Latest / Empower Your Menopause / Episode 76: Not just anxiety. PMDD, Perimenopause & Self-Advocacy with Veronica Kirin

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Episode 76: Not just anxiety. PMDD, Perimenopause & Self-Advocacy with Veronica Kirin · Empower Your Menopause

• 0:13
  SPEAKER_00: Hello and welcome back to Empower Your Menopause, the first episode of the New Year 2026.
• 0:19
  SPEAKER_00: This is a podcast all about health, happiness, and hormones for women, 40 and beyond.
• 0:24
  SPEAKER_00: I'm Coach James Ellis.
• 0:26
  SPEAKER_02: And I'm Coach Julie Medacy.
• 0:28
  SPEAKER_00: And together we are fabulous Beyond 40, and we're glad to have you with us today.
• 0:33
  SPEAKER_00: We've got a special guest.
• 0:35
  SPEAKER_00: You know, sometimes you meet someone within five minutes, you know, two things.
• 0:39
  SPEAKER_00: One, that they're incredibly, incredibly brilliant at what they do, and two, you've definitely not booked enough time to speak to them.
• 0:46
  SPEAKER_00: That's what happened when somebody in our network connected us with today's guest, Veronica Kierin.
• 0:51
  SPEAKER_00: Now, Veronica is an award-winning anthropologist, writer, speaker, and coach.
• 0:56
  SPEAKER_00: She specialises in how humans cope with big shifts, and that includes a fun little trio no woman ever asks for, which is stress, laid with perimenopause and laid with a condition called PMDD or premenstrual dysphoric disorder.
• 1:10
  SPEAKER_00: So today we're going to unpack a little bit what that overlap can look like in real life, why it can feel so intense, and how to advocate for yourself when you feel as though you're not being heard, including how to switch clinicians without any guilt spiral.
• 1:25
  SPEAKER_00: Now, as always, this is educational, not medical advocate advice.
• 1:28
  SPEAKER_00: So if anything lands for you, maybe use it as a starting point for a conversation with your clinician.
• 1:33
  SPEAKER_00: But for now, let's bring Veronica in.
• 1:38
  SPEAKER_02: Yay, Veronica.
• 1:39
  SPEAKER_02: We're so glad that you're here.
• 1:43
  SPEAKER_02: Start us off with the headlines.
• 1:44
  SPEAKER_02: Like for people who aren't familiar with you, who are you?
• 1:47
  SPEAKER_02: What do you do?
• 1:48
  SPEAKER_02: What brought you into this particular corner of women's health and advocacy?
• 1:52
  SPEAKER_02: You got a lot to say, I know.
• 1:55
  SPEAKER_01: Oh, yeah.
• 1:56
  SPEAKER_01: Yeah, you're gonna have a hard time shutting me up.
• 1:58
  SPEAKER_01: Um, well, thanks for having me here.
• 2:01
  SPEAKER_01: I'm I'm yeah, I'm super passionate about this topic, obviously.
• 2:05
  SPEAKER_01: Um, so I personally have three female non-reproductive health disorders, which means they are either exclusively female or female biased, which also means that my healthcare is kind of shit.
• 2:15
  SPEAKER_01: And I didn't understand why.
• 2:16
  SPEAKER_01: I was living in the United States most of my life, and so I just figured that's why.
• 2:20
  SPEAKER_01: That must be it.
• 2:21
  SPEAKER_01: But when I moved to Germany, which is the original country that created universal healthcare, I all of a sudden had way more access to healthcare, which I thought was the problem.
• 2:33
  SPEAKER_01: Turns out it's not.
• 2:34
  SPEAKER_01: The problem is an enormous data gap, which is where I started to rabbit hole.
• 2:40
  SPEAKER_01: So when I get curious, I want to learn more, I start to find out these truths and go, oh my God, what do I do about it?
• 2:48
  SPEAKER_01: I'm a firm believer that um anger should be used as fuel.
• 2:53
  SPEAKER_01: Anger is a positive emotion that teaches us when an injustice is being done to us or around us.
• 2:58
  SPEAKER_01: Um, and if we hold it in, it hurts us.
• 3:01
  SPEAKER_01: And so I said, okay, what can I do?
• 3:03
  SPEAKER_01: Well, I am a serial entrepreneur, so I know how to start businesses.
• 3:07
  SPEAKER_01: And I like businesses because social enterprise kind of is a way to manipulate capitalism to be better, or at least that's the idea.
• 3:19
  SPEAKER_01: So I started Asterisk Women's Health in order to really work with clinicians and researchers to close the data gap.
• 3:27
  SPEAKER_01: In the meantime, I also launched Anodyne magazine, which publishes art and literature in all formats in order to advocate for the reality that people are living in.
• 3:41
  SPEAKER_01: So Anodyne is the is the true lived experience, the emotional center to which Asterisk pivots in order to take action in the medical sphere.
• 3:54
  SPEAKER_01: Um and so yeah, we've been both of those going for two years.
• 3:59
  SPEAKER_01: Because why start one business?
• 4:02
  SPEAKER_01: Um and and going well, yeah.
• 4:05
  SPEAKER_00: A woman after my own heart.
• 4:07
  SPEAKER_00: Tell us a little bit, if you if you don't mind, about the three female specific conditions that you discovered you have, and how did that affect your life?
• 4:19
  SPEAKER_00: And how did that make you, I guess, drive you down that particular rabbit hole even further?
• 4:25
  SPEAKER_01: Well, one of them doesn't have a name, because that's women's health.
• 4:30
  SPEAKER_01: So I can I can tell you definitively that when I don't eat gluten, I have a normal menstrual cycle.
• 4:38
  SPEAKER_01: When I do eat gluten, it's all kinds of crazy.
• 4:41
  SPEAKER_01: And it's been like that all my life.
• 4:43
  SPEAKER_01: To which point I was slept on birth control when I was 12 because that is the band-aid, right?
• 4:47
  SPEAKER_01: We hear over and over again perimenopause, birth control.
• 4:51
  SPEAKER_01: We have you have a weird cycle, we don't understand it.
• 4:53
  SPEAKER_01: We're not gonna look into it because you're not trying to get pregnant.
