September 18, 2025 • 46 mins
Episode Description:
Perimenopause doesn’t come with a guidebook, but this conversation might be the next best thing. We’re joined by Dr. Erica Lambert, a board-certified urologist, hormone replacement therapy specialist, and founder of Uplift Medical Aesthetics.
Dr. Lambert breaks down what perimenopause really is, why so many women are dismissed when they bring up their symptoms, and how hormone replacement therapy—when done safely and appropriately—can be a game-changer for energy, mood, libido, brain health, and long-term wellness.
Kristina also shares her own experience as Dr. Lambert’s patient, bringing a personal lens to what can feel like an overwhelming or confusing topic. Together, we’re busting myths, talking about the science, and giving you tools to advocate for your own health.
This is part one of our conversation with Dr. Lambert. In part two (coming next week), we’ll be covering pelvic floor health—what it is, why it matters, and the treatments that can actually help.
💗 Pink Spotlight
Each week, we highlight a moment, product, or practice that’s bringing us joy:
✨ Erica: Vaginal estrogen cream — “Every vagina needs estrogen.” Dr. Lambert shares why she believes this is one of the most important tools in women’s health.
✨ Kristina: Divi scalp drops
— helping with hair regrowth and overall scalp health.
✨ Christina: Bose Open Earbuds — game-changer for listening while still hearing what’s going on around the kids.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
I'm Christina, and I'm t Andthis is the Pretty and Pink
Again podcast.
where Motherhood meetsrediscovery.
Today we are sitting down withDr.
Erica Lambert, a board certifiedurologist and the founder of
(00:21):
Uplift Medical Aesthetics.
Dr.
Lambert is also certified inhormone replacement therapy and
has dedicated her career tohelping women navigate the
changes that come withperimenopause, menopause, pelvic
floor health and beyond.
Her work blends science,compassion, and innovation to
address issues that so many ofus women struggle with, but very
(00:42):
rarely talk about openly.
We are so excited to dive intothis conversation with her
today.
This is part one of ourconversation with Dr.
Erica Lambert and then next weekin part two, we'll be talking
all about pelvic floor health,what it is, why it matters, and
the real solutions that are outthere.
So let's get into it.
I Hello.
Hi.
We are welcoming a virtual guesttoday, Dr.
(01:04):
Erica Lambert.
Hello.
Hi.
Thank you for having me.
Thank you for coming on here.
This has been long overdue.
Very long overdue, we've beenteasing this to our listeners,
to friends, to family, and we,everybody's oh my God, when is
she coming on?
I often say this about like ourguests that are really experts
(01:26):
in their fields becauseeverybody has a voice on social
media and like we even talkedabout this, like anybody can go
on social media and youralgorithm right now, if you're
in between the ages of like 35and 45 is perimenopause is
everywhere.
And I was telling you like, youare an expert in this.
You are a urologist, you knowabout perimenopause, sexual
(01:47):
health, all these differentthings.
So I'm so excited for ourlisteners to get to hear it from
an actual expert who specializesin this i'm really passionate
about this and I'm reallyexcited to answer any questions
that come up about this.
I can tell you a little bitabout my story Yes.
And why urologists would betalking about perimenopause and
(02:10):
menopause and sexualdysfunction.
I so I'll tell you a quick blurbabout myself.
So I, graduated medical schoolback in 2003 and did a urology
residency up in New York Cityand then did a fellowship in
actually cancer.
So how does someone that's doingurologic cancers get into this
(02:32):
field?
So one, one reason is, being agirl or a woman in urology,
there were only about 2% of uswhen I first became board
certified.
I ended up seeing all thesefemale patients.
So I started realizing that I dohave to treat them for a lot of
(02:52):
their pelvic floor disc functionand some of the recurrent UTIs
and certain things that we see.
But then, just to give you someinformation about my personal
life.
I had my kids later in life, usbeing doctors, we wait and wait
and wait.
And then obviously when we wannahave kids, we wanted to have
them yesterday.
So I had both my kids bothactually are 10 months apart in
(03:14):
2013.
It was a big year for us.
And then I was around 38 when Ihad my daughter.
And then basically two yearslater I stopped getting my
period and I was like, oh myGod.
What is happening?
And really for me aside fromyour sort of typical symptoms
you hear about is the hotflashes, knife, sweats,
(03:37):
moodiness.
I didn't even have a ton ofthat, but I would always joke
around my vagina died.
What is happening?
All of a sudden, like my libidowas different and all of these
things changed.
And the first thing I did was Iwent to my gynecologist and I
said, is this really happeningto me?
And she's like, no, no, no,you're fine.
You're fine.
(03:57):
And I was like I'm not gettingmy period.
Very long story short, I didn'tget a lot of good information
and not a lot of people weretreating menopause, whether it's
gynecology, primary care,endocrine.
And then I started exploringurology.
So obviously we do a ton of malesexual dysfunction, billion
dollar business, right?
Every, you watch ESPN, you'rewatching sports during the fall
(04:20):
season everywhere.
Testosterone, Viagra, yada,yada, right?
But female sexual dysfunction noone talks about.
So I started getting interestedin this and, through my journey
of my own sort of pelvic floorissues and hormonal issues, I
became really interested.
And actually Christina hashelped me so much and really was
(04:44):
an inspiration to me and got megoing with, a lot of these ideas
of how can we let women livetheir best lives, their best
sexual lives, their besteverything life.
And which Christina helped mestart uplift medical aesthetic,
which was a pop of your verywell established urology
(05:06):
practice.
Urology practice, exactly right.
So I started to do a lot offemale sexual dysfunction,
vaginal rejuvenation some workwith stress incontinence and
public floor work.
And it really has led to.
Such a passion of mine.
I started learning more abouthormones and hormone replacement
(05:29):
and perimenopause.
And all of a sudden all thepeople that are finally, or
unfortunately finally catchingup with me are all my own peers.
And now I'm 49 and all of myfriends are starting to talk
about it is what is this?
And I realize I'm just bringingso many women together to
finally talk about it, givewomen voices, and it, it's
(05:52):
really been so rewarding.
Although I still do generalurology I do have a hormone
practice, one or two days a weekwhere I just spend time treating
women and talking to them andseeing how we could make their
lives better.
So I came to Erica.
'Cause we're gonna talk aboutall the different things that
(06:12):
affect your pelvic floor.
So I came to Erica,'cause we'vebeen friends for a while, since
you moved here.
So probably right around thetime that you were going through
menopause, early on right afteryou had the kids we met, yes.
And I was going to Erica'cause Iwas having recurrent UTIs.
But what was happening with meis that after having kids, I
couldn't empty my bladder.
(06:33):
It would stay full.
And so it would feel like I hada UTI'cause I could never fully
void.
So you always felt like you hadto pee?
I always felt like I had to peeand Erica tried.
All these different medicationsand they worked.
But what worked best was she hadthis technology that she had
just brought in that nobody elsearound us had.
And it was called the EllaChair.
(06:54):
And it was essentially a chairthat pulsates and it does the,
essentially does what was it,like 10,000 Kegels or something?
It's, yeah.
It's almost if you've ever beento like a chiropractor or
physical therapist where they doa Tims, the skin, whatever.
Yes.
It's like that for your pelvicfloor.
Okay.
And it really retrains yourpelvic floor and brings blood
(07:15):
flow to the pelvic floor.
And it treats all differentthings, but for me it does.
For me it was life changing.
Yeah.
'cause it allowed me to voidfully.
When was the last time I calledyou for a prescription?
Oh, I have a UTI.
I think I have another, yeah.
Haven't done it in years.
Yeah, because I ne I didn'treally ever have one.
Wow.
And again, that's very benign onthe scale of what women have to
go through in terms of theirpelvic floor.
(07:37):
Erica has to sometimes intervenesurgically, which she'll talk
about.
But that was just like my entrypoint into this.
And then when we, I went intothe office and Erica was like,
I'm envisioning this space backhere and women are asking me
about hormone replacementtherapy and this, and people are
peeing their pants when they doa jumping jack or when they
sneeze and then there's peopleare having like dryness and they
(08:01):
can't have sex and this andthat.
Erica was like, I know how tofix all of this and treat all of
this.
And I love and respect so muchthat this became like a
dedicated part of your business.
Like not the full business.
But just that it spun off fromthis need that.
We know women are lost.
And you keep saying this, theopposite for males, it's just
(08:25):
it's, there's a plethora ofinformation.
There's the waiting room wasfull of males that day.
There's a plethora ofinformation.
Old men like resources.
You for them.
And women tend to feel very lostand they don't even know who to
go to.
Do I go see my ob, do I go seemy primary care?
Like you don't even know whereto go.
There's just, and Right.
And it's taboo to bring it up,like in, in public or to, to
(08:46):
people.
And so I, this is amazing andincredible.
That's what I have noticed, thatit's really hard for women to
find information.
So they're going on Facebookand, all these podcasts and
TikTok I'll have people comingto see me and they're like,
okay, based on an algorithm Ifound on Instagram, I have low
(09:11):
testosterone.
And I'm like, oh, it isfascinating.
I'm like the TikTok doctors, theInstagram mike mic.
But, maybe we can, investigateand, and really dive into what
your symptoms are, how you'refeeling, and what is actually
going on with you.
So I have to admit though, evenwith perimenopause, I feel like
(09:33):
that's a buzzword.
That's hot right now.
Like tea was saying.
Yes.
It's all over the place.
I know we're in the age range,of that could happen to us.
We're both.
And I'm not aging tea by oneday, but we're both 39 and so we
could be in that timeframe ofperimenopause.
But I started seeing this kindof recently, like obviously
(09:54):
everybody knows, every womanknows about menopause, but I
started seeing this word thrownaround within the last several
years.
And I've always been curiousabout what that means.
So my first question would be,what is the difference between
perimenopause and menopause?
Sure.
So menopause, is what everyonethinks of you.
(10:15):
You are no longer getting aperiod.
Okay.
The time before menopause, whichcould be one year, six months,
10 years is perimenopause.
And what's happening during thattime is your hormones made by
your ovaries are starting todecrease.
And which hormones are those?
And those are your estrogen,progesterone, and testosterone.
(10:37):
So all of these hormones thebrain is working harder and
harder to get those, the ovariesand stimulating them to get
these hormones out.
And over time, they startgetting less and less the reason
perimenopause is so confusing isbecause you might still be
getting regular periods, butjust something feels off.
