Latest / Follow the Leighder / Menopause, Women's Health, and Refugee Care | Dr. Shelagh Larson

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Menopause, Women's Health, and Refugee Care | Dr. Shelagh Larson · Follow the Leighder

• Leigh/@followtheleighder: Well, howdy folks and welcome back to another episode of Follow the Leighder. I'm your host, Leigh Larson. And joining me from Fort Worth, Texas is my mom and Dr. Shelagh Larson, women's health nurse practitioner. Welcome to the studio, mom. Shelagh Larson: See you. Hi baby, hi, hi baby dog in the background. Leigh/@followtheleighder: Eww. ⁓ my gosh, for those who are not watching, who doing this audio, my dog, Professor Huckleberry, is generally sleeping on the couch behind me. ⁓ I am bringing my mom on here, not just because she's an awesome mom, thank you for birthing me, but she's a very accomplished women's healthcare professional. And I am so looking forward to talking about menopause today with you, as well as just general women's healthcare. ⁓ in Texas and folks in order to establish a little bit more credibility Dr. DMP APRN ⁓ ⁓ FAA ⁓ that's lot of letters it is alphabet soup behind your name ⁓ you are a board women's health nurse practitioner nationally certified menopause provider and International Society for the Study of Women's Sexual fellow You're down in Fort Worth, Texas. ⁓ You went to UT, got your BSN from UT Medical Branch and ⁓ You your women's health nurse practitioner in 2003 and your doctorate in 2018. But that's not all though. You've also ⁓ led seminars translated into 23 languages for refugee services to educate thousands of refugee women that have come to the United States and are in Fort Worth, Texas, ⁓ how they navigate women's health care. ⁓ I am just blown away by that aspect, but you also do all these conferences around the country talking about menopause, about processes, and I mean you're a very very accomplished woman so I'm really excited ⁓ but before we get into the advocacy and the women's health care part, guys ⁓ We have a common enemy. Ted Cruz, we have to talk about this. We have to talk about this. know, mom's been doing this all my life, all this advocacy, running down to the Texas Capitol, doing conferences around the country. ⁓ not, I almost said it sarcastically, but I couldn't even bring myself to joke about it. I almost called him your personal close best friend, Ted Cruz, who you have met. Shelagh Larson: you Leigh/@followtheleighder: Your best friend. Yeah, yeah. Your top eight on MySpace. He's in your close friends. ⁓ No, opposite. My mom has gone for women's healthcare advocacy related issues to Ted Cruz and he has said no countless times over the years and guess what folks, in the last year. ⁓ Shelagh Larson: My buddy, my bud, we're tight. No! Leigh/@followtheleighder: their marketing person on the Ted Cruz, you know, his website used a photo of him and my mom and another women's health colleague all shaking hands, you know, doing the lobbying thing ⁓ on his website as if he is an ally. And, and, and, ⁓ Shelagh Larson: Yeah, like he's ever, ever addressed anything. Leigh/@followtheleighder: I was so you like the shock of it. I mean we laugh because it's so insulting. Like this man has done so little for women's health care in Texas. Here's you this advocate with another advocate for women's health care. They snap a photo and then they use it on his campaign website. It's A, disingenuous, but it's, mean, it's, it's, you have to laugh because it's so insulting. And we made a big stink about it, or at least I did online about a year ago, and it was removed. Like enough people tagged his team to be like, hey, and a lot of women kind of rallied around that. And again, we're laughing because it's just a mad, like, I'm like, you son of a, and, but, uh. Shelagh Larson: Yes, whoops It is an outward sign of how out of touch they are with their voters. Leigh/@followtheleighder: Yeah. Yeah. Right. It's like, it's, it's, it's, it's funny. It's like hysteria. It's like an angry hysterical like you, you're out of touch with the voters you are using and exploiting my mom. Like I'm like, Ted Cruz, I left Texas, but I'll come back. Right. You're like, what'd do? I'm going after my mom. Why? ⁓ and Shelagh Larson: You Don't make me come back to Texas. Leigh/@followtheleighder: Now it's personal. But anyway, ⁓ that has been done, but it still comes up. for my listeners, my gosh, what a story that we went through with that Ted Cruz thing. And like I said to the followers, y'all got it handled. The website took it down and she's not on there anymore, ⁓ which is correct because you have not supported my mother or women's healthcare. she has lobbied for over the years. talk to me, mean, wow, Fort Worth, Texas, Dallas, Fort Worth, the airport is, that is one of the largest known areas of where we're seeing a lot of immigration, a lot of refugees. I think Atlanta airport is also another port of entry. I learned all this when I was down at the border of Mexico that it's our airports, not our bit borders with that most folks are coming through. And you see a lot of that on the women's healthcare side. So talk to me about how you started these seminars and again, translated in 23 languages. What does that, what are some of those seminars look like? Shelagh Larson: Well, first of all, thank you, baby, for having me on. DFW as well as Atlanta Airport, not only is it a hub for so many immigrants, it is ⁓ the rest of the country has this great big picture of how all these immigrants are coming through the border and swimming across the Rio Grande, particularly in Texas, which, by