• 4:56
  SPEAKER_01: So birth control, like it just they send you down that rabbit hole.
• 5:00
  SPEAKER_01: Um, and so every doctor I've met says, I don't know, when it comes to that.
• 5:06
  SPEAKER_01: Some of them will say, even women will say that's not possible.
• 5:10
  SPEAKER_01: But obviously it is because I've proven it in my own body.
• 5:14
  SPEAKER_01: Um, I also have um premenstrual dysphoric disorder, which means that there is a receptor that's kind of weird in my brain.
• 5:24
  SPEAKER_01: So instead of just typical PMS, which is already a challenge that is valid, um, you see a dip in serotonin um as well as other physiological traits that happen during PMS.
• 5:36
  SPEAKER_01: Um, with PMDD, your serotonin actually just completely goes away, which comes with lots of other fun symptoms, which includes suicidal ideation, deep depression, anxiety, anger, frustration.
• 5:51
  SPEAKER_01: Um, I basically say that during my symptomatic phase, um, which I am actually symptomatic right now, managed, but um, this is my symptomatic phase.
• 6:01
  SPEAKER_01: Um, so the two weeks before I menstruate, um, I say when I'm symptomatic, my ability to cope in general goes down.
• 6:11
  SPEAKER_01: Um so that of course expresses itself in many ways.
• 6:17
  SPEAKER_01: And when I was younger and didn't understand it, because even though as many women as have diabetes have PMDD, um, basically no one talks about it, nobody researches it.
• 6:29
  SPEAKER_01: Um because it's female specific.
• 6:31
  SPEAKER_01: So I didn't understand what was happening to me when I was younger, and it led directly to my first burnout because I had no coping skills because I didn't know what was happening.
• 6:40
  SPEAKER_01: It took me going to my therapist and saying, I think I'm bipolar, which is common.
• 6:45
  SPEAKER_01: That's common misdiagnosis for PMDD, for her to say, I think, I think your symptoms follow your cycle, don't they?
• 6:56
  SPEAKER_01: How did she notice that?
• 6:57
  SPEAKER_01: And I didn't, I don't know, but that's how I got diagnosed.
• 7:00
  SPEAKER_01: Thank God.
• 7:01
  SPEAKER_01: Um, and since we're here to talk also about being over 40 and being perimetapausal and menopausal, PMDD has a good and a bad side.
• 7:11
  SPEAKER_01: The awesome thing is that it ends because when you stop menstruating after uh menopause, it's over.
• 7:19
  SPEAKER_01: The bad thing is it get it gets worse as you go into perimetapause because your cycle starts to sputter like a car.
• 7:27
  SPEAKER_01: And so then you have no idea when you're going to be symptomatic.
• 7:30
  SPEAKER_01: And so it does.
• 7:31
  SPEAKER_01: Um when I was in my 20s, uh my symptom out my symptom phase was like three to five days, and now it's a full two weeks.
• 7:37
  SPEAKER_01: So exciting.
• 7:38
  SPEAKER_01: And then, yeah, perimenopause, of course, female specific.
• 7:42
  SPEAKER_01: Um, I guess you wouldn't call it a disorder, but it is a condition.
• 7:45
  SPEAKER_00: Sure.
• 7:45
  SPEAKER_01: Um, and we're there.
• 7:47
  SPEAKER_00: So yay! Yeah, so basically then the changing hormones of perimenopause are making it harder for you to recognize, control, and manage the symptoms of the PMDD.
• 8:00
  SPEAKER_00: Am I getting that right?
• 8:02
  SPEAKER_01: A thousand percent, yes.
• 8:03
  SPEAKER_01: Yes, yeah.
• 8:04
  SPEAKER_01: It's longer and it's and it's um worse.
• 8:08
  unknown: Yeah, yeah.
• 8:10
  SPEAKER_01: And I laugh because that's all that's my choice, right?
• 8:13
  SPEAKER_01: Like I so I don't have a choice.
• 8:16
  SPEAKER_01: Um something that Julie and I touched base on previously is that my background is actually in anthropology and I study paradigm shifts.
• 8:24
  SPEAKER_01: I study how change works.
• 8:25
  SPEAKER_01: And so I don't I don't have a choice when my cycle is changing and when my conditions are changing.
• 8:32
  SPEAKER_01: What I do have is agency, and my agency says I can laugh.
• 8:36
  SPEAKER_01: And so I'm just gonna laugh.
• 8:38
  SPEAKER_02: It's like what else can I do?
• 8:40
  SPEAKER_02: I love it.
• 8:41
  SPEAKER_02: It's a great attitude, yeah.
• 8:43
  SPEAKER_02: And I I think I think like you were saying, PMDD is probably a lot more common than than we think.
• 8:51
  SPEAKER_02: But so um, because I'd never heard of it until you and I had the conversation.
• 8:58
  SPEAKER_02: Oh, really?
• 8:59
  SPEAKER_02: Oh wow, yeah.
• 9:00
  SPEAKER_01: Yeah, they think it's about as common as diabetes.
• 9:03
  SPEAKER_02: Yeah, yeah.
• 9:04
  SPEAKER_02: And I so I think it, I think it really needs to be talked about, especially because when we start in this phase of life, I mean, like you said, PMS is bad enough.
• 9:12
  SPEAKER_02: But when we start into this phase of life of peramenopause and our bodies are changing, and all of this stuff is in upheaval, if if women don't know that that's an issue for them, right?
• 9:25
  SPEAKER_02: That whole sense of I'm losing my mind, I don't have any control over my body could probably be pretty devastating.
• 9:32
  SPEAKER_02: And so many women are stuck in depressants and you know, yes.
• 9:37
  SPEAKER_01: To be fair, for PMDD, the first line treatment is SSRI because the number one symptom is your serotonin going away.
• 9:47
  SPEAKER_03: Sure.
• 9:47
  SPEAKER_01: So they give you a SSRI to help your brain balance, and I'll tell you, it works.
• 9:52
  SPEAKER_01: Here's a fun thing if you were a researcher, I just I can't imagine not wanting to know more about this.
• 9:57
  SPEAKER_01: It's amazing.
