November 17, 2025 • 29 mins
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We discuss a clear, practical guide to menopause, explaining what it is, why it happens, and how to manage the most common symptoms with everyday steps and evidence-based options. We set up next week’s deep dive on hormone therap.
• Defining menopause and typical timing
• Why estrogen declines and bodywide effects
• Common symptoms across sleep, mood, and metabolism
• Hot flashes and night sweats frequency and duration
• Vaginal and urinary symptoms that mimic UTIs
• Bone density loss and changing heart risk
• Lifestyle tactics that actually help
• When to ask about hormonal and non-hormonal treatments
• Teaser for hormone therapy update next week
Send us an email at yourcheckuppod@gmail.com
References
1. Menopause-Biology, Consequences, Supportive Care, and Therapeutic Options. Davis SR, Pinkerton J, Santoro N, Simoncini T. Cell. 2023;186(19):4038-4058. doi:10.1016/j.cell.2023.08.016.
2. The Menopause Transition: Signs, Symptoms, and Management Options. Santoro N, Roeca C, Peters BA, Neal-Perry G. The Journal of Clinical Endocrinology and Metabolism. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764.
3. Management of Menopausal Symptoms: A Review. Crandall CJ, Mehta JM, Manson JE. JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140.
4. Menopause. Davis SR, Lambrinoudaki I, Lumsden M, et al. Nature Reviews. Disease Primers. 2015;1:15004. doi:10.1038/nrdp.2015.4.
5. Menopause: Physiology, Definitions, and Symptoms. Gatenby C, Simpson P. Best Practice & Research. Clinical Endocrinology & Metabolism. 2024;38(1):101855. doi:10.1016/j.beem.2023.101855.
6. Reproductive Aging in Biological Females: Mechanisms and Immediate Consequences. Muhammad YA. Frontiers in Endocrinology. 2025;16:1658592. doi:10.3389/fendo.2025.1658592.
7. Treating Menopause - MHT and Beyond. Davis SR, Baber RJ. Nature Reviews. Endocrinology. 2022;18(8):490-502. doi:10.1038/s41574-022-00685-4.
8. Management of Perimenopausal and Menopausal Symptoms. Duralde ER, Sobel TH, Manson JE. BMJ (Clinical Research Ed.). 2023;382:e072612. doi:10.1136/bmj-2022-072612.
9. Hormone Therapy for Postmenopausal Women. Pinkerton JV. The New England Journal of Medicine. 2020;382(5):446-455. doi:10.1056/NEJMcp1714787.
10. An Empowerment Model for Managing Menopause. Hickey M, LaCroix AZ, Doust J, et al. Lancet (London, England). 2024;403(10430):947-957. doi:10.1016/S0140-6736(23)02799-X.
11. Menopause. Carter AE, Merriam S. The Medical Clinics of North America. 2023;107(2):199-212. doi:10.1016/j.mcna.2022.10.003.
Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN
Artwork Rebrand and Avatars:
Vantage Design Works (Vanessa Jones)
Website: https://www.vantagedesignworks.com/
Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr
Original Artwork Concept: Olivia Pawlowski
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:04):
Hi, welcome to your checkup.
We are the Patient EducationPodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try to bringmedicine closer to its patients.
I'm Ed Delesky, a familymedicine doctor in the
Philadelphia area.
SPEAKER_01 (00:20):
And I'm Nicole Ruffel.
I'm a nurse.
SPEAKER_00 (00:22):
And we are so excited you were able to join us
here again today.
So I we're uh jumping in herestraight off of this was a big
180.
Um, I I was moody.
It was very moody.
I don't know why.
SPEAKER_01 (00:42):
Yeah, you were because you were hungry
yesterday and today.
SPEAKER_00 (00:46):
I know.
Well, I got up and got right touh doing stuff after our talk
and like got busy and then hadlike a couple chips here and
there, had a couple espressobeans, and like that, no, that's
uh it's not sustenance now thatI look back on it.
Yesterday confused.
SPEAKER_01 (01:02):
Well, I made you breakfast.
SPEAKER_00 (01:03):
You did, you made me a great breakfast.
You did, you did, you did, youdid.
No, I I don't want the goodpeople to forget that like my
breakfast was amazing today.
There is not a gun pointed at myhead.
But yeah, we like walked over tothe grocery store, and for some
reason, like even peoplestanding next to me was
irritating, and I was likesnapping to myself.
(01:26):
It was kind of crazy, veryunlike me.
Except for people are botheringme.
SPEAKER_01 (01:32):
I know that's usually like my line.
I'm the one who's usuallybothered.
SPEAKER_00 (01:37):
I know.
Well, I um you know it was uh itwas upsetting to me, and I
didn't understand why until Ifound out that I was hangry.
I put our Monday dinner in thecrock pot, and I was like, you
know what?
I went to throw out the garbage.
Um you did?
I did.
(01:57):
No one no one came at me.
So there's I'll tell that story.
But then I heated up some whitechicken chili, delicious.
I do a good job with that, andthen within four minutes, I felt
completely normal.
When you came down the stairs, Ididn't want to rip anyone's head
off.
And I am officially someone whogets hangry.
SPEAKER_01 (02:17):
Yeah, you've been like this.
I've been trying to tell you.
SPEAKER_00 (02:21):
It felt like when it's like rainy outside and it
stops and the clouds give way tosunshine.
Like, no, it's crazy.
I was like thinking like screwit.
We're gonna put a reboot episodeup this week.
I'm not doing this today.
No, here we are, tried and true,coming through by the grace of
(02:43):
white chicken chili in my belly.
We're here.
Your checkup day and night.
Oh my god.
Bringing balanced healthconversation to the people.
Oh, well, how was your week thisweek?
SPEAKER_01 (02:59):
My week?
I don't know, it's fine.
Yeah.
Regular, degular week.
SPEAKER_00 (03:04):
I do love when you say regular, degular.
Um so we're going Christmas modenow.
Um, it's the earliest I've everengaged in Christmas mode.
And I think the I was thelimiting factor last year where
like, I think sincerely you werelike, let's do it, let's do it,
let's do it.
Around the same time.
And I ended up saying no.
(03:26):
And I was also a busy residentat the time.
But this year, even beforeThanksgiving, we're like, those
stockings are up.
SPEAKER_01 (03:33):
The stockings are up.
We'll put this janky Christmastree up.
SPEAKER_00 (03:37):
By the end of the night, the Christmas tree will
be up.
I'm nervous.
Um, last year it gave me a lotof Ajida.
Chris Nicholson, I'm gonna sendthis one to him because he um he
taught me that one back in theday, and I want him to hear
this.
Um Chris Nicholson, that is.
Um I put the lights upvertically and I can't tell if
you were just gonna be able toget the light.
SPEAKER_01 (03:57):
I want to get twinkle lights.
But I don't feel like waitingfor them, so we're just gonna
use our lights this year.
And then hopefully we're nothere for next Christmas and we
can have a new Christmas treeand our new house with twinkle
lights.
SPEAKER_00 (04:11):
Yeah, that'll be ideal.
Oh yeah, so I did well, so I Iput the lights up vertically
last year because I think I sawa video somewhere that that was
the best way to go.
And I don't know, I kept staringat it and I was like, I can so
obviously see that like this isso imperfect and looks weird.
So I don't know, I have to thinkabout how I'm gonna do it this
(04:34):
year.
SPEAKER_01 (04:36):
Probably just the old way.
The tree's a little like I don'tknow.
SPEAKER_00 (04:43):
Sparse.
