What is Perimenopause and Can We Make it Easier?

Perimenopause has long been misunderstood and understood, but new research indicates it impacts health in a multitude of ways. Anney and Samantha shift through fluctuating beliefs, recent research and potential ways to improve the situation.

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Episode Transcript

Speaker 1 (00:05):
Hey, this is Annie and Samantha, and welcome to Stuff
When never told your protection of iHeartRadio.

Speaker 2 (00:18):
So today Annie, we are doing a selfish episode one
that is something I'm trying to figure out, and I
feel like if I'm dealing with this, and there's probably
a lot of us who's dealing with it in general,
especially if you've been with us for a while. If
you've been with Stuff, well I've never told you, you've
been a listener, you've probably experienced this as well, or
already experienced it or again experiencing it as we go along.

(00:43):
So we are talking about the world of perimenopause specifically,
and originally I was going to do perimenopause and menopause,
but actually this episode again grew into a bigger so
menopause will be its own episode, not right now, not
in the episode, as well as probably the drug industry
profiting off of perimenopause as we speak, and things like HRT.

(01:05):
But we are also going to talk a little bit
about periods as well. And please note that a lot
of the reports and the way we're speaking it is
in gender binaries. We absolutely acknowledge that trans women are women,
and we are including TRANSMN as well, but the way
the reports come out and saying the words like female women,

(01:25):
biologically female, all of that, it is a.

Speaker 3 (01:27):
Part of that report.

Speaker 2 (01:29):
And sometimes it's just really hard to navigate when we're
talking about uteruses in general. But typically we are talking
about anybody with uterus A and those I guess who.

Speaker 3 (01:40):
May not have You know they have uterus, Yeah, no,
they don't. If they have hysterectomy, they don't write.

Speaker 2 (01:45):
Yeah yeah, some people who may not have uteruses anymore,
but understand what we're talking about. So it is all inclusive,
and I have talked about it a bit before.

Speaker 3 (01:57):
I believe I am.

Speaker 2 (01:59):
Quickly approaching the time frame of perimenopause if I'm not
already in it, And if you're over the age of
thirty five, you may be dealing with it as well.
But you just don't realize that although the average age
of perimenopause is around forty seven, that doesn't mean it
can't happen at a younger age, and it does. As

(02:19):
the average age of menopause is in your early sixties.
I believe there have been cases in which premature menopause
has occurred, and those as the youngest in their twenties
and we're going to talk a little bit about that
in a bit. And early menopause is considered around forties.
So that's how they kind of differentiate the types or
how age.

Speaker 3 (02:40):
Frame, timeframe of menopause, I guess.

Speaker 2 (02:42):
And as we mentioned before, we covered it before with
a Monday Mini a couple of years ago. I know
the show has talked about periods in many ways. I
don't think we've actually broken down periods as a show.
I was going back through some of the old stuff.
It is like specific subjects pertaining two periods, but not

(03:04):
necessarily the overall. So that was something like, maybe we
should talk about some of that because we've talked about
the taboos of.

Speaker 3 (03:11):
Having periods and all of that.

Speaker 2 (03:13):
I think we've talked about indimitriosis, which is kind of
pertaining to that as well. So there are definitely episodes
that we've done, but not necessarily in a broader aspect.

Speaker 3 (03:21):
I will say we've even talked about it as a
horror movie trope.

Speaker 1 (03:25):
We have one of my best puns a period piece.
To this day, sometimes I'll think about that and be
like Chef's.

Speaker 2 (03:33):
Kiss, I'm glad we got to revisit that that's a
good one. Yes, And as we did this with the
Monday Mining because I was like, Hey, this is might
be me coming up. We're going to talk about it
more in depth in this episode. And we actually had
a guest on last year, doctor Sharon Malone, who is
a certified menopause practitioner OBGYN, who mentioned HRT on their

(03:57):
episode with us, and I feel like.

Speaker 3 (03:58):
We might need to bring our back on one day.

Speaker 1 (04:01):
Yes, because she mentioned, yeah, wanting to talk more about this.

Speaker 2 (04:05):
Yes, And at that point I was like yeah, yeah,
and then kind of bypass because we had such a
great conversation with her in general about her show that
we were like, oh, and now that we're coming back
to visit, I'm like, you know, we really need to
have this conversation, especially because the industry feels predatory.

Speaker 3 (04:20):
Once again, we're not talking about that yet.

Speaker 2 (04:23):
That's probably gonna be an episode in it self in
general about women's health and pharmaceuticals taking over and profiting
off of that.

Speaker 3 (04:32):
But it is.

Speaker 2 (04:33):
It's kind of harder to navigate, as I've learned recently,
trying to get all this information because people are really
good at manipulating conversations. Slash statistics in order to get
you to buy their products. Yeah, and you know what,
at this point, I am desperate enough for some of
these symptoms to be gone that I would try anything.

(04:56):
This is how they get you. This is how they
get you. But again we'll talk about that a bit later.
In a reminder, we are not doctors. We don't have
any medical expertise. Do not take anything we say as
an expert, advice or expertise in any way, shape or form.
We are learning just like you, which is why we
wanted to do episodes like this.

Speaker 3 (05:17):
But you should definitely.

Speaker 2 (05:18):
Talk to a doctor if something like some of these
things are concerning to you.

Speaker 3 (05:23):
I think it is absolutely great.

Speaker 2 (05:25):
Also one of the things that we hope we're able
to help you with as well as that you will
do for yourself. Advocating for yourself is important. So understanding
some of these things is important as well. So do
your research too, because sometimes the doctors might just say, eh,
I don't think that's it and then dismiss you, which
happened to me. So moving on, which is also why

(05:47):
pharmaceyal companies are making make.

Speaker 3 (05:51):
Okay.

Speaker 2 (05:51):
So that is your reminder. I'm sure I have to
say it again towards the end of the episode. So,
as per usual, Annie, let's do some definitions. You're ready, yes,
So what is perimenopause? From the Columbia University Medical Center
site CUIMC, Columbia dot ADU, they write, Perry means near
in perimenopause is the time of transitioning from having regular

(06:14):
periods to having none. In menopause, the end of menstrution
reflects at the end of ovulation, when the stop releasing
eggs and estrogen production slows.

Speaker 3 (06:23):
Changes occur throughout the body.

Speaker 2 (06:26):
So with that, it is about the transitioning oftentimes has
been referred to as the transition the change, because you
are not exactly done with your period, and you feel
like you're constantly pmssing maybe or going through some of
those symptoms and you're probably spotting. You may have like
one period or a long time and then nothing for

(06:46):
a couple of months. This could be a part of
that period. And they go on to explain that this
is a gradual process that happens to different people at
different speeds, so essentially it could happen within a year
or five. Yeah, that is so fun. And even though
we're not going to talk much about it. We are
going to tell you what menopause is because we are

(07:07):
obviously going to refer to it. According to the National
Institute of Aging, it is quote menopause describes the stage
of women's life when her menstrual periods stopped permanently and
she can no longer get pregnant, and a bit more
from the World Health Organization quote. Menopause is marked by
the end of monthly minstration, also known as menstrual period
or period, due to loss of ovarian follicular function. This

(07:29):
means that the ovaries stop releasing eggs for fertilization. Natural
menopause is deemed to have occurred after twelve consecutive months
without menstruation for which there is no other obvious physiological
or pathological cause in the absence of clinical intervention. Menopause
can also be induced as a consequence of surgical procedures
that involve removal of both ovaries or medical interventions that

(07:52):
cause cessation of ovariant function, for example, radiation therapy or chemotherapy.
So I wanted to knowledge that as well. Sometimes the
abrupt thing, the minstrual abrupt is because of something outside
of your biology, meaning you've had some type of surgery,
you've had hystori direectomy, you've had chemotherapy, or any of

(08:13):
those types of things that have caused what they would
call menopause. Okay, be there, all right. Postmenopause also, we're
going to refer to it. From Cleveland Clinic, postmenopause is
the time after you've been without a menstrual period four
twelve months and it lasts for the rest of your life.
And I believe I was told it is lovely because

(08:34):
you kind of finally bypass those stages of all of
those symptoms and such stupid ovaries.

