January 4, 2025 • 38 mins
This episode emphasizes the long-term health risks associated with menopause and encourages women to take proactive measures for their well-being. Dr. Cat offers valuable insights on nutrition, exercise, and the importance of understanding one’s body, all while advocating for a cultural shift in how we discuss women's health issues.
• Discussion of the lack of long-term health education regarding menopause
• Importance of understanding menopause's impact on bone health and cardiovascular risks
• Need for women to advocate for their health and educate themselves
• Emphasis on resistance training and proper nutrition to combat health decline
• Insights into the role of telemedicine in bridging healthcare gaps for women
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Medovia Menopause Podcast, your
trusted source for informationabout menopause and midlife.
Join us each episode, as wehave great conversations with
great people.
Tune in and enjoy the show.
Hi everyone, welcome to theshow.
We are thrilled to have DrKathleen Brown with us today,
(00:22):
fondly known as Dr Kat.
Dr Kat is an incredibleboard-certified OBGYN leading
the charge at Winona, a companydedicated to revolutionizing
women's health.
So welcome, dr.
Speaker 2 (00:37):
Kat, thank you.
Thank you so much for having metoday.
Speaker 1 (00:41):
Yeah, this will be a great conversation.
We're going to talk aboutmenopause, of course, but we're
going to look at it from along-term health perspective.
We're really excited to haveyou on the show talking about
this specific topic, because wefind, in the work that we do,
long-term health isn't alwaysdiscussed and it matters.
(01:02):
It's incredibly important, asyou know, as we consider health
span versus lifespan.
So with that, I'm sure thatthere's a lot of information
that we'll unpack.
Let me start by asking you, drKat, why this particular topic
is important for you.
Speaker 2 (01:21):
Well, I think you know, the main thing for me is
that.
You know, as an OBGYN I'vededicated my career to women's
health.
But this particular topic isreally important to me because I
in the last year have beenwatching the health of my own
mother decline as she gets intoher late 60s.
But I am also perimenopausalmyself and starting to navigate
(01:42):
all of this fun excitementmyself and I really feel like
many of us have been done adisservice with the lack of
education and the lack ofknowledge out there.
Like, even as a board certifiedOBGYN, I felt very, very ill
equipped to start dealing withthe symptoms as they started
creeping into my own life.
(02:04):
You know, and I think that evenwith the education, taking care
of women, my entire career, Ireally had no idea.
I mean, I really thought I wasgoing to be fine until I turned
50.
And then suddenly symptomswould start happening.
And I don't think we realize,when we're young women and we're
in the prime of our lives andthe prime of our reproductive
health, that there are so manychanges coming and so much that
(02:26):
we have to navigate.
And it's such a greattransition.
You know, it's very similar toyou know, when we go through
puberty, there's huge hormonalshifts.
I think that we need to starthaving the conversation more
about how to navigate that, howto do our best to take care of
ourselves, and I think that youknow that's.
That's why, right now, this isa commitment that I've made to
(02:48):
really making this the focus ofmy career, moving forward,
because it's not only helping mebut also my patients as I go on
as well.
Speaker 1 (02:58):
Yeah, it's so interesting a point that you
just brought up, though, whenwe're in the prime of our
reproductive years and we'rehaving children, I'm kind of
going back, you know myself, andremembering I never thought
about menopause when I was inthe midst of raising kids, right
even even when they were teens,it never occurred to me that I
(03:22):
would need to think aboutperimenopause, and I think at
least my generation, I think westill have this image of
menopause in our minds, that itis for older people right, we
still have that stereotypicalimage, and shame on us.
I mean I'm in the menopausespace and I mean I'm admitting
(03:43):
that right now.
Okay, everyone, I'm admittingthat.
Speaker 3 (03:47):
That was the image that I had.
Speaker 1 (03:50):
And Dr Kat, I've worked in the menopause sexual
reproductive health space forover a decade, but it was
menstrual health, right.
So we silo these life stagesthat we have, what these life
stages that we have, and yetit's so important for us to
think about menopause when weare in other stages of life,
(04:12):
because there are things that wecan do for preventative
measures, right.
Absolutely Long term health andand so you know, on that note,
I can think of a few things thatlong-term health risks for
individuals in post-menopause.
But can you kind of unpack thata little bit and talk about
(04:32):
some of those significantlong-term health risks, the
reason why, right?
Why do we need to?
Speaker 2 (04:37):
think about it Absolutely so.
I mean, the biggest things thatwe worry about as women age are
our strength and vitality, youknow, directly linked to bone
health and bone density.
I think many of us probablyknow of a woman in our lives at
some point in our lives thatwe've watched deteriorate and
become frail.
You know we always think aboutthe older women with the little
(05:00):
hump on their back and you knowI mean I even watched it happen
to my own grandmother that youknow, once there's a fall and
you lose that sense of balanceand the strength of your body,
women never quite get back tobaseline after significant falls
or fractures, especially ifthey get osteopenia or
osteoporosis.
So there is a significantdownward spiral if we don't
(05:23):
maintain our physical strengthand especially for our bone
health.
And so with that, I think it'sso important for us to really
find ways to move our bodiesthat maintain our strength.
Right of all or none beliefthat we need to work out
(05:46):
perfectly, have the perfectLululemon workout gear and work
out five days a week to be ableto be someone who works out.
But it doesn't need to be thatcomplicated.
We all need to find ways thatwe move our body that make us
feel good and that bring us joy,that we can incorporate into
our lifestyle the best andmaking that an important part of
our lives, like moving ourbodies regularly, especially
like one of the most underratedexercises for maintaining our
(06:06):
bone health is walking, you know, and it's something that's so
very important.
But I think in our society, andespecially when it comes to
like all the technology that'savailable and us working and
being behind computers all day,like we've gotten away from
regular movement and now we dogrocery pickup instead of
walking the aisles of thegrocery store, and there's so
(06:27):
many different things that we'vechanged about our lifestyle
that is actually contributing toour decline as we age.
So that's one aspect, is thebone health, and I think that's
so very important.
But another thing to think aboutas women is our cardiovascular
health too about, as women isour cardiovascular health too.
So, you know, as we loseestrogen and menopause and as we
age, every tissue in our bodyis affected and doesn't maintain
(06:52):
its health as well.
But I don't think women realizethat the leading killer of
women is actually cardiovasculardisease and heart attack.
I think we all worry about somuch breast cancer and we worry
about these things that arepretty rare in the grand scheme
of things, but we don't thinkabout actually what is the
leading killer of women, andit's actually heart disease.
(07:12):
So that's another reason why tobring back our health in the
prime of our focus is that weneed to focus on our nutrition,
to focus on movement.
Again, it all gets back tomoving our bodies and taking
care of ourselves to keepourselves feeling well.
But that's those are the twomain things I think about.
(07:34):
And then also another piece ofthat is our mind and body.
Right is our cognition and ourability to actually maintain our
cognition and avoid developmentof dementia and cognitive
decline as we age as well.
So you know we do that in somany ways by challenging
ourselves, by learning newthings that create brain
(07:55):
pathways.
You know there's so many thingsthat we need to do to try to
maintain that.
You know.
I think you know you think aboutpeople.
You know men and women alikethat once they retire like we
work our lives, you know ourentire lives to get to
retirement and then often atretirement, people kind of slow
down and kind of backshift alittle bit and then we watch
(08:16):
their vitality decline.
You know we need to normalizeliving well and enjoying life
and continuing to learn things.
It may not necessarily be in acareer, but we need to normalize
living well and enjoying lifeand continuing to learn things.
It may not necessarily be in acareer, but we need to keep
challenging our minds and ourbodies.
As we age, too, we have tochange that stereotype.
Speaker 1 (08:34):
Yeah, yes, I want to come to get to some of the
things that you mentionedexercise and nutrition and I
want to unpack that a little bitas well.
But before we do that, can youhelp our listeners understand
why menopause increases the riskfor these conditions?
Speaker 2 (08:57):
Yeah, absolutely so.
Basically what happens is thatas our female hormones are
declining and our ovaries are nolonger producing estrogen in
particular and adequate amounts,the benefit of the estrogen
throughout our body is startingto decline.
So our muscles no longermaintain the same strength.
Estrogen helps to maintain bonehealth as well and helps us to
(09:20):
maintain our calcium stores inour bones.
So as that estrogen level isdeclining as we age, especially
post-menopause, we start to seethe structure and the function
of all the tissues in our bodydecline.