(11:00):
And I think a lot of doctor,I'll say the primary care
doctors who, you know.
I think are wonderful.
So needed.
And they, but they don't treatreally well.
They're not specialists in this.
They're very generalized.
They don't do this.
But what they generally do, likea lot of the women will say I
just don't feel right.
(11:21):
I'm irritable.
I don't feel depressed, but I'mso irritable.
I'm so anxious.
I'm just getting, more shortwith things that I never really
felt that way about or somecomplaints are, ah, I'm just
like, something is wrong with mysleep.
I'm scrolling between one andthree in the morning.
Why am I doing that?
I'm just awake.
I fall asleep easy.
(11:41):
This is not that I'm tired, butI'm awake.
Some people will feel likethey're just getting hotter.
Like they're not having nightsweats.
They're not having flashes, butsomething just feels off.
Their libido may be down.
Now libido is tough to treatbecause you have tiny kids.
Obviously your libido is gonnabe down, but when it's just so
(12:05):
much more than you would haveanticipated, these are some of
the things that people willcomplain about.
And you know what's reallyremarkable and Christina, when
you said like this is a newbuzzword, perimenopause is
because that is the time whereif you are really in tune with
(12:26):
what's going on in your body,and you may start some low dose
replacement, you're protecting,your bones, your cardiovascular
system, your brain.
We have estrogen receptorseverywhere.
So as we start losing.
All of this, it really doesimpact our entire bodies.
(12:46):
Being proactive about it.
And then once you hit menopause,if you're already starting, you
may really save yourself from alot of the, real miserable
symptoms that people talk about.
So what would be like an entrypoint for somebody if they came
to you?
Yeah.
And expl and expressed all ofthis.
And as a 39-year-old who's stillgetting I regular period, but is
(13:10):
up all night scrolling.
Yeah.
Hot, join some of these otherthings.
How would you then look for likefurther investigate?
Would you do blood work?
I put it all together.
Yeah.
So I usually do blood work day19 of your period.
Where I'll check a lot ofdifferent hormones, mostly
estradiol, testosterone,progesterone, FSA, all the
typical female hormones.
(13:31):
And what's range know, and thenrange, we assess.
So a normal range for someonenot in menopause, someone not,
pre menopause would be, a lowFSH and elevated, estrogen
levels in the sixties,seventies.
Progesterone one or two, likethey, they would be higher
(13:52):
levels when we see them fall.
The FSH being pretty low.
When you start seeing people andtheir labs start changing, you
might see FSH levels in thethirties, and the estradiol
dropping in the twenties, andthen you might, the first
hormone usually to decrease isyour progesterone.
So we'll see that go less thanone or, it's just starting to
(14:16):
decrease.
Your testosterone levels may bea little low, like in the teens
and, your free testosterone,which is your available
testosterone may be pretty lowin the, 1.1, like in kind of
those ranges.
It's hard to say like flat innumbers because obviously
everybody's different.
But that's generally what I see.
(14:37):
Okay.
So I have a question becauseSure.
Me and you had our kids a littlebit later in our later thirties.
Are you seeing,'cause I'm sureonce you run a lab, the lab
confirms like what you're sayingthat these things, yes.
You are in pre menopause, thelabs are indicating that this is
all adding up.
Are you seeing people coming inthat have kids later in life
(15:00):
that are also dealing with thesesymptoms?
Because I feel like when you'regoing from a postpartum period
where a lot of these things seemvery similar, a lot of these hot
flashes, the brain fog, theinsomnia, the low libido, the
anxiety, the bladder issues, theincontinence, all of these
issues, do they overlap withpostpartum and are you seeing a
(15:22):
little bit of a, it's funny youask not specifically but I think
what's happening is as women aregetting out of the baby years.
And then their symptoms arestill persisting.
That tends to be some red flagsfor me.
Okay.
When like the babies arestarting to sleep again, like
(15:43):
you're getting into a routinebecause you're right.
Postpartum, you're up all night.
It's a really tough time in ourlives, because the
responsibilities put on us,caring for a newborn, feeding
the newborn being up all nightwith the newborn and the crying
and the, everything that we gothrough and trying to, manage
the other kids at home.
(16:04):
And so I think it's really hardto really understand those
symptoms.
The other thing that's prettyhard is, to understand the
contraception part of it, so alot of women, when they're done
having babies, they'll go onlike a marina or they'll be on
the birth control pill and whenthings start getting a little.
(16:25):
Different with the way they'refeeling.
You're wondering, is this themarina?
Is it not working?
Is this perimenopause?
What, what's happening?
So I think it's, I think it'sreally a challenge in this age
group because we don't reallyknow, I had so much that's so
much going on yeah.
There's so much going on.
And I had someone see me, who'son the birth control pill.
She's 47 years old, and she's Ithink I'm going through this.
(16:49):
I just, I don't feel right, Idon't let you know.
She's still on the birth controlpill and so she doesn't do a
bleed cycle.
You know how you can have theplacebos, right?
So she was saying, she's but I'mgetting hotter and I'm
irritable.
And so it's but how do you evencheck the labs, right?
Because you're on the birthcontrol pill, you're on a high
dose of estrogen and, it'ssometimes hard to determine that
(17:12):
and, when do you pull thetrigger from the morena or when
do you pull the trigger from thebirth control pill and start
switching things out.
But I think you bring up a greatpoint.
I think it is really tough.
To determine.
I do see, some women in theirlate thirties and sometimes I'm
like you still have reallylittle kids.
It's really hard for me to, I'mhappy to test your hormones, we
(17:34):
can see what's going on, itmight be a better,
environmental.
Yeah.
That's me right now.
It might be environmental.
I am always spiraling withsymptoms and I'll see something.
Of course, like we've beentalking about like the TikTok
doctors and all these things.
I will see something and I'mlike, I have that and then.
I'll come here.
Like t will be like, no, youhave a one and a 3-year-old.
That's what's happening.
(17:54):
We went from a generation ofmothers who shared nothing'cause
they knew nothing.
Really.
They didn't know anything.
They went through this alone.
Alone and they had to just suckit off and sweat through their
sheets every night.
To, we've now skipped to ageneration that overshare and
you can't differentiate what'scorrect, what's not, where
you're getting the informationfrom.
(18:16):
So now it's coming straight fromthe doctor.
Yep.
And I think that the FDA justcame out with a statement that
it's really been a tragedy forwomen and probably the, biggest
tragedy of the modern era in thelast 20 years that we have not
offered women hormonereplacement.
So talk to us about that alittle bit.
Yeah.
Hormone replacement therapy.
(18:36):
I know.
A lot of women are afraid ofthat, yeah.
Talk to us a little bit about ifwe came into you and you looked
at our levels and you said,okay, you would be a terrific
candidate for this because asyou get older and your estrogen
decreases, you said like you'reat risk of like bone loss and
muscle loss.
And your cognitive.
You always said you haveestrogen receptors everywhere.
(18:57):
Yeah.
So what would be, the next stepand what exactly is hormone
replacement therapy?
Yeah, so I could kinda, again,overshare.
So I was not on hormonereplacement.
Love overshare.
Go for it.
Yeah.
Wait, I love to overshare.
All my patients know me.
It's funny, my husband's also aurologist and he'll see some of
my patients.
He's like, how do they all knowabout our lives?
I'm like,'cause I overshare.
(19:18):
I like to talk.
He does not overshareconnections.
He does not overshare.
There's always one that marriesthe other one.
That's, That's always how itworks.
Yeah, he does not overshare.
He'd probably be horrified thatI'm even talking about this.
But so what happened with me,I'm like the best example of
this, I did not go on hormonereplacement for a multitude of
reasons, but really, I really.
(19:38):
I was not properly educated onit.
And at 47 I got a bone densityscan and I had osteopenia,
almost osteoporosis.
So that is strictly from nothaving hormones for seven years.
And I was devastated.
I was like, oh my God I have todo something because it's very
(20:01):
like for our, I'm way too young.
Our, for our listeners thatdon't know what that is, do you
wanna just explain in lay termsYeah.
And why that's so dangerous?
It's basic.
Yeah.
If you see, if you think aboutsort of your grandparents and
what they look like, a lot ofthe women were like this.
Yeah, right?
They're all like, punched over.
Yep.
Punched over.
They have fractures, hipfractures their bones are
(20:22):
brittle.
So basically when you see yourbones have.
Estrogen receptors, and it'svery important to have estrogen,
to build your bombs.
So what happens is as you gothrough menopause and when you
stop having estrogen, your bonesbecome really thin, really
brittle, and we talk aboutosteoporosis.
(20:43):
And osteoporosis is a leadingcause of hip fractures, any type
of bone fractures, and reallyhas a lot of mortality
associated with it.
You stop being able to move, youhear about blood clots and all
of these different things.
And it's, it can be verydebilitating and we have a lot
of medications to treat it onceyou have it.
(21:04):
But really, I think in today's,in the modern era, a lot of
people are looking forprevention.
And I think, aside from sayinganything, I think our health
system should be focusing moreon prevention and when we talk
about some of these myths rightabout the Women's Health
Initiative that came out inabout 2002 that basically
(21:24):
stopped all hormone replacement,and I'll get into that in a
minute.
But what they did show was thatit did prevent osteoporosis and
it did, lead to less mortalityfor women.
So there's a lot of problemswith the Women's health
Initiative study, the truth iswhat had come out of that study
(21:46):
was that that estrogen causedbreast cancer.
That was the big thing that whenpeople were on estrogen, they
had a higher likelihood ofbreast cancer.
So is that true?
Yes, but the way it was done, itwas a lot of women were on oral
estrogens.
The patients in the study were alot older.
They were already 10 years postmenopause, which the, so they
(22:09):
had a higher rate of breastcancer anyway.
Exactly.
And were being given oralestrogen and oral estrogen.
The byproducts, like when itgets transferred through the
liver is something called estro,which does increase your risk of
breast cancer.
So a lot of times thegynecologist will take women
(22:29):
over the age of 45 to 50 offtheir birth control pills
because we don't wanna givewomen oral estrogens.
Got it.
Okay.
So that really affected thestudy.
So this is why this was gettinglike a bad reputation this study
came out and it was done in thelate nineties, so it all came
out in about 2000.
My mother's age when they weregoing through all of this, none
(22:52):
of them were on hormonereplacement because they said
cause breast cancer.
Okay.
Exactly.
Okay.
Because that's always what Ithought.
So yes.