So this is a little reassuringto me.
Maybe it's not my technique.
SPEAKER_01 (04:47):
I don't think it's you, I think it's the tree.
SPEAKER_00 (04:49):
Does it even really matter what way I put it up?
SPEAKER_01 (04:52):
No, because I think it's gonna look janky
regardless.
You know what I think willmotivate us to like not that we
need any more motivation to moveout of the city and buy a house.
When Christmas is over, yeah,we're putting the tree on the
curb.
SPEAKER_00 (05:12):
Oh.
SPEAKER_01 (05:13):
So we will be Christmas treeless.
SPEAKER_00 (05:15):
Right.
SPEAKER_01 (05:16):
So we will need to buy a new Christmas tree.
But we haven't bought a newChristmas tree because we don't
they're like not inexpensive.
SPEAKER_00 (05:22):
That's a good point.
SPEAKER_01 (05:23):
And I feel like if we are buying a new one, we want
to get kind of like a nicer one,or one that's like at least
nicer looking, maybe one thatalready has lights on it, you
know.
SPEAKER_00 (05:33):
Yep.
SPEAKER_01 (05:34):
But then we don't know like where our new house,
what that layout's gonna be.
Exactly.
What size tree we're gonna need.
So I don't want to buy one forthis.
SPEAKER_00 (05:43):
Yep.
SPEAKER_01 (05:43):
Like, I don't want to buy another little janky tree
for our little janky house.
SPEAKER_00 (05:49):
I gotta say, it's not you know the ceilings are
really tall though.
SPEAKER_01 (05:52):
So like you could go for it and get like a but where
are you putting a go for it treein our living room?
SPEAKER_00 (05:58):
I know, it wouldn't go over there.
It would it would the go for ittree would have to live in the
like the I'm walking into thehouse area.
SPEAKER_01 (06:05):
That's not a place for a go uh Christmas tree.
SPEAKER_00 (06:08):
Yeah, I feel like it's not cozy.
I would love to listen back tothese episodes from last year
and see what we were talkingabout and be like, yeah, yeah,
yeah.
This time next year, we're gonnawe're gonna do it.
Yeah, did we December 26th?
SPEAKER_01 (06:20):
It's going to the curb.
SPEAKER_00 (06:22):
I don't think we had a date for the wedding this time
last year, did we?
SPEAKER_01 (06:26):
No, we picked it in like April for a wedding in
October.
Yeah, sick.
SPEAKER_00 (06:30):
We're good.
We're good.
We did some good work.
Shout out Heather.
Yeah, so that's something that'sbeen happening here.
Um, on the menu this week is ateriyaki chicken in the crock
pot.
I bought a teriyaki sauce andwhile whilst me being hangry,
(06:51):
read the recipe again andfigured out that I did not need
a teriyaki sauce, and I waslike, GD, I just wasted so much
money doing this.
It was probably like fivedollars.
Um, all the stuff we had alreadylike soy sauce, um a ginger,
some garlic, uh, the chicken,honey, and then slap that all in
(07:17):
the crock pot for five hours.
Put some rice, and then you makethe like the light yum yum
sauce.
Which you don't like this mealfor some reason.
SPEAKER_01 (07:27):
I think it's the yum yum sauce I don't like.
I don't find it very yum yum.
SPEAKER_00 (07:32):
You don't need no, and it doesn't need a yum yum
sauce, but like I don't know.
It's like it's chicken, it'slean, it's tasty, it's like has
an Asian flair to it.
I don't understand.
Well, actually, we talked aboutthis.
SPEAKER_01 (07:46):
We yeah, I don't like chicken thighs.
SPEAKER_00 (07:47):
So it's chicken boob this time.
SPEAKER_01 (07:49):
Chicken boob.
SPEAKER_00 (07:50):
Oh god.
Um, yeah, that's what it is thistime.
So maybe you'll feel differentlyabout it, is my hope.
SPEAKER_01 (07:56):
We'll see.
I'll report back tomorrow.
SPEAKER_00 (07:59):
And then last night we got into a holiday movie,
Christmas movie, um, Holiday inHandcuffs, um, Melissa Joan Hart
special.
I got through about 45 minutesof the movie wondering what this
woman's name was, knowing that Ihad seen her in multiple places.
And nice movie, still half hourto go.
Unsure if we'll ever finish it,but we can finish it tonight.
(08:21):
Yeah, maybe we do finish ittonight.
Um, I like how you were like,oh, well, we'll watch a movie in
bed and it'll be so cozy.
And I turn on and you're out intwo minutes.
SPEAKER_01 (08:31):
Yeah, it was cozy.
What about it?
SPEAKER_00 (08:35):
Anyway.
And then um, in our reality TVviewing experience, as you can
tell, we haven't like gone outto dinner, which is fine.
You know, we're just regular,degular guys.
SPEAKER_01 (08:46):
Um the more you downloaded a new a new money
app, so now we can never go outto dinner.
unknown (08:52):
I did.
SPEAKER_00 (08:52):
I was like, that was also part of me freaking out
last night, just looking atstuff.
And then I like the governmentwebsite for my loans are back
on, and I was like, oop, dang.
Dang, this looks different.
Uh we'll see how the months go.
If and if the numbers don't gocrazy.
I know now I'm back to my oldways.
SPEAKER_01 (09:10):
No one's getting a Christmas gift this year.
We can't spend any money.
SPEAKER_00 (09:14):
No, Scrooge is cut Scrooge is coming in now.
Um, that's not, of course, thecase.
Uh I'd like to think I'm agenerous guy, but who knows?
Um and then oh, Secret Lives ofMormon Wives.
They're back on.
SPEAKER_01 (09:30):
Uh yeah, they're back on.
SPEAKER_00 (09:35):
You're not as into it.
SPEAKER_01 (09:37):
No, I mean like half the girls aren't on the show
anymore.
Or they're not like full-timecast people.
SPEAKER_00 (09:45):
Yeah.
SPEAKER_01 (09:45):
I am excited to watch um The Bachelorette this
year.
Probably for the first time inlike a decade, honestly.
SPEAKER_00 (09:52):
Oh, right, because she's gonna be oh yeah, yeah,
yeah.
SPEAKER_01 (09:55):
And she's like so problematic, so you know it'll
be good.
SPEAKER_00 (09:58):
That's a good point.
Oh my god, I forgot you saidthat.
When's that come on?
SPEAKER_01 (10:03):
I don't know.
SPEAKER_00 (10:04):
Yeah, we'll have to find out.
SPEAKER_01 (10:06):
Maybe like the spring.
I don't know what the the cycleof bachelor nation is anymore.
Let's see.
March 22nd, 2026.
SPEAKER_00 (10:16):
Oh, we've got some time.
SPEAKER_01 (10:17):
Yeah.
SPEAKER_00 (10:18):
Yeah, well, we're we're set up with a couple of
our other shows.
A couple Bravo shows coming toan end, a couple starting.
They're always good to us.
You know, they pace them out,they have like one show after
another.
And then for the two TV setup,basketball is coming back on,
football's in full swing.
So, you know, ourentertainment's pretty much
covered.
I feel like there was there'ssomething else that happened
(10:39):
this week that I meant to talkabout.
SPEAKER_01 (10:44):
Did you write it down?
SPEAKER_00 (10:46):
No, I didn't have a big banter write down section
because last week we just likewent for it without having
written like written it down.
SPEAKER_01 (10:54):
Did you know they're discontinuing the penny?