• 9:59
  SPEAKER_01: PMDD is the only condition that we know of that responds to SSRIs within 24 hours.
• 10:06
  SPEAKER_01: I respond within six to eight hours.
• 10:09
  SPEAKER_01: SSRIs typically have to be taken for a month to build up within the body in order to be effective.
• 10:15
  SPEAKER_01: What?
• 10:16
  SPEAKER_01: That's fascinating.
• 10:18
  SPEAKER_01: Wouldn't you want to know more about that if you were a researcher?
• 10:21
  SPEAKER_01: And yet, no, we know.
• 10:22
  SPEAKER_00: Well, well, the thing that interests me, the thing that interests me there is that I was gonna say, surely there's a sort of like big pharma reason for not wanting to investigate PMDD more.
• 10:33
  SPEAKER_00: But the fact that SSRIs can be so effective, surely that is a huge trick to be going, actually, this is something that we can really work on, right?
• 10:44
  SPEAKER_01: Right.
• 10:45
  SPEAKER_01: The problem is, uh, from a clinical standpoint, women are more expensive to research, but they will never say that.
• 10:54
  SPEAKER_01: They're going to say that women are too complicated.
• 10:56
  SPEAKER_01: I literally sat at the FemTech Germany summit at the end of last year and listened to one of the um like the ministers of research of Germany say that we can finally research women's bodies now that we have AI.
• 11:15
  SPEAKER_01: I told I like I took everything inside my body not to jump out of my seat because we sent people to the moon with the basic S computers, and yet you couldn't research people by it's not that we're too complicated, it's that it takes more money because you need a longer cycle of research, right?
• 11:34
  SPEAKER_01: We need months over months in order to see how every single day the cycle affects the research, the medication, the modality, whatever they are looking into.
• 11:44
  SPEAKER_01: And that's why that's the core reason why um women are excluded or um routinely ignored in research.
• 11:53
  SPEAKER_00: So too complicated and too expensive.
• 11:56
  SPEAKER_00: How does that make you feel?
• 12:01
  SPEAKER_01: Like, I don't am I complicated, Julie?
• 12:03
  SPEAKER_01: Are you complicated?
• 12:04
  SPEAKER_01: Oh no.
• 12:05
  SPEAKER_01: I seem to handle it.
• 12:07
  SPEAKER_03: Are you handling it?
• 12:12
  SPEAKER_02: Yeah, it's it's just it's bizarre.
• 12:14
  SPEAKER_02: So, so when you add in, so you've got PMDD, and then you've got the joys of the fluctuations that are happening in paramenopause.
• 12:23
  SPEAKER_02: And if you don't know that either of those things are happening for you, then you add stress on top of it.
• 12:31
  SPEAKER_01: Yes, which is like gas on a fire.
• 12:34
  SPEAKER_02: Yeah.
• 12:36
  SPEAKER_02: A thousand percent.
• 12:37
  SPEAKER_02: It's gotta be just the I I mean, how do you even start counseling women who are who are trying to figure all of this out?
• 12:47
  SPEAKER_02: Is is PMD something that can be easily diagnosed if someone's looking for if the clinician knows to look for it.
• 12:56
  SPEAKER_01: Right.
• 12:57
  SPEAKER_01: Yeah, there's no there's no test besides just tracking your symptoms across a month or two.
• 13:04
  SPEAKER_01: Um there, I think that is a reason why a lot of women don't get diagnosed earlier because, like I said, I had three to five days in my 20s.
• 13:14
  SPEAKER_01: I mean, it looks like PMS, except for I wasn't able to get out of the couch, off the couch, I wasn't able to get out of bed.
• 13:19
  SPEAKER_01: I literally have memories of just working from bed.
• 13:22
  SPEAKER_01: The worst times were where I would have to be texting the I would text, not call the hotline.
• 13:30
  SPEAKER_01: Um and I would wonder why.
• 13:34
  SPEAKER_01: I thought it was good.
• 13:35
  SPEAKER_01: And like just to be clear, like when you're ovulating, the euphoria is real.
• 13:42
  SPEAKER_01: Like you feel fly as fuck.
• 13:44
  SPEAKER_01: I don't know if we can swear, but I'm swearing.
• 13:46
  SPEAKER_01: You feel amazing, you feel shiny.
• 13:49
  SPEAKER_01: It's like a Taylor Swift music video.
• 13:51
  SPEAKER_01: There's glitter everywhere.
• 13:53
  SPEAKER_01: You are bouncing down the street, the red lips, the wings and the eyes, all of it.
• 13:57
  SPEAKER_01: You feel amazing.
• 13:58
  SPEAKER_01: It's so I would get into this mindset like, yeah, I'm finally on top of life.
• 14:03
  SPEAKER_01: I feel like I finally figured it out.
• 14:04
  SPEAKER_01: I feel like I finally got it.
• 14:06
  SPEAKER_01: And then the crash would happen, and I would be so puzzled and so heartbroken because I thought I'd figured out life.
• 14:13
  SPEAKER_01: I thought I'd and it wasn't my fault.
• 14:16
  SPEAKER_01: But so that's that cycling, of course, is heartbreaking.
• 14:20
  SPEAKER_01: But it's only a couple days usually in your 20s, or at least for me it was.
• 14:26
  SPEAKER_01: A lot of women I notice in the perimenopause uh subreddits are starting to figure out they have PMDD because now it's so exacerbated by your hormones getting more extreme.
• 14:40
  SPEAKER_01: Um, you know, even if your cycle isn't on paper changing, your hormones are starting to change.
• 14:48
  SPEAKER_01: Right.
• 14:48
  SPEAKER_01: Um, and so that's when they start to discover it.
• 14:50
  SPEAKER_01: Not to mention that PMDD symptoms also look a lot like ADHD symptoms.
• 14:56
  SPEAKER_01: And in perimenopause, ADHD is exacerbated.
• 14:59
  SPEAKER_00: Yeah, yeah.
• 15:01
  SPEAKER_01: We're having so much fun.
• 15:02
  SPEAKER_00: It's just it's just layer on layer on layer, isn't it?
• 15:05
  SPEAKER_00: Of stuff.
