September 12, 2025 • 33 mins
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Speaker 1 (00:00):
First, let me give a little context, shall I, because
this one's out of left field unless you really know
me and my goals for this show, and then it
makes absolute sense. So my mom passed September nineteenth, you
know that, and my dad was there and we had
we had caretakers around the clock, but he was there
(00:21):
by himself, and my brother's not there anymore to swing
behind and check on him. He's a very, very severe diabetic.
His blood sugar can get really low, he can end
up in the hospital. He has over the years. So
we made the decision to bring him in Houston, and
we found a great institution. We looked everywhere, we talked
to everybody, and boy, did ever turn out to be
(00:43):
the right choice for us. But you worry, And it
also happens to be walking distance from where I live,
so I can stop in on him all day every day.
Why is he not at my house? Why would you
put your dad in a facility? Well, a couple of reasons,
but most importantly because they have twenty four hour care
and we couldn't provide that travel a lot. So it's
turned out to be great. He's happy, I'm happy. But
(01:05):
we had all these doctors that he had in the
Golden Triangle. For those of you who don't know where
that the Golden Triangle was Orange Beaumont, Port Arthur. It's
southeast Texas on the Louisiana border. So we needed to
find doctors in Houston. And that's kind of my specialty
is I like to find good doctors and reward them
with lots of referrals. So I called around various doctors
(01:28):
and I asked for suggestions, and one of them that
was suggested to me was by my cardiologist, Dan Dukman.
He said, Hey, I got a guy that I know
named Jay Davis. He's a concierge doctor. I wanted a
conciers doctor, but he said, he's a concierge doctor. But
he's got a partner in his practice. Her name is
Andrew Davis Anu, it's an Indian name. He's got a
(01:49):
partner named ONUW. Davis. And she's great and your dad
would love it and you would love her. So we
tried her out, and I told you the story. My
wife took him for the appointment. Now she comes to
his old folks home. She will come to the old
folks home. She'll make house visits, she's now one of
my wife's many doctors. So anyway, she walks in and
(02:12):
she's sitting on her butt Indian style, appropriately remonte. She's
sitting on her butt. She takes off his socks and
she's rubbing his feet. If you know anything about diabetes,
you know that you don't get circulation to your toes
and you end up losing your toes. She is looking
for sores. She's talking about his feet, but she's lovingly
caressing his feet. If you don't think that I wasn't
locked in, send me whatever bill you want. Lady, you
(02:35):
are touching my dad's feet and loving on him, and
he's eighty five. You have won my heart, right, so
we really like him. We were like her. Concierge's medicine
is very different than the traditional medicine you're used to.
You can call these doctors that you have their cell
phone number, and so my dad does, Hey, I call
doctor Davis. I'm like, Dad, don't call her too much.
You know, she's got other patients. So we have a
(02:57):
dinner party, and at the dinner party, I put myself
right next to her because I still haven't met her
through all this, but we've had text conversations and phone conversations,
and I put our boyfriend on the other end of
the of the table and my wife next to him,
and then we had some other friends in between. But
I'm focused on her. I want to know about her practice,
(03:18):
what she does. I'm fascinated by this stuff. And at
some point I said, you know, how did you get
into diabetes. What's your passion for diabetes? She said, My
passion is for diabetes, and I love treating diabetes. But
if you were to ask me what number one passion,
and I can have several, it is menopause. And we
started talking about as an endocrinologist, the glands you know,
(03:39):
thyroid and a dream or you don't know your glands
are mown. You need to learn all your glands because
otherwise you can't have a dinner party with her. And
we started talking about women's hormones. So I'm fascinated by
all this because I just like to learn about everything
I possibly can from people who know things. So we're
laying in bed and my wife said the next morning,
(03:59):
she says, I don't know if you noticed what happened
at the party last night, But when ANU started talking
about menopause. Every woman leaned forward, and all of our
other conversation stopped, whereupon the men leaned forward and they
started listening about menopause. And I said, no, I didn't.
(04:20):
Why do you think that was She said, it's a
topic nobody will talk about, and everybody's affected by it,
and everybody's interested in it. You should have her on
the air. I said, well, let's be clear right now.
Know your place, woman, You don't tell me what to
do on the show. So our guest is doctor Anew Davis,
and it is my honor to have her on. I've
become a fan. Let's start with this very simple question.
(04:43):
And by the way, if you want to look her up,
it's river Oaks Doctor's Group. But her name is spelled Anu.
She won't be only on New I knew the short
for Honorah. That's a very common end the name, but
it's Anew Davis. I guarantee it's probably the only one
of those. So let's start with a very simple question.
What is menopau.
Speaker 2 (05:03):
So, Michael, thank you for having me on, and I'm
excited to talk to you about and answer all your burning
menopause questions.
Speaker 1 (05:10):
So, first, are related to a uti. But that's a
whole different question.
Speaker 2 (05:16):
Okay, well those are different questions, but you're burning menopause questions.
You want to know the answers. So the most important
first thing is to actually know what menopause is. So
menopause is the point at which women stop having cycles
and minstrel cycles, that is, and once a woman has
(05:39):
not had a minstrel cycle for twelve months, that's when
it's she's called in menopause. The big issue with all
this is Pete. Women's mintraal cycles can start changing up
to ten years before the cycles actually actually stop, so
then the whole time before that is called perimenopause. So
(06:00):
that's what we tend to be talking about, is perimenopause
and menopause.
Speaker 1 (06:04):
I've heard that I didn't know what it meant. Is
that is that about a ten year Is that that
happens about ten years before she goes into menopause.
Speaker 2 (06:12):
Well, sometimes it can be a nice, happy twelve months
of stuff. Sometimes it can be up to ten years.
So somewhere in the four to ten year range is
what perimenopause can be. But up to ten years of
fluctuation and transition before the actual pause happens, all right,
go ahead, and then menopause is the twenty or thirty
(06:37):
years that women live after the cycle stop. Then they're
considered to be postmenopausal. And that's the whole. Our job
is to maintain health through that twenty or thirty years,
so the whole. When people start talking about menopause or perimenopause,
the words are often interchangeable. But menopause itself is one
(06:59):
of the periods stopped for twelve months.
