Latest / Get Real with Jim Weiss / Dr. Mary Claire Haver, #1 Menopause Expert and Founder of The Pause Life

Transcript

Dr. Mary Claire Haver, #1 Menopause Expert and Founder of The Pause Life · Get Real with Jim Weiss

0:00
Speaker 1: Hey, everybody you know really excited about our next guest,
0:03
Speaker 1: doctor Mary Clair Have. I think it's going to probably
0:07
Speaker 1: create real personal impact for a lot of people. I
0:10
Speaker 1: think she gives a lot of practical, real time advice,
0:14
Speaker 1: and I know you learned a ton from her tons.
0:17
Speaker 2: I mean, I was saying, I'm literally drinking creatine and
0:21
Speaker 2: protein powder in my smoothie now just because of her.
0:24
Speaker 2: And I feel like she has so much to offer,
0:25
Speaker 2: even in the lead up to perimenopause and how women
0:28
Speaker 2: just plateau so fast their hormonest completely change or evaporate overnight,
0:33
Speaker 2: and how to prepare for that.
0:34
Speaker 3: She made me think, And she was also so inspiring.
0:37
Speaker 2: This is like career number three for her, and she
0:41
Speaker 2: just keeps iterating.
0:42
Speaker 3: She's built six million.
0:43
Speaker 2: Followers since twenty twenty one. She's just incredible. And her book,
0:48
Speaker 2: The New Menopause is the number one bestseller.
0:50
Speaker 1: I've been talking to people, you know. Of course, when
0:53
Speaker 1: you record these things, you don't know how relevant they're
0:56
Speaker 1: going to be entirely, But then everyone you meet as
1:00
Speaker 1: some story around. I'm early into perimenopause or menopause, and
1:06
Speaker 1: I took hormones and it changed my life, you know,
1:08
Speaker 1: all the stuff that she talks about in the podcast
1:11
Speaker 1: that I think maybe run counter to current belief systems
1:15
Speaker 1: or the status who, which of course is what we're
1:18
Speaker 1: trying to break up here and help patients and caregivers,
1:22
Speaker 1: you know, come up with better solutions to feel better
1:25
Speaker 1: and lead better, longer, healthier life.
1:28
Speaker 2: Totally, and I felt like you really resonated with the
1:30
Speaker 2: longevity conversation, the nursing home protection program and all the
1:35
Speaker 2: recommendations she has for that. I know you've been looking
1:38
Speaker 2: into that for yourself, and it sparked a lot of
1:40
Speaker 2: conversation for us and our team.
1:42
Speaker 1: I know, well, she and I talked about it. You
1:44
Speaker 1: kind of have about twenty summers left the buddy of
1:46
Speaker 1: mine always you know that are really good. So how
1:49
Speaker 1: do we make them the best they can be? Obviously,
1:52
Speaker 1: you know all the things we've been talking about on
1:54
Speaker 1: the show. Knowledge is power early and often, you know,
1:58
Speaker 1: all the usual things that should make people healthier. So
2:02
Speaker 1: I'm excited for people to tune into this one. I
2:05
Speaker 1: think we're going to get a lot out of it.
2:07
Speaker 1: It's a great one.
2:07
Speaker 2: Yeah, I can't wait.
2:09
Speaker 1: So how did a girl from Gabbath, Texas become the menopause. Goat,
2:15
Speaker 1: how did that happen? Tell us your story.
2:18
Speaker 3: Ah, it was not intentional. I was a practicing academic obgyn.
2:26
Speaker 3: I was a residency program director, and I was having
2:30
Speaker 3: increasing burden from the academic institution, which they were hiring
2:36
Speaker 3: more and more people in the administrative level and less
2:39
Speaker 3: and less of us. And it was the paperwork, the
2:43
Speaker 3: thing that brought me to medicine, were no longer able
2:45
Speaker 3: to keep me there in that kind of setting, and
2:48
Speaker 3: so I was getting more and more burned out. I
2:50
Speaker 3: was exhausted. I was having less and less job satisfaction.
2:54
Speaker 3: I got to the point where I could not see
2:57
Speaker 3: myself doing this for the next twenty years. That I
3:00
Speaker 3: would lose years of my life and it wasn't worth it.
3:02
Speaker 3: So I'm getting more exhausted going through menopause, not able
3:06
Speaker 3: to answer my own menopause questions. And my biggest thing
3:09
Speaker 3: that kind of made me go huh was wakain sadly,
3:12
Speaker 3: and it was purely cosmetic. I was frustrated with this
3:15
Speaker 3: new abdominal fat, this belly that I'd never had, and
3:18
Speaker 3: I thought back to my training. It was this like
3:21
Speaker 3: light bulb moment of we were taught from an institutional
3:25
Speaker 3: basis that women tend to samaticize psychological conditions, especially in
3:29
Speaker 3: their thirties, forties, and fifties. If you can't find anything
3:31
Speaker 3: wrong with them in their labs, they're just kind of
3:34
Speaker 3: crazy and they'll get over it. And I'm like, wait,
3:38
Speaker 3: I'm not crazy. These women are not crazy. This is
3:41
Speaker 3: something biological. This is not psychological. So that kind of
3:45
Speaker 3: started me going down these niahe rabbit hole of inflammation,
3:49
Speaker 3: weight gain, and where loss of sex womans may tie
3:52
Speaker 3: into this. I'm like, wait a minute, no one's talking
3:54
Speaker 3: about this. This isn't common knowledge in medicine. I wasn't
3:58
Speaker 3: given any information about this in my training or I'm
4:01
Speaker 3: not teaching the residents this. And this is really really important.
4:04
Speaker 3: This is massively impacting one hundred percent of my patients
4:07
Speaker 3: after reproduction ins and so I learned about intermittent fasting,
4:11
Speaker 3: I learned about quality nutrition. I went back to school
4:14
Speaker 3: and got culinary medicine certified, and I developed a program
4:17
Speaker 3: for my patients and myself called the Gals and Diet,
4:19
Speaker 3: but had no name. It was just like, here's a
4:21
Speaker 3: bunch of gobbledygook I scribbled on the back of napkins
4:24
Speaker 3: and threw it together, went to office depot Xerox did
4:27
Speaker 3: all and we're handing out little copies of my program
4:30
Speaker 3: to my friends, my girlfriends, and my patients, and it
4:33
Speaker 3: just kind of grew a life on its own. I
4:35
Speaker 3: started talking about it on Facebook one day, just for
4:38
Speaker 3: fun to see what would happen, and lo and behold,
4:41
Speaker 3: I turned out to be a great science educator on
4:43
Speaker 3: social media. That's where things kind of started exploding. And
4:46
Speaker 3: as I talked about menopause and weight gain and menopause
4:49
Speaker 3: and inflammation, more and more questions start coming in. So
4:53
Speaker 3: when ten thousand women DM you about frozen shoulder in menopause,
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Speaker 3: I kept seeing patterns in the questions, like all these
5:00
Speaker 3: women can't be lying or crazy, You're making it up.
