Speaker 2: with your day. But hair loss on your head is

692
00:37:35,320 --> 00:37:37,920
Speaker 2: a little more complicated because there's multiple things that can

693
00:37:37,960 --> 00:37:41,200
Speaker 2: cause that. We have genetic issues, nutritional issues, of course,

694
00:37:41,239 --> 00:37:44,520
Speaker 2: hormone issues. I have a YouTube video if anyone cares,

695
00:37:44,719 --> 00:37:47,040
Speaker 2: where I talk about all the ways women can lose

696
00:37:47,080 --> 00:37:49,919
Speaker 2: hair and all the different treatment options. Sometimes it takes

697
00:37:49,920 --> 00:37:51,919
Speaker 2: a visit to a dermatologist to figure out what's really

698
00:37:51,960 --> 00:37:52,319
Speaker 2: going on.

699
00:37:52,760 --> 00:37:57,400
Speaker 1: Another symptom that is often not talked about. But she asked,

700
00:37:57,560 --> 00:37:59,759
Speaker 1: I sometimes leak urine or can't make it to the

701
00:37:59,760 --> 00:38:01,640
Speaker 1: back through me in time. Is this something I just

702
00:38:01,719 --> 00:38:02,399
Speaker 1: have to live with?

703
00:38:02,920 --> 00:38:06,360
Speaker 2: Absolutely not, no. So Urinarian continence can be one of

704
00:38:06,400 --> 00:38:10,719
Speaker 2: the most devastating hallmarks of menopause because it's so life

705
00:38:10,719 --> 00:38:14,760
Speaker 2: disruptive and it's frankly embarrassing, and so there is basically

706
00:38:14,800 --> 00:38:19,200
Speaker 2: three buckets of incontinents. Again, one is stress in continence,

707
00:38:19,239 --> 00:38:22,239
Speaker 2: which is you cough, you laugh, you sneeze, you put

708
00:38:22,280 --> 00:38:24,480
Speaker 2: pressure on the bladder and it leaks where it used

709
00:38:24,520 --> 00:38:25,680
Speaker 2: to not. You used to be able to go out

710
00:38:25,719 --> 00:38:28,600
Speaker 2: with your girlfriends, laugh, tell a story and you wouldn't leak.

711
00:38:29,200 --> 00:38:32,480
Speaker 2: And that is an anatomic issue. You have overridden the

712
00:38:32,520 --> 00:38:37,200
Speaker 2: pressure valve that held the urethra up, and having babies, smoking,

713
00:38:37,400 --> 00:38:40,240
Speaker 2: being overweight, that's all contributing factors. And loss of hormones

714
00:38:40,239 --> 00:38:42,920
Speaker 2: from menopause. So for some patients, just getting them on

715
00:38:42,960 --> 00:38:45,880
Speaker 2: hormone therapy or putting estrogen back will help strengthen that

716
00:38:45,920 --> 00:38:48,240
Speaker 2: tissue back up where you can hold that valve back.

717
00:38:48,640 --> 00:38:53,480
Speaker 2: Then there's urging continents, which is an autonomic spasm of

718
00:38:53,520 --> 00:38:56,120
Speaker 2: the bladder. You're not telling your brain to do anything,

719
00:38:56,120 --> 00:38:57,960
Speaker 2: it just kind of sometimes it's a key in the

720
00:38:58,000 --> 00:39:00,360
Speaker 2: lock or there's some kind of a trigger, but you

721
00:39:00,400 --> 00:39:02,160
Speaker 2: feel like you have to go and you run to

722
00:39:02,200 --> 00:39:04,319
Speaker 2: the bathroom immediately and it's just running down your leg.

723
00:39:04,800 --> 00:39:07,640
Speaker 2: And so that is treated with medication to relax the

724
00:39:07,640 --> 00:39:10,280
Speaker 2: walls of the bladder. And then there's a neurogenic bladder.

