September 29, 2025 • 28 mins
Covering Your Health with Evelyn Erives is Presented by IEHP
In Part Two of our special series on perimenopause and menopause, Evelyn Erives is back with Dr. Samar Nahas from UCR Health to answer real questions from our listeners. From managing symptoms like brain fog and hot flashes to understanding hormone therapy and emotional changes, Dr. Nahas provides thoughtful, expert insights to help you feel informed and empowered.
If you’ve ever wondered, “Is this normal?” — this episode is for you. Tune in for honest answers, compassionate advice, and the support you deserve during this important life transition.
For more information on this show's topic visit IEHP.org or (800) 440-IEHP.
To learn more about UCR Health visit UCRHealth.org.
Reach out to Evelyn via Instagram @evelynerives or email her at EvelynErives@iHeartMedia.com
In Part Two of our special series on perimenopause and menopause, Evelyn Erives is back with Dr. Samar Nahas from UCR Health to answer real questions from our listeners. From managing symptoms like brain fog and hot flashes to understanding hormone therapy and emotional changes, Dr. Nahas provides thoughtful, expert insights to help you feel informed and empowered.
If you’ve ever wondered, “Is this normal?” — this episode is for you. Tune in for honest answers, compassionate advice, and the support you deserve during this important life transition.
For more information on this show's topic visit IEHP.org or (800) 440-IEHP.
To learn more about UCR Health visit UCRHealth.org.
Reach out to Evelyn via Instagram @evelynerives or email her at EvelynErives@iHeartMedia.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hey, welcome back.
Speaker 2 (00:02):
It is Covering Your Health presented by i EhP, hosted
by me Evelyn Erivez. So happy to have you here
for every episode, and if it's your first episode, well let.
Speaker 1 (00:12):
Me stop you for one second.
Speaker 2 (00:14):
We are actually in a part two of a show
I want, So if you haven't seen part one of
my chat, you may want to pause right now and
just go back to the last one. I'm gonna tell
you why, because in this episode we're diving back into
our chat with doctor Nahas on perimenopause and menopause, and
we're asking and answering questions from our listener community.
Speaker 1 (00:37):
This is gonna be really great.
Speaker 2 (00:38):
So if you missed part one, maybe pause this episode,
click back into the archives, use your favorite app iHeartRadio,
any of your favorite podcast apps, or of course, if
you're on YouTube, you could just go back to the
other the previous episode, and then come back to this
one for more because both are so good.
Speaker 1 (00:57):
You're gonna get.
Speaker 2 (00:58):
So much out of them. Tons of information. Probably questions
that you wouldn't even think to ask are going to
be answered in these episodes, So let's get going.
Speaker 3 (01:10):
Welcome to Covering your Health, a wellness podcast. Dedicated to
covering all areas of living a healthy and happy lifestyle,
from healthy hearts to understanding health plans and everything in between.
Each episode will provide you with a better understanding of
managing your health, preventative care, and staying on the right
path for your family's wellness journey. The Covering Your Health
(01:32):
podcast is presented by i EhP Now your host Evelina Revez.
Speaker 2 (01:38):
Okay, we are back with doctor Nahas. I'm so excited
to have you back again. We obviously had a lot
to discuss in the first episode, but now we're going
to dive even deeper into perimenopause and menopause, and we
have questions from many of our viewers and our listeners
who have been like are going through it?
Speaker 1 (01:58):
Who are in it right now?
Speaker 4 (02:00):
So are you happy to answer them? Yes?
Speaker 1 (02:02):
Okay, so here we go submitted questions.
Speaker 2 (02:05):
Although menopause shows up differently for each woman, what side
effects have been the most documented.
Speaker 4 (02:11):
I won't say side effects because side effects, at least
in my definition or my understanding, side effects is something
that is a reaction to something you took. So it's
usually what are the worst symptoms or presentation of menopause?
I'll say it that way. It's just the little language education.
I think the worst is when they see a drastical,
(02:32):
acute change in their life because and very fortunately it
doesn't happen to a lot of patients, like let's say
less than three percent. Don't quote me wrong, I did
not read the last sety six. But not a lot
of patients suffer from menopause. They they are most they
don't suffer, or they have mild symptoms. So some hot
flashes that transient or you get used to them. It's
(02:54):
very hard to track them because it's a lifelong of
kind of living through menopause. So it's very hard to
to know exactly what happens with each woman in this universe.
But I think we either get used to it or
it phades off. It's like it's a transition either or.
But unfortunately there are there is less than three percent
of a woman that will suffer from menopause, and that
(03:17):
is in either one symptoms or one aspect of it,
or variety of symptoms. The most it would be the
hot flashes and the sweating the night that insomnia and
being unable to sleep, and the sexual dryness and sexual dysfunction.
The look it not as much, but usually it is
(03:38):
the other symptoms that is more significant. And some also
mood swings or emotional being very emotional. One other thing
just cross my mind or I remember is a lot
of people will say I can't lose weight. I can't
lose weight. I'm gaining a lot of weight. So it is.
(04:00):
It is kind of a variety of pictures, and some
patients will have all of them, unfortunately, and some will
have one specifically that is bothering them the most. Right,
But some patients, unfortunately, which is the smaller percentage of
the population luckily, will suffer significantly from menopause, either one
kind of one aspect of it or the whole spectrum.
(04:24):
Most will have one aspect that is bothering the most,
bothering them the most. The most difficult is the weight,
the not being able. I'm eating exactly the same, and
again it's a I believe my patients, but also it's
a lot of variables in this right. So I'm eating
(04:45):
the same, I'm doing the same activities, but I can't
lose weight. It does happen. I'm a witness of that.
I'm three menopausal, but I am not burning as much
as I burned ten years agore. Right, so I have
to do a lot more. I have to eat a
lot less. It sucks. Sorry, it does.
Speaker 1 (05:03):
You can say that because it does suck. I know it.
Speaker 4 (05:07):
I know. And you like like like eat air.
Speaker 1 (05:12):
Like all I eat is broccoli now, and it's just ridiculous.
