Latest / How Hard Can It Be? with Diana Maria Riva / Menopause 101: Symptoms, Hormones and the Mental Toll with Dr. Suzanne Gilberg

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Menopause 101: Symptoms, Hormones and the Mental Toll with Dr. Suzanne Gilberg · How Hard Can It Be? with Diana Maria Riva

0:00
Speaker 1: It's time for some doctor talk, and today's episode is
0:03
Speaker 1: just a discussion. We need to get answers to some
0:05
Speaker 1: of our most pressing questions. We're sitting with an OBGUI
0:09
Speaker 1: in of over twenty five years, discussing everything from symptoms
0:12
Speaker 1: and solutions, to menopause boot Camp to calling the doctor's
0:17
Speaker 1: office at five on one on a Friday for that
0:19
Speaker 1: UTI prescription. They're on to us How hard can It Be?
0:29
Speaker 1: I am Diana made Ariva, host of How Hard Can
0:31
Speaker 1: It Be? And here we are with another episode navigating
0:33
Speaker 1: Midlfe's most fantastic Bullshit. I'm very excited about this guest
0:38
Speaker 1: because I have been waiting to have this discussion since
0:41
Speaker 1: we launched a few weeks ago, and this guest is
0:44
Speaker 1: the perfect person to have this conversation with today. She
0:47
Speaker 1: is a Board certified OBGYN, practicing of over twenty five years.
0:51
Speaker 1: She is the author of Menopause boot Camp, of which
0:54
Speaker 1: you can tell I read, studied and noted, very willing
0:57
Speaker 1: to ready to talk about it, and she is a
0:59
Speaker 1: huge advocate for women's health. This is why we align.
1:02
Speaker 1: Please help me. Welcome doctor Suzanne Gilberg.
1:06
Speaker 2: And.
1:07
Speaker 1: I'm so excited you're here. I'm excited to be here.
1:10
Speaker 2: I think around someone who's excited, I am very excited.
1:14
Speaker 1: That's it. That's it. There is a growing excitement about
1:16
Speaker 1: men of Eiz because we are getting to know getting answers. Yes,
1:22
Speaker 1: and you are at the forefront of bringing answers. And
1:24
Speaker 1: this is why I'm so happy you're here.
1:26
Speaker 2: Oh, thank you for saying that. And I mean, let's
1:29
Speaker 2: get into it, because I'm sure you have I do
1:31
Speaker 2: love questions.
1:32
Speaker 1: I'm so ready. But let me let me tell you
1:34
Speaker 1: what really got me. Because I've seen you talk on
1:37
Speaker 1: other shows, I've seen you news clips with you, and
1:40
Speaker 1: then I read your book and there was something that
1:43
Speaker 1: you said. First of all, you have a chapter in
1:45
Speaker 1: here called societal Bullshit. I'm like, we are comrades, we
1:49
Speaker 1: are using the same language. But this chapter, this was already.
1:54
Speaker 1: You know. I like to start my episodes usually with
1:57
Speaker 1: an icebreaker. Oh I got a look you I can see.
1:59
Speaker 1: Oh no, I don't know. Oh my god, yes, I'm
2:02
Speaker 1: a school child here. No, no, no, I'm ready. I'm ready.
2:07
Speaker 1: I'm ready. She's commenting because I couldn't find my highlighters.
2:10
Speaker 1: I wrote right in it. But sometimes, Hygler, you know,
2:12
Speaker 1: I don't see well with the yellow. So here's what
2:16
Speaker 1: I liked, and this is what got me. You created
2:19
Speaker 1: this menopause Menopause boot Camp, and when I heard about it,
2:22
Speaker 1: I was like, oh shit, well we're going to a
2:24
Speaker 1: boot camp. We're going to be doing burpies, We're going
2:26
Speaker 1: to be doing all these ship that I can't stand.
2:29
Speaker 1: And it's better than that because it's strengthening of your
2:34
Speaker 1: intellect with menopause. And you said, I'm gonna I'm gonna
2:38
Speaker 1: paraphrase just a tiny bit here that the truth is
2:41
Speaker 1: whether a group forms out of necessity to help people
2:44
Speaker 1: overcome addictions, adopt, adopt and maintain healthy habits, or manage
2:49
Speaker 1: their diabetes diabetes, or focuses on general well being, such
2:54
Speaker 1: as as controlling stress and other factors that influence health.
2:58
Speaker 1: Even if it's just an informal group of friends, finding
3:01
Speaker 1: a community of people with whom you can talk about
3:03
Speaker 1: menopause makes a difference. When I pitched to iHeart the
3:08
Speaker 1: idea of this show, I wanted the conversation to be
3:13
Speaker 1: something that was that would create a community and empower us.
3:17
Speaker 1: That is exactly it seems to be. I don't want
3:19
Speaker 1: before you the impetus yep for this boot camp. Yeah,
3:23
Speaker 1: that's exactly.
3:23
Speaker 2: That's amazing to me that of the entire book, that's
3:27
Speaker 2: the paragraph you're opening with. Because look, I published the
3:30
Speaker 2: book was published almost four years ago, which means it
3:33
Speaker 2: was written like six years ago at this point, right,
3:36
Speaker 2: So you know, I haven't learned it for a minute.
3:38
Speaker 2: But what's really really profound to me and interesting to
3:42
Speaker 2: me is two things. One, and I think I talk
3:45
Speaker 2: about this in the book. I started menopause boot camps,
3:47
Speaker 2: and we can back up and talk about what that
3:49
Speaker 2: was briefly. Yeah, because there was a need in the
3:53
Speaker 2: community for information.
3:55
Speaker 1: Yeah.
3:55
Speaker 2: I mean, if people feel like they're not getting information now,
3:57
Speaker 2: I want them to dial back six years, ten, twenty years. Right.
4:02
Speaker 2: I started doing this because I could not accomplish the
4:05
Speaker 2: educational task, the information task. And I like to always
4:10
Speaker 2: say it's not informed consent if you don't have all
4:12
Speaker 2: the information. So I was in an insurance based high
4:15
Speaker 2: volume practice. How am I doing your PAP and did
4:18
Speaker 2: you get your mamogramma? And what happened with your kid?
4:20
Speaker 2: And how's your mom? You know, knew my patients for years,
4:23
Speaker 2: and I'm gonna also now I'm gonna explain everything about
4:25
Speaker 2: menopause and answer all your questions. They manage it. No
4:27
Speaker 2: way in fifteen minutes. It's not happening. Yeah. And anytime
4:31
Speaker 2: I would make a public appearance about anything, at the
4:34
Speaker 2: end of the talk, the hands would shoot up and
4:37
Speaker 2: have a million questions. What are bioidentical hormones? What is
4:40
Speaker 2: menopaud da?
4:40
Speaker 1: Da da da da?
4:41
Speaker 2: And I thought I gotta do something right, So I thought,
4:44
Speaker 2: I'm creating this educational opportunity. It became clear to me
4:48
Speaker 2: very quickly. Sure, sure, sure, I'm giving information. It was
4:52
Speaker 2: about community. It was about creating a community destigmatizing saying
4:56
Speaker 2: the word. Women did not want to say the word.
4:59
Speaker 2: They would say, hey, I'm going to the yoga studio.
5:02
Speaker 2: And I actually had one lady come to me at
5:04
Speaker 2: the end and say, hey, this was great.
5:06
Speaker 1: Could you change the name of menopause? I was like, oh, you.
5:09
Speaker 2: Need a hug, No, I love you not changing the name.
5:12
Speaker 1: They didn't want.
5:13
Speaker 2: They were like embarrassed ye to say they had gone
5:16
Speaker 2: to a menopause related activity.
5:18
Speaker 1: I think that has changed. So it's changing.
5:21
Speaker 2: If that's all I had a part of I'm thrilled.
5:25
Speaker 2: I mean, it's obviously not enough. But the other thing
5:28
Speaker 2: that came out of it for me, I found my community.
5:32
Speaker 1: Love it.
5:32
Speaker 2: I didn't have a community in medicine around me. I
5:35
Speaker 2: have all these amazing experts and girlfriends that I've learned
5:39
Speaker 2: with and from that support me through all of it.
5:42
Speaker 2: So the community is medicine. That's where the healing is.