5:02
Speaker 3: And I started asking my ORTHO colleagues, Hey, you know
5:06
Speaker 3: and short, yeah, women in their forties tend to get
5:08
Speaker 3: this end of story. And I start digging, and I
5:10
Speaker 3: start realizing there's a lot of data out there about
5:14
Speaker 3: all these other multi organ things that are happening across
5:17
Speaker 3: the menopause transition. No one's teaching about it. So I
5:20
Speaker 3: just decided to use the Internet as an education tool
5:23
Speaker 3: and it just kept growing. So during COVID, my kids
5:27
Speaker 3: were like, you should do TikTok because I was growing
5:29
Speaker 3: on Facebook. You have tens of thousands on Facebook, and
5:31
Speaker 3: I'm like, TikTok's for kids. So they go, no, no, no,
5:33
Speaker 3: look at these doctors. So they're showing me physician educators
5:36
Speaker 3: who were dancing, pointing to medical teaching terminology or top
5:41
Speaker 3: ten ways to you know whatever. I was like, I
5:44
Speaker 3: think I could do this, So I just started doing
5:47
Speaker 3: it on TikTok in little short bites. I would literally
5:50
Speaker 3: put on cute music and point to medical facts about
5:54
Speaker 3: women's health and menopause. And it just exploded. So within
5:58
Speaker 3: a year we hit a million followers on tik and
6:00
Speaker 3: I just I didn't know what was happening. And so
6:02
Speaker 3: I'm reading the comments, looking at the questions, realizing I
6:06
Speaker 3: am validating women by the millions. Other people were doing
6:11
Speaker 3: the work, they just didn't have a platform to share it.
6:14
Speaker 3: And I lean on the shoulders of those giants and
6:16
Speaker 3: all the research they did, and I give them credit
6:18
Speaker 3: and the books and everything. But I left the academics
6:21
Speaker 3: institution I was in and I became a hospitalist during COVID,
6:24
Speaker 3: right before COVID, and then COVID hit and I've never
6:28
Speaker 3: worked more hours in my life as all hospitalists were doing.
6:32
Speaker 3: And then once things with COVID calmed down and I
6:34
Speaker 3: felt like me leaving that position would not took people
6:37
Speaker 3: in danger. I decided to open a menopause call. I
6:39
Speaker 3: didn't even know how to do that. I've been employed
6:41
Speaker 3: my entire life in medicine. How do you do? I
6:44
Speaker 3: got the Idiot's Guide to opening a medical practice. I
6:46
Speaker 3: didn't know if anyone would come. I took my girlfriends
6:48
Speaker 3: out to dinner. I'm like, would you come see me? Like,
6:50
Speaker 3: is this something viable? And they'd all were like, yes,
6:53
Speaker 3: it's so needed. And I made it up. I built
6:56
Speaker 3: my dream practice exactly the way I wanted it. I
6:59
Speaker 3: decided to step away from the third party model because
7:01
Speaker 3: insurance is a nightmare, and we have a waiting list
7:04
Speaker 3: of two thousand people like our class. It's just really
7:10
Speaker 3: I tapped into something that people were ready for. We're
7:14
Speaker 3: hungry for. Generation X is not putting up with this,
7:18
Speaker 3: so here I am across all platforms, well over six
7:22
Speaker 3: million followers. We have an email list, have got a
7:24
Speaker 3: million and a half, millions and millions and millions of
7:27
Speaker 3: views on podcasts. It's just been nothing I ever dreamed
7:30
Speaker 3: of or expected. But I really feel like this is
7:34
Speaker 3: where I'm meant to be at this part of my life.
7:36
Speaker 1: Tell me, you've been talking about perimenopause and menopause. Can
7:40
Speaker 1: you just explain what's the difference?
7:43
Speaker 2: Oh?
7:43
Speaker 3: Yeah, sorry, let's good to one oh one. So what
7:45
Speaker 3: is menopause?
7:46
Speaker 1: Okay?
7:47
Speaker 3: Menopause medically is defined as one day in a woman's life.
7:50
Speaker 3: It is one year after the final minstrual period. There's
7:53
Speaker 3: a lot of problems with that. What if it's leap here?
7:55
Speaker 3: Do we wagit three hundred and sixty six days? What
7:57
Speaker 3: if she's had to insurrect? To me, what if she
7:59
Speaker 3: has what if she does period? It's what if she
8:00
Speaker 3: has pcos?
8:01
Speaker 1: What all?
8:02
Speaker 3: It's ridiculous We use a symptom to describe a cataclysmic event. Okay,
8:06
Speaker 3: what's really happening is human females are born with their
8:11
Speaker 3: entire egg supply. Our ovaries are a repository of eggs.
8:14
Speaker 3: In the surrounding tissues around each egg, the follicles we
8:17
Speaker 3: call them, the testicles, make their shit fresh every day
8:19
Speaker 3: from puberty till death. You probably don't want to, but
8:22
Speaker 3: you could follow a child. As you know most men,
8:24
Speaker 3: it might get harder as you get older, but as possible.
8:26
Speaker 3: We have a shelf life on our egg supply. By
8:29
Speaker 3: the time we're born, we're down to about one to
8:31
Speaker 3: two million, But the time a female is thirty, she's
8:33
Speaker 3: down to about ten percent of the original egg supply,
8:36
Speaker 3: and by the time she's forty it's about three percent
8:39
Speaker 3: on average. So in pre menopause and a healthy woman
8:43
Speaker 3: without PCOS or some indocrinsysfunction, she has an EBB and
8:47
Speaker 3: flow of hormones that cause her to ovulate month after
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Speaker 3: month after month, and the average cycle length is twenty
8:53
Speaker 3: eight days. Okay, most women know this pretty well, right.
8:56
Speaker 3: But ovulation starts in the brain. There's a gland called
8:59
Speaker 3: the hypothalmus, and it's a master regulator of multiple hormones
9:02
Speaker 3: in the body, and it senses for things like thyroid
9:06
Speaker 3: hormone and estradol in the random. When the estradol gets low,
9:09
Speaker 3: which it normally does in a cycle, it says, well,
9:12
Speaker 3: where's my estrogen? It wants a continuous supply of estrogen,
9:16
Speaker 3: that is its goal. Ores can't give you a continuous supply.
9:18
Speaker 3: It's you get a bump and then you get a
9:21
Speaker 3: decline each month. So it sends a signal to the pituitary,
9:24
Speaker 3: which creates two hormones called LH and FSH, which then
9:27
Speaker 3: go down to the ovres and bind to the cells
9:32
Speaker 3: around each egg. Those are called the follicular and the
9:35
Speaker 3: granulosa cells, and those cells produce estradol. And it's kind
9:39
Speaker 3: of like a Rugelberg machine where you start with cholesterol
9:43
Speaker 3: and you cleave down to DHA dhas, and then you
9:46
Speaker 3: end up with testosterone, which then gets converted interesting dione.