Speaker 4 (05:15):
I'm gonna drink green all of a sudden. It's like
from the broccolia media. So yeah, So that's one aspect
that is very challenging. The patient need to know. Okay,
it's a transition like anything else. My hair is turning white,
my skin is wrinkling. It's an aspect of life, and
it's a difficult aspect and we have to just address
(05:35):
it differently. Yes, it is a change, and most people
will feel it, especially people that were onto a little
higher spectrum of their weight. Yes, not if you if,
because it's also genetic. Appetite is genetic, metabolism is genetic.
But you see, the people that are naturally skinny, with
(05:57):
with being peteeth and small body usually don't get affected
as much because even if they gain, you don't even
see it, right, But if it's an average weight like
me or a little more, the more the more effect right,
because you can see any game you can see and
it bothers you. So that requires a lot of education.
(06:18):
And I tell the patients no easy fix. Hormones won't
fix it. Nothing will fix it. You have as you
transition in a lot of other things. You have to
transition by living your life differently. Unfortunately, eat a lot healthier,
eat a lot less than you ate five years ago,
and really really needing to do cardio and exercising and walking.
(06:39):
It's good also for longevity because your bone needs you
to active, to be active more for you not to
lose your bone density. Everything is a signal. If our
bone is not doing much, then you're telling your bone
I don't need you. Then in twenty years from now,
I'm gonna not be able to do anything because I have,
you know, as opinion, thin bones and stuff like that.
(07:00):
So that's the more difficult one. But education and lifestyle,
and it's a big topic. It's a heavy topic. So
I tell them go to like a weight watch program.
The problem is it's not covered by insurance. It's expensive.
I said, just learn the principles. As much as we
learned from the internet about many silly things. We can
(07:21):
use it also to our advantage. JIPT give me a
healthy diet and calories and program my meals. We can
use it to good things instead of just strolling and
going silly thing. So the balance. But if there's a will,
if you really want a change, it won't come easy.
You have to change your whole lifestyle. And it's good
(07:42):
for the family because if you then a mom, or
if you're a sister, or if you're a daughter, if
you bring that, you bring it also to your family.
Everyone will be happy, healthy longevity and looking better from
the vasomotor like the hot flashes the wedding. You can
definitely treat it with hormonal therapy. A long topic for
(08:04):
hormonal therapy. You can always cover it in a different day.
Difficulty to sleep is gonna hit and miss, some patients
will and multifactorial. Is it Was it really really like
a sharp transaction? Was it really like you woke up
twelve months? Was it really twelve months and you felt
that I'm not sleeping anymore? Was there no other factors
(08:28):
in your life that happened, a divorce, a child, going away,
job paying you less, changing, There's a lot of variables
that we don't see. But it's internally causing us a
lot of stress. So if you have any hormonal imbalance
on top of that, it just exaggerates everything. So but
(08:52):
also it is education because we don't unless if you
go to a therapist, even the therapists won't merge all
the symptoms together. Okay, it's all give me a pill
and I'm good. No, it's not pills. It's lifestyle. It's
it's going deep inside you and breaking things down and saying, okay, cut,
eliminate change, and I'm going to leave healthier. So that
(09:12):
will be also difficult to treat. But if it's purely, purely,
purely hormonal, hormonal therapy should help it. But if it's
multifactorial and there are other factors in it, it's more difficult.
But education, education, education helps the patient. Even if I
don't have time to dive deep, I'll just briefly mention
those things and like be honest with yourself, sit with
(09:35):
yourself on the last what is really like when you're quiet?
What are you thinking about? And write it down journaling
and go to your therapist after and say okay, I
have these things help me? Or you do programming or
look on the internet, there are lots of great programs
the sexuality and the dryness. It's also difficult to difficul component.
(10:00):
If it was absolutely just dryness, like everything else is perfect, right, drive, relationship, intimacy,
then yes, perfect easy prescription will help, But most patients
had suffered with lack of connection for many reasons, a
lot of soccer a soccer game, or like resentful or
(10:25):
like you know, being with someone is not easy, right,
you have to do a lot of work to make
it work. And then the easy we a lot of
us live in the comfort of I don't want to
change it, so but you live in it, but you're miserable,
but you don't admit that you're miserable, and then it
doesn't even if it's day to day you're pretending all
the happy pictures on social media that you see, it
(10:47):
appears in your intimacy when you're intimate, right, and then
you A lot of patient will comes that I have
low libido, I don't have six to sex drive. I'm like, well, man,
it is. That is a lot of factors. Again, if
it's a short line, usually usually usually I'm saying there's
always an exception that the dryness, yes, but the libido
(11:07):
and the drive. It's it's hard for me to tell
the drive like drive like it's hard for me that's
loving the person that's being attracted to the person has
nothing to do with hormones. Like even if I'm like,
if I'm loving someone has nothing to do with hormone.
Libido could be, but also some hormones. And if you're
(11:28):
intimate and you're if you have a good connection to
your shartner, that comes out. And then if you then
with some little hormones and some little healthy lubricants, it
will all be fixed. But then it depends on how
deep that issue, on how healthy or unhealthy it is.
Speaker 3 (11:47):
Uh.
Speaker 4 (11:47):
There's a little picture on social media. There's a machine
with one button and a machine with many many buttons.
I don't know if you saw it. That's a woman
and that woman's sex drive and the female sex drive.
The man is one button and females like complex. It's
how stressed she is, how long was her day, how
(12:08):
tired was she We're different creatures that we're just different.
Speaker 2 (12:11):
So yeah, oh my goodness. Yeah, Okay, I think you
covered like four of the questions that Okay, here's an
interesting question. Is there any data link to menopause with
frozen shoulder.
Speaker 4 (12:27):
Frozen shoulder is with with either from an acute incident,
so like I played tennis or I went to the gym,
did something wrong and then one of the ligaments got
tendinitis and with time I didn't heal it and it's
card and then the rotation of my like there's a
range of rotation that a person can do that is
within norm But with frozen shoulder, with time, it might start.
(12:51):
It doesn't usually start right away. As a frozen shoulder.