5:47
Speaker 1: I love that. So whether you had community and healing
5:50
Speaker 1: in the same sentence, yeah, and medicine and healing in
5:53
Speaker 1: the same sentence. Because when you talk about the you know,
5:57
Speaker 1: someone being afraid to say the word menopause. I love
6:00
Speaker 1: your analogy about saying that. It's like when you decide
6:03
Speaker 1: to go gray. Yeah. Yeah, the minute we decided to
6:06
Speaker 1: go gray would be like, oh my, I'm giving over,
6:09
Speaker 1: I'm letting go, it's nearing the end, I'm embracing my
6:13
Speaker 1: morteme whatever. It is. Like, there's a thousand words, But
6:15
Speaker 1: when I read that, I laughed out loud because I
6:17
Speaker 1: thought it is a little bit like that when you
6:19
Speaker 1: say I'm in menopause, I feel like I just announced
6:22
Speaker 1: to the world I'm one hundred and seven. Yeah, and
6:24
Speaker 1: I kind of feel like that when I leave, my
6:26
Speaker 1: grace come in as well. So that was a great analogy,
6:29
Speaker 1: and there it is getting We are getting more. I
6:32
Speaker 1: don't want to say embolden. We should just be confident
6:34
Speaker 1: and embrace it, but we are getting more emboldened and
6:37
Speaker 1: powered to say that we're because of conversations like a big.
6:41
Speaker 2: Thing for me too, was just the sort of the
6:44
Speaker 2: narrative busting that you already have named it, you know,
6:48
Speaker 2: but this idea that we fade away, that we are
6:51
Speaker 2: not vital, that we are defined by other people's versions
6:56
Speaker 2: of us, that as women we exist only for a
7:00
Speaker 2: for very specific purposes, whether it's reproduction or sexual objectification.
7:07
Speaker 2: You know, when we buy into those myths, like at
7:11
Speaker 2: a certain point, it's on us. I'm not saying that
7:15
Speaker 2: we're not dealing with these large forces that feel impossible
7:19
Speaker 2: to come up against. But when you use that word
7:21
Speaker 2: emboldened and confidence, we have the right to be that
7:27
Speaker 2: person at any point in our lives. But there is
7:31
Speaker 2: something about this transition, and I have theories that really
7:38
Speaker 2: puts us into a position to say, now's the moment
7:42
Speaker 2: like I'm no longer going to accept your definition of me.
7:46
Speaker 2: I'm defining me.
7:47
Speaker 1: So if we were to jump into a mini menopause,
7:51
Speaker 1: boot camp, and I love that you just break it
7:54
Speaker 1: down just from the very beginning about the basics and whatnot,
7:57
Speaker 1: and you start talking. You begin with talking about perry menopause.
8:01
Speaker 1: I never looked at it this way, and I kind
8:02
Speaker 1: of love it. You kind of you went so far
8:04
Speaker 1: as to say, like, I want to get rid of that.
8:05
Speaker 2: Word because that I had a triggered hormonal moment.
8:09
Speaker 1: But I kind of like it because when perimenopause to me,
8:12
Speaker 1: sounds like menopause on deck, So deck, you're like, shit,
8:16
Speaker 1: well on deck.
8:17
Speaker 2: I think, especially at this time, I was like, it's
8:20
Speaker 2: being used like like a pathology, and I think it
8:24
Speaker 2: is now too, I mean in a weird way. I
8:26
Speaker 2: was like, because nobody was talking about perimenopause, and now
8:28
Speaker 2: everybody's obsessed with perimenopause, which I think as long as
8:32
Speaker 2: it's a tool for us to get in the door
8:33
Speaker 2: and like talk and get some good information and get help,
8:36
Speaker 2: I don't have a problem with it. But at the time,
8:38
Speaker 2: I was like, why are we pathologizing? Why are we
8:41
Speaker 2: turning a physiologic process into a disease. It's not a disease,
8:45
Speaker 2: it's a natural life stage. It still deserves attention management, solutions, treatment,
8:52
Speaker 2: but this idea that like there's something wrong with you,
8:54
Speaker 2: And I think the other thing is that there's a
8:56
Speaker 2: lot of fear that comes from that because it's like,
8:59
Speaker 2: oh my god, what is going to happen to me?
9:01
Speaker 1: Like how this is.
9:03
Speaker 2: Gonna last seven to ten years?
9:04
Speaker 1: Oh my god?
9:05
Speaker 2: You know, just all this anxiety and distress and like
9:12
Speaker 2: kind of solution oriented, but in a way that's like
9:16
Speaker 2: covering it up or fixing it as if you are
9:18
Speaker 2: a problem, your body is a problem. I just don't.
9:22
Speaker 2: I don't look at it that way.
9:23
Speaker 1: No, you do. You make a great analogy though, and
9:25
Speaker 1: I really like this too. It's like you said, it's
9:27
Speaker 1: not a disease. It's not a diagnosis. It's like puberty.
9:30
Speaker 1: We don't say I've diagnosed my child with puberty. Right,
9:33
Speaker 1: my child is not an asshole because you're going through
9:35
Speaker 1: puberty and she might acting be very emotional because whatever
9:39
Speaker 1: it is. But that's a great mindset, a shift away.
9:41
Speaker 1: It's not a diagnosis. It does help explain changes because you,
9:46
Speaker 1: as you said, you're either in the child bearing years
9:48
Speaker 1: or you're not right. So why do we need this
9:50
Speaker 1: in between word of perimenopass unless it gives everybody. It's
9:54
Speaker 1: like a heads up, yeah, perimenoos heads up. Yeah, And
9:57
Speaker 1: that's fine. But I do think it amps anxiet. It
10:00
Speaker 1: can yeah, it can't.
10:02
Speaker 2: Again, I think any words are tools, just like anything else.
10:06
Speaker 2: And so if the word is being used to help
10:08
Speaker 2: you name something that feels off to you, which is legitimate, and.
10:12
Speaker 1: I'm fine with it.
10:13
Speaker 2: But again, like when it's just being thrown at you
10:17
Speaker 2: with no support, it's just it's unhelpful.
10:20
Speaker 1: That's unnecessary. I hear yeah when you talk. So let's
10:23
Speaker 1: go through just some of these basics, because there are
10:26
Speaker 1: a lot of women that are not aware exactly some
10:29
Speaker 1: of the things that you experienced during perimenopause. Broad stroke basics.
10:33
Speaker 2: I mean, I think one of the first things that
10:35
Speaker 2: happens well before your your period changes very much, or
10:39
Speaker 2: the interval between your bleeds changes. And this is for
10:42
Speaker 2: people who are bleeding, because then of course there's all
10:44
Speaker 2: those people who are not. Mood is a huge thing,
10:48
Speaker 2: mood and sleep.
10:49
Speaker 1: I can blame this for a many years of my life.
10:52
Speaker 2: Yeah, it's not just my personality, right, you weren't just
10:57
Speaker 2: yeah I did, I like heard us or there was
11:00
Speaker 2: a little snicker, but go ahead.
11:03
Speaker 1: I'm sorry.
11:04
Speaker 2: Mood is a big one. Mood is one of the
11:06
Speaker 2: biggest ones. And this is a really important thing to understand.
11:09
Speaker 2: And you know, we were talking beforehand and I was saying,
11:11
Speaker 2: my thinking has evolved around some of this. This is
11:13
Speaker 2: where I think understanding perimenopause is important because this is
11:17
Speaker 2: the era where women get slapped on antidepressants. And I'm
11:21
Speaker 2: not against antidepressants again. Tools are tools. You know, how
11:25
Speaker 2: we use the tool and the thought process behind the
11:29
Speaker 2: decision making to select a specific tool is much more
11:32
Speaker 2: important to me. But if the only tool you have
11:34
Speaker 2: is an antidepressant, and you don't realize that this forty
11:37
Speaker 2: six year old is having anxiety attacks, you know, on
11:41
Speaker 2: schedule with ovulation and PMS, you know she might do
11:45
Speaker 2: better with hormones or hormonal management of some sort. So
11:49
Speaker 2: that is a big one during perimenopause.
11:51
Speaker 1: Oh yeah, yeah, yeah.
11:52
Speaker 2: People who maybe didn't have a big deal PMS mood wise,
11:56
Speaker 2: or even physical symptom wise like fatigue, hot flashes, they
12:01
Speaker 2: they all of a sudden do have a big deal.