9:50
Speaker 3: So your androgens actually get converted to estrogens, so we
9:53
Speaker 3: have to have them. Women have more diazosterone in their
9:56
Speaker 3: body than estrogen, by the way, still a lot less
9:59
Speaker 3: than men, but it is the precursor to most of
10:01
Speaker 3: our estra dial So then the hypothamas calms down, stop
10:05
Speaker 3: sending the signal at ovulation. When we get our surge
10:07
Speaker 3: of estrogen. That surge lasts ten days or so, then
10:10
Speaker 3: it starts dropping off, and then the hypodamas gets upset
10:14
Speaker 3: again and says, where's my estrogen, and the whole cycle
10:17
Speaker 3: starts over and over again. When we reached a critical
10:20
Speaker 3: egg threshold level, perimenopause begins, which is the same signals
10:25
Speaker 3: come from the brain. Let's do it again, guys, it's
10:28
Speaker 3: that time of the month. But we don't have enough
10:30
Speaker 3: eggs and follicular and granulosis cells around those eggs to
10:33
Speaker 3: respond to those signals. So the hypothamas doesn't get its
10:37
Speaker 3: fixed and it gets mad. Where's the estrogen? Petuitary says dude,
10:41
Speaker 3: I sent the signal, and the hypothemas gets mad, sends
10:43
Speaker 3: a bigger burst of GnRH. Then the pituitary starts pounding
10:48
Speaker 3: the ovary with much higher F S H in LH
10:51
Speaker 3: levels than a woman has ever seen in her life.
10:54
Speaker 3: So what used to look like this beautiful ekg eban
10:56
Speaker 3: flui hormones becomes a zone of chaos. We have aid
11:00
Speaker 3: estrogen surges, we get much higher surges than we ever had.
11:04
Speaker 3: It crashes to lower levels and progesterone never quite get
11:07
Speaker 3: you know, we have delayed ovulations, so we have delayed
11:09
Speaker 3: progesterone production, and the whole thing becomes complete chaos. And
11:13
Speaker 3: our brains hate chaos. So the female brain likes a
11:17
Speaker 3: steady state of estrogen, or at least fluctuations that can
11:20
Speaker 3: count on and in perimenopause that goes away so often.
11:24
Speaker 3: The first symptoms in perimenopause, well before the cycle becomes
11:27
Speaker 3: disrupted are mental health challenges, cognition changes, brain fog, depression
11:34
Speaker 3: and anxiety, and sleep disruptions before your period's ever become
11:38
Speaker 3: a regular.
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Speaker 1: Maybe that's how that myth started, right that, Oh they're
11:42
Speaker 1: just crazy, you know, that's really happening.
11:46
Speaker 3: Yeah, it's really happening. But it has a biological cost.
11:49
Speaker 3: It's not because she needs a vacation. She needs the
11:51
Speaker 3: glack of lines, she needs someone to do the laundry,
11:53
Speaker 3: and she probably needs all that too. And this is
11:55
Speaker 3: also occurring at some really stressful times of our life.
11:59
Speaker 3: But my patients are coming in going listen, I had
12:01
Speaker 3: it handled. I have a stressful life, but I had
12:03
Speaker 3: it handled, like I had the systems in place. I
12:06
Speaker 3: was rocking and rolling, and then all of a sudden,
12:08
Speaker 3: the rug is pulled out from under her. And that's
12:10
Speaker 3: what I was seeing in clinic. These were PhDs, school teachers,
12:14
Speaker 3: stay at home moms, realtors who had these incredibly busy
12:18
Speaker 3: lives who were doing great and then all of a
12:20
Speaker 3: sudden they can't. I was taught that this is going
12:23
Speaker 3: to happen to her, but never.
12:24
Speaker 1: Why and what can you do about it? I mean,
12:27
Speaker 1: now we can do something about it. Before it was tolerated,
12:31
Speaker 1: deal with it, ignore it.
12:33
Speaker 3: Well, it turns out we can start hormone therapy and
12:36
Speaker 3: perimenopause and these patients do great, great, Okay, So the
12:40
Speaker 3: earlier the better. The biggest acceleration in bone loss. So
12:43
Speaker 3: the biggest rate of bone loss begins in perimenopause, my postmenopause. Wow,
12:48
Speaker 3: So we know if we give a woman HRT at menopause, okay,
12:52
Speaker 3: at fifty one on average, we can decrease the risk
12:55
Speaker 3: of osteoporoduct fractures by fifty percent. If she stays on it,
12:57
Speaker 3: that's huge. That'll take her down to a man's risk.
13:00
Speaker 3: To you, a prodict fracture, I'll take it. And then
13:02
Speaker 3: if we like have her strain train and eat protein,
13:04
Speaker 3: we can take that down even more, give her creatine
13:06
Speaker 3: and all the things. But what if we started in perimenopause.
13:09
Speaker 3: What if we got that six percent back that you
13:11
Speaker 3: know we lose six percent a year in late perimenopause,
13:14
Speaker 3: we could really really really make some changes for these
13:17
Speaker 3: when in long term and mental health. So if a
13:19
Speaker 3: woman comes in with nuancet anxiety depression in perimenopause, you're
13:23
Speaker 3: better off starting hormone therapy in the form of menopause
13:26
Speaker 3: hormone therapy, so lower doses than an SSRI, they do better.
13:30
Speaker 3: But if she was on an SSRI and well controlled,
13:32
Speaker 3: then all of a sudden she's starting to have breakthrough.
13:35
Speaker 3: Give her hormone therapy on top of her SSRI.
13:37
Speaker 1: Yeah, I would say, have we ever really had a
13:40
Speaker 1: guru in this area? Mary Claire? I mean when you
13:43
Speaker 1: say you stood on the shoulders giants who were some
13:46
Speaker 1: of the people early on.
13:48
Speaker 3: There is a position of female and she's Canadian who
13:52
Speaker 3: practices in the US, who had written the Menopause Manifesto
13:56
Speaker 3: and it did really, really well, And that was one
13:58
Speaker 3: of the very earliest voices. Arbara Taylor is a obg
14:01
Speaker 3: an who has done a lot of work on social media.
14:04
Speaker 3: She was another really early voice on the research side. Gosh,
14:08
Speaker 3: Nanette Centaurro has been talking about this for ages. Jim
14:12
Speaker 3: Simon and Wendy Mack and Roger Lobo, their work has
14:16
Speaker 3: been incredible. Lauren Striker talking about women's sexual health.
14:19
Speaker 1: Was there a stigma around that? And pause? I do
14:21
Speaker 1: kind of feel like it.
14:23
Speaker 3: So about forty percent of women, we think if we
14:25
Speaker 3: look at the data pre WHI. So there was a
14:28
Speaker 3: landmark study that kind of shifted the trajectory of women's
14:31
Speaker 3: health after reproduction ins so about forty percent of women
14:35
Speaker 3: were on hormone therapy. It was recommended by the Americ
14:37
Speaker 3: Kandom Academy of Physicians all women should consider this because
14:40
Speaker 3: we knew that women on HRT had less heart attacks
14:43
Speaker 3: and had heart attacks later in life and less all
14:45
Speaker 3: cause mortality. That was clear. But was it because those
14:49
Speaker 3: women were healthier and wealthier that women with access to
14:52
Speaker 3: HRT tended to have better habits? You know? Was this
14:55
Speaker 3: truly an artifact of hormone therapy or was this just
14:58
Speaker 3: this certain subset of pag who were giving a HRT.
