Latest / Minnesota Masonic Histories and Mysteries / Episode 134: “The Change” (ft. Dr. Laura Mayer)

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Episode 134: “The Change” (ft. Dr. Laura Mayer) · Minnesota Masonic Histories and Mysteries

0:01
Well, I got to admit, we've never exactly gone down this road topic-wise before.
0:09
Oh, wait.
0:09
We're rolling?
0:11
the engineer's giving me the sign What would you say are some big misconceptions about menopause and other women's issues right now?
0:24
I think some big misconceptions are that certain things happen as women get older, and they're just normal, and we just have to accept them.
0:35
And while I agree that many things are normal and many things are not dangerous, but they are very bothersome and really can affect one's quality of life.
0:46
And so I think it's important to look at various, aspects as we're getting older especially, um, and if there's something that we can do about it, a bothersome issue that we might be dealing with that we should do so I've never typed up a mission statement before an episode, but to share some of my notes, with your help, I'm hoping that we can help our mostly male audience understand and support our wives and partners through menopause.
1:18
Got some questions that are gonna focus on decoding those mystery symptoms and just give us as men a practical, actionable playbook to become more supportive partners.
1:33
Does the world need that right now?
1:35
I, I think it could always benefit from that.
1:39
Dr.
1:39
Laura Mayer, can you tell us a bit more about your background before we get into the conversation?
1:45
I'm a board-certified OBGYN.
1:47
I've been in practice now for 22 years.
1:50
and I do, uh, all aspects of, of obstetrics and gynecology Let's just dive in.
1:57
What is actually happening biologically during perimenopause, and why does it affect her mood and energy so deeply?
2:07
Well, as we get older, the ovaries are running out of eggs.
2:11
the ovaries are sh- gradually shutting down, and those hormone changes, um, more significant fluctuations can lead to a variety of things, irregular periods or, uh, irregular bleeding, hot flashes, night sweats, and a variety of other symptoms.
2:33
and I think all of that together affects our quality of life, affects how we feel, uh, how we cope with day-to-day stressors, how we sleep, leading to fatigue and, perhaps more emotionality.
2:48
Maybe the dumb things we do as husbands and partners are magnified when one doesn't feel that great already.
2:53
Well, I think when we're, yeah, we're not feeling as great, we're not getting as great of sleep, uh, even little things that others might do could be more irritating So why is it called the silent phase, and how might a husband notice it before his wife even realizes what's happening?
3:15
Is that even possible?
3:17
do think some things are either very subtle or are seen as just what happens.
3:26
They're normal, so why does anyone need to talk about it or do anything about it?
3:33
and so I think, uh, like sometimes I've seen patients that are having, um, very frequent bleeding, which is very bothersome.
3:42
and that too can lead to, you know, being very irritable, but we don't wanna talk about that.
3:50
So then we, then they don't talk about that.
3:51
Whereas we can sort of a- address- Yeah this is going on, this affects how you feel day to day, then we maybe can think about, yeah, let's, let's look into what can be done about this.
4:04
Why do we bottle it up in this world?
4:06
We're getting better at- I know talking about everything.
4:09
We talk about so many other things- Yes so much more, and I still feel like a lot of this stuff for women is just seen as normal.
4:22
You, you have hot flashes as you get older.
4:25
Well, that's just normal.
4:26
You, you have crazy bleeding before periods stop, before you are in menopause.
4:33
Well, that's just normal.
4:34
And, and while I admit again that a lot of these things aren't dangerous, that doesn't mean that they're easy to deal with or not impacting our quality of life.
4:48
And, and so I always wanna focus on quality of life and what can we do to improve on that?
4:57
We like to say on this podcast we are unafraid of talking about everything.
5:02
And in the spirit of not bottling up, we've covered a lot of time on men's mental health.
5:09
That's been something, same thing.
5:10
Well, we better not talk about that because would that make me a wimp?
5:13
Would that make my, my friends, my colleagues, my lodge brothers think I'm a wuss?
5:18
I, I can't handle the rigors of life.
5:20
And this falls into me into that same bucket.
5:24
Mm-hmm.
5:25
It's just one of those things, and we don't talk about it, but then we as men...