• 15:07
  SPEAKER_00: And I wonder, you I've heard you talk about the trifecta of stress, PMDD, and perimenopause.
• 15:15
  SPEAKER_00: And those three things together.
• 15:17
  SPEAKER_00: Obviously, the PMDD, it sounds like it's PMS on steroids, right?
• 15:23
  SPEAKER_00: You you kind of room for a couple of days a week.
• 15:27
  SPEAKER_01: I yeah, I try not to call it that simply because it is actually a broken receptor in the brain.
• 15:33
  SPEAKER_00: Right, okay.
• 15:34
  SPEAKER_00: But it's most easily but symptomatically, I I suppose is what I'm getting at.
• 15:39
  SPEAKER_00: And then you've got perimenopause, which is throwing everything all over the place because your estrogen's going up, it's coming down, it's going up, it's coming down, and it's then it's variously dropping off.
• 15:49
  SPEAKER_00: And it would seem that within that trifecta, the the one thing that you can probably have the greatest input in would be on stress.
• 15:59
  SPEAKER_00: Would that be right or on or not?
• 16:03
  SPEAKER_01: Um, I'm thinking of like all the mothers uh on this listening to this, all the parents going, like, I don't control my stress.
• 16:12
  SPEAKER_01: Well, exactly, right?
• 16:13
  SPEAKER_01: I mean, you most likely your children are preteens and teens when you are going through perimenopause.
• 16:24
  SPEAKER_01: Just like on averages, stress is not controllable during that time.
• 16:30
  SPEAKER_01: Um, it is it is an important thing to consider.
• 16:33
  SPEAKER_01: Stress is definitely important because um cortisol is another hormone that absolutely can get in the way of the menstrual cycle.
• 16:40
  SPEAKER_01: We know that doctors will say, well, is it stress?
• 16:42
  SPEAKER_01: Is that why your cycle is acting weird?
• 16:44
  SPEAKER_01: And it's an overuse question, but it's not wrong because cortisol does affect your ability to produce the rest of your hormones.
• 16:54
  SPEAKER_01: So um, so it is important to try to manage stress because it will affect your symptoms.
• 17:00
  SPEAKER_01: I mean, absolutely, it's well discussed that PMDD is exacerbated by stress, as is perimenopause.
• 17:07
  SPEAKER_00: Sure.
• 17:07
  SPEAKER_00: But yeah, it's hard to so when you're trying to put, I guess my question is when you're trying to pull a lever to to try and make things more manageable for you, which where where are you trying to which lever are you trying to pull?
• 17:23
  SPEAKER_00: It feels like there's so much going on, right?
• 17:27
  SPEAKER_01: Yeah, yeah.
• 17:29
  SPEAKER_01: Um, so for me at least, and this is just this is based on my journey, everybody is different.
• 17:36
  SPEAKER_01: So for me, what I found worked was first of all, I got a full blood panel because I have the access to do so here in the United States over a decade ago.
• 17:44
  SPEAKER_01: I was offered to do it, it would have cost me$750 out of pocket.
• 17:49
  SPEAKER_01: Today, it probably would be a grand.
• 17:50
  SPEAKER_01: Couldn't afford it.
• 17:51
  SPEAKER_01: Here, thank God, it's just part of the system.
• 17:55
  SPEAKER_01: I got it done.
• 17:56
  SPEAKER_01: Turns out I was deficient in a lot, a lot of vitamins and minerals.
• 18:02
  SPEAKER_01: So once I got those kind of balanced out, I really started to notice a difference in in my symptoms themselves, that they lessened.
• 18:13
  SPEAKER_01: They didn't go away, but they lessened for me.
• 18:15
  SPEAKER_01: It there's research says that there's not a whole lot you can do with vitamins and minerals.
• 18:20
  SPEAKER_01: However, if you are deficient, you will feel worse.
• 18:22
  SPEAKER_01: So I would love for for people to try to do that because it's a a less chemically altering uh approach, and it does you need these things, so you might as well figure it out.
• 18:36
  SPEAKER_01: Um the only vitamin that is clinically proven to help PMDD is calcium.
• 18:42
  SPEAKER_01: So that is always going into my body every single day.
• 18:45
  SPEAKER_01: So you can take calcium if you don't want to take an SSRI, then yes, you can look at your stress.
• 18:50
  SPEAKER_01: That also does help and you know make symptoms a little bit better.
• 18:55
  SPEAKER_01: Um and uh sleep is obviously massively critical for PMDD, for perimetopause, for ADHD, for all of it.
• 19:06
  SPEAKER_01: So um, again, if you've got kids, this is hard.
• 19:09
  SPEAKER_01: But if you can get your sleep hygiene taken care of, at least to some extent, your brain will do better.
• 19:17
  SPEAKER_01: Um progesterone supplementation is a gorgeous sleep aid.
• 19:23
  SPEAKER_01: It's amazing.
• 19:25
  SPEAKER_01: It's also protective against, you know, like um, like if you are estrogen dominant, it does help to protect yourselves from that.
• 19:33
  SPEAKER_01: Um, but it's your progesterone sleep will be the best sleep you get all the time.
• 19:39
  SPEAKER_02: Yeah.
• 19:40
  SPEAKER_02: For sure.
• 19:41
  SPEAKER_02: Well, and it's it's probably, especially for parents, it's probably a good opportunity to educate their their daughters in these things because who knows what they might, you know, they're right in the throes, as James Well knows with twin teenage daughters.
• 19:56
  SPEAKER_02: Um they're right in the throes of the you know, major hormonal switches.
• 20:02
  SPEAKER_02: So it's um yeah, I think it's it's so important to be more knowledgeable and more educated.
• 20:09
  SPEAKER_02: And I and I know you and I discussed that's one of the frustrations about the lack of data and the lack of research in in the area for women, certainly.
• 20:18
  SPEAKER_02: So if somebody wanted to, you know, somebody's listening and they say, Wow, this sounds like me, um what what do you think would be the most useful data points for them to bring into to their clinician?
• 20:34
  SPEAKER_02: Because I know one of the things we want to talk about is how to fire your clinician with grace.
