August 7, 2024 • 56 mins
Jennie is joined by OBGYN and NY Times best-selling author of "The New Menopause", Dr. Mary Claire Haver for an insightful conversation about all things menopause! In this deep dive, they cover why sleep deprivation and menopause coexist, the benefits of hormone replacement therapy, and Jennie inquires with the doctor on behalf of women suffering from low libido on how they can get their partners to understand. Plus - we find out why Dr. Haver is always in her weighted vest!
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Episode Transcript
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Speaker 1 (00:01):
You're listening to I Choose Me with Jenny Garth. Hi, everyone,
welcome to I Choose Me. This podcast is all about
the choices we make and where they lead us. So yeah,
I've talked a little bit about it before, but menopause
is finally getting its day in the sun. Today I
(00:25):
choose to get into it. Let's talk about it. There
is so much to discuss about menopause and all its
phases and symptoms and side effects. Whether you are going
through it, or about to go through it, or you
know someone who's going through it, there's just too much
stigma about this chapter of life that all of us
(00:46):
women will eventually go through. My guest today is the
author of the number one New York Times best selling book,
The New Menopause. She's a Board certified OBGYN, a certified
menopause practitioner from the Menopause Society, and a certified culinary
medicine specialist. She's all about demystifying menopause, which I love.
(01:10):
She is a leading voice on the topic. Please welcome
doctor Mary Claire Haver to the Iye Choose Me podcast.
I'm so so happy to have you with us today.
I'm so happy to be here.
Speaker 2 (01:21):
This is so fun.
Speaker 1 (01:22):
It's so good. It's so good. Let me just tell
you something that happened last night. My husband, he thinks
he's funny. He said, what is going on with this
menopause stuff? It's more like manopause. I feel like you're
in your mano pause phase. I was like, that's a
good one, babe. Have you heard that yet?
Speaker 2 (01:40):
Absolutely all the time, all the time or menopause man
man no more.
Speaker 1 (01:46):
I know, there's a million things we can do with it.
Talk to me about like, what happened with you? Why
did you decide that amplifying this conversation around menopause and
women's health in this category was so important to you.
Speaker 2 (02:01):
Kind Of my journey was I was a traditional obgyn
and a big academic institution, I know, taught residents medical students,
and I had a very robust private practice and I
was happy, and I really thought I'd do that job
till I retired, you know, in like twenty more years.
And then my patients were aging with me because you
kind of get out and you get all the newly
(02:22):
pregnant people and I was newly pregnant, so we have
babies together and then we get old.
Speaker 1 (02:26):
We were all.
Speaker 2 (02:27):
Together, and you know, I was seeing these trends in
my patients who were aging of you know, these random
complaints that we couldn't seem to get to the bottom of,
like joint pain, not sleeping well, libido, weight gain, you know.
And I was just kind of taught this is what
happens when women age and get over it. We call
them whining women in clinic when I was in training,
(02:50):
you know, meaning she's just whining. This is the time
of her life, she needs to seck it up.
Speaker 1 (02:56):
There's nothing we can do.
Speaker 2 (02:57):
Never in all of my training was I ever taught
that this constellation of symptoms might be related to what
the hell's going on in her ovaries right now.
Speaker 1 (03:07):
Wow.
Speaker 2 (03:07):
So I'm like, something's not right with me, something's not
right with all my patients. Because I go to church
with these women, we go out to dinner. It's a
small town with a big university, right, I know them
outside of their little complaint list in the office, and
I know they run marathon, you know, Like, and You're like,
these are women who this should not be happening to
(03:27):
in this percentage, right, And they're eating right, they're working out,
they're doing all the things, and they're like, look, I'm
falling apart. And so you know, we're testing for a thyroid,
we're doing all the walk ups and everything's coming back
normal and they're not fully men apuzzles, so their hormone
levels really aren't diagnostic at this point. And I'm like,
we're doing this wrong. Something's wrong. So the main complaint
(03:51):
was white game. So that's where I started, you know,
and that's what was happening to me. Suddenly I was
you know, I'd had then privilege most of my life,
and then all of a sudden, I had a belly
and I couldn't get rid of it despite dumbling down
from Ike. So I called the PhD, you know, nutrition
scientists at the university. You know, I delivered all their kids,
(04:13):
and so what the hell is going on with this?
Like what about women in menopause? Why is this happening?
This is nearly universal? And they're like, yeah, so there's
something to do with inflammation. And they just sent me
down the like PubMed, which is the repository for medical
data studies, and I started reading all this stuff about
inflammation and how you know, inflammation and menopause are definitely
tied and then this weight gain and this new belly
(04:35):
fat deposition and inflammation is tied. And I start like, well,
wait a minute, this is happening, and this is happening.
Menopause and inflammation seems to be a thing. I just
realized there was such little data there, and no one
was teaching it to me. I was busy delivering babies
and pap swears and all the stuff we do. So
I just went down rabbit hole after rabbit hole, put
together a nutrition program for my patients and me and
(04:56):
my girlfriends, and you know, started talking about it on
social media. I didn't have a Macavelian plan to become
one of the leading voices in the menopause movement. I
was a busy mom of two kids, my husband worked overseas.
You know, I was just trying to stay alive. But
as I talked more about it and more, people started
listening and asking me more questions, which would fuel my
(05:17):
curiosity and I go look up more stuff. So really,
it wasn't planned. I just started talking about it, started
validating people's symptoms, telling them that they weren't crazy. This
is actually a thing, and it just grew and grew
and grew and the more I would teach and share,
the more people would join. And now we have got
almost over four and a half million followers across you know,
(05:38):
the different channels in.
Speaker 1 (05:39):
Your meno posse. I'm happy to be in your menopasse.
Speaker 2 (05:44):
By the way, it's really, you know, my miniverse is
I like to call it. It is just a bunch
of people who are there to help each other out
and share experiences and make of that crazy.
Speaker 1 (05:59):
Yeah, that sounds like an amazing way of platform, a
way to develop a platform, and such an incredible way
for you to reach so many women. It's because you're
so passionate about it, because it's happening to you.
Speaker 2 (06:11):
I love that I went through it. I'm still going
through it. I'm you know, I'm still aging and I
accept that. But you know, I just read a quote
today from one of my friends who has this program
called Menopause boot Camp, and she's an incredible personal trainer,
but she's really focusing on us now. Because forever I
was a cardio queen, I worked out to be Thinn.
(06:32):
That was the goal. I had no thoughts of muscles
or any of that. And you know, our mothers and
grandmothers just kind of got to our age and were like,
this is it, and yeah, I am. They end up
in nursing homes with cognitive deficits and dementia and frailty
and all this stuff, by and large, you know, not all,
thank God, But I don't want to accept that, and
(06:53):
that there's stuff that we can do now to prevent
that in thirty years.
Speaker 1 (06:59):
I mean there has to be. That's a driving force
for me too, Like I don't want to go down
the road that my parents went down as far as
their health, you know. So that pushes me every day
to just stay healthy and take better care of myself
than because I have the knowledge and they didn't.
Speaker 2 (07:14):
Right, right, when I think of the things that came
out of my mom's mouth about trying to stay healthy,
like eating olio instead of butter, you know, like that's
her conception of health, and you know, fighting forever to
stay thin and not giving herself proper nutrition just so
that she could be thin. Now she's paying the price, yeah,
(07:36):
you know, so same same. So when you know, when
I have patients come into clinic and we take care
of the acute problems, the joint pain, the brain fog,
the whatever, you know, we fix all of that. Then
I'm like, okay, now.
Speaker 1 (07:47):
Let's plan the next thirty years. They're like, what I
love that, I need you my life.
Speaker 2 (07:54):
What can we do? What path can we put you
on to avoid ending up? Like And if they come
in and they're like, my mom's amazing, she's eighty five,
she's driving around car, she's taking care of herself, Da
da da da, I'm like, let's do whatever she's doing,
because that's working. But if they're like, she's can't take
care of herself, we're looking at home. So we're having
to disrupt our lives like I want to don't want
to disrupt my kids lives, you know, as little as possible.
(08:17):
You know, I don't expect to live for ever, but
I don't want one of those long, protracted, you know,
times of infirmity.
Speaker 1 (08:24):
If it can be avoided, it is a big I
wouldn't say disruptance because I have my mom now, who's
in her eighties and is getting less and less mobile
and doesn't want to leave her house, and she spends
a lot of time reading, and I'm always calling her
and saying, Mom, how about a walk today? Just let's
go out, let's get a get a walk in and
(08:45):
I don't want my kids to have to worry about me.
Same as you. In your book, you say that every
organ system in a woman's body is affected by menopause,
their brain health, their heart, their lungs, and their kidneys.
Speaker 2 (08:57):
Explain this, I think that's you know, forever, we define
menopause a cessation of period, so the end of your
cycles and hot flashes, the vasomotor symptoms. But what we're
now realizing is, my goodness, the cognitive changes, the mental
health changes. So starting out the brain, you know, palpitations
are now recognized as a common vasomotor symptom. They're lumped
(09:19):
in there with hot flashes and night sweats. No very
few cardiologists know this because they weren't taught this, you know,
right Like in the lungs, new onset asthma very common
in menopause, and it tends to be a typical. This
doesn't happen to men, you know, in their midlife. It
just happens to women. Autoimmune disease, joint pain, muscle pain.
(09:40):
Of course, the genital urinary system recurrent UTI is vaginal pain,
loss of lubrication, on and on and on and so
what you go through is very different than what I
go through. Our menopause footprint, you know, our symptom profile
is as unique as we are, and doctors love a checklist,
you know, that's how we're trained. Like it looks like
a duck and walks like duck. It's a duck and
(10:02):
the duck. For me, it's just outside of your period.
Stopping and hof flashes can be really hard or can
overlap with several of the disease states. You know, it's
hard to tell hypotheridism away from perimenoplaus sometimes, and as.
Speaker 1 (10:14):
It is because you go in and you're wondering what's
going on with you and you have all these other different,
weird symptoms and they're not really linked, so everybody's just confused.
That's was my experience.
Speaker 2 (10:26):
So my goal, you know, besides educating my followers so
that they can have an informed conversation, is really you know,
part of our like the doctor menopause, the clinician menopause,
because we have nurse partitioners and lots of you know,
psychologists and stuff, is we're now pushing the medical societies
to recognize these things and start training our clinicians coming
(10:48):
up in the world so that you know, at least
the next generation we're going to have to fight.
Speaker 1 (10:54):
I mean, we're all the fighters, but they're going to
benefit so much from all of your messaging and all
this data that gathering and this information. Right, it's incredible.
Speaker 2 (11:03):
So yeah, we're not men with breasts, you know, where
we're gender help on that.
Speaker 1 (11:08):
So our skin too, though, that's another organ that is
incredibly affected by medicine.
Speaker 2 (11:15):
So wound healing besides the obvious cosmetic things, which you
know which are It's shocking because in five years, Jenny,
we lose thirty to fifty percent of for college.
Speaker 1 (11:26):
Oh my god, where'd it go?
Speaker 2 (11:29):
Like, I feel like overnight? You know? Now, definitely, you know,
hormon therapy helps. You can do very safe topical hormone
therapy that works beautifully. Of course, all the cosmetic treatments
and stuff, but I don't know a woman who goes
through it who like wakes up every day and is like,
what happened to dudes, not saying what happened to my skin.
It's a cosmetic stuff, you know, wound healing and you know,
(11:51):
just the health of your skin. The trends to epidermal
water loss, you know, We're much more likely to become dehydrated,
you know, because our skin becomes so thin and we're
just blowing off, you know, plus the hot slashes you know,
in sweatings.
Speaker 1 (12:03):
So it's just crazy how it affects us all. It's
like a massive cyclone that comes into your life and
just does all kinds of destruction and then it's like
bye bye, and I'll take all that with me. Explain
the difference for those that don't know, because I definitely
did not know when I didn't know when I was
in perimenopause. I didn't know what perimenopause was. I didn't
(12:26):
know the definition of menopause being twelve months after your
last period, which I learned once I was twelve months
after my last period. So can you explain the difference
for people like paris meno and then postal.
Speaker 2 (12:38):
Okay, so we'll do a little baby lesson in endochronology. Okay,
perfect to educate your listeners. This is this is so critical,
so big difference between females and males. We have lots
of differences, but as far as our gonads go, so
overs and testicles, men make their genetic material, their sperm
fresh every day Okay. Women are born with a limited
(13:01):
egg supply. They form when we're still in our mother's uteruses, right,
and then we're born with one to two million eggs.
By the time we're thirty, we're down to ten percent.
By the time we're forty, we're down to three percent.
Menopause really represents you've run out of eggs. Okay, So
now let's go to your normal, your twenty five year
old self for ninety percent of as of normal regular cycles,
(13:22):
very predictable if you're healthy.
Speaker 1 (13:23):
Okay.
Speaker 2 (13:24):
What happens why we ovulate, is that the hypothalmus, which
is a gland in our brain, is constantly sampling our
blood supply for estrogen estra dial, and when the levels
get low, as they do towards the end of the cycle,
it sends a signal to the pituitary gland, another gland
to make stimulating hormones. That will say, ovary, let's get
an egg out and ovulate, so that'll begin the production
(13:45):
of estra dial through the ovulation process. What happened, and
that goes a very ekg like, very predictable rise and
fall of our hormones month after month after month in
a healthy woman. Okay, Okay, it happens in perimenopause. So
menopause by definition is the transition between what I just
talked about, normal reproducible cycles to no more cycles. The
(14:08):
chaos zone in the middle is perimenopause. Now what happens
here reach a critical egg threshold level where the same
signals that we're sending down each month stop working because
we don't have enough eggs. We don't have enough follicles
left to respond. So the hypothalamus is like, hey, where's
my xtra diol?
