Latest / Healing Her Story with Riva Jean-Paul / Why Women Are Dismissed in Perimenopause (And How to Advocate for Yourself) with Dana Culp from Thrive Midlife Medicine

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Why Women Are Dismissed in Perimenopause (And How to Advocate for Yourself) with Dana Culp from Thrive Midlife Medicine · Healing Her Story with Riva Jean-Paul

1:37
SPEAKER_01: Hello everyone.
1:39
SPEAKER_01: Welcome to another episode of the Healing Her Story podcast.
1:43
SPEAKER_01: I am, as always, just so delighted and excited to be here with you today with another guest episode.
1:50
SPEAKER_01: I'm really looking forward to this guest.
1:52
SPEAKER_01: I feel so um, yeah, so special to be able to spend a little bit of time with her today.
1:58
SPEAKER_01: And as always, on the show with these guest episodes, they make their way to me in the most just divine and synchronistic ways.
2:07
SPEAKER_01: And this topic of menopause and perimenopause has been something that I've really been wanting to have on the show.
2:13
SPEAKER_01: It's something that I've been talking to my clients about.
2:16
SPEAKER_01: And interestingly enough, it's been something, not that I work specifically with menopause, but I've been seeing more women at this stage of their life come into my practice.
2:25
SPEAKER_01: And so as much as these episodes are for you to be informed and educated and empowered, uh, today's a special one for me too, because I'm really looking forward to learning more from this incredible woman that we have on today.
2:39
SPEAKER_01: Dana is a doctor of nursing practicing.
2:42
SPEAKER_01: Uh, excuse me, Dana is a doctor of nursing practice and founder of Thrive Midlife Medicine with over 25 years of clinical experience supporting women's health.
2:53
SPEAKER_01: She specializes in perimenopause and menopause care, offering evidence-based individualized treatment to help women move through midlife with clarity, confidence, and relief.
3:05
SPEAKER_01: Her passion for this work is personal.
3:07
SPEAKER_01: When she entered perimenopause herself, she encountered firsthand how fragmented and dismissive the system can be.
3:16
SPEAKER_01: After visiting four providers and receiving inadequate or concerning treatment options, she knew women deserve better.
3:23
SPEAKER_01: Today, her mission is to close the gap, helping women experience meaningful symptom improvement so they can feel like themselves again.
3:31
SPEAKER_01: She provides virtual care for women in California and Nevada, accepting most major insurance plans and partners with healthcare professionals who want better solutions for their patients.
3:42
SPEAKER_01: Dana, welcome to the show.
3:45
SPEAKER_00: Thank you so much.
3:46
SPEAKER_00: I'm thrilled to be here today with you and your listeners.
3:49
SPEAKER_01: Oh, thank you again for your time today.
3:51
SPEAKER_01: And before we go too deep into this topic of perimenopause and menopause, I would love to hear a little bit about your story, Dana.
3:59
SPEAKER_01: What brought you to this work?
4:02
SPEAKER_00: So, what brought me to this work was my own personal experience uh going through this phase of life.
4:09
SPEAKER_00: I had been taking care of women for years at different stage, you know, life stages.
4:14
SPEAKER_00: And when it came to, you know, menopause care, I cared for them the way the guidelines of old told us to, and thought I was doing a great job.
4:24
SPEAKER_00: Um and realized when it started happening to me that those guidelines are very outdated and we do a lot better now.
4:36
SPEAKER_00: So um, you know, much to my horror, realizing that I thought uh you just like so many other providers, but we just were not educated.
4:45
SPEAKER_00: So when I started having some life changes, pretty significant changes, a lot of weight gain, mood changes, a lot of challenges, sleeping, low-level anxiety when I've never had anxiety before, trouble with brain fog, keeping you know my thoughts straight, low energy, all of these things were impacting my work, my interpersonal relationships, my health.
5:10
SPEAKER_00: But I didn't realize all of those things were related to perimenopause.
5:15
SPEAKER_00: What actually drove me to the doctor's office was my blood pressure was going up.
5:20
SPEAKER_00: Um yes.
5:22
SPEAKER_00: Uh and I thought, well, of course, because I'm not sleeping.
5:26
SPEAKER_00: And there was some little piece in the back of my mind that thought, well, maybe I'm not sleeping because of hormones.
5:32
SPEAKER_00: And honestly, that's the only thing I connected the dots with.
5:35
SPEAKER_00: I thought the rest of those things I described were just, you know, part of life, part of aging.
5:41
SPEAKER_00: And it didn't occur to me as a healthcare provider who takes care of women in midlife.
5:46
SPEAKER_00: So it's it happened to me.
5:48
SPEAKER_00: I want to get my blood pressure uh under control.
5:50
SPEAKER_00: So I made an appointment with my trusted primary care provider.
5:55
SPEAKER_00: Uh, I waited weeks and weeks for that appointment.
5:58
SPEAKER_00: Uh and mind you, I still can't sleep and it's affecting every part of my life.
6:02
SPEAKER_00: I got to that appointment and was told I am not comfortable dealing with hormones.
6:08
SPEAKER_00: I don't think this is what's going on.
6:10
SPEAKER_00: Here's some blood pressure medicine and have a nice day.
6:13
SPEAKER_01: Wow.
6:14
SPEAKER_00: I left that appointment and this is I went into that appointment basically as a contemporary, as a colleague.
6:20
SPEAKER_00: I take care of the same patient population she does, having been practicing in family medicine for so long.
6:25
SPEAKER_00: So I say that to just to make note that I walked in there with knowing the language, knowing how to advocate, knowing for myself, knowing how the system works, and asking for what I wanted.
6:39
SPEAKER_00: And I was still dismissed.
6:41
SPEAKER_00: And I left that appointment in tears, devastated.
6:44
SPEAKER_00: I I felt I felt pretty, pretty hopeless.
6:46
SPEAKER_00: Then I ended up at a OBGYN office because isn't OBGYN, you know, the specialty that takes care of women their whole lives?
6:56
SPEAKER_00: They're not.
6:56
SPEAKER_00: They're great, but they also um have very little uh if this stage of life, uh, you know, after the reproductive years.
7:04
SPEAKER_00: So I went to um that appointment again, not knowing if she was prepared to care for, you know, talk to me about hormones.
7:11
SPEAKER_00: She had one thing that she prescribes.
7:15
SPEAKER_00: She gave that to me and sent me on my way.
7:17
SPEAKER_00: I did take that medication and I did feel a little bit better.
7:21
SPEAKER_00: My hair, my head cleared, I could sleep now.
7:23
SPEAKER_00: It wasn't until I started learning more about this type of care that I realized nobody prescribes that anymore.
7:30
SPEAKER_00: It has serious safe that what I was prescribed has has some significant safety concerns.
7:34
SPEAKER_00: And it's been a couple decades since um that was recommended.