You don't move it, and then you don't move it
and then you're never pain. It reaches to the point
that you're limited. So the range of movement to the
shoulder is not as normal as it was or as
normal compared to other people. Okay, I cannot tell you
that I read anything that. Again, science is big, there's
(13:12):
always new evidence. There is no direct link in my
knowledge in my experience from my studying. But if you're
unhealthy in general and you have inflammation with age, I
don't think it's menopause. I think age arthritis is something
with age that flirs as you get older, goes with
family history. If you and if you had some sort
(13:35):
of subclinical injury. It could get worse with time, and
then bone density, which is kind of related to hormone.
But if you're doing all the other factors, the supplements
and the weight bearing exercise, the healthy way bearing exercises,
you shouldn't have it. You shouldn't like our body. The creator, God,
in my opinion, created us perfectly right, So menopause is
(14:00):
part of it and that's part of nature. If it
was bad for us, I don't believe that we'll ever
have it. We could continue having period for the rest
of our life. I think our creation was just perfect
in every aspect. Part menopause is one of it. It's
just that, how what else are we doing in our
life that is affecting that?
Speaker 1 (14:20):
So beautifully said?
Speaker 2 (14:22):
Okay, another question, are there any approved holistic approaches to
tackling menopause?
Speaker 4 (14:29):
There are a lot of studies about different hormones and
supplements and soy and black kosher and stuff. And I
do believe there is holistic medicine in the in the past,
uh people from older tribes or older medicine in China
that is thousands of years old. I do believe that
(14:52):
there is a remedy but the problem is it's a
dying secret. And now you go to someone that has
nothing to do with holistic but they say that they're holistic,
and I don't know, I don't know, and pharma is
not perfect. They probably will censor me for that part.
Pharma is also very bad because they also give us
(15:13):
a lot of good some good medicine, some awful medicine
that is that we don't need. Right, But if we go,
they taught us wrong or right to be evidence based medicine.
They taught us to be as a physician for my
license that everything is according to evidence based medicine, and
anything that has no very evidence based medicine is wrong.
(15:34):
I don't believe this is right or that's right. I
believe it's the balance. So if you know there's someone
that can help you, and there's a good holistic medicine person,
I can't prescribe it, I can't advise it right, And
but where is that person? What are there credentialing? How
can we measure their credentialing? That's the problem.
Speaker 1 (15:53):
So just do your research, just like you were.
Speaker 4 (15:55):
Saying, research, but also from where what is research? Google
is not a real search reading the internet is not
research like the research. Research is the double blinded the
best research, double blinded randomized trials. It's taking large group
of women's same aide, same factors, less less variables between
(16:18):
the two groups. Everything is almost similar. Start with one
group with this, start one group with that, and they
don't know which which group is which the pill is
exactly the same. And then after a few years, especially
if we're talking about menabas, twenty years, you study any
life events, good and bad, their symptoms. That's the only
(16:40):
research that I can say, do your research. But everything else,
we have a lot of information that could be all wrong.
So that's that's where it become a problem. So I
can't tell you that I don't advise it because we
don't have strong evidence showing there's some evidence here and there,
not long enough, not strong enough, and there is not
(17:01):
enough knowledge out there that taught that the person that
passed their holistic medicine from in the whole family, from
a grandfather to it was a it was a family
that that was holistic in like a thousand or two
thousand years ago.
Speaker 2 (17:19):
Yes, and you saw the cure, Yeah, you saw your eyes.
Speaker 4 (17:26):
I don't think we have anything like that now. So
because of that, I'll stay away from it. And also
the variability of where do you get your stuff from,
because if it's not FD approved, then what's the dose?
What's the real dose I'll take? You take this flower
and eat it. Where does this flower come from? How
much of the specific medicine that we're looking into this
flower has? Is this flower good or not? Was it
(17:49):
toxic or not? Was it strayed with pesticide or not?
So a lot of factors that that's why I don't
recommend it. But I'm not again a holistic medicine in general.
But you where to go? Yeah, that's the question.
Speaker 1 (18:01):
No, No, No, that's a good answer though, because it does
make sense.
Speaker 2 (18:04):
You're like, look, this is what I know and this
I believe that there is probably things out there, But
I wouldn't know where to even send you because I
don't know how where they get their science from exactly.
Speaker 4 (18:15):
But if you do a good hormonal therapy that is balanced,
that starts at a specific age after doing eliminating all
the risk factors, it is their good studies showing that
after years of the w Woman's Health Study that initially
said no No to hormones, and then after when they
did the sub analysis, after a lot of patients that
suffered from menopause, they analyzed subgroups and they saw, oh, no, no, no,
(18:39):
it's actually good for you. This subgroup with this age.
When they started like, this is actually very good for you.
So then I'll go with science and I'll say go
to a good doctor, start with good hormonal therapy, and
that will be my recommendation. And this is what I
would do for myself in the future as well.
Speaker 2 (18:55):
Yes, okay, here's another good question. This was actually from
a community health worker. They say, I'm a community health
worker who's in the field a lot. I work face
to face with members and the topic of perimenopause menopause
comes up all the time. Many perimenopause and menopause symptoms
like heart palpitations, anxiety, mood changes, brain fog, sudden weight gain,
(19:19):
they're all misdiagnosed with other chronic conditions. You've kind of
pointed that out, leading to unnecessary referrals or prescriptions. As
a community health worker aiming to prevent delays and care,
what conversation should I be encouraging between these women and
their primary care physicians in to ensure menopause is truly
(19:41):
considered a possible cause.
Speaker 1 (19:43):
And how can I also support that process?
Speaker 4 (19:46):
I think education first, because the family, you go to
family doctor. This is a big top. This is a
life changing event. Like pregnancy. I can learn a lot.
I can go to my doctor even for an hour,
but I won't get all the information. So find a good,
trustworthy book or even five books. Like a lot of
(20:06):
people read a lot of science fiction book good for them.
Go read as many as you want, but educate yourself
in the first not more important, but the also very
important life changing event with menopause is a big one
of them. And then read a lot about body metabolism.
(20:27):
Read about a lot, and the more you read you
will know what is garbage reading and what's true reading.
But it will require not one book, it will require hours.
It's like when they say you're not going to be
good at something before you do it a thousand hour.