Speaker 1 (14:29):
The tutory is like I.
Speaker 2 (14:31):
Sent the signal and is like send more. So we
end up getting much higher levels of the stimulating hormones
from the pituitary, but you don't have the same temporals.
So what used to look like this now is delayed
because it took a while for the signals to go
back and forth. Then you get a much higher surge
of that FSH and then you get much lower drops.
And so what used to look like in EKG now
(14:52):
becomes chaotic month after month, and it's not predictable at all.
And so in that chaos zone, percent of us will
have abnormal uterine bleeding heavy periods like periods no periods
too many, too frequent, too few, to craziness. Only about
ten percent will just wake up and not have a
period again. There's usually a calling card, hot flashing and
(15:14):
the night sweats, the joint pain that you know, the symptoms.
But most importantly, the brain hates chaos. It loves predictability.
And when our estrogen and progesterone and testosterone levels start
going haywire in perimenopause is when we see the biggest
changes in the brain both mental health. We have a
forty percent increase of depression anxiety across the perimenopause transition.
(15:37):
So you were living your best life, nothing has changed,
no stressors have changed, and all of a sudden you've
lost your resilience. You're cranky or depressed or snappy, or
the things that used to bother you or now bothering.
Speaker 1 (15:51):
You, you know, and a lot more, uh huh.
Speaker 2 (15:54):
And so also our cognitive ability, so our ability. Think
you're forgetting names, you can't remember, your job is suddenly
becoming harder. You're you've got something that took your tongue
and you can't you know, And like that all happens
to us every once in a while. But this is
like a consistent pattern. This is a hallmark of the
cognitive changes in perimenopause.
Speaker 1 (16:14):
And then you have this crazy fluctuation.
Speaker 2 (16:16):
Busy time turns into full menopause. Now bottomed out, there
are no eggs left, and now you have no estrogen.
Speaker 1 (16:25):
Oh, then the fun. You know. When I was in Perry,
I was like, all right, let's get this over with
enough already, just stop already, period so that I can
be done with this. And I was kind of like
hoping for it. And now that I'm in it, I'm like, wait,
I gotta miss it. Yeah.
Speaker 2 (16:40):
I mean a lot of women are grateful, thankful that,
especially if they had horrible periods or just ems or
menstrual migraines, that is over and they can get on
with their lives. But there are benefits to estrogen in
our body, especially in the brain and the joints, you know,
and our gut microbiome, all of it's affected.
Speaker 1 (17:00):
Yeah, And that no one has ever taught us this
as bonkers to me.
Speaker 2 (17:04):
Right that I just saw a study where ninety percent
of you know, girls were never taught about menopause in school,
like nothing like in their health class, Like that there
would ever be even if it's just like the end
of your fertility. You know, it's just like this vague
kind of.
Speaker 1 (17:19):
Something your grandma deals with, right, Yeah.
Speaker 2 (17:23):
And so, and I really had a negative connotation about
menopause myself, and I just know that's the same for people.
I remember thinking I hate menopause, like I don't want
to take care of people at menopause. And now that's
all I do. And God, you know, I am living
my best life. I am happier, healthier, better relationships, better boundaries.
I'm guiltless, I have no shame. I am just you know,
(17:45):
I feel like I'm helping people, I'm teaching. But if
I had not overhauled everything I think about health and
how I'm going to age and learn how to prioritize
myself and stop putting everybody's needs in front of mine,
I would not be here today. And all I want
is for what I feel, for everyone to have that chance. Oh.
Speaker 1 (18:05):
I love that, and you. I feel it from you
when I look at you, when I read your book.
By the way, your book, I have it right here
the New Men of oz. Oh, it's really great. Thank
you for writing that, because it's conversations that we haven't
had before, and we need to have. I agree you
are inspiring women our age to go for their best life,
(18:27):
and I love that about you. What about birth control.
I've been on and off birth control my whole life.
Does that affect the onset any perry?
Speaker 2 (18:42):
Yeah, so we need more studies. But we have lots
of women who are birth control, and I was on
one of them. I was on it god thirty years
too well contraception, but also for treatment of my PC
or you know, covering the symptoms of my pcos. And
I was happy on them, did great on them, no problem.
We know that because we suppress ovulation with birth control pills,
(19:06):
women who are the longer you're on them, you tend.
Speaker 1 (19:08):
To get an extra year or so.
Speaker 2 (19:12):
You know, if you're on like long term ten plus years,
you might get an extra year or so out of
the shelf life of your ovaries because we suppressed ovulation.
We lose about eleven thousand eggs each month with the
ovulatory process. So so a little bit not hugely clinically significant,
but there is a little bit, you know, I worry
about and probably what happened to me was, you know,
(19:32):
when we're on long term birth control, and for me,
it was medically treating something that I was happy with.
You know, what did that do to my bone and
muscle strength? You know, not having those normal levels of
tasosterone and estrogen.
Speaker 1 (19:44):
It's just always something scary when when you're like, well,
I hope this goes well.
Speaker 2 (19:48):
Yeah, you know, and I was happy to be treated
because I have PCOS and what it did to me.
You know, there's trade offs, there's were sympnefits for everything.
But nobody sat me down and was like, okay, listen,
you know, this is is a bigger conversation than we thought,
and we do need to have more studies, but this,
you know, you probably should be doing more weight lifting
in the gym to hang on to your muscle mass
(20:08):
because we're going to be suppressing your natural disosterone as
well with this.
Speaker 1 (20:13):
Our symptoms change according to what phase we're in.
Speaker 2 (20:16):
Right in a menstrual cycle, yeah, so if you're you know,
pre minstrel, your estrogen levels are rising. So the first
halfier cycle, progesterone is zero almost very very low. Disascone
does e and flow, but not nearly as much as estrogen,
but it's fairly steady state compared to the others, and
then we have a rise in estrogen mid cycle, and
(20:38):
then it kind of goes down right after, and then
we have a little bit more of a rise and
then it plummets in a healthy menstrual cycle.
Speaker 1 (20:44):
Imperimental policy, we even know, ye, there's no way to
We need more studies, we need more more data we do.
Speaker 2 (20:52):
Let me, let me give you this, Okay. PubMed is
like where I go. It's like Google for doctors or
Google for clinicians to look up vetted medical journal articles,
like you know. Everything in there's pretty upfront. And I
just type in the word pregnancy. I get one point
one million articles. Amazing, right, that's great. We need healthy pregnancies.
(21:12):
I've had two of them. Then I type in the
word in menopause. There's ninety seven thousand articles, so ten
to one difference, uh huh on one roughly a little
less thanton one. I'm like, am I ninety percent less
important in this phase of my life than I was
when I was pregnant?
Speaker 1 (21:27):
And that's what they want us to believe, That's what
we've been led to believe.
Speaker 2 (21:31):
Wait, so I type in the word perimenopause. I just
did this, and there's six thousand, seven hundred articles.
Speaker 1 (21:36):
WHOA, Yeah, we got work to do. People don't know
that there are stages, that there are different symptoms, that
everybody's different. It's a real mystery to so many people,
and definitely to men.
Speaker 2 (21:49):
Right now here, you are a partner trying to support
a loved one through this.
Speaker 1 (21:53):
You she.
Speaker 2 (21:56):
So the best appointments I have are when the partners come,
usually coming for a place of support and understanding, and
I just love talking you know about all these things
for them and they need it really helps.
Speaker 1 (22:09):
It really does, because they're so in the dark. They're
so in the dark. So why but why is that?
Historically speaking? Why are we as women so underserved from.
Speaker 2 (22:19):
A medical standpoint when you look at where how women
have been treated, You know, so much of women's health
has been you know, how a woman expresses certain diseases
has been compared to how a man does it. So
like atypical chest pain is female chest pain. You know,
a woman is much more likely to die if she
comes into the er with a heart attack than a man.
(22:41):
Because everything's based off of how the average white male. Sorry,
that's just how the US medical system developed acts and
how drugs affect him. They didn't even study female rats
in all the animal models. It was always males because
women are harder. Females are harder because we have psychic fluctuations,
and so being excluded from all these studies. So that's
(23:01):
one thing, it's all in her head is another thing.
It is real.
Speaker 1 (23:05):
It's taught.
Speaker 2 (23:06):
I was taught that a woman tends to tomaticize psychological issues.
Speaker 1 (23:11):
Right, and then you're gas lit.
Speaker 2 (23:13):
Yeah, so yeah, and so instead of believing a woman
and what she's saying is true, we.
Speaker 1 (23:19):
Were taught.
Speaker 2 (23:21):
You know, is she having a bad day? Is does
she need some rest? Do you need her vacation? Does
she need some wine? You know, give her nanny depressant,
she'll be fine. Yeah.
Speaker 1 (23:33):
Yeah, This is this is why I don't even understand
what a hot flash is, like why that happens.
Speaker 2 (23:40):
So there is a thermoregulatory center in our brain that
controls our body temperature. So everybody has head of fever, right,
and you know what that feels like.
Speaker 1 (23:52):
You are hot.
Speaker 2 (23:52):
You can't figure out why you start sweating, you know,
especially if you have the flu and you have a
really bad that's kind of a hot flash. So mine
and the way most are it feels like so the
therma regulatory center becomes unstable from the loss of estrogen,
we think, and you just start profusely sweating for no
reason without a trigger. So I could just be sitting
(24:13):
here and all of a sudden, I'd feel something in
my chest and then it would I would just feel
this heat wave come up my neck and head, and
like for me, the back of my head starts sweating
and it would just drip down my back and my
chest would be sweating. And at night it would wake
me up, you know when that would happen because I'm
hot and then I throw the covers off and I'm
soaking wet, and then I'm freezing exactly.
Speaker 1 (24:32):
It's the hot cold for me. You get so hot
that you sweat and then you're freezing because you're basically
naked in a Yeah, you're wet.
Speaker 2 (24:42):
So and that you know, and then when you disrupt.
I mean, there is one of the top menopause researchers.
She's much older in the US, and I just read
a quote from her and I wanted to roll my
eyes so hard. I mean, there's the old school menopause,
the old guard I'm probably going to get in trouble
for saying this. But the people who kind of, you know,
and God bless them, they did great research back in
the day, but they kind of are really reluctant to
(25:05):
accept that other organ systems can be affected by menopause.
And she's like, no, no, no, no. The reason why
you're having brain fog is because your hot splashes are
waking you up.
Speaker 1 (25:14):
At night and you're losing sleep.
Speaker 2 (25:16):
Despite multiple medical journal articles coming out showing pet scans
all the brain going through menopause.
Speaker 1 (25:23):
Oh that I mean, it's just that kind of mis knowledge,
I think, and people talking about that as much as they.
Speaker 2 (25:32):
Have, I thought it a narrative that they have that like, listen,
women are just And then she similar researcher out of
Australia is like, it's just tough to be a midlife woman.
It has nothing to do with menopause. This is just
what women go through at this stage.
Speaker 1 (25:47):
I'm like, no, that's not good enough.
Speaker 2 (25:49):
I was living my I was perfectly fine until I
hit a certain age. I changed nothing, no stressors, no.
Speaker 1 (25:57):
Diet, no exercise. My body completely changed.
Speaker 2 (26:00):
My brain has to completely check.
Speaker 1 (26:01):
I'm not a doctor. I didn't go to med school.
It makes sense to me, and so I don't understand
how it couldn't make sense to much more intelligent people.
Speaker 2 (26:10):
And I started hormone therapy and I got ninety percent better.
Speaker 1 (26:14):
Yep.
Speaker 2 (26:15):
I just gave my body back what I used to have,
and turns out all those things kind of went away.
Speaker 1 (26:21):
Let's talk about it then, hormone replacement therapy.
Speaker 2 (26:25):
So I look at it as if I had hypothyroidism.
So if every woman's thyroid tanked at fifty and you
were born with, you know, all of your thyroid globulin
cells and they started deteriorating, you know, and then all
of a sudden at fifty they were gone, no one
would question you going on thyroid hormones for the rest
(26:47):
of your life, you know. And why do we do
this to women? And so menopause hormone therapy is basically
just giving your body back estrogen, progesterone, and sometimes testosterone
in levels that were similar to what you would have
gotten in your pre you know, in your pre menopause years.
And for me, it's like basically telling my body functions
(27:09):
to just operate at their usual level because the loss
of estrogen and tastosterone leads to dysfunction.
Speaker 1 (27:17):
Well it makes sense, but why why did it get
such a bad wrap?
Speaker 2 (27:20):
Well, okay, so scared in the eighties and nineties, probably
you know, depending on the numbers, forty to forty four
percent of women, it was recommended all women should be
on HRT. Okay, so about forty four percent of women
chose to be on it. Now, some had hoflashes, some didn't.
And what they knew from observational data was that women
tended to have less heart attacks and less death from
cardiovascular disease or at later ages than women who weren't
(27:44):
taking HRT that were age matched. But that was an
observational study. That's not proof. That's just like, hm, why
is this happening now? The theory was that, well, women
on HRT tend to be healthier and wealthier because they
have access to you know, medical doctors more often, and
maybe it's just an artifact of the healthier, wealthy patient population.
So let's do this large, randomized controlled study to see
(28:06):
if hormone therapy will decrease, truly decrease the risk of
party of vascular disease. So that was the Women's Health
Initiative billion dollar study thirty seven thousand patients enroll. They
have two arms, so it was placebo controlled. This is
like the gold standard study. So at the time, the
top two prescriptions given were premarent and prempro. Not really
what we give now, so that that's one caveat the
(28:26):
only tested one formulation. If you had a uterist, you
have to have a progestogen, So they gave premaran, which
is conjugated decoin estrogen and metroxy progesterine estate. Lots of
big words to say primpro, and then the women who
had had hysterectomies got premro because you don't need the
extra progesterone.