SPEAKER_00 (10:57):
Whoa, okay.
No, I did not.
SPEAKER_01 (10:59):
I feel like we should have a set, like a
current event segment for youspecifically, because you never
know what's going on.
I'm in there in the world.
I feel like you're not.
SPEAKER_00 (11:11):
No, I've been trying.
No, no, no.
I'm in there as in we should dothis because I've been trying to
like, you know, we have ourbanter section, we have our
medsection.
SPEAKER_01 (11:19):
I want this is the section we need because like I
remember even a couple weeks agowhen it was raining a lot, and
you were like, wow, it's reallyraining.
And I'm like, Yeah, there's acategory five hurricane that
just took out half of Jamaica.
You were like, Really?
No way.
And then wait, something elsehappened.
Oh, the um when they robbed theLouvre.
Oh, that was a big one.
(11:39):
No idea.
And then we were at a Halloweenparty, and two people like dress
up as robbers, and they had likejewels and whatever.
And he had no idea why, and likewhy people thought that was
funny.
SPEAKER_00 (11:50):
No, I had no clue.
No, this is good.
So let's um, and it'sorganically happening.
So hit me with the highlights.
What's happening with the penny?
SPEAKER_01 (11:57):
Um, I think they're gonna stop production of it in
2026.
Well, I think some of the mintsalready stopped because it c I
think it's that it costs.
See, I should have came preparednow with my facts.
I was just trying to haveconversation.
I think it costs uh like 13cents to make a penny.
SPEAKER_00 (12:17):
Oh, it sounds like it's not worth it.
SPEAKER_01 (12:21):
So they're yeah.
SPEAKER_00 (12:22):
Wow.
Inflation.
Well, and production.
That's crazy.
SPEAKER_01 (12:29):
Yeah.
You really you didn't hear aboutthis?
SPEAKER_00 (12:31):
Like not a single word.
No.
My life exists between twopatient rooms.
SPEAKER_01 (12:36):
Yeah, yeah, we know.
SPEAKER_00 (12:37):
All right.
SPEAKER_01 (12:38):
You're such a busy doctor, we know.
SPEAKER_00 (12:42):
Oops.
Um, wow, the penny's gone.
What's next?
Well, I mean, it also soundslike the nickel is on its way
out.
The dime not too far behind.
SPEAKER_01 (12:54):
A nickel, it also I forget.
I was reading a thing about it.
I think like for every onedollar made at least for coins.
I don't know if this is uh thesame with like paper bills.
For every one dollar made, itcost like$175 or something.
(13:14):
Something like that.
SPEAKER_00 (13:16):
Wow.
SPEAKER_01 (13:16):
Like it costs more to make our money.
SPEAKER_00 (13:18):
Huh.
SPEAKER_01 (13:20):
Than what it's worth.
SPEAKER_00 (13:22):
That's kind of crazy.
SPEAKER_01 (13:25):
I know.
Especially since money is fake.
SPEAKER_00 (13:28):
So yeah, you say that, but I I downloaded that
app now and it's time to pay thepiper.
Um let's see, maybe I did writesomething down.
Wow.
Any other current events you gotgoing on?
SPEAKER_01 (13:41):
Um, not off the top of my head.
SPEAKER_00 (13:43):
There's one related to an episode like this week's
and next week's episode.
SPEAKER_01 (13:46):
So that's why the hormone replacement stuff.
SPEAKER_00 (13:49):
Yeah.
Um, which is important, butwe're going to dole out our
information slowly because we'rein no rush.
Let's see.
Maybe if I had any banter.
SPEAKER_01 (14:00):
What are we talking about today, Ed?
SPEAKER_00 (14:02):
Oh, that's different.
So today we are talking aboutmenopause.
You probably heard in the news,um, there's a New York Times
article that came out explainingthat the black box warning for
hormone replacement therapy wasbeing removed by the FDA.
So that's something we're goingto talk about specifically next
(14:25):
week.
But this week we are going tointroduce the concept of
menopause for everyonelistening.
And this is not just for men.
This is not just for women.
This is for men who often getconfused, probably, about
menopause and maybe don't knowenough about it.
And so, without further ado, whydon't we take our journey about
(14:50):
menopause, which should probablybe called metastop.
So, menopause is something everywoman who lives past midlife
will experience.
But it's a hot topic that issurrounded by confusion and a
little bit of silence.
So, today we're talking aboutwhat menopause is, why it
(15:10):
happens, and how it affects thebody.
And we're doing all of thisbefore we dive into treatments
like hormone replacementtherapy.
SPEAKER_01 (15:16):
We'll walk through the biology, common symptoms,
and ways to stay healthy duringthis time.
SPEAKER_00 (15:23):
And all of this is based on evidence from journals
at JAMA, the BMJ, Cell, and theAmerican Heart Association.
So our first section is what ismenopause?
Menopause is a natural stage oflife when the ovaries stop
making hormones like estrogen,and periods stop for good.
It's diagnosed, which is a weirdthing to say because it's not a
(15:45):
disease, but for lack of abetter word, it's diagnosed
after 12 months without a periodthat isn't caused by another
condition.
SPEAKER_01 (15:54):
Most women reach menopause somewhere between the
ages of 45 and 56, with theaverage obviously being
somewhere right around themiddle at 51.
It can happen earlier,especially if there are certain
surgeries, medical treatments,or other health conditions.
SPEAKER_00 (16:11):
And a quick but interesting fact is that about
one million women in the UnitedStates enter menopause each
year.
So our next segment is about whymenopause happens.
Menopause happens because overtime the ovaries gradually stop
working.
They make fewer eggs andtherefore produce less estrogen
(16:32):
and progesterone.
And these hormones help regulatethe menstrual cycle.
They also support bone, heart,and brain health.
SPEAKER_01 (16:40):
And as these hormones drop, a woman's periods
will become irregular and theneventually stop completely.
And it's the drop in estrogenthat affects many body systems,
which is why I can feel well,not feel like it affects your
whole body.
It does affect your whole body.
SPEAKER_00 (16:59):
Right.
So specifically, the things thathappen is because um are, like
you said, related to estrogenand it does a lot.
It keeps bone strong, it doessupport heart health.
It is why women have a lowercardiovascular risk all the way
through up until menopause.
And then afterwards, they havesimilar rates and rates of
(17:19):
cardiovascular disease as menafter menopause.
So when we notice this withestrogen dropping, that's when
symptoms appear.
And these symptoms are thethings that bother women the
most.
And I'm talking about thingslike hot flashes or night
sweats.
Women also experience thingslike sleep problems.
There also may be some moodswings that people experience or
(17:41):
vaginal dryness.
And so these symptoms themselvescan be extremely bothersome.
They can last for several yearsand affect daily life.
Things that you're doing everyday, they can affect your
function.
I've seen women who arepractically driven mad by these
symptoms.
And it affects their functionbecause they're moody, they
(18:03):
can't sleep, maybe they'reexperiencing some metabolic
changes, gaining weightcentrally, and it's impacting
their function ultimately.
And while these changes arehappening, they're also
technically completely normal,maybe, because it's what the
body is naturally doing.
(18:25):
So, Nikki, can you tell us alittle bit more about how common
menopause is and who's affected?
SPEAKER_01 (18:30):
Well, it's very common, so much so that every
woman who reaches midlife.
I why is it worded that way?
Who reaches midlife willexperience menopause?
SPEAKER_00 (18:41):
Because some people don't reach midlife.
SPEAKER_01 (18:44):
Um, globally, the average age is about 49, but
that can vary by many differentfactors.
