September 9, 2024 • 23 mins
This is part 3 in a series of conversations about perimenopause and menopause. I've heard from so many women who felt like they went through it alone, or didn't have anyone to confide in or help them through it. So let's normalize talking about menopause - what it can look like, what to expect, and ideas for how to best navigate the inevitable changes that come with this phase of life.
Maria's story is different than Lisa's and Nancy's, in particular because she had 2 babies in her 50s, but if you've listened to all 3 conversations about perimenopause, you will surely recognize some commonalities. And if you are noticing these symptoms yourself - you're not going crazy! There is support available- information, treatments, other women having similar experiences.
Our stories are unique. We are not doctors, nor are we giving medical advice. Please talk to your doctor about your health and follow their professional advice.
Here are some books we mention that we have found to be helpful on this journey:
-The New Menopause by Dr Mary Claire Haver
-Outlive by Dr. Peter Attia
-Estrogen Matters by Arum Bluming, MD, and Carol Tavris, PhD
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:02):
Hi, I'm Adriana Medina Kagan.
Welcome to Bien Fuerte.
It's time to speak.
This podcast was created toconnect our community to others
who are interested in exercisingnot only their physical bodies,
but their mind, spirit, and soulas well.
Listen to life experiences,themes, and topics that have
(00:23):
taught us how to shed thoselimiting beliefs.
Get advice from fitness experts.
clients, business owners, andother community members that
have inspired us to embraceabundance and freedom in all
departments of our lives.
Be brave enough to borrow otherpeople's courage until we find
(00:43):
our own strength to blaze ourown way in this life and know
that you are not alone.
Hola, Madria.
Thank you for joining me again.
I loved speaking to you.
And this, is an hour dedicatedjust to you and your experience
(01:06):
with perimetopause.
I love having greatconversations with you as we're
training.
about our experience and whatwe're reading and everything
that we're learning I appreciateyou taking out the time of your
busy schedule to do this for me.
Thank you, mujer.
Thank you for having me.
Gracias.
De nada.
Okay.
Tell me all about it.
(01:27):
This is something that we canshare with your wine night
friends.
Yeah.
So I have a confusingperimenopause journey because I
decided to do IVF to have babiesI decided at 48.
But by the time I delivered thatfirst baby, I was 50.
(01:48):
And I think I was still prettygood.
I don't think I wasperimenopausal yet because I was
just telling Matt, my husband,this morning that between
pregnancy one and pregnancy two,I see pictures and my body went
back to what it was.
I had a nice waistline.
I was slender.
And I had energy things were,you know, within like a newborn
(02:10):
wakes you up and all that, but Igot back once you're past that
initial, like really rough twoto three months, I got back to
fairly normal and I wasn't.
Exercising at the same level asI used to.
So I should have blown up or, myhealth should have suffered
dramatically, but it didn't.
So that's a sign to me that Iwas not yet in that last
(02:34):
perimenopausal period.
But I feel like my body gotpretty back to normal, but then
with my second pregnancy Idelivered right before turning
52.
And then I thought I hadpostpartum depression and I was,
you know, I like to gloss overthings and there's always a
questionnaire for you at thepediatrician, at the lactation
(02:54):
consultant, they're reallylooking for it.
And I remember being one shy ofPositive for referral to treat
your postpartum depression withmy lactation consultant and, but
I was sobbing during that visit.
And so she handed me thequestionnaire and I was very
close, but looking back now, Ithink I had the combination of
(03:15):
you have that estrogen drop,deliver your baby.
Plus I also probably went into.
Deep perimenopause at thatmoment.
And you knew it was comingbecause you mentioned that if
people haven't listened to her,the first podcast of her
pregnancy journey at 50, youshould listen to that because
this is like a part two for herbecause as she was talking about
(03:38):
that, I was going through thesigns of perimenopause and I was
like, we got the, this target,that little spot of life right
now.
So pause on that.
Here it is, people.
Yeah, I told my obstetrician inthe middle of my second
pregnancy, I said, I'mterrified.
I'm terrified that the secondthis baby comes out, I'm going
to sink into menopause.
(03:59):
And she said, no, you probablywon't want, but when you stop
breastfeeding, you will.
So I breastfed that baby for twoyears, not just because I
thought, Hey, these are goodhormones.
These are keeping me young andThey say that when you stop
breastfeeding, you put onweight.
That did not happen to me thefirst time that I had the
opposite reaction where I had tostop breastfeeding in order to
(04:22):
stop eating like a maniac andfinally lose some weight.
But with my second one when Ifinally stopped breastfeeding, I
did not drop the weight.
I did not lose the belly fat andI just thought it was because
your second pregnancy stretchesout your abs in a way that the
first one doesn't because thingshave already been relaxed and
then you build on that.
So I assumed it was like, Ohwow, well the second kid really
(04:45):
undoes your abs.
But then it was everything else.
It was the distribution of thatfat.
It was the fatigue.