Speaker 1 (07:04):
Yeah, and is that just nature's way because we probably
weren't meant to live this long, that a woman is
beyond her reproductive life, and so there's no need for
that cycle. And let me just say before we start,
First of all, I'm a dude, so never having gone
through that, we all know it's secondhand. I'm trying to
(07:27):
I have had a lot of women tell me they
are excited to hear what you have to say and
to learn more about this, and they're glad that it's
being discussed publicly, including some folks, some rather prominent folks
that surprised me. They were willing to put their name
behind this, but I'm not going to say their names,
who were quite interested to learn more but we will
talk more to doctor anu A. N You Davis of
the river Oaks Doctors Group about Yeah, menopause, that's what
(07:51):
we're talking about. I don't care if somebody disrespects you,
you can't shoot them. Michael, it's been refolks. I took
to more I to introduced because this comes out of
left field and I wanted people to understand not going
to do that again. Doctor Anew Davis is our guest.
She's a menopause expert river Oaks Doctors Group. She's in Houston,
and this is something she is passionate about, is treating
(08:13):
women with menopause. And my question was do women stop
having a menstrual cycle because they are past the age
that they should be, or are typically giving birth or
is there some other reason.
Speaker 2 (08:30):
No, it's a natural process. Okay, the periods stop because
your past reproductive age. The issue is is that we
live for another thirty years after that. Right, our life
expectancy is seventy five to eighty five, So in that
thirty years we want to maintain our health. There has
been a lot of issue and discussion about whether these
(08:52):
hormones are useful and what happens and how do we
maintain women's health in that thirty years because we all
want to be upright and functional and thinking straight. So
that's the reason that menopause gets so much discussion. And
what happens to women's hormones and how do we treat
this and what other symptoms and issues come up because
(09:15):
of them?
Speaker 1 (09:16):
And what are these hormones that we're talking about. What
do they control? Is this sexual drive? Is it diet?
Speaker 2 (09:23):
Is it?
Speaker 1 (09:24):
You know when I was when my mom was forty
in nineteen eighty five, she started, I lost my mom
and I a crazy woman. Poltrygeisted into her body and
she screamed and hollered, and when we would go, Mom,
what in the world, And she'd say, I'm going through menopause.
I'm having hot flashes. Can you talk through that? Because
I can be as clinical and not silly as I
(09:48):
want to be, but there's a lot of dudes going,
can you explain to me what's going on with my
wife right now?
Speaker 2 (09:54):
Well, so we know that hormones fluctuate all the time,
but as the hormones decline, we have realized that there's
estrogen receptors everywhere, and so the hot flashes and the
night sweats. That's the first thing that we talk about.
But the mood can become just mood stability can become
(10:16):
a problem, sleep can become a problem. Women start to
have joint pain, vaginal dryness, pain with sex. There's up
to one hundred different symptoms that can occur once as
the hormones are fluctuating and declining. So that's the problem
women are suffering and it's making them less functional. So
(10:37):
so yeah, so there's lots of different things going on,
and the big question is, you know, are is replacing
these hormones It it's been taboo for a long time.
And part of the reason for that is because there
was a big study it came out in two thousand
(10:58):
and two that called the Women's Health Initiative. And when
that happened. When that study came out, because of the
way the study ended, it was publicized that hormone replacement
is bad and that hormone replacement causes breast cancer and
increases cardiovascular disease. So when that happened, the women who
(11:20):
were on hormone replacement at that time for treatment of
their menopausal symptoms, the rate of hormone replacement went from
forty percent of women postmenopause were taking hormone replacement to
something like five to six percent. The guidelines from all
the medical societies came out that hormone replacement causes breast cancer.
So for twenty years, many women did not receive hormone
(11:44):
replacement that they received because the doctors were taught that
hormones breast cancer.
Speaker 1 (11:51):
In your reason, do you think though, that hormone replacement
causes breast cancer.
Speaker 2 (11:58):
Hormone replacement does not cause breast cancer. So the reason
some of this has come to light in this last
year is because in twenty twenty four last year, they
came back and reanalyzed all the data from the Women's
Health Initiative. And so now twenty years later, they've come
(12:18):
back out and they've started talking about where how the
data was analyzed incorrectly, and they've come back out and said, well,
women's hormone replacement does not cause cardiovascal disease, it does
not cause breast cancer. And for those of us who've
been sitting in our corner of the world treating this,
(12:40):
we never stopped giving hormone replacement because we know that
hormone replacement is important for bone health. It's important for
cardiovascar health, it's important for brain health, and it may
and so that's why we get hormone replacement.
Speaker 1 (13:00):
Doctor Davis, I can't help but think the parallel here.
I'm a big proponent of testosterone and a testosterone replacement,
and our mutual friend Moe with Kara is a big
boat believer in testosterone replacements. It's done wonders for me,
and the same thing. I get people emailing me and say, hey,
(13:20):
my general physician who hasn't kept up with developments, and
this says I'm going to get prostate cancer if I
do it because of one study forever ago that said that,
And now most people don't believe it. And it's very
frustrating because it seems like there's a strange parallel between this,
because I think a lot of women do need hormone
replacement for them to be happier and healthier and have
(13:44):
healthier marriages. I see a lot of guys divorcing their
wives because they think she went crazy. She didn't go crazy.
Her body is working against her. Am I right in that.
Speaker 2 (13:54):
You are correct. So there was even time when obi
Jen's were taught that cognitive behavioral therapy would help hot flashes.
But if your body is having a physiologic reaction, you
can't talk it out of a hot flash. You cannot
talk your body out of having a hot flash. So
(14:15):
there are there's exactly that that women struggle and suffer
with hormone fluctuations that and you know, for a long
time they're ignored anyway because they're trying to get pregnant
during reproductive age and there's you know, during pregnancy, you
just have to deal with that because your focus is
(14:35):
on being pregnant and protecting the baby. But post pregnancy,
like women are struggling with all these hormonal fluctuations, and
because they've been sold that hormone replacement is not good
for you or can be harmful to you, many women avoid,
they avoid. Not only do they avoid hormone replacement after menopause,
(14:58):
it some will actively avoid birth control pills and treatments
for their hormone fluctuations, which are really affecting their day
to day life. But sometimes this is nuanced, right, like
you have to get in there and understand where these
(15:19):
hormones can benefit you.
Speaker 1 (15:22):
Well, it just strikes me that a lot of married
couples divorce after they've been through the toughest and maybe
most rewarding years of their marriage, that is, their kids
leave high school. And the thing I hear men say
in the locker room at the cigar lounge at the
bar is I just couldn't deal with her moods anymore.
