November 20, 2025 • 40 mins
Centered on Health 11-20-25 - Recognizing perimenopause and treatments for menopause symptoms with Dr. Jennifer Ford
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Speaker 1 (00:01):
It's now time for Centered on Health with Baptists Health
on use Radio. Wait forty WYJS Now, here's doctor Jeff Tumbler.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on News Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We're joined
as always by our producer, mister Jim Fenn, who's on
standby to take your calls this evening to talk to
our guest. Our phone number is five oh two, five
seven one, eight four eighty four if you want to
(00:32):
call in and be a part of the show. Greater
than one million women in the United States enter menopause
every year, and the vast majority have symptoms that go
along with the presentation. So tonight we're going to discuss
premenopause and menopause with obgu i N.
Speaker 3 (00:49):
Jennifer Ford. Doctor Ford is an obgu i N with the.
Speaker 2 (00:53):
Baptist Hospital Medical Group with offices in Louisville and Shelbyville.
She attended medical school at Mercer University School and Meta,
and did residency at the University of Louisville School of Medicine.
She has a clinical focus in abnormal menstrual bleeding, contraceptive counseling,
minimally invasive surgeries, polycystic ovarium syndrome, and other routine obstetrical care. Tonight,
(01:16):
our focus is on perimenopause and menopause. Welcome to center
it on health, doctor Ford.
Speaker 4 (01:22):
Thank you, Thank you, Jack.
Speaker 2 (01:24):
Yeah, we are very fortunate to have you on. This
is actually its topic we haven't haven't talked about, so
I'm really thrilled to have you. I did like listening
all of your other clinical interest in case we have
listeners that have questions that they want to get your
expertise on. But I want to just get started, get
to know you, Like, how did this area of medicine
become an interest for you?
Speaker 4 (01:47):
An apolos or gynecology.
Speaker 3 (01:50):
Both, Yes, mostly menopause, I.
Speaker 4 (01:53):
Guess okay, menopause. Yeah, it's very interesting, probably experiencing in
myself and seeing women all day come into the office
and tell me the same stories over and over again. Unfortunately,
in residency, we get little to no training in Perrymanopaul's
(02:14):
and BOOKOTAUS, which is so you're just kind of you're
put out there to practice and you learn a lot
about obstetrics and other gnological issues, but not perimenopaus and menopause.
And so I recognized very quickly in my practice that
women were coming in at a certain age and they
were all I could hit her a quarter. They were
telling me the same thing all day, every day, and
(02:36):
I was like, this sounds terrible, and so I started
to get into it more and then again started going
through it myself, which I think was the biggest eye
opener because there were things even at the gynecologist that
I did not realize were related to perimenopause. So that's
how I really got interested in it.
Speaker 3 (02:54):
You know.
Speaker 2 (02:55):
And it's interesting that you say about, you know, us
even as medical professionals, being aware, because there was just
a recent article in one of our Louisville magazines and
the title of the article was, you know, menopause is
having a moment, and.
Speaker 3 (03:08):
So, yeah, what does that mean to you? And why
is this topic so important?
Speaker 4 (03:14):
It's definitely having a moment, and that is wonderful news
because I believe that we have failed a generation of women.
And I go back to when I came out to
practice and I heard all of these women listing these
complaints and struggling for years with things, and we were
taught that from in placement therapy was not safe and
(03:36):
there was no way to help them. And I think
women started getting a little you know, angry about this
and saying, yeah, we can't suffer, We can't suffer like this.
We have to have help. And women, i think in
medicine and then just women in general, started saying, what
this research that came out twenty years ago, as you know,
(03:59):
as scientific as it was, was it really statistically significant
And they started looking into it and it wasn't and
so they realized we needed to look a little further.
And I think as that information has been coming out,
that has shifted the trajectory of menopause, perimenopause normal replacement therapy,
(04:20):
and I think finally doctors started listening to women more.
That's really what I think.
Speaker 3 (04:26):
Yeah, I mean that's pretty important.
Speaker 2 (04:27):
And you know, we haven't set the groundwork about the
perimenopause and penapause yet, but you mentioned, you know, the
the understanding, and there was just recently, you know, a
change with the Food and Drug Administration. Can you tell
us a little bit about what just happened in the news.
Speaker 4 (04:44):
Yes, So the FDA just removed the black box warnings
that were on the hormone replacement products for the last
twenty years to basically say, you know, removed the labeling
to remove references to risk of course of vascular disease,
breast cancer, and dementia that did not find that homer
(05:06):
in placement therapy significantly increase the risk of these things,
and actually found for more recent studies that it may
reduce the risk of cardiovascular diseases, Alzheimer's disease, and bone fractures.
So the benefits outlay the risk.
Speaker 3 (05:24):
It's so important.
Speaker 2 (05:25):
And I know you and I both know being in
the medical field, how how hard it is to change
a label once it's once it's there. So this is
huge news and really really important stuff. So thank you
for bringing that to our listener's attention. So let's just
go jump in. Let we're going to start with with perimenopause.
Trying to understand that what what does that mean?
Speaker 3 (05:46):
What is perimenopause?
Speaker 4 (05:49):
Well, I was recently at the National the Society of
Menopause conference and I loved what one of the speakers
started out with her definition of perimenopause. And this really
to me because it was when our patience notice something
has changed. And that's why I don't love putting a
(06:10):
finite age or a finite you know. I often have
women come in and say, well, my doctor told me
I can't be im paerimenopause because I'm too young or
you know. And so I think women know their bodies
better than anybody else, and when they listen to their
bodies and when they noticed something's not right, this is
not the same body I've been living with in the
(06:31):
last forty years. So that's my favorite definition as far
as getting into a more scientific definition, and it's basically
the time leading up to menopause. So it's where you
have these wild fluctuations of estrogen. This can start anywhere
in the late thirties to the mid to late forties.
The average age is about forty seven. The sad thing
(06:54):
is it can last from like two to ten years.
The average perimenopause.
Speaker 3 (07:01):
Day that can last that long.
Speaker 4 (07:03):
Okay, yes, two to ten years, with the average for
perimenopause being around four years for most women. And then
it's the lead up to menopause. And the tough thing
about menopause is menopause is a date in the past.
So menopause is once you've gone without a mental cycle
(07:23):
for twelve months, so you don't know until you get there.
The perimenopause is the time leading.
Speaker 5 (07:29):
Up to that.
Speaker 2 (07:32):
So there's really like a strict definition of what menopause is.
This there's this actual time period of twelve months, no
mental cycle, that's menopause, But this perimenopause can be pretty varied.
Speaker 3 (07:45):
It sounds like very much okay, And then just when.
Speaker 2 (07:50):
You said, you know, somebody can tell I love that
definition because it does sound like for each person it's
an individual experience. Not everybody has the same set of symptoms,
and not everybody experiences the same process. But in general,
if somebody's out there listening and saying, well, I don't
necessarily feel exactly the same way I do. What are
(08:10):
some of the big ones, and we'll get into them
a little bit more in general, what are some of
those symptoms?
Speaker 4 (08:17):
The ones that most people are familiar with would be
the besomotor symptoms, which are your hot flashes and nights
with and a lot of women you feel like that's
they don't have those, they're not imperimenopause. It's the other
ones that we don't hear a lot about that most
women experience, such as heart palpitations, insomnia, sleep disturbances, the
(08:37):
pea brain fog, anxiety, depression, decrease, sex strives, painful intercourse,
joint pain, weight gain, skin changes. All of those things
are the complaints that we hear from women when they're
going through perimenopause.
Speaker 2 (08:53):
And these are the things that can last two to
seven years.
Speaker 4 (08:58):
Correct.
Speaker 2 (08:59):
So obviously this awareness becomes even more important when you
think about getting in and getting some of the help
that you know that we're going to be talking about tonight.
Speaker 3 (09:10):
So I think that's a great place to start.
Speaker 2 (09:14):
I hope everybody out there is listening because it sounds
like we're going to jump into this after our first break,
But we are talking tonight about Perry, menopause and menopause
with doctor Jennifer Ford. You're listening to Senate on Health
with Baptist Health here on News Radio eight forty whas.
I'm your host, doctor Jeff Telblin. Give us a call
at five oh two, five seven one, eight four eighty
(09:34):
four if you want to.
Speaker 3 (09:35):
Be a part of this conversation and we will be
right back.
Speaker 2 (09:55):
Welcome back to Senate on Health with Baptist Health here
on news radio eight for W A H A S.