I was gonna say, I feel like Ieven grew up with that
messaging, hearing that, and itwas like hormone replacement
therapy was like a scary thing,it was, yeah.
Yeah.
So now, but I think 20, 25.
Yeah.
You talk about hormonereplacement therapy and you do
(23:13):
patches, it's not just oralestrogen, it's a patch estrogen.
So that bypasses the liver.
That, and that's exactly right.
That bypasses the liver.
We're not giving synthetichormones, they're all
plant-based hormones and they'renot going through the liver.
So it's really going right tothe areas of the body where it's
needed.
Okay.
The reason it's so importantsort of to understand
(23:35):
perimenopause and even to bethinking about this, is because
once you go into menopause, youhad the best bang for your buck
in terms of starting hormonereplacement is those first 10
years.
And those are the years where,you'll have the bone protection,
the cardiovascular protection,the brain protection, then one
(23:58):
would say my mom is 65.
What about she was never onhormones.
Can she go on hormones?
Yes.
Or if she's symptomatic probablynot with top flashes anymore,
but they, some women do havethat.
And, but I would say libido andvaginal dryness and all
different reasons.
They may wanna start hormones,but that bone protection is may
(24:20):
or may not be there.
We still need more studies toreally understand that.
So it's definitely, it's withinthe first 10 years of menopause,
that's when you really wanna getthis going.
That's when you start.
Yeah, absolutely.
So what about, absolutely.
What about preventative inperimenopause?
Is this something that you canstart earlier?
Yeah, so I have a lot of womenthat are still menstruating,
(24:43):
that are on low dose hormonetherapy, and it's really just to
regulate mood, to regulate theirperiods.
Like you'll notice inperimenopause you might get
longer periods, shorter periods,heavier periods, and real
cramping, the gynecologist saidthat there's, it's all
considered normal, having thesevariations.
(25:04):
When I asked him, I'm like,that's right.
If it's, I was like, some monthsit's five days, some months it's
10 days.
And he said, that's allconsidered normal.
And I said, but it's not normalfor me.
But it's right, normal for himenough to say it's, he's not
gonna do anything more.
He's not worried.
He's not worried.
Yeah.
Yeah.
I think it's more of when thetime between the periods.
(25:27):
Start changing, right?
Like they're getting longer,like you might miss a period and
then you get a period or you gotyour period and it was three
weeks apart instead of fourweeks.
Those kinds of changes thelength of the period and the
heaviness of the period arealso, are changes.
Like I would say a lot of womencome to me and they're just,
they're cramping.
(25:47):
They have really heavy periodswhen all of that happens.
I would like to say I am aurologist.
I'm not a gynecologist, so Ialways tell the women to make
sure they see their gynecologistjust to make sure that there's
no pathologic bleeding, right?
But a lot of times puttingpeople on a low dose
progesterone supplement, a lotof times it will help a lot of
(26:09):
those symptoms.
And that's all perimenopause.
And is the progesterone oral aswell?
Or is it a patch?
Like how does that work?
Progesterone is oral.
It's taken at night because theprogesterone will help you
sleep.
Oh.
So I have women hugging me,after the visit.
They're like, I'm sleeping.
And it's real.
So you have women taking lowdose of progesterone in the
(26:29):
evening?
A coupled with a patch of, is itestradiol that you said?
Or Estradiol?
Estradiol.
Estradiol.
Which is that the, and sometimesthey will be.
Yeah.
And then what abouttestosterone?
That's like the third one thatwe talked about.
What does that control and whatdoes that do?
So testosterone actually was thefirst hormone I felt most
comfortable giving, just becauseI am a urologist and we give
(26:52):
obviously a lot.
And you said you're giving it tomen?
Testosterone, yeah.
Forever.
Men walk and they're like, Ihave low testosterone.
I'm like, why do you think that?
I just feel it, typical man, Iknow.
But there is, we were jokingsomething.
If I have to give one more man ashot of testosterone, I'm gonna
scream.
It's they all come in and theyall want it.
It's like doping, and they wantmore.
(27:13):
Now.
Some women start to want that aswell, but it's different in
women.
So I would say testosterone isreally important for libido.
Really important for joints andmuscles for muscle mass.
And you'll hear a lot of peopleperimenopause, menopause, who
will complain of like musclewasting and they just feel
weaker.
(27:33):
They have joint pains brain fogand testosterone is really good
for that.
The problem with testosteronethat I tell everybody is that
there also are side effects oftestosterone and, a lot of the
women that have gone throughmenopause, they'll talk about
facial hair, but once you're onsupplement that will.
Be worse.
(27:54):
People will definitely get that.
They get acne.
They can have a deepening oftheir voice.
A lot of people really like theother effects, meaning the
increased libido, increasedsexuality, and, we can get your
testosterone levels pretty highin women.
We don't wanna get it too high'cause you can get, so your
clitoris can get larger.
(28:15):
You can almost feel hypersexual,which people don't like either.
I haven't prescribed anytestosterone that had that for
women, but a really close friendwho's also a urologist, she had
really bad side effects fromtestosterone.
You could give medication tostop it, but, so you really
(28:35):
just, again, all of hormone.
Management is all teetering thedoses and figuring out the right
balance.
And then the nice thing is onceyou are on a good regimen,
you're, you fly and as long asyou are, getting your annual
mammograms and make sure youcome in for appointments just to
(28:56):
make sure you're feeling good,it's really beneficial for women
and women are happier, theirrelationships are better.
I always say when I started, itjust, it just took the edge off
Yeah.
Of that kinda, oof, because likeI have a wonderful life.
Osteo, have you, has yourosteoporosis or osteopenia has
it.
Reversed or improved sinceyou've been on estrogen?
(29:19):
No, I've just started it.
So I'll be a year in November,so I'm gonna be getting bone
density scans, so when I comeback in a couple months to talk,
I'll let you know.
Perfect.
Yes, we can, you can give us anupdate.
That's amazing.
But I'll give you updates nowwhat about if you have a family
history of breast cancer or ifyou had breast cancer?
(29:41):
Are you no longer a candidatefor this and how does what do
you do about that?
Yeah, so I think anyone with afamily history of breast cancer
as long as they don't havebreast cancer, I think they are
candidates with the knowledgethat it's really important to
get annual mammograms.
And work with the doses.
You don't wanna go on oralestrogens, I think any of the
patches, creams, pellet,something that is not being
(30:03):
taken by mouth and controllingthe doses.
If you have breast cancer,that's a lot of women I see.
Or they're, what is that timeagain?
I think the most importantperson to talk to is your
medical oncologist to feel,there's all different types of
breast cancer, estrogenpositive, negative.
There's so many things that gointo it that it really has to be
(30:24):
a joint decision between, thepatient, the oncologist, myself,
what everyone feels comfortablewith.
A lot of times after five years,if you're cancer free, and you
have low risk disease, theoncologist feel that it would be
okay to start hormonereplacement.
I know.
So we've talked about this'causeyou were very helpful with my
mom when she had breast cancer.
(30:45):
You set her up with the bestteam of doctors, I think like
Erica, cherry picked aphenomenal team for her.
She had excellent care, but shewas also seeing Erica prior to
breast cancer.
And I mean my mom is very openabout this, but she was seeing
Erica to help her.
'cause she was, she had gonethrough menopause, right?
And so she had to stop theestrogen replacement therapy and
(31:08):
she developed osteopenia.
So she developed that becauseshe had been off her hormones
now Wow.
For a couple of years.
Wow.
So she's now at this crossroadspersonally, we're going to Italy
in a few weeks.
And she's I'm afraid to fall'cause I'm afraid I'm gonna
break my hip and what is worse?
So it's hard.
I guess that's, so I'm assumingI'm answering my own question,
(31:28):
but then this is something thatyou have to continue on with
because it can reverse back.
If you go off of the hormonereplacement therapy, this is
something that you, this isongoing.
Yes.
Yes.
Okay.
Yes.
Yeah.
Your body needs continuedcontinuous estrogen of in order
course.
I didn't realize was responsiblefor so many things.
Is it something that like, Iknow you're saying that you have
(31:49):
to play around with the dosageto get it right.
But then is it something that asyou're aging, is it something
that you need to keep up withand continue figuring out the
dose?
Because does stuff still startchanging lowering?
Do you is it something that youneed to tweak?
Yeah.
Yeah.
It's always open for discussion.
Okay.
Like, how are you feeling onyour hormones?
I think, it's really how they'refeeling, and as long as you
(32:13):
always have to check in withtheir medical history.
And now unfortunately, as weage, high blood pressure,
diabetes, you know, all thoseother things.
I tend to think that a lot ofwomen that are coming to me for
hormone replacement, they'rereally looking for preventative
medicine.
How to prevent any type offurther decline.
(32:33):
Like we talk all about, thiscould be a whole other subject
about lifestyle management,right?
Like during menopause, what kindof exercises do you wanna do?
You'll hear about weightbearing.
I always tell people to getweighted vests and all these
other things that you can do toreally.
Not so much prevent the agingprocess, but just to stay
(32:54):
healthy and strong during theaging process.
Because these are things that,because you're more specifically
looking for people keeping theirbones more dense, their bone
strong.
So it's more about exactly theexercise obviously is for the
cardiovascular benefits of ittoo, but you're really looking
for that bone density.
Yes.
And stronger.
(33:15):
And that's where testosteronecan come in and it can help, not
so much with bone density, butit can help with muscle mass and
strength and energy and which iswhy the men said, I guess I need
to get my weighted vest.
I had it in my Amazon cart and Inever bought it.
And Oh yeah, it's great.
That's why people should use itfor, that's there's a real
reason.
There's a science behind it.
(33:35):
Right.
That's really interesting.
You should be able to pay for itwith your HSA card.
I know, right?
That's right.
You can't.
You can't.
But you should be able to fail.
But you should if you thinkabout it.
Yeah.
You should be able to.
Yeah, I tell everyone to get aweight to best.
I walk with my weight to best.
I used to try to walk around thehouse, but I don't really do
that.
But I always, whenever I takewalks, I just went up five
pounds in it.
(33:56):
Wow.
But yeah, I really like it.
Okay.
Helps with your to Yeah, I know.
I, it's really good.
I miss walking with you.
Yeah, I know.
I know.
And I have one great friendwho's here that I tend to walk
with, but it's not the same.
It's harder as we get older andmaking friends.
I just moved to New Jersey,which has been a good move from
my family and I, but, and me, webut I do, I miss my people.