And the low mood and I was like,I'm just not interested in
socializing that much right nowand I would go to things and
sort of be almost a littleanxious about talking to people
(05:07):
and I just assumed, well, it'sbecause I'm a busy mom.
I have two kids under the age ofthree but then there was the one
thing that just didn't getbetter that really bothered me.
The vaginal dryness was reallybugging me.
And that was the thing that waslike, In my face, like you can't
look away from this.
You can't keep ignoring this.
(05:28):
You can't keep thinking you'renot in perimenopause because
this is very different from myyounger life.
And your younger life.
Exactly.
First.
And you got the support that youneeded because you were going
post having a baby.
And it's funny how you said thequestionnaire about depression
and all that.
There's so much support for youwhen you're having a baby.
(05:51):
But what if you're not?
Right.
And you're in perimenopause.
Where is the support?
Correct.
And I, I just read the newmenopause by Marie Claire Haver
and and she mentions that likeevery single place you go to
after you have a baby, they'reasking you like, are you
depressed?
they're really screening for it.
(06:12):
It's a super important time too,because you're not only
responsible for your own life,you're responsible for another
person's life now that youbrought into the world.
So I get that.
That carries a, an additionalweight to it, but this is
another massively changing timein a woman's body and hormone
life that just gets overlooked.
I went to see the primary careupdate at my hospital where I
(06:34):
work.
And.
One of the speakers was talkingabout menopause.
I was so excited about this.
This, like, in the whole day, Iwas like, great, high blood
pressure, great, diabetes, I'mgonna learn about all that, but
really, really, I'm here for themenopause talk.
And then I was so disappointedto learn that treatment is only
approved for hot flashes.
(06:55):
And it's not even like the, likeestradiol isn't necessarily the
first choice either.
They'll offer you gabapentin or,you know, like so many women
have been complaining about allthese different symptoms, which
I'm going to get into now.
Yes.
That are all you can fix withone Pill or two, because if you
(07:16):
still have a uterus, you alsoneed progesterone, but all the
ways that we treat theperimenopausal symptoms, like
the mood changes, you get anSSRI, you get antidepressant,
the hot flushes, you getgabapentin, which is a nerve
medication I, you know, I'm notgoing to list every single one,
but the point is that when Istarted taking So, Estradiol I
(07:38):
started with a vaginal becausethat was the one thing that was
really bothering me.
And I had enough absorption thatall these other things started
to get better.
And I was like, Oh my goodness,I'm not as tired.
My mood is better.
I'm not as irritable.
And it just dawned on me thatall these things have been
(08:01):
perimenopause, perimenopausesigns.
And you were stronger in yourworkout.
I remember you said that.
And I got stronger, right?
It's definitely a goodcombination of exercise plus
the, hormone replacement hashelped a lot because they like
work together.
So yes.
I'm stronger because I'm workingout, but I can work out better
and more effectively because Ihave the muscle reserve and the
(08:23):
energy to do it.
So this week I've also noticedthat, you know, I'm recovering
from having a Mohs procedure andI haven't been allowed to work
out for a week.
And I can tell that I don't feelas good.
And the exercise has really madea difference, but I don't think
I felt like I could.
exercise.
(08:43):
It really took me a long time tohave my mind wrapped around
getting back and do a goodexercise routine because I was
so tired.
And I was just like, I don'teven know where I'm going to fit
it in.
I feel like my body needs topreserve energy.
And it was really hard to stickwith something because I felt
like I was balancing gettingenough sleep and so on.
But part of why you don't getenough sleep is because when
(09:05):
your hormones are off, you'rewaking up.
And it's not the hot flushes.
I've never had hot flushes.
I've had like a slightly,probably different version of
it.
Whereas.
where I will get more sweaty inthe armpits than I used to.
And like my smell changed a bitbefore I started treating.
(09:25):
So that was an indication.
These were all little thingsthat no one ever talks about,
but then you're like, butsomething's different about me.
Something's different about mybody.
And I just want us to be able tonormalize and talk about it.
I do too.
That is having theseconversations on any part of my
podcast from trauma torelationships to having kids to
(09:47):
managing life to death to yoursupport system to all of that.
So I'm glad that you're talkingabout it.
And it's great to be able totalk to other ladies, Having
been through it and then myselfgoing through it and I feel like
I would have prepped a littlebit more for my clients had I
gone through it.
(10:07):
Now, from here on out, I feellike you guys are gonna get it.
You're going to get all thesupport because of the fact that
I'm experiencing it now.
And then I'm going back to myclients that have had it and
what their experience wasbecause some of them, I mean,
you're going to hear Lisa andNancy, they couldn't talk to
their parents.
That generational gap is such abig deal and you just tough it
(10:31):
out.
What is your support system andwho do you talk to and do you
have other people to support?
Like, I'm glad you have thatgroup that you meet with and you
can chat about it, but are theya little bit further along?
Are they just going through it alittle bit of both?
Right.
I tend to have like, even beforeI had kids, I tended to have
younger friends.
Because I didn't have kids untilI was older.
(10:54):
So I was still doing the stuffthat younger friends were doing.