Speaker 3 (08:40):
I'm just kidding. Your body is wonderful. My body is wonderful.
Everything is fine.

Speaker 2 (08:46):
So another definition we want to talk about is hormones.
This seems like a no brainer. I think we need
to talk about what exactly it is. So from another
article from the Cleveland Clinic site, they say, hormones are
chemicals that coordinate different functions in your body by carrying
messages through your blood to your organs, skins, muscles, and
other tissues. And for this specific episode, we're talking about

(09:07):
female sex, organs sells growth. Saying that again, I'm saying
it clinically just fy from Morelando obgyn dot com. Female
sex hormones estrogen and progesterone have the most significant effect
on a woman's health from menstruation to pregnancy, to menopause
and more, but your body makes and utilizes a variety
of other hormones that affect other aspects of your health,

(09:28):
from your energy level, weight, mood, and more. Before I
read this definition again, binari gender binaries, I'm so sorry.

Speaker 3 (09:35):
Anyway.

Speaker 2 (09:35):
Estrogen is responsible for the physical changes that turn a
girl into a woman doing puberty, including breast development, growth
of pubic and underarm hair, and the start of minstral cycles.
Aside from estrogen's obvious importance to childbearing, it helps to
keep cholesterol in control, contributes to protecting bone health, and
affects your brain including mood, heart, skin, and other tissues
throughout the body. So a bit more detail about its function.

(09:58):
The primary source of estrogen in women is the ovaries,
which produce women's eggs. However, your adrenal glands, which are
located at the top of each kidney, also make small
amounts of estrogen along with batty tissues. Estrogen moves throughout
your body in your bloodstreams and acts everywhere throughout your body.
Estrogen levels change throughout the month and are highest in
the middle of your mentrual cycle and lowest during your period.

(10:21):
At menopause, estrogen levels drop, so that's really important obviously.
So Progesterone as a steroid hormone secreted by the corpus luteum,
a temporary integrine gland that women produce after ovulation. Progesterone
prepares the endometrium, the lining of the uterus, for the
possibility of pregnancy. After ovulation, progesterone works to encourage the

(10:41):
lining to accept a fertilized egg while prohibiting non painful
urine muscle contractions that may cause the body to reject
an egg. If a woman does not become pregnant, the
corpus lutum breaks down, the progesterone levels decreases in the body,
causing the woman to menstrate. In the event of pregnancy,
progesterone content used to stimulate body vessels in the indometrium

(11:02):
that will nourish and support the growing baby.

Speaker 3 (11:06):
Okay, so we're just talking about that, and we're going.

Speaker 2 (11:08):
To talk a little more about other hormones later on
in our conversations about perimenopause, but just those are the
two to keep in mind. HRT hormone replacement therapy are
also known as the menopausal hormone therapy MHT, is a
quote treatment that helps people with symptoms of menopause. So
a bit more from the Cleveland Clinic dot com. Hormone

(11:30):
replacement therapy HRT helps treat symptoms of menopause like vaginal
dryness and hot flashes. HRT replaces the hormones that your
body isn't making enough of. In talking about this type
of treatment, there are a few types of treatment revolving
around HRT, and also should be noted that it is
considered only HT when receiving the treatment after the age
of fifty, so that replacement part comes out. Some people

(11:52):
have been saying restoration, so it could be hormone restoration
therapy I have. I'm typically hard it as hormone replacement therapy.
This may be one of those add things that people
are trying to do to make it sound more feminine.

Speaker 3 (12:06):
I don't know.

Speaker 1 (12:07):
Yeah, it sounds very marketing heavy, yeah to.

Speaker 2 (12:11):
Me, which, by the way, that should be another caveat here.
As much research as I'm trying to find through clinical
researchers and such. I get as much from like essentially
sites that are trying to.

Speaker 3 (12:23):
Sell you things.

Speaker 2 (12:24):
They do have good bits of information and I do
think it's important, but just again one of those things like,
don't take advice from us. We want to educate you
so you can go and ask the right questions, you know,
But we are not doctors, we are not experts, and
we might be getting things that people trying to sell
you stuff, so be careful. Yeah, we're going to note
those by the way.

Speaker 1 (12:45):
Oh yeah, and it's like what we talked about in
our codependency episode because I had.

Speaker 3 (12:50):
A similar vibe.

Speaker 1 (12:52):
Yeah, do your own research, but be aware that a
lot of these places are trying to sell you something
and that could just be it the idea that something's
wrong with you need by their products.

Speaker 4 (13:03):
Yeah, like a body pillow, Yeah, yeah, which you know
I might need one for my knee because the little
small knee pillows are not helping anyway.

Speaker 2 (13:13):
Moving on, Okay, so with that out of the way,
let's talk about it. When it comes to periods in
women's health in general, we know that science and research
is very far behind, and it's even worse when it
comes to science and research on things like women's pain
or discomfort or comfort. The old adage that women deserve
pain when it comes to reproduction has had more influence

(13:35):
than people may want to it. Men, we've talked about
this with the e curse, and it's it's been a constant.
It's a trope that will not let go, and science
has also cloned to it for a while now. Now
that isn't to say that periods haven't been studied. It has,
and a wonderful misinformation spread because of that. And we
want to talk about some of this misinformation. So from

(13:57):
Historycolorado dot org. They include some great ones, like hypocrisies
saying women on their period could sink ships, tarnish silver,
and kill a livestock or plenty the philosopher to cause
infertile seeds, so killing crops, kill so many more things
like flowers and grass, and even cause dogs to go
out of their minds. Oh and the bees. Somehow this

(14:19):
really affects the bees, like it kills all the bees,
according to several philosophers.

Speaker 3 (14:26):
I love bees.

Speaker 2 (14:28):
I didn't understand, but sure, okay. One of the first
noted studies was found in eighteen seventy seven by doctor
Mary Putnam Jacoby, who wrote a prize winning as they
titled the Question of Rest for Women during Administration, where
she argued with someone who has said women were not
fit to work while on their period. So during her time,
another scientist had written that women were not fit enough

(14:48):
for higher education because of their periods.

Speaker 3 (14:51):
So this is.

Speaker 2 (14:52):
From WIMLF dot com. They wrote when nineteenth century physician
Edward Clarke argued that women were not suited to higher
education and to do their quote periodical tides and reproductive apparatus,
he was merely expressing a belief common among medical professionals
at the time. The notion that women, especially while on
their periods, were weak and prone to various physical and

(15:12):
psychological woes, including infertility, was widely held in the medical community.
But doctor Jacoby was able to prove him wrong with
a quote scathing rebuttal claiming that his research lacked proper experimentation,
employed embellished facts, and was swayed by non scientific interests. Yeah,
as in fact, there was no real evidence outside of

(15:34):
those theories that we talked about earlier that he had
put in there. What we really know as per usual
it was that men just did not want to share
space with women. I will say I think doctor Jacoby
was the second woman to become a doctor in her school,
so like she was already doing some things and the
first woman was someone that she was learning under. Like
they were making history and men were not having it.

