Latest / Follow the Leighder / Menopause Is a Whole-Body Issue | Amanda Otterman (@menohealthnurse)
Transcript
- Leigh/@followtheleighder: Well, howdy folks and welcome back to another episode of Follow the Leader. I'm your host, Leigh Larson. And joining me from Canada, the Toronto area, is Amanda Otterman. Welcome. Amanda Otterman RN: Hi, thanks for having me on your show. Leigh/@followtheleighder: Absolutely. Folks, y'all have to know Amanda Ottoman online. She's known as the Menno health nurse or the Meno. Meno, that's how I've been saying it in my head, but she's a Menno health nurse focusing on menopause. She's registered nurse, been doing nursing for a minute, but now is really focused on ⁓ sharing her knowledge, her wisdom and experience with menopause ⁓ while also doing personal fitness, which Amanda Otterman RN: Meadow, like as in Meadow. Leigh/@followtheleighder: Thank you so much for tying that in that specific niche and you're also writing a book we have so I'm so excited Y'all like for like the dummies like the real like the the dummies series Metapods for dummies. Congratulations. That's huge Amanda Otterman RN: Yes. Yes. Thank you. And what's to be coming out end of January next year, joining January 2027, is the date. So still in the early phases of writing, but yeah, it's done deal. It's coming. Leigh/@followtheleighder: Congratulations. We are going to talk about that, because that is menopause for dummies. Yeah, let's put that in every household, actually. Amanda Otterman RN: Yeah, you did, right? Yes, we're there. Leigh/@followtheleighder: Well, talk about how you went from, you know, nursing, working in nursing and healthcare to this ⁓ role of sharing your message about menopause. Talk about that journey. Amanda Otterman RN: ⁓ It's a little convoluted, but I'll try and like make it so that you can follow. ⁓ So really my journey sort of started 13 years ago. ⁓ I had a condition of my uterus called adenomyosis. ⁓ For those of you don't know that, it's the cousin, it's the ugly cousin to endometriosis. ⁓ But it stays in the uterus and what happens is that endometrial lining grows into the uterine muscle. ⁓ It can happen for many reasons. ⁓ Mine, suspectively, happened because I had C-sections with my babies. And that endometrial lining gets invasive and it goes into the muscle. And then with every cycle, ⁓ it basically does what it does. It grows and it tries to shed. but it's doing it in the uterine muscle. So it's extremely painful. It's, ⁓ you know, lots of heavy bleeding for up to two weeks sometimes for me. I was becoming really anemic, but the pain is what would take me out every month. It was unbearable. And even with ⁓ like localized progesterone treatment, like via IUD and whatever, ⁓ it never, never responded to it. So I ended up with a hysterectomy at 33 years old. ⁓ During that process, I really wasn't given a whole lot of information as to what could happen with my body, what to expect. ⁓ All I know is that I woke up out of surgery ⁓ feeling very different. ⁓ They did manage to save my ovaries, but they took the uterus the cervix and the fallopian tubes. And if you know the anatomy, the fallopian tubes are sort of the branch of the ovaries that egg travels through and all of that. So they took everything but the ovaries. And what we know now is that even though ovaries can be spared with a partial hysterectomy and that the expectation is you would continue to make your hormones For some women, ⁓ they experience early menopause. And I know right after I had my surgery, everything in my pelvis felt different. Everything from the vagina becoming extremely dry, ⁓ increased of urinary tract infections started. I had bladder spasms. I had... Leigh/@followtheleighder: Mm. Amanda Otterman RN: ⁓ urinary urgency, ⁓ it was a real gong show. ⁓ And on top of that, I started to have some mood symptoms as well, sleep issues. And I actually ended up ⁓ with really severe depression afterwards, which we all know now are sort of these earlier symptoms of perimenopause. So for me, ovarian failure started to happen almost immediately. ⁓ and progressively got worse throughout my 30s. I couldn't get any help. My doctor was basically like, well, yeah, you could probably go through natural menopause a little earlier, but you shouldn't. It was kind of brushed off and dismissed. Even though I was having all these other symptoms, I had antidepressants thrown at me. And with the depression and stuff, I ended up actually like... going off work for a few months, like gained a ton of weight. I was probably at my heaviest, about 320, 330 pounds, and just a complete hot mess. I even went to a naturopath, and the naturopathic doctor didn't really have any understanding of what was happening with my body. So, you know, for two years I really struggled, and then that's when I decided. I needed to do something or something was going to happen to me. ⁓ So I decided that I needed to work out and exercise and just kind of change my lifestyle completely to try and combat whatever I was feeling and whatever was happening in my body and try to heal my body