Joints become less lubricatedless, tissues become less
elastic, less supple.
Even the blood vessels in ourbodies you know that normally
(09:41):
are pretty elastic and actuallyhave good tensile strength lose
that and lose that ability.
So the blood vessels feedingthe heart, you know, start to
change and then that canactually increase our chances of
you know, coronary arterydisease and the development of
plaques in the arteries and theblockages which can lead to
heart attack.
Also, estrogen is so veryimportant for the development of
(10:06):
neurotransmission in the braintoo.
So that's how it can reallyaffect our cognitive decline,
because you absolutely needestrogen to optimize the
development of neurotransmittersand those signals and new brain
pathways.
And in fact right now I'mreading a book that I don't know
if you've both read.
It's the menopausal brain.
Speaker 1 (10:28):
Oh, yeah, Love that book.
Lisa Dr Dr.
Yeah.
Speaker 2 (10:33):
I'm so glad there's someone like her in the world
that's doing the work that she'sdoing, because I don't think
enough focus has been placed onthis, because I think for
decades, and you know, for along time, medicine as a culture
has treated us just like aslittle versions of men, right?
So a lot of research has notincluded women over the years
(10:54):
and it's just not been on theforefront.
And she's really dedicated hercareer to studying neuroscience,
for women especially, and someof the work she's doing has been
so pivotal in our understandingof how this is so different and
why this is affecting our brainso much.
It's such a good book.
Speaker 1 (11:14):
Yeah, it's one of our favorites right, kim?
Speaker 3 (11:16):
Yeah, I always talk about it, though in the sense
that it's a scientific read.
It's not like a.
You know, you aren't going toread it at 10 o'clock at night,
right, right, it's got greatinformation in it.
You know, we were talkingearlier on about what we thought
(11:44):
would happen with menopausewhen we got to this age, right,
and I was one of those peoplewho just thought it would be
this.
Right now, this isn't somethingthat I should, I even need to
deal with.
So, thinking about all thethings that happen as you age
and what's happening with yourestrogen and sort of the process
that you just described, whatshould somebody in their
thirties and forties start doingto build a foundation for
(12:04):
better health now, so that whenthey get there, they're you know
, you know?
Speaker 2 (12:08):
feeling good.
Yeah, I mean, I think ultimatelyreally focusing on nutrition
and sleep hygiene are so veryimportant.
I think that when we're young,we underestimate, you know, how
well our bodies are going to beable to deal with those changes
as we, as we get older.
But the other thing too, isthat women need to learn their
own bodies, like women, need tobe tracking their cycles,
(12:31):
knowing and feeling comfortablein their own bodies, knowing
when symptoms creep up.
Because I think that's probablyone of the most common reasons
why women don't recognize theearly symptoms of perimenopause
is because we're so busy in ourlives and that you know there's
this glorification of being busy, especially in the US.
(12:51):
You know where it's just likeyou're going, going, going, and
as women, we're so good attaking care of everybody else.
We're not so good at focusingon ourselves and self-care.
And I think that, as thosesymptoms which are very, very
subtle in the beginning you know, like mood changes, brain fog,
some of these things start tocreep in, we tend to rationalize
and blame it on other things orwe tend to say, well, it's
(13:13):
stress or you know somethinggoing on at work.
But if you really understandyour cycle, you really
understand your own body and youknow what you are like at a
baseline and you understand yourown physiology, I think it's
going to be easier for women torecognize when things start to
change, and so I think that'sone of the most important things
(13:35):
.
I mean, I can't tell you overthe years how many women that
I've met in my career that haveabsolutely no idea what their
anatomy looks like.
You know they don't understandthat where the bladder is in
relation to the uterus, and I,over the years, have lost count
of how many women think thatthey pee out of their vagina you
(13:55):
know, it's simple things, right.
But simple things, but I thinkit it starts, you know, with the
simple education of justknowing our own anatomy and
knowing our own bodies and andhaving an understanding of how
our hormones change during ourmenstrual cycle and what is our
normal pattern because everywoman is unique, right so that
when there are changes we canrecognize those, to start to
(14:19):
know what's happening in ourbody.
I think that's so very importantand I think so much importance
and value is placed on women'sfertility, not so much their
wellbeing, right.
It's almost like that's whatwe're good in society for and
that's what so much effort andtime and, you know, information
is put into.
But then after that, afterwe're done with our fertility,
(14:42):
it's almost like we fall off atthe face of the earth.
And I can tell you as aphysician, our medical system is
not meant to promote wellness.
It is really designed to treatand diagnose disease, but it's
really not designed to helppromote wellness and wellbeing.
(15:04):
And I think that as patients,we have to take the ownership of
doing that and we have to findwhat works for us and how we can
best function in our own bodiesto really maintain our own
wellness and vitality as we getolder.
Speaker 1 (15:18):
Yeah, so hard to do our own education.
What were you going to say?
Speaker 3 (15:23):
I was going to say it's so hard for women, after
they've spent a lifetime oftaking care of everyone else
other than themselves, to evenknow what well-being means.
Right, what do they want to doto what, what?
What do they want?
What do they want to feel good,what do they need to do?
And I love the idea, like,seriously, just get to know your
body, as your body is, so thatyou can, you know, listen and
(15:43):
respond.
Speaker 1 (15:46):
I actually had a little side note.
Kim and I both are yogateachers and it's just our love
and our passion and do it.
You know, kind of on the side,for ourselves just as much as
for others, that I, you know,oftentimes, even in a yoga class
, as instructors, we say listento your body.
Right, listen to your body, butwe don't know how to do that.
(16:09):
listen to your body, but wedon't know how to do that you
know, and it was an aha moment,cause I had someone come up to
me after class several weeks agothat just said what do you mean
by that?
And I was like, wow, okay, weneed to back up Right, like even
even, uh, you know, yogis don'tknow how to listen to our
bodies.
So, yeah, I thank you forbringing that up.
(16:31):
It's the starting point, right,and even backing up further
than that, I think, the lack ofeducation in elementary school
with menstrual health education.
Oftentimes it's well, here's atampon and here's a pad and
here's your secret code word toask your teacher if you need one
of these, and you can go to thenurse and you can get one,
(16:53):
right, and it's this shamedsecret thing.
Speaker 2 (16:57):
Yes, that it'd be.
Yeah, no, it shouldn't be atall.
No, and in fact I have.
I have two sons and a daughter.
My youngest is a girl.
My sons know very well aboutwhat periods are and menstrual
health.
Um, you know, and and it's justsomething that I've talked to
them about and and my, my boyshave gotten in trouble in school
(17:18):
throughout the years because,using correct anatomical terms,
which I've had talks with theteacher, I'm like, sorry, I'm a
gynecologist, they're going tolearn appropriate anatomical
terms.
I'm not going to talk about codewords and I think slowly, like
we're changing that.
But you know, I think that weneed to think about sexual
health and menstrual health aswellness, not ashamed.
(17:41):
It goes back to those oldPuritan ways in our country
where it's like you know, menare given praise for having
conquest, but women God forbidthey talk about their body in
public.
That's right.
I mean, things have changed.
I mean, obviously 20 years agoyou didn't even see commercials
on TV for menstrual products orcondoms or anything, and now
(18:01):
that's changed a little bit.
So you know it's more and moreout there.
But but yeah, we still have alot of work to do to normalize
the discussion and theconversations.
I think we do.
Speaker 1 (18:10):
We do, and it's and it's conversations like this
that will do that.
My daughter is 21 and you knowKim has a daughter that is the
same age, and we're talkingabout menopause, like
perimenopause, like you vaginalhealth, like don't wait until
you have painful sex to takeyour vaginal estrogen, like if I
die.
Before I can tell you that, letme tell you now the book you
(18:35):
know you read advice from momsto daughters that they've
written years ago.
I'm sure that if we wrote itall over again today, that those
books are going to lookcompletely different.
Here's the advice I would giveyou yeah, we should do that.
Yeah, we should do that.
Yeah, no, absolutely.
And I, you know one of, do that.
Yeah, we should do that.
Speaker 2 (18:50):
No, absolutely, and I you know one of the things that
I I think we need to also takethe negative connotation out of
some of the words we use, likeperimenopause and menopause,
like take the pause, as apositive thing.
So for women who have gonethrough their lives focusing on
work, focusing on expectationsof others, worrying about what
(19:10):
everyone else thinks and takingcare of everyone else.
Take that pause as a positiveto bring your direction and all
your efforts back into yourself.