(15:56):
So she did this essay and it won her awards,
like they were like, oh okay, cocoa cool, you really
are smart, will allow you. Of course, as a white woman,
she had a little more privileged, so I hope she
put her power to good.

Speaker 3 (16:09):
But at least this was good.

Speaker 2 (16:12):
We're gonna give a credit for this specific moment, right,
And because many still held onto their theories instead of
actual research and science, this was the thing. In fact,
it was used as a way to shame women from
furthering their education and just stay at home, even up
until the seventies.

Speaker 3 (16:27):
Yeah, we know, we know.

Speaker 2 (16:28):
It was real gross, right, And though we aren't focusing
on periods this time around, which I think we should
come back to. Like I said, I felt like we
need to get a little more nuanced about periods because
we seem to assume we know everything about We know
as much we can, especially since we've experienced it. But
we've talked about how like, oh, period pain should not

(16:48):
be this painful. There's something wrong when it's this bad,
when the clotting is this bad, and we've never really
talked about it. So I feel like we do need
to come back and address it, but we're going to,
like I said, touch on it a little bit. It
is some saying to note that even within this decade,
women are still shamed for anything related periods, whether it's
the products, PMS or even the actual pain. The Conversation

(17:09):
dot com writes this in their articles titled dirty Red
How periods have been stigmatized throughout history to the modern day.
A twenty eighteen survey found that seventy nine percent of
girls and young women had faced symptoms linked to their
period that concerned them, but they hadn't seen a doctor
or a health professional. Similarly, statistics from charity Indimetriosis UK

(17:30):
revealed that sixty two percent of women aged sixteen to
fifty four would put off going to a doctor with
symptoms of indomatriosis because they don't think it's serious enough
to bother a doctor with, or they're embarrassed or don't
think they'd been taken seriously. Or think symptoms including painful periods.

Speaker 3 (17:47):
Are normal.

Speaker 2 (17:48):
And again, I know we've had a past episode about indimatriosis,
and I'm glad we definitely need to revisit that conversation.
But the fact that in twenty eighteen women still fel
that way, and I bet even I mean even today,
those eight years later, that's still a conversation. We do
not think that it's a big deal, or we think
is normal. Crying on the floor and having to take

(18:09):
a day off seems to be normal, and that it
shouldn't be. It isn't and it isn't hard to understand
how shaming and misinformation like this may also cause studies
on later in life stages to be impeded as well.
That same attitude is it's just normal, instead of understanding.

Speaker 3 (18:26):
Maybe not, maybe not.

Speaker 2 (18:28):
And one of the things we do want to return
to is the conversation about heavy minstral bleeding and irregular
administration is associated with cardiovascular disease, because I don't think
we're talking about this enough. From a study title Association
of heavy mistral bleeding with cardiovascular disease and US Female Hospitalization,
which is published in the National Library of Medicine, they
write heavy minstrual bleeding or HMB is a common minstrel

(18:50):
disorder associated with multiple risk factors of cardiovascular disease CVD
and women, and in its conclusion, they write this HMB
was strongly associated with CVD the outcomes regardless of obesity,
metabolic disorders, hormonal use, anemia, and uterine fibroids among US
hospitalizations of young women. In addition, HMB without im or

(19:11):
irregularminstration was profoundly associated with most CBD outcomes among US
hospitalizations of young women. So it is common, it is common,
and this is the problem that we're having because we
also are not talking about what is normal in bleeding.

Speaker 3 (19:26):
I don't think we just assume.

Speaker 2 (19:28):
Of course super flow this, that, and then you move
on because it's too stigmatized and no one's gonna know,
because how would they unless you told them right, Instead,
you try to hide it. And some more information along
those lines, there are studies that show that women whose
first menstruation was that ten years or younger are at
higher risk of cardiac events. So this is from a

(19:52):
US Health dot Org. Their study found that women whose
first menstruation called monarchy was at age ten or younger
had a fourfold higher of adverse cardiac events. That is
compared with those whose monarchy occurred at the US average
age twelve. For women whose monarchy came at age fifteen
or later, that risk was elevated two and a half times.

(20:13):
These are signs that we are not talking enough about
and when we don't get the history because I don't
think I've been asked the past few times that have
gone to a doctor's appointment or when I've gone to
an obgyn appointment when my first administration was do you
get this question?

Speaker 1 (20:28):
Oh no, I've never gotten ever gotten that question, And
usually yeah, they asked when your last one was. But
I feel like that right mostly to figure out if
you're pregnant exactly exactly, so they don't care about it.

Speaker 3 (20:39):
They don't.

Speaker 2 (20:39):
We are. So we also know that like heart cardiovascular
disease and heart disease was not attributed to women like
people were like women don't get that and then realize, oh,
that's one of the number one killers of women. This
might be a link to that number one killer thing,
and we might have early alerts if we need this
type of information or if we were aware ourselves, because

(21:00):
how is the doctor going to guess when our first
period was right, and they don't. If they don't ask us,
how are they going to know? So these are some
of those questions like, oh my god, this makes sense.
And add to that, administrating can exacerbate some conditions, including
asthma attacks, IBS, diabetes, and even increased seizure activities like
these are things that happened that we know a lot
of people have, and then those moments of being on

(21:20):
your period can exasper exacerbate those moments and we're not prepared.

Speaker 3 (21:26):
How are we supposed to handle that? Did you know
any of these any? No?

Speaker 1 (21:29):
I didn't know any of this. I think the only
thing I've known about my period outside of you know,
your body is changing and pregnancy health item that I
knew was it can impact migraines because that's they gave.
They put me on birth control for migraines, and that.

Speaker 2 (21:51):
Like acne acne right right, and those are the two
things they put you on birth control for. But these
linkages to caro vascular disease has been around. I believe
one of the studies I just talked about was from
twenty eleven. So there's conversations that have been had but
no one's really recognizing it's like, whether it's used to
its full potential for us to talk about, Oh, these

(22:13):
could be things that could be why I've experienced these things.
And as we talk about it more in a minute,
the loss of estrogen can also increase your risk of
cardiovascular disease or heart related incidents.

Speaker 3 (22:25):
So you're like, what this doesn't we're screwed all together. Sorry,
that's not the way I wanted to go.

Speaker 2 (22:33):
But yeah, so again we're not going to go into
this too much. But obviously with just that bit of information,
there's a lot to be said. So we really should
be looking into what this looks like and having people
have this thorough conversation so that we, as the people
having periods, are able to advocate for ourselves to be like,
these are things that have concerns about. What do you
think if you have symptoms of heart problems And we're like, wait,

(22:57):
maybe it's because of this this knowledge could help us. Yeah, no, maybe,
so let's talk about perimenopause. So perimenopause wasn't recognized until
the seventies, as it was often still referred to and
it is still referred to as the change I really
love like the drama of it, the che have you
gone through the chase?

Speaker 3 (23:18):
Going through the chase?