725
00:39:10,320 --> 00:39:14,920
Speaker 2: Pretty rare, usually in diabetics or spinal cord injuries where

726
00:39:15,080 --> 00:39:18,400
Speaker 2: you lose the ability your brain cannot get the signal

727
00:39:18,440 --> 00:39:20,520
Speaker 2: that the bladder's full and you need to be And

728
00:39:20,600 --> 00:39:23,400
Speaker 2: so most women have stress or urge, your combination of

729
00:39:23,440 --> 00:39:26,880
Speaker 2: the two. And there's fortunately EU rogoncologists who can help you.

730
00:39:27,040 --> 00:39:28,799
Speaker 2: They're a specialist and what I did and they did

731
00:39:28,800 --> 00:39:31,879
Speaker 2: more training to help you kind of figure out what's

732
00:39:31,880 --> 00:39:33,360
Speaker 2: going on and get you the right treatment.

733
00:39:33,800 --> 00:39:37,760
Speaker 1: I'm not sure if this came with the hot flash issue,

734
00:39:37,760 --> 00:39:40,480
Speaker 1: but Lisa asked, what can I do if I have

735
00:39:40,600 --> 00:39:44,000
Speaker 1: trouble sleeping, which is something else that probably comes with

736
00:39:44,040 --> 00:39:45,280
Speaker 1: the hot flashes and everything.

737
00:39:45,840 --> 00:39:49,200
Speaker 2: Yes, sleep disruption is one of the top complaints more

738
00:39:49,200 --> 00:39:54,000
Speaker 2: than hot flashes and so, and it's complicated definitely. If

739
00:39:54,000 --> 00:39:58,040
Speaker 2: your hot flashes are waking you up, then sleep then

740
00:39:58,280 --> 00:40:01,440
Speaker 2: you know, hormone replacement therapy really really helpful for you.

741
00:40:02,719 --> 00:40:05,120
Speaker 2: There's a lot of you know, environment things that you

742
00:40:05,160 --> 00:40:07,520
Speaker 2: can do, like cooling the room and things that I

743
00:40:07,600 --> 00:40:09,960
Speaker 2: kind of took for Randa before that. I absolutely have

744
00:40:10,040 --> 00:40:11,719
Speaker 2: to have the right pillow, the right blanket, the right

745
00:40:11,840 --> 00:40:14,960
Speaker 2: night down, the right you know. I also my alcohol

746
00:40:15,000 --> 00:40:20,880
Speaker 2: tolerance in menopause has gone away, and one glass of

747
00:40:20,920 --> 00:40:23,080
Speaker 2: wine and I will not sleep. And that is a choice.

748
00:40:23,080 --> 00:40:25,840
Speaker 2: If I choose to drink, I'm choosing to not sleep.

749
00:40:25,880 --> 00:40:27,480
Speaker 1: And you know what's coming.

750
00:40:28,520 --> 00:40:31,960
Speaker 2: I know what's coming. And so you have to prioritize

751
00:40:31,960 --> 00:40:34,360
Speaker 2: your sleep and menopause. Like you have to prioritize your muscle.

752
00:40:34,719 --> 00:40:36,680
Speaker 2: You have to prioritize your sleep or it's going to

753
00:40:36,719 --> 00:40:39,919
Speaker 2: go away. And so hormon therapy can go a long way.

754
00:40:40,000 --> 00:40:42,920
Speaker 2: I sleep beautifully now as long as I don't drink.

755
00:40:43,200 --> 00:40:45,799
Speaker 2: But again, sleep's more complicated. There's you know, you have

756
00:40:45,840 --> 00:40:48,000
Speaker 2: to make sure you have all the sleep hygiene things

757
00:40:48,040 --> 00:40:52,160
Speaker 2: done same bedtime. You know. I did a podcast with

758
00:40:52,160 --> 00:40:53,720
Speaker 2: a sleep specialist and.

759
00:40:53,880 --> 00:40:57,359
Speaker 1: Especially treatise like we are children when you have kids, right,

760
00:40:57,480 --> 00:40:59,719
Speaker 1: you swear by that schedule, do not get off the

761
00:40:59,719 --> 00:41:00,440
Speaker 1: scale schule.