It's not selfish Like it's.
It's absolutely, very highlyneeded that we take great care
of ourselves, especially if wewant to age well and continue
the youth and vitality that wehave now.
(19:32):
We want to continue that intoour lives.
You know we don't want to bethe golden girls of the past.
You know you think back likelooking at that show.
The average age of the women onthat show was in their 40, late
forties, early fifties.
And I remember like lookingback at reruns now, cause I've
watched it with my daughteroccasionally Like that's what we
(19:56):
would consider 60s and 70s Now,like the way, that's right.
It's a totally different timeand women are demanding better
and want better for their lives,and that's what we need to
teach our younger women how todo.
Yeah, yeah absolutely Well.
Speaker 1 (20:09):
On that note, let's talk about let's talk about some
of the things that youmentioned.
So, lifestyle, exercise,movement, nutrition can we leave
the audience with maybe sometangible action steps that they
can take for long term health?
(20:30):
So when we, when we talk aboutlifestyle, what are some things
that they can take for long termhealth?
So when we, when we talk aboutlifestyle, what are some things
that they can do?
We talk about exercise wementioned walking, but what are
other forms of exercise thatthey can do to take care of
their bone health, for example?
And then nutrition, you know,are there some tips and tricks
that we can share with theaudience?
Speaker 2 (20:50):
Absolutely yeah, I mean as far as tips and tricks
that we can share with theaudience.
Absolutely yeah, I mean as faras lifestyle and wellness and
exercise.
I think another thing that's sovery important, which a lot of
women don't focus most of theirexercise lives on, is actually
weight bearing or resistanceexercise.
I think for so long, women havehad this fear that if they lift
weights, they are going to getbig and that they're going to
(21:11):
get bulky, and it's just nottrue.
And so when we lift weights, weactually are encouraging new
bone growth and we'restrengthening our muscles, we're
improving our posture.
I think, even when you liftweights and you get stronger, it
helps with your self-confidence, it helps with how you carry
yourself too, but it really hastremendous benefits for your
(21:32):
bone health.
And so and it doesn't have tobe something dramatic you don't
have to get a gym membership andgo for an hour every day.
You know these could be.
You know, with resistanceexercises, this could be doing
pushups against a wall, evengetting some free hand weights
to have in your house, and ifyou don't want to pay for
weights, use cans of soup orwhatever you have around the
(21:55):
house.
Or if you have young kids.
You use your kids as weights,all kinds of things, and also I
think that incorporatingmovement and exercise into our
day-to-day life makes it moretangible and easier to
incorporate into our schedule.
So, you know, maybe park alittle further from a store, you
know, rather than the frontspot.
(22:16):
If you're someone who works inan office where there's
elevators, maybe try to take acouple flights of stairs instead
of the elevators and work yourway up to being able to do four
flights of stairs or fivewithout getting winded.
These are little changes thatwe can make and these moments of
movement add up.
Often people think, well, thatwas only five minutes, it
(22:37):
doesn't count.
But I mean, if you're, I'm oneof those people that I love
wearing a Fitbit and I track mymovement and I track my sleep,
because I'm always trying to getbetter and trying to add more
moments of movement in, and so Ithink that's what we need to do
.
We need to incorporate theselittle changes into our
day-to-day lives so that theybecome lasting habits, not
(22:58):
necessarily like a diet plan ora workout plan that you're going
to put yourself in.
These have to be things that wecan do, even on bad days, even
on good days, even when we'refeeling like we don't have the
energy to do a full-blownworkout, we can still do these
little things that arebeneficial for our health.
And when it comes to nutrition,I mean, I give patients the same
(23:20):
advice that I give my kids Iwant them to eat as many colors
of the rainbow as possible, andit's many things that are fresh
and that are perishable, because, you know, the more you eat
highly processed, highly shelfstable foods, um, they stay in
your body and they, if they'regood, on the shelf for three,
four years.
And how is your body utilizingthat?
(23:42):
Um, and I've taught my kids howto read nutrition labels if
they can't pronounce it, wedon't eat it.
Also, I have one child that hasADHD, and so we're really
focused on trying to avoid a lotof chemicals and dyes and
things like that.
But I think, as adults like wereally need to take into account
you know, we are what we eat.
(24:03):
Literally Some days, if we havepoor nutrition, if you're
eating French fries and noodles,like yeah, you can feel like a
really soggy old French fry yourbody will feel that way.
I always encourage women to payattention to how they feel an
hour or two after they eat ameal, because I think that so
often we get into this habit ofeating things because it tastes
(24:24):
good and it's a comfort food orit has some kind of emotional
connection to us Like in myfamily, pasta was always a big,
big thing, and so you know,paying attention to, do you feel
like you need a nap after thatmeal or do you feel energized?
And that sometimes takes slowingdown and really focusing on how
(24:44):
we feel, only eating when we'rehungry, not necessarily because
it's a standardized mealtime.
The other thing that's reallyimportant, I think, in
perimenopause and menopause anda lot of women don't realize
this is that we need so muchmore protein than we really
think to maintain our musclestrength and our body strength
as well.
So that's something that Ithink that we need to be real
(25:06):
cognizant of is just reallytrying to make sure we get
enough protein, because, as ourbodies are aging and as we're
losing the estrogen, our musclemass is declining.
The other part of that, too, isthat we have our own endogenous
testosterone, and testosteroneis also declining because the
ovaries aren't making it inadequate amounts, and so we're
not maintaining the musclehealth and the muscle mass that
(25:26):
we had before, and in order todo that, we need to give our
bodies the building blocks tomake muscle and maintain it, and
that's protein.
How?
Speaker 1 (25:36):
much protein should we be getting in, let's say, a
postmenopausal woman?
Is there a baseline that weshould be, a goal that we should
be looking at?
Speaker 2 (25:46):
Yeah, I mean there's there's different guidelines out
there that you can find on theinternet, and each of us have
different body types, but I tendto look at what someone's
height is and based on whattheir goal is.
So, if someone is like a normalbody composition, like what we
consider to be like a mesomorphtype of body, you know, for me,
(26:07):
like I'll tell you, I'm 5'8",although I might be shrinking a
little bit, but my protein goaldaily is 120 grams of protein.
Wow, okay, because I, you know,for the goal of fat loss and
muscle maintenance, that's mygoal.
So the only way that Iconsistently hit that is the
days that I track what I'meating and I've incorporated
(26:28):
using protein shakes assupplements, protein bars as
well.
And you have to be carefulbecause a lot of the things out
there also have high amounts ofsugar as well.
So it's a it's a balancing actthat you have to make, but
there's so much more availablenow with, like the high protein
Greek yogurts and things intoour diet.
But, yeah, 120 grams is a lotof protein.
Speaker 1 (26:51):
It's hard.
Yeah, we've been focusing onprotein and you're like holy
guacamole, like I am not at myprotein goal and I feel like I
ate a lot of protein today, soit takes a little bit of
forethought.
I think what can I throw in therefrigerator that's easy to
grab, that instead of openingthe pantry?
(27:14):
Right, it has to be there, orI'm going to open the pantry.
So, yeah, it takes a whole dayor whatever.
Speaker 2 (27:21):
And you know, you have to have the mindset that
you are worth it, that that timeand those hours and meal
planning and grocery shoppingand having healthy foods is for
your health, it's for yourbenefit, it's it's for your,
your future.
I mean, a lot of times we thinkthat it's just one more thing
to add to our to-do list, andthen, but if you know that if
(27:42):
you're eating things out ofconvenience and you're not
preparing foods at home as well,you're not going to eat as well
, like you're going to reach forthings that are not as good for
you and there's no bad foods.
Everything is okay inmoderation.
But I just tell my kids as manygreen things as you can, as
many colors as a rainbow, youknow, and generally, if you shop
the periphery of the grocerystore, you know where things are
(28:05):
perishable and go bad and tryto eat more of that in your diet
than the processed foods, thenyou're in a good place.
But focusing on getting fiber isanother thing too.
Especially as you're trying toget the protein in, it can be
really easy to get constipatedif you don't write that.
With enough fiber, you know foryour colon health as well.
Right, and drinking lots ofwater.
(28:25):
I don't think any of us drinkenough.
Yeah, so many things that wecan do to optimize our wellness.
Speaker 3 (28:32):
I like that you talk about.
You know you have to track itit.