Speaker 2 (23:20):
I've heard that a feel and actual research didn't start
until the eighties. So from health dot Yahoo dot com quote,
it was in the nineteen eighties that there was more
medical documentation of this time before menopause, and the term
perimenopause was added to the scientific literature. Doctor Andrea Kamano
tells a flow space and while the conversations can't be
attributed to one person, expert say that doctor Wolfe H.

(23:44):
Union is a familiar name in the space. He conducted
extensive experiments in the nineteen eighties and is recognized for
helping to distinguish perimenopause from menopause.

Speaker 3 (23:53):
Again, I think that's important in knowing your stages.

Speaker 2 (23:55):
Right now, the exact timing of the study of perimenopause
or history of it doesn't seem to be important enough
to be easily found, I will say, because I was like,
oh no, I can't. I don't know where this information
is coming from. But the idea and the understanding have
been around for some time. Again, oftentimes referring to that
timeframe as the change or transition, and just to note premenopause,

(24:17):
which is confused for perimenopause, actually is a reference to
the time of your first period to perimenopause, so that
during that stage just pre menopause, so your actual period times.

Speaker 3 (24:28):
During this phase.

Speaker 2 (24:29):
There's a lot of known and unknown symptoms, so let's
go over some of them. Ones you may be familiar
with include night sweats, hot flashes of moodiness, low libido,
and irregular or lessened periods. And though hot flashes or
vascomotor symptoms are experienced by thirty to seventy percent of
perimenopausible women, which by the way, that's.

Speaker 3 (24:49):
A giant gap.

Speaker 2 (24:51):
Like estimated numbers, not much is actually known about these
hot flashes, which is the other part of the language,
which by the way, can also be attributed to why
you might have heart palpitations these heart flasters. Apparently it
can be treated with the catch all drug gabapentin, which
has been used for everything. At this point, like, I

(25:12):
am very confused what gabapentin is because I've been on
it for nerve pain, but it's also for seizures, it's
also for apparently hot flashes.

Speaker 3 (25:22):
What what is this medication? Anyway?

Speaker 2 (25:25):
Here's some information from a twenty sixteen study titled Perimenopause
from Research to Practice quote, hot flash prevalence and perhaps
effectiveness of treatment varies by race and ethnicity. African American
and Native American women appear to have the highest reporting
of hot flashes. In the Swan study, which is one
of the studies that they use for perimenopause, Chinese and
Japanese women had lower rates of hot hot flashes reporting

(25:47):
and a shorter overall duration of hot flashes. As a
Korean woman, I've experienced them already, so I don't know
if I'm a part of this.

Speaker 3 (25:56):
These groups.

Speaker 2 (25:58):
Body size also affects the survey in frequency of hot
flashes reporting in a complex way. So women of high
body mass index B and my report worse hot flashes
when they are perimen apozzle, but fewer and milder hot
flashes once they're postmen A puzzle which is interesting to
me because I feel like it would have been I

(26:18):
guess I would make sense actually, because like during the
worst part of the stages.

Speaker 3 (26:22):
So yeah, okay.

Speaker 2 (26:22):
Although hot flashes are believed to be related to the
withdrawal of estradal epidemiological studies which examine extra dial annually
do not demonstrate a low relationship to extra dil but
elevated f SH, which is a predictive.

Speaker 3 (26:35):
Of hot flashes.

Speaker 2 (26:36):
And we're gonna talk about FSH in a minute, because
it's another.

Speaker 3 (26:39):
Hormone in there.

Speaker 2 (26:41):
They think they know, but they don't quite know. And
apparently it's not just annoying but bad for you. Again,
from that same report, Apart from their bother hot flashes
may have implications for women's health, hot flashes have been
shown to be linked to reduced heart rate variability HRV,
a marker of vagual control, the loss of which is
associate with increased a cardiovascular disease risk.

Speaker 3 (27:02):
Once again, y'all, we are in danger, not scary or anything.
I know.

Speaker 2 (27:10):
I feel like everything is associated obviously with the blood
and the heart, and that makes sense. But damn, I
really did not put these together and like it did
not compute to be like, oh wow, this is this
could be a marketer of things, and this could be
high risk.

Speaker 3 (27:24):
This makes a lot of sense, which is by the way.

Speaker 2 (27:26):
Why HRT was kind of pushed to the wayside on
it's long ago because of risks like this.

Speaker 3 (27:32):
But again we'll come back to that.

Speaker 2 (27:35):
So hot flashes need to be understood a little more
because come on, man, come on, Although they are bad,
it feels like you're burning out from the burning out
from the inside out. It was a newse I was like,
I can't get cool. I've had those feelings before, but man,
so that that's something with the hot flashes, and that's
something that we do know is more commonly understood. People
kind of like get hot flashes is a sign of this.

(27:58):
But some of the ones you may not be aware
of include brain fog, hair loss, heart palpitations which could
be associated with the hot flashes, joint pain, gum problems,
yeah utiyes, tingling in extremities, panic attacks, decent dizziness, and
something called burning mouth syndrome, which I was like, what, which,

(28:18):
according to vela bio dot com, is a persistent burning
sensation in the mouth, lips, or tongue which bted ups.
As of recently, some of these spicy foods that were
never spicy to me have all of a sudden started
to make my mouth tingle. I'm starting to wonder. My
corner says BS that I'm just losing my tolerance. But

(28:41):
it could be it could be like the things that
I'm like, this is not usually spicy to me.

Speaker 3 (28:47):
All of a sudden, it's starting to make my mouth
tingle M. Yeah, more me search is needed. Well, this
is what this is.

Speaker 2 (29:10):
So here's what's happening in your body if you're going
through the stages of perimenopause. According to Reproductive Facts dot
org so quote, hormones work together to promote balance. As
hormone levels go up or down, they trigger the ovaries
of petulgary gland in the brain to make more or
less of other hormones. As a woman gets older, hormonal
balances change. So an of the first hormones to decrease

(29:33):
is the inhibit which is produced by the ovary to
work with the petuitary gland to produce less f SH
or follicle stimulating hormone. The FSH controls the level of estrogen. So,
going back to that Reproductive Facts dot org, FSH is
made by the petulgary gland. Levels often go up and
down during the menopause transition. FSH levels can be very

(29:56):
high one day and very low the next day. When
f SA levels are high, the ovaries make more estrogen.
When FSH levels drop, estrogen levels drop. These changes in
FSH and estrogen can happen months two years before metopause.

Speaker 3 (30:11):
Once again we don't have a timeframe.

Speaker 2 (30:15):
Then we have the progesterone, which we defined earlier, and
as we ovulate less, the progesterone level stays low, which.

Speaker 3 (30:22):
Can lead to missed periods. So this is kind of
that moment.

Speaker 2 (30:26):
Then there is the AMH or the antabularian hormone, which
is also produced in the ovaries, and when it starts
to drop, the transition begins. So apparently I believe it
has something to do with the eggs being dropped. I
don't know why I'm showing you a shape any like
the listeners can see what I'm doing. This is all right,
I'm a stop, now you can I'm sure my cup

(30:49):
like an egg?

Speaker 3 (30:50):
All right?