15:02
Speaker 3: So the purpose of the WHI was to determine does
15:05
Speaker 3: roma therapy truly decrease the risk of cardiovascular disease. The
15:10
Speaker 3: average age of the patients was sixty three, because it
15:13
Speaker 3: takes about ten years to develop athroscorotic disease to the
15:16
Speaker 3: point where you're going to have a heart attack. So
15:18
Speaker 3: the thought was, if we're measuring heart attacks, we don't
15:20
Speaker 3: want to take the twenty years from menopause, between their
15:23
Speaker 3: sixties and seventies. We're going to start older and then
15:25
Speaker 3: see what happens. But that was a little bit flawed
15:28
Speaker 3: thinking because most of those women, if they were going
15:31
Speaker 3: to have a heart attack, had already developed plaques in
15:34
Speaker 3: their coronary arteries and they were just on the way
15:36
Speaker 3: to their heart attack when we tried to intervene with estrogen.
15:40
Speaker 3: The initial findings that were released in a press conference, like,
15:44
Speaker 3: when is the last time the NIH held a press
15:46
Speaker 3: conference to release data? Okay, so there's drama around it.
15:49
Speaker 3: So these handful of researchers, four guys and one woman
15:53
Speaker 3: got together and said, I looked at the data very preliminarily,
15:57
Speaker 3: there were arms. There was an estrogen progesterone armed women
16:00
Speaker 3: with uterus, and the estrogen only arm for women who'd
16:02
Speaker 3: had hystoric. The estrogen plus progestine arm showed that women
16:07
Speaker 3: had an increased risk appeared that women might have an
16:10
Speaker 3: increased risk of breast cancer. It did not reach statistical significance,
16:15
Speaker 3: but they called a press conference and tell that to
16:17
Speaker 3: the world. They let that genie out of a bottle,
16:20
Speaker 3: that estrogen was somehow dangerous we knew that in certain
16:23
Speaker 3: populations it might increase the risk of stroke. That was
16:25
Speaker 3: known data. It's a small risk, it's an acceptable risk
16:28
Speaker 3: for most patients. It's tiny, okay. But so they were like,
16:31
Speaker 3: not only does it not decrease the risk of heart
16:34
Speaker 3: attacks if you started sixty three. So when they looked
16:37
Speaker 3: at the whole data, they said, oh, it doesn't help
16:39
Speaker 3: with heart attacks, and it's increasing the risk of breast cancer.
16:42
Speaker 3: That arm of the study was stopped. The estrogen only
16:44
Speaker 3: arm continued for a couple of more years. They had
16:46
Speaker 3: a decreased risk of breast cancer and an estrogen only arm.
16:49
Speaker 3: No one ever heard of that. And then they showed
16:52
Speaker 3: increased risk of stroke with the estrogen only arm, which
16:56
Speaker 3: we knew about, okay, And it was his mind, tiny tiny, tiny,
16:59
Speaker 3: tiny yah. Hysteria around that press conference announcement. The physicians,
17:03
Speaker 3: you know, the world was not even allowed to read
17:05
Speaker 3: the report for another week. They made this broadcast. Every
17:08
Speaker 3: news organization picked it up. It was viral before the internet.
17:11
Speaker 3: It was the number one medical news story of two
17:13
Speaker 3: thousand and two. Basically, HRT prescriptions dropped to less than
17:18
Speaker 3: four percent of women, down from forty so we had
17:20
Speaker 3: about a ninety percent decrease in the amount of hormone
17:23
Speaker 3: prescriptions when doctors were scared to prescribe it. Now we
17:26
Speaker 3: had doctors who had prescribed it for years and years
17:28
Speaker 3: and years round forty percent of when we're getting it.
17:30
Speaker 3: Those doctors right now are retiring. We're kind of hamstrung
17:33
Speaker 3: right now on how to get women HRT. So so
17:37
Speaker 3: many redos of this study have been done, deaggregating the data,
17:41
Speaker 3: looking at if you start early in the first ten
17:43
Speaker 3: years of your menopause before you developed cardiovascular disease series
17:47
Speaker 3: cardiovascular disease, estrogen is protected up to fifty percent per year,
17:51
Speaker 3: decreased risk of cardiovascular incidents in the form of part attacks,
17:54
Speaker 3: decreased risk of cardiovascular mortality more than status, they're more
17:59
Speaker 3: likely to prevent a heart attack, and a statin is
18:01
Speaker 3: in a woman only. So much of this has come
18:04
Speaker 3: out that has just negated those initial claims, but none
18:07
Speaker 3: of that has been touted right, none of it's. The
18:11
Speaker 3: other thing is plain estradiol JIM is cheap. So let's
18:15
Speaker 3: talk about economics. What are big farma investing in things
18:18
Speaker 3: that make the money? This is basic economics. One oh one.
18:21
Speaker 3: These alternatives to estrogen. They've spent millions developing vioza and
18:26
Speaker 3: those drugs. Those are a very, very weak secondhand to
18:31
Speaker 3: what estradiol can do for your body. They're only protecting
18:34
Speaker 3: the besimotors symptoms in your brain. You know, you have
18:37
Speaker 3: to demonize estrogen to make these drugs make money. So
18:41
Speaker 3: we have this whole undercurrent of oh, estrogen's dangerous, Esrogen's dangers.
18:45
Speaker 3: We need to make all these other drugs. And I
18:46
Speaker 3: love having options for my patients, but for the vast
18:49
Speaker 3: majority or estra dial is two dollars. It is the
18:53
Speaker 3: most affordable, easiest thing to give a patient, and it's
18:57
Speaker 3: just not being utilized.
18:58
Speaker 1: How does that change? Because you know, I've been talking
19:00
Speaker 1: to my doctor about tea all that, and there doesn't
19:03
Speaker 1: seem to be much hesitance to try that.
19:07
Speaker 3: The cardiovascular disease risk for taesocrens totally vind negated. The
19:10
Speaker 3: American College of OBGN, the American Academy of Physicians, the
19:13
Speaker 3: American you know, all of the societies have to pick
19:16
Speaker 3: up there because this is not just hot flashes. This
19:19
Speaker 3: is skin changes, bone changes, brain changes, art changes. Our
19:22
Speaker 3: brains shrink, our bones disintegrate, you know I'm not making
19:25
Speaker 3: this up, and so every specialty has to get on board.
