August 14, 2023 • 34 mins
Roselyn Sanchez is fabulous at 50, but her body is changing and her moods are swinging!
As Ros and Eric seek ways to alleviate her sudden symptoms, menopause expert, Dr. Suzanne Gilberg-Lenz, creator of The Menopause Bootcamp and senior medical advisor for Kindra, a leader in the menopause wellness space, shares some news flashes about her hot flashes.
Plus the treatments she says women should stay away from and the truth about "male menopause."
The doctor will see you now!
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This is, he said, a yadjo with Eric Winter and
Rosalind Fantaz.
Speaker 2 (00:07):
Hey, good day, he said, a yead o listeners, how
are you, Eric.
Speaker 3 (00:10):
I'm doing good. Excited at so great, I guess so
we have good for you.
Speaker 2 (00:15):
A guynecologist to the stars, including Drew Barrymore and creator
of the Menopause boot Camp, and a board certified obstrician
gaynecologists affiliated with Cedar's sigin I'm medical centered. Do you
know that we did an episode maybe a week and
a half ago that I mentioned that I went to
my doctor and he declared that I started my menopause,
(00:38):
And it was really interesting to listen to all the comments,
not listen here, not not here, read all the comments
of people because menopause is such a I don't know
if it's taboo. It's just not something that you hear
about a lot unless you're people my age. But for
the rest of the world men and young girls, menopause
is kind of like a far away thought. So we
(01:00):
think it's very educational and fun to bring somebody to
educators about this crucial time in women's life.
Speaker 4 (01:07):
That's pretty rim Hello, Hi, Hello.
Speaker 3 (01:11):
Thank you for joining us. Yes, thank you Thank you
very excited. This is well for you. It's been a
quite a journey just in this past week, but you
just put this together that she also is one of
the doctors out of the same practice as doctor j Goldberg. Correct,
you're going to call it just for years.
Speaker 2 (01:29):
Yeah, delivered both of our babies. Now we'll have a
new doctor. So I'm happy we're in good hands today.
In this podcast, your book Menopause book camp, let me
ask you something super simple, but I know a lot
of our listeners everybody knows the word menopause, right, but
when it comes to the specific meaning of the word,
(01:52):
what is besides oh you don't get your period anymore?
Speaker 4 (01:55):
What else is menopause?
Speaker 1 (01:56):
Such a good question, Thank you for asking, and you're
a great to discuss it with for a number of reasons,
because there are certain criteria that you won't be able
to understand, right.
Speaker 5 (02:06):
So, actually.
Speaker 1 (02:08):
The definition is twelve months consecutively without a menstrual bleed
for no other medical reason between the ages of forty
five and fifty five. So if you've had a hysterectomy,
of course you're not going to know where you are
in the process because you can't track it. To the
menstrual bleeding is you know, I'm menster writing you don't
have a uterist to bleed anymore.
Speaker 5 (02:30):
I think now.
Speaker 1 (02:31):
We're starting to talk about it again, which is so great,
and thank you for being willing to discuss it and
be vulnerable yourself. I listened to your last podcast, so
I have a little hint of how you're feeling about it.
And by the way, I think a lot of people
feel that way, like freaked out, like what does this mean?
Are you saying I'm old? You know, we can unpack
that as much as you guys have time for. But
(02:55):
the other associated symptoms, the classic ones are hot flashes,
nights with mood changes, vaginal dryness, urinary tract infections, but
weird stuff too, frozen shoulder achy joints, skin changes, gut changes,
not just like weight gain, because there is some weight gain,
but also people seem to have changes in their digestion.
(03:19):
I've heard vertigo, dry mouth, like we could go on
and on and on, and there's really a lot of
those symptoms seem to be the worst or peak in
the years leading up to that menopause, which is really
one day.
Speaker 5 (03:33):
It's one day of your life. You guys, you've.
Speaker 1 (03:36):
Reached that the final period for those of us that
are still bleeding. The lead up is where you're having
a lot of hormonal fluctuations. So the way your ovaries
are producing hormones is changing. Instead of being regular and
having sort of a smooth cycle, they're erratic. The way
your brain and your ovaries are talking to each other
and the way the rest of your body is responding
(03:57):
is being impacted because it turns that we have receptors
for estrogen and pretty much every tissue in our body
our brain. I didn't talk about brain fog, probably because
I have some brain fog. You know, your gut, your bones,
your heart, your blood vessels, So not just the obvious
reproductive stuff, but the rest of your body is affected.
And that explains and helps us understand why we have
(04:21):
all these varied symptoms, and also why if we don't
understand what we're getting into and how to deal with it,
we are going to have long term health impacts if
we don't address those things.
Speaker 3 (04:33):
Can I ask you a question, because you brought up
something I would never would have thought when you brought
up gut. What are the extreme symptoms of gut issues
that you've seen with someone going through menopause, because she's
been dealing with gut issues that she's been trying to
diagnose with gastros for a couple of years. Now, it
feels like.
Speaker 2 (04:52):
It gots so bad that I thought, I was like,
I think I have a stomach cancer. It's like, what
I'm going through is not normal. It's like, my mom
is a survivor of column cancer, right, so I guess
it's in the family, you know, it's part of our
family history, a lot of goud issues. And I'm going
this this pain that I'm feeling everything that I eat,
is it?
Speaker 4 (05:13):
It bothers me.
Speaker 2 (05:14):
And when I'm telling you that, I went to two
different gastros, right, I started with one. I did every
single test, city scans, X rays, colonoscopy. Then I moved
to another gastro endoscopy and everything comes back normal.
Speaker 4 (05:29):
You're perfectly normal.
Speaker 2 (05:30):
And then and then I went to a functional doctor
and that said to me, what you have is h
pylori And I'm going no, I tested for that and
I don't have h pylori or seboard, none of that.
And then funny enough, it came back super positive and
and strap of my in testings, and I'm.
Speaker 4 (05:44):
Still dealing with it.
Speaker 2 (05:44):
I'm going through this massive protocol, but I'm still having
gut issues.
Speaker 3 (05:48):
Can menopause actually be a part of that type of
gut So we.
Speaker 5 (05:51):
Don't have a lot of really good data for the book.
Speaker 1 (05:53):
I actually interviewed Emran Mayer, who's a professor at UCLA
who's kind of the really the father of the microbiome world, right,
He's the guy who's done probably the most research of
anybody on the microbiome. And I talked to him because
here's what we do know about the gut. The gut
is actually the seat of the immune system. So you
(06:13):
guys may or may not know that most of our
immune system lives actually in our gut. And also a
lot of our hormones are made in the gut. Not
the reproductive hormones per se, but a lot of other hormones,
especially things that are connected to mood and energy, serotonin,
stuff like that, are part of that pathway is.
Speaker 5 (06:33):
In your gut.
Speaker 1 (06:33):
So I said to him, it just biologically makes sense
to me that there's going to be a shift when
our hormones are fluctuating and shifting in what's living in
the gut and he said, absolutely, I agree with you.
Speaker 5 (06:45):
And I was like, okay, so tell me.
Speaker 1 (06:46):
He's like, we don't know, which is, by the way,
that what the experts told me.
Speaker 5 (06:52):
You know, I did. Listen.
Speaker 1 (06:53):
I've done a lot of my own work and study,
and I consider myself an expert, but I also reached
out to other fields and other experts in other fields.
Speaker 5 (07:00):
It's because I really wanted to be inclusive.
Speaker 1 (07:02):
And you know, do you know how many times I
heard that we don't know, we don't know, we don't know.
I mean, that's a whole other podcast, right, because how
come we don't know? Yeah, I know, it's fifty percent
of the population exactly.
Speaker 2 (07:14):
I'm blaming it on COVID now because a lot of
people says, you know, I got COVID. I have so
many gie issues and I've had it three times. So
now I'm thinking, you know what, it's COVID.
Speaker 4 (07:22):
It's COVID.
Speaker 2 (07:23):
I don't know what I'm talking about. I'm just blaming
COVID because I just want to find it.
Speaker 1 (07:26):
I could be in any and all. And also, you
have a history of andandometriosis.
Speaker 2 (07:30):
Too, right, That's why I have.
Speaker 1 (07:32):
An impact on your gut too, right, So who knows.
But it's hard for me to believe that the menopausal
transition didn't have any effect. I don't think this is
the thing because I live in this world. I talk
about this all the time and people come to me
about this, but I always try to remind people. Look,
we can't point the finger always at menopause. I mean,
everything isn't menopause or perimenopause. But do these things interact?
(07:52):
Of course they do, so I think if you have
at least that perspective that, like I said, is a
little bit more expansive and inclusive, and you understand and
that hormones are chemical messengers. They are a means of communication.
If the communication is being altered or disrupted in any way,
the outcome will be different, the message will be changed.
And I think when we think about it that way,
(08:14):
it also doesn't feel as out of control and like
there's nothing you can do about it.
Speaker 3 (08:20):
Well, and I wonder, and maybe I'm wrong, you can
answer this, but when you had your hysterectomy, did you
already have the gut issues or did that come after
the hystrectomy?