Speaker 2 (30:50):
Moving on, So now we kind of have an idea
about what is happening to our bodies as the hormone
levels are dropping. So let's go back to some of
these symptoms. One that has surprised me recently was that
about joint pain and bone lows. It's been noted that
bone laws absolutely occurs during menopause and it continues to decline,
so a lot of broken bones and this is where

(31:11):
it kind of ossioporosis comes in. And we're talking about
these early big hazards, all hazards and all of that,
but the study of bone laws during perimenopause is not
as much. We don't have as much information. One study
was completed in twenty eleven to see if there was
bone loss during perimenopause as well. And here's what they
have to say. The findings from perspective examinations of bone

(31:31):
mass density BMD change across the menopausal transition demonstrate an
early and accelerated rate of bone loss, particularly in the
lumbar spine. Bone laws begins to accelerate one to two
years before menopause, concurrently with the prolonged aminarrhea that characterizes
the late menopausal transition. Importantly, these rates of bone laws
are also influenced by body size, with greater bone laws

(31:52):
and non obese women and those with lower bad body mass,
independent of differences in the race and ethnicity. The greatest
reduction in BMD occurs in the year before the final
minstrual period and the first two years after the final
minstrual period, with lower rates of loss during the ensuing
one to seven years. So yes, this is during the

(32:13):
perimenoplause time frame. And with that there is the frozen shoulder.
I don't know if you've heard of this any which
is a sharp pain that occurs at night, causing you
to struggle to use your arms to do things like
unfasten your braw, wash your hair, or even get dressed.
So this condition is also known as adhesive capsulitis YEP
adhesive castlelitis, which the beettermenopause dot Com says is quote

(32:36):
occurs when that capsule of connective tissues surrounding the shoulder
joint becomes inflamed, thickened, and tight. This limits movement and
causes persistent, often worsening pain. Which last year, y'all, I
had one of the worst pains in my shoulders that
I've ever had. It caused tingling off the hand and
like I had to like keep my arms up. It
was awful, Like I could not exercise, I couldn't even sleep.

(32:58):
And now I'm looking back, like was that that frozen shoulder?
I was told that it probably was a nerve thing,
but they can never really find anything, so I was like, wait,
so what is it? Of course, they didn't take any
MORI y'all, they just gave me steroids and sent me
on my way.

Speaker 3 (33:15):
So and Gavinpinin. This is where I knew about Gavinpintin.
A big part of the.

Speaker 2 (33:19):
Reason all of this is happening is because the loss
of hormones. So back to the beettermenopause dot com article,
hormones like estradiol, progesterone, and testesterones support joint librication, connect
the tissue integrity and inflammation regulation. When these levels drop
in midlife, joints may become more punent, stiffness, inflammation, and injury.

Speaker 3 (33:40):
This is a.

Speaker 2 (33:40):
Common thing that I did not realize happened. I don't
know why this did not connect with me. Maybe it's
the agism that I harbor, not realizing that this is
a part of just the transition, but that it comes
younger than I thought, or it can come younger than
you think. And much like the heavy minstrual bleeding being
a contributor factor of cardiovascular disease risk, so is perimenopause.

(34:03):
So add just one more thing that I didn't realize
that might destroy your heart. So this is from healthrx
dot com. Cardiovascular disease is the leading cause of death
in women and the menopause transition is the period when
risk begins to accelerate. So the Swan Heart Study or

(34:25):
the Study of Women's Health across the Nation study carotid
into my media thickness or CIMT across the transition and
found a statistically significant acceleration in CIMT progress beginning in
the two years before the final minstrual period, independent of
chronological age or traditional risk factors. In the celial think function,
measured by flow mediated dilation, declines during perimenopause in parallel

(34:49):
with following extra dial blood pressure often rises by five
to ten MMHD during the transition years, partly from estrogen loss,
partly from sleep disruption mediated sympathetic activation, and partly from
weight gain. So all these things are happening and it
causes sheer risk of cardiovascular disease.

Speaker 3 (35:09):
To go up. Love it wonderful? Aren't you so excited
by this?

Speaker 2 (35:13):
Fantastic And with this different symptoms or causes, it isn't
too hard to see how there could be some misdiagnosis.
So from thepauselife dot Com. Unfortunately, the lack of education
and awareness about payment and pause among healthcare providers has
led to a dramatic increase in misdiagnosed conditions during this time,
Many women experiencing the onset of paimant pause symptoms are

(35:35):
instead diagnosed with conditions such as ADHD, leaky gut syndrome
which I don't go into, but other what yeah, fibromyologia,
long covid, interstitual cystitis, adrenal fatigue, depression, anxiety, or even
fatty liver disease. There's so much in this. I have
started to think maybe I have ADHD.

Speaker 3 (35:55):
I've talked about.

Speaker 2 (35:55):
I'm like I'm on some level of something because I'm struggling.
I say, it has to be a struggle, but it's
a different level of my way. I'm functioning right, And
it could be true. Maybe I have been and never
been diagnosed, and I have seen an increase in symptoms lately.
But then looking at the timeline, I'm wondering, has it
always been or is it perimenopause?

Speaker 3 (36:17):
You know what I mean?

Speaker 2 (36:19):
So back to that same article, they write a surprising
diagnosis often given given to perimenopause women is a diygen
deficit hyperactive disorder ADHD. Women in midlife may report difficulty focusing,
poor memory, and general cognitive decline symptoms that overlap significantly with.

Speaker 3 (36:34):
Those of ADHD.

Speaker 2 (36:36):
However, this mental fog is often a result of hormonal
fluctuations during perimenopause, particularly declining estrogen levels, which affect no
transmitters in the brain like serotonin and dopamine. These shifts
can impair memory, focus, and cognitive sharpness. Many women who
are incorrectly diagnosed with ADHD during perimenopause may instead be
experiencing what is sometimes referred to as menopause brain. So

(37:00):
there is this conversation because there's a back and forth
about like women not being properly diagnosed to begin with
with ADHD, so they maybe they've had it all along
or feeling like they've all of a sudden are seeing
these symptoms. And again like I didn't think I had ADHD.
I definitely am procrastinator, but as of late I've struggled
in several things in a way that I'm like, this

(37:22):
is new. Trying to think of words has become hard,
Trying to think of my feet, for like, feel a
little harder getting it together. It's a different pattern of level.
So it does wonder like, is this what's happening? Is
this what they're talking about with the dropping of the estrogen.
And again there's also thanks to covid, there have been

(37:43):
even more confusion in these conversations and diagnosis. And this
is a little more from the Pauselive dot Com specifically
about long COVID. Long COVID, a relatively new diagnosis resulting
from the ongoing pandemic, has a striking overlap with payment
apostle symptoms. Fatigue, brain fog, and muscle pain are some
of the features. Key features of long COVID, but there

(38:05):
are also hallmark signs of the menopause transition. Similarly, interstitual
societis and often pain and frustrating bladder condition diagnosed in
many perimenopausal women may sometimes be incorrectly attributed to chronic
pelvit pain that is instead driven by falling estrogen levels
which influence bladder health. Okay, so this could go back

(38:26):
and forth, because maybe there are things that are actually
wrong that they're gonna blame on menopause.

Speaker 3 (38:30):
So it could be both of those things that like,
oh no, but I hate that.

Speaker 2 (38:34):
We have even more levels of confusion and concerns about
misdiagnosis here. And it isn't just physical no, no, great.

Speaker 3 (38:45):
Great, So it's more anxiety.

Speaker 2 (38:47):
Yeah, the feeling of being overwhelmed or anxious can have
to do with your hormones. So here's a bit from
Hopkinsmedicine dot org. It's common for women to experience some
mood changes during perimenopause and menopause. In fact, about four
and ten women experienced mood symptoms similar to pre menstrual
syndrome or PMS. In fact, about four in ten women
experience mood symptoms similar to pre minstrel syndrome or PMS

(39:09):
during perimenopause. So during perimenopause, PMS symptoms may come at
times unrelated to your minstral cycle. Women who have a
previous diagnosis of anxieties are at greater risk during their
perimenopausal time.

