February 27, 2025 • 42 mins
Menopause is not just a personal journey for women; it profoundly shapes their professional lives too. In this episode, we sit down with Dr. Mache, a distinguished expert in women's health, as he uncovers the transformational effects of menopause in the workplace. We delve into how menopause can affect productivity and organizational dynamics, with statistics revealing that nearly 10% of women may leave their jobs due to its symptoms.
Dr. Mache emphasizes that menopause starts earlier than most realize and that the associated challenges can significantly hinder career advancement for many women. He discusses how a lack of understanding and support in workplaces often leads to presenteeism—employees are there physically but not mentally engaged, leading to a loss of productivity, increased stress, and even changes in career paths.
This eye-opening conversation explores solutions and insights, highlighting the importance of advocacy and awareness. Dr. Mache encourages both women and organizations to engage in discussions about menopause openly, breaking the taboo surrounding it. He advocates for actionable strategies to transform workplace culture, ensuring women not only survive but thrive during this significant life transition.
Join us as we unpack the connection between menopause and workplace wellness, and discover how awareness and understanding can lead to healthier outcomes for all. Don't miss out on these essential discussions—your health and career are worth prioritizing! Tune in today, and let’s keep the conversation going. Subscribe for more insights and share your thoughts with us!
Dr. Mache Seibel is a nationally renowned women’s wellness and menopause expert. When his wife entered early menopause after surgery—just months after a flawed study linked estrogen to breast cancer—he was determined to uncover the truth.
A former leading fertility expert, Dr. Mache shifted his focus to estrogen and menopause. He’s passionate about helping professional women take back control of their health, work, and relationships. His philosophy: care for the SUM of you, not just SOME of you™.
His books, The Estrogen Window and The Estrogen Fix, explore the best timing for estrogen therapy to reduce disease risk and ease symptoms. His latest, Working Through Menopause, addresses menopause’s impact on women, businesses, and the bottom line—and what to do about it.
Website: https://drmache.com
Coaching: MenopauseCoaching.com
Magazine: https://drmache.com/resources
LINKS:
Website: https://www.midovia.com/
Instagram: https://www.instagram.com/mymidovia
LinkedIn: http://www.linkedin.com/midovia
Email Us: info@midovia.com
MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness & supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.
The information, including but not limited to, text, graphics, images & other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
April Haberman (00:00):
Welcome to the MiDOViA Menopause Podcast
Business Edition, your trustedsource for insights on menopause
and midlife in the workplace.
Each episode featuresmeaningful conversations with
inspiring guests.
Tune in and enjoy the show.
Kim Hart (00:16):
Hello, welcome everybody.
We're excited today to have DrMache.
He is a world-renowned women'shealth and menopause treatment
expert and a sought-afterspeaker and consultant and a
coach.
There's a lot going on there,dr Mache.
We're excited to break thatdown.
We were excited to have DrMache on our show because he
(00:37):
wrote a book called WorkingThrough Menopause the Impact on
Women, businesses and the BottomLine, which is a fantastic read
and supports the MiDOViAbusiness so well.
So welcome, Dr Mache.
Dr. Mache (00:51):
Pleasure to be joining you, kim, in April and
pleased to be here.
Kim Hart (00:57):
Oh, thanks.
So why don't you tell ouraudience a little bit about who
you are and how you got to thisplace where you're talking about
menopause in the workplace?
Dr. Mache (01:06):
Well, I began my career as I am a gynecologist
and a reproductiveendocrinologist.
I actually began my career asan infertility specialist.
I did some of the first invitro fertilizations in the
United States, developed thetiming of ovulation and some of
the things that ultrasounds thatyou now get for follicle sizes.
(01:29):
I did a lot of that originalwork.
I even helped monkeys getpregnant at the zoo.
But in 2002, only six monthsafter the Women's Health
Initiative, my wife had surgerythat threw her into early
menopause, and that was only sixmonths after the Women's Health
(01:52):
Initiative came out saying thatestrogen could be increasing
the risk of breast cancer, heartdisease and so forth.
That's subsequently beendisputed and it's well
demonstrated in my books, theEstrogen Window and the Estrogen
Fix.
But nevertheless the damage wasdone and doctors were not
(02:14):
interested in really treatingher at that point in time, and
so as she transitioned intomenopause, I also transitioned
into menopause.
Into menopause, I alsotransitioned into menopause, and
I moved my practice and focusfrom the reproductive arena to
the post-reproductive arena andhave spent the last 20 some odd
(02:38):
years focused on helping womenfeel better and live better.
I spent 25 years on the Harvardfaculty.
I was a division chief and headof the fellowship program and
ran the laboratories and thingslike that.
But now I'm primarily focusedon coaching and working with
(02:59):
women who are business andprofessional women or women
executives, who are reallystruggling with their midlife
challenges and they want to takeback control of their lives,
their work and theirrelationships, because midlife
and the symptoms that can comewith it impact all of those
areas.
And I do that throughmenopausecoachingcom.
April Haberman (03:22):
Yeah, it's wonderful, and we often find
that people do change theircareers, you know, based on
their personal experiences.
And and we could probably do anentire podcast on surgical
menopause, I'm sure, I'm sure wecould we get a lot of questions
about that as well.
(03:43):
But I'm curious you know youwork with executive women.
You work in the menopause space, post-menopause space, right
now.
Your book highlights theeconomic impacts of menopause on
businesses, and so I'd love foryou to share a few of the key
statistics and findings to thatrespect as well.
Dr. Mache (04:08):
Well, let me just say one thing.
You say I changed careers, butI really didn't change careers
as such, because I believe thatlife and health are a continuum.
And so I used to do you mightsay sperm to term, but now I'm
doing like womb to term.
And so basically, I see that wego before reproduction,
(04:32):
reproduction, then we dotransitioning out of
reproduction, which isperimenopause, and then we have
menopause, which is postreproduction and the years
beyond.
And so I see what I'm doing isjust continuing the ongoing life
sequence or life journey thatwomen travel through.
(04:53):
And so I see many of the womenwho were having trouble getting
pregnant actually werestruggling with entering
perimenopause and they are notrecognizing it because they feel
they're too young.
But in fact, 5% to 10% of womenare already in menopause before
age 45 and 1% before age 40.
(05:15):
So the symptoms begin about 5to 10 years before that.
So you could well be in your30s and have symptoms that feel
really weird to you and it couldbe a sign that you're in
perimenopause.
In terms of statistics,menopause will affect every
woman if she lives long enough,and while the majority of women
(05:37):
you know the mean age that awoman lived men too, for that
matter, the lifespan in 1900 was48 years, so menopause didn't
happen for a lot of women.
Today, the mean age issomewhere around 83 years, with
mean age of menopause beingroughly 51, with a typical span
(06:00):
of 45 to 55.
And, as I said, five to 10% ofwomen will be in menopause
before that.
So, and women are a very bigpart of the workforce they're
half of the workforce and halfof them are either in
perimenopause or menopause.
So symptoms are like you know,10% of women have dropped out
(06:23):
because of menopause.
They've just left work.
One in four are not pursuingleadership positions that they
could be.
They just feel that they're notin charge of their bodies and
their minds the way they want tobe and they don't have the
capacity or feel too taxed by itat this point because they're
(06:44):
struggling with so many otherthings combined with they're
taking care of kids off, andthen they're taking care of
parents, et cetera.
And then we have two out offive that, because of that, end
up getting a new job.
They just move on.
Maybe they take something lesstaxing or, you know, closer to
home or what have you?
(07:04):
And you know, 25% have thoughtabout leaving their job and
almost 40% feel that menopauseis impacting their presenteeism,
their ability to actually showup and be there.
I mean, it's hard to focus ifyou're having hot flashes, if
(07:25):
your brain is foggy, if yourmood swings are happening, if
you're bleeding through yourslacks or you're, you know,
soiling the chair with heavybleeding from perimenopause, or
you have to go to the bladderissues and sensitive bladder.