Speaker 4 (08:31):
I think after, I think after.
Speaker 3 (08:34):
And is it true that hysterectomies can tend to speed
up the menopausal process.
Speaker 2 (08:38):
Yes, yes, it can, even if you leave your ovaries
because I kept ovaries.
Speaker 1 (08:42):
Yeah, because we're disrupting the blood supply, plus the surgery
itself and the stress of the surgery, plus if you
had antibiotics during that surgery. So there are, like you
have sort of a laundry list of things that could
be interacting. But I think if you kind of tick
off those things and you look at like, well, not
just putting the putting the proper bacteria back in its place,
(09:04):
but feeding it properly, that might be beneficial to you.
Speaker 5 (09:08):
I mean, this has gone far afield.
Speaker 1 (09:10):
But that's because this is such a big topic, right,
and there's so many surprising aspects to it.
Speaker 2 (09:15):
Yeah, what is the difference between perimenopause. I have never
heard that before my life. Perimenopause and menopause PERI.
Speaker 1 (09:33):
Menopause is the period of time leading up to the
actual menopause. So, now that you started the conversation with
the definitions, which is what I always like to start
a conversation with, right, otherwise we are not speaking the
same language. So the definition of menopause is that one
day at the end of twelve months, Perry menopause is
what leads up to it. And look, I joke with people,
if you're a menopause expert, everything is leading to menopause,
(09:54):
So you could define your entire life if perimenopausal. Yeah,
but I'm going to I'm not going to do that.
It's usually seven to ten years leading up to it,
and it's where we start seeing that there are these
subtle shifts in the hormones and in the smooth transition
month to month of your cycle.
Speaker 5 (10:11):
There are people who start to report.
Speaker 1 (10:12):
Symptoms and changes in the way they feel in their
body as early as their mid to late thirties, and
there are some people who really aren't noticing anything until
you know, three to five years before. But again, it
would be a lot of those symptoms that I discussed,
whether it's sleep disruption, hot blushes, brain fog, you know,
a change in the way their body feels to them.
People will start I hear a lot of like panic
(10:33):
and anxiety that sort of comes out of the blue.
People who've never had mood disorders start having the irritability
that is disruptive.
Speaker 2 (10:42):
So discuss believe so somebody wants to go somebody like
me that I I didn't have the twelve months without
a period, right, it happens from one day to the next. Like,
am I is this menopause or perimenopause? Am I, i'man
full menopause?
Speaker 1 (10:56):
Then right, well you're menopausal because you don't have a uterus,
But are you hormonally menopausal? The problem for you is
like you're the one group that I would recommend doing
some hormone testing on why because we have no other
way to track what's going on. But the reality, yes,
but that's that's a moment in time, and the reality
is at the age of fifty, the average age is
(11:16):
about fifty one and a half fifty two. I see
a lot of people in our community much older when
they go through menopause, actually fifty four to fifty seven even.
And some of it would depend on your personal history
or your family history, whatever the thing is for you, Roz,
like you could test again in six months and your
numbers are going to be completely different, because maybe you're
not really there.
Speaker 5 (11:36):
But the truth is that we would be treating you
for symptoms, not for the numbers.
Speaker 1 (11:43):
It's not a it's not really a diagnosis it's because
it's not a disease, it's a physiologic state of being.
Speaker 5 (11:50):
It's like puberty. We don't test our kids for puberty.
Speaker 1 (11:55):
There're eleven and they start acting like an a hole,
you know, and they're growing some hair.
Speaker 5 (12:00):
Hello, it's puberty.
Speaker 1 (12:01):
Like, you don't need to diagnose that, you know, it's
common sense. The problem is if we don't know what's
coming and we haven't been educated ourselves, we can't anticipate
and say, oh, this could be my menopausal transition or perimenopause.
And in the end, what your numbers are are not
really important to me. How you feel is what's important.
We're going to treat you to support you and your
(12:23):
body and your experience. We're not going to treat you
because oh, now you hit menopause or oh sorry, you're
month eight. We're not going to give you any hormones yet.
Speaker 5 (12:31):
I mean, we're not going.
Speaker 2 (12:32):
To do that.
Speaker 3 (12:34):
This is like a little bit of a silly question.
But there's a version I'm assuming right for Obviously, menopause
is what women go through, but men also go through
this stage in their lives where hormones drop, production of
key hormones change, They experience some of the same moods.
Speaker 4 (12:50):
So what is that called. Does it have a name?
Speaker 5 (12:53):
Yeah, it's called andropause andropause.
Speaker 3 (12:56):
So if men have their own version of menopause andropause,
they do.
Speaker 1 (12:59):
It's it's a little more subtle in people, and it's
a little bit less dramatic in terms of it's not
like a cliff that you kind of fall off of.
But for sure, testosterone levels start to decline and people
start to feel different. You know, their muscle mass changes,
their sexual function can change. But again, just like with women,
I mean, if you want to talk about sexual function,
(13:19):
sexual function is not just hormonal in men and women,
and a lot of it has to do with tissue integrity,
namely blood flow. So I think if we make the
mistake of saying that every sexual function issue in men
or women is related to testosterone, we're missing a really
big opportunity for health overall. We know that erectile dysfunction, actually,
(13:42):
I mean, any of your male listeners should know this.
Speaker 5 (13:45):
They may not.
Speaker 1 (13:47):
Erectile dysfunction is almost like the body's early warning system
for heart disease because a lot of it has to
do with blood flow. So hormones are playing a role,
But it's not just that, and that could be the
case for women as well. We know as we age,
cardiobacvascular disease really starts to increase. And so these are opportunities. Again,
I like to always frame these things. It's opportunities to
(14:08):
understand so that we can take better care of ourselves
and live our best lives.
Speaker 2 (14:13):
So for women like somebody like me that I'm experimenting,
not like super severe hot flashes, but I'm getting a
little hot, irritable.
Speaker 4 (14:23):
Libido.
Speaker 2 (14:23):
That's what you're saying, libido, the little things that I'm noticing. Right,
I did my hormone the blood test that it was
very comprehensive. I'm waiting for the results. So let's say
that you guys determine. You know, this is the issue.
We don't want to follow numbers. But based on the
blood test results and the way she's feeling when you
prepare the cocktail that is going to be good for me,
(14:45):
introducing estrogen and all those things, is this something that
is going to truly make me feel, oh my god,
at least eighty percent better?
Speaker 5 (14:54):
Well that's a great question.
Speaker 1 (14:56):
Maybe okay, because the thing is, like I said, I
everything is in hormones, but it will probably improve a
lot of the symptoms. And it's a little bit idiosyncratic
and a little bit individualize how people respond. I will
tell you that I would be very careful to get
caught up in this test treat, test treat, test treat model,
(15:18):
because we're not, like I mentioned, it's not like thyroid. Okay,
your thyroid has to be between here and here in
order to function optimally, and we got to keep it
between here and here. There's a narrow therapeutic range with
estrogen therapy, for instance, or testosterone, that's not really the case.
There is an upper limit that would be unsafe. But
(15:38):
just because the number looks a certain way isn't going
to be predictive of how you feel. And so I
think it's better to be looking at clinical symptoms and
function and how do you feel in your body and
how you like function in your life than to be
like constantly chasing the numbers, which, by the way, is
a business strategy because people will keep you coming back
for test test test test tests, because every time you're
(16:01):
coming in and they're testing you, they're charging you, and
then they're changing your hormones and they're changing your hormones
and they're changing your hormones. I just got off the
phone with a patient who was experiencing that, and she
finally said to me, after two and a half years
of working with this person, he wasn't listening to me.
Speaker 5 (16:15):
Wow, because he wasn't He was chasing the numbers.
Speaker 1 (16:19):
And I want to believe that this guy his heart
was in it and he's trying to do the right thing.
I'm going to give him credit there, but I also
see that, you know, sometimes it's a solution looking for
a problem.
Speaker 4 (16:31):
Wow.
Speaker 2 (16:32):
Interesting the whole craze about pellets. Do you believe in pellets?
Speaker 1 (16:37):
It's not about belief, Okay, it's not my personal belief system,
it's where's the evidence. Now. Having said that, I'm a
big fan of using things that are also not FDA
approved and not pharmacologic. I'm open about that. I have
an integrated medicine background. I have a background, and I'm
holistic ier Veda specifically.
Speaker 5 (16:58):
I've been a big believer in prevention and lifestyle.
Speaker 1 (17:01):
But I'm always very honest about the studies that I
use to to indicate effectiveness. That these studies are not
the best studies, but there are studies. The problem with
the pellets is that they don't have and they refuse
to create or publish data to indicate safety and efficacy.
And I mean, just do it, Just do it. If
(17:22):
you do it, then maybe we'll use it. The doses
that I see or used that are very very very high.
People frequently come into me as what I call refugees
from these pellet clinics where their testosterone is you know,
three four times the normal range.
Speaker 2 (17:36):
But they don't but let me ask. They don't do
a specific one for each person. It's not a generic pellet, right.