in that regard. ⁓ So I went from 330-ish pounds down to about 170 ⁓ in about a year and a half time. And I did that with just changing my nutrition and adding strength training and ⁓ regular movement, stress reduction, all those wellness things ⁓ into my lifestyle. And that's sort of where my love for fitness and working out and self care and all of that started. Leigh/@followtheleighder: Wow. Amanda Otterman RN: And at the time I was still working frontline nursing. ⁓ Then as I started to get into my early 40s, late 30s, early 40s, ⁓ the symptoms of perimenopause really started to kick in. You know, the sleep disruption was incredible. The fatigue. ⁓ I really started to notice that I wasn't getting through my workouts anymore. ⁓ That exercise. Leigh/@followtheleighder: Mm. Amanda Otterman RN: and tolerance is what they call it. ⁓ And then the weight gain. And I kept saying, maybe it was like that COVID period where we were all locked up and like everyone was drinking wine every night and take out. But I'm like, well, maybe that did contribute to some of it. I mean, it was like, but it was so rapid because I didn't really change a whole lot of what was going on like around me. So I like, I still Leigh/@followtheleighder: Right. Amanda Otterman RN: ate fairly well, I still tried to get workouts in, but it just progressively got worse ⁓ after like age 42. And it was also the COVID period where I started to burn out clinically, right? ⁓ As a nurse, everybody knows the medical community was just taxed during that time and I needed to walk away. And I'm like, you know, I really want to kind of go into like the fitness space and you know, see what that can do for me. So I did a bit of a job shift, took a nursing position, like in a private industry, but at the same time, I went and did my certified personal training just to see where it goes. ⁓ So I became a fitness trainer and a personal trainer. I work at a fantastic like boutique gym and like have one-to-one clients. And while I was doing this, my own health started to kind of like shift again with perimenopause, although I wasn't really sure if it was related to that, but now I look back, I'm like, yes it is. ⁓ But I realized a lot of the clientele that I was working with, started to talk about some of the things that they're going through as far as like some menopause symptoms and like all the hot flashes and this and that and the waking and they don't know where it's coming from and all of the things. And I started to kind of poke around and see what kind of ⁓ things I could find out about menopause and how it affects us and what's really going on with our bodies in our 40s and I know I had seen a few things online about people talking about perimenopause and all of that. And I'm like, I just of want to look into it because I think it was, you know, the early 2020s is when it really kind of 2020 is kind of when it really started to surface even online a little bit about menopause. So I dove in and started reading and looking at some research and the websites and I'm like, ⁓ wow, this is a real thing. And then started to like put the pieces together for me. And I'm like, okay, like this is what I've been living for the last 10 years. And like, and I'm like, there's gotta be a way to like support my clients better. So really it came from a place of wanting to just have the information to support my clients. And I found a awesome menopause specialist ⁓ certification program that actually was designed for medical professionals who also may be working in the fitness space or in a wellness space. And the two came together so nicely. So I took that, got my certification, and then ever since then it was like, it took off from there. So I started to use that information with my clients. It started to kind of get out a little bit. I started to be more present online with it. ⁓ And then all of a sudden I have health teams in my region calling me, Hey, do you mind doing like a little workshop on perimenopause? And then I did one and then two, three, and then it turned into 10 and then it turned into, you do virtuals? And like, now it's like exploded and you know, like my own community is like, yeah, we need you to like, they're booking in workshops and then they're telling their other service providers, Hey, we have someone here that does these. Leigh/@followtheleighder: Wow. Amanda Otterman RN: So now I'm doing workshops for the Toronto area, ⁓ which is huge. So it just kind of exploded in the last, I'd say, little over a year and half, ⁓ where people are really craving that education. So that's sort of where mental health nurse came in and became, you know, was born. And it really stemmed from just people wanting that education and wanting... Leigh/@followtheleighder: Yeah. Amanda Otterman RN: you know, the information so that they know what's happening with their body so that they can go to their doctors and talk to their doctors about it. Because at the end of the day, most women are still getting pretty dismissed by their healthcare practitioners, right? So yeah, that's sort of in a nutshell where