Um 10% of women will experiencemenopause before the age of 45,
and about 2% will experience itbefore the age of 40, which is
called premature menopause.
Um, this can also happensuddenly if your like ovaries
(19:09):
were removed, or um, things likechemotherapy can make this
happen probably earlier than itwould have.
SPEAKER_00 (19:17):
Yeah.
I I found those figuresinteresting and helpful because
I think perimenopause, whichwill get its own episode, don't
you worry.
But perimenopause is somethingthat is very much in the
zeitgeist and talked about.
Um, I've had patients come inand say, like, oh, you know, all
the girlies are talking aboutperimenopause now, and
(19:37):
reasonably so.
And I think this is very helpfulto say this out, like, oh, well,
one in ten women gets before age45.
And like it's a concrete thingto to go for and say, like,
yeah, you know, it's earlierthan some, but maybe not
completely abnormal.
(19:58):
You know?
Um so common symptoms.
We've alluded to some, butsymptoms can vary widely from
person to person, but here itends up being what's most common
with a little bit of extrainformation.
So hot flashes and night sweatsare very common, so common, in
fact, that they affect up to 75%of women, and I'm sorry, can
(20:21):
also last over seven years.
SPEAKER_01 (20:28):
You know, that TikTok sound.
I I forget what it's from, butit's that girl, and she's like,
oh, I love being a woman.
SPEAKER_00 (20:37):
Well, you know, this actually helps because the
recent lifting of the black boxwarning, um, a little do like
ditty into next week, is thatyou know, now it's reasonable to
consider doing hormonereplacement therapy, which is
like the most effectivetreatment.
SPEAKER_01 (20:53):
I'm definitely gonna get myself some of that.
Is what's that average age?
49 for my 49th birthday.
Well, that's what I want.
SPEAKER_00 (21:00):
For 50.
It's like within 10 women within10 years of menopause that it's
reasonable to do this.
So if the hot flash is likeroutinely average, maybe, or
they can, rather not routinely,but they can last seven years.
You know, you're well coveredusing the treatments until like
age 60 or whatever.
So that's something.
Before I move on, did you haveany other thoughts about your
(21:22):
49th birthday?
SPEAKER_01 (21:24):
No, luckily it's very, very, very far away.
SPEAKER_00 (21:27):
Very far away.
Um, women can also experiencevaginal and urinary symptoms.
This would include things likedryness, discomfort, and
irritation.
So these often worsen with time.
This is a little nugget.
It's interesting because I tendto see that women of a certain
age get something that feelslike a urinary tract infection,
(21:50):
and then it kind of goes on,goes off, bothers them.
You do all of the routinetesting, get the urine, maybe
you get a urine culture, and yousee that there's nothing and
there's no bug growing in therethat's giving them this.
But it actually could be thesevaginal symptoms of menopause.
So this is something that has asolution.
(22:13):
We're gonna talk about thoselater in the episode and next
week.
But these are not things thatwomen have to live with,
especially now.
And even before there wereoptions that were totally
reasonable.
So it's definitely things to doand be proactive, not just kind
of suffer in silence, like whatwe talked about earlier in the
episode.
(22:33):
Um, women can also experiencesleep problems, and this can
look like a variety of thingsdifficulty falling or staying
asleep.
Mood changes are also common,um, looking more like things
like anxiety or symptoms ofworry, worry about anything in
life, irritability, anddepression or sadness, or just a
(22:54):
deep, you know, very broad-baseddefinition that we have a whole
episode about.
There are other changes thathappen in menopause, which
include lower libido or sexdrive, memory issues, weight
gain, especially around thebelly, some, I mean, people's
bone health.
We talked about this last week,peaks at 30, but there's even a
more of a decline withmenopause, so uh bone loss, and
(23:18):
shifts in cholesterol and bloodpressure.
All things that go hand in handwith menopause.
But something that's reallyimportant to know is that not
everyone has all of thesesymptoms.
So this is not a sentence forall women who reach midlife that
you're going to get thesethings, thankfully.
(23:39):
And just because they're commondoesn't mean that you'll just
have to, you know, tough themout as if it's something that's
you're destined to have.
Something, just a little dittyto include in here is something
I mentioned earlier, but wantedto call out specifically.
Going through menopause doestend to increase your risk of
osteoporosis.
That's why the guidance forscreening for osteoporosis and
(24:02):
osteopenia mainly starts inwomen at age 65, and that's
usually where the guidancestarts and ends.
There are other situations, ofcourse, but because that
decreased estrogen is present,because there is decreased
estrogen, that leads to not aslike vivaceous bone health.
What we also know is that whenwomen enter menopause, the
(24:26):
cardiovascular risk kind ofevens out between them, women,
and men.
Um biologically, of course.
So, Nikki, I've been rambling.
Just wanted to put those couplethings in there.
Can you give us some ideas orthings to be proactive about?
I think a lot of women probablyalready do these things, but
(24:48):
maybe there's some that peopledon't know about.
So, what are some lifestyle tipsfor women to help with symptoms
of menopause?
SPEAKER_01 (24:56):
Let's see.
Oh, for the good, lovely hotflashes, you can dress in layers
so that, you know, when you'reout in public and get a hot
flash, you can take a couplelayers off.
Using a fan, you can get one ofthose little handheld fans on
Amazon.
Keeping your bedroom cool foragain, hot flashes or night
(25:18):
sweats.
Also, if you're not alreadykeeping your bedroom cool when
you're sleeping, um, what areyou doing?
Staying active, um, doing thingslike walking, yoga, swimming.
These will just all around helpwith your mood, your sleep, and
your weight, eating balancedmeals with fruits, veggies, lean
(25:38):
proteins and whole grains, maybesomething like the Mediterranean
diet, which we love to talkabout.
We do love a Mediterranean diet.
Um, avoid smoking and limitingalcohol and caffeine.
Um, practicing relaxation, sodeep breathing, meditation, or
mindfulness.
And then um you can use awater-based vaginal moisturizer
(26:02):
or lubricants if that's givingyou some trouble.
SPEAKER_00 (26:06):
Yeah, all great options, things you can quite
literally start tonight orwhenever you're listening to
this.
And if you do all of thesethings and you find that
symptoms still interfere withthe quality of your life, there
are now, I mean, plenty, therealways were, but there are
plenty of medical options thatexist.
And what ends up happening isthe most effective of them is
(26:28):
some way, shape, or form ofhormone therapy.
And that is exactly what we'regoing to explore next week
because it's a hot topic in thenews.
There is a lot of conversation,which I think is perfect for a
podcast, to kind of explain whythis was such a poo-poo, or like
in the medical world, likesomething that was just like
(26:50):
reserved on the side and kind oflike, oof, it's very high risk.
SPEAKER_01 (26:54):
It's because everyone hates women.
SPEAKER_00 (26:57):
I can't wait to talk about it, but for next week.
And then but there are alsoother ones, too.
There are also non-hormonaltreatments to ask your doctor
about that.
We won't go in and dive in eachand every option, but it's a
reasonable question.
You could sit in front of themand say, Hi, I'm having
vasomotor symptoms of menopause,or I'm having hot flashes.
(27:20):
Are there non-hormonal optionsthat can help with this?
And they will either say, Yes, Iam familiar, or they will refer
you to someone who knows morethan them.
Um reasonable things to ask yourdoctor.
And now increasingly so, likealso reasonable to probably ask
about hormone replacementtherapy.
(27:41):
So, menopause.