Speaker 1 (17:45):
I think that I think they're dosed. But the thing
is absorption is very is very individualized. And once you
put that thing in rosalin, it's in. They're cutting a
little incision and putting this rice grain sized thing with
the hormones and then they're being released and that's it
your sol until that thing stops working. So there are
(18:05):
other ways we can give you testosterone an estradile that
are bioidentical, that are that are pharmaceutical grade, that are
have been tested, that are FDA approved. I'm not the
biggest fan of the FDA, but it is what it is.
Speaker 5 (18:17):
It's what we have. I'm not against the FDA.
Speaker 1 (18:19):
I'm not for the FDA. It's a tool, but I
mean it's a tool to help try to keep us safe.
So just there are options out there that are available
that are safe and that are tested. You can do
testesterone cream. It works really, really well. There's other ways
to do it. I'm not a fan of the pellets.
Speaker 3 (18:36):
What are some of the side effects you were mentioning
that you've seen patients come in.
Speaker 1 (18:38):
Oh my god, growing acne, oil, hair loss on the
top of their head, hair growth, their included is growing
in a way that does not you know, phone or
cute bleeding. The biggest problem I see is the testosterones
can start getting converted to estrogen or the estrogen is
very high, and then they start having abnormal bleeding and
they can have pre cancer or cancer.
Speaker 5 (18:59):
Viewers, it's not cool, It's not okay.
Speaker 4 (19:02):
Yeah at all.
Speaker 2 (19:04):
Your hair changes with menopause. Did you start losing hair the.
Speaker 1 (19:08):
People can start losing hair? Yeah, definitely, definitely.
Speaker 2 (19:11):
Because that's something that for sure I'm going through. Like
my hair is a little bit of a mess. It
doesn't show that it's a mess because I have a
lot I'm very blessed that I have a lot of hair.
So even if I lose hair and it gets kind
of like funky, people think, oh, your Harry is gorgeous.
But I know my hair, you know, so I.
Speaker 1 (19:26):
Know it's the same way I'm the same way I've
lost I had very, very, very thick hair as a
young person. My daughter has crazy hair the same way
I used to have, and I'm like a to a
third of mytail.
Speaker 4 (19:37):
That's how I feel.
Speaker 5 (19:38):
It's a lot of hair, I know, and you feel
bad you don't like it.
Speaker 1 (19:42):
I hate it.
Speaker 5 (19:43):
I hate it.
Speaker 2 (19:44):
So it's it's not safe to say that that So menopause,
there's no way of knowing. It could last five years,
could be ten. It depends on the person. It doesn't.
Speaker 4 (19:53):
Nobody knows.
Speaker 1 (19:54):
And the problem that we see is that there's just
a lack of education on the part of the public,
which is why something like this is so enormously important.
So thank you for being willing to talk about it
and bringing me on. And then you know, I work
with this with this company Kindra that creates educational opportunities
(20:14):
and some really very science based supplements and products, and
they just did a big study. Oh my god, and
I'm totally bling on who it was, but you know,
one of the like sort of gallop, I think. And
they found stuff that I already intuitively knew and have
seen in my practice, which is that essentially a third
(20:35):
of patients are getting misdiagnosed gas lit not listen to
you know, people go into the doctor and they don't
feel well, like you said, and I don't want to
point the finger at your specialists, who aren't you know,
women's health specialists, and people don't even connect the dots like, hey,
this lady's forty seven. It could be that this is
a hormonal this is hormonally mediated in some way. They
(20:58):
just the doctors themselves don't know. And this is an
enormous problem. The misdiagnosis thing happens too, where you get
diagnosed with anxiety or depression or an autoimmune disorder and
it turns out it's perimenopause.
Speaker 2 (21:08):
Wow.
Speaker 1 (21:09):
But if we can come in as patients and advocate
for ourselves and say, hey, I've been reading out myself.
I listened to a podcast and I heard then it
might sort of, you know, raise a little flag, and
a really good physician is gonna know what they don't know,
and I've learned over the years from my patients saying
(21:30):
I'm not really sure. Let's work on this together. There's
no shame in that I'm not supposed to know everything.
No doctor is supposed to know everything. But I think
there's a way in which we can educate ourselves and
educate each other rather than have this be a black
box shame read and stigmatized, like as if being a
woman who lives past an expiration date is a bad thing.
Speaker 2 (21:51):
Yeah, it's very important to listen. And I went through
it first with ENDO. I have never I always know
that I had ENDO because I was diagnosed fairly young,
but I don't remember the doctors or my MoMA. No,
but nobody ever really sitting me down saying, let me
explain to you what this means, and this is the solution.
This is what you're going to feel for the rest
of your life unless we do AB and C. Like
(22:12):
I never had the conversation. I don't remember any school
ever or college teaching me about even when you're learning
about your reproduction, you know, life, or your sexuality or
all of that. Never, you know, my mom is eighty four,
I'm fifty. The first time I had a conversation with
my mom about menopause was maybe six months ago that
(22:33):
I asked my mom, when did you have your menopause?
And she said, I think I was fifty five, and
I said, well, I still have time. That's why when
the doctor last week said to me, this is what's
going on, I was so ignorant because I should have
put the dots together. I had a hysterectomy. Even though
it's partial, that means that, yeah, my menopause is going
to come a little earlier. To me, I was going,
you know what, I feel so fabulous, I look so young.
(22:55):
I'm not going to get out until I'm sixty because
I'm an anomaly right and now here I am at
fifty getting it before my mom. But that was the
only conversation that I've ever had with my mom about menopause.
Speaker 5 (23:07):
And it's because you asked about.
Speaker 2 (23:08):
It, and it's because I ask and I don't understand.
Like my daughter, she's eleven, she's going to what is
a name of the class at her school human development,
right and they're teaching them namba, but a little bit
about sexuality and the body parts and all that. I
can guarantee you, she's going to graduate, she's going to
be a senior, she's going to go to college, and
the word endo or menopause or none of that is
(23:28):
ever going to come up.
Speaker 1 (23:31):
Well, and the data out there about an ametriosis is
terrible too, as you know, it can take you know,
between six to ten years for the idea of that
diagnosis even coming up if you guys don't advocate for yourselves.
Which is why I'm a big, big proponent of grassroots changes.
I feel like when it comes to these kinds of topics, really,
as women were better off just bringing attention to the
(23:54):
people who care for us, rather than waiting for them
to bring it to us. We just have to take
we have to take control of it. Do you have
an opportunity because you can teach your daughter, You can
teach your daughter that her body or I think that
we're already My kids are in their twenties and they
were just raised totally differently than me. You guys, even
more so because your kids, for better or worse, have
been even more exposed and immersed in social media. But
(24:15):
this idea of like not being ashamed of our bodies,
being proud of our bodies that needs to extend to
all of our bodily functions, and you, as a woman,
get you can say, Mom, I had to hysterect me.
This is why I had to hysterect me. I'm so
glad that I taught myself and that I found doctors
who care about me. This is what I'm dealing with
right now. You know, if I'm a little not so
(24:38):
patient with you guys, sometimes I'm a human being, and
this is what's going on with me, Just like I'm
going to be patient with you when you're going through
whatever you're going through. Really just a matter of fact,
it's like no big deal, exactly if we make it
a big deal. It's a big deal if if we
accept the narrative that, look, I stop coloring my hair
like five six years ago. At least, I'm not saying
everybody should stop coloring their hair.
Speaker 5 (25:00):
Was the choice I made.
Speaker 1 (25:01):
If I could tell you what kind of reaction that was,
I had because I deigned to admit that I'm you know,
in my fifties. Hello, we go prematurely gray in my family. Anyways, Seriously,
I'm hot stuff. That's what how I feel about myself.
Fifty seven.
Speaker 5 (25:17):
I'm hot stuff and my hair is gray.
Speaker 4 (25:19):
And you're happy and you look fantastic.
Speaker 1 (25:22):
But my point is like I can accept the narrative
that's leveled at me, or I cannot accept it.
Speaker 4 (25:27):
Yeah.
Speaker 2 (25:36):
One of my closest friends in Puerto Rico, I'm fifty.
She is eleven years older, so she is sixty one.
Of course she's dealing with menopause. She married somebody I
think maybe five or seven years.
Speaker 4 (25:47):
Younger than her. We love him.
Speaker 2 (25:48):
They're like family. She said to me years ago, because
she came to visit and she was like, oh my god,
I'm going crazy. I have these hort flashes. I'm going
through menopause.
Speaker 4 (25:57):
Oh my god.
Speaker 2 (25:58):
And I said really, and to me even then, which
is not a long time ago, it was so foreign
in the conversation. I was like, what do you mean
you're going to anapas was I wasn't even paying attention,
but I said something as I said, how does your husband.
Speaker 3 (26:09):
Deal with it?
Speaker 2 (26:10):
And she's like, oh no, no, no, no, no, no no, I
don't talk about it.
Speaker 4 (26:13):
He doesn't even know. Don't ever.
Speaker 2 (26:15):
Don't you ever mention Eric that you're going through menopause.