And most of those friends I havehere don't have kids, but now
that I've made new friends with,as parents, their kids are my
kid's age.
So they're younger.
So I basically am leading thecharge for most people that I'm
around as far as experiencingmenopause early.
(11:14):
And at first, it's kind ofembarrassing.
You're like, Oh no, this thing,like I was just like everybody
else.
And now There's a change and I'mnot, I can't just keep up with
everyone, but then you discoverthat you could replace your
hormones and then you can again,and you're never going to be 20
or 25 again, but you are able toadapt to the, you know, the
(11:38):
slight differences and stillkeep a pretty high level of
activity and everything andthat, and then, and that all
feeds itself.
It does, because even some ofthe signs like joint pain was a
big one for Lisa.
Yeah.
So, and you as well felt yourjoint pain and then having had
the medication.
Yeah.
These are all things that no oneever mentioned.
(12:01):
And you know, my mom died acouple of years ago as anybody
who listened to the last podcastknows.
So, I don't have anyone to talkto because when I really started
experiencing these symptoms, shewas already, like, I wasn't
going to talk to my mom aboutvaginal dryness.
Because we had a goodrelationship, but not like that
kind of good relationship.
No se habla, you know.
(12:22):
No se habla, we're Latins, youknow, it's kind of hard to talk
about sex with your parents, butwe got a little bit better.
But every little thing you'relike my body's changing in a way
and it like I said in my case Itwas confusing because I didn't
know if what I was experiencingwas sleep deprivation,
exhaustion from parenting twokids and working.
(12:43):
And so, each time you're like,am I imagining this?
Do I really wake up with jointpains everywhere?
And do I have rheumatoidarthritis?
Like, what's going on?
And all the things that swirl inyour head, which don't help at
all, because you get anxietyfrom menopause.
And perimenopause.
So then you're like, everythingjust swirls like, Oh no, I'm
getting old.
I'm going to die younger than Iactually thought I was going to
(13:05):
die.
I can't do this.
And then all of a sudden when Istarted just kind of dipping my
toe into treatment, everythingstarted to fall into place.
And another symptom is tinnitusringing in the ears.
That I have to admit has notgotten better, but it's not a
bothersome tinnitus.
The other book I really lovedeven possibly more is Estrogen
(13:27):
Matters.
Estrogen Matters.
Yes.
It's so good.
Basically, his wife wasdiagnosed with cancer and her
hormones changed as a result ofmedications that she had to
take.
And he did a very deep dive intoall the research because he
couldn't support his wife.
Yeah.
I wanted to support his wife.
The author is Avram Blooming, MD and Carol Tavris, P H D.
(13:54):
Great.
That's good.
It's good.
I would say estrogen matters isslightly more scientific and
the.
Okay.
Thanks.
New menopause is more like a, ithas a toolkit and it lists all
the symptoms and I feel likeit's a reference.
Estrogen matters debunks thewhole reason that we stopped
treating women because thewomen's health initiative, the
(14:14):
news got ahold of it like a daybefore they actually released
information about it.
And all they highlighted wasthat there was an increase in
breast cancer and the increasein breast cancer was so small.
And they also did the study onwomen who were obese.
Past 60 smokers, there was justa very big population of
(14:34):
unhealthy women who had beenpast menopause for 10 years.
So that this is one of theimportant things is if you are
experiencing perimenopause, youneed to jump on treatment before
you have lapsed 10 years.
Or before you turn 60, becauseafter that, it's not that it's
impossible for you to treat it,but the scales start to tip as
(14:54):
far as risks go.
So if you have all yourreceptors intact and you are
jumping on it while your body isstill ready to receive estrogen
and convert things the way it'ssupposed to, then it's good, but
if you get past 60, your bodyhas kind of already changed.
And then it can potentially giveyou an increase in those risks,
but again, they're tiny.
(15:16):
And the other thing is they usedPremarin, which they don't do
that now.
Now, you know, we know estradiolis what you should take.
And a lot of people do either apatch or oral.
Some people compound, but I'mnot a fan of that because
compounding is less regulated.
I mean, it's basically apharmacist mixing it up.
Mm-Hmm.
It could work fine.
A lot of people, my best friendloves it, but I personally feel
(15:38):
like orals or the patch, whichhas a consistent delivery
amount, what are you taking?
That's my preference.
So I take estradiol by mouth.
I increased to 1.5 milligramslike probably two months ago,
three months ago.
Because at one milligram I wasdoing really well.
But there were still some thingsthat weren't quite right.
(16:01):
And, oh, my libido still wasn'tquite back to normal.
And like your orgasms get moreflat, that's another symptom.
And so we increased to 1.
5 and I feel great.
So you, there are certain thingsthat you have to go through.
So at the beginning, because ofall this, you can have spotting.
(16:21):
Like when I first started, I wason a combination patch and I had
bleeding.
Like four times I had a periodor whatever it was bleeding.
I mean, it wasn't a real periodcause it was, I had gone at that
point six to eight monthswithout a natural period.
