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What is Perimenopause and Can We Make it Easier? · Stuff Mom Never Told You

• 0:05
  Speaker 1: Hey, this is Annie and Samantha, and welcome to Stuff
• 0:08
  Speaker 1: When never told your protection of iHeartRadio.
• 0:18
  Speaker 2: So today Annie, we are doing a selfish episode one
• 0:22
  Speaker 2: that is something I'm trying to figure out, and I
• 0:25
  Speaker 2: feel like if I'm dealing with this, and there's probably
• 0:28
  Speaker 2: a lot of us who's dealing with it in general,
• 0:29
  Speaker 2: especially if you've been with us for a while. If
• 0:32
  Speaker 2: you've been with Stuff, well I've never told you, you've
• 0:34
  Speaker 2: been a listener, you've probably experienced this as well, or
• 0:37
  Speaker 2: already experienced it or again experiencing it as we go along.
• 0:43
  Speaker 2: So we are talking about the world of perimenopause specifically,
• 0:47
  Speaker 2: and originally I was going to do perimenopause and menopause,
• 0:50
  Speaker 2: but actually this episode again grew into a bigger so
• 0:54
  Speaker 2: menopause will be its own episode, not right now, not
• 0:57
  Speaker 2: in the episode, as well as probably the drug industry
• 1:01
  Speaker 2: profiting off of perimenopause as we speak, and things like HRT.
• 1:05
  Speaker 2: But we are also going to talk a little bit
• 1:06
  Speaker 2: about periods as well. And please note that a lot
• 1:11
  Speaker 2: of the reports and the way we're speaking it is
• 1:13
  Speaker 2: in gender binaries. We absolutely acknowledge that trans women are women,
• 1:18
  Speaker 2: and we are including TRANSMN as well, but the way
• 1:22
  Speaker 2: the reports come out and saying the words like female women,
• 1:25
  Speaker 2: biologically female, all of that, it is a.
• 1:27
  Speaker 3: Part of that report.
• 1:29
  Speaker 2: And sometimes it's just really hard to navigate when we're
• 1:31
  Speaker 2: talking about uteruses in general. But typically we are talking
• 1:34
  Speaker 2: about anybody with uterus A and those I guess who.
• 1:40
  Speaker 3: May not have You know they have uterus, Yeah, no,
• 1:43
  Speaker 3: they don't. If they have hysterectomy, they don't write.
• 1:45
  Speaker 2: Yeah yeah, some people who may not have uteruses anymore,
• 1:50
  Speaker 2: but understand what we're talking about. So it is all inclusive,
• 1:55
  Speaker 2: and I have talked about it a bit before.
• 1:57
  Speaker 3: I believe I am.
• 1:59
  Speaker 2: Quickly approaching the time frame of perimenopause if I'm not
• 2:03
  Speaker 2: already in it, And if you're over the age of
• 2:05
  Speaker 2: thirty five, you may be dealing with it as well.
• 2:10
  Speaker 2: But you just don't realize that although the average age
• 2:12
  Speaker 2: of perimenopause is around forty seven, that doesn't mean it
• 2:16
  Speaker 2: can't happen at a younger age, and it does. As
• 2:19
  Speaker 2: the average age of menopause is in your early sixties.
• 2:23
  Speaker 2: I believe there have been cases in which premature menopause
• 2:26
  Speaker 2: has occurred, and those as the youngest in their twenties
• 2:29
  Speaker 2: and we're going to talk a little bit about that
• 2:31
  Speaker 2: in a bit. And early menopause is considered around forties.
• 2:35
  Speaker 2: So that's how they kind of differentiate the types or
• 2:39
  Speaker 2: how age.
• 2:40
  Speaker 3: Frame, timeframe of menopause, I guess.
• 2:42
  Speaker 2: And as we mentioned before, we covered it before with
• 2:45
  Speaker 2: a Monday Mini a couple of years ago. I know
• 2:49
  Speaker 2: the show has talked about periods in many ways. I
• 2:52
  Speaker 2: don't think we've actually broken down periods as a show.
• 2:58
  Speaker 2: I was going back through some of the old stuff.
• 3:00
  Speaker 2: It is like specific subjects pertaining two periods, but not
• 3:04
  Speaker 2: necessarily the overall. So that was something like, maybe we
• 3:07
  Speaker 2: should talk about some of that because we've talked about
• 3:10
  Speaker 2: the taboos of.
• 3:11
  Speaker 3: Having periods and all of that.
• 3:13
  Speaker 2: I think we've talked about indimitriosis, which is kind of
• 3:15
  Speaker 2: pertaining to that as well. So there are definitely episodes
• 3:18
  Speaker 2: that we've done, but not necessarily in a broader aspect.
• 3:21
  Speaker 3: I will say we've even talked about it as a
• 3:24
  Speaker 3: horror movie trope.
• 3:25
  Speaker 1: We have one of my best puns a period piece.
• 3:29
  Speaker 1: To this day, sometimes I'll think about that and be
• 3:33
  Speaker 1: like Chef's.
• 3:33
  Speaker 2: Kiss, I'm glad we got to revisit that that's a
• 3:37
  Speaker 2: good one. Yes, And as we did this with the
• 3:42
  Speaker 2: Monday Mining because I was like, Hey, this is might
• 3:44
  Speaker 2: be me coming up. We're going to talk about it
• 3:46
  Speaker 2: more in depth in this episode. And we actually had
• 3:49
  Speaker 2: a guest on last year, doctor Sharon Malone, who is
• 3:52
  Speaker 2: a certified menopause practitioner OBGYN, who mentioned HRT on their
• 3:57
  Speaker 2: episode with us, and I feel like.
• 3:58
  Speaker 3: We might need to bring our back on one day.
• 4:01
  Speaker 1: Yes, because she mentioned, yeah, wanting to talk more about this.
• 4:05
  Speaker 2: Yes, And at that point I was like yeah, yeah,
• 4:07
  Speaker 2: and then kind of bypass because we had such a
• 4:09
  Speaker 2: great conversation with her in general about her show that
• 4:12
  Speaker 2: we were like, oh, and now that we're coming back
• 4:14
  Speaker 2: to visit, I'm like, you know, we really need to
• 4:16
  Speaker 2: have this conversation, especially because the industry feels predatory.
• 4:20
  Speaker 3: Once again, we're not talking about that yet.
• 4:23
  Speaker 2: That's probably gonna be an episode in it self in
• 4:25
  Speaker 2: general about women's health and pharmaceuticals taking over and profiting
• 4:31
  Speaker 2: off of that.
• 4:32
  Speaker 3: But it is.
• 4:33
  Speaker 2: It's kind of harder to navigate, as I've learned recently,
• 4:36
  Speaker 2: trying to get all this information because people are really
• 4:40
  Speaker 2: good at manipulating conversations. Slash statistics in order to get
• 4:44
  Speaker 2: you to buy their products. Yeah, and you know what,
• 4:48
  Speaker 2: at this point, I am desperate enough for some of
• 4:52
  Speaker 2: these symptoms to be gone that I would try anything.
• 4:56
  Speaker 2: This is how they get you. This is how they
• 4:58
  Speaker 2: get you. But again we'll talk about that a bit later.
• 5:01
  Speaker 2: In a reminder, we are not doctors. We don't have
• 5:04
  Speaker 2: any medical expertise. Do not take anything we say as
• 5:09
  Speaker 2: an expert, advice or expertise in any way, shape or form.
• 5:12
  Speaker 2: We are learning just like you, which is why we
• 5:15
  Speaker 2: wanted to do episodes like this.
• 5:17
  Speaker 3: But you should definitely.
• 5:18
  Speaker 2: Talk to a doctor if something like some of these
• 5:22
  Speaker 2: things are concerning to you.
• 5:23
  Speaker 3: I think it is absolutely great.
• 5:25
  Speaker 2: Also one of the things that we hope we're able
• 5:28
  Speaker 2: to help you with as well as that you will
• 5:30
  Speaker 2: do for yourself. Advocating for yourself is important. So understanding
• 5:35
  Speaker 2: some of these things is important as well. So do
• 5:37
  Speaker 2: your research too, because sometimes the doctors might just say, eh,
• 5:41
  Speaker 2: I don't think that's it and then dismiss you, which
• 5:44
  Speaker 2: happened to me. So moving on, which is also why
• 5:47
  Speaker 2: pharmaceyal companies are making make.
• 5:51
  Speaker 3: Okay.
• 5:51
  Speaker 2: So that is your reminder. I'm sure I have to
• 5:54
  Speaker 2: say it again towards the end of the episode. So,
• 5:57
  Speaker 2: as per usual, Annie, let's do some definitions. You're ready, yes,
• 6:01
  Speaker 2: So what is perimenopause? From the Columbia University Medical Center
• 6:05
  Speaker 2: site CUIMC, Columbia dot ADU, they write, Perry means near
• 6:10
  Speaker 2: in perimenopause is the time of transitioning from having regular
• 6:14
  Speaker 2: periods to having none. In menopause, the end of menstrution
• 6:17
  Speaker 2: reflects at the end of ovulation, when the stop releasing
• 6:21
  Speaker 2: eggs and estrogen production slows.
• 6:23
  Speaker 3: Changes occur throughout the body.
• 6:26
  Speaker 2: So with that, it is about the transitioning oftentimes has
• 6:31
  Speaker 2: been referred to as the transition the change, because you
• 6:36
  Speaker 2: are not exactly done with your period, and you feel
• 6:38
  Speaker 2: like you're constantly pmssing maybe or going through some of
• 6:41
  Speaker 2: those symptoms and you're probably spotting. You may have like
• 6:44
  Speaker 2: one period or a long time and then nothing for
• 6:46
  Speaker 2: a couple of months. This could be a part of
• 6:48
  Speaker 2: that period. And they go on to explain that this
• 6:51
  Speaker 2: is a gradual process that happens to different people at
• 6:54
  Speaker 2: different speeds, so essentially it could happen within a year
• 6:58
  Speaker 2: or five. Yeah, that is so fun. And even though
• 7:04
  Speaker 2: we're not going to talk much about it. We are
• 7:05
  Speaker 2: going to tell you what menopause is because we are
• 7:07
  Speaker 2: obviously going to refer to it. According to the National
• 7:10
  Speaker 2: Institute of Aging, it is quote menopause describes the stage
• 7:13
  Speaker 2: of women's life when her menstrual periods stopped permanently and
• 7:16
  Speaker 2: she can no longer get pregnant, and a bit more
• 7:18
  Speaker 2: from the World Health Organization quote. Menopause is marked by
• 7:21
  Speaker 2: the end of monthly minstration, also known as menstrual period
• 7:25
  Speaker 2: or period, due to loss of ovarian follicular function. This
• 7:29
  Speaker 2: means that the ovaries stop releasing eggs for fertilization. Natural
• 7:33
  Speaker 2: menopause is deemed to have occurred after twelve consecutive months
• 7:36
  Speaker 2: without menstruation for which there is no other obvious physiological
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  Speaker 2: or pathological cause in the absence of clinical intervention. Menopause
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  Speaker 2: can also be induced as a consequence of surgical procedures
• 7:49
  Speaker 2: that involve removal of both ovaries or medical interventions that
• 7:52
  Speaker 2: cause cessation of ovariant function, for example, radiation therapy or chemotherapy.