• 20:40
  SPEAKER_02: Yes.
• 20:40
  SPEAKER_02: If it comes to that.
• 20:43
  SPEAKER_01: Yes.
• 20:44
  SPEAKER_01: Um, I mean, it a thousand percent.
• 20:47
  SPEAKER_01: I I wouldn't even say if it comes to that, you're probably going to have to do that many more times than you've ever been told you will.
• 20:53
  SPEAKER_01: Um, I'd say I've I've fired maybe 80% of my practitioners.
• 20:57
  SPEAKER_01: Just because it's it's it's like trying to find um uh the the I I don't even have a good analogy, but yeah, you're not meant to make when you're going on dates, uh that's a good analogy.
• 21:12
  SPEAKER_01: When you go on dates, you're not going to fall in love with every single person you meet.
• 21:15
  SPEAKER_01: They're not right for you.
• 21:17
  SPEAKER_01: So it's okay to let them go.
• 21:19
  SPEAKER_01: Um, I for PMDD specifically, I would be looking at your mood and really try to track it very well.
• 21:26
  SPEAKER_01: There's an app I love out of Harvard called How We Feel.
• 21:30
  SPEAKER_01: It was developed during the pandemic, and it does a really good job of the full emotional spectrum of the human experience.
• 21:37
  SPEAKER_01: Plus, it will provide human, I have to say that these days, human videos of how to deal with certain emotions as you experience them.
• 21:49
  SPEAKER_01: Um so you can check in a few times a day.
• 21:51
  SPEAKER_01: It will eventually give you a graph.
• 21:53
  SPEAKER_01: Um, I really like that app.
• 21:54
  SPEAKER_01: There are PMDD specific apps for tracking absolutely everything.
• 22:00
  SPEAKER_01: For me, they feel overwhelming because they're they're gathering on so many data points that I'm like I I just need to know if I'm if I'm symptomatic at all.
• 22:11
  SPEAKER_01: Um I'm also a bullet journaler.
• 22:14
  SPEAKER_01: So if you like paper, go for it, make yourself a chart and just draw and bring that to your doctor coupled with the latest research because your doctor may not know and they may not they might not get it right away.
• 22:31
  SPEAKER_01: So you need to go.
• 22:31
  SPEAKER_01: This is me, this is the research.
• 22:34
  SPEAKER_01: We're gonna put them together now.
• 22:35
  SPEAKER_01: Help me.
• 22:36
  SPEAKER_01: Yeah, for sure.
• 22:37
  SPEAKER_00: How long would you track your symptoms for before going to see a clinician?
• 22:43
  SPEAKER_00: Then, Veronica.
• 22:44
  SPEAKER_00: Do you have any advice?
• 22:45
  SPEAKER_00: I mean, is it like Yeah.
• 22:48
  SPEAKER_00: A month, a couple of months, three months?
• 22:51
  SPEAKER_01: Thinking like God, I would not ever ask somebody to suffer for a year, right?
• 22:57
  SPEAKER_01: So like before getting help.
• 22:59
  SPEAKER_01: If you've got a really good clinician, they'll listen to you after just a month.
• 23:03
  SPEAKER_01: If you don't have a great clinician, right, you might have to bring in more.
• 23:07
  SPEAKER_01: Um, the the like research um boundary for female inclusivity in research is three months.
• 23:17
  SPEAKER_01: So um, like three full cycles.
• 23:19
  SPEAKER_01: And that's what they actually will tell you as well.
• 23:21
  SPEAKER_01: Julie, you've probably been told this when you go to get uh like birth control, they say like try it for three months because you don't know if it's really working for you until yeah, you've had three basically three data points.
• 23:34
  SPEAKER_01: Um so I would say go and ask for help ASAP if you even have a suspicion and the doctor hopefully will listen to you.
• 23:42
  SPEAKER_01: If not, then track for as long as you can stand, but make sure you also have your support network surrounding you.
• 23:50
  SPEAKER_01: Inform your partner, inform your friends.
• 23:52
  SPEAKER_01: I tell my friends, like there are going to be times I'm gonna call you because I'm having a bad time, and I just need someone to be the voice of reason because the moment that you start to externalize your experience and I even just like say the feelings you're experiencing, they they no longer rule you, and you can start to see that doesn't actually make sense, but it felt so real inside of me.
• 24:16
  SPEAKER_01: Um so so if you can't get help, at the very least, start to build your support network around you so that you can do the tracking you need to do for that period of time.
• 24:28
  SPEAKER_01: Sure, sure.
• 24:29
  SPEAKER_00: So Julie mentioned there sort of this idea of self-advocacy and being able to have a choice over who your clinician is, firing them.
• 24:40
  SPEAKER_00: You mentioned that you fired 80%, I think, of your clinicians, I think you said.
• 24:45
  SPEAKER_00: Oh, what how how okay, I suppose first question first.
• 24:49
  SPEAKER_00: How do you actually judge if a clinician is any good or not?
• 24:52
  SPEAKER_00: As Veronica, yeah, what what what's the starting point?
• 24:56
  SPEAKER_03: Yeah.
• 24:58
  SPEAKER_01: Did I feel seen, heard, and understood?
• 25:00
  SPEAKER_00: Okay.
• 25:02
  SPEAKER_01: Right?
• 25:02
  SPEAKER_01: Um, like when when um when we spend time with our friends, our family, uh, our bosses, our neighbors, um, we know in our bodies was that a good experience or not.
• 25:16
  SPEAKER_01: And it's the same thing with a clinician.
• 25:18
  SPEAKER_01: So um, even if it didn't feel bad, did you get help?
• 25:22
  SPEAKER_01: Did you feel seen, heard, and understood?
• 25:24
  SPEAKER_01: If not, it's okay to not go back.
• 25:28
  SPEAKER_01: You owe them nothing, except for you know, like pay your bill, but you owe them nothing.
• 25:33
  SPEAKER_01: Um if if it's really bad, the the medical misogyny is is a very real experience for women.
• 25:43
  SPEAKER_01: And so if if you feel like you have been pushed around in the wrong way, gaslit, misinformed, all the way to the worst case scenario, there are reporting bodies.