I'm your host, doctor Jeff Toblin. We're talking tonight with
doctor Jennifer Ford about perimenopause and menopause. Our phone number
is five O two five seven one eight four eighty
four and our producer misterarch Ji and Finn is on
standby to take your calls. And we do actually have
(10:16):
a caller on the line who has a question for you,
doctor Ford about menopause and symptimes of headaches. So Clark,
if you're on the if you're on the line, you're
on with doctor Ford.
Speaker 6 (10:28):
Hi. Hi, Hello, Hello, I'm asking for my wife because
do you want to get on the radio and menopause.
Forduce headaches there that are more severer than usual.
Speaker 4 (10:45):
Absolutely absolutely. I have patients who are actually on hormon
replacement therapy strictly for their headaches. That is the only
thing they have found that can can keep their headaches
away and reduce their migraines or lifelong headaches that they've had.
So it's absolutely can be a symptom of perimenopause or menopause.
Speaker 6 (11:08):
I knew it, I knew it. Come here, I just
discovered your menopause and making my headache work. Come here, all.
Speaker 3 (11:17):
Right, thank you very much, Clark.
Speaker 2 (11:18):
All right, doctor Ford, going back to going going back
to what we were talking about before the break, Can
you tell us a little bit about what's happening physiologically
with our with the hormones, progesterone and estrogens.
Speaker 4 (11:33):
Yes, So you know, the loss of a varying function
is what defines perimenopause. So basically the side for the
edge of the overies basically start depleting from the time
that a person is born, a woman is born, So
that process happens over many years and then complete again
(11:55):
around the age of fifty two, which is the average
age of menopause. But you're literally pretty do you seem
less and less o sides or you know, eggs and
the ovaries, and so the function of that ovary is
literally dying, which is what produces the estrogen and the
progester in our body. So we're gradually losing that. Now,
it's not the loss of estrogen. Some people think because
(12:18):
your ovary is dying that the estrogen is slowly declining.
It's not that simple. Actually, the estrogen is fluctuating wildly,
which is what contributes to the symptoms. The estrogen is
up and down for several different reasons based on kind
of what it's called a loop population cycle, where the
(12:38):
body is just getting confused because it's creating produce sorry,
it's creating another follicle too early, and so your body
gets confused and raises the hormones before it's time to
really have that process.
Speaker 2 (13:00):
When somebody is going through these symptoms and they come
to see the doctor and there's a suspicion of this,
is this a diagnosis that's made by a set of
symptoms and clinical symptoms, or.
Speaker 3 (13:12):
Is this a diagnosis that's made through testing.
Speaker 4 (13:17):
So that's a great question, and I'm so glad you
asked that because that is one of the most difficult
things to explain to patients. There is no blood test
to test for perimenopause. It is a usual clinical diagnosis.
But that to be saye and saying that, I'm saying
(13:37):
there are things that need to be ruled out, and
those have tests that we can do, if that makes sense.
Those have blood tests. It's one walks in at you know,
forty five years old, and it's having palpitations and insomnia
and anxiety and fatigue and boint pain. I don't jump
to paramenopause. We rule out things with other blood work
(13:59):
that it could be, and in ones we know it's
not those things. Then we say this is a diagnosis
of exclusion and clinical diagnosis.
Speaker 2 (14:08):
And you mentioned earlier a little bit about how in
the medical field we were kind of a little bit
slow to talk about this. Do you think there's still
a stigma around discussing women's health. Are you seeing more
education out there? Are you happy with where the trends
are going in this direction.
Speaker 4 (14:28):
I'm happy where the trends are going, but I think
we still have a very long way to go.
Speaker 2 (14:34):
And do you feel like women are bringing this up
to providers freely at office visits or do you think
this is something that the provider is having to kind
of get out of people.
Speaker 4 (14:45):
I do believe women are bringing up freely. I think
social media has obviously helped with that. I do believe,
though I still hear.
Speaker 6 (14:52):
Too many stories every week.
Speaker 4 (14:54):
Of patients going to their doctors, and their doctors saying
we can't do that, it's not safe, or dismissing their
symptoms and saying they're too young to be experiencing this yet,
so just the lack of knowledge of the medical knowledge.
Speaker 3 (15:11):
Yeah, yeah, no, that's great. That's why I'm so glad
that we have you.
Speaker 2 (15:16):
And before we get into sort of some of the
treatments and things like that, you know, we're talking about,
you know, a period in life where there's obviously there's
a transition and there's a focus here on symptoms, and
you know, we'll talk about health and some of the
other things.
Speaker 3 (15:31):
That are going along.
Speaker 2 (15:32):
But what's the conversation like that you have with your
patients about what health looks like for women at this
age and who are going through this. How do you
help them focus on what they should be thinking about
and prioritizing for their health.
Speaker 4 (15:48):
And that's a really good question, Jef, because I think
one of the things that we as physicians need to
start doing is anticipating this for women and telling them
this is going to happen. There is no escape from this.
We're all going to go through this. We're going to
go through it differently and it might feel different for us,
but we can't escape it. And so I like to
(16:09):
start talking to my patients in their mid thirties, late
thirties and saying this is what looks up ahead, This is
what you can expect to come. These are some of
the things you may experience, because that's a shift. We again,
this used to blindside women and they had no idea
what was happening to them. So we can start anticipating
that for women. I think that would be truly helpful.
(16:31):
I often recommend certain books for patients to start reading,
just to know that, you know, your friends are going
to start calling you and you're going to start talking
about things, and you'll be the one who can give
them the right information. But to be prepared for it,
because like I said, no one can escape it. And
as far as what things people can do to prepare
(16:51):
for it, you know, a lot of that comes down
to very basic health, very basic health, eating well, exercise,
sleeping well, the things that we need to do in
every area of our health. It becomes even more vital
for women when they're in perimenopause and menopause, and just.
Speaker 2 (17:13):
Kind of as a general umbrella, what are some of
the other health things for women that go along during
this time period that perimenopause and menopause can sort.
Speaker 3 (17:24):
Of affect health of other areas for women.
Speaker 4 (17:29):
I mean, I will say, the biggest complaint I hear
from women is weight gain. Okay, and you know, no
one looks to gain weight, and.
Speaker 6 (17:38):
That is a.
Speaker 4 (17:40):
Very big challenge for women in a perimenopause time. And
one of the things they don't understand is that as
we are aging, you know, after thirty women we start
losing muscle mass, and because we lose muscle mass, then
muscle burns more calories than fat. Losing muscles means fewer
(18:02):
calories are burned at rest, so we have to eat less.
We have to literally take our caloric intake down to
prevent waking. So a lot of women will come in
and I don't understand I'm doing the same thing. I'm
doing the same thing I've always done, but I'm gaining
weight and I'm gaining weight around the middle. And so
(18:22):
it's kind of knowing that you're exactly right, but there
is this is why that's happening, and so we have
to change the way we do things a little bit.
We have to move a little more, we have to
lower our calories, we have to eat better, we have
to lower our stress, we have to sleep better. So
sometimes it's very interesting. I think sometimes women start getting
(18:45):
healthier as they get into the periopause menopause because they
need to be to feel the same that they felt
at a younger age.
Speaker 2 (18:57):
And you may have actually just answered this question, but
we did have a question submitted from Beth who wanted
to know if there I know we haven't talked about
the medications yet, but if there are things one can
do to prevent needing to be on medications, or if
because of the changes in hormones it's sort of a
foregone conclusion that you'll need to be on medications.
Speaker 4 (19:18):
If we're talking about formal replacement therapy as the medications
what helps women with perimid apausal symptoms is yes, that's
going to be hormone replacement therapy. That is what is
going to alleviate the symptoms that are impacting their quality
of life. There are also medications that are not hormone
(19:40):
related for women who cannot take those to help to
those symptoms. That that's what we're asking, Yeah, and we.
Speaker 2 (19:48):
Will jump into that after our next break, because I
do want to get into both the hormonal replacement therapy
that you were talking about and also some of these
non hormonal therapies. But we are going to take a
quick break.
Speaker 1 (20:01):
Here.
Speaker 2 (20:01):
You are listening to Center It On Health with Baptist
Health here on news radio eight forty wahas. I'm your host,
doctor Jeff Tvlin. We're talking tonight with doctor Jennifer Ford
about paramenopause and menopause symptoms. Our phone number five oh two,
five seven one, eight four eight four. If you want
to call in and be a part of the show,
we'll be right back. I want to welcome you all
(20:35):
back to Center It On Health with Baptist Health here
on news radio eight forty wahs. I'm your host, doctor
Jeff Tublin. And if you're just joining us, we are
talking tonight with doctor Jennifer Ford about perimenopause and menopause.