7:38
SPEAKER_00: But I indeed took it and I did feel a little bit better.
7:42
SPEAKER_00: So I guess that's a silver lining.
7:44
SPEAKER_00: Uh, but I ended up then in another OBG myana office.
7:47
SPEAKER_00: She was highly regarded from Stanford.
7:50
SPEAKER_00: And it was the same thing.
7:52
SPEAKER_00: This is this is what I do, and this is what you're gonna get prescription-wise.
7:57
SPEAKER_00: And when I push back a little bit, you know, let's talk about other options, uh, another way to go about this.
8:02
SPEAKER_00: No, that's this is what we're this is what we're doing.
8:05
SPEAKER_00: So that appointment was when I really got in high gear of educating myself.
8:10
SPEAKER_00: I just thought, if this happened to me, what do women who really don't know how to navigate the system, health system, um, what are they gonna do?
8:19
SPEAKER_00: How are they gonna get any help?
8:21
SPEAKER_00: And so that's about when everything kicked in gear for me.
8:23
SPEAKER_00: I became a certified menopause expert.
8:26
SPEAKER_00: I read every study that I could get my hands on.
8:29
SPEAKER_00: I um have an incredible network of uh like-minded colleagues now where we share our care for our patients.
8:35
SPEAKER_00: Um so I then walked into my fourth doctor's office appointment, my new primary, and she admitted she knew nothing about this topic, had never been trained, was really uncomfortable with it, but she was open to being my partner in this journey and learning from me, basically, of how to provide this care.
8:53
SPEAKER_00: So I am still with her, she's amazing.
8:55
SPEAKER_00: But now I feel like the care at that stage that I was receiving was really, really optimal.
9:03
SPEAKER_00: And for me, it was utterly life-changing.
9:06
SPEAKER_00: I didn't realize what bad shape I was in, that all of these, this constellation of terrible symptoms that were really damaging my life, how much of those were perimenopause.
9:17
SPEAKER_00: And so for me, it was life-changing.
9:20
SPEAKER_00: And I I I at that point decided this is what I'm gonna do with the rest of my career is is help women.
9:27
SPEAKER_00: So, in this way, this very specific way.
9:30
SPEAKER_00: So I founded um Thrive Midlife Medicine, which is a virtual telehealth practice, and I wanted to make sure as w many women as possible had access to this care.
9:41
SPEAKER_00: So I am one of the very few out there that take insurance because so um there's a there's you can find providers now.
9:50
SPEAKER_00: Um, you know, if you look really hard, there's some um uh national telehealth providers, and then there's some small practices or individual practices like I have.
10:00
SPEAKER_00: But the vast majority are um uh cash pay, self-pay.
10:04
SPEAKER_00: And I I completely understand the move to go that direction dealing with insurance companies as a provider is exceedingly challenging.
10:11
SPEAKER_00: But I just I thought I can't leave more women out of this, um, out of this care.
10:16
SPEAKER_00: So so it's a concierge type practice, but you can use your insurance.
10:21
SPEAKER_00: So um yeah, so that is my story of how I ended up in this space and doing the most meaningful work I've ever done in my entire career.
10:30
SPEAKER_01: Yeah, I can really feel your love and your passion for your work.
10:34
SPEAKER_01: I get little goosebumps all up and down my arms just listening to your story and really thank you for your story.
10:41
SPEAKER_01: And I know that women listening to this are going to see even just a little bit of themselves, whether they're in this stage of perimenopause or not, because even I can see some of my own experience of, you know, going to the doctor's office and being dismissed and, you know, not really having someone listen to you and really wanting to get to the root causes of of what's going on.
11:04
SPEAKER_01: And it's wild to me that even as someone like yourself who understands the language and how to navigate the healthcare system, that you still had this experience.
11:15
SPEAKER_01: It's it's actually quite infuriating to me, if I'm being honest, that we're we're really missing so much here, so many missed opportunities in women's health.
11:26
SPEAKER_01: Absolutely.
11:27
SPEAKER_01: I couldn't uh say it better.
11:29
SPEAKER_01: Well, I'm just so grateful you're here, grateful you're doing this work and really excited to continue this conversation today.
11:36
unknown: Yeah.
11:37
SPEAKER_01: Um, I'm curious, could you tell us uh biologically what is perimenopause?
11:44
SPEAKER_00: So uh perimenopause, which is probably a new term for some some folks.
11:49
SPEAKER_00: We all know what menopause is, or at least we've heard the term is marks when a woman has gone 12 consecutive months without having a menstrual cycle, she now is considered to be menopausal.
12:00
SPEAKER_00: No longer the ovaries are have basically so um so that I think is something most of us have heard of and and understand the concept.
12:08
SPEAKER_00: But what is um is understood now very, very well is the um years leading up to menopause um are really a time of of hormonal chaos.
12:19
SPEAKER_00: So um in the United States, the average age for menopause is 51.
12:26
SPEAKER_00: Um, and so there's a 10-year span where 80% of us will go into menopause, and that span is anywhere from 45 to 55.
12:35
SPEAKER_00: We do know now perimenopause um can happen around 10 years, start happening around 10 years earlier when we start having significant hormonal fluctuations that can um can be very, very subtle and very you know gentle, and and or they can hit you like a ton of bricks.
12:54
SPEAKER_00: And sometimes it's both of those, you know, I was fine until I wasn't type of thing.
12:59
SPEAKER_00: So if if 45 is the on the younger side uh for most women, now we're talking a woman in her 30s, maybe 35 years old.
13:08
SPEAKER_00: I actually have several women in my practice who are um uh in their early 30s, 31, 30.
13:15
SPEAKER_00: And that's just their family tends to, you know, go into menopause early.
13:19
SPEAKER_00: So, so menopause, you are now depleted, but perimenopause is marked by wild fluctuations, specifically in estrogen.
13:29
SPEAKER_00: And uh some days the estrogen is really high and some days it's really low.
13:33
SPEAKER_00: And that hormonal chaos is really the thing that causes so much, um, so many changes in our brains.
13:40
SPEAKER_00: Our brains really cannot, they don't not, it does not like all that chaos.
13:44
SPEAKER_00: And it gets tough, and especially the farther along you are in perimenopause.
13:48
SPEAKER_00: So early menopause can just be um some slight things, you know.
13:52
SPEAKER_00: Most of us are pretty resilient, we're used to just powering through and um can can usually manage for a while.
13:58
SPEAKER_00: Uh but later perimenopauses, a woman gets closer to menopause, which of course she never knows when that's going to happen.
14:04
SPEAKER_00: That's probably the most difficult time and when women have um have the toughest symptoms.
14:11
SPEAKER_01: Yeah, okay.
14:12
SPEAKER_01: Thank you for for clearing that up.