it all began. Leigh/@followtheleighder: Mm-hmm. Yes. Well, and I, I mean, like you said from the very start, you didn't know what you were getting into. Like, you. And, ⁓ Amanda Otterman RN: No. And I don't know about you, but your mom never talked to me about menopause. Leigh/@followtheleighder: I mean, that was significant. No, I mean, I well my mom does menopause now but like, yeah, the schools don't keep you don't know about menopause. That's just not a thing. And Amanda Otterman RN: Never talked about it school. Nothing. Leigh/@followtheleighder: And I mean, so many, almost all women will go through that and have no idea what's coming. And the thing about hormones as we know, I mean, that's what changes us. mean, those are fundamentally. there are personality ⁓ I mean, it can change everything getting ⁓ having the right balance or having them imbalanced and ⁓ so can you I want to acknowledge that the pain you went through the loneliness I can just I can I see how that drives you to wanting to educate other women because it I mean, that sounds excruciatingly painful like you said to have the surgery to go through what you did and then Really not feel like you had a lot of support or knowledge going into it. ⁓ Have you heard since sharing your journey? I know that you're getting these professional calls, you're getting folks, you know, like clinics or even podcasters like me who want to hear from you. Are you hearing similar stories as you've been sharing your message? And what are those like? Amanda Otterman RN: Uh-uh. 100%. I have to say every time I do either a virtual workshop or I'm doing an in-person workshop, there's got to be at least two or three women who raised their hands and said, you know, I've had a hysterectomy and I've been feeling this and I had no idea that this is what it was. Even though they kept their ovaries, right? We know that hysterectomies, if they remove the ovaries, yes, you're immediately in menopause. most of the time they're offered HRT and it's that's the education they get but it's these women who don't who have kept their ovaries but have had everything else removed are the ones that are still slipping through the cracks because the notion is well, we've left your ovaries you should still go You should go through menopause, know naturally still around this bright eight around, you know age 52 as expected But now we're starting to understand that when you remove the large uterine organ and the fallopian tubes and cervix, you're disrupting the blood supply to the ovaries, right? That's all, it all lives together in the pelvis. So how do you not disrupt the blood supply going to the ovary by removing all of that stuff, all that cauterization, all of the scar tissue that forms and stuff? How do you- How are you not disrupting things down there? So it makes a lot of sense that yeah, that we do experience symptoms sometimes right away, sometimes maybe give it a couple of years and you start to experience some symptoms. But at the end of the day, it's still a lot earlier than expected if you're in your 30s and 40s and you have a partial hysterectomy, right? Leigh/@followtheleighder: Yeah, no, absolutely. And I have noticed, I know this isn't directly your specialty, but that how naming ⁓ medical conditions is huge for research, it's huge for funding, it's also huge for asking the right questions and research, getting the right treatment. And we saw this this past week or two with the PCOS being renamed. Can you talk about what its renaming is and what that means? Amanda Otterman RN: Yes. Yeah, so the renaming now is PMOS. ⁓ previously it was polycystic ovarian syndrome. Now it's ⁓ poly ovarian metabolic ovarian syndrome. it really ⁓ does... make a big difference on how we view that condition now. ⁓ Because we knew that women who, when it was previously labeled PCOS, we knew that women were having systemic issues with it. So the name polycystic ovarian syndrome makes it sound like it's a condition that's just isolated to the ovaries and the reproductive system. But when you really look at how it affects the woman, we knew that all of these androgens running around in her body at higher levels than they're supposed to was causing facial hair. We knew it was causing voice deepening. We knew it was causing insulin resistance. We knew it was causing uncontrollable weight gain or resistance to losing weight. We knew that women with severe PCOS, had even like a different type of body shape, right? They had more of an upper body, know, metabolic syndrome type body shape. We knew that they were more susceptible to cardiovascular disease and type 2 diabetes because of this hormone ⁓ imbalance. So now with that new name being poly ovarian metabolic. syndrome I think is the right term I'm have to look at again, PMOS, ⁓ it ⁓ really does now ⁓ highlight that and gives recognition that this is actually a whole body systemic problem. And by recognizing that, now we can actually address how these women are assessed. how they're treated and the treatment options available to them and hopefully opens the door for better research