(15:46):
And I think, man, you built a life together. It's
one thing if he's running off chasing strippers or he's
running away with the secretary. But when he can't be
in the house with her because of the mood swings
and the hot flashes, that's a horrible, horrible thing to
lose a marriage over that hold with me, doctor and
new Davis, we're talking about menopause coming up with hell.
Speaker 2 (16:06):
Yes, we're gonna take your ar fifteen eighty opaedo Michael Show, Yes, Yes, yes, yes.
Speaker 1 (16:13):
Doctor and new Davis is our guest. She is passionate
about the treatment of women with menopause. She's a concierge doctor.
She's actually my father's doctor. No, he doesn't have menopause,
he's eighty five with diabetes. But she's a concierge doctor.
That is your general practitioner. That means just your primary
(16:34):
that you go to for whatever else. With a specialty
into chronology, and that's all your glands and hormones and
all those sorts of things. And she handles my dad's
diabetes and may I say, masterfully, which is not an
easy thing. And she handles and focuses on menopause. And
(16:55):
we decided it was time to have that conversation in public.
So I want to I guess I'm going into the
soft science opposed to the medical science. I want your expertise.
One of the things that bothers me a lot, and
I will confess this is to watch couples who are
fifty three to sixty five. They got the kids through
(17:18):
high school, they seemingly had a solid marriage, and then
he says I'm done with you, or maybe she thinks
she wants out, and then he may go off and remarry,
but she's miserable and all of that is lost, and
the kids are sad because their innocence and their childhood
is lost. They didn't fight all those years. I think
it's this hormonal imbalance. Can you speak to that.
Speaker 2 (17:45):
I mean, there is a significant amount of dysfunction that happens,
right like if you're not able to have, if you're
not able to sleep and then you're not able to
have conversations, and then sex is painful and you're not
able to have those conversations with your partner, then the
(18:05):
health of your of your relationship declines, and that from
the testosterone side, that that becomes the thing that the
whole marriage has to be treated. Right, the sexual health
of a marriage has to be treated, but some of
that has to be treated. Each person has to individually
be healthy. So these women they've been they're they're suffering, right,
(18:28):
They're suffering because they they can't think straight, and they
can't sleep, and they're you know, sex is painful and
they're and they're not able to fix it, and they
go see their doctor and their doctors have said, well,
I mean, there's not really much we can do, and
(18:50):
then they get when they get that answer, they they
do feel like they're losing their minds, right, And when
that happens, I mean how they aren't able to communicate
with their partners, to talk to them. So it is
part of it, right, the whole the relationship has to
be treated, and that can contribute to them. It's a
(19:11):
sad thing to see.
Speaker 1 (19:12):
You've spoken generally about treatment. What does treatment look like?
So give me kind I know there is no standard patient,
but lady walks in. Roughly what age is she most
likely to be if she walks in? If I'm building
a profile, why did she come to you? How did
she know she had a problem, What are the tests,
what's the diagnosis, and how are you treating her? I
(19:34):
got five minutes in this segment.
Speaker 2 (19:38):
So the average age for menopause, for when the periods
actually stop, is about fifty one. I would say most
people come to me in their mid forties starting to
notice certain symptoms. They start to notice hot flashes and
night slits. Everybody's different. Other things people notice are point pain,
(20:01):
pain with sex, brain fog. So people come for different
reasons and they start to notice some irregularity in their
cycles when they show up. The main way of figuring
this out is by history. We do do labs to
make sure that there isn't something else causing these symptoms.
(20:24):
It's and then we start really thinking about you know,
and we do history, take a history to learn about
how her cycles were before and how things have changed,
and you know, all the way through pregnancies, so all
that stuff. It makes a difference and helps us prepare
(20:48):
for the transition through menopause and determine what the best
treatments would be. So in addition to using hormones as treatment,
which is which are very useful in treating the hot
flashes and some of those symptoms, then we also assess
risk for health for the long term. Right, we also
(21:10):
want to increase nutrition, and we also want to improve
exercise because hormones can do a lot, but they can't
fix everything. So in order to help overall health and
prevent complications and keep women stronger for those last thirty
years of their lives, we spend a lot of time
(21:32):
in addition to talking about how hormones may be part
of the treatment, but also nutrition and also exercise.
Speaker 1 (21:40):
Why is nutrition important to menopause, because that's a question
I received a lot of emails from listener women fifty
to eighty about how does that affect it?
Speaker 2 (21:54):
Because one of the biggest things that we have to
do in the last part part of our life is
keep ourselves mobile, and in the most important thing in
keeping ourselves mobile is maintaining our muscle mass and preventing fractures. Okay,
and hormone replacement can help us with maintaining our bone health.
(22:18):
But to maintain our muscle mass, we have to focus
on nutrition. We have to focus on nutrition in new
ways that maybe we haven't in the years before, and
we have to try to make up for what we
messed up, you know, way back when, in all the
years we weren't that.
Speaker 1 (22:38):
I was talking to Stan Dukman, our mutual friend, the cardiologist,
and we're talking about strategies for good health, especially as
you get older. We're talking about my dad's health, and
he said, you know, Michael, I can't figure out a
good way to say it, but what we want to do.
We're all going to get sick, and what we want
to do is get the body strong enough that when
(22:59):
that sickness hits, we've got some reserves to draw on.
We've got good core strength. Yeah, we've got low body fat.
We've got good muscle and bone density and these sorts
of things. Let me ask you this a minute left
in this segment hair loss, And I'm trying to kind
of make a compositive question. A lot of questions about
(23:22):
hair loss. It sounds like that's typical. What can be
done about that in your treatment?
Speaker 2 (23:31):
Depend I mean, we do have to dig in to
do a little bit of search for what is causing
the hair loss. Hair loss is common with menopause. Hair
loss can have a genetic component, right if it runs
in your family and everyone has that male pattern baldness,
there's not as much you can do about it. But
nutrition is important. Protein is important, and then there are
(23:55):
some other medications and topical treatments that can help.
Speaker 1 (24:02):
When you talk about these treatments, I'm gonna be up
against a break here in just a moment, so I
will ask you and we'll address it on the other side.
How are these being delivered? Is this a pill regiment?
Is it typically one pill a day? And I know
that's going to vary, but I mean talk about the composite.