I know that when I'mconcentrating on protein which
is every day I do so much betterwhen I'm tracking it, when I
measure it and track it and eventhough it takes an extra 30
seconds, I can know at the endof the day oh my gosh, I better
have my protein shake because Ididn't get enough.
(28:52):
And right, you can't justremember it through your head.
It's easier for me to justtrack it before I even eat it to
be able to go like oh gosh, Ineed another three ounces of
chicken today by the time I getto dinner.
So I really appreciate thatreminder.
We could probably talk to youfor hours.
I know I love this conversation.
(29:15):
I love the conversations, but wedidn't get a chance to talk
about who you are and whereyou're from.
We want our listeners to know alittle bit about my Winona and
how you got there and sort ofwhere they can find you.
Speaker 2 (29:29):
Sure, sure.
So I'm from the Philadelphiaarea, did all my college in
Pennsylvania and medical school,but then was on an Army
scholarship, so I traveledaround the country working at
Army hospitals for most of mycareer.
I did 12 years in the Army andthen, when I got out, moved back
to the Philadelphia area andwas working as a traditional
(29:50):
OBGYN until I was approached byour chief medical officer at
Winona who basically told meabout the platform.
We started in California, thenexpanded to Texas and when they
were looking to expand toPennsylvania, they contacted me
because they needed a doctor inPennsylvania, so started working
with them in December of 2021.
We were born during COVID, whenaccess to care really became
(30:12):
pitiful and so many patients outthere were not getting the care
that they needed.
And we found the founders ofthe company really found that
women's health was really areally underserved population,
especially when it came totelemedicine, and you know so
many companies have realizedthat telemedicine is such a
feasible option to help bridgethe gap for care.
(30:33):
You know we've used it now forbirth control, for, you know,
visits that don't really requirean exam, like maybe
preconceptual counseling orfertility counseling, things
like that.
But perimenopause and menopauseis also something that is
really.
It's helped bridge the gap.
So we don't really replace yourin-person OBGYN you still need
(30:54):
to have an annual visit, youstill need to have a breast exam
, mammogram and if you stillhave a uterus, you still need to
have pap smears.
But we helped to bridge thatgap.
We started out in those threestates, you know, back in 2021.
And now I think we're in 34states.
Every state has their owntelemedicine laws.
That's why we're slowly adding,but we are.
We are a site where women whomaybe have no other option for
(31:17):
maybe getting hormonereplacement therapy from an
in-person provider can come torequest treatment.
We offer hormone replacementtherapy in several different
forms.
We have mostly topical forms,like creams and patches, but
also oral as well.
Well, and so that's somethingthat you know.
(31:38):
We're committed to being ableto make treatment available to
women that are low risk, thatcould use treatment and maybe
have been told no, or maybethey've had a provider who just
wasn't willing to have theconversation in the past.
The other thing, too on ourwebsite at winonacom, you can
find a lot of education andmaterials.
We have a medical journal, partof our website, and some free
resources, too, that likesymptom trackers.
(31:58):
If you're not quite sure whereyou fit on this spectrum and
you're not really quite sure,like if what you're feeling is
perimenopause or is it somethingelse, there's resources that
you can do on our website tokind of figure that out and it
can help you with that.
But it's it's a fairly easyprocess.
If women decide that they wantto pursue treatment with us,
they go through an onlinemedical history questionnaire.
(32:20):
We don't ask every single thingabout your medical history.
We don't need to know that youbroke your leg at age five Like
it's all women's health focusedso that we can really know if
you're a safe candidate fortreatment or not and if
everything goes through yourchart.
Once you complete thatonboarding, it's forwarded to a
doctor in your state for reviewand then we might get back to
(32:41):
you to try to clarify some ofthe questions in your medical
history.
But ultimately we come up witha treatment plan and some of my
patients come knowing that theywant the body cream, they want
to get started, and some womendon't really know what form is
best for them.
So we have a littleconversation back and forth.
It's all asynchronous, meaningthat the patients message us
into the portal, we message back.
You don't require a live videovisit or phone call, and so it's
(33:06):
nice because the patients canmessage us 24 seven and the
doctors get back to them within24 hours.
So but it's a it's a nice wayto add junk to your in person
care, especially if you wanttreatment and you don't have the
option for getting treatmentthrough your traditional doctor
or provider.
Speaker 1 (33:22):
So I love that you're filling that gap.
Yeah, there's definitely a gapand you know we've we've talked
to individuals who have, who mayhave been dismissed by other
doctors who want hormone therapy, and you're filling that need
as well.
So thank you so much for whatyou do.
I'd like to get to know you alittle bit better.
(33:45):
On a personal note we always endwith a rapid fire, and so we
have some fun questions for you.
If we can start our rapid fire,we'd love.
Yeah, let's do it Right.
Right, let's just.
Let's start with what yourfavorite way to unwind is.
Speaker 2 (34:02):
Oh, my favorite way to unwind is to be outside in
nature.
Obviously it's harder in thewinter.
I have a new found love ofgardening that blossomed during
COVID when I was stuck at homein between my hospital shifts
and no matter what, like I'velost count of how many babies
I've delivered and how manysurgeries I've done.
(34:22):
But I'm so proud of my tomatoesand my basil and I have plants
propagating and most of mywindows in my house.
You know my, my kids and myhusband think I'm a little
obsessed, but I, I, I love it,no matter what.
Like getting my hands in thedirt just helps to relax me and
helps me unwind.
Speaker 3 (34:41):
Love that.
Okay coffee or tea, and we arein Seattle.
Just keep that in mind.
Speaker 1 (34:47):
There's no wrong answer, Dr.
Speaker 2 (34:48):
Kat no, no wrong answer no, I actually like both,
so I'm a coffee in the morningkind of person, but in the later
part of the day I like a goodafternoon tea.
My father's actually fromEngland and so I have a love of
like British tea, but I love agood latte or especially a good
mocha every once in a while too.
Speaker 1 (35:10):
Yeah, especially this time of year, a really good one
is just fantastic.
Speaker 2 (35:14):
I'm definitely a coffee drinker.
Like I need flavoring in mycoffee though, oh okay okay, I'm
a, I'm a.
Speaker 1 (35:21):
Um, don't put anything in my coffee.
Give me the vodka so I cantaste it.
No, I don't drink.
I was gonna say, yeah, Iactually don't drink a lot of
vodka, but, um, okay, this isabout you.
One last question city orcountry?
Speaker 2 (35:41):
It's so hard.
I love being in the city forthe proximity to everything and
for the arts and culture, but II like the suburbs where I live.
I'm just a quick train rideaway to going into downtown
Philly and taking my kids intothe city to explore, but I
prefer to live outside the city.
I'd love to go to the city toexplore, but live outside.
Speaker 3 (36:05):
I like that you can have both, yes.
So our last question that weask everyone what's the best
piece of advice you've everreceived or given best piece of
advice you've ever received orgiven.
Speaker 2 (36:23):
I think the best advice is to expand your
knowledge about yourself.
I mean, I think that probably Ineed to take my own advice more
when I tell women, I tell mypatients to focus on self-care.
I need to practice that morethan I preach, for sure.
But knowledge is power andthat's one of the tenets of my
career that I have tried to pushto my patients as much as
possible, like I want them tolearn about their bodies and to
(36:45):
learn about their anatomy and tolearn as much about themselves,
because I tell them like I'mwith them for 10, 15 minutes,
but they're with their body allthe time, every day.
They know it best if they learnit, and so I think that's
that's the most important thingI can push you know out there to
your, to your audiences.
Learn as much as you can aboutyour body and about your health
(37:05):
and take control of your ownhealth.
I think it's so very important.
That's great.
Speaker 1 (37:09):
I love that yeah, agency Love it Right, great
advice.
Speaker 3 (37:14):
Great pleasure to meet.
Have you on the show today, drKat.
I do an amazing work and thankyou for all that you're doing to
spread the word in this space.
We're honored to have you heretoday.
Speaker 2 (37:25):
Thank you so much for having me.
I love chatting with you guys.
We could do it for hours.
I know We'll have you on againand we'll talk about something
else.
Yeah, sounds good, I lovehaving you.
Speaker 3 (37:33):
Sounds like a plan.
Speaker 1 (37:41):
So I echo what Kim said Thanks so much for what you
do and audience.
That is a wrap.
Until we meet again.
Go find joy in the journey.
Speaker 3 (37:44):
Bye everyone.
Speaker 1 (37:46):
Thank you for listening to the Medovia
menopause podcast.
If you enjoyed today's show,please give it a thumbs up.