Speaker 1 (28:41):
So off they go.
Speaker 2 (28:42):
They see after a couple of years in the estrogen
plus progestogen arm that the women had a very slight
increased risk of breast cancer over the placebo group. Okay,
so it went from h four out of ten thousand
per year to like seven out of ten thousand per year,
which so there's relative risk and absolute risk relative risks.
That was like a twenty five percent increase in relative risk,
(29:04):
different than the absolute risk which was less than one
percent per year. Okay, just it depends on how you
skew the statistics.
Speaker 1 (29:10):
So they halt the.
Speaker 2 (29:11):
Study for that arm. They called press conference, don't release
the data, don't let any of the doctors review it,
you know, and say at this press conference, estrogen causes
breast cancer. We've stopped the study. This is horrible, Okay.
Every newspaper, every news show was before social media. Front
page cover was the number one new medical news story
of two thousand and two. It was my last year
(29:31):
of training, by the way, I'll never forget this. And
eighty percent went through their stuff in the trash, stopped
taking it. I don't want to die, blah blah, blah,
blah blah. Antidepressants went up four times, sleeping medications went
up three times, blood pressure medication, cholesterol, all that statins.
Speaker 1 (29:48):
You know.
Speaker 2 (29:48):
The loss of hormone therapy, women had to go on
polypharmacy to get everything control that hormones used to control.
The estrogen only arm continued for a couple more years,
and they did see an increased risk slightly of stroke,
which we knew. We knew, okay that after the age
of sixty, if you're on hormone therapy, your risk of
stroke goes up a little bit. Like, oh my god,
it caused a stroke. They did not see an improvement
(30:09):
in cardiovascular disease risk, no improvement. So now the average
age was sixty three because they're looking for cardiovascular disease
as an outcome, okay, which is reasonable if you're looking
for heart disease. Get it takes time to develop it,
so much older population than would have really started h RT,
usually at fifty to fifty one, forty nine, you know,
(30:32):
somewhere in that age. And they excluded everyone with hot
flashes because you would know if you had placebo jaw
flashes get better. So women with hot flashes tend to
have the you know, really really bad disease. And so
when with se of your hot flashes, are higher risks
for other conditions later on. So it was a really
(30:53):
kind of skewed study. And when they've gone back and
looked at it the women, they had younger women in
the st ST. So when they looked at the patients
who started HRT within ten years of their menopause, they
did have decreased risk of cardiovascular disease. It was just
the older patients. So estrogens that turns out, is better
at prevention than cure. It's very stabilizing to the blood vessels.
(31:15):
That line our carotid arteries and our hearts is where
strokes come from and where the alproscorotic disease happens.
Speaker 1 (31:22):
And you know, not to say you'll never.
Speaker 2 (31:24):
Develop those diseases, but it can delay the progression. But
you must start early, early.
Speaker 1 (31:29):
It turns out in the brain.
Speaker 2 (31:31):
Estrogen is a huge, huge, huge.
Speaker 1 (31:34):
Benefit in the brain.
Speaker 2 (31:35):
But you've got to start kind of early in order
to see those benefits. At least ten years as well.
Speaker 1 (31:40):
Okay, so what's a number early?
Speaker 2 (31:42):
So right now, the quote is to have the cardiovascular
preventative and cognitive preventative benefits, So within ten years of
your menopause or before the age sixty.
Speaker 1 (31:54):
Okay, Now that being said.
Speaker 2 (31:55):
I do start patients now, if you've turned sixty and
you're on HRT and you're doing great, and you have
no risk.
Speaker 1 (32:00):
Factors, you can keep going. There's no age at which you.
Speaker 2 (32:04):
Have to see.
Speaker 1 (32:04):
You don't have to stop it if you're sixty, no, okay,
you can continue those preventative benefits.
Speaker 2 (32:10):
But if you already have severe athloskrotic disease, estrogen is
not going to make it better, okay, And some people
think it may make it worse. So in my patients
like above sixty with risk factors, I'm getting a calcium
cardiac score and like extensive testing to see if they
have disease. I don't want to add estrogen on top
for you know, potentially making that disease worse.
Speaker 1 (32:29):
Right, Okay, I heard today. I've known this before a
friend of mine has a company, but I heard today
in the news about estrogen in the form of a
vaginal topical ointment being used.
Speaker 2 (32:48):
On the face.
Speaker 1 (32:49):
This on the face, I think natural about is my friend.
Speaker 2 (32:52):
So I've been using topical estrogen.
Speaker 1 (32:54):
What's it called estra deal how do you say it?
Estra dial estradiyle sore.
Speaker 2 (32:58):
There's two forms that have been tested. There's estriol, so estrogen.
Vaginal cream is typically estra dial point zero one percent
or yeaer point oh one percent vaginal cream.
Speaker 1 (33:09):
And that's something someone's supposed to just rub on their
vagina and it's to absorb.
Speaker 2 (33:13):
So that's for the treatment of vaginal atrophy and it
works beautifully. Well, Okay, some people have been putting it
on their face as well, and they've actually done studies
with the topical estrogen. This is a very very low dose.
This is not the estrogen that you would get the
cream and the sprays and everything for systemic therapy. This
is a much lower percentage. They tested the blood levels
(33:36):
of women putting it on their vaginas and on their faces,
and there's no systemic absorption, so there's no worries about
block clots or any of that, or endimatoral cancer, none
of that. Okay, as long as you use that preparation
meant for the vagina, the low low dose, the low
low dose and estreol cream, which is another form of estrogen.
It's actually the estrogen that's created in our placinas when
(34:00):
we're pregnant, and so they've been able to synthesize that
and the estray All cream get used on the face
as well with some similar efficacy, and those are usually compounded.
So that's the one that I've been using because my
friend's company made it and I was like, yeah, yeah,
I'll try it. She sent me one for free. I
fell in love with it, and of course now I
just buy it so I can talk about it without
(34:21):
having to say sponsored no, this is good.
Speaker 1 (34:24):
I mean, it's a conversation that's been going on, but
now it seems like it's becoming public and I think
everybody's going to be talking about it.
Speaker 2 (34:31):
Don't skip the vagina if you're you know, people are like, well,
I'm just trying to down there. I'm like, no, please,
you know she's staged it down there.
Speaker 1 (34:40):
That's the health part. This is cosmetic. Yes, we talked
a lot about symptoms. Hot flashes obviously that's like the
no brainer symptom. But brain fog, you know, it's just
like when you have postpartum, when you just had your
baby and your hormones are gone, whack a dooodle. It's
a silence like misery, and nobody knows what's going on
(35:03):
in you, but you I feel like the brain fog
is another just silent struggle that people don't understand because
I mean, it happens to me at least three times
a day where I walk into a room and I
have no idea why I'm in there. That's brain fog.
Speaker 2 (35:19):
M yeah. Or you can't find a word, or you
you know, can't remember a name or you know, in
these these things that will happen to us from time
to time. But when it becomes a pattern and all
of a sudden, you're questioning your judgment. One in five
women are quitting their jobs at our age because of this.
It's so bad, especially since they feel inadequate positions who
(35:41):
require lots of cognitive ability. You know, our missions are
they are really struggling and like not and hitting a wall,
hitting a wall at work.
Speaker 1 (35:50):
It's scary.
Speaker 2 (35:51):
It's so scary, and you know we're losing that. Mckensey
company just did this incredible report looking at lost economic
the economic impact of these women who are supposed to
be leading companies who can't do it. You know, twenty
percent of women walk away not because of an aging
payriner stuff. They can't they don't want to be up.
You know, they can't do their job confidently.
Speaker 1 (36:11):
Is there a correlation between brain fog and early onset dementia?
Speaker 2 (36:18):
Okay, so we all tend to have cognitive decline okay
in early in perimenopause and early menopause, and then for
those of us not on the path to dementia, it recovers.
Speaker 1 (36:30):
Okay later, Oh thank goodness.
Speaker 2 (36:33):
It does tend to recover. You will never quite be
where you were, but it does. The brain rewires, you know,
from the lack of estrogen, and then you learn how
to kind of compensate for it. Okay, that brain keeps
going unless you're on the Alzheimer dementia spectrum, and you
can keep going down. So, you know, the greatest book
written on this, and a brand new article just came out.
Lisa Musconi wrote The Menopause Brain. When she's a neuroscientist
(36:57):
out of will Cornell and she does pet scan after
pet scan of women's brains in different levels of menopause
and it's absolutely fascinating and it's just so validating. You know,
it's almost like I don't care if it's fixed at
this point, like at least I know I'm not nuts,
and you know, but she says, Alzheimer's is a disease
with symptoms of in old age, but it begins in
(37:18):
the life and menopause accelerates the deposition of the plex.
Speaker 1 (37:24):
Yeah, it's a shame.
Speaker 2 (37:25):
But even with the APO E four gene HRT, like
women on HRT.
Speaker 1 (37:31):
Have involume better scores and women not what you call
it the APO.
Speaker 2 (37:36):
So there's a APO E four I think gene which
is the genetic marker for Alzheimer's, Alzheimer's.
Speaker 1 (37:42):
And even people.
Speaker 2 (37:43):
So they studied that group and there was a few
of the women who actually got put on HRT for
hot flashes, and they had bigger brain volumes and better
cognition scores than their age match women, you know when
they started young, than the women who never got HRT
with the genetic predisposition.
Speaker 1 (38:00):
It's so fascinating. Bodies are so crazy facinating. Wow, I
totally get it. Why you became a doctor. Loss of sleep,
that's another huge I had a lot of loss of sleep,
and that is what was the final driving factor. Combined
with the hot flashes of the marine fog. I guess
they'll go together. But I said, I can't lose my sleep,
(38:21):
and I'm not sleeping. I just wake up like five
times a night, whether it's from a hot flash or
just because. And that's why I decided to go on estrogen.
Why are we losing our sleep? Is it because of
the hot flashes? Few reasons. The hot flashes are just
sleep disruptive.
Speaker 2 (38:35):
They'll wake you up right right. So, but even though
we can get those under control, women are still struggling
to sleep, not as much as before. So with the anxiety,
if someone is on the spectrum of their anxieties getting
higher in the racing thoughts at night.
Speaker 1 (38:51):
That's one of the things.
Speaker 2 (38:52):
Progesterone works incredibly well for that, or that three am
wake up and then you can't shut your ain off
to go back to sleep.
Speaker 1 (39:02):
Progesterone works for that. The other thing is our bladders
can wake us up.
Speaker 2 (39:06):
So if you're having irritable bladder or you're having you know,
incontinence or bladder spasms, then you know, vaginal estrogen can
do a beautiful job here of calming all that tissue
down so that you can sleep through that disruption. But
for my patients who you know, we've gotten the hot
flashes under control and she's still struggling, you know, with
(39:26):
the wake ups or the racing thoughts, progesterone we can
you know, you can go up to three and even
four hundred milligrams a night for that. The other thing
is if I choose to drink, and this is most
of my patients, if I choose alcohol, I am choosing
not to sleep. There's no way around it for.
Speaker 1 (39:42):
Me, I know, man. And then there's just that's not
a decision you have to make because I'd rather sleep
than have a glass of wine. Yeah, I'd rather wake
up refreshed, yeah, yeah, and I'm sad because I'd love
to just you know, have wine or drink like my friends.
But I know how it affects me.
Speaker 2 (40:01):
Yeah, so I have good I have really serious conversations
with my patients, like I can't fix this. We don't
know what you know, no one studied this yet. We
know it's happening, you know. And it could be that
our body composition is changing and.
Speaker 1 (40:14):
Getting to cut out of your life.
Speaker 2 (40:17):
And there's really no medical benefit to it.
Speaker 1 (40:19):
I mean, it's boyson. We can work on other ways
to stress release. So yeah, yes, please, let's talk about
this Hypoactive sexual desire disorder. Yeah probably aka low libido,
AKA I'm not in the mood. There's many ways, so
we can sumb that one up.
Speaker 2 (40:38):
Fifty percent of my patients have HSDD and it's it's
very very common. So hypoactive sexual desires source. So when
a woman comes in and I screen all my patients
for this, when they hit the door, my I have
low libido. There's kind of a medical checklist we have
to go through. Are you having pain? Okay? So when
we look at the buckets of why a woman's sexual
function is not where she wants it to be. One
(40:59):
is relationship disorder.
Speaker 1 (41:01):
I'm not going to fix.
Speaker 2 (41:02):
That, you know, Yeah, do you have a supportive partner?
You know, if when you're by yourself you're happy, and
when you're with this person there's zero interest. That's you know,
that's a counseling issue or whatever. That's you know here, no, no, no,
I love him. I w you know.
Speaker 1 (41:16):
Did you ever have a great desire?
Speaker 2 (41:19):
Yes? I used to, and it's just gone. I can't
seem to make it come back. I'm like, Okay, are
you having pain?
Speaker 1 (41:24):
Yes or no?
Speaker 2 (41:24):
And we have to fix that, get to the bottom
of that. Then there's arousal disorders, which are not that
common in women that they can happen, and orgasmic disorders.
So arousal disorder is you're struggling to get blood flow
to the area your brain saying yes, but nothing's happening
in the pelvis. Okay, that's where female viagra can come
into play, because that will increase just like in a man.
It will increase blood flow to the genitalia and kind
(41:46):
of get things moving in that direction, but it's not
going to do anything for your brain.
Speaker 1 (41:49):
Wait, what's female viagra? Is it called viagraf.