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  Speaker 2: So I wanted to knowledge that as well. Sometimes the
• 8:02
  Speaker 2: abrupt thing, the minstrual abrupt is because of something outside
• 8:06
  Speaker 2: of your biology, meaning you've had some type of surgery,
• 8:10
  Speaker 2: you've had hystori direectomy, you've had chemotherapy, or any of
• 8:13
  Speaker 2: those types of things that have caused what they would
• 8:16
  Speaker 2: call menopause. Okay, be there, all right. Postmenopause also, we're
• 8:21
  Speaker 2: going to refer to it. From Cleveland Clinic, postmenopause is
• 8:25
  Speaker 2: the time after you've been without a menstrual period four
• 8:27
  Speaker 2: twelve months and it lasts for the rest of your life.
• 8:31
  Speaker 2: And I believe I was told it is lovely because
• 8:34
  Speaker 2: you kind of finally bypass those stages of all of
• 8:38
  Speaker 2: those symptoms and such stupid ovaries.
• 8:40
  Speaker 3: I'm just kidding. Your body is wonderful. My body is wonderful.
• 8:44
  Speaker 3: Everything is fine.
• 8:46
  Speaker 2: So another definition we want to talk about is hormones.
• 8:49
  Speaker 2: This seems like a no brainer. I think we need
• 8:52
  Speaker 2: to talk about what exactly it is. So from another
• 8:54
  Speaker 2: article from the Cleveland Clinic site, they say, hormones are
• 8:57
  Speaker 2: chemicals that coordinate different functions in your body by carrying
• 9:00
  Speaker 2: messages through your blood to your organs, skins, muscles, and
• 9:04
  Speaker 2: other tissues. And for this specific episode, we're talking about
• 9:07
  Speaker 2: female sex, organs sells growth. Saying that again, I'm saying
• 9:10
  Speaker 2: it clinically just fy from Morelando obgyn dot com. Female
• 9:15
  Speaker 2: sex hormones estrogen and progesterone have the most significant effect
• 9:19
  Speaker 2: on a woman's health from menstruation to pregnancy, to menopause
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  Speaker 2: and more, but your body makes and utilizes a variety
• 9:25
  Speaker 2: of other hormones that affect other aspects of your health,
• 9:28
  Speaker 2: from your energy level, weight, mood, and more. Before I
• 9:31
  Speaker 2: read this definition again, binari gender binaries, I'm so sorry.
• 9:35
  Speaker 3: Anyway.
• 9:35
  Speaker 2: Estrogen is responsible for the physical changes that turn a
• 9:38
  Speaker 2: girl into a woman doing puberty, including breast development, growth
• 9:42
  Speaker 2: of pubic and underarm hair, and the start of minstral cycles.
• 9:45
  Speaker 2: Aside from estrogen's obvious importance to childbearing, it helps to
• 9:48
  Speaker 2: keep cholesterol in control, contributes to protecting bone health, and
• 9:51
  Speaker 2: affects your brain including mood, heart, skin, and other tissues
• 9:55
  Speaker 2: throughout the body. So a bit more detail about its function.
• 9:58
  Speaker 2: The primary source of estrogen in women is the ovaries,
• 10:01
  Speaker 2: which produce women's eggs. However, your adrenal glands, which are
• 10:04
  Speaker 2: located at the top of each kidney, also make small
• 10:07
  Speaker 2: amounts of estrogen along with batty tissues. Estrogen moves throughout
• 10:11
  Speaker 2: your body in your bloodstreams and acts everywhere throughout your body.
• 10:14
  Speaker 2: Estrogen levels change throughout the month and are highest in
• 10:17
  Speaker 2: the middle of your mentrual cycle and lowest during your period.
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  Speaker 2: At menopause, estrogen levels drop, so that's really important obviously.
• 10:25
  Speaker 2: So Progesterone as a steroid hormone secreted by the corpus luteum,
• 10:29
  Speaker 2: a temporary integrine gland that women produce after ovulation. Progesterone
• 10:34
  Speaker 2: prepares the endometrium, the lining of the uterus, for the
• 10:37
  Speaker 2: possibility of pregnancy. After ovulation, progesterone works to encourage the
• 10:41
  Speaker 2: lining to accept a fertilized egg while prohibiting non painful
• 10:45
  Speaker 2: urine muscle contractions that may cause the body to reject
• 10:48
  Speaker 2: an egg. If a woman does not become pregnant, the
• 10:51
  Speaker 2: corpus lutum breaks down, the progesterone levels decreases in the body,
• 10:55
  Speaker 2: causing the woman to menstrate. In the event of pregnancy,
• 10:59
  Speaker 2: progesterone content used to stimulate body vessels in the indometrium
• 11:02
  Speaker 2: that will nourish and support the growing baby.
• 11:06
  Speaker 3: Okay, so we're just talking about that, and we're going.
• 11:08
  Speaker 2: To talk a little more about other hormones later on
• 11:11
  Speaker 2: in our conversations about perimenopause, but just those are the
• 11:14
  Speaker 2: two to keep in mind. HRT hormone replacement therapy are
• 11:19
  Speaker 2: also known as the menopausal hormone therapy MHT, is a
• 11:23
  Speaker 2: quote treatment that helps people with symptoms of menopause. So
• 11:27
  Speaker 2: a bit more from the Cleveland Clinic dot com. Hormone
• 11:30
  Speaker 2: replacement therapy HRT helps treat symptoms of menopause like vaginal
• 11:34
  Speaker 2: dryness and hot flashes. HRT replaces the hormones that your
• 11:37
  Speaker 2: body isn't making enough of. In talking about this type
• 11:40
  Speaker 2: of treatment, there are a few types of treatment revolving
• 11:42
  Speaker 2: around HRT, and also should be noted that it is
• 11:45
  Speaker 2: considered only HT when receiving the treatment after the age
• 11:48
  Speaker 2: of fifty, so that replacement part comes out. Some people
• 11:52
  Speaker 2: have been saying restoration, so it could be hormone restoration
• 11:56
  Speaker 2: therapy I have. I'm typically hard it as hormone replacement therapy.
• 12:00
  Speaker 2: This may be one of those add things that people
• 12:03
  Speaker 2: are trying to do to make it sound more feminine.
• 12:06
  Speaker 3: I don't know.
• 12:07
  Speaker 1: Yeah, it sounds very marketing heavy, yeah to.
• 12:11
  Speaker 2: Me, which, by the way, that should be another caveat here.
• 12:15
  Speaker 2: As much research as I'm trying to find through clinical
• 12:18
  Speaker 2: researchers and such. I get as much from like essentially
• 12:22
  Speaker 2: sites that are trying to.
• 12:23
  Speaker 3: Sell you things.
• 12:24
  Speaker 2: They do have good bits of information and I do
• 12:26
  Speaker 2: think it's important, but just again one of those things like,
• 12:29
  Speaker 2: don't take advice from us. We want to educate you
• 12:33
  Speaker 2: so you can go and ask the right questions, you know,
• 12:36
  Speaker 2: But we are not doctors, we are not experts, and
• 12:39
  Speaker 2: we might be getting things that people trying to sell
• 12:41
  Speaker 2: you stuff, so be careful. Yeah, we're going to note
• 12:44
  Speaker 2: those by the way.
• 12:45
  Speaker 1: Oh yeah, and it's like what we talked about in
• 12:48
  Speaker 1: our codependency episode because I had.
• 12:50
  Speaker 3: A similar vibe.
• 12:52
  Speaker 1: Yeah, do your own research, but be aware that a
• 12:54
  Speaker 1: lot of these places are trying to sell you something
• 12:58
  Speaker 1: and that could just be it the idea that something's
• 13:01
  Speaker 1: wrong with you need by their products.
• 13:03
  Speaker 4: Yeah, like a body pillow, Yeah, yeah, which you know
• 13:08
  Speaker 4: I might need one for my knee because the little
• 13:11
  Speaker 4: small knee pillows are not helping anyway.
• 13:13
  Speaker 2: Moving on, Okay, so with that out of the way,
• 13:19
  Speaker 2: let's talk about it. When it comes to periods in
• 13:21
  Speaker 2: women's health in general, we know that science and research
• 13:23
  Speaker 2: is very far behind, and it's even worse when it
• 13:26
  Speaker 2: comes to science and research on things like women's pain
• 13:29
  Speaker 2: or discomfort or comfort. The old adage that women deserve
• 13:33
  Speaker 2: pain when it comes to reproduction has had more influence
• 13:35
  Speaker 2: than people may want to it. Men, we've talked about
• 13:38
  Speaker 2: this with the e curse, and it's it's been a constant.
• 13:40
  Speaker 2: It's a trope that will not let go, and science
• 13:43
  Speaker 2: has also cloned to it for a while now. Now
• 13:46
  Speaker 2: that isn't to say that periods haven't been studied. It has,
• 13:49
  Speaker 2: and a wonderful misinformation spread because of that. And we
• 13:54
  Speaker 2: want to talk about some of this misinformation. So from
• 13:57
  Speaker 2: Historycolorado dot org. They include some great ones, like hypocrisies
• 14:01
  Speaker 2: saying women on their period could sink ships, tarnish silver,
• 14:05
  Speaker 2: and kill a livestock or plenty the philosopher to cause
• 14:09
  Speaker 2: infertile seeds, so killing crops, kill so many more things
• 14:12
  Speaker 2: like flowers and grass, and even cause dogs to go
• 14:16
  Speaker 2: out of their minds. Oh and the bees. Somehow this
• 14:19
  Speaker 2: really affects the bees, like it kills all the bees,
• 14:22
  Speaker 2: according to several philosophers.
• 14:26
  Speaker 3: I love bees.
• 14:28
  Speaker 2: I didn't understand, but sure, okay. One of the first
• 14:31
  Speaker 2: noted studies was found in eighteen seventy seven by doctor
• 14:34
  Speaker 2: Mary Putnam Jacoby, who wrote a prize winning as they
• 14:37
  Speaker 2: titled the Question of Rest for Women during Administration, where
• 14:40
  Speaker 2: she argued with someone who has said women were not
• 14:43
  Speaker 2: fit to work while on their period. So during her time,
• 14:46
  Speaker 2: another scientist had written that women were not fit enough
• 14:48
  Speaker 2: for higher education because of their periods.
• 14:51
  Speaker 3: So this is.
• 14:52
  Speaker 2: From WIMLF dot com. They wrote when nineteenth century physician
• 14:56
  Speaker 2: Edward Clarke argued that women were not suited to higher
• 14:59
  Speaker 2: education and to do their quote periodical tides and reproductive apparatus,
• 15:04
  Speaker 2: he was merely expressing a belief common among medical professionals
• 15:07
  Speaker 2: at the time. The notion that women, especially while on
• 15:10
  Speaker 2: their periods, were weak and prone to various physical and
• 15:12
  Speaker 2: psychological woes, including infertility, was widely held in the medical community.
• 15:18
  Speaker 2: But doctor Jacoby was able to prove him wrong with
• 15:21
  Speaker 2: a quote scathing rebuttal claiming that his research lacked proper experimentation,
• 15:26
  Speaker 2: employed embellished facts, and was swayed by non scientific interests. Yeah,
• 15:31
  Speaker 2: as in fact, there was no real evidence outside of
• 15:34
  Speaker 2: those theories that we talked about earlier that he had
• 15:37
  Speaker 2: put in there. What we really know as per usual
• 15:40
  Speaker 2: it was that men just did not want to share
• 15:41
  Speaker 2: space with women. I will say I think doctor Jacoby
• 15:45
  Speaker 2: was the second woman to become a doctor in her school,
• 15:48
  Speaker 2: so like she was already doing some things and the
• 15:50
  Speaker 2: first woman was someone that she was learning under. Like
• 15:53
  Speaker 2: they were making history and men were not having it.