I won't say, go read thousand hour about menopause. But
menopause is the rest of your second half of your life,
(20:50):
so it is very important to spend a good amount
of time educating yourself. You can't find it in school,
you can't find it even in medicine, there is no
rotation about metabosi. You have to read and read more
and see more patients and with experience and with life,
so change way change. Yes, yes, metabolism changes. Yes, you
(21:12):
will gain weight. So it's a whole it changed. There's
no pill that's again our society get pilled. There is
a pill that is a magical pill for everything. No, no, no,
there is no pill for anything. Yes, antibiotics maybe, but
also they say keep the decision clean, do this, avoid that.
But when it comes to more deeper topics like this, uh,
(21:34):
it is an education, life change, mental health. It's a
whole balance of multidisciplinary approach to this issue. If you're
an anxiety to start with, yeah, you will have more
anxiety because I am. If I am, let's say me,
there's something that's scaring me. I have an exam coming
(21:55):
or an interview. Okay, but also the room is hot,
and I'm wearing a fixed wage. I'm going to be
so uncomfortable, like I'm already uncomfortable, like my baseline is
already here. So if you have some mental health issue
to start with, you're anxious, you can't sleep well, you're overthinker,
(22:15):
you're over analyzer. You're taking a burden that is not necessary. Yes,
any symptoms will increase that because you're gaining weight, you're
not happy about your body image, your sexuality is not
there as another layer. You can't sleep because you're sweating
as another layer. And those layers, it keeps adding up.
And there's no one easy pill that can actually dive
(22:38):
deep take all those layers and then make you perfect again. Right,
So make yourself as perfect as you can before even menopause. Right,
educate yourself, do those changes even earlier in life, so
when when menopause come, you welcome it with big hug
and say I'm ready for you. No one, I'm not
ready for.
Speaker 1 (22:56):
Me, No, no one is. We can get as close
to that as well.
Speaker 2 (23:02):
Yes, Okay, one more question because I don't want to
take it more of your time, but we're definitely going
to have another topic on this because I feel like
there's I have a lot of questions.
Speaker 1 (23:10):
This is a good This is a really No, that's okay.
Speaker 2 (23:14):
You're thorough and you're I think you're answering a lot
of questions within the questions, so that's good. Okay, this
is a good one, though, How can we talk to
our children and our spouses about menopause? In short, how
can I tell them that I don't hate them despite
this roller coaster of emotional and hormonal changes.
Speaker 4 (23:35):
That's what I struggled with my kids, my own life.
I'm far away from advising anyone about that, but I'll
drive my best okay. So it's the connection. It's not
about menopause. Are you even connected? How many families do
you see? I go to a restaurant, and you don't
go to a lot of people's family. They're sitting on
a table, They're spending a lot of money, but everyone
(23:55):
is scrolling on stupid things on the phone. How are
you connected? How are you connected when you're disconnected to
start with? And we became a society of like a
zombie society, I call them. So that comes even earlier
into connecting. No phones, have some As a mom, as
(24:15):
a dad, you're the leader of the family for us.
You see the generation A lot of people, including myself,
I did it. I want to get rid of my
not get rid of like keep my child distracted so
I can do something else for myself. Give them iPad,
give them iPhone, and then that becomes worse and worse
and worse. And then yes, you are a family, and
(24:37):
but you have you know nothing about each other, and
we became And I'm struggling from that too. You come
to the point that no one cares like you're connecting,
but you're not connecting. You're not connecting. You have kids,
but you don't have kids. And if our connection is
only eating a meal on the same table, or saying
hi and bye, or how was your day, that's not
(24:59):
a connection. So that's a very deep question. You go
back in time. You connect on a no phone. Let's
go back to the god that play game boards. Tell
me about the best thing that happened to you today,
the worst thing that happened to you. Again, I'm far
far from advising anyone.
Speaker 1 (25:16):
Oh No, I struggle from day to day.
Speaker 4 (25:18):
But I'm trying. I'm trying to go what is it?
No phone, not movie all the time. Because it was
easy for me. Put a movie and everyone is distracted.
It felt good to me, But we're not actually connected.
So no movie, no phone, an hour of talk, deep connection,
no makeup, not celebrities. How do you feel? What's your job?
(25:38):
And yes, you'll have some kids, some family members, that
automatically will love that, and some will resist for a
long time. You persist, persist, keep going, and then when
menopause comes, say man, I'm going through changes, can you
help me. I read about this because you have already
talked to them about their period, talked about them about
your preuberty at some point, talk to them about new
(26:01):
relationship that started way back. So when you talked of
them about menopause, they want to hear from you, you know, But.
Speaker 1 (26:11):
I think that's yeah.
Speaker 2 (26:13):
Education, I feel like, okay, so the last thing I'm
gonna ask you, and I want you to kind of
rapid fire with this.
Speaker 1 (26:20):
Okay, So the I always ask wrap up with this.
Speaker 2 (26:24):
What are your three biggest takeaways that you hope that
our listeners, our viewers who watched both both episodes, take
away from our conversation today.
Speaker 1 (26:36):
Three.
Speaker 2 (26:36):
I think one of them I already know in my
head because you brought it up so many education.
Speaker 4 (26:40):
Education, and one of them. It is a big event
in our life and it's a life change. It's not
a stigma. You're not less beautiful, you're not less sexy.
You are a bad ass, amazing woman. You've done a
lot and you'll still do a lot. You've traveled a lot,
you lived a lot of great moments, and this is
more great moments to come. This is a transition to
(27:01):
a better future. Live it, enjoy it, experience it. If
you need help, seek some help, and sometimes it actually
opens your eyes into okay, how can I change your
life to being a healthier life. So sometimes we make
lemonade out of lemon So education live its, live through it,
(27:23):
own it, own it and talk about it, talk about it,
and don't only bring the bad discussion, bring the good discussion.
What can I change in my life? How can I
discuss it with others? How can I educate others? And
then the last thing is engaging, engaging because menopause, like
anything else, just it helps you engage, seek help, seek
(27:45):
help early on. And if that help was not connecting
with you, there are plenty of doctors out there.
Speaker 1 (27:52):
Perfect. You are fantastic, You really are. I learned a
lot I with you.
Speaker 4 (28:00):
We are awesome.