5:31
I just really appreciate you being here so that we can get some guidance This fits into the Masonic experience in that pursuit of becoming a better version of ourself.
5:41
We wanna be a better husband.
5:43
We wanna be a better partner, and navigating this is tough.
5:48
We don't wanna ask the stupid question.
5:50
We're all such fixers as men, too.
5:52
We can't fix this.
5:53
Mm-hmm.
5:53
But how can we be more cognizant of what's going on provide that presence, if nothing else?
6:00
Mm-hmm.
6:02
no, I just think, uh, we can just acknowledge various symptoms.
6:08
Uh, it's not a critique of anything, it's just,"Hey, I've noticed this.
6:14
You know, what have you been noticing?" Uh, trying to have more of a communication and, and maybe there's ways that this can be improved, and, and I want what's best for you, as a husband to a, you know, a husband would say to a wife.
6:27
Um, and, and we want you to be feeling as best as possible You touched on some of the common physical symptoms already, hot flash, night sweat, fatigue.
6:38
Are there more symptoms that maybe we are, unaware of?
6:43
what do you see day to day in your line of work that maybe some things that aren't commonly known?
6:49
Mm-hmm.
6:50
I, I do think that the hot flashes and night sweats, um, and subsequent fatigue are sort of the most classic menopause symptoms.
6:58
that along with, like, irregular bleeding or even frequent bleeding.
7:02
and then other things, uh, well, I, I think we're learning a lot more as time has gone on about other possible things that might be connected.
7:11
Maybe not 100% all the time, but, um, joint changes, joint soreness, skin changes, um- What does that look like?
7:23
Mostly, like, drier skin or I know sometimes people say,"Well, it just looks, it looks older," which granted, of course, we are gonna still get older regardless of anything else.
7:33
but I think there's a bigger change sort of at that transition in a woman's life.
7:39
What age does this start?
7:42
Well, I mean, while the average age of periods stopping and the ovaries being shut down is 51 and a half, sometimes some of these changes can start up many years prior to that.
7:56
Uh, for sure by mid-40s and, but sometimes even earlier for some patients.
8:02
And some, you have seen that maybe- Mm-hmm someone in their late 30s, early 40s even.
8:05
Sometimes, mm-hmm, and sometimes it can be very subtle, and so then you're not quite sure, is there a connection, uh, to the ovaries starting the shutdown process, or could there be something else going on?
8:17
But it's worth to look into and see if we can figure it out.
8:23
So the age can vary.
8:24
Mm-hmm.
8:25
But there, there is, it sounds like there's a bit of that gradual and then sudden aspect of this.
8:31
It, it can be different for everyone.
8:33
Um, I think for most women, it's more of a gradual process, and then ultimately ending with the period stopping and the ovaries being completely shut down.
8:45
Although even then, that's not to say that those menopause symptoms stop because that aspect of things can continue on for years and years.
8:55
Oh, tell us more.
8:57
Uh, and we're- Mm I'm a little reluctant to say that, but, like, we need to know this.
9:00
Yeah.
9:01
Well- What's that look like?
9:01
Well, I mean, I think the average timeframe of, like, hot flashes, night sweats, the classic kind of symptoms being present, is about four years.
9:12
but then of course there's patients that are like,"Hot flash?
9:15
What?
9:15
I've never had that." Never saw, yeah.
9:17
And then there's patients or, or sometimes even, patients will say,"Oh, my mom is 78," or,"My mom is 82, and she still has hot flashes." Granted, that's very extreme, but it, it can linger on for many, many years.
9:37
So the demographic window could start sooner and could last longer- Mm-hmm than the, the textbook.
9:42
Mm-hmm.
9:45
How much impact would you say lifestyle choices exacerbate when it comes to, like, uh, not getting enough sleep or dr- having, having too many glasses of wine at night?
9:57
Mm-hmm.
9:57
And, and I know those two aren't connected- Mm-hmm but is that a, is there a bit of a correlation there with making you already feel not great, and this is only making it worse?
10:07
I think that for many women, things like alcohol use, not being very active can make things, uh, carrying extra weight can make things worse.
10:21
Granted, there are some patients that are doing everything they possibly can do, um, really limiting alcohol, exercising regularly, maintaining a normal healthy weight, and they might still have s- really significant symptoms.