Speaker 3 (39:21):
So it's only going to get worse. A lot to
look forward to, you, Yeah, and they continue.

Speaker 2 (39:29):
When estrogen and progesterone hormone levels drop during perimenopause, serotonin
levels also fall, contributing to increased airtability, nervousness, and anxiety.
Higher levels of cortisol, the stress hormone that increases with age,
can also create feelings of anxiety. Yeah, and those not
great is a relief to understand what is happening and

(39:49):
why things feel like they may be spiraling out of control.
I will say my anxiety has gotten worse for sure,
but my moodiness I don't feel like is bad. But
I haven't been cranky cranky. Don't get me wrong, I'm
still cranky, but not cranky cranky from what I've heard
from people that it could get to. But yeah, the
anxiety part, I will say, for me, being a lifelong

(40:13):
anxious person, having that disorder for a while, now I
feel like I've got a better control on it and
that I can recognize that it's not a normal reaction.
So as in like, it's not as bad as I
think it is. It is my anxiety trying to make
it worse. Yeah, that's for me, that's the good news.

Speaker 1 (40:30):
Yeah, And going back to that conversation we had with
doctor Sharon Malone, she made that point of you know,
being your own advocate, you know your body better than
someone else, better than a doctor. So knowing that this
is a different type of anxiety than I normally have, like,
this is right. Something has changed. This is not what

(40:52):
I have been have, I what I've considered as normal.

Speaker 3 (40:57):
Something's going on something's going on, right.

Speaker 2 (41:01):
But with all that, all of the bad news, I
know we have to start asking what is being done
about these issues that can be life altering. So back
to the pauselife dot com and yes, I think if
you can tell by the site, it's a site that's
going to try to sell you something.

Speaker 3 (41:15):
Probably or at least advocate to sell you something.

Speaker 2 (41:18):
The dramatic rise in diagnoses such as ADHD, leaky gut, fibromylogia,
long covid, interstidual societis, adrenal fatigue, depression, anxiety, and fatty
liver in perimenopausal women may often reflect the effects of
perimenopause itself, rather than separate unrelated conditions. The lack of
formal menopause education in medical training has left many clinicians

(41:38):
ill equipped to diagnose and treat women in this stage
of life properly. As a result, women may be receiving
treatments for conditions that are actually manifestations of the menopause transition.
Addressing this gap requires comprehensive training in menopause and hormone health,
ensuring that perimenopausal women receive accurate diagnosis and appropriate care
tailored to their specific needs. Yes, And this is a

(42:01):
conversation that we definitely have been having for a minute about, like, oh,
we need to figure out how to let people know
this could be the thing, right, And there's so many
reasons why this should be done, we just named a few.
The good news is people are starting to understand what
is happening and actually realizing they need to change how
they diagnose her what they're diagnosing. But it does seem
like many patients are the ones who are having to

(42:22):
be the ones to suggest.

Speaker 3 (42:24):
That maybe this looks like Perry menopause.

Speaker 2 (42:27):
My obg I an that I saw a year ago,
really had her doubts about whether or not I might
be going through it, and honestly me too at the time.
But as I'm here like a year later, I feel
like the symptoms have changed or at least added on.
And she then has said, h I don't think so,
but if it is, come back to me and come

(42:47):
talk to me a little later, And I will say,
she is significantly younger than me, and I am still
under on an IUD, which can also help. Consistently being
on birth control can actually help the symptoms already, so
like this may be activating helping my hormones. But as
it is maybe getting worse, I'm seeing more and more
stuff that I'm like, Okay, this feels like this is

(43:10):
what's happening at this point. But at that point she
was like, are you come back that she wasn't telling
me no, she just said, you know, waited out a bit.
And in my most recent attempts to try and figure
out why my body slashed, my knees in my back
are in such severe pain that I can't walk sometimes.
This has been recent. I talked to my doctor at

(43:30):
the time. He was looking at my knees and talking
about things and now I said, could this be paramenopause
And he was actually quick to say that, yeah, you
know what, there have been a lot of confirmed cases
of improving after that type of diagnosis, and talking about
how the estrogen lessening has caused a lot of joint
problems and continues to cause joint problems. Frozen shoulder, he
talked about and talked about women falling. So he, who

(43:51):
is not in the OBGI in field, understood that this
was a diagnosis that can be talked about. So he
understood that this was real. Like he didn't try to
dismiss me, So that was hopeful, you know what I mean.

Speaker 3 (44:04):
Did he help me?

Speaker 2 (44:05):
No, But I will say I myself have already been
started my HRT treatment and we're gon talk a little
bit more more about that. So of course there would
be nothing else for him to do outside of helping
me with this current excruciating pain. But it was interesting
that he actually acknowledged it and understood it.

Speaker 3 (44:25):
So I was I was nice to see that.

Speaker 2 (44:28):
And he's not young, but he's a younger, like thirty
something doctor, so you know, So we wanted to take
a second to mention a little bit about early menopause
because I think it's something that we have never talked about.

Speaker 3 (44:49):
I've never talked about and I don't think.

Speaker 2 (44:51):
I've heard it mentioned on the show as we're not
going but we're not going to completely into that topic,
but again, felt it could be really important. So according
to medicine dot org, about five percent of women can
go through early menopause, which is women from ages forty
to forty five who experienced menopause, and then women who
are under the age of forty going through menopause is
called premature menopause. So there's two levels to that, which

(45:14):
is still like outside of the norm, which happens to
about one percent of the women, so you know, pretty
low number, but still enough numbers. Unfortunately for those who
may be going through this at the stages are going
through the same symptoms and problems, and oftentimes this bypasses
the perimenopause stage and quickly jumps into menopause stage, which
can be very jarring, like all like your body is

(45:35):
just like what just happened.

Speaker 3 (45:36):
From Yalmedicine dot Org. They ride.

Speaker 2 (45:38):
Estrogen is a natural hormone mostly produced in the ovaries
that is important for building and maintaining bone in young women.
It can also prevent vascular damage. However, after menopause, the
ovaries do not produce much estrogen. So this was from
doctor Hugh Taylor, who is the chair of Yal Medicine Obstetrics,
Gynocology and Reproductive Science, and he said, notably, women who

(46:01):
experienced premature or early menopause have higher risks of heart
disease in osteoporosis because they will spend more years of
their lives without the benefits of estrogen when it continues.
He says, if you have healthy blood vessels and estrogen
tends to keep them healthy by allowing them to be
relaxed and open, and by helping the body maintain a
healthy balance of good and bad cholesterol. However, if you

(46:21):
have damaged blood vessels, such as from aging or diseases
like obesity, having supplemental estrogen around maybe a risk. So
they're talking about the different levels of why you should
and shouldn't take estrogen. And for the people who maybe
thirty going through perimenopause or menopause, it is actually beneficial
because it preserves cardiovascular benefits, so that estrogen is really important.

(46:42):
And for the people who might be going through early
or premature menopause, this is.

Speaker 3 (46:45):
Really important to have.

