Latest / Clearly Hormonal / Ep 15: The Menopause Roadmap

Transcript

Ep 15: The Menopause Roadmap · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to the Reset Recharge podcast with your host, Dr.
• 0:05
  Dr. Komal Patil-Sisodia: Komal Patil Sisodia, a board certified endocrinologist, internist, and obesity medicine specialist.
• 0:11
  Dr. Komal Patil-Sisodia: This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health.
• 0:18
  Dr. Komal Patil-Sisodia: And recharge the conversations you are having with your healthcare providers.
• 0:22
  Dr. Komal Patil-Sisodia: While I am a physician, this podcast is purely for educational purposes.
• 0:26
  Dr. Komal Patil-Sisodia: No individualized medical advice is being given on this podcast.
• 0:30
  Dr. Komal Patil-Sisodia: If you do find information that is helpful, please discuss it with your healthcare provider at your next visit.
• 0:41
  Dr. Komal Patil-Sisodia: Hi, everyone.
• 0:42
  Dr. Komal Patil-Sisodia: Welcome back to Reset Recharge.
• 0:43
  Dr. Komal Patil-Sisodia: Today's episode is one that I've been working on for a while, and I'm calling it the Menopause Roadmap.
• 0:51
  Dr. Komal Patil-Sisodia: The reason that I find this topic so important is that most women don't know how to navigate menopause.
• 0:58
  Dr. Komal Patil-Sisodia: There is this mindset around the fact that menopause is a one to two year transition, whereas for some women, It can last a decade or more.
• 1:08
  Dr. Komal Patil-Sisodia: So one of the top, one of the points that I want to drive home today is that menopause is a journey, not a destination.
• 1:15
  Dr. Komal Patil-Sisodia: If you think about the changing hormones during a woman's lifetime, there are several different stages.
• 1:21
  Dr. Komal Patil-Sisodia: You go through puberty, you go through your peak reproductive years, then you hit perimenopause, which we've not done a great job on educating women about.
• 1:29
  Dr. Komal Patil-Sisodia: followed by menopause, which is a point in time where your menstrual cycles stop, to what happens in post menopause.
• 1:36
  Dr. Komal Patil-Sisodia: This is a long journey that is throughout the course of your lifetime.
• 1:41
  Dr. Komal Patil-Sisodia: For some women, perimenopause can last up to 5 to 10 years, it, sometimes a little bit longer, depending on how their symptoms are going and when their periods actually stop.
• 1:52
  Dr. Komal Patil-Sisodia: It is so important to start thinking about this early.
• 1:56
  Dr. Komal Patil-Sisodia: We are not taught to be preventative.
• 2:00
  Dr. Komal Patil-Sisodia: We're taught to be reactive in terms of our health.
• 2:02
  Dr. Komal Patil-Sisodia: There are a few different things that women can do in order to get ready for this transition.
• 2:09
  Dr. Komal Patil-Sisodia: I think that this is just good practice for anybody in general, who is looking to be more preventative instead of reactive about their health.
• 2:16
  Dr. Komal Patil-Sisodia: For me, I don't know that I necessarily understood how perimenopause would affect me, even though I knew my family history, even though I'm a physician, even though I saw what my mom went through, in my mind, they were all kind of in different silos and not really interconnected, but they really are.
• 2:34
  Dr. Komal Patil-Sisodia: And there is a lot that you can learn about yourself.
• 2:36
  Dr. Komal Patil-Sisodia: So I've broken it down into several different categories, and we're briefly going to go through each one of these.
• 2:42
  Dr. Komal Patil-Sisodia: So that you can maybe start preparing to have these conversations with your health care provider around how to approach these oncoming changes.
• 2:53
  Dr. Komal Patil-Sisodia: The first thing that I recommend for patients is to know your personal and family history.
• 2:58
  Dr. Komal Patil-Sisodia: A lot of times, and this is very common for Indian culture, we find that our parents, grandparents, they don't really talk about their health journey or what they've gone through.