762
00:41:00,719 --> 00:41:02,719
Speaker 2: Yeah, I swear by the schedule lab at.

763
00:41:02,600 --> 00:41:03,080
Speaker 1: The same time.

764
00:41:03,560 --> 00:41:05,040
Speaker 2: Baby. I mean that's us.

765
00:41:05,120 --> 00:41:10,719
Speaker 1: Now it all comes full circle, doesn't it. Okay? Can

766
00:41:10,760 --> 00:41:12,279
Speaker 1: I be a guy for two seconds?

767
00:41:12,480 --> 00:41:12,680
Speaker 2: Sure?

768
00:41:13,680 --> 00:41:17,759
Speaker 1: Do men go through a similar yeah, menopause.

769
00:41:18,760 --> 00:41:25,400
Speaker 2: So I've looked at this data and the main way

770
00:41:25,560 --> 00:41:28,000
Speaker 2: that we make to sascer one, both men and women

771
00:41:28,880 --> 00:41:31,400
Speaker 2: about fifty percent and a woman is from the adrenal

772
00:41:31,400 --> 00:41:34,719
Speaker 2: glands for androgens, and then we make out some in

773
00:41:34,760 --> 00:41:39,399
Speaker 2: about half or in the ovaries, and so men it's

774
00:41:39,480 --> 00:41:44,000
Speaker 2: mostly from the testicles and then some from precursors from

775
00:41:44,000 --> 00:41:48,040
Speaker 2: the adrenal glands as well. We see your peak for

776
00:41:48,160 --> 00:41:51,840
Speaker 2: men at about nineteen and then it kind of gently

777
00:41:51,920 --> 00:41:55,160
Speaker 2: drifts down to about forty, and for the vast majority

778
00:41:55,200 --> 00:41:58,560
Speaker 2: of men from forty till death it remains about the same.

779
00:41:59,120 --> 00:42:03,120
Speaker 2: What happens is is a very large intervariability of taesoscer

780
00:42:03,320 --> 00:42:07,040
Speaker 2: levels between men. Where normal is two hundred and I

781
00:42:07,040 --> 00:42:10,239
Speaker 2: think fifty six to about one thousand. Okay, most men

782
00:42:10,280 --> 00:42:13,680
Speaker 2: don't feel okay till they're about four hundred, so that's

783
00:42:13,680 --> 00:42:18,400
Speaker 2: still a pretty wide window for sure variability. And so

784
00:42:19,719 --> 00:42:22,520
Speaker 2: aging does a lot to us. And so you're kind of,

785
00:42:22,560 --> 00:42:24,440
Speaker 2: you know, living your best life going about and then

786
00:42:24,480 --> 00:42:27,760
Speaker 2: the aging factors kicked in. You know, you're getting older,

787
00:42:27,800 --> 00:42:31,879
Speaker 2: things are slowing down. Sometimes a little extra testosterone can

788
00:42:31,960 --> 00:42:36,520
Speaker 2: help you improve performance, feel better, you know, muscle, performance, brain,

789
00:42:37,000 --> 00:42:37,880
Speaker 2: all the things.

790
00:42:37,880 --> 00:42:38,960
Speaker 1: Like estag everything.

791
00:42:39,520 --> 00:42:43,360
Speaker 2: There are testosterone receptors throughout our body. And so this

792
00:42:43,480 --> 00:42:46,560
Speaker 2: is not my area of expertise, So there's not a manopause. No,

793
00:42:46,760 --> 00:42:49,040
Speaker 2: we do see a gentle decline and then a kind

794
00:42:49,040 --> 00:42:52,480
Speaker 2: of a stabilization about age forty. But for some men,

795
00:42:52,600 --> 00:42:58,799
Speaker 2: testosterone supplementation in physiologic ranges can be really helpful to

796
00:42:58,840 --> 00:43:01,080
Speaker 2: help them feel better and perform and function better.