• 25:54
  SPEAKER_01: And I really encourage folks to at least make an anonymous report, if not actually take action because it's stressful to do, but you're not the only one who is going to that doctor, and there has to be accountability.
• 26:10
  SPEAKER_01: And unfortunately, it falls to us.
• 26:12
  SPEAKER_01: It falls to us to say, I'm not getting help here, I need to go someplace else.
• 26:16
  SPEAKER_01: I know we've been taught that the doctors have been trained and should just be able to help us for someone we go to, and unfortunately it's not the case.
• 26:23
  SPEAKER_01: Um, so it just falls to us to advocate for ourselves, to bring the research with ourselves, and to um to report when something does go wrong.
• 26:36
  SPEAKER_01: Yeah, of course.
• 26:38
  SPEAKER_02: Yeah, I I remember uh it took me six and a half years to get a diagnosis of an autoimmune condition with the same, yeah.
• 26:47
  SPEAKER_02: So I went through that firing process many years ago now.
• 26:53
  SPEAKER_02: But um I I remember I remember hearing a doctor online, I can't remember which one, but she said when she was trained, they made notations in the file, and WW was one that they used for women who came in and and complained a lot about their symptoms, and that meant whiny woman.
• 27:13
  SPEAKER_02: And um yeah, I mean it's it's a real thing because even even gynecologists, OBGYNs, aren't necessarily trained in these specific conditions, and especially not in parametopause and menopause, it's such a minor part of their of their education.
• 27:32
  SPEAKER_01: So I think but it's like it's such a big part of our lives, like it's it's actually more than half of our lives, it's wild.
• 27:40
  SPEAKER_01: But if we center fertility over care, right, then that's what happens.
• 27:48
  SPEAKER_00: Yeah.
• 27:49
  unknown: Yeah.
• 27:50
  SPEAKER_00: How do you talk us through changing a clinician, Veronica, when you when you're not happy, you've made that decision, but it's time to move on.
• 28:00
  SPEAKER_00: How do you actually do that?
• 28:01
  SPEAKER_00: And I suppose there's a secondary question here.
• 28:05
  SPEAKER_00: You're now in Germany where the healthcare is nationalized, and is there a difference there between doing it privately?
• 28:12
  SPEAKER_00: Because privately, right?
• 28:13
  SPEAKER_00: You take your checkbook and pay another clinician, I I I guess.
• 28:17
  SPEAKER_00: So that must be easier if you're doing it via private healthcare than maybe it is somewhere where there's institutionalized healthcare like there is in Germany and here in the UK.
• 28:26
  unknown: Yeah.
• 28:27
  SPEAKER_01: Yeah.
• 28:27
  SPEAKER_01: Um, so at least um, I've heard it's different in other countries.
• 28:32
  SPEAKER_01: Julie, you've told me it's different in Italy.
• 28:34
  SPEAKER_01: Um, but here in Germany, you can choose your GP.
• 28:38
  SPEAKER_01: You're not assigned a GP.
• 28:40
  SPEAKER_01: So um I've I've bonked around.
• 28:43
  SPEAKER_01: You have to tell your insurance like who your GP is.
• 28:46
  SPEAKER_01: You have to like nominate them.
• 28:48
  SPEAKER_01: But other than that, I've I've bumped around to a few different ones, found one that I felt like I had a rapport of.
• 28:55
  SPEAKER_01: So um, I funnily enough, my GP is male.
• 28:59
  SPEAKER_01: Um, and he does make fun of me for coming in often.
• 29:03
  SPEAKER_01: And we laugh together.
• 29:05
  SPEAKER_01: He remembers everything I tell him, and he will take action when I ask for it.
• 29:08
  SPEAKER_01: So when this is a great one, actually, speaking of perimenopause, two years ago, when I was convinced I had Alzheimer's, because my grandma had Alzheimer's, and uh I was missing memories and I couldn't remember stuff, frightened as heck.
• 29:26
  SPEAKER_01: I go in and please, please help.
• 29:32
  SPEAKER_01: So I I go into my GP, I say, please help.
• 29:35
  SPEAKER_01: And he says, Okay, here's an MRI.
• 29:38
  SPEAKER_01: Go get an MRI.
• 29:40
  SPEAKER_01: So that is definitely a difference here in Germany that um I'm able to just walk into my GP, say I need an MRI or something, help me and get it done.
• 29:51
  SPEAKER_01: And turns out I don't have Alzheimer's, I have pyramidopause.
• 29:55
  SPEAKER_01: Um so as far as so far as access goes, it's very good.
• 30:00
  SPEAKER_01: It's definitely very good.
• 30:02
  SPEAKER_01: And I can easily change doctors.
• 30:05
  SPEAKER_01: Basically, of course, I still owe uh owe a bill if I if I use their services at any point, but then I just pay them, I never make another appointment, and that's it.
• 30:16
  SPEAKER_01: Um, I usually don't escalate.
• 30:19
  SPEAKER_01: I haven't had a situation here that was so bad, and I actually wouldn't say that I ever really did in the USA.
• 30:27
  SPEAKER_01: There's been moments where I'm like, I I don't I don't really know.
• 30:31
  SPEAKER_01: There actually, there was one here where I told, as I mentioned, I have this weird gluten situation.
• 30:37
  SPEAKER_01: I told the doctor, this was a different doctor here.
• 30:41
  SPEAKER_01: Um, don't test me for celiac.
• 30:43
  SPEAKER_01: I know it's not celiac.
• 30:45
  SPEAKER_01: My guts are fine.
• 30:47
  SPEAKER_01: The only thing he tested me for was celiac.
• 30:50
  SPEAKER_01: So I probably could have said something about that, but um, otherwise, most of it has just been benign.
• 30:58
  SPEAKER_01: Either that doesn't sound right, that doesn't seem real.
• 31:02
  SPEAKER_01: I don't know what to do.
• 31:04
  SPEAKER_01: Yeah.
• 31:07
  SPEAKER_02: Yeah.
• 31:07
  SPEAKER_01: So anyway.
• 31:09
  SPEAKER_02: I've I've enjoyed a similar kind of dismissal from the doctors, both in the US and and here a couple of times, but I also had some really good doctors in the national health system.