the way, three quarters of it is dried up in his land. So I don't know where they're swimming, but And for the most part, it is also a huge sex trafficking gate. That's where so many, not a majority, if not all of the women that have been sex trafficked outside the country, that is their port of entry as well. Some of those ⁓ may be the one and the same, the immigrants and the sex trafficking, but ⁓ we hear that all the time from people that aren't in Texas, you know, ⁓ my gosh, you've got all these immigrants pouring in and you're gonna do about the border and I'm like forget the border they need to go to DFW Airport because many of those many people come in on a holiday visa and don't leave but regardless of how they get there how they get to to either Texas or the United States I believe in the humanity efforts, humanitarian efforts. We got to take care of the people. I don't care where you're from, what color you are. It makes no difference. I am one person taking care of another one. So we worked with the Refugee Service of Texas, which had the Fort Worth chapter, and women or families that were sponsored to come into the United States, and literally countries across the country. ⁓ across the globe, Africa, Middle East, South America, the Philippines, ⁓ you name it, I have done training on those women because for many of the women, particularly the low income women that have come in, their healthcare system over in their country, either does not exist or it's very limited. mostly are, they teach, they do only treat women and children and families only when they're sick. They only go to the doctor when they're sick. That's hopefully not how we do it in the United States. Our goal is to prevent ⁓ illnesses and therefore you don't have as many hospital or emergency room visits. So we brought in with the Refugee Service of Texas when they would bring women in, families in, I would have at least a two hour seminar with those women. And I have anywhere from three to seven translators at one time in those classes. They're very informal. They come in, we sit around and I show them ⁓ all about the differences. I tell them about what is a well visit and why is that well visit important? Not only for that mom, but also for her children. Why do we bring children in for vaccines, for hearing tests, for eye tests? We talk about what is the expectation on a well visit. For many, that is something they've never heard of, a new concept. I also talk to them about pharmacy. They don't understand. They think that they have to come to me every time they need a prescription, for example, birth control pill. They think they have to come back to me to get the next month or that they think on some of these other clinics across the globe that we're hand them the bottle right there. ⁓ It doesn't really work that way. We CVS, Walmart, Walgreens, we have all these pharmacies that we send to. So that is a new concept for them. We had the conversation of when to call your clinic visit. When do you go to the clinic versus when do you go to the emergency room? Don't go to the emergency room because you need a refill of your prenatal vitamins. ⁓ You know, those kind of things. ⁓ Really interesting because these and they had no concept. The last part of the talk, I actually brought out the speculum and passed it around, let them touch it, let them feel it, open it, and explain to them, when I'm doing a pap, this is what I'm doing, this is what we're looking for. I also brought all the different birth control options, discussed each one of those, what they do, and how our job is not to prevent ⁓ total pregnancies, but just until you you're ready to get pregnant again. Buy you a little time. And how each one works and it doesn't, those don't cause sterility permanent. ⁓ Contrary to some of the cultures out there, they will tell women that that's actually what causes sterility is being on birth control. We have a long talk about that. Allow them to ask questions. Interestingly enough, some of the older women that are in the group, ⁓ because they have been the matriarch of the group and they will tell women you can't, you you don't do birth control. I actually kind of go against some of what they've been taught and their cultural norms. So it is very interesting because some of these young girls are kind of looking at me and them and like who do I believe? I might give them information. The goal is now they're having a conversation. Leigh/@followtheleighder: That's hard. Shelagh Larson: Now they have a conversation. Even if they didn't buy everything I said, now they can go back and have conversation. They have knowledge. And that is my whole goal of those who's knowledge is power. We did these quarterly. up until the COVID and COVID came. Everybody was afraid and so they recorded me and that's where it went to so many different languages. They recorded me in English and then they can go to the Nepali, the Afghanistan, the Dari, the Karyawanda, the Swahili, the Spanish and they could break that up and have the translator do it while the video was on. So that is how it got started. so the numbers got so exponentially high is quite honestly, I don't know how many times that was translated because they now can do more one on one. And since they stopped it during COVID, I mean stopped having me come in for COVID reasons, unfortunately they ⁓ lost their grant. And so after COVID they had to fold and so we haven't been able to pick that up, unfortunately. ⁓ Another part of that was we did talk a little bit about menopause because many of those women had ⁓ no idea what that And so we