You have to run to the bathroomall the time.
These are life affectingsituations, you know conditions.
(07:46):
So those are some of thestatistics and they're impacting
women and their desire to stayat work, be happy at work, be
maximally productive at work andrise up through the chain of
the work ladder to the top ofthe rung if that's their
(08:08):
ambition, or to perform at theirbest at whatever they happen to
work at.
April Haberman (08:13):
Right.
Kim Hart (08:14):
Yeah.
April Haberman (08:14):
Hey friends, I'm excited to share a significant
milestone that you may haveheard mentioned.
Medovia has launched the firstever menopause friendly US
accreditation program.
This program sets acomprehensive standard overseen
by a third party panel ofexperts, ensuring air quotes
here that menopause friendly ismore than just a term.
(08:37):
It reflects a real commitmentto meaningful, sustainable
workplace changes.
It's important to us that themenopause friendly logo is
meaningful and marks a highstandard within the menopause
space.
We hope you'll join us on thejourney to becoming menopause
friendly as a leading pioneer inthe States.
(08:57):
You can find more informationat menopausefriendlyuscom.
So there's seems to be all.
That being said, thank you forthose statistics.
It is a challenge for people inthe workplace that are going
through menopause, and yet inthe US, less than 15% of
(09:19):
organizations have any type ofmenopause support programming in
place.
Even beyond benefits andmedical care, there's no support
for menopause in the workplace.
So can you share with us inyour experience what some of
those misconceptions thatemployers have about menopause
(09:41):
in the workplace, and maybe evenemployees as well?
Dr. Mache (09:46):
menopause in the workplace, and maybe even
employees as well.
Well, from the woman's side,it's often a taboo topic because
we have a situation where manytimes menopause is considered
being older.
And I've just told youmenopause is not about age.
Menopause is about transition,but people equate it with age.
(10:08):
There is ageism in our country,so women don't want to be
perceived as looking old orbeing old.
Why would they look at any adon television and see that only
recently we have somebody that'snot 25 talking about anything,
and we have only recently begunto hear the word menopause come
(10:32):
out of someone's mouth.
Prior to that it was taboo,just like, at one point,
erectile dysfunction wassomething nobody talked about.
But now it comes on withprimetime television, as casual
as you would be talking aboutsomething that is a siding for
your house or anything else.
(10:54):
It's remarkable how much it'spermeated.
So it's, first of all, it'staboo, but many times there's a
misperception that it's just alittle inconvenient thing.
It's number one.
It's natural.
Okay, death is natural.
That doesn't make it pleasant.
Menopause is natural.
(11:14):
Number two you feel a littlewarm.
What's the big deal?
Not understanding that hotflashes can have actually
negative impact on a woman'shealth, sleep and other things
that are now being uncovered?
The third is that there's notthat much advocacy for women,
(11:37):
and this is just something thatwomen feel they have to tough it
out, and so they go to workwith their symptoms and we
didn't talk about it.
But I will just set it up,which is the way my book sets up
, and let me say that I did thebook together with my wife,
sharon Seibel.
The two of us co-wrote the booktogether.
(11:57):
But the whole thing really camecrushing down with the Women's
Health Initiative, the so-calledWHI, which happened in 2002,
which I mentioned.
Prior to that time, at least50% of women were on hormone
(12:19):
therapy and they typically gotit sometime after menopause.
You know, as you have yoursymptoms coming around midlife
and doctors would give out thehormones and women's symptoms
were abated.
I mean, they dealt with it andthey weren't symptomatic at work
, it was addressing their issues.
After the Women's HealthInitiative, that number dropped
(12:44):
to under 5% and if you look atthe most recent data that's been
published, within the last year, the number of women on hormone
therapy is down from what itwas two, three or four years ago
.
So it's now got 3.8% and 3.9%.
(13:04):
And then you say okay, say okay,well, they got other stuff.
Yeah, they do, as a result ofestrogen being thrown away by
millions of women.
That's when we got into thewhole bioidentical thing, which
is basically available not onlyin compounding pharmacies, but
the same stuff's available inregular prescription pharmacies.
(13:25):
But be that as it may, even ifwe take into account all of that
and even if we take in all theother over-the-counter
treatments and all the otheralternatives to estrogen that
are prescription-based and thereare some good ones but we're
still dealing with only anotherquarter of women that are taking
anything.
(13:45):
70% of women 5% are on estrogen, to make numbers easy and 25%
on something else.
So you've got 70% of womensucking it up.
They have nothing right.
They're toughing it out they gowith all of these symptoms and
people say live with it, dealwith it.
(14:07):
It's, you know it be just theright thing to do for the women.
It's also affecting thebusiness, because the women are
(14:37):
not able to be as productive andthey're not able to be as
present and they're not able tobe as focused as they would be
if they were simply treatingtheir symptoms.
And yet it's not happening.
And so this window ofperimenopause most of the
(15:00):
symptoms come in perimenopause,approaching menopause, and then
in the one or two years after.
So it's about three to fiveyear window when symptoms are
worse, and that could be allmitigated.
I mean, there is no.
No one needs to tough it out,figure it out.
No one needs.
There are treatments for almosteverything, safe and effective
(15:24):
treatments, and if you wanthormones, that's good.
It goes to every cell in yourbody.
It affects all of your symptoms.
It will address them.
If you don't want hormonesbecause you can't or won't take
them, that's also good.
There are other options for youto consider.
But doing nothing is thebiggest mistake you can possibly
make, because there's no needto tough it out and that will
(15:47):
improve the things that I alwaystalk about with women, midlife
women is your life, your workand your relationships.
April Haberman (15:55):
Yeah, yeah Well, and you bring up so many
important points here, it justlights me on fire over here.
Kim Hart (16:04):
Well, we're all on fire about it, which?
April Haberman (16:05):
I love.
You know menopause affectseveryone.
You know we always say itaffects women directly, but it
affects everyone.
You just mentionedrelationships.
So you know we often find thatpartners, spouses, they may not
be performing at work either attheir peak performance.
(16:26):
If you're sleeping next tosomeone that is having hot
flashes and can't sleep, orheavy flooding, bleeding or, you
know, fill in the blank, you'renot sleeping either.
And we know that sleep isimportant for our clarity and
brain function and to be able toconcentrate at work.
So I think that menopauseaffects everyone in the
(16:48):
workplace, not just those thatare going through menopause.
But I also think that it ispresenteeism, absenteeism.
There's data there, but not alot of data.
And we find that we come upagainst an obstacle in the
workplace in folding inmenopause in the workplace
(17:09):
programs, because there isn'tenough reporting.
So it's kind of chicken and theegg right, like well, we have
yeah the workplace is chicken.
Yeah.
Dr. Mache (17:21):
That's the chicken part, right Right.
April Haberman (17:24):
Yeah, you just it.
Um, yeah, so a lot oforganizations we find are stuck
like well, give me the data,give me the reporting so that I
can take it to, um, you know,c-suite and get this approved.
We don't have it in the budget,but we know that workplace
programs are not that expensive,you know it.
Expensive Compared to the costof losing, compared to the cost
(17:46):
of losing employees andreplacing employees.
It just takes retaining oneperson to pay for menopause in
the workplace programs, right?
Dr. Mache (17:55):
So we're not talking about Her annual salary is what
it takes to replace one person.
Her annual salary is what it'sgoing to take to replace that
woman in the workplace in mostinstances.
And you have a situation whereif you had support from women,
(18:17):
then you would have a moreengaged workforce, you would
have a more productive workforce, you would have a more present
workforce.
Presenteeism means I mean yourbody shows up, you're present.
Presenteeism is okay.
I'm here.
Am I paying attention?
Am I?
(18:38):
Am I at my peak in terms of myproductivity and ability?
Menopause causes women to loseup to an hour a day in
productivity.
It's not like they're offfiddling and piddling and
playing you know, video games orsomething like that.
They can't focus.
And if you're always having toread, you know rein in your
(19:01):
thoughts and bring them back towhere you are currently
addressing, to what you'recurrently addressing.