• 3:07
  Dr. Komal Patil-Sisodia: And you can sometimes get it in bits and pieces instead of something that you've been keeping tabs of over, over several years.
• 3:16
  Dr. Komal Patil-Sisodia: And your genetics matter in perimenopause and menopause because what is coded in your DNA is really what's going to start manifesting.
• 3:25
  Dr. Komal Patil-Sisodia: I have so many stories of women who come into my office and they'll say, well, you know, my mom didn't have any health problems, but then she started to develop high cholesterol, high blood pressure, high blood sugars later in life.
• 3:36
  Dr. Komal Patil-Sisodia: And it just kind of came out of nowhere.
• 3:38
  Dr. Komal Patil-Sisodia: Well, that history of your mom potentially developing hypertension, what we call hyperlipidemia or high cholesterol or prediabetes or diabetes is coded in the genetics.
• 3:49
  Dr. Komal Patil-Sisodia: So if this is what's happened to a parent in your lifetime or say aunts or sisters.
• 3:57
  Dr. Komal Patil-Sisodia: It can give you clues into what you would need to look for and what you might be higher risk for, and certain.
• 4:05
  Dr. Komal Patil-Sisodia: The conditions that I really I recommend that women talk to their moms, aunts, sisters about are going to be things like heart disease, stroke history, high cholesterol, high blood pressure, diabetes or prediabetes, osteoporosis, a history of breast cancer, uterine cancer, ovarian cancer.
• 4:25
  Dr. Komal Patil-Sisodia: It's important to know all of these pieces because all of these things can have a profound impact on how your health shapes up as you start to hit perimenopause.
• 4:35
  Dr. Komal Patil-Sisodia: The second tip that I have for patients is to track your symptoms.
• 4:38
  Dr. Komal Patil-Sisodia: I did a podcast episode on this earlier about how we are so busy in our lives that a lot of times we don't pay attention to us.
• 4:47
  Dr. Komal Patil-Sisodia: It is really hard to sit down and be aware of the changes that are happening in your body until they've already started to happen.
• 4:54
  Dr. Komal Patil-Sisodia: One of the things that I recommend for women as they're hitting their mid 30s, early 40s is really just start to track changes in your menstrual cycle.
• 5:02
  Dr. Komal Patil-Sisodia: Look at if there are any changes in your mood, in your sleep habits, and then just in other things that you're feeling in your body.
• 5:08
  Dr. Komal Patil-Sisodia: We know that we have estrogen and progesterone receptors in every part of our body from head to toe.
• 5:14
  Dr. Komal Patil-Sisodia: One person's perimenopause can look very different from another person's perimenopause and the symptoms that you can have Are not just the stereotypical hot flashes, night sweats, Vaginal dryness, pain with intercourse.
• 5:28
  Dr. Komal Patil-Sisodia: There's so much more to it and we're getting more and more data Thank goodness because there is more research that's being done in women now, but joint pain, brain fog, impaired concentration, irritability, and palpitations can be a part of this.
• 5:43
  Dr. Komal Patil-Sisodia: There's so many that I'm not going to go through and list them here, but it is important to start paying attention to the changes in your body.
• 5:51
  Dr. Komal Patil-Sisodia: And it may not be symptoms, it may just be things that you start recognizing in terms of your body composition is shifting, your muscle strength is going down, or you're noticing that You're gaining a little bit more weight around your middle.
• 6:04
  Dr. Komal Patil-Sisodia: All of these things are things that you should be paying attention to.
• 6:07
  Dr. Komal Patil-Sisodia: Nowadays we have so many different tracking apps and methods.
• 6:11
  Dr. Komal Patil-Sisodia: There are places where you can monitor your weight and your body composition.
• 6:17
  Dr. Komal Patil-Sisodia: There are apps that allow you to track your cycle and look for any symptoms affecting your body.