Speaker 2 (28:01):
Oh no, this has been so wonderful. I cannot wait
to have you back. We have a lot of other
just side conversations I'm thinking of, like, oh my gosh,
we should talk about this makes time and so you
will definitely be back. I just want to thank you
again for joining us on.
Speaker 4 (28:16):
Coming my pleasure. Thank you for having me. It's so
close to my heart when I'm able to educate and
when when I'm able to connect, because I feel that
this is one of our rules in life as a mom,
as an educator, as a as a woman, is just
to go there and hug the whole universe and.
Speaker 1 (28:33):
Yes, no, thank you again.
Speaker 2 (28:39):
You have a wonderful rest of your day and we'll selene.
Speaker 4 (28:42):
Thank you, take care, Bye bye bye
Hey, welcome back.
Speaker 2 (00:02):
It is Covering Your Health presented by i EhP, hosted
by me Evelyn Erivez. So happy to have you here
for every episode, and if it's your first episode, well let.
Speaker 1 (00:12):
Me stop you for one second.
Speaker 2 (00:14):
We are actually in a part two of a show
I want, So if you haven't seen part one of
my chat, you may want to pause right now and
just go back to the last one. I'm gonna tell
you why, because in this episode we're diving back into
our chat with doctor Nahas on perimenopause and menopause, and
we're asking and answering questions from our listener community.
Speaker 1 (00:37):
This is gonna be really great.
Speaker 2 (00:38):
So if you missed part one, maybe pause this episode,
click back into the archives, use your favorite app iHeartRadio,
any of your favorite podcast apps, or of course, if
you're on YouTube, you could just go back to the
other the previous episode, and then come back to this
one for more because both are so good.
Speaker 1 (00:57):
You're gonna get.
Speaker 2 (00:58):
So much out of them. Tons of information. Probably questions
that you wouldn't even think to ask are going to
be answered in these episodes, So let's get going.
Speaker 3 (01:10):
Welcome to Covering your Health, a wellness podcast. Dedicated to
covering all areas of living a healthy and happy lifestyle,
from healthy hearts to understanding health plans and everything in between.
Each episode will provide you with a better understanding of
managing your health, preventative care, and staying on the right
path for your family's wellness journey. The Covering Your Health
(01:32):
podcast is presented by i EhP Now your host Evelina Revez.
Speaker 2 (01:38):
Okay, we are back with doctor Nahas. I'm so excited
to have you back again. We obviously had a lot
to discuss in the first episode, but now we're going
to dive even deeper into perimenopause and menopause, and we
have questions from many of our viewers and our listeners
who have been like are going through it?
Speaker 1 (01:58):
Who are in it right now?
Speaker 4 (02:00):
So are you happy to answer them? Yes?
Speaker 1 (02:02):
Okay, so here we go submitted questions.
Speaker 2 (02:05):
Although menopause shows up differently for each woman, what side
effects have been the most documented.
Speaker 4 (02:11):
I won't say side effects because side effects, at least
in my definition or my understanding, side effects is something
that is a reaction to something you took. So it's
usually what are the worst symptoms or presentation of menopause?
I'll say it that way. It's just the little language education.
I think the worst is when they see a drastical,
(02:32):
acute change in their life because and very fortunately it
doesn't happen to a lot of patients, like let's say
less than three percent. Don't quote me wrong, I did
not read the last sety six. But not a lot
of patients suffer from menopause. They they are most they
don't suffer, or they have mild symptoms. So some hot
flashes that transient or you get used to them. It's
(02:54):
very hard to track them because it's a lifelong of
kind of living through menopause. So it's very hard to
to know exactly what happens with each woman in this universe.
But I think we either get used to it or
it phades off. It's like it's a transition either or.
But unfortunately there are there is less than three percent
of a woman that will suffer from menopause, and that
(03:17):
is in either one symptoms or one aspect of it,
or variety of symptoms. The most it would be the
hot flashes and the sweating the night that insomnia and
being unable to sleep, and the sexual dryness and sexual dysfunction.
The look it not as much, but usually it is
(03:38):
the other symptoms that is more significant. And some also
mood swings or emotional being very emotional. One other thing
just cross my mind or I remember is a lot
of people will say I can't lose weight. I can't
lose weight. I'm gaining a lot of weight. So it is.
(04:00):
It is kind of a variety of pictures, and some
patients will have all of them, unfortunately, and some will
have one specifically that is bothering them the most. Right,
But some patients, unfortunately, which is the smaller percentage of
the population luckily, will suffer significantly from menopause, either one
kind of one aspect of it or the whole spectrum.
(04:24):
Most will have one aspect that is bothering the most,
bothering them the most. The most difficult is the weight,
the not being able. I'm eating exactly the same, and
again it's a I believe my patients, but also it's
a lot of variables in this right. So I'm eating
(04:45):
the same, I'm doing the same activities, but I can't
lose weight. It does happen. I'm a witness of that.
I'm three menopausal, but I am not burning as much
as I burned ten years agore. Right, so I have
to do a lot more. I have to eat a
lot less. It sucks. Sorry, it does.
Speaker 1 (05:03):
You can say that because it does suck. I know it.
Speaker 4 (05:07):
I know. And you like like like eat air.
Speaker 1 (05:12):
Like all I eat is broccoli now, and it's just ridiculous.
Speaker 4 (05:15):
I'm gonna drink green all of a sudden. It's like
from the broccolia media. So yeah, So that's one aspect
that is very challenging. The patient need to know. Okay,
it's a transition like anything else. My hair is turning white,
my skin is wrinkling. It's an aspect of life, and
it's a difficult aspect and we have to just address
(05:35):
it differently. Yes, it is a change, and most people
will feel it, especially people that were onto a little
higher spectrum of their weight. Yes, not if you if,
because it's also genetic. Appetite is genetic, metabolism is genetic.
But you see, the people that are naturally skinny, with
(05:57):
with being peteeth and small body usually don't get affected
as much because even if they gain, you don't even
see it, right, But if it's an average weight like
me or a little more, the more the more effect right,
because you can see any game you can see and
it bothers you. So that requires a lot of education.