But because of that, you have tojust, I mean, you have to
(16:41):
balance.
Waiting out the side effects.
In my case, we did an ultrasoundof my uterus to make sure I
didn't have fibroids because Ido have a history of fibroids.
And although with my last Csection, she took out the
fibroid I had and I should befine.
I actually had no fibroids andwe just made an adjustment to
the medication and moved on.
(17:02):
And so you're.
Potentially going to have two tothree months of spotting or
other things like breasttenderness.
And if you can tolerate it, Isay, stick it out.
And then at the end of threemonths, if it hasn't gotten
better, like right now, I'mcoming up on three months of
this new dose and my breasttenderness finally got better.
So You know, it just depends.
(17:22):
If you tell me I'm going to havea little bit of breast
tenderness, but I'm going tohave everything back.
Sure, I'll take it.
I'm done.
Because the other thing with mewith, perimenopause was I felt
like I was in PMS all the time.
I don't know if anybody sufferedfrom PMS.
But it was like, it was so roughbecause my whole life I've had
(17:44):
it and probably every othermonth that would get it pretty
intensely.
But you know, it lasts two orthree days.
And then you get your period andyou're like, Oh, thank goodness.
That's why I was a raging, badperson.
But the other thing was I had a40 day cycle, my whole life.
And then, oh, so here's aninteresting thing.
(18:04):
So when we talk aboutperimenopause, like the actual
symptoms that start to botheryou, they'll probably start like
late forties to early fifties.
And so I didn't have anythinguntil I was what, 51, 52, right?
Right.
But prior to that, when Iremember my forties that all of
a sudden I on a dime changed toa 28 day cycle.
(18:26):
And it was so weird.
Cause I had just had this veryregular 40 day cycle and it was,
for a long time, I was like, amI late?
Am I late?
No, no, no, and I would watch itand it would hit 40 days and be
like, okay, I'm still good.
But that's the thing that if younotice it's happening to you,
that is the beginning of yourbody starting to change, shift
its hormones.
Yeah.
(18:47):
And then with your medicationfor your pregnancies, did it
change even more so or becauseyou're, you are prepping your
body for pregnancy.
Well, so they put you on birthcontrol pills like a month
before.
Your scheduled embryo transferand that's just so you won't
ovulate because if you ovulatewell, number one, it also preps
(19:10):
your uterine lining cause youwant it nice and thin because
the embryo attaches when thelining is thin.
So you take a birth controlpill, that's really just to
prevent the drama of you gotpregnant and now there's this
embryo and all this other stuffthat we had planned.
It just keeps things clean.
Then you start injectingestradiol at some point, I've
(19:33):
forgotten now, but there wasalways like an elaborate
calendar of what day you startthis and when you do that.
But the estradiol is actuallythen I think to prep your
lining, but then six days beforethe transfer, you start
injecting progesterone becausethe embryo is six days old when
they put it in.
You start your progesterone andthen you just start making HCG,
(19:53):
which is the hormone ofpregnancy.
And then you get that embryo andyou're, you're levels are
already starting to kick inbecause I mean, the body's
amazing.
Then you just start making HCG,which is the hormone of
pregnancy.
That, helps the embryo grow and,they check you two days after
the embryo goes in and then twodays after that, and it's like,
(20:16):
yeah, my numbers doubled.
And so I had no problems withthat.
I don't know if that's a sign ofthe fact that I was still in an
okay place or hormonally orwhat, when I started hormone
therapy, my lab work actuallyshowed that I wasn't quite, I
wasn't postmenopausal.
I was peristal.
(20:37):
So I had low estrogen, I wasgoing to say, but the hormone,
so FSH, I believe was the onethat was still a little low, but
not completely out.
So my body was still trying totell my ovaries, Hey, it's time
to work.
It's time to put out an egg, butI just didn't have the estrogen
levels yet.
Right.
(20:58):
So that's crazy.
I was also going to mention thatyou had read Peter Attea's book
and he was also talking aboutwhen you are on hormone
replacement, it does reallycounter the cognitive loss or
the brain fog or the dementia orit just goes on, right?
Yeah.
(21:18):
So this is funny because now inretrospect.
One thing I did have in my lateforties was brain fog.
There were just moments in theworkday where I was like, I
can't access what I need from mybrain.
And I've always had an easy timewith school, with learning
stuff.
I mean, I was like a sponge andI remembered so much actually
(21:39):
that it was sometimes a burden.
And then I finally justattributed it to, I work with
brain surgeons.
They're just really smart.
And I just feel stupid aroundthem.
But then now looking back, Ifeel like, Oh, those were
probably times where I washaving a hormonal imbalance.
Yeah.
And it's hard to monitor alsobecause it changes hormones,
your body at different times tocheck those.
(22:02):
I did it twice and saw that my.
Estrogen was fine, but myprogesterone was in the dump.
Yeah.
Isn't that crazy?
The progesterone, by the way, isthe sleep one.
So now that we split it, and Idon't just do it as a patch, I
take the progesterone at night.