Our phone number is five oh two, five seven one
eight four a four. Our producer mister Jim Finn is
on standby to take your calls. Doctor Ford. Welcome back.
(20:57):
And during the break, we did have a caller call
in and her name is Emmy and she is calling in.
She had some questions about osteopenia.
Speaker 3 (21:06):
So, Emmy, are you on, Yes, I'm here, well welcome.
Speaker 5 (21:13):
I have a question. So after I had been a pause,
I was diagnosed with osteopenia, and I didn't really want
to go on any medicines, but a friend told me
about places in Louisville that where they build bone density
through exercise and no medicines. Do you know about these
places or do you what do they work?
Speaker 4 (21:35):
In your opinion?
Speaker 6 (21:37):
I do.
Speaker 4 (21:37):
I do know about these places, and I've often refer
patients to them that do not want to take medicines
for ostiopinia and osteoporosis because I do think they help. Unfortunately,
I don't think they help as much as the medicines.
And you know, there was reason trial that came out
and you might want to look it up. It's called
the Lift More Trial. The thing that a little discouraging
(22:01):
for these places for me was that the Lift More
trial really did point out that the amount of weight
you have to lift for it to increase your bone
density is often more than these places offer. And again
I don't know about the place that you go to,
but it talked about a lot of loading impact very
(22:22):
heavy weights was what was required to increased bone disy.
So I think those places are wonderful. I'm never going
to say anything negative about exercise. I just don't know
that they're enough.
Speaker 5 (22:37):
Okay, well, thanks, I appreciate your honesty.
Speaker 3 (22:40):
Thanks for calling in.
Speaker 2 (22:42):
And we actually have another caller, Sharry is on the
phone and had a question about sleep.
Speaker 3 (22:48):
So share are you on?
Speaker 1 (22:50):
Yes, I am, thank you.
Speaker 3 (22:51):
Well, welcome to Center on Health.
Speaker 1 (22:54):
Thank you so much. This this radio show has been great.
But my question is I think, say, to get some
of these symptoms and now I'm pretty much up every
day at three in the morning and can't go back
to bed, and just know what to do about that,
if there's any you know, vitamins or something, or if
(23:14):
it's just you know, lay there and just have good
thoughts type of thing.
Speaker 4 (23:19):
No, No sleep is so important, and there is more
and more research wor search coming about the in quality
of sleep is important. So I definitely tell my patience
if you're not sleeping or if you're waking up. I
often hear I'm waking up at two and three and
I can't go back to sleep, or I'm falling I'm
having trouble falling asleep. The most common no is what
you just mentioned, and you've got to sleep. Lack of
(23:43):
sleep impacts so much regarding other health problems that we
can have. So sleep is important. You have to figure
out a way to sleep. If you're truly perimenopausal or menopausal.
Formal replacement therapy is one of the best ways to
get sleep, although it's not indicated for sleep. One of
(24:04):
the questions I asked my patients is it night slits
or hot flash? Is waking you up at night?
Speaker 1 (24:10):
No?
Speaker 4 (24:11):
No, it's just purely sleep disturbance.
Speaker 6 (24:15):
Yeah.
Speaker 4 (24:16):
No, there are lots of medicines for sleep. You kind
of just have to talk to your doctor. There's several
categories to use for sleep. But I definitely would not
just struttle through it. It's very important that you get
on something for sleep. There's a lot of new medications
coming out. There is natural stuff like melatonin, and sometimes
(24:36):
patients will take I don't recommend anything like nightly ambient
or any of the stronger medications. But sleep hygiene is
incredibly important. And I don't know about your sleep hygiene,
but it's very important.
Speaker 6 (24:51):
You know.
Speaker 4 (24:51):
The research is showing that we go to bed at
the same time, and we go to wake up at
the same time, and then we do certain things before
we go to bed, like not lutch TV and like
there are phones and have the room cool enough, and
you know the sleep hygiene thing, and if those things
aren't working that I recommend you talk to your doctor
about getting on something to help sleep. Okay, thanks so much.
Speaker 3 (25:13):
I appreciate you're insight. Thanks for calling in. You know,
doctor Ford.
Speaker 2 (25:17):
As I'm listening to these questions and I'm listening to
your answers and your description, I think what's.
Speaker 3 (25:23):
Interesting to me is that I think a lot of.
Speaker 2 (25:26):
People are familiar with menopause and they've heard of the
term perimenopause, but they're waiting until they hit menopause to
realize they're in menopause, when there's so much that you're
talking about that can be done during these time periods
before they reach menopause to have quality of life.
Speaker 4 (25:45):
Absolutely absolutely, and that I was thinking about the lady
who called and said that after menopause you would diagnosed
with osteopenia. That's another thing that we're learning is that
we need to start doing bone densities much earlier in
women because bone law starts in the perimenopausal period, and
there's a lot we can do to prevent bone laws
(26:05):
so that patients who are menopausal are not diagnosed with osteopenia.
So that's a perfect example.
Speaker 2 (26:11):
Yeah, So it's one of my questions that I was
going to ask earlier, but you've answered it beautifully. Is
that Look, why is it so important to diagnose it early?
And you've answered that many times in great ways. So
I hope people who are listening are paying attention and
asking their doctors and getting some of this help early.
But speaking of that help, let's talk about hormone replacement therapy.
(26:34):
We've sort of talked about it and it needs to
be used in certain situations. But what is hormone replacement therapy?
Why did it have a bad wrap, and.
Speaker 3 (26:43):
What does it do?
Speaker 4 (26:45):
Yes, so when we talk about formal replacement therapy, we're
talking about estrogen. That is what if I have a
patient who does not have a uterus, who has had
a hysterectomy, is having perimenopausal or menopausal symptoms, I'm getting
them s. A lot of people get confused because there's
also progesterone, and some women have to be on both.
(27:07):
The only indication for progesterone is for women who have
a uterus to protect the lining of their uterus, because
if I give that patient estrogen alone, that can increase
the proliferation of their lining and lead to endometrial or
uterine cancer. So the reason for the progesterone is to
(27:27):
protect their lining. What's helping them to feel better and
has the long term benefits is the estrogen. So that's
basically what hormone replacement is. It got a back wrap
because there was a study back in the early two
thousands that basically linked it to an increased risk of
breast cancer. The study was balled because it used women
(27:52):
at an average age of like sixty three years old,
which is not even the age that we initiate hormone
replacement therapy. Study was not being statistically significant. What we
recommend now is that women we initiate hormon replacement therapy
within ten years of the onset of menopause, generally before
(28:13):
the age of sixty and if we do this, we
see women reduce their risk of cardiovascular disease Alzheimer's disease,
bond fractoris. It actually has protective effects for a lot
of women. They come into my office they're like, I
don't want to do HRT and I'm like, are you
sure about that? Because we're not even we're not just
talking about treating symptoms. Here we're talking about long term
(28:37):
health benefits for you, and that's the framework that we're
trying to shift to. There's been such a bad rap
for so long, people are terrified of it. They don't
know and actually do really good things for you. And
because we have failed a certain generation of women, we
(28:59):
are seeing women with heart disease and increased fractures and dementia,
and so it's kind of one of those things. Not
only is it going to help you feel better, but
it's going to help you with a better helps span
along the way.
Speaker 2 (29:15):
And do you feel like when you have those conversations,
you know, because a lot of times, you know, in
any medical specialty, you know, patients who are somewhat prescription
adverse for whatever reason, they're pretty there. A lot of
times they're very set in that perspective. But when you
share what you just shared with us, do you find
most people are open to that and then make sometimes
(29:38):
make different decisions about the treatment I do I do?
Speaker 4 (29:41):
And you know, it doesn't have to be a pill.
You know, Estagon comes in lots of different forms. There's
a patch, there's gels, there's lotions, there's rings. So it
doesn't have to be a pill because a lot of
people like I don't want to take a pill every day.
You know, it's always very interesting, just tho when these
women come in and talk to me about what they're
going through and we start talking about ESTRA and they're
(30:01):
very skeptical of it. And I look at their medication
list of like ten other medicines they're taking they have
not questioned.
Speaker 3 (30:10):
At all at all.
Speaker 4 (30:11):
Yeah, the other doctors have given them. So this is
how I feel like we have failed women. We have
really terrified them of something that doesn't need they don't
need to be terrified of. And so, you know, I
tell women, I tell my patients, I'm not here to
convince you to use hormone replacement therapy, but I don't
want you to come back to me in ten years
and say, why didn't you tell me I needed to
(30:33):
do this? Why did you fail me? I want you
to know it's here, I recommend it. You have to
make the decision that's best for you.