It's like that's something between you and yourself, and men
don't like that so act like nothing is going on.
And I was like, again, I wasn't going through it.
To me, I was like, okay, okay, no problem, right,
But I didn't really pay attention. But I never forgot
the comment anyways, And now that I'm going through it,
I am shocked that I'm being so open, because how
(26:36):
do you feel about it?
Speaker 4 (26:38):
That you're with a fabulous old lady.
Speaker 3 (26:42):
And that's all that matters. That's all that matters. Honestly
to me, I'm very relaxed with these kinds of conversations,
like it doesn't bother them at all. I mean, that's
kind of how I was brought up. My dad was
always very open and direct with me about everything with
you know, as far as being a male and these
kind of conversations. I just know our life and they
don't really affect me. I don't think anything less of her.
(27:04):
In fact, I probably appreciate it more because there's an
open dialogue about it. So for me, I have zero
problem with it.
Speaker 4 (27:11):
Do you get good, thank you so much?
Speaker 2 (27:12):
Do you get a lot of patients that are uncomfortable
with their spouses?
Speaker 5 (27:18):
Yeah?
Speaker 1 (27:18):
In fact, so you know the book Menopause boot Camp
came out of real life experiences that I do called
a menopause boot camp, and one of the most frequently
asked questions that I've gotten when I do a boot
camp is can you do this for our spouses?
Speaker 5 (27:34):
And I really I think that I probably.
Speaker 1 (27:35):
Will because people become Look, if we can't talk to
ourselves about something, how are we going to talk to
somebody else about it? And I think if there's so
much cultural stigma around this time in our lives, everybody's
being subjected to that, men, women, children, partners of all stripes.
(28:01):
I think it's changing because people are starting to talk
about it more. And I mean, look, you guys are
in the media. We're in California. I'm living in like
metopause bubble. So sometimes I have to remind myself that
everybody is not living in this bubble where we talk
openly about stuff. But I do think things are changing
on a pretty high level, but it's not enough, and
(28:21):
it's going to take a long time. So every little
conversation really does help. And I do find that a
lot of women struggle with how to talk about it
with family members and with male partners. But I think
it's it's again, it's individual. I will tell you it's
really interesting. A lot of my Latina friends have told
me that they feel like in their various cultures because
(28:43):
obviously that's not one culture that there seems to be
a little bit more stigma around it.
Speaker 5 (28:48):
So that's really interesting to me.
Speaker 1 (28:50):
And I have actually a good friend in Miami that
is very involved in the space who's Latina. She's Colombian
and has been wanting me to come to Miami to
do stuff. And it's like, there's a lot of stigma
around people admitting that they would go to a menopausemic camp.
Speaker 2 (29:04):
I believe it interesting because there's a connotation. He's like,
oh my god, Okay, I finally hit that I'm old,
and exactly, I'm all, my sexuality is it's over. Is
my man gonna start wondering and looking for a younger
person because now it's it's it's a trip. It's a
lot of it's a lot of stuff like insecurities that
(29:27):
that that can come up. But the reality is I
have decided. Listen, you can ask your colleague Guile, Gail,
how do you pronounce it? Gile?
Speaker 4 (29:37):
I was laughing.
Speaker 2 (29:38):
I was like, I thought I was so nervous that
I was laughing. I was like, this is the funniest
thing ever. And then he hit me and I was like,
oh okay. But then I was like, I'm going to
embrace it because the reality is listen. Whether it's going
to get more severe, I don't know, you know, like
maybe the hot flags are going to be even more
intense and my mood swings. But if they stay as is,
and now that I'm going to start supplementing and helping
(29:59):
my body with things that I know they're gonna help
me a little bit. If it's gonna be like this,
I'm fine riding this wave and have a laugh and
be like it is what it is.
Speaker 1 (30:09):
Yeah, just another life transition exactly right.
Speaker 2 (30:13):
And I've been through so many already, you know, with
like the various surgeries and life and changes and leaving
my country coming to this country. I've dealt with things
that I'm much bigger then. Also, I'm gonna do yes, but.
Speaker 5 (30:24):
That's the biggest So I love that.
Speaker 1 (30:26):
God, the transitions and the conversation are perfect because I
see menopause as this amazing life experience where we really
start to dig into how resilient we are, what are
our skills, what are our values? What lights us up?
What does the next half of our life get to be?
Because if the statistics are that the average age of
(30:47):
menopause is fifty one and the average lifespan is eighty something,
then we're spending at least a third of our lives
in menopause.
Speaker 5 (30:55):
It is not even close to being over.
Speaker 1 (30:57):
And it is a really, really great opportunity to just like,
what's the next step, what's the next phase.
Speaker 5 (31:05):
It's so to me.
Speaker 1 (31:06):
If you're supported and you don't feel crappy about yourself,
it's fun. I'm not saying all of it's fun. Is
it fun to be in a bad mood and feel
fat and not sleep? No, I'm not trying to sell
you on that. But if you have the toolkit and
you have support and you don't feel silenced, once you
can get through that, you can laugh, You can laugh
at yourself, and you can dig in to see how
(31:29):
resilient you are, and you get to locate your agency,
where is your power in all of this. It's kind
of great for me, It's been great, amazing. So I
just want other people to know that that's an option
for them too.
Speaker 4 (31:41):
Yeah. I love that.
Speaker 3 (31:42):
It's incredible, really really great work. Awesome for the listeners
and for you.
Speaker 4 (31:46):
Yeah, no, I've learned.
Speaker 5 (31:48):
I say hi next time you're in the office.
Speaker 4 (31:49):
Yes, I will for sure. Thank you so much.
Speaker 3 (31:52):
Doctor Menopause boot Camp is out right. People can buy
it everywhere else.
Speaker 5 (31:57):
Yes, they can. They can buy it everywhere.
Speaker 3 (31:59):
That is awesome. Thank you so much for being with
us and sharing all your knowledge.
Speaker 4 (32:03):
Thank you.
Speaker 5 (32:04):
Oh it was so great. What a great conversation.
Speaker 4 (32:06):
Thanks, thank you.
Speaker 5 (32:07):
Have a great day.
Speaker 4 (32:09):
Bye.
Speaker 2 (32:11):
Wow. Very, I can't believe she's part of the Woman's
Care of Beverly Hills practice. I mean, I know I
can't believe because I've seen her name for twenty years,
but I didn't put it together. And I told Goldberg,
my doctor all his patients. They transitioned to doctor Guile.
But the whole practice is fantastic. Anyways, this was very
(32:32):
very education. You're okay with that, I'm totally I just said,
meaning the podcast dedicated to I love.
Speaker 3 (32:39):
These kinds of conversations. I'm all about anything science based.
Speaker 4 (32:42):
And I forgot that you are a psychologist. I want
your major.
Speaker 3 (32:46):
I wanted to be a doctor. I love this kind
of stuffinating.
Speaker 4 (32:49):
Are you're going through Andre? What is it at and
are you going through that?
Speaker 3 (32:55):
Who knows? Probably probably with all the stuff going on.
Speaker 4 (32:59):
You know, whats in interesting?
Speaker 2 (33:00):
Eric, But you remember that I said to you my shoulder,
I can move my shoulder, and I'm still dealing with
my shoulder, my shoulder, and it got so bad. I
call my brother and then somebody said to me. One
of the actresses on the show said to me, you
have frozen shoulder.
Speaker 4 (33:13):
And I said, what do you mean? And he's like,
that's what happens. How old are you?
Speaker 2 (33:16):
And I was forty it was two years ago, forty eight.
And she said, go to the doctor. I think you
have frozen shoulder. So I call my brother Peter, which
is a doctor. I said, Peter, I'm dealing with this
thing that I get this pain my left shoulder out
of nowhere. I can sleep on that side. And he
said to me, yeah, that's frozen shoulder. And I have
never done anything about it because I'm just thinking.
Speaker 3 (33:38):
What she said, frozen shoulder.
Speaker 2 (33:42):
Yes, she said, you know there's a lot of studies
now that frozen shoulder. Yeah, frozen shoulder. And you're and
your bones and you know, like everything starts getting achy.
Speaker 4 (33:51):
And my job.
Speaker 2 (33:53):
I heard that my job is a nimer right, my
my my job, my bone, my left side, my shoulder
has never been the same. So and this is literally
I started having the frozen shoulder a month after my hysterectomy,
so I think I went into harry menopause immediately after
this posatory. It is crazy, this stuff that you have
(34:13):
to learn after the fact.
Speaker 4 (34:15):
This is what I want people.
Speaker 2 (34:16):
I want people to learn things before the fact so
you can be educated and you can actually be proactive
before the issues arise.
Speaker 4 (34:24):
That's my intention.
Speaker 2 (34:25):
Anyways, thank you.
Speaker 3 (34:28):
Thanks for listening. Don't forget to write us a review
and tell us what you think.
Speaker 2 (34:32):
If you want to follow us on Instagram, check goes
out at he said. Ajason is an email Eric and
Ross at iHeartRadio dot com.
