April 11, 2025 • 27 mins
🔥 Welcome to Bookkast – Bestsellers in Minutes! In today’s episode, we dive into one of the most groundbreaking wellness books of our time: "The New Menopause" by Dr. Mary Claire Haver, a comprehensive guide for women navigating the hormonal changes of midlife with purpose, power, and facts. 💪🌸
🧠 Whether you're in perimenopause, menopause, or postmenopause, this book is your roadmap to understanding what’s happening to your body — and what you can do about it.
📘 Dr. Haver, a board-certified OB-GYN and Certified Menopause Specialist, offers evidence-based advice on:
🩺 With over 3.5 million followers, Dr. Haver is leading a movement of awareness, honesty, and healing — and in this Bookkast episode, we unpack her message, chapter by chapter.
👉 Don’t forget to subscribe for more bestsellers explained in minutes. Whether you're going through menopause or supporting someone who is, this is a must-watch!
💬👇 Leave a comment sharing your experience or questions!
🎧 LISTEN on your favorite podcast platform
📲 FOLLOW us for more daily insights
🧠 Whether you're in perimenopause, menopause, or postmenopause, this book is your roadmap to understanding what’s happening to your body — and what you can do about it.
📘 Dr. Haver, a board-certified OB-GYN and Certified Menopause Specialist, offers evidence-based advice on:
- 🌡️ Hormonal therapy & treatment options
- 🥗 Anti-inflammatory nutrition and lifestyle changes
- 💬 How to advocate for yourself with your doctor
- 🧘 Stress reduction, sleep hygiene & sexual wellness
- 💊 Supplements, exercise, and The Menopause Tool Kit
🩺 With over 3.5 million followers, Dr. Haver is leading a movement of awareness, honesty, and healing — and in this Bookkast episode, we unpack her message, chapter by chapter.
👉 Don’t forget to subscribe for more bestsellers explained in minutes. Whether you're going through menopause or supporting someone who is, this is a must-watch!
💬👇 Leave a comment sharing your experience or questions!
🎧 LISTEN on your favorite podcast platform
📲 FOLLOW us for more daily insights
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
All right, so welcome to Bookcast. We bring you best
selling books in minutes. And guess what today we're diving
deep into a book that's been like everywhere, the New Menopause,
Navigating your Path through Hormonal Change with Purpose, Power and Facts.
It's by doctor Mary clare haveor that's right, it's me
Sarah and I'm Paul.
Speaker 2 (00:20):
And for everyone listening, whether you're like personally curious about menopause,
maybe you know someone going through it, or you just
like to stay in the know about you know, those
big health topics, this deep dive is for you. We're
going to pull out all the important stuff from doctor
Haer's book, and we're going to do it fast, but
we're going to make sure you get it all.
Speaker 1 (00:37):
Yeah, exactly. Uh. Our mission is to really break down
all the most important things doctor Haver's saying. So we
want you to understand all the ins and outs of menopause.
I feel like you've got the power of knowledge, you know,
so you can advocate for the best care possible. Oh yes,
so let's jump right in. You know, doctor Have really
hits on this whole thing about substandard care, like so
(00:59):
many women just feel dismissed when they go see a
doctor about menopause.
Speaker 2 (01:03):
Oh for sure.
Speaker 1 (01:04):
And it's like, you really feel it when you read
some of these stories, right, I mean both from like
her social media and also a study from the Journal of.
Speaker 2 (01:12):
Women's Health, Yes, from twenty twenty three.
Speaker 1 (01:15):
Women are hearing things like, oh, just pop some time
and I'll get some rest. Or you can't be a perimenopause,
you're not having hot flashes.
Speaker 2 (01:21):
Yeah. The common thread, though, really is that women just
don't feel validated, right, right. They have to see so
many different doctors before someone actually takes them seriously. Ohay,
or worse, they're told it's just natural, get over it,
or welcome to your new normal, as if their struggles
are you know, nothing.
Speaker 1 (01:39):
And doctor Haber's really saying this isn't just a few
isolated incidents. This is more common than we want to believe.
Speaker 2 (01:46):
Oh absolutely, And she even talks about how this can
lead to unhealthy coping mechanisms, you know, yeah, like maybe
why we see increased alcohol use among women going through this.
Speaker 1 (01:55):
It makes you wonder like why why are so many
women at this, you know, really important time in their
life just feeling dismissed and unheard?