12:02
Speaker 2: Or maybe you had you know, two to three predictable
12:05
Speaker 2: days and now it's ten days, or now when you
12:07
Speaker 2: start skipping your cycles. It's thirty five days and you
12:10
Speaker 2: think you're going crazy. Yeah, so that's a big one.
12:13
Speaker 2: A lot of the brain stuff, because I think what
12:15
Speaker 2: we really understand now is that this whole process is
12:19
Speaker 2: a conversation.
12:20
Speaker 1: Between your ovaries.
12:22
Speaker 2: And your brain and everything else. Your brain is heavily
12:25
Speaker 2: involved in this so mood, word finding, memory difficulty, brain fog,
12:33
Speaker 2: sleep disruption, sexual changes. So the other thing is that
12:36
Speaker 2: people will start having more dryness or pain nothing else
12:40
Speaker 2: has changed, and they think they have an infection or
12:43
Speaker 2: they're thinking they're having bladder infections and it's no. Hormones
12:46
Speaker 2: are changing. UTI is oh yeah, yeah, every single one
12:50
Speaker 2: of you who calls at five oh one on Friday
12:54
Speaker 2: with a UTI you're talking about men and you know
12:58
Speaker 2: who you are because you all do it.
13:03
Speaker 1: Five oh one.
13:04
Speaker 2: It's been bothering me for five days, Doc, Really wait,
13:08
Speaker 2: five day's not going to date this week right, I'm
13:10
Speaker 2: going away this weekend.
13:12
Speaker 1: Okay, I hear that. So, but here's the thing right now,
13:14
Speaker 1: we can't now, we can't out our asses on that girl.
13:18
Speaker 2: I am one of you, Okay, I don't I know
13:22
Speaker 2: where the bodies are buried. For multiple reasons, okay, so,
13:27
Speaker 2: but I mean making a joke because it's real. But
13:30
Speaker 2: the problem is now you can't come in and now
13:33
Speaker 2: you're getting antibiotics, and you're getting antibiotics, and you're getting antibiotics,
13:36
Speaker 2: and maybe you never had an infection, maybe you need
13:38
Speaker 2: vaginal estrogen. So now you're killing all the microbes that
13:41
Speaker 2: you need in your gut. Yes, and now you're really
13:44
Speaker 2: getting and guess what else changes your gut microbiome hormone changes,
13:49
Speaker 2: So you're just like putting fuel to the fire, like
13:51
Speaker 2: is some of it a bladder infection that needs an antibatic?
13:54
Speaker 2: Of course, but we don't know if we don't know,
13:56
Speaker 2: So I think if people can pay more attention to
14:00
Speaker 2: the changes of their body is going through and say, hmm,
14:04
Speaker 2: can I track this, I mean and see if there's
14:07
Speaker 2: a pattern, or can I make some notation so that
14:11
Speaker 2: I understand myself better, then you can advocate for yourself
14:15
Speaker 2: and you can come into your clinician's office with a
14:16
Speaker 2: little bit more detailed information and then you do have
14:19
Speaker 2: the question, right you do.
14:20
Speaker 1: And I'm going to side on I play a little
14:23
Speaker 1: bit of Devil's advocate because I do think women, a
14:26
Speaker 1: women of many cultures be and also just gen X
14:29
Speaker 1: women generationally, we muscle through Oh my god, absolutely, you're
14:34
Speaker 1: like you t I what you try till five oh
14:36
Speaker 1: one when you're getting in a shower and you realize,
14:38
Speaker 1: oh my god, I know. And so I do think
14:41
Speaker 1: that it's a mindset that we have to change. When
14:43
Speaker 1: you said the magic word, if we take notes and
14:46
Speaker 1: even if we I feel that if we have the
14:49
Speaker 1: permission to not know if this is attributed to hormones,
14:54
Speaker 1: but we can call and ask.
14:56
Speaker 2: Yeah. No, I'm not saying I say to this to
14:58
Speaker 2: patients all the time. Your job as a patient is
15:01
Speaker 2: not to make the diagnosis. That is not fair to you,
15:06
Speaker 2: you know. But you're but you are always going to
15:09
Speaker 2: know your body better than your doctor. Even if you
15:11
Speaker 2: only had one doctor for the rest of your life,
15:13
Speaker 2: she's not going to know you as well as you're
15:15
Speaker 2: going to know you. And so, but I think it's
15:17
Speaker 2: powerful to hear that from your clinician, right to be like,
15:20
Speaker 2: you're the expert of your experience. I am the medical
15:23
Speaker 2: expert supposedly, you know, if you come to me with
15:27
Speaker 2: the information, we can look at it together. Now, listen,
15:29
Speaker 2: I have a practice that I can take time and
15:32
Speaker 2: I can sit with you, can I can unwind it
15:34
Speaker 2: and we have a relationship, and all of a sudden,
15:36
Speaker 2: most of us don't have that opportunity. So I think
15:40
Speaker 2: if you again, if you can sort of plug in
15:42
Speaker 2: and stop muscling through and like take responsibility for yourself
15:48
Speaker 2: in a different kind of way, which is not the
15:50
Speaker 2: responsibility of the world, Like I have to muscle through
15:53
Speaker 2: because I've got to take care of everybody else's business
15:55
Speaker 2: except my own, Like I don't count because that's just
15:58
Speaker 2: not the will start to fall off and they this
16:01
Speaker 2: age group, but we just you can't do it anymore.
16:03
Speaker 2: So if you can do that and give yourself permission
16:06
Speaker 2: and then come to your clinician and invite them to
16:09
Speaker 2: participate and partner with you, you're gonna see who they
16:13
Speaker 2: are because they're either going to be down for it
16:15
Speaker 2: or they're not. If they're not, now we have other challenges,
16:19
Speaker 2: but you know, there are a lot more people who
16:21
Speaker 2: are devoting their practice to this, that are training in this,
16:24
Speaker 2: and you know, hopefully we can put some stuff in
16:27
Speaker 2: the show notes so people can know where to look
16:29
Speaker 2: for a clinician. So I'm not here to say it's
16:33
Speaker 2: not hard.
16:33
Speaker 1: Because it is. I mean, even symptoms as simple as
16:42
Speaker 1: dry mouth, dry eyes.
16:44
Speaker 2: Psoriasis, any kind of dryness or inflammatory condition. If you
16:48
Speaker 2: have it, it's gonna get worse. And if you never
16:52
Speaker 2: had it and it's presenting. It's so classic in perimenopause
16:57
Speaker 2: because hormonal fluctuations, you know, huge ups and downs, because
17:03
Speaker 2: that's the hallmark of perimenopause. It's your ovaries just kind
17:07
Speaker 2: of like doing the best they can. Right Those fluctuations
17:12
Speaker 2: are in and of themselves inflammatory signals to your body.
17:16
Speaker 2: So that's where we see a lot of this stuff.
17:18
Speaker 2: And by the way, it's also contributing to things that
17:21
Speaker 2: you are not feeling, like increased metabolic disease risk, you know, diabetes,
17:26
Speaker 2: starts to develop her high cholesterol, cardiac disease, which is
17:30
Speaker 2: the number one killer of women, osteopenia, and osteoporosis, bone loss,
17:34
Speaker 2: and these are things not to be scared of, but
17:36
Speaker 2: to know because if you don't know and your doctor
17:39
Speaker 2: isn't talking to you about it and you don't ask,
17:42
Speaker 2: you are gonna shorten the window of intervention. Because you
17:46
Speaker 2: can change this. Can you can know about this, and
17:49
Speaker 2: you could change your health span that which is the
17:53
Speaker 2: life spent as how long you live? Right? Who cares
17:55
Speaker 2: if you live an extra decade in poorer health, which
17:58
Speaker 2: is on average what happens to women. We live longer,
18:01
Speaker 2: but in poorer health. I don't want that for you.
18:03
Speaker 2: I don't want it for me. So again, if we're
18:06
Speaker 2: armed with this information, and yes it is asking you
18:09
Speaker 2: to do the homework and come in with your book
18:12
Speaker 2: like that, which is you know some of our dream
18:15
Speaker 2: and some of our nightmare. But I mean, I think
18:17
Speaker 2: if you want to have the conversation and as the
18:19
Speaker 2: clinician and you have the time to have the conversation,
18:21
Speaker 2: this is fantastic.