Speaker 4 (34:39):
He said.
Speaker 2 (34:40):
Ajab is part of iHeartRadio's Mike would do that podcast network.
Speaker 3 (34:44):
See you next time.
Speaker 1 (34:44):
I
This is, he said, a yadjo with Eric Winter and
Rosalind Fantaz.
Speaker 2 (00:07):
Hey, good day, he said, a yead o listeners, how
are you, Eric.
Speaker 3 (00:10):
I'm doing good. Excited at so great, I guess so
we have good for you.
Speaker 2 (00:15):
A guynecologist to the stars, including Drew Barrymore and creator
of the Menopause boot Camp, and a board certified obstrician
gaynecologists affiliated with Cedar's sigin I'm medical centered. Do you
know that we did an episode maybe a week and
a half ago that I mentioned that I went to
my doctor and he declared that I started my menopause,
(00:38):
And it was really interesting to listen to all the comments,
not listen here, not not here, read all the comments
of people because menopause is such a I don't know
if it's taboo. It's just not something that you hear
about a lot unless you're people my age. But for
the rest of the world men and young girls, menopause
is kind of like a far away thought. So we
(01:00):
think it's very educational and fun to bring somebody to
educators about this crucial time in women's life.
Speaker 4 (01:07):
That's pretty rim Hello, Hi, Hello.
Speaker 3 (01:11):
Thank you for joining us. Yes, thank you Thank you
very excited. This is well for you. It's been a
quite a journey just in this past week, but you
just put this together that she also is one of
the doctors out of the same practice as doctor j Goldberg. Correct,
you're going to call it just for years.
Speaker 2 (01:29):
Yeah, delivered both of our babies. Now we'll have a
new doctor. So I'm happy we're in good hands today.
In this podcast, your book Menopause book camp, let me
ask you something super simple, but I know a lot
of our listeners everybody knows the word menopause, right, but
when it comes to the specific meaning of the word,
(01:52):
what is besides oh you don't get your period anymore?
Speaker 4 (01:55):
What else is menopause?
Speaker 1 (01:56):
Such a good question, Thank you for asking, and you're
a great to discuss it with for a number of reasons,
because there are certain criteria that you won't be able
to understand, right.
Speaker 5 (02:06):
So, actually.
Speaker 1 (02:08):
The definition is twelve months consecutively without a menstrual bleed
for no other medical reason between the ages of forty
five and fifty five. So if you've had a hysterectomy,
of course you're not going to know where you are
in the process because you can't track it. To the
menstrual bleeding is you know, I'm menster writing you don't
have a uterist to bleed anymore.
Speaker 5 (02:30):
I think now.
Speaker 1 (02:31):
We're starting to talk about it again, which is so great,
and thank you for being willing to discuss it and
be vulnerable yourself. I listened to your last podcast, so
I have a little hint of how you're feeling about it.
And by the way, I think a lot of people
feel that way, like freaked out, like what does this mean?
Are you saying I'm old? You know, we can unpack
that as much as you guys have time for. But
(02:55):
the other associated symptoms, the classic ones are hot flashes,
nights with mood changes, vaginal dryness, urinary tract infections, but
weird stuff too, frozen shoulder achy joints, skin changes, gut changes,
not just like weight gain, because there is some weight gain,
but also people seem to have changes in their digestion.
(03:19):
I've heard vertigo, dry mouth, like we could go on
and on and on, and there's really a lot of
those symptoms seem to be the worst or peak in
the years leading up to that menopause, which is really
one day.
Speaker 5 (03:33):
It's one day of your life. You guys, you've.
Speaker 1 (03:36):
Reached that the final period for those of us that
are still bleeding. The lead up is where you're having
a lot of hormonal fluctuations. So the way your ovaries
are producing hormones is changing. Instead of being regular and
having sort of a smooth cycle, they're erratic. The way
your brain and your ovaries are talking to each other
and the way the rest of your body is responding
(03:57):
is being impacted because it turns that we have receptors
for estrogen and pretty much every tissue in our body
our brain. I didn't talk about brain fog, probably because
I have some brain fog. You know, your gut, your bones,
your heart, your blood vessels, So not just the obvious
reproductive stuff, but the rest of your body is affected.
And that explains and helps us understand why we have
(04:21):
all these varied symptoms, and also why if we don't
understand what we're getting into and how to deal with it,
we are going to have long term health impacts if
we don't address those things.
Speaker 3 (04:33):
Can I ask you a question, because you brought up
something I would never would have thought when you brought
up gut. What are the extreme symptoms of gut issues
that you've seen with someone going through menopause, because she's
been dealing with gut issues that she's been trying to
diagnose with gastros for a couple of years. Now, it
feels like.
Speaker 2 (04:52):
It gots so bad that I thought, I was like,
I think I have a stomach cancer. It's like, what
I'm going through is not normal. It's like, my mom
is a survivor of column cancer, right, so I guess
it's in the family, you know, it's part of our
family history, a lot of goud issues. And I'm going
this this pain that I'm feeling everything that I eat,
is it?
Speaker 4 (05:13):
It bothers me.
Speaker 2 (05:14):
And when I'm telling you that, I went to two
different gastros, right, I started with one. I did every
single test, city scans, X rays, colonoscopy. Then I moved
to another gastro endoscopy and everything comes back normal.
Speaker 4 (05:29):
You're perfectly normal.
Speaker 2 (05:30):
And then and then I went to a functional doctor
and that said to me, what you have is h
pylori And I'm going no, I tested for that and
I don't have h pylori or seboard, none of that.
And then funny enough, it came back super positive and
and strap of my in testings, and I'm.
Speaker 4 (05:44):
Still dealing with it.
Speaker 2 (05:44):
I'm going through this massive protocol, but I'm still having
gut issues.
Speaker 3 (05:48):
Can menopause actually be a part of that type of
gut So we.
Speaker 5 (05:51):
Don't have a lot of really good data for the book.
Speaker 1 (05:53):
I actually interviewed Emran Mayer, who's a professor at UCLA
who's kind of the really the father of the microbiome world, right,
He's the guy who's done probably the most research of
anybody on the microbiome. And I talked to him because
here's what we do know about the gut. The gut
is actually the seat of the immune system. So you
(06:13):
guys may or may not know that most of our
immune system lives actually in our gut. And also a
lot of our hormones are made in the gut. Not
the reproductive hormones per se, but a lot of other hormones,
especially things that are connected to mood and energy, serotonin,
stuff like that, are part of that pathway is.
Speaker 5 (06:33):
In your gut.
Speaker 1 (06:33):
So I said to him, it just biologically makes sense
to me that there's going to be a shift when
our hormones are fluctuating and shifting in what's living in
the gut and he said, absolutely, I agree with you.
Speaker 5 (06:45):
And I was like, okay, so tell me.
Speaker 1 (06:46):
He's like, we don't know, which is, by the way,
that what the experts told me.
Speaker 5 (06:52):
You know, I did. Listen.
Speaker 1 (06:53):
I've done a lot of my own work and study,
and I consider myself an expert, but I also reached
out to other fields and other experts in other fields.
Speaker 5 (07:00):
It's because I really wanted to be inclusive.
Speaker 1 (07:02):
And you know, do you know how many times I
heard that we don't know, we don't know, we don't know.
I mean, that's a whole other podcast, right, because how
come we don't know? Yeah, I know, it's fifty percent
of the population exactly.
Speaker 2 (07:14):
I'm blaming it on COVID now because a lot of
people says, you know, I got COVID. I have so
many gie issues and I've had it three times. So
now I'm thinking, you know what, it's COVID.
Speaker 4 (07:22):
It's COVID.
Speaker 2 (07:23):
I don't know what I'm talking about. I'm just blaming
COVID because I just want to find it.
Speaker 1 (07:26):
I could be in any and all. And also, you
have a history of andandometriosis.
Speaker 2 (07:30):
Too, right, That's why I have.
Speaker 1 (07:32):
An impact on your gut too, right, So who knows.
But it's hard for me to believe that the menopausal
transition didn't have any effect. I don't think this is
the thing because I live in this world. I talk
about this all the time and people come to me
about this, but I always try to remind people. Look,
we can't point the finger always at menopause. I mean,
everything isn't menopause or perimenopause. But do these things interact?
(07:52):
Of course they do, so I think if you have
at least that perspective that, like I said, is a
little bit more expansive and inclusive, and you understand and
that hormones are chemical messengers. They are a means of communication.
If the communication is being altered or disrupted in any way,
the outcome will be different, the message will be changed.
And I think when we think about it that way,
(08:14):
it also doesn't feel as out of control and like
there's nothing you can do about it.
Speaker 3 (08:20):
Well, and I wonder, and maybe I'm wrong, you can
answer this, but when you had your hysterectomy, did you
already have the gut issues or did that come after
the hystrectomy?
Speaker 4 (08:31):
I think after, I think after.
Speaker 3 (08:34):
And is it true that hysterectomies can tend to speed
up the menopausal process.
Speaker 2 (08:38):
Yes, yes, it can, even if you leave your ovaries
because I kept ovaries.