(06:18):
And I tell the patients no easy fix. Hormones won't
fix it. Nothing will fix it. You have as you
transition in a lot of other things. You have to
transition by living your life differently. Unfortunately, eat a lot healthier,
eat a lot less than you ate five years ago,
and really really needing to do cardio and exercising and walking.
(06:39):
It's good also for longevity because your bone needs you
to active, to be active more for you not to
lose your bone density. Everything is a signal. If our
bone is not doing much, then you're telling your bone
I don't need you. Then in twenty years from now,
I'm gonna not be able to do anything because I have,
you know, as opinion, thin bones and stuff like that.
(07:00):
So that's the more difficult one. But education and lifestyle,
and it's a big topic. It's a heavy topic. So
I tell them go to like a weight watch program.
The problem is it's not covered by insurance. It's expensive.
I said, just learn the principles. As much as we
learned from the internet about many silly things. We can
(07:21):
use it also to our advantage. JIPT give me a
healthy diet and calories and program my meals. We can
use it to good things instead of just strolling and
going silly thing. So the balance. But if there's a will,
if you really want a change, it won't come easy.
You have to change your whole lifestyle. And it's good
(07:42):
for the family because if you then a mom, or
if you're a sister, or if you're a daughter, if
you bring that, you bring it also to your family.
Everyone will be happy, healthy longevity and looking better from
the vasomotor like the hot flashes the wedding. You can
definitely treat it with hormonal therapy. A long topic for
(08:04):
hormonal therapy. You can always cover it in a different day.
Difficulty to sleep is gonna hit and miss, some patients
will and multifactorial. Is it Was it really really like
a sharp transaction? Was it really like you woke up
twelve months? Was it really twelve months and you felt
that I'm not sleeping anymore? Was there no other factors
(08:28):
in your life that happened, a divorce, a child, going away,
job paying you less, changing, There's a lot of variables
that we don't see. But it's internally causing us a
lot of stress. So if you have any hormonal imbalance
on top of that, it just exaggerates everything. So but
(08:52):
also it is education because we don't unless if you
go to a therapist, even the therapists won't merge all
the symptoms together. Okay, it's all give me a pill
and I'm good. No, it's not pills. It's lifestyle. It's
it's going deep inside you and breaking things down and saying, okay, cut,
eliminate change, and I'm going to leave healthier. So that
(09:12):
will be also difficult to treat. But if it's purely, purely,
purely hormonal, hormonal therapy should help it. But if it's
multifactorial and there are other factors in it, it's more difficult.
But education, education, education helps the patient. Even if I
don't have time to dive deep, I'll just briefly mention
those things and like be honest with yourself, sit with
(09:35):
yourself on the last what is really like when you're quiet?
What are you thinking about? And write it down journaling
and go to your therapist after and say okay, I
have these things help me? Or you do programming or
look on the internet, there are lots of great programs
the sexuality and the dryness. It's also difficult to difficul component.
(10:00):
If it was absolutely just dryness, like everything else is perfect, right, drive, relationship, intimacy,
then yes, perfect easy prescription will help, But most patients
had suffered with lack of connection for many reasons, a
lot of soccer a soccer game, or like resentful or
(10:25):
like you know, being with someone is not easy, right,
you have to do a lot of work to make
it work. And then the easy we a lot of
us live in the comfort of I don't want to
change it, so but you live in it, but you're miserable,
but you don't admit that you're miserable, and then it
doesn't even if it's day to day you're pretending all
the happy pictures on social media that you see, it
(10:47):
appears in your intimacy when you're intimate, right, and then
you A lot of patient will comes that I have
low libido, I don't have six to sex drive. I'm like, well, man,
it is. That is a lot of factors. Again, if
it's a short line, usually usually usually I'm saying there's
always an exception that the dryness, yes, but the libido
(11:07):
and the drive. It's it's hard for me to tell
the drive like drive like it's hard for me that's
loving the person that's being attracted to the person has
nothing to do with hormones. Like even if I'm like,
if I'm loving someone has nothing to do with hormone.
Libido could be, but also some hormones. And if you're
(11:28):
intimate and you're if you have a good connection to
your shartner, that comes out. And then if you then
with some little hormones and some little healthy lubricants, it
will all be fixed. But then it depends on how
deep that issue, on how healthy or unhealthy it is.
Speaker 3 (11:47):
Uh.
Speaker 4 (11:47):
There's a little picture on social media. There's a machine
with one button and a machine with many many buttons.
I don't know if you saw it. That's a woman
and that woman's sex drive and the female sex drive.
The man is one button and females like complex. It's
how stressed she is, how long was her day, how
(12:08):
tired was she We're different creatures that we're just different.
Speaker 2 (12:11):
So yeah, oh my goodness. Yeah, Okay, I think you
covered like four of the questions that Okay, here's an
interesting question. Is there any data link to menopause with
frozen shoulder.
Speaker 4 (12:27):
Frozen shoulder is with with either from an acute incident,
so like I played tennis or I went to the gym,
did something wrong and then one of the ligaments got
tendinitis and with time I didn't heal it and it's
card and then the rotation of my like there's a
range of rotation that a person can do that is
within norm But with frozen shoulder, with time, it might start.
(12:51):
It doesn't usually start right away. As a frozen shoulder.
You don't move it, and then you don't move it
and then you're never pain. It reaches to the point
that you're limited. So the range of movement to the
shoulder is not as normal as it was or as
normal compared to other people. Okay, I cannot tell you
that I read anything that. Again, science is big, there's
(13:12):
always new evidence. There is no direct link in my
knowledge in my experience from my studying. But if you're
unhealthy in general and you have inflammation with age, I
don't think it's menopause. I think age arthritis is something
with age that flirs as you get older, goes with
family history. If you and if you had some sort
(13:35):
of subclinical injury. It could get worse with time, and
then bone density, which is kind of related to hormone.
But if you're doing all the other factors, the supplements
and the weight bearing exercise, the healthy way bearing exercises,
you shouldn't have it. You shouldn't like our body. The creator, God,
in my opinion, created us perfectly right, So menopause is
(14:00):
part of it and that's part of nature. If it
was bad for us, I don't believe that we'll ever
have it. We could continue having period for the rest
of our life. I think our creation was just perfect
in every aspect. Part menopause is one of it. It's
just that, how what else are we doing in our
life that is affecting that?