Speaker 2 (02:04):
Right, And like without any real hope for getting better.
Speaker 1 (02:07):
Right.
Speaker 2 (02:07):
You know, in the medical field we talk about access
to care, but what are the barriers for women actually
having a good experience, you know, a positive, helpful experience
with their healthcare during menopause.
Speaker 1 (02:20):
Well, and one of the biggest things seems to be
just how different menopause can be for everyone.
Speaker 2 (02:26):
Oh absolutely, I.
Speaker 1 (02:27):
Mean, doctor Haer makes it clear. It's not just those
things we always hear about, you know, right, the hot flashes,
the night sweats, bone density, or problems with your you know,
lady parts.
Speaker 2 (02:38):
Right, It's so much more than that, so much more.
The list of potential symptoms, it's huge. We're talking about
stuff like acid reflux, acne breakouts, women are even noticing
their bodies are processing alcohol differently.
Speaker 1 (02:50):
Wow.
Speaker 2 (02:50):
So when you have such a wide range of symptoms,
it can be hard for doctors to even recognize it,
let alone diagnose it accurately or treat it effectively.
Speaker 1 (02:58):
Right, And for you listening, it's important to remember that
the menopause will transition. It's not a one size fits.
Speaker 2 (03:03):
All, definitely not.
Speaker 1 (03:05):
Some women have a ton of symptoms during perimenopause, and
then you know, everything's kind of smooth sailing after that, right,
But other women it's the total opposite, totally.
Speaker 2 (03:13):
It's unique for everyone and how menopause affects you. It
depends on so many things, your genes, your lifestyle, like
your diet, how much you exercise, whether you smoke, you know,
even your reproductive history. It all comes into play.
Speaker 1 (03:28):
Doctor Haver makes this really interesting point, you know, where
she talks about how doctors usually diagnose things right, Like
they use what they remember learning and then try to
match your symptoms to what they think the problem might be. Yeah,
but a lot of doctors they just haven't been trained
enough to recognize all these wider symptoms of menopause.
Speaker 2 (03:45):
That's right. It's like traditional medical training. It focuses on
just a handful of symptoms hot flashes, night sweats, problems peeing,
and not being able to sleep. Yeah, it's just such
a narrow view of what's actually a really complicated shift
in your body.
Speaker 1 (04:00):
For doctor Have it took her own personal experience going
through menopause, you know, to really get it, and she
had to do a lot of research on her own. Yeah,
she had to go way beyond what she learned in
med school.
Speaker 2 (04:11):
Absolutely, and I think that's why she calls it endocrinological aging,
because it's just so much more than just you know,
a few simple symptoms.
Speaker 1 (04:18):
And all that personal experience, plus being a doctor, it
makes her really believe that understanding the research, that's what
gives women the power to talk to their doctors about
hormone therapy or MHT and all those other ways to
deal with menopause.
Speaker 2 (04:32):
Absolutely, that knowledge is power, and ultimately it's about breaking
down those barriers to getting good quality care during menopause.
That's what she wants. More awareness, better education for women
and doctors, and just being proactive taking those steps to
get what you need.
Speaker 1 (04:48):
That's so important.
Speaker 2 (04:49):
Yeah.
Speaker 1 (04:50):
So, speaking of perspective, doctor have actually officially hit menopause
in October twenty twenty two.
Speaker 2 (04:55):
Oh wow, so she's right there with us.
Speaker 1 (04:57):
Yeah, at age fifty six. So this is all very
fresh for her, very recent. Yeah, and she really highlights
that historically, people going through menopause and beyond, they just
haven't been a priority, not in society and definitely not
in the medical world. It's true, research and funding for
women's health has lagged behind big time.
Speaker 2 (05:18):
And it's fascinating right when you look back at how
the treatment for menopause has changed so much over time.
It's almost like we've gone back and forth, back and
forth trying to figure out the best way to manage
symptoms and avoid those health risks totally.
Speaker 1 (05:32):
And you know, despite the fact that hormones were the
lack of them, that's what menopause is all about, there
hasn't always been a clear, trusted approach to it.
Speaker 2 (05:42):
And it's almost scary when you read about those historical perspectives, right,
Like doctor Haber talks about the whole idea of menopausal madness.
Speaker 1 (05:48):
Oh yeah, it's crazy.