(34:18):
Yeah.
You are certainly missed here aswell.
Yeah.
Yeah.
So I guess as we wrap this up,what is one myth that you would
want every woman listening tounlearn about perimenopause and
menopause and hormones?
Good question.
So I would say the first one,which we didn't really talk
(34:39):
about, but vaginal estrogen,it's so important.
You get a lot of dryness even,through perimenopause.
The birth control pill, themarina, all of that can cause a
lot of vaginal dryness, vaginalestrogen.
If I have one mantra, everyvagina needs estrogen and
vaginal estrogen is amazing.
(35:02):
It does not cause cancer.
It does not get absorbed.
It is wonderful.
It's local, it's necessary.
And you will feel better on it.
It will help.
Is that a cream typically?
Is It's a cream, yeah.
Yeah.
The vaginal estrogen.
It comes in a cream.
But, and you can write aprescription for this, or is
this over the counter?
Yeah.
Or you were just gonna answer?
No you need a prescription.
Okay.
(35:22):
And then there's all different.
Vaginal treatments we could do,but probably estrogen is the
most important.
If you have a history of breastcancer, you can do intra rows,
which is DHEA, which will helpnot as good as estrogen, but
still good.
But really it's so important toprevent UTIs for pelvic floor
(35:43):
health, for painful intercourse.
So I would say that's reallyimportant and that, hormone
replacement causes breast canceror causes cancer, or causes
blood clots, all of that now.
In some situations you may notbe a candidate for it based on
your history, but in general,most people, the benefits
(36:06):
outweigh the risks, right?
And obviously this is all shareddecision making with your
doctor, with your personalmedical history, your concerns.
But I would say, for so manyreasons, it's important and
probably the most important willmake you feel better.
So you see patients now in NewJersey, but do you see patients
(36:27):
remotely?
And would you then work with, ifyou saw patients here in
Connecticut, would you then workin tandem with their primary
care doctor, ob, GYN Cardi,whoever, what other team of
doctors would you be able to?
Absolutely.
And then can you order bloodwork?
I definitely do theconsultations.
Yep.
I can order blood work, I can doconsultations.
(36:50):
I still have a medical licensein Connecticut so I can
prescribe and Amazing.
Okay, so that was, see all ofour, Pippa, I know Pippa's,
we're gonna leave all of herinformation of course, in our
show notes, but I'm alwayscurious about how to go about
and who to ask.
Like when you are on TikTok oryou're on Instagram and you see
something and it flags right,and you're like I might be
(37:12):
having those symptoms.
Or you start tracking your ownbody and you're curious, yeah,
this sounds like this might besomething that I'm going through
or could be going through.
Where does one start?
Do you go to your primary?
I not, do you go to your Westart her with Erica Lambert.
You just go right to you?
Yeah, A lot of times it dependswhat type of insurance you have.
Okay.
It's very interesting.
(37:34):
Most people will not go to aurologist and be like, I'm
looking for hormone replacement.
I would say most urologistsdon't do this.
But a lot of people will startwith our primary care doctors
and a lot of them will havepeople they know that do hormone
replacement.
If you just look in your area,who does menopause,
perimenopause there's,unfortunately there's not a ton
(37:57):
of people that do it.
I wish there was you even saidyou yourself are newer to this.
It's been 10 years and you're,you're learning, you're doing
tons of research because youknew there was such a need for
it.
Yeah, and I actually, I got mycertification in hormone
replacement.
That's amazing.
Because, I needed, I, I justwanna make sure I was doing it
(38:19):
right and, make sure Iunderstood everything.
But, there's, a lot of the.
Wellness centers, med spas,they're starting to pick this
up, but I would try to go tosomeone that is certified in
either NAMS is, the nationalAssociation of Menopause
society, just so you make surethat you are, you're being
(38:42):
heard, your voice is beingheard.
That's a great tip.
That's a great tip.
'cause people always wanna knowwho to go to the correct way.
The, and like you're saying wejust have had, I feel like
multiple discussions if thingsbecome too buzzwordy, all of a
sudden everybody offers thesethings.
And you really wanna make sure,especially when it's something
you're putting into your body,you wanna make sure that it's
(39:04):
done correctly.
You have the right peoplefollowing you and giving you the
advice and administrating theright prescriptions and Right.
And you may not need what Ineed.
Exactly.
So it's best to have your bloodwork done followed up yearly.
In tandem with, like you said,your annual pelvic exams, your
mammograms, just so you don'twanna be doing more harm than
(39:26):
good.
Yeah.
Like the person that does myhormone replacement is a primary
care doctor.
And she got certified and Ifound her, where I live close to
the J or I live on the JerseyShore.
She's in Borhees an hour away,so there, there's no one down
here.
So it's been really exciting tobe able to take care of the
(39:46):
patients down here.
That is amazing.
I know.
Thank you for sharing so muchabout this.
We're gonna close out thisepisode and we do have Erica
coming back next time in ournext episode.
And we're gonna get into whatwe're gonna talk about at the
end of this episode.
But we're gonna close out thisepisode with our pink spotlight,
which is our person, placething, mantra or tip that's
making your life or your week alittle bit better.
(40:09):
So my mantra for everyone isevery vagina needs estrogen.
Please, if you are feelingvaginal dryness, please go to
your doctor and get some vaginalestrogen.
It will elevate your life, yoursexual life to everything.
And you spoke about this atlength during the episode, how
it has so many benefits.
(40:30):
So it's really super important.
Love that tip.
What about Yout?
Do you have anything today?
So I have a product.
I am.
Obsessed with these drops.
So my sister Nicole has likethinner hair and she's oh, my
hair is getting thinner.
I'm like, I know mine is gettingthinner too.
I always had like thick, coarsehair.
So at the beginning of thesummer she gave me these drops
(40:52):
and I've been using them on myscalp.
And I went to the hair salontoday and my hairdresser told me
she sees new hair growth.
So I got the divvy scalp serum.
I love divvy.
Those are, you love this.
I love that.
I used that through both of mypostpartum periods.
And I love it.
It works.
And I've been wanting, I've beenwanting to share it and I'm
(41:12):
like, I don't even know if it'sreally working.
I feel like my hair has beenlooking a little thicker.
Like I took my hair extensionsout at the beginning of the
summer.
And I was like, oh, my hairfeels thin.
But I thought maybe, ah, it feltthin'cause of the extensions.
But then after like severalwashes, I was like, I don't
know, it still feels thin.
But then when Sam and Shawneesaid to me, you are getting new
growth.
That's amazing.
(41:32):
So it's working, so it's thisdivvy, scalp serum.
I guess it works with your, likethe pores on your scalp and
keeps things, open and clean.
It does.
And detoxifies.
So I guess that's like thescience behind it, so that's why
it helps promote hair growth.
You feel like a little s.
Ting you feel like a little,yep.
Tingle ish, but I don't know.
I really like it a lot.
(41:52):
Yep.
They're great.
And I was finding, obviouslywith postpartum hair loss, it's
it's gonna come back.
It's like everybody always says,it's oh I, I have all this hair
growth.
And it's it's supposed to comeback, but with that, I really
felt,'cause I used thatespecially the last time, and it
was like more of thatdetoxifying feeling of the
buildup.
Because when you're goingthrough postpartum, I feel not
(42:13):
only do you lose your hair, butlike your hair feels different.
It just doesn't feel the same.
It feels lifeless.
I've talked to so many peopleabout it and I've shared it on
my own stories and I've alwayshad people respond.
And that helped a lot with that.
It just felt like it gave itsome life back.
Like after, I would use it for acouple of days and I tried to be
like pretty religious about itand use it all the time.
(42:33):
But it would just really, itjust gives you like that, a
really good feeling on yourscalp.
And I felt like it liftedeverything and helped to
volumize.
So I love that too.
I'm stealing yours, but good.
Good.
That's a good recommendation.
Good product.
Every so often I like a goodproduct.
Fine.
What about you?
So mine, I'm guilty of buyingthese for my husband and then I
liked them so much that I boughtthem for myself.
(42:54):
But they are, I thought you weregonna say you stole them from
him because that would be I thatalso on brand.
I was, but I did.
I, no, I did not.
But I love these.
They are a Bose ear pod.
Okay.
Like for listening to thingsand, but it's a cuff.
And I like this so much becauseI've always struggled with the
Apple AirPods.
Like they just don't sit well inmy ears or they start to hurt my
(43:17):
ears after a long time.
And you're also feels like ahearing aid.
Yes.
And they also like block whatelse is going on.
So what I end up doing is I wearone.
Yeah.
Because I'm like, I don't wantmy hearing impaired.
If I'm out on a walk or if I'mdoing something or if I'm with
my kids, but I'm just trying tolisten to something or multitask
or do something else.
I can't just be, it's not like Ihave my noise canceling
(43:38):
headphones.
But then I didn't like the factthat it was like.
Impairing my hearing.
Like when I'm trying to do otherthings.
So this actually sits in yourear.
I can't do it'cause I have myheadphones on, but it sits in
your ear like an ear cuff.
And so you can hear it'swonderful sound quality, but you
can hear life around you.
And so you could actually haveboth in and go for a walk and
not feel like you're going toget killed on your walk because
(44:00):
you're not paying attention toyour surroundings.
Or if you're trying to do otherthings, if you wanna still hear
your kids asking for you, you'renot tuned out as much.
And I like it.
It works for like when you don'twanna be tuned out.
If you're trying to go on aflight or something, that's
probably not when you wouldwanna use these, but if you want
just to listen to somethingwithout being zoned out, it's
wonderful.
(44:20):
They look too, they like,they're so cute.
Yeah.
It's like a clip on your Is thecost, so is the price point.
They're about 200 something.
So they're still Yeah, theApple, they're similar to Apple
and the Sound Boys girl youlove.
I'm a Bose girl and I have theirnoise canceling headphones, so I
love those.
But there's a time and a placeand like these, I've actually
gotten so much more use out of,and they are so comfortable.
I've had them in my ear like.
(44:42):
For 10 hours.
Like I forget that they'rethere.
Oh, wow.
And you, I could never do that.
What are you doing for 10 hours?
I'm not listening to somethingfor 10 hours, but I'll have
something on and then it's it'susually when it's an accessory.
They're on and they'recomfortable enough that you
could wear them all day.
And then it's, I don't know ifI'm going to listen to
something, I don't have to putit back in my ear.
It's like literally been lifechanging, oh, I love that.
Good tip.