and better care down the road. Leigh/@followtheleighder: Thank you for that and for taking the time. We haven't talked about that yet on this podcast and I really appreciate because like you said, ⁓ it's all connected. Can you talk about the treatment options? Amanda Otterman RN: it is. Leigh/@followtheleighder: that you can revisit that that you had or that you did in your time, but also the differences now. What have you learned and what are you also adding when you message this to the online world? Amanda Otterman RN: Yeah. Are we talking more like menopause, menopause, insomnia, or hysterectomy? Right. Yeah, sure. So when I was going through, when I had my hysterectomy, I wasn't offered anything. And I wasn't offered anything based on the premise that I had my ovaries and that my ovaries were still going to work properly and give me the hormones that I needed as a young woman in her 30s. Leigh/@followtheleighder: Yeah, yeah, more menopause. Like what was available for you like when you went through and then what have you learned? Amanda Otterman RN: ⁓ and that there shouldn't be any hormonal issues. ⁓ So I was offered zero. And as I went to ⁓ naturopathic doctors and my own doctors and gynecologists, you know, I would go with my symptoms. And the only thing that I was being offered was an antidepressant ⁓ and maybe some oxybutynin for the bladder spasms. That was it. no one really even bothered to bring up any type of, you know, investigation on whether it could be hormonal at all. So I wasn't offered a thing. ⁓ when I started to educate myself, I started to realize that this is a hormonal thing. And I was actually even starting to get hot flashes and I was in my late thirties. So I'm like, this is. this feels like menopause, you know, and I'm like, as I'm soaking up the information and learning about it, I'm like, I need to talk to my doctor about this. And my doctor kind of blew me off a couple of times about HRTs, how many HRTs like causes cancer and all of this stuff. And at that point, I really hadn't honed in on the WHI study and the new information that's out, which I'm very well aware of now that that's all changed. But it wasn't until I was 44. So I'm 46 on Saturday actually this week. But when I was about 44 was when I decided that I really needed to put my foot down and start looking at getting some treatment because I was really struggling with symptoms. It took a couple of doctor visits, but I finally was able to be like, hey, I need something. I'm having hot flashes. It's affecting my sleep. ⁓ know, my mood is affected. I brain fog, like there's all kinds of stuff happening. And at first my doctor was like, well, you're too young for perimenopause. And I said, well, not when I've had a hysterectomy, you know, more than 10 years ago. And he had actually even sort of forgot that I had had that hysterectomy. I had to remind him. that I had had this hysterectomy. He said, well, if you got hot flashes or whatever, I'll give you something for it. And initially he tried to give me a very old version of hormone replacement therapy, which I am thankful that I was educated enough to know that that was not really appropriate for me. So he did switch that. Leigh/@followtheleighder: Wow. Amanda Otterman RN: for me to something that was more appropriate and more body identical that would be tolerated better. And I've been on that for the last two and a half years. And then I did have to go back to him to try and get some vaginal estrogen because I knew, A, I mean, I'm a firm believer that any woman over 40 just needs to start using it anyways. It's gonna protect your... urinary tract, it's going to protect your vagina. It's going to be like, I feel that that's just not even something that needs a prescription, but that's my opinion. but I had to go back to him to get some vaginal estrogen cream and he's like, Nope, you have to come off of your systemic before I give you that. And I'm like, that makes no sense. This is very low dose. It doesn't go systemic in the body, at least not the cream. There's other formulations that have more system. systemic effects like the fem ring. ⁓ But the cream does not. ⁓ And my systemic estrogen wasn't doing enough to deal with the pelvic system, the pelvic symptoms. So that was a fight. ⁓ He would not give me the prescription for it. Even though I, you know, we know that we can do both. ⁓ And I ended up having to go to a private provider. in Canada ⁓ to get a vaginal estrogen ⁓ formulation. ⁓ Leigh/@followtheleighder: No. That is so many obstacles. And again, you're doing this as someone who's trained in it. Like you're an RN, but you know this layout and you are still just having such a struggle. again, you know the language. Amanda Otterman RN: way. Yeah. I know how to navigate the system, but like the system itself was even working against me. So a lot of gatekeeping. Leigh/@followtheleighder: Mm hmm. Yeah, and that's, and that's powerful to learn. And it's also very motivating and inspiring as to why you need to be out there. Because I mean, there are people ⁓ either just apathetic, or just willingly