That adds up over time.
If it's five minutes an hourwhere you're struggling, at the
end of the day it's an hour lost.
So that's what happens and theinability to understand that.
(19:22):
I mean you're talking about themen.
I mean, let's just say I meanhalf of the workforce is women,
half of the workforce is men,more or less, and even in
industries you wouldn't expectand in the police departments,
in the fire departments, inother places.
There are women working there inuniforms that are too hot for
them, in situations wherethey're not being supported for
(19:43):
just the basic kinds ofconsiderations that would make
their jobs easier, better, andif the workforce is happier,
they're going to be moreproductive, they're going to be
more likely to stay in theirwork.
And I remember when I was doingthe fertility work and I was
(20:04):
advocating for coverage forinfertility work and people,
finally insurances, came aroundand got the idea hey, you know,
maybe you know this, infertilitydoes work, but it's too
expensive.
It turns out that if coveragewas provided in workplaces for
(20:35):
these kinds of issues for youngwomen, when young women were
looking for jobs, they wentwhere the coverage and the
support was there for them.
They didn't want to go to aplace where, if they got
pregnant or needed help with IVFor some other thing, that it
was a problem.
It was a problem and it turnedout it only ended up, on average
, adding even IVF, which can bevery expensive, much more than
menopause, but that at its peakwas about $7.30 a month to get
(20:57):
that policy into the workplace.
For that measly little bit, youcould attract women to stay, and
I believe this will happen aswe get coverage and more
awareness, because I'm not goingto work at a place that doesn't
support me at this point in mylife and women are.
(21:18):
More than 75% of women areworking through menopause Right,
and more and more women areworking longer and longer.
And also, if you think aboutthis from a money point of view,
midlife is when this the poophits the fan in turn, starting
to acquire diseases.
(21:39):
Autoimmune diseases come up,other kinds of conditions come
up.
You have more problems withheart issues, with bone issues,
bone loss, which is very bad inmenopause.
You lose about 30% of activebone in the transition of
perimenopause.
I mean it is a big time to bepreventing things.
(22:01):
And so if we addressedmenopause at midlife, we would
have much healthier women at endof life and throughout, and
then your health span would getcloser to your lifespan and then
you'd be in a position to bemuch better protected from
(22:22):
whatever happens.
Because, let's face it, ourbrain is the software and our
body is the hardware, and Idon't know what kind of hardware
you got in your house, but Ibet it breaks after 50 years.
So there's things breaking downand the more we prevent it, the
more we repair it as littlethings go along.
(22:46):
The more we invest in that bitof effort, the more we're going
to have a healthier, productiveworkforce and lives.
And don't forget women makeprobably 90% of the health care
decisions for families and forevery woman.
You protect every woman thatyou have able to be at her peak.
(23:11):
You are impacting the guy whoseappointments for his prostate
check the wife is making thepartner is making.
you're protecting the kids fromgoing in to see what happens if
their ear is infected orwhatever the issue is.
So you're impacting the country, one family at a time, and
(23:32):
eventually it will hit a tippingpoint, but we have to be
proactive and be aware.
Kim Hart (23:38):
That's such a great example on the impact on the
family.
I don't think people thinkabout that from a healthcare
decision perspective.
I know at my house it's me butbecause I know I've sold
benefits before.
But in generally speaking, if Ilook at all my friends, they're
the ones.
April Haberman (23:55):
It's me right.
It's me right In our house too.
So I think it's an excellentpoint.
Yeah, yeah.
Kim Hart (24:01):
So what should organizations be doing, how can
they support women during thistime, and what you know, what
are some of the best ones thatyou've run into are doing to
help support women during theirmenopause years?
Dr. Mache (24:14):
Well, in my book I put a process visual that really
talks to this, and the firstthing is we have to have
awareness.
We have to have, have awareness.
We have to have.
Menopause happens.
You know there's menopauseawareness.
You know month there'smenopause, there is a world
(24:40):
menopause day.
Make it part of what thecompany is able to talk about.
Menopause cannot get stuck inyour throat.
Not get stuck in your throat,you have to be able to utter it,
to talk about it comfortably,comfortably.
Once you begin to get awareness,then you can begin to create
(25:01):
advocacy.
There may be one person that'sthe designated advocate that can
go and try to be and help, youknow, help promote this kind of
thing.
And at some point, when you,you know you first you have to,
when in any process with that,in change, you have to first
think about something and thenyou have to be able to become.
You know it's like in your mindand then you have to be able to
speak it out loud and that'swhat the advocacy does.
(25:24):
And then, once you get to thatpoint, you can begin to have
acceptance.
You have awareness, advocacy,and then you get acceptance.
And when you have acceptance,then you can take action and it
is that action that leads totransformation.
It has to be transformation.
(25:44):
Now you can do all thisincrementally and that is the
reality that the world we livein, but awareness, advocacy,
acceptance, take action,transformation, and it has to go
incrementally and there has tobe these progression of steps.
Kim Hart (26:06):
I love that visual, by the way.
Maybe we can include that inthe show notes, because I was
looking at that again last nightin your book.
Just as for any change, I thinkthat it's a really great way to
think about.
You can't skip steps right.
You can't expect informationand transformation to happen.
(26:28):
You have to work hard to get tothat transformation.
Dr. Mache (26:31):
I have a saying that's my own it goes, the
slower I go, the faster I getthere, and I believe that you've
got to go steady and straightahead and not get impatient,
because if you do, that's whenthings trip and fall.
Kim Hart (26:54):
Well, I agree with you , except when I'm lifting
weights I try and go as quicklyas I can so I can get it over
with.
Dr. Mache (27:00):
You must eat spinach with one of the you know, chug
it down or something.
Yeah, exactly.
Don't you swallow home yeah.
Kim Hart (27:09):
Well, what advice would you give to women in your
coaching business and otherwise?
On menopause symptoms whiletrying to maintain their careers
, and who you know, especiallythose in the senior level
positions who really are at theheight of their career important
(27:35):
to realize.
Dr. Mache (27:35):
no person is an island.
It's very lonely at the top andpeople really do need someone
to bounce things off of, someonewho is able to hear what
they're saying and to be able tomirror it back to them in a way
that actually is helpful forthem to see how they could
actually change things.
Because if you're always, youknow we get tapes in our head.
(27:56):
We think you know, it is what itis and isn't.
I'm just gonna, I'm just here,I'm dealing with this and that,
and it is what it is and I'mstuck here.
No, that is not true.
There are paths and solutionsand ways to address things that
will free women up to be theiroptimum selves, and I think that
(28:18):
women have all the ability todo anything they want.
They're always talking aboutthe glass ceiling.
I think there is a glassceiling, but I also think
there's a silent ceiling, but Ialso think there's a silent
ceiling.
There's an estrogen ceiling.
April Haberman (28:34):
And.
Dr. Mache (28:34):
I mean that not in any pejorative way.
What I mean is that whenestrogen gets lower, it has a
biologic effect and whether youtreat it with hormones or many
alternatives to hormones thatare available, you will find
that you are functioning at awhole different level If you're
(28:55):
not having all the symptoms, ifyou don't have to run to the
bathroom, you don't have toworry about if you're going to
soil your chair, which is legal.
Cases have happened with womenbeing dismissed for a chair
dismissed for a chair for God.
And then there is if you havethe ability to focus the ability
(29:18):
.
I've had situations where awoman was telling me that she
was working so hard to get areport in and she worked so long
and hard to finish it, and thenI said how did it go?
She said she forgot to turn itin you know, it's like these
(29:40):
kinds of things are justshattering.
And then what do you end up with?
A self-esteem issue because youdon't have it anymore.
You have it, but you, you knoweverything needs to be nurtured.
We have to nurture the nurturerand have to go to the people at
(30:01):
the top and the ones who areabove others and ones who are
making decisions, and help themwith estrogen.
I will say that estrogen isinteresting in that there are
estrogen receptors in almostevery cell in the body.