Is the shots? How often are those shots? How often
(24:22):
does somebody A lot of people I think are afraid
to engage in a relationship where it's going to be
I'm having to come to the doctor every day or
is this a one and done? What does that look like?
I'm assuming you have to adjust those. We'll continue that
conversation with doctor Anu a n U doctor anew Davis,
a Houston concierge, doctor, intochronologist, diabetes expertise, and we're talking
(24:43):
menopause what a maroon Michael Very show. So it strikes
me that menopause is something that my mother suffered horribly
from during my teenage years. And I'll be on it
and I've told her this and she's We've had deep conversations.
(25:05):
She passed September nineteenth. But I left nothing out and
she left nothing out. I resented her. I resented the
crazy woman who took over my sweet mother. I adored
my mother, and there was this period of time that
this awful monster took over my mother my mid teenage years,
fifteen to eighteen. And I didn't like that lady. And
(25:25):
then at some point that person got bored of her
and moved on to the next lady. Maybe it was
your mother or wife. But my mother didn't have access
to all of the great medical advancements we do today.
And an expert like a new Davis, who is our guest,
that spelled an u anew Davis, and we're talking about menopause.
(25:47):
Let's talk about hair loss, because that was one of
the many questions I have in my stack. And by
the way, I was shocked how many women reached out
and were willing to say yes, I want to know
more about menopause upsetting me or my mother, So let's
talk about that.
Speaker 2 (26:06):
Yeah, I mean, the menopause question is is kind of
a crazy one, right, Like I remember back I was
a baby doctor and I was doing a house call
at like maybe like when I first started my practice,
like ten or fifteen years ago, and I was doing
this house call on this Saturday morning, and I was
seeing this little eighty one year old woman and I
told her I was going to give a talk after
(26:28):
I finished her house call, and I was going to
give this talk about menopause. And she's like, you don't
lie to those people. I was like, that's funny. I
just can remember her saying, don't lie to them, tell
them the truth. And I said, okay, well, and you know,
the truth has changed and we are learning more every
day and having been able to go having this change
(26:52):
in the guidelines and this next year is really going
to help women. Okay. The guy the Menopause Society and
the UK societies that write about menopause actually changed the
guidelines in twenty twenty four at and took back all
the initial recommendations from two thousand and two. So because
(27:14):
of this, this is why this is so important now
and why we're trying to do our part to educate.
You know, all the internists who have to see patients
all day long and who want to be able to
treat their patients well and give them good treatment, but
didn't have the knowledge up until then. So the way
(27:36):
that this looks is that the history is the most
important thing. Right. First, we take a long history and
we try to understand kind of how each patients has
done through her cycles, and then how her menopause and
how the transitions are affecting her, and then we aim
(28:00):
our treatments specifically at helping her and also preventing disease
in the long term, keeping her strong and healthy, protecting bones,
protecting her heart, protecting her brain, and making sure that
she is feeling in control.
Speaker 1 (28:23):
Let's talk about the bones first. My mom had severe osteoporosis,
so she was on a pretty heavy calcium treatment. She
never had She had one fall that messed her back up.
She had to have a surgery. She got on a
darn step ladder like they shouldn't be doing. We all know,
but in any case.
Speaker 2 (28:44):
It happens. Yeah, sure, the.
Speaker 1 (28:46):
Bone strength, I have a trainer Michael Petrow petru in
home fitness and he trains a lot of elderly folks
and a big issue there is avoiding falls because you
know the old you know, you see it happen, You fall,
you break your hip, you ever really recover And people say,
you know, the last three years of his life were horrible,
or her life because of the hip never really fixed.
(29:10):
How much can you do to fix We're gonna I'm
asking one by one, the bone strength, the bone density,
depending on how bad it's degraded.
Speaker 2 (29:20):
So when we see women in their forties, we're able
to We have medications that help us build bone. We're
able if we're able to start hormone replacement before before
we are at menopause. Bone strength, bone density decreases significantly
in the first thirty six months after menopause. So if
(29:42):
we're able to start hormone replacement to where they never
lose any estrogen, we're able to protect the bones that
they've built up up to that point and we don't
see that loss, and we're able to early to prevent fracture.
We actually have lots of tools for fracture prevention. But
(30:06):
if women are able to start hormones to where they
aren't deprived of these hormones. Because realistically, when we talk
about hormone replacement therapy, we're replacing something that their body's
just not making anymore. Taking their body's not making anymore
doesn't mean they can't they can't benefit from it, right,
(30:29):
So they benefit from it. Their bodies just stopped making
it because of you know, where we came from, and
because before we only lived to fifty five or sixty five,
and once we were done reproducing, we were finished, right,
But that's not where we are. We we're replacing something
our body's not making anymore. So if we do that before,
(30:51):
the bones feel the depletion of estrogen. So if we
get that early, then the bones don't deteriorate in that
initial postmonom puzzle Parian.
Speaker 1 (31:05):
And so when what's the delivery mechanism? Is that a pill?
Is that a shot? And how soon do women start
noticing a real change in life from the hot flashes
to feeling better to a better And I'm assuming most
of this is estrogen, but can you speak to that?
Speaker 2 (31:27):
Sure? So there's three hormones, The main two are estrogen
and progesterone. Okay, the estrogen is the one that's responsible
for protecting the heart and protecting the bones, and probably
protecting the brain and protecting the colon. And so that's
(31:51):
the hormon, the main hormone that needs to be replaced.
If women have a uterus, we give them progesterone also
to protect their uterus in the in the menopausal time.
We the medications can be given by pill, they can
give by patch, they can be given by cream, and
(32:16):
so some of that is preference, and some of that
is just kind of what works for people and what
works for their day to day lives. But the form
the medications are the same. It's still we're just replacing
hormon that their bodies aren't making. So the form is
(32:38):
just a preference issue.
Speaker 1 (32:43):
That brings me to the next question. You said, if
they have a uterus, meaning of course that if they
don't have a uterus, they've had a hysterectomy, which my
mom had. And by the way, if anybody out there
is wondering, why is he throwing his mom under the
bus given her medical history. She was interviewed by the
local news about all of this in Beaumont. She was
(33:06):
happy to talk about it. She was a little ahead
of her time in terms of being willing to talk
about women's issues when other people wouldn't. She was a
tough woman. But we will talk about post hysterectomy and
treatments for that. Yeah, we're actually talking menopause with an expert,
doctor Anu Anu. Doctor Anu Davis went up
First, let me give a little context, shall I, because
this one's out of left field unless you really know
me and my goals for this show, and then it
makes absolute sense. So my mom passed September nineteenth, you
know that, and my dad was there and we had
we had caretakers around the clock, but he was there
(00:21):
by himself, and my brother's not there anymore to swing
behind and check on him. He's a very, very severe diabetic.
