June 23, 2025 • 55 mins
The whispers about hormones, perimenopause, and menopause have remained frustratingly quiet for too long. Dr. Kristen Markell, a double-board certified OBGYN and certified menopause practitioner, breaks the silence with game-changing clarity in this essential conversation moderated by VEST Member Alison Anthony.
For decades, women experiencing brain fog, anxiety, fatigue, and mood changes during perimenopause have been dismissed or told to "just deal with it." Dr. Markell reveals the biological truth: these symptoms aren't character flaws but natural responses to dramatic hormonal fluctuations that can begin up to a decade before menopause. She expertly explains how progesterone typically declines first, while estrogen levels become erratic with extreme highs and lows—a process many healthcare providers themselves don't fully understand.
The consequences of this knowledge gap are serious. Women's highest risk of suicide attempts occurs between ages 45-49, coinciding precisely with perimenopause. Beyond mental health, these hormonal changes affect bone density, heart health, and cognitive function. Yet many women suffer silently, especially in professional settings where they fear being perceived as weak or incompetent if they acknowledge their symptoms.
Dr. Markell guides listeners through the confusing landscape of treatment options—from hormone replacement therapy and bioidenticals to supplements and lifestyle modifications. She emphasizes that finding the right provider is crucial, suggesting resources like the North American Menopause Society to locate certified practitioners. Most importantly, she frames perimenopause not as a decline but as "a portal into the second half of life"—an opportunity to refocus energy on what truly matters.
Whether you're in your 20s planning for future hormonal health, navigating perimenopause now, or supporting someone who is, this conversation provides the knowledge, validation, and practical guidance to transform how we approach this universal yet uniquely personal journey. Your hormones aren't just about symptoms—they're foundational to how you show up in every area of your life.
For our guest full bio and show notes click here.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
You help us understand the science of it a
little bit.
Speaker 2 (00:02):
So menopause is defined as one year after your
last period.
At that point, obviously, youhave to have uterus right.
So if people have had ahysterectomy or have had some
sort of ablation or an IED inplace, then they may not be
having regular periods or havingperiods at all.
But for those of us with theuterus, you know, one year after
(00:24):
the last period is now you haveentered menopause and at that
point the hormone levelsestrogen and progesterone are
very, very low, sometimes evenzero.
Perimenopause, which you know,I'll be honest, when I did my
training in OBGYN we didn't talkabout perimenopause Like this
is just now.
Over the last five to 10 years,people are, you know,
(00:46):
acknowledging this sometimesdecade long life, the seven to
10 years before your last period.
What's happening inperimenopause is your hormones
are starting to become a bitmore erratic.
In perimenopause what ishappening there is that the
progesterone is usually gettinglower in that second half of the
(01:08):
cycle.
Sometimes that change in thatprogesterone level can lead to
symptoms similar to PMS, right,some people will notice them in
that premenstrual time, thatweek before your cycle starts,
and sometimes it's physical,like breast tenderness,
headaches, and sometimes it'smental or emotional.
It can be more anxiety, feelingoverwhelmed, irritability,
(01:33):
brain fog, poor sleep.
Speaker 4 (01:36):
In this episode, we talked to Dr Kristen Markell, a
double-bore certified OBGYN andcertified menopause practitioner
, about one of the mostunder-discussed and
misunderstood pillars of women'shealth our hormones.
Special thanks to Vest memberAllison Anthony, ceo of Tulsa
Area United Way, for moderatingthis session.
(01:57):
Whether you're in your 20s, 40sor beyond, understanding
hormonal health isn't just aboutnavigating menopause or beyond.
Understanding hormonal healthisn't just about navigating
menopause.
It's about reclaiming yourenergy, brain function, mood,
sleep, sexual drive andlong-term vitality.
Yet, for far too many, theseconversations remain taboo,
confusing or quietly dismissed,especially when it comes to
(02:19):
professional settings, wheresymptoms like brain fog, fatigue
or anxiety are ofteninternalized as a personal
failure rather than recognizedas a psychological shift.
And that's exactly why thisconversation matters.
Hormones aren't just a midlifetopic.
They're foundational to how weshow up in every area of our
(02:40):
life, from our ambition to ourfocus, relationships and, yes,
even our leadership.
If we're going to support womenin their full power, we need to
normalize these conversationsaround hormonal health so that
we can equip ourselves with theknowledge and resources to
rewrite the narrative, one thatsees midlife and aging not as a
(03:02):
decline but as a vital time forgrowth, energy and purpose.
For our guest's full bio andshow notes go to wwwvastherco
forward slash podcast.
This conversation was part of amore intimate coaching session
with VAS members and has beenrepurposed to accommodate this
(03:22):
episode.
If you enjoyed the episode,share with a friend, leave us a
review and don't forget to hitthe subscribe button.
And if you're ready to takeyour career in business to the
next level, apply to join ourcommunity of powerful women
eager to help you get there andstay there.
Go to wwwbestherco forwardslash membership.
Speaker 1 (03:44):
I was with my primary care provider, my physician,
yesterday and I told her that Iwas helping facilitate this
conversation today and she youknow she's a long time
practicing internal medicinespecialist and she said, oh my
gosh, I wish I didn't havepatients so I could attend that.
She said when I was in medschool and we covered women's,
(04:05):
you know menopausal and hormonalhealth.
I was like is that all?
Is that all you're going toteach us?
And she said it just, themedical community has not caught
up either.
So with that, I would love toask you you know why?
Why are we still, when we thinkabout menopause and aging in
(04:28):
our hormonal health, why arethese subjects still feeling
taboo, when we are half theworld, you know women, and we
all are going through these samethings?
Why?
Why is this still a kind of tooquiet topic?
Speaker 2 (04:44):
Yeah, that's such a good question.
First off, thanks so much forhaving me.
I love talking about this.
I think the more awareness wehave around it then, you know,
the more help we can get forpeople.
But yeah, you know, I think wecould all look at the different
reasons why talking aboutwomen's health is taboo, whether
(05:04):
we're talking about menopauseor we're talking about periods
or we're talking about pregnancy.
You know this has these havetypically been taboo subjects
and, just like you mentionedwith your primary care provider,
you know not, hasn't been thefocus, right, hasn't been the
(05:25):
focus for 50% of the population.
And we could look at why, right, what, what is that?
Well, first off, we don't talkabout those things, right, we
don't talk about Bruno, we don'ttalk about periods and and and
aging, and and menopause.
And then you know we have tolook at our culture.
Especially this Western cultureis very, you know, anti-aging,
(05:50):
right, you know there's a lot ofpeople that are talking about
anti-aging and I always say,well, the goal is that we want
to continue to age, right, thealternative is not what we want.
And when we look at people whoare professional, professional
women you know there have beensome studies that have been done
(06:13):
about menopause andperimenopause and aging in the
workplace and some of the thingsthat come out of these studies
that are that women feel likedisclosing, you know, menopausal
or perimenopausal symptoms?
Um could make them be seen asweak or incompetent, right, and
so, um, some of these symptoms,like brain fog or fatigue or
(06:37):
more anxious symptoms, um arenot the ones that we have been
talking about as much as wecould.
Right, I do think that'schanging.
We're hearing about hot flashesand night sweats and vaginal
dryness, but some of these otherearly perimenopause symptoms
that people may start toquestion like am I losing my
(06:59):
edge?
Am I, you know, not where Iused to be?
You know that can definitelyaffect how they feel, like
they're showing up not only atwork but at home and in their
relationships.
Speaker 1 (07:12):
Well, and I'm so grateful for Erica and team to
help us on the path ofnormalizing these conversations.
I am just off track, but I havea master's thesis in my
background in 17th centurywomen's literature and sometimes
I think they were more frankabout their bodies in the 17th
century than we are today, whichis not okay.
(07:34):
Not okay, you know.
I look around the Zoom room andwe have a multitude of ages
here, which is one of the thingsI love about Vest so much.
I think we help keep our edgeby working across and getting
the wisdom from older women andthe energy and the ideas and the
boldness from some of ouryounger colleagues.
(07:55):
So when you think about womenin their 20s and 30s many of
whom are on this call, who maynot be thinking about menopause
yet but I know, still have totackle issues of their hormonal
health and how that sets them upfor better energy, fertility
and longevity, what advice wouldyou have for how they approach
those topics?
Speaker 2 (08:16):
Yeah, that's a topic close to my heart too.
So I work with women throughoutthe lifespan and, you know, in
the twenties and thirties, thisis when I'm hoping, you know
that we have have had someawareness of what's going on
with our hormones, right?
I want people to learn abouttheir hormones and their teens
(08:37):
so that, you know, as we'reaging, we just build on that
self-awareness and thatknowledge about what's happening
Right.
Build on that self-awarenessand that knowledge about what's
happening Right, and so reallyunderstanding how your hormones
support you.
You know, I'm not of the beliefthat you can't do certain
things in your cycle right.
Like you, you can't do it atthis time, you can only do it
this time.
I don't believe that.
(08:58):
But I do believe that there arecertain times things feel easier
, right, and there are certaintimes that we may need an extra
tool or more support, or wemight just kill it.
You know, at ovulation, becausewe're, you know, feeling so good
and radiant, and so knowing howthat is for you, knowing what
your symptoms feel like duringyour cycle, how to support them,
(09:24):
is going to be key.
And then you know, as weprogress throughout different
seasons of life, intoperimenopause and menopause,
then we're aware of how thingsare changing, we're aware of,
well, this is not how it used tobe for me, or this symptom has
become very problematic for myeveryday life and you know,
(09:45):
because I focus a lot onwell-being and coach women and
that I always talk about good,deep, restorative sleep, you
know that can be a little trickyat certain seasons of life,
depending on yourself, otherpeople that are affecting sleep.
But focusing on that deep,restorative sleep, finding a
(10:06):
regular stress managementpractice, which that may include
movement, it may includecommunity, it may include
something fun and joyful thatreally takes us into that more
creative space, these are thethings that I that I work with,
with patients and clients on.
Speaker 1 (10:27):
I think all of us on this call are going to get
something, and for our presentand our future.
So hormones just affects somany aspects of our health and
whether that's mood, like yousaid, metabolism, sleep, energy.
When I started to go I had ahysterectomy, I think 12 years
ago and my symptoms were moreabout brain fog and anxiety and
(10:53):
I've never had anxiety or brainfog issues and I had no idea
initially that that was tied tohormonal shifts because, like
you said, we hear about, youknow, vaginal dryness, or we
hear about and I you know, canwe just celebrate being on a
webinar?
We would get to say vaginal,that's fun.
Yay for today, I mean yay, todaywe got to say vaginal on a
(11:15):
webinar.
That's a good, that's, that's awin.
So Jay's like oh mother.
Speaker 2 (11:21):
Sit with me and we talk about all the things.
Speaker 1 (11:28):
But while I was in the energy business we didn't
say that a lot so we didn't kindof work that into most
conversations.
But what is actually happening?
Can you help us understandwhat's actually happening to our
bodies and our hormones inparamenopause and menopause?
You know what's happening andwhy it matters.
Why do these things matter, andcan you help us understand the
(11:50):
science of it a little bit?
Speaker 2 (11:51):
Yeah, oh, yeah so.