10:36
But I do think that when we aren't, uh, otherwise being as healthy as we can be, things can be even worse.
10:45
And that doesn't mean run a marathon.
10:47
No.
10:48
It's just get up and, and go for a walk.
10:50
Yep.
10:50
Mm-hmm.
10:51
And just keep, keep moving.
10:51
Mm-hmm.
10:51
Yep, yep.
10:52
Just regular mild activity can be very helpful, and doing what we can to, uh, maintain healthy weight or get to healthy weight if possible.
11:01
Are we getting enough sleep in general?
11:03
What do we need?
11:03
Probably not, although that's a tough one- I, I know, yeah'cause there's so many different factors to that.
11:10
And, uh, I feel like, of course, right as many women are sort of in this transition, they've got kids that are, you know, graduating high school, going off to college, so the stressors of that.
11:20
We've got parents that are aging.
11:22
We're dealing with that.
11:24
And so we've got so many other extrinsic factors affecting sleep.
11:31
What do you suggest for men and women as far as giving ourselves the opportunity at least to get sufficient rest?
11:38
Yeah.
11:38
How many hours?
11:40
I think most, most of us could use seven or eight hours.
11:44
And I, and I do think that, you know, could various, uh, supplements or medications to help with that maybe be useful?
11:52
They might be.
11:53
So perhaps not being as, uh, hesitant to use that if that, again, is going to improve our quality of life Is that something you would recommend asking your family doctor about?
12:07
I u- I usually do have patients, if they're really having difficulty with sleeping, that could be benefited by other medications than seeing family practice.
12:17
We recently welcomed a couple brothers in, and we talked about men's health and the importance of scheduling your physical when you're over 40.
12:25
Knowing your blood pressure, knowing your cholesterol, knowing your, your prostate numbers, all those important things that so many men will say,"Well, I feel fine.
12:34
I'm healthy.
12:34
I don't need to do that.
12:35
I don't have time for that." We can't fool ourselves into thinking that we, we, we have to go get checked.
12:42
But are women better at...
12:44
In your line of work, do you see women are going in for their annual exams or a physical?
12:51
You gotta be way better than men at this, right?
12:53
No.
12:54
Granted, since I don't see men, I can't exactly say, but I do think, in general, that women are overall better at it.
13:01
Um, years and years ago, women were always told you need a Pap smear every year, and so many women got in that mindset of,"I have to go in every year." and while, granted, some of those recommendations have changed slightly, I think a lot of women have passed along to their daughters,"You should go in every year." And so I, I think they're overall pretty good at it.
13:25
and many times, even if a year becomes 15 or 18 months, it's still not too bad.
13:31
Is the Pap smear not a thing anymore?
13:33
It is a thing, but we've found that we don't need to do them quite as often as we once thought.
13:39
Why is that?
13:40
most abnormal Pap smears, um, take a long time to progress to something of any significance.
13:49
So if you have a normal Pap smear or a couple of them in a row, your chance of developing anything significant in five years is extremely low, ergo, we don't need to do the Paps every year, but every five years or three years, depending on various factors.
14:05
That's great news, right?
14:07
it is great news, although sometimes hard mentally to, like,"Wait a second, I don't need that every year?" Um, and then I al- oftentimes have to tell my patients,"But you should still come in a- about every year.
14:18
I'll keep track of that, but we need to make sure that we're, up to date on all of our other things, the cholesterol, the diabetes check," universal for everybody.
14:27
Mm-hmm.
14:27
Um, and then things like mammogram and colon cancer screening, those kind of things.
14:33
A lot of men, I think they're unaware that going to the doctor to have your physical now, your prostate check is through your labs.
14:43
As I have a younger doctor now, I was most men are relieved that- Mm.
14:47
He said,"By the...
14:48
Dude, the lab is gonna be way more accurate than my digit will be, and if the labs look off, well, then we may have to go old school." things have evolved in a good way- Mm-hmm that it's a little less invasive for both men and women- Mm-hmm on some of these maybe less than pleasant procedures that we may avoid the doctor as a result.
15:07
Mm-hmm.
15:11
I feel like all the questions I have are going to make me look like the dim, bald man that doesn't know any of...
15:17
But maybe I'm, I'm asking this on behalf of all of us as men that want to know more, to learn.