It is a normal stage of life,but I imagine, because I have
not experienced menopause, Iwill not experience menopause,
then it feels overwhelming andmaybe not talked about so much.
So that's why, you know,altogether on this show we feel
that knowledge is power.
(28:01):
And that's why we covered whatwe think is a really important
topic today.
Uh, like we said, next week weare going to talk about hormone
replacement therapy and updatesin the recent news and why we
are where we are today.
But until then, thank you forcoming back to another episode
(28:21):
of Your Checkup.
Hopefully, you were able tolearn something for yourself, a
loved one, or a neighbor goingthrough menopause.
Send us an email atyourcheckuppod at gmail.com.
You can find us on Instagram.
You can follow me on personalInstagram and see my reels.
Um you can share this with aloved one or a neighbor or a
friend.
Um, we are always looking formore people to tune in.
(28:44):
And most importantly, stayhealthy, my friends.
Until next time, I'm Ed Delesky.
SPEAKER_01 (28:49):
I'm Cole Ruffo.
SPEAKER_00 (28:50):
Thank you and goodbye.
SPEAKER_01 (28:52):
Bye.
SPEAKER_00 (28:59):
This information may provide a brief overview of
diagnosis, treatment, andmedications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments, or
medications for a specificperson.
This is not medical advice or anattempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
(29:21):
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorse anytreatments or medications for a
specific patient.
Always talk to your healthcareprovider for a complete
information tailored to you.
In short, I'm not your doctor.
I am not your nurse.
And make sure you go get yourown checkup with your own
personal doctor.
Hi, welcome to your checkup.
We are the Patient EducationPodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try to bringmedicine closer to its patients.
I'm Ed Delesky, a familymedicine doctor in the
Philadelphia area.
SPEAKER_01 (00:20):
And I'm Nicole Ruffel.
I'm a nurse.
SPEAKER_00 (00:22):
And we are so excited you were able to join us
here again today.
So I we're uh jumping in herestraight off of this was a big
180.
Um, I I was moody.
It was very moody.
I don't know why.
SPEAKER_01 (00:42):
Yeah, you were because you were hungry
yesterday and today.
SPEAKER_00 (00:46):
I know.
Well, I got up and got right touh doing stuff after our talk
and like got busy and then hadlike a couple chips here and
there, had a couple espressobeans, and like that, no, that's
uh it's not sustenance now thatI look back on it.
Yesterday confused.
SPEAKER_01 (01:02):
Well, I made you breakfast.
SPEAKER_00 (01:03):
You did, you made me a great breakfast.
You did, you did, you did, youdid.
No, I I don't want the goodpeople to forget that like my
breakfast was amazing today.
There is not a gun pointed at myhead.
But yeah, we like walked over tothe grocery store, and for some
reason, like even peoplestanding next to me was
irritating, and I was likesnapping to myself.
(01:26):
It was kind of crazy, veryunlike me.
Except for people are botheringme.
SPEAKER_01 (01:32):
I know that's usually like my line.
I'm the one who's usuallybothered.
SPEAKER_00 (01:37):
I know.
Well, I um you know it was uh itwas upsetting to me, and I
didn't understand why until Ifound out that I was hangry.
I put our Monday dinner in thecrock pot, and I was like, you
know what?
I went to throw out the garbage.
Um you did?
I did.
(01:57):
No one no one came at me.
So there's I'll tell that story.
But then I heated up some whitechicken chili, delicious.
I do a good job with that, andthen within four minutes, I felt
completely normal.
When you came down the stairs, Ididn't want to rip anyone's head
off.
And I am officially someone whogets hangry.
SPEAKER_01 (02:17):
Yeah, you've been like this.
I've been trying to tell you.
SPEAKER_00 (02:21):
It felt like when it's like rainy outside and it
stops and the clouds give way tosunshine.
Like, no, it's crazy.
I was like thinking like screwit.
We're gonna put a reboot episodeup this week.
I'm not doing this today.
No, here we are, tried and true,coming through by the grace of
(02:43):
white chicken chili in my belly.
We're here.
Your checkup day and night.
Oh my god.
Bringing balanced healthconversation to the people.
Oh, well, how was your week thisweek?
SPEAKER_01 (02:59):
My week?
I don't know, it's fine.
Yeah.
Regular, degular week.
SPEAKER_00 (03:04):
I do love when you say regular, degular.
Um so we're going Christmas modenow.
Um, it's the earliest I've everengaged in Christmas mode.
And I think the I was thelimiting factor last year where
like, I think sincerely you werelike, let's do it, let's do it,
let's do it.
Around the same time.
And I ended up saying no.
(03:26):
And I was also a busy residentat the time.
But this year, even beforeThanksgiving, we're like, those
stockings are up.
SPEAKER_01 (03:33):
The stockings are up.
We'll put this janky Christmastree up.
SPEAKER_00 (03:37):
By the end of the night, the Christmas tree will
be up.
I'm nervous.
Um, last year it gave me a lotof Ajida.
Chris Nicholson, I'm gonna sendthis one to him because he um he
taught me that one back in theday, and I want him to hear
this.
Um Chris Nicholson, that is.
Um I put the lights upvertically and I can't tell if
you were just gonna be able toget the light.
SPEAKER_01 (03:57):
I want to get twinkle lights.
But I don't feel like waitingfor them, so we're just gonna
use our lights this year.
And then hopefully we're nothere for next Christmas and we
can have a new Christmas treeand our new house with twinkle
lights.
SPEAKER_00 (04:11):
Yeah, that'll be ideal.
Oh yeah, so I did well, so I Iput the lights up vertically
last year because I think I sawa video somewhere that that was
the best way to go.
And I don't know, I kept staringat it and I was like, I can so
obviously see that like this isso imperfect and looks weird.
So I don't know, I have to thinkabout how I'm gonna do it this
(04:34):
year.
SPEAKER_01 (04:36):
Probably just the old way.
The tree's a little like I don'tknow.
SPEAKER_00 (04:43):
Sparse.
So this is a little reassuringto me.
Maybe it's not my technique.
SPEAKER_01 (04:47):
I don't think it's you, I think it's the tree.
SPEAKER_00 (04:49):
Does it even really matter what way I put it up?
SPEAKER_01 (04:52):
No, because I think it's gonna look janky
regardless.
You know what I think willmotivate us to like not that we
need any more motivation to moveout of the city and buy a house.
When Christmas is over, yeah,we're putting the tree on the
curb.
SPEAKER_00 (05:12):
Oh.
SPEAKER_01 (05:13):
So we will be Christmas treeless.
SPEAKER_00 (05:15):
Right.
SPEAKER_01 (05:16):
So we will need to buy a new Christmas tree.
But we haven't bought a newChristmas tree because we don't
they're like not inexpensive.
SPEAKER_00 (05:22):
That's a good point.
SPEAKER_01 (05:23):
And I feel like if we are buying a new one, we want
to get kind of like a nicer one,or one that's like at least
nicer looking, maybe one thatalready has lights on it, you
know.
SPEAKER_00 (05:33):
Yep.
SPEAKER_01 (05:34):
But then we don't know like where our new house,
what that layout's gonna be.
Exactly.
What size tree we're gonna need.
So I don't want to buy one forthis.
SPEAKER_00 (05:43):
Yep.
SPEAKER_01 (05:43):
Like, I don't want to buy another little janky tree
for our little janky house.
SPEAKER_00 (05:49):
I gotta say, it's not you know the ceilings are
really tall though.