• 31:18
  SPEAKER_02: So um it you're right.
• 31:21
  SPEAKER_02: I mean, you just have to be patient and insist.
• 31:26
  SPEAKER_01: You literally are a patient, like you are patients.
• 31:29
  SPEAKER_01: Like the word patient is I I don't know as a writer, I should know the etymology.
• 31:36
  SPEAKER_01: I don't, um, but yeah, you there is a lot of patience in going to a doctor and letting them practice on you.
• 31:44
  SPEAKER_02: Yeah.
• 31:45
  SPEAKER_02: Well, and I, you know, I I said to my doctor once, we were getting into a uh, I'll call it an elevated discussion, and I said, I I respect your education and your knowledge, and that you are an expert in medicine.
• 32:01
  SPEAKER_02: But I am an expert in my body.
• 32:04
  SPEAKER_02: I've lived in it for however many years it was at the time.
• 32:08
  SPEAKER_02: You don't know my body the way I know my body.
• 32:10
  SPEAKER_02: So when I tell you something's going on, it's because I know the body.
• 32:17
  SPEAKER_02: So I want to work with your expertise and my expertise to find out what's going on.
• 32:23
  SPEAKER_02: Of course, you just dismissed me, but it felt good to say.
• 32:27
  SPEAKER_01: But that was a brilliant thing to say.
• 32:28
  SPEAKER_01: Yes, absolutely.
• 32:29
  SPEAKER_01: Because sometimes you do have to kind of like recenter the the I I try to put myself into a doctor's shoes.
• 32:39
  SPEAKER_01: And if I know that I don't know, because there's no data, um I I guess I would feel kind of protective of my position and my expertise.
• 32:50
  SPEAKER_01: And and so what you said was really good because it doesn't, it doesn't, you're not there to threaten, even though it you are a challenge.
• 32:59
  SPEAKER_01: So are we all.
• 33:01
  SPEAKER_01: But um, but yeah, we're I I think all of us are there just to try to work with our practitioners as a team.
• 33:10
  SPEAKER_01: And a lot of them are are just there to to go through the day, unfortunately.
• 33:17
  SPEAKER_01: Yeah.
• 33:17
  SPEAKER_01: Yeah.
• 33:18
  SPEAKER_02: Yeah.
• 33:19
  SPEAKER_01: I actually have a piece coming out in a magazine um in the next month or two.
• 33:25
  SPEAKER_01: I actually don't know the date, but what I wrote about here, where I needed some support for my cycle, something wasn't quite right.
• 33:33
  SPEAKER_01: And I just went into the pharmacy and asked for what I needed.
• 33:36
  SPEAKER_01: And I'm so used to, as you said, Julie, being questions that, like, are you sure?
• 33:41
  SPEAKER_01: Do you really like I've been in this body for almost 40 years?
• 33:44
  SPEAKER_01: I kind of do.
• 33:45
  SPEAKER_01: I kind of really do know what I need.
• 33:47
  SPEAKER_01: And it was so easy and effortless.
• 33:49
  SPEAKER_01: Whereas my experience in the States was very much that um there's no way that you can know you must be stupid, kind of attitude that that we receive.
• 33:59
  SPEAKER_02: Well, yeah, plus there's a lot more available over the counter here than there is over there.
• 34:04
  SPEAKER_02: So much.
• 34:05
  SPEAKER_01: Yeah.
• 34:06
  SPEAKER_01: So much.
• 34:07
  SPEAKER_02: Yeah.
• 34:09
  SPEAKER_02: Yeah.
• 34:10
  SPEAKER_02: So so speaking of you know, the article you're writing, like talk us through some of the things that you're working on now and and what's coming up for you.
• 34:19
  SPEAKER_02: Especially, I know you've been busy with your magazine, you're doing some speaking.
• 34:23
  SPEAKER_00: Aside from our top project, however, that we'll tease at the end of this.
• 34:28
  SPEAKER_02: Yes, yes.
• 34:31
  SPEAKER_01: Yes, indeed.
• 34:32
  SPEAKER_01: Um, oh yeah, uh, so the magazine is going through a growth spurt by design.
• 34:40
  SPEAKER_01: Um, I'm really looking forward to seeing what happens with it this year.
• 34:44
  SPEAKER_01: We're leaning into community because just as you, Julie and James, have discovered, community is where it's at when you feel disenfranchised from a dominant system.
• 34:54
  SPEAKER_01: Um, and so not only are we gathering pieces to publish in the magazine so that people can feel seen, heard, and understood in their own homes at least.
• 35:06
  SPEAKER_01: Um, and my goal is to also have this magazine be in waiting rooms, because it should be.
• 35:13
  SPEAKER_01: But then also to have workshops and other events curated throughout the year so people feel like there's a space for them.
• 35:20
  SPEAKER_01: Um, we we specifically cater to Flinta people, which is a German acronym for female, lesbian, intersex, non-binary, trans, and e-gender.
• 35:30
  SPEAKER_01: Um, and so basically women and queer people who are just totally disenfranchised from the medical community.
• 35:39
  SPEAKER_01: Um, and knowing that that is a space specifically for those groups, then you know, that community gels around there.
• 35:46
  SPEAKER_01: Um at asterisk, we're taking a step step back to re-examine because there are important market markers that we are noticing.
• 35:55
  SPEAKER_01: Um, so where we want to serve women, where we want more women involved in research, um the way to do that is obviously different in the EU versus the US versus Latin America versus India versus Southeast Asia, right?
• 36:11
  SPEAKER_01: Like there's there's different systems all around the world, and we feel strongly that we need to close the global north-south research divide where 90% of research is conducted in the global north.
• 36:24
  SPEAKER_01: So where we have women's health, we have white women's health.
• 36:27
  SPEAKER_03: Right.
• 36:28
  SPEAKER_01: So that is a huge passion of mine, but it also is complicated.
• 36:35
  SPEAKER_01: So um we've done two years of research and RD and development, and I we're taking this moment to breathe to say, okay, how do we go to market in a way that really serves women and serves the equitable future of the industry?