Speaker 1 (14:20):
So beautifully said?
Speaker 2 (14:22):
Okay, another question, are there any approved holistic approaches to
tackling menopause?
Speaker 4 (14:29):
There are a lot of studies about different hormones and
supplements and soy and black kosher and stuff. And I
do believe there is holistic medicine in the in the past,
uh people from older tribes or older medicine in China
that is thousands of years old. I do believe that
(14:52):
there is a remedy but the problem is it's a
dying secret. And now you go to someone that has
nothing to do with holistic but they say that they're holistic,
and I don't know, I don't know, and pharma is
not perfect. They probably will censor me for that part.
Pharma is also very bad because they also give us
(15:13):
a lot of good some good medicine, some awful medicine
that is that we don't need. Right, But if we go,
they taught us wrong or right to be evidence based medicine.
They taught us to be as a physician for my
license that everything is according to evidence based medicine, and
anything that has no very evidence based medicine is wrong.
(15:34):
I don't believe this is right or that's right. I
believe it's the balance. So if you know there's someone
that can help you, and there's a good holistic medicine person,
I can't prescribe it, I can't advise it right, And
but where is that person? What are there credentialing? How
can we measure their credentialing? That's the problem.
Speaker 1 (15:53):
So just do your research, just like you were.
Speaker 4 (15:55):
Saying, research, but also from where what is research? Google
is not a real search reading the internet is not
research like the research. Research is the double blinded the
best research, double blinded randomized trials. It's taking large group
of women's same aide, same factors, less less variables between
(16:18):
the two groups. Everything is almost similar. Start with one
group with this, start one group with that, and they
don't know which which group is which the pill is
exactly the same. And then after a few years, especially
if we're talking about menabas, twenty years, you study any
life events, good and bad, their symptoms. That's the only
(16:40):
research that I can say, do your research. But everything else,
we have a lot of information that could be all wrong.
So that's that's where it become a problem. So I
can't tell you that I don't advise it because we
don't have strong evidence showing there's some evidence here and there,
not long enough, not strong enough, and there is not
(17:01):
enough knowledge out there that taught that the person that
passed their holistic medicine from in the whole family, from
a grandfather to it was a it was a family
that that was holistic in like a thousand or two
thousand years ago.
Speaker 2 (17:19):
Yes, and you saw the cure, Yeah, you saw your eyes.
Speaker 4 (17:26):
I don't think we have anything like that now. So
because of that, I'll stay away from it. And also
the variability of where do you get your stuff from,
because if it's not FD approved, then what's the dose?
What's the real dose I'll take? You take this flower
and eat it. Where does this flower come from? How
much of the specific medicine that we're looking into this
flower has? Is this flower good or not? Was it
(17:49):
toxic or not? Was it strayed with pesticide or not?
So a lot of factors that that's why I don't
recommend it. But I'm not again a holistic medicine in general.
But you where to go? Yeah, that's the question.
Speaker 1 (18:01):
No, No, No, that's a good answer though, because it does
make sense.
Speaker 2 (18:04):
You're like, look, this is what I know and this
I believe that there is probably things out there, But
I wouldn't know where to even send you because I
don't know how where they get their science from exactly.
Speaker 4 (18:15):
But if you do a good hormonal therapy that is balanced,
that starts at a specific age after doing eliminating all
the risk factors, it is their good studies showing that
after years of the w Woman's Health Study that initially
said no No to hormones, and then after when they
did the sub analysis, after a lot of patients that
suffered from menopause, they analyzed subgroups and they saw, oh, no, no, no,
(18:39):
it's actually good for you. This subgroup with this age.
When they started like, this is actually very good for you.
So then I'll go with science and I'll say go
to a good doctor, start with good hormonal therapy, and
that will be my recommendation. And this is what I
would do for myself in the future as well.
Speaker 2 (18:55):
Yes, okay, here's another good question. This was actually from
a community health worker. They say, I'm a community health
worker who's in the field a lot. I work face
to face with members and the topic of perimenopause menopause
comes up all the time. Many perimenopause and menopause symptoms
like heart palpitations, anxiety, mood changes, brain fog, sudden weight gain,
(19:19):
they're all misdiagnosed with other chronic conditions. You've kind of
pointed that out, leading to unnecessary referrals or prescriptions. As
a community health worker aiming to prevent delays and care,
what conversation should I be encouraging between these women and
their primary care physicians in to ensure menopause is truly
(19:41):
considered a possible cause.
Speaker 1 (19:43):
And how can I also support that process?
Speaker 4 (19:46):
I think education first, because the family, you go to
family doctor. This is a big top. This is a
life changing event. Like pregnancy. I can learn a lot.
I can go to my doctor even for an hour,
but I won't get all the information. So find a good,
trustworthy book or even five books. Like a lot of
(20:06):
people read a lot of science fiction book good for them.
Go read as many as you want, but educate yourself
in the first not more important, but the also very
important life changing event with menopause is a big one
of them. And then read a lot about body metabolism.
(20:27):
Read about a lot, and the more you read you
will know what is garbage reading and what's true reading.
But it will require not one book, it will require hours.
It's like when they say you're not going to be
good at something before you do it a thousand hour.
I won't say, go read thousand hour about menopause. But
menopause is the rest of your second half of your life,
(20:50):
so it is very important to spend a good amount
of time educating yourself. You can't find it in school,
you can't find it even in medicine, there is no
rotation about metabosi. You have to read and read more
and see more patients and with experience and with life,
so change way change. Yes, yes, metabolism changes. Yes, you
(21:12):
will gain weight. So it's a whole it changed. There's
no pill that's again our society get pilled. There is
a pill that is a magical pill for everything. No, no, no,
there is no pill for anything. Yes, antibiotics maybe, but
also they say keep the decision clean, do this, avoid that.