So menopause is defined as oneyear after your last period and
so at that point, obviously youhave to have uterus, right?
So if people have had ahysterectomy or have had some
sort of ablation or an IED inplace, then they may not be
having regular periods or havingperiods at all.
(12:13):
But for those of us with theuterus, you know, one year after
the last period is now you haveentered menopause and at that
point the hormone levelsestrogen and progesterone are
very, very low, sometimes evenzero.
And perimenopause which youknow, I'll be honest, when I did
my training in OBGYN we didn'ttalk about perimenopause Like
(12:36):
this is just now, over the lastfive to 10 years, people are,
you know, acknowledging thissometimes decade long life of
life is the seven to 10 yearsbefore your last period, because
what's happening inperimenopause is your hormones
(12:56):
are starting to become a bitmore erratic, right?
So you know, in our quoteunquote, you know fertile years
where we're, you know, typicallyhaving a regular cycle and if
you look, you can see like, oh,the estrogen comes up here and
then it, it, it comes up in thesecond half and then the
progesterone stays low but comesup in the second half in
(13:17):
perimenopause.
What is happening there is thatthe progesterone is usually
getting lower in that secondhalf of the cycle, and so
sometimes that change in thatprogesterone level can lead to
symptoms similar to PMS.
Right, some people will noticethem in that premenstrual time,
that week before your cyclestarts, and sometimes it's
(13:40):
physical, like breast tenderness, headaches, you know, and
sometimes it's mental oremotional.
It can be more anxiety, feelingoverwhelmed, irritability,
brain fog, poor sleep, right,you know, and maybe it's
clustered in that time period.
(14:02):
Right, as we progress throughperimenopause, what starts
happening with the estrogen?
You know, we used to think like, oh, it just kind of starts
coming down.
Now we know that it's veryerratic, it's having extreme
highs and it's having extremelows, and so we think that it's
these huge shifts that arereally contributing, and
(14:25):
contributing a lot, to ourperimenopause symptoms, along
with the declining progesterone.
And so the interesting thingabout perimenopause is that it
looks different at the beginningof it than it does in that year
before you're going to haveyour last period, right, and so
that's where it can get a bittricky for people, because maybe
(14:46):
one month they're like oh, thatwas a little off, I didn't feel
well, I was very fatigued and,you know, more irritability and
anxious.
But then the next month, maybethe brain and the ovaries are
communicating better that monthand it feels like, oh, that
wasn't so bad.
It feels like, oh, that wasn'tso bad.
(15:07):
And so, you know, what I hope todo with perimenopause education
is to just remind people thatthese are things that we're
looking out for, not in a scaryway, but just in a way that we
don't have to get to thatsuffering point right when
people are coming in like Ithought it was nothing, but this
has been going on for years andthey're really very depleted.
And so why it's important isfor that reason for sure,
(15:31):
because women are suffering forlong periods of time sometimes
and then they come in and wehave to really shore them up to
get them back to normal, versushaving this awareness of, okay,
these things might be changing.
What can I do to support myself?
Who do I need to check in with?
(15:52):
You know so from a, from aneveryday standpoint.
That's why it's important.
And then, when we thinklong-term, you know why is it
important?
Because you know these changesin hormones can affect our
long-term health, can affect ourlongevity, because they are
going to influence, you know,our heart health, our brain
health and our bone health thatis.
Speaker 1 (16:14):
you know, if anybody had drifted away that, coming
back to that point that you knowit's not just about I love the
words you use suffering andbeing depleted and you know and
not minimalizing the realsymptoms, but also thinking
about the organs in our bodythat need all these other parts
(16:35):
to be healthy, and heart healththat's so critical.
So you're not, you're notwhining ladies, you're not, you
know, you're not overreacting,you're, you're taking care.
We only get this one body inour life.
One body, that's all we get.
I had we take better care of ourcars and our refrigerators you
know our air conditioners thanwe do this one body, so take
(16:56):
care of this right.
I am dying to know gabby andsarah and jay and erica.
Uh, I'm seeing, but I'm notable to keep up with it all.
Do you have some comments thatyou'd like to tease out that
have been especially interesting, that you'd like to mention, or
questions that have come up inthe chat?
Speaker 6 (17:14):
Yeah, we've had a lot , of, a lot of comments and
questions in the chat to come upalready.
I know a lot of people are justreally praising that come up
already.
I know a lot of people are justreally praising that, again,
we're having this conversation,talking about really
understanding the symptoms thatare going on, so they can be
aware whether you know they'realready experiencing it or
(17:34):
they're, you know, just gettingprepared for it.
A lot of talk about how a lotof women in this group are
already sharing those symptomsin their workplaces too, just to
normalize the conversation intheir circles as well.
So, kudos to all the women hereas well.
And I did just see a questionpop up from Kit.
(17:56):
I don't know if, kit, you'reable to unmute yourself and ask
her, if you want us to just goahead and ask for you.
Speaker 3 (18:03):
Hi there, yeah, good morning, I would love to.
So when I figured out that Imight be in perimenopause, I
went to my doctor and was like,okay, I have all these questions
and I understand that these aremy symptoms and I feel like a
crazy person.
And she's like yeah, we don'thave a lot of research and I had
a hysterectomy eight years ago,so I have no like ability to
(18:25):
track any kind of cycle.
Um, and so I was like so whatdo I do?
And she goes really we're gonnahave to put you on a dose of
birth control.
And uh, I was like well, thatfeels really strange compared to
I had a hysterectomy, so Ididn't have to do that anymore.
And so why would I do that?
(18:45):
And she's like you know, it'sjust unfortunately.
She was like this is theprotocol, like this is the
standard kind of procedure forwhat we recommend.
So then of course, my phone islistening to me and so now I get
all these ads for everythingelse and it's like here's the
(19:08):
you know berry tea that you cantake, and here's the saffron tea
that you can take and here'sthe oil that you can rub on your
body.
And HRT testing and salivatesting and blood testing works
and it doesn't work.
I just I feel like there's somuch conflicting information out
there, um, and like when we didblood work.
For me she's like your bloodwork looks great, like your
hormone levels are right, whatwe would expect them to be.
So we're going to do thisanyway, but you might just still
(19:31):
like try to see what you think,and I was like that doesn't
feel like an answer, and I thinkthat's my biggest frustration
is nothing feels definitive.
Um, like this is the realprotocol that we've tested,
we've tried that we know isgoing to be helpful.
It's so speculative, um, so Iwould love any more insights
that you have.
(19:51):
Is it hrt?
Is it birth control?
Are those the same thing?
I don't have a medical degree,like I have no idea right.
Speaker 1 (19:58):
I think those are great questions and thank you
for boldly asking that.
I have to say, dr Markell, Ihad an employee yesterday say I
have indigestion, really badthis weekend.
Today I think it's menopauseand I was like I was thinking
about you and I said, well,that's a new one, you know, and
I was thinking about thisconversation.
I thought you must get from theinternet and all the you know,
(20:23):
just like you said, kit, all theads and all the you know, just
like you said, kit, all the adsand all that.
You just have people coming soconfused.
So what can you tell us aboutconfusion and fear and hormone
replacement therapy, or not talkabout that?
Speaker 2 (20:35):
Yeah, well, first off , thank you, kit, for, yes,
voicing that, normalizing that.
So the interesting thing is isthat you know, we have we have
estrogen and progesteronereceptors like all over our body
, all over our organ systems,different organ systems, and so
(20:57):
this is why perimenopause willshow up differently for
different people and some peoplehave different clusters, right,
more anxious type symptoms aremental or emotional, some people
have more physical, some peoplehave like a lovely mix of all
the different bits, and it'sdifficult to create a protocol
(21:18):
when everybody shows up a bitdifferently.
Right, and, like you mentioned,we are in the beginning of like
, really talking about this,right, and so there are
providers like me who have doneadditional training in
perimenopause menopause,prescribing hormones, sexual
health, like the things thatmaybe were, you know, just not
(21:40):
talked about as much, and, likewe talked about at the beginning
, not everybody's had thattraining.
And so when I was a, you know,traditional OBGYN, that's what I
would have done.
I would have said like, hey,here, let's try this birth
control, right, and some peoplewould have stayed on birth
control until they probably wentinto menopause.
(22:01):
But now we know more, right,and so there are some times when
birth control might beindicated in the perimenopause
transition for certain symptomsthat people are having.
But birth control is notmenopausal hormonal therapy.
It is a different type ofsynthetic hormones, right, and
(22:22):
not the same.
Synthetic is bad, right, butit's just a type of hormones
that's suppressing people'shormones to help benefit
symptoms, right?
Some people, those big, hugefluctuations they are like
please stop these now I cannothandle these.
And so we do have that optionfor using a birth control that
(22:44):
suppresses the hormones.
But for people who maybe havehad a hysterectomy and, um, you
know they are having someperimenopausal symptoms, we can
use, and not even for peoplewith a hysterectomy.
Let me let me be clear withthat for people in perimenopause
, we can use menopausal hormonaltherapy to support their
(23:06):
symptoms, and this is where youwant to see someone that that
knows how to do that Right, thatunderstands that it usually is
a let's try this and see how yourespond.
Right, because you know, forthose of us that have been in
medicine for a very long time,not everybody looks like the
(23:27):
people in the studies, right?
Like we could say like oh well,in this study of all these
people, I don't look like themajority of those people, and
some people don't respond thatway.
So the point of that is to saythere's different options.
Perimenopause is a clinicaldiagnosis.
(23:49):
It's not diagnosed with labs,but I do labs, right, like this
is where you have people in thesocial media and they're
fighting it out Like don't dolabs, do labs.
And here's what I sayPerimenopause is a clinical
diagnosis and I also do labsbecause sometimes I'll get
surprised.
I'll get surprised in that, oh,wow, your FSH and your
(24:11):
estradiol are really close tomenopause, and so we are further
along in this perimenopausejourney than we would have
expected, based on your age.
And then other times I'll dolabs and someone is 51, average
age of menopause, but their labslook completely normal.
And I will say you know what,on this day, the brain and the
ovaries were communicatingreally well with each other, but
(24:33):
you have all of these symptomsthat are consistent with
perimenopause.
Let's try something to see ifthose symptoms improve, and then
we'll go from there Right.
And so it is really the practiceof medicine.
It's really, you know, likelooking at each person
personally and saying, okay,here's what we know.
We're not discounting yoursymptoms, this is what we've got
(24:56):
from a lab standpoint and wecan continue to follow that to
see you know how it changes overthe next, you know, three to
five years, because we did notused to do labs.
This is new, right?
You know some people are like,no, we don't go by labs, we just
go by symptoms, and I'm like Ishould do labs.
If we had done labs for thelast 30 to 40 years, we would
(25:20):
have more information for women,right, we would be able to say
like, well, these are the trendsthat we notice with
perimenopause and what'shappening with lab work.
So I am a fan of you know,having that data, watching the
changes.
But you're going to see peopleout there that are like, no,
(25:40):
never check labs.
Speaker 1 (25:42):
I'm like okay, yeah, I'm thinking if men were having
these symptoms, we would bedoing the labs because they'd be
like.
Oh my God, I'm out.