did touch a little bit on that. ⁓ the beautiful thing about whole setup, Lee, is it set them up ⁓ to going now to provider and they're not afraid. ⁓ my whole, the premise that was, again, knowledge is power. but also I cannot tell you how many times I said over and over in those two, two and a half hours, I am here to support you. What you tell me, I can't tell your husband, I can't tell eyes. I am here to support you. And I think for many of those women, it was the first time they had been seen and heard. Leigh/@followtheleighder: Well, particularly if you're refugee or if you have a lower income and haven't had healthcare like that. Whatever's going on. ⁓ And there's also so many different cultures too that the husband accompanies the wife and speaks for her in medical situations. And so some of this is probably a little overwhelming or new or scary. And what you're doing is trying to empower them with information. And like you said, There's just a lot of nuance and things that folks don't consider with culture and healthcare that have been really eye-opening, at least in my travels and I'm sure for you as well. Can you talk about, wanna stay on this for a little bit longer, forgot to ask earlier. Can you talk about this Ted Cruz? Like, what did that feel like to, to like, be denied by some like, by advocating for women for over a decade and then to see like him use that, like that it just feels so dirty. Shelagh Larson: I have gone to DC 13 times to see him. ⁓ Not just him, both of our senators, my House of Representatives. Sometimes I will go see other House of Representatives. And as much as it is women's health, it's also just flat out healthcare. ⁓ Things that, you know, is non-gender, mean just flat, basic healthcare that we're fighting for. We are, I work for a county hospital and in a clinic, so I not only see the immigrant, the refugees. I also see the low or the under conserved, the under insured, and it's kind of like we're the safety net for everybody else. But during the latest cuts in insurance, we also get ⁓ in my clinic, of course, I see women in the women's clinic. We have women that have good jobs, but they've dropped their insurance and so they have to come to a county hospital. So I'm actually seeing the women that are on the Medicare, Medicaid, all of the state-funded Medicaid that's out there. And so I am speaking to those patients that they are making decisions on really at the Medicare Medicaid level. And so I know what is going on in the field. I know I'm kind of that Calvary that's having to go out and I'm coming back saying, hey, this is what's working. This is what's not year after year after year. And all he wants to do is take a picture. ⁓ Hey, just smile for the camera next. And so it's really frustrating because when you really come in there some solid concerns. And all he wants to do is take a picture and he just looks around the room and find out, you know, who's the biggest donor. And that's the one I'll talk to. It is, it is frustrating because you just sit there and shake your head. And as more and more research comes out about women's health, STDs, ⁓ that are, you know, both men and women, you're going to see how many diabetes, all of this stuff. And you're like, we have some answers for you if you would just listen. And that's what's really frustrating for a healthcare provider that's working out in the grind out there and not having your legislation, your policy makers hear what's going on out in the real world. Leigh/@followtheleighder: Yeah, and it's just frustrating overall. Shelagh Larson: But to see him turn around and use that picture, you're like, really? Because you're looking dough-like in my eyes like you're proposing, but you aren't listening to a thing I'm saying. So yeah, we had to laugh really, really hard on that one. Leigh/@followtheleighder: Yeah. Well, it's just so, it's so typical and I don't even know if his, you know, I don't know if the web person, the photographer even knew, like that, I don't even think it was intentional. I think they just saw that picture and they were like, this is great, we're gonna use it. And it was like, you kidding? Like. Shelagh Larson: Well, they didn't have my name on it anything, you know, as much as it's Ted Cruz and it's so funny because I have actually, the last few times he's run, because of his actions of when I personally have been in his presence, I have actually campaigned against him. I want somebody there that sees me and hears me. And therefore hearing and seeing what is going on with his constituents. that's the part that's really frustrating. I mean, the irony that he would choose my picture. Leigh/@followtheleighder: And folks, this isn't just like... on the website page. It's like the main photo when you, was like issues, I think was the page name. Like, you know, yeah, yeah, yeah. Or something, was just like, you know, on the tabs, or it's like about, issue, services, contact. Like you click on services and it was like, that's my mom. Like front and center, big picture. So ⁓ like, services, have you ever said, God, but, ⁓ Shelagh Larson: Services, yeah, services. Leigh/@followtheleighder: Whatever. Okay. Well, let's talk you mentioned earlier that a lot of the ⁓ refugee, low income refugee women that you are seeing are not are not familiar with menopause. But turns out a lot of American women aren't either. It's just something we don't talk about. In fact, the world really doesn't. ⁓ And it's something that every woman will like or every you know, if Shelagh Larson: Yeah. Every single woman will go through. Leigh/@followtheleighder: as long as