I sleep like a tired teenager.
I love it.
(22:22):
I dream.
I have vivid dreams.
Again, it's the best.
Thank you for all the time thatyou spend here.
You're welcome.
Thank you for joining me.
Okay.
It's my pleasure.
Yes.
Yeah.
And we can always do a bookreview on any of those.
I just got my copy of the newmenopause.
Okay.
(22:43):
Awesome.
I look forward to it.
Okay.
Bye.
Bye.
Adios.
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Gracias y adios.
Hi, I'm Adriana Medina Kagan.
Welcome to Bien Fuerte.
It's time to speak.
This podcast was created toconnect our community to others
who are interested in exercisingnot only their physical bodies,
but their mind, spirit, and soulas well.
Listen to life experiences,themes, and topics that have
(00:23):
taught us how to shed thoselimiting beliefs.
Get advice from fitness experts.
clients, business owners, andother community members that
have inspired us to embraceabundance and freedom in all
departments of our lives.
Be brave enough to borrow otherpeople's courage until we find
(00:43):
our own strength to blaze ourown way in this life and know
that you are not alone.
Hola, Madria.
Thank you for joining me again.
I loved speaking to you.
And this, is an hour dedicatedjust to you and your experience
(01:06):
with perimetopause.
I love having greatconversations with you as we're
training.
about our experience and whatwe're reading and everything
that we're learning I appreciateyou taking out the time of your
busy schedule to do this for me.
Thank you, mujer.
Thank you for having me.
Gracias.
De nada.
Okay.
Tell me all about it.
(01:27):
This is something that we canshare with your wine night
friends.
Yeah.
So I have a confusingperimenopause journey because I
decided to do IVF to have babiesI decided at 48.
But by the time I delivered thatfirst baby, I was 50.
(01:48):
And I think I was still prettygood.
I don't think I wasperimenopausal yet because I was
just telling Matt, my husband,this morning that between
pregnancy one and pregnancy two,I see pictures and my body went
back to what it was.
I had a nice waistline.
I was slender.
And I had energy things were,you know, within like a newborn
(02:10):
wakes you up and all that, but Igot back once you're past that
initial, like really rough twoto three months, I got back to
fairly normal and I wasn't.
Exercising at the same level asI used to.
So I should have blown up or, myhealth should have suffered
dramatically, but it didn't.
So that's a sign to me that Iwas not yet in that last
(02:34):
perimenopausal period.
But I feel like my body gotpretty back to normal, but then
with my second pregnancy Idelivered right before turning
52.
And then I thought I hadpostpartum depression and I was,
you know, I like to gloss overthings and there's always a
questionnaire for you at thepediatrician, at the lactation
(02:54):
consultant, they're reallylooking for it.
And I remember being one shy ofPositive for referral to treat
your postpartum depression withmy lactation consultant and, but
I was sobbing during that visit.
And so she handed me thequestionnaire and I was very
close, but looking back now, Ithink I had the combination of
(03:15):
you have that estrogen drop,deliver your baby.
Plus I also probably went into.
Deep perimenopause at thatmoment.
And you knew it was comingbecause you mentioned that if
people haven't listened to her,the first podcast of her
pregnancy journey at 50, youshould listen to that because
this is like a part two for herbecause as she was talking about
(03:38):
that, I was going through thesigns of perimenopause and I was
like, we got the, this target,that little spot of life right
now.
So pause on that.
Here it is, people.
Yeah, I told my obstetrician inthe middle of my second
pregnancy, I said, I'mterrified.
I'm terrified that the secondthis baby comes out, I'm going
to sink into menopause.
(03:59):
And she said, no, you probablywon't want, but when you stop
breastfeeding, you will.
So I breastfed that baby for twoyears, not just because I
thought, Hey, these are goodhormones.
These are keeping me young andThey say that when you stop
breastfeeding, you put onweight.
That did not happen to me thefirst time that I had the
opposite reaction where I had tostop breastfeeding in order to
(04:22):
stop eating like a maniac andfinally lose some weight.
But with my second one when Ifinally stopped breastfeeding, I
did not drop the weight.
I did not lose the belly fat andI just thought it was because
your second pregnancy stretchesout your abs in a way that the
first one doesn't because thingshave already been relaxed and
then you build on that.
So I assumed it was like, Ohwow, well the second kid really
(04:45):
undoes your abs.
But then it was everything else.
It was the distribution of thatfat.
It was the fatigue.
And the low mood and I was like,I'm just not interested in
socializing that much right nowand I would go to things and
sort of be almost a littleanxious about talking to people
(05:07):
and I just assumed, well, it'sbecause I'm a busy mom.
I have two kids under the age ofthree but then there was the one
thing that just didn't getbetter that really bothered me.
The vaginal dryness was reallybugging me.
And that was the thing that waslike, In my face, like you can't
look away from this.
You can't keep ignoring this.
(05:28):
You can't keep thinking you'renot in perimenopause because
this is very different from myyounger life.
And your younger life.
Exactly.
First.