His blood sugar can get really low, he can end
up in the hospital. He has over the years. So
we made the decision to bring him in Houston, and
we found a great institution. We looked everywhere, we talked
to everybody, and boy, did ever turn out to be
(00:43):
the right choice for us. But you worry, And it
also happens to be walking distance from where I live,
so I can stop in on him all day every day.
Why is he not at my house? Why would you
put your dad in a facility? Well, a couple of reasons,
but most importantly because they have twenty four hour care
and we couldn't provide that travel a lot. So it's
turned out to be great. He's happy, I'm happy. But
(01:05):
we had all these doctors that he had in the
Golden Triangle. For those of you who don't know where
that the Golden Triangle was Orange Beaumont, Port Arthur. It's
southeast Texas on the Louisiana border. So we needed to
find doctors in Houston. And that's kind of my specialty
is I like to find good doctors and reward them
with lots of referrals. So I called around various doctors
(01:28):
and I asked for suggestions, and one of them that
was suggested to me was by my cardiologist, Dan Dukman.
He said, Hey, I got a guy that I know
named Jay Davis. He's a concierge doctor. I wanted a
conciers doctor, but he said, he's a concierge doctor. But
he's got a partner in his practice. Her name is
Andrew Davis Anu, it's an Indian name. He's got a
(01:49):
partner named ONUW. Davis. And she's great and your dad
would love it and you would love her. So we
tried her out, and I told you the story. My
wife took him for the appointment. Now she comes to
his old folks home. She will come to the old
folks home. She'll make house visits, she's now one of
my wife's many doctors. So anyway, she walks in and
(02:12):
she's sitting on her butt Indian style, appropriately remonte. She's
sitting on her butt. She takes off his socks and
she's rubbing his feet. If you know anything about diabetes,
you know that you don't get circulation to your toes
and you end up losing your toes. She is looking
for sores. She's talking about his feet, but she's lovingly
caressing his feet. If you don't think that I wasn't
locked in, send me whatever bill you want. Lady, you
(02:35):
are touching my dad's feet and loving on him, and
he's eighty five. You have won my heart, right, so
we really like him. We were like her. Concierge's medicine
is very different than the traditional medicine you're used to.
You can call these doctors that you have their cell
phone number, and so my dad does, Hey, I call
doctor Davis. I'm like, Dad, don't call her too much.
You know, she's got other patients. So we have a
(02:57):
dinner party, and at the dinner party, I put myself
right next to her because I still haven't met her
through all this, but we've had text conversations and phone conversations,
and I put our boyfriend on the other end of
the of the table and my wife next to him,
and then we had some other friends in between. But
I'm focused on her. I want to know about her practice,
(03:18):
what she does. I'm fascinated by this stuff. And at
some point I said, you know, how did you get
into diabetes. What's your passion for diabetes? She said, My
passion is for diabetes, and I love treating diabetes. But
if you were to ask me what number one passion,
and I can have several, it is menopause. And we
started talking about as an endocrinologist, the glands you know,
(03:39):
thyroid and a dream or you don't know your glands
are mown. You need to learn all your glands because
otherwise you can't have a dinner party with her. And
we started talking about women's hormones. So I'm fascinated by
all this because I just like to learn about everything
I possibly can from people who know things. So we're
laying in bed and my wife said the next morning,
(03:59):
she says, I don't know if you noticed what happened
at the party last night, But when ANU started talking
about menopause. Every woman leaned forward, and all of our
other conversation stopped, whereupon the men leaned forward and they
started listening about menopause. And I said, no, I didn't.
(04:20):
Why do you think that was She said, it's a
topic nobody will talk about, and everybody's affected by it,
and everybody's interested in it. You should have her on
the air. I said, well, let's be clear right now.
Know your place, woman, You don't tell me what to
do on the show. So our guest is doctor Anew Davis,
and it is my honor to have her on. I've
become a fan. Let's start with this very simple question.
(04:43):
And by the way, if you want to look her up,
it's river Oaks Doctor's Group. But her name is spelled Anu.
She won't be only on New I knew the short
for Honorah. That's a very common end the name, but
it's Anew Davis. I guarantee it's probably the only one
of those. So let's start with a very simple question.
What is menopau.
Speaker 2 (05:03):
So, Michael, thank you for having me on, and I'm
excited to talk to you about and answer all your burning
menopause questions.
Speaker 1 (05:10):
So, first, are related to a uti. But that's a
whole different question.
Speaker 2 (05:16):
Okay, well those are different questions, but you're burning menopause questions.
You want to know the answers. So the most important
first thing is to actually know what menopause is. So
menopause is the point at which women stop having cycles
and minstrel cycles, that is, and once a woman has
(05:39):
not had a minstrel cycle for twelve months, that's when
it's she's called in menopause. The big issue with all
this is Pete. Women's mintraal cycles can start changing up
to ten years before the cycles actually actually stop, so
then the whole time before that is called perimenopause. So
(06:00):
that's what we tend to be talking about, is perimenopause
and menopause.
Speaker 1 (06:04):
I've heard that I didn't know what it meant. Is
that is that about a ten year Is that that
happens about ten years before she goes into menopause.
Speaker 2 (06:12):
Well, sometimes it can be a nice, happy twelve months
of stuff. Sometimes it can be up to ten years.
So somewhere in the four to ten year range is
what perimenopause can be. But up to ten years of
fluctuation and transition before the actual pause happens, all right,
go ahead, and then menopause is the twenty or thirty
(06:37):
years that women live after the cycle stop. Then they're
considered to be postmenopausal. And that's the whole. Our job
is to maintain health through that twenty or thirty years,
so the whole. When people start talking about menopause or perimenopause,
the words are often interchangeable. But menopause itself is one
(06:59):
of the periods stopped for twelve months.