18:23
Speaker 1: Yeah. But also when I go to my doctor's office,
18:26
Speaker 1: she asks me, I don't have to have all the
18:28
Speaker 1: questions ready. I may have a list of I've been
18:31
Speaker 1: feeling this or that. She does a lot of tests
18:33
Speaker 1: to see where my vitamin D levels are at and
18:37
Speaker 1: all that, and I wouldn't know. I can't tell if
18:39
Speaker 1: my vitamin D levels or low. Would in California, I
18:42
Speaker 1: feel like I get plenty of vitamining I believe it
18:43
Speaker 1: or not, they're low and so I need a supplement.
18:46
Speaker 1: But when you find the right doctor or community to
18:51
Speaker 1: get together and discuss with doctors in charge and clinicians
18:55
Speaker 1: in charge. You start to hear the language and the
18:58
Speaker 1: vocabulary and you start to repeat it yourself, and then
19:00
Speaker 1: until then it's being asked of you. Then you know
19:03
Speaker 1: you're in the right place. So when we move on
19:05
Speaker 1: to you know, you talk about it's a bit of
19:11
Speaker 1: a slippery slope when someone comes in and says, I
19:13
Speaker 1: want you to test my hormone. Yeah, yeah, And I
19:16
Speaker 1: was a little stuck on that. I was like, well yet, yeah, no,
19:20
Speaker 1: I don't I kind of get it, and I kind
19:22
Speaker 1: of don't get it, yeah, because I know, having my
19:26
Speaker 1: hormones tested told me that my estrogen level was on
19:29
Speaker 1: the floor. Yeah, that's what she said, And so I
19:32
Speaker 1: needed to and so I started my journey with the
19:36
Speaker 1: what do you call it, bio, the hormone placement therapy,
19:39
Speaker 1: and it is there has been a big difference. I
19:43
Speaker 1: would say that my hot flashes were like one every
19:46
Speaker 1: forty minutes. And by the way, when I read in
19:48
Speaker 1: the book that when they're happening that often, that could
19:50
Speaker 1: be a cardiac issue, as oh my god. First of all,
19:52
Speaker 1: this was years ago, and the hormone replacement therapy knocked
19:56
Speaker 1: that out.
19:57
Speaker 2: Of the wall. Part.
19:58
Speaker 1: I had to because they were there and they're not there,
20:00
Speaker 1: like I'll have them, but I have a lot of hair,
20:01
Speaker 1: so I can never tell if it's my hair or hormones. Right,
20:04
Speaker 1: But so you say it's a little tricky to come
20:08
Speaker 1: in and just say test my hormones.
20:10
Speaker 2: Yeah, because why so during perimenopause. Remember I kind of
20:13
Speaker 2: did this in my hand. What day are we testing you?
20:16
Speaker 1: Where are you?
20:16
Speaker 2: And it's not going to really it's not going to
20:18
Speaker 2: impact our management of what's going on because.
20:21
Speaker 1: I'm going to treat you clinically.
20:23
Speaker 2: If your hormones are four hundred today and less than
20:27
Speaker 2: five tomorrow and you're having crazy hot flashes, I'm just
20:29
Speaker 2: going to use that as an example. I'm going to
20:31
Speaker 2: treat you. You don't need to meet any specific criteria,
20:35
Speaker 2: like in terms of you've been having it for this,
20:37
Speaker 2: like if we know it's not any other reason, I'm
20:40
Speaker 2: going to treat it. I will say that this is
20:44
Speaker 2: another area where my thinking has evolved, and again it's
20:47
Speaker 2: because of the way I practice now. Right, I have
20:49
Speaker 2: more time with my patients. I explained to them, Look,
20:52
Speaker 2: your management is not going to change based on these
20:55
Speaker 2: hormone levels. If you want to see something visually, if
20:59
Speaker 2: you want to see snapshot, let's do it. Just understand
21:02
Speaker 2: what it does and doesn't mean. I think there's an
21:05
Speaker 2: evolving conversation around what are we doing with follicle stimulating
21:10
Speaker 2: hormone FSH. I mean, this is a little bit in
21:12
Speaker 2: the weeds, and is that really indicative of disease prevention
21:17
Speaker 2: and stuff like that postmenopause.
21:19
Speaker 1: Also, like.
21:22
Speaker 2: This friend of mine who's not had a period for
21:25
Speaker 2: four years, she's obviously in menopause. This is a whole
21:28
Speaker 2: side conversation. But she finally went to the doctor. I've
21:31
Speaker 2: been begging her, right, hello, you're friends with me. I
21:33
Speaker 2: don't even understand any of this, but whatever, it is
21:36
Speaker 2: what it is. And she's like, oh my god, I
21:39
Speaker 2: have no hormones. I was like, I know, you do
21:43
Speaker 2: talk about that, which is so great. You do, say
21:45
Speaker 2: listen testing your hormones or not?
21:47
Speaker 1: If you come in. I wish I could find the
21:49
Speaker 1: quote I wrote it here. I underline, here's someone where
21:52
Speaker 1: you like, if you come in and you tell me
21:54
Speaker 1: you are dripping in sweat throughout the day, you can't sleep,
21:59
Speaker 1: and you want to kill your family like I'm going
22:01
Speaker 1: to treat that. I can see what that is.
22:03
Speaker 2: I mean, and that's also kind of based on consensus
22:06
Speaker 2: and guidelines. Now I'm kind of because I'm so deeply
22:09
Speaker 2: in this, like there's a lot more progressive thinking going on,
22:12
Speaker 2: and there are reasons why I would check your hormones
22:14
Speaker 2: once you're on homeown therapy therapy. Potentially this is like
22:17
Speaker 2: individualization and precision medicine. This is not Unfortunately, this is
22:21
Speaker 2: not what the majority of people who are listening to
22:24
Speaker 2: this art can expect. Okay, so just know that, like
22:27
Speaker 2: the general scheme is, we're going to treat your symptoms,
22:31
Speaker 2: and then I think you have to sort of take
22:33
Speaker 2: the temperature with your clinician and see are they open
22:36
Speaker 2: to following and what would be the utility because there
22:39
Speaker 2: may not really be any utility there. Your curiosity is
22:42
Speaker 2: something that is legitimate. Just understand what it doesn't doesn't do,
22:46
Speaker 2: which is weird because for everything else again, right, we
22:49
Speaker 2: were talking about this, it's not a disease, right, if
22:51
Speaker 2: you have a thyroid disorder, we need to check your thyroid,
22:54
Speaker 2: you know, if you have any other number of diseases,
22:56
Speaker 2: we're watching you with testing and you know, all this
23:01
Speaker 2: other stuff. And I think because this has been framed
23:03
Speaker 2: as a disease state, which it's not, people are in
23:07
Speaker 2: the under the impression that they need to do it
23:09
Speaker 2: a certain way, and when it comes to hormone specifically,
23:12
Speaker 2: that's not necessarily the case.
23:14
Speaker 1: And let's slip right into that. So we see we
23:17
Speaker 1: got a little taste there of all the wide range
23:20
Speaker 1: of things that you can experience during perimienopausa. Right, menopause
23:24
Speaker 1: is clinically no period twelve months, correct, and that thing
23:29
Speaker 1: can go. I remember going ten months. Yeah, yeah, so fun,
23:34
Speaker 1: and then all of a sudden the clock resets. Yeah right, yeah, okay,
23:37
Speaker 1: so twelve months. And then there are the four big
23:40
Speaker 1: hormones that we're talking about that take a hit. Yeah,
23:43
Speaker 1: and they are estrogen, progesterone, testone, testosterone, and DHA which
23:49
Speaker 1: stands for can you tell me get it long? Oh,
23:51
Speaker 1: that's such a long one.
23:52
Speaker 2: I don't even use it, dihydro epiandrostine dione. It's a
23:56
Speaker 2: precursor that one doesn't necessarily take a huge hit in
23:59
Speaker 2: the same way that's a pre cursor hormone though, so
24:01
Speaker 2: I like to talk about it. It's a hormone that
24:03
Speaker 2: gets converted into testosterone or estrogen. So the majority of
24:08
Speaker 2: the hormones you just noted are coming from your ovaries.