Yeah, they're really great.
(45:03):
Link those away.
I will, I'll link these in theshow notes too, but we are so
excited.
We're gonna have Erica back nextweek.
Next week Erica will be back on.
And we're gonna go into, whatelse, Erica, what else are we
gonna talk about next week?
I think we're gonna do somepelvic floor health.
Yes.
Urinary incontinence.
After childbirth, we're gonna dosome painful intercourse.
(45:24):
We're gonna get into more of thepelvic floor genital area.
Alright, so this was just thetip.
Pun intended.
Alright, we'll see everybodynext week.
Thank you.
Thank you Erica, so much.
Okay, bye.
Thank you so much.
Bye bye.
I'm Christina, and I'm t Andthis is the Pretty and Pink
Again podcast.
where Motherhood meetsrediscovery.
Today we are sitting down withDr.
Erica Lambert, a board certifiedurologist and the founder of
(00:21):
Uplift Medical Aesthetics.
Dr.
Lambert is also certified inhormone replacement therapy and
has dedicated her career tohelping women navigate the
changes that come withperimenopause, menopause, pelvic
floor health and beyond.
Her work blends science,compassion, and innovation to
address issues that so many ofus women struggle with, but very
(00:42):
rarely talk about openly.
We are so excited to dive intothis conversation with her
today.
This is part one of ourconversation with Dr.
Erica Lambert and then next weekin part two, we'll be talking
all about pelvic floor health,what it is, why it matters, and
the real solutions that are outthere.
So let's get into it.
I Hello.
Hi.
We are welcoming a virtual guesttoday, Dr.
(01:04):
Erica Lambert.
Hello.
Hi.
Thank you for having me.
Thank you for coming on here.
This has been long overdue.
Very long overdue, we've beenteasing this to our listeners,
to friends, to family, and we,everybody's oh my God, when is
she coming on?
I often say this about like ourguests that are really experts
(01:26):
in their fields becauseeverybody has a voice on social
media and like we even talkedabout this, like anybody can go
on social media and youralgorithm right now, if you're
in between the ages of like 35and 45 is perimenopause is
everywhere.
And I was telling you like, youare an expert in this.
You are a urologist, you knowabout perimenopause, sexual
(01:47):
health, all these differentthings.
So I'm so excited for ourlisteners to get to hear it from
an actual expert who specializesin this i'm really passionate
about this and I'm reallyexcited to answer any questions
that come up about this.
I can tell you a little bitabout my story Yes.
And why urologists would betalking about perimenopause and
(02:10):
menopause and sexualdysfunction.
I so I'll tell you a quick blurbabout myself.
So I, graduated medical schoolback in 2003 and did a urology
residency up in New York Cityand then did a fellowship in
actually cancer.
So how does someone that's doingurologic cancers get into this
(02:32):
field?
So one, one reason is, being agirl or a woman in urology,
there were only about 2% of uswhen I first became board
certified.
I ended up seeing all thesefemale patients.
So I started realizing that I dohave to treat them for a lot of
(02:52):
their pelvic floor disc functionand some of the recurrent UTIs
and certain things that we see.
But then, just to give you someinformation about my personal
life.
I had my kids later in life, usbeing doctors, we wait and wait
and wait.
And then obviously when we wannahave kids, we wanted to have
them yesterday.
So I had both my kids bothactually are 10 months apart in
(03:14):
2013.
It was a big year for us.
And then I was around 38 when Ihad my daughter.
And then basically two yearslater I stopped getting my
period and I was like, oh myGod.
What is happening?
And really for me aside fromyour sort of typical symptoms
you hear about is the hotflashes, knife, sweats,
(03:37):
moodiness.
I didn't even have a ton ofthat, but I would always joke
around my vagina died.
What is happening?
All of a sudden, like my libidowas different and all of these
things changed.
And the first thing I did was Iwent to my gynecologist and I
said, is this really happeningto me?
And she's like, no, no, no,you're fine.
You're fine.
(03:57):
And I was like I'm not gettingmy period.
Very long story short, I didn'tget a lot of good information
and not a lot of people weretreating menopause, whether it's
gynecology, primary care,endocrine.
And then I started exploringurology.
So obviously we do a ton of malesexual dysfunction, billion
dollar business, right?
Every, you watch ESPN, you'rewatching sports during the fall
(04:20):
season everywhere.
Testosterone, Viagra, yada,yada, right?
But female sexual dysfunction noone talks about.
So I started getting interestedin this and, through my journey
of my own sort of pelvic floorissues and hormonal issues, I
became really interested.
And actually Christina hashelped me so much and really was
(04:44):
an inspiration to me and got megoing with, a lot of these ideas
of how can we let women livetheir best lives, their best
sexual lives, their besteverything life.
And which Christina helped mestart uplift medical aesthetic,
which was a pop of your verywell established urology
(05:06):
practice.
Urology practice, exactly right.
So I started to do a lot offemale sexual dysfunction,
vaginal rejuvenation some workwith stress incontinence and
public floor work.
And it really has led to.
Such a passion of mine.
I started learning more abouthormones and hormone replacement
(05:29):
and perimenopause.
And all of a sudden all thepeople that are finally, or
unfortunately finally catchingup with me are all my own peers.
And now I'm 49 and all of myfriends are starting to talk
about it is what is this?
And I realize I'm just bringingso many women together to
finally talk about it, givewomen voices, and it, it's
(05:52):
really been so rewarding.
Although I still do generalurology I do have a hormone
practice, one or two days a weekwhere I just spend time treating
women and talking to them andseeing how we could make their
lives better.
So I came to Erica.
'Cause we're gonna talk aboutall the different things that
(06:12):
affect your pelvic floor.
So I came to Erica,'cause we'vebeen friends for a while, since
you moved here.
So probably right around thetime that you were going through
menopause, early on right afteryou had the kids we met, yes.
And I was going to Erica'cause Iwas having recurrent UTIs.
But what was happening with meis that after having kids, I
couldn't empty my bladder.
(06:33):
It would stay full.
And so it would feel like I hada UTI'cause I could never fully
void.
So you always felt like you hadto pee?
I always felt like I had to peeand Erica tried.
All these different medicationsand they worked.
But what worked best was she hadthis technology that she had
just brought in that nobody elsearound us had.
And it was called the EllaChair.
(06:54):
And it was essentially a chairthat pulsates and it does the,
essentially does what was it,like 10,000 Kegels or something?
It's, yeah.
It's almost if you've ever beento like a chiropractor or
physical therapist where they doa Tims, the skin, whatever.
Yes.
It's like that for your pelvicfloor.
Okay.
And it really retrains yourpelvic floor and brings blood
(07:15):
flow to the pelvic floor.
And it treats all differentthings, but for me it does.
For me it was life changing.
Yeah.
'cause it allowed me to voidfully.
When was the last time I calledyou for a prescription?
Oh, I have a UTI.
I think I have another, yeah.
Haven't done it in years.
Yeah, because I ne I didn'treally ever have one.
Wow.
And again, that's very benign onthe scale of what women have to
go through in terms of theirpelvic floor.
(07:37):
Erica has to sometimes intervenesurgically, which she'll talk
about.
But that was just like my entrypoint into this.
And then when we, I went intothe office and Erica was like,
I'm envisioning this space backhere and women are asking me
about hormone replacementtherapy and this, and people are
peeing their pants when they doa jumping jack or when they
sneeze and then there's peopleare having like dryness and they
(08:01):
can't have sex and this andthat.
Erica was like, I know how tofix all of this and treat all of
this.
And I love and respect so muchthat this became like a
dedicated part of your business.
Like not the full business.
But just that it spun off fromthis need that.
We know women are lost.
And you keep saying this, theopposite for males, it's just
(08:25):
it's, there's a plethora ofinformation.
There's the waiting room wasfull of males that day.
There's a plethora ofinformation.
Old men like resources.
You for them.
And women tend to feel very lostand they don't even know who to
go to.
Do I go see my ob, do I go seemy primary care?
Like you don't even know whereto go.
There's just, and Right.
And it's taboo to bring it up,like in, in public or to, to
(08:46):
people.
And so I, this is amazing andincredible.
That's what I have noticed, thatit's really hard for women to
find information.
So they're going on Facebookand, all these podcasts and
TikTok I'll have people comingto see me and they're like,
okay, based on an algorithm Ifound on Instagram, I have low
(09:11):
testosterone.
And I'm like, oh, it isfascinating.
I'm like the TikTok doctors, theInstagram mike mic.
But, maybe we can, investigateand, and really dive into what
your symptoms are, how you'refeeling, and what is actually
going on with you.
So I have to admit though, evenwith perimenopause, I feel like
(09:33):
that's a buzzword.
That's hot right now.
Like tea was saying.
Yes.
It's all over the place.
I know we're in the age range,of that could happen to us.
We're both.
And I'm not aging tea by oneday, but we're both 39 and so we
could be in that timeframe ofperimenopause.
But I started seeing this kindof recently, like obviously
(09:54):
everybody knows, every womanknows about menopause, but I
started seeing this word thrownaround within the last several
years.
And I've always been curiousabout what that means.
So my first question would be,what is the difference between
perimenopause and menopause?
Sure.
So menopause, is what everyonethinks of you.
(10:15):
You are no longer getting aperiod.
Okay.
The time before menopause, whichcould be one year, six months,
10 years is perimenopause.
And what's happening during thattime is your hormones made by
your ovaries are starting todecrease.
And which hormones are those?
And those are your estrogen,progesterone, and testosterone.
(10:37):
So all of these hormones thebrain is working harder and
harder to get those, the ovariesand stimulating them to get
these hormones out.
And over time, they startgetting less and less the reason
perimenopause is so confusing isbecause you might still be
getting regular periods, butjust something feels off.
(11:00):
And I think a lot of doctor,I'll say the primary care
doctors who, you know.
I think are wonderful.
So needed.
And they, but they don't treatreally well.
They're not specialists in this.
They're very generalized.
They don't do this.
But what they generally do, likea lot of the women will say I
just don't feel right.
(11:21):
I'm irritable.
I don't feel depressed, but I'mso irritable.
I'm so anxious.
I'm just getting, more shortwith things that I never really
felt that way about or somecomplaints are, ah, I'm just
like, something is wrong with mysleep.
I'm scrolling between one andthree in the morning.
Why am I doing that?
I'm just awake.
I fall asleep easy.
(11:41):
This is not that I'm tired, butI'm awake.