• 6:24
  Dr. Komal Patil-Sisodia: The third thing that I recommend is taking a hard look at how you are eating, because your nutrition definitely impacts how you are feeling through menopause and can affect how your body composition is shifting.
• 6:37
  Dr. Komal Patil-Sisodia: We know that as estrogen levels decline, women have a harder time holding on to their muscle mass and they have a much easier time unfortunately gaining fat tissue, especially around their middle.
• 6:49
  Dr. Komal Patil-Sisodia: And that can be in the form of visceral fat and can be very inflammatory.
• 6:54
  Dr. Komal Patil-Sisodia: So common recommendations that you'll see out there across social media and things that I recommend to my patients include increasing the amount of protein you're taking in, making sure that you're getting enough fiber, making sure that you're hydrating well.
• 7:07
  Dr. Komal Patil-Sisodia: The other thing as an endocrinologist that I like to talk about is the pairing of your foods.
• 7:12
  Dr. Komal Patil-Sisodia: There is data that shows if you are eating protein, fat, and fiber as the first part of your meal, and eating just some of it before you dig into the carbs on your plate, it can actually help regulate your blood sugars, and that's huge.
• 7:26
  Dr. Komal Patil-Sisodia: People can have a profound difference in their blood sugars if they're just pairing their foods appropriately.
• 7:32
  Dr. Komal Patil-Sisodia: The other important thing to do is to look at the sources of carbohydrates that you're eating in your diet.
• 7:40
  Dr. Komal Patil-Sisodia: I am big on saying that carbohydrates from nature are the best way to go.
• 7:45
  Dr. Komal Patil-Sisodia: Meaning fruit or vegetables that are starchier to get your carbs.
• 7:50
  Dr. Komal Patil-Sisodia: In one of my previous episodes, I had the pleasure of interviewing Dr.
• 7:54
  Dr. Komal Patil-Sisodia: Susan Baumgartel who talked a lot about, who wrote a book called the menopause menu, which is such a fun read because it talks about the medicine, It talks about the science behind perimenopause and menopause, what different symptoms can be foods that can help manage symptoms, and then also some medical recommendations and non medical recommendations for how to navigate menopause.
• 8:26
  Dr. Komal Patil-Sisodia: And I think it's a great read.
• 8:27
  Dr. Komal Patil-Sisodia: It's fun.
• 8:28
  Dr. Komal Patil-Sisodia: It breaks it down in a way that it's not overwhelming.
• 8:30
  Dr. Komal Patil-Sisodia: So if you haven't had the chance to check that out, I would highly recommend it.
• 8:34
  Dr. Komal Patil-Sisodia: The fourth thing that I recommend for patients is start moving your body.
• 8:37
  Dr. Komal Patil-Sisodia: If you are not exercising regularly, start with five to ten minute walks around your neighborhood and build up over time with that.
• 8:47
  Dr. Komal Patil-Sisodia: If you're not doing strength training, you can start with short bursts of strength training as you build up your stamina.
• 8:56
  Dr. Komal Patil-Sisodia: And there's data showing that even just three ten minute workouts of strength training will help you maintain your muscle mass.
• 9:04
  Dr. Komal Patil-Sisodia: If you are wanting to do more And change your body composition.
• 9:09
  Dr. Komal Patil-Sisodia: It can actually help you gain muscle over a period of time, provided you're eating the right foods to fuel your muscle.
• 9:15
  Dr. Komal Patil-Sisodia: I think that a combination of strength training, as well as some cardiovascular exercises is important.
• 9:21
  Dr. Komal Patil-Sisodia: There was a study that came out.
• 9:23
  Dr. Komal Patil-Sisodia: Gosh, I don't even know how many years ago now, but it basically said that 11 minutes of getting your heart rate up per day So 11 minutes of what we call cardiovascular activity can help reduce your cardiac risk by 33 percent, right?