And if you take hormone therapyand I'm not advocating for it
and I don't get anything foranybody taking medicine, I'm
(30:24):
saying if you take it, then youhave basically taken something
that if you're having brain fog,it's going to affect it, if
you're having hot flashes, it'sgoing to affect it, if you're
having difficulty with yourbladder, it's going to affect it
, et cetera, et cetera.
But if you don't take hormonetherapy, you have to divide your
(30:46):
life into two things.
You have noisy symptoms likehot flashes.
Divide your life into twothings.
You have noisy symptoms likehot flashes, which you damn sure
know you got.
You have silent symptoms, likebone loss, which you will not
know you have unless you get abone density or you fall and
break a bone to find it out, orheart disease or other things,
(31:14):
disease or other things.
So estrogen is dealing with allof those things.
But my concept of menopause isyou have to take care of the
some of you and not some of you.
The only way to do that is towork with people who can help
you identify noisy and silenthelp you realize taking care of
the sum of you and then turnthat into a more I call holistic
(31:35):
approach, w-h-o-l-e holistic,because that is the secret to
having a much happier,productive, positive menopause
transition, which is inevitable.
Yeah, you may not have hotflashes.
You may be one in the one ofthe one in five women who don't,
(31:59):
or whatever the number is.
It's about 20, 15, 20 don'thave hot flashes, but you know
that doesn't mean nothing'shappened to you.
I mean right yeah, just maybesilently, but you have to be
aware of all this stuff.
If you're not aware, then, as Isaid, the things you could have
been taking preventively aregoing to come forward 10 years
(32:24):
behind.
Kim Hart (32:28):
I love that.
April Haberman (32:29):
I love that too, you talk about.
Kim Hart (32:31):
The first stage of transition is awareness right.
And that's just what you'resaying, yeah, yeah.
April Haberman (32:39):
Can I ask a question?
Because we often hear fromwomen oh, I've already been
through that, I don't need toworry about that, Right, I've
reached menopause, so thereforeI don't need to worry about that
, right, I've reached menopause,so therefore I don't have to
worry about it anymore.
And oftentimes they're seniorlevel executives.
And if you had a senior levelexecutive woman sitting in front
(33:02):
of you right now who isexperiencing still menopause
symptoms and who's looking aheadat that post menopausal stage
with some of those silentsymptoms, what would you say to
her?
Dr. Mache (33:17):
Well, you're either not in menopause, approaching
menopause, or in menopause.
You don't go out of menopause.
Menopause does ease up to agingand these two things are going
on simultaneously.
The fact that you are partiallycorrect if you are a woman who
(33:43):
has been dealing with terriblehot flashes and you are able to
wait, tough it out for three,five, seven years For some women
it'll be more than 10 years butif you are one of those women,
you will eventually emerge onthe other side and you'll stop
having those hot flashes or atleast it'll be reduced
(34:05):
sufficiently where they're notreally bothering you anymore.
So right, you get through that.
But your bone loss, youratherosclerosis or artery
hardening, other components ofyour health are ongoing and they
(34:25):
can be intervened upon andslowed down, because as you
treat menopause, you're alsotreating aging.
April Haberman (34:37):
Yeah.
Dr. Mache (34:37):
And it doesn't have to be hormones.
I don't want to get stuck onhormones here.
I mean, I'm very much authorityon hormone therapy, but you got
to live in the real world.
95% of women aren't on hormones.
So why focus on hormones unlessthey want them and want to take
them safely and mosteffectively and know more about
(35:00):
it?
On the other hand, doingnothing is a huge mistake.
Feeling that you've got this,you're gone through this, is
really simply simplistic andnaive thinking, and I have
learned as a patient and as aprovider.
(35:20):
People know a lot in silos, youknow, but when you need
something out of what peopleknow, they don't know.
And then you have to realizethat in medicine, the most
recent surveys which came outjust months ago, was only three
(35:42):
of 10 doctors that are OBGYNs intraining get any information,
any training in menopause, andthat can be as little as two
hours per year.
That's a shame.
April Haberman (35:59):
Yeah.
Dr. Mache (36:00):
Now you have the primary care.
They get half of that.
Maybe 15% of them get trainingin menopause.
So you have the vast majorityof caregivers who are not
knowledgeable in menopausegiving advice.
I don't care if they're men orthey're women.
Right Training is the trainingand it ends up undermining the
(36:27):
general health of women.
And then you have women who nowhave been told they don't need
to have pap smears anymore.
You know, you've had two in arow and you're 50 or whatever
you are, and you don't have tocome back.
Okay, maybe they don't need apap smear.
There's more to them than theircervix.
Kim Hart (36:46):
What about the rest of the?
Dr. Mache (36:47):
women.
What about, you know?
What about the rest of thewomen?
What about checking on theircholesterol, checking on their
bladders, checking on theirheart function, their blood
pressures, all the things thatneed to be looked at, plus other
things, their bone health?
I mean, if you're a 50-year-oldwoman and you're healthy,
(37:13):
you're just as likely to diefrom a complication of
osteoporosis or thinning of thebones as you are from heart
disease.
So I mean breast cancer, excuseme, you're just as likely to
die from a complication ofosteoporosis as you are from
breast cancer.
So everybody's got a pinkribbon and a mammogram.
That's wonderful, knock, knockon that.
But that ain't it.
You're more than two breasts.
You have the rest of you, thesum of you.
(37:36):
And so these reasons, I thinkthat any woman would benefit
from talking to somebody whoW-H-O-L-E holistic.
Holistic, because in only doingthat are you considering things
?
And there are many things.
Once you feel better, onceyou're functioning better,
you're going to be moreeffective personally,
(37:57):
professionally and inrelationships.
And, yes, after a while you getused to the new threshold of
how you live.
You now have come to this newstate of OK, I'm not really.
I'm doing okay, I'm used tothis, I know I can deal Fine,
but why would you want to besuboptimum?
Why would you want to be notoptimized for your health, for
(38:20):
your well-being, for yourhappiness, for your
effectiveness?
Kim Hart (38:26):
I 100% agree.
I love this.
We could talk forever.
April Haberman (38:29):
I know I'm like, oh my gosh, we're gonna have to
have you back because there'sso much that we can unpack here.
And I do agree with you and Ithink that we, we don't know
what we don't know and we getused to feeling lousy sometimes
and we don't even realize whatgood feels like anymore until we
get that help.
And then it's a hindsight we'relooking back in the rearview
(38:52):
mirror going, oh my gosh, whydidn't I do this?
Do this earlier, Right Shouldhave, would have.
Kim Hart (38:59):
Yes absolutely Well, dr Mache.
Dr. Mache (39:06):
Where can our listeners learn more about your
work and the resources thatyou've worked so hard on, that
you've worked so hard on.
Well, they can come to mywebsite, drmachecom,
d-r-m-a-c-h-ecom, and I havetons of resources.
And also, together, my wife andI do the Hot Years magazine and
(39:29):
it's at hotyearsmagcom.
But I would like to give all ofyour listeners a free copy of
the magazine.
Kim Hart (39:38):
I think it's so nice interesting and useful.
Dr. Mache (39:41):
It has videos, it has exercise videos, it has all
kinds of stuff in it and so theycan use that as a resource and
if they're interested they cansubscribe.
But I think that it's importantto get the information you need
and make sure it's accurate.
There's a lot of not onlymisunderstandings but myth
(40:04):
understandings out there thatare simply wrong and get cut and
pasted and perpetuated, thatare doing harm to women instead
of optimizing them.
So those are, drmachecom.
If you're interested in workingtogether at some point or want
to discuss it, you can reach meat menopausecoachingcom.
Kim Hart (40:28):
Excellent, fabulous.
Well, I told you that we askthe all of our guests.
The final question is what isthe best piece of advice you've
ever received or given?
Dr. Mache (40:42):
Well, I'd like to think there's been a lot of
those.