15:23
Mm-hmm.
15:25
Is hormone replacement theory a good thing?
15:28
Is that common?
15:29
Or I know it's, I think it's also, did you say menopausal hormone therapy?
15:32
Menopausal hormone therapy.
15:33
Is, is that...
15:34
Tell us more.
15:35
I mean, granted menopausal hormone therapy in some way, shape, or form has been around for many, many, many years.
15:42
but there was a study that came out in the early 2000s that, that really, um- had some negative aspects to it and, and made it sa- seem like, uh, this was a very dangerous thing to do that significantly increased a woman's risk of breast cancer and cardiac issues and, um, put up a lot of red flags.
16:07
And so then many women didn't use it for a long time.
16:12
Granted, if you looked closer at the study, the red flags were completely blow- blown out of proportion, and actually not applicable to many, many women.
16:23
and now we've got e- even newer data that further suggests that, uh, hormone replacement therapy is indeed very safe for the vast majority of women, and can be very beneficial in a lot of different ways.
16:39
Um- Did it take a while to get beyond that- Yes.
16:43
Yeah?
16:43
It took years and years before women were willing to maybe reconsider it.
16:50
or, like, maybe sometimes their doctor's been talking to them about it for a couple years and they finally like,"Okay, wait.
16:57
They keep saying..." You know, uh- Little push, pull just educating.
17:00
Yes.
17:00
Yeah.
17:01
Mm-hmm.
17:01
it can be very...
17:02
It just, uh, can be very beneficial to a lot of those classic symptoms, and maybe some of the less common classic ones.
17:11
and so a worthwhile consideration- Yeah, it's- I think in a lot of situations.
17:14
It's worth a conversation- Mm-hmm with, okay.
17:17
Mm-hmm.
17:20
Mood swings, anxiety, what is the healthiest way for a husband to respond when his wife or partner is highly overwhelmed or irritable in, in the eye of the storm?
17:35
Oh gosh, that, that could be different for a lot of people, I would guess.
17:40
Is the answer leave the house?
17:41
No, I wouldn't, I wouldn't think so.
17:43
I don't know if instead of, uh...
17:45
'cause I think, as you said, sometimes, uh, men tend to wanna try and fix things, although maybe what they might suggest is not what a woman wants to hear.
17:55
so I don't know if a more, more, uh, general statement of, uh,"Let me know how I can help." Uh- Is that good or bad?
18:06
I, I think that's good because then it, it's, I, I...
18:09
it says,"Hey, I wanna help.""I'm here for you.""I'm here for you, but I don't want to assume I know how I could be most helpful to you.
18:18
So you...
18:19
I'm here.
18:19
You just let me know if there's something I can do that would, you would find beneficial.
18:27
Tell me about it." How does menopause change or affect a woman's libido?
18:35
Couples navigating that shift can leave a husband feeling- Mm-hmm insecure- Mm-hmm rejected.
18:43
I, what- Yeah.
18:44
I, I don't...
18:44
I think there's a lot of different components to, uh, libido.
18:49
and I think especially around menopause, there's a lot of things.
18:52
You know, we've got, we do have those hormone shifts, that poor sleeping, and, and of course, if we're, if we're tired, uh, sex might not be very, uh, the first thing on our mind.
19:05
Um, and then we've also, again, got the kids issues that might be going on, especially if you've got teenagers in the house, that, that I think makes it difficult.
19:14
And then, oh, yes, I've had to deal with my mom's health issues, and so your, your efforts, your focus is, is elsewhere.
19:21
And stress at work.
19:22
Mm-hmm.
19:23
Everything compounds.
19:23
Mm-hmm.
19:24
Everything- Yeah and so I think to acknowledge all of these extenuating circumstances, acknowledge it, it very likely is not that a, a wife is not in love with her husband, not, uh, appreciative of what he might do for her.
19:39
Um, but that might n- not be how she wants to show love, um, or wants to be shown love, but- And, and so to explain that, to talk about it.
19:51
"Hey, wait, I'm not rejecting you, or I'm not saying I w- don't want to be intimate.