Some people will feel likethey're just getting hotter.
Like they're not having nightsweats.
They're not having flashes, butsomething just feels off.
Their libido may be down.
Now libido is tough to treatbecause you have tiny kids.
Obviously your libido is gonnabe down, but when it's just so
(12:05):
much more than you would haveanticipated, these are some of
the things that people willcomplain about.
And you know what's reallyremarkable and Christina, when
you said like this is a newbuzzword, perimenopause is
because that is the time whereif you are really in tune with
(12:26):
what's going on in your body,and you may start some low dose
replacement, you're protecting,your bones, your cardiovascular
system, your brain.
We have estrogen receptorseverywhere.
So as we start losing.
All of this, it really doesimpact our entire bodies.
(12:46):
Being proactive about it.
And then once you hit menopause,if you're already starting, you
may really save yourself from alot of the, real miserable
symptoms that people talk about.
So what would be like an entrypoint for somebody if they came
to you?
Yeah.
And expl and expressed all ofthis.
And as a 39-year-old who's stillgetting I regular period, but is
(13:10):
up all night scrolling.
Yeah.
Hot, join some of these otherthings.
How would you then look for likefurther investigate?
Would you do blood work?
I put it all together.
Yeah.
So I usually do blood work day19 of your period.
Where I'll check a lot ofdifferent hormones, mostly
estradiol, testosterone,progesterone, FSA, all the
typical female hormones.
(13:31):
And what's range know, and thenrange, we assess.
So a normal range for someonenot in menopause, someone not,
pre menopause would be, a lowFSH and elevated, estrogen
levels in the sixties,seventies.
Progesterone one or two, likethey, they would be higher
(13:52):
levels when we see them fall.
The FSH being pretty low.
When you start seeing people andtheir labs start changing, you
might see FSH levels in thethirties, and the estradiol
dropping in the twenties, andthen you might, the first
hormone usually to decrease isyour progesterone.
So we'll see that go less thanone or, it's just starting to
(14:16):
decrease.
Your testosterone levels may bea little low, like in the teens
and, your free testosterone,which is your available
testosterone may be pretty lowin the, 1.1, like in kind of
those ranges.
It's hard to say like flat innumbers because obviously
everybody's different.
But that's generally what I see.
(14:37):
Okay.
So I have a question becauseSure.
Me and you had our kids a littlebit later in our later thirties.
Are you seeing,'cause I'm sureonce you run a lab, the lab
confirms like what you're sayingthat these things, yes.
You are in pre menopause, thelabs are indicating that this is
all adding up.
Are you seeing people coming inthat have kids later in life
(15:00):
that are also dealing with thesesymptoms?
Because I feel like when you'regoing from a postpartum period
where a lot of these things seemvery similar, a lot of these hot
flashes, the brain fog, theinsomnia, the low libido, the
anxiety, the bladder issues, theincontinence, all of these
issues, do they overlap withpostpartum and are you seeing a
(15:22):
little bit of a, it's funny youask not specifically but I think
what's happening is as women aregetting out of the baby years.
And then their symptoms arestill persisting.
That tends to be some red flagsfor me.
Okay.
When like the babies arestarting to sleep again, like
(15:43):
you're getting into a routinebecause you're right.
Postpartum, you're up all night.
It's a really tough time in ourlives, because the
responsibilities put on us,caring for a newborn, feeding
the newborn being up all nightwith the newborn and the crying
and the, everything that we gothrough and trying to, manage
the other kids at home.
(16:04):
And so I think it's really hardto really understand those
symptoms.
The other thing that's prettyhard is, to understand the
contraception part of it, so alot of women, when they're done
having babies, they'll go onlike a marina or they'll be on
the birth control pill and whenthings start getting a little.
(16:25):
Different with the way they'refeeling.
You're wondering, is this themarina?
Is it not working?
Is this perimenopause?
What, what's happening?
So I think it's, I think it'sreally a challenge in this age
group because we don't reallyknow, I had so much that's so
much going on yeah.
There's so much going on.
And I had someone see me, who'son the birth control pill.
She's 47 years old, and she's Ithink I'm going through this.
(16:49):
I just, I don't feel right, Idon't let you know.
She's still on the birth controlpill and so she doesn't do a
bleed cycle.
You know how you can have theplacebos, right?
So she was saying, she's but I'mgetting hotter and I'm
irritable.
And so it's but how do you evencheck the labs, right?
Because you're on the birthcontrol pill, you're on a high
dose of estrogen and, it'ssometimes hard to determine that
(17:12):
and, when do you pull thetrigger from the morena or when
do you pull the trigger from thebirth control pill and start
switching things out.
But I think you bring up a greatpoint.
I think it is really tough.
To determine.
I do see, some women in theirlate thirties and sometimes I'm
like you still have reallylittle kids.
It's really hard for me to, I'mhappy to test your hormones, we
(17:34):
can see what's going on, itmight be a better,
environmental.
Yeah.
That's me right now.
It might be environmental.
I am always spiraling withsymptoms and I'll see something.
Of course, like we've beentalking about like the TikTok
doctors and all these things.
I will see something and I'mlike, I have that and then.
I'll come here.
Like t will be like, no, youhave a one and a 3-year-old.
That's what's happening.
(17:54):
We went from a generation ofmothers who shared nothing'cause
they knew nothing.
Really.
They didn't know anything.
They went through this alone.
Alone and they had to just suckit off and sweat through their
sheets every night.
To, we've now skipped to ageneration that overshare and
you can't differentiate what'scorrect, what's not, where
you're getting the informationfrom.
(18:16):
So now it's coming straight fromthe doctor.
Yep.
And I think that the FDA justcame out with a statement that
it's really been a tragedy forwomen and probably the, biggest
tragedy of the modern era in thelast 20 years that we have not
offered women hormonereplacement.
So talk to us about that alittle bit.
Yeah.
Hormone replacement therapy.
(18:36):
I know.
A lot of women are afraid ofthat, yeah.
Talk to us a little bit about ifwe came into you and you looked
at our levels and you said,okay, you would be a terrific
candidate for this because asyou get older and your estrogen
decreases, you said like you'reat risk of like bone loss and
muscle loss.
And your cognitive.
You always said you haveestrogen receptors everywhere.
(18:57):
Yeah.
So what would be, the next stepand what exactly is hormone
replacement therapy?
Yeah, so I could kinda, again,overshare.
So I was not on hormonereplacement.
Love overshare.
Go for it.
Yeah.
Wait, I love to overshare.
All my patients know me.
It's funny, my husband's also aurologist and he'll see some of
my patients.
He's like, how do they all knowabout our lives?
I'm like,'cause I overshare.
(19:18):
I like to talk.
He does not overshareconnections.
He does not overshare.
There's always one that marriesthe other one.
That's, That's always how itworks.
Yeah, he does not overshare.
He'd probably be horrified thatI'm even talking about this.
But so what happened with me,I'm like the best example of
this, I did not go on hormonereplacement for a multitude of
reasons, but really, I really.
(19:38):
I was not properly educated onit.
And at 47 I got a bone densityscan and I had osteopenia,
almost osteoporosis.
So that is strictly from nothaving hormones for seven years.
And I was devastated.
I was like, oh my God I have todo something because it's very
(20:01):
like for our, I'm way too young.
Our, for our listeners thatdon't know what that is, do you
wanna just explain in lay termsYeah.
And why that's so dangerous?
It's basic.
Yeah.
If you see, if you think aboutsort of your grandparents and
what they look like, a lot ofthe women were like this.
Yeah, right?
They're all like, punched over.
Yep.
Punched over.
They have fractures, hipfractures their bones are
(20:22):
brittle.
So basically when you see yourbones have.
Estrogen receptors, and it'svery important to have estrogen,
to build your bombs.
So what happens is as you gothrough menopause and when you
stop having estrogen, your bonesbecome really thin, really
brittle, and we talk aboutosteoporosis.
(20:43):
And osteoporosis is a leadingcause of hip fractures, any type
of bone fractures, and reallyhas a lot of mortality
associated with it.
You stop being able to move, youhear about blood clots and all
of these different things.
And it's, it can be verydebilitating and we have a lot
of medications to treat it onceyou have it.
(21:04):
But really, I think in today's,in the modern era, a lot of
people are looking forprevention.
And I think, aside from sayinganything, I think our health
system should be focusing moreon prevention and when we talk
about some of these myths rightabout the Women's Health
Initiative that came out inabout 2002 that basically
(21:24):
stopped all hormone replacement,and I'll get into that in a
minute.
But what they did show was thatit did prevent osteoporosis and
it did, lead to less mortalityfor women.
So there's a lot of problemswith the Women's health
Initiative study, the truth iswhat had come out of that study
(21:46):
was that that estrogen causedbreast cancer.
That was the big thing that whenpeople were on estrogen, they
had a higher likelihood ofbreast cancer.
So is that true?
Yes, but the way it was done, itwas a lot of women were on oral
estrogens.
The patients in the study were alot older.
They were already 10 years postmenopause, which the, so they
(22:09):
had a higher rate of breastcancer anyway.
Exactly.
And were being given oralestrogen and oral estrogen.
The byproducts, like when itgets transferred through the
liver is something called estro,which does increase your risk of
breast cancer.
So a lot of times thegynecologist will take women
(22:29):
over the age of 45 to 50 offtheir birth control pills
because we don't wanna givewomen oral estrogens.
Got it.
Okay.
So that really affected thestudy.
So this is why this was gettinglike a bad reputation this study
came out and it was done in thelate nineties, so it all came
out in about 2000.
My mother's age when they weregoing through all of this, none
(22:52):
of them were on hormonereplacement because they said
cause breast cancer.
Okay.
Exactly.
Okay.
Because that's always what Ithought.
So yes.
I was gonna say, I feel like Ieven grew up with that
messaging, hearing that, and itwas like hormone replacement
therapy was like a scary thing,it was, yeah.
Yeah.
So now, but I think 20, 25.
Yeah.
You talk about hormonereplacement therapy and you do
(23:13):
patches, it's not just oralestrogen, it's a patch estrogen.
So that bypasses the liver.
That, and that's exactly right.
That bypasses the liver.
We're not giving synthetichormones, they're all
plant-based hormones and they'renot going through the liver.
So it's really going right tothe areas of the body where it's
needed.
Okay.
The reason it's so importantsort of to understand
(23:35):
perimenopause and even to bethinking about this, is because
once you go into menopause, youhad the best bang for your buck
in terms of starting hormonereplacement is those first 10
years.