you have a uterus, I guess, we'll go through, but we just don't know anything about it. So let's talk. What is, you did labor and delivery for a while, then you moved over to menopause. What are things about menopause that, what is it? What is menopause? Let's start there. Shelagh Larson: Well, menopause literally defined as menopause. It's a pause administration. It's when you have become your three point, if you will, your three point ⁓ self, the little girl before you have periods. I call that your one point ⁓ self. You know, back in the days, I don't know here, Barbies, dolls, the time when boys had cooties. We did not make the reproductive hormones. And then once your period starts, you have a reproductive hormones, primarily estradiol and the gesture. Women also make testosterone. It's a misnomer that men have cornered the market on that. Yeah, they make more, but women actually make testosterone too. Those hormones go together like peanut butter and jelly and bread. And then starting at about 35, those hormones decline. They decline because we've been throwing eggs out every month. to have our periods ovulation and we only have a finite number of eggs. And so when we decline, when those eggs get thrown out or when they've been used up, then our periods stop and we are no longer reproductive. We actually say after the age of 35, pregnant, pregnancy, you're at high risk. Pregnancy after the age of 35, we call it advanced maternal age. It's hard to believe a 35 year old is advanced. But if you don't like that name, we also call it geriatric pregnancy. That I don't use, because I have an image of Sarah in the Bible that's 99 and pregnant. Leigh/@followtheleighder: Right, yeah. Shelagh Larson: I don't like to use that word. But that's because we don't make the stabilizing hormones anymore because we're running out of eggs. And so you're at higher risk for miscarriages, high blood pressure, and all the safe diabetes, the baby having genetic disorders. But what the average age of menopause? Menopause is defined as one full year without a period. Average age is about 51. average range is 40 to 55. And so at any point there, is when we have run out of eggs. The problem is, that as we transform from that reproductive woman to the non-reproductive woman to that 3.0 cell, our bodies go through physical changes. Our brain goes through physical changes. We're gonna have our bones. You're going to see a lot of things happen as the body is changing. into that and many times women are given all kinds of medication by the time they get into the menopause clinic they're on something for depression, something for anxiety, something for body aches and pains, something so that they don't cough, laughs, knee and pee on themselves and not to mention they have no libido and it's crazy because this is not anything new that we've just started. ⁓ Every woman goes through it But they have been, as a culture, we actually came out with hormones in 1942 for primarin, which ironically enough, I'm sure was... probably developed by man. The reason I say that is because somebody looked at a pregnant horse urinating and said, oh, I wonder if we dried up that urine and made it into a pill and gave it to women, we quit having hot flashes. And well, what do you know? We do. And so that's prim Marin, pregnant mare urine. And now we have been giving that for decades for almost a century now and works very well. Later on in the sixties, we learned to get the bioidentical, the human actually from plants and we give them those hormones to women now for the menopausal those to help prevent not only the hot flashes which prevent sleep which make can make you anxious though and all kinds of stuff it can make social anxiety we give them the hormones to help with all that but the hormones also help prevent osteoporosis so it does a lot of things And this has been a big push. there was people, our providers, nurse practitioners, our PAs, our physicians, we were taught on it. There was a study done in the late 1990s, it started in the late 1990s, called the Women's Health Initiative. I just mentioned PrimRim. Prim was just estrogen, ⁓ worked very well, very well. Think of Oprah, you get Primrin, you get Primrin. Everybody got Primrin. It helped with hot flashes, it helped with moods, it helped with sleep, did a lot of really good things. ⁓ But realize some people have a uterus still and they started bleeding. So we had to protect the uterus with progesterone. So we add back the progesterone, this Prim Pro. That was given for decades. a pharmaceutical company acquired Premon in the late 90s. They wanted to promote it not only as a hot flash medicine, but also prevention of breast cancer, prevention of breast cancer, prevention of cardiovascular disease, as well as osteoporosis. So they had to do a study, largest study ever done on women, 162,000 women, 50s, 60s, and 70s. and half of the uterus have to not. Gave them the hormones to see how they did. The women across the board who had estrogen alone had decreased rates of breast cancer and cardiovascular disease and no osteoporosis. It did what they thought it was going to do. The women who started it within 10 years of their last menstrual period or less than 60 years old, great, decreased breast cancer and helped prevent cardiovascular disease and deaths from cardiovascular and prevents osteoporosis. But the group that were in the 60 and older that had the synthetic, the synthetic progesterone, that same Prim Pro, they found that they had one, one more case of breast cancer per 10,000, or 1,000 compared to the control group. They pulled everybody