19:56
Um, it's just I got all these other things going on, and that's tough for me to focus on when I've got everything else." Would it be a best practice for a man to read the room, to be self-aware, take a little inventory of maybe all the moving parts in our lives right now with the kids, the aging parents- Mm-hmm college tuition- Mm-hmm the stress at work, the annoying neighbors, on and on?
20:19
Mm-hmm.
20:20
Yeah, I think you can sort of think about all these other things.
20:24
I, and I, there's a, a generalization that I, I heard at one point where, um, women might see sex as something yet additional they have to do or, or are expected to do with everything else going on in their life, whereas men might see sex as a getting away from all those other things that are going on, and so they see it as a very relieving thing, a very, um,"I, I get to get away from everything else," whereas women see it as at another thing to do.
20:57
And so just looking at that different...
21:00
It's, you look at it differently.
21:02
It's- That's really good.
21:03
It's, it's- That, that's helpful again, not that, not that a wife doesn't love her husband.
21:09
She's got the, the different way to look at things.
21:13
Earlier we touched on some of the day-to-day things that you see that are not commonly known.
21:20
When it comes to women's quality of life, what are your thoughts or suggestions on not being bogged down by various medical things that are either urban legends or maybe self-diagnosing on WebMD or,"My friend told me..." What, what...
21:36
Help us through that.
21:37
Mm-hmm.
21:38
I, I think the biggest thing that I see that is, really bothersome to a lot of women is various period issues, heavier bleeding, more painful bleeding, more frequent bleeding, more prolonged bleeding.
21:50
it, it, it's a variety of different reasons that might be occurring, um, and all the more common for those kind of things to occur as we get older.
22:03
and I do fully admit that many times these things don't represent something dangerous or life-threatening, but they are very bothersome, and I think there's so many things that can be done about these situations that can really improve a woman's quality of life.
22:23
And so to be, not to accept this is just how it is.
22:28
Mm-hmm.
22:29
It's not- Do you have some examples like that?
22:31
Um, like I see a lot of women who they have really heavy bleeding, so for a day or two every period, they feel like they can't leave the house.
22:41
Or they, um,"Oh, let's bring an extra change of clothes because who knows And they think,"Oh, this is just how it is," and, that's, that's awful to think that regularly you feel unable to do your normal daily routine.
23:00
Even if it's just, quote,"one to two days a month." That's- It's just, I think that's a lot.
23:06
You look,'cause I, I've seen some patients, they're like 40,"Well, it's just how it is, and I'll hit menopause soon." And yes, they will hit menopause eventually, but that's l- probably longer f- from, uh, a longer timeframe than they even think.
23:21
And so if you say two days a period, and that's every four weeks on average, so that's 26 days a year times 10 years, 10 pl- it just adds up to- Yeah a lot of days.
23:38
So are you saying if that is someone's situation, don't just accept it as,"Well, this is how it is- Mm-hmm and I just have to suffer in silence." Mm-hmm.
23:45
Go make an appointment.
23:45
Yeah.
23:46
Go have a conversation.
23:47
Make an appointment, yeah, yeah.
23:48
Let's, let's evaluate.
23:49
Is there a distinct reason for this?
23:53
Just because I think sometimes that can guide what options we have to manage it.
23:58
Um, so let's do some lab work.
23:59
Let's do an ultrasound.
24:02
Let's see what's going on, and then let's talk about the variety of different options we have to address these situations.
24:11
How much do you think fear plays into that?
24:14
I think, I think a lot of fear.
24:17
Um, I don't know if it's about, like, is this something really bad?
24:21
Do I have cancer?
24:22
Maybe part of that is that.
24:25
but I also think a large part of it is, misconceptions of, because,"Well, they're just gonna have me, go on birth control, and I don't wanna go on birth control'cause that's dangerous." And I don't, I don't think that's quite true.
24:39
I think there's a lot of misconceptions about what various hormonal medications can do for us and what real risks are.
24:46
And then also, there's procedures that can be done to help address those things, and there's a lot of misconceptions about that, like, um, like removing the uterus.
24:56
"Oh my gosh, that's such a big surgery, and it has a such a huge recovery.
25:00
And then once I do that, then I'll, I'll be in menopause, and my hormones will be crazy, and I'll be miserable that way." And, and so j- there's just a lot of misconceptions.
25:15
Speaking of that, is the hysterectomy common still?