Speaker 2 (46:47):
And we're going to talk about it a bit more,
but honestly, the sooner the better, is what it seems,
because some of the tests that we're going to talk
about that caused the law to panic was because it
was women who are already like ten years past menopause
that might be taking it. That caused a lot of
problems apparently, And these are all the scary things. So

(47:07):
what are some of those solutions. Again, I've already talked
about it. There are a few things that have been
revived when it comes to perimenopause and menopause HRT. But
before we jump in there, of course, there are also
old go tos of like be active, eat healthier, do
weight chaining, and so on and so forth, and I
think like some of those things definitely do have benefit,
Like obviously if you are at risk or heart related things,

(47:29):
eating healthier can help you, Doing more cardio can help you,
doing weightlifting to build up your bones, to like, you know,
protect to build up your muscles, to protect your bones.
All of those things are really important so you don't
get things like dead but syndrome, which by the way,
my doctor did not know of, so I don't.

Speaker 3 (47:46):
Think that's the thing anyway.

Speaker 2 (47:48):
But the real conversation starter and real controversy comes with HRT.
First we have we kind of want to take the
timeline of how HRT began and what it is. So
first we have the creation of conjugated aquined estrogen better
known as PREMIERN, which was approved by the FDA in
nineteen forty two, and by the nineteen fifties and sixties,
we have gynecologists prescribing them pretty broadly, like really quickly,

(48:13):
to any symptom that looked like menopause. And not so
fun fact that they use to market this specifically to men.

Speaker 3 (48:23):
Of course they did, and it was real, all.

Speaker 2 (48:26):
Real sexist, both of these things. So this was a
Guardian article. The article is titled she Will Not Become
Dull and an Attractive The Charming History of Menopause and HRT.

Speaker 3 (48:36):
So this is a quote.

Speaker 2 (48:38):
There are also as targeted at men, who are obviously
the real victims. Here are sarcasm husbands too, like Premier
and said one of the ads from the nineteen fifties
that hormone pills men are assured make a woman quote
pleasant to live with once again in A particularly low
point was the publication in nineteen sixty six of Feminine
Forever by Robert A. Wilson, an American Guydan clause Just.

(49:00):
In the best selling book, he called menopause quote a serious,
painful and often crippling disease and even more alarming, all
postmenopausal women are castrates. Wow, just put them in a
barn and set it on fire.

Speaker 3 (49:17):
Geez.

Speaker 2 (49:19):
Yeah, So the book, the article is hilarious in itself,
but of course I had to make mention of quotes.
Of course they wanted to give it to men first.
Let's show men, hey, drug your women essentially in a
different way, get those hormones together. But by the seventies
we get two independent studies that show women take in
from here and have a higher chance of indimetrial cancer

(49:40):
than those who don't. So this is this article that
was like, oh my god, what is happening. So this
is from health rx dot com. Prescribing of unopposed estrogen
dropped sharply among women with intact eatery terry. The fill
rapidly pivoted to adding a progestogen, creating what would be
combined estrogen progestogen therapy EP. Interestingly, in the nineteen eighties,

(50:03):
some reports and studies were showing that estrogen therapy could
actually be helpful helping the heart.

Speaker 3 (50:08):
So back to the health article.

Speaker 2 (50:11):
The Nurses Health Study, which eventually enrolled over one hundred
and twenty one thousand women, became the most cited source
for this hypothesis. Early analysis suggested women using postmenopausal hormones
had roughly fifty percent lower coordinary heart disease risk compared
with the non users. So there's a lot happening.

Speaker 3 (50:29):
Throughout the years.

Speaker 2 (50:30):
They proceeded to test whether these treatments were both effective
for menopausal symptoms like hot flashes as well as hardcare,
and whether synthetic versus natural bioidentical made eight difference. But
then we come to two thousand and two with the
Women's Health Initiative WHI, who changed the course of the
popularity of the treatment, like it pretty much stopped it

(50:51):
in its tracks.

Speaker 3 (50:52):
So from Women's Hormone.

Speaker 2 (50:54):
Network dot org, yes, they are trying to sell you
something if you go look it up anyway, they say.
In two thousand and two, the trial was one of
the largest prevention studies done in the US, with more
than one hundred and sixty thousand women over fifteen years.
If further reported on the use of the daily conjugated
estrogens from pregnant horses combined with progestin not progesterone, it
found that women taking these chemicals were at a higher

(51:17):
risk of heart disease, stroke, and breast cancer after five years. However,
the estrogen only arm in women with a hesterectomy resulted
in twenty one percent less breast cancer. So the health
arx dot com says, this is about this about the
news media's reaction to that result. So this is really like,
oh no, newspapers reported the breast cancer finding as a

(51:37):
dramatic absolute risk increase. The actual absolute risk was eight
additional breast cancers per ten thousand women per year, a
small increase that was lost in the headline coverage. The
Menopausal Society would later note quote the WHI findings were
frequently misrepresented in media and clinical settings, leading to unnecessary

(51:57):
fear and under treatment of symtematic women. So US hormone
therapy prescriptions dropped by approximately fifty percent in two thousand
and two and two thousand and four. So this really
and we've heard this. I think that's the one thing
I heard is that this can cause cancer. HRT can
cause cancer, which Women's Hormone Network says this about the time.

(52:18):
This study led to millions of women avoiding hormone therapy
and many new men apausal women never.

Speaker 3 (52:23):
Starting hormone therapy.

Speaker 2 (52:25):
The real problem with the study it led to mass
confusion in the medical community, and unfortunately natural bioidentical estrogen
and progesterone were mistakenly thrown into the same category as
horse derived estrogen and synthetic progesterone. So there's so much
in this conversation, like the different people have different analysis
and different parts of the report that they kind of

(52:47):
pick apart essentially, But what it comes down to is
this was a misresrepresentation in the numbers and the findings,
and all we heard was it causes cancer, which we
know misinformation happens a lot, and this is that part
of that conversation. Since then, more studies have come about
showing different effects of different treatments and also debunking the

(53:08):
conversation that had women fearful of the treatment. One research
completed in two thousand and eight from the European Society
of Cardiology showed a bit of a difference. So back
to the Women's Hormone Network dot org, it has found
that overall there was no increased risk of heart attacks
and current users of HRT compared to women who had
never taken it, and they continue. The study also found

(53:28):
that the type of HRT and the way that women
took it made a difference to the risk of heart attacks.
Continuous HRT, a continuous combination of estrogen and progesterone, carried
at thirty five percent increased risk of heart tax compared
with women who had never used HRT. But if HRT
was taken on a cyclical basis estrogen followed by a
combination of estrogen and progesterone. There was a tendency for

(53:49):
these women to have a reduced risk of heart attacks
compared to women who had never used HRT, and this
was also seen if a synthetic hormone, tipolone was used.
It was also found that if used early and even
for longer than ten years, this did not result in
an increased risk of breast cancer, so that timing really
does make a difference, it seems so perhaps the way

(54:10):
and the combo of treatment makes a difference with that timing.
So back to the healtharx dot com article, the whi
reanalysis by h subgroup showed that women who initiated homone
therapy within ten years of menopause had a non significant
trend toward reduced cardiovascular events, while women who initiated twenty
or more years after menopause had elevated risks. The absolute

(54:33):
confidence intervals were wide, but the pattern was consistent and
clinically meaningful. Again, I think this is why we're being
encouraged to look at perimenopause as a beginning treatment as
opposed to just menopause. So this is really important and
from Medicine dot yl dot edu. Today, the literature suggests
that HRT can be beneficial for women within ten years
of menopause or below the age of sixty, with many

(54:55):
physicians recommending starting treatment early in perimenopause to maximize the
benefit and avoid complication. This makes a big difference. So
we also need to know and to know a very metopause.