• 15:56
  Speaker 2: So she did this essay and it won her awards,
• 16:00
  Speaker 2: like they were like, oh okay, cocoa cool, you really
• 16:02
  Speaker 2: are smart, will allow you. Of course, as a white woman,
• 16:06
  Speaker 2: she had a little more privileged, so I hope she
• 16:08
  Speaker 2: put her power to good.
• 16:09
  Speaker 3: But at least this was good.
• 16:12
  Speaker 2: We're gonna give a credit for this specific moment, right,
• 16:15
  Speaker 2: And because many still held onto their theories instead of
• 16:18
  Speaker 2: actual research and science, this was the thing. In fact,
• 16:21
  Speaker 2: it was used as a way to shame women from
• 16:23
  Speaker 2: furthering their education and just stay at home, even up
• 16:26
  Speaker 2: until the seventies.
• 16:27
  Speaker 3: Yeah, we know, we know.
• 16:28
  Speaker 2: It was real gross, right, And though we aren't focusing
• 16:31
  Speaker 2: on periods this time around, which I think we should
• 16:34
  Speaker 2: come back to. Like I said, I felt like we
• 16:35
  Speaker 2: need to get a little more nuanced about periods because
• 16:39
  Speaker 2: we seem to assume we know everything about We know
• 16:43
  Speaker 2: as much we can, especially since we've experienced it. But
• 16:46
  Speaker 2: we've talked about how like, oh, period pain should not
• 16:48
  Speaker 2: be this painful. There's something wrong when it's this bad,
• 16:51
  Speaker 2: when the clotting is this bad, and we've never really
• 16:53
  Speaker 2: talked about it. So I feel like we do need
• 16:55
  Speaker 2: to come back and address it, but we're going to,
• 16:57
  Speaker 2: like I said, touch on it a little bit. It
• 16:59
  Speaker 2: is some saying to note that even within this decade,
• 17:02
  Speaker 2: women are still shamed for anything related periods, whether it's
• 17:06
  Speaker 2: the products, PMS or even the actual pain. The Conversation
• 17:09
  Speaker 2: dot com writes this in their articles titled dirty Red
• 17:12
  Speaker 2: How periods have been stigmatized throughout history to the modern day.
• 17:16
  Speaker 2: A twenty eighteen survey found that seventy nine percent of
• 17:19
  Speaker 2: girls and young women had faced symptoms linked to their
• 17:21
  Speaker 2: period that concerned them, but they hadn't seen a doctor
• 17:24
  Speaker 2: or a health professional. Similarly, statistics from charity Indimetriosis UK
• 17:30
  Speaker 2: revealed that sixty two percent of women aged sixteen to
• 17:32
  Speaker 2: fifty four would put off going to a doctor with
• 17:35
  Speaker 2: symptoms of indomatriosis because they don't think it's serious enough
• 17:39
  Speaker 2: to bother a doctor with, or they're embarrassed or don't
• 17:42
  Speaker 2: think they'd been taken seriously. Or think symptoms including painful periods.
• 17:47
  Speaker 3: Are normal.
• 17:48
  Speaker 2: And again, I know we've had a past episode about indimatriosis,
• 17:52
  Speaker 2: and I'm glad we definitely need to revisit that conversation.
• 17:55
  Speaker 2: But the fact that in twenty eighteen women still fel
• 17:58
  Speaker 2: that way, and I bet even I mean even today,
• 18:00
  Speaker 2: those eight years later, that's still a conversation. We do
• 18:04
  Speaker 2: not think that it's a big deal, or we think
• 18:06
  Speaker 2: is normal. Crying on the floor and having to take
• 18:09
  Speaker 2: a day off seems to be normal, and that it
• 18:12
  Speaker 2: shouldn't be. It isn't and it isn't hard to understand
• 18:14
  Speaker 2: how shaming and misinformation like this may also cause studies
• 18:18
  Speaker 2: on later in life stages to be impeded as well.
• 18:21
  Speaker 2: That same attitude is it's just normal, instead of understanding.
• 18:26
  Speaker 3: Maybe not, maybe not.
• 18:28
  Speaker 2: And one of the things we do want to return
• 18:30
  Speaker 2: to is the conversation about heavy minstral bleeding and irregular
• 18:33
  Speaker 2: administration is associated with cardiovascular disease, because I don't think
• 18:37
  Speaker 2: we're talking about this enough. From a study title Association
• 18:40
  Speaker 2: of heavy mistral bleeding with cardiovascular disease and US Female Hospitalization,
• 18:44
  Speaker 2: which is published in the National Library of Medicine, they
• 18:47
  Speaker 2: write heavy minstrual bleeding or HMB is a common minstrel
• 18:50
  Speaker 2: disorder associated with multiple risk factors of cardiovascular disease CVD
• 18:55
  Speaker 2: and women, and in its conclusion, they write this HMB
• 18:58
  Speaker 2: was strongly associated with CVD the outcomes regardless of obesity,
• 19:02
  Speaker 2: metabolic disorders, hormonal use, anemia, and uterine fibroids among US
• 19:07
  Speaker 2: hospitalizations of young women. In addition, HMB without im or
• 19:11
  Speaker 2: irregularminstration was profoundly associated with most CBD outcomes among US
• 19:16
  Speaker 2: hospitalizations of young women. So it is common, it is common,
• 19:20
  Speaker 2: and this is the problem that we're having because we
• 19:22
  Speaker 2: also are not talking about what is normal in bleeding.
• 19:26
  Speaker 3: I don't think we just assume.
• 19:28
  Speaker 2: Of course super flow this, that, and then you move
• 19:32
  Speaker 2: on because it's too stigmatized and no one's gonna know,
• 19:36
  Speaker 2: because how would they unless you told them right, Instead,
• 19:40
  Speaker 2: you try to hide it. And some more information along
• 19:43
  Speaker 2: those lines, there are studies that show that women whose
• 19:45
  Speaker 2: first menstruation was that ten years or younger are at
• 19:48
  Speaker 2: higher risk of cardiac events. So this is from a
• 19:52
  Speaker 2: US Health dot Org. Their study found that women whose
• 19:55
  Speaker 2: first menstruation called monarchy was at age ten or younger
• 19:58
  Speaker 2: had a fourfold higher of adverse cardiac events. That is
• 20:03
  Speaker 2: compared with those whose monarchy occurred at the US average
• 20:06
  Speaker 2: age twelve. For women whose monarchy came at age fifteen
• 20:09
  Speaker 2: or later, that risk was elevated two and a half times.
• 20:13
  Speaker 2: These are signs that we are not talking enough about
• 20:16
  Speaker 2: and when we don't get the history because I don't
• 20:18
  Speaker 2: think I've been asked the past few times that have
• 20:21
  Speaker 2: gone to a doctor's appointment or when I've gone to
• 20:23
  Speaker 2: an obgyn appointment when my first administration was do you
• 20:26
  Speaker 2: get this question?
• 20:28
  Speaker 1: Oh no, I've never gotten ever gotten that question, And
• 20:31
  Speaker 1: usually yeah, they asked when your last one was. But
• 20:34
  Speaker 1: I feel like that right mostly to figure out if
• 20:35
  Speaker 1: you're pregnant exactly exactly, so they don't care about it.
• 20:39
  Speaker 3: They don't.
• 20:39
  Speaker 2: We are. So we also know that like heart cardiovascular
• 20:43
  Speaker 2: disease and heart disease was not attributed to women like
• 20:46
  Speaker 2: people were like women don't get that and then realize, oh,
• 20:48
  Speaker 2: that's one of the number one killers of women. This
• 20:51
  Speaker 2: might be a link to that number one killer thing,
• 20:53
  Speaker 2: and we might have early alerts if we need this
• 20:56
  Speaker 2: type of information or if we were aware ourselves, because
• 21:00
  Speaker 2: how is the doctor going to guess when our first
• 21:02
  Speaker 2: period was right, and they don't. If they don't ask us,
• 21:04
  Speaker 2: how are they going to know? So these are some
• 21:06
  Speaker 2: of those questions like, oh my god, this makes sense.
• 21:09
  Speaker 2: And add to that, administrating can exacerbate some conditions, including
• 21:12
  Speaker 2: asthma attacks, IBS, diabetes, and even increased seizure activities like
• 21:16
  Speaker 2: these are things that happened that we know a lot
• 21:18
  Speaker 2: of people have, and then those moments of being on
• 21:20
  Speaker 2: your period can exasper exacerbate those moments and we're not prepared.
• 21:26
  Speaker 3: How are we supposed to handle that? Did you know
• 21:27
  Speaker 3: any of these any? No?
• 21:29
  Speaker 1: I didn't know any of this. I think the only
• 21:32
  Speaker 1: thing I've known about my period outside of you know,
• 21:39
  Speaker 1: your body is changing and pregnancy health item that I
• 21:43
  Speaker 1: knew was it can impact migraines because that's they gave.
• 21:47
  Speaker 1: They put me on birth control for migraines, and that.
• 21:51
  Speaker 2: Like acne acne right right, and those are the two
• 21:55
  Speaker 2: things they put you on birth control for. But these
• 21:58
  Speaker 2: linkages to caro vascular disease has been around. I believe
• 22:02
  Speaker 2: one of the studies I just talked about was from
• 22:03
  Speaker 2: twenty eleven. So there's conversations that have been had but
• 22:07
  Speaker 2: no one's really recognizing it's like, whether it's used to
• 22:11
  Speaker 2: its full potential for us to talk about, Oh, these
• 22:13
  Speaker 2: could be things that could be why I've experienced these things.
• 22:17
  Speaker 2: And as we talk about it more in a minute,
• 22:19
  Speaker 2: the loss of estrogen can also increase your risk of
• 22:22
  Speaker 2: cardiovascular disease or heart related incidents.
• 22:25
  Speaker 3: So you're like, what this doesn't we're screwed all together. Sorry,
• 22:31
  Speaker 3: that's not the way I wanted to go.
• 22:33
  Speaker 2: But yeah, so again we're not going to go into
• 22:35
  Speaker 2: this too much. But obviously with just that bit of information,
• 22:38
  Speaker 2: there's a lot to be said. So we really should
• 22:40
  Speaker 2: be looking into what this looks like and having people
• 22:43
  Speaker 2: have this thorough conversation so that we, as the people
• 22:47
  Speaker 2: having periods, are able to advocate for ourselves to be like,
• 22:50
  Speaker 2: these are things that have concerns about. What do you
• 22:52
  Speaker 2: think if you have symptoms of heart problems And we're like, wait,
• 22:57
  Speaker 2: maybe it's because of this this knowledge could help us. Yeah, no, maybe,
• 23:03
  Speaker 2: so let's talk about perimenopause. So perimenopause wasn't recognized until
• 23:07
  Speaker 2: the seventies, as it was often still referred to and
• 23:10
  Speaker 2: it is still referred to as the change I really
• 23:13
  Speaker 2: love like the drama of it, the che have you
• 23:17
  Speaker 2: gone through the chase?
• 23:18
  Speaker 3: Going through the chase?
• 23:20
  Speaker 2: I've heard that a feel and actual research didn't start
• 23:24
  Speaker 2: until the eighties. So from health dot Yahoo dot com quote,
• 23:28
  Speaker 2: it was in the nineteen eighties that there was more
• 23:30
  Speaker 2: medical documentation of this time before menopause, and the term
• 23:34
  Speaker 2: perimenopause was added to the scientific literature. Doctor Andrea Kamano
• 23:38
  Speaker 2: tells a flow space and while the conversations can't be
• 23:40
  Speaker 2: attributed to one person, expert say that doctor Wolfe H.