Speaker 2 (41:52):
Yeah, okay, giving a woman viagra can help with that,
and sometimes they just put the pill in the vagina
and let it dissolve and work there. Oh. The other
is orgasmic disorder, and you know, like ten percent of
women never ever ever have orgasms and their lives. And
you know if that was men, wouldn't this be a
national emergency?
Speaker 1 (42:11):
We would have heard about it.
Speaker 2 (42:12):
And so there's primary and secretary, so you know, we
get to the bottom of that. Then what's left is
HSDD hypoactive sexual desire disorder. Basically like love this person, right,
everything's great in my life. I can't figure out why
I can't get the signal up here. There's some medications
that work really well for that. So there's two FDA
approved medications. One is Addie, which is the pill you
(42:32):
take every day. It works at the level of neuro receptors.
Great story on how long it took for them to
get past the FDA compared to viagra, which took like
thirty seven minutes.
Speaker 1 (42:42):
Okay, oh my god, story Cindy Ekkerd.
Speaker 2 (42:45):
You have to listen to her. She's amazing. Then there's
v Lasi, which is an injection that you give yourself
thirty minutes before.
Speaker 1 (42:53):
But some patients who does.
Speaker 2 (42:54):
Well, they love it. It works on Milana Courton and you know,
kind of opens up things in the brain there.
Speaker 1 (43:00):
Where do you inject it anywhere?
Speaker 2 (43:01):
Okay, usually an ADAM and most people just grab the
scin and pop it in and you just wait and
then you wait thirty minutes. And then there's testosterone which works.
That's works the best, but unfortunately we don't have an
FDA proved medication. It works and postmona balls with women beautifully,
and so probably half of my patients end up on testosterone.
(43:23):
As long as you give it in physiologic doses, then
they usually don't have a lot of side effects and
we're just restoring their levels and they're so happy. It also,
you know, has very promising research on brain function on
But there's just a sasterm receptors everywhere. And when my
patients come in and they are sycopenic because I have
a body scanner in my office, or they have local density,
(43:44):
you know, peniostioporosis, I'm using it in their toolkit of
how are we going to get your bone stronger, you know,
or keep your bone strong of you know, resistance training, protein,
the weighted vest, all that plus testosterone. So most of
my patients when we go through the options, choose testosterone
because it seems to have multiple benefits.
Speaker 1 (44:03):
And can you be on estrogen, progesterone, and testosterone. Yeah,
we call it the megapack. That's like a dream come try.
I'm on all three. Yeah, wow, I got to get
on that train. I've seen you before with your weighted vest.
What the heck is happening with that?
Speaker 2 (44:24):
So there's great studies there. You know, women our a
genteralder are rarely studied. It's really sad, but there are
actually some really nice studies looking on women and men
in long term care facilities, measuring muscle and bone strength
and all the tools that they used. So I call
it my osteoporsus Prevention pack. And because you know you
(44:44):
fall and break a head, you dead. Thirty percent of
us will die even with surgery in a year after
the age of sixty five.
Speaker 1 (44:51):
That's in nine years for me.
Speaker 2 (44:53):
That's not good.
Speaker 1 (44:54):
That's coming up.
Speaker 2 (44:55):
So you know, I'm doing everything I can. So the
weighted vest is just a hack. I'm actually going to
develop one with QVC. I love this. I'm in line
because I have one and I love it, but it
doesn't fit over the when women's chests very well. They
were made for men as per us, and so I
want to make one where we can kind of slide
the stuff around and fit around our girl parts.
Speaker 1 (45:16):
So, God, you, I'm so excited for you to come
to the queue with all your packs, all your things.
It's going to be really great. So that's just like
a weighted thing that you do. You wear that like hiking,
working out.
Speaker 2 (45:30):
Yeah, so I tell my patients. Start wearing it around
the house, doing housework, walk the dog, you know, until
you start with about ten percent of your body weight,
so you know, twelve rounds or fifty nothing crazy. And
then as you get stronger, you wear it more and more.
I now wear it when I'm working out, like and
I also I turn my treadmill into a walking desk
and so I'll put the desk on an encline, throw
(45:50):
on my weight to vest and I'm doing research or
doing zoom calls for work not not a podcast.
Speaker 1 (45:55):
But yeah, you're not doing it right now. No, how
high are you is your weight up to?
Speaker 2 (46:00):
Oh? Of course my husband got into it. So now
we have eight which no one wears anymore. We have twelve, fifteen, twenty,
twenty five, thirty, and thirty five.
Speaker 1 (46:08):
So he wears the heavier ones.
Speaker 2 (46:09):
Every once in a while, I'll put the heavier one
just to feel, but I'll take it off in like
thirty minutes.
Speaker 1 (46:14):
So that is great though, What a way to strengthen yourself,
I mean, just overall.
Speaker 2 (46:20):
So the studies showed improved bondensity and improved muscle strength
and improved balance.
Speaker 1 (46:24):
So that's so important for us to decrease risk. You
know what I'm obsessed with right now. Stretching. Yeah, I
cannot get enough of it. Every night, I lay in
front of the TV on the floor, I put my
little yoga mat down and my dogs come around and
we stretch, and like, I get into every joint because
I I feel like when you get sedentary and your
(46:48):
joints lock up, they get rusty, you know.
Speaker 2 (46:52):
I mean, there's there's data showing stretching decreases the risk
of falls because you're your decreasing motion if you don't stretch.
Speaker 1 (47:01):
Can we go back for one second about the balbido thing.
How can we get our partners to be understanding or
compassionate or I don't even know what the right word is.
But it's a challenge because they don't understand what's happening
right and we ourselves don't understand exactly what's happening.
Speaker 2 (47:20):
Some of the most impassioned letters I get our DMS
are from partners. Help me help her how you know,
And I'm like, educate yourself so that you can understand
what she's going through. And this is not her fault.
She is in there and she still loves you more
than likely, you know, but she isn't likely. She is
going through a cataclysmic change right now, and none of
(47:43):
this is your fault. And so here are the ways
to support her.
Speaker 1 (47:46):
Go with her.
Speaker 2 (47:47):
I mean, the study is showing that when the men
go with the women to the doctor, they're much more
likely to be believed and get therapy. Absolutely, then if
and then help her find a menopause educated provider so
that you can have you guys can have an informed
conversation about her healthcare.
Speaker 1 (48:05):
I love that it's just about supporting her. I mean,
if something were to happen to your spouse physically, you
would support them automatically. So this is just something that
needs to be on the partner's radars. For sure, for sure,
I did want to talk about you are a mother
of two. I am a mother of three daughters as well,
(48:29):
and I just want to know, Okay, so our moms
and grandma's weren't talking about it. Now our daughters are
starting to hear us talk about it. It's becoming less
taboo to talk about what can we do to help
them not be afraid of it, to not be you know,
to not be so fearful of it.
Speaker 2 (48:48):
So I have this what I would tell myself at
thirty five. So these are like the tenets I try
to teach them. But again, they're prone to social media
and you have societal expectations. My oldest is in medical
school now, so she's you know a little radicalized for
menopausecare because of me. And my youngest is twenty in
college and she's actually interning for a menopause telemedicine company
(49:13):
this summer. So again, my kids are not the normal.
Speaker 1 (49:16):
No, they're going to carry on though, they're going to help. No,
But my daughter what.
Speaker 2 (49:20):
I would tell, you know, what things I would the
tenants I would try to teach my children, you know,
or teach the next generation strong over skinny. Okay, yes,
you know, moving your body to be strong and not
thin is key here because we're going to you know,
trying to get that in their head that they're going
to reach a maximum muscle and moon strength around age thirty,
(49:40):
and then age is going to start trying to take
it away from us and aging process, and then that
accelerates in menopause. So so these habits of getting this
stuff down now, of moving your body for strength and
our strong brain and a strong heart and strong muscles
and strong bones, you can do that now and not
just focused on cardio to be skinny is going to
(50:01):
serve you so much better.
Speaker 1 (50:02):
Nutrition over calories, this.
Speaker 2 (50:04):
Obsessive you know, calorie counting, it's not helping us. It's
not helping you know, still living with you know, incredible
levels more but obesity, and you know, really looking at
their nutrition. You know, how much magnesium are you getting,
how much fiber, how much protein? These are the things
I talked to my kid about. How much sugar is
in that are you know, like like trying to fill
(50:25):
your like trying to eat more instead of being so
restrictive and then educate learning about this is a natural
phase of life. Shouldn't be scared of it, but it
is going to happen, and it can affect you. And
kind of here's what happened to mom. You know you
watched me go through it. My older daughter now says,
I guess it was kind of not fair that I
was a teenager. I was the teenager I was, and
you were going through very menopause at the same, right.
Speaker 1 (50:48):
If they only knew, So she knows now.
Speaker 2 (50:51):
And I look back at that, Mary Claire, I'm like,
oh my god, oh my god. Yeah, who buying off
the handle?
Speaker 1 (50:59):
Uh huh dark, But look how much better we are now.
Speaker 2 (51:02):
Yeah.
Speaker 1 (51:02):
Yeah, tell me though about that. You are a certified
culinary medicine specialist, so that goes hand in hand with
that giving the right nutritional messages.
Speaker 2 (51:11):
So when I decided to like, I was like, I'm
going to fix this menopause fat problem, weight gain whatever.
I didn't even know about visceral fat. I just thought
fat was fat.
Speaker 1 (51:21):
So I enrolled in this.
Speaker 2 (51:22):
I wanted to get a master's in nutrition, and again
I was at a university and one of the professors
was like, well, there's this culinary medicine program that's popped
up and there's a professor at Tulane who's running it.
You know, you probably could 'en roll in that. It
looks like it's going to give you all the basics
you need without having to like enroll in a university
while you're a teaching professor like that.
Speaker 1 (51:40):
It was too hard.
Speaker 2 (51:41):
Yeah, Like okay, so I learned so much. We didn't
learn much nutrition in medical school hardly, like scratch the surface.
This was like the best thing I ever did about
you know, the blue zone and Mediterranean and dietary patterns
and how you know. It was just incredible, and so
I wrapped up all of that to like create the
Galveston Diet, my first book for my patients and followers,
(52:03):
and then it turned into a book and a thing.
But quickly as soon as I wrote that, I was
you know, sharing on social media about it, and people
were asking me more and more menopause questions in general.
So then I, you know, I'm curious, so I just
keep researching, and that's how Pause came about.
Speaker 1 (52:19):
Yeah, I mean, the connection with food and the sugar
and the like what you were saying right now, I'm
just it's all about for me, protein intake and fiber
intake same.
Speaker 2 (52:29):
I look at my plate and it's like protein plants,
you know, and.
Speaker 1 (52:33):
How much of that is fiber?
Speaker 2 (52:34):
So right, I just made a huge smat of like
beans with ground turkey, and that's like our meal prep
for the week. You know, we can munch on it whenever,
and I know I'm going on hand and my fiber exactly.
Speaker 1 (52:48):
Well, I feel like we've talked about so many great things.
You have been doing the circuit, talking so much about
menopause and your new book, and you've just been doing
such a great jobs. Is there anything that you ever
would think like, Oh, I wish we could just talk
a little bit about that.
Speaker 2 (53:05):
You know, just menopause is inevitable, but suffering is not.
And the more we normalize this and talk about it
in our own unique experiences, and the more the world's
going to pay attention, because I think they're paying attention now.
Speaker 1 (53:19):
They are now.
Speaker 2 (53:20):
It's like getting our legislators and our you know, government agencies,
and our medical schools and stuff.
Speaker 1 (53:26):
To like get on board.
Speaker 2 (53:29):
We're probably twenty years away from like our daughters being
able to confidently walk into a clinician's office and discuss
their menopause and have adequate care. So it's it's just,
you know, we have to fill in the gaps for now.
Speaker 1 (53:41):
Oh my god. It just makes me so excited, though.
I have to throw my cards up because the work
you're doing is so important to our generation, our daughters,
our granddaughters. I just I'm so motivated by you and inspired,
and I'm glad that we met at the Q fifty.
Speaker 2 (53:57):
Yeah, that was awesome.
Speaker 1 (53:58):
Before we go, I want to ask you, what was
your last I choose me moment?
Speaker 2 (54:04):
You know, I've had to put up boundaries in relationships
and it's okay. I have to put my own mental
health first. And you know, it doesn't mean I don't
love someone or whatever, but in order to live my
best life and be the person I want to be,
(54:25):
sometimes I have to say no and put up a
boundary where I'm not going to let this affect me
or I'm not going to get involved in that drama.
And that is one of the most powerful things of
my metopause, is just having no guilt or shame about that.
Speaker 1 (54:39):
I love that. Well, thank you, doctor Haber, You're welcome.
Oh how I love her. That conversation with doctor Mary
Claire Haveer was so interesting. And honestly, it just gives
me so much hope. I feel inspired and I feel heard.
I'm just I'm so grateful that she came on the
(54:59):
podcast and gave us all this information. Menopause is something
that half the population is going to go through, and
I'm just really happy to be a part of the
conversation and to use my platform to destigmatize this because
it's something as women we shouldn't be ashamed to talk about.