Yeah, I'd say you had some inthis podcast but I would say the
biggest thing I would say isdon't tough it out.
Figure it out, because there isa path for each person.
It has to be individualized,but if you figure it out you
will not have to tough it out.
April Haberman (41:05):
I love the simplicity but the depth of that
.
So, gosh, thank you for that.
I'm writing that one down, kim.
Well, thank you so much, drMesh, for coming on the show,
for sharing your knowledge.
We'll definitely have you back.
Listeners will put theinformation on the magazine
(41:25):
subscription in show notes, aswell as all of your contact
information.
And until we meet again,everyone go find joy in the
journey.
Thanks, dr Baish.
Thank you for listening to theMedovia menopause podcast.
If you enjoyed today's show,please give it a thumbs up,
subscribe for future episodes,leave a review and share this
(41:48):
episode with a friend.
There are more than 50 millionwomen in the US who are
navigating the menopausetransition.
The situation is compounded bythe presence of stigma, shame
and secrecy surroundingmenopause, posing significant
challenges and disruptions inwomen's personal and
(42:08):
professional spheres.
Medovia is out to change thenarrative.
Learn more at medoviacom.
That's M-I-D-O-V-I-A dot com.
Welcome to the MiDOViA Menopause Podcast
Business Edition, your trustedsource for insights on menopause
and midlife in the workplace.
Each episode featuresmeaningful conversations with
inspiring guests.
Tune in and enjoy the show.
Kim Hart (00:16):
Hello, welcome everybody.
We're excited today to have DrMache.
He is a world-renowned women'shealth and menopause treatment
expert and a sought-afterspeaker and consultant and a
coach.
There's a lot going on there,dr Mache.
We're excited to break thatdown.
We were excited to have DrMache on our show because he
(00:37):
wrote a book called WorkingThrough Menopause the Impact on
Women, businesses and the BottomLine, which is a fantastic read
and supports the MiDOViAbusiness so well.
So welcome, Dr Mache.
Dr. Mache (00:51):
Pleasure to be joining you, kim, in April and
pleased to be here.
Kim Hart (00:57):
Oh, thanks.
So why don't you tell ouraudience a little bit about who
you are and how you got to thisplace where you're talking about
menopause in the workplace?
Dr. Mache (01:06):
Well, I began my career as I am a gynecologist
and a reproductiveendocrinologist.
I actually began my career asan infertility specialist.
I did some of the first invitro fertilizations in the
United States, developed thetiming of ovulation and some of
the things that ultrasounds thatyou now get for follicle sizes.
(01:29):
I did a lot of that originalwork.
I even helped monkeys getpregnant at the zoo.
But in 2002, only six monthsafter the Women's Health
Initiative, my wife had surgerythat threw her into early
menopause, and that was only sixmonths after the Women's Health
(01:52):
Initiative came out saying thatestrogen could be increasing
the risk of breast cancer, heartdisease and so forth.
That's subsequently beendisputed and it's well
demonstrated in my books, theEstrogen Window and the Estrogen
Fix.
But nevertheless the damage wasdone and doctors were not
(02:14):
interested in really treatingher at that point in time, and
so as she transitioned intomenopause, I also transitioned
into menopause.
Into menopause, I alsotransitioned into menopause, and
I moved my practice and focusfrom the reproductive arena to
the post-reproductive arena andhave spent the last 20 some odd
(02:38):
years focused on helping womenfeel better and live better.
I spent 25 years on the Harvardfaculty.
I was a division chief and headof the fellowship program and
ran the laboratories and thingslike that.
But now I'm primarily focusedon coaching and working with
(02:59):
women who are business andprofessional women or women
executives, who are reallystruggling with their midlife
challenges and they want to takeback control of their lives,
their work and theirrelationships, because midlife
and the symptoms that can comewith it impact all of those
areas.
And I do that throughmenopausecoachingcom.
April Haberman (03:22):
Yeah, it's wonderful, and we often find
that people do change theircareers, you know, based on
their personal experiences.
And and we could probably do anentire podcast on surgical
menopause, I'm sure, I'm sure wecould we get a lot of questions
about that as well.
(03:43):
But I'm curious you know youwork with executive women.
You work in the menopause space, post-menopause space, right
now.
Your book highlights theeconomic impacts of menopause on
businesses, and so I'd love foryou to share a few of the key
statistics and findings to thatrespect as well.
Dr. Mache (04:08):
Well, let me just say one thing.
You say I changed careers, butI really didn't change careers
as such, because I believe thatlife and health are a continuum.
And so I used to do you mightsay sperm to term, but now I'm
doing like womb to term.
And so basically, I see that wego before reproduction,
(04:32):
reproduction, then we dotransitioning out of
reproduction, which isperimenopause, and then we have
menopause, which is postreproduction and the years
beyond.
And so I see what I'm doing isjust continuing the ongoing life
sequence or life journey thatwomen travel through.
(04:53):
And so I see many of the womenwho were having trouble getting
pregnant actually werestruggling with entering
perimenopause and they are notrecognizing it because they feel
they're too young.
But in fact, 5% to 10% of womenare already in menopause before
age 45 and 1% before age 40.
(05:15):
So the symptoms begin about 5to 10 years before that.
So you could well be in your30s and have symptoms that feel
really weird to you and it couldbe a sign that you're in
perimenopause.
In terms of statistics,menopause will affect every
woman if she lives long enough,and while the majority of women
(05:37):
you know the mean age that awoman lived men too, for that
matter, the lifespan in 1900 was48 years, so menopause didn't
happen for a lot of women.
Today, the mean age issomewhere around 83 years, with
mean age of menopause beingroughly 51, with a typical span
(06:00):
of 45 to 55.
And, as I said, five to 10% ofwomen will be in menopause
before that.
So, and women are a very bigpart of the workforce they're
half of the workforce and halfof them are either in
perimenopause or menopause.
So symptoms are like you know,10% of women have dropped out
(06:23):
because of menopause.
They've just left work.
One in four are not pursuingleadership positions that they
could be.
They just feel that they're notin charge of their bodies and
their minds the way they want tobe and they don't have the
capacity or feel too taxed by itat this point because they're
(06:44):
struggling with so many otherthings combined with they're
taking care of kids off, andthen they're taking care of
parents, et cetera.
And then we have two out offive that, because of that, end
up getting a new job.
They just move on.
Maybe they take something lesstaxing or, you know, closer to
home or what have you?
(07:04):
And you know, 25% have thoughtabout leaving their job and
almost 40% feel that menopauseis impacting their presenteeism,
their ability to actually showup and be there.
I mean, it's hard to focus ifyou're having hot flashes, if
(07:25):
your brain is foggy, if yourmood swings are happening, if
you're bleeding through yourslacks or you're, you know,
soiling the chair with heavybleeding from perimenopause, or
you have to go to the bladderissues and sensitive bladder.
You have to run to the bathroomall the time.
These are life affectingsituations, you know conditions.
(07:46):
So those are some of thestatistics and they're impacting
women and their desire to stayat work, be happy at work, be
maximally productive at work andrise up through the chain of
the work ladder to the top ofthe rung if that's their
(08:08):
ambition, or to perform at theirbest at whatever they happen to
work at.
April Haberman (08:13):
Right.
Kim Hart (08:14):
Yeah.
April Haberman (08:14):
Hey friends, I'm excited to share a significant
milestone that you may haveheard mentioned.
Medovia has launched the firstever menopause friendly US
accreditation program.
This program sets acomprehensive standard overseen
by a third party panel ofexperts, ensuring air quotes
here that menopause friendly ismore than just a term.
(08:37):
It reflects a real commitmentto meaningful, sustainable
workplace changes.
It's important to us that themenopause friendly logo is
meaningful and marks a highstandard within the menopause
space.
We hope you'll join us on thejourney to becoming menopause
friendly as a leading pioneer inthe States.
(08:57):
You can find more informationat menopausefriendlyuscom.
So there's seems to be all.
That being said, thank you forthose statistics.