• 23:44
  Speaker 2: Union is a familiar name in the space. He conducted
• 23:46
  Speaker 2: extensive experiments in the nineteen eighties and is recognized for
• 23:50
  Speaker 2: helping to distinguish perimenopause from menopause.
• 23:53
  Speaker 3: Again, I think that's important in knowing your stages.
• 23:55
  Speaker 2: Right now, the exact timing of the study of perimenopause
• 23:58
  Speaker 2: or history of it doesn't seem to be important enough
• 24:00
  Speaker 2: to be easily found, I will say, because I was like,
• 24:04
  Speaker 2: oh no, I can't. I don't know where this information
• 24:06
  Speaker 2: is coming from. But the idea and the understanding have
• 24:08
  Speaker 2: been around for some time. Again, oftentimes referring to that
• 24:12
  Speaker 2: timeframe as the change or transition, and just to note premenopause,
• 24:17
  Speaker 2: which is confused for perimenopause, actually is a reference to
• 24:21
  Speaker 2: the time of your first period to perimenopause, so that
• 24:24
  Speaker 2: during that stage just pre menopause, so your actual period times.
• 24:28
  Speaker 3: During this phase.
• 24:29
  Speaker 2: There's a lot of known and unknown symptoms, so let's
• 24:32
  Speaker 2: go over some of them. Ones you may be familiar
• 24:34
  Speaker 2: with include night sweats, hot flashes of moodiness, low libido,
• 24:39
  Speaker 2: and irregular or lessened periods. And though hot flashes or
• 24:44
  Speaker 2: vascomotor symptoms are experienced by thirty to seventy percent of
• 24:47
  Speaker 2: perimenopausible women, which by the way, that's.
• 24:49
  Speaker 3: A giant gap.
• 24:51
  Speaker 2: Like estimated numbers, not much is actually known about these
• 24:56
  Speaker 2: hot flashes, which is the other part of the language,
• 24:58
  Speaker 2: which by the way, can also be attributed to why
• 25:01
  Speaker 2: you might have heart palpitations these heart flasters. Apparently it
• 25:06
  Speaker 2: can be treated with the catch all drug gabapentin, which
• 25:09
  Speaker 2: has been used for everything. At this point, like, I
• 25:12
  Speaker 2: am very confused what gabapentin is because I've been on
• 25:15
  Speaker 2: it for nerve pain, but it's also for seizures, it's
• 25:19
  Speaker 2: also for apparently hot flashes.
• 25:22
  Speaker 3: What what is this medication? Anyway?
• 25:25
  Speaker 2: Here's some information from a twenty sixteen study titled Perimenopause
• 25:28
  Speaker 2: from Research to Practice quote, hot flash prevalence and perhaps
• 25:32
  Speaker 2: effectiveness of treatment varies by race and ethnicity. African American
• 25:36
  Speaker 2: and Native American women appear to have the highest reporting
• 25:38
  Speaker 2: of hot flashes. In the Swan study, which is one
• 25:41
  Speaker 2: of the studies that they use for perimenopause, Chinese and
• 25:44
  Speaker 2: Japanese women had lower rates of hot hot flashes reporting
• 25:47
  Speaker 2: and a shorter overall duration of hot flashes. As a
• 25:50
  Speaker 2: Korean woman, I've experienced them already, so I don't know
• 25:54
  Speaker 2: if I'm a part of this.
• 25:56
  Speaker 3: These groups.
• 25:58
  Speaker 2: Body size also affects the survey in frequency of hot
• 26:01
  Speaker 2: flashes reporting in a complex way. So women of high
• 26:04
  Speaker 2: body mass index B and my report worse hot flashes
• 26:07
  Speaker 2: when they are perimen apozzle, but fewer and milder hot
• 26:10
  Speaker 2: flashes once they're postmen A puzzle which is interesting to
• 26:15
  Speaker 2: me because I feel like it would have been I
• 26:18
  Speaker 2: guess I would make sense actually, because like during the
• 26:21
  Speaker 2: worst part of the stages.
• 26:22
  Speaker 3: So yeah, okay.
• 26:22
  Speaker 2: Although hot flashes are believed to be related to the
• 26:25
  Speaker 2: withdrawal of estradal epidemiological studies which examine extra dial annually
• 26:30
  Speaker 2: do not demonstrate a low relationship to extra dil but
• 26:33
  Speaker 2: elevated f SH, which is a predictive.
• 26:35
  Speaker 3: Of hot flashes.
• 26:36
  Speaker 2: And we're gonna talk about FSH in a minute, because
• 26:38
  Speaker 2: it's another.
• 26:39
  Speaker 3: Hormone in there.
• 26:41
  Speaker 2: They think they know, but they don't quite know. And
• 26:44
  Speaker 2: apparently it's not just annoying but bad for you. Again,
• 26:47
  Speaker 2: from that same report, Apart from their bother hot flashes
• 26:50
  Speaker 2: may have implications for women's health, hot flashes have been
• 26:53
  Speaker 2: shown to be linked to reduced heart rate variability HRV,
• 26:57
  Speaker 2: a marker of vagual control, the loss of which is
• 26:59
  Speaker 2: associate with increased a cardiovascular disease risk.
• 27:02
  Speaker 3: Once again, y'all, we are in danger, not scary or anything.
• 27:10
  Speaker 3: I know.
• 27:10
  Speaker 2: I feel like everything is associated obviously with the blood
• 27:13
  Speaker 2: and the heart, and that makes sense. But damn, I
• 27:15
  Speaker 2: really did not put these together and like it did
• 27:19
  Speaker 2: not compute to be like, oh wow, this is this
• 27:21
  Speaker 2: could be a marketer of things, and this could be
• 27:23
  Speaker 2: high risk.
• 27:24
  Speaker 3: This makes a lot of sense, which is by the way.
• 27:26
  Speaker 2: Why HRT was kind of pushed to the wayside on
• 27:30
  Speaker 2: it's long ago because of risks like this.
• 27:32
  Speaker 3: But again we'll come back to that.
• 27:35
  Speaker 2: So hot flashes need to be understood a little more
• 27:38
  Speaker 2: because come on, man, come on, Although they are bad,
• 27:41
  Speaker 2: it feels like you're burning out from the burning out
• 27:43
  Speaker 2: from the inside out. It was a newse I was like,
• 27:46
  Speaker 2: I can't get cool. I've had those feelings before, but man,
• 27:50
  Speaker 2: so that that's something with the hot flashes, and that's
• 27:52
  Speaker 2: something that we do know is more commonly understood. People
• 27:55
  Speaker 2: kind of like get hot flashes is a sign of this.
• 27:58
  Speaker 2: But some of the ones you may not be aware
• 27:59
  Speaker 2: of include brain fog, hair loss, heart palpitations which could
• 28:04
  Speaker 2: be associated with the hot flashes, joint pain, gum problems,
• 28:08
  Speaker 2: yeah utiyes, tingling in extremities, panic attacks, decent dizziness, and
• 28:15
  Speaker 2: something called burning mouth syndrome, which I was like, what, which,
• 28:18
  Speaker 2: according to vela bio dot com, is a persistent burning
• 28:22
  Speaker 2: sensation in the mouth, lips, or tongue which bted ups.
• 28:26
  Speaker 2: As of recently, some of these spicy foods that were
• 28:29
  Speaker 2: never spicy to me have all of a sudden started
• 28:31
  Speaker 2: to make my mouth tingle. I'm starting to wonder. My
• 28:35
  Speaker 2: corner says BS that I'm just losing my tolerance. But
• 28:41
  Speaker 2: it could be it could be like the things that
• 28:45
  Speaker 2: I'm like, this is not usually spicy to me.
• 28:47
  Speaker 3: All of a sudden, it's starting to make my mouth
• 28:50
  Speaker 3: tingle M. Yeah, more me search is needed. Well, this
• 28:58
  Speaker 3: is what this is.
• 29:10
  Speaker 2: So here's what's happening in your body if you're going
• 29:12
  Speaker 2: through the stages of perimenopause. According to Reproductive Facts dot
• 29:16
  Speaker 2: org so quote, hormones work together to promote balance. As
• 29:20
  Speaker 2: hormone levels go up or down, they trigger the ovaries
• 29:23
  Speaker 2: of petulgary gland in the brain to make more or
• 29:25
  Speaker 2: less of other hormones. As a woman gets older, hormonal
• 29:29
  Speaker 2: balances change. So an of the first hormones to decrease
• 29:33
  Speaker 2: is the inhibit which is produced by the ovary to
• 29:36
  Speaker 2: work with the petuitary gland to produce less f SH
• 29:40
  Speaker 2: or follicle stimulating hormone. The FSH controls the level of estrogen. So,
• 29:45
  Speaker 2: going back to that Reproductive Facts dot org, FSH is
• 29:49
  Speaker 2: made by the petulgary gland. Levels often go up and
• 29:51
  Speaker 2: down during the menopause transition. FSH levels can be very
• 29:56
  Speaker 2: high one day and very low the next day. When
• 29:59
  Speaker 2: f SA levels are high, the ovaries make more estrogen.
• 30:02
  Speaker 2: When FSH levels drop, estrogen levels drop. These changes in
• 30:07
  Speaker 2: FSH and estrogen can happen months two years before metopause.
• 30:11
  Speaker 3: Once again we don't have a timeframe.
• 30:15
  Speaker 2: Then we have the progesterone, which we defined earlier, and
• 30:19
  Speaker 2: as we ovulate less, the progesterone level stays low, which.
• 30:22
  Speaker 3: Can lead to missed periods. So this is kind of
• 30:25
  Speaker 3: that moment.
• 30:26
  Speaker 2: Then there is the AMH or the antabularian hormone, which
• 30:30
  Speaker 2: is also produced in the ovaries, and when it starts
• 30:32
  Speaker 2: to drop, the transition begins. So apparently I believe it
• 30:35
  Speaker 2: has something to do with the eggs being dropped. I
• 30:38
  Speaker 2: don't know why I'm showing you a shape any like
• 30:41
  Speaker 2: the listeners can see what I'm doing. This is all right,
• 30:45
  Speaker 2: I'm a stop, now you can I'm sure my cup
• 30:49
  Speaker 2: like an egg?
• 30:50
  Speaker 3: All right?