Speaker 2 (30:43):
And hopefully obviously having educated providers like you help. But
maybe this SDA lifting, it's going to help with sort
of some public awareness. So hopefully this will get more
disseminated even beyond, you know, the point of care when
they finally come in into the office. And just for clarification,
once you go on hormone replacement therapy, is it lifelong
(31:05):
or is there a point in time where it can
be stopped?
Speaker 4 (31:08):
It can be stopped. It's a conversation with your doctor.
I have women who do both. I have women who
take it for ten to fifteen years and they're like,
I think I'm good now. I have women who are
in their seventies.
Speaker 3 (31:20):
You know.
Speaker 4 (31:20):
I have situations where they're like, if I've stopped this,
I can't remember anything. And there are very very noses
of estrogen, but they truly you have reasons or if
I stop this, my migraines come back. So I think
those are shared decision making, you know, decisions to be
shared with your doctor regarding your It's a case by
(31:41):
case basis. You know, it's like, what are your risk,
what are your cardiovascular risk, what are your breast cancer risk?
Is this a good choice for you? It's very tailored
to each patient.
Speaker 2 (31:52):
Fantastic, Well, we are going to take our final break
here and I want to remind everybody that you are
listening to Centered on Health with Baptists Health here on
news radio eight forty WJS. Our guest this evening is
doctor Jennifer Ford, who's talking to us tonight about perrymenopause
and menopause. Remember to download the iHeartRadio app and to
re listen to any of this or any of our
(32:14):
previous segments, and to have access to all the other
features that the app has to offer.
Speaker 3 (32:18):
I'm doctor Jeff Tublin, will be right back.
Speaker 2 (32:34):
Welcome back to Center It on Health with Baptist Health
here on news radio eight forty WJS. I'm your host,
doctor Jeff Tublin, and we're talking tonight with doctor Jennifer Ford,
obg y N with the Baptist Hospital Medical Group about
perrymenopause and menopause and treatments. Remember to download the iHeartRadio app.
It's free, it's easy to use, and it gives you
(32:54):
access to tonight's show in its entirety. So, doctor Ford,
right before we went to break, we were talking a
lot about the hormone replacement therapy and hope everybody's heard
all about that, but there are still going to be
individuals who are looking for complimentary ways to treat either
their symptoms or what they're going through So just in general,
(33:18):
do you incorporate any complimentary medicine in your practice? Are
there ones in particular you've heard of that are particularly
helpful for symptoms, Well, there's.
Speaker 4 (33:32):
Other symptoms, you mean, hormone place in therapy other than
hormone place in therapy, or just for overall.
Speaker 2 (33:38):
Help for either but for symptoms of perimounopause or for
their overall health.
Speaker 4 (33:45):
Yeah, I mean some women will use some over the
counter things black cohash things like that.
Speaker 6 (33:51):
You know.
Speaker 4 (33:52):
I say, I tend to recommend against supplements because they're
not regulated and FDA approved, And I tell women that,
you know, I can't really support that because I don't
know what's in all of these things. But I tell
women too, you have to do what makes you feel better,
and you're the one taking the risk, you know, I do.
(34:14):
I try to talk to my patients about shifting their
mindset as they interpermenopause and menopause to being strong and
be healthy. Your body is going to change, there is
no way around it. And I see women come in
and have this internal dialogue with themselves about I'm not
looking the same, I don't feel the same. A body
(34:37):
is changing. I can't stop it. And it's like, yes,
your body is changing, and if we can kind of
embrace that a little bit and turn it into but
you're also a lot wiser. They're also a lot less
concerned what other people think. At this age, there's a
lot of freedoms, there's a lot of wisdom that comes
with this kind of life. And let's think about how
(35:00):
can we be as healthy and strong because the things
that you're doing to be healthy and strong will help
you get through this journey better, whether you decide to
take hormone in placement therapy or not. And those things
are you know, eating well, you know, getting enough protein.
I see women's diets that don't have enough protein in them,
and you know, women need about one point two grams
(35:21):
of protein per kilogram of body weight a day, and
that sounds like a full time job to get that
in and for vegetables and lean proteins and limiting the
alcohol and just moving and getting outside, putting themselves first.
Addressing sleep. A flady talked about earlier and stress management.
All of those things complicate the journey of perimenopause and menopause.
(35:47):
And I don't think women understand how much those contribute,
and so I really try to take them back to
the very simple things about being healthy, because it really
is not as complicated as like to make.
Speaker 2 (36:00):
It, you know, and I think you have done an
amazing job of shedding shedding that light. And one thing
that I'm hearing, which is amazing, is that there's a
there's really an empowerment that you're talking about here that
you know, you're you're flipping the script. You're taking something
that it seems a lot of times feels a little
(36:22):
bit almost helpless, like I can't control these symptoms, but
you're you're giving that control back, and I feel like
that's really it's really amazing what you're what you're doing.
I wanted to ask you there's a lot you know,
we live in this world of digital information and social media.
We all know that, so there's so much information, so
(36:43):
some of the some of the myths and misconceptions. I
just wanted to maybe spend the last couple of minutes
of our of our time maybe dispelling some or pointing
out the biggest ones. But one of the ones that
I see is can you get Can you get pregnant
while you're in paerim impots?
Speaker 4 (37:01):
You can you can?
Speaker 3 (37:04):
You can?
Speaker 4 (37:04):
It is unlikely and your fertility decreases as you get
closer to menopause, But it only takes one time of ovulation,
and so for women in perimenopause, yes, you could still
get pregnant.
Speaker 2 (37:19):
And how often on therapy do people have to come
in and see, like, if they're taking hormonal replacement therapy,
how often do they need to be seen by their
OPG an annual exam?
Speaker 4 (37:30):
Their annual exam.
Speaker 3 (37:31):
Were so and not any more frequent than that.
Speaker 4 (37:35):
No, Usually, when I initiate hormone replacement therapy, I'll see
a patient back in six to eight weeks to see
how they're doing, See if there's any negative side effects,
see if the dosing then is correct, see if it's
in the form that they want it in and they're
happy with it, And then if they are, it's just
a once a year check in to do their regular exam.
Speaker 2 (37:55):
One of the things that I've been trying to do
on each episode is come up with these myths and
misconceptions that are out there. I mean, you have done
such an amazing job that you've pretty much answered all
the ones that I found that are floating out there.
Speaker 3 (38:09):
But what do you see.
Speaker 2 (38:11):
Kind of you mentioned at the beginning of the hour,
sort of you know that you get the same you
hear the same things all the time, Like what are
the biggest misconceptions that you think patients out there have
about menopause?
Speaker 4 (38:24):
There is a lab test for perimenopause, that there are
labs we can draw to tell you whether you're in perimenopause.
That is the number one biggest myth.
Speaker 3 (38:35):
Interesting.
Speaker 4 (38:35):
So what I yeah, what I explained to patients is
I cantrol because as I talked about earlier, our hormones
are fluctuating wildly. So I control your labs on Monday
and then I can draw them on Friday and they
will be completely different. They tell me nothing, Well.
Speaker 3 (38:55):
I can tell you that. I mean, I know, I've
learned a lot.
Speaker 2 (38:57):
I don't know how much that says, but I'm helpful
everybody that's listening. Really, I think you can tell by
the callers and the topic that this.
Speaker 3 (39:05):
Is just so so that's great information.
Speaker 2 (39:07):
I've really enjoyed having you on so much more to
have you on to talk about in other areas.
Speaker 3 (39:11):
But that's going to do it.
Speaker 2 (39:13):
For tonight's segment of Centered on Health, with Baptist Health.
I'm your host, doctor Jeff's help, and I want to
thank our guests, Doctor Jennifer Board, our producer mister Jim Benn,
all of our callers tonight, and of course the listener.
So I hope everybody has a wonderful rest of the
week and a great weekend, and we will see you
for another episode next week.
Speaker 3 (39:39):
This program is for informational purposes only.
Speaker 4 (39:41):
It should not be relied upon as medical advice.
Speaker 3 (39:44):
The content of this program is not intended to be
a substitute for professional medical advice, diagnosis, or treatment.
Speaker 4 (39:50):
This show is not designed to replace a physician's medical
assessment and medical judgment. Always seek the advice of your
physician with any questions or concerns have related to your
personal health or regarding specific medical conditions. To find a
Baptist Health provider, please visit Baptistealth dot com.