You know it would be very muchpart of the medical mainstream
to do the lab Exactly, yes, yeah, well, talk a little bit about.
You use some terms there that Ithink is part of confusion in
(26:04):
the among those of us thataren't medical professionals
hormone replacement therapy,supplements, bioidenticals,
supplements, bioidenticals wehear all these different terms
and birth controls and you know,and and all these different
types of protocols that mightcome up.
Can you just do some definingand what we should be listening
(26:24):
for?
There are just a lot ofconfusing information out there.
Speaker 2 (26:26):
We could do a whole podcast on this, right, you know
?
Again, because we are focusingnow on perimenopause and
menopause, which, yay, there's alot of things coming out of the
woodwork, there's a lot ofpeople that have something for
you, and I don't think that'snecessarily a bad thing.
But it can be confusing and itmay be a little bit tricky to
discern, like, what is needed,what's indicated.
(26:48):
And so, you know, I didadditional training and
integrative fellowship insupplements and herbs because I
was like I don't know, like what, what should I be considering
as a must have for patients indifferent seasons of life?
And what would be a?
You know, okay, we might addthis in once we get these
(27:11):
foundational pieces supported.
Know, okay, we might add thisin once we get these
foundational pieces supported.
And so when I look atperimenopause and menopause, you
know I'm always thinking aboutlike, okay, let's check some lab
levels, let's look at ourvitamin D, let's look at some of
these inflammation markers sowe can see, let's, you know,
what we need to supplement withfrom a vitamin D perspective.
(27:32):
You know, I love magnesium.
I think magnesium is just, youknow, so helpful for many women
in relation to deeper sleep,helpful for mood support, you
know, and so that's somethingthat I'm always talking with
people about.
But once we start to get out of, like, the baseline must haves,
(27:53):
those are typically going to bepatient to patient, specific,
based on what we're seeing withtheir labs, their symptoms, what
they tolerate, what they don'ttolerate.
Um, when we talk aboutmenopausal hormonal therapy,
there's lots of differentoptions wrapped up in that right
options wrapped up in thatright.
There's different modes of waysto give hormone therapy right.
(28:20):
There's oral, there'stransdermal, there's things that
you put in the vagina there, wesaid it again.
There's, you know, injections,there's pellets, and so you want
to always have someone thatunderstands all of it right.
One way that I really look atwho's saying what, who's doing,
(28:44):
what is noticing when people arelike nope, this is the only way
.
I'm like, yeah, I wish thatcould be true for all of us, but
that just does not, thatdoesn't work.
So you want to have someonethat understands, you know all
the different options and isable to counsel you on, okay A,
if we're thinking about hormonaltherapy, what are the risks,
(29:05):
what are the benefits for you,particularly, why would we want
to be using this?
What are we thinking from asymptom management standpoint
and a long-term healthstandpoint.
Right?
If grandma and your mom bothhad osteoporosis and broke hips,
like you know, I have patientscoming in saying like I don't
want that to happen.
What can I do from a lifestylestandpoint?
(29:25):
And then I want to add inhormonal therapy to keep my
bones as healthy as long aspossible.
And then again, we talked aboutyou know, we talked about birth
control pills and we talkedabout hormone therapy.
Those are different things,right?
Those are used for differentreasons and one's not good and
(29:47):
one's not bad, right?
You know, I always say, likeeverybody needs their own
symptoms addressed and sometimeswe're not going to address it
with this thing over here.
Sometimes we do need to bringin something that maybe not all
your friends are using, right?
Bioidentical is a term that wehear a lot and sometimes people
(30:08):
mean that they say bioidenticalto mean like a compounded
hormone.
But the way that I look at itis that bioidentical means that
when you take this hormone, yourbody recognizes it as the
hormone that you have, right, ifyou're still making hormones.
So, if you take estradiol, thenyour body recognizes it as
(30:31):
estradiol, it puts it on theestrogen receptor throughout the
body and it activates thatreceptor as if it were your own
hormone versus synthetichormones.
Don't do the exact same.
They don't do that exactly thesame way.
Now, the great thing aboutbioidentical hormones is that
you can get them anywhere.
You can get them at the regularpharmacy.
(30:52):
You can get them at thecompounding pharmacy.
Like there's not, there's not.
You know, people don't just getbioidentical from compounding
pharmacies, and so you know.
Again, I think it can cause alittle confusion, but when we
talk about it that way, it helpsus understand.
Like, oh, we are choosing thisbecause, you know, I want my
(31:15):
body to function as efficientlyas it has been, or even better.
Right, but sometimes we'regoing to use different options,
like birth control, or sometimeswe do use a synthetic hormone
option because people don'ttolerate the bioidenticals,
right?
So just knowing that there'slots of options out there and
that if you have a providerthat's well-versed in it, then
(31:39):
you will be able to findsomething that works for you,
let's.
Speaker 1 (31:46):
I want to definitely come back to the provider
question because I'm seeing alot of traffic in the chat about
that and I think that'd be agreat point to end, a very
action oriented point for us toend on.
But I want to talk a little bitabout something that hopefully
is going to happen for all of uson this call at some point or
another is happening or hashappened, and that is when we
get to midlife, and the questionthat Gabby and Sarah gave me
(32:09):
was 40s, 50s.
I'm going to say I'm 60 if Ilive to be 120, maybe, but I
still feel in the middle, youknow, thriving and thinking
about how we move from survivingand feeling depleted and those
types of things or put aside orthe loss of, you know, the loss
(32:30):
of some of what society tells us.
That you know kind of a timewhen we're facing real change.
I also have seen that you'vetalked about it as an
opportunity and I definitelyfeel that way.
I feel like I'm at some of mymost creative.
I've been wanting to write abook for a long time and I'm 60.
And I feel it.
You know, I feel that wisdomkind of bubbling up and the lack
(32:53):
of like as I have one friend myage that says, you know,
finally, our give a shit.
Factors in the negative, likewe're okay, like we can say the
things that we need to say.
And so let's talk about thehabits you think for women as we
come into middle age, whateveryou define that for you.
Um, what are some of the habitsand the things that we can do
(33:17):
right now to build a foundationfor that long-term vitality and
creativity and resilience?
Speaker 2 (33:23):
Yeah, yeah, I, I love that, right.
I love midlife, the um.
We have so many.
I did a group withperimenopause menopausal women
and they were like.
They were like we don't give anF, we only have so many Fs to
give.
But we know where we want toput that energy now, Right, like
it's all going towards thesethings that are important to us.
(33:46):
And I love that clarity at, uh,midlife, because you have that
experience that we've drawn onthrough our whole life and now
we know like, oh, this is whereI want to really put that energy
.
But you know, we talked alittle bit about some of these
foundational practices and theystill hold true in midlife,
(34:09):
right, and perimenopause andmenopause of getting deep,
restorative sleep.
Now, I entered into thisintegrative and functional world
through sleep.
That was my gateway.
I always tell people because Iwas a practicing OBGYN and I was
(34:30):
on call sometimes three nightsa week, 24 hours some, and then
go to you know clinic the nextday for eight to 10 hours.
And so my goal when I noticedthat wow, I cannot bounce back
from these anymore was I've gotto get really good sleep when
I'm not on call.
And so I started digging intohow can I make my sleep more
deep, more restorative?
Sometimes it was interrupted.
(34:51):
I had two small kiddos underthree, and so it didn't mean
that, you know, I failed if Ididn't get the eight hours, but
I was doing the practices tomake that sleep as good as it
could be, right, and so I get it.
When people are like, but I havethe tiny people, or I work
nights or you know, my schedulefluctuates I get that there's
(35:13):
things that are, um, that arereally they're just part of a
season, right, that we're likewe're going to do the best we
can with where we are in thisseason.
But when we look at from along-term health standpoint, um,
sleep is huge.
It's huge for your brain, right.
Like you know, the next day,like you know, brain fog is,
(35:38):
it's real, when we're notgetting that deep sleep.
It also affects our cravings.
It affects our hormone levelsthat affect craving and satiety,
so that can affect ourmetabolic health.
And so I always talk to peopleabout, like, how can we get
better sleep?
And that is not an overnightthing, this isn't something that
(35:59):
happens in a week.
For me, it took three to sixmonths of working with my family
, first because I had littlepeople and so I had to, like,
really get them on a lovelyrhythm and we were turning down
the lights and all these cuesthat not only helped them but
helped me and my body, like,just, you know, bring it down.
(36:21):
And so once they were bettersupported, then I could really
focus on what I could controlfrom my standpoint.
And so, looking back after thatsix months, you know it was a
significant change and because Ilike to track data, I also, you
know that's when I got my auraring.
This was many years ago, and soI was looking at the data, you
(36:43):
know, throughout the week orthroughout the month to say like
, oh, these things reallyaffected it.
This thing, you know, reallyhelped my sleep to get better,
and using that information toadjust what I did.
Speaker 1 (36:57):
In short, prioritizing our health.
Right, you know so that we, if,if we need other people to take
, if we have other people totake care of and jobs and we all
have something, we're not ableto do it if we're not taking
care of our health first.
Great questions going on andlots of in the chat.
Gabby and Sarah and Jay,anything you'd like to tease out
(37:19):
at this point and follow up on?
Speaker 4 (37:23):
One of the reasons we decided to have this
conversation.
Kendra Lauper is on here, and Isaw a message that she posted
on social media recently aboutyou know, there's so much
information which we've alreadytalked about, and also a lot of
supplements and I just talkedabout.
I personally take ashwagandhato sleep and maybe I should
change to magnesium, and I thinkthis goes back to like, how do
(37:46):
we personalize what's right forus, based on working with the
care provider that actuallyunderstands us as an individual?
So, kendra, I'm going to putyou on the spot and ask you to
unmute yourself.
Speaker 5 (38:02):
I'm unmuted.
Yeah, I have so many questions.
Thank you for hosting thisconversation because it maybe it
is just for me, but I, you know, I've tried so many supplements
and part of it is I I'm alittle worried because
supplements, as I understand it,are not regulated Right.
So there's so much out therethat I'm like is this even what
they say it is?
And how do I know?
(38:22):
Until I spend the dollars andtry it and it works or doesn't
work Right.
And so I've tried severalthings and some work, some don't
, some work better than others,but it's, you know, finding a
provider that can really walk methrough it and understand what
exactly will help and whichproducts are, you know, the best
and trustworthy, and all ofthose things has been really
(38:42):
tough.
So we'd love your thoughts onthat.
Speaker 2 (38:45):
Yeah, yeah, so you know there are third-party
certifications for supplementsso you can always look and see
if they've done the additionaltesting, had a third party come
in and, you know, check to seethat what's in there is exactly
what they say it is.
And you know, then I, with mytraining, I have certain
(39:09):
companies that I feel moreconfident in and um, so a lot of
times it's it's really talkingto each person about.
You know, what are your goals,what are your labs showing?
What are your symptoms?
Um, because you know I'll takecreatine, for example.
Creatine is out there and andyou know everyone is like,
(39:32):
should I take creatine, should Inot take creatine?
And, um, you know the answer isit depends, right, it depends on
do you have space to bringcreatine into your, into your
regimen right now?