So as we continue to choose ourselves each week, this week,
(55:21):
I want to encourage you to have a conversation with
another woman in your life, your mother, your best friend,
your sister, your partner, about menopause. What do they know
about it? Are they in it? How was it, what
was their experience? Did they feel alone? How did they
(55:42):
handle it? As women, we talk about a lot of
things we go through, So why don't we talk about
the menopause chapter. Let's just all do our part to
amplify this topic, and it starts right here by talking
about it with each other. I love you, Thanks for
listening to I Choose Me. You can check out all
our social links and doctor Mary Claire Haver's info in
(56:04):
our show notes. Make sure to follow, rate, and review
the podcast, and use the hashtag I Choose Me. I'll
be right here next week, and I hope you choose
to be here too,
You're listening to I Choose Me with Jenny Garth. Hi, everyone,
welcome to I Choose Me. This podcast is all about
the choices we make and where they lead us. So yeah,
I've talked a little bit about it before, but menopause
is finally getting its day in the sun. Today I
(00:25):
choose to get into it. Let's talk about it. There
is so much to discuss about menopause and all its
phases and symptoms and side effects. Whether you are going
through it, or about to go through it, or you
know someone who's going through it, there's just too much
stigma about this chapter of life that all of us
(00:46):
women will eventually go through. My guest today is the
author of the number one New York Times best selling book,
The New Menopause. She's a Board certified OBGYN, a certified
menopause practitioner from the Menopause Society, and a certified culinary
medicine specialist. She's all about demystifying menopause, which I love.
(01:10):
She is a leading voice on the topic. Please welcome
doctor Mary Claire Haver to the Iye Choose Me podcast.
I'm so so happy to have you with us today.
I'm so happy to be here.
Speaker 2 (01:21):
This is so fun.
Speaker 1 (01:22):
It's so good. It's so good. Let me just tell
you something that happened last night. My husband, he thinks
he's funny. He said, what is going on with this
menopause stuff? It's more like manopause. I feel like you're
in your mano pause phase. I was like, that's a
good one, babe. Have you heard that yet?
Speaker 2 (01:40):
Absolutely all the time, all the time or menopause man
man no more.
Speaker 1 (01:46):
I know, there's a million things we can do with it.
Talk to me about like, what happened with you? Why
did you decide that amplifying this conversation around menopause and
women's health in this category was so important to you.
Speaker 2 (02:01):
Kind Of my journey was I was a traditional obgyn
and a big academic institution, I know, taught residents medical students,
and I had a very robust private practice and I
was happy, and I really thought I'd do that job
till I retired, you know, in like twenty more years.
And then my patients were aging with me because you
kind of get out and you get all the newly
(02:22):
pregnant people and I was newly pregnant, so we have
babies together and then we get old.
Speaker 1 (02:26):
We were all.
Speaker 2 (02:27):
Together, and you know, I was seeing these trends in
my patients who were aging of you know, these random
complaints that we couldn't seem to get to the bottom of,
like joint pain, not sleeping well, libido, weight gain, you know.
And I was just kind of taught this is what
happens when women age and get over it. We call
them whining women in clinic when I was in training,
(02:50):
you know, meaning she's just whining. This is the time
of her life, she needs to seck it up.
Speaker 1 (02:56):
There's nothing we can do.
Speaker 2 (02:57):
Never in all of my training was I ever taught
that this constellation of symptoms might be related to what
the hell's going on in her ovaries right now.
Speaker 1 (03:07):
Wow.
Speaker 2 (03:07):
So I'm like, something's not right with me, something's not
right with all my patients. Because I go to church
with these women, we go out to dinner. It's a
small town with a big university, right, I know them
outside of their little complaint list in the office, and
I know they run marathon, you know, Like, and You're like,
these are women who this should not be happening to
(03:27):
in this percentage, right, And they're eating right, they're working out,
they're doing all the things, and they're like, look, I'm
falling apart. And so you know, we're testing for a thyroid,
we're doing all the walk ups and everything's coming back
normal and they're not fully men apuzzles, so their hormone
levels really aren't diagnostic at this point. And I'm like,
we're doing this wrong. Something's wrong. So the main complaint
(03:51):
was white game. So that's where I started, you know,
and that's what was happening to me. Suddenly I was
you know, I'd had then privilege most of my life,
and then all of a sudden, I had a belly
and I couldn't get rid of it despite dumbling down
from Ike. So I called the PhD, you know, nutrition
scientists at the university. You know, I delivered all their kids,
(04:13):
and so what the hell is going on with this?
Like what about women in menopause? Why is this happening?
This is nearly universal? And they're like, yeah, so there's
something to do with inflammation. And they just sent me
down the like PubMed, which is the repository for medical
data studies, and I started reading all this stuff about
inflammation and how you know, inflammation and menopause are definitely
tied and then this weight gain and this new belly
(04:35):
fat deposition and inflammation is tied. And I start like, well,
wait a minute, this is happening, and this is happening.
Menopause and inflammation seems to be a thing. I just
realized there was such little data there, and no one
was teaching it to me. I was busy delivering babies
and pap swears and all the stuff we do. So
I just went down rabbit hole after rabbit hole, put
together a nutrition program for my patients and me and
(04:56):
my girlfriends, and you know, started talking about it on
social media. I didn't have a Macavelian plan to become
one of the leading voices in the menopause movement. I
was a busy mom of two kids, my husband worked overseas.
You know, I was just trying to stay alive. But
as I talked more about it and more, people started
listening and asking me more questions, which would fuel my
(05:17):
curiosity and I go look up more stuff. So really,
it wasn't planned. I just started talking about it, started
validating people's symptoms, telling them that they weren't crazy. This
is actually a thing, and it just grew and grew
and grew and the more I would teach and share,
the more people would join. And now we have got
almost over four and a half million followers across you know,
(05:38):
the different channels in.
Speaker 1 (05:39):
Your meno posse. I'm happy to be in your menopasse.
Speaker 2 (05:44):
By the way, it's really, you know, my miniverse is
I like to call it. It is just a bunch
of people who are there to help each other out
and share experiences and make of that crazy.
Speaker 1 (05:59):
Yeah, that sounds like an amazing way of platform, a
way to develop a platform, and such an incredible way
for you to reach so many women. It's because you're
so passionate about it, because it's happening to you.
Speaker 2 (06:11):
I love that I went through it. I'm still going
through it. I'm you know, I'm still aging and I
accept that. But you know, I just read a quote
today from one of my friends who has this program
called Menopause boot Camp, and she's an incredible personal trainer,
but she's really focusing on us now. Because forever I
was a cardio queen, I worked out to be Thinn.
(06:32):
That was the goal. I had no thoughts of muscles
or any of that. And you know, our mothers and
grandmothers just kind of got to our age and were like,
this is it, and yeah, I am. They end up
in nursing homes with cognitive deficits and dementia and frailty
and all this stuff, by and large, you know, not all,
thank God, But I don't want to accept that, and
(06:53):
that there's stuff that we can do now to prevent
that in thirty years.
Speaker 1 (06:59):
I mean there has to be. That's a driving force
for me too, Like I don't want to go down
the road that my parents went down as far as
their health, you know. So that pushes me every day
to just stay healthy and take better care of myself
than because I have the knowledge and they didn't.
Speaker 2 (07:14):
Right, right, when I think of the things that came
out of my mom's mouth about trying to stay healthy,
like eating olio instead of butter, you know, like that's
her conception of health, and you know, fighting forever to
stay thin and not giving herself proper nutrition just so
that she could be thin. Now she's paying the price, yeah,
(07:36):
you know, so same same. So when you know, when
I have patients come into clinic and we take care
of the acute problems, the joint pain, the brain fog,
the whatever, you know, we fix all of that. Then
I'm like, okay, now.
Speaker 1 (07:47):
Let's plan the next thirty years. They're like, what I
love that, I need you my life.
Speaker 2 (07:54):
What can we do? What path can we put you
on to avoid ending up? Like And if they come
in and they're like, my mom's amazing, she's eighty five,
she's driving around car, she's taking care of herself, Da
da da da, I'm like, let's do whatever she's doing,
because that's working. But if they're like, she's can't take
care of herself, we're looking at home. So we're having
to disrupt our lives like I want to don't want
to disrupt my kids lives, you know, as little as possible.
(08:17):
You know, I don't expect to live for ever, but
I don't want one of those long, protracted, you know,
times of infirmity.
Speaker 1 (08:24):
If it can be avoided, it is a big I
wouldn't say disruptance because I have my mom now, who's
in her eighties and is getting less and less mobile
and doesn't want to leave her house, and she spends
a lot of time reading, and I'm always calling her
and saying, Mom, how about a walk today? Just let's
go out, let's get a get a walk in and
(08:45):
I don't want my kids to have to worry about me.
Same as you. In your book, you say that every
organ system in a woman's body is affected by menopause,
their brain health, their heart, their lungs, and their kidneys.
Speaker 2 (08:57):
Explain this, I think that's you know, forever, we define
menopause a cessation of period, so the end of your
cycles and hot flashes, the vasomotor symptoms. But what we're
now realizing is, my goodness, the cognitive changes, the mental
health changes. So starting out the brain, you know, palpitations
are now recognized as a common vasomotor symptom. They're lumped
(09:19):
in there with hot flashes and night sweats. No very
few cardiologists know this because they weren't taught this, you know,
right Like in the lungs, new onset asthma very common
in menopause, and it tends to be a typical. This
doesn't happen to men, you know, in their midlife. It
just happens to women. Autoimmune disease, joint pain, muscle pain.
(09:40):
Of course, the genital urinary system recurrent UTI is vaginal pain,
loss of lubrication, on and on and on and so
what you go through is very different than what I
go through. Our menopause footprint, you know, our symptom profile
is as unique as we are, and doctors love a checklist,
you know, that's how we're trained. Like it looks like
a duck and walks like duck. It's a duck and
(10:02):
the duck. For me, it's just outside of your period.
Stopping and hof flashes can be really hard or can
overlap with several of the disease states. You know, it's
hard to tell hypotheridism away from perimenoplaus sometimes, and as.
Speaker 1 (10:14):
It is because you go in and you're wondering what's
going on with you and you have all these other different,
weird symptoms and they're not really linked, so everybody's just confused.
That's was my experience.
Speaker 2 (10:26):
So my goal, you know, besides educating my followers so
that they can have an informed conversation, is really you know,
part of our like the doctor menopause, the clinician menopause,
because we have nurse partitioners and lots of you know,
psychologists and stuff, is we're now pushing the medical societies
to recognize these things and start training our clinicians coming
(10:48):
up in the world so that you know, at least
the next generation we're going to have to fight.
Speaker 1 (10:54):
I mean, we're all the fighters, but they're going to
benefit so much from all of your messaging and all
this data that gathering and this information. Right, it's incredible.
Speaker 2 (11:03):
So yeah, we're not men with breasts, you know, where
we're gender help on that.
Speaker 1 (11:08):
So our skin too, though, that's another organ that is
incredibly affected by medicine.
Speaker 2 (11:15):
So wound healing besides the obvious cosmetic things, which you
know which are It's shocking because in five years, Jenny,
we lose thirty to fifty percent of for college.
Speaker 1 (11:26):
Oh my god, where'd it go?
Speaker 2 (11:29):
Like, I feel like overnight? You know? Now, definitely, you know,
hormon therapy helps. You can do very safe topical hormone
therapy that works beautifully. Of course, all the cosmetic treatments
and stuff, but I don't know a woman who goes
through it who like wakes up every day and is like,
what happened to dudes, not saying what happened to my skin.
It's a cosmetic stuff, you know, wound healing and you know,
(11:51):
just the health of your skin. The trends to epidermal
water loss, you know, We're much more likely to become dehydrated,
you know, because our skin becomes so thin and we're
just blowing off, you know, plus the hot slashes you know,
in sweatings.
Speaker 1 (12:03):
So it's just crazy how it affects us all. It's
like a massive cyclone that comes into your life and
just does all kinds of destruction and then it's like
bye bye, and I'll take all that with me. Explain
the difference for those that don't know, because I definitely
did not know when I didn't know when I was
in perimenopause. I didn't know what perimenopause was. I didn't
(12:26):
know the definition of menopause being twelve months after your
last period, which I learned once I was twelve months
after my last period. So can you explain the difference
for people like paris meno and then postal.
Speaker 2 (12:38):
Okay, so we'll do a little baby lesson in endochronology. Okay,
perfect to educate your listeners. This is this is so critical,
so big difference between females and males. We have lots
of differences, but as far as our gonads go, so
overs and testicles, men make their genetic material, their sperm
fresh every day Okay. Women are born with a limited
(13:01):
egg supply. They form when we're still in our mother's uteruses, right,
and then we're born with one to two million eggs.
By the time we're thirty, we're down to ten percent.
By the time we're forty, we're down to three percent.
Menopause really represents you've run out of eggs. Okay, So
now let's go to your normal, your twenty five year
old self for ninety percent of as of normal regular cycles,
(13:22):
very predictable if you're healthy.
Speaker 1 (13:23):
Okay.
Speaker 2 (13:24):
What happens why we ovulate, is that the hypothalmus, which
is a gland in our brain, is constantly sampling our
blood supply for estrogen estra dial, and when the levels
get low, as they do towards the end of the cycle,
it sends a signal to the pituitary gland, another gland
to make stimulating hormones. That will say, ovary, let's get
an egg out and ovulate, so that'll begin the production
(13:45):
of estra dial through the ovulation process. What happened, and
that goes a very ekg like, very predictable rise and
fall of our hormones month after month after month in
a healthy woman. Okay, Okay, it happens in perimenopause. So
menopause by definition is the transition between what I just
talked about, normal reproducible cycles to no more cycles. The
(14:08):
chaos zone in the middle is perimenopause. Now what happens
here reach a critical egg threshold level where the same
signals that we're sending down each month stop working because
we don't have enough eggs. We don't have enough follicles
left to respond. So the hypothalamus is like, hey, where's
my xtra diol?
Speaker 1 (14:29):
The tutory is like I.
Speaker 2 (14:31):
Sent the signal and is like send more. So we
end up getting much higher levels of the stimulating hormones
from the pituitary, but you don't have the same temporals.