off, threw the baby out with the bath water. And it was kind of like, I always tell my patients, it's kind of like that telephone game where you tell a secret to your little kid, you know, in kindergarten or elementary school and they tell the secret and it goes around and at the end they say what the secret was or what the whisper was and it has nothing to do with what was started. It kind of turned into that. ⁓ It did not say that hormone therapy causes breast cancer. That's not what it said. It said that there was a risk for, you know, it was actually considered statistically rare. But by the time it was said and done, it was all over the place that hormone therapy causes breast cancer. Not only were physicians now afraid to use it, it is now being taught in medical schools and nurse practitioner schools and PA schools that hormone therapy causes breast cancer next. there was not, they missed the whole, the whole thing. Like that's not what it said. And so when I went to my nurse practitioner program, I got out with the intention and started straight into menopause. So that was over 20 years ago, going straight into menopause because it was so confusing. People have down babies. We know how to have babies and we know how to deliver. We got that. But nobody talks about, as you said, the menopause. And so it's just not spoken about. ⁓ Not only is it not spoken in general public ⁓ or between women, but it's not spoken in the clinical room with your provider. ⁓ Women will come in, they're like, why am I having these weird periods? Or why am I getting so? so moody and they're going to go, ⁓ you're, know, you're just a crazy woman. Here's a psychotic medicine. Here's, and not realizing, ⁓ this is what you're supposed to do. Menopause is natural, but that has been ostracized in the education. We're not allowed to really talk about it. And now it has become really big, really big. That is because the FDA came out in November. because after the WHI, they splashed all kinds of things on labels that hormone therapy causes breast cancer. wasn't true, but more importantly, also put it on the vaginal estrogen. Then that actually keeps that when the, as we age, whether we age or we're breastfeeding or we're on IUDs that have hormones or Nexplanons or depo, anything that can lower your estrogen or suppress your estrogen can actually dry up the vagina, which keeps it from getting lubricated, which maintains the pH, which also helps it kind of be thick, which means it holds that bladder up in the second floor. It keeps you from urinating all the time, frequent urinations. can cause, ⁓ encourage UTIs because the vagina has, is drying up. And not to mention you have sex, it hurts. It hurts, you're not gonna wanna do it again. And the nerves in those, in that area dry up because you don't have those big healthy cells that are supported by estrogen. They even slapped it on that. It's going to cause breast cancer. That is not true. Vaginal estrogen only works in the vagina. It does not go into the whole body. We actually give it to our breast cancer patients. We give it to stroke patients. Yes, I give it to patients that are breastfeeding and that are on hormone therapy like Depo or Nexplanon or Morena's. ⁓ So we're now learning more and more. And so the FDA They got called on the carpet by a bunch ⁓ of the menopause thought leaders and they had to come out and they did in November and said, were wrong. Hormone therapy does not cause breast cancer. It actually prevents breast cancer if started early. It prevents osteoporosis. It actually can keep your blood vessels, cardiovascular disease at bay. So now we're having this huge big comeback. In fact, right now, estradiol, we can actually give it in a patch. There is a national shortage of hormone therapy in the patch form, which women like it, and a little patch that you change twice. There's a national shortage. And we laugh because like, there's never been a national shortage of Viagra. There's never been a national shortage of Cialis. But they are like, ⁓ yeah, we're not gonna make enough. It is menopause, every woman goes through it. The difference is, Lee, you are one of the ones that is helping with this whole movement and you don't know it, is actually now women are becoming empowered and wanting to know what... I wanna know what's going on in my body. I'm tired of other people telling me what's going on. I want to know. And I think with this empowerment and this real big female movement of knowing who I am, I think we're getting a lot more people interested in it and actually trying to buck the system of you, of you know, I wanna know and what can I do? So I believe that is the big deal with menopause. Leigh/@followtheleighder: Yeah, no, it was a fantastic answer and there's a lot to pull from it. You covered a lot of ground, which was fantastic. Thank you. Shelagh Larson: long answer to that. Leigh/@followtheleighder: Like you said, there's always going to be Viagra. I know and we talked about on this channel, Project 2025 and this movement, particularly to go after birth control, IVF, menopause, like this control. And also it's very easy for men who don't value women beyond the womb to just disregard, like and disregard menopause and say, whatever. that's your son setting, why? And it's just such a manly thing to do is not care about minibus. And just such a... Shelagh Larson: mean, if you think about it, Lee, if somebody goes through menopause, let's say 38, and they live till they're 88, how many years did they just spend in menopause? I mean, on average, Leigh/@followtheleighder: ⁓ Shelagh Larson: Women in the