14:14
SPEAKER_01: So I'm really taking away this hormonal chaos specifically with estrogen, these really big fluctuations leading up to menopause.
14:22
SPEAKER_00: Yes.
14:23
SPEAKER_00: Um, progesterone and testosterone are are other, there's that's the trifecta of our hormone um group.
14:30
SPEAKER_00: They also are changing, but it's not quite as chaotic and it is impactful, but those decreases are a little more gradual.
14:38
SPEAKER_00: So that's why estrogen kind of seems to be the star at this stage.
14:42
SPEAKER_00: Yeah.
14:43
SPEAKER_01: Okay.
14:43
SPEAKER_01: And you you did answer one of my next questions, which was, you know, around when does perimenopause start?
14:50
SPEAKER_01: Because I do have clients that are, like you've mentioned, kind of in their early 30s, you know, going up to late 30s, early 40s, and they're wondering if they're in perimenopause.
15:02
SPEAKER_01: And so it sounds like you could potentially be as early as 31, you said, as some women you're seeing.
15:08
SPEAKER_00: Yeah, that's definitely on the earlier side, but um, but I see I do see it.
15:12
SPEAKER_01: Yeah.
15:13
SPEAKER_01: I'm curious, and this may not be something that you can speak to, but I'm wondering if that number has changed over time, like if perimenopause has started earlier compared to, you know, maybe 10 years ago.
15:26
SPEAKER_01: And maybe you don't have that that data, but I'm just curious.
15:30
SPEAKER_00: Yeah, that's a really great question.
15:31
SPEAKER_00: And I don't know of any research that tells us why there might be a change.
15:37
SPEAKER_00: What I suspect is we just now have some language around it and that possibly this might be what is happening.
15:44
SPEAKER_00: Um, Western medicine specifically tends to uh treat symptoms, you know, the you know, I have this problem, here's a pill, or here's a fill in the fill in the blank.
15:54
SPEAKER_00: Um and taking an approach where you're looking like a little further upstream, well, what might be causing these symptoms?
16:01
SPEAKER_00: That is not typical in in Western medicine.
16:03
SPEAKER_00: And I'm again, you know, I'm generalizing for a fact.
16:06
SPEAKER_00: So um I think it just might be because we know better, we're trying to do better, and we actually have language for it as patients.
16:14
SPEAKER_00: Ah, okay.
16:15
SPEAKER_01: So maybe it's been happening, but now we have the language and we have the understanding that maybe we didn't have 10 years ago.
16:21
SPEAKER_00: Yeah, I think uh, as women, we juggle a lot.
16:25
SPEAKER_00: We are strong and powerful, and we just keep pushing.
16:29
SPEAKER_00: So um, you know, if I can't sleep, okay.
16:32
SPEAKER_00: We always think that if we just work harder and try harder and do better, we can change things.
16:36
SPEAKER_00: And and while that might be true, again, that's why I think we're maybe we're identifying an external cause to why we feel the way we do, so we don't have to suffer as much.
16:47
SPEAKER_01: Yeah.
16:48
SPEAKER_01: Yeah, it makes sense.
16:49
SPEAKER_01: Yeah, that conditioning, it really runs very deep and it's it it creeps in in these very subtle ways and it can kind of creep in here too.
16:58
SPEAKER_01: Um yeah, I'm wondering what are some of the most common early signs that perimenopause is beginning.
17:06
SPEAKER_00: Okay, so some cycles are usually still pretty uh regular at that stage, but they might uh be heavier.
17:15
SPEAKER_00: So that's one thing.
17:16
SPEAKER_00: Sleep um is often something that can be impacted, but that's tough.
17:22
SPEAKER_00: Maybe I have stress from my job, maybe you know, but I'd say worsening PMS, that is pretty common.
17:28
SPEAKER_00: The sleep changes, anxiety.
17:31
SPEAKER_00: That is such a common um sensation, especially for somebody who hasn't had anxiety before, or that it has worsened.
17:37
SPEAKER_00: So anxiety and then those are those are the biggest things.
17:41
SPEAKER_00: Uh weight changes can start happening, um, but probably not as dramatic.
17:46
SPEAKER_00: Um maybe uh a woman can still manage if she works out the way she did before.
17:52
SPEAKER_00: But later on in this perimenopause journey, uh the same things we did before just don't work anymore.
17:58
SPEAKER_00: But sometimes in early menopause, they still do.
18:01
SPEAKER_00: And then there can be some skin changes, you know, dry skin, itchy skin, and uh definitely sexual changes can start happening, sexual function changes can start happening in this early stage of perimenopause.
18:13
SPEAKER_00: So would you say like dryness or lack of libido or um the most common would be yeah, changes in um lubrication, um, changes in desire or libido, changes in um arousal, difficulty with arousal orgasm, um, things like that.
18:31
SPEAKER_01: Interesting.
18:32
SPEAKER_01: As far as the anxiety piece, is there something that contributes to that specifically that you you understand?
18:40
SPEAKER_00: Yes, that is the estrogen specifically.
18:43
SPEAKER_00: Estrogen is really really calms our nervous system.
18:46
SPEAKER_00: And when it is either getting depleted or fluctuating, that's is a direct link with um with anxiety without without getting too science-y, but it is usually specifically the estrogen.
18:59
SPEAKER_01: Okay.
19:01
SPEAKER_01: Wow, so much to to take note of there.
19:04
SPEAKER_01: It sounds like the heavier periods and the worsening PMS are you wouldn't you say those are some of the things to pay most attention to if listeners are noticing that?
19:14
SPEAKER_01: Mm-hmm.
19:14
SPEAKER_01: Yeah, okay.
19:16
SPEAKER_01: And I'm curious too.
19:17
SPEAKER_01: I'm kind of in this phase of my own health journey where I'm doing more testing and less guessing.
19:23
SPEAKER_01: And so and so I'm just kind of like, you know, thinking, oh, I think this is what's happening.
19:27
SPEAKER_01: It's like, let's get some data to actually confirm this is what's happening.
19:30
SPEAKER_01: So I'm wondering if there are any biological markers that confirm perimenabas.
19:35
SPEAKER_01: Maybe it's the estrogen levels themselves or blood work, anything like that.
19:41
SPEAKER_00: So um, those of us who really are up on this topic recognize that certain labs have very little value at this stage because of the fluctuations.
19:51
SPEAKER_00: They do change from day to day, week to week.
19:54
SPEAKER_00: So chasing the lab values for our sex hormones really has little value.
19:59
SPEAKER_00: With that said, I I always love to say, you know, hormones aren't the cure for everything and they're not the cause for everything.
20:05
SPEAKER_00: So there can be two things happening at the same time.
20:08
SPEAKER_00: So uh if a woman, say for instance, is having weight changes, although she's done nothing new or nothing different, anxiety, then there's some other markers that really need to be checked.
20:19
SPEAKER_00: There can be two things going on at the same time.