So what used to look like this now is delayed
because it took a while for the signals to go
back and forth. Then you get a much higher surge
of that FSH and then you get much lower drops.
And so what used to look like in EKG now
(14:52):
becomes chaotic month after month, and it's not predictable at all.
And so in that chaos zone, percent of us will
have abnormal uterine bleeding heavy periods like periods no periods
too many, too frequent, too few, to craziness. Only about
ten percent will just wake up and not have a
period again. There's usually a calling card, hot flashing and
(15:14):
the night sweats, the joint pain that you know, the symptoms.
But most importantly, the brain hates chaos. It loves predictability.
And when our estrogen and progesterone and testosterone levels start
going haywire in perimenopause is when we see the biggest
changes in the brain both mental health. We have a
forty percent increase of depression anxiety across the perimenopause transition.
(15:37):
So you were living your best life, nothing has changed,
no stressors have changed, and all of a sudden you've
lost your resilience. You're cranky or depressed or snappy, or
the things that used to bother you or now bothering.
Speaker 1 (15:51):
You, you know, and a lot more, uh huh.
Speaker 2 (15:54):
And so also our cognitive ability, so our ability. Think
you're forgetting names, you can't remember, your job is suddenly
becoming harder. You're you've got something that took your tongue
and you can't you know, And like that all happens
to us every once in a while. But this is
like a consistent pattern. This is a hallmark of the
cognitive changes in perimenopause.
Speaker 1 (16:14):
And then you have this crazy fluctuation.
Speaker 2 (16:16):
Busy time turns into full menopause. Now bottomed out, there
are no eggs left, and now you have no estrogen.
Speaker 1 (16:25):
Oh, then the fun. You know. When I was in Perry,
I was like, all right, let's get this over with
enough already, just stop already, period so that I can
be done with this. And I was kind of like
hoping for it. And now that I'm in it, I'm like, wait,
I gotta miss it. Yeah.
Speaker 2 (16:40):
I mean a lot of women are grateful, thankful that,
especially if they had horrible periods or just ems or
menstrual migraines, that is over and they can get on
with their lives. But there are benefits to estrogen in
our body, especially in the brain and the joints, you know,
and our gut microbiome, all of it's affected.
Speaker 1 (17:00):
Yeah, And that no one has ever taught us this
as bonkers to me.
Speaker 2 (17:04):
Right that I just saw a study where ninety percent
of you know, girls were never taught about menopause in school,
like nothing like in their health class, Like that there
would ever be even if it's just like the end
of your fertility. You know, it's just like this vague
kind of.
Speaker 1 (17:19):
Something your grandma deals with, right, Yeah.
Speaker 2 (17:23):
And so, and I really had a negative connotation about
menopause myself, and I just know that's the same for people.
I remember thinking I hate menopause, like I don't want
to take care of people at menopause. And now that's
all I do. And God, you know, I am living
my best life. I am happier, healthier, better relationships, better boundaries.
I'm guiltless, I have no shame. I am just you know,
(17:45):
I feel like I'm helping people, I'm teaching. But if
I had not overhauled everything I think about health and
how I'm going to age and learn how to prioritize
myself and stop putting everybody's needs in front of mine,
I would not be here today. And all I want
is for what I feel, for everyone to have that chance. Oh.
Speaker 1 (18:05):
I love that, and you. I feel it from you
when I look at you, when I read your book.
By the way, your book, I have it right here
the New Men of oz. Oh, it's really great. Thank
you for writing that, because it's conversations that we haven't
had before, and we need to have. I agree you
are inspiring women our age to go for their best life,
(18:27):
and I love that about you. What about birth control.
I've been on and off birth control my whole life.
Does that affect the onset any perry?
Speaker 2 (18:42):
Yeah, so we need more studies. But we have lots
of women who are birth control, and I was on
one of them. I was on it god thirty years
too well contraception, but also for treatment of my PC
or you know, covering the symptoms of my pcos. And
I was happy on them, did great on them, no problem.
We know that because we suppress ovulation with birth control pills,
(19:06):
women who are the longer you're on them, you tend.
Speaker 1 (19:08):
To get an extra year or so.
Speaker 2 (19:12):
You know, if you're on like long term ten plus years,
you might get an extra year or so out of
the shelf life of your ovaries because we suppressed ovulation.
We lose about eleven thousand eggs each month with the
ovulatory process. So so a little bit not hugely clinically significant,
but there is a little bit, you know, I worry
about and probably what happened to me was, you know,
(19:32):
when we're on long term birth control, and for me,
it was medically treating something that I was happy with.
You know, what did that do to my bone and
muscle strength? You know, not having those normal levels of
tasosterone and estrogen.
Speaker 1 (19:44):
It's just always something scary when when you're like, well,
I hope this goes well.
Speaker 2 (19:48):
Yeah, you know, and I was happy to be treated
because I have PCOS and what it did to me.
You know, there's trade offs, there's were sympnefits for everything.
But nobody sat me down and was like, okay, listen,
you know, this is is a bigger conversation than we thought,
and we do need to have more studies, but this,
you know, you probably should be doing more weight lifting
in the gym to hang on to your muscle mass
(20:08):
because we're going to be suppressing your natural disosterone as
well with this.
Speaker 1 (20:13):
Our symptoms change according to what phase we're in.
Speaker 2 (20:16):
Right in a menstrual cycle, yeah, so if you're you know,
pre minstrel, your estrogen levels are rising. So the first
halfier cycle, progesterone is zero almost very very low. Disascone
does e and flow, but not nearly as much as estrogen,
but it's fairly steady state compared to the others, and
then we have a rise in estrogen mid cycle, and
(20:38):
then it kind of goes down right after, and then
we have a little bit more of a rise and
then it plummets in a healthy menstrual cycle.
Speaker 1 (20:44):
Imperimental policy, we even know, ye, there's no way to
We need more studies, we need more more data we do.
Speaker 2 (20:52):
Let me, let me give you this, Okay. PubMed is
like where I go. It's like Google for doctors or
Google for clinicians to look up vetted medical journal articles,
like you know. Everything in there's pretty upfront. And I
just type in the word pregnancy. I get one point
one million articles. Amazing, right, that's great. We need healthy pregnancies.
(21:12):
I've had two of them. Then I type in the
word in menopause. There's ninety seven thousand articles, so ten
to one difference, uh huh on one roughly a little
less thanton one. I'm like, am I ninety percent less
important in this phase of my life than I was
when I was pregnant?
Speaker 1 (21:27):
And that's what they want us to believe, That's what
we've been led to believe.
Speaker 2 (21:31):
Wait, so I type in the word perimenopause. I just
did this, and there's six thousand, seven hundred articles.
Speaker 1 (21:36):
WHOA, Yeah, we got work to do. People don't know
that there are stages, that there are different symptoms, that
everybody's different. It's a real mystery to so many people,
and definitely to men.
Speaker 2 (21:49):
Right now here, you are a partner trying to support
a loved one through this.
Speaker 1 (21:53):
You she.
Speaker 2 (21:56):
So the best appointments I have are when the partners come,
usually coming for a place of support and understanding, and
I just love talking you know about all these things
for them and they need it really helps.
Speaker 1 (22:09):
It really does, because they're so in the dark. They're
so in the dark. So why but why is that?
Historically speaking? Why are we as women so underserved from.
Speaker 2 (22:19):
A medical standpoint when you look at where how women
have been treated, You know, so much of women's health
has been you know, how a woman expresses certain diseases
has been compared to how a man does it. So
like atypical chest pain is female chest pain. You know,
a woman is much more likely to die if she
comes into the er with a heart attack than a man.
(22:41):
Because everything's based off of how the average white male. Sorry,
that's just how the US medical system developed acts and
how drugs affect him. They didn't even study female rats
in all the animal models. It was always males because
women are harder. Females are harder because we have psychic fluctuations,
and so being excluded from all these studies. So that's
(23:01):
one thing, it's all in her head is another thing.
It is real.
Speaker 1 (23:05):
It's taught.
Speaker 2 (23:06):
I was taught that a woman tends to tomaticize psychological issues.
Speaker 1 (23:11):
Right, and then you're gas lit.
Speaker 2 (23:13):
Yeah, so yeah, and so instead of believing a woman
and what she's saying is true, we.
Speaker 1 (23:19):
Were taught.
Speaker 2 (23:21):
You know, is she having a bad day? Is does
she need some rest? Do you need her vacation? Does
she need some wine? You know, give her nanny depressant,
she'll be fine. Yeah.
Speaker 1 (23:33):
Yeah, This is this is why I don't even understand
what a hot flash is, like why that happens.
Speaker 2 (23:40):
So there is a thermoregulatory center in our brain that
controls our body temperature. So everybody has head of fever, right,
and you know what that feels like.
Speaker 1 (23:52):
You are hot.
Speaker 2 (23:52):
You can't figure out why you start sweating, you know,
especially if you have the flu and you have a
really bad that's kind of a hot flash. So mine
and the way most are it feels like so the
therma regulatory center becomes unstable from the loss of estrogen,
we think, and you just start profusely sweating for no
reason without a trigger. So I could just be sitting
(24:13):
here and all of a sudden, I'd feel something in
my chest and then it would I would just feel
this heat wave come up my neck and head, and
like for me, the back of my head starts sweating
and it would just drip down my back and my
chest would be sweating. And at night it would wake
me up, you know when that would happen because I'm
hot and then I throw the covers off and I'm
soaking wet, and then I'm freezing exactly.
Speaker 1 (24:32):
It's the hot cold for me. You get so hot
that you sweat and then you're freezing because you're basically
naked in a Yeah, you're wet.
Speaker 2 (24:42):
So and that you know, and then when you disrupt.
I mean, there is one of the top menopause researchers.
She's much older in the US, and I just read
a quote from her and I wanted to roll my
eyes so hard. I mean, there's the old school menopause,
the old guard I'm probably going to get in trouble
for saying this. But the people who kind of, you know,
and God bless them, they did great research back in
the day, but they kind of are really reluctant to
(25:05):
accept that other organ systems can be affected by menopause.
And she's like, no, no, no, no. The reason why
you're having brain fog is because your hot splashes are
waking you up.
Speaker 1 (25:14):
At night and you're losing sleep.
Speaker 2 (25:16):
Despite multiple medical journal articles coming out showing pet scans
all the brain going through menopause.
Speaker 1 (25:23):
Oh that I mean, it's just that kind of mis knowledge,
I think, and people talking about that as much as they.
Speaker 2 (25:32):
Have, I thought it a narrative that they have that like, listen,
women are just And then she similar researcher out of
Australia is like, it's just tough to be a midlife woman.
It has nothing to do with menopause. This is just
what women go through at this stage.
Speaker 1 (25:47):
I'm like, no, that's not good enough.
Speaker 2 (25:49):
I was living my I was perfectly fine until I
hit a certain age. I changed nothing, no stressors, no.
Speaker 1 (25:57):
Diet, no exercise. My body completely changed.
Speaker 2 (26:00):
My brain has to completely check.
Speaker 1 (26:01):
I'm not a doctor. I didn't go to med school.
It makes sense to me, and so I don't understand
how it couldn't make sense to much more intelligent people.
Speaker 2 (26:10):
And I started hormone therapy and I got ninety percent better.
Speaker 1 (26:14):
Yep.
Speaker 2 (26:15):
I just gave my body back what I used to have,
and turns out all those things kind of went away.
Speaker 1 (26:21):
Let's talk about it then, hormone replacement therapy.
Speaker 2 (26:25):
So I look at it as if I had hypothyroidism.
So if every woman's thyroid tanked at fifty and you
were born with, you know, all of your thyroid globulin
cells and they started deteriorating, you know, and then all
of a sudden at fifty they were gone, no one
would question you going on thyroid hormones for the rest
(26:47):
of your life, you know. And why do we do
this to women? And so menopause hormone therapy is basically
just giving your body back estrogen, progesterone, and sometimes testosterone
in levels that were similar to what you would have
gotten in your pre you know, in your pre menopause years.
And for me, it's like basically telling my body functions
(27:09):
to just operate at their usual level because the loss
of estrogen and tastosterone leads to dysfunction.
Speaker 1 (27:17):
Well it makes sense, but why why did it get
such a bad wrap?
Speaker 2 (27:20):
Well, okay, so scared in the eighties and nineties, probably
you know, depending on the numbers, forty to forty four
percent of women, it was recommended all women should be
on HRT. Okay, so about forty four percent of women
chose to be on it. Now, some had hoflashes, some didn't.
And what they knew from observational data was that women
tended to have less heart attacks and less death from
cardiovascular disease or at later ages than women who weren't
(27:44):
taking HRT that were age matched. But that was an
observational study. That's not proof. That's just like, hm, why
is this happening now? The theory was that, well, women
on HRT tend to be healthier and wealthier because they
have access to you know, medical doctors more often, and
maybe it's just an artifact of the healthier, wealthy patient population.
So let's do this large, randomized controlled study to see
(28:06):
if hormone therapy will decrease, truly decrease the risk of
party of vascular disease. So that was the Women's Health
Initiative billion dollar study thirty seven thousand patients enroll. They
have two arms, so it was placebo controlled. This is
like the gold standard study. So at the time, the
top two prescriptions given were premarent and prempro. Not really
what we give now, so that that's one caveat the
(28:26):
only tested one formulation. If you had a uterist, you
have to have a progestogen, So they gave premaran, which
is conjugated decoin estrogen and metroxy progesterine estate. Lots of
big words to say primpro, and then the women who
had had hysterectomies got premro because you don't need the
extra progesterone.