Speaker 1 (08:42):
Yeah, because we're disrupting the blood supply, plus the surgery
itself and the stress of the surgery, plus if you
had antibiotics during that surgery. So there are, like you
have sort of a laundry list of things that could
be interacting. But I think if you kind of tick
off those things and you look at like, well, not
just putting the putting the proper bacteria back in its place,
(09:04):
but feeding it properly, that might be beneficial to you.
Speaker 5 (09:08):
I mean, this has gone far afield.
Speaker 1 (09:10):
But that's because this is such a big topic, right,
and there's so many surprising aspects to it.
Speaker 2 (09:15):
Yeah, what is the difference between perimenopause. I have never
heard that before my life. Perimenopause and menopause PERI.
Speaker 1 (09:33):
Menopause is the period of time leading up to the
actual menopause. So, now that you started the conversation with
the definitions, which is what I always like to start
a conversation with, right, otherwise we are not speaking the
same language. So the definition of menopause is that one
day at the end of twelve months, Perry menopause is
what leads up to it. And look, I joke with people,
if you're a menopause expert, everything is leading to menopause,
(09:54):
So you could define your entire life if perimenopausal. Yeah,
but I'm going to I'm not going to do that.
It's usually seven to ten years leading up to it,
and it's where we start seeing that there are these
subtle shifts in the hormones and in the smooth transition
month to month of your cycle.
Speaker 5 (10:11):
There are people who start to report.
Speaker 1 (10:12):
Symptoms and changes in the way they feel in their
body as early as their mid to late thirties, and
there are some people who really aren't noticing anything until
you know, three to five years before. But again, it
would be a lot of those symptoms that I discussed,
whether it's sleep disruption, hot blushes, brain fog, you know,
a change in the way their body feels to them.
People will start I hear a lot of like panic
(10:33):
and anxiety that sort of comes out of the blue.
People who've never had mood disorders start having the irritability
that is disruptive.
Speaker 2 (10:42):
So discuss believe so somebody wants to go somebody like
me that I I didn't have the twelve months without
a period, right, it happens from one day to the next. Like,
am I is this menopause or perimenopause? Am I, i'man
full menopause?
Speaker 1 (10:56):
Then right, well you're menopausal because you don't have a uterus,
But are you hormonally menopausal? The problem for you is
like you're the one group that I would recommend doing
some hormone testing on why because we have no other
way to track what's going on. But the reality, yes,
but that's that's a moment in time, and the reality
is at the age of fifty, the average age is
(11:16):
about fifty one and a half fifty two. I see
a lot of people in our community much older when
they go through menopause, actually fifty four to fifty seven even.
And some of it would depend on your personal history
or your family history, whatever the thing is for you, Roz,
like you could test again in six months and your
numbers are going to be completely different, because maybe you're
not really there.
Speaker 5 (11:36):
But the truth is that we would be treating you
for symptoms, not for the numbers.
Speaker 1 (11:43):
It's not a it's not really a diagnosis it's because
it's not a disease, it's a physiologic state of being.
Speaker 5 (11:50):
It's like puberty. We don't test our kids for puberty.
Speaker 1 (11:55):
There're eleven and they start acting like an a hole,
you know, and they're growing some hair.
Speaker 5 (12:00):
Hello, it's puberty.
Speaker 1 (12:01):
Like, you don't need to diagnose that, you know, it's
common sense. The problem is if we don't know what's
coming and we haven't been educated ourselves, we can't anticipate
and say, oh, this could be my menopausal transition or perimenopause.
And in the end, what your numbers are are not
really important to me. How you feel is what's important.
We're going to treat you to support you and your
(12:23):
body and your experience. We're not going to treat you
because oh, now you hit menopause or oh sorry, you're
month eight. We're not going to give you any hormones yet.
Speaker 5 (12:31):
I mean, we're not going.
Speaker 2 (12:32):
To do that.
Speaker 3 (12:34):
This is like a little bit of a silly question.
But there's a version I'm assuming right for Obviously, menopause
is what women go through, but men also go through
this stage in their lives where hormones drop, production of
key hormones change, They experience some of the same moods.
Speaker 4 (12:50):
So what is that called. Does it have a name?
Speaker 5 (12:53):
Yeah, it's called andropause andropause.
Speaker 3 (12:56):
So if men have their own version of menopause andropause,
they do.
Speaker 1 (12:59):
It's it's a little more subtle in people, and it's
a little bit less dramatic in terms of it's not
like a cliff that you kind of fall off of.
But for sure, testosterone levels start to decline and people
start to feel different. You know, their muscle mass changes,
their sexual function can change. But again, just like with women,
I mean, if you want to talk about sexual function,
(13:19):
sexual function is not just hormonal in men and women,
and a lot of it has to do with tissue integrity,
namely blood flow. So I think if we make the
mistake of saying that every sexual function issue in men
or women is related to testosterone, we're missing a really
big opportunity for health overall. We know that erectile dysfunction, actually,
(13:42):
I mean, any of your male listeners should know this.
Speaker 5 (13:45):
They may not.
Speaker 1 (13:47):
Erectile dysfunction is almost like the body's early warning system
for heart disease because a lot of it has to
do with blood flow. So hormones are playing a role,
But it's not just that, and that could be the
case for women as well. We know as we age,
cardiobacvascular disease really starts to increase. And so these are opportunities. Again,
I like to always frame these things. It's opportunities to
(14:08):
understand so that we can take better care of ourselves
and live our best lives.
Speaker 2 (14:13):
So for women like somebody like me that I'm experimenting,
not like super severe hot flashes, but I'm getting a
little hot, irritable.
Speaker 4 (14:23):
Libido.
Speaker 2 (14:23):
That's what you're saying, libido, the little things that I'm noticing. Right,
I did my hormone the blood test that it was
very comprehensive. I'm waiting for the results. So let's say
that you guys determine. You know, this is the issue.
We don't want to follow numbers. But based on the
blood test results and the way she's feeling when you
prepare the cocktail that is going to be good for me,
(14:45):
introducing estrogen and all those things, is this something that
is going to truly make me feel, oh my god,
at least eighty percent better?
Speaker 5 (14:54):
Well that's a great question.
Speaker 1 (14:56):
Maybe okay, because the thing is, like I said, I
everything is in hormones, but it will probably improve a
lot of the symptoms. And it's a little bit idiosyncratic
and a little bit individualize how people respond. I will
tell you that I would be very careful to get
caught up in this test treat, test treat, test treat model,
(15:18):
because we're not, like I mentioned, it's not like thyroid. Okay,
your thyroid has to be between here and here in
order to function optimally, and we got to keep it
between here and here. There's a narrow therapeutic range with
estrogen therapy, for instance, or testosterone, that's not really the case.
There is an upper limit that would be unsafe. But
(15:38):
just because the number looks a certain way isn't going
to be predictive of how you feel. And so I
think it's better to be looking at clinical symptoms and
function and how do you feel in your body and
how you like function in your life than to be
like constantly chasing the numbers, which, by the way, is
a business strategy because people will keep you coming back
for test test test test tests, because every time you're
(16:01):
coming in and they're testing you, they're charging you, and
then they're changing your hormones and they're changing your hormones
and they're changing your hormones. I just got off the
phone with a patient who was experiencing that, and she
finally said to me, after two and a half years
of working with this person, he wasn't listening to me.
Speaker 5 (16:15):
Wow, because he wasn't He was chasing the numbers.
Speaker 1 (16:19):
And I want to believe that this guy his heart
was in it and he's trying to do the right thing.
I'm going to give him credit there, but I also
see that, you know, sometimes it's a solution looking for
a problem.
Speaker 4 (16:31):
Wow.
Speaker 2 (16:32):
Interesting the whole craze about pellets. Do you believe in pellets?
Speaker 1 (16:37):
It's not about belief, Okay, it's not my personal belief system,
it's where's the evidence. Now. Having said that, I'm a
big fan of using things that are also not FDA
approved and not pharmacologic. I'm open about that. I have
an integrated medicine background. I have a background, and I'm
holistic ier Veda specifically.
Speaker 5 (16:58):
I've been a big believer in prevention and lifestyle.
Speaker 1 (17:01):
But I'm always very honest about the studies that I
use to to indicate effectiveness. That these studies are not
the best studies, but there are studies. The problem with
the pellets is that they don't have and they refuse
to create or publish data to indicate safety and efficacy.
And I mean, just do it, Just do it. If
(17:22):
you do it, then maybe we'll use it. The doses
that I see or used that are very very very high.
People frequently come into me as what I call refugees
from these pellet clinics where their testosterone is you know,
three four times the normal range.
Speaker 2 (17:36):
But they don't but let me ask. They don't do
a specific one for each person. It's not a generic pellet, right.
Speaker 1 (17:45):
I think that I think they're dosed. But the thing
is absorption is very is very individualized. And once you
put that thing in rosalin, it's in. They're cutting a
little incision and putting this rice grain sized thing with
the hormones and then they're being released and that's it
your sol until that thing stops working. So there are
(18:05):
other ways we can give you testosterone an estradile that
are bioidentical, that are that are pharmaceutical grade, that are
have been tested, that are FDA approved. I'm not the
biggest fan of the FDA, but it is what it is.