neglectful. I mean, there is that I that just don't care. And it's Amanda Otterman RN: or they're really suffering and they don't even really know where to go. Right. I'm meeting. ⁓ yeah. On medical side. ⁓ for sure. The medical side is there's so much gatekeeping on the medical side. ⁓ There's so many medical providers that are not caught up to the current research. ⁓ The ones that are close to retirement, they just don't care. They're, as you said, they're apathetic. Leigh/@followtheleighder: ⁓ that, yeah, I meant from the medical side, but yes, yeah, the patient side. Amanda Otterman RN: ⁓ and there's the whole medical misogyny still exists too. you know, a lot of women are just seen as whining. ⁓ you know, still being told it's part of aging. ⁓ I had a client that I work with, ⁓ her doctor before he retired, she tried to get even just like vaginal estrogen and her physician said to her, well, I can't help you out with that because they don't make Viagra for women. Leigh/@followtheleighder: Wow. Amanda Otterman RN: Yeah. Yeah, he said. Yeah. Leigh/@followtheleighder: What? that's a see and that's danger. I mean, that is a weird. Yeah, that it's insulting how how ignorant, neglectful and dismissive it is. Amanda Otterman RN: Yeah. Yeah. And, you know, she was really struggling with painful insertion and, you know, dryness and, you know, she didn't want to be intimate with her husband because it was going to hurt. And he was just like, well, you know, just have a glass of wine and put up with it because they don't make Viagra for women. Yikes. Leigh/@followtheleighder: Right? Mm hmm. Well, like, what so in terms of options, when someone starts this journey, ⁓ there is so much misinformation out there. And then there's also there's also valid concern. So there's a particularly when we look at the quote, Western medication, and then also looking at homeopathic more natural. Talk about like, how you have walked through this journey. I know that you talk a lot about your personal ⁓ fitness, how exercise is important. Talk about what options women might have when they start their menopause journey. Amanda Otterman RN: Absolutely. There's so many options, but it's always gonna boil down to like basics. So if you feel like you wanna go the route of hormone replacement therapy, if it is appropriate for you, there are a small subsect of women who it's not appropriate for. If you've had a... a history yourself of breast cancer. So not necessarily a family history. That doesn't necessarily exclude you anymore. It's just your own personal history of either breast or ovarian cancer. ⁓ If you have like active cardiovascular disease, untreated high blood pressure, liver issues, ⁓ or like if you think you're pregnant, which for most people in menopause, that's not an issue. but like, there's like that small subsect of women that it's not appropriate for. The majority of women are decent candidates for HRT, especially within the first 10 years of the last menstrual period. So in the peri-menopausal period, and then that first 10 years after you've stopped having your period, that is like the best time to start HRT. So definitely getting up to speed with that, getting some education around that. Leigh/@followtheleighder: Okay. Amanda Otterman RN: There's still a lot of fear around cancer risk ⁓ with HRT. A lot of that has been debunked. ⁓ We know that women who've had hysterectomies don't need progesterone. If you don't have a uterus, you really don't need progesterone. And those studies actually indicate that estrogen alone therapy decreases that cancer risk by 22%. ⁓ If you do have a uterus though, you must be on a progesterone to protect the uterine lining. ⁓ That being said, know, HRT is one modality, especially if you have symptoms that you're really struggling with. ⁓ Does HRT cure all the symptoms? No. ⁓ It is definitely supportive with some other symptoms too. So a lot of women, you know, talk about the weight gain and all of that. It doesn't help you lose weight, but it helps your body manage the symptoms so that you actually can do the workout. So it helps with that fatigue because it's going to help your sleep, right? If you're exhausted, you're not going to work out. But if you're on HRT and your sleep is improving, then you're going to have the energy to actually do that workout, right? So it's kind of like... Leigh/@followtheleighder: Okay. Amanda Otterman RN: complementary for some symptoms and actually helps treat others. ⁓ So you always want to though combine your hormone replacement therapy with lifestyle changes as well. So you want to be looking at what's my nutrition like right now. You want to be making adjustments in your nutrition. Our nutritional needs change as we go into perimenopause. ⁓ We often require more protein, more fiber. ⁓ And a lot of women tend to lower the amount of calories that they're eating because they're afraid of the weight gain. When in reality, they should actually be eating to keep up their metabolism and their muscle mass so that they are actually able to lose the weight, right? So the body doesn't go into that