19:29
Speaker 3: Our training programs must enact mandatory education around women's health
19:34
Speaker 3: after reproduction ends. We are not little men. We disease differently,
19:38
Speaker 3: we age differently, We die of the same things, but
19:40
Speaker 3: in different ways. And if you look at it like this,
19:43
Speaker 3: most men, not all men, their life spans are shorter
19:46
Speaker 3: than women's. Because I hear this all well, when I
19:48
Speaker 3: love longer, here's the problem. He has a better health span,
19:52
Speaker 3: he lives a healthier life for longer, He has a
19:55
Speaker 3: shorter course of decline than he dies quickly. Women tend
19:59
Speaker 3: to have a much longer loss of independence, disability, frailty,
20:04
Speaker 3: dementia that men don't have, not just because they're older,
20:07
Speaker 3: not just because they're living longer, but because of menopause.
20:12
Speaker 3: My patients come in, we put out the fires of menopause,
20:15
Speaker 3: and then they're like, I don't want to be like
20:16
Speaker 3: my mom. I don't want my kids arguing amost each
20:19
Speaker 3: other on how to take care of mom. We have
20:21
Speaker 3: a window of opportunity here for those of us who
20:23
Speaker 3: aren't going to be taken out by cancer or other things,
20:25
Speaker 3: to set ourselves up for decreasing that loss of independents time.
20:29
Speaker 1: So what are you doing with patients right now to
20:31
Speaker 1: do that?
20:32
Speaker 3: So my clinic is kind of morphed into a health
20:35
Speaker 3: span clinics, and now we're talking about lifestyle, nutrition, stress reduction,
20:40
Speaker 3: sleep optimization. Like those pillars of health are all vertical,
20:43
Speaker 3: they're foundational to longevity. It's not just slapin estrat gen
20:46
Speaker 3: pouch on someone and kick her out the door. We
20:48
Speaker 3: try to help her build a foundation where she's going
20:51
Speaker 3: to live as healthy as possible. I did a survey
20:54
Speaker 3: on social and I had thousands of people what scares
20:56
Speaker 3: you the most about aging? And in my family, it's cancer.
20:59
Speaker 3: I had two bread there's die of cancer, multiple aunts
21:02
Speaker 3: and uncles in their sixties. So you know, I'm fifty seven,
21:05
Speaker 3: so I'm like, oh, and so I thought it would
21:07
Speaker 3: be cancer because that's my world. No, the vast majority
21:11
Speaker 3: of patients, it was that they couldn't think, or couldn't move,
21:14
Speaker 3: They couldn't take care of themselves.
21:16
Speaker 1: Well, id she did die of cancer at fifty five. Yeah,
21:19
Speaker 1: we didn't really catch it soon enough, but I do
21:23
Speaker 1: remember when she was going through it. You know, at
21:26
Speaker 1: this age, she was having the chemo, and it seemed
21:30
Speaker 1: like that triggered even more of the hot flashes. And
21:35
Speaker 1: is there some association.
21:37
Speaker 3: Well, a lot of the chemotherapy we use for breast
21:39
Speaker 3: cancer we use for other cancers. They go and attack
21:41
Speaker 3: certain cells that are dividing rapidly, and that's in all cancers.
21:44
Speaker 3: And so what we're seeing is that these patients are
21:48
Speaker 3: having hypopolamic suppressions. So their hypothemas pituitary ovariant axis is
21:52
Speaker 3: being suppressed by the chemotherapy, so they're going through menopause sooner.
21:57
Speaker 3: And also we're bathing them in this toxic stuff that
22:00
Speaker 3: is attacking the help of their ovaries. In the effort
22:03
Speaker 3: to kill the cancer cells, we take out a few
22:05
Speaker 3: things along the way too. Those are slide effects, and
22:08
Speaker 3: so yeah, we often see in chemotherapy patient, not just
22:10
Speaker 3: breast cancer patients. But that's where we're getting the most data,
22:14
Speaker 3: is that the treatment does speed menopause up for these
22:17
Speaker 3: patients and makes it worse. They don't have that easing
22:20
Speaker 3: in of perimenopause. They kind of just get shocked into it.
22:23
Speaker 3: Now for some patients, after their chemo is over, the
22:25
Speaker 3: ovaries will kind of wake up, depending on their age,
22:27
Speaker 3: and their ovars will kind of perk up and those
22:29
Speaker 3: symptoms get better. But there's so much misinformation around who
22:33
Speaker 3: can and can't take. You know, I have people with
22:34
Speaker 3: thyroid cancer or lung cancer who told they can't take estrogen.
22:38
Speaker 3: I'm like, are you crazy. It's the most powerful anti
22:40
Speaker 3: inflammatory formone in our body. Nothing's going to help her
22:43
Speaker 3: fight the cancer better than giving her back estrogen. Estrogen
22:46
Speaker 3: is not trying to kill her. So it turns out
22:48
Speaker 3: vaginal estrogen is safe for everybody, every cancer, Like, anybody
22:52
Speaker 3: with a vagina, regardless of what else is going on,
22:55
Speaker 3: can use vaginal estrogen. Why because it's extremely low doos.
22:58
Speaker 3: It's a microdose compared to system therapy, and it will
23:01
Speaker 3: save the vagina. Like these poor women are going through
23:04
Speaker 3: loss of elasticity, loss of nucus production, the tissues actually shrink,
23:09
Speaker 3: and so sex becomes incredibly painful and such a horrific thing.
23:12
Speaker 3: And you know, it's nothing to do with their partner
23:14
Speaker 3: or their brain is everything's fine, and so vaginal estrogen
23:17
Speaker 3: can just restore so much quality of life besides the
23:20
Speaker 3: UTIs and the discomfort from the loss of estrogen to
23:24
Speaker 3: those tissues.
23:25
Speaker 1: You think people know all this.
23:27
Speaker 3: You know, I'm screaming at the top of my lungs.
23:30
Speaker 3: My girl gang menoposse is screaming it on social media.
23:33
Speaker 3: I think a lot more people know about it now,
23:35
Speaker 3: but we still have a long ways to go. So
23:38
Speaker 3: every platform, every book, I have a substack, every oprah,
23:42
Speaker 3: you know, all of these. Yeah, anytime people want me
23:45
Speaker 3: to talk about it, I come up and talk about
23:46
Speaker 3: it because I'm going to reach one more person.
23:48
Speaker 1: Is it one person at a time or is this
23:50
Speaker 1: catching on?
23:51
Speaker 3: I think it's catching on. I know clinicians are starting
23:54
Speaker 3: to catch on. When you self reflect, most clinicians realize
23:58
Speaker 3: they receive very little clinically menopause training. Doctors go into
24:02
Speaker 3: medicine for the right reasons and they don't want to
24:05
Speaker 3: harm patients, but you don't know what you haven't been taught.
24:07
Speaker 3: I just feel like this shouldn't be siloed to Obijuian.
24:10
Speaker 3: This should be mandatory for all clinicians who touch females.
24:13
Speaker 1: And well, tell me, does Maha get it? I mean
24:16
Speaker 1: they just put out a report.
24:18
Speaker 3: I don't know. I've done a pretty good job of
24:20
Speaker 3: keeping politics out of menopause because I have my followers.