24:12
Speaker 2: Your adrenal glands, which are those little guys that sit
24:14
Speaker 2: on top of your kidneys, also are responsible for DHA
24:18
Speaker 2: and testosterone. So that's why they don't necessarily disappear completely,
24:22
Speaker 2: but they they unlike estrogen and progesterone, they kind of
24:27
Speaker 2: have a slow, steady decline, the DHA and the testosterone
24:33
Speaker 2: specifically because testosterone. What's important about DHA, I mean, I'm
24:37
Speaker 2: really going to simplify this is that it can become
24:40
Speaker 2: estrogen and testosterone, which are acting all over your body.
24:43
Speaker 2: Estrogen and progesterone are coming really from the ovaries, and
24:46
Speaker 2: so as the ovarian lifespan starts to be coming to
24:52
Speaker 2: its conclusion. Although I want to put a pin in
24:54
Speaker 2: that because it looks like maybe it's an immune there's
24:56
Speaker 2: immune function function after reproduction. So it's this new stuff, right,
25:02
Speaker 2: Like the body is smart. Why would make an organ
25:05
Speaker 2: that just like.
25:06
Speaker 1: Fifty five or something?
25:07
Speaker 2: Yeah, so tbd, right, But we're just for these purposes.
25:11
Speaker 2: Is estrogen and progesterone are coming from there, and that
25:14
Speaker 2: they're spinning it out and they're trying so hard, and
25:16
Speaker 2: then they're finding like, Okay, we're done.
25:18
Speaker 1: We're just done.
25:18
Speaker 2: Now you will if you do not replace that, you
25:20
Speaker 2: will not have any really okay, with the exception of
25:24
Speaker 2: some other I don't know.
25:25
Speaker 1: I'm getting in the weeds a little bit.
25:26
Speaker 2: It's hard to testosterone. It doesn't do that crazy up
25:31
Speaker 2: and down fluctuations. It's just sort of slowly declining. And
25:33
Speaker 2: what people are starting I think that conversation is really
25:36
Speaker 2: ramping up right now, which is very important because what
25:39
Speaker 2: women don't often understand is that there are points in
25:42
Speaker 2: our lives, especially when we're younger, that we have more
25:45
Speaker 2: testosterone than estrogen, not more than men, but more so
25:49
Speaker 2: to say that declining testosterone doesn't have a health impact,
25:53
Speaker 2: it's just not correct. And if you think you are
25:58
Speaker 2: going to have a hard time finding somebody who's menopausem formed,
26:00
Speaker 2: I mean testosterone informed, is you know, even a smaller subgroup.
26:04
Speaker 2: But it's happening because we're starting to discuss it than
26:06
Speaker 2: you guys are. But those are the big four hormones
26:11
Speaker 2: that we really talk about in terms of their changes
26:14
Speaker 2: in our body and what they do in our body.
26:16
Speaker 2: And so these are the things that we should be
26:18
Speaker 2: looking at supplementing or replacing as we because them, because
26:23
Speaker 2: there are health consequences. Okay, there's talk about the daily
26:26
Speaker 2: life stuff that we've talked about, the night sweat.
26:29
Speaker 1: Let me see you for half a second. Yeah, so
26:31
Speaker 1: we're we're pivoting to now that when our estrogen and
26:35
Speaker 1: progesterone levels declined severely, we see results like we see
26:40
Speaker 1: outcomes like the mood stuff.
26:42
Speaker 2: We were talking about, the brain changes in terms of
26:44
Speaker 2: mood or cognition, the sleep changes. So the things that
26:49
Speaker 2: you guys are noticing, the body aches, the joint aches,
26:54
Speaker 2: the skin changes. Obviously we talked about hot flushes and
26:57
Speaker 2: night sweats, but then all those things that we talked
26:59
Speaker 2: about that are silent. Yes, the gut changes, and I'm
27:02
Speaker 2: talking about not just the gut changes, but like internally,
27:05
Speaker 2: how your microbiome is functioning, the bone changes, the risk
27:10
Speaker 2: for dementia, the cardio metabolic disease, diabetes, high blood pressure,
27:15
Speaker 2: high cholesterol. These are all the things that you can't
27:18
Speaker 2: feel and you can't see, and we know that the
27:22
Speaker 2: fluctuations and then the ultimate decline in these hormones is
27:26
Speaker 2: at least a very very significant part of the development
27:29
Speaker 2: of these diseases. It's also why women catch up to
27:32
Speaker 2: men because they also have estrogen and progesterone, but not
27:37
Speaker 2: in the same amounts that we have, and they're protective.
27:39
Speaker 2: Those are protective hormones for us until they're no longer there.
27:44
Speaker 2: So you know, we have two thirds of women or
27:49
Speaker 2: two thirds of Alzheimer's dementia patients are women methods?
27:54
Speaker 1: Yes, wow, yes? And do we are we at a
27:58
Speaker 1: place then with medically with medical science that that they're
28:02
Speaker 1: blaming hormones or is it still too Oh it's such
28:06
Speaker 1: a surreal topic.
28:07
Speaker 2: But I mean, to me, the science is so overwhelming.
28:09
Speaker 2: We know for a fact that estrogen concentration declines, estrogen
28:13
Speaker 2: receptor concentration in brain imaging declines, and that it is
28:18
Speaker 2: exactly at the same time that things are starting to develop.
28:21
Speaker 2: So can we say with ultimate authority that hormone replacement
28:25
Speaker 2: therapy will prevent these We can't. I think most of
28:28
Speaker 2: us who are in the field feel that there is
28:30
Speaker 2: enough robust evidence to support it as a support to
28:35
Speaker 2: decrease your risk. I mean, nothing is an on off switch.
28:38
Speaker 2: I feel really comfortable saying that same thing with heart disease.
28:41
Speaker 2: I think there's a lot of data that's interesting from
28:44
Speaker 2: pre you know, Women's Health Initiative that indicated how important
28:48
Speaker 2: estrogen specifically is on the functioning of your blood vessels,
28:51
Speaker 2: on cholesterol, all these other things. I mean, it's way
28:53
Speaker 2: more complicated because your immune system and gut and all
28:56
Speaker 2: these other things are involved.
28:58
Speaker 1: But like osteoporosis, I.
28:59
Speaker 2: Don't think women and realize that fifty percent of us
29:02
Speaker 2: are going to have an osteoporotic fracture, and that in
29:06
Speaker 2: the year following a fracture for men and women, by
29:08
Speaker 2: the way, you have like a twenty five percent risk
29:10
Speaker 2: of death.
29:11
Speaker 1: Oh so, like this is no joke, all.
29:13
Speaker 2: This stuff about vaginal estrogen right now, and how oh
29:16
Speaker 2: my god, as it should be because women as we age,
29:19
Speaker 2: I was making a joke, but it's not funny about
29:21
Speaker 2: bladder infections. But as women age and now they're less mobile,
29:26
Speaker 2: they're less strong, they're less flexible that they got to
29:30
Speaker 2: go to the bathroom, they don't make it to the bathroom.
29:32
Speaker 2: That's when they fall and they have the hip fracture
29:34
Speaker 2: or they get a bladder infection that quickly goes into
29:37
Speaker 2: the kidneys quickly gets into their bloodstream and they die
29:41
Speaker 2: of sepsis.
29:42
Speaker 1: Yeah, there's no reason for it.
29:45
Speaker 2: Just use the vaginal estrogen like every woman should be
29:49
Speaker 2: on that.
29:55
Speaker 1: So you're in menopause and you're experiencing all these things,
30:00
Speaker 1: and so let's talk about the things that you can
30:02
Speaker 1: do for yourself because you do. This is what I
30:04
Speaker 1: do love about this book is that you mentioned it all,
30:06
Speaker 1: but you don't leave us without here's what you can
30:09
Speaker 1: do to be a cognizant of or just be ready
30:14
Speaker 1: to avoid risk factor of dementia or I have to
30:19
Speaker 1: watch type two diabetes. I had gestational twice and I
30:23
Speaker 1: was insulin dependent. Even though I followed everything to the tea,
30:28
Speaker 1: I only gained eleven pounds and my children were nice
30:31
Speaker 1: lean six seven pounds. But I know that my journey
30:34
Speaker 1: for you entire risk like I have to watch it.
30:37
Speaker 1: So I know that. But I went in with again
30:39
Speaker 1: my obgi an saying this is what you need to
30:41
Speaker 1: watch out right. So my life hand. So you have
30:44
Speaker 1: a lot of things, and it starts with you go
30:47
Speaker 1: from the hormone replacement therapies one. You have natural remedies
30:52
Speaker 1: and you have lifestyle changes and I'm like, let's start
30:54
Speaker 1: with the easiest stuff. The lifestyle changes. Well are they
30:57
Speaker 1: the easiest?