20:21
SPEAKER_00: So, you know, checking thyroid and checking um, you know, insulin sensitivity and comprehensive metabolic panels, I think that is imperative.
20:29
SPEAKER_00: Um, now it still can't say, oh, okay, we've ruled out these other things, so aha, it's perimetopause.
20:36
SPEAKER_00: Uh, but the best way to diagnose it is um to track symptoms.
20:42
SPEAKER_00: And for a woman to kind of you know, just start documenting, writing things down, like you said, having some um, you know, um objective data in front of you, you can start seeing patterns and you can start um really uh making sense of what's happening.
20:56
SPEAKER_00: No, there's not a lab that can say you're in perimenopause, it's a symptom-driven diagnosis.
21:02
SPEAKER_00: And also, if during that stage a woman does want to trial, trying to even things out, balance her hormones, I feel like that's a low bar for seeing how much of what is happening to me can be impacted by balancing my hormones.
21:15
SPEAKER_00: If it, if it nothing changes, then you just stop taking them.
21:18
SPEAKER_00: But if it dramatically brings you back to yourself, which we see every day, um, it was an experiment worth doing.
21:26
SPEAKER_01: Yeah, yeah, absolutely.
21:28
SPEAKER_01: I mean, I try to look at it that way too, is like experimentation and um, yeah, just kind of seeing if things work and if they work, great.
21:34
SPEAKER_01: And if they don't, then moving on to the next thing.
21:38
SPEAKER_01: Yes, agreed.
21:40
SPEAKER_01: So you've already explained what's happening with estrogen.
21:45
SPEAKER_01: And I know that there is a connection between estrogen and cortisol, if I'm remembering correctly.
21:51
SPEAKER_01: And so I'm curious if there's any connection there when you're speaking of like perimenopause and a menopause, how the estrogen might influence cortisol levels, how cortisol might influence estrogen levels, and kind of that relationship of those two hormones specifically.
22:10
SPEAKER_00: Um so I will simplify this part as well.
22:13
SPEAKER_00: Yes, there can be a connection.
22:15
SPEAKER_00: So, but what I try to do is not overcomplicate things.
22:20
SPEAKER_00: I do think cortisol, which is our stress hormone, which can when our body is stressed from these chaotic hormones, and we also have busy, busy, busy lives at our cortisol levels can go up.
22:31
SPEAKER_00: And so back to two things can be happening at the same time.
22:35
SPEAKER_00: Um, so that's why a little bit of extra labs um are really important because we don't want to walk around with high cortisol levels, but they can be impacted by um uh, you know, of course, stress.
22:48
SPEAKER_00: Um, also the way we eat, the way we don't sleep.
22:52
SPEAKER_00: Um, you know, fasting, how there's a lot of a lot of folks who do intermittent fasting.
22:57
SPEAKER_00: That has to change the way you do that.
22:59
SPEAKER_00: I think I'm a fan of that, but you can't do it the same way you did five years ago or 10 years ago.
23:04
SPEAKER_00: That will raise your cortisol.
23:05
SPEAKER_00: So so there is definitely a connection.
23:08
SPEAKER_00: Um uh and that has to be considered and looked at as well.
23:12
SPEAKER_01: Yeah, yeah.
23:13
SPEAKER_01: Okay, thank you for that.
23:15
SPEAKER_01: I'm I'm kind of remembering something I I heard, maybe it was in like a training or a workshop or on a podcast.
23:21
SPEAKER_01: Um, but as that transition to menopause is happening, there's kind of like a switching over as far as like responsibility for of body parts or or organs that is kind of like regulating the system.
23:36
SPEAKER_01: And so when it switches.
23:37
SPEAKER_01: Is over to um perimenopause and into menopause, the um adrenals are taking over.
23:45
SPEAKER_01: Can you speak to that?
23:47
SPEAKER_00: They definitely are playing a bigger role.
23:49
SPEAKER_00: So we can make some of our hormones mostly, you know, in our ovaries, but um, but our adrenals play a part too.
23:58
SPEAKER_00: So that also goes back to what you were you were talking about.
24:01
SPEAKER_00: So when our ovaries are kind of winding down, they're they're running out of of lifespan, our adrenals um can can not necessarily work harder, but they still can help us because we can make some of the hormones in our adrenal glands as well.
24:16
SPEAKER_00: But then you have that stress on your adrenal glands, and so it goes.
24:21
SPEAKER_00: It just is this circular thing.
24:23
SPEAKER_00: Yeah.
24:23
SPEAKER_00: But I love that you're talking about this um this particular way, without going so sciencey that that nobody can follow us.
24:30
SPEAKER_00: That um that this this just illustrates why you need somebody who really knows what they're doing in this space to be able to see each woman as the whole person and not just this one size fits all, because again, more than one thing can be happening at a time.
24:45
SPEAKER_01: Yeah, yeah.
24:46
SPEAKER_01: Thank you for that.
24:46
SPEAKER_01: Both and, right?
24:47
SPEAKER_01: It's not always just a black or white answer.
24:50
SPEAKER_01: There's lots of different things to consider and lots of things that can influence what a woman is experiencing.
24:57
SPEAKER_01: Absolutely.
24:58
SPEAKER_01: Yeah.
24:59
SPEAKER_01: Well, what I would love to do next is clear up some of the biggest myths about perimenopause.
25:06
SPEAKER_01: Yeah.
25:06
SPEAKER_01: And so what are some of the biggest myths that you that you hear that you wish would just disappear about perimenopause and maybe menopause too?
25:14
SPEAKER_00: Well, since we're talking about early, but early perimenopause is um that you're too young.
25:20
SPEAKER_00: That is one of the most common dismissive things women hear is oh, you're only filling the blank age, what however that particular provider was um trained.
25:30
SPEAKER_00: You're in your 30s, uh, that's not possible.
25:32
SPEAKER_00: You're in your 40s, that's not possible.
25:34
SPEAKER_00: And that's just not true.
25:35
SPEAKER_00: So there's two ways to look at um at answer of you're too young.
25:41
SPEAKER_00: Well, first of all, it's wrong.
25:43
SPEAKER_00: But the symptoms are very real and can, like we said, impact a woman's life tremendously.
25:49
SPEAKER_00: So we want to look at this stage of managing symptoms, which is vitally important to somebody's quality of life, but also their lifespan, their health span, the future version of them.
26:01
SPEAKER_00: Being dismissed that you're too young without taking that opportunity to potentially get a kind of a jump start on balancing out the hormones, replacing what needs to be replaced, to protect a woman's long-term health, her bone health, her brain health, her cardiovascular health.
26:16
SPEAKER_00: It's it's I don't I wouldn't say missed opportunity.
26:19
SPEAKER_00: I think it is not good care.
26:22
SPEAKER_00: So that is the biggest thing that I hear.