If I've got somebody coming inand we're at the beginning,
we're really depleted, like evenadding that in is going to be
too much.
Then I'm like, no, we're nottaking creatine.
(39:54):
We're getting you deep sleep,we're moving our body, we're
making sure you're nourishedwell, and maybe we take a
multivitamin to fill in thosegaps right now, as we're, you
know, also addressing what yourspecific lab values were and
what those specific needs are.
And then, once we get thosepatterns and habits in, then
maybe we do talk about creatinefor muscle health and for brain
(40:16):
health.
But I think sometimes you know,we get, like you said, so many
things coming at us that weforget that.
You know, the baseline,foundational pieces is where we
start and then working withsomeone that understands, like
okay, here's our main thingswe're thinking about from a
(40:37):
long-term health standpointbrain, bone, heart but also
right now, from a symptomstandpoint, what am I going to
start incorporating to make surethat those things are affected
later on?
Speaker 5 (40:49):
Yeah, thank you.
I just I mentioned that, Ithink, in my post.
I said I just want to read anarticle about X, Y or Z and not
have 8,000 other ads show up forX, y or Z, and I'm like, how do
I?
I just want to, I would justwant to learn, and it's so hard.
There's, you know, the internetis great and the internet is
terrible, right, it's like howdo you find the information?
And, like you know someone,like you, I think, in Oklahoma
(41:11):
City probably I think someonesaid this in the chat because of
all the political issuesrelated to women's health in our
state, it's hard to findproviders who are really
addressing the issuesholistically, and so that's been
a challenge.
And so do you recommend lookingfor people online, right?
(41:34):
Like looking for virtualproviders?
I think you do that too right.
Speaker 1 (41:40):
Yeah, I think that that is a question I'm seeing
popping up a lot in the chat.
Like we all know, we need toadvocate.
Kendra, it's a great question.
We all know we need to advocatefor ourselves, we know we need
to inform ourselves, but there'sso much misinformation.
So we need to partneradvocating for ourselves, but
partner with great clinicalexperts.
(42:01):
And so how, dr Markell, do wefind them?
Where do we go?
Where's the best resources toguide us to our best clinical
partners?
Speaker 2 (42:11):
Yeah, so it kind of depends on what you're looking
for.
There are groups that certifypeople in menopause and
perimenopause sexual health andso you can.
You can go to thesecertification groups.
The North American MenopauseSociety is a groups.
(42:37):
The North American menopausesociety is a is the certifying
group for menopause andperimenopause, and so you'll see
people listed in your area thatthat is something they
specialize in.
Now, I always say that withinthat there's going to be just
different types of people, right, you know, and sometimes you
just have to feel people out andfigure out like who your person
is.
Uh, ish wish is theinternational society for the
(43:01):
study of women's sexual health,and they are the certifying body
for people that are focused onsexual health, and so you can
always look up there to see ifthere are providers in your area
and sometimes they overlaprelated to perimenopause,
menopause and sexual health.
And you know, I think, becauseI'm also in the integrative and
(43:23):
functional medicine world, youknow I always say take little
bits of things to pull them intomy programs for women because,
you know, typically we can findgreat bits um throughout the
wisdom of all of the different,uh um, ways to care for ourself
over, you know, generations,even if we're just now talking
(43:45):
about perimenopause, uh, alittle bit more in depth.
And so you know, I get thatthere's a lot of people out
there that may practice quote,quote, unquote natural medicine
or some of these different termsthat we'll use, but I like to
say that sometimes I'm a bridgein between a lot of these
(44:06):
different types of medicine,because I understand all of it
and, based on who's sitting infront of me, we're able to pull
the pieces that may work forsomeone but for someone else is
not going to be the first thingwe would go to.
Speaker 1 (44:23):
So it's really helpful and I'm while you were
talking, I was remembering arheumatologist I went to one
time who was about 70 year old,white male, who said you know,
are you you're taking thyroidmedication and you know hormone
replacement therapy.
You women this was the exactquote he said you women just
need to get over it and just goahead and get old and let that
(44:45):
happen.
And you know and at the sametime the same physician was
calling his you know, 50 yearold nurses, my girls, my girls.
So, as I was, as I was leavingand I said you know what this
isn't going to work, thisdiscussion and, by the way, your
50 year old nurse does not wantto be called your girl, so you
might talk to her about that.
So we parted ways after a shortvisit, but you know you're
(45:10):
talking about.
I mean, when we hear the term,just deal with it, whether it's
from a doctor in anotherspecialty or or, or friends, or
family, well meaning family, oh,just grow gracefully.
Whatever you know, when we'retalking about brain fog or low
libido or all these things, whatare some of the risks?
Talk about the actual risks tous of ignoring these things.
(45:32):
And also, can you shareexamples of when someone has
finally been able to crack thecode on all the information,
find a good provider and reclaimsome of their energy?
Give us an example of what thatswing can look like.
Speaker 2 (45:47):
Yeah, the risks and the swing.
So yeah, we're just done withthe, just deal with it, right?
Everyone is so done with thatand you know, I look back
through my training of you knowkind of what this doctor was
saying to you.
Like you women just need to doand how women, how women I mean.
Speaker 1 (46:09):
If someone says you women just run, yeah, run away.
How many women have been?
Speaker 2 (46:14):
gaslit for this decade-long hormonal shift
that's happening.
And you know, if a man had atestosterone of zero, do you
think he would be saying that tohim Like no?
You'd be like, oh, we gotta getthat replaced, right?
These are hormones that ourbody has used throughout our
whole life and so, of course,these symptoms that show up in
(46:40):
perimenopause, like the fatigue,the brain fog, the mood
symptoms that people have beentold to just deal with it.
They've been told like, oh,you've got small kids, you're
working full-time job, you'reopening a new business, of
course you're tired, of course,of course, of course.
And now we're starting tounderstand that the hormonal
shifts behind this are leadingto this, and of course it
(47:02):
affects us in the day to day,but it's actually a very risky
thing to ignore for some women.
You know there's a study out ofEngland that says that women's
highest chance of suicideattempt is in the ages of 45 to
49.
And so what is happening then?
(47:25):
Perimenopause, menopause, right?
So this isn't about justsucking it up.
These things can belife-threatening, right.
This can really affect people'smental and emotional health,
and it also can affect long-termhealth symptoms, right, bone
(47:46):
health, right, people fallinglater on in life, breaking hips
and that initially and thateventually leading to, you know,
their death.
I mean, I hate to be all likescary here, but this is, these
are real things that arehappening, right, and you know
there was just a recent study Iwant to say it's out of
(48:08):
Australia which you know.
I'm so thankful when I see newstudies out about hormonal
therapy and perimenopause andmenopause that showed that some
of these emotional symptoms thatare happening in perimenopause
are actually best served withstarting women on hormonal
therapy.
Now that doesn't mean thateveryone will just stop there.
(48:30):
Some people may need additionalsupport with, you know, ssris,
snris you know mental healthtype symptoms, type
prescriptions, but that in thisstudy the women's symptoms the
brain fog, the anxiety, thedepression type symptoms were
improved significantly withhormonal therapy and so I think
(48:53):
we're just going to see more andmore of that over the next
decade, right?
So hopefully people in thiscall who are in their twenties
are going to benefit so muchfrom you know this time where
people were like we got to learnmore are going to benefit so
much from you know this timewhere people were like we got to
learn more.
And you know what I see whenpeople come in and we get them
supported and we start.
(49:13):
You know, if they want to starthormone therapy, we do that is
that people get their life back.
Right, you know, a commonsymptom is I don't feel like
myself, right, there's even aacronym NFL and not feeling like
myself.
People come in and say I don'tfeel like myself, right, there's
even a acronym NFLM not feelinglike myself.
People come in and say I don'tfeel like myself and so, as we,
you know, support them from alifestyle standpoint, you know,
(49:35):
make, get those labs supported,start hormonal therapy if that's
indicated.
Then they come back in sixmonths and say, wow, like this
has changed everything.
My fatigue has affected how I'mshowing up with, you know, my
work in the world, with mypeople, my relationships, like,
(49:57):
like it's really, it's affectingthe things that we we are here
for, right To you know, livethis beautiful life Right.
And then, when we think aboutit from from a long-term health
perspective, it's important forall the reasons.
Speaker 1 (50:18):
Yeah, yeah, that is so helpful and I think just
advocating for ourselves.
On the labs you talked about,you know symptoms are one thing,
but when it's your own symptomsyou don't really know always
how to express that and what'snormal.
And sometimes the lab work justyesterday my lab work was
showing that my thyroid I'vebeen on thyroid medication was
really low.
And you know she says thingslike are you sleepy, are you
(50:43):
losing some hair?
Yes, yes, but I'm also, youknow, 60 and work 70 hours a
week so you never know what'sgoing on with that.
And so just making sure thatyou're advocating to actually
have your providers do the labwork, so they have, just like we
talk about in our businessesand our nonprofits get the data
and make data informed decisions, and I love that it all ties
(51:05):
together.
So do we want to have one morequestion before we let Dr
Markell close us out Anything?
Anyone that's just dying to aska question?
Speaker 4 (51:16):
I think there are so many questions on the chat that
unfortunately, we're not goingto get to them.
So definitely, dr Markell.
How can people get ahold of youor attend your practice or your
workshops?
I know you do a lot of those.
Speaker 2 (51:28):
I do as well.
Yes, so, yeah, I mean, pleasefollow me on Instagram, kristen
Markell MD.
Um, or my website is the same.
I'll just write it in here justfor my name.
Um, because you know I love toanswer questions.
I love to, uh, you know, a lotof times I'm sending out um free
(51:49):
guides and things like that toexplore different aspects of
perimenopause or health andwellbeing, um, even, you know,
during different seasons of life, not just perimenopause and
menopause, uh, but, yeah, Iwould love to connect with with
y'all.
I know we had a lot ofquestions.
I wish we had more time toanswer them because they're
(52:10):
definitely these are thequestions that I hear from women
and what we address in myprogram.
So, yeah, thank y'all so much.
Nobody says we can't haveanother session right.
Speaker 1 (52:21):
I mean probably the topic of menopause and hormonal
health could fill two sessions,I'm pretty sure.
Let me ask this last question.
I think I mean I'm just thereframing of so much.
You said we just want tocelebrate our body and celebrate
aging, because the alternativeis not what we want.
Right, we should never feelashamed of our.
(52:41):
Yesterday I asked my doctorabout something I was seeing on
the underside of my left breastand I mean we laughed.
She said Are you just seeingthis?
And I'm like, well, I have tothrow it over my shoulder before
I could really look.
So you know, I mean we laugh.
Enjoy our bodies they're notwhat we once were, maybe, but
they are fabulous and celebratethat aging and that wisdom and
(53:03):
creativity and ability to laughat ourselves that comes with
that.
But also just get some damnsleep, women.
Just prioritize your sleep.
If you don't take away anythingelse when you think I have to
work one more hour or you knownot, take a nap.
I love that.
And Shaga and Monica and somany of my friends on here who
(53:27):
build that community, build acommunity of women that you can
talk to and you trust acrossgenerations I think the
intergenerational.
I keep saying that.
But that's why I invest investbecause I love that.
I love that I continue to learnfrom women across generations.