797
00:43:01,760 --> 00:43:03,680
Speaker 1: I'm not going to say he deserves a book, but

798
00:43:04,120 --> 00:43:06,719
Speaker 1: if you could go back and write your husband a

799
00:43:06,760 --> 00:43:12,279
Speaker 1: pamphlet how to guide to help you and be there

800
00:43:12,320 --> 00:43:15,160
Speaker 1: for you as you're going through menopause, are there some

801
00:43:15,239 --> 00:43:18,040
Speaker 1: things that you would tell other men that, gosh, are

802
00:43:18,080 --> 00:43:20,520
Speaker 1: going to be going through this with their significant other.

803
00:43:21,080 --> 00:43:25,680
Speaker 2: That's such a good question. I went through So I

804
00:43:25,719 --> 00:43:29,440
Speaker 2: was on birth control pills for most of my perimenopause,

805
00:43:29,480 --> 00:43:31,600
Speaker 2: so mine was kind of mass okay, and then I

806
00:43:31,640 --> 00:43:35,160
Speaker 2: came off. And then if you read my book, one

807
00:43:35,200 --> 00:43:37,520
Speaker 2: of my brothers passed away, and so I was going

808
00:43:37,560 --> 00:43:42,120
Speaker 2: through this like horrific life event and perimenopausal. I was

809
00:43:42,160 --> 00:43:44,480
Speaker 2: gaslighting myself. He didn't know what the hell to do

810
00:43:44,520 --> 00:43:47,920
Speaker 2: with me. I mean I was not sleeping, sweating, flashing,

811
00:43:48,120 --> 00:43:51,360
Speaker 2: crying dramatic. I mean everything. My brother died in and

812
00:43:51,400 --> 00:43:53,279
Speaker 2: I was like crying all the way home. From work,

813
00:43:53,320 --> 00:43:55,799
Speaker 2: I go to clinic and patch myself together and take

814
00:43:55,840 --> 00:43:57,759
Speaker 2: care of patients and go be the you know, then

815
00:43:57,800 --> 00:44:00,719
Speaker 2: come home and move the whole way home. And I

816
00:44:00,760 --> 00:44:04,200
Speaker 2: didn't even recognize my own perim. I thought I was

817
00:44:04,200 --> 00:44:07,360
Speaker 2: a dang. I just thought I was crazy and grieving.

818
00:44:07,440 --> 00:44:10,520
Speaker 2: And then one day, like the grief got better and

819
00:44:10,560 --> 00:44:13,200
Speaker 2: I was like, you know, I realized I wasn't a

820
00:44:13,280 --> 00:44:15,960
Speaker 2: sad whatever, but I was still miserable. I felt horrible.

821
00:44:16,400 --> 00:44:19,479
Speaker 2: That joint pain for me was like, Okay, I'm dying,

822
00:44:19,600 --> 00:44:23,120
Speaker 2: something is wrong, and he's just tiptoeing around, scheduling a

823
00:44:23,120 --> 00:44:25,120
Speaker 2: lot of you know, trips out of town.

824
00:44:25,560 --> 00:44:28,120
Speaker 1: You know, just like just scared to death. He's scared

825
00:44:28,120 --> 00:44:28,560
Speaker 1: to death.

826
00:44:29,600 --> 00:44:32,640
Speaker 2: So I think, I think the more we talk and

827
00:44:32,680 --> 00:44:34,719
Speaker 2: the more we educate, and the more women get on

828
00:44:34,800 --> 00:44:37,360
Speaker 2: board with being able to recognize their own symptoms and

829
00:44:37,400 --> 00:44:40,799
Speaker 2: empower and educate themselves, and then their partners getting on board,

830
00:44:40,840 --> 00:44:43,000
Speaker 2: I think it's going to make I really hope it's

831
00:44:43,000 --> 00:44:45,440
Speaker 2: going to decrease the divorce rate at this age, you know,

832
00:44:46,000 --> 00:44:49,240
Speaker 2: and so so much of divorces lack of communication and

833
00:44:49,480 --> 00:44:51,839
Speaker 2: not understanding where the other person's coming from. And so

834
00:44:52,280 --> 00:44:54,200
Speaker 2: I mean, there was also a really rough time in

835
00:44:54,239 --> 00:44:56,759
Speaker 2: our marriage as well. I'm sure we just weren't communicate.