Speaker 5 (18:17):
It's what we have. I'm not against the FDA.
Speaker 1 (18:19):
I'm not for the FDA. It's a tool, but I
mean it's a tool to help try to keep us safe.
So just there are options out there that are available
that are safe and that are tested. You can do
testesterone cream. It works really, really well. There's other ways
to do it. I'm not a fan of the pellets.
Speaker 3 (18:36):
What are some of the side effects you were mentioning
that you've seen patients come in.
Speaker 1 (18:38):
Oh my god, growing acne, oil, hair loss on the
top of their head, hair growth, their included is growing
in a way that does not you know, phone or
cute bleeding. The biggest problem I see is the testosterones
can start getting converted to estrogen or the estrogen is
very high, and then they start having abnormal bleeding and
they can have pre cancer or cancer.
Speaker 5 (18:59):
Viewers, it's not cool, It's not okay.
Speaker 4 (19:02):
Yeah at all.
Speaker 2 (19:04):
Your hair changes with menopause. Did you start losing hair the.
Speaker 1 (19:08):
People can start losing hair? Yeah, definitely, definitely.
Speaker 2 (19:11):
Because that's something that for sure I'm going through. Like
my hair is a little bit of a mess. It
doesn't show that it's a mess because I have a
lot I'm very blessed that I have a lot of hair.
So even if I lose hair and it gets kind
of like funky, people think, oh, your Harry is gorgeous.
But I know my hair, you know, so I.
Speaker 1 (19:26):
Know it's the same way I'm the same way I've
lost I had very, very, very thick hair as a
young person. My daughter has crazy hair the same way
I used to have, and I'm like a to a
third of mytail.
Speaker 4 (19:37):
That's how I feel.
Speaker 5 (19:38):
It's a lot of hair, I know, and you feel
bad you don't like it.
Speaker 1 (19:42):
I hate it.
Speaker 5 (19:43):
I hate it.
Speaker 2 (19:44):
So it's it's not safe to say that that So menopause,
there's no way of knowing. It could last five years,
could be ten. It depends on the person. It doesn't.
Speaker 4 (19:53):
Nobody knows.
Speaker 1 (19:54):
And the problem that we see is that there's just
a lack of education on the part of the public,
which is why something like this is so enormously important.
So thank you for being willing to talk about it
and bringing me on. And then you know, I work
with this with this company Kindra that creates educational opportunities
(20:14):
and some really very science based supplements and products, and
they just did a big study. Oh my god, and
I'm totally bling on who it was, but you know,
one of the like sort of gallop, I think. And
they found stuff that I already intuitively knew and have
seen in my practice, which is that essentially a third
(20:35):
of patients are getting misdiagnosed gas lit not listen to
you know, people go into the doctor and they don't
feel well, like you said, and I don't want to
point the finger at your specialists, who aren't you know,
women's health specialists, and people don't even connect the dots like, hey,
this lady's forty seven. It could be that this is
a hormonal this is hormonally mediated in some way. They
(20:58):
just the doctors themselves don't know. And this is an
enormous problem. The misdiagnosis thing happens too, where you get
diagnosed with anxiety or depression or an autoimmune disorder and
it turns out it's perimenopause.
Speaker 2 (21:08):
Wow.
Speaker 1 (21:09):
But if we can come in as patients and advocate
for ourselves and say, hey, I've been reading out myself.
I listened to a podcast and I heard then it
might sort of, you know, raise a little flag, and
a really good physician is gonna know what they don't know,
and I've learned over the years from my patients saying
(21:30):
I'm not really sure. Let's work on this together. There's
no shame in that I'm not supposed to know everything.
No doctor is supposed to know everything. But I think
there's a way in which we can educate ourselves and
educate each other rather than have this be a black
box shame read and stigmatized, like as if being a
woman who lives past an expiration date is a bad thing.
Speaker 2 (21:51):
Yeah, it's very important to listen. And I went through
it first with ENDO. I have never I always know
that I had ENDO because I was diagnosed fairly young,
but I don't remember the doctors or my MoMA. No,
but nobody ever really sitting me down saying, let me
explain to you what this means, and this is the solution.
This is what you're going to feel for the rest
of your life unless we do AB and C. Like
(22:12):
I never had the conversation. I don't remember any school
ever or college teaching me about even when you're learning
about your reproduction, you know, life, or your sexuality or
all of that. Never, you know, my mom is eighty four,
I'm fifty. The first time I had a conversation with
my mom about menopause was maybe six months ago that
(22:33):
I asked my mom, when did you have your menopause?
And she said, I think I was fifty five, and
I said, well, I still have time. That's why when
the doctor last week said to me, this is what's
going on, I was so ignorant because I should have
put the dots together. I had a hysterectomy. Even though
it's partial, that means that, yeah, my menopause is going
to come a little earlier. To me, I was going,
you know what, I feel so fabulous, I look so young.
(22:55):
I'm not going to get out until I'm sixty because
I'm an anomaly right and now here I am at
fifty getting it before my mom. But that was the
only conversation that I've ever had with my mom about menopause.
Speaker 5 (23:07):
And it's because you asked about.
Speaker 2 (23:08):
It, and it's because I ask and I don't understand.
Like my daughter, she's eleven, she's going to what is
a name of the class at her school human development,
right and they're teaching them namba, but a little bit
about sexuality and the body parts and all that. I
can guarantee you, she's going to graduate, she's going to
be a senior, she's going to go to college, and
the word endo or menopause or none of that is
(23:28):
ever going to come up.
Speaker 1 (23:31):
Well, and the data out there about an ametriosis is
terrible too, as you know, it can take you know,
between six to ten years for the idea of that
diagnosis even coming up if you guys don't advocate for yourselves.
Which is why I'm a big, big proponent of grassroots changes.
I feel like when it comes to these kinds of topics, really,
as women were better off just bringing attention to the
(23:54):
people who care for us, rather than waiting for them
to bring it to us. We just have to take
we have to take control of it. Do you have
an opportunity because you can teach your daughter, You can
teach your daughter that her body or I think that
we're already My kids are in their twenties and they
were just raised totally differently than me. You guys, even
more so because your kids, for better or worse, have
been even more exposed and immersed in social media. But
(24:15):
this idea of like not being ashamed of our bodies,
being proud of our bodies that needs to extend to
all of our bodily functions, and you, as a woman,
get you can say, Mom, I had to hysterect me.
This is why I had to hysterect me. I'm so
glad that I taught myself and that I found doctors
who care about me. This is what I'm dealing with
right now. You know, if I'm a little not so
(24:38):
patient with you guys, sometimes I'm a human being, and
this is what's going on with me, Just like I'm
going to be patient with you when you're going through
whatever you're going through. Really just a matter of fact,
it's like no big deal, exactly if we make it
a big deal. It's a big deal if if we
accept the narrative that, look, I stop coloring my hair
like five six years ago. At least, I'm not saying
everybody should stop coloring their hair.
Speaker 5 (25:00):
Was the choice I made.
Speaker 1 (25:01):
If I could tell you what kind of reaction that was,
I had because I deigned to admit that I'm you know,
in my fifties. Hello, we go prematurely gray in my family. Anyways, Seriously,
I'm hot stuff. That's what how I feel about myself.
Fifty seven.
Speaker 5 (25:17):
I'm hot stuff and my hair is gray.
Speaker 4 (25:19):
And you're happy and you look fantastic.
Speaker 1 (25:22):
But my point is like I can accept the narrative
that's leveled at me, or I cannot accept it.
Speaker 4 (25:27):
Yeah.
Speaker 2 (25:36):
One of my closest friends in Puerto Rico, I'm fifty.
She is eleven years older, so she is sixty one.
Of course she's dealing with menopause. She married somebody I
think maybe five or seven years.
Speaker 4 (25:47):
Younger than her. We love him.
Speaker 2 (25:48):
They're like family. She said to me years ago, because
she came to visit and she was like, oh my god,
I'm going crazy. I have these hort flashes. I'm going
through menopause.
Speaker 4 (25:57):
Oh my god.
Speaker 2 (25:58):
And I said really, and to me even then, which
is not a long time ago, it was so foreign
in the conversation. I was like, what do you mean
you're going to anapas was I wasn't even paying attention,
but I said something as I said, how does your husband.
Speaker 3 (26:09):
Deal with it?
Speaker 2 (26:10):
And she's like, oh no, no, no, no, no, no no, I
don't talk about it.
Speaker 4 (26:13):
He doesn't even know. Don't ever.
Speaker 2 (26:15):
Don't you ever mention Eric that you're going through menopause.
It's like that's something between you and yourself, and men
don't like that so act like nothing is going on.
And I was like, again, I wasn't going through it.
To me, I was like, okay, okay, no problem, right,
But I didn't really pay attention. But I never forgot
the comment anyways, And now that I'm going through it,
I am shocked that I'm being so open, because how
(26:36):
do you feel about it?