Speaker 1 (07:04):
Yeah, and is that just nature's way because we probably
weren't meant to live this long, that a woman is
beyond her reproductive life, and so there's no need for
that cycle. And let me just say before we start,
First of all, I'm a dude, so never having gone
through that, we all know it's secondhand. I'm trying to
(07:27):
I have had a lot of women tell me they
are excited to hear what you have to say and
to learn more about this, and they're glad that it's
being discussed publicly, including some folks, some rather prominent folks
that surprised me. They were willing to put their name
behind this, but I'm not going to say their names,
who were quite interested to learn more but we will
talk more to doctor anu A. N You Davis of
the river Oaks Doctors Group about Yeah, menopause, that's what
(07:51):
we're talking about. I don't care if somebody disrespects you,
you can't shoot them. Michael, it's been refolks. I took
to more I to introduced because this comes out of
left field and I wanted people to understand not going
to do that again. Doctor Anew Davis is our guest.
She's a menopause expert river Oaks Doctors Group. She's in Houston,
and this is something she is passionate about, is treating
(08:13):
women with menopause. And my question was do women stop
having a menstrual cycle because they are past the age
that they should be, or are typically giving birth or
is there some other reason.
Speaker 2 (08:30):
No, it's a natural process. Okay, the periods stop because
your past reproductive age. The issue is is that we
live for another thirty years after that. Right, our life
expectancy is seventy five to eighty five, So in that
thirty years we want to maintain our health. There has
been a lot of issue and discussion about whether these
(08:52):
hormones are useful and what happens and how do we
maintain women's health in that thirty years because we all
want to be upright and functional and thinking straight. So
that's the reason that menopause gets so much discussion. And
what happens to women's hormones and how do we treat
this and what other symptoms and issues come up because
(09:15):
of them?
Speaker 1 (09:16):
And what are these hormones that we're talking about. What
do they control? Is this sexual drive? Is it diet?
Speaker 2 (09:23):
Is it?
Speaker 1 (09:24):
You know when I was when my mom was forty
in nineteen eighty five, she started, I lost my mom
and I a crazy woman. Poltrygeisted into her body and
she screamed and hollered, and when we would go, Mom,
what in the world, And she'd say, I'm going through menopause.
I'm having hot flashes. Can you talk through that? Because
I can be as clinical and not silly as I
(09:48):
want to be, but there's a lot of dudes going,
can you explain to me what's going on with my
wife right now?
Speaker 2 (09:54):
Well, so we know that hormones fluctuate all the time,
but as the hormones decline, we have realized that there's
estrogen receptors everywhere, and so the hot flashes and the
night sweats. That's the first thing that we talk about.
But the mood can become just mood stability can become
(10:16):
a problem, sleep can become a problem. Women start to
have joint pain, vaginal dryness, pain with sex. There's up
to one hundred different symptoms that can occur once as
the hormones are fluctuating and declining. So that's the problem
women are suffering and it's making them less functional. So
(10:37):
so yeah, so there's lots of different things going on,
and the big question is, you know, are is replacing
these hormones It it's been taboo for a long time.
And part of the reason for that is because there
was a big study it came out in two thousand
(10:58):
and two that called the Women's Health Initiative. And when
that happened. When that study came out, because of the
way the study ended, it was publicized that hormone replacement
is bad and that hormone replacement causes breast cancer and
increases cardiovascular disease. So when that happened, the women who
(11:20):
were on hormone replacement at that time for treatment of
their menopausal symptoms, the rate of hormone replacement went from
forty percent of women postmenopause were taking hormone replacement to
something like five to six percent. The guidelines from all
the medical societies came out that hormone replacement causes breast cancer.
So for twenty years, many women did not receive hormone
(11:44):
replacement that they received because the doctors were taught that
hormones breast cancer.
Speaker 1 (11:51):
In your reason, do you think though, that hormone replacement
causes breast cancer.
Speaker 2 (11:58):
Hormone replacement does not cause breast cancer. So the reason
some of this has come to light in this last
year is because in twenty twenty four last year, they
came back and reanalyzed all the data from the Women's
Health Initiative. And so now twenty years later, they've come
(12:18):
back out and they've started talking about where how the
data was analyzed incorrectly, and they've come back out and said, well,
women's hormone replacement does not cause cardiovascal disease, it does
not cause breast cancer. And for those of us who've
been sitting in our corner of the world treating this,
(12:40):
we never stopped giving hormone replacement because we know that
hormone replacement is important for bone health. It's important for
cardiovascar health, it's important for brain health, and it may
and so that's why we get hormone replacement.
Speaker 1 (13:00):
Doctor Davis, I can't help but think the parallel here.
I'm a big proponent of testosterone and a testosterone replacement,
and our mutual friend Moe with Kara is a big
boat believer in testosterone replacements. It's done wonders for me,
and the same thing. I get people emailing me and say, hey,
(13:20):
my general physician who hasn't kept up with developments, and
this says I'm going to get prostate cancer if I
do it because of one study forever ago that said that,
And now most people don't believe it. And it's very
frustrating because it seems like there's a strange parallel between this,
because I think a lot of women do need hormone
replacement for them to be happier and healthier and have
(13:44):
healthier marriages. I see a lot of guys divorcing their
wives because they think she went crazy. She didn't go crazy.
Her body is working against her. Am I right in that.
Speaker 2 (13:54):
You are correct. So there was even time when obi
Jen's were taught that cognitive behavioral therapy would help hot flashes.
But if your body is having a physiologic reaction, you
can't talk it out of a hot flash. You cannot
talk your body out of having a hot flash. So
(14:15):
there are there's exactly that that women struggle and suffer
with hormone fluctuations that and you know, for a long
time they're ignored anyway because they're trying to get pregnant
during reproductive age and there's you know, during pregnancy, you
just have to deal with that because your focus is
(14:35):
on being pregnant and protecting the baby. But post pregnancy,
like women are struggling with all these hormonal fluctuations, and
because they've been sold that hormone replacement is not good
for you or can be harmful to you, many women avoid,
they avoid. Not only do they avoid hormone replacement after menopause,
(14:58):
it some will actively avoid birth control pills and treatments
for their hormone fluctuations, which are really affecting their day
to day life. But sometimes this is nuanced, right, like
you have to get in there and understand where these
(15:19):
hormones can benefit you.
Speaker 1 (15:22):
Well, it just strikes me that a lot of married
couples divorce after they've been through the toughest and maybe
most rewarding years of their marriage, that is, their kids
leave high school. And the thing I hear men say
in the locker room at the cigar lounge at the
bar is I just couldn't deal with her moods anymore.