United States have, I don't know what that looks like, but 2.1 children. ⁓ I guess those are account for miscarriages. We have 2.2 children in the United States. So we spend all that time from about the average age is about 11 to about, they say 51, fighting all of that time trying to keep us from getting pregnant. And on average, we only have about 2.2 children or two children on average. So then after that, it's one of those, so them coming out, people coming out and say, ⁓ it's contraception and banning birth control. We use birth control far more than just contraception. ⁓ Women who... Leigh/@followtheleighder: ⁓ yeah. Shelagh Larson: have polycystic ovarian syndrome, who desire pregnancy. How do we jumpstart them? Well, a of times we jumpstart them with birth control. Women that have acne, that have heavy periods, have fibroids, therefore they can't go to work, or they can't take care of the children because they're having cramps that are so bad, or bleeding that are so bad. We use those products not just for contraception. And when you have some of these corporations out there that say, we don't believe in birth control and therefore we're not going to cover it on our insurance, I have a problem with that because this may not be for birth control. This is maybe the answer that she has to enable her to get pregnant. ⁓ And so it is... It is a hard-fought ⁓ reality that we live in of misconceptions and misunderstandings of what it does. Leigh/@followtheleighder: Yeah, it's such a patriarchal bullshit thing to do to just like not care about menopause. Just to be like, well, it doesn't have anything to do with me and it's not making more babies. Go F yourself. Shelagh Larson: Yes. Well, let me ask you, what is it called when you remove the uterus, when you have your uterus removed? What's that called? Uh-huh. Which literally translates into the removal of hysteria. We still have that name. That was done in the late 1800s when they thought if you took a woman's uterus out, we'd no longer be crazy. Leigh/@followtheleighder: hysterectomy. Shelagh Larson: I don't know why because that obviously is not the case. they remove, when they, man gets a vasectomy and just, and therefore can't have children, that thing he's removing is his vas deferus. It's called a vas, it's not a dicectomy. And so why is it weird, his direct, why is that name still out there? In animals, we call it a uterectomy because we're removing the uterus, but they still call it a hysterectomy, removal of hysteria. Leigh/@followtheleighder: Hmm? ⁓ We're too emotional to lead, we're clearly, but we're in a holy war right now and Trump's out here tweeting that he's gonna nuke a civilization, but we're the hysterical ones. ⁓ Who was it that started every war? The women, famously, right? All the matriarchy? No, not at all. Shelagh Larson: Yeah Well, quite honestly, if they let a bunch of menopausal women get out there, this would have been over a long time ago. Leigh/@followtheleighder: My God, every, you imagine if a bunch of menopause of women around the world were leading, you know how good our schools would be, like our healthcare, like gardens, farms, like move, right? ⁓ man, yeah, think about it a lot. Well, and that's the thing too, is menopause is so just not. Shelagh Larson: Yeah. Leigh/@followtheleighder: You know, there's a lot of misconceptions, a of confusion. You have worked in both the very like clinical medical space you have. You've worked for pharmaceuticals, you've worked for birth control, but you've also worked in the natural holistic homeopathic space. And so you're not like you now, how does that impact your caregiving as a medical provider having walked in both spaces? Shelagh Larson: Yes, I have. I am, have been, still are. I'm a speaker for pharmaceuticals. Yes, I have done that. I am doing that. I have some women who don't believe in hormones for that medical. They just want to know. They all come into my clinic and say, tell me what's going on. I don't want anything. I just want to know what's going on. The problem I'm finding is, and again, I see some of the patients that slip through cracks. They're the under-insured. They may be the refugees. These women are not, I've got plenty of them that are college ⁓ and multiple degrees, but I have some women who are not. It is very hard because culturally I'm having to go against what they have been taught in their culture for a long time, long seated cultural norms that they have. ⁓ I have women that come in at, I don't know, 53 and not having periods anymore and they are so concerned because why is my pregnancy test still negative? I mean, I'm not having periods. They don't even know that this is such a thing that we actually stop having periods at a while at some point that at some point you are no longer reproductive. And that's a hard conversation when these women realize that they no longer can have children in some cultures, if a woman is no longer able to have children, the men are allowed and it is okay for them to marry a younger woman to carry on his lineage. ⁓ and the woman that is now the older one, she has to take care of this younger woman's children. So it is very difficult to have that conversation. It is, but you also have to meet them where they are. You come in with all this high tech, high education, know, pharmaceutical mumbo jumbo. they're just thinking you're pulling one over on them. So it's really a situation where you gotta look them in the eye, you gotta sit down at their level, there is no standing up and talking. You sit down and just have just a conversation and just, and let them know this