836
00:44:56,880 --> 00:44:58,160
Speaker 1: It's like a stranger moves in.

837
00:44:59,280 --> 00:45:02,200
Speaker 2: Yeah, yeah, so he didn't know what to do. He's

838
00:45:02,280 --> 00:45:04,720
Speaker 2: just living his life. You know. Everything's fine.

839
00:45:05,480 --> 00:45:07,799
Speaker 1: So and some of this stuff can be embarrassing. So

840
00:45:07,840 --> 00:45:12,799
Speaker 1: maybe the takeaway is for both sides communicate, communicate, try.

841
00:45:12,920 --> 00:45:14,279
Speaker 2: But I think if you were to touch me on

842
00:45:14,320 --> 00:45:16,399
Speaker 2: the shoulder and said, could you be menopausal? I would

843
00:45:16,400 --> 00:45:20,000
Speaker 2: have killed him, you know, because of this negative stereotype

844
00:45:20,040 --> 00:45:21,440
Speaker 2: of menopause at the time.

845
00:45:21,480 --> 00:45:29,160
Speaker 1: I dare you, so, I guess your advice would be

846
00:45:29,200 --> 00:45:33,200
Speaker 1: keep your head down and playing a bunch of golf yourself.

847
00:45:33,400 --> 00:45:37,680
Speaker 2: You know, there's there's great books out there, you know.

848
00:45:37,880 --> 00:45:40,560
Speaker 2: Open the conversation. I think though, the conversation needs to

849
00:45:40,600 --> 00:45:43,120
Speaker 2: start with her and her saying something in my body

850
00:45:43,160 --> 00:45:45,400
Speaker 2: is changing. You know. I can't tell you. I have

851
00:45:45,440 --> 00:45:46,360
Speaker 2: a menopause clinic.

852
00:45:46,360 --> 00:45:46,520
Speaker 1: Now.

853
00:45:46,560 --> 00:45:48,960
Speaker 2: That's all I do. I don't do babies or surgery.

854
00:45:49,040 --> 00:45:52,080
Speaker 2: I just take care of menopause patients and probably fifteen

855
00:45:52,120 --> 00:45:54,120
Speaker 2: to twenty percent of them will bring in a loved one,

856
00:45:54,560 --> 00:45:57,640
Speaker 2: usually their partner, who just want to hear it. Who

857
00:45:57,800 --> 00:46:00,279
Speaker 2: just want to be part of this solution, who want

858
00:46:00,320 --> 00:46:02,920
Speaker 2: to be helpful, and it's really just touches me so

859
00:46:03,080 --> 00:46:03,839
Speaker 2: much to see that.

860
00:46:05,160 --> 00:46:07,400
Speaker 1: You mean, it's not like it, but I guess it's

861
00:46:07,480 --> 00:46:10,879
Speaker 1: somewhat like going through childbirth, where when you go through

862
00:46:10,920 --> 00:46:12,680
Speaker 1: it all together and you hear it all and you're

863
00:46:12,760 --> 00:46:16,360
Speaker 1: educated at the same time, it makes sense. Yeah, and

864
00:46:17,000 --> 00:46:21,680
Speaker 1: it probably allows the communication to flow a little bit better. Doctor.

865
00:46:21,760 --> 00:46:25,279
Speaker 1: I can't thank you enough. I have absolutely loved this,

866
00:46:25,360 --> 00:46:26,840
Speaker 1: believe it or not. I don't know if that's weird

867
00:46:27,320 --> 00:46:29,920
Speaker 1: or not, but I've really enjoyed our conversation.

868
00:46:31,360 --> 00:46:34,040
Speaker 2: Well, thank you. I love talking about this. It's my passion.