(15:46):
And I think, man, you built a life together. It's
one thing if he's running off chasing strippers or he's
running away with the secretary. But when he can't be
in the house with her because of the mood swings
and the hot flashes, that's a horrible, horrible thing to
lose a marriage over that hold with me, doctor and
new Davis, we're talking about menopause coming up with hell.
Speaker 2 (16:06):
Yes, we're gonna take your ar fifteen eighty opaedo Michael Show, Yes, Yes, yes, yes.
Speaker 1 (16:13):
Doctor and new Davis is our guest. She is passionate
about the treatment of women with menopause. She's a concierge doctor.
She's actually my father's doctor. No, he doesn't have menopause,
he's eighty five with diabetes. But she's a concierge doctor.
That is your general practitioner. That means just your primary
(16:34):
that you go to for whatever else. With a specialty
into chronology, and that's all your glands and hormones and
all those sorts of things. And she handles my dad's
diabetes and may I say, masterfully, which is not an
easy thing. And she handles and focuses on menopause. And
(16:55):
we decided it was time to have that conversation in public.
So I want to I guess I'm going into the
soft science opposed to the medical science. I want your expertise.
One of the things that bothers me a lot, and
I will confess this is to watch couples who are
fifty three to sixty five. They got the kids through
(17:18):
high school, they seemingly had a solid marriage, and then
he says I'm done with you, or maybe she thinks
she wants out, and then he may go off and remarry,
but she's miserable and all of that is lost, and
the kids are sad because their innocence and their childhood
is lost. They didn't fight all those years. I think
it's this hormonal imbalance. Can you speak to that.
Speaker 2 (17:45):
I mean, there is a significant amount of dysfunction that happens,
right like if you're not able to have, if you're
not able to sleep and then you're not able to
have conversations, and then sex is painful and you're not
able to have those conversations with your partner, then the
(18:05):
health of your of your relationship declines, and that from
the testosterone side, that that becomes the thing that the
whole marriage has to be treated. Right, the sexual health
of a marriage has to be treated, but some of
that has to be treated. Each person has to individually
be healthy. So these women they've been they're they're suffering, right,
(18:28):
They're suffering because they they can't think straight, and they
can't sleep, and they're you know, sex is painful and
they're and they're not able to fix it, and they
go see their doctor and their doctors have said, well,
I mean, there's not really much we can do, and
(18:50):
then they get when they get that answer, they they
do feel like they're losing their minds, right, And when
that happens, I mean how they aren't able to communicate
with their partners, to talk to them. So it is
part of it, right, the whole the relationship has to
be treated, and that can contribute to them. It's a
(19:11):
sad thing to see.
Speaker 1 (19:12):
You've spoken generally about treatment. What does treatment look like?
So give me kind I know there is no standard patient,
but lady walks in. Roughly what age is she most
likely to be if she walks in? If I'm building
a profile, why did she come to you? How did
she know she had a problem, What are the tests,
what's the diagnosis, and how are you treating her? I
(19:34):
got five minutes in this segment.
Speaker 2 (19:38):
So the average age for menopause, for when the periods
actually stop, is about fifty one. I would say most
people come to me in their mid forties starting to
notice certain symptoms. They start to notice hot flashes and
night slits. Everybody's different. Other things people notice are point pain,
(20:01):
pain with sex, brain fog. So people come for different
reasons and they start to notice some irregularity in their
cycles when they show up. The main way of figuring
this out is by history. We do do labs to
make sure that there isn't something else causing these symptoms.
(20:24):
It's and then we start really thinking about you know,
and we do history, take a history to learn about
how her cycles were before and how things have changed,
and you know, all the way through pregnancies, so all
that stuff. It makes a difference and helps us prepare
(20:48):
for the transition through menopause and determine what the best
treatments would be. So in addition to using hormones as treatment,
which is which are very useful in treating the hot
flashes and some of those symptoms, then we also assess
risk for health for the long term. Right, we also
(21:10):
want to increase nutrition, and we also want to improve
exercise because hormones can do a lot, but they can't
fix everything. So in order to help overall health and
prevent complications and keep women stronger for those last thirty
years of their lives, we spend a lot of time
(21:32):
in addition to talking about how hormones may be part
of the treatment, but also nutrition and also exercise.
Speaker 1 (21:40):
Why is nutrition important to menopause, because that's a question
I received a lot of emails from listener women fifty
to eighty about how does that affect it?
Speaker 2 (21:54):
Because one of the biggest things that we have to
do in the last part part of our life is
keep ourselves mobile, and in the most important thing in
keeping ourselves mobile is maintaining our muscle mass and preventing fractures. Okay,
and hormone replacement can help us with maintaining our bone health.
(22:18):
But to maintain our muscle mass, we have to focus
on nutrition. We have to focus on nutrition in new
ways that maybe we haven't in the years before, and
we have to try to make up for what we
messed up, you know, way back when, in all the
years we weren't that.
Speaker 1 (22:38):
I was talking to Stan Dukman, our mutual friend, the cardiologist,
and we're talking about strategies for good health, especially as
you get older. We're talking about my dad's health, and
he said, you know, Michael, I can't figure out a
good way to say it, but what we want to do.
We're all going to get sick, and what we want
to do is get the body strong enough that when
(22:59):
that sickness hits, we've got some reserves to draw on.
We've got good core strength. Yeah, we've got low body fat.
We've got good muscle and bone density and these sorts
of things. Let me ask you this a minute left
in this segment hair loss, And I'm trying to kind
of make a compositive question. A lot of questions about
(23:22):
hair loss. It sounds like that's typical. What can be
done about that in your treatment?
Speaker 2 (23:31):
Depend I mean, we do have to dig in to
do a little bit of search for what is causing
the hair loss. Hair loss is common with menopause. Hair
loss can have a genetic component, right if it runs
in your family and everyone has that male pattern baldness,
there's not as much you can do about it. But
nutrition is important. Protein is important, and then there are
(23:55):
some other medications and topical treatments that can help.
Speaker 1 (24:02):
When you talk about these treatments, I'm gonna be up
against a break here in just a moment, so I
will ask you and we'll address it on the other side.
How are these being delivered? Is this a pill regiment?
Is it typically one pill a day? And I know
that's going to vary, but I mean talk about the composite.