Speaker 3 (55:08):
Yeah, I know.

Speaker 2 (55:10):
So with that, where does that leave us today? There
are different types of HRTs. I'm not even sure if
that's the way we should say it, Like, I don't
know if there's different types of HRT, as in like
if you ask your doctor, I want this type versus
the type, or if it's completely something different. Women's Hormone
Network dot org really really pushes for what's called physiological

(55:32):
hormone restoration therapy and they have copywriter this y'all, which
seems to work on the idea that it goes based
on the twenty eight cycle, so it tries to mimic
what your actual cycle is and going with your body
and cycling the types of medication or how much medication
you get, which makes sense to me, I will say,
but I don't know, like I'm not going to tell
you yes, yes, you absolutely should. Typically what I've seen

(55:55):
is HRT you just take it daily at a certain time.
With this, there's even conversations about DHA, which is a
type of drug that I think does something with your testosterones.
So which women's you know, do have levels of and
whether or not you should use that. I've seen that.
There's a conversation about vaginal hormone therapy, so like you inserted,

(56:17):
I believe, and it's directly there. There's this conversation about
I think there's vaginal rings for this too. See this
is where I'm like, you know, I'm trying to look
at all these things and I'm looking it up, but
I don't get a lot of information outside of like
this is what we think, and they gave you flowery
language to make it sound appealing. So I don't exactly

(56:37):
know what all this is because like this website that
I was talking to, which does give a lot of
great information. So Women's Hormone Network dot org giving you
a lot of great information. But then when you read
like you know, what is traditional HRT? They write For years,
we've been conditioned to fear estrogen, largely due to flawed
Women's Health Initiative study conducted two decades ago, and then

(56:57):
tells you why, and then talking about the publication, But
then they never tell you what it is other than
we used to fear it. Then they talk about non
traditional HRT models, which say is talking about falls short
and acknowledging the significance of hormone relationships, specifically the interplay
between estrogen progesterone. So I'm like, okay, but what but

(57:19):
you do you still wait? And then they talk about
their recommendation, which is the physiological hormone restoration therapy, which
is to fully harness the potential of hormones a more
comprehensive understanding of molecular biology and genetics. This includes knowledge
of natural levels and timings of estrogen progesterone release in body.
It talks about like Morre's code, where single tone can

(57:41):
convey an entire language to its frequency and pattern. So
like a lot of flowery language, that doesn't really explain
to me other than I believe it based on what
they think is your natural cycle, the twenty eight day cycle.
I have seen the conversation of it being I think
this is the same thing mink hormone replacement therapy, which

(58:03):
is becoming a newer thing, and it is just the
doses of hormones on a regular day to day basis
replicating a woman's natural hormone cycle that becomes disrupted and
ultimately abandoned during menopause. So that is what I assume
that this other physiological.

Speaker 3 (58:18):
Hormone restorative therapy is.

Speaker 2 (58:22):
But this is what it's telling me is on this level,
so that with make hormone replacement therapy, which again makes
sense to me because I will say I had a
hard time adjusting and what I was given, and I
was like, ay, I'm so taughed because like some of
the things in trying to adjust your body is like
it's almost like it's going through perimenopause or menopause on itself.

Speaker 3 (58:40):
So I felt really fatigued.

Speaker 2 (58:42):
My allergy symptoms went weird, and apparently perimenopause can make
your allergies worse too, by the way, I didn't know
if you know that any but all of these things
so I could see where this type of therapy is
maybe a little more better, especially because women are not
all the same, like we need people to recognize it.
I don't feel like it's being recognized enough, especially by

(59:03):
the pharmaceutical companies who are selling us so much crap.

Speaker 3 (59:07):
But like, yeah, this makes sense to me.

Speaker 2 (59:10):
I will say, when I told my people that this
was happening, they put me on a cream.

Speaker 3 (59:16):
Versus the pills.

Speaker 2 (59:17):
I think there's a difference, and I don't know if
it's because of the way it's absorbing and maybe I'm
not getting as much as typically. I actually decided to
pace myself. I did it on my own, which I
would not recommend. Do you talk to your doctors, but
I and I felt like that did help me. So
maybe I was following that procedure just naturally because it
made sense to me. I don't know, but there are

(59:39):
different levels that you can look at when it comes
to HRT, and then there should be different levels. There's
also patches. There's so many ways that you can get
this different avenue. But you definitely need to be talking
to a doctor because I don't feel like this one
size fits all is what should be happening and what
is slowly happening.

Speaker 3 (59:56):
Unfortunately.

Speaker 2 (59:57):
There is this conversation also that like again, you could
treat the individual symptoms which has been happening. Like when
we talked about the gabapentin for the hot flashes and
entai anxiety imads for different things.

Speaker 3 (01:00:08):
Like you can do that. Some people have said therapy.
I don't know. I don't know if talk.

Speaker 2 (01:00:15):
Therapy is what they're talking about, if that's that conversation maybe,
but I feel like if it's hormonal, that's not gonna
let Some things just don't make sense, Like even if
you try to rationalize it, you can't. You might know
why you're having anxiety, but it doesn't stop you from
having an anxiety attack. Right, So there's a lot in
this field, and I know we've covered just a small detail,

(01:00:37):
even though this is a longer episode of what this
looks like and what this is. So there's a much
more information that we need to have. And this again
doesn't really even cover into menopause, which is a lot
more studied.

Speaker 1 (01:00:51):
Yeah, yeah, I'm glad that there are people are talking
about it more, but there is a lot more we
need to uncover and talk about, a lot more we
need to research into. And yeah, I would hazard, I
guess hazard to guess that most people don't know about this.
I didn't really know about a lot of this, So.

Speaker 3 (01:01:10):
Yeah, you can't call you doctor, now.

Speaker 1 (01:01:14):
No, but you know what you know, what I was
thinking is that I recently went on a beach trip
and we've gone on this, this group of friends has
gone on this beach trip since I was in high school,
right and I'm much way outside of high school now,
And I just brought up the point that you can

(01:01:36):
see that it's changed. And there were a couple of
like there are a lot of c PAT machines involved
now there pretty much everyone but me was wearing like shoes,
like comfortable shoes for I guess plantar fasciiis.

Speaker 3 (01:01:53):
Which can yet? Which can happen?

Speaker 1 (01:01:55):
Yes, I had heard that that could be related to perimenopause.
So maybe I'll float this in our group chat, like,
just you know, listen to this episode.

Speaker 3 (01:02:09):
This show is about us.

Speaker 1 (01:02:10):
Oh yes, sometimes sometimes well listeners. I know last time
we did the Monday mini on it, several of you
wrote in. So if you have any thoughts about this,
resources or and or ideas about future episodes we should
do related to this, please let us know. You can

(01:02:33):
email us at Hello at Stuffmanever told You dot com.
You can find us some Blue Skuy at mostuff podcast
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We're also on YouTube. We have sub merchandise at Cootton Bureau,
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get your books. Thanks as always to our super produce
Arima Andre, executive Bruce Maya, thank you and thanks to
you for listening Stuff Never Told You re inspection of
my Heart Radio. For more podcast from my Heart Radio,

(01:02:54):
you can check out the heart Radio app, Apple Podcasts,
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