26:24
SPEAKER_00: Um, probably second is now you're too old, but that's that's another, that's that's a little more nuanced conversation.
26:31
SPEAKER_00: But um, hormones cause cancer.
26:33
SPEAKER_00: That's probably one that a lot of us have heard if we're of a certain age.
26:38
SPEAKER_00: Uh, we know that that is not true.
26:40
SPEAKER_00: Um, we that is um a tiny bit of background.
26:45
SPEAKER_00: Um, the women's health initiative study is the root of that misunderstanding about hormone replacement therapy that happened about 25 years ago, where they stopped this study short.
26:58
SPEAKER_00: They were studying the impact of hormone replacement therapy on um heart attacks and cardiovascular health.
27:04
SPEAKER_00: And they stopped the study short and said, we have this other thing that's happening, is we think this might be causing breast cancer.
27:10
SPEAKER_00: And which was a complete misinterpretation of the data.
27:13
SPEAKER_00: They tried to backtrack that very quickly, but the bell was already rung.
27:18
SPEAKER_00: Women were petrified and got rid of their, threw their hormones away.
27:23
SPEAKER_00: Doctors stopped not only prescribing it, but also stopped getting trained on it.
27:27
SPEAKER_00: And so that's where that misconception came from.
27:29
SPEAKER_00: And it has persisted up until probably a few years ago, at least as far as the general public goes.
27:35
SPEAKER_00: Um, and I'll just want to mention like how could that happen?
27:40
SPEAKER_00: Well, first of all, the medication that was used in that study is not what we use today.
27:46
SPEAKER_00: It's higher doses, a synthetic version, and nobody who is practicing current best practice would ever use that at this point.
27:54
SPEAKER_00: And so we use what most of us use as often as possible, what's called bioidentical or body identical hormones, which just is kind of a marketing term, but does mean it's the molecules that our body recognizes as our own.
28:08
SPEAKER_00: So that's a huge differentiating thing I want to point out.
28:12
SPEAKER_00: And the second is the um study population that they used in that in that study did not use the age that most women either go into perimenopause or start menopause.
28:22
SPEAKER_00: They had much older patient population, you know, in their 60s and in their 70s.
28:27
SPEAKER_00: And the reason that that makes a difference is because it's like, well, they're menopausal.
28:32
SPEAKER_00: So what are you saying?
28:33
SPEAKER_00: So hormone replacement therapy, I like to say it is great at prevention, but it is not great at cure.
28:40
SPEAKER_00: So if a woman has is already gone, say 10, 15 or more years depleted of estrogen, which would have protected her heart, her brain, her bones, disease processes can probably have already started.
28:54
SPEAKER_00: And the hormone replacement can't reverse that.
28:57
SPEAKER_00: So those women already had cardiovascular problems.
29:01
SPEAKER_00: They already had potentially early cancers that had nothing to do with the hormone replacement therapy.
29:07
SPEAKER_00: Um, so that's two things that I like to point out.
29:10
SPEAKER_00: And um, there's studies and great resources to show over and over and over again that that was really misinterpreted.
29:18
SPEAKER_00: So, so that's another big one that hormone replacement, yeah, it really is.
29:23
SPEAKER_00: And let's see if I had to pick one more.
29:26
SPEAKER_00: That it's that that the suffering is like we're just it's just part of aging and we just have to deal with it.
29:31
SPEAKER_00: And um, back to symptom management, because some women do go through the stage of life with not not having it be too difficult.
29:38
SPEAKER_00: And that's great for them.
29:40
SPEAKER_00: I'm happy for them.
29:41
SPEAKER_00: But again, what about the long-term health, the long-term impact of being deprived of those hormones?
29:46
SPEAKER_00: So that's those are the three.
29:48
SPEAKER_01: Yeah, I mean, those are huge, right?
29:50
SPEAKER_01: This huge understanding that it's you know, you're not too young.
29:54
SPEAKER_01: And while you may or may not be experiencing prairie menopause specifically, it sounds like you can certainly get like a head start on supporting yourself through that transition to make things a little smoother, right?
30:05
SPEAKER_01: Which is is helpful.
30:07
SPEAKER_01: It's very helpful.
30:08
SPEAKER_00: I love that you I love that you use the word supported.
30:11
SPEAKER_00: I think in that, in this stage uh prior to menopause, that is really what we're doing, is helping a woman feel like herself so she can just continue having her amazing life.
30:23
SPEAKER_01: Yeah, it's it's important, you know.
30:25
SPEAKER_01: This support piece is is a huge piece of of my work and what I think so many of us could really benefit from is just getting more support.
30:34
SPEAKER_01: And it sounds like the hormone therapy is a wonderful way to do that.
30:37
SPEAKER_01: And I myself have heard things about it not being safe.
30:41
SPEAKER_01: And so it's it's nice to have you explain so articulately, articulately, so clearly explain um that it is safe and how a lot of these misunderstandings were that exactly their misunderstandings, misinterpretation of data, which I think really iterates how important it is to understand the kind of ins and outs of a study before just taking the study as truth.
31:06
SPEAKER_01: Agree.
31:07
SPEAKER_01: Yeah, okay.
31:09
SPEAKER_01: Well, definitely taking note of those things.
31:12
SPEAKER_01: And yeah, I'm excited to continue this conversation.
31:15
SPEAKER_01: I know we're kind of slowly approaching our time here.
31:18
SPEAKER_01: I'm really curious to learn more about your experience um through medical school.
31:22
SPEAKER_01: And it's something you already kind of mentioned here that your training was lacking when you were being trained on how to take care of people.
31:32
SPEAKER_01: And so, yeah, I'd love to hear a little bit more about what that kind of process was for you, kind of realizing that things were missing in your training.
31:41
SPEAKER_01: And then where did you go to start learning more?
31:44
SPEAKER_01: What did that look like?
31:46
SPEAKER_00: That's such a great question.
31:47
SPEAKER_00: And it is readily evident from surveys that are done across specialties, across disciplines, that in medical schools, residencies, medical training, there's uh, I believe it's one in five have any of programs, so that's 20%, have any type of um formal training on post-reproductive years, you know, hormone um treatment and and like you said so well, supporting women in that stage of life.
32:16
SPEAKER_00: And then even if there is part of the curriculum that does address that life stage, it can be so tiny, like an hour, two hours.
32:24
SPEAKER_00: And so that is a shame.
32:26
SPEAKER_00: The training is usually, especially when it comes to women's health, is usually focused on the reproductive years.
32:32
SPEAKER_00: I'm trying to get pregnant, now I'm pregnant, I don't want to get pregnant, my you know, reproductive system isn't functioning properly.
32:38
SPEAKER_00: But post-reproductive years, the words might be used, menopause, and we all, you know, hear the hormone names, but the actual care that is not delineated for the vast, vast majority of providers.