• 9:36
  Dr. Komal Patil-Sisodia: So small amounts of exercise can make a difference.
• 9:38
  Dr. Komal Patil-Sisodia: It's the additive effect of all of that that is going to be helpful and another thing that is important to Another thing that's important to understand in perimenopause is that as your body starts to change It can affect the way that you're able to move through your workouts.
• 10:05
  Dr. Komal Patil-Sisodia: There was a great paper by Dr.
• 10:08
  Dr. Komal Patil-Sisodia: Vonda Wright called the musculoskeletal syndrome of menopause.
• 10:12
  Dr. Komal Patil-Sisodia: And it talks about the joint pain, the incidence of frozen shoulder, muscle loss, just things that we see that shift in terms of body composition for women that can make it harder for them to exercise.
• 10:25
  Dr. Komal Patil-Sisodia: So.
• 10:26
  Dr. Komal Patil-Sisodia: While in our 20s and 30s we're able to push a little harder at the gym or take these high intensity classes, there is no harm or shame in Dialing the intensity of the workouts down so that you get good quality movements that's supporting your joints and your muscles for where your body's at now.
• 10:45
  Dr. Komal Patil-Sisodia: So it's important to adapt your workouts to how you're feeling.
• 10:48
  Dr. Komal Patil-Sisodia: You can really injure yourself pretty severely if you were trying to push through and do the same thing you were doing in your 20s and your 40s.
• 10:56
  Dr. Komal Patil-Sisodia: And I'm not saying that if you've done that all along and you're still tracking along well with that to stop doing that.
• 11:02
  Dr. Komal Patil-Sisodia: You should continue doing what feels good to your body.
• 11:06
  Dr. Komal Patil-Sisodia: The fifth thing that I recommend for patients is practicing good sleep habits.
• 11:10
  Dr. Komal Patil-Sisodia: In my last episode, I had the pleasure of interviewing Dr.
• 11:13
  Dr. Komal Patil-Sisodia: Andrea Matsumura, who laid out some really great data around sleep in perimenopausal and menopausal women.
• 11:20
  Dr. Komal Patil-Sisodia: And she pointed out that if your sleep is truly impaired because of perimenopause and menopause, within a month of starting hormone replacement therapy, if that's available to you, you should start to see a difference.
• 11:33
  Dr. Komal Patil-Sisodia: If your sleep is not improving, that means there are many other things that are impacting it.
• 11:37
  Dr. Komal Patil-Sisodia: And it could be what time you're shutting off your devices, how you're preparing for sleep.
• 11:43
  Dr. Komal Patil-Sisodia: Do you have a backup plan for how to get back to sleep?
• 11:46
  Dr. Komal Patil-Sisodia: So there's many pieces to this.
• 11:47
  Dr. Komal Patil-Sisodia: The other thing that can also be an issue for women is Sleep apnea, it is underdiagnosed in women.
• 11:55
  Dr. Komal Patil-Sisodia: And I think the statistic is somewhere that 80 to 90 percent of women who have sleep apnea don't know about it and have not been tested about it.
• 12:02
  Dr. Komal Patil-Sisodia: So if you are working on changing your sleep habits and creating a sleep routine for yourself, and that's not helping, or you've tried the hormone replacement therapy on top of all of that, and your sleep is not improving.
• 12:13
  Dr. Komal Patil-Sisodia: It makes sense to go see a sleep specialist to see if you fall in that category of women who have sleep apnea and don't know it.
• 12:20
  Dr. Komal Patil-Sisodia: Practicing good sleep habits is one of the core pillars of menopause care in my mind The next thing that I recommend women do is take a look at their stress management And what how their mindset is It is so easy in this day and age to get overwhelmed from all of the different roles that we fill that we are constantly busy and not thinking about how stress is affecting us and when stress goes up cortisol goes up.