starvation mode or stress mode where it hangs on to fat. So it sounds counterintuitive, but you actually Leigh/@followtheleighder: Right. Amanda Otterman RN: probably should be eating more in perimenopause, just more of the right macronutrients, right? Focusing on protein and fiber. ⁓ You definitely want to be moving your body. ⁓ And for some women, this is when they just pick up weights for the very first time. ⁓ You know, they may have been avid runners or walkers, swimmers, ⁓ but never really picked up strength training. ⁓ All of that other stuff is fantastic. It's great for heart health, great for ⁓ our bodies in general to walk, run, whatever, whatever cardio you were doing. But strength training is what is going to help you maintain that muscle mass and bone mass, which are two things that we lose with aging. going into menopause, just, that just accelerates because the estrogen has left the building. ⁓ And estrogen we know helps to rebuild bone tissue. So if we don't have that on board and we're not strength training to help build that bone and muscle mass, we're going to lose that and be more at risk for things like osteoporosis. ⁓ So we want to look at movement, intentional movement, intentional type of strength training. Really, you only need two to three times a week. That's perfect. ⁓ You want to look at stress reduction, ⁓ ways to... manage that stress throughout your day, know, making sure that you're adding in things that bring you joy. Definitely you want to look at your sleep. What's your sleep routine like? ⁓ That might need some adjustments so that you are getting seven hours of sleep at night, that you are prioritizing sleep hygiene, ⁓ and that you have conditions around you that is going to help with sleep quality. And those are sort of the major lifestyle factors we look at. Of course, there's other things that can come up, right? There could be relationship issues that change that might need attention. Mental health might get in the way that might need some attention. Even from a spiritual context, I you understand those pieces. So that changes for some people. Some women even experience... re-traumatization in menopause, just with that hormonal shift, ⁓ and sort of try to work through those types of things too. So there's other factors that tend to come up. We are the sandwich generation. So we have like kids that are, know, teenagers, young adults still in the house driving you crazy, and then you've got aging parents on the other side of the spectrum. So like, ⁓ it's definitely a... a very involved time, both externally and internally, and just being able to manage all of those things. So ⁓ I really do ⁓ teach the importance of self-care during this time. ⁓ And then, of course, if you choose not to do hormone replacement therapy and maybe go more of a natural route, ⁓ Leigh/@followtheleighder: Nice. Amanda Otterman RN: working maybe with a natural path, homeopathic therapies. I mean, I'll tell you right now, there's some fantastic natural path doctors out there that really do understand menopause and actually are menopause certified through the Menopause Society. ⁓ They can help you from those aspects ⁓ as far as symptom management. But these other things that I'm talking about, the stress management, the sleep, all of that. that all still needs to be addressed, whether you choose to do HRT or not, and probably need to be even more emphasized if you are going to not choose to use HRT, really focusing on those lifestyle changes. Leigh/@followtheleighder: Mm-hmm. Absolutely. And you know, it's so in you know, people, particularly women, here strength training and they think bulk and they think, you know, and that's not really what you're talking about. You're literally shh. It's so hard. Yes. And Amanda Otterman RN: Yeah, we can't do that anyways. Like all these women train, like women who are bulked up that are doing all this heavy lifting, a lot of them are on like massive amounts of like peptides and some of them even take steroids and like our bodies naturally just can't bulk up like that. You have to be working out like three hours a day, six days a week and eating so Leigh/@followtheleighder: Yeah. Amanda Otterman RN: much food, like literally eating what I would probably eat in three days if they're eating in a day, right? We just can't do it. Our bodies can't do it. Leigh/@followtheleighder: Mm-hmm. No, no. I it's, like you said, there's whatever path you go, there are just things that you need to address. And things that are in your control, too, is what I'm hearing. And things that should empower you to support your own health. I want to kind of shift into ⁓ you writing your book, talk about the ⁓ Amanda Otterman RN: Yes. Yes. Leigh/@followtheleighder: Quote four dummies book series people coming and talking to you I know you said you started to build a name for yourself with local clinics and medical ⁓ Communities, what is this book series been like that or this book writing? What has that been like? Amanda Otterman RN: It was actually a surprise. ⁓ I was actually approached by Wiley to write it. ⁓ And I guess