Speaker 1 (28:41):
So off they go.
Speaker 2 (28:42):
They see after a couple of years in the estrogen
plus progestogen arm that the women had a very slight
increased risk of breast cancer over the placebo group. Okay,
so it went from h four out of ten thousand
per year to like seven out of ten thousand per year,
which so there's relative risk and absolute risk relative risks.
That was like a twenty five percent increase in relative risk,
(29:04):
different than the absolute risk which was less than one
percent per year. Okay, just it depends on how you
skew the statistics.
Speaker 1 (29:10):
So they halt the.
Speaker 2 (29:11):
Study for that arm. They called press conference, don't release
the data, don't let any of the doctors review it,
you know, and say at this press conference, estrogen causes
breast cancer. We've stopped the study. This is horrible, Okay.
Every newspaper, every news show was before social media. Front
page cover was the number one new medical news story
of two thousand and two. It was my last year
(29:31):
of training, by the way, I'll never forget this. And
eighty percent went through their stuff in the trash, stopped
taking it. I don't want to die, blah blah, blah,
blah blah. Antidepressants went up four times, sleeping medications went
up three times, blood pressure medication, cholesterol, all that statins.
Speaker 1 (29:48):
You know.
Speaker 2 (29:48):
The loss of hormone therapy, women had to go on
polypharmacy to get everything control that hormones used to control.
The estrogen only arm continued for a couple more years,
and they did see an increased risk slightly of stroke,
which we knew. We knew, okay that after the age
of sixty, if you're on hormone therapy, your risk of
stroke goes up a little bit. Like, oh my god,
it caused a stroke. They did not see an improvement
(30:09):
in cardiovascular disease risk, no improvement. So now the average
age was sixty three because they're looking for cardiovascular disease
as an outcome, okay, which is reasonable if you're looking
for heart disease. Get it takes time to develop it,
so much older population than would have really started h RT,
usually at fifty to fifty one, forty nine, you know,
(30:32):
somewhere in that age. And they excluded everyone with hot
flashes because you would know if you had placebo jaw
flashes get better. So women with hot flashes tend to
have the you know, really really bad disease. And so
when with se of your hot flashes, are higher risks
for other conditions later on. So it was a really
(30:53):
kind of skewed study. And when they've gone back and
looked at it the women, they had younger women in
the st ST. So when they looked at the patients
who started HRT within ten years of their menopause, they
did have decreased risk of cardiovascular disease. It was just
the older patients. So estrogens that turns out, is better
at prevention than cure. It's very stabilizing to the blood vessels.
(31:15):
That line our carotid arteries and our hearts is where
strokes come from and where the alproscorotic disease happens.
Speaker 1 (31:22):
And you know, not to say you'll never.
Speaker 2 (31:24):
Develop those diseases, but it can delay the progression. But
you must start early, early.
Speaker 1 (31:29):
It turns out in the brain.
Speaker 2 (31:31):
Estrogen is a huge, huge, huge.
Speaker 1 (31:34):
Benefit in the brain.
Speaker 2 (31:35):
But you've got to start kind of early in order
to see those benefits. At least ten years as well.
Speaker 1 (31:40):
Okay, so what's a number early?
Speaker 2 (31:42):
So right now, the quote is to have the cardiovascular
preventative and cognitive preventative benefits, So within ten years of
your menopause or before the age sixty.
Speaker 1 (31:54):
Okay, Now that being said.
Speaker 2 (31:55):
I do start patients now, if you've turned sixty and
you're on HRT and you're doing great, and you have
no risk.
Speaker 1 (32:00):
Factors, you can keep going. There's no age at which you.
Speaker 2 (32:04):
Have to see.
Speaker 1 (32:04):
You don't have to stop it if you're sixty, no, okay,
you can continue those preventative benefits.
Speaker 2 (32:10):
But if you already have severe athloskrotic disease, estrogen is
not going to make it better, okay, And some people
think it may make it worse. So in my patients
like above sixty with risk factors, I'm getting a calcium
cardiac score and like extensive testing to see if they
have disease. I don't want to add estrogen on top
for you know, potentially making that disease worse.
Speaker 1 (32:29):
Right, Okay, I heard today. I've known this before a
friend of mine has a company, but I heard today
in the news about estrogen in the form of a
vaginal topical ointment being used.
Speaker 2 (32:48):
On the face.
Speaker 1 (32:49):
This on the face, I think natural about is my friend.
Speaker 2 (32:52):
So I've been using topical estrogen.
Speaker 1 (32:54):
What's it called estra deal how do you say it?
Estra dial estradiyle sore.
Speaker 2 (32:58):
There's two forms that have been tested. There's estriol, so estrogen.
Vaginal cream is typically estra dial point zero one percent
or yeaer point oh one percent vaginal cream.
Speaker 1 (33:09):
And that's something someone's supposed to just rub on their
vagina and it's to absorb.
Speaker 2 (33:13):
So that's for the treatment of vaginal atrophy and it
works beautifully. Well, Okay, some people have been putting it
on their face as well, and they've actually done studies
with the topical estrogen. This is a very very low dose.
This is not the estrogen that you would get the
cream and the sprays and everything for systemic therapy. This
is a much lower percentage. They tested the blood levels
(33:36):
of women putting it on their vaginas and on their faces,
and there's no systemic absorption, so there's no worries about
block clots or any of that, or endimatoral cancer, none
of that. Okay, as long as you use that preparation
meant for the vagina, the low low dose, the low
low dose and estreol cream, which is another form of estrogen.
It's actually the estrogen that's created in our placinas when
(34:00):
we're pregnant, and so they've been able to synthesize that
and the estray All cream get used on the face
as well with some similar efficacy, and those are usually compounded.
So that's the one that I've been using because my
friend's company made it and I was like, yeah, yeah,
I'll try it. She sent me one for free. I
fell in love with it, and of course now I
just buy it so I can talk about it without
(34:21):
having to say sponsored no, this is good.
Speaker 1 (34:24):
I mean, it's a conversation that's been going on, but
now it seems like it's becoming public and I think
everybody's going to be talking about it.
Speaker 2 (34:31):
Don't skip the vagina if you're you know, people are like, well,
I'm just trying to down there. I'm like, no, please,
you know she's staged it down there.
Speaker 1 (34:40):
That's the health part. This is cosmetic. Yes, we talked
a lot about symptoms. Hot flashes obviously that's like the
no brainer symptom. But brain fog, you know, it's just
like when you have postpartum, when you just had your
baby and your hormones are gone, whack a dooodle. It's
a silence like misery, and nobody knows what's going on
(35:03):
in you, but you I feel like the brain fog
is another just silent struggle that people don't understand because
I mean, it happens to me at least three times
a day where I walk into a room and I
have no idea why I'm in there. That's brain fog.
Speaker 2 (35:19):
M yeah. Or you can't find a word, or you
you know, can't remember a name or you know, in
these these things that will happen to us from time
to time. But when it becomes a pattern and all
of a sudden, you're questioning your judgment. One in five
women are quitting their jobs at our age because of this.
It's so bad, especially since they feel inadequate positions who
(35:41):
require lots of cognitive ability. You know, our missions are
they are really struggling and like not and hitting a wall,
hitting a wall at work.
Speaker 1 (35:50):
It's scary.
Speaker 2 (35:51):
It's so scary, and you know we're losing that. Mckensey
company just did this incredible report looking at lost economic
the economic impact of these women who are supposed to
be leading companies who can't do it. You know, twenty
percent of women walk away not because of an aging
payriner stuff. They can't they don't want to be up.
You know, they can't do their job confidently.
Speaker 1 (36:11):
Is there a correlation between brain fog and early onset dementia?
Speaker 2 (36:18):
Okay, so we all tend to have cognitive decline okay
in early in perimenopause and early menopause, and then for
those of us not on the path to dementia, it recovers.
Speaker 1 (36:30):
Okay later, Oh thank goodness.
Speaker 2 (36:33):
It does tend to recover. You will never quite be
where you were, but it does. The brain rewires, you know,
from the lack of estrogen, and then you learn how
to kind of compensate for it. Okay, that brain keeps
going unless you're on the Alzheimer dementia spectrum, and you
can keep going down. So, you know, the greatest book
written on this, and a brand new article just came out.
Lisa Musconi wrote The Menopause Brain. When she's a neuroscientist
(36:57):
out of will Cornell and she does pet scan after
pet scan of women's brains in different levels of menopause
and it's absolutely fascinating and it's just so validating. You know,
it's almost like I don't care if it's fixed at
this point, like at least I know I'm not nuts,
and you know, but she says, Alzheimer's is a disease
with symptoms of in old age, but it begins in
(37:18):
the life and menopause accelerates the deposition of the plex.
Speaker 1 (37:24):
Yeah, it's a shame.
Speaker 2 (37:25):
But even with the APO E four gene HRT, like
women on HRT.
Speaker 1 (37:31):
Have involume better scores and women not what you call
it the APO.
Speaker 2 (37:36):
So there's a APO E four I think gene which
is the genetic marker for Alzheimer's, Alzheimer's.
Speaker 1 (37:42):
And even people.
Speaker 2 (37:43):
So they studied that group and there was a few
of the women who actually got put on HRT for
hot flashes, and they had bigger brain volumes and better
cognition scores than their age match women, you know when
they started young, than the women who never got HRT
with the genetic predisposition.
Speaker 1 (38:00):
It's so fascinating. Bodies are so crazy facinating. Wow, I
totally get it. Why you became a doctor. Loss of sleep,
that's another huge I had a lot of loss of sleep,
and that is what was the final driving factor. Combined
with the hot flashes of the marine fog. I guess
they'll go together. But I said, I can't lose my sleep,
(38:21):
and I'm not sleeping. I just wake up like five
times a night, whether it's from a hot flash or
just because. And that's why I decided to go on estrogen.
Why are we losing our sleep? Is it because of
the hot flashes? Few reasons. The hot flashes are just
sleep disruptive.
Speaker 2 (38:35):
They'll wake you up right right. So, but even though
we can get those under control, women are still struggling
to sleep, not as much as before. So with the anxiety,
if someone is on the spectrum of their anxieties getting
higher in the racing thoughts at night.
Speaker 1 (38:51):
That's one of the things.
Speaker 2 (38:52):
Progesterone works incredibly well for that, or that three am
wake up and then you can't shut your ain off
to go back to sleep.
Speaker 1 (39:02):
Progesterone works for that. The other thing is our bladders
can wake us up.
Speaker 2 (39:06):
So if you're having irritable bladder or you're having you know,
incontinence or bladder spasms, then you know, vaginal estrogen can
do a beautiful job here of calming all that tissue
down so that you can sleep through that disruption. But
for my patients who you know, we've gotten the hot
flashes under control and she's still struggling, you know, with
(39:26):
the wake ups or the racing thoughts, progesterone we can
you know, you can go up to three and even
four hundred milligrams a night for that. The other thing
is if I choose to drink, and this is most
of my patients, if I choose alcohol, I am choosing
not to sleep. There's no way around it for.
Speaker 1 (39:42):
Me, I know, man. And then there's just that's not
a decision you have to make because I'd rather sleep
than have a glass of wine. Yeah, I'd rather wake
up refreshed, yeah, yeah, and I'm sad because I'd love
to just you know, have wine or drink like my friends.
But I know how it affects me.
Speaker 2 (40:01):
Yeah, so I have good I have really serious conversations
with my patients, like I can't fix this. We don't
know what you know, no one studied this yet. We
know it's happening, you know. And it could be that
our body composition is changing and.
Speaker 1 (40:14):
Getting to cut out of your life.
Speaker 2 (40:17):
And there's really no medical benefit to it.
Speaker 1 (40:19):
I mean, it's boyson. We can work on other ways
to stress release. So yeah, yes, please, let's talk about
this Hypoactive sexual desire disorder. Yeah probably aka low libido,
AKA I'm not in the mood. There's many ways, so
we can sumb that one up.
Speaker 2 (40:38):
Fifty percent of my patients have HSDD and it's it's
very very common. So hypoactive sexual desires source. So when
a woman comes in and I screen all my patients
for this, when they hit the door, my I have
low libido. There's kind of a medical checklist we have
to go through. Are you having pain? Okay? So when
we look at the buckets of why a woman's sexual
function is not where she wants it to be. One
(40:59):
is relationship disorder.
Speaker 1 (41:01):
I'm not going to fix.
Speaker 2 (41:02):
That, you know, Yeah, do you have a supportive partner?
You know, if when you're by yourself you're happy, and
when you're with this person there's zero interest. That's you know,
that's a counseling issue or whatever. That's you know here, no, no, no,
I love him. I w you know.
Speaker 1 (41:16):
Did you ever have a great desire?
Speaker 2 (41:19):
Yes? I used to, and it's just gone. I can't
seem to make it come back. I'm like, Okay, are
you having pain?
Speaker 1 (41:24):
Yes or no?
Speaker 2 (41:24):
And we have to fix that, get to the bottom
of that. Then there's arousal disorders, which are not that
common in women that they can happen, and orgasmic disorders.
So arousal disorder is you're struggling to get blood flow
to the area your brain saying yes, but nothing's happening
in the pelvis. Okay, that's where female viagra can come
into play, because that will increase just like in a man.
It will increase blood flow to the genitalia and kind
(41:46):
of get things moving in that direction, but it's not
going to do anything for your brain.
Speaker 1 (41:49):
Wait, what's female viagra? Is it called viagraf.
Speaker 2 (41:52):
Yeah, okay, giving a woman viagra can help with that,
and sometimes they just put the pill in the vagina
and let it dissolve and work there. Oh. The other
is orgasmic disorder, and you know, like ten percent of
women never ever ever have orgasms and their lives. And
you know if that was men, wouldn't this be a
national emergency?