• 12:49
  Dr. Komal Patil-Sisodia: In my Experience when you are chronically stressed it makes everything worse so there are things that you can do if you are noticing mood changes irritability high stress levels there are self care strategies such as mindfulness practices or meditation or even finding a therapist to help work on improving those symptoms.
• 13:11
  Dr. Komal Patil-Sisodia: The other thing that I think is really important is perimenopause and menopause should not be looked at as this decline that is going to happen to you.
• 13:19
  Dr. Komal Patil-Sisodia: If you were proactive and you take charge of this.
• 13:23
  Dr. Komal Patil-Sisodia: It can be a very positive transition for most people.
• 13:27
  Dr. Komal Patil-Sisodia: Unfortunately, we haven't done that and we haven't treated women for it for several years.
• 13:31
  Dr. Komal Patil-Sisodia: So it can be hard to see it as that because you hear so much negativity around the change.
• 13:36
  Dr. Komal Patil-Sisodia: But one of the key things that you have is that your mind has developed from when you were in your twenties.
• 13:42
  Dr. Komal Patil-Sisodia: And I often joke with my girlfriends that I would love to have my 25 year old body with my 45 year old mind.
• 13:48
  Dr. Komal Patil-Sisodia: I would be killing it at life.
• 13:50
  Dr. Komal Patil-Sisodia: But that's not the reality of it.
• 13:52
  Dr. Komal Patil-Sisodia: But you can still optimize things for your body and have the wisdom and experience of your mid forties mind that is carrying you forward.
• 14:01
  Dr. Komal Patil-Sisodia: So that mastering that mindset and reframing menopause as a positive transition is very important.
• 14:08
  Dr. Komal Patil-Sisodia: The seventh thing, I have a list of ten, so we're going to work through them, is what you need to do in your doctor's office when you're preparing for perimenopause and menopause transition.
• 14:18
  Dr. Komal Patil-Sisodia: Okay.
• 14:19
  Dr. Komal Patil-Sisodia: I have been guilty of this.
• 14:20
  Dr. Komal Patil-Sisodia: I have not talked to women about this transition until probably a few years ago when I realized that I was starting to go through some of these same things and the patterns that I was seeing in my patients who were my age were clueing me into the fact that we needed to start talking about this.
• 14:38
  Dr. Komal Patil-Sisodia: I just recorded an episode with Dr.
• 14:40
  Dr. Komal Patil-Sisodia: Lindsay Ogle that talks about women's preventative health screenings that I think is so helpful.
• 14:45
  Dr. Komal Patil-Sisodia: And if you take a listen to that episode, which should be coming out shortly after this one, you'll know what tests and what screenings to consider.
• 14:53
  Dr. Komal Patil-Sisodia: And there are different ones that are recommended for each decade of your life.
• 14:57
  Dr. Komal Patil-Sisodia: I am guilty of not having established a primary care doctor until my mid 30s, which is terrible.
• 15:03
  Dr. Komal Patil-Sisodia: My primary care doctor.
• 15:04
  Dr. Komal Patil-Sisodia: She's wonderful.
• 15:05
  Dr. Komal Patil-Sisodia: She was laughing at me because when I went in for my first visit, she asked me when my last doctor's appointment was and I gave her a date and she figured out that it was my postpartum visit from having given birth to my son and I just hadn't seen a doctor in five years It is very easy to put your care on the back burner and not realize the importance of it.
• 15:26
  Dr. Komal Patil-Sisodia: But there are things you can be doing in your 20s and 30s to make sure that there is a healthy transition into your 40s.
• 15:33
  Dr. Komal Patil-Sisodia: the 8th thing that I recommend is managing your metabolic health.
• 15:38
  Dr. Komal Patil-Sisodia: This is really important because I don't think we understand or we talk enough about the impact of overweight and obesity and if that starts to become something that you are diagnosed with or struggling with.
• 15:54
  Dr. Komal Patil-Sisodia: Weight gain, as we talked about, happens because our hormones are shifting, our body starts trying to hold on to fat mass and let's go of muscle mass.