they had some editors that have been following me for a while. ⁓ And we know what the Four Dummies series is like, right? They really cater to people who just want the basics information. don't need all of the lingo and... Leigh/@followtheleighder: Wow. Amanda Otterman RN: They want the reading material to be picked up and the person who's never heard about it can read it and understand it. And that's how I teach. That's how I teach online. That's how I teach like when I do workshops and work with one-to-one with clients, just meeting people where they're at. ⁓ And in writing menopause for dummies, I feel like There really isn't anything out there like that. ⁓ I have read so many books about menopause and estrogen and like, and for me, they're great because I understand the material, but I could never take that book and give it to my 60 something year old mother and her underste- a lot of it, right? Even some of the ones that are more popular out there, I've read them. Leigh/@followtheleighder: Right. Amanda Otterman RN: And it's like, this is all great, but there's still a lot of like clinical, really clinical information in there that really is just redundant to the lay person. So my focus on this particular book and the way I'm writing it is to give you all the info, give the reader all the information that they need to feel empowered that they know what's going on with their body. So like, Leigh/@followtheleighder: Right. Amanda Otterman RN: tell them in layman's terms what's happening with your body, ⁓ what your treatment options are, and from both a more traditional standpoint and holistic standpoint, what you need to focus on, what are some warning signs, some tips, ⁓ ways to work through certain things, whether it's symptoms or treatment or side effects or whatever. ⁓ I even have a... Like I'm even probably, I've got a portion in there that might be about GLP-1s, because that's a big thing that's coming up now in the menopause space is the use of GLP-1s ⁓ in menopausal women. ⁓ You know, I'm going to talk about nutrition in a simple way. You know, there's going to be no rules about nutrition in there. Just, you know, these are the basics that you need to understand. ⁓ Same with fitness. These are some basic things that you need to understand, but also move in a way that feels good. ⁓ And then just some of the other external factors, all the lifestyle factors that I talked about briefly here, sleep and stress reduction. ⁓ But there's even going to be, and I really made this clear when I did my author proposal. Leigh/@followtheleighder: Mm-hmm. Amanda Otterman RN: was that I wanted to have a section in there that the woman can take the book and give it to her husband and say, read this chapter. Partners can understand how to support their partner going through metaphors because Leigh/@followtheleighder: right. Mm-hmm. Or even, yeah, sorry. I was just thinking, you could start a study group on it. You could start a little book club and do that. Amanda Otterman RN: Okay. Yeah, exactly. Right. The the statistics for relationships breaking down at this point in life is very high. So, you know, and a lot of it is probably misunderstanding, you know, she's just not putting up with things anymore. She's tired. She's ragey, you know, he's probably going through his own little midlife crisis and like, communication breaks down. So it's very Leigh/@followtheleighder: Yeah, that too. Mm-hmm. Amanda Otterman RN: Um, it was really important for me to have that piece, you know, in there somewhere as well, so that both people feel supported having this book there, right? It's not going to be just about her, but also like, you know, hey, honey, I want you to read this chapter. Um, yeah. So those are basically the elements that, that are going to be in there. And like I said, it's. Leigh/@followtheleighder: Yeah. ⁓ Amanda Otterman RN: It's going to be designed for an easy read and, you know, help women, you know, pick it up and go to any chapter. you know, if she's struggling with that one day, she can pick it up almost like a manual. It'd be like a menopause manual. Yeah. Leigh/@followtheleighder: Right. Right. I'm so excited for you. That is excellent news. There's so many. I, you know, you're absolutely right. The relationship shift, because as we stated, mean, hormones are everything and you're a different, you evolve, you change. like you said, ⁓ a woman has changed. She's not gonna put up with the same stuff that she used to. That could be at work, that could be at home, that could be with her kids. Like, I know I've heard it, you know. Amanda Otterman RN: Thank you. Leigh/@followtheleighder: the last few years of some of my friends whose moms were kind of one of the more helpful, like, oh, I'll be there for you, you know, I'll do everything for you kind of, and then went through menopause and you're on your own. I'm in Rome. I'm on a cruise now, like, bye. Amanda Otterman RN: You're on the phone. Yeah, I'm not doing that. that priority shift and you you get up one morning, you just like, don't feel like doing that today. Like, wow, I'm not doing