But when it comes to more deeper topics like this, uh,
(21:34):
it is an education, life change, mental health. It's a
whole balance of multidisciplinary approach to this issue. If you're
an anxiety to start with, yeah, you will have more
anxiety because I am. If I am, let's say me,
there's something that's scaring me. I have an exam coming
(21:55):
or an interview. Okay, but also the room is hot,
and I'm wearing a fixed wage. I'm going to be
so uncomfortable, like I'm already uncomfortable, like my baseline is
already here. So if you have some mental health issue
to start with, you're anxious, you can't sleep well, you're overthinker,
(22:15):
you're over analyzer. You're taking a burden that is not necessary. Yes,
any symptoms will increase that because you're gaining weight, you're
not happy about your body image, your sexuality is not
there as another layer. You can't sleep because you're sweating
as another layer. And those layers, it keeps adding up.
And there's no one easy pill that can actually dive
(22:38):
deep take all those layers and then make you perfect again. Right,
So make yourself as perfect as you can before even menopause. Right,
educate yourself, do those changes even earlier in life, so
when when menopause come, you welcome it with big hug
and say I'm ready for you. No one, I'm not
ready for.
Speaker 1 (22:56):
Me, No, no one is. We can get as close
to that as well.
Speaker 2 (23:02):
Yes, Okay, one more question because I don't want to
take it more of your time, but we're definitely going
to have another topic on this because I feel like
there's I have a lot of questions.
Speaker 1 (23:10):
This is a good This is a really No, that's okay.
Speaker 2 (23:14):
You're thorough and you're I think you're answering a lot
of questions within the questions, so that's good. Okay, this
is a good one, though, How can we talk to
our children and our spouses about menopause? In short, how
can I tell them that I don't hate them despite
this roller coaster of emotional and hormonal changes.
Speaker 4 (23:35):
That's what I struggled with my kids, my own life.
I'm far away from advising anyone about that, but I'll
drive my best okay. So it's the connection. It's not
about menopause. Are you even connected? How many families do
you see? I go to a restaurant, and you don't
go to a lot of people's family. They're sitting on
a table, They're spending a lot of money, but everyone
(23:55):
is scrolling on stupid things on the phone. How are
you connected? How are you connected when you're disconnected to
start with? And we became a society of like a
zombie society, I call them. So that comes even earlier
into connecting. No phones, have some As a mom, as
(24:15):
a dad, you're the leader of the family for us.
You see the generation A lot of people, including myself,
I did it. I want to get rid of my
not get rid of like keep my child distracted so
I can do something else for myself. Give them iPad,
give them iPhone, and then that becomes worse and worse
and worse. And then yes, you are a family, and
(24:37):
but you have you know nothing about each other, and
we became And I'm struggling from that too. You come
to the point that no one cares like you're connecting,
but you're not connecting. You're not connecting. You have kids,
but you don't have kids. And if our connection is
only eating a meal on the same table, or saying
hi and bye, or how was your day, that's not
(24:59):
a connection. So that's a very deep question. You go
back in time. You connect on a no phone. Let's
go back to the god that play game boards. Tell
me about the best thing that happened to you today,
the worst thing that happened to you. Again, I'm far
far from advising anyone.
Speaker 1 (25:16):
Oh No, I struggle from day to day.
Speaker 4 (25:18):
But I'm trying. I'm trying to go what is it?
No phone, not movie all the time. Because it was
easy for me. Put a movie and everyone is distracted.
It felt good to me, But we're not actually connected.
So no movie, no phone, an hour of talk, deep connection,
no makeup, not celebrities. How do you feel? What's your job?
(25:38):
And yes, you'll have some kids, some family members, that
automatically will love that, and some will resist for a
long time. You persist, persist, keep going, and then when
menopause comes, say man, I'm going through changes, can you
help me. I read about this because you have already
talked to them about their period, talked about them about
your preuberty at some point, talk to them about new
(26:01):
relationship that started way back. So when you talked of
them about menopause, they want to hear from you, you know, But.
Speaker 1 (26:11):
I think that's yeah.
Speaker 2 (26:13):
Education, I feel like, okay, so the last thing I'm
gonna ask you, and I want you to kind of
rapid fire with this.
Speaker 1 (26:20):
Okay, So the I always ask wrap up with this.
Speaker 2 (26:24):
What are your three biggest takeaways that you hope that
our listeners, our viewers who watched both both episodes, take
away from our conversation today.
Speaker 1 (26:36):
Three.
Speaker 2 (26:36):
I think one of them I already know in my
head because you brought it up so many education.
Speaker 4 (26:40):
Education, and one of them. It is a big event
in our life and it's a life change. It's not
a stigma. You're not less beautiful, you're not less sexy.
You are a bad ass, amazing woman. You've done a
lot and you'll still do a lot. You've traveled a lot,
you lived a lot of great moments, and this is
more great moments to come. This is a transition to
(27:01):
a better future. Live it, enjoy it, experience it. If
you need help, seek some help, and sometimes it actually
opens your eyes into okay, how can I change your
life to being a healthier life. So sometimes we make
lemonade out of lemon So education live its, live through it,
(27:23):
own it, own it and talk about it, talk about it,
and don't only bring the bad discussion, bring the good discussion.
What can I change in my life? How can I
discuss it with others? How can I educate others? And
then the last thing is engaging, engaging because menopause, like
anything else, just it helps you engage, seek help, seek
(27:45):
help early on. And if that help was not connecting
with you, there are plenty of doctors out there.
Speaker 1 (27:52):
Perfect. You are fantastic, You really are. I learned a
lot I with you.
Speaker 4 (28:00):
We are awesome.
Speaker 2 (28:01):
Oh no, this has been so wonderful. I cannot wait
to have you back. We have a lot of other
just side conversations I'm thinking of, like, oh my gosh,
we should talk about this makes time and so you
will definitely be back. I just want to thank you
again for joining us on.
Speaker 4 (28:16):
Coming my pleasure. Thank you for having me. It's so
close to my heart when I'm able to educate and
when when I'm able to connect, because I feel that
this is one of our rules in life as a mom,
as an educator, as a as a woman, is just
to go there and hug the whole universe and.
Speaker 1 (28:33):
Yes, no, thank you again.
Speaker 2 (28:39):
You have a wonderful rest of your day and we'll selene.
Speaker 4 (28:42):
Thank you, take care, Bye bye bye
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