Speaker 2 (05:49):
And those treatments back then leaches asylums, Like wow, it
definitely makes you appreciate how far we've come.
Speaker 1 (05:55):
Yeah, thankfully. And you know, she brings in this evolutionary
biology perspective, which is really interesting.
Speaker 2 (06:00):
Yeah, like women living so long after their reproductive years,
it's not really common in nature. I mean, we're living
into our seventies eighties. Menopause usually hits around fifty one,
so that's a lot of extra years, that's true. So
you know, she suggests maybe this longer life, this post
reproductive life, it's more like a modern thing, you know,
not something that evolution really had time to like perfect
(06:23):
that's mind blowing.
Speaker 1 (06:24):
It's like we're outliving our egg supply because of how
we live now.
Speaker 2 (06:26):
Right exactly, and that's a real challenge. But as doctor
Haber points out, even though menopause can be tough, at
least we're living in a time where we can try
to understand it and actually manage it.
Speaker 1 (06:36):
That's a good point.
Speaker 2 (06:37):
So, you know, to understand estrogen's role, we got to
go back a bit, back to the early research that
set the stage. As early as in nineteen thirty three,
they were already making and prescribing estrogen. It was called
eminine back then.
Speaker 1 (06:51):
Eminine.
Speaker 2 (06:52):
Yeah. First they got it from placentas, then from pregnant
women's urine. It was supposed to help with menstrual cramps
and menopause.
Speaker 1 (07:00):
So that's before Premarin exactly.
Speaker 2 (07:02):
Premarin came along later and it was made from a
pregnant mayor's urine. The FDA approved it in nineteen forty two.
But thankfully, like doctor Haer points out, we have more
options now that don't involve animals.
Speaker 1 (07:13):
That's good.
Speaker 2 (07:13):
But the interesting thing is how Premarin kind of kicked
off this back and forth about hormone treatments for menopause.
Once companies realized there was money to be made, they
jumped in. By nineteen forty seven, there were already over
fifty different types of estrogen products on the market.
Speaker 1 (07:28):
Wow.
Speaker 2 (07:29):
And then pop culture got involved. Doctor Haer talks about
this bestseller from nineteen sixty eight called Feminine Forever. It
basically said estrogen therapy would keep women feminine and prevent diseases.
But she does point out this kind of icky, get
your wife back message in the marketing nicks. Yeah, it's like,
while the book did talk about women having a good
(07:49):
sex life at any age, the underlying message was more
about what men wanted.
Speaker 1 (07:53):
You know. It was a different time for sure.
Speaker 2 (07:55):
Yeah, b cringe worthy looking back, but either way, the
book boosted sales. By nineteen s seventy five, estrogen was
one of the most prescribed drugs in the US.
Speaker 1 (08:03):
Where everyone was taking it pretty much.
Speaker 2 (08:05):
But then same year nineteen seventy five, boom, a big
study comes out in the New England Journal of Medicine.
It linked taking estrogen alone without progesterone to a higher
risk of endometrial cancer in women who still had a uterus.
Oh wow, Yeah, it was a game changer. Lots of
women stopped taking estrogen. It made everyone rethink hormone products,
(08:26):
not just menopause treatments, but birth control pills too. It
really shifted the whole approach to menopause.
Speaker 1 (08:31):
That's a huge deal. It makes you realize, you know,
when we talk about big shifts in menopause treatment, we
got to talk about the Women's Health Initiative, the WHI. Oh.
Speaker 2 (08:39):
Absolutely, the WHI was a game changer. It completely reshaped
the landscape of hormone therapy and it impacted so many
women going through menopause. For sure.
Speaker 1 (08:49):
Leading up to the WHI, there was a lot of
hope around MHT, right, Yeah, definitely. We knew it helped
with hot flashes, night sweats, and we thought it could
also protect against things like osteoporosis and vaginal atrophy.
Speaker 2 (09:00):
And the WHI it was designed to look at those
potential benefits and also you know, figure out if there
were any risks, like you know, for heart disease or cancer.
But the initial findings they were pretty negative about those risks,
especially for heart disease and breast cancer, which wasn't what
anyone expected, right, It was a shock and the fallout
was huge. Many doctors just wouldn't prescribe HRT anymore. Some
(09:21):
even took women off of it even if they were
doing well on it, you know, wow, which was tough
for a lot of women who really felt those hormones
were helping them. Doctor Haber points out that because of this,
millions of women lost access to something that was easing
their symptoms.