Subscribe for future episodes,leave a review and share this
episode with a friend.
Subscribe for future episodes,leave a review and share this
episode with a friend.
Medovia is out to change thenarrative.
Learn more at Medoviacom.
(38:06):
That's M-I-D-O-V-I-A dot com.
Welcome to the Medovia Menopause Podcast, your
trusted source for informationabout menopause and midlife.
Join us each episode, as wehave great conversations with
great people.
Tune in and enjoy the show.
Hi everyone, welcome to theshow.
We are thrilled to have DrKathleen Brown with us today,
(00:22):
fondly known as Dr Kat.
Dr Kat is an incredibleboard-certified OBGYN leading
the charge at Winona, a companydedicated to revolutionizing
women's health.
So welcome, dr.
Speaker 2 (00:37):
Kat, thank you.
Thank you so much for having metoday.
Speaker 1 (00:41):
Yeah, this will be a great conversation.
We're going to talk aboutmenopause, of course, but we're
going to look at it from along-term health perspective.
We're really excited to haveyou on the show talking about
this specific topic, because wefind, in the work that we do,
long-term health isn't alwaysdiscussed and it matters.
(01:02):
It's incredibly important, asyou know, as we consider health
span versus lifespan.
So with that, I'm sure thatthere's a lot of information
that we'll unpack.
Let me start by asking you, drKat, why this particular topic
is important for you.
Speaker 2 (01:21):
Well, I think you know, the main thing for me is
that.
You know, as an OBGYN I'vededicated my career to women's
health.
But this particular topic isreally important to me because I
in the last year have beenwatching the health of my own
mother decline as she gets intoher late 60s.
But I am also perimenopausalmyself and starting to navigate
(01:42):
all of this fun excitementmyself and I really feel like
many of us have been done adisservice with the lack of
education and the lack ofknowledge out there.
Like, even as a board certifiedOBGYN, I felt very, very ill
equipped to start dealing withthe symptoms as they started
creeping into my own life.
(02:04):
You know, and I think that evenwith the education, taking care
of women, my entire career, Ireally had no idea.
I mean, I really thought I wasgoing to be fine until I turned
50.
And then suddenly symptomswould start happening.
And I don't think we realize,when we're young women and we're
in the prime of our lives andthe prime of our reproductive
health, that there are so manychanges coming and so much that
(02:26):
we have to navigate.
And it's such a greattransition.
You know, it's very similar toyou know, when we go through
puberty, there's huge hormonalshifts.
I think that we need to starthaving the conversation more
about how to navigate that, howto do our best to take care of
ourselves, and I think that youknow that's.
That's why, right now, this isa commitment that I've made to
(02:48):
really making this the focus ofmy career, moving forward,
because it's not only helping mebut also my patients as I go on
as well.
Speaker 1 (02:58):
Yeah, it's so interesting a point that you
just brought up, though, whenwe're in the prime of our
reproductive years and we'rehaving children, I'm kind of
going back, you know myself, andremembering I never thought
about menopause when I was inthe midst of raising kids, right
even even when they were teens,it never occurred to me that I
(03:22):
would need to think aboutperimenopause, and I think at
least my generation, I think westill have this image of
menopause in our minds, that itis for older people right, we
still have that stereotypicalimage, and shame on us.
I mean I'm in the menopausespace and I mean I'm admitting
(03:43):
that right now.
Okay, everyone, I'm admittingthat.
Speaker 3 (03:47):
That was the image that I had.
Speaker 1 (03:50):
And Dr Kat, I've worked in the menopause sexual
reproductive health space forover a decade, but it was
menstrual health, right.
So we silo these life stagesthat we have, what these life
stages that we have, and yetit's so important for us to
think about menopause when weare in other stages of life,
(04:12):
because there are things that wecan do for preventative
measures, right.
Absolutely Long term health andand so you know, on that note,
I can think of a few things thatlong-term health risks for
individuals in post-menopause.
But can you kind of unpack thata little bit and talk about
(04:32):
some of those significantlong-term health risks, the
reason why, right?
Why do we need to?
Speaker 2 (04:37):
think about it Absolutely so.
I mean, the biggest things thatwe worry about as women age are
our strength and vitality, youknow, directly linked to bone
health and bone density.
I think many of us probablyknow of a woman in our lives at
some point in our lives thatwe've watched deteriorate and
become frail.
You know we always think aboutthe older women with the little
(05:00):
hump on their back and you knowI mean I even watched it happen
to my own grandmother that youknow, once there's a fall and
you lose that sense of balanceand the strength of your body,
women never quite get back tobaseline after significant falls
or fractures, especially ifthey get osteopenia or
osteoporosis.
So there is a significantdownward spiral if we don't
(05:23):
maintain our physical strengthand especially for our bone
health.
And so with that, I think it'sso important for us to really
find ways to move our bodiesthat maintain our strength.
Right of all or none beliefthat we need to work out
(05:46):
perfectly, have the perfectLululemon workout gear and work
out five days a week to be ableto be someone who works out.
But it doesn't need to be thatcomplicated.
We all need to find ways thatwe move our body that make us
feel good and that bring us joy,that we can incorporate into
our lifestyle the best andmaking that an important part of
our lives, like moving ourbodies regularly, especially
like one of the most underratedexercises for maintaining our
(06:06):
bone health is walking, you know, and it's something that's so
very important.
But I think in our society, andespecially when it comes to
like all the technology that'savailable and us working and
being behind computers all day,like we've gotten away from
regular movement and now we dogrocery pickup instead of
walking the aisles of thegrocery store, and there's so
(06:27):
many different things that we'vechanged about our lifestyle
that is actually contributing toour decline as we age.
So that's one aspect, is thebone health, and I think that's
so very important.
But another thing to think aboutas women is our cardiovascular
health too about, as women isour cardiovascular health too.
So, you know, as we loseestrogen and menopause and as we
age, every tissue in our bodyis affected and doesn't maintain
(06:52):
its health as well.
But I don't think women realizethat the leading killer of
women is actually cardiovasculardisease and heart attack.
I think we all worry about somuch breast cancer and we worry
about these things that arepretty rare in the grand scheme
of things, but we don't thinkabout actually what is the
leading killer of women, andit's actually heart disease.
(07:12):
So that's another reason why tobring back our health in the
prime of our focus is that weneed to focus on our nutrition,
to focus on movement.
Again, it all gets back tomoving our bodies and taking
care of ourselves to keepourselves feeling well.
But that's those are the twomain things I think about.
(07:34):
And then also another piece ofthat is our mind and body.
Right is our cognition and ourability to actually maintain our
cognition and avoid developmentof dementia and cognitive
decline as we age as well.
So you know we do that in somany ways by challenging
ourselves, by learning newthings that create brain
(07:55):
pathways.
You know there's so many thingsthat we need to do to try to
maintain that.
You know.
I think you know you think aboutpeople.
You know men and women alikethat once they retire like we
work our lives, you know ourentire lives to get to
retirement and then often atretirement, people kind of slow
down and kind of backshift alittle bit and then we watch
(08:16):
their vitality decline.
You know we need to normalizeliving well and enjoying life
and continuing to learn things.
It may not necessarily be in acareer, but we need to normalize
living well and enjoying lifeand continuing to learn things.
It may not necessarily be in acareer, but we need to keep
challenging our minds and ourbodies.
As we age, too, we have tochange that stereotype.
Speaker 1 (08:34):
Yeah, yes, I want to come to get to some of the
things that you mentionedexercise and nutrition and I
want to unpack that a little bitas well.
But before we do that, can youhelp our listeners understand
why menopause increases the riskfor these conditions?
Speaker 2 (08:57):
Yeah, absolutely so.
Basically what happens is thatas our female hormones are
declining and our ovaries are nolonger producing estrogen in
particular and adequate amounts,the benefit of the estrogen
throughout our body is startingto decline.
So our muscles no longermaintain the same strength.
Estrogen helps to maintain bonehealth as well and helps us to
(09:20):
maintain our calcium stores inour bones.
So as that estrogen level isdeclining as we age, especially
post-menopause, we start to seethe structure and the function
of all the tissues in our bodydecline.
Joints become less lubricatedless, tissues become less
elastic, less supple.
Even the blood vessels in ourbodies you know that normally
(09:41):
are pretty elastic and actuallyhave good tensile strength lose
that and lose that ability.