It's now time for Centered on Health with Baptists Health
on use Radio. Wait forty WYJS Now, here's doctor Jeff Tumbler.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on News Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We're joined
as always by our producer, mister Jim Fenn, who's on
standby to take your calls this evening to talk to
our guest. Our phone number is five oh two, five
seven one, eight four eighty four if you want to
(00:32):
call in and be a part of the show. Greater
than one million women in the United States enter menopause
every year, and the vast majority have symptoms that go
along with the presentation. So tonight we're going to discuss
premenopause and menopause with obgu i N.
Speaker 3 (00:49):
Jennifer Ford. Doctor Ford is an obgu i N with the.
Speaker 2 (00:53):
Baptist Hospital Medical Group with offices in Louisville and Shelbyville.
She attended medical school at Mercer University School and Meta,
and did residency at the University of Louisville School of Medicine.
She has a clinical focus in abnormal menstrual bleeding, contraceptive counseling,
minimally invasive surgeries, polycystic ovarium syndrome, and other routine obstetrical care. Tonight,
(01:16):
our focus is on perimenopause and menopause. Welcome to center
it on health, doctor Ford.
Speaker 4 (01:22):
Thank you, Thank you, Jack.
Speaker 2 (01:24):
Yeah, we are very fortunate to have you on. This
is actually its topic we haven't haven't talked about, so
I'm really thrilled to have you. I did like listening
all of your other clinical interest in case we have
listeners that have questions that they want to get your
expertise on. But I want to just get started, get
to know you, Like, how did this area of medicine
become an interest for you?
Speaker 4 (01:47):
An apolos or gynecology.
Speaker 3 (01:50):
Both, Yes, mostly menopause, I.
Speaker 4 (01:53):
Guess okay, menopause. Yeah, it's very interesting, probably experiencing in
myself and seeing women all day come into the office
and tell me the same stories over and over again. Unfortunately,
in residency, we get little to no training in Perrymanopaul's
(02:14):
and BOOKOTAUS, which is so you're just kind of you're
put out there to practice and you learn a lot
about obstetrics and other gnological issues, but not perimenopaus and menopause.
And so I recognized very quickly in my practice that
women were coming in at a certain age and they
were all I could hit her a quarter. They were
telling me the same thing all day, every day, and
(02:36):
I was like, this sounds terrible, and so I started
to get into it more and then again started going
through it myself, which I think was the biggest eye
opener because there were things even at the gynecologist that
I did not realize were related to perimenopause. So that's
how I really got interested in it.
Speaker 3 (02:54):
You know.
Speaker 2 (02:55):
And it's interesting that you say about, you know, us
even as medical professionals, being aware, because there was just
a recent article in one of our Louisville magazines and
the title of the article was, you know, menopause is
having a moment, and.
Speaker 3 (03:08):
So, yeah, what does that mean to you? And why
is this topic so important?
Speaker 4 (03:14):
It's definitely having a moment, and that is wonderful news
because I believe that we have failed a generation of women.
And I go back to when I came out to
practice and I heard all of these women listing these
complaints and struggling for years with things, and we were
taught that from in placement therapy was not safe and
(03:36):
there was no way to help them. And I think
women started getting a little you know, angry about this
and saying, yeah, we can't suffer, We can't suffer like this.
We have to have help. And women, i think in
medicine and then just women in general, started saying, what
this research that came out twenty years ago, as you know,
(03:59):
as scientific as it was, was it really statistically significant
And they started looking into it and it wasn't and
so they realized we needed to look a little further.
And I think as that information has been coming out,
that has shifted the trajectory of menopause, perimenopause normal replacement therapy,
(04:20):
and I think finally doctors started listening to women more.
That's really what I think.
Speaker 3 (04:26):
Yeah, I mean that's pretty important.
Speaker 2 (04:27):
And you know, we haven't set the groundwork about the
perimenopause and penapause yet, but you mentioned, you know, the
the understanding, and there was just recently, you know, a
change with the Food and Drug Administration. Can you tell
us a little bit about what just happened in the news.
Speaker 4 (04:44):
Yes, So the FDA just removed the black box warnings
that were on the hormone replacement products for the last
twenty years to basically say, you know, removed the labeling
to remove references to risk of course of vascular disease,
breast cancer, and dementia that did not find that homer
(05:06):
in placement therapy significantly increase the risk of these things,
and actually found for more recent studies that it may
reduce the risk of cardiovascular diseases, Alzheimer's disease, and bone fractures.
So the benefits outlay the risk.
Speaker 3 (05:24):
It's so important.
Speaker 2 (05:25):
And I know you and I both know being in
the medical field, how how hard it is to change
a label once it's once it's there. So this is
huge news and really really important stuff. So thank you
for bringing that to our listener's attention. So let's just
go jump in. Let we're going to start with with perimenopause.
Trying to understand that what what does that mean?
Speaker 3 (05:46):
What is perimenopause?
Speaker 4 (05:49):
Well, I was recently at the National the Society of
Menopause conference and I loved what one of the speakers
started out with her definition of perimenopause. And this really
to me because it was when our patience notice something
has changed. And that's why I don't love putting a
(06:10):
finite age or a finite you know. I often have
women come in and say, well, my doctor told me
I can't be im paerimenopause because I'm too young or
you know. And so I think women know their bodies
better than anybody else, and when they listen to their
bodies and when they noticed something's not right, this is
not the same body I've been living with in the
(06:31):
last forty years. So that's my favorite definition as far
as getting into a more scientific definition, and it's basically
the time leading up to menopause. So it's where you
have these wild fluctuations of estrogen. This can start anywhere
in the late thirties to the mid to late forties.
The average age is about forty seven. The sad thing
(06:54):
is it can last from like two to ten years.
The average perimenopause.
Speaker 3 (07:01):
Day that can last that long.
Speaker 4 (07:03):
Okay, yes, two to ten years, with the average for
perimenopause being around four years for most women. And then
it's the lead up to menopause. And the tough thing
about menopause is menopause is a date in the past.
So menopause is once you've gone without a mental cycle
(07:23):
for twelve months, so you don't know until you get there.
The perimenopause is the time leading.
Speaker 5 (07:29):
Up to that.
Speaker 2 (07:32):
So there's really like a strict definition of what menopause is.
This there's this actual time period of twelve months, no
mental cycle, that's menopause, But this perimenopause can be pretty varied.
Speaker 3 (07:45):
It sounds like very much okay, And then just when.
Speaker 2 (07:50):
You said, you know, somebody can tell I love that
definition because it does sound like for each person it's
an individual experience. Not everybody has the same set of symptoms,
and not everybody experiences the same process. But in general,
if somebody's out there listening and saying, well, I don't
necessarily feel exactly the same way I do. What are
(08:10):
some of the big ones, and we'll get into them
a little bit more in general, what are some of
those symptoms?
Speaker 4 (08:17):
The ones that most people are familiar with would be
the besomotor symptoms, which are your hot flashes and nights
with and a lot of women you feel like that's
they don't have those, they're not imperimenopause. It's the other
ones that we don't hear a lot about that most
women experience, such as heart palpitations, insomnia, sleep disturbances, the
(08:37):
pea brain fog, anxiety, depression, decrease, sex strives, painful intercourse,
joint pain, weight gain, skin changes. All of those things
are the complaints that we hear from women when they're
going through perimenopause.
Speaker 2 (08:53):
And these are the things that can last two to
seven years.
Speaker 4 (08:58):
Correct.
Speaker 2 (08:59):
So obviously this awareness becomes even more important when you
think about getting in and getting some of the help
that you know that we're going to be talking about tonight.
Speaker 3 (09:10):
So I think that's a great place to start.
Speaker 2 (09:14):
I hope everybody out there is listening because it sounds
like we're going to jump into this after our first break,
But we are talking tonight about Perry, menopause and menopause
with doctor Jennifer Ford. You're listening to Senate on Health
with Baptist Health here on News Radio eight forty whas.
I'm your host, doctor Jeff Telblin. Give us a call
at five oh two, five seven one, eight four eighty
(09:34):
four if you want to.
Speaker 3 (09:35):
Be a part of this conversation and we will be
right back.
Speaker 2 (09:55):
Welcome back to Senate on Health with Baptist Health here
on news radio eight for W A H A S.