And those are the years where,you'll have the bone protection,
the cardiovascular protection,the brain protection, then one
(23:58):
would say my mom is 65.
What about she was never onhormones.
Can she go on hormones?
Yes.
Or if she's symptomatic probablynot with top flashes anymore,
but they, some women do havethat.
And, but I would say libido andvaginal dryness and all
different reasons.
They may wanna start hormones,but that bone protection is may
(24:20):
or may not be there.
We still need more studies toreally understand that.
So it's definitely, it's withinthe first 10 years of menopause,
that's when you really wanna getthis going.
That's when you start.
Yeah, absolutely.
So what about, absolutely.
What about preventative inperimenopause?
Is this something that you canstart earlier?
Yeah, so I have a lot of womenthat are still menstruating,
(24:43):
that are on low dose hormonetherapy, and it's really just to
regulate mood, to regulate theirperiods.
Like you'll notice inperimenopause you might get
longer periods, shorter periods,heavier periods, and real
cramping, the gynecologist saidthat there's, it's all
considered normal, having thesevariations.
(25:04):
When I asked him, I'm like,that's right.
If it's, I was like, some monthsit's five days, some months it's
10 days.
And he said, that's allconsidered normal.
And I said, but it's not normalfor me.
But it's right, normal for himenough to say it's, he's not
gonna do anything more.
He's not worried.
He's not worried.
Yeah.
Yeah.
I think it's more of when thetime between the periods.
(25:27):
Start changing, right?
Like they're getting longer,like you might miss a period and
then you get a period or you gotyour period and it was three
weeks apart instead of fourweeks.
Those kinds of changes thelength of the period and the
heaviness of the period arealso, are changes.
Like I would say a lot of womencome to me and they're just,
they're cramping.
(25:47):
They have really heavy periodswhen all of that happens.
I would like to say I am aurologist.
I'm not a gynecologist, so Ialways tell the women to make
sure they see their gynecologistjust to make sure that there's
no pathologic bleeding, right?
But a lot of times puttingpeople on a low dose
progesterone supplement, a lotof times it will help a lot of
(26:09):
those symptoms.
And that's all perimenopause.
And is the progesterone oral aswell?
Or is it a patch?
Like how does that work?
Progesterone is oral.
It's taken at night because theprogesterone will help you
sleep.
Oh.
So I have women hugging me,after the visit.
They're like, I'm sleeping.
And it's real.
So you have women taking lowdose of progesterone in the
(26:29):
evening?
A coupled with a patch of, is itestradiol that you said?
Or Estradiol?
Estradiol.
Estradiol.
Which is that the, and sometimesthey will be.
Yeah.
And then what abouttestosterone?
That's like the third one thatwe talked about.
What does that control and whatdoes that do?
So testosterone actually was thefirst hormone I felt most
comfortable giving, just becauseI am a urologist and we give
(26:52):
obviously a lot.
And you said you're giving it tomen?
Testosterone, yeah.
Forever.
Men walk and they're like, Ihave low testosterone.
I'm like, why do you think that?
I just feel it, typical man, Iknow.
But there is, we were jokingsomething.
If I have to give one more man ashot of testosterone, I'm gonna
scream.
It's they all come in and theyall want it.
It's like doping, and they wantmore.
(27:13):
Now.
Some women start to want that aswell, but it's different in
women.
So I would say testosterone isreally important for libido.
Really important for joints andmuscles for muscle mass.
And you'll hear a lot of peopleperimenopause, menopause, who
will complain of like musclewasting and they just feel
weaker.
(27:33):
They have joint pains brain fogand testosterone is really good
for that.
The problem with testosteronethat I tell everybody is that
there also are side effects oftestosterone and, a lot of the
women that have gone throughmenopause, they'll talk about
facial hair, but once you're onsupplement that will.
Be worse.
(27:54):
People will definitely get that.
They get acne.
They can have a deepening oftheir voice.
A lot of people really like theother effects, meaning the
increased libido, increasedsexuality, and, we can get your
testosterone levels pretty highin women.
We don't wanna get it too high'cause you can get, so your
clitoris can get larger.
(28:15):
You can almost feel hypersexual,which people don't like either.
I haven't prescribed anytestosterone that had that for
women, but a really close friendwho's also a urologist, she had
really bad side effects fromtestosterone.
You could give medication tostop it, but, so you really
(28:35):
just, again, all of hormone.
Management is all teetering thedoses and figuring out the right
balance.
And then the nice thing is onceyou are on a good regimen,
you're, you fly and as long asyou are, getting your annual
mammograms and make sure youcome in for appointments just to
(28:56):
make sure you're feeling good,it's really beneficial for women
and women are happier, theirrelationships are better.
I always say when I started, itjust, it just took the edge off
Yeah.
Of that kinda, oof, because likeI have a wonderful life.
Osteo, have you, has yourosteoporosis or osteopenia has
it.
Reversed or improved sinceyou've been on estrogen?
(29:19):
No, I've just started it.
So I'll be a year in November,so I'm gonna be getting bone
density scans, so when I comeback in a couple months to talk,
I'll let you know.
Perfect.
Yes, we can, you can give us anupdate.
That's amazing.
But I'll give you updates nowwhat about if you have a family
history of breast cancer or ifyou had breast cancer?
(29:41):
Are you no longer a candidatefor this and how does what do
you do about that?
Yeah, so I think anyone with afamily history of breast cancer
as long as they don't havebreast cancer, I think they are
candidates with the knowledgethat it's really important to
get annual mammograms.
And work with the doses.
You don't wanna go on oralestrogens, I think any of the
patches, creams, pellet,something that is not being
(30:03):
taken by mouth and controllingthe doses.
If you have breast cancer,that's a lot of women I see.
Or they're, what is that timeagain?
I think the most importantperson to talk to is your
medical oncologist to feel,there's all different types of
breast cancer, estrogenpositive, negative.
There's so many things that gointo it that it really has to be
(30:24):
a joint decision between, thepatient, the oncologist, myself,
what everyone feels comfortablewith.
A lot of times after five years,if you're cancer free, and you
have low risk disease, theoncologist feel that it would be
okay to start hormonereplacement.
I know.
So we've talked about this'causeyou were very helpful with my
mom when she had breast cancer.
(30:45):
You set her up with the bestteam of doctors, I think like
Erica, cherry picked aphenomenal team for her.
She had excellent care, but shewas also seeing Erica prior to
breast cancer.
And I mean my mom is very openabout this, but she was seeing
Erica to help her.
'cause she was, she had gonethrough menopause, right?
And so she had to stop theestrogen replacement therapy and
(31:08):
she developed osteopenia.
So she developed that becauseshe had been off her hormones
now Wow.
For a couple of years.
Wow.
So she's now at this crossroadspersonally, we're going to Italy
in a few weeks.
And she's I'm afraid to fall'cause I'm afraid I'm gonna
break my hip and what is worse?
So it's hard.
I guess that's, so I'm assumingI'm answering my own question,
(31:28):
but then this is something thatyou have to continue on with
because it can reverse back.
If you go off of the hormonereplacement therapy, this is
something that you, this isongoing.
Yes.
Yes.
Okay.
Yes.
Yeah.
Your body needs continuedcontinuous estrogen of in order
course.
I didn't realize was responsiblefor so many things.
Is it something that like, Iknow you're saying that you have
(31:49):
to play around with the dosageto get it right.
But then is it something that asyou're aging, is it something
that you need to keep up withand continue figuring out the
dose?
Because does stuff still startchanging lowering?
Do you is it something that youneed to tweak?
Yeah.
Yeah.
It's always open for discussion.
Okay.
Like, how are you feeling onyour hormones?
I think, it's really how they'refeeling, and as long as you
(32:13):
always have to check in withtheir medical history.
And now unfortunately, as weage, high blood pressure,
diabetes, you know, all thoseother things.
I tend to think that a lot ofwomen that are coming to me for
hormone replacement, they'rereally looking for preventative
medicine.
How to prevent any type offurther decline.
(32:33):
Like we talk all about, thiscould be a whole other subject
about lifestyle management,right?
Like during menopause, what kindof exercises do you wanna do?
You'll hear about weightbearing.
I always tell people to getweighted vests and all these
other things that you can do toreally.
Not so much prevent the agingprocess, but just to stay
(32:54):
healthy and strong during theaging process.
Because these are things that,because you're more specifically
looking for people keeping theirbones more dense, their bone
strong.
So it's more about exactly theexercise obviously is for the
cardiovascular benefits of ittoo, but you're really looking
for that bone density.
Yes.
And stronger.
(33:15):
And that's where testosteronecan come in and it can help, not
so much with bone density, butit can help with muscle mass and
strength and energy and which iswhy the men said, I guess I need
to get my weighted vest.
I had it in my Amazon cart and Inever bought it.
And Oh yeah, it's great.
That's why people should use itfor, that's there's a real
reason.
There's a science behind it.
(33:35):
Right.
That's really interesting.
You should be able to pay for itwith your HSA card.
I know, right?
That's right.
You can't.
You can't.
But you should be able to fail.
But you should if you thinkabout it.
Yeah.
You should be able to.
Yeah, I tell everyone to get aweight to best.
I walk with my weight to best.
I used to try to walk around thehouse, but I don't really do
that.
But I always, whenever I takewalks, I just went up five
pounds in it.
(33:56):
Wow.
But yeah, I really like it.
Okay.
Helps with your to Yeah, I know.
I, it's really good.
I miss walking with you.
Yeah, I know.
I know.
And I have one great friendwho's here that I tend to walk
with, but it's not the same.
It's harder as we get older andmaking friends.
I just moved to New Jersey,which has been a good move from
my family and I, but, and me, webut I do, I miss my people.
(34:18):
Yeah.
You are certainly missed here aswell.
Yeah.
Yeah.
So I guess as we wrap this up,what is one myth that you would
want every woman listening tounlearn about perimenopause and
menopause and hormones?
Good question.
So I would say the first one,which we didn't really talk
(34:39):
about, but vaginal estrogen,it's so important.
You get a lot of dryness even,through perimenopause.
The birth control pill, themarina, all of that can cause a
lot of vaginal dryness, vaginalestrogen.
If I have one mantra, everyvagina needs estrogen and
vaginal estrogen is amazing.
(35:02):
It does not cause cancer.
It does not get absorbed.
It is wonderful.
It's local, it's necessary.