25:19
I, I don't think we talk about it enough.
25:21
Really?
25:22
Because- The floor is yours, doctor.
25:25
So I do admit, so in years past, let's say 30, 40 years ago, if you were having a hysterectomy, everything was being removed, including the ovaries.
25:36
And so indeed, with that kind of procedure, the ovaries were gone.
25:40
You were jump off the cliff into menopause.
25:43
It was really harsh.
25:44
It's like a switch went off, right?
25:45
Yes, it was a switch.
25:47
But, um, as the years have gone on, and for really all of my practice, we've realized that in most situations, leaving the ovaries in place is the safer and healthier way to go.
25:59
And so if you remove the uterus but you don't remove the ovaries, hormonally there is no changes.
26:08
Yes, the ovaries are gonna shut down gradually as they were going to, but you don't have that jump off the cliff, abrupt hormone shift.
26:17
and removing the uterus gives us a lot of great, uh, guaranteed results.
26:24
It, it eliminates all bleeding Forever, guaranteed.
26:28
Any pain from the uterus is gone.
26:32
if there's benign growths of the uterus that might be of developing, it eliminates those.
26:37
and it's done in, in, um, less invasive ways than it used to be done, which makes the procedure itself overall much safer, much easier to recover from.
26:49
Um, there are some restrictions for a few weeks, but you get past those, and then you are free of bleeding and pain for perhaps, you know, years and years or even longer.
27:04
and it's a great benefit.
27:06
Why do you think this isn't talked about as much?
27:09
Because I think people still think that there's those big hormone shifts.
27:15
When, when it- W- w- done the way you just described.
27:17
Yes.
27:17
Mm-hmm.
27:17
Okay.
27:17
Yeah.
27:18
And they also think,"Well, that's, that's a really invasive procedure, and so I don't wanna do the r- recovery." I've had some patients like,"Well, I can't really take the, the, the 12 weeks of recovery." I go,"What?
27:30
What?
27:31
12 weeks?
27:32
No, it's not 12 weeks." What chat room did you see that in?
27:34
Yeah, I don't know where- Yeah you've seen this.
27:36
Um- What is recovery then?
27:39
So I always think about the restrictions with that kind of surgery, and the main restriction is no lifting more than 20 pounds for six weeks.
27:47
So if someone has a really physical job, okay, then you need to be off for six weeks.
27:52
But many, many don't have a really physical job, and some are able to go back to work within even a couple weeks.
28:00
How long are you in the hospital?
28:01
It's a same-day procedure the- See vast majority of the time.
28:04
Wow.
28:04
Um- so because that is so The, people don't know that.
28:10
They, they just forget about this option altogether.
28:14
Is the bottom line have a conversation with your- I think have a conversation with your gynecologist.
28:20
A gynecologist is the most knowledgeable about this kind of thing.
28:23
Um, not to discount my family practice colleagues that know a lot about a lot of things, but I think a gynecologist is the best.
28:31
Um And I, ugh.
28:35
To find someone that is open to all the options.
28:40
I, I've heard too much about even other gynecologists say,"Yep, well, your hemoglobin, your blood level is normal.
28:46
You're not anemic, and your biopsy is normal, and your ultrasound is normal.
28:51
Yep, everything is fine." And then that ends the conversation And again, that implies that unless something really dangerous is going on, this is just normal and you have to live with this.
29:06
And I, I get frustrated with that- Yeah because I don't think...
29:10
I, I think quality of life is so important, and yes, we should rule out the bad things.
29:17
Yes.
29:19
But once we've ruled out that, okay, now what, what should we, what options do we have to still address this and improve our quality of life?
29:28
Do we need to ask more questions of curiosity at the doctor just in general, men and women?
29:34
I think so.
29:35
I think so.
29:36
yeah, so when someone says,"Oh, yep, everything's okay," then the question should be,"Okay, but I'm still dealing with this.
29:44
What kind of options might we have- Yeah, I'm glad we ruled out- to address this?" Yes.
29:48
I'm glad we ruled out all the really serious things.
29:50
Mm-hmm.
29:51
However, to your point, what else could we do- Mm-hmm to remedy- Mm-hmm some of those very challenging thing that does...
29:59
Oh my gosh, when you did the math over that decade, that's a lot.