it. ⁓ Leigh/@followtheleighder: Yeah. And thank God for it. there are so many, I would love to have you back to do a deeper dive on like even like the history of menopause information, what we've known over time, not only in the quote, you know, Western United States, Canada, but just what did other cultures do? You know, menopause isn't new to 2026. Amanda Otterman RN: And even what we still do, There's so many, menopause affects so many different cultures differently. For example, I come from a Caribbean background. We don't talk about it. We don't talk about it. We just go through it. You might see your aunt in the corner going like this, that she's hot, but she's not gonna tell you that it's hot flashes or menopause, because she probably doesn't even know what's going on either. We know that. Leigh/@followtheleighder: Mm. Amanda Otterman RN: know, blacks and African Americans don't seek treatment because of history of, you know, medical racism and all of that, right? So, and then we know that women in Japan, like, openly, lovingly, like, celebrate it. ⁓ And they have a completely different experience with menopause. And guess what? Their symptoms are like almost nil. ⁓ Even though they experience more osteoporosis. because of the lack of calcium in their diets, but they have a high soy diet. So their symptoms are not as bad. And it lasts a lot less time than, say, the Black woman, who's like 10 years, and the Japanese woman's like two to three. So it's very different for so many different cultures, different around the world, how they perceive it, what it's like, for some it's taboo, for some it's celebrated. Leigh/@followtheleighder: Wow. Mm-hmm. Amanda Otterman RN: You know, we know whales go through it. ⁓ I think there's only four species in the world that actually go through menopause. ⁓ Humans and whales, think elephants is another one, but yeah, it's wild. There's just so much more that you can discuss about menopause and so many different... Leigh/@followtheleighder: Wow. Yeah. Amanda Otterman RN: It's a topic that you probably could have me here for three hours and we wouldn't be done. Yeah. Leigh/@followtheleighder: ⁓ yeah. ⁓ no, I would love, yeah, please come back. ⁓ But in the meantime, can you tell folks how they can follow you and where they can learn more about you? Amanda Otterman RN: up smooth. Absolutely. So ⁓ my primary presence is on Instagram. ⁓ So you can find me on Instagram at Menno Health Nurse, M-E-N-O Health, H-E-A-L-T-H Nurse. It's all one word. So you can find me there and follow. ⁓ And then from there, I have a link tree ⁓ that is set up to explore my website. ⁓ That's where I've got lots of free downloads that anyone can just go in, download information. I've got some menopause guides in there, some nutrition guides in there. ⁓ I'm always refreshing those guides, so there's always something new in there to pull from. You can also take a look at my coaching packages and workshops and stuff. If I've got anything going on, sometimes I do have virtual ones that are happening that you can join. And then I also have a sub stack. So I think the link to my sub stack is also in my link tree. You can click on that and read some blog posts that I put in there once in a while. Just some information. Again, I do a lot of that education piece. A lot of it is available for free. And I just think that's the way to do it in a lot of ways. Leigh/@followtheleighder: Yeah. Amanda Otterman RN: to offer that type of education for just the woman that's snooping around and looking and just looking for somewhere to start. ⁓ So definitely you can follow me there and then you can check out my website from there and there's stuff to download. Leigh/@followtheleighder: Yeah. Well, you are just an angel providing a public good and service. Thank you so much ⁓ for all that you have done. I know that you have certainly suffered and been ⁓ lost or alone in this. And ⁓ thank you for doing the work that you needed to do to heal yourself so that you can continue being a healer for others. know, that is. Amanda Otterman RN: Bye. Leigh/@followtheleighder: that it's vital. And earlier you mentioned it was your birthday. So happy birthday a few days ago. We were kind of deep in the conversation, so I didn't want to derail it, but happy birthday. Amanda Otterman RN: Yeah, yeah. Perfectly cute. Saturday, so it's on its coming. Leigh/@followtheleighder: Well, Amanda, thank you for giving me your time. do hope, like I said, that you come back. And to my listeners, ⁓ now that you know that you might be coming back, please drop your comments and questions for this particular video so that we can roll those into the next conversation. Yeah, that'd so... Yeah, so for sure, it'd be fun. Yeah. Amanda Otterman RN: Thank you so much. you Yeah, yeah, I look forward to that. That would be great to answer some questions. Yeah. Leigh/@followtheleighder: Well, and folks, don't forget to like, follow, subscribe. You know the drill. This has been another episode of Follow the Leader. I'm your host, Leigh Larson, and until next time, see ya. Amanda Otterman RN: Bye.