And you will feel better on it.
It will help.
Is that a cream typically?
Is It's a cream, yeah.
Yeah.
The vaginal estrogen.
It comes in a cream.
But, and you can write aprescription for this, or is
this over the counter?
Yeah.
Or you were just gonna answer?
No you need a prescription.
Okay.
(35:22):
And then there's all different.
Vaginal treatments we could do,but probably estrogen is the
most important.
If you have a history of breastcancer, you can do intra rows,
which is DHEA, which will helpnot as good as estrogen, but
still good.
But really it's so important toprevent UTIs for pelvic floor
(35:43):
health, for painful intercourse.
So I would say that's reallyimportant and that, hormone
replacement causes breast canceror causes cancer, or causes
blood clots, all of that now.
In some situations you may notbe a candidate for it based on
your history, but in general,most people, the benefits
(36:06):
outweigh the risks, right?
And obviously this is all shareddecision making with your
doctor, with your personalmedical history, your concerns.
But I would say, for so manyreasons, it's important and
probably the most important willmake you feel better.
So you see patients now in NewJersey, but do you see patients
(36:27):
remotely?
And would you then work with, ifyou saw patients here in
Connecticut, would you then workin tandem with their primary
care doctor, ob, GYN Cardi,whoever, what other team of
doctors would you be able to?
Absolutely.
And then can you order bloodwork?
I definitely do theconsultations.
Yep.
I can order blood work, I can doconsultations.
(36:50):
I still have a medical licensein Connecticut so I can
prescribe and Amazing.
Okay, so that was, see all ofour, Pippa, I know Pippa's,
we're gonna leave all of herinformation of course, in our
show notes, but I'm alwayscurious about how to go about
and who to ask.
Like when you are on TikTok oryou're on Instagram and you see
something and it flags right,and you're like I might be
(37:12):
having those symptoms.
Or you start tracking your ownbody and you're curious, yeah,
this sounds like this might besomething that I'm going through
or could be going through.
Where does one start?
Do you go to your primary?
I not, do you go to your Westart her with Erica Lambert.
You just go right to you?
Yeah, A lot of times it dependswhat type of insurance you have.
Okay.
It's very interesting.
(37:34):
Most people will not go to aurologist and be like, I'm
looking for hormone replacement.
I would say most urologistsdon't do this.
But a lot of people will startwith our primary care doctors
and a lot of them will havepeople they know that do hormone
replacement.
If you just look in your area,who does menopause,
perimenopause there's,unfortunately there's not a ton
(37:57):
of people that do it.
I wish there was you even saidyou yourself are newer to this.
It's been 10 years and you're,you're learning, you're doing
tons of research because youknew there was such a need for
it.
Yeah, and I actually, I got mycertification in hormone
replacement.
That's amazing.
Because, I needed, I, I justwanna make sure I was doing it
(38:19):
right and, make sure Iunderstood everything.
But, there's, a lot of the.
Wellness centers, med spas,they're starting to pick this
up, but I would try to go tosomeone that is certified in
either NAMS is, the nationalAssociation of Menopause
society, just so you make surethat you are, you're being
(38:42):
heard, your voice is beingheard.
That's a great tip.
That's a great tip.
'cause people always wanna knowwho to go to the correct way.
The, and like you're saying wejust have had, I feel like
multiple discussions if thingsbecome too buzzwordy, all of a
sudden everybody offers thesethings.
And you really wanna make sure,especially when it's something
you're putting into your body,you wanna make sure that it's
(39:04):
done correctly.
You have the right peoplefollowing you and giving you the
advice and administrating theright prescriptions and Right.
And you may not need what Ineed.
Exactly.
So it's best to have your bloodwork done followed up yearly.
In tandem with, like you said,your annual pelvic exams, your
mammograms, just so you don'twanna be doing more harm than
(39:26):
good.
Yeah.
Like the person that does myhormone replacement is a primary
care doctor.
And she got certified and Ifound her, where I live close to
the J or I live on the JerseyShore.
She's in Borhees an hour away,so there, there's no one down
here.
So it's been really exciting tobe able to take care of the
(39:46):
patients down here.
That is amazing.
I know.
Thank you for sharing so muchabout this.
We're gonna close out thisepisode and we do have Erica
coming back next time in ournext episode.
And we're gonna get into whatwe're gonna talk about at the
end of this episode.
But we're gonna close out thisepisode with our pink spotlight,
which is our person, placething, mantra or tip that's
making your life or your week alittle bit better.
(40:09):
So my mantra for everyone isevery vagina needs estrogen.
Please, if you are feelingvaginal dryness, please go to
your doctor and get some vaginalestrogen.
It will elevate your life, yoursexual life to everything.
And you spoke about this atlength during the episode, how
it has so many benefits.
(40:30):
So it's really super important.
Love that tip.
What about Yout?
Do you have anything today?
So I have a product.
I am.
Obsessed with these drops.
So my sister Nicole has likethinner hair and she's oh, my
hair is getting thinner.
I'm like, I know mine is gettingthinner too.
I always had like thick, coarsehair.
So at the beginning of thesummer she gave me these drops
(40:52):
and I've been using them on myscalp.
And I went to the hair salontoday and my hairdresser told me
she sees new hair growth.
So I got the divvy scalp serum.
I love divvy.
Those are, you love this.
I love that.
I used that through both of mypostpartum periods.
And I love it.
It works.
And I've been wanting, I've beenwanting to share it and I'm
(41:12):
like, I don't even know if it'sreally working.
I feel like my hair has beenlooking a little thicker.
Like I took my hair extensionsout at the beginning of the
summer.
And I was like, oh, my hairfeels thin.
But I thought maybe, ah, it feltthin'cause of the extensions.
But then after like severalwashes, I was like, I don't
know, it still feels thin.
But then when Sam and Shawneesaid to me, you are getting new
growth.
That's amazing.
(41:32):
So it's working, so it's thisdivvy, scalp serum.
I guess it works with your, likethe pores on your scalp and
keeps things, open and clean.
It does.
And detoxifies.
So I guess that's like thescience behind it, so that's why
it helps promote hair growth.
You feel like a little s.
Ting you feel like a little,yep.
Tingle ish, but I don't know.
I really like it a lot.
(41:52):
Yep.
They're great.
And I was finding, obviouslywith postpartum hair loss, it's
it's gonna come back.
It's like everybody always says,it's oh I, I have all this hair
growth.
And it's it's supposed to comeback, but with that, I really
felt,'cause I used thatespecially the last time, and it
was like more of thatdetoxifying feeling of the
buildup.
Because when you're goingthrough postpartum, I feel not
(42:13):
only do you lose your hair, butlike your hair feels different.
It just doesn't feel the same.
It feels lifeless.
I've talked to so many peopleabout it and I've shared it on
my own stories and I've alwayshad people respond.
And that helped a lot with that.
It just felt like it gave itsome life back.
Like after, I would use it for acouple of days and I tried to be
like pretty religious about itand use it all the time.
(42:33):
But it would just really, itjust gives you like that, a
really good feeling on yourscalp.
And I felt like it liftedeverything and helped to
volumize.
So I love that too.
I'm stealing yours, but good.
Good.
That's a good recommendation.
Good product.
Every so often I like a goodproduct.
Fine.
What about you?
So mine, I'm guilty of buyingthese for my husband and then I
liked them so much that I boughtthem for myself.
(42:54):
But they are, I thought you weregonna say you stole them from
him because that would be I thatalso on brand.
I was, but I did.
I, no, I did not.
But I love these.
They are a Bose ear pod.
Okay.
Like for listening to thingsand, but it's a cuff.
And I like this so much becauseI've always struggled with the
Apple AirPods.
Like they just don't sit well inmy ears or they start to hurt my
(43:17):
ears after a long time.
And you're also feels like ahearing aid.
Yes.
And they also like block whatelse is going on.
So what I end up doing is I wearone.
Yeah.
Because I'm like, I don't wantmy hearing impaired.
If I'm out on a walk or if I'mdoing something or if I'm with
my kids, but I'm just trying tolisten to something or multitask
or do something else.
I can't just be, it's not like Ihave my noise canceling
(43:38):
headphones.
But then I didn't like the factthat it was like.
Impairing my hearing.
Like when I'm trying to do otherthings.
So this actually sits in yourear.
I can't do it'cause I have myheadphones on, but it sits in
your ear like an ear cuff.
And so you can hear it'swonderful sound quality, but you
can hear life around you.
And so you could actually haveboth in and go for a walk and
not feel like you're going toget killed on your walk because
(44:00):
you're not paying attention toyour surroundings.
Or if you're trying to do otherthings, if you wanna still hear
your kids asking for you, you'renot tuned out as much.
And I like it.
It works for like when you don'twanna be tuned out.
If you're trying to go on aflight or something, that's
probably not when you wouldwanna use these, but if you want
just to listen to somethingwithout being zoned out, it's
wonderful.
(44:20):
They look too, they like,they're so cute.
Yeah.
It's like a clip on your Is thecost, so is the price point.
They're about 200 something.
So they're still Yeah, theApple, they're similar to Apple
and the Sound Boys girl youlove.
I'm a Bose girl and I have theirnoise canceling headphones, so I
love those.
But there's a time and a placeand like these, I've actually
gotten so much more use out of,and they are so comfortable.
I've had them in my ear like.
(44:42):
For 10 hours.
Like I forget that they'rethere.
Oh, wow.
And you, I could never do that.
What are you doing for 10 hours?
I'm not listening to somethingfor 10 hours, but I'll have
something on and then it's it'susually when it's an accessory.
They're on and they'recomfortable enough that you
could wear them all day.
And then it's, I don't know ifI'm going to listen to
something, I don't have to putit back in my ear.
It's like literally been lifechanging, oh, I love that.
Good tip.
Yeah, they're really great.
(45:03):
Link those away.
I will, I'll link these in theshow notes too, but we are so
excited.
We're gonna have Erica back nextweek.
Next week Erica will be back on.
And we're gonna go into, whatelse, Erica, what else are we
gonna talk about next week?
I think we're gonna do somepelvic floor health.
Yes.
Urinary incontinence.
After childbirth, we're gonna dosome painful intercourse.
(45:24):
We're gonna get into more of thepelvic floor genital area.
Alright, so this was just thetip.
Pun intended.
Alright, we'll see everybodynext week.
Thank you.
Thank you Erica, so much.
Okay, bye.
Thank you so much.
Bye bye.
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