• 30:50
  Speaker 2: Moving on, So now we kind of have an idea
• 30:53
  Speaker 2: about what is happening to our bodies as the hormone
• 30:56
  Speaker 2: levels are dropping. So let's go back to some of
• 30:59
  Speaker 2: these symptoms. One that has surprised me recently was that
• 31:02
  Speaker 2: about joint pain and bone lows. It's been noted that
• 31:06
  Speaker 2: bone laws absolutely occurs during menopause and it continues to decline,
• 31:09
  Speaker 2: so a lot of broken bones and this is where
• 31:11
  Speaker 2: it kind of ossioporosis comes in. And we're talking about
• 31:13
  Speaker 2: these early big hazards, all hazards and all of that,
• 31:16
  Speaker 2: but the study of bone laws during perimenopause is not
• 31:20
  Speaker 2: as much. We don't have as much information. One study
• 31:23
  Speaker 2: was completed in twenty eleven to see if there was
• 31:25
  Speaker 2: bone loss during perimenopause as well. And here's what they
• 31:28
  Speaker 2: have to say. The findings from perspective examinations of bone
• 31:31
  Speaker 2: mass density BMD change across the menopausal transition demonstrate an
• 31:35
  Speaker 2: early and accelerated rate of bone loss, particularly in the
• 31:38
  Speaker 2: lumbar spine. Bone laws begins to accelerate one to two
• 31:42
  Speaker 2: years before menopause, concurrently with the prolonged aminarrhea that characterizes
• 31:46
  Speaker 2: the late menopausal transition. Importantly, these rates of bone laws
• 31:50
  Speaker 2: are also influenced by body size, with greater bone laws
• 31:52
  Speaker 2: and non obese women and those with lower bad body mass,
• 31:57
  Speaker 2: independent of differences in the race and ethnicity. The greatest
• 32:00
  Speaker 2: reduction in BMD occurs in the year before the final
• 32:03
  Speaker 2: minstrual period and the first two years after the final
• 32:07
  Speaker 2: minstrual period, with lower rates of loss during the ensuing
• 32:10
  Speaker 2: one to seven years. So yes, this is during the
• 32:13
  Speaker 2: perimenoplause time frame. And with that there is the frozen shoulder.
• 32:17
  Speaker 2: I don't know if you've heard of this any which
• 32:20
  Speaker 2: is a sharp pain that occurs at night, causing you
• 32:22
  Speaker 2: to struggle to use your arms to do things like
• 32:24
  Speaker 2: unfasten your braw, wash your hair, or even get dressed.
• 32:27
  Speaker 2: So this condition is also known as adhesive capsulitis YEP
• 32:31
  Speaker 2: adhesive castlelitis, which the beettermenopause dot Com says is quote
• 32:36
  Speaker 2: occurs when that capsule of connective tissues surrounding the shoulder
• 32:39
  Speaker 2: joint becomes inflamed, thickened, and tight. This limits movement and
• 32:43
  Speaker 2: causes persistent, often worsening pain. Which last year, y'all, I
• 32:47
  Speaker 2: had one of the worst pains in my shoulders that
• 32:50
  Speaker 2: I've ever had. It caused tingling off the hand and
• 32:52
  Speaker 2: like I had to like keep my arms up. It
• 32:54
  Speaker 2: was awful, Like I could not exercise, I couldn't even sleep.
• 32:58
  Speaker 2: And now I'm looking back, like was that that frozen shoulder?
• 33:02
  Speaker 2: I was told that it probably was a nerve thing,
• 33:06
  Speaker 2: but they can never really find anything, so I was like, wait,
• 33:09
  Speaker 2: so what is it? Of course, they didn't take any
• 33:11
  Speaker 2: MORI y'all, they just gave me steroids and sent me
• 33:14
  Speaker 2: on my way.
• 33:15
  Speaker 3: So and Gavinpinin. This is where I knew about Gavinpintin.
• 33:18
  Speaker 3: A big part of the.
• 33:19
  Speaker 2: Reason all of this is happening is because the loss
• 33:22
  Speaker 2: of hormones. So back to the beettermenopause dot com article,
• 33:25
  Speaker 2: hormones like estradiol, progesterone, and testesterones support joint librication, connect
• 33:30
  Speaker 2: the tissue integrity and inflammation regulation. When these levels drop
• 33:35
  Speaker 2: in midlife, joints may become more punent, stiffness, inflammation, and injury.
• 33:40
  Speaker 3: This is a.
• 33:40
  Speaker 2: Common thing that I did not realize happened. I don't
• 33:43
  Speaker 2: know why this did not connect with me. Maybe it's
• 33:46
  Speaker 2: the agism that I harbor, not realizing that this is
• 33:50
  Speaker 2: a part of just the transition, but that it comes
• 33:52
  Speaker 2: younger than I thought, or it can come younger than
• 33:55
  Speaker 2: you think. And much like the heavy minstrual bleeding being
• 33:58
  Speaker 2: a contributor factor of cardiovascular disease risk, so is perimenopause.
• 34:03
  Speaker 2: So add just one more thing that I didn't realize
• 34:08
  Speaker 2: that might destroy your heart. So this is from healthrx
• 34:13
  Speaker 2: dot com. Cardiovascular disease is the leading cause of death
• 34:17
  Speaker 2: in women and the menopause transition is the period when
• 34:20
  Speaker 2: risk begins to accelerate. So the Swan Heart Study or
• 34:25
  Speaker 2: the Study of Women's Health across the Nation study carotid
• 34:28
  Speaker 2: into my media thickness or CIMT across the transition and
• 34:32
  Speaker 2: found a statistically significant acceleration in CIMT progress beginning in
• 34:36
  Speaker 2: the two years before the final minstrual period, independent of
• 34:39
  Speaker 2: chronological age or traditional risk factors. In the celial think function,
• 34:44
  Speaker 2: measured by flow mediated dilation, declines during perimenopause in parallel
• 34:49
  Speaker 2: with following extra dial blood pressure often rises by five
• 34:52
  Speaker 2: to ten MMHD during the transition years, partly from estrogen loss,
• 34:57
  Speaker 2: partly from sleep disruption mediated sympathetic activation, and partly from
• 35:03
  Speaker 2: weight gain. So all these things are happening and it
• 35:06
  Speaker 2: causes sheer risk of cardiovascular disease.
• 35:09
  Speaker 3: To go up. Love it wonderful? Aren't you so excited
• 35:12
  Speaker 3: by this?
• 35:13
  Speaker 2: Fantastic And with this different symptoms or causes, it isn't
• 35:16
  Speaker 2: too hard to see how there could be some misdiagnosis.
• 35:19
  Speaker 2: So from thepauselife dot Com. Unfortunately, the lack of education
• 35:24
  Speaker 2: and awareness about payment and pause among healthcare providers has
• 35:27
  Speaker 2: led to a dramatic increase in misdiagnosed conditions during this time,
• 35:31
  Speaker 2: Many women experiencing the onset of paimant pause symptoms are
• 35:35
  Speaker 2: instead diagnosed with conditions such as ADHD, leaky gut syndrome
• 35:39
  Speaker 2: which I don't go into, but other what yeah, fibromyologia,
• 35:43
  Speaker 2: long covid, interstitual cystitis, adrenal fatigue, depression, anxiety, or even
• 35:49
  Speaker 2: fatty liver disease. There's so much in this. I have
• 35:52
  Speaker 2: started to think maybe I have ADHD.
• 35:55
  Speaker 3: I've talked about.
• 35:55
  Speaker 2: I'm like I'm on some level of something because I'm struggling.
• 36:00
  Speaker 2: I say, it has to be a struggle, but it's
• 36:01
  Speaker 2: a different level of my way. I'm functioning right, And
• 36:05
  Speaker 2: it could be true. Maybe I have been and never
• 36:07
  Speaker 2: been diagnosed, and I have seen an increase in symptoms lately.
• 36:12
  Speaker 2: But then looking at the timeline, I'm wondering, has it
• 36:15
  Speaker 2: always been or is it perimenopause?
• 36:17
  Speaker 3: You know what I mean?
• 36:19
  Speaker 2: So back to that same article, they write a surprising
• 36:21
  Speaker 2: diagnosis often given given to perimenopause women is a diygen
• 36:24
  Speaker 2: deficit hyperactive disorder ADHD. Women in midlife may report difficulty focusing,
• 36:30
  Speaker 2: poor memory, and general cognitive decline symptoms that overlap significantly with.
• 36:34
  Speaker 3: Those of ADHD.
• 36:36
  Speaker 2: However, this mental fog is often a result of hormonal
• 36:38
  Speaker 2: fluctuations during perimenopause, particularly declining estrogen levels, which affect no
• 36:44
  Speaker 2: transmitters in the brain like serotonin and dopamine. These shifts
• 36:47
  Speaker 2: can impair memory, focus, and cognitive sharpness. Many women who
• 36:51
  Speaker 2: are incorrectly diagnosed with ADHD during perimenopause may instead be
• 36:55
  Speaker 2: experiencing what is sometimes referred to as menopause brain. So
• 37:00
  Speaker 2: there is this conversation because there's a back and forth
• 37:03
  Speaker 2: about like women not being properly diagnosed to begin with
• 37:06
  Speaker 2: with ADHD, so they maybe they've had it all along
• 37:08
  Speaker 2: or feeling like they've all of a sudden are seeing
• 37:11
  Speaker 2: these symptoms. And again like I didn't think I had ADHD.
• 37:16
  Speaker 2: I definitely am procrastinator, but as of late I've struggled
• 37:20
  Speaker 2: in several things in a way that I'm like, this
• 37:22
  Speaker 2: is new. Trying to think of words has become hard,
• 37:26
  Speaker 2: Trying to think of my feet, for like, feel a
• 37:28
  Speaker 2: little harder getting it together. It's a different pattern of level.
• 37:34
  Speaker 2: So it does wonder like, is this what's happening? Is
• 37:36
  Speaker 2: this what they're talking about with the dropping of the estrogen.
• 37:41
  Speaker 2: And again there's also thanks to covid, there have been
• 37:43
  Speaker 2: even more confusion in these conversations and diagnosis. And this
• 37:48
  Speaker 2: is a little more from the Pauselive dot Com specifically
• 37:50
  Speaker 2: about long COVID. Long COVID, a relatively new diagnosis resulting
• 37:55
  Speaker 2: from the ongoing pandemic, has a striking overlap with payment
• 37:58
  Speaker 2: apostle symptoms. Fatigue, brain fog, and muscle pain are some
• 38:02
  Speaker 2: of the features. Key features of long COVID, but there
• 38:05
  Speaker 2: are also hallmark signs of the menopause transition. Similarly, interstitual
• 38:10
  Speaker 2: societis and often pain and frustrating bladder condition diagnosed in
• 38:14
  Speaker 2: many perimenopausal women may sometimes be incorrectly attributed to chronic
• 38:18
  Speaker 2: pelvit pain that is instead driven by falling estrogen levels
• 38:22
  Speaker 2: which influence bladder health. Okay, so this could go back
• 38:26
  Speaker 2: and forth, because maybe there are things that are actually
• 38:29
  Speaker 2: wrong that they're gonna blame on menopause.
• 38:30
  Speaker 3: So it could be both of those things that like,
• 38:33
  Speaker 3: oh no, but I hate that.
• 38:34
  Speaker 2: We have even more levels of confusion and concerns about
• 38:38
  Speaker 2: misdiagnosis here. And it isn't just physical no, no, great.
• 38:45
  Speaker 3: Great, So it's more anxiety.
• 38:47
  Speaker 2: Yeah, the feeling of being overwhelmed or anxious can have
• 38:50
  Speaker 2: to do with your hormones. So here's a bit from
• 38:52
  Speaker 2: Hopkinsmedicine dot org. It's common for women to experience some
• 38:56
  Speaker 2: mood changes during perimenopause and menopause. In fact, about four
• 38:59
  Speaker 2: and ten women experienced mood symptoms similar to pre menstrual
• 39:02
  Speaker 2: syndrome or PMS. In fact, about four in ten women
• 39:06
  Speaker 2: experience mood symptoms similar to pre minstrel syndrome or PMS
• 39:09
  Speaker 2: during perimenopause. So during perimenopause, PMS symptoms may come at
• 39:13
  Speaker 2: times unrelated to your minstral cycle. Women who have a
• 39:17
  Speaker 2: previous diagnosis of anxieties are at greater risk during their
• 39:20
  Speaker 2: perimenopausal time.