I'm your host, doctor Jeff Toblin. We're talking tonight with
doctor Jennifer Ford about perimenopause and menopause. Our phone number
is five O two five seven one eight four eighty
four and our producer misterarch Ji and Finn is on
standby to take your calls. And we do actually have
(10:16):
a caller on the line who has a question for you,
doctor Ford about menopause and symptimes of headaches. So Clark,
if you're on the if you're on the line, you're
on with doctor Ford.
Speaker 6 (10:28):
Hi. Hi, Hello, Hello, I'm asking for my wife because
do you want to get on the radio and menopause.
Forduce headaches there that are more severer than usual.
Speaker 4 (10:45):
Absolutely absolutely. I have patients who are actually on hormon
replacement therapy strictly for their headaches. That is the only
thing they have found that can can keep their headaches
away and reduce their migraines or lifelong headaches that they've had.
So it's absolutely can be a symptom of perimenopause or menopause.
Speaker 6 (11:08):
I knew it, I knew it. Come here, I just
discovered your menopause and making my headache work. Come here, all.
Speaker 3 (11:17):
Right, thank you very much, Clark.
Speaker 2 (11:18):
All right, doctor Ford, going back to going going back
to what we were talking about before the break, Can
you tell us a little bit about what's happening physiologically
with our with the hormones, progesterone and estrogens.
Speaker 4 (11:33):
Yes, So you know, the loss of a varying function
is what defines perimenopause. So basically the side for the
edge of the overies basically start depleting from the time
that a person is born, a woman is born, So
that process happens over many years and then complete again
(11:55):
around the age of fifty two, which is the average
age of menopause. But you're literally pretty do you seem
less and less o sides or you know, eggs and
the ovaries, and so the function of that ovary is
literally dying, which is what produces the estrogen and the
progester in our body. So we're gradually losing that. Now,
it's not the loss of estrogen. Some people think because
(12:18):
your ovary is dying that the estrogen is slowly declining.
It's not that simple. Actually, the estrogen is fluctuating wildly,
which is what contributes to the symptoms. The estrogen is
up and down for several different reasons based on kind
of what it's called a loop population cycle, where the
(12:38):
body is just getting confused because it's creating produce sorry,
it's creating another follicle too early, and so your body
gets confused and raises the hormones before it's time to
really have that process.
Speaker 2 (13:00):
When somebody is going through these symptoms and they come
to see the doctor and there's a suspicion of this,
is this a diagnosis that's made by a set of
symptoms and clinical symptoms, or.
Speaker 3 (13:12):
Is this a diagnosis that's made through testing.
Speaker 4 (13:17):
So that's a great question, and I'm so glad you
asked that because that is one of the most difficult
things to explain to patients. There is no blood test
to test for perimenopause. It is a usual clinical diagnosis.
But that to be saye and saying that, I'm saying
(13:37):
there are things that need to be ruled out, and
those have tests that we can do, if that makes sense.
Those have blood tests. It's one walks in at you know,
forty five years old, and it's having palpitations and insomnia
and anxiety and fatigue and boint pain. I don't jump
to paramenopause. We rule out things with other blood work
(13:59):
that it could be, and in ones we know it's
not those things. Then we say this is a diagnosis
of exclusion and clinical diagnosis.
Speaker 2 (14:08):
And you mentioned earlier a little bit about how in
the medical field we were kind of a little bit
slow to talk about this. Do you think there's still
a stigma around discussing women's health. Are you seeing more
education out there? Are you happy with where the trends
are going in this direction.
Speaker 4 (14:28):
I'm happy where the trends are going, but I think
we still have a very long way to go.
Speaker 2 (14:34):
And do you feel like women are bringing this up
to providers freely at office visits or do you think
this is something that the provider is having to kind
of get out of people.
Speaker 4 (14:45):
I do believe women are bringing up freely. I think
social media has obviously helped with that. I do believe,
though I still hear.
Speaker 6 (14:52):
Too many stories every week.
Speaker 4 (14:54):
Of patients going to their doctors, and their doctors saying
we can't do that, it's not safe, or dismissing their
symptoms and saying they're too young to be experiencing this yet,
so just the lack of knowledge of the medical knowledge.
Speaker 3 (15:11):
Yeah, yeah, no, that's great. That's why I'm so glad
that we have you.
Speaker 2 (15:16):
And before we get into sort of some of the
treatments and things like that, you know, we're talking about,
you know, a period in life where there's obviously there's
a transition and there's a focus here on symptoms, and
you know, we'll talk about health and some of the
other things.
Speaker 3 (15:31):
That are going along.
Speaker 2 (15:32):
But what's the conversation like that you have with your
patients about what health looks like for women at this
age and who are going through this. How do you
help them focus on what they should be thinking about
and prioritizing for their health.
Speaker 4 (15:48):
And that's a really good question, Jef, because I think
one of the things that we as physicians need to
start doing is anticipating this for women and telling them
this is going to happen. There is no escape from this.
We're all going to go through this. We're going to
go through it differently and it might feel different for us,
but we can't escape it. And so I like to
(16:09):
start talking to my patients in their mid thirties, late
thirties and saying this is what looks up ahead, This is
what you can expect to come. These are some of
the things you may experience, because that's a shift. We again,
this used to blindside women and they had no idea
what was happening to them. So we can start anticipating
that for women. I think that would be truly helpful.
(16:31):
I often recommend certain books for patients to start reading,
just to know that, you know, your friends are going
to start calling you and you're going to start talking
about things, and you'll be the one who can give
them the right information. But to be prepared for it,
because like I said, no one can escape it. And
as far as what things people can do to prepare
(16:51):
for it, you know, a lot of that comes down
to very basic health, very basic health, eating well, exercise,
sleeping well, the things that we need to do in
every area of our health. It becomes even more vital
for women when they're in perimenopause and menopause, and just.
Speaker 2 (17:13):
Kind of as a general umbrella, what are some of
the other health things for women that go along during
this time period that perimenopause and menopause can sort.
Speaker 3 (17:24):
Of affect health of other areas for women.
Speaker 4 (17:29):
I mean, I will say, the biggest complaint I hear
from women is weight gain. Okay, and you know, no
one looks to gain weight, and.
Speaker 6 (17:38):
That is a.
Speaker 4 (17:40):
Very big challenge for women in a perimenopause time. And
one of the things they don't understand is that as
we are aging, you know, after thirty women we start
losing muscle mass, and because we lose muscle mass, then
muscle burns more calories than fat. Losing muscles means fewer
(18:02):
calories are burned at rest, so we have to eat less.
We have to literally take our caloric intake down to
prevent waking. So a lot of women will come in
and I don't understand I'm doing the same thing. I'm
doing the same thing I've always done, but I'm gaining
weight and I'm gaining weight around the middle. And so
(18:22):
it's kind of knowing that you're exactly right, but there
is this is why that's happening, and so we have
to change the way we do things a little bit.
We have to move a little more, we have to
lower our calories, we have to eat better, we have
to lower our stress, we have to sleep better. So
sometimes it's very interesting. I think sometimes women start getting
(18:45):
healthier as they get into the periopause menopause because they
need to be to feel the same that they felt
at a younger age.
Speaker 2 (18:57):
And you may have actually just answered this question, but
we did have a question submitted from Beth who wanted
to know if there I know we haven't talked about
the medications yet, but if there are things one can
do to prevent needing to be on medications, or if
because of the changes in hormones it's sort of a
foregone conclusion that you'll need to be on medications.
Speaker 4 (19:18):
If we're talking about formal replacement therapy as the medications
what helps women with perimid apausal symptoms is yes, that's
going to be hormone replacement therapy. That is what is
going to alleviate the symptoms that are impacting their quality
of life. There are also medications that are not hormone
(19:40):
related for women who cannot take those to help to
those symptoms. That that's what we're asking, Yeah, and we.
Speaker 2 (19:48):
Will jump into that after our next break, because I
do want to get into both the hormonal replacement therapy
that you were talking about and also some of these
non hormonal therapies. But we are going to take a
quick break.
Speaker 1 (20:01):
Here.
Speaker 2 (20:01):
You are listening to Center It On Health with Baptist
Health here on news radio eight forty wahas. I'm your host,
doctor Jeff Tvlin. We're talking tonight with doctor Jennifer Ford
about paramenopause and menopause symptoms. Our phone number five oh two,
five seven one, eight four eight four. If you want
to call in and be a part of the show,
we'll be right back. I want to welcome you all
(20:35):
back to Center It On Health with Baptist Health here
on news radio eight forty wahs. I'm your host, doctor
Jeff Tublin. And if you're just joining us, we are
talking tonight with doctor Jennifer Ford about perimenopause and menopause.