30:57
Speaker 2: I don't know, but I will tell you I can
31:01
Speaker 2: dip you in hormones. And if you don't do any
31:03
Speaker 2: lifestyle stuff and nothing good gonna happen.
31:06
Speaker 1: That that's a that's a quote. I think you need
31:10
Speaker 1: to write that. I can dip you so many T
31:11
Speaker 1: shirts in my brain make up.
31:15
Speaker 2: Anybody who wants to help me with that, please, I.
31:18
Speaker 1: Can dip you in hormones. But if you're smoking, I
31:20
Speaker 1: can't help you. Yeah, I mean, it's not going to
31:22
Speaker 1: do anything. Now. You talk about that, you talk about exercise.
31:25
Speaker 2: We and these are the things. I mean, I'll joking aside.
31:27
Speaker 2: These are the things that we can do, and they
31:30
Speaker 2: are most of them are free.
31:31
Speaker 1: Yes, you know so.
31:33
Speaker 2: I think honestly, exercise resistance training. If you've never done
31:39
Speaker 2: any lifted anything heavy, you're not going straight to Olympic lifting.
31:42
Speaker 2: That does not make any sense. I mean, if you
31:44
Speaker 2: have Olympic lifting is freaking amazing, it's super power, you
31:48
Speaker 2: feel amazing and it's so good for you. But any
31:50
Speaker 2: kind of resistance training your body weight bands, lightweights graduate
31:54
Speaker 2: to heavier weights, do something you like. You like to dance,
31:58
Speaker 2: fantastic lateral movement is great for your brain, you know,
32:01
Speaker 2: any kind of any kind of.
32:02
Speaker 1: I bought a weighted hula hoop. Oh my god, how's
32:06
Speaker 1: it going. It's fun? It was so cool. That's great.
32:09
Speaker 1: First of all, I just was like, well, I saw
32:11
Speaker 1: this woman on on on Instagram and she had all
32:14
Speaker 1: this great music. I'm like, Okay, I think maybe I
32:16
Speaker 1: love the music more than I love the hulloop. So
32:18
Speaker 1: now put it together, and it was like, it's fun.
32:20
Speaker 1: And by the way, it's a workout.
32:21
Speaker 2: It is.
32:23
Speaker 1: It's weighted. But even the hula hoop. I mean, you
32:25
Speaker 1: think about it.
32:25
Speaker 2: When you were like ten, it's just like something you
32:27
Speaker 2: did and now you're like, oh my god, I don't
32:29
Speaker 2: even know.
32:29
Speaker 1: What those muscles are. That's the thing. You like, you're
32:31
Speaker 1: moving and things like it looks so easy. Now it's
32:33
Speaker 1: not so but go ahead, please no, But that's exactly right.
32:35
Speaker 2: So any kind of aerobic activity, even walking, has been
32:39
Speaker 2: shown to reduce your risk of cardiovascular disease and dementia.
32:42
Speaker 2: You know, all these things are doing triple duty. Right.
32:45
Speaker 2: You're building muscle mass, which is really important for your
32:48
Speaker 2: metabolic health right, because you're using calories to build those muscles,
32:53
Speaker 2: maintain those muscles, use those muscles rather than storing them
32:56
Speaker 2: as fat or just turning into sugar and floating around.
32:59
Speaker 1: So I mean, it's just you know.
33:00
Speaker 2: It's good for your brain, it's good for your bones,
33:02
Speaker 2: it's good for your heart, it's good for your soul.
33:05
Speaker 2: It's releasing all those feel good hormones. If you're a
33:07
Speaker 2: lot of times we're doing these things around other people
33:10
Speaker 2: we talked to. We started, you know, the conversation talking
33:12
Speaker 2: about community is healing. So like, I have a dance
33:15
Speaker 2: class that I go to and it is so much fun.
33:21
Speaker 2: It is a bunch of middle aged women. Occasionally there's
33:24
Speaker 2: a dude there, God bless him. And there's also like
33:27
Speaker 2: some young women established a poblis great at everything and
33:33
Speaker 2: also can snort.
33:35
Speaker 1: With absolutely no blowback.
33:38
Speaker 2: But it's so fun and it is so goofy, and
33:41
Speaker 2: it's so great and you're sweating and you're using muscles,
33:44
Speaker 2: and I'm around people and I'm laughing and it's beautiful.
33:48
Speaker 2: So maybe that's not your bag, but you love pickleball
33:50
Speaker 2: whatever it is, so exercise, Honestly, it's going to make
33:53
Speaker 2: your sleep better. It's going to distress you. You're gonna
33:56
Speaker 2: feel good in your body. I cannot say enough for movement. Yeah,
34:01
Speaker 2: but you know that stress management, which just feels so
34:04
Speaker 2: like overwhelming. What even is that?
34:07
Speaker 1: You know what?
34:08
Speaker 2: Put your phone away, put your phone down. There are
34:13
Speaker 2: apps that turn all my social media off at five.
34:17
Speaker 1: Point thirty every day. Oh that sounds early. It is.
34:20
Speaker 1: The here is just like done. Everybody's horrified. I'm not
34:24
Speaker 1: missing anything. I'm sure you're not. Yeah, I'm sure you're not.
34:28
Speaker 1: I mean that's me.
34:28
Speaker 2: That's but that's a get outside, get some sunshine, get
34:33
Speaker 2: some fresh air. Nature is healing, Like, get back to reality.
34:37
Speaker 2: Like what are the kids saying?
34:38
Speaker 1: Now? Touch grass? That's a real thing.
34:41
Speaker 2: I have the kids. I have a couple that came
34:45
Speaker 2: out of me. So I am no authority, but you know,
34:49
Speaker 2: I overhear things. I think the other the other big
34:52
Speaker 2: one that's really really really hard for us to sleep.
34:55
Speaker 1: Oh god, that's a big time. That has come up
34:58
Speaker 1: a million times on this episode and it's kind of
35:00
Speaker 1: our very first episode was with my dear friend and
35:03
Speaker 1: executive producer of the show, Eva Longoria, and she's I said,
35:05
Speaker 1: so get more sleep. She's like, no, no, no, no, not
35:07
Speaker 1: just get more sleep. She's like, you have to prioritize sleep.
35:10
Speaker 1: It's like your make up, your skin routine. It's the
35:13
Speaker 1: same thing. There's a sleep routine. And we do not
35:16
Speaker 1: sleep enough. We don't sleep well. And what we do sleep,
35:20
Speaker 1: we don't sleep enough.
35:21
Speaker 2: And I will say I think when we give people instructions,
35:24
Speaker 2: like you know, the whole sleep hygiene thing, it's very
35:26
Speaker 2: very helpful, but it does feel like another thing we
35:29
Speaker 2: have to do, and especially as women. And I want
35:32
Speaker 2: to say this because this is something that's really important
35:35
Speaker 2: that I've learned in the last five or six years.
35:38
Speaker 2: Women's sleep disorders are really underrecognized and underdiagnosed. And so
35:44
Speaker 2: if you are doing everything right and you're still waking
35:47
Speaker 2: up and you're still frustrated, you should get a sleep
35:50
Speaker 2: study and you should see a sleep expert who understands
35:55
Speaker 2: women's sleep disorders because they are different. Like we don't
35:59
Speaker 2: always preson that with sleep apnea like guys do with
36:02
Speaker 2: my snoring, And if you're consistently waking up exhausted, there
36:06
Speaker 2: might be something else going on. So it's not always
36:09
Speaker 2: like you're just not especially with the gen X. I know,
36:12
Speaker 2: like we do the list and we're not doing it right.
36:14
Speaker 2: It's like, well, it may not be that you're not
36:15
Speaker 2: doing it right. May not, and maybe that you didn't
36:17
Speaker 2: realize you should be getting support in a different area.
36:20
Speaker 2: So we are all catching up at the same time together.
36:23
Speaker 1: Well that's that's very specific though, because I didn't think
36:26
Speaker 1: about it this. You know, I have family members who
36:27
Speaker 1: have seen sleep experts, but it's for the stereotypical things
36:31
Speaker 1: sleep apna. I mean, I've just started snoring. I believe
36:34
Speaker 1: later in life. Here I'm not loud, but apparently I
36:38
Speaker 1: do snore. I do wake up with myself up. And
36:40
Speaker 1: then I wonder, I'm going to move on to one
36:43
Speaker 1: other area though, in menopause that we need to take
36:46
Speaker 1: care of. I wrote this down because I loved it.