SPEAKER_01 (05:52):
So like you could go for it and get like a but where
are you putting a go for it treein our living room?
SPEAKER_00 (05:58):
I know, it wouldn't go over there.
It would it would the go for ittree would have to live in the
like the I'm walking into thehouse area.
SPEAKER_01 (06:05):
That's not a place for a go uh Christmas tree.
SPEAKER_00 (06:08):
Yeah, I feel like it's not cozy.
I would love to listen back tothese episodes from last year
and see what we were talkingabout and be like, yeah, yeah,
yeah.
This time next year, we're gonnawe're gonna do it.
Yeah, did we December 26th?
SPEAKER_01 (06:20):
It's going to the curb.
SPEAKER_00 (06:22):
I don't think we had a date for the wedding this time
last year, did we?
SPEAKER_01 (06:26):
No, we picked it in like April for a wedding in
October.
Yeah, sick.
SPEAKER_00 (06:30):
We're good.
We're good.
We did some good work.
Shout out Heather.
Yeah, so that's something that'sbeen happening here.
Um, on the menu this week is ateriyaki chicken in the crock
pot.
I bought a teriyaki sauce andwhile whilst me being hangry,
(06:51):
read the recipe again andfigured out that I did not need
a teriyaki sauce, and I waslike, GD, I just wasted so much
money doing this.
It was probably like fivedollars.
Um, all the stuff we had alreadylike soy sauce, um a ginger,
some garlic, uh, the chicken,honey, and then slap that all in
(07:17):
the crock pot for five hours.
Put some rice, and then you makethe like the light yum yum
sauce.
Which you don't like this mealfor some reason.
SPEAKER_01 (07:27):
I think it's the yum yum sauce I don't like.
I don't find it very yum yum.
SPEAKER_00 (07:32):
You don't need no, and it doesn't need a yum yum
sauce, but like I don't know.
It's like it's chicken, it'slean, it's tasty, it's like has
an Asian flair to it.
I don't understand.
Well, actually, we talked aboutthis.
SPEAKER_01 (07:46):
We yeah, I don't like chicken thighs.
SPEAKER_00 (07:47):
So it's chicken boob this time.
SPEAKER_01 (07:49):
Chicken boob.
SPEAKER_00 (07:50):
Oh god.
Um, yeah, that's what it is thistime.
So maybe you'll feel differentlyabout it, is my hope.
SPEAKER_01 (07:56):
We'll see.
I'll report back tomorrow.
SPEAKER_00 (07:59):
And then last night we got into a holiday movie,
Christmas movie, um, Holiday inHandcuffs, um, Melissa Joan Hart
special.
I got through about 45 minutesof the movie wondering what this
woman's name was, knowing that Ihad seen her in multiple places.
And nice movie, still half hourto go.
Unsure if we'll ever finish it,but we can finish it tonight.
(08:21):
Yeah, maybe we do finish ittonight.
Um, I like how you were like,oh, well, we'll watch a movie in
bed and it'll be so cozy.
And I turn on and you're out intwo minutes.
SPEAKER_01 (08:31):
Yeah, it was cozy.
What about it?
SPEAKER_00 (08:35):
Anyway.
And then um, in our reality TVviewing experience, as you can
tell, we haven't like gone outto dinner, which is fine.
You know, we're just regular,degular guys.
SPEAKER_01 (08:46):
Um the more you downloaded a new a new money
app, so now we can never go outto dinner.
unknown (08:52):
I did.
SPEAKER_00 (08:52):
I was like, that was also part of me freaking out
last night, just looking atstuff.
And then I like the governmentwebsite for my loans are back
on, and I was like, oop, dang.
Dang, this looks different.
Uh we'll see how the months go.
If and if the numbers don't gocrazy.
I know now I'm back to my oldways.
SPEAKER_01 (09:10):
No one's getting a Christmas gift this year.
We can't spend any money.
SPEAKER_00 (09:14):
No, Scrooge is cut Scrooge is coming in now.
Um, that's not, of course, thecase.
Uh I'd like to think I'm agenerous guy, but who knows?
Um and then oh, Secret Lives ofMormon Wives.
They're back on.
SPEAKER_01 (09:30):
Uh yeah, they're back on.
SPEAKER_00 (09:35):
You're not as into it.
SPEAKER_01 (09:37):
No, I mean like half the girls aren't on the show
anymore.
Or they're not like full-timecast people.
SPEAKER_00 (09:45):
Yeah.
SPEAKER_01 (09:45):
I am excited to watch um The Bachelorette this
year.
Probably for the first time inlike a decade, honestly.
SPEAKER_00 (09:52):
Oh, right, because she's gonna be oh yeah, yeah,
yeah.
SPEAKER_01 (09:55):
And she's like so problematic, so you know it'll
be good.
SPEAKER_00 (09:58):
That's a good point.
Oh my god, I forgot you saidthat.
When's that come on?
SPEAKER_01 (10:03):
I don't know.
SPEAKER_00 (10:04):
Yeah, we'll have to find out.
SPEAKER_01 (10:06):
Maybe like the spring.
I don't know what the the cycleof bachelor nation is anymore.
Let's see.
March 22nd, 2026.
SPEAKER_00 (10:16):
Oh, we've got some time.
SPEAKER_01 (10:17):
Yeah.
SPEAKER_00 (10:18):
Yeah, well, we're we're set up with a couple of
our other shows.
A couple Bravo shows coming toan end, a couple starting.
They're always good to us.
You know, they pace them out,they have like one show after
another.
And then for the two TV setup,basketball is coming back on,
football's in full swing.
So, you know, ourentertainment's pretty much
covered.
I feel like there was there'ssomething else that happened
(10:39):
this week that I meant to talkabout.
SPEAKER_01 (10:44):
Did you write it down?
SPEAKER_00 (10:46):
No, I didn't have a big banter write down section
because last week we just likewent for it without having
written like written it down.
SPEAKER_01 (10:54):
Did you know they're discontinuing the penny?
SPEAKER_00 (10:57):
Whoa, okay.
No, I did not.
SPEAKER_01 (10:59):
I feel like we should have a set, like a
current event segment for youspecifically, because you never
know what's going on.
I'm in there in the world.
I feel like you're not.
SPEAKER_00 (11:11):
No, I've been trying.
No, no, no.
I'm in there as in we should dothis because I've been trying to
like, you know, we have ourbanter section, we have our
medsection.
SPEAKER_01 (11:19):
I want this is the section we need because like I
remember even a couple weeks agowhen it was raining a lot, and
you were like, wow, it's reallyraining.
And I'm like, Yeah, there's acategory five hurricane that
just took out half of Jamaica.
You were like, Really?
No way.
And then wait, something elsehappened.
Oh, the um when they robbed theLouvre.
Oh, that was a big one.
(11:39):
No idea.
And then we were at a Halloweenparty, and two people like dress
up as robbers, and they had likejewels and whatever.
And he had no idea why, and likewhy people thought that was
funny.
SPEAKER_00 (11:50):
No, I had no clue.
No, this is good.
So let's um, and it'sorganically happening.
So hit me with the highlights.
What's happening with the penny?
SPEAKER_01 (11:57):
Um, I think they're gonna stop production of it in
2026.
Well, I think some of the mintsalready stopped because it c I
think it's that it costs.
See, I should have came preparednow with my facts.
I was just trying to haveconversation.
I think it costs uh like 13cents to make a penny.
SPEAKER_00 (12:17):
Oh, it sounds like it's not worth it.