It is a challenge for people inthe workplace that are going
through menopause, and yet inthe US, less than 15% of
(09:19):
organizations have any type ofmenopause support programming in
place.
Even beyond benefits andmedical care, there's no support
for menopause in the workplace.
So can you share with us inyour experience what some of
those misconceptions thatemployers have about menopause
(09:41):
in the workplace, and maybe evenemployees as well?
Dr. Mache (09:46):
menopause in the workplace, and maybe even
employees as well.
Well, from the woman's side,it's often a taboo topic because
we have a situation where manytimes menopause is considered
being older.
And I've just told youmenopause is not about age.
Menopause is about transition,but people equate it with age.
(10:08):
There is ageism in our country,so women don't want to be
perceived as looking old orbeing old.
Why would they look at any adon television and see that only
recently we have somebody that'snot 25 talking about anything,
and we have only recently begunto hear the word menopause come
(10:32):
out of someone's mouth.
Prior to that it was taboo,just like, at one point,
erectile dysfunction wassomething nobody talked about.
But now it comes on withprimetime television, as casual
as you would be talking aboutsomething that is a siding for
your house or anything else.
(10:54):
It's remarkable how much it'spermeated.
So it's, first of all, it'staboo, but many times there's a
misperception that it's just alittle inconvenient thing.
It's number one.
It's natural.
Okay, death is natural.
That doesn't make it pleasant.
Menopause is natural.
(11:14):
Number two you feel a littlewarm.
What's the big deal?
Not understanding that hotflashes can have actually
negative impact on a woman'shealth, sleep and other things
that are now being uncovered?
The third is that there's notthat much advocacy for women,
(11:37):
and this is just something thatwomen feel they have to tough it
out, and so they go to workwith their symptoms and we
didn't talk about it.
But I will just set it up,which is the way my book sets up
, and let me say that I did thebook together with my wife,
sharon Seibel.
The two of us co-wrote the booktogether.
(11:57):
But the whole thing really camecrushing down with the Women's
Health Initiative, the so-calledWHI, which happened in 2002,
which I mentioned.
Prior to that time, at least50% of women were on hormone
(12:19):
therapy and they typically gotit sometime after menopause.
You know, as you have yoursymptoms coming around midlife
and doctors would give out thehormones and women's symptoms
were abated.
I mean, they dealt with it andthey weren't symptomatic at work
, it was addressing their issues.
After the Women's HealthInitiative, that number dropped
(12:44):
to under 5% and if you look atthe most recent data that's been
published, within the last year, the number of women on hormone
therapy is down from what itwas two, three or four years ago
.
So it's now got 3.8% and 3.9%.
(13:04):
And then you say okay, say okay,well, they got other stuff.
Yeah, they do, as a result ofestrogen being thrown away by
millions of women.
That's when we got into thewhole bioidentical thing, which
is basically available not onlyin compounding pharmacies, but
the same stuff's available inregular prescription pharmacies.
(13:25):
But be that as it may, even ifwe take into account all of that
and even if we take in all theother over-the-counter
treatments and all the otheralternatives to estrogen that
are prescription-based and thereare some good ones but we're
still dealing with only anotherquarter of women that are taking
anything.
(13:45):
70% of women 5% are on estrogen, to make numbers easy and 25%
on something else.
So you've got 70% of womensucking it up.
They have nothing right.
They're toughing it out they gowith all of these symptoms and
people say live with it, dealwith it.
(14:07):
It's, you know it be just theright thing to do for the women.
It's also affecting thebusiness, because the women are
(14:37):
not able to be as productive andthey're not able to be as
present and they're not able tobe as focused as they would be
if they were simply treatingtheir symptoms.
And yet it's not happening.
And so this window ofperimenopause most of the
(15:00):
symptoms come in perimenopause,approaching menopause, and then
in the one or two years after.
So it's about three to fiveyear window when symptoms are
worse, and that could be allmitigated.
I mean, there is no.
No one needs to tough it out,figure it out.
No one needs.
There are treatments for almosteverything, safe and effective
(15:24):
treatments, and if you wanthormones, that's good.
It goes to every cell in yourbody.
It affects all of your symptoms.
It will address them.
If you don't want hormonesbecause you can't or won't take
them, that's also good.
There are other options for youto consider.
But doing nothing is thebiggest mistake you can possibly
make, because there's no needto tough it out and that will
(15:47):
improve the things that I alwaystalk about with women, midlife
women is your life, your workand your relationships.
April Haberman (15:55):
Yeah, yeah Well, and you bring up so many
important points here, it justlights me on fire over here.
Kim Hart (16:04):
Well, we're all on fire about it, which?
April Haberman (16:05):
I love.
You know menopause affectseveryone.
You know we always say itaffects women directly, but it
affects everyone.
You just mentionedrelationships.
So you know we often find thatpartners, spouses, they may not
be performing at work either attheir peak performance.
(16:26):
If you're sleeping next tosomeone that is having hot
flashes and can't sleep, orheavy flooding, bleeding or, you
know, fill in the blank, you'renot sleeping either.
And we know that sleep isimportant for our clarity and
brain function and to be able toconcentrate at work.
So I think that menopauseaffects everyone in the
(16:48):
workplace, not just those thatare going through menopause.
But I also think that it ispresenteeism, absenteeism.
There's data there, but not alot of data.
And we find that we come upagainst an obstacle in the
workplace in folding inmenopause in the workplace
(17:09):
programs, because there isn'tenough reporting.
So it's kind of chicken and theegg right, like well, we have
yeah the workplace is chicken.
Yeah.
Dr. Mache (17:21):
That's the chicken part, right Right.
April Haberman (17:24):
Yeah, you just it.
Um, yeah, so a lot oforganizations we find are stuck
like well, give me the data,give me the reporting so that I
can take it to, um, you know,c-suite and get this approved.
We don't have it in the budget,but we know that workplace
programs are not that expensive,you know it.
Expensive Compared to the costof losing, compared to the cost
(17:46):
of losing employees andreplacing employees.
It just takes retaining oneperson to pay for menopause in
the workplace programs, right?
Dr. Mache (17:55):
So we're not talking about Her annual salary is what
it takes to replace one person.
Her annual salary is what it'sgoing to take to replace that
woman in the workplace in mostinstances.
And you have a situation whereif you had support from women,
(18:17):
then you would have a moreengaged workforce, you would
have a more productive workforce, you would have a more present
workforce.
Presenteeism means I mean yourbody shows up, you're present.
Presenteeism is okay.
I'm here.
Am I paying attention?
Am I?
(18:38):
Am I at my peak in terms of myproductivity and ability?
Menopause causes women to loseup to an hour a day in
productivity.
It's not like they're offfiddling and piddling and
playing you know, video games orsomething like that.
They can't focus.
And if you're always having toread, you know rein in your
(19:01):
thoughts and bring them back towhere you are currently
addressing, to what you'recurrently addressing.
That adds up over time.
If it's five minutes an hourwhere you're struggling, at the
end of the day it's an hour lost.
So that's what happens and theinability to understand that.
(19:22):
I mean you're talking about themen.
I mean, let's just say I meanhalf of the workforce is women,
half of the workforce is men,more or less, and even in
industries you wouldn't expectand in the police departments,
in the fire departments, inother places.
There are women working there inuniforms that are too hot for
them, in situations wherethey're not being supported for
(19:43):
just the basic kinds ofconsiderations that would make
their jobs easier, better, andif the workforce is happier,
they're going to be moreproductive, they're going to be
more likely to stay in theirwork.
And I remember when I was doingthe fertility work and I was
(20:04):
advocating for coverage forinfertility work and people,
finally insurances, came aroundand got the idea hey, you know,
maybe you know this, infertilitydoes work, but it's too
expensive.
It turns out that if coveragewas provided in workplaces for
(20:35):
these kinds of issues for youngwomen, when young women were
looking for jobs, they wentwhere the coverage and the
support was there for them.