And you got the support that youneeded because you were going
post having a baby.
And it's funny how you said thequestionnaire about depression
and all that.
There's so much support for youwhen you're having a baby.
(05:51):
But what if you're not?
Right.
And you're in perimenopause.
Where is the support?
Correct.
And I, I just read the newmenopause by Marie Claire Haver
and and she mentions that likeevery single place you go to
after you have a baby, they'reasking you like, are you
depressed?
they're really screening for it.
(06:12):
It's a super important time too,because you're not only
responsible for your own life,you're responsible for another
person's life now that youbrought into the world.
So I get that.
That carries a, an additionalweight to it, but this is
another massively changing timein a woman's body and hormone
life that just gets overlooked.
I went to see the primary careupdate at my hospital where I
(06:34):
work.
And.
One of the speakers was talkingabout menopause.
I was so excited about this.
This, like, in the whole day, Iwas like, great, high blood
pressure, great, diabetes, I'mgonna learn about all that, but
really, really, I'm here for themenopause talk.
And then I was so disappointedto learn that treatment is only
approved for hot flashes.
(06:55):
And it's not even like the, likeestradiol isn't necessarily the
first choice either.
They'll offer you gabapentin or,you know, like so many women
have been complaining about allthese different symptoms, which
I'm going to get into now.
Yes.
That are all you can fix withone Pill or two, because if you
(07:16):
still have a uterus, you alsoneed progesterone, but all the
ways that we treat theperimenopausal symptoms, like
the mood changes, you get anSSRI, you get antidepressant,
the hot flushes, you getgabapentin, which is a nerve
medication I, you know, I'm notgoing to list every single one,
but the point is that when Istarted taking So, Estradiol I
(07:38):
started with a vaginal becausethat was the one thing that was
really bothering me.
And I had enough absorption thatall these other things started
to get better.
And I was like, Oh my goodness,I'm not as tired.
My mood is better.
I'm not as irritable.
And it just dawned on me thatall these things have been
(08:01):
perimenopause, perimenopausesigns.
And you were stronger in yourworkout.
I remember you said that.
And I got stronger, right?
It's definitely a goodcombination of exercise plus
the, hormone replacement hashelped a lot because they like
work together.
So yes.
I'm stronger because I'm workingout, but I can work out better
and more effectively because Ihave the muscle reserve and the
(08:23):
energy to do it.
So this week I've also noticedthat, you know, I'm recovering
from having a Mohs procedure andI haven't been allowed to work
out for a week.
And I can tell that I don't feelas good.
And the exercise has really madea difference, but I don't think
I felt like I could.
exercise.
(08:43):
It really took me a long time tohave my mind wrapped around
getting back and do a goodexercise routine because I was
so tired.
And I was just like, I don'teven know where I'm going to fit
it in.
I feel like my body needs topreserve energy.
And it was really hard to stickwith something because I felt
like I was balancing gettingenough sleep and so on.
But part of why you don't getenough sleep is because when
(09:05):
your hormones are off, you'rewaking up.
And it's not the hot flushes.
I've never had hot flushes.
I've had like a slightly,probably different version of
it.
Whereas.
where I will get more sweaty inthe armpits than I used to.
And like my smell changed a bitbefore I started treating.
(09:25):
So that was an indication.
These were all little thingsthat no one ever talks about,
but then you're like, butsomething's different about me.
Something's different about mybody.
And I just want us to be able tonormalize and talk about it.
I do too.
That is having theseconversations on any part of my
podcast from trauma torelationships to having kids to
(09:47):
managing life to death to yoursupport system to all of that.
So I'm glad that you're talkingabout it.
And it's great to be able totalk to other ladies, Having
been through it and then myselfgoing through it and I feel like
I would have prepped a littlebit more for my clients had I
gone through it.
(10:07):
Now, from here on out, I feellike you guys are gonna get it.
You're going to get all thesupport because of the fact that
I'm experiencing it now.
And then I'm going back to myclients that have had it and
what their experience wasbecause some of them, I mean,
you're going to hear Lisa andNancy, they couldn't talk to
their parents.
That generational gap is such abig deal and you just tough it
(10:31):
out.
What is your support system andwho do you talk to and do you
have other people to support?
Like, I'm glad you have thatgroup that you meet with and you
can chat about it, but are theya little bit further along?
Are they just going through it alittle bit of both?
Right.
I tend to have like, even beforeI had kids, I tended to have
younger friends.
Because I didn't have kids untilI was older.
(10:54):
So I was still doing the stuffthat younger friends were doing.
And most of those friends I havehere don't have kids, but now
that I've made new friends with,as parents, their kids are my
kid's age.
So they're younger.
So I basically am leading thecharge for most people that I'm
around as far as experiencingmenopause early.
(11:14):
And at first, it's kind ofembarrassing.
You're like, Oh no, this thing,like I was just like everybody
else.