869
00:46:34,239 --> 00:46:37,040
Speaker 1: You are phenomenal at it the way you articulate it

870
00:46:37,080 --> 00:46:39,520
Speaker 1: and put it in these bite sized pieces. And by

871
00:46:39,520 --> 00:46:42,520
Speaker 1: the way, just if you don't want to just listen

872
00:46:42,520 --> 00:46:45,320
Speaker 1: to me, talk to the doctor. Find her on Instagram

873
00:46:45,360 --> 00:46:47,440
Speaker 1: because you put up so much good stuff. I know

874
00:46:47,480 --> 00:46:49,640
Speaker 1: you're on TikTok as well. I'm not, but find you

875
00:46:49,680 --> 00:46:53,440
Speaker 1: on TikTok. Clearly you have YouTube videos at doctor Mary

876
00:46:53,520 --> 00:46:58,480
Speaker 1: Clare on Instagram. You also have the book The Galveston Diet.

877
00:46:58,880 --> 00:47:00,919
Speaker 2: And our website is undiet dot com.

878
00:47:00,960 --> 00:47:04,720
Speaker 1: Okay, Galvestondiet dot com and are you working on another book?

879
00:47:05,239 --> 00:47:09,839
Speaker 2: I am. So it's called The New Menopause, and take

880
00:47:09,920 --> 00:47:12,320
Speaker 2: everything I just said in the last hour and expand

881
00:47:12,360 --> 00:47:15,160
Speaker 2: it times one hundred and I really want it to

882
00:47:15,200 --> 00:47:19,359
Speaker 2: be a critical resource guide for patients and partners and

883
00:47:19,520 --> 00:47:23,960
Speaker 2: loved ones to understand what's out there, what's available, what

884
00:47:24,000 --> 00:47:26,840
Speaker 2: the symptoms might be. It's something you would hand a

885
00:47:26,880 --> 00:47:29,960
Speaker 2: twenty thirty year old so she's ready, you know. Remember

886
00:47:30,000 --> 00:47:31,680
Speaker 2: that it's like what to expect when you're never going

887
00:47:31,719 --> 00:47:32,719
Speaker 2: to expect again. Right.

888
00:47:33,400 --> 00:47:35,600
Speaker 1: Uh. And by the way, what a great thing, because

889
00:47:35,600 --> 00:47:38,600
Speaker 1: it is as we started this whole conversation, it is

890
00:47:38,640 --> 00:47:41,320
Speaker 1: astounding to me that we don't do more to educate

891
00:47:41,400 --> 00:47:44,440
Speaker 1: women for something that you are all going to go

892
00:47:44,520 --> 00:47:48,240
Speaker 1: through and we just kind of blindly and hopefully maybe

893
00:47:48,239 --> 00:47:51,120
Speaker 1: your mom's mentioned something, and that's how you that's how

894
00:47:51,160 --> 00:47:53,680
Speaker 1: you get educated. So hopefully you are kind of breaking

895
00:47:53,719 --> 00:47:57,040
Speaker 1: down that barrier and knocking down that wall so at

896
00:47:57,120 --> 00:47:59,560
Speaker 1: least at the very least you can see what's coming

897
00:47:59,600 --> 00:48:03,600
Speaker 1: and underst stand it when it hits. That's it, doctor,

898
00:48:03,640 --> 00:48:05,680
Speaker 1: Thank you, thank you so much for the time, for

899
00:48:05,760 --> 00:48:09,439
Speaker 1: the knowledge, and we need to do this again, I'd

900
00:48:09,440 --> 00:48:11,840
Speaker 1: love to. We will continue this conversation because it is

901
00:48:11,840 --> 00:48:13,759
Speaker 1: incredibly important. So thank you so much.

902
00:48:14,320 --> 00:48:16,480
Speaker 2: Okay, take care, Thanks for listening.

903
00:48:16,680 --> 00:48:19,279
Speaker 1: Follow us on Instagram at the most Dramatic pod ever,

904
00:48:19,719 --> 00:48:21,480
Speaker 1: and make sure to write us a review and leave

905
00:48:21,560 --> 00:48:23,919
Speaker 1: us five stars. I'll talk to you next time.