They didn't want to go to aplace where, if they got
pregnant or needed help with IVFor some other thing, that it
was a problem.
It was a problem and it turnedout it only ended up, on average
, adding even IVF, which can bevery expensive, much more than
menopause, but that at its peakwas about $7.30 a month to get
(20:57):
that policy into the workplace.
For that measly little bit, youcould attract women to stay, and
I believe this will happen aswe get coverage and more
awareness, because I'm not goingto work at a place that doesn't
support me at this point in mylife and women are.
(21:18):
More than 75% of women areworking through menopause Right,
and more and more women areworking longer and longer.
And also, if you think aboutthis from a money point of view,
midlife is when this the poophits the fan in turn, starting
to acquire diseases.
(21:39):
Autoimmune diseases come up,other kinds of conditions come
up.
You have more problems withheart issues, with bone issues,
bone loss, which is very bad inmenopause.
You lose about 30% of activebone in the transition of
perimenopause.
I mean it is a big time to bepreventing things.
(22:01):
And so if we addressedmenopause at midlife, we would
have much healthier women at endof life and throughout, and
then your health span would getcloser to your lifespan and then
you'd be in a position to bemuch better protected from
(22:22):
whatever happens.
Because, let's face it, ourbrain is the software and our
body is the hardware, and Idon't know what kind of hardware
you got in your house, but Ibet it breaks after 50 years.
So there's things breaking downand the more we prevent it, the
more we repair it as littlethings go along.
(22:46):
The more we invest in that bitof effort, the more we're going
to have a healthier, productiveworkforce and lives.
And don't forget women makeprobably 90% of the health care
decisions for families and forevery woman.
You protect every woman thatyou have able to be at her peak.
(23:11):
You are impacting the guy whoseappointments for his prostate
check the wife is making thepartner is making.
you're protecting the kids fromgoing in to see what happens if
their ear is infected orwhatever the issue is.
So you're impacting the country, one family at a time, and
(23:32):
eventually it will hit a tippingpoint, but we have to be
proactive and be aware.
Kim Hart (23:38):
That's such a great example on the impact on the
family.
I don't think people thinkabout that from a healthcare
decision perspective.
I know at my house it's me butbecause I know I've sold
benefits before.
But in generally speaking, if Ilook at all my friends, they're
the ones.
April Haberman (23:55):
It's me right.
It's me right In our house too.
So I think it's an excellentpoint.
Yeah, yeah.
Kim Hart (24:01):
So what should organizations be doing, how can
they support women during thistime, and what you know, what
are some of the best ones thatyou've run into are doing to
help support women during theirmenopause years?
Dr. Mache (24:14):
Well, in my book I put a process visual that really
talks to this, and the firstthing is we have to have
awareness.
We have to have, have awareness.
We have to have.
Menopause happens.
You know there's menopauseawareness.
You know month there'smenopause, there is a world
(24:40):
menopause day.
Make it part of what thecompany is able to talk about.
Menopause cannot get stuck inyour throat.
Not get stuck in your throat,you have to be able to utter it,
to talk about it comfortably,comfortably.
Once you begin to get awareness,then you can begin to create
(25:01):
advocacy.
There may be one person that'sthe designated advocate that can
go and try to be and help, youknow, help promote this kind of
thing.
And at some point, when you,you know you first you have to,
when in any process with that,in change, you have to first
think about something and thenyou have to be able to become.
You know it's like in your mindand then you have to be able to
speak it out loud and that'swhat the advocacy does.
(25:24):
And then, once you get to thatpoint, you can begin to have
acceptance.
You have awareness, advocacy,and then you get acceptance.
And when you have acceptance,then you can take action and it
is that action that leads totransformation.
It has to be transformation.
(25:44):
Now you can do all thisincrementally and that is the
reality that the world we livein, but awareness, advocacy,
acceptance, take action,transformation, and it has to go
incrementally and there has tobe these progression of steps.
Kim Hart (26:06):
I love that visual, by the way.
Maybe we can include that inthe show notes, because I was
looking at that again last nightin your book.
Just as for any change, I thinkthat it's a really great way to
think about.
You can't skip steps right.
You can't expect informationand transformation to happen.
(26:28):
You have to work hard to get tothat transformation.
Dr. Mache (26:31):
I have a saying that's my own it goes, the
slower I go, the faster I getthere, and I believe that you've
got to go steady and straightahead and not get impatient,
because if you do, that's whenthings trip and fall.
Kim Hart (26:54):
Well, I agree with you , except when I'm lifting
weights I try and go as quicklyas I can so I can get it over
with.
Dr. Mache (27:00):
You must eat spinach with one of the you know, chug
it down or something.
Yeah, exactly.
Don't you swallow home yeah.
Kim Hart (27:09):
Well, what advice would you give to women in your
coaching business and otherwise?
On menopause symptoms whiletrying to maintain their careers
, and who you know, especiallythose in the senior level
positions who really are at theheight of their career important
(27:35):
to realize.
Dr. Mache (27:35):
no person is an island.
It's very lonely at the top andpeople really do need someone
to bounce things off of, someonewho is able to hear what
they're saying and to be able tomirror it back to them in a way
that actually is helpful forthem to see how they could
actually change things.
Because if you're always, youknow we get tapes in our head.
(27:56):
We think you know, it is what itis and isn't.
I'm just gonna, I'm just here,I'm dealing with this and that,
and it is what it is and I'mstuck here.
No, that is not true.
There are paths and solutionsand ways to address things that
will free women up to be theiroptimum selves, and I think that
(28:18):
women have all the ability todo anything they want.
They're always talking aboutthe glass ceiling.
I think there is a glassceiling, but I also think
there's a silent ceiling, but Ialso think there's a silent
ceiling.
There's an estrogen ceiling.
April Haberman (28:34):
And.
Dr. Mache (28:34):
I mean that not in any pejorative way.
What I mean is that whenestrogen gets lower, it has a
biologic effect and whether youtreat it with hormones or many
alternatives to hormones thatare available, you will find
that you are functioning at awhole different level If you're
(28:55):
not having all the symptoms, ifyou don't have to run to the
bathroom, you don't have toworry about if you're going to
soil your chair, which is legal.
Cases have happened with womenbeing dismissed for a chair
dismissed for a chair for God.
And then there is if you havethe ability to focus the ability
(29:18):
.
I've had situations where awoman was telling me that she
was working so hard to get areport in and she worked so long
and hard to finish it, and thenI said how did it go?
She said she forgot to turn itin you know, it's like these
(29:40):
kinds of things are justshattering.
And then what do you end up with?
A self-esteem issue because youdon't have it anymore.
You have it, but you, you knoweverything needs to be nurtured.
We have to nurture the nurturerand have to go to the people at
(30:01):
the top and the ones who areabove others and ones who are
making decisions, and help themwith estrogen.
I will say that estrogen isinteresting in that there are
estrogen receptors in almostevery cell in the body.
And if you take hormone therapyand I'm not advocating for it
and I don't get anything foranybody taking medicine, I'm
(30:24):
saying if you take it, then youhave basically taken something
that if you're having brain fog,it's going to affect it, if
you're having hot flashes, it'sgoing to affect it, if you're
having difficulty with yourbladder, it's going to affect it
, et cetera, et cetera.
But if you don't take hormonetherapy, you have to divide your
(30:46):
life into two things.
You have noisy symptoms likehot flashes.
Divide your life into twothings.
You have noisy symptoms likehot flashes, which you damn sure
know you got.
You have silent symptoms, likebone loss, which you will not
know you have unless you get abone density or you fall and
break a bone to find it out, orheart disease or other things,
(31:14):
disease or other things.
So estrogen is dealing with allof those things.
But my concept of menopause isyou have to take care of the
some of you and not some of you.
The only way to do that is towork with people who can help
you identify noisy and silenthelp you realize taking care of
the sum of you and then turnthat into a more I call holistic
(31:35):
approach, w-h-o-l-e holistic,because that is the secret to
having a much happier,productive, positive menopause
transition, which is inevitable.