24:24
Speaker 3: Are I don't know how they voted, but I can
24:26
Speaker 3: tell you it's probably all over the you know, right,
24:28
Speaker 3: left center, and menopause is not an option. Every single woman,
24:33
Speaker 3: regardless of who she voted for, is going to go
24:35
Speaker 3: through menopause. One positive thing I did see So when
24:38
Speaker 3: the big cuts came, one of the things I got
24:40
Speaker 3: cut was the Woman's Self initiative and there was such
24:44
Speaker 3: an uproar from females about loss of funding to that study.
24:49
Speaker 3: Within two or three days that was reversed and they
24:51
Speaker 3: were stored funding at least I think till January twenty
24:54
Speaker 3: twenty six. So you know, all the flaws of the
24:57
Speaker 3: WA don't demonize a data set. It's data, and so
25:01
Speaker 3: I'm like, the more data the better. And I don't
25:04
Speaker 3: love the interpretation of the WHI So that was a
25:07
Speaker 3: positive thing for me. Do I love all the funding cuts,
25:10
Speaker 3: of the loss of years of building these you know?
25:13
Speaker 3: Do I think what we had was perfect? Absolutely not?
25:17
Speaker 3: But blowing it up is it the best thing? What
25:20
Speaker 3: worries me is that I don't know how much of
25:22
Speaker 3: this is just crap I get served on social media,
25:24
Speaker 3: but there seems to be at least in like the
25:27
Speaker 3: VA that they're limiting publications that can come out. There's
25:32
Speaker 3: going to be like a politically appointed committee that says
25:35
Speaker 3: what you can and can't publish. And I believe in
25:37
Speaker 3: the scientific method and it can't be encumbered by politics.
25:41
Speaker 3: And so that's the stuff I worry about. But listen,
25:44
Speaker 3: politics come and go, Presidents come and go. So I'm
25:49
Speaker 3: not saying I'm staying on message and staying away from
25:52
Speaker 3: the drama.
25:53
Speaker 1: Yeah, and I want to talk about that. Can your
25:55
Speaker 1: voice and the voice of everyone you're getting on board here.
25:58
Speaker 1: So that started at the thousand and an hour millions,
26:02
Speaker 1: and it's going to be that many more millions if
26:04
Speaker 1: we have anything to do with it. Isn't it about
26:06
Speaker 1: women deciding? You know, I gotta get answers. I got
26:10
Speaker 1: to get out there to find them.
26:12
Speaker 3: The last election prove that women by and large will
26:18
Speaker 3: consider reproductive rights important enough to vote over other aspects.
26:22
Speaker 3: But if we separate the abortion debate from women's health,
26:27
Speaker 3: I think that women will vote for themselves. I mean,
26:30
Speaker 3: we take the politics out of it, I think that
26:32
Speaker 3: they might. But again, I'm not a politician. I'm a
26:34
Speaker 3: scientist and I'm just here to educate. And so no
26:39
Speaker 3: administration has done women's health well, right. The bidens tried
26:43
Speaker 3: to do a little bit. It was one hundred million
26:45
Speaker 3: here and there, but that's a drop in the bucket.
26:47
Speaker 3: NIH budget was forty three billion. Women's Health got ten
26:51
Speaker 3: percent of that, about forty five million inmen Applause got
26:55
Speaker 3: fifteen million. Like do the mats point oh three percent
26:58
Speaker 3: of the NIH budget. No one gave a shit about
27:01
Speaker 3: us after being production ended, And so I'm going to
27:04
Speaker 3: take a win where I get one.
27:06
Speaker 1: So tell me how glp ones and that whole situation
27:10
Speaker 1: is either helping or complicating the situation, because I would
27:15
Speaker 1: think that would be where everybody starts, Oh my god,
27:18
Speaker 1: I'm gaining ate.
27:19
Speaker 3: Yeah, so big, big complaint. And I was very skeptical
27:22
Speaker 3: of golp ones being used for weight loss when I
27:24
Speaker 3: first heard about it. I'd built a whole program based
27:27
Speaker 3: on nutrition and exercise, but it wasn't helping everyone. We
27:29
Speaker 3: live in an obiesagenic society that didn't exist one hundred
27:32
Speaker 3: years ago, and so I had twenty thirty forty fifty
27:35
Speaker 3: percent of patients would do okay with the lifestyle changes
27:38
Speaker 3: we recommended in HRT, but there were still a few
27:41
Speaker 3: that were like doing all the things and just struggling,
27:44
Speaker 3: and their risks were going up. Their inflammation. I'm checking
27:47
Speaker 3: inflammation markers, I'm checking insulin resistance. I'm not just getting
27:50
Speaker 3: around a scale. That's the worst thing to do to
27:52
Speaker 3: a woman. And then when the gop ones came out,
27:54
Speaker 3: I was skeptical, but I talked to some obesity medicine
27:57
Speaker 3: certified physicians who changed my mind, who taught me, and
28:01
Speaker 3: then we started adding it into practice. We usually don't
28:04
Speaker 3: do everything at once. We usually start with hormone replacement,
28:06
Speaker 3: give them a few months, see how they do, do
28:08
Speaker 3: their body composition. I don't want to pretend not putting
28:11
Speaker 3: someone on estrogen is a magic weight loss bill.
28:13
Speaker 1: It is not.
28:14
Speaker 3: But it does tend to make the efforts you are
28:17
Speaker 3: utilizing work better for you. You tend to hang on a
28:19
Speaker 3: muscle better, you tend to stop shifting fat to the viscera,
28:22
Speaker 3: and patients are happy with that. Once we started adding
28:25
Speaker 3: gop ones, it was miraculous for those patients, absolutely miraculous.
28:29
Speaker 3: Now we do extensive counseling, adequate protein intake, heavy lifting,
28:33
Speaker 3: like they know when they leave our office what they
28:35
Speaker 3: need to do, and that gop one somehow gives them
28:38
Speaker 3: that brain space bat that the food noise was giving
28:40
Speaker 3: them to do the things. For the first time, it
28:44
Speaker 3: sticks and they are hitting the gem, they're doing the lifting,
28:47
Speaker 3: they're eating the protein, they're prioritizing the plants like long term,
28:50
Speaker 3: and I've never seen them happier or healthier, and it's amazing.
28:54
Speaker 1: So there's a menopause publications. How long has that been around?
28:59
Speaker 3: Yeah, so this is a great story as a scientist. Okay,
29:02
Speaker 3: So we have the American College of Obigin. I've been
29:04
Speaker 3: a member since day one. I get recertified every year.
29:08
Speaker 3: And I had never heard of the Menopause Society. Okay,
29:11
Speaker 3: until I got involved in menopause. I'm like, oh, there's
29:13
Speaker 3: a whole society. So this started I think twenty five
29:16
Speaker 3: years ago, maybe thirty, kind of a rogue group, and
29:18
Speaker 3: they weren't obg Waynes. They for mostly internest researchers who
29:23
Speaker 3: are like, hey, no one's really talking about menopause every year.