SPEAKER_01 (12:21):
So they're yeah.
SPEAKER_00 (12:22):
Wow.
Inflation.
Well, and production.
That's crazy.
SPEAKER_01 (12:29):
Yeah.
You really you didn't hear aboutthis?
SPEAKER_00 (12:31):
Like not a single word.
No.
My life exists between twopatient rooms.
SPEAKER_01 (12:36):
Yeah, yeah, we know.
SPEAKER_00 (12:37):
All right.
SPEAKER_01 (12:38):
You're such a busy doctor, we know.
SPEAKER_00 (12:42):
Oops.
Um, wow, the penny's gone.
What's next?
Well, I mean, it also soundslike the nickel is on its way
out.
The dime not too far behind.
SPEAKER_01 (12:54):
A nickel, it also I forget.
I was reading a thing about it.
I think like for every onedollar made at least for coins.
I don't know if this is uh thesame with like paper bills.
For every one dollar made, itcost like$175 or something.
(13:14):
Something like that.
SPEAKER_00 (13:16):
Wow.
SPEAKER_01 (13:16):
Like it costs more to make our money.
SPEAKER_00 (13:18):
Huh.
SPEAKER_01 (13:20):
Than what it's worth.
SPEAKER_00 (13:22):
That's kind of crazy.
SPEAKER_01 (13:25):
I know.
Especially since money is fake.
SPEAKER_00 (13:28):
So yeah, you say that, but I I downloaded that
app now and it's time to pay thepiper.
Um let's see, maybe I did writesomething down.
Wow.
Any other current events you gotgoing on?
SPEAKER_01 (13:41):
Um, not off the top of my head.
SPEAKER_00 (13:43):
There's one related to an episode like this week's
and next week's episode.
SPEAKER_01 (13:46):
So that's why the hormone replacement stuff.
SPEAKER_00 (13:49):
Yeah.
Um, which is important, butwe're going to dole out our
information slowly because we'rein no rush.
Let's see.
Maybe if I had any banter.
SPEAKER_01 (14:00):
What are we talking about today, Ed?
SPEAKER_00 (14:02):
Oh, that's different.
So today we are talking aboutmenopause.
You probably heard in the news,um, there's a New York Times
article that came out explainingthat the black box warning for
hormone replacement therapy wasbeing removed by the FDA.
So that's something we're goingto talk about specifically next
(14:25):
week.
But this week we are going tointroduce the concept of
menopause for everyonelistening.
And this is not just for men.
This is not just for women.
This is for men who often getconfused, probably, about
menopause and maybe don't knowenough about it.
And so, without further ado, whydon't we take our journey about
(14:50):
menopause, which should probablybe called metastop.
So, menopause is something everywoman who lives past midlife
will experience.
But it's a hot topic that issurrounded by confusion and a
little bit of silence.
So, today we're talking aboutwhat menopause is, why it
(15:10):
happens, and how it affects thebody.
And we're doing all of thisbefore we dive into treatments
like hormone replacementtherapy.
SPEAKER_01 (15:16):
We'll walk through the biology, common symptoms,
and ways to stay healthy duringthis time.
SPEAKER_00 (15:23):
And all of this is based on evidence from journals
at JAMA, the BMJ, Cell, and theAmerican Heart Association.
So our first section is what ismenopause?
Menopause is a natural stage oflife when the ovaries stop
making hormones like estrogen,and periods stop for good.
It's diagnosed, which is a weirdthing to say because it's not a
(15:45):
disease, but for lack of abetter word, it's diagnosed
after 12 months without a periodthat isn't caused by another
condition.
SPEAKER_01 (15:54):
Most women reach menopause somewhere between the
ages of 45 and 56, with theaverage obviously being
somewhere right around themiddle at 51.
It can happen earlier,especially if there are certain
surgeries, medical treatments,or other health conditions.
SPEAKER_00 (16:11):
And a quick but interesting fact is that about
one million women in the UnitedStates enter menopause each
year.
So our next segment is about whymenopause happens.
Menopause happens because overtime the ovaries gradually stop
working.
They make fewer eggs andtherefore produce less estrogen
(16:32):
and progesterone.
And these hormones help regulatethe menstrual cycle.
They also support bone, heart,and brain health.
SPEAKER_01 (16:40):
And as these hormones drop, a woman's periods
will become irregular and theneventually stop completely.
And it's the drop in estrogenthat affects many body systems,
which is why I can feel well,not feel like it affects your
whole body.
It does affect your whole body.
SPEAKER_00 (16:59):
Right.
So specifically, the things thathappen is because um are, like
you said, related to estrogenand it does a lot.
It keeps bone strong, it doessupport heart health.
It is why women have a lowercardiovascular risk all the way
through up until menopause.
And then afterwards, they havesimilar rates and rates of
(17:19):
cardiovascular disease as menafter menopause.
So when we notice this withestrogen dropping, that's when
symptoms appear.
And these symptoms are thethings that bother women the
most.
And I'm talking about thingslike hot flashes or night
sweats.
Women also experience thingslike sleep problems.
There also may be some moodswings that people experience or
(17:41):
vaginal dryness.
And so these symptoms themselvescan be extremely bothersome.
They can last for several yearsand affect daily life.
Things that you're doing everyday, they can affect your
function.
I've seen women who arepractically driven mad by these
symptoms.
And it affects their functionbecause they're moody, they
(18:03):
can't sleep, maybe they'reexperiencing some metabolic
changes, gaining weightcentrally, and it's impacting
their function ultimately.
And while these changes arehappening, they're also
technically completely normal,maybe, because it's what the
body is naturally doing.
(18:25):
So, Nikki, can you tell us alittle bit more about how common
menopause is and who's affected?
SPEAKER_01 (18:30):
Well, it's very common, so much so that every
woman who reaches midlife.
I why is it worded that way?
Who reaches midlife willexperience menopause?
SPEAKER_00 (18:41):
Because some people don't reach midlife.
SPEAKER_01 (18:44):
Um, globally, the average age is about 49, but
that can vary by many differentfactors.
Um 10% of women will experiencemenopause before the age of 45,
and about 2% will experience itbefore the age of 40, which is
called premature menopause.
Um, this can also happensuddenly if your like ovaries
(19:09):
were removed, or um, things likechemotherapy can make this
happen probably earlier than itwould have.
SPEAKER_00 (19:17):
Yeah.
I I found those figuresinteresting and helpful because
I think perimenopause, whichwill get its own episode, don't
you worry.
But perimenopause is somethingthat is very much in the
zeitgeist and talked about.
Um, I've had patients come inand say, like, oh, you know, all
the girlies are talking aboutperimenopause now, and
(19:37):
reasonably so.
And I think this is very helpfulto say this out, like, oh, well,
one in ten women gets before age45.
And like it's a concrete thingto to go for and say, like,
yeah, you know, it's earlierthan some, but maybe not
completely abnormal.
(19:58):
You know?
Um so common symptoms.
We've alluded to some, butsymptoms can vary widely from
person to person, but here itends up being what's most common
with a little bit of extrainformation.
So hot flashes and night sweatsare very common, so common, in
fact, that they affect up to 75%of women, and I'm sorry, can
(20:21):
also last over seven years.
SPEAKER_01 (20:28):
You know, that TikTok sound.
I I forget what it's from, butit's that girl, and she's like,
oh, I love being a woman.
SPEAKER_00 (20:37):
Well, you know, this actually helps because the
recent lifting of the black boxwarning, um, a little do like
ditty into next week, is thatyou know, now it's reasonable to
consider doing hormonereplacement therapy, which is
like the most effectivetreatment.