Our phone number is five oh two, five seven one
eight four a four. Our producer mister Jim Finn is
on standby to take your calls. Doctor Ford. Welcome back.
(20:57):
And during the break, we did have a caller call
in and her name is Emmy and she is calling in.
She had some questions about osteopenia.
Speaker 3 (21:06):
So, Emmy, are you on, Yes, I'm here, well welcome.
Speaker 5 (21:13):
I have a question. So after I had been a pause,
I was diagnosed with osteopenia, and I didn't really want
to go on any medicines, but a friend told me
about places in Louisville that where they build bone density
through exercise and no medicines. Do you know about these
places or do you what do they work?
Speaker 4 (21:35):
In your opinion?
Speaker 6 (21:37):
I do.
Speaker 4 (21:37):
I do know about these places, and I've often refer
patients to them that do not want to take medicines
for ostiopinia and osteoporosis because I do think they help. Unfortunately,
I don't think they help as much as the medicines.
And you know, there was reason trial that came out
and you might want to look it up. It's called
the Lift More Trial. The thing that a little discouraging
(22:01):
for these places for me was that the Lift More
trial really did point out that the amount of weight
you have to lift for it to increase your bone
density is often more than these places offer. And again
I don't know about the place that you go to,
but it talked about a lot of loading impact very
(22:22):
heavy weights was what was required to increased bone disy.
So I think those places are wonderful. I'm never going
to say anything negative about exercise. I just don't know
that they're enough.
Speaker 5 (22:37):
Okay, well, thanks, I appreciate your honesty.
Speaker 3 (22:40):
Thanks for calling in.
Speaker 2 (22:42):
And we actually have another caller, Sharry is on the
phone and had a question about sleep.
Speaker 3 (22:48):
So share are you on?
Speaker 1 (22:50):
Yes, I am, thank you.
Speaker 3 (22:51):
Well, welcome to Center on Health.
Speaker 1 (22:54):
Thank you so much. This this radio show has been great.
But my question is I think, say, to get some
of these symptoms and now I'm pretty much up every
day at three in the morning and can't go back
to bed, and just know what to do about that,
if there's any you know, vitamins or something, or if
(23:14):
it's just you know, lay there and just have good
thoughts type of thing.
Speaker 4 (23:19):
No, No sleep is so important, and there is more
and more research wor search coming about the in quality
of sleep is important. So I definitely tell my patience
if you're not sleeping or if you're waking up. I
often hear I'm waking up at two and three and
I can't go back to sleep, or I'm falling I'm
having trouble falling asleep. The most common no is what
you just mentioned, and you've got to sleep. Lack of
(23:43):
sleep impacts so much regarding other health problems that we
can have. So sleep is important. You have to figure
out a way to sleep. If you're truly perimenopausal or menopausal.
Formal replacement therapy is one of the best ways to
get sleep, although it's not indicated for sleep. One of
(24:04):
the questions I asked my patients is it night slits
or hot flash? Is waking you up at night?
Speaker 1 (24:10):
No?
Speaker 4 (24:11):
No, it's just purely sleep disturbance.
Speaker 6 (24:15):
Yeah.
Speaker 4 (24:16):
No, there are lots of medicines for sleep. You kind
of just have to talk to your doctor. There's several
categories to use for sleep. But I definitely would not
just struttle through it. It's very important that you get
on something for sleep. There's a lot of new medications
coming out. There is natural stuff like melatonin, and sometimes
(24:36):
patients will take I don't recommend anything like nightly ambient
or any of the stronger medications. But sleep hygiene is
incredibly important. And I don't know about your sleep hygiene,
but it's very important.
Speaker 6 (24:51):
You know.
Speaker 4 (24:51):
The research is showing that we go to bed at
the same time, and we go to wake up at
the same time, and then we do certain things before
we go to bed, like not lutch TV and like
there are phones and have the room cool enough, and
you know the sleep hygiene thing, and if those things
aren't working that I recommend you talk to your doctor
about getting on something to help sleep. Okay, thanks so much.
Speaker 3 (25:13):
I appreciate you're insight. Thanks for calling in. You know,
doctor Ford.
Speaker 2 (25:17):
As I'm listening to these questions and I'm listening to
your answers and your description, I think what's.
Speaker 3 (25:23):
Interesting to me is that I think a lot of.
Speaker 2 (25:26):
People are familiar with menopause and they've heard of the
term perimenopause, but they're waiting until they hit menopause to
realize they're in menopause, when there's so much that you're
talking about that can be done during these time periods
before they reach menopause to have quality of life.
Speaker 4 (25:45):
Absolutely absolutely, and that I was thinking about the lady
who called and said that after menopause you would diagnosed
with osteopenia. That's another thing that we're learning is that
we need to start doing bone densities much earlier in
women because bone law starts in the perimenopausal period, and
there's a lot we can do to prevent bone laws
(26:05):
so that patients who are menopausal are not diagnosed with osteopenia.
So that's a perfect example.
Speaker 2 (26:11):
Yeah, So it's one of my questions that I was
going to ask earlier, but you've answered it beautifully. Is
that Look, why is it so important to diagnose it early?
And you've answered that many times in great ways. So
I hope people who are listening are paying attention and
asking their doctors and getting some of this help early.
But speaking of that help, let's talk about hormone replacement therapy.
(26:34):
We've sort of talked about it and it needs to
be used in certain situations. But what is hormone replacement therapy?
Why did it have a bad wrap, and.
Speaker 3 (26:43):
What does it do?
Speaker 4 (26:45):
Yes, so when we talk about formal replacement therapy, we're
talking about estrogen. That is what if I have a
patient who does not have a uterus, who has had
a hysterectomy, is having perimenopausal or menopausal symptoms, I'm getting
them s. A lot of people get confused because there's
also progesterone, and some women have to be on both.
(27:07):
The only indication for progesterone is for women who have
a uterus to protect the lining of their uterus, because
if I give that patient estrogen alone, that can increase
the proliferation of their lining and lead to endometrial or
uterine cancer. So the reason for the progesterone is to
(27:27):
protect their lining. What's helping them to feel better and
has the long term benefits is the estrogen. So that's
basically what hormone replacement is. It got a back wrap
because there was a study back in the early two
thousands that basically linked it to an increased risk of
breast cancer. The study was balled because it used women
(27:52):
at an average age of like sixty three years old,
which is not even the age that we initiate hormone
replacement therapy. Study was not being statistically significant. What we
recommend now is that women we initiate hormon replacement therapy
within ten years of the onset of menopause, generally before
(28:13):
the age of sixty and if we do this, we
see women reduce their risk of cardiovascular disease Alzheimer's disease,
bond fractoris. It actually has protective effects for a lot
of women. They come into my office they're like, I
don't want to do HRT and I'm like, are you
sure about that? Because we're not even we're not just
talking about treating symptoms. Here we're talking about long term
(28:37):
health benefits for you, and that's the framework that we're
trying to shift to. There's been such a bad rap
for so long, people are terrified of it. They don't
know and actually do really good things for you. And
because we have failed a certain generation of women, we
(28:59):
are seeing women with heart disease and increased fractures and dementia,
and so it's kind of one of those things. Not
only is it going to help you feel better, but
it's going to help you with a better helps span
along the way.
Speaker 2 (29:15):
And do you feel like when you have those conversations,
you know, because a lot of times, you know, in
any medical specialty, you know, patients who are somewhat prescription
adverse for whatever reason, they're pretty there. A lot of
times they're very set in that perspective. But when you
share what you just shared with us, do you find
most people are open to that and then make sometimes
(29:38):
make different decisions about the treatment I do I do?
Speaker 4 (29:41):
And you know, it doesn't have to be a pill.
You know, Estagon comes in lots of different forms. There's
a patch, there's gels, there's lotions, there's rings. So it
doesn't have to be a pill because a lot of
people like I don't want to take a pill every day.
You know, it's always very interesting, just tho when these
women come in and talk to me about what they're
going through and we start talking about ESTRA and they're
(30:01):
very skeptical of it. And I look at their medication
list of like ten other medicines they're taking they have
not questioned.
Speaker 3 (30:10):
At all at all.
Speaker 4 (30:11):
Yeah, the other doctors have given them. So this is
how I feel like we have failed women. We have
really terrified them of something that doesn't need they don't
need to be terrified of. And so, you know, I
tell women, I tell my patients, I'm not here to
convince you to use hormone replacement therapy, but I don't
want you to come back to me in ten years
and say, why didn't you tell me I needed to
(30:33):
do this? Why did you fail me? I want you
to know it's here, I recommend it. You have to
make the decision that's best for you.