32:52
SPEAKER_00: So, and that even goes for OBGYNs, who we think of as they're the ones who take care of women, readily admit that they're they're also not prepared.
33:02
SPEAKER_00: They have to and we have to seek out additional training on our own if this is an area we want to go into.
33:09
SPEAKER_00: Like a lot of things, um, you know, if somebody was going to specialize in a certain, say, disease process or certain type of treatment, you seek that extra training out.
33:18
SPEAKER_00: So for um, so for menopause expert status, um there are a few certifications that can be pursued.
33:30
SPEAKER_00: Um, the menopause society is well known for uh having a um high standard for certifying their practitioners.
33:38
SPEAKER_00: There is an internal medicine uh physician named Heather Hirsch, who um part a big huge part of her mission is to educate providers.
33:47
SPEAKER_00: And she's got really structured and crap trainings that really teach just the latest, the greatest, and she continues to update providers.
33:56
SPEAKER_00: So that's that's a really great source.
33:58
SPEAKER_00: And then just like any other area of interest, reading the studies, talking to your colleagues, and just learning as much as you can.
34:07
SPEAKER_00: But no, we're not trained in school.
34:09
SPEAKER_01: Yeah, wow.
34:10
SPEAKER_01: I mean, I see that as just such a um, yeah, such a huge blind spot, it sounds like to not include this in the education process.
34:19
SPEAKER_01: And of course, if you want to go into a specialty, then you know, you would explore and research and study even deeper.
34:26
SPEAKER_01: And I do wonder if like if our even our general healthcare providers aren't being trained on this, then how could we expect women to to know this if even the people who are taking care of them aren't trained to know either?
34:41
SPEAKER_00: I do have a couple of helpful messages in that regard because it can be really challenging to show up, be dismissed.
34:48
SPEAKER_00: You know, you maybe took time off of work, maybe got a babysitter, had to find parking, you know, rushing around and then do show up and there's no care.
34:57
SPEAKER_00: And I I've waited a month or two months or three months for this appointment.
35:00
SPEAKER_00: So there's a couple of things I like to suggest because you cannot assume somebody is has any education in this area or any or it will help you in this area, regardless of what their specialty is or how fabulous they are.
35:14
SPEAKER_00: This is specialized.
35:15
SPEAKER_00: So a couple of things to do.
35:17
SPEAKER_00: One is talking to your to your ladies, your talking to your your girlfriends and your sisters, and and the fact that we are talking about this more and more and more openly and sharing experiences so reinforcing that we can uh advocate for ourselves and at least at least have an assessment.
35:34
SPEAKER_00: So I love that.
35:35
SPEAKER_00: This conversation didn't used to happen.
35:38
SPEAKER_00: Um it was um nobody would talk about menopause.
35:41
SPEAKER_00: It was almost uh shameful to, you know, how dare we get old and age.
35:46
SPEAKER_00: So um, so a couple of things to do is definitely share with your friends because um that that helps to make us feel like our experience is real and it gives us maybe a little bit more motivation or or energy or power to feel like we can advocate ourselves.
36:01
SPEAKER_00: Then um, a couple of things you can do.
36:03
SPEAKER_00: When you're making an appointment at your doctor's office, you can ask the person who answers the phone um, hey, do you know if they take care of women in menopause?
36:11
SPEAKER_00: Or and it doesn't have to be hormone replacement therapy.
36:14
SPEAKER_00: There's there's hormone replacement therapy, non-hormonal options, diet and lifestyle cannot be ignored.
36:20
SPEAKER_00: It just depends on what a woman's goal is.
36:22
SPEAKER_00: But but the people who answer the phone, they know they do.
36:25
SPEAKER_00: Even if they don't know the details, so that's a place to start because then maybe you just don't make that appointment.
36:30
SPEAKER_00: But if you do have, say, a trusted primary or um a trusted OBGYN or something like that, is to ask them.
36:38
SPEAKER_00: And it's okay to ask them, what kind of training do you have in menopause care or perimenopause care?
36:45
SPEAKER_00: And you can ask, how do you individualize care?
36:48
SPEAKER_00: Because that will speak to you as an individual.
36:52
SPEAKER_00: You know, you have a different health history, you have different goals, you know.
36:56
SPEAKER_00: Um, and then what are the risks and benefits for me?
37:00
SPEAKER_00: That's a very, very important.
37:01
SPEAKER_00: Again, speaking to assessment and um looking at again goals and options.
37:07
SPEAKER_00: And then how will we follow up?
37:09
SPEAKER_00: I believe just like any change or any anything you're gonna initiate in healthcare, you have to do proper follow-up to um assess efficacy and you know, make changes if you need to.
37:20
SPEAKER_00: So I feel like those four things need to be in place.
37:24
SPEAKER_00: And when a woman walks into that doctor's appointment, whether it's a an MD, you know, an NP, a PA, there's some fabulous, you know, family medicine folks with different um credentials, to walk in and and you and recognize you are part of that team and you can ask those questions.
37:40
SPEAKER_00: I know it's hard for most of us walking into that type of situation, there's already a different power dynamic, but we have power too.
37:49
SPEAKER_00: And it's not to say we're being pushy or critical, but we're part of that dialogue and stepping into that power just by asking some simple questions.
37:57
SPEAKER_00: And you can always Google Google menopause specialist, and that's how you can find me and some of my amazing colleagues.
38:04
SPEAKER_01: Yeah, okay.
38:05
SPEAKER_01: So, you know, even if we are going to our primary care providers and we're not getting the kind of support that we need, there are people out there who are offering the support and empowering ourselves to to go about finding those people or to ask more questions.
38:20
SPEAKER_01: I love that you you mentioned this, to simply ask the person who's who's uh you know, seeing you, you know, what experience do you have?
38:29
SPEAKER_01: What training do you have?
38:31
SPEAKER_01: And yeah, I think that wouldn't necessarily be the first thing that I would go towards is like being so direct and asking that.
38:37
SPEAKER_01: So I really appreciate you naming that.
38:39
SPEAKER_01: That's very empowering, I think.
38:41
SPEAKER_01: Yeah, to make yourself a part of that process too.
38:44
SPEAKER_01: Well, I'm wondering, um, you mentioned lifestyle shifts, and I'm I'd love to share a little bit more about what lifestyle shifts truly matter during this phase.
38:56
SPEAKER_00: First, I want to say that um lifestyle changes um or shifts or new focus, they are imperative, but they are not going to replace depleted hormones.
39:10
SPEAKER_00: So again, while while it's so, so important, that shouldn't be the the place that's that is where we start because you cannot out-exercise, out-diet, um, out-supplement your way out of of this stage of life.
39:25
SPEAKER_00: So I think it's really, really important to look at the basics, look at your hormones.