And now There's a change and I'mnot, I can't just keep up with
everyone, but then you discoverthat you could replace your
hormones and then you can again,and you're never going to be 20
or 25 again, but you are able toadapt to the, you know, the
(11:38):
slight differences and stillkeep a pretty high level of
activity and everything andthat, and then, and that all
feeds itself.
It does, because even some ofthe signs like joint pain was a
big one for Lisa.
Yeah.
So, and you as well felt yourjoint pain and then having had
the medication.
Yeah.
These are all things that no oneever mentioned.
(12:01):
And you know, my mom died acouple of years ago as anybody
who listened to the last podcastknows.
So, I don't have anyone to talkto because when I really started
experiencing these symptoms, shewas already, like, I wasn't
going to talk to my mom aboutvaginal dryness.
Because we had a goodrelationship, but not like that
kind of good relationship.
No se habla, you know.
(12:22):
No se habla, we're Latins, youknow, it's kind of hard to talk
about sex with your parents, butwe got a little bit better.
But every little thing you'relike my body's changing in a way
and it like I said in my case Itwas confusing because I didn't
know if what I was experiencingwas sleep deprivation,
exhaustion from parenting twokids and working.
(12:43):
And so, each time you're like,am I imagining this?
Do I really wake up with jointpains everywhere?
And do I have rheumatoidarthritis?
Like, what's going on?
And all the things that swirl inyour head, which don't help at
all, because you get anxietyfrom menopause.
And perimenopause.
So then you're like, everythingjust swirls like, Oh no, I'm
getting old.
I'm going to die younger than Iactually thought I was going to
(13:05):
die.
I can't do this.
And then all of a sudden when Istarted just kind of dipping my
toe into treatment, everythingstarted to fall into place.
And another symptom is tinnitusringing in the ears.
That I have to admit has notgotten better, but it's not a
bothersome tinnitus.
The other book I really lovedeven possibly more is Estrogen
(13:27):
Matters.
Estrogen Matters.
Yes.
It's so good.
Basically, his wife wasdiagnosed with cancer and her
hormones changed as a result ofmedications that she had to
take.
And he did a very deep dive intoall the research because he
couldn't support his wife.
Yeah.
I wanted to support his wife.
The author is Avram Blooming, MD and Carol Tavris, P H D.
(13:54):
Great.
That's good.
It's good.
I would say estrogen matters isslightly more scientific and
the.
Okay.
Thanks.
New menopause is more like a, ithas a toolkit and it lists all
the symptoms and I feel likeit's a reference.
Estrogen matters debunks thewhole reason that we stopped
treating women because thewomen's health initiative, the
(14:14):
news got ahold of it like a daybefore they actually released
information about it.
And all they highlighted wasthat there was an increase in
breast cancer and the increasein breast cancer was so small.
And they also did the study onwomen who were obese.
Past 60 smokers, there was justa very big population of
(14:34):
unhealthy women who had beenpast menopause for 10 years.
So that this is one of theimportant things is if you are
experiencing perimenopause, youneed to jump on treatment before
you have lapsed 10 years.
Or before you turn 60, becauseafter that, it's not that it's
impossible for you to treat it,but the scales start to tip as
(14:54):
far as risks go.
So if you have all yourreceptors intact and you are
jumping on it while your body isstill ready to receive estrogen
and convert things the way it'ssupposed to, then it's good, but
if you get past 60, your bodyhas kind of already changed.
And then it can potentially giveyou an increase in those risks,
but again, they're tiny.
(15:16):
And the other thing is they usedPremarin, which they don't do
that now.
Now, you know, we know estradiolis what you should take.
And a lot of people do either apatch or oral.
Some people compound, but I'mnot a fan of that because
compounding is less regulated.
I mean, it's basically apharmacist mixing it up.
Mm-Hmm.
It could work fine.
A lot of people, my best friendloves it, but I personally feel
(15:38):
like orals or the patch, whichhas a consistent delivery
amount, what are you taking?
That's my preference.
So I take estradiol by mouth.
I increased to 1.5 milligramslike probably two months ago,
three months ago.
Because at one milligram I wasdoing really well.
But there were still some thingsthat weren't quite right.
(16:01):
And, oh, my libido still wasn'tquite back to normal.
And like your orgasms get moreflat, that's another symptom.
And so we increased to 1.
5 and I feel great.
So you, there are certain thingsthat you have to go through.
So at the beginning, because ofall this, you can have spotting.
(16:21):
Like when I first started, I wason a combination patch and I had
bleeding.
Like four times I had a periodor whatever it was bleeding.
I mean, it wasn't a real periodcause it was, I had gone at that
point six to eight monthswithout a natural period.
But because of that, you have tojust, I mean, you have to
(16:41):
balance.
Waiting out the side effects.
In my case, we did an ultrasoundof my uterus to make sure I
didn't have fibroids because Ido have a history of fibroids.
And although with my last Csection, she took out the
fibroid I had and I should befine.
I actually had no fibroids andwe just made an adjustment to
the medication and moved on.
(17:02):
And so you're.
Potentially going to have two tothree months of spotting or
other things like breasttenderness.