Speaker 1 (42:11):
We would have heard about it.
Speaker 2 (42:12):
And so there's primary and secretary, so you know, we
get to the bottom of that. Then what's left is
HSDD hypoactive sexual desire disorder. Basically like love this person, right,
everything's great in my life. I can't figure out why
I can't get the signal up here. There's some medications
that work really well for that. So there's two FDA
approved medications. One is Addie, which is the pill you
(42:32):
take every day. It works at the level of neuro receptors.
Great story on how long it took for them to
get past the FDA compared to viagra, which took like
thirty seven minutes.
Speaker 1 (42:42):
Okay, oh my god, story Cindy Ekkerd.
Speaker 2 (42:45):
You have to listen to her. She's amazing. Then there's
v Lasi, which is an injection that you give yourself
thirty minutes before.
Speaker 1 (42:53):
But some patients who does.
Speaker 2 (42:54):
Well, they love it. It works on Milana Courton and you know,
kind of opens up things in the brain there.
Speaker 1 (43:00):
Where do you inject it anywhere?
Speaker 2 (43:01):
Okay, usually an ADAM and most people just grab the
scin and pop it in and you just wait and
then you wait thirty minutes. And then there's testosterone which works.
That's works the best, but unfortunately we don't have an
FDA proved medication. It works and postmona balls with women beautifully,
and so probably half of my patients end up on testosterone.
(43:23):
As long as you give it in physiologic doses, then
they usually don't have a lot of side effects and
we're just restoring their levels and they're so happy. It also,
you know, has very promising research on brain function on
But there's just a sasterm receptors everywhere. And when my
patients come in and they are sycopenic because I have
a body scanner in my office, or they have local density,
(43:44):
you know, peniostioporosis, I'm using it in their toolkit of
how are we going to get your bone stronger, you know,
or keep your bone strong of you know, resistance training, protein,
the weighted vest, all that plus testosterone. So most of
my patients when we go through the options, choose testosterone
because it seems to have multiple benefits.
Speaker 1 (44:03):
And can you be on estrogen, progesterone, and testosterone. Yeah,
we call it the megapack. That's like a dream come try.
I'm on all three. Yeah, wow, I got to get
on that train. I've seen you before with your weighted vest.
What the heck is happening with that?
Speaker 2 (44:24):
So there's great studies there. You know, women our a
genteralder are rarely studied. It's really sad, but there are
actually some really nice studies looking on women and men
in long term care facilities, measuring muscle and bone strength
and all the tools that they used. So I call
it my osteoporsus Prevention pack. And because you know you
(44:44):
fall and break a head, you dead. Thirty percent of
us will die even with surgery in a year after
the age of sixty five.
Speaker 1 (44:51):
That's in nine years for me.
Speaker 2 (44:53):
That's not good.
Speaker 1 (44:54):
That's coming up.
Speaker 2 (44:55):
So you know, I'm doing everything I can. So the
weighted vest is just a hack. I'm actually going to
develop one with QVC. I love this. I'm in line
because I have one and I love it, but it
doesn't fit over the when women's chests very well. They
were made for men as per us, and so I
want to make one where we can kind of slide
the stuff around and fit around our girl parts.
Speaker 1 (45:16):
So, God, you, I'm so excited for you to come
to the queue with all your packs, all your things.
It's going to be really great. So that's just like
a weighted thing that you do. You wear that like hiking,
working out.
Speaker 2 (45:30):
Yeah, so I tell my patients. Start wearing it around
the house, doing housework, walk the dog, you know, until
you start with about ten percent of your body weight,
so you know, twelve rounds or fifty nothing crazy. And
then as you get stronger, you wear it more and more.
I now wear it when I'm working out, like and
I also I turn my treadmill into a walking desk
and so I'll put the desk on an encline, throw
(45:50):
on my weight to vest and I'm doing research or
doing zoom calls for work not not a podcast.
Speaker 1 (45:55):
But yeah, you're not doing it right now. No, how
high are you is your weight up to?
Speaker 2 (46:00):
Oh? Of course my husband got into it. So now
we have eight which no one wears anymore. We have twelve, fifteen, twenty,
twenty five, thirty, and thirty five.
Speaker 1 (46:08):
So he wears the heavier ones.
Speaker 2 (46:09):
Every once in a while, I'll put the heavier one
just to feel, but I'll take it off in like
thirty minutes.
Speaker 1 (46:14):
So that is great though, What a way to strengthen yourself,
I mean, just overall.
Speaker 2 (46:20):
So the studies showed improved bondensity and improved muscle strength
and improved balance.
Speaker 1 (46:24):
So that's so important for us to decrease risk. You
know what I'm obsessed with right now. Stretching. Yeah, I
cannot get enough of it. Every night, I lay in
front of the TV on the floor, I put my
little yoga mat down and my dogs come around and
we stretch, and like, I get into every joint because
I I feel like when you get sedentary and your
(46:48):
joints lock up, they get rusty, you know.
Speaker 2 (46:52):
I mean, there's there's data showing stretching decreases the risk
of falls because you're your decreasing motion if you don't stretch.
Speaker 1 (47:01):
Can we go back for one second about the balbido thing.
How can we get our partners to be understanding or
compassionate or I don't even know what the right word is.
But it's a challenge because they don't understand what's happening
right and we ourselves don't understand exactly what's happening.
Speaker 2 (47:20):
Some of the most impassioned letters I get our DMS
are from partners. Help me help her how you know,
And I'm like, educate yourself so that you can understand
what she's going through. And this is not her fault.
She is in there and she still loves you more
than likely, you know, but she isn't likely. She is
going through a cataclysmic change right now, and none of
(47:43):
this is your fault. And so here are the ways
to support her.
Speaker 1 (47:46):
Go with her.
Speaker 2 (47:47):
I mean, the study is showing that when the men
go with the women to the doctor, they're much more
likely to be believed and get therapy. Absolutely, then if
and then help her find a menopause educated provider so
that you can have you guys can have an informed
conversation about her healthcare.
Speaker 1 (48:05):
I love that it's just about supporting her. I mean,
if something were to happen to your spouse physically, you
would support them automatically. So this is just something that
needs to be on the partner's radars. For sure, for sure,
I did want to talk about you are a mother
of two. I am a mother of three daughters as well,
(48:29):
and I just want to know, Okay, so our moms
and grandma's weren't talking about it. Now our daughters are
starting to hear us talk about it. It's becoming less
taboo to talk about what can we do to help
them not be afraid of it, to not be you know,
to not be so fearful of it.
Speaker 2 (48:48):
So I have this what I would tell myself at
thirty five. So these are like the tenets I try
to teach them. But again, they're prone to social media
and you have societal expectations. My oldest is in medical
school now, so she's you know a little radicalized for
menopausecare because of me. And my youngest is twenty in
college and she's actually interning for a menopause telemedicine company
(49:13):
this summer. So again, my kids are not the normal.
Speaker 1 (49:16):
No, they're going to carry on though, they're going to help. No,
But my daughter what.
Speaker 2 (49:20):
I would tell, you know, what things I would the
tenants I would try to teach my children, you know,
or teach the next generation strong over skinny. Okay, yes,
you know, moving your body to be strong and not
thin is key here because we're going to you know,
trying to get that in their head that they're going
to reach a maximum muscle and moon strength around age thirty,
(49:40):
and then age is going to start trying to take
it away from us and aging process, and then that
accelerates in menopause. So so these habits of getting this
stuff down now, of moving your body for strength and
our strong brain and a strong heart and strong muscles
and strong bones, you can do that now and not
just focused on cardio to be skinny is going to
(50:01):
serve you so much better.
Speaker 1 (50:02):
Nutrition over calories, this.
Speaker 2 (50:04):
Obsessive you know, calorie counting, it's not helping us. It's
not helping you know, still living with you know, incredible
levels more but obesity, and you know, really looking at
their nutrition. You know, how much magnesium are you getting,
how much fiber, how much protein? These are the things
I talked to my kid about. How much sugar is
in that are you know, like like trying to fill
(50:25):
your like trying to eat more instead of being so
restrictive and then educate learning about this is a natural
phase of life. Shouldn't be scared of it, but it
is going to happen, and it can affect you. And
kind of here's what happened to mom. You know you
watched me go through it. My older daughter now says,
I guess it was kind of not fair that I
was a teenager. I was the teenager I was, and
you were going through very menopause at the same, right.
Speaker 1 (50:48):
If they only knew, So she knows now.
Speaker 2 (50:51):
And I look back at that, Mary Claire, I'm like,
oh my god, oh my god. Yeah, who buying off
the handle?
Speaker 1 (50:59):
Uh huh dark, But look how much better we are now.
Speaker 2 (51:02):
Yeah.
Speaker 1 (51:02):
Yeah, tell me though about that. You are a certified
culinary medicine specialist, so that goes hand in hand with
that giving the right nutritional messages.
Speaker 2 (51:11):
So when I decided to like, I was like, I'm
going to fix this menopause fat problem, weight gain whatever.
I didn't even know about visceral fat. I just thought
fat was fat.
Speaker 1 (51:21):
So I enrolled in this.
Speaker 2 (51:22):
I wanted to get a master's in nutrition, and again
I was at a university and one of the professors
was like, well, there's this culinary medicine program that's popped
up and there's a professor at Tulane who's running it.
You know, you probably could 'en roll in that. It
looks like it's going to give you all the basics
you need without having to like enroll in a university
while you're a teaching professor like that.
Speaker 1 (51:40):
It was too hard.
Speaker 2 (51:41):
Yeah, Like okay, so I learned so much. We didn't
learn much nutrition in medical school hardly, like scratch the surface.
This was like the best thing I ever did about
you know, the blue zone and Mediterranean and dietary patterns
and how you know. It was just incredible, and so
I wrapped up all of that to like create the
Galveston Diet, my first book for my patients and followers,
(52:03):
and then it turned into a book and a thing.
But quickly as soon as I wrote that, I was
you know, sharing on social media about it, and people
were asking me more and more menopause questions in general.
So then I, you know, I'm curious, so I just
keep researching, and that's how Pause came about.
Speaker 1 (52:19):
Yeah, I mean, the connection with food and the sugar
and the like what you were saying right now, I'm
just it's all about for me, protein intake and fiber
intake same.
Speaker 2 (52:29):
I look at my plate and it's like protein plants,
you know, and.
Speaker 1 (52:33):
How much of that is fiber?
Speaker 2 (52:34):
So right, I just made a huge smat of like
beans with ground turkey, and that's like our meal prep
for the week. You know, we can munch on it whenever,
and I know I'm going on hand and my fiber exactly.
Speaker 1 (52:48):
Well, I feel like we've talked about so many great things.
You have been doing the circuit, talking so much about
menopause and your new book, and you've just been doing
such a great jobs. Is there anything that you ever
would think like, Oh, I wish we could just talk
a little bit about that.
Speaker 2 (53:05):
You know, just menopause is inevitable, but suffering is not.
And the more we normalize this and talk about it
in our own unique experiences, and the more the world's
going to pay attention, because I think they're paying attention now.
Speaker 1 (53:19):
They are now.
Speaker 2 (53:20):
It's like getting our legislators and our you know, government agencies,
and our medical schools and stuff.
Speaker 1 (53:26):
To like get on board.
Speaker 2 (53:29):
We're probably twenty years away from like our daughters being
able to confidently walk into a clinician's office and discuss
their menopause and have adequate care. So it's it's just,
you know, we have to fill in the gaps for now.
Speaker 1 (53:41):
Oh my god. It just makes me so excited, though.
I have to throw my cards up because the work
you're doing is so important to our generation, our daughters,
our granddaughters. I just I'm so motivated by you and inspired,
and I'm glad that we met at the Q fifty.
Speaker 2 (53:57):
Yeah, that was awesome.
Speaker 1 (53:58):
Before we go, I want to ask you, what was
your last I choose me moment?
Speaker 2 (54:04):
You know, I've had to put up boundaries in relationships
and it's okay. I have to put my own mental
health first. And you know, it doesn't mean I don't
love someone or whatever, but in order to live my
best life and be the person I want to be,
(54:25):
sometimes I have to say no and put up a
boundary where I'm not going to let this affect me
or I'm not going to get involved in that drama.
And that is one of the most powerful things of
my metopause, is just having no guilt or shame about that.
Speaker 1 (54:39):
I love that. Well, thank you, doctor Haber, You're welcome.
Oh how I love her. That conversation with doctor Mary
Claire Haveer was so interesting. And honestly, it just gives
me so much hope. I feel inspired and I feel heard.
I'm just I'm so grateful that she came on the
(54:59):
podcast and gave us all this information. Menopause is something
that half the population is going to go through, and
I'm just really happy to be a part of the
conversation and to use my platform to destigmatize this because
it's something as women we shouldn't be ashamed to talk about.
So as we continue to choose ourselves each week, this week,
(55:21):
I want to encourage you to have a conversation with
another woman in your life, your mother, your best friend,
your sister, your partner, about menopause. What do they know
about it? Are they in it? How was it, what
was their experience? Did they feel alone? How did they
(55:42):
handle it? As women, we talk about a lot of
things we go through, So why don't we talk about
the menopause chapter. Let's just all do our part to
amplify this topic, and it starts right here by talking
about it with each other. I love you, Thanks for
listening to I Choose Me. You can check out all
our social links and doctor Mary Claire Haver's info in
(56:04):
our show notes. Make sure to follow, rate, and review
the podcast, and use the hashtag I Choose Me. I'll
be right here next week, and I hope you choose
to be here too,
Host
Jennie Garth
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