30:02
Mm-hmm, mm-hmm.
30:03
Yeah, I like to do the math for a lot of my patients just so, just to say,"Here's what it really looks like,"'cause I think numbers are, they're just more concrete.
30:14
You know, when, once someone says,"Oh, it's only a day, a month, or two days a month," and you're just thinking about, like, month to month, you, you miss how long, widespread long it is.
30:28
Let's just keep rolling, and you consider this your bully pulpit, doctor.
30:32
What else would you tell women as far as advocating for themselves or learning some of these, these options that they may not be aware?
30:41
They might be right in front of them, but they might not be aware.
30:45
I guess, uh, the...
30:47
So although I think removing the uterus, the hysterectomy, is a very good option, um, there's other options that I think are out there that are very legit and safe that many patients, uh, don't think about, for various bleeding issues or pain issues.
31:03
a lot of times they say,"Oh, yep, I've had my kids and my husband had a vasectomy, so I don't need to be on any medication." And, and that is true in regards to preventing pregnancy.
31:14
I get that.
31:15
Um, but there's so many of our birth control medications that are also very beneficial for bleeding and pain issues, and then could be a good management strategy.
31:26
and while sometimes various health issues might make certain medications not ideal, there's many that can be used even if someone has some other health issues.
31:37
and so we could consider things like that.
31:40
So don't say,"Oh, well, I, I shouldn't be on the pill because I'm 40." And, and maybe there's some 40-year-olds that are not...
31:49
There's certain risks to something like the pill, but many 40-year-olds are, are reasonably healthy, and it's a very safe option.
31:57
Um, there's- Do you, do you hear that all the time?
31:59
All the time.
32:00
Yeah.
32:01
Mm-hmm.
32:01
I'm this age, so there's no way that- Yep, that can't be, that can't be safe for me to be doing this for so many years or as I'm getting older.
32:09
and actually, I would say most of the time it is safer or at least as safe to do something.
32:17
Is that a result of urban legend or- Mm-hmm someone told me this way back when, that we just hang on to some of those misperceptions- Mm-hmm and treat them as fact?
32:24
Mm-hmm.
32:25
Mm-hmm, yep, and I think, yeah, I think people have heard,"Oh, this causes cancer," or,"This, uh, causes me to gain weight." And at least the studies haven't shown that to be true for the vast majority of medications.
32:43
What else can women do to reduce the risk of female cancer?
32:49
Well, I know we've already talked about the Pap test and getting that at the appropriate intervals, and so that addresses cervical cancer risk.
32:57
uterine cancer is another relatively common female cancer.
33:01
and so I think either, um, addressing abnormal bleeding if it's occurring, uh, because that can be a sign of precancerous changes, and then those various hormonal medications can actually reduce the risk of uterine cancer.
33:19
there's also an IUD out there, or several IUDs, that can also reduce the risk of uterine cancer, so that can be a good option.
33:29
Uh, there's also been a lot of, uh, research, uh, now we're coming up on almost 10 years, where they found out that what was previously thought c- to be cases of ovarian cancer were probably really fallopian tube cancer.
33:44
And so now it's the medical recommendation that whenever a uterus is removed, that the tubes are also removed for that cancer risk reduction.
33:56
And if a woman is undergoing, um, like a tubal ligation, now we actually remove the tubes completely, so they get that cancer risk reduction for the rest of their life.
34:11
And so I know sometimes I'm talking to patients about,"Oh, we're gonna-- this is gonna be our last child.
34:16
He's gonna get a vasectomy." And it's not that I don't appreciate his willingness to get a vasectomy, but her getting her tubes removed is not only, I think, the most effective permanent birth control, but it also has that cancer risk reduction benefit.
34:35
So just a, an additional consideration.
34:38
Totally, like, we're not even thinking about that when we're having our last child or, oh, we've now decided, you know, our family's complete.
34:45
We're not having-- you don't think about that cancer risk reduction, but we can get that extra benefit.
34:50
I think both parties in the couple are only thinking about the birth control fact.
34:55
Yes.
34:56
Yes.
34:56
And, again, if a guy's gonna go get his vasectomy, I do applaud him for that.
35:00
It's just that many, many wives I've seen said,"Nope, he's getting a vasectomy.