So last thing I would like toto ask is if you could rewrite
(53:52):
the narrative, as you're doing,about women's health, aging and
menopause.
What would be your rallying cry?
What would you want that tosound like?
And and leave us with that, andthen Erica will toss it back to
you.
Speaker 2 (54:05):
Yeah, I always say that perimenopause is a portal,
right, it's this portal into thesecond half of your life and,
um, you know, that is really thegoal, right?
We're here to age and to takewhat we learned in the first
half of our life and refine itand put our energy towards the
(54:27):
things that mean the most to us.
And so, you know, I tell peopleto listen to themselves, listen
to what they need, to find apartner in that, so that you can
really take that time periodand just set yourself up for
success for the second half ofyour life.
Speaker 4 (54:48):
If you enjoyed the episode, share with a friend,
leave us a review and don'tforget to hit the subscribe
button.
And if you're ready to takeyour career in business to the
next level, apply to join ourcommunity of powerful women
eager to help you get there andstay there.
Go to wwwbestherco forwardslash membership.
You help us understand the science of it a
little bit.
Speaker 2 (00:02):
So menopause is defined as one year after your
last period.
At that point, obviously, youhave to have uterus right.
So if people have had ahysterectomy or have had some
sort of ablation or an IED inplace, then they may not be
having regular periods or havingperiods at all.
But for those of us with theuterus, you know, one year after
(00:24):
the last period is now you haveentered menopause and at that
point the hormone levelsestrogen and progesterone are
very, very low, sometimes evenzero.
Perimenopause, which you know,I'll be honest, when I did my
training in OBGYN we didn't talkabout perimenopause Like this
is just now.
Over the last five to 10 years,people are, you know,
(00:46):
acknowledging this sometimesdecade long life, the seven to
10 years before your last period.
What's happening inperimenopause is your hormones
are starting to become a bitmore erratic.
In perimenopause what ishappening there is that the
progesterone is usually gettinglower in that second half of the
(01:08):
cycle.
Sometimes that change in thatprogesterone level can lead to
symptoms similar to PMS, right,some people will notice them in
that premenstrual time, thatweek before your cycle starts,
and sometimes it's physical,like breast tenderness,
headaches, and sometimes it'smental or emotional.
It can be more anxiety, feelingoverwhelmed, irritability,
(01:33):
brain fog, poor sleep.
Speaker 4 (01:36):
In this episode, we talked to Dr Kristen Markell, a
double-bore certified OBGYN andcertified menopause practitioner
, about one of the mostunder-discussed and
misunderstood pillars of women'shealth our hormones.
Special thanks to Vest memberAllison Anthony, ceo of Tulsa
Area United Way, for moderatingthis session.
(01:57):
Whether you're in your 20s, 40sor beyond, understanding
hormonal health isn't just aboutnavigating menopause or beyond.
Understanding hormonal healthisn't just about navigating
menopause.
It's about reclaiming yourenergy, brain function, mood,
sleep, sexual drive andlong-term vitality.
Yet, for far too many, theseconversations remain taboo,
confusing or quietly dismissed,especially when it comes to
(02:19):
professional settings, wheresymptoms like brain fog, fatigue
or anxiety are ofteninternalized as a personal
failure rather than recognizedas a psychological shift.
And that's exactly why thisconversation matters.
Hormones aren't just a midlifetopic.
They're foundational to how weshow up in every area of our
(02:40):
life, from our ambition to ourfocus, relationships and, yes,
even our leadership.
If we're going to support womenin their full power, we need to
normalize these conversationsaround hormonal health so that
we can equip ourselves with theknowledge and resources to
rewrite the narrative, one thatsees midlife and aging not as a
(03:02):
decline but as a vital time forgrowth, energy and purpose.
For our guest's full bio andshow notes go to wwwvastherco
forward slash podcast.
This conversation was part of amore intimate coaching session
with VAS members and has beenrepurposed to accommodate this
(03:22):
episode.
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Speaker 1 (03:44):
I was with my primary care provider, my physician,
yesterday and I told her that Iwas helping facilitate this
conversation today and she youknow she's a long time
practicing internal medicinespecialist and she said, oh my
gosh, I wish I didn't havepatients so I could attend that.
She said when I was in medschool and we covered women's,
(04:05):
you know menopausal and hormonalhealth.
I was like is that all?
Is that all you're going toteach us?
And she said it just, themedical community has not caught
up either.
So with that, I would love toask you you know why?
Why are we still, when we thinkabout menopause and aging in
(04:28):
our hormonal health, why arethese subjects still feeling
taboo, when we are half theworld, you know women, and we
all are going through these samethings?
Why?
Why is this still a kind of tooquiet topic?
Speaker 2 (04:44):
Yeah, that's such a good question.
First off, thanks so much forhaving me.
I love talking about this.
I think the more awareness wehave around it then, you know,
the more help we can get forpeople.
But yeah, you know, I think wecould all look at the different
reasons why talking aboutwomen's health is taboo, whether
(05:04):
we're talking about menopauseor we're talking about periods
or we're talking about pregnancy.
You know this has these havetypically been taboo subjects
and, just like you mentionedwith your primary care provider,
you know not, hasn't been thefocus, right, hasn't been the
(05:25):
focus for 50% of the population.
And we could look at why, right, what, what is that?
Well, first off, we don't talkabout those things, right, we
don't talk about Bruno, we don'ttalk about periods and and and
aging, and and menopause.
And then you know we have tolook at our culture.
Especially this Western cultureis very, you know, anti-aging,
(05:50):
right, you know there's a lot ofpeople that are talking about
anti-aging and I always say,well, the goal is that we want
to continue to age, right, thealternative is not what we want.
And when we look at people whoare professional, professional
women you know there have beensome studies that have been done
(06:13):
about menopause andperimenopause and aging in the
workplace and some of the thingsthat come out of these studies
that are that women feel likedisclosing, you know, menopausal
or perimenopausal symptoms?
Um could make them be seen asweak or incompetent, right, and
so, um, some of these symptoms,like brain fog or fatigue or
(06:37):
more anxious symptoms, um arenot the ones that we have been
talking about as much as wecould.
Right, I do think that'schanging.
We're hearing about hot flashesand night sweats and vaginal
dryness, but some of these otherearly perimenopause symptoms
that people may start toquestion like am I losing my
(06:59):
edge?
Am I, you know, not where Iused to be?
You know that can definitelyaffect how they feel, like
they're showing up not only atwork but at home and in their
relationships.
Speaker 1 (07:12):
Well, and I'm so grateful for Erica and team to
help us on the path ofnormalizing these conversations.
I am just off track, but I havea master's thesis in my
background in 17th centurywomen's literature and sometimes
I think they were more frankabout their bodies in the 17th
century than we are today, whichis not okay.
(07:34):
Not okay, you know.
I look around the Zoom room andwe have a multitude of ages
here, which is one of the thingsI love about Vest so much.
I think we help keep our edgeby working across and getting
the wisdom from older women andthe energy and the ideas and the
boldness from some of ouryounger colleagues.
(07:55):
So when you think about womenin their 20s and 30s many of
whom are on this call, who maynot be thinking about menopause
yet but I know, still have totackle issues of their hormonal
health and how that sets them upfor better energy, fertility
and longevity, what advice wouldyou have for how they approach
those topics?
Speaker 2 (08:16):
Yeah, that's a topic close to my heart too.
So I work with women throughoutthe lifespan and, you know, in
the twenties and thirties, thisis when I'm hoping, you know
that we have have had someawareness of what's going on
with our hormones, right?
I want people to learn abouttheir hormones and their teens
(08:37):
so that, you know, as we'reaging, we just build on that
self-awareness and thatknowledge about what's happening
Right.
Build on that self-awarenessand that knowledge about what's
happening Right, and so reallyunderstanding how your hormones
support you.
You know, I'm not of the beliefthat you can't do certain
things in your cycle right.
Like you, you can't do it atthis time, you can only do it
this time.
I don't believe that.
(08:58):
But I do believe that there arecertain times things feel easier
, right, and there are certaintimes that we may need an extra
tool or more support, or wemight just kill it.
You know, at ovulation, becausewe're, you know, feeling so good
and radiant, and so knowing howthat is for you, knowing what
your symptoms feel like duringyour cycle, how to support them,
(09:24):
is going to be key.
And then you know, as weprogress throughout different
seasons of life, intoperimenopause and menopause,
then we're aware of how thingsare changing, we're aware of,
well, this is not how it used tobe for me, or this symptom has
become very problematic for myeveryday life and you know,
(09:45):
because I focus a lot onwell-being and coach women and
that I always talk about good,deep, restorative sleep, you
know that can be a little trickyat certain seasons of life,
depending on yourself, otherpeople that are affecting sleep.
But focusing on that deep,restorative sleep, finding a
(10:06):
regular stress managementpractice, which that may include
movement, it may includecommunity, it may include
something fun and joyful thatreally takes us into that more
creative space, these are thethings that I that I work with,
with patients and clients on.
Speaker 1 (10:27):
I think all of us on this call are going to get
something, and for our presentand our future.
So hormones just affects somany aspects of our health and
whether that's mood, like yousaid, metabolism, sleep, energy.
When I started to go I had ahysterectomy, I think 12 years
ago and my symptoms were moreabout brain fog and anxiety and
(10:53):
I've never had anxiety or brainfog issues and I had no idea
initially that that was tied tohormonal shifts because, like
you said, we hear about, youknow, vaginal dryness, or we
hear about and I you know, canwe just celebrate being on a
webinar?
We would get to say vaginal,that's fun.
Yay for today, I mean yay, todaywe got to say vaginal on a
(11:15):
webinar.
That's a good, that's, that's awin.
So Jay's like oh mother.
Speaker 2 (11:21):
Sit with me and we talk about all the things.
Speaker 1 (11:28):
But while I was in the energy business we didn't
say that a lot so we didn't kindof work that into most
conversations.
But what is actually happening?
Can you help us understandwhat's actually happening to our
bodies and our hormones inparamenopause and menopause?
You know what's happening andwhy it matters.
Why do these things matter, andcan you help us understand the
(11:50):
science of it a little bit?
Speaker 2 (11:51):
Yeah, oh, yeah so.
So menopause is defined as oneyear after your last period and
so at that point, obviously youhave to have uterus, right?
So if people have had ahysterectomy or have had some
sort of ablation or an IED inplace, then they may not be
having regular periods or havingperiods at all.
(12:13):
But for those of us with theuterus, you know, one year after
the last period is now you haveentered menopause and at that
point the hormone levelsestrogen and progesterone are
very, very low, sometimes evenzero.
And perimenopause which youknow, I'll be honest, when I did
my training in OBGYN we didn'ttalk about perimenopause Like
(12:36):
this is just now, over the lastfive to 10 years, people are,
you know, acknowledging thissometimes decade long life of
life is the seven to 10 yearsbefore your last period, because
what's happening inperimenopause is your hormones
(12:56):
are starting to become a bitmore erratic, right?
So you know, in our quoteunquote, you know fertile years
where we're, you know, typicallyhaving a regular cycle and if
you look, you can see like, oh,the estrogen comes up here and
then it, it, it comes up in thesecond half and then the
progesterone stays low but comesup in the second half in
(13:17):
perimenopause.