29:26
Speaker 3: Let's make our own society and our own publications. So
29:30
Speaker 3: they did, but I never heard of them. It had
29:33
Speaker 3: never been put in front of me until probably three
29:36
Speaker 3: years ago, and I'm like, oh my no, there's this
29:39
Speaker 3: whole society they're publishing. I had seen a few articles.
29:41
Speaker 3: I'm like, what is this journal of menopause? When they
29:44
Speaker 3: updated the menopause warmont therapy guidelines in twenty twenty two,
29:47
Speaker 3: it was like earth shattering because forever it was the
29:50
Speaker 3: lowest dose for the shortest time possible, only with severe symptoms.
29:53
Speaker 3: Never talked about prevention of ostuo pursis DA DA, DA,
29:55
Speaker 3: DA DA, and three past presidents and the current president
29:59
Speaker 3: there me speak about menopause and what we're doing wrong,
30:02
Speaker 3: the needless turning. They're just really busy with reproductive rights.
30:06
Speaker 3: I don't think all of women's health that for reproduction
30:08
Speaker 3: should be dumped in the lap of the poor busy obgyn.
30:11
Speaker 3: But kind of here we are. So until we get
30:13
Speaker 3: internal medicine, family medicine, you know, all the primary care
30:16
Speaker 3: specialties up to speed on this, it gets dumped in
30:19
Speaker 3: the lap of the obglan.
30:20
Speaker 1: Let's walk through your nursing home protection program by decade,
30:24
Speaker 1: because I guess if you really start in your thirties,
30:27
Speaker 1: when you get knowledgeable, you can really get ahead of
30:30
Speaker 1: this whole thing.
30:31
Speaker 3: I really feel like lifestyle is such a huge part
30:34
Speaker 3: of it, and You have to think of the evolution
30:36
Speaker 3: of what I was taught on, like what was healthy? Healthy?
30:39
Speaker 3: To spin?
30:39
Speaker 1: That was it.
30:40
Speaker 3: If the patient was spined, she was healthy. If she
30:42
Speaker 3: was female. There was never ever discussion of muscle mass,
30:45
Speaker 3: ever talk about body composition. That number of the scale
30:48
Speaker 3: you was ride or die, And now you wanted that
30:51
Speaker 3: number to be as little as possible, as close to starvation,
30:54
Speaker 3: you know, as close to starclopenic as you could get
30:57
Speaker 3: her without like making her emaciated. I look back at that,
31:00
Speaker 3: and so it was calories and calories out. That was it.
31:03
Speaker 3: We knew about severe protein malnutrition like quarkduloricore, we knew
31:07
Speaker 3: about scurvy and like severe severe things, but never on
31:11
Speaker 3: like what good nutrition was. So when I talk to
31:14
Speaker 3: my daughters who are in their twenties, you know, and
31:16
Speaker 3: I talked to thirties and forties, and I'm writing the
31:18
Speaker 3: new perimenopause right now, strong over skinning. Do everything in
31:23
Speaker 3: your power to hang on to your bone and muscle
31:25
Speaker 3: strainth You want heavy bones and strong muscles in those
31:28
Speaker 3: way a lot, and so invest in a body scanner
31:32
Speaker 3: if you can. Resistance training is not negotiable. Non negotiable
31:36
Speaker 3: so you must lift weights, and you must lift heavy.
31:38
Speaker 3: Self care is more than a bubble bath and whatever
31:40
Speaker 3: it is, make sure you are prioritizing your needs first.
31:44
Speaker 3: Cardio is very important, not just resistance training, but like
31:48
Speaker 3: keeping your VOTWO max up higher, so walking, running, sprints,
31:53
Speaker 3: just prioritizing your exercise. Your body does not care. If
31:56
Speaker 3: you're busy, it will break. And so if if you
32:00
Speaker 3: are too busy to exercise, you are too busy. That
32:02
Speaker 3: has got to be a non negotiable part of your day,
32:05
Speaker 3: like brushing your teeth. So build your life around the
32:08
Speaker 3: ability to have time to exercise. There's thirteen pillars of
32:12
Speaker 3: health and dementia, risk factors, hypertension, diabetes, all the chronic
32:15
Speaker 3: disease stuff, but also connection with serious connection with other humans.
32:19
Speaker 3: Maintaining those relationships. Making time for that kind of stuff
32:23
Speaker 3: is really really important. Now, once you get into menopause,
32:26
Speaker 3: we can start adding discussion of hormones back into that.
32:29
Speaker 3: You know, when we talk about supplements, we have to think,
32:32
Speaker 3: what does supplements do? I take supplements, I sell supplements.
32:35
Speaker 3: Supplements can fill a gap in your nutrition that you're
32:37
Speaker 3: struggling to reach, and there is a lot of claims
32:40
Speaker 3: being made in the menopause market with supplements, and let
32:44
Speaker 3: me just be clear, there is no supplement that will
32:46
Speaker 3: resuscitate the life of your ovaries or balance your hormones
32:49
Speaker 3: in perimenopause, So buyer beware. I love all the attention
32:53
Speaker 3: menopause and perimenopaus is getting, but the predators are out
32:57
Speaker 3: and they're pink washing, mental washing product, recycling products, and
33:01
Speaker 3: you know, saying it cures your menopause, and that now
33:04
Speaker 3: nothing this is going to happen to you no matter
33:06
Speaker 3: what supplement that you take. So supplements, I do recommend
33:10
Speaker 3: Vitamin D. Eighty percent of my menopausal patients are deficient fiber.
33:15
Speaker 3: Most patients struggle to get enough fiber in their diets.
33:17
Speaker 3: Those are two huge things. I got really interested in
33:20
Speaker 3: mastuporosis prevention. Ran across a few studies looking at a
33:23
Speaker 3: certain collagen that our company sells now that has been
33:26
Speaker 3: shown to improve ostroporosis and mastereuopenia. Creatine is another product
33:30
Speaker 3: that we offer. Why because there's amazing studies coming out
33:34
Speaker 3: looking at menopausal women taking creatine combined with resistance training
33:39
Speaker 3: and seeing improved gains and strength, which is so huge
33:42
Speaker 3: for us. You know as we are ticking time bombs
33:46
Speaker 3: when we begin perimenopause and menopause, and we are raising
33:49
Speaker 3: the clock for our bone and muscle strength. So I
33:51
Speaker 3: am like there's not one magical thing. I do all
33:54
Speaker 3: the things as much as I can in order to
33:57
Speaker 3: maintain my strength, my balance, decrease my risk of falls
34:01
Speaker 3: so that I don't end up with a hip fracture.
34:04
Speaker 3: And once you fracture your hip, your risk of death
34:07
Speaker 3: is thirty percent with surgery in the first year after
34:09
Speaker 3: the age of sixty five for a woman, if you
34:12
Speaker 3: not well enough to have the surgery or you can't
34:14
Speaker 3: afford it, seventy nine percent of women will die that
34:16
Speaker 3: first year. And it's a miserable year. So my mother
34:19
Speaker 3: broke her hip January, first New Year's Day. She's never
34:22
Speaker 3: walked again. She's in a wheelchair. She's eighty eight.