35:04
It's his turn to do something." And they keep saying,"Yep, he's gonna do it.
35:09
Yep, still waiting for him to do it." It-- I get that you've had the kids and you think it's his turn to do something, but if he's not actually gonna do it, maybe you should do something yourself, and then we can get these extra benefits.
35:25
A lot of those wives wanna see their dude with that bag of peas for a few days, right?
35:29
Yeah, yeah.
35:30
And I, and I get that.
35:31
And I'm not dis- again, they've done amazing things carrying pregnancies, giving birth.
35:36
but we also, you know, like what can we do safely?
35:40
I, I, let's, let's hopefully, uh, prevent the chance of an- Yeah unexpected pregnancy after we were saying we're done.
35:49
But all kidding aside of men being maybe not necessarily excited about that procedure- Mm-hmm what the procedure itself entails and the recovery, you make a huge point about the c- the cancer factor- Mm-hmm in removing that part of that procedure.
36:04
Mm-hmm.
36:05
Had no idea.
36:06
Mm-hmm.
36:08
Can you think of any other monumental mistakes that men make when trying to, quote-unquote,"fix" their wife's menopause symptoms?
36:19
I think perhaps either ignoring it completely or just saying you have to, you have to just deal with it.
36:29
You have to manage it and Not, not that perhaps suggesting,"Well, maybe you should go in and talk about what options you have," but there are options and, and like,"Hey, I see you're suffering.
36:47
That I think there's options t- that can help you out.
36:50
Maybe you should go talk to someone about that,'cause I want you to be fully functional and happy with your life, and this is getting in the way of that." Definitely not the jokey banter though, right?
37:06
A friend of mine- Probably not.
37:08
Yeah.
37:08
A friend of mine tried to go down the humor.
37:10
He...
37:11
Well, he thought it was going to be funny, and it was so not funny.
37:15
Yeah.
37:15
I feel like a lot of times in the moment there- Yeah uh, that humor that might normally work doesn't, doesn't come across well.
37:24
Random question out of the blue.
37:27
Can you describe the worst person you've ever had to work with, whether that now or in a prior job?
37:35
I, I think probably a person that you, you can't be open and honest with, so they're hard to communicate with, uh, they don't communicate back with you, and They, uh, put the blame for various things on everyone else and don't take the blame themselves If you had a personal assistance, what's the first thing you'd have them do?
38:00
Or maybe you have a personal assistant I, I don't have a personal assistant.
38:03
I, I would have a hard time because I'm very controlling and I wanna do everything myself.
38:10
So I've often said if I could clone myself and be in two different places at once, that would be my most beneficial thing What's the backstory of a personal item on your desk?
38:26
I have a crocheted uterus and ovaries on my desk- that a patient got me to thank me for removing her uterus.
38:40
I actually thought her sister made it'cause her sister crochets, but she got it off of Etsy, which is also fine.
38:47
It's a very cute little uterus.
38:50
That was not what I was expecting.
38:51
No, it's awesome.
38:53
Yeah.
38:55
What social convention do you refuse to participate in?
39:00
With social media account?
39:02
I'm, I'm not on any social media.
39:05
I, and I don't know if it's that I refuse to participate in it.
39:07
I'm, I'm sort of inept as that goes, and I just, never gotten into it.
39:12
It's a blessing, though.
39:14
Yeah, I think it is.
39:15
For those that have never been on- Mm-hmm to miss all the toxic, the place where people go to be miserable.
39:21
Mm-hmm.
39:22
It, it's, you really, that's a, that's a win.
39:26
What's the most beautiful place you've ever been to?
39:31
I guess I'll say Hawaii.
39:33
That was very beautiful.
39:34
I, I like tropical places, warm places, Seeing sort of the history of, of the Hawaiian Islands and, and other locations in that area I think is very, uh very amazing Was it hard to leave?
39:50
A little bit, but I still like to be at home.
39:54
The comforts of home Dr.
39:57
Laura Mayer, I feel a combination of smarter, better equipped to ideally be a better husband and partner, and really great to talk about a lot of things that we just don't talk about in life these days, which we should.
40:12
Yeah, I definitely think there's, there's so much more, uh, information, so much more we could be doing to help women just be able to enjoy their life as much as possible