• 39:21
  Speaker 3: So it's only going to get worse. A lot to
• 39:26
  Speaker 3: look forward to, you, Yeah, and they continue.
• 39:29
  Speaker 2: When estrogen and progesterone hormone levels drop during perimenopause, serotonin
• 39:33
  Speaker 2: levels also fall, contributing to increased airtability, nervousness, and anxiety.
• 39:39
  Speaker 2: Higher levels of cortisol, the stress hormone that increases with age,
• 39:42
  Speaker 2: can also create feelings of anxiety. Yeah, and those not
• 39:46
  Speaker 2: great is a relief to understand what is happening and
• 39:49
  Speaker 2: why things feel like they may be spiraling out of control.
• 39:53
  Speaker 2: I will say my anxiety has gotten worse for sure,
• 39:56
  Speaker 2: but my moodiness I don't feel like is bad. But
• 40:00
  Speaker 2: I haven't been cranky cranky. Don't get me wrong, I'm
• 40:03
  Speaker 2: still cranky, but not cranky cranky from what I've heard
• 40:06
  Speaker 2: from people that it could get to. But yeah, the
• 40:09
  Speaker 2: anxiety part, I will say, for me, being a lifelong
• 40:13
  Speaker 2: anxious person, having that disorder for a while, now I
• 40:16
  Speaker 2: feel like I've got a better control on it and
• 40:18
  Speaker 2: that I can recognize that it's not a normal reaction.
• 40:22
  Speaker 2: So as in like, it's not as bad as I
• 40:24
  Speaker 2: think it is. It is my anxiety trying to make
• 40:26
  Speaker 2: it worse. Yeah, that's for me, that's the good news.
• 40:30
  Speaker 1: Yeah, And going back to that conversation we had with
• 40:34
  Speaker 1: doctor Sharon Malone, she made that point of you know,
• 40:38
  Speaker 1: being your own advocate, you know your body better than
• 40:41
  Speaker 1: someone else, better than a doctor. So knowing that this
• 40:46
  Speaker 1: is a different type of anxiety than I normally have, like,
• 40:49
  Speaker 1: this is right. Something has changed. This is not what
• 40:52
  Speaker 1: I have been have, I what I've considered as normal.
• 40:57
  Speaker 3: Something's going on something's going on, right.
• 41:01
  Speaker 2: But with all that, all of the bad news, I
• 41:03
  Speaker 2: know we have to start asking what is being done
• 41:06
  Speaker 2: about these issues that can be life altering. So back
• 41:09
  Speaker 2: to the pauselife dot com and yes, I think if
• 41:12
  Speaker 2: you can tell by the site, it's a site that's
• 41:14
  Speaker 2: going to try to sell you something.
• 41:15
  Speaker 3: Probably or at least advocate to sell you something.
• 41:18
  Speaker 2: The dramatic rise in diagnoses such as ADHD, leaky gut, fibromylogia,
• 41:22
  Speaker 2: long covid, interstidual societis, adrenal fatigue, depression, anxiety, and fatty
• 41:27
  Speaker 2: liver in perimenopausal women may often reflect the effects of
• 41:31
  Speaker 2: perimenopause itself, rather than separate unrelated conditions. The lack of
• 41:35
  Speaker 2: formal menopause education in medical training has left many clinicians
• 41:38
  Speaker 2: ill equipped to diagnose and treat women in this stage
• 41:41
  Speaker 2: of life properly. As a result, women may be receiving
• 41:44
  Speaker 2: treatments for conditions that are actually manifestations of the menopause transition.
• 41:49
  Speaker 2: Addressing this gap requires comprehensive training in menopause and hormone health,
• 41:53
  Speaker 2: ensuring that perimenopausal women receive accurate diagnosis and appropriate care
• 41:57
  Speaker 2: tailored to their specific needs. Yes, And this is a
• 42:01
  Speaker 2: conversation that we definitely have been having for a minute about, like, oh,
• 42:05
  Speaker 2: we need to figure out how to let people know
• 42:07
  Speaker 2: this could be the thing, right, And there's so many
• 42:09
  Speaker 2: reasons why this should be done, we just named a few.
• 42:11
  Speaker 2: The good news is people are starting to understand what
• 42:14
  Speaker 2: is happening and actually realizing they need to change how
• 42:17
  Speaker 2: they diagnose her what they're diagnosing. But it does seem
• 42:20
  Speaker 2: like many patients are the ones who are having to
• 42:22
  Speaker 2: be the ones to suggest.
• 42:24
  Speaker 3: That maybe this looks like Perry menopause.
• 42:27
  Speaker 2: My obg I an that I saw a year ago,
• 42:29
  Speaker 2: really had her doubts about whether or not I might
• 42:32
  Speaker 2: be going through it, and honestly me too at the time.
• 42:35
  Speaker 2: But as I'm here like a year later, I feel
• 42:38
  Speaker 2: like the symptoms have changed or at least added on.
• 42:41
  Speaker 2: And she then has said, h I don't think so,
• 42:46
  Speaker 2: but if it is, come back to me and come
• 42:47
  Speaker 2: talk to me a little later, And I will say,
• 42:49
  Speaker 2: she is significantly younger than me, and I am still
• 42:52
  Speaker 2: under on an IUD, which can also help. Consistently being
• 42:56
  Speaker 2: on birth control can actually help the symptoms already, so
• 43:00
  Speaker 2: like this may be activating helping my hormones. But as
• 43:03
  Speaker 2: it is maybe getting worse, I'm seeing more and more
• 43:06
  Speaker 2: stuff that I'm like, Okay, this feels like this is
• 43:10
  Speaker 2: what's happening at this point. But at that point she
• 43:13
  Speaker 2: was like, are you come back that she wasn't telling
• 43:16
  Speaker 2: me no, she just said, you know, waited out a bit.
• 43:19
  Speaker 2: And in my most recent attempts to try and figure
• 43:21
  Speaker 2: out why my body slashed, my knees in my back
• 43:23
  Speaker 2: are in such severe pain that I can't walk sometimes.
• 43:26
  Speaker 2: This has been recent. I talked to my doctor at
• 43:30
  Speaker 2: the time. He was looking at my knees and talking
• 43:32
  Speaker 2: about things and now I said, could this be paramenopause
• 43:35
  Speaker 2: And he was actually quick to say that, yeah, you
• 43:36
  Speaker 2: know what, there have been a lot of confirmed cases
• 43:38
  Speaker 2: of improving after that type of diagnosis, and talking about
• 43:42
  Speaker 2: how the estrogen lessening has caused a lot of joint
• 43:45
  Speaker 2: problems and continues to cause joint problems. Frozen shoulder, he
• 43:48
  Speaker 2: talked about and talked about women falling. So he, who
• 43:51
  Speaker 2: is not in the OBGI in field, understood that this
• 43:55
  Speaker 2: was a diagnosis that can be talked about. So he
• 43:58
  Speaker 2: understood that this was real. Like he didn't try to
• 44:00
  Speaker 2: dismiss me, So that was hopeful, you know what I mean.
• 44:04
  Speaker 3: Did he help me?
• 44:05
  Speaker 2: No, But I will say I myself have already been
• 44:11
  Speaker 2: started my HRT treatment and we're gon talk a little
• 44:14
  Speaker 2: bit more more about that. So of course there would
• 44:17
  Speaker 2: be nothing else for him to do outside of helping
• 44:19
  Speaker 2: me with this current excruciating pain. But it was interesting
• 44:24
  Speaker 2: that he actually acknowledged it and understood it.
• 44:25
  Speaker 3: So I was I was nice to see that.
• 44:28
  Speaker 2: And he's not young, but he's a younger, like thirty
• 44:30
  Speaker 2: something doctor, so you know, So we wanted to take
• 44:44
  Speaker 2: a second to mention a little bit about early menopause
• 44:47
  Speaker 2: because I think it's something that we have never talked about.
• 44:49
  Speaker 3: I've never talked about and I don't think.
• 44:51
  Speaker 2: I've heard it mentioned on the show as we're not
• 44:53
  Speaker 2: going but we're not going to completely into that topic,
• 44:56
  Speaker 2: but again, felt it could be really important. So according
• 44:59
  Speaker 2: to medicine dot org, about five percent of women can
• 45:02
  Speaker 2: go through early menopause, which is women from ages forty
• 45:05
  Speaker 2: to forty five who experienced menopause, and then women who
• 45:08
  Speaker 2: are under the age of forty going through menopause is
• 45:10
  Speaker 2: called premature menopause. So there's two levels to that, which
• 45:14
  Speaker 2: is still like outside of the norm, which happens to
• 45:16
  Speaker 2: about one percent of the women, so you know, pretty
• 45:19
  Speaker 2: low number, but still enough numbers. Unfortunately for those who
• 45:22
  Speaker 2: may be going through this at the stages are going
• 45:25
  Speaker 2: through the same symptoms and problems, and oftentimes this bypasses
• 45:29
  Speaker 2: the perimenopause stage and quickly jumps into menopause stage, which
• 45:32
  Speaker 2: can be very jarring, like all like your body is
• 45:35
  Speaker 2: just like what just happened.
• 45:36
  Speaker 3: From Yalmedicine dot Org. They ride.
• 45:38
  Speaker 2: Estrogen is a natural hormone mostly produced in the ovaries
• 45:41
  Speaker 2: that is important for building and maintaining bone in young women.
• 45:45
  Speaker 2: It can also prevent vascular damage. However, after menopause, the
• 45:49
  Speaker 2: ovaries do not produce much estrogen. So this was from
• 45:53
  Speaker 2: doctor Hugh Taylor, who is the chair of Yal Medicine Obstetrics,
• 45:57
  Speaker 2: Gynocology and Reproductive Science, and he said, notably, women who
• 46:01
  Speaker 2: experienced premature or early menopause have higher risks of heart
• 46:04
  Speaker 2: disease in osteoporosis because they will spend more years of
• 46:07
  Speaker 2: their lives without the benefits of estrogen when it continues.
• 46:11
  Speaker 2: He says, if you have healthy blood vessels and estrogen
• 46:14
  Speaker 2: tends to keep them healthy by allowing them to be
• 46:15
  Speaker 2: relaxed and open, and by helping the body maintain a
• 46:18
  Speaker 2: healthy balance of good and bad cholesterol. However, if you
• 46:21
  Speaker 2: have damaged blood vessels, such as from aging or diseases
• 46:24
  Speaker 2: like obesity, having supplemental estrogen around maybe a risk. So
• 46:28
  Speaker 2: they're talking about the different levels of why you should
• 46:31
  Speaker 2: and shouldn't take estrogen. And for the people who maybe
• 46:33
  Speaker 2: thirty going through perimenopause or menopause, it is actually beneficial
• 46:37
  Speaker 2: because it preserves cardiovascular benefits, so that estrogen is really important.
• 46:42
  Speaker 2: And for the people who might be going through early
• 46:43
  Speaker 2: or premature menopause, this is.
• 46:45
  Speaker 3: Really important to have.