Speaker 1 (09:35):
Right, they couldn't get relief.
Speaker 2 (09:36):
Exactly, and countless others missed out on the potential benefits,
especially if they had started MHT at the right.
Speaker 1 (09:42):
Time, right right.
Speaker 2 (09:43):
And the big question then and now is about the
cancer risks. Doctor Haver doesn't shy away from it. She
knows it's a big concern and that people connect hormone
therapy with cancer and.
Speaker 1 (09:55):
It's understandable, right, Like it's scary to think.
Speaker 2 (09:57):
About, absolutely.
Speaker 1 (09:59):
Yeah.
Speaker 2 (09:59):
But what's in interesting is this idea of the timing hypothesis.
It suggests that starting MHT closer to menopause, when your
hormones are still closer to their premenopause levels, might actually
help prevent some diseases.
Speaker 1 (10:12):
Oh that makes sense, yeah.
Speaker 2 (10:13):
Think about it. The drop in estrogen during menopause can
increase the risk of breast cancer in some women. And
it can also mess with your heart health. Your cholesterol
levels go up, you get more plaque and your arteries.
Speaker 1 (10:25):
Yeah.
Speaker 2 (10:25):
Yeah, basically without enough estrogen, your body is less protected.
The American Heart Association even said in twenty twenty that
going through menopause is a big factor in those rise
in cholesterol levels, metabolic syndrome risk, and even changes in
your blood vessels.
Speaker 1 (10:41):
Wow, so it's not just about getting older, it's about
the hormonal changes exactly.
Speaker 2 (10:45):
And here's a key takeaway. Doctor Haver says women who
started MHT within ten years of menopause they had about
half the risk of heart disease compared to those who
started later or didn't use it at all.
Speaker 1 (10:55):
So timing really does matter big time.
Speaker 2 (10:58):
That's why it's so important to know when you hit
menopause and talk to your doctor about MHT for sure.
Speaker 1 (11:03):
And you know, doctor Haber also talks about this problem
within the medical field, how women's health specialties have been
kind of siloed. Yeah, like it wasn't always common for
a doctor to be an expert in everything delivering babies, gynecology, cancer,
and menopause. That's true, and that lack of like being
able to see the whole picture has sometimes made it
(11:23):
harder for women to get good care. Yeah, she's saying
that any doctor who takes care of women should be
able to talk about menopause and MHT. Yeah, explain the
good and the bad, the risks and the benefits. Yeah.
Speaker 2 (11:35):
No more brushing women off. They deserve better than that, exactly.
The good news is new doctors are now learning that
MHT is generally safe and should be part of the conversation.
That's great, but it takes time for those changes in
training to actually reach all the doctors out there. So
doctor Haber says, women need to be proactive and really
advocate for themselves, right, don't be afraid to speak up.
Speaker 1 (11:56):
And that brings us to these, you know, bigger problems
that are affecting menopause care. Doctor Haver points to the
lack of research funding as a huge reason why a
lot of women can't find good help.
Speaker 2 (12:08):
It's a shame. But thankfully people are getting frustrated and
that's actually creating change.
Speaker 1 (12:12):
Oh, that's good.
Speaker 2 (12:13):
Yeah, Like she describes it as this ground swal of change.
We're seeing companies investing more than ever before in menopause research.
Speaker 1 (12:21):
Really, that's great news.
Speaker 2 (12:22):
It is. They're also developing new technologies and products specifically
for menopausal health. There's a real momentum building. I love
to hear that, and the scope of the research is expanding.
It's not just about those obvious symptoms anymore. Doctor Haver
highlights how they're looking into new treatments, how menopause effects
our mood, brain fog and other cognitive issues, the risks
(12:44):
for heart disease and diabetes, problems with muscles and bones,
even skin solutions.
Speaker 1 (12:49):
Wow, it's amazing how much more we're learning.
Speaker 2 (12:51):
And here's something really exciting. There's this new focus on perimenopause,
which you know, for a lot of women can be
even harder than postmenopause.
Speaker 1 (13:00):
Yeah, for sure.
Speaker 2 (13:01):
Doctor have also talks about the work of doctor Lisa
Mosconi who