• 16:03
  Dr. Komal Patil-Sisodia: When that happens, the fat mass is something we call visceral fat, because it tends to, instead of being under the skin, be inside the abdominal cavity and creating all this inflammation and insulin resistance.
• 16:13
  Dr. Komal Patil-Sisodia: That insulin resistance is the start of your metabolic health going sideways.
• 16:19
  Dr. Komal Patil-Sisodia: There are simple lifestyle tweaks that you can do for metabolic health, which we have talked about previously, which is, you know, looking at your diet, making sure you're moving, making sure you're managing your stress and your sleep.
• 16:30
  Dr. Komal Patil-Sisodia: All of those things will also help your metabolic health.
• 16:33
  Dr. Komal Patil-Sisodia: But if you have a strong family history of it, understanding when The lifestyle changes are not working versus when you might have to start considering some medication is very important and that is important to talk to your doctor about.
• 16:48
  Dr. Komal Patil-Sisodia: A lot of times we push this.
• 16:51
  Dr. Komal Patil-Sisodia: mindset that everything needs to be done naturally or should be done naturally or you're failing and that is not true.
• 16:57
  Dr. Komal Patil-Sisodia: Our genetics determine how we will respond to things and sometimes despite people's best efforts, all of the lifestyle changes, even if they do them perfectly, for whatever reason their metabolic health continues to deteriorate and that is not your fault.
• 17:13
  Dr. Komal Patil-Sisodia: That is your genetics coming into play and that requires medical intervention.
• 17:18
  Dr. Komal Patil-Sisodia: That's why we have science.
• 17:19
  Dr. Komal Patil-Sisodia: That's why we have medicine so we can help people with this the ninth thing on my list, and again, this is not something that is available to everybody, but hormone replacement therapy should be a consideration for most women.
• 17:32
  Dr. Komal Patil-Sisodia: I say most women because not everybody has hormone replacement therapy available to them.
• 17:38
  Dr. Komal Patil-Sisodia: There are some women who have what we call contraindications, which means you should not take hormones because you have some high risk medical conditions.
• 17:48
  Dr. Komal Patil-Sisodia: And that is women who have had a personal history of breast cancer, uterine cancer, ovarian cancer.
• 17:55
  Dr. Komal Patil-Sisodia: When I say hormone replacement therapy, I'm talking from a systemic sense.
• 17:59
  Dr. Komal Patil-Sisodia: Vaginal estrogen is available to most women regardless of these contra indications.
• 18:05
  Dr. Komal Patil-Sisodia: If there's a strong family history that puts you at risk for breast cancer ovarian cancer, uterine cancer, having heart disease, having a history of stroke, having a liver disease, blood clots, those things can all put you in a higher risk category and hormone replacement therapy may not be available to you.
• 18:25
  Dr. Komal Patil-Sisodia: I've talked at length about the Women's Health Initiative and the benefits and the risks of these therapies And we still don't have good data about whether it reduces cardiovascular risk We just need more studies.
• 18:38
  Dr. Komal Patil-Sisodia: There are several different types of hormone replacement therapy that you need to discuss with your doctor and this needs to be a nuanced discussion.
• 18:46
  Dr. Komal Patil-Sisodia: And then the last thing that I recommend people consider is if they've tried everything else and or hormones are not available to them.
• 18:53
  Dr. Komal Patil-Sisodia: There are other non hormonal medications that can be used to treat hot flashes and libido and mood changes that come along with perimenopause and menopause.
• 19:04
  Dr. Komal Patil-Sisodia: There are also some supplements that have some data behind them that may help the symptoms of menopause.
• 19:10
  Dr. Komal Patil-Sisodia: There are some women who benefit from things like acupuncture to help minimize their symptoms.
• 19:15
  Dr. Komal Patil-Sisodia: So there are things that can be done that fall outside of that category of hormones that women can try and get relief from those symptoms.