What is happening there is thatthe progesterone is usually
getting lower in that secondhalf of the cycle, and so
sometimes that change in thatprogesterone level can lead to
symptoms similar to PMS.
Right, some people will noticethem in that premenstrual time,
that week before your cyclestarts, and sometimes it's
(13:40):
physical, like breast tenderness, headaches, you know, and
sometimes it's mental oremotional.
It can be more anxiety, feelingoverwhelmed, irritability,
brain fog, poor sleep, right,you know, and maybe it's
clustered in that time period.
(14:02):
Right, as we progress throughperimenopause, what starts
happening with the estrogen?
You know, we used to think like, oh, it just kind of starts
coming down.
Now we know that it's veryerratic, it's having extreme
highs and it's having extremelows, and so we think that it's
these huge shifts that arereally contributing, and
(14:25):
contributing a lot, to ourperimenopause symptoms, along
with the declining progesterone.
And so the interesting thingabout perimenopause is that it
looks different at the beginningof it than it does in that year
before you're going to haveyour last period, right, and so
that's where it can get a bittricky for people, because maybe
(14:46):
one month they're like oh, thatwas a little off, I didn't feel
well, I was very fatigued and,you know, more irritability and
anxious.
But then the next month, maybethe brain and the ovaries are
communicating better that monthand it feels like, oh, that
wasn't so bad.
It feels like, oh, that wasn'tso bad.
(15:07):
And so, you know, what I hope todo with perimenopause education
is to just remind people thatthese are things that we're
looking out for, not in a scaryway, but just in a way that we
don't have to get to thatsuffering point right when
people are coming in like Ithought it was nothing, but this
has been going on for years andthey're really very depleted.
And so why it's important isfor that reason for sure,
(15:31):
because women are suffering forlong periods of time sometimes
and then they come in and wehave to really shore them up to
get them back to normal, versushaving this awareness of, okay,
these things might be changing.
What can I do to support myself?
Who do I need to check in with?
(15:52):
You know so from a, from aneveryday standpoint.
That's why it's important.
And then, when we thinklong-term, you know why is it
important?
Because you know these changesin hormones can affect our
long-term health, can affect ourlongevity, because they are
going to influence, you know,our heart health, our brain
health and our bone health thatis.
Speaker 1 (16:14):
you know, if anybody had drifted away that, coming
back to that point that you knowit's not just about I love the
words you use suffering andbeing depleted and you know and
not minimalizing the realsymptoms, but also thinking
about the organs in our bodythat need all these other parts
(16:35):
to be healthy, and heart healththat's so critical.
So you're not, you're notwhining ladies, you're not, you
know, you're not overreacting,you're, you're taking care.
We only get this one body inour life.
One body, that's all we get.
I had we take better care of ourcars and our refrigerators you
know our air conditioners thanwe do this one body, so take
(16:56):
care of this right.
I am dying to know gabby andsarah and jay and erica.
Uh, I'm seeing, but I'm notable to keep up with it all.
Do you have some comments thatyou'd like to tease out that
have been especially interesting, that you'd like to mention, or
questions that have come up inthe chat?
Speaker 6 (17:14):
Yeah, we've had a lot , of, a lot of comments and
questions in the chat to come upalready.
I know a lot of people are justreally praising that come up
already.
I know a lot of people are justreally praising that, again,
we're having this conversation,talking about really
understanding the symptoms thatare going on, so they can be
aware whether you know they'realready experiencing it or
(17:34):
they're, you know, just gettingprepared for it.
A lot of talk about how a lotof women in this group are
already sharing those symptomsin their workplaces too, just to
normalize the conversation intheir circles as well.
So, kudos to all the women hereas well.
And I did just see a questionpop up from Kit.
(17:56):
I don't know if, kit, you'reable to unmute yourself and ask
her, if you want us to just goahead and ask for you.
Speaker 3 (18:03):
Hi there, yeah, good morning, I would love to.
So when I figured out that Imight be in perimenopause, I
went to my doctor and was like,okay, I have all these questions
and I understand that these aremy symptoms and I feel like a
crazy person.
And she's like yeah, we don'thave a lot of research and I had
a hysterectomy eight years ago,so I have no like ability to
(18:25):
track any kind of cycle.
Um, and so I was like so whatdo I do?
And she goes really we're gonnahave to put you on a dose of
birth control.
And uh, I was like well, thatfeels really strange compared to
I had a hysterectomy, so Ididn't have to do that anymore.
And so why would I do that?
(18:45):
And she's like you know, it'sjust unfortunately.
She was like this is theprotocol, like this is the
standard kind of procedure forwhat we recommend.
So then of course, my phone islistening to me and so now I get
all these ads for everythingelse and it's like here's the
(19:08):
you know berry tea that you cantake, and here's the saffron tea
that you can take and here'sthe oil that you can rub on your
body.
And HRT testing and salivatesting and blood testing works
and it doesn't work.
I just I feel like there's somuch conflicting information out
there, um, and like when we didblood work.
For me she's like your bloodwork looks great, like your
hormone levels are right, whatwe would expect them to be.
So we're going to do thisanyway, but you might just still
(19:31):
like try to see what you think,and I was like that doesn't
feel like an answer, and I thinkthat's my biggest frustration
is nothing feels definitive.
Um, like this is the realprotocol that we've tested,
we've tried that we know isgoing to be helpful.
It's so speculative, um, so Iwould love any more insights
that you have.
(19:51):
Is it hrt?
Is it birth control?
Are those the same thing?
I don't have a medical degree,like I have no idea right.
Speaker 1 (19:58):
I think those are great questions and thank you
for boldly asking that.
I have to say, dr Markell, Ihad an employee yesterday say I
have indigestion, really badthis weekend.
Today I think it's menopauseand I was like I was thinking
about you and I said, well,that's a new one, you know, and
I was thinking about thisconversation.
I thought you must get from theinternet and all the you know,
(20:23):
just like you said, kit, all theads and all the you know, just
like you said, kit, all the adsand all that.
You just have people coming soconfused.
So what can you tell us aboutconfusion and fear and hormone
replacement therapy, or not talkabout that?
Speaker 2 (20:35):
Yeah, well, first off , thank you, kit, for, yes,
voicing that, normalizing that.
So the interesting thing is isthat you know, we have we have
estrogen and progesteronereceptors like all over our body
, all over our organ systems,different organ systems, and so
(20:57):
this is why perimenopause willshow up differently for
different people and some peoplehave different clusters, right,
more anxious type symptoms aremental or emotional, some people
have more physical, some peoplehave like a lovely mix of all
the different bits, and it'sdifficult to create a protocol
(21:18):
when everybody shows up a bitdifferently.
Right, and, like you mentioned,we are in the beginning of like
, really talking about this,right, and so there are
providers like me who have doneadditional training in
perimenopause menopause,prescribing hormones, sexual
health, like the things thatmaybe were, you know, just not
(21:40):
talked about as much, and, likewe talked about at the beginning
, not everybody's had thattraining.
And so when I was a, you know,traditional OBGYN, that's what I
would have done.
I would have said like, hey,here, let's try this birth
control, right, and some peoplewould have stayed on birth
control until they probably wentinto menopause.
(22:01):
But now we know more, right,and so there are some times when
birth control might beindicated in the perimenopause
transition for certain symptomsthat people are having.
But birth control is notmenopausal hormonal therapy.
It is a different type ofsynthetic hormones, right, and
(22:22):
not the same.
Synthetic is bad, right, butit's just a type of hormones
that's suppressing people'shormones to help benefit
symptoms, right?
Some people, those big, hugefluctuations they are like
please stop these now I cannothandle these.
And so we do have that optionfor using a birth control that
(22:44):
suppresses the hormones.
But for people who maybe havehad a hysterectomy and, um, you
know they are having someperimenopausal symptoms, we can
use, and not even for peoplewith a hysterectomy.
Let me let me be clear withthat for people in perimenopause
, we can use menopausal hormonaltherapy to support their
(23:06):
symptoms, and this is where youwant to see someone that that
knows how to do that Right, thatunderstands that it usually is
a let's try this and see how yourespond.
Right, because you know, forthose of us that have been in
medicine for a very long time,not everybody looks like the
(23:27):
people in the studies, right?
Like we could say like oh well,in this study of all these
people, I don't look like themajority of those people, and
some people don't respond thatway.
So the point of that is to saythere's different options.
Perimenopause is a clinicaldiagnosis.
(23:49):
It's not diagnosed with labs,but I do labs, right, like this
is where you have people in thesocial media and they're
fighting it out Like don't dolabs, do labs.
And here's what I sayPerimenopause is a clinical
diagnosis and I also do labsbecause sometimes I'll get
surprised.
I'll get surprised in that, oh,wow, your FSH and your
(24:11):
estradiol are really close tomenopause, and so we are further
along in this perimenopausejourney than we would have
expected, based on your age.
And then other times I'll dolabs and someone is 51, average
age of menopause, but their labslook completely normal.
And I will say you know what,on this day, the brain and the
ovaries were communicatingreally well with each other, but
(24:33):
you have all of these symptomsthat are consistent with
perimenopause.
Let's try something to see ifthose symptoms improve, and then
we'll go from there Right.
And so it is really the practiceof medicine.
It's really, you know, likelooking at each person
personally and saying, okay,here's what we know.
We're not discounting yoursymptoms, this is what we've got
(24:56):
from a lab standpoint and wecan continue to follow that to
see you know how it changes overthe next, you know, three to
five years, because we did notused to do labs.
This is new, right?
You know some people are like,no, we don't go by labs, we just
go by symptoms, and I'm like Ishould do labs.
If we had done labs for thelast 30 to 40 years, we would
(25:20):
have more information for women,right, we would be able to say
like, well, these are the trendsthat we notice with
perimenopause and what'shappening with lab work.
So I am a fan of you know,having that data, watching the
changes.
But you're going to see peopleout there that are like, no,
(25:40):
never check labs.
Speaker 1 (25:42):
I'm like okay, yeah, I'm thinking if men were having
these symptoms, we would bedoing the labs because they'd be
like.
Oh my God, I'm out.
You know it would be very muchpart of the medical mainstream
to do the lab Exactly, yes, yeah, well, talk a little bit about.
You use some terms there that Ithink is part of confusion in
(26:04):
the among those of us thataren't medical professionals
hormone replacement therapy,supplements, bioidenticals,
supplements, bioidenticals wehear all these different terms
and birth controls and you know,and and all these different
types of protocols that mightcome up.
Can you just do some definingand what we should be listening
(26:24):
for?
There are just a lot ofconfusing information out there.
Speaker 2 (26:26):
We could do a whole podcast on this, right, you know
?
Again, because we are focusingnow on perimenopause and
menopause, which, yay, there's alot of things coming out of the
woodwork, there's a lot ofpeople that have something for
you, and I don't think that'snecessarily a bad thing.
But it can be confusing and itmay be a little bit tricky to
discern, like, what is needed,what's indicated.
(26:48):
And so, you know, I didadditional training and
integrative fellowship insupplements and herbs because I
was like I don't know, like what, what should I be considering
as a must have for patients indifferent seasons of life?