• 36:54
  SPEAKER_01: Um instead of just moving forward with the original plan, um, which we've kind of proven is just not the right fit.
• 37:04
  SPEAKER_01: Um, we were involving AI, that's fine, um, except for there's a really healthy amount of skepticism for women with AI.
• 37:12
  SPEAKER_01: I mean, really understandable, um, and a few other markers as well.
• 37:17
  SPEAKER_01: Then we just really want to take a moment for mindfulness.
• 37:21
  SPEAKER_01: What we are still doing is publishing our reports.
• 37:25
  SPEAKER_01: Um, so right now, as you probably well know, if you go to WebND or you go to Healthline's website, they're gonna tell you about whatever condition you're looking up, but it's not going to be a sex segregated viewpoint.
• 37:39
  SPEAKER_01: So you still have no idea if it's relevant to you as a woman.
• 37:44
  SPEAKER_01: And so we publish these reports that are um disease state specific, but only involving research that included women.
• 37:54
  SPEAKER_01: And so when we talk about diabetes, we're talking only about what we know about women in diabetes.
• 37:58
  SPEAKER_01: When we talk about uh Alzheimer's, we talk about only what we know about women in Alzheimer's, et cetera, et cetera.
• 38:04
  SPEAKER_01: So that is moving forward and that will continue to exist.
• 38:07
  SPEAKER_02: Great.
• 38:08
  SPEAKER_02: And I and I know um it's on it's kind of on the um on hold at the moment, but can you just explain a little bit about the project or what asterisk actually is for people who might not know?
• 38:22
  SPEAKER_01: Yeah, so our goal is simply to close the gender gap.
• 38:26
  SPEAKER_01: That's the whole goal.
• 38:27
  SPEAKER_01: Um, in health research specifically.
• 38:30
  SPEAKER_01: So um the wait list is still open if you want to get involved, because uh the app was originally designed as a tracker for non-reproductive health.
• 38:40
  SPEAKER_01: Um, we still want to be involving women in clinical trials.
• 38:44
  SPEAKER_01: And so that's really the where the wait list is going to be landing in the future.
• 38:48
  SPEAKER_01: Um, but we have to reorient ourselves as to how to do that properly so that it really serves women.
• 38:53
  SPEAKER_01: And um and again, there's there's there's a few markers that we the technology is great, but if the technology isn't something that people will adopt, then it doesn't matter how perfect it is.
• 39:05
  SPEAKER_01: For example, we want to guarantee to researchers that this is an all-female database.
• 39:11
  SPEAKER_01: To do that, I have to draw a line as to what is female that's not comfortable, and um, I have to use a technology that will exclude anyone else, uh, which means submitting your identification papers, which feels very dystopian.
• 39:28
  SPEAKER_01: So the technology works great, the the application isn't right for us, and so we have to go back to the drawing board to say how do we do this in a way that is secure, equitable, and means what we want it to mean.
• 39:42
  SPEAKER_01: So great, yeah.
• 39:44
  SPEAKER_02: It's I mean, I it's amazing, and I really respect your having taken that step back because I know a lot of times people are just like, we gotta get to market, we gotta get to market, we set a deadline, and that's not how our bodies work, it's not how our health works, it's not yeah, that's great.
• 40:02
  SPEAKER_01: Yeah, yeah, we have amazing partners still.
• 40:05
  SPEAKER_01: Um, and like I said, we're going to be continuing to publish alongside them to at least just help with the data gap where it is, right?
• 40:13
  SPEAKER_01: So at the very least, we can do something about the communication gap.
• 40:16
  SPEAKER_01: You print this report out, you take it to your doctor, you say, This is what I believe is happening to me, and here is the research that is female inclusive.
• 40:24
  SPEAKER_01: Um, we can do that while we pivot and regroup.
• 40:30
  SPEAKER_01: Fabulous.
• 40:32
  SPEAKER_00: Veronica, you've got so many different things going on.
• 40:36
  SPEAKER_00: Where's the one sort of like touch point that people want to find out more about your work, where should they come to?
• 40:45
  SPEAKER_01: The easiest place is my website.
• 40:48
  SPEAKER_01: It's my name, um, veronicain.com.
• 40:52
  SPEAKER_01: I laugh because it's like not hard to spell, but hard to spell.
• 40:55
  SPEAKER_01: Um, but so I know you'll link it.
• 40:58
  SPEAKER_01: Um but yeah, my website is the best place because that's where you'll find asterisk, that's where you'll find Anodyne magazine, um, and that's also where you'll find um my own coaching to help people through times of change, which of course, perimenopause, menopause, and post-menopause is certainly a time of change.
• 41:19
  SPEAKER_01: They do call it the change, literally.
• 41:21
  SPEAKER_01: So there we go.
• 41:23
  SPEAKER_01: Very much so.
• 41:24
  SPEAKER_00: Yeah, and then obviously we're quietly putting together something special for next month.
• 41:28
  SPEAKER_00: Veronica's gonna be part of that, so we're gonna share details for that in the coming weeks.
• 41:33
  SPEAKER_00: But for this, for now, that's a little sparkly breadcrumb for you for for moving forward.
• 41:39
  SPEAKER_00: So, Veronica, thank you.
• 41:40
  SPEAKER_00: It's one of those conversations I think that we're done.
• 41:43
  SPEAKER_00: I'm gonna immediately press rewind and have a listen and start taking some notes because we've touched on so many different things and so so many fascinating things.
• 41:54
  SPEAKER_00: Um, but for now, yeah.
• 41:56
  SPEAKER_01: I hope it's been helpful for for listeners.
• 41:59
  SPEAKER_00: Yeah, yeah, it's incredible.
• 42:01
  SPEAKER_00: So, we'll include all our uh links for Veronica in the show notes where you can follow her, you can explore her writing, her speaking, her various entrepreneurial uh exploits, and her coaching as well.
• 42:13
  SPEAKER_00: So we've been coaches, James and Julie of Fabulous Beyond 40.
• 42:16
  SPEAKER_00: We might need to stay strong, stay fabulous, and we will see you next time.
• 42:20
  SPEAKER_00: Take care.
• 42:21
  SPEAKER_02: Bye, everybody.