So the blood vessels feedingthe heart, you know, start to
change and then that canactually increase our chances of
you know, coronary arterydisease and the development of
plaques in the arteries and theblockages which can lead to
heart attack.
Also, estrogen is so veryimportant for the development of
(10:06):
neurotransmission in the braintoo.
So that's how it can reallyaffect our cognitive decline,
because you absolutely needestrogen to optimize the
development of neurotransmittersand those signals and new brain
pathways.
And in fact right now I'mreading a book that I don't know
if you've both read.
It's the menopausal brain.
Speaker 1 (10:28):
Oh, yeah, Love that book.
Lisa Dr Dr.
Yeah.
Speaker 2 (10:33):
I'm so glad there's someone like her in the world
that's doing the work that she'sdoing, because I don't think
enough focus has been placed onthis, because I think for
decades, and you know, for along time, medicine as a culture
has treated us just like aslittle versions of men, right?
So a lot of research has notincluded women over the years
(10:54):
and it's just not been on theforefront.
And she's really dedicated hercareer to studying neuroscience,
for women especially, and someof the work she's doing has been
so pivotal in our understandingof how this is so different and
why this is affecting our brainso much.
It's such a good book.
Speaker 1 (11:14):
Yeah, it's one of our favorites right, kim?
Speaker 3 (11:16):
Yeah, I always talk about it, though in the sense
that it's a scientific read.
It's not like a.
You know, you aren't going toread it at 10 o'clock at night,
right, right, it's got greatinformation in it.
You know, we were talkingearlier on about what we thought
(11:44):
would happen with menopausewhen we got to this age, right,
and I was one of those peoplewho just thought it would be
this.
Right now, this isn't somethingthat I should, I even need to
deal with.
So, thinking about all thethings that happen as you age
and what's happening with yourestrogen and sort of the process
that you just described, whatshould somebody in their
thirties and forties start doingto build a foundation for
(12:04):
better health now, so that whenthey get there, they're you know
, you know?
Speaker 2 (12:08):
feeling good.
Yeah, I mean, I think ultimatelyreally focusing on nutrition
and sleep hygiene are so veryimportant.
I think that when we're young,we underestimate, you know, how
well our bodies are going to beable to deal with those changes
as we, as we get older.
But the other thing too, isthat women need to learn their
own bodies, like women, need tobe tracking their cycles,
(12:31):
knowing and feeling comfortablein their own bodies, knowing
when symptoms creep up.
Because I think that's probablyone of the most common reasons
why women don't recognize theearly symptoms of perimenopause
is because we're so busy in ourlives and that you know there's
this glorification of being busy, especially in the US.
(12:51):
You know where it's just likeyou're going, going, going, and
as women, we're so good attaking care of everybody else.
We're not so good at focusingon ourselves and self-care.
And I think that, as thosesymptoms which are very, very
subtle in the beginning you know, like mood changes, brain fog,
some of these things start tocreep in, we tend to rationalize
and blame it on other things orwe tend to say, well, it's
(13:13):
stress or you know somethinggoing on at work.
But if you really understandyour cycle, you really
understand your own body and youknow what you are like at a
baseline and you understand yourown physiology, I think it's
going to be easier for women torecognize when things start to
change, and so I think that'sone of the most important things
(13:35):
.
I mean, I can't tell you overthe years how many women that
I've met in my career that haveabsolutely no idea what their
anatomy looks like.
You know they don't understandthat where the bladder is in
relation to the uterus, and I,over the years, have lost count
of how many women think thatthey pee out of their vagina you
(13:55):
know, it's simple things, right.
But simple things, but I thinkit it starts, you know, with the
simple education of justknowing our own anatomy and
knowing our own bodies and andhaving an understanding of how
our hormones change during ourmenstrual cycle and what is our
normal pattern because everywoman is unique, right so that
when there are changes we canrecognize those, to start to
(14:19):
know what's happening in ourbody.
I think that's so very importantand I think so much importance
and value is placed on women'sfertility, not so much their
wellbeing, right.
It's almost like that's whatwe're good in society for and
that's what so much effort andtime and, you know, information
is put into.
But then after that, afterwe're done with our fertility,
(14:42):
it's almost like we fall off atthe face of the earth.
And I can tell you as aphysician, our medical system is
not meant to promote wellness.
It is really designed to treatand diagnose disease, but it's
really not designed to helppromote wellness and wellbeing.
(15:04):
And I think that as patients,we have to take the ownership of
doing that and we have to findwhat works for us and how we can
best function in our own bodiesto really maintain our own
wellness and vitality as we getolder.
Speaker 1 (15:18):
Yeah, so hard to do our own education.
What were you going to say?
Speaker 3 (15:23):
I was going to say it's so hard for women, after
they've spent a lifetime oftaking care of everyone else
other than themselves, to evenknow what well-being means.
Right, what do they want to doto what, what?
What do they want?
What do they want to feel good,what do they need to do?
And I love the idea, like,seriously, just get to know your
body, as your body is, so thatyou can, you know, listen and
(15:43):
respond.
Speaker 1 (15:46):
I actually had a little side note.
Kim and I both are yogateachers and it's just our love
and our passion and do it.
You know, kind of on the side,for ourselves just as much as
for others, that I, you know,oftentimes, even in a yoga class
, as instructors, we say listento your body.
Right, listen to your body, butwe don't know how to do that.
(16:09):
listen to your body, but wedon't know how to do that you
know, and it was an aha moment,cause I had someone come up to
me after class several weeks agothat just said what do you mean
by that?
And I was like, wow, okay, weneed to back up Right, like even
even, uh, you know, yogis don'tknow how to listen to our
bodies.
So, yeah, I thank you forbringing that up.
(16:31):
It's the starting point, right,and even backing up further
than that, I think, the lack ofeducation in elementary school
with menstrual health education.
Oftentimes it's well, here's atampon and here's a pad and
here's your secret code word toask your teacher if you need one
of these, and you can go to thenurse and you can get one,
(16:53):
right, and it's this shamedsecret thing.
Speaker 2 (16:57):
Yes, that it'd be.
Yeah, no, it shouldn't be atall.
No, and in fact I have.
I have two sons and a daughter.
My youngest is a girl.
My sons know very well aboutwhat periods are and menstrual
health.
Um, you know, and and it's justsomething that I've talked to
them about and and my, my boyshave gotten in trouble in school
(17:18):
throughout the years because,using correct anatomical terms,
which I've had talks with theteacher, I'm like, sorry, I'm a
gynecologist, they're going tolearn appropriate anatomical
terms.
I'm not going to talk about codewords and I think slowly, like
we're changing that.
But you know, I think that weneed to think about sexual
health and menstrual health aswellness, not ashamed.
(17:41):
It goes back to those oldPuritan ways in our country
where it's like you know, menare given praise for having
conquest, but women God forbidthey talk about their body in
public.
That's right.
I mean, things have changed.
I mean, obviously 20 years agoyou didn't even see commercials
on TV for menstrual products orcondoms or anything, and now
(18:01):
that's changed a little bit.
So you know it's more and moreout there.
But but yeah, we still have alot of work to do to normalize
the discussion and theconversations.
I think we do.
Speaker 1 (18:10):
We do, and it's and it's conversations like this
that will do that.
My daughter is 21 and you knowKim has a daughter that is the
same age, and we're talkingabout menopause, like
perimenopause, like you vaginalhealth, like don't wait until
you have painful sex to takeyour vaginal estrogen, like if I
die.
Before I can tell you that, letme tell you now the book you
(18:35):
know you read advice from momsto daughters that they've
written years ago.
I'm sure that if we wrote itall over again today, that those
books are going to lookcompletely different.
Here's the advice I would giveyou yeah, we should do that.
Yeah, we should do that.
Yeah, no, absolutely.
And I, you know one of, do that.
Yeah, we should do that.
Speaker 2 (18:50):
No, absolutely, and I you know one of the things that
I I think we need to also takethe negative connotation out of
some of the words we use, likeperimenopause and menopause,
like take the pause, as apositive thing.
So for women who have gonethrough their lives focusing on
work, focusing on expectationsof others, worrying about what
(19:10):
everyone else thinks and takingcare of everyone else.
Take that pause as a positiveto bring your direction and all
your efforts back into yourself.
It's not selfish Like it's.
It's absolutely, very highlyneeded that we take great care
of ourselves, especially if wewant to age well and continue
the youth and vitality that wehave now.
(19:32):
We want to continue that intoour lives.
You know we don't want to bethe golden girls of the past.