And what would be a?
You know, okay, we might addthis in once we get these
(27:11):
foundational pieces supported.
Know, okay, we might add thisin once we get these
foundational pieces supported.
And so when I look atperimenopause and menopause, you
know I'm always thinking aboutlike, okay, let's check some lab
levels, let's look at ourvitamin D, let's look at some of
these inflammation markers sowe can see, let's, you know,
what we need to supplement withfrom a vitamin D perspective.
(27:32):
You know, I love magnesium.
I think magnesium is just, youknow, so helpful for many women
in relation to deeper sleep,helpful for mood support, you
know, and so that's somethingthat I'm always talking with
people about.
But once we start to get out of, like, the baseline must haves,
(27:53):
those are typically going to bepatient to patient, specific,
based on what we're seeing withtheir labs, their symptoms, what
they tolerate, what they don'ttolerate.
Um, when we talk aboutmenopausal hormonal therapy,
there's lots of differentoptions wrapped up in that right
options wrapped up in thatright.
There's different modes of waysto give hormone therapy right.
(28:20):
There's oral, there'stransdermal, there's things that
you put in the vagina there, wesaid it again.
There's, you know, injections,there's pellets, and so you want
to always have someone thatunderstands all of it right.
One way that I really look atwho's saying what, who's doing,
(28:44):
what is noticing when people arelike nope, this is the only way
.
I'm like, yeah, I wish thatcould be true for all of us, but
that just does not, thatdoesn't work.
So you want to have someonethat understands, you know all
the different options and isable to counsel you on, okay A,
if we're thinking about hormonaltherapy, what are the risks,
(29:05):
what are the benefits for you,particularly, why would we want
to be using this?
What are we thinking from asymptom management standpoint
and a long-term healthstandpoint.
Right?
If grandma and your mom bothhad osteoporosis and broke hips,
like you know, I have patientscoming in saying like I don't
want that to happen.
What can I do from a lifestylestandpoint?
(29:25):
And then I want to add inhormonal therapy to keep my
bones as healthy as long aspossible.
And then again, we talked aboutyou know, we talked about birth
control pills and we talkedabout hormone therapy.
Those are different things,right?
Those are used for differentreasons and one's not good and
(29:47):
one's not bad, right?
You know, I always say, likeeverybody needs their own
symptoms addressed and sometimeswe're not going to address it
with this thing over here.
Sometimes we do need to bringin something that maybe not all
your friends are using, right?
Bioidentical is a term that wehear a lot and sometimes people
(30:08):
mean that they say bioidenticalto mean like a compounded
hormone.
But the way that I look at itis that bioidentical means that
when you take this hormone, yourbody recognizes it as the
hormone that you have, right, ifyou're still making hormones.
So, if you take estradiol, thenyour body recognizes it as
(30:31):
estradiol, it puts it on theestrogen receptor throughout the
body and it activates thatreceptor as if it were your own
hormone versus synthetichormones.
Don't do the exact same.
They don't do that exactly thesame way.
Now, the great thing aboutbioidentical hormones is that
you can get them anywhere.
You can get them at the regularpharmacy.
(30:52):
You can get them at thecompounding pharmacy.
Like there's not, there's not.
You know, people don't just getbioidentical from compounding
pharmacies, and so you know.
Again, I think it can cause alittle confusion, but when we
talk about it that way, it helpsus understand.
Like, oh, we are choosing thisbecause, you know, I want my
(31:15):
body to function as efficientlyas it has been, or even better.
Right, but sometimes we'regoing to use different options,
like birth control, or sometimeswe do use a synthetic hormone
option because people don'ttolerate the bioidenticals,
right?
So just knowing that there'slots of options out there and
that if you have a providerthat's well-versed in it, then
(31:39):
you will be able to findsomething that works for you,
let's.
Speaker 1 (31:46):
I want to definitely come back to the provider
question because I'm seeing alot of traffic in the chat about
that and I think that'd be agreat point to end, a very
action oriented point for us toend on.
But I want to talk a little bitabout something that hopefully
is going to happen for all of uson this call at some point or
another is happening or hashappened, and that is when we
get to midlife, and the questionthat Gabby and Sarah gave me
(32:09):
was 40s, 50s.
I'm going to say I'm 60 if Ilive to be 120, maybe, but I
still feel in the middle, youknow, thriving and thinking
about how we move from survivingand feeling depleted and those
types of things or put aside orthe loss of, you know, the loss
(32:30):
of some of what society tells us.
That you know kind of a timewhen we're facing real change.
I also have seen that you'vetalked about it as an
opportunity and I definitelyfeel that way.
I feel like I'm at some of mymost creative.
I've been wanting to write abook for a long time and I'm 60.
And I feel it.
You know, I feel that wisdomkind of bubbling up and the lack
(32:53):
of like as I have one friend myage that says, you know,
finally, our give a shit.
Factors in the negative, likewe're okay, like we can say the
things that we need to say.
And so let's talk about thehabits you think for women as we
come into middle age, whateveryou define that for you.
Um, what are some of the habitsand the things that we can do
(33:17):
right now to build a foundationfor that long-term vitality and
creativity and resilience?
Speaker 2 (33:23):
Yeah, yeah, I, I love that, right.
I love midlife, the um.
We have so many.
I did a group withperimenopause menopausal women
and they were like.
They were like we don't give anF, we only have so many Fs to
give.
But we know where we want toput that energy now, Right, like
it's all going towards thesethings that are important to us.
(33:46):
And I love that clarity at, uh,midlife, because you have that
experience that we've drawn onthrough our whole life and now
we know like, oh, this is whereI want to really put that energy
.
But you know, we talked alittle bit about some of these
foundational practices and theystill hold true in midlife,
(34:09):
right, and perimenopause andmenopause of getting deep,
restorative sleep.
Now, I entered into thisintegrative and functional world
through sleep.
That was my gateway.
I always tell people because Iwas a practicing OBGYN and I was
(34:30):
on call sometimes three nightsa week, 24 hours some, and then
go to you know clinic the nextday for eight to 10 hours.
And so my goal when I noticedthat wow, I cannot bounce back
from these anymore was I've gotto get really good sleep when
I'm not on call.
And so I started digging intohow can I make my sleep more
deep, more restorative?
Sometimes it was interrupted.
(34:51):
I had two small kiddos underthree, and so it didn't mean
that, you know, I failed if Ididn't get the eight hours, but
I was doing the practices tomake that sleep as good as it
could be, right, and so I get it.
When people are like, but I havethe tiny people, or I work
nights or you know, my schedulefluctuates I get that there's
(35:13):
things that are, um, that arereally they're just part of a
season, right, that we're likewe're going to do the best we
can with where we are in thisseason.
But when we look at from along-term health standpoint, um,
sleep is huge.
It's huge for your brain, right.
Like you know, the next day,like you know, brain fog is,
(35:38):
it's real, when we're notgetting that deep sleep.
It also affects our cravings.
It affects our hormone levelsthat affect craving and satiety,
so that can affect ourmetabolic health.
And so I always talk to peopleabout, like, how can we get
better sleep?
And that is not an overnightthing, this isn't something that
(35:59):
happens in a week.
For me, it took three to sixmonths of working with my family
, first because I had littlepeople and so I had to, like,
really get them on a lovelyrhythm and we were turning down
the lights and all these cuesthat not only helped them but
helped me and my body, like,just, you know, bring it down.
(36:21):
And so once they were bettersupported, then I could really
focus on what I could controlfrom my standpoint.
And so, looking back after thatsix months, you know it was a
significant change and because Ilike to track data, I also, you
know that's when I got my auraring.
This was many years ago, and soI was looking at the data, you
(36:43):
know, throughout the week orthroughout the month to say like
, oh, these things reallyaffected it.
This thing, you know, reallyhelped my sleep to get better,
and using that information toadjust what I did.
Speaker 1 (36:57):
In short, prioritizing our health.
Right, you know so that we, if,if we need other people to take
, if we have other people totake care of and jobs and we all
have something, we're not ableto do it if we're not taking
care of our health first.
Great questions going on andlots of in the chat.
Gabby and Sarah and Jay,anything you'd like to tease out
(37:19):
at this point and follow up on?
Speaker 4 (37:23):
One of the reasons we decided to have this
conversation.
Kendra Lauper is on here, and Isaw a message that she posted
on social media recently aboutyou know, there's so much
information which we've alreadytalked about, and also a lot of
supplements and I just talkedabout.
I personally take ashwagandhato sleep and maybe I should
change to magnesium, and I thinkthis goes back to like, how do
(37:46):
we personalize what's right forus, based on working with the
care provider that actuallyunderstands us as an individual?
So, kendra, I'm going to putyou on the spot and ask you to
unmute yourself.
Speaker 5 (38:02):
I'm unmuted.
Yeah, I have so many questions.
Thank you for hosting thisconversation because it maybe it
is just for me, but I, you know, I've tried so many supplements
and part of it is I I'm alittle worried because
supplements, as I understand it,are not regulated Right.
So there's so much out therethat I'm like is this even what
they say it is?
And how do I know?
(38:22):
Until I spend the dollars andtry it and it works or doesn't
work Right.
And so I've tried severalthings and some work, some don't
, some work better than others,but it's, you know, finding a
provider that can really walk methrough it and understand what
exactly will help and whichproducts are, you know, the best
and trustworthy, and all ofthose things has been really
(38:42):
tough.
So we'd love your thoughts onthat.
Speaker 2 (38:45):
Yeah, yeah, so you know there are third-party
certifications for supplementsso you can always look and see
if they've done the additionaltesting, had a third party come
in and, you know, check to seethat what's in there is exactly
what they say it is.
And you know, then I, with mytraining, I have certain
(39:09):
companies that I feel moreconfident in and um, so a lot of
times it's it's really talkingto each person about.
You know, what are your goals,what are your labs showing?
What are your symptoms?
Um, because you know I'll takecreatine, for example.
Creatine is out there and andyou know everyone is like,
(39:32):
should I take creatine, should Inot take creatine?
And, um, you know the answer isit depends, right, it depends on
do you have space to bringcreatine into your, into your
regimen right now?
If I've got somebody coming inand we're at the beginning,
we're really depleted, like evenadding that in is going to be
too much.
Then I'm like, no, we're nottaking creatine.
(39:54):
We're getting you deep sleep,we're moving our body, we're
making sure you're nourishedwell, and maybe we take a
multivitamin to fill in thosegaps right now, as we're, you
know, also addressing what yourspecific lab values were and
what those specific needs are.
And then, once we get thosepatterns and habits in, then
maybe we do talk about creatinefor muscle health and for brain
(40:16):
health.
But I think sometimes you know,we get, like you said, so many
things coming at us that weforget that.
You know, the baseline,foundational pieces is where we
start and then working withsomeone that understands, like
okay, here's our main thingswe're thinking about from a
(40:37):
long-term health standpointbrain, bone, heart but also
right now, from a symptomstandpoint, what am I going to
start incorporating to make surethat those things are affected
later on?
Speaker 5 (40:49):
Yeah, thank you.
I just I mentioned that, Ithink, in my post.
I said I just want to read anarticle about X, Y or Z and not
have 8,000 other ads show up forX, y or Z, and I'm like, how do
I?