Yeah, you may not have hotflashes.
You may be one in the one ofthe one in five women who don't,
(31:59):
or whatever the number is.
It's about 20, 15, 20 don'thave hot flashes, but you know
that doesn't mean nothing'shappened to you.
I mean right yeah, just maybesilently, but you have to be
aware of all this stuff.
If you're not aware, then, as Isaid, the things you could have
been taking preventively aregoing to come forward 10 years
(32:24):
behind.
Kim Hart (32:28):
I love that.
April Haberman (32:29):
I love that too, you talk about.
Kim Hart (32:31):
The first stage of transition is awareness right.
And that's just what you'resaying, yeah, yeah.
April Haberman (32:39):
Can I ask a question?
Because we often hear fromwomen oh, I've already been
through that, I don't need toworry about that, Right, I've
reached menopause, so thereforeI don't need to worry about that
, right, I've reached menopause,so therefore I don't have to
worry about it anymore.
And oftentimes they're seniorlevel executives.
And if you had a senior levelexecutive woman sitting in front
(33:02):
of you right now who isexperiencing still menopause
symptoms and who's looking aheadat that post menopausal stage
with some of those silentsymptoms, what would you say to
her?
Dr. Mache (33:17):
Well, you're either not in menopause, approaching
menopause, or in menopause.
You don't go out of menopause.
Menopause does ease up to agingand these two things are going
on simultaneously.
The fact that you are partiallycorrect if you are a woman who
(33:43):
has been dealing with terriblehot flashes and you are able to
wait, tough it out for three,five, seven years For some women
it'll be more than 10 years butif you are one of those women,
you will eventually emerge onthe other side and you'll stop
having those hot flashes or atleast it'll be reduced
(34:05):
sufficiently where they're notreally bothering you anymore.
So right, you get through that.
But your bone loss, youratherosclerosis or artery
hardening, other components ofyour health are ongoing and they
(34:25):
can be intervened upon andslowed down, because as you
treat menopause, you're alsotreating aging.
April Haberman (34:37):
Yeah.
Dr. Mache (34:37):
And it doesn't have to be hormones.
I don't want to get stuck onhormones here.
I mean, I'm very much authorityon hormone therapy, but you got
to live in the real world.
95% of women aren't on hormones.
So why focus on hormones unlessthey want them and want to take
them safely and mosteffectively and know more about
(35:00):
it?
On the other hand, doingnothing is a huge mistake.
Feeling that you've got this,you're gone through this, is
really simply simplistic andnaive thinking, and I have
learned as a patient and as aprovider.
(35:20):
People know a lot in silos, youknow, but when you need
something out of what peopleknow, they don't know.
And then you have to realizethat in medicine, the most
recent surveys which came outjust months ago, was only three
(35:42):
of 10 doctors that are OBGYNs intraining get any information,
any training in menopause, andthat can be as little as two
hours per year.
That's a shame.
April Haberman (35:59):
Yeah.
Dr. Mache (36:00):
Now you have the primary care.
They get half of that.
Maybe 15% of them get trainingin menopause.
So you have the vast majorityof caregivers who are not
knowledgeable in menopausegiving advice.
I don't care if they're men orthey're women.
Right Training is the trainingand it ends up undermining the
(36:27):
general health of women.
And then you have women who nowhave been told they don't need
to have pap smears anymore.
You know, you've had two in arow and you're 50 or whatever
you are, and you don't have tocome back.
Okay, maybe they don't need apap smear.
There's more to them than theircervix.
Kim Hart (36:46):
What about the rest of the?
Dr. Mache (36:47):
women.
What about, you know?
What about the rest of thewomen?
What about checking on theircholesterol, checking on their
bladders, checking on theirheart function, their blood
pressures, all the things thatneed to be looked at, plus other
things, their bone health?
I mean, if you're a 50-year-oldwoman and you're healthy,
(37:13):
you're just as likely to diefrom a complication of
osteoporosis or thinning of thebones as you are from heart
disease.
So I mean breast cancer, excuseme, you're just as likely to
die from a complication ofosteoporosis as you are from
breast cancer.
So everybody's got a pinkribbon and a mammogram.
That's wonderful, knock, knockon that.
But that ain't it.
You're more than two breasts.
You have the rest of you, thesum of you.
(37:36):
And so these reasons, I thinkthat any woman would benefit
from talking to somebody whoW-H-O-L-E holistic.
Holistic, because in only doingthat are you considering things
?
And there are many things.
Once you feel better, onceyou're functioning better,
you're going to be moreeffective personally,
(37:57):
professionally and inrelationships.
And, yes, after a while you getused to the new threshold of
how you live.
You now have come to this newstate of OK, I'm not really.
I'm doing okay, I'm used tothis, I know I can deal Fine,
but why would you want to besuboptimum?
Why would you want to be notoptimized for your health, for
(38:20):
your well-being, for yourhappiness, for your
effectiveness?
Kim Hart (38:26):
I 100% agree.
I love this.
We could talk forever.
April Haberman (38:29):
I know I'm like, oh my gosh, we're gonna have to
have you back because there'sso much that we can unpack here.
And I do agree with you and Ithink that we, we don't know
what we don't know and we getused to feeling lousy sometimes
and we don't even realize whatgood feels like anymore until we
get that help.
And then it's a hindsight we'relooking back in the rearview
(38:52):
mirror going, oh my gosh, whydidn't I do this?
Do this earlier, Right Shouldhave, would have.
Kim Hart (38:59):
Yes absolutely Well, dr Mache.
Dr. Mache (39:06):
Where can our listeners learn more about your
work and the resources thatyou've worked so hard on, that
you've worked so hard on.
Well, they can come to mywebsite, drmachecom,
d-r-m-a-c-h-ecom, and I havetons of resources.
And also, together, my wife andI do the Hot Years magazine and
(39:29):
it's at hotyearsmagcom.
But I would like to give all ofyour listeners a free copy of
the magazine.
Kim Hart (39:38):
I think it's so nice interesting and useful.
Dr. Mache (39:41):
It has videos, it has exercise videos, it has all
kinds of stuff in it and so theycan use that as a resource and
if they're interested they cansubscribe.
But I think that it's importantto get the information you need
and make sure it's accurate.
There's a lot of not onlymisunderstandings but myth
(40:04):
understandings out there thatare simply wrong and get cut and
pasted and perpetuated, thatare doing harm to women instead
of optimizing them.
So those are, drmachecom.
If you're interested in workingtogether at some point or want
to discuss it, you can reach meat menopausecoachingcom.
Kim Hart (40:28):
Excellent, fabulous.
Well, I told you that we askthe all of our guests.
The final question is what isthe best piece of advice you've
ever received or given?
Dr. Mache (40:42):
Well, I'd like to think there's been a lot of
those.
Yeah, I'd say you had some inthis podcast but I would say the
biggest thing I would say isdon't tough it out.
Figure it out, because there isa path for each person.
It has to be individualized,but if you figure it out you
will not have to tough it out.
April Haberman (41:05):
I love the simplicity but the depth of that
.
So, gosh, thank you for that.
I'm writing that one down, kim.
Well, thank you so much, drMesh, for coming on the show,
for sharing your knowledge.
We'll definitely have you back.
Listeners will put theinformation on the magazine
(41:25):
subscription in show notes, aswell as all of your contact
information.
And until we meet again,everyone go find joy in the
journey.
Thanks, dr Baish.
Thank you for listening to theMedovia menopause podcast.
If you enjoyed today's show,please give it a thumbs up,
subscribe for future episodes,leave a review and share this
(41:48):
episode with a friend.
There are more than 50 millionwomen in the US who are
navigating the menopausetransition.
The situation is compounded bythe presence of stigma, shame
and secrecy surroundingmenopause, posing significant
challenges and disruptions inwomen's personal and
(42:08):
professional spheres.
Medovia is out to change thenarrative.
Learn more at medoviacom.
That's M-I-D-O-V-I-A dot com.
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