36:48
Speaker 1: Your vagina, use it or lose it? Yeah, because of this.
36:54
Speaker 2: I mean I regret that a little bit, but we'll
36:55
Speaker 2: talk about it. But yes, it is your friend.
36:58
Speaker 1: It's your friend. Try you to take care of her.
37:01
Speaker 1: You're going to make friends with her again. And there's
37:03
Speaker 1: a lot of there's a lot of I don't want
37:04
Speaker 1: to say follow out, but it takes it takes a it.
37:08
Speaker 1: I don't want to say, a beating eat. I know
37:10
Speaker 1: there's swirling this toilet bowl. That's okay.
37:13
Speaker 2: They just it goes through a lot, It goes through
37:16
Speaker 2: her a lot, it goes through thery again, that was perfect,
37:20
Speaker 2: through a lot and.
37:20
Speaker 1: We and and not recognizing. Okay, So we know that
37:23
Speaker 1: there's vaginal dryness. We know that the libido takes a hit,
37:26
Speaker 1: and that all comes back to the testosterone, right, we
37:29
Speaker 1: carry that testosterone.
37:30
Speaker 2: It's relationships, it's exhaustion, it's everything. It's by it. You know,
37:34
Speaker 2: sex is I have a good friend who's a sexual
37:37
Speaker 2: health expert and has a big platform, and she likes
37:39
Speaker 2: to say libido is a mood.
37:42
Speaker 1: So it's a full brain thing.
37:43
Speaker 2: It's like there's the one spot where the testosterone turns
37:46
Speaker 2: it on and off. Loss of testosterone definitely plays a role,
37:49
Speaker 2: but it is not going to fix a dry, painful vagina,
37:52
Speaker 2: or a pelvic floor that is not functional and is
37:56
Speaker 2: causing pain, or a relationship that is not working for you,
37:59
Speaker 2: you know, like it is all of those things, or
38:01
Speaker 2: the fact that you're up half the night because you're
38:03
Speaker 2: worrying about your kids and your aging parents, you know,
38:06
Speaker 2: or whatever. So, but yes, the vagina is important. We
38:11
Speaker 2: got to give her her props and we got to
38:13
Speaker 2: take care of her. She doesn't just like show up
38:15
Speaker 2: without any attention and talk about the routine.
38:18
Speaker 1: You need to have a routine for your care, right.
38:21
Speaker 2: You need to have the vulva it get things get dry.
38:23
Speaker 2: Hormones we already talked about so so, so so important.
38:26
Speaker 1: And vaginal estrogen has become a big, big thing. I'm
38:29
Speaker 1: so happy to hear that it's everywhere, Like, wait, where
38:32
Speaker 1: are we putting it? Are we put it on our face?
38:33
Speaker 1: Are we putting it up? Putting it everywhere? I don't
38:35
Speaker 1: know what's happening everywhere. Yeah, and so I I but
38:39
Speaker 1: it's it's that's information that I wasn't talking about three years,
38:43
Speaker 1: two years, yeah, three yeah ago. Yeah, people will get well.
38:47
Speaker 2: But I mean if we don't like talking about women's
38:49
Speaker 2: bodies or women's self, I mean, we definitely have so
38:52
Speaker 2: many hang ups around sex.
38:55
Speaker 1: So even if you're not using your vagina.
38:57
Speaker 2: For sex, like it just because it's become this like
39:00
Speaker 2: thing and it's like, no, it's a body part.
39:03
Speaker 1: Yes, if you're not using it for sex, then it's
39:05
Speaker 1: like sitting here on a shelf, like there's nothing else
39:08
Speaker 1: to do with it because I'm gonna have a baby,
39:10
Speaker 1: so here it.
39:10
Speaker 2: Is, right. But we talked about the fact that if
39:13
Speaker 2: you're not taking care of the urinary tract stuff, which
39:16
Speaker 2: is basically inside you know, scooched inside the vagina and
39:20
Speaker 2: getting losing estrogen in the same way, like, you're gonna
39:23
Speaker 2: have problems. So you know, that is a whole episode estrogen.
39:29
Speaker 1: If there's so just the quick takeaway from this for women,
39:32
Speaker 1: because I know my girls in Ohio they were like,
39:35
Speaker 1: I'm sorry, what are we doing? Right, is if there
39:38
Speaker 1: is a loss of libido and or there is the
39:42
Speaker 1: dryness and the painfulness or the what do they call
39:45
Speaker 1: it muted orgasms, muted orgasm? I always call them diluted
39:49
Speaker 1: muted orgasms. That a conversation with your ogu I N
39:53
Speaker 1: about vaginal estrogen could be.
39:55
Speaker 2: Absolutely having to go absolutely a place to start. And again,
40:01
Speaker 2: there are doctors who are really devoted to sexual health
40:04
Speaker 2: who can dive into that in a way that's more detailed,
40:08
Speaker 2: because it's sometimes it's more than that, but it's super important,
40:13
Speaker 2: very important, and it's important for your overall health.
40:15
Speaker 1: Totally. We all want to work in vagina even if
40:18
Speaker 1: we're not having babies anymore. The other thing that you know,
40:21
Speaker 1: you you talk about is you go you move on
40:25
Speaker 1: to society because this is where like the mental health
40:27
Speaker 1: aspect of at all. This was my log line. I
40:30
Speaker 1: say it every time I launched my show, Navigating Midlife's
40:32
Speaker 1: Most Fantastic Bullshit because it is bullshit and it is fantastic.
40:36
Speaker 1: There's a lot there. It's it's a little bit of
40:38
Speaker 1: a of a double entrap when I came up with
40:40
Speaker 1: this title of how can it be? You know, because
40:42
Speaker 1: I could be like menopause, how are going to be?
40:45
Speaker 1: Vaginal dryness? How are can it be? That could be
40:47
Speaker 1: really hard, But the mental health of it and and
40:52
Speaker 1: struggling with the muscling through because of either cultural, generational
40:57
Speaker 1: that's what women do, and getting that kind of help
41:01
Speaker 1: as well in this journey. And you do incorporate that
41:04
Speaker 1: in your menopause book. Absolutely, it's so important.
41:07
Speaker 2: I mean, we sort of are booke ending because we
41:09
Speaker 2: talked about how a lot of the earliest signs of
41:13
Speaker 2: entering into this transition are mental health changes, and you know,
41:19
Speaker 2: ignoring them is just not an option. The scary stats
41:24
Speaker 2: are the highest rates of suicide amongst women are in
41:27
Speaker 2: that age group like twenty five to fifty five where
41:29
Speaker 2: you're going to tell me that that's not come one,
41:32
Speaker 2: and I think it's for a variety of reasons, right,
41:35
Speaker 2: It's never one thing. But the hormonal changes are absolutely contributing.
41:41
Speaker 2: So you talked about like you had had a history
41:43
Speaker 2: of gestational diabetes during our pregnancies. Women who have had
41:46
Speaker 2: any kind of hormonal mental health issue, especially like a
41:50
Speaker 2: pregnancy related anxiety or postpartum depression, or maybe they had
41:54
Speaker 2: a really really rough transition in puberty, they are at
41:56
Speaker 2: such high women with eating disorders people. So since abuse history,
42:01
Speaker 2: trauma history, it's much more likely to get unroofed and
42:06
Speaker 2: destabilize around this time. So this is a point of caution.
42:12
Speaker 2: This is again, this is information. If you know that
42:14
Speaker 2: you can be going into your physician or to a
42:17
Speaker 2: mental health professional and saying, hey, I heard that I'm
42:21
Speaker 2: at higher risk or I'm starting to have these issues,
42:23
Speaker 2: like things were going great and why are they not?
42:25
Speaker 1: Now? What can we do?