Is the shots? How often are those shots? How often
(24:22):
does somebody A lot of people I think are afraid
to engage in a relationship where it's going to be
I'm having to come to the doctor every day or
is this a one and done? What does that look like?
I'm assuming you have to adjust those. We'll continue that
conversation with doctor Anu a n U doctor anew Davis,
a Houston concierge, doctor, intochronologist, diabetes expertise, and we're talking
(24:43):
menopause what a maroon Michael Very show. So it strikes
me that menopause is something that my mother suffered horribly
from during my teenage years. And I'll be on it
and I've told her this and she's We've had deep conversations.
(25:05):
She passed September nineteenth. But I left nothing out and
she left nothing out. I resented her. I resented the
crazy woman who took over my sweet mother. I adored
my mother, and there was this period of time that
this awful monster took over my mother my mid teenage years,
fifteen to eighteen. And I didn't like that lady. And
(25:25):
then at some point that person got bored of her
and moved on to the next lady. Maybe it was
your mother or wife. But my mother didn't have access
to all of the great medical advancements we do today.
And an expert like a new Davis, who is our guest,
that spelled an u anew Davis, and we're talking about menopause.
(25:47):
Let's talk about hair loss, because that was one of
the many questions I have in my stack. And by
the way, I was shocked how many women reached out
and were willing to say yes, I want to know
more about menopause upsetting me or my mother, So let's
talk about that.
Speaker 2 (26:06):
Yeah, I mean, the menopause question is is kind of
a crazy one, right, Like I remember back I was
a baby doctor and I was doing a house call
at like maybe like when I first started my practice,
like ten or fifteen years ago, and I was doing
this house call on this Saturday morning, and I was
seeing this little eighty one year old woman and I
told her I was going to give a talk after
(26:28):
I finished her house call, and I was going to
give this talk about menopause. And she's like, you don't
lie to those people. I was like, that's funny. I
just can remember her saying, don't lie to them, tell
them the truth. And I said, okay, well, and you know,
the truth has changed and we are learning more every
day and having been able to go having this change
(26:52):
in the guidelines and this next year is really going
to help women. Okay. The guy the Menopause Society and
the UK societies that write about menopause actually changed the
guidelines in twenty twenty four at and took back all
the initial recommendations from two thousand and two. So because
(27:14):
of this, this is why this is so important now
and why we're trying to do our part to educate.
You know, all the internists who have to see patients
all day long and who want to be able to
treat their patients well and give them good treatment, but
didn't have the knowledge up until then. So the way
(27:36):
that this looks is that the history is the most
important thing. Right. First, we take a long history and
we try to understand kind of how each patients has
done through her cycles, and then how her menopause and
how the transitions are affecting her, and then we aim
(28:00):
our treatments specifically at helping her and also preventing disease
in the long term, keeping her strong and healthy, protecting bones,
protecting her heart, protecting her brain, and making sure that
she is feeling in control.
Speaker 1 (28:23):
Let's talk about the bones first. My mom had severe osteoporosis,
so she was on a pretty heavy calcium treatment. She
never had She had one fall that messed her back up.
She had to have a surgery. She got on a
darn step ladder like they shouldn't be doing. We all know,
but in any case.
Speaker 2 (28:44):
It happens. Yeah, sure, the.
Speaker 1 (28:46):
Bone strength, I have a trainer Michael Petrow petru in
home fitness and he trains a lot of elderly folks
and a big issue there is avoiding falls because you
know the old you know, you see it happen, You fall,
you break your hip, you ever really recover And people say,
you know, the last three years of his life were horrible,
or her life because of the hip never really fixed.
(29:10):
How much can you do to fix We're gonna I'm
asking one by one, the bone strength, the bone density,
depending on how bad it's degraded.
Speaker 2 (29:20):
So when we see women in their forties, we're able
to We have medications that help us build bone. We're
able if we're able to start hormone replacement before before
we are at menopause. Bone strength, bone density decreases significantly
in the first thirty six months after menopause. So if
(29:42):
we're able to start hormone replacement to where they never
lose any estrogen, we're able to protect the bones that
they've built up up to that point and we don't
see that loss, and we're able to early to prevent fracture.
We actually have lots of tools for fracture prevention. But
(30:06):
if women are able to start hormones to where they
aren't deprived of these hormones. Because realistically, when we talk
about hormone replacement therapy, we're replacing something that their body's
just not making anymore. Taking their body's not making anymore
doesn't mean they can't they can't benefit from it, right,
(30:29):
So they benefit from it. Their bodies just stopped making
it because of you know, where we came from, and
because before we only lived to fifty five or sixty five,
and once we were done reproducing, we were finished, right,
But that's not where we are. We we're replacing something
our body's not making anymore. So if we do that before,
(30:51):
the bones feel the depletion of estrogen. So if we
get that early, then the bones don't deteriorate in that
initial postmonom puzzle Parian.
Speaker 1 (31:05):
And so when what's the delivery mechanism? Is that a pill?
Is that a shot? And how soon do women start
noticing a real change in life from the hot flashes
to feeling better to a better And I'm assuming most
of this is estrogen, but can you speak to that?
Speaker 2 (31:27):
Sure? So there's three hormones, The main two are estrogen
and progesterone. Okay, the estrogen is the one that's responsible
for protecting the heart and protecting the bones, and probably
protecting the brain and protecting the colon. And so that's
(31:51):
the hormon, the main hormone that needs to be replaced.
If women have a uterus, we give them progesterone also
to protect their uterus in the in the menopausal time.
We the medications can be given by pill, they can
give by patch, they can be given by cream, and
(32:16):
so some of that is preference, and some of that
is just kind of what works for people and what
works for their day to day lives. But the form
the medications are the same. It's still we're just replacing
hormon that their bodies aren't making. So the form is
(32:38):
just a preference issue.
Speaker 1 (32:43):
That brings me to the next question. You said, if
they have a uterus, meaning of course that if they
don't have a uterus, they've had a hysterectomy, which my
mom had. And by the way, if anybody out there
is wondering, why is he throwing his mom under the
bus given her medical history. She was interviewed by the
local news about all of this in Beaumont. She was
(33:06):
happy to talk about it. She was a little ahead
of her time in terms of being willing to talk
about women's issues when other people wouldn't. She was a
tough woman. But we will talk about post hysterectomy and
treatments for that. Yeah, we're actually talking menopause with an expert,
doctor Anu Anu. Doctor Anu Davis went up
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