39:30
SPEAKER_00: If hormone replacement resonates and a woman is interested in trialing that, or non-hormonal options that will at least they won't, it won't protect her long-term health, but it will at least help her function today.
39:43
SPEAKER_00: And then next step, optimize diet and lifestyle as as best you can.
39:49
SPEAKER_00: Um, I gosh, I hope I said that right, because diet and lifestyle really does, really does matter.
39:55
SPEAKER_00: Um, but if I can't sleep, I can't get up and go for a walk or you know, I can't necessarily make the best choices in eating because you know, I'm starting to start craving carbohydrates to get energy.
40:06
SPEAKER_00: So, but some really, really impactful things um that can uh start to shift in in habits.
40:13
SPEAKER_00: One is of course moving every day, um, some kind of joyful movement, dancing, walking, lifting weights is I know we all keep hearing we have to lift heavy.
40:23
SPEAKER_00: That is um important because we do lose our muscle over time.
40:29
SPEAKER_00: And our muscle is our metabolism, it's um it's our strength that helps our bones.
40:36
SPEAKER_00: So um, so that is something to consider adding uh as we can, um, changing how we eat.
40:44
SPEAKER_00: Um, for the longest time, I think our culture talks to us as about being as small as we can, uh having our bodies be as small as possible.
40:53
SPEAKER_00: And how do you accomplish that?
40:55
SPEAKER_00: You accomplish that by um calorie depth calorie um um yeah, um deficit.
41:04
SPEAKER_00: Thank you.
41:04
SPEAKER_00: Um calorie deficit.
41:07
SPEAKER_00: And so, you know, high volume uh low calorie foods, so you know, salads and vegetables and fruits and things like that.
41:12
SPEAKER_00: And while those are super important for the micronutrients, we can't do that the same way anymore because unfortunately, if um if we focused our our diet in that way, it'll lead to more muscle loss.
41:26
SPEAKER_00: So prioritizing protein, whether it's you know from animal sources or plant sources, but that in my opinion should be the first thing we we focus on, and then add in the beautiful, you know, gifts from the earth, uh, plants and and uh fruits and vegetables.
41:41
SPEAKER_00: So uh so those are two things, and then protect your sleep like it's your job.
41:46
SPEAKER_00: And however, however you need to do that, it uh it becomes more and more impactful to us when we are sleep deprived.
41:53
SPEAKER_00: We can manage for a long time putting our sleep last, um, but we really can't in this phase.
41:58
SPEAKER_00: So those are the three biggest things.
42:00
SPEAKER_00: And I do want to reiterate that I I the way I practice, I really try to simplify things.
42:07
SPEAKER_00: And I don't want women to start getting overwhelmed with all of these supplements and all of this.
42:11
SPEAKER_00: I now I have to go to the gym and do changing all of these things about my life.
42:15
SPEAKER_00: Get the foundation right and then start adding in, you know, stacking on these new habits.
42:21
SPEAKER_00: And it'll come easier when you feel like yourself.
42:23
SPEAKER_01: Yeah, definitely.
42:25
SPEAKER_01: Thank you for naming that because it can be very difficult to go about creating lifestyle change if we're sleep deprived and we're anxious and we have all these other things going on.
42:34
SPEAKER_01: We're not gonna necessarily be making the best decisions from that place.
42:38
SPEAKER_01: So really getting the foundation in and doing a little bit at a time, which I think is more sustainable anyway, than trying to make these really grand big sweeping changes all of a sudden.
42:49
SPEAKER_01: Um, yeah, we're not as likely to keep them from my experience.
42:53
SPEAKER_01: Yeah.
42:54
SPEAKER_01: I'm wondering if you've had the opportunity to see the difference of preparing for menopause and the difference of like not preparing for menopause.
43:05
SPEAKER_01: Have you come across that in your practice where you've been able to actually see the difference of what that looks like?
43:11
SPEAKER_00: Absolutely.
43:12
SPEAKER_00: As far as health goes, I think the amount of osteoporosis we're seeing, osteopenia and osteoporosis, is kind of shocking.
43:20
SPEAKER_00: Again, if if a woman isn't having terrible symptoms and she thinks, okay, I'm gonna power through, but the result of that, and and we start seeing very significant changes in our bone health within those first few years, it really, really speeds up.
43:34
SPEAKER_00: So preparing in that way, again, hormones maybe aren't going to be the choice for every woman, but then if if you're not gonna support your body in that way, then you have to do every other thing possible to protect your bones.
43:48
SPEAKER_00: I think the statistic is one in two of us will have an osteoprotic fracture in our lives, and that can be devastating to independence and of course pain if you had you know vertebral fractures.
44:00
SPEAKER_00: So that is a preparation type question, I think that you're alluding to.
44:05
SPEAKER_00: And then the other that I see more common because it just is so dramatic, is the emotional toll it takes on women.
44:13
SPEAKER_00: They do, they power through as long as they can.
44:16
SPEAKER_00: And usually, if they are not one of the few lucky ones who are getting this message earlier that they can have these conversations, they wait until they're just at that this tipping point where they tip over and can't and cannot handle life anymore.
44:29
SPEAKER_00: And if the conversations were more accessible, if the shame was not there, if a little bit more education was there of knowing that I have options and they can be based on my own personal belief, then I think they can be prepared in that way where they don't have these devastating things that happen.
44:49
SPEAKER_00: I've seen many women, many, many women, either leave the workforce or about to leave the workforce because they can't juggle their job anymore.
44:58
SPEAKER_00: They're afraid to speak up in a meeting because they're gonna maybe lose their train of thought and they don't want to have their colleagues and their bosses see them fail in that way.
45:06
SPEAKER_00: So they start making themselves very, very small.
45:08
SPEAKER_00: Marriages end because of the emotional uh, you know, things that can happen.
45:13
SPEAKER_00: Um, also the sexual dysfunction that can happen that men uh or partners might not understand and feel rejected.
45:22
SPEAKER_00: Um they just don't know what's happening.
45:24
SPEAKER_00: And yeah, so these all of these things are really um potentially devastating.
45:29
SPEAKER_00: And if a woman was prepared when she started seeing these changes um and addressed them as early as possible, um, then maybe.
45:37
SPEAKER_00: She wouldn't have to suffer like that and have significant life changes.
45:41
SPEAKER_01: Yeah.
45:41
SPEAKER_01: Wow.
45:42
SPEAKER_01: Okay.
45:42
SPEAKER_01: Yeah.
45:43
SPEAKER_01: It's, it's, it's funny, like how just a little bit of preparation, or you know, maybe not a little bit, maybe it's a lot for some of us, but just that preparation can make such a huge difference.
45:52
SPEAKER_01: And I think this carries over into other topics for women's health too.
45:56
SPEAKER_01: I'm like starting to feel my way into having a baby and I'm preparing.
46:02
SPEAKER_01: I've got the book.