Speaker 4 (26:38):
That you're with a fabulous old lady.
Speaker 3 (26:42):
And that's all that matters. That's all that matters. Honestly
to me, I'm very relaxed with these kinds of conversations,
like it doesn't bother them at all. I mean, that's
kind of how I was brought up. My dad was
always very open and direct with me about everything with
you know, as far as being a male and these
kind of conversations. I just know our life and they
don't really affect me. I don't think anything less of her.
(27:04):
In fact, I probably appreciate it more because there's an
open dialogue about it. So for me, I have zero
problem with it.
Speaker 4 (27:11):
Do you get good, thank you so much?
Speaker 2 (27:12):
Do you get a lot of patients that are uncomfortable
with their spouses?
Speaker 5 (27:18):
Yeah?
Speaker 1 (27:18):
In fact, so you know the book Menopause boot Camp
came out of real life experiences that I do called
a menopause boot camp, and one of the most frequently
asked questions that I've gotten when I do a boot
camp is can you do this for our spouses?
Speaker 5 (27:34):
And I really I think that I probably.
Speaker 1 (27:35):
Will because people become Look, if we can't talk to
ourselves about something, how are we going to talk to
somebody else about it? And I think if there's so
much cultural stigma around this time in our lives, everybody's
being subjected to that, men, women, children, partners of all stripes.
(28:01):
I think it's changing because people are starting to talk
about it more. And I mean, look, you guys are
in the media. We're in California. I'm living in like
metopause bubble. So sometimes I have to remind myself that
everybody is not living in this bubble where we talk
openly about stuff. But I do think things are changing
on a pretty high level, but it's not enough, and
(28:21):
it's going to take a long time. So every little
conversation really does help. And I do find that a
lot of women struggle with how to talk about it
with family members and with male partners. But I think
it's it's again, it's individual. I will tell you it's
really interesting. A lot of my Latina friends have told
me that they feel like in their various cultures because
(28:43):
obviously that's not one culture that there seems to be
a little bit more stigma around it.
Speaker 5 (28:48):
So that's really interesting to me.
Speaker 1 (28:50):
And I have actually a good friend in Miami that
is very involved in the space who's Latina. She's Colombian
and has been wanting me to come to Miami to
do stuff. And it's like, there's a lot of stigma
around people admitting that they would go to a menopausemic camp.
Speaker 2 (29:04):
I believe it interesting because there's a connotation. He's like,
oh my god, Okay, I finally hit that I'm old,
and exactly, I'm all, my sexuality is it's over. Is
my man gonna start wondering and looking for a younger
person because now it's it's it's a trip. It's a
lot of it's a lot of stuff like insecurities that
(29:27):
that that can come up. But the reality is I
have decided. Listen, you can ask your colleague Guile, Gail,
how do you pronounce it? Gile?
Speaker 4 (29:37):
I was laughing.
Speaker 2 (29:38):
I was like, I thought I was so nervous that
I was laughing. I was like, this is the funniest
thing ever. And then he hit me and I was like,
oh okay. But then I was like, I'm going to
embrace it because the reality is listen. Whether it's going
to get more severe, I don't know, you know, like
maybe the hot flags are going to be even more
intense and my mood swings. But if they stay as is,
and now that I'm going to start supplementing and helping
(29:59):
my body with things that I know they're gonna help
me a little bit. If it's gonna be like this,
I'm fine riding this wave and have a laugh and
be like it is what it is.
Speaker 1 (30:09):
Yeah, just another life transition exactly right.
Speaker 2 (30:13):
And I've been through so many already, you know, with
like the various surgeries and life and changes and leaving
my country coming to this country. I've dealt with things
that I'm much bigger then. Also, I'm gonna do yes, but.
Speaker 5 (30:24):
That's the biggest So I love that.
Speaker 1 (30:26):
God, the transitions and the conversation are perfect because I
see menopause as this amazing life experience where we really
start to dig into how resilient we are, what are
our skills, what are our values? What lights us up?
What does the next half of our life get to be?
Because if the statistics are that the average age of
(30:47):
menopause is fifty one and the average lifespan is eighty something,
then we're spending at least a third of our lives
in menopause.
Speaker 5 (30:55):
It is not even close to being over.
Speaker 1 (30:57):
And it is a really, really great opportunity to just like,
what's the next step, what's the next phase.
Speaker 5 (31:05):
It's so to me.
Speaker 1 (31:06):
If you're supported and you don't feel crappy about yourself,
it's fun. I'm not saying all of it's fun. Is
it fun to be in a bad mood and feel
fat and not sleep? No, I'm not trying to sell
you on that. But if you have the toolkit and
you have support and you don't feel silenced, once you
can get through that, you can laugh, You can laugh
at yourself, and you can dig in to see how
(31:29):
resilient you are, and you get to locate your agency,
where is your power in all of this. It's kind
of great for me, It's been great, amazing. So I
just want other people to know that that's an option
for them too.
Speaker 4 (31:41):
Yeah. I love that.
Speaker 3 (31:42):
It's incredible, really really great work. Awesome for the listeners
and for you.
Speaker 4 (31:46):
Yeah, no, I've learned.
Speaker 5 (31:48):
I say hi next time you're in the office.
Speaker 4 (31:49):
Yes, I will for sure. Thank you so much.
Speaker 3 (31:52):
Doctor Menopause boot Camp is out right. People can buy
it everywhere else.
Speaker 5 (31:57):
Yes, they can. They can buy it everywhere.
Speaker 3 (31:59):
That is awesome. Thank you so much for being with
us and sharing all your knowledge.
Speaker 4 (32:03):
Thank you.
Speaker 5 (32:04):
Oh it was so great. What a great conversation.
Speaker 4 (32:06):
Thanks, thank you.
Speaker 5 (32:07):
Have a great day.
Speaker 4 (32:09):
Bye.
Speaker 2 (32:11):
Wow. Very, I can't believe she's part of the Woman's
Care of Beverly Hills practice. I mean, I know I
can't believe because I've seen her name for twenty years,
but I didn't put it together. And I told Goldberg,
my doctor all his patients. They transitioned to doctor Guile.
But the whole practice is fantastic. Anyways, this was very
(32:32):
very education. You're okay with that, I'm totally I just said,
meaning the podcast dedicated to I love.
Speaker 3 (32:39):
These kinds of conversations. I'm all about anything science based.
Speaker 4 (32:42):
And I forgot that you are a psychologist. I want
your major.
Speaker 3 (32:46):
I wanted to be a doctor. I love this kind
of stuffinating.
Speaker 4 (32:49):
Are you're going through Andre? What is it at and
are you going through that?
Speaker 3 (32:55):
Who knows? Probably probably with all the stuff going on.
Speaker 4 (32:59):
You know, whats in interesting?
Speaker 2 (33:00):
Eric, But you remember that I said to you my shoulder,
I can move my shoulder, and I'm still dealing with
my shoulder, my shoulder, and it got so bad. I
call my brother and then somebody said to me. One
of the actresses on the show said to me, you
have frozen shoulder.
Speaker 4 (33:13):
And I said, what do you mean? And he's like,
that's what happens. How old are you?
Speaker 2 (33:16):
And I was forty it was two years ago, forty eight.
And she said, go to the doctor. I think you
have frozen shoulder. So I call my brother Peter, which
is a doctor. I said, Peter, I'm dealing with this
thing that I get this pain my left shoulder out
of nowhere. I can sleep on that side. And he
said to me, yeah, that's frozen shoulder. And I have
never done anything about it because I'm just thinking.
Speaker 3 (33:38):
What she said, frozen shoulder.
Speaker 2 (33:42):
Yes, she said, you know there's a lot of studies
now that frozen shoulder. Yeah, frozen shoulder. And you're and
your bones and you know, like everything starts getting achy.
Speaker 4 (33:51):
And my job.
Speaker 2 (33:53):
I heard that my job is a nimer right, my
my my job, my bone, my left side, my shoulder
has never been the same. So and this is literally
I started having the frozen shoulder a month after my hysterectomy,
so I think I went into harry menopause immediately after
this posatory. It is crazy, this stuff that you have
(34:13):
to learn after the fact.
Speaker 4 (34:15):
This is what I want people.
Speaker 2 (34:16):
I want people to learn things before the fact so
you can be educated and you can actually be proactive
before the issues arise.
Speaker 4 (34:24):
That's my intention.
Speaker 2 (34:25):
Anyways, thank you.
Speaker 3 (34:28):
Thanks for listening. Don't forget to write us a review
and tell us what you think.
Speaker 2 (34:32):
If you want to follow us on Instagram, check goes
out at he said. Ajason is an email Eric and
Ross at iHeartRadio dot com.
Speaker 4 (34:39):
He said.
Speaker 2 (34:40):
Ajab is part of iHeartRadio's Mike would do that podcast network.
Speaker 3 (34:44):
See you next time.
Speaker 1 (34:44):
I
Host
Roselyn Sanchez
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