I just want to, I would justwant to learn, and it's so hard.
There's, you know, the internetis great and the internet is
terrible, right, it's like howdo you find the information?
And, like you know someone,like you, I think, in Oklahoma
(41:11):
City probably I think someonesaid this in the chat because of
all the political issuesrelated to women's health in our
state, it's hard to findproviders who are really
addressing the issuesholistically, and so that's been
a challenge.
And so do you recommend lookingfor people online, right?
(41:34):
Like looking for virtualproviders?
I think you do that too right.
Speaker 1 (41:40):
Yeah, I think that that is a question I'm seeing
popping up a lot in the chat.
Like we all know, we need toadvocate.
Kendra, it's a great question.
We all know we need to advocatefor ourselves, we know we need
to inform ourselves, but there'sso much misinformation.
So we need to partneradvocating for ourselves, but
partner with great clinicalexperts.
(42:01):
And so how, dr Markell, do wefind them?
Where do we go?
Where's the best resources toguide us to our best clinical
partners?
Speaker 2 (42:11):
Yeah, so it kind of depends on what you're looking
for.
There are groups that certifypeople in menopause and
perimenopause sexual health andso you can.
You can go to thesecertification groups.
The North American MenopauseSociety is a groups.
(42:37):
The North American menopausesociety is a is the certifying
group for menopause andperimenopause, and so you'll see
people listed in your area thatthat is something they
specialize in.
Now, I always say that withinthat there's going to be just
different types of people, right, you know, and sometimes you
just have to feel people out andfigure out like who your person
is.
Uh, ish wish is theinternational society for the
(43:01):
study of women's sexual health,and they are the certifying body
for people that are focused onsexual health, and so you can
always look up there to see ifthere are providers in your area
and sometimes they overlaprelated to perimenopause,
menopause and sexual health.
And you know, I think, becauseI'm also in the integrative and
(43:23):
functional medicine world, youknow I always say take little
bits of things to pull them intomy programs for women because,
you know, typically we can findgreat bits um throughout the
wisdom of all of the different,uh um, ways to care for ourself
over, you know, generations,even if we're just now talking
(43:45):
about perimenopause, uh, alittle bit more in depth.
And so you know, I get thatthere's a lot of people out
there that may practice quote,quote, unquote natural medicine
or some of these different termsthat we'll use, but I like to
say that sometimes I'm a bridgein between a lot of these
(44:06):
different types of medicine,because I understand all of it
and, based on who's sitting infront of me, we're able to pull
the pieces that may work forsomeone but for someone else is
not going to be the first thingwe would go to.
Speaker 1 (44:23):
So it's really helpful and I'm while you were
talking, I was remembering arheumatologist I went to one
time who was about 70 year old,white male, who said you know,
are you you're taking thyroidmedication and you know hormone
replacement therapy.
You women this was the exactquote he said you women just
need to get over it and just goahead and get old and let that
(44:45):
happen.
And you know and at the sametime the same physician was
calling his you know, 50 yearold nurses, my girls, my girls.
So, as I was, as I was leavingand I said you know what this
isn't going to work, thisdiscussion and, by the way, your
50 year old nurse does not wantto be called your girl, so you
might talk to her about that.
So we parted ways after a shortvisit, but you know you're
(45:10):
talking about.
I mean, when we hear the term,just deal with it, whether it's
from a doctor in anotherspecialty or or, or friends, or
family, well meaning family, oh,just grow gracefully.
Whatever you know, when we'retalking about brain fog or low
libido or all these things, whatare some of the risks?
Talk about the actual risks tous of ignoring these things.
(45:32):
And also, can you shareexamples of when someone has
finally been able to crack thecode on all the information,
find a good provider and reclaimsome of their energy?
Give us an example of what thatswing can look like.
Speaker 2 (45:47):
Yeah, the risks and the swing.
So yeah, we're just done withthe, just deal with it, right?
Everyone is so done with thatand you know, I look back
through my training of you knowkind of what this doctor was
saying to you.
Like you women just need to doand how women, how women I mean.
Speaker 1 (46:09):
If someone says you women just run, yeah, run away.
How many women have been?
Speaker 2 (46:14):
gaslit for this decade-long hormonal shift
that's happening.
And you know, if a man had atestosterone of zero, do you
think he would be saying that tohim Like no?
You'd be like, oh, we gotta getthat replaced, right?
These are hormones that ourbody has used throughout our
whole life and so, of course,these symptoms that show up in
(46:40):
perimenopause, like the fatigue,the brain fog, the mood
symptoms that people have beentold to just deal with it.
They've been told like, oh,you've got small kids, you're
working full-time job, you'reopening a new business, of
course you're tired, of course,of course, of course.
And now we're starting tounderstand that the hormonal
shifts behind this are leadingto this, and of course it
(47:02):
affects us in the day to day,but it's actually a very risky
thing to ignore for some women.
You know there's a study out ofEngland that says that women's
highest chance of suicideattempt is in the ages of 45 to
49.
And so what is happening then?
(47:25):
Perimenopause, menopause, right?
So this isn't about justsucking it up.
These things can belife-threatening, right.
This can really affect people'smental and emotional health,
and it also can affect long-termhealth symptoms, right, bone
(47:46):
health, right, people fallinglater on in life, breaking hips
and that initially and thateventually leading to, you know,
their death.
I mean, I hate to be all likescary here, but this is, these
are real things that arehappening, right, and you know
there was just a recent study Iwant to say it's out of
(48:08):
Australia which you know.
I'm so thankful when I see newstudies out about hormonal
therapy and perimenopause andmenopause that showed that some
of these emotional symptoms thatare happening in perimenopause
are actually best served withstarting women on hormonal
therapy.
Now that doesn't mean thateveryone will just stop there.
(48:30):
Some people may need additionalsupport with, you know, ssris,
snris you know mental healthtype symptoms, type
prescriptions, but that in thisstudy the women's symptoms the
brain fog, the anxiety, thedepression type symptoms were
improved significantly withhormonal therapy and so I think
(48:53):
we're just going to see more andmore of that over the next
decade, right?
So hopefully people in thiscall who are in their twenties
are going to benefit so muchfrom you know this time where
people were like we got to learnmore are going to benefit so
much from you know this timewhere people were like we got to
learn more.
And you know what I see whenpeople come in and we get them
supported and we start.
(49:13):
You know, if they want to starthormone therapy, we do that is
that people get their life back.
Right, you know, a commonsymptom is I don't feel like
myself, right, there's even aacronym NFL and not feeling like
myself.
People come in and say I don'tfeel like myself, right, there's
even a acronym NFLM not feelinglike myself.
People come in and say I don'tfeel like myself and so, as we,
you know, support them from alifestyle standpoint, you know,
(49:35):
make, get those labs supported,start hormonal therapy if that's
indicated.
Then they come back in sixmonths and say, wow, like this
has changed everything.
My fatigue has affected how I'mshowing up with, you know, my
work in the world, with mypeople, my relationships, like,
(49:57):
like it's really, it's affectingthe things that we we are here
for, right To you know, livethis beautiful life Right.
And then, when we think aboutit from from a long-term health
perspective, it's important forall the reasons.
Speaker 1 (50:18):
Yeah, yeah, that is so helpful and I think just
advocating for ourselves.
On the labs you talked about,you know symptoms are one thing,
but when it's your own symptomsyou don't really know always
how to express that and what'snormal.
And sometimes the lab work justyesterday my lab work was
showing that my thyroid I'vebeen on thyroid medication was
really low.
And you know she says thingslike are you sleepy, are you
(50:43):
losing some hair?
Yes, yes, but I'm also, youknow, 60 and work 70 hours a
week so you never know what'sgoing on with that.
And so just making sure thatyou're advocating to actually
have your providers do the labwork, so they have, just like we
talk about in our businessesand our nonprofits get the data
and make data informed decisions, and I love that it all ties
(51:05):
together.
So do we want to have one morequestion before we let Dr
Markell close us out Anything?
Anyone that's just dying to aska question?
Speaker 4 (51:16):
I think there are so many questions on the chat that
unfortunately, we're not goingto get to them.
So definitely, dr Markell.
How can people get ahold of youor attend your practice or your
workshops?
I know you do a lot of those.
Speaker 2 (51:28):
I do as well.
Yes, so, yeah, I mean, pleasefollow me on Instagram, kristen
Markell MD.
Um, or my website is the same.
I'll just write it in here justfor my name.
Um, because you know I love toanswer questions.
I love to, uh, you know, a lotof times I'm sending out um free
(51:49):
guides and things like that toexplore different aspects of
perimenopause or health andwellbeing, um, even, you know,
during different seasons of life, not just perimenopause and
menopause, uh, but, yeah, Iwould love to connect with with
y'all.
I know we had a lot ofquestions.
I wish we had more time toanswer them because they're
(52:10):
definitely these are thequestions that I hear from women
and what we address in myprogram.
So, yeah, thank y'all so much.
Nobody says we can't haveanother session right.
Speaker 1 (52:21):
I mean probably the topic of menopause and hormonal
health could fill two sessions,I'm pretty sure.
Let me ask this last question.
I think I mean I'm just thereframing of so much.
You said we just want tocelebrate our body and celebrate
aging, because the alternativeis not what we want.
Right, we should never feelashamed of our.
(52:41):
Yesterday I asked my doctorabout something I was seeing on
the underside of my left breastand I mean we laughed.
She said Are you just seeingthis?
And I'm like, well, I have tothrow it over my shoulder before
I could really look.
So you know, I mean we laugh.
Enjoy our bodies they're notwhat we once were, maybe, but
they are fabulous and celebratethat aging and that wisdom and
(53:03):
creativity and ability to laughat ourselves that comes with
that.
But also just get some damnsleep, women.
Just prioritize your sleep.
If you don't take away anythingelse when you think I have to
work one more hour or you knownot, take a nap.
I love that.
And Shaga and Monica and somany of my friends on here who
(53:27):
build that community, build acommunity of women that you can
talk to and you trust acrossgenerations I think the
intergenerational.
I keep saying that.
But that's why I invest investbecause I love that.
I love that I continue to learnfrom women across generations.
So last thing I would like toto ask is if you could rewrite
(53:52):
the narrative, as you're doing,about women's health, aging and
menopause.
What would be your rallying cry?
What would you want that tosound like?
And and leave us with that, andthen Erica will toss it back to
you.
Speaker 2 (54:05):
Yeah, I always say that perimenopause is a portal,
right, it's this portal into thesecond half of your life and,
um, you know, that is really thegoal, right?
We're here to age and to takewhat we learned in the first
half of our life and refine itand put our energy towards the
(54:27):
things that mean the most to us.
And so, you know, I tell peopleto listen to themselves, listen
to what they need, to find apartner in that, so that you can
really take that time periodand just set yourself up for
success for the second half ofyour life.
Speaker 4 (54:48):
If you enjoyed the episode, share with a friend,
leave us a review and don'tforget to hit the subscribe
button.
And if you're ready to takeyour career in business to the
next level, apply to join ourcommunity of powerful women
eager to help you get there andstay there.
Go to wwwbestherco forwardslash membership.
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