You know you think back likelooking at that show.
The average age of the women onthat show was in their 40, late
forties, early fifties.
And I remember like lookingback at reruns now, cause I've
watched it with my daughteroccasionally Like that's what we
(19:56):
would consider 60s and 70s Now,like the way, that's right.
It's a totally different timeand women are demanding better
and want better for their lives,and that's what we need to
teach our younger women how todo.
Yeah, yeah absolutely Well.
Speaker 1 (20:09):
On that note, let's talk about let's talk about some
of the things that youmentioned.
So, lifestyle, exercise,movement, nutrition can we leave
the audience with maybe sometangible action steps that they
can take for long term health?
(20:30):
So when we, when we talk aboutlifestyle, what are some things
that they can take for long termhealth?
So when we, when we talk aboutlifestyle, what are some things
that they can do?
We talk about exercise wementioned walking, but what are
other forms of exercise thatthey can do to take care of
their bone health, for example?
And then nutrition, you know,are there some tips and tricks
that we can share with theaudience?
Speaker 2 (20:50):
Absolutely yeah, I mean as far as tips and tricks
that we can share with theaudience.
Absolutely yeah, I mean as faras lifestyle and wellness and
exercise.
I think another thing that's sovery important, which a lot of
women don't focus most of theirexercise lives on, is actually
weight bearing or resistanceexercise.
I think for so long, women havehad this fear that if they lift
weights, they are going to getbig and that they're going to
(21:11):
get bulky, and it's just nottrue.
And so when we lift weights, weactually are encouraging new
bone growth and we'restrengthening our muscles, we're
improving our posture.
I think, even when you liftweights and you get stronger, it
helps with your self-confidence, it helps with how you carry
yourself too, but it really hastremendous benefits for your
(21:32):
bone health.
And so and it doesn't have tobe something dramatic you don't
have to get a gym membership andgo for an hour every day.
You know these could be.
You know, with resistanceexercises, this could be doing
pushups against a wall, evengetting some free hand weights
to have in your house, and ifyou don't want to pay for
weights, use cans of soup orwhatever you have around the
(21:55):
house.
Or if you have young kids.
You use your kids as weights,all kinds of things, and also I
think that incorporatingmovement and exercise into our
day-to-day life makes it moretangible and easier to
incorporate into our schedule.
So, you know, maybe park alittle further from a store, you
know, rather than the frontspot.
(22:16):
If you're someone who works inan office where there's
elevators, maybe try to take acouple flights of stairs instead
of the elevators and work yourway up to being able to do four
flights of stairs or fivewithout getting winded.
These are little changes thatwe can make and these moments of
movement add up.
Often people think, well, thatwas only five minutes, it
(22:37):
doesn't count.
But I mean, if you're, I'm oneof those people that I love
wearing a Fitbit and I track mymovement and I track my sleep,
because I'm always trying to getbetter and trying to add more
moments of movement in, and so Ithink that's what we need to do
.
We need to incorporate theselittle changes into our
day-to-day lives so that theybecome lasting habits, not
(22:58):
necessarily like a diet plan ora workout plan that you're going
to put yourself in.
These have to be things that wecan do, even on bad days, even
on good days, even when we'refeeling like we don't have the
energy to do a full-blownworkout, we can still do these
little things that arebeneficial for our health.
And when it comes to nutrition,I mean, I give patients the same
(23:20):
advice that I give my kids Iwant them to eat as many colors
of the rainbow as possible, andit's many things that are fresh
and that are perishable, because, you know, the more you eat
highly processed, highly shelfstable foods, um, they stay in
your body and they, if they'regood, on the shelf for three,
four years.
And how is your body utilizingthat?
(23:42):
Um, and I've taught my kids howto read nutrition labels if
they can't pronounce it, wedon't eat it.
Also, I have one child that hasADHD, and so we're really
focused on trying to avoid a lotof chemicals and dyes and
things like that.
But I think, as adults like wereally need to take into account
you know, we are what we eat.
(24:03):
Literally Some days, if we havepoor nutrition, if you're
eating French fries and noodles,like yeah, you can feel like a
really soggy old French fry yourbody will feel that way.
I always encourage women to payattention to how they feel an
hour or two after they eat ameal, because I think that so
often we get into this habit ofeating things because it tastes
(24:24):
good and it's a comfort food orit has some kind of emotional
connection to us Like in myfamily, pasta was always a big,
big thing, and so you know,paying attention to, do you feel
like you need a nap after thatmeal or do you feel energized?
And that sometimes takes slowingdown and really focusing on how
(24:44):
we feel, only eating when we'rehungry, not necessarily because
it's a standardized mealtime.
The other thing that's reallyimportant, I think, in
perimenopause and menopause anda lot of women don't realize
this is that we need so muchmore protein than we really
think to maintain our musclestrength and our body strength
as well.
So that's something that Ithink that we need to be real
(25:06):
cognizant of is just reallytrying to make sure we get
enough protein, because, as ourbodies are aging and as we're
losing the estrogen, our musclemass is declining.
The other part of that, too, isthat we have our own endogenous
testosterone, and testosteroneis also declining because the
ovaries aren't making it inadequate amounts, and so we're
not maintaining the musclehealth and the muscle mass that
(25:26):
we had before, and in order todo that, we need to give our
bodies the building blocks tomake muscle and maintain it, and
that's protein.
How?
Speaker 1 (25:36):
much protein should we be getting in, let's say, a
postmenopausal woman?
Is there a baseline that weshould be, a goal that we should
be looking at?
Speaker 2 (25:46):
Yeah, I mean there's there's different guidelines out
there that you can find on theinternet, and each of us have
different body types, but I tendto look at what someone's
height is and based on whattheir goal is.
So, if someone is like a normalbody composition, like what we
consider to be like a mesomorphtype of body, you know, for me,
(26:07):
like I'll tell you, I'm 5'8",although I might be shrinking a
little bit, but my protein goaldaily is 120 grams of protein.
Wow, okay, because I, you know,for the goal of fat loss and
muscle maintenance, that's mygoal.
So the only way that Iconsistently hit that is the
days that I track what I'meating and I've incorporated
(26:28):
using protein shakes assupplements, protein bars as
well.
And you have to be carefulbecause a lot of the things out
there also have high amounts ofsugar as well.
So it's a it's a balancing actthat you have to make, but
there's so much more availablenow with, like the high protein
Greek yogurts and things intoour diet.
But, yeah, 120 grams is a lotof protein.
Speaker 1 (26:51):
It's hard.
Yeah, we've been focusing onprotein and you're like holy
guacamole, like I am not at myprotein goal and I feel like I
ate a lot of protein today, soit takes a little bit of
forethought.
I think what can I throw in therefrigerator that's easy to
grab, that instead of openingthe pantry?
(27:14):
Right, it has to be there, orI'm going to open the pantry.
So, yeah, it takes a whole dayor whatever.
Speaker 2 (27:21):
And you know, you have to have the mindset that
you are worth it, that that timeand those hours and meal
planning and grocery shoppingand having healthy foods is for
your health, it's for yourbenefit, it's it's for your,
your future.
I mean, a lot of times we thinkthat it's just one more thing
to add to our to-do list, andthen, but if you know that if
(27:42):
you're eating things out ofconvenience and you're not
preparing foods at home as well,you're not going to eat as well
, like you're going to reach forthings that are not as good for
you and there's no bad foods.
Everything is okay inmoderation.
But I just tell my kids as manygreen things as you can, as
many colors as a rainbow, youknow, and generally, if you shop
the periphery of the grocerystore, you know where things are
(28:05):
perishable and go bad and tryto eat more of that in your diet
than the processed foods, thenyou're in a good place.
But focusing on getting fiber isanother thing too.
Especially as you're trying toget the protein in, it can be
really easy to get constipatedif you don't write that.
With enough fiber, you know foryour colon health as well.
Right, and drinking lots ofwater.
(28:25):
I don't think any of us drinkenough.
Yeah, so many things that wecan do to optimize our wellness.
Speaker 3 (28:32):
I like that you talk about.
You know you have to track itit.
I know that when I'mconcentrating on protein which
is every day I do so much betterwhen I'm tracking it, when I
measure it and track it and eventhough it takes an extra 30
seconds, I can know at the endof the day oh my gosh, I better
have my protein shake because Ididn't get enough.
(28:52):
And right, you can't justremember it through your head.
It's easier for me to justtrack it before I even eat it to
be able to go like oh gosh, Ineed another three ounces of
chicken today by the time I getto dinner.