SPEAKER_01 (20:53):
I'm definitely gonna get myself some of that.
Is what's that average age?
49 for my 49th birthday.
Well, that's what I want.
SPEAKER_00 (21:00):
For 50.
It's like within 10 women within10 years of menopause that it's
reasonable to do this.
So if the hot flash is likeroutinely average, maybe, or
they can, rather not routinely,but they can last seven years.
You know, you're well coveredusing the treatments until like
age 60 or whatever.
So that's something.
Before I move on, did you haveany other thoughts about your
(21:22):
49th birthday?
SPEAKER_01 (21:24):
No, luckily it's very, very, very far away.
SPEAKER_00 (21:27):
Very far away.
Um, women can also experiencevaginal and urinary symptoms.
This would include things likedryness, discomfort, and
irritation.
So these often worsen with time.
This is a little nugget.
It's interesting because I tendto see that women of a certain
age get something that feelslike a urinary tract infection,
(21:50):
and then it kind of goes on,goes off, bothers them.
You do all of the routinetesting, get the urine, maybe
you get a urine culture, and yousee that there's nothing and
there's no bug growing in therethat's giving them this.
But it actually could be thesevaginal symptoms of menopause.
So this is something that has asolution.
(22:13):
We're gonna talk about thoselater in the episode and next
week.
But these are not things thatwomen have to live with,
especially now.
And even before there wereoptions that were totally
reasonable.
So it's definitely things to doand be proactive, not just kind
of suffer in silence, like whatwe talked about earlier in the
episode.
(22:33):
Um, women can also experiencesleep problems, and this can
look like a variety of thingsdifficulty falling or staying
asleep.
Mood changes are also common,um, looking more like things
like anxiety or symptoms ofworry, worry about anything in
life, irritability, anddepression or sadness, or just a
(22:54):
deep, you know, very broad-baseddefinition that we have a whole
episode about.
There are other changes thathappen in menopause, which
include lower libido or sexdrive, memory issues, weight
gain, especially around thebelly, some, I mean, people's
bone health.
We talked about this last week,peaks at 30, but there's even a
more of a decline withmenopause, so uh bone loss, and
(23:18):
shifts in cholesterol and bloodpressure.
All things that go hand in handwith menopause.
But something that's reallyimportant to know is that not
everyone has all of thesesymptoms.
So this is not a sentence forall women who reach midlife that
you're going to get thesethings, thankfully.
(23:39):
And just because they're commondoesn't mean that you'll just
have to, you know, tough themout as if it's something that's
you're destined to have.
Something, just a little dittyto include in here is something
I mentioned earlier, but wantedto call out specifically.
Going through menopause doestend to increase your risk of
osteoporosis.
That's why the guidance forscreening for osteoporosis and
(24:02):
osteopenia mainly starts inwomen at age 65, and that's
usually where the guidancestarts and ends.
There are other situations, ofcourse, but because that
decreased estrogen is present,because there is decreased
estrogen, that leads to not aslike vivaceous bone health.
What we also know is that whenwomen enter menopause, the
(24:26):
cardiovascular risk kind ofevens out between them, women,
and men.
Um biologically, of course.
So, Nikki, I've been rambling.
Just wanted to put those couplethings in there.
Can you give us some ideas orthings to be proactive about?
I think a lot of women probablyalready do these things, but
(24:48):
maybe there's some that peopledon't know about.
So, what are some lifestyle tipsfor women to help with symptoms
of menopause?
SPEAKER_01 (24:56):
Let's see.
Oh, for the good, lovely hotflashes, you can dress in layers
so that, you know, when you'reout in public and get a hot
flash, you can take a couplelayers off.
Using a fan, you can get one ofthose little handheld fans on
Amazon.
Keeping your bedroom cool foragain, hot flashes or night
(25:18):
sweats.
Also, if you're not alreadykeeping your bedroom cool when
you're sleeping, um, what areyou doing?
Staying active, um, doing thingslike walking, yoga, swimming.
These will just all around helpwith your mood, your sleep, and
your weight, eating balancedmeals with fruits, veggies, lean
(25:38):
proteins and whole grains, maybesomething like the Mediterranean
diet, which we love to talkabout.
We do love a Mediterranean diet.
Um, avoid smoking and limitingalcohol and caffeine.
Um, practicing relaxation, sodeep breathing, meditation, or
mindfulness.
And then um you can use awater-based vaginal moisturizer
(26:02):
or lubricants if that's givingyou some trouble.
SPEAKER_00 (26:06):
Yeah, all great options, things you can quite
literally start tonight orwhenever you're listening to
this.
And if you do all of thesethings and you find that
symptoms still interfere withthe quality of your life, there
are now, I mean, plenty, therealways were, but there are
plenty of medical options thatexist.
And what ends up happening isthe most effective of them is
(26:28):
some way, shape, or form ofhormone therapy.
And that is exactly what we'regoing to explore next week
because it's a hot topic in thenews.
There is a lot of conversation,which I think is perfect for a
podcast, to kind of explain whythis was such a poo-poo, or like
in the medical world, likesomething that was just like
(26:50):
reserved on the side and kind oflike, oof, it's very high risk.
SPEAKER_01 (26:54):
It's because everyone hates women.
SPEAKER_00 (26:57):
I can't wait to talk about it, but for next week.
And then but there are alsoother ones, too.
There are also non-hormonaltreatments to ask your doctor
about that.
We won't go in and dive in eachand every option, but it's a
reasonable question.
You could sit in front of themand say, Hi, I'm having
vasomotor symptoms of menopause,or I'm having hot flashes.
(27:20):
Are there non-hormonal optionsthat can help with this?
And they will either say, Yes, Iam familiar, or they will refer
you to someone who knows morethan them.
Um reasonable things to ask yourdoctor.
And now increasingly so, likealso reasonable to probably ask
about hormone replacementtherapy.
(27:41):
So, menopause.
It is a normal stage of life,but I imagine, because I have
not experienced menopause, Iwill not experience menopause,
then it feels overwhelming andmaybe not talked about so much.
So that's why, you know,altogether on this show we feel
that knowledge is power.
(28:01):
And that's why we covered whatwe think is a really important
topic today.
Uh, like we said, next week weare going to talk about hormone
replacement therapy and updatesin the recent news and why we
are where we are today.
But until then, thank you forcoming back to another episode
(28:21):
of Your Checkup.
Hopefully, you were able tolearn something for yourself, a
loved one, or a neighbor goingthrough menopause.
Send us an email atyourcheckuppod at gmail.com.
You can find us on Instagram.
You can follow me on personalInstagram and see my reels.
Um you can share this with aloved one or a neighbor or a
friend.
Um, we are always looking formore people to tune in.
(28:44):
And most importantly, stayhealthy, my friends.
Until next time, I'm Ed Delesky.
SPEAKER_01 (28:49):
I'm Cole Ruffo.
SPEAKER_00 (28:50):
Thank you and goodbye.
SPEAKER_01 (28:52):
Bye.
SPEAKER_00 (28:59):
This information may provide a brief overview of
diagnosis, treatment, andmedications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments, or
medications for a specificperson.
This is not medical advice or anattempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
(29:21):
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorse anytreatments or medications for a
specific patient.
Always talk to your healthcareprovider for a complete
information tailored to you.
In short, I'm not your doctor.
I am not your nurse.
And make sure you go get yourown checkup with your own
personal doctor.
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