And if you can tolerate it, Isay, stick it out.
And then at the end of threemonths, if it hasn't gotten
better, like right now, I'mcoming up on three months of
this new dose and my breasttenderness finally got better.
So You know, it just depends.
(17:22):
If you tell me I'm going to havea little bit of breast
tenderness, but I'm going tohave everything back.
Sure, I'll take it.
I'm done.
Because the other thing with mewith, perimenopause was I felt
like I was in PMS all the time.
I don't know if anybody sufferedfrom PMS.
But it was like, it was so roughbecause my whole life I've had
(17:44):
it and probably every othermonth that would get it pretty
intensely.
But you know, it lasts two orthree days.
And then you get your period andyou're like, Oh, thank goodness.
That's why I was a raging, badperson.
But the other thing was I had a40 day cycle, my whole life.
And then, oh, so here's aninteresting thing.
(18:04):
So when we talk aboutperimenopause, like the actual
symptoms that start to botheryou, they'll probably start like
late forties to early fifties.
And so I didn't have anythinguntil I was what, 51, 52, right?
Right.
But prior to that, when Iremember my forties that all of
a sudden I on a dime changed toa 28 day cycle.
(18:26):
And it was so weird.
Cause I had just had this veryregular 40 day cycle and it was,
for a long time, I was like, amI late?
Am I late?
No, no, no, and I would watch itand it would hit 40 days and be
like, okay, I'm still good.
But that's the thing that if younotice it's happening to you,
that is the beginning of yourbody starting to change, shift
its hormones.
Yeah.
(18:47):
And then with your medicationfor your pregnancies, did it
change even more so or becauseyou're, you are prepping your
body for pregnancy.
Well, so they put you on birthcontrol pills like a month
before.
Your scheduled embryo transferand that's just so you won't
ovulate because if you ovulatewell, number one, it also preps
(19:10):
your uterine lining cause youwant it nice and thin because
the embryo attaches when thelining is thin.
So you take a birth controlpill, that's really just to
prevent the drama of you gotpregnant and now there's this
embryo and all this other stuffthat we had planned.
It just keeps things clean.
Then you start injectingestradiol at some point, I've
(19:33):
forgotten now, but there wasalways like an elaborate
calendar of what day you startthis and when you do that.
But the estradiol is actuallythen I think to prep your
lining, but then six days beforethe transfer, you start
injecting progesterone becausethe embryo is six days old when
they put it in.
You start your progesterone andthen you just start making HCG,
(19:53):
which is the hormone ofpregnancy.
And then you get that embryo andyou're, you're levels are
already starting to kick inbecause I mean, the body's
amazing.
Then you just start making HCG,which is the hormone of
pregnancy.
That, helps the embryo grow and,they check you two days after
the embryo goes in and then twodays after that, and it's like,
(20:16):
yeah, my numbers doubled.
And so I had no problems withthat.
I don't know if that's a sign ofthe fact that I was still in an
okay place or hormonally orwhat, when I started hormone
therapy, my lab work actuallyshowed that I wasn't quite, I
wasn't postmenopausal.
I was peristal.
(20:37):
So I had low estrogen, I wasgoing to say, but the hormone,
so FSH, I believe was the onethat was still a little low, but
not completely out.
So my body was still trying totell my ovaries, Hey, it's time
to work.
It's time to put out an egg, butI just didn't have the estrogen
levels yet.
Right.
(20:58):
So that's crazy.
I was also going to mention thatyou had read Peter Attea's book
and he was also talking aboutwhen you are on hormone
replacement, it does reallycounter the cognitive loss or
the brain fog or the dementia orit just goes on, right?
Yeah.
(21:18):
So this is funny because now inretrospect.
One thing I did have in my lateforties was brain fog.
There were just moments in theworkday where I was like, I
can't access what I need from mybrain.
And I've always had an easy timewith school, with learning
stuff.
I mean, I was like a sponge andI remembered so much actually
(21:39):
that it was sometimes a burden.
And then I finally justattributed it to, I work with
brain surgeons.
They're just really smart.
And I just feel stupid aroundthem.
But then now looking back, Ifeel like, Oh, those were
probably times where I washaving a hormonal imbalance.
Yeah.
And it's hard to monitor alsobecause it changes hormones,
your body at different times tocheck those.
(22:02):
I did it twice and saw that my.
Estrogen was fine, but myprogesterone was in the dump.
Yeah.
Isn't that crazy?
The progesterone, by the way, isthe sleep one.
So now that we split it, and Idon't just do it as a patch, I
take the progesterone at night.
I sleep like a tired teenager.
I love it.
(22:22):
I dream.
I have vivid dreams.
Again, it's the best.
Thank you for all the time thatyou spend here.
You're welcome.
Thank you for joining me.
Okay.
It's my pleasure.
Yes.
Yeah.
And we can always do a bookreview on any of those.
I just got my copy of the newmenopause.
Okay.
(22:43):
Awesome.
I look forward to it.
Okay.
Bye.
Bye.
Adios.
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(23:06):
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