• 19:22
  Dr. Komal Patil-Sisodia: But all of this requires conversations with your healthcare provider and making sure that you're taking a look at your lifestyle, at your mind, at your habits to put you on the best path towards prevention instead of reaction.
• 19:37
  Dr. Komal Patil-Sisodia: As we wrap up this episode, I just want to list out the 10 things we talked about.
• 19:42
  Dr. Komal Patil-Sisodia: Number one, know your personal and family history.
• 19:45
  Dr. Komal Patil-Sisodia: Number two, track your symptoms.
• 19:48
  Dr. Komal Patil-Sisodia: Number three, eat for wellness.
• 19:50
  Dr. Komal Patil-Sisodia: Number four, move your body.
• 19:53
  Dr. Komal Patil-Sisodia: Number five, practice good sleep habits.
• 19:55
  Dr. Komal Patil-Sisodia: Number six, master your mindset and work on stress management.
• 20:00
  Dr. Komal Patil-Sisodia: Number seven, work with your healthcare provider to prepare for your perimenopause and menopause transition.
• 20:06
  Dr. Komal Patil-Sisodia: Number eight, manage your metabolic health.
• 20:09
  Dr. Komal Patil-Sisodia: Number nine, consider hormone replacement therapy if it's available to you.
• 20:14
  Dr. Komal Patil-Sisodia: And number 10, consider non hormonal treatment options if you are doing all the lifestyle things and hormone replacement therapy is not available to you.
• 20:23
  Dr. Komal Patil-Sisodia: I really hope that this encourages you to, that this episode encourages you to reach out your healthcare provider and take a look.
• 20:31
  Dr. Komal Patil-Sisodia: Internally, and self reflect on how things are going in your life in terms of your health.
• 20:40
  Dr. Komal Patil-Sisodia: There are several places to find resources, there are several great podcasts that are out there, menopause.
• 20:48
  Dr. Komal Patil-Sisodia: org is a great website for patient information The last thought and question that I want to leave you with today.
• 20:55
  Dr. Komal Patil-Sisodia: What is the one thing you'll start doing today in order to prepare yourself to be more preventative versus reactive?
• 21:01
  Dr. Komal Patil-Sisodia: Think about how you are going to prepare for this life journey and step into taking care of yourself.
• 21:05
  Dr. Komal Patil-Sisodia: I hope this episode resonated and was informative for you.
• 21:09
  Dr. Komal Patil-Sisodia: Please reach out via my socials.
• 21:10
  Dr. Komal Patil-Sisodia: You can find me.
• 21:11
  Dr. Komal Patil-Sisodia: On TikTok or Instagram at Dr.
• 21:15
  Dr. Komal Patil-Sisodia: Patil Sisodia, or through buzzsprout fan mail that's been live.
• 21:18
  Dr. Komal Patil-Sisodia: I'd love to hear questions from you all or ideas for episodes for things that you want to hear about.
• 21:24
  Dr. Komal Patil-Sisodia: I do have one announcement that I wanted to make.
• 21:27
  Dr. Komal Patil-Sisodia: I am opening my own practice for women who are looking to take care of their metabolic health.
• 21:34
  Dr. Komal Patil-Sisodia: and start planning for this perimenopause and menopause transition.
• 21:38
  Dr. Komal Patil-Sisodia: I'm located in Redmond, Washington.
• 21:40
  Dr. Komal Patil-Sisodia: The clinic is called East Side Menopause and Metabolism.
• 21:44
  Dr. Komal Patil-Sisodia: My website is eastsidemm.
• 21:47
  Dr. Komal Patil-Sisodia: com.
• 21:48
  Dr. Komal Patil-Sisodia: If you want more information or you'd like to schedule an appointment, you can reach out that way as well.
• 21:53
  Dr. Komal Patil-Sisodia: I look forward to seeing you all on the next episode.