42:27
Speaker 2: So it's just it's so important because some of it's
42:29
Speaker 2: coming from inside the house. But then on top of it,
42:33
Speaker 2: the societal bullshit constant narratives about like how we're supposed
42:37
Speaker 2: to look we should have a deep plane facelift. No,
42:40
Speaker 2: we shouldn't. We should have all of our wrinkles or
42:43
Speaker 2: you know whatever. Like everybody's gone an opinion and they're
42:45
Speaker 2: shoving it down your throat. You know what it reminds
42:46
Speaker 2: me of because we're probably in the same we're in
42:49
Speaker 2: the same age group, right, Like when I was early
42:52
Speaker 2: in my obg wan career and I was having my babies,
42:56
Speaker 2: all the mommy wars, right, the mommy wars, remember that, like, Oh,
43:00
Speaker 2: you're staying at home, you left work, you stayed at work,
43:02
Speaker 2: you had a sea section, you're breastfeeding, you had a doula,
43:04
Speaker 2: you didn't. Ah, it's the same shit. It's the same people.
43:07
Speaker 2: By the way, too, Really, I think shoving this down,
43:10
Speaker 2: which is not we as women are torturing each other.
43:14
Speaker 2: And then we have, you know, the messaging like oh,
43:16
Speaker 2: you're old, you're not reproductive, you're not sexy, you're not
43:20
Speaker 2: vital viable, you're not hirable, you've hit the glass ceiling.
43:24
Speaker 2: All this stuff, which is not made up, it's real,
43:27
Speaker 2: and it's been coming at us since we were five
43:30
Speaker 2: years old. Like it's pretty hard to deal with that
43:34
Speaker 2: and then like, you know, you're on fire all night.
43:36
Speaker 1: Yeah, yeah, what could be so hard? Yeah? I want
43:40
Speaker 1: to end on one thing that I that I let's see. Oh,
43:43
Speaker 1: first of all, what I loved two is at the
43:47
Speaker 1: end of all of this, you recommend starting your own
43:50
Speaker 1: menopause Bouqueteah, it doesn't have to be that fancy. You
43:54
Speaker 1: just to get a bunch of your girlfriends you meet.
43:56
Speaker 1: Is it once a month for four months? You said,
43:58
Speaker 1: you get do whatever you want. You can walk around
44:02
Speaker 1: the block and just I bet if.
44:04
Speaker 2: You start with like just educational, it'll turn into something
44:07
Speaker 2: you're just doing all the time.
44:09
Speaker 1: I bet it wouldn't. Next thing, you know, we're going
44:11
Speaker 1: to bor my girl's trip, having a good time. And
44:14
Speaker 1: I just love that you recommend that it doesn't have
44:16
Speaker 1: to be something so official. It can just be in
44:18
Speaker 1: agreement to meet and discuss and compare notes.
44:22
Speaker 2: Well, and you know what I did, because when I
44:24
Speaker 2: wrote the book, I already knew there's no way I'm
44:27
Speaker 2: going to go around be doing all these I mean,
44:29
Speaker 2: a person can only do so many things right, And
44:31
Speaker 2: so I actually have a certification program, so I teach
44:35
Speaker 2: people how to become menopause bo camp facilitators.
44:39
Speaker 1: Oh, that's just great and it's amazing, and.
44:40
Speaker 2: It's great for lay leaders, for clinicians, for non licensed clinicians.
44:46
Speaker 2: I have a lot of therapists and dietitians and fitness people.
44:50
Speaker 1: Gym'st to offer that it's all and I will have
44:53
Speaker 1: women who have trained all over the world.
44:54
Speaker 2: In fact, this is like, I am so excited. I'm
44:57
Speaker 2: proud of all of them. We do quarterly coaching and
45:00
Speaker 2: they us to a self paced course it's not very long,
45:02
Speaker 2: and then they have information that they can use. They
45:06
Speaker 2: have like direct they have videos that they can play
45:08
Speaker 2: to the consumers. They can do it however they want
45:11
Speaker 2: to do it. Honestly, women have run with this and
45:13
Speaker 2: created really communal experiences. But one of my trainers helped
45:18
Speaker 2: instigate the formation of the first Menopause Society in Puerto Rico,
45:24
Speaker 2: a medical society, and they're having their first conference in October,
45:28
Speaker 2: and they have invited me to come speak. Yes, and
45:30
Speaker 2: I am dying. Okay, first of all, have been in
45:32
Speaker 2: Puerto Rico.
45:32
Speaker 1: No, I'm so excited. I'll tell you where to go eat.
45:35
Speaker 2: Okay, this is amazing and I'm so proud. Like lead
45:38
Speaker 2: those right, lead lace woman is so amazing and she
45:42
Speaker 2: was just inspired and she said, we don't have enough
45:44
Speaker 2: here in our community. We're not talking about it. She
45:47
Speaker 2: rallied physicians, clinicians. I mean so all. I didn't do it.
45:52
Speaker 2: I just like gave her a little like, yeah, you're good,
45:55
Speaker 2: She's amazing, you know. But the point is so the
45:58
Speaker 2: talk about the community in the community, in the community,
46:01
Speaker 2: and then the ripples outside. So you can take I
46:04
Speaker 2: have a series of questions that you can use as
46:05
Speaker 2: prompts and you can get together and have you know,
46:08
Speaker 2: cozy on the couch or take a walk, or go
46:10
Speaker 2: ice skating or whatever you want. Or you could do
46:12
Speaker 2: a formal thing, or you could train.
46:14
Speaker 1: Yeah, you have all the options there, and I love
46:17
Speaker 1: that you you don't. What's what I think is wonderful
46:20
Speaker 1: about you is that you don't keep it. Your heart
46:23
Speaker 1: is in such a good place of wanting to see
46:25
Speaker 1: us rise together with this. And I literally wrote, like
46:28
Speaker 1: how too, because she she broke it down like here,
46:32
Speaker 1: you can do it like this like that, just like
46:33
Speaker 1: you said the twelve conversation starters. It's all there and
46:37
Speaker 1: and together we'll get this figured out and make it
46:40
Speaker 1: the journey that is just fantastic yeah versus bullshit Yeah.
46:44
Speaker 1: And in addition to this book, Menopause boot Camp, you're
46:48
Speaker 1: in the process of writing another one.
46:49
Speaker 2: I am on my first love on botanical medicine, so
46:53
Speaker 2: it's called plant Medicine. It's not really about menopause. It's
46:56
Speaker 2: about the history of medicine and the history of how
46:58
Speaker 2: we've interacted as inhaling communities and with the planet and
47:03
Speaker 2: the natural world for all of humanity. And it's just
47:06
Speaker 2: it's been really interesting and delightful to work on.
47:09
Speaker 1: So I'm excited about I can't I can't wait to
47:11
Speaker 1: read that either. I can't wait. So I said to
47:14
Speaker 1: end here on this. People are squeamish in the beginning.
47:16
Speaker 1: This is about putting together a group. Seldom are we
47:19
Speaker 1: invited to talk about this life event. When we do,
47:23
Speaker 1: we are so often made to feel bad. To make
47:26
Speaker 1: to feel bad. Watching a group of people go from
47:28
Speaker 1: anxiety to relief and being the agent of that metamorphosis
47:33
Speaker 1: is the most incredible thing. You see their posture change.
47:36
Speaker 1: They go from being scrunched up to sitting tall, shoulders back.
47:39
Speaker 1: They exude openness. You see them going from breathing shallowly
47:44
Speaker 1: to holding in their bellies, signs of stress and a
47:47
Speaker 1: desire to conform to breathing big, laughing loudly, and releasing
47:53
Speaker 1: their bodies to their own space. What happens next is incredible.
47:58
Speaker 1: They take all that beautiful energy and reinvigorate a spirit
48:02
Speaker 1: and share it with others. If we can do that
48:07
Speaker 1: just by more conversations like this, you think women are unstoppable.
48:11
Speaker 1: Now just you Waitte. You have been wonderful and thank
48:15
Speaker 1: you so much for this great conversation. Loved it. We
48:17
Speaker 1: will put in the link as to where you can
48:19
Speaker 1: find Menopause boot Camp. I highly recommend it. It's a
48:22
Speaker 1: great read and I'd love to have you on again
48:24
Speaker 1: because there's just more we can talk about absolutely anytime.
48:26
Speaker 1: Thank you so much. Welcome. How hard can it be?
48:30
Speaker 1: With the animade Ariva is a Hyphenit media group production
48:33
Speaker 1: in partnership with Iheart'smeikeultura podcast Network. For more of your
48:37
Speaker 1: favorite shows, visit the iHeartRadio app, Apple Podcasts, or wherever
48:41
Speaker 1: you get your podcasts.