is what's going, this is what is happening. And it's not that you have gone crazy, it is not that you are, A lot of them will come to me, the menopausal, and think I'm crazy. I feel like I'm crazy. I've lost my job. My husband's left me because I no longer find him sexually attractive or I no longer want sex or I can't get out of bed because I'm so depressed or anxious. A lot of things happen. Jobs are lost. Marriages are lost. ⁓ during this time and most of it's because of misunderstanding. And so it's my job not to judge. You know, you don't know what they were brought up with and just to inform and give them options. ⁓ What are you gonna do? Okay, if you don't wanna take medications, what can you do? And those women that don't wanna take, I just talked about vaginal listerine, one of the best things out there that you can use is probably in your cup or right now, if you have dryness with sex, is coconut oil. Good old fashioned Walmart brand. Doesn't need to be extra virgin, you're not. ⁓ coconut oil and we use that all the time in our business. Leigh/@followtheleighder: Yeah. Well, and you talked about how a lot of refugee cultures, like you said, a lot of low income, a lot of refugee folks come through in these seminars and then also your clinic. ⁓ But it's also not like just low income or cultures. mean, like the trad wife, white Christian woman denouncing birth control Eve, think it's Evee Christian magazine is one of like the most popular American publications right now. It's a Christian woman's Shelagh Larson: Yeah. Leigh/@followtheleighder: heavily sponsored by the way guys by Palantir Peter Teal you know how much I hate that man ⁓ Peter Thiel is the guy behind Palantir, named after Lord of the Rings, all seeing ball of wisdom. Anyway, AI Data guy out here sponsoring articles in EV Christian Magazine to not use birth control. And ⁓ so there's a lot of information out there that is peddled by men ⁓ in Christian white spaces of telling women not to use Western science And I think like the problem is, as someone who's had my own journey with Western medication, is like there is a, it's hard to find the right hormones for you. And it's messy and it sucks and there's, it's a whole struggle. And yet, We have come so far in our understanding of the woman's body. ⁓ Western medication has done so much for us and then it's also just been such a challenge. What ⁓ a mess, what a nightmare. You talk about the cultures and the refugees on that side, but I, know, up here in Montana, we hear it up too. We don't see as many refugees and it's very sparsely populated, but we have the same concerns of wanting a more natural approach or having concerns about quote, what's in it, you know? And... It's just, it's just a tricky thing. And the best I want to do is just make sure that every woman knows as many options like for herself. Like if she wants to track it using the moon. Okay. Like I, I, I, I, and, or, you know, have, I know some people are using apps. I'm a little scared to use apps like with privacy and data and all that. But, ⁓ that there's, there's just so much about our own bodies that we're learning. And it's important that people like you who have that kind of knowledge in both the natural space and the quote, pharmaceutical space, like that stuff is critical. I wish more people on both sides had holistic training like you had and exposure. I wish more, you know, and I think that's really. It's just good good service good health care to know like what can I do naturally and what can I do? And we'll get with my body just not doing that. We need to get the lab involved, you know, and So it's amazing You talk Shelagh Larson: Well, what's really crazy is a lot of times we a lot, we spoke earlier about birth control, birth control. lot of people do, I'll do birth control. I'll do birth control pills because they'll say, cause I heard hormone therapy causes breast cancer. Birth control pills are five, five times the concentration, minimum of five times the concentration of what's in hormone therapy. And so I'll ask these ones, I how long were you on birth control? ⁓ I was on it 20 years. Uh-huh, did you get breast cancer on that? Cause that's twice the amount. Well, I heard that this is, yeah, it is different. It is a fifth of the dose that is in birth control. And they're like, well, I didn't know that. And not only are we having to tell patients what this is, but also we're having to tell our own providers what it is ⁓ because they don't realize, wait a minute, those are kind of the same thing. They're just big sister and little sister, if you will, and how to use it. ⁓ So not only is the woman confused, our providers have been confused because we have not really been taught anything on menopause the last 25 years since this study came out. I hormone therapy, menopause, education for providers literally just got squashed. And it's the demand of the woman nowadays that are lanking. I'm demanding to know what's going on and many times they're going to their provider and they're like, I don't know because I wasn't educated in it. Leigh/@followtheleighder: Well, we are coming up to towards the end now. Can you tell me or the audience listening, what do you wish every woman aged 35 and over knew? Shelagh Larson: Well, if it's gonna be on menopause, well, you can still have babies. If you are having periods, you can still get pregnant. ⁓ you get closer to 40, they're going to be harder and harder, but there still is a chance. Some women think in my mind, I think I'm too old to get pregnant. So ⁓ therefore I am not going to get pregnant because mind over met. That