• 46:47
  Speaker 2: And we're going to talk about it a bit more,
• 46:48
  Speaker 2: but honestly, the sooner the better, is what it seems,
• 46:52
  Speaker 2: because some of the tests that we're going to talk
• 46:54
  Speaker 2: about that caused the law to panic was because it
• 46:57
  Speaker 2: was women who are already like ten years past menopause
• 47:01
  Speaker 2: that might be taking it. That caused a lot of
• 47:02
  Speaker 2: problems apparently, And these are all the scary things. So
• 47:07
  Speaker 2: what are some of those solutions. Again, I've already talked
• 47:09
  Speaker 2: about it. There are a few things that have been
• 47:11
  Speaker 2: revived when it comes to perimenopause and menopause HRT. But
• 47:15
  Speaker 2: before we jump in there, of course, there are also
• 47:17
  Speaker 2: old go tos of like be active, eat healthier, do
• 47:21
  Speaker 2: weight chaining, and so on and so forth, and I
• 47:23
  Speaker 2: think like some of those things definitely do have benefit,
• 47:25
  Speaker 2: Like obviously if you are at risk or heart related things,
• 47:29
  Speaker 2: eating healthier can help you, Doing more cardio can help you,
• 47:32
  Speaker 2: doing weightlifting to build up your bones, to like, you know,
• 47:36
  Speaker 2: protect to build up your muscles, to protect your bones.
• 47:39
  Speaker 2: All of those things are really important so you don't
• 47:41
  Speaker 2: get things like dead but syndrome, which by the way,
• 47:44
  Speaker 2: my doctor did not know of, so I don't.
• 47:46
  Speaker 3: Think that's the thing anyway.
• 47:48
  Speaker 2: But the real conversation starter and real controversy comes with HRT.
• 47:54
  Speaker 2: First we have we kind of want to take the
• 47:56
  Speaker 2: timeline of how HRT began and what it is. So
• 48:00
  Speaker 2: first we have the creation of conjugated aquined estrogen better
• 48:03
  Speaker 2: known as PREMIERN, which was approved by the FDA in
• 48:05
  Speaker 2: nineteen forty two, and by the nineteen fifties and sixties,
• 48:08
  Speaker 2: we have gynecologists prescribing them pretty broadly, like really quickly,
• 48:13
  Speaker 2: to any symptom that looked like menopause. And not so
• 48:17
  Speaker 2: fun fact that they use to market this specifically to men.
• 48:23
  Speaker 3: Of course they did, and it was real, all.
• 48:26
  Speaker 2: Real sexist, both of these things. So this was a
• 48:30
  Speaker 2: Guardian article. The article is titled she Will Not Become
• 48:33
  Speaker 2: Dull and an Attractive The Charming History of Menopause and HRT.
• 48:36
  Speaker 3: So this is a quote.
• 48:38
  Speaker 2: There are also as targeted at men, who are obviously
• 48:41
  Speaker 2: the real victims. Here are sarcasm husbands too, like Premier
• 48:45
  Speaker 2: and said one of the ads from the nineteen fifties
• 48:47
  Speaker 2: that hormone pills men are assured make a woman quote
• 48:50
  Speaker 2: pleasant to live with once again in A particularly low
• 48:53
  Speaker 2: point was the publication in nineteen sixty six of Feminine
• 48:57
  Speaker 2: Forever by Robert A. Wilson, an American Guydan clause Just.
• 49:00
  Speaker 2: In the best selling book, he called menopause quote a serious,
• 49:03
  Speaker 2: painful and often crippling disease and even more alarming, all
• 49:07
  Speaker 2: postmenopausal women are castrates. Wow, just put them in a
• 49:14
  Speaker 2: barn and set it on fire.
• 49:17
  Speaker 3: Geez.
• 49:19
  Speaker 2: Yeah, So the book, the article is hilarious in itself,
• 49:23
  Speaker 2: but of course I had to make mention of quotes.
• 49:24
  Speaker 2: Of course they wanted to give it to men first.
• 49:26
  Speaker 2: Let's show men, hey, drug your women essentially in a
• 49:30
  Speaker 2: different way, get those hormones together. But by the seventies
• 49:35
  Speaker 2: we get two independent studies that show women take in
• 49:37
  Speaker 2: from here and have a higher chance of indimetrial cancer
• 49:40
  Speaker 2: than those who don't. So this is this article that
• 49:43
  Speaker 2: was like, oh my god, what is happening. So this
• 49:46
  Speaker 2: is from health rx dot com. Prescribing of unopposed estrogen
• 49:49
  Speaker 2: dropped sharply among women with intact eatery terry. The fill
• 49:53
  Speaker 2: rapidly pivoted to adding a progestogen, creating what would be
• 49:57
  Speaker 2: combined estrogen progestogen therapy EP. Interestingly, in the nineteen eighties,
• 50:03
  Speaker 2: some reports and studies were showing that estrogen therapy could
• 50:05
  Speaker 2: actually be helpful helping the heart.
• 50:08
  Speaker 3: So back to the health article.
• 50:11
  Speaker 2: The Nurses Health Study, which eventually enrolled over one hundred
• 50:14
  Speaker 2: and twenty one thousand women, became the most cited source
• 50:17
  Speaker 2: for this hypothesis. Early analysis suggested women using postmenopausal hormones
• 50:22
  Speaker 2: had roughly fifty percent lower coordinary heart disease risk compared
• 50:25
  Speaker 2: with the non users. So there's a lot happening.
• 50:29
  Speaker 3: Throughout the years.
• 50:30
  Speaker 2: They proceeded to test whether these treatments were both effective
• 50:33
  Speaker 2: for menopausal symptoms like hot flashes as well as hardcare,
• 50:36
  Speaker 2: and whether synthetic versus natural bioidentical made eight difference. But
• 50:41
  Speaker 2: then we come to two thousand and two with the
• 50:43
  Speaker 2: Women's Health Initiative WHI, who changed the course of the
• 50:47
  Speaker 2: popularity of the treatment, like it pretty much stopped it
• 50:51
  Speaker 2: in its tracks.
• 50:52
  Speaker 3: So from Women's Hormone.
• 50:54
  Speaker 2: Network dot org, yes, they are trying to sell you
• 50:56
  Speaker 2: something if you go look it up anyway, they say.
• 50:58
  Speaker 2: In two thousand and two, the trial was one of
• 51:00
  Speaker 2: the largest prevention studies done in the US, with more
• 51:03
  Speaker 2: than one hundred and sixty thousand women over fifteen years.
• 51:06
  Speaker 2: If further reported on the use of the daily conjugated
• 51:09
  Speaker 2: estrogens from pregnant horses combined with progestin not progesterone, it
• 51:14
  Speaker 2: found that women taking these chemicals were at a higher
• 51:17
  Speaker 2: risk of heart disease, stroke, and breast cancer after five years. However,
• 51:21
  Speaker 2: the estrogen only arm in women with a hesterectomy resulted
• 51:25
  Speaker 2: in twenty one percent less breast cancer. So the health
• 51:28
  Speaker 2: arx dot com says, this is about this about the
• 51:31
  Speaker 2: news media's reaction to that result. So this is really like,
• 51:34
  Speaker 2: oh no, newspapers reported the breast cancer finding as a
• 51:37
  Speaker 2: dramatic absolute risk increase. The actual absolute risk was eight
• 51:42
  Speaker 2: additional breast cancers per ten thousand women per year, a
• 51:46
  Speaker 2: small increase that was lost in the headline coverage. The
• 51:49
  Speaker 2: Menopausal Society would later note quote the WHI findings were
• 51:53
  Speaker 2: frequently misrepresented in media and clinical settings, leading to unnecessary
• 51:57
  Speaker 2: fear and under treatment of symtematic women. So US hormone
• 52:01
  Speaker 2: therapy prescriptions dropped by approximately fifty percent in two thousand
• 52:05
  Speaker 2: and two and two thousand and four. So this really
• 52:07
  Speaker 2: and we've heard this. I think that's the one thing
• 52:09
  Speaker 2: I heard is that this can cause cancer. HRT can
• 52:12
  Speaker 2: cause cancer, which Women's Hormone Network says this about the time.
• 52:18
  Speaker 2: This study led to millions of women avoiding hormone therapy
• 52:21
  Speaker 2: and many new men apausal women never.
• 52:23
  Speaker 3: Starting hormone therapy.
• 52:25
  Speaker 2: The real problem with the study it led to mass
• 52:27
  Speaker 2: confusion in the medical community, and unfortunately natural bioidentical estrogen
• 52:33
  Speaker 2: and progesterone were mistakenly thrown into the same category as
• 52:37
  Speaker 2: horse derived estrogen and synthetic progesterone. So there's so much
• 52:41
  Speaker 2: in this conversation, like the different people have different analysis
• 52:44
  Speaker 2: and different parts of the report that they kind of
• 52:47
  Speaker 2: pick apart essentially, But what it comes down to is
• 52:49
  Speaker 2: this was a misresrepresentation in the numbers and the findings,
• 52:53
  Speaker 2: and all we heard was it causes cancer, which we
• 52:56
  Speaker 2: know misinformation happens a lot, and this is that part
• 53:01
  Speaker 2: of that conversation. Since then, more studies have come about
• 53:04
  Speaker 2: showing different effects of different treatments and also debunking the
• 53:08
  Speaker 2: conversation that had women fearful of the treatment. One research
• 53:12
  Speaker 2: completed in two thousand and eight from the European Society
• 53:14
  Speaker 2: of Cardiology showed a bit of a difference. So back
• 53:17
  Speaker 2: to the Women's Hormone Network dot org, it has found
• 53:20
  Speaker 2: that overall there was no increased risk of heart attacks
• 53:23
  Speaker 2: and current users of HRT compared to women who had
• 53:25
  Speaker 2: never taken it, and they continue. The study also found
• 53:28
  Speaker 2: that the type of HRT and the way that women
• 53:30
  Speaker 2: took it made a difference to the risk of heart attacks.
• 53:33
  Speaker 2: Continuous HRT, a continuous combination of estrogen and progesterone, carried
• 53:38
  Speaker 2: at thirty five percent increased risk of heart tax compared
• 53:40
  Speaker 2: with women who had never used HRT. But if HRT
• 53:43
  Speaker 2: was taken on a cyclical basis estrogen followed by a
• 53:46
  Speaker 2: combination of estrogen and progesterone. There was a tendency for
• 53:49
  Speaker 2: these women to have a reduced risk of heart attacks
• 53:52
  Speaker 2: compared to women who had never used HRT, and this
• 53:55
  Speaker 2: was also seen if a synthetic hormone, tipolone was used.
• 53:58
  Speaker 2: It was also found that if used early and even
• 54:01
  Speaker 2: for longer than ten years, this did not result in
• 54:03
  Speaker 2: an increased risk of breast cancer, so that timing really
• 54:06
  Speaker 2: does make a difference, it seems so perhaps the way
• 54:10
  Speaker 2: and the combo of treatment makes a difference with that timing.
• 54:14
  Speaker 2: So back to the healtharx dot com article, the whi
• 54:18
  Speaker 2: reanalysis by h subgroup showed that women who initiated homone
• 54:21
  Speaker 2: therapy within ten years of menopause had a non significant
• 54:25
  Speaker 2: trend toward reduced cardiovascular events, while women who initiated twenty
• 54:29
  Speaker 2: or more years after menopause had elevated risks. The absolute
• 54:33
  Speaker 2: confidence intervals were wide, but the pattern was consistent and
• 54:36
  Speaker 2: clinically meaningful. Again, I think this is why we're being
• 54:39
  Speaker 2: encouraged to look at perimenopause as a beginning treatment as
• 54:43
  Speaker 2: opposed to just menopause. So this is really important and
• 54:46
  Speaker 2: from Medicine dot yl dot edu. Today, the literature suggests
• 54:50
  Speaker 2: that HRT can be beneficial for women within ten years
• 54:53
  Speaker 2: of menopause or below the age of sixty, with many
• 54:55
  Speaker 2: physicians recommending starting treatment early in perimenopause to maximize the
• 54:59
  Speaker 2: benefit and avoid complication. This makes a big difference. So
• 55:04
  Speaker 2: we also need to know and to know a very metopause.