Speaker 2 (30:43):
And hopefully obviously having educated providers like you help. But
maybe this SDA lifting, it's going to help with sort
of some public awareness. So hopefully this will get more
disseminated even beyond, you know, the point of care when
they finally come in into the office. And just for clarification,
once you go on hormone replacement therapy, is it lifelong
(31:05):
or is there a point in time where it can
be stopped?
Speaker 4 (31:08):
It can be stopped. It's a conversation with your doctor.
I have women who do both. I have women who
take it for ten to fifteen years and they're like,
I think I'm good now. I have women who are
in their seventies.
Speaker 3 (31:20):
You know.
Speaker 4 (31:20):
I have situations where they're like, if I've stopped this,
I can't remember anything. And there are very very noses
of estrogen, but they truly you have reasons or if
I stop this, my migraines come back. So I think
those are shared decision making, you know, decisions to be
shared with your doctor regarding your It's a case by
(31:41):
case basis. You know, it's like, what are your risk,
what are your cardiovascular risk, what are your breast cancer risk?
Is this a good choice for you? It's very tailored
to each patient.
Speaker 2 (31:52):
Fantastic, Well, we are going to take our final break
here and I want to remind everybody that you are
listening to Centered on Health with Baptists Health here on
news radio eight forty WJS. Our guest this evening is
doctor Jennifer Ford, who's talking to us tonight about perrymenopause
and menopause. Remember to download the iHeartRadio app and to
re listen to any of this or any of our
(32:14):
previous segments, and to have access to all the other
features that the app has to offer.
Speaker 3 (32:18):
I'm doctor Jeff Tublin, will be right back.
Speaker 2 (32:34):
Welcome back to Center It on Health with Baptist Health
here on news radio eight forty WJS. I'm your host,
doctor Jeff Tublin, and we're talking tonight with doctor Jennifer Ford,
obg y N with the Baptist Hospital Medical Group about
perrymenopause and menopause and treatments. Remember to download the iHeartRadio app.
It's free, it's easy to use, and it gives you
(32:54):
access to tonight's show in its entirety. So, doctor Ford,
right before we went to break, we were talking a
lot about the hormone replacement therapy and hope everybody's heard
all about that, but there are still going to be
individuals who are looking for complimentary ways to treat either
their symptoms or what they're going through So just in general,
(33:18):
do you incorporate any complimentary medicine in your practice? Are
there ones in particular you've heard of that are particularly
helpful for symptoms, Well, there's.
Speaker 4 (33:32):
Other symptoms, you mean, hormone place in therapy other than
hormone place in therapy, or just for overall.
Speaker 2 (33:38):
Help for either but for symptoms of perimounopause or for
their overall health.
Speaker 4 (33:45):
Yeah, I mean some women will use some over the
counter things black cohash things like that.
Speaker 6 (33:51):
You know.
Speaker 4 (33:52):
I say, I tend to recommend against supplements because they're
not regulated and FDA approved, And I tell women that,
you know, I can't really support that because I don't
know what's in all of these things. But I tell
women too, you have to do what makes you feel better,
and you're the one taking the risk, you know, I do.
(34:14):
I try to talk to my patients about shifting their
mindset as they interpermenopause and menopause to being strong and
be healthy. Your body is going to change, there is
no way around it. And I see women come in
and have this internal dialogue with themselves about I'm not
looking the same, I don't feel the same. A body
(34:37):
is changing. I can't stop it. And it's like, yes,
your body is changing, and if we can kind of
embrace that a little bit and turn it into but
you're also a lot wiser. They're also a lot less
concerned what other people think. At this age, there's a
lot of freedoms, there's a lot of wisdom that comes
with this kind of life. And let's think about how
(35:00):
can we be as healthy and strong because the things
that you're doing to be healthy and strong will help
you get through this journey better, whether you decide to
take hormone in placement therapy or not. And those things
are you know, eating well, you know, getting enough protein.
I see women's diets that don't have enough protein in them,
and you know, women need about one point two grams
(35:21):
of protein per kilogram of body weight a day, and
that sounds like a full time job to get that
in and for vegetables and lean proteins and limiting the
alcohol and just moving and getting outside, putting themselves first.
Addressing sleep. A flady talked about earlier and stress management.
All of those things complicate the journey of perimenopause and menopause.
(35:47):
And I don't think women understand how much those contribute,
and so I really try to take them back to
the very simple things about being healthy, because it really
is not as complicated as like to make.
Speaker 2 (36:00):
It, you know, and I think you have done an
amazing job of shedding shedding that light. And one thing
that I'm hearing, which is amazing, is that there's a
there's really an empowerment that you're talking about here that
you know, you're you're flipping the script. You're taking something
that it seems a lot of times feels a little
(36:22):
bit almost helpless, like I can't control these symptoms, but
you're you're giving that control back, and I feel like
that's really it's really amazing what you're what you're doing.
I wanted to ask you there's a lot you know,
we live in this world of digital information and social media.
We all know that, so there's so much information, so
(36:43):
some of the some of the myths and misconceptions. I
just wanted to maybe spend the last couple of minutes
of our of our time maybe dispelling some or pointing
out the biggest ones. But one of the ones that
I see is can you get Can you get pregnant
while you're in paerim impots?
Speaker 4 (37:01):
You can you can?
Speaker 3 (37:04):
You can?
Speaker 4 (37:04):
It is unlikely and your fertility decreases as you get
closer to menopause, But it only takes one time of ovulation,
and so for women in perimenopause, yes, you could still
get pregnant.
Speaker 2 (37:19):
And how often on therapy do people have to come
in and see, like, if they're taking hormonal replacement therapy,
how often do they need to be seen by their
OPG an annual exam?
Speaker 4 (37:30):
Their annual exam.
Speaker 3 (37:31):
Were so and not any more frequent than that.
Speaker 4 (37:35):
No, Usually, when I initiate hormone replacement therapy, I'll see
a patient back in six to eight weeks to see
how they're doing, See if there's any negative side effects,
see if the dosing then is correct, see if it's
in the form that they want it in and they're
happy with it, And then if they are, it's just
a once a year check in to do their regular exam.
Speaker 2 (37:55):
One of the things that I've been trying to do
on each episode is come up with these myths and
misconceptions that are out there. I mean, you have done
such an amazing job that you've pretty much answered all
the ones that I found that are floating out there.
Speaker 3 (38:09):
But what do you see.
Speaker 2 (38:11):
Kind of you mentioned at the beginning of the hour,
sort of you know that you get the same you
hear the same things all the time, Like what are
the biggest misconceptions that you think patients out there have
about menopause?
Speaker 4 (38:24):
There is a lab test for perimenopause, that there are
labs we can draw to tell you whether you're in perimenopause.
That is the number one biggest myth.
Speaker 3 (38:35):
Interesting.
Speaker 4 (38:35):
So what I yeah, what I explained to patients is
I cantrol because as I talked about earlier, our hormones
are fluctuating wildly. So I control your labs on Monday
and then I can draw them on Friday and they
will be completely different. They tell me nothing, Well.
Speaker 3 (38:55):
I can tell you that. I mean, I know, I've
learned a lot.
Speaker 2 (38:57):
I don't know how much that says, but I'm helpful
everybody that's listening. Really, I think you can tell by
the callers and the topic that this.
Speaker 3 (39:05):
Is just so so that's great information.
Speaker 2 (39:07):
I've really enjoyed having you on so much more to
have you on to talk about in other areas.
Speaker 3 (39:11):
But that's going to do it.
Speaker 2 (39:13):
For tonight's segment of Centered on Health, with Baptist Health.
I'm your host, doctor Jeff's help, and I want to
thank our guests, Doctor Jennifer Board, our producer mister Jim Benn,
all of our callers tonight, and of course the listener.
So I hope everybody has a wonderful rest of the
week and a great weekend, and we will see you
for another episode next week.
Speaker 3 (39:39):
This program is for informational purposes only.
Speaker 4 (39:41):
It should not be relied upon as medical advice.
Speaker 3 (39:44):
The content of this program is not intended to be
a substitute for professional medical advice, diagnosis, or treatment.
Speaker 4 (39:50):
This show is not designed to replace a physician's medical
assessment and medical judgment. Always seek the advice of your
physician with any questions or concerns have related to your
personal health or regarding specific medical conditions. To find a
Baptist Health provider, please visit Baptistealth dot com.
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