does not work. If you're still having periods, technically you can still get pregnant. Hormone therapy. When you start seeing heavy periods, when you start seeing a change in your periods, whether it's coming longer or they're all of a sudden it went from 28 days to now 21 days, and then it goes to twice a week, or twice a month, and then you're having those irregular. You have started the perimenopause natural transition. It is natural, unfortunately. It is not pain-free. It is very confusing because it affects the brain. It affects your bones, your joints, your blood vessel, your skin, your hair gets thin. There's a big transition. And I want women, instead of going out there and thinking they're crazy or reaching for everything, because I've had some women that come in with literally a bag of stuff off Amazon, quit buying all that stuff off Amazon, please come in and talk to us because you have spent more on that stuff than you will if you come to and talk to a provider and get the real truth and find out what's going on. Many times we have find that just giving back just plain old good old estradiol and we give bioidentical, the stuff your ovaries make. that that actually is better than doing a bunch of antidepressants, anti-anxieties, which those can make you gain weight, kill your sex drive, which then again makes you gain weight and then even kills it more so. And so we get in there and hopefully realize that life isn't over when you become menopausal. Unfortunately, the second highest STD rate is in some of those senior women because now they're like, I can't get pregnant. They're like, woohoo. yeah, so yeah, you can still get STDs too. So you may not get pregnant, but you can still do that. And life is really good. We have a lot of knowledge and there's a lot of us out there that do this for a living and take care of those women in that transition. Leigh/@followtheleighder: ⁓ no. Yeah. Shelagh Larson: this transition a lot longer than you are having babies. so, embrace it. It's part of it. Every woman goes through it. Every woman goes through it, but just at a different degree. And so, at 35 years old, this is what's coming somewhere in the next five years, it's coming to you, is the hot flashes, the brain fog. the body aches, lack of sex drive, inability to fall asleep or stay asleep. Those are all symptoms that to us is natural. We're like, yeah, yeah. I mean, I've had some women in my visits that are 30 minutes long and they cry three times. They're like, where is this coming from? And I'm like, and I explained to them, it's everything going up and down as you're trying to transition over. It's natural. We don't have to put up with it. But what you're doing is we see all the time. You're not crazy. You're not crazy. Leigh/@followtheleighder: Thank you so much. How can people learn more about you or follow or yeah, how can folks know more about you, Dr. Shelagh Larson? Shelagh Larson: Well, I actually do a lot of conferences. In fact, I'm in the middle of lunch break right now. I'm in a conference that I'm getting ready to speak on here in just a few minutes. I'm talking about menopause in these different clinics and our struggles, ⁓ not only with the culture, but also with our own providers that don't believe in menopause. ⁓ You can also, if you're out there and you're like, I'm going through menopause, how do I find a provider that is actually trained in this? Because that's the other thing is you can actually go into the Menopause Society. Don't work for them, I am board certified for them. The Menopause Society and look up, they have certified providers on there that you can find in your state or in your area, just put in your zip code and you can actually find one that is actually certified in Menopause. That's one of the things that you can do and mostly is look at some more, ⁓ I wouldn't believe everything that you're gonna read on TikTok. ⁓ Thanks for coming to this one. ⁓ you know, go in and look at some medical societies and look up some actual guidelines. There are plenty of guidelines out there on true what is going on in menopause and be educated. Be educated. actually, like I said, I've got a couple of chapters of books. I've got one textbook. I've got three chapters in this one. I've got another one that's getting ready to come out so you can read books about it. Power is knowledge. Just like I tell those refugees, power is knowledge. And the more you know and make sure it's from a reputable source, the better you're going to be. Leigh/@followtheleighder: Do you have a social media or a website that folks can follow you on or read more about you if they would like to follow up? Shelagh Larson: I think you did it and it was like, um, Dr. Shelagh, Dr. Shishi. Leigh/@followtheleighder: yes. ⁓ ⁓ remember your Instagram handle. It's Dr. Larson in P or something. Is that? Okay. Well, cool. That is a lovely ⁓ conversation today. you, mom, for coming on and sharing ⁓ how... ⁓ Shelagh Larson: Yes. Yes. Leigh/@followtheleighder: misinformed. So many of us are on our own bodies. I hope you'll come back. We'll do more questions. Simply an hour is not enough time, but I really appreciate you and you hanging out with me in the middle of your conference. thank you. Thanks for coming on, Alrighty, folks. So that was another episode. Shelagh Larson: Love you, Bye, guys. Leigh/@followtheleighder: That was another episode of Follow the Leighder. I'm your host, Leigh Larson. Let me know what you thought of that. Let me know in the comments. And make sure you like, follow, subscribe, you know the drill. And until next time, I'll see ya. Bye bye.