34:24
Speaker 1: Really, is there stuff you can do in your eighties?
34:28
Speaker 3: So wonderful studies done in nursing homes looking at resistance
34:32
Speaker 3: training at all ages. They had women's seventies, eighties, even
34:35
Speaker 3: a couple like early nineties. All of them showed gains.
34:38
Speaker 3: There was no age limit on improving your strength and
34:42
Speaker 3: waiting until you're frail is not the way to do it.
34:45
Speaker 3: Do not wait until you break, start now. And it's
34:48
Speaker 3: not about esthetics. This is about resilience to the nursing
34:53
Speaker 3: home prevention and patients really get motivated. Of course, we
34:56
Speaker 3: all want to be the best versions of ourselves, but
34:59
Speaker 3: this is about well your children not fighting over your
35:02
Speaker 3: healthcare for a short time as possible, and that is
35:06
Speaker 3: really motivational for a lot of women because who ends
35:10
Speaker 3: up taking care of their parents. It's the oldest daughter usually.
35:13
Speaker 1: So tell me, are there new treatments you're excited about?
35:16
Speaker 1: Worth behind?
35:17
Speaker 3: So one, I'm excited about improving access to just the
35:20
Speaker 3: basics what's not happening, so improving access and education amongst providers.
35:25
Speaker 3: But new stuff is there's a few companies that are
35:28
Speaker 3: looking at and it started kind of in the fertility
35:30
Speaker 3: world of extending the life of the ovary. So a
35:34
Speaker 3: lot of women struggle getting pregnant in their thirties and
35:36
Speaker 3: forties due to their on the earlier end of menopause
35:40
Speaker 3: and so the close you already menopause are less like
35:42
Speaker 3: you already get pregnant. So if you were genetically programmed
35:44
Speaker 3: to go through metopause at forty six, you're going to
35:46
Speaker 3: start having fertility problems in your thirties. There's two companies,
35:49
Speaker 3: probably more, but I've met the owners of two companies
35:52
Speaker 3: that are looking at different ways to help extend the
35:57
Speaker 3: shelf life for the ovaries. This would be medication, and
36:00
Speaker 3: you know they're working on a biochemical basis on what
36:02
Speaker 3: can we do to make the ovary healthier for longer,
36:05
Speaker 3: and it's specifically working on the fertility side. The other is, well,
36:08
Speaker 3: these women don't want to get pregnant after fifty, but
36:10
Speaker 3: what could we do to extend estradiol production naturally in
36:14
Speaker 3: low enough levels that they would protect their bones in
36:17
Speaker 3: their brains as the age Because we know there's no
36:19
Speaker 3: doubt that women who go through menopause at a later
36:22
Speaker 3: age live longer, live healthier, have less dementia, less heart attacks,
36:27
Speaker 3: and less royalty.
36:28
Speaker 1: What's the next big thing for you?
36:29
Speaker 3: I'm finishing up the manuscript for the New Perimenopause that
36:32
Speaker 3: will be released. We're negotiating spring probably sometime in April
36:36
Speaker 3: of twenty twenty six, so that'll be two years almost
36:39
Speaker 3: exactly after the New Menopause came out. We are starting
36:42
Speaker 3: our own podcasts at this fall called pusper effect. So
36:47
Speaker 3: I'm excited to give more of the scientists of voice
36:51
Speaker 3: and a bigger platform, and also all women who are
36:54
Speaker 3: successful at this age. It's not you know, menopause is
36:57
Speaker 3: more than just you know, ovaries. It's everything. And I
37:00
Speaker 3: want to talk to women who are killing it and
37:02
Speaker 3: who are happy and who are like living their best
37:04
Speaker 3: life and what tools did they use and talk about that.
37:06
Speaker 3: We are launching a tour around the new book, So
37:08
Speaker 3: I'll be going on a nationwide tour in the spring
37:12
Speaker 3: with like a bus and everything going from city to city.
37:16
Speaker 1: That's cool.
37:17
Speaker 3: So those are the big things.
37:18
Speaker 1: Yeah, well we're going to be watching. I know one
37:20
Speaker 1: of our Audre's bestie is helping you, so that we
37:23
Speaker 1: all will help you.
37:24
Speaker 3: Yeah, she's amazing too.
37:27
Speaker 1: Well, yeah, it's all going to happen. It's all happening.
37:30
Speaker 1: And with that in mind, with all your busyness, I
37:33
Speaker 1: always like to ask you questions, and one of them
37:36
Speaker 1: is what's your dream vacation? Oh gosh, but when you
37:39
Speaker 1: get off the bus.
37:40
Speaker 3: Dream vacation anything with my kids. So my kids for
37:45
Speaker 3: their graduations, we always give them with travel for the big,
37:48
Speaker 3: big events in their life. So We've done Greece, we
37:51
Speaker 3: did a safari in Africa, and next year my youngest
37:55
Speaker 3: is graduating from college and she is asked to go
37:57
Speaker 3: to Egypt. So we are figuring that out right now.
38:00
Speaker 3: How are we going to make that happen? Anytime that
38:03
Speaker 3: I am with loved ones and we're just laughing and learning.
38:06
Speaker 3: And I like to be active. I could do a
38:08
Speaker 3: couple of days on the beach, but I'm a big
38:11
Speaker 3: hiker activity person. I also love museums, so I am
38:15
Speaker 3: not to sit around and stare out of a condo person.
38:19
Speaker 1: No good, and then tell me you're gonna end up
38:23
Speaker 1: on a desert island. What album would you take?
38:26
Speaker 3: Oh? God, probably like an eighty's Greatest Hits, Nice Dance Edition.
38:32
Speaker 3: Things I like to dance too, that make me want
38:35
Speaker 3: to move around.
38:35
Speaker 1: Great. Well, that goes along with all your tips. Well,
38:39
Speaker 1: this was fun and we'll do it again when the
38:41
Speaker 1: bus sets out, and I hope to see you soon.
38:44
Speaker 1: Thanks for all the time. I think you just gave
38:47
Speaker 1: more information in one hour than most people get in years.
38:51
Speaker 1: And we all can learn from each other, so it's
38:53
Speaker 1: been great learning from you. Thanks so much.
38:56
Speaker 3: Yeah, thanks all right, right, take care.
39:00
Speaker 1: Hey everyone, thanks for joining me on the Get Real podcast.
39:03
Speaker 1: You know, I hope you feel a little healthier hanging
39:05
Speaker 1: out with me. You know it's going to be a
39:08
Speaker 1: lot of fun. Passing this along to others. Please subscribe below,
39:12
Speaker 1: Please share. I'm excited not just to talk about healthcare,
39:16
Speaker 1: but a lot of other fun topics. It's about making
39:20
Speaker 1: healthy Talk about healthcare is not a lecture. This is
39:24
Speaker 1: supposed to be fun. And look forward to spending more
39:27
Speaker 1: time with you in the future.