46:03
SPEAKER_01: I'm like building up my nutrient stores and I'm really giving myself what I need to really feel more supported and prepared for that process.
46:12
SPEAKER_01: And I think that can make such a huge difference.
46:15
SPEAKER_00: I I think for women to just recognize that this is going to happen to all of us.
46:21
SPEAKER_00: Not everybody is going to have a baby, but all of us will go into menopause if we're lucky to live that long.
46:27
SPEAKER_00: And preparing ourselves, our bodies, as best we can.
46:31
SPEAKER_00: And that starts with education.
46:33
SPEAKER_00: Um, I I my mission is not for all women to be on hormones.
46:39
SPEAKER_00: My my mission is to educate women.
46:42
SPEAKER_00: So they know what's happening to them, they know it's coming to some degree or another.
46:47
SPEAKER_00: They know that there are options and then they can make the best choice for themselves of how they want to walk, walk through that journey.
46:57
SPEAKER_01: Yeah, absolutely.
46:58
SPEAKER_01: Yeah, the education piece is huge, which is a really a big mission of the show here.
47:03
SPEAKER_01: And yeah, really grateful for all the wisdom that you've shared here today.
47:06
SPEAKER_01: I'm I'm curious, I have a few more questions before we end for today.
47:10
SPEAKER_01: What are you able to offer now through your private practice that you weren't able to do at some of the bigger organizations you worked at?
47:20
SPEAKER_00: Definitely the convenience factor, and that I can decide that yes, my appointment will be a 60-minute appointment with my beautiful woman, that I'm not relegated to a 10-minute appointment or a 15-minute appointment.
47:33
SPEAKER_00: Um so that is uh a big piece.
47:36
SPEAKER_00: Um also you don't necessarily have to answer to uh maybe somebody, say a medical director that does not who they themselves are not up on this care and they might uh you know challenge, which as long as you're practicing by the evidence and um you know the best care, it's okay.
47:56
SPEAKER_00: It's just a hassle.
47:58
SPEAKER_00: Uh it's is yeah.
48:00
SPEAKER_00: Um and I think those are the two biggest things, uh, convenience uh access.
48:06
SPEAKER_00: Um access is a challenge.
48:07
SPEAKER_00: So being able to provide that access and part of what we're doing is expanding so quickly across the United States to uh train up more people to uh create more access.
48:20
SPEAKER_00: But again, as long as you're giving great care, um, it's just how it how the big organizations kind of force you to deliver it.
48:28
SPEAKER_00: And I want the delivery to be just top-notch.
48:32
SPEAKER_00: Yeah, yeah, yeah.
48:33
SPEAKER_00: And a in a partnership, you know, not just the provider dictating what's going to happen.
48:38
SPEAKER_01: Right.
48:39
SPEAKER_01: Yeah, I can definitely hear that.
48:40
SPEAKER_01: And it sounds like you're able to not only honor your values as a practitioner, but also able to better support the women that are coming to you in this way.
48:51
SPEAKER_01: Yes.
48:52
SPEAKER_01: Beautiful.
48:53
SPEAKER_01: So grateful that you're you're doing this work, Dana.
48:56
SPEAKER_01: It's it's really important.
48:58
SPEAKER_01: I'm wondering if there is something that you could offer to women listening right now, maybe in their early 30s, mid-40s, if there's one thing that you'd want them to take away from today, what would that be?
49:10
SPEAKER_00: That they are not crazy, that there is help, there is hope, if nothing else, there's education, that they do not have to be dismissed.
49:18
SPEAKER_00: You know, if they are, you just you go to the next place, and that you are part of the process and stepping into that power.
49:27
SPEAKER_00: I want them to know that, that that is that is you can find that.
49:32
SPEAKER_00: And if a woman is confused, like, I don't know, what if I'm wrong?
49:37
SPEAKER_00: You know, I don't want to show up and I'm not sure.
49:40
SPEAKER_00: I have a quiz on my website that's super helpful, super impactful.
49:45
SPEAKER_00: It's a perimenopause quiz.
49:47
SPEAKER_00: Takes a couple of minutes, checking boxes, symptoms, time frames, and things like that.
49:51
SPEAKER_00: And at the end of those couple minutes, you're gonna have a good idea if this needs to be looked into or give you that power to be able to walk in because you're like pretty sure that this is a component of what's going on with you.
50:02
SPEAKER_00: So, yeah, hope and our society does is okay with so much suffering for women.
50:07
SPEAKER_00: I don't know why.
50:08
SPEAKER_00: It's just the way it's always been.
50:10
SPEAKER_00: We um tolerate a lot.
50:11
SPEAKER_00: Men, we don't force them to suffer as much as we do women, and that we don't have to suffer.
50:17
SPEAKER_01: Yeah, thank you more.
50:18
SPEAKER_01: Push back.
50:19
SPEAKER_01: Push back, use your voice, get educated, and and find the right support for you because there are options out there.
50:26
SPEAKER_01: There are women like Dana out there doing this work that the medical care system isn't doing.
50:32
SPEAKER_01: So again, so appreciative for your time today, Dana.
50:35
SPEAKER_01: This has been really wonderful.
50:37
SPEAKER_00: I'm so happy to be here.
50:38
SPEAKER_00: I love your work and all that you do for women.
50:41
SPEAKER_01: Well, thank you.
50:42
SPEAKER_01: Yeah, right back at you.
50:43
SPEAKER_01: We'll put all of your uh information in the show notes.
50:46
SPEAKER_01: Anything else, any of our listeners, anything our listeners should know about getting in touch with you or maybe taking that next step with you if they are they're feeling the call.
50:55
SPEAKER_00: My practice is Thrive Midlife Medicine, and the website is thrive midlifemed.com.
51:02
SPEAKER_00: Um, and then slash perimenopause quiz.
51:05
SPEAKER_00: It's it's on the website.
51:06
SPEAKER_00: Um that's a great place to start.
51:08
SPEAKER_00: There's a lot of great information, um, contact information.
51:12
SPEAKER_00: And if they're in a different state, that's okay.
51:14
SPEAKER_00: I have colleagues across the country that are amazing and like-minded that I I trust and we send patients to each other all the time.
51:24
SPEAKER_00: So I know that they're they're well trained.
51:26
SPEAKER_00: So it is a good, really good place to start.
51:28
SPEAKER_01: Yes.
51:29
SPEAKER_01: That's great.
51:30
SPEAKER_01: Yeah, it's it's nice to know there's a network out there that you're a part of, and that is hopefully growing as this demand continues to grow.
51:38
SPEAKER_01: Absolutely.
51:39
SPEAKER_01: Yeah.
51:39
SPEAKER_01: Well, thank you again, Dana.
51:40
SPEAKER_01: We'll leave all your information in the show notes for our listeners.
51:43
SPEAKER_01: Okay, thank you so much.