• 55:08
  Speaker 3: Yeah, I know.
• 55:10
  Speaker 2: So with that, where does that leave us today? There
• 55:13
  Speaker 2: are different types of HRTs. I'm not even sure if
• 55:17
  Speaker 2: that's the way we should say it, Like, I don't
• 55:18
  Speaker 2: know if there's different types of HRT, as in like
• 55:22
  Speaker 2: if you ask your doctor, I want this type versus
• 55:24
  Speaker 2: the type, or if it's completely something different. Women's Hormone
• 55:28
  Speaker 2: Network dot org really really pushes for what's called physiological
• 55:32
  Speaker 2: hormone restoration therapy and they have copywriter this y'all, which
• 55:36
  Speaker 2: seems to work on the idea that it goes based
• 55:38
  Speaker 2: on the twenty eight cycle, so it tries to mimic
• 55:41
  Speaker 2: what your actual cycle is and going with your body
• 55:43
  Speaker 2: and cycling the types of medication or how much medication
• 55:47
  Speaker 2: you get, which makes sense to me, I will say,
• 55:50
  Speaker 2: but I don't know, like I'm not going to tell
• 55:51
  Speaker 2: you yes, yes, you absolutely should. Typically what I've seen
• 55:55
  Speaker 2: is HRT you just take it daily at a certain time.
• 55:59
  Speaker 2: With this, there's even conversations about DHA, which is a
• 56:03
  Speaker 2: type of drug that I think does something with your testosterones.
• 56:06
  Speaker 2: So which women's you know, do have levels of and
• 56:09
  Speaker 2: whether or not you should use that. I've seen that.
• 56:12
  Speaker 2: There's a conversation about vaginal hormone therapy, so like you inserted,
• 56:17
  Speaker 2: I believe, and it's directly there. There's this conversation about
• 56:20
  Speaker 2: I think there's vaginal rings for this too. See this
• 56:23
  Speaker 2: is where I'm like, you know, I'm trying to look
• 56:25
  Speaker 2: at all these things and I'm looking it up, but
• 56:26
  Speaker 2: I don't get a lot of information outside of like
• 56:30
  Speaker 2: this is what we think, and they gave you flowery
• 56:33
  Speaker 2: language to make it sound appealing. So I don't exactly
• 56:37
  Speaker 2: know what all this is because like this website that
• 56:41
  Speaker 2: I was talking to, which does give a lot of
• 56:43
  Speaker 2: great information. So Women's Hormone Network dot org giving you
• 56:46
  Speaker 2: a lot of great information. But then when you read
• 56:48
  Speaker 2: like you know, what is traditional HRT? They write For years,
• 56:51
  Speaker 2: we've been conditioned to fear estrogen, largely due to flawed
• 56:54
  Speaker 2: Women's Health Initiative study conducted two decades ago, and then
• 56:57
  Speaker 2: tells you why, and then talking about the publication, But
• 57:00
  Speaker 2: then they never tell you what it is other than
• 57:03
  Speaker 2: we used to fear it. Then they talk about non
• 57:06
  Speaker 2: traditional HRT models, which say is talking about falls short
• 57:10
  Speaker 2: and acknowledging the significance of hormone relationships, specifically the interplay
• 57:15
  Speaker 2: between estrogen progesterone. So I'm like, okay, but what but
• 57:19
  Speaker 2: you do you still wait? And then they talk about
• 57:21
  Speaker 2: their recommendation, which is the physiological hormone restoration therapy, which
• 57:26
  Speaker 2: is to fully harness the potential of hormones a more
• 57:29
  Speaker 2: comprehensive understanding of molecular biology and genetics. This includes knowledge
• 57:33
  Speaker 2: of natural levels and timings of estrogen progesterone release in body.
• 57:37
  Speaker 2: It talks about like Morre's code, where single tone can
• 57:41
  Speaker 2: convey an entire language to its frequency and pattern. So
• 57:45
  Speaker 2: like a lot of flowery language, that doesn't really explain
• 57:48
  Speaker 2: to me other than I believe it based on what
• 57:52
  Speaker 2: they think is your natural cycle, the twenty eight day cycle.
• 57:55
  Speaker 2: I have seen the conversation of it being I think
• 57:58
  Speaker 2: this is the same thing mink hormone replacement therapy, which
• 58:03
  Speaker 2: is becoming a newer thing, and it is just the
• 58:06
  Speaker 2: doses of hormones on a regular day to day basis
• 58:08
  Speaker 2: replicating a woman's natural hormone cycle that becomes disrupted and
• 58:12
  Speaker 2: ultimately abandoned during menopause. So that is what I assume
• 58:17
  Speaker 2: that this other physiological.
• 58:18
  Speaker 3: Hormone restorative therapy is.
• 58:22
  Speaker 2: But this is what it's telling me is on this level,
• 58:24
  Speaker 2: so that with make hormone replacement therapy, which again makes
• 58:27
  Speaker 2: sense to me because I will say I had a
• 58:29
  Speaker 2: hard time adjusting and what I was given, and I
• 58:32
  Speaker 2: was like, ay, I'm so taughed because like some of
• 58:35
  Speaker 2: the things in trying to adjust your body is like
• 58:37
  Speaker 2: it's almost like it's going through perimenopause or menopause on itself.
• 58:40
  Speaker 3: So I felt really fatigued.
• 58:42
  Speaker 2: My allergy symptoms went weird, and apparently perimenopause can make
• 58:46
  Speaker 2: your allergies worse too, by the way, I didn't know
• 58:48
  Speaker 2: if you know that any but all of these things
• 58:51
  Speaker 2: so I could see where this type of therapy is
• 58:55
  Speaker 2: maybe a little more better, especially because women are not
• 58:58
  Speaker 2: all the same, like we need people to recognize it.
• 59:01
  Speaker 2: I don't feel like it's being recognized enough, especially by
• 59:03
  Speaker 2: the pharmaceutical companies who are selling us so much crap.
• 59:07
  Speaker 3: But like, yeah, this makes sense to me.
• 59:10
  Speaker 2: I will say, when I told my people that this
• 59:12
  Speaker 2: was happening, they put me on a cream.
• 59:16
  Speaker 3: Versus the pills.
• 59:17
  Speaker 2: I think there's a difference, and I don't know if
• 59:20
  Speaker 2: it's because of the way it's absorbing and maybe I'm
• 59:22
  Speaker 2: not getting as much as typically. I actually decided to
• 59:25
  Speaker 2: pace myself. I did it on my own, which I
• 59:28
  Speaker 2: would not recommend. Do you talk to your doctors, but
• 59:32
  Speaker 2: I and I felt like that did help me. So
• 59:34
  Speaker 2: maybe I was following that procedure just naturally because it
• 59:37
  Speaker 2: made sense to me. I don't know, but there are
• 59:39
  Speaker 2: different levels that you can look at when it comes
• 59:42
  Speaker 2: to HRT, and then there should be different levels. There's
• 59:44
  Speaker 2: also patches. There's so many ways that you can get
• 59:47
  Speaker 2: this different avenue. But you definitely need to be talking
• 59:49
  Speaker 2: to a doctor because I don't feel like this one
• 59:51
  Speaker 2: size fits all is what should be happening and what
• 59:56
  Speaker 2: is slowly happening.
• 59:56
  Speaker 3: Unfortunately.
• 59:57
  Speaker 2: There is this conversation also that like again, you could
• 1:00:00
  Speaker 2: treat the individual symptoms which has been happening. Like when
• 1:00:03
  Speaker 2: we talked about the gabapentin for the hot flashes and
• 1:00:06
  Speaker 2: entai anxiety imads for different things.
• 1:00:08
  Speaker 3: Like you can do that. Some people have said therapy.
• 1:00:13
  Speaker 3: I don't know. I don't know if talk.
• 1:00:15
  Speaker 2: Therapy is what they're talking about, if that's that conversation maybe,
• 1:00:19
  Speaker 2: but I feel like if it's hormonal, that's not gonna
• 1:00:22
  Speaker 2: let Some things just don't make sense, Like even if
• 1:00:24
  Speaker 2: you try to rationalize it, you can't. You might know
• 1:00:27
  Speaker 2: why you're having anxiety, but it doesn't stop you from
• 1:00:29
  Speaker 2: having an anxiety attack. Right, So there's a lot in
• 1:00:33
  Speaker 2: this field, and I know we've covered just a small detail,
• 1:00:37
  Speaker 2: even though this is a longer episode of what this
• 1:00:40
  Speaker 2: looks like and what this is. So there's a much
• 1:00:43
  Speaker 2: more information that we need to have. And this again
• 1:00:45
  Speaker 2: doesn't really even cover into menopause, which is a lot
• 1:00:49
  Speaker 2: more studied.
• 1:00:51
  Speaker 1: Yeah, yeah, I'm glad that there are people are talking
• 1:00:54
  Speaker 1: about it more, but there is a lot more we
• 1:00:57
  Speaker 1: need to uncover and talk about, a lot more we
• 1:01:00
  Speaker 1: need to research into. And yeah, I would hazard, I
• 1:01:04
  Speaker 1: guess hazard to guess that most people don't know about this.
• 1:01:07
  Speaker 1: I didn't really know about a lot of this, So.
• 1:01:10
  Speaker 3: Yeah, you can't call you doctor, now.
• 1:01:14
  Speaker 1: No, but you know what you know, what I was
• 1:01:17
  Speaker 1: thinking is that I recently went on a beach trip
• 1:01:21
  Speaker 1: and we've gone on this, this group of friends has
• 1:01:24
  Speaker 1: gone on this beach trip since I was in high school,
• 1:01:27
  Speaker 1: right and I'm much way outside of high school now,
• 1:01:33
  Speaker 1: And I just brought up the point that you can
• 1:01:36
  Speaker 1: see that it's changed. And there were a couple of
• 1:01:41
  Speaker 1: like there are a lot of c PAT machines involved
• 1:01:43
  Speaker 1: now there pretty much everyone but me was wearing like shoes,
• 1:01:49
  Speaker 1: like comfortable shoes for I guess plantar fasciiis.
• 1:01:53
  Speaker 3: Which can yet? Which can happen?
• 1:01:55
  Speaker 1: Yes, I had heard that that could be related to perimenopause.
• 1:01:59
  Speaker 1: So maybe I'll float this in our group chat, like,
• 1:02:04
  Speaker 1: just you know, listen to this episode.
• 1:02:09
  Speaker 3: This show is about us.
• 1:02:10
  Speaker 1: Oh yes, sometimes sometimes well listeners. I know last time
• 1:02:17
  Speaker 1: we did the Monday mini on it, several of you
• 1:02:18
  Speaker 1: wrote in. So if you have any thoughts about this,
• 1:02:23
  Speaker 1: resources or and or ideas about future episodes we should
• 1:02:30
  Speaker 1: do related to this, please let us know. You can
• 1:02:33
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• 1:02:36
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• 1:02:37
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• 1:02:40
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• 1:02:43
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• 1:02:44
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• 1:02:47
  Speaker 1: Arima Andre, executive Bruce Maya, thank you and thanks to
• 1:02:50
  Speaker 1: you for listening Stuff Never Told You re inspection of
• 1:02:53
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• 1:02:54
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