So I really appreciate thatreminder.
We could probably talk to youfor hours.
I know I love this conversation.
(29:15):
I love the conversations, but wedidn't get a chance to talk
about who you are and whereyou're from.
We want our listeners to know alittle bit about my Winona and
how you got there and sort ofwhere they can find you.
Speaker 2 (29:29):
Sure, sure.
So I'm from the Philadelphiaarea, did all my college in
Pennsylvania and medical school,but then was on an Army
scholarship, so I traveledaround the country working at
Army hospitals for most of mycareer.
I did 12 years in the Army andthen, when I got out, moved back
to the Philadelphia area andwas working as a traditional
(29:50):
OBGYN until I was approached byour chief medical officer at
Winona who basically told meabout the platform.
We started in California, thenexpanded to Texas and when they
were looking to expand toPennsylvania, they contacted me
because they needed a doctor inPennsylvania, so started working
with them in December of 2021.
We were born during COVID, whenaccess to care really became
(30:12):
pitiful and so many patients outthere were not getting the care
that they needed.
And we found the founders ofthe company really found that
women's health was really areally underserved population,
especially when it came totelemedicine, and you know so
many companies have realizedthat telemedicine is such a
feasible option to help bridgethe gap for care.
(30:33):
You know we've used it now forbirth control, for, you know,
visits that don't really requirean exam, like maybe
preconceptual counseling orfertility counseling, things
like that.
But perimenopause and menopauseis also something that is
really.
It's helped bridge the gap.
So we don't really replace yourin-person OBGYN you still need
(30:54):
to have an annual visit, youstill need to have a breast exam
, mammogram and if you stillhave a uterus, you still need to
have pap smears.
But we helped to bridge thatgap.
We started out in those threestates, you know, back in 2021.
And now I think we're in 34states.
Every state has their owntelemedicine laws.
That's why we're slowly adding,but we are.
We are a site where women whomaybe have no other option for
(31:17):
maybe getting hormonereplacement therapy from an
in-person provider can come torequest treatment.
We offer hormone replacementtherapy in several different
forms.
We have mostly topical forms,like creams and patches, but
also oral as well.
Well, and so that's somethingthat you know.
(31:38):
We're committed to being ableto make treatment available to
women that are low risk, thatcould use treatment and maybe
have been told no, or maybethey've had a provider who just
wasn't willing to have theconversation in the past.
The other thing, too on ourwebsite at winonacom, you can
find a lot of education andmaterials.
We have a medical journal, partof our website, and some free
resources, too, that likesymptom trackers.
(31:58):
If you're not quite sure whereyou fit on this spectrum and
you're not really quite sure,like if what you're feeling is
perimenopause or is it somethingelse, there's resources that
you can do on our website tokind of figure that out and it
can help you with that.
But it's it's a fairly easyprocess.
If women decide that they wantto pursue treatment with us,
they go through an onlinemedical history questionnaire.
(32:20):
We don't ask every single thingabout your medical history.
We don't need to know that youbroke your leg at age five Like
it's all women's health focusedso that we can really know if
you're a safe candidate fortreatment or not and if
everything goes through yourchart.
Once you complete thatonboarding, it's forwarded to a
doctor in your state for reviewand then we might get back to
(32:41):
you to try to clarify some ofthe questions in your medical
history.
But ultimately we come up witha treatment plan and some of my
patients come knowing that theywant the body cream, they want
to get started, and some womendon't really know what form is
best for them.
So we have a littleconversation back and forth.
It's all asynchronous, meaningthat the patients message us
into the portal, we message back.
You don't require a live videovisit or phone call, and so it's
(33:06):
nice because the patients canmessage us 24 seven and the
doctors get back to them within24 hours.
So but it's a it's a nice wayto add junk to your in person
care, especially if you wanttreatment and you don't have the
option for getting treatmentthrough your traditional doctor
or provider.
Speaker 1 (33:22):
So I love that you're filling that gap.
Yeah, there's definitely a gapand you know we've we've talked
to individuals who have, who mayhave been dismissed by other
doctors who want hormone therapy, and you're filling that need
as well.
So thank you so much for whatyou do.
I'd like to get to know you alittle bit better.
(33:45):
On a personal note we always endwith a rapid fire, and so we
have some fun questions for you.
If we can start our rapid fire,we'd love.
Yeah, let's do it Right.
Right, let's just.
Let's start with what yourfavorite way to unwind is.
Speaker 2 (34:02):
Oh, my favorite way to unwind is to be outside in
nature.
Obviously it's harder in thewinter.
I have a new found love ofgardening that blossomed during
COVID when I was stuck at homein between my hospital shifts
and no matter what, like I'velost count of how many babies
I've delivered and how manysurgeries I've done.
(34:22):
But I'm so proud of my tomatoesand my basil and I have plants
propagating and most of mywindows in my house.
You know my, my kids and myhusband think I'm a little
obsessed, but I, I, I love it,no matter what.
Like getting my hands in thedirt just helps to relax me and
helps me unwind.
Speaker 3 (34:41):
Love that.
Okay coffee or tea, and we arein Seattle.
Just keep that in mind.
Speaker 1 (34:47):
There's no wrong answer, Dr.
Speaker 2 (34:48):
Kat no, no wrong answer no, I actually like both,
so I'm a coffee in the morningkind of person, but in the later
part of the day I like a goodafternoon tea.
My father's actually fromEngland and so I have a love of
like British tea, but I love agood latte or especially a good
mocha every once in a while too.
Speaker 1 (35:10):
Yeah, especially this time of year, a really good one
is just fantastic.
Speaker 2 (35:14):
I'm definitely a coffee drinker.
Like I need flavoring in mycoffee though, oh okay okay, I'm
a, I'm a.
Speaker 1 (35:21):
Um, don't put anything in my coffee.
Give me the vodka so I cantaste it.
No, I don't drink.
I was gonna say, yeah, Iactually don't drink a lot of
vodka, but, um, okay, this isabout you.
One last question city orcountry?
Speaker 2 (35:41):
It's so hard.
I love being in the city forthe proximity to everything and
for the arts and culture, but II like the suburbs where I live.
I'm just a quick train rideaway to going into downtown
Philly and taking my kids intothe city to explore, but I
prefer to live outside the city.
I'd love to go to the city toexplore, but live outside.
Speaker 3 (36:05):
I like that you can have both, yes.
So our last question that weask everyone what's the best
piece of advice you've everreceived or given best piece of
advice you've ever received orgiven.
Speaker 2 (36:23):
I think the best advice is to expand your
knowledge about yourself.
I mean, I think that probably Ineed to take my own advice more
when I tell women, I tell mypatients to focus on self-care.
I need to practice that morethan I preach, for sure.
But knowledge is power andthat's one of the tenets of my
career that I have tried to pushto my patients as much as
possible, like I want them tolearn about their bodies and to
(36:45):
learn about their anatomy and tolearn as much about themselves,
because I tell them like I'mwith them for 10, 15 minutes,
but they're with their body allthe time, every day.
They know it best if they learnit, and so I think that's
that's the most important thingI can push you know out there to
your, to your audiences.
Learn as much as you can aboutyour body and about your health
(37:05):
and take control of your ownhealth.
I think it's so very important.
That's great.
Speaker 1 (37:09):
I love that yeah, agency Love it Right, great
advice.
Speaker 3 (37:14):
Great pleasure to meet.
Have you on the show today, drKat.
I do an amazing work and thankyou for all that you're doing to
spread the word in this space.
We're honored to have you heretoday.
Speaker 2 (37:25):
Thank you so much for having me.
I love chatting with you guys.
We could do it for hours.
I know We'll have you on againand we'll talk about something
else.
Yeah, sounds good, I lovehaving you.
Speaker 3 (37:33):
Sounds like a plan.
Speaker 1 (37:41):
So I echo what Kim said Thanks so much for what you
do and audience.
That is a wrap.
Until we meet again.
Go find joy in the journey.
Speaker 3 (37:44):
Bye everyone.
Speaker 1 (37:46):
Thank you for listening to the Medovia
menopause podcast.
If you enjoyed today's show,please give it a thumbs up.
Subscribe for future episodes,leave a review and share this
episode with a friend.
Subscribe for future episodes,leave a review and share this
episode with a friend.
Medovia is out to change thenarrative.
Learn more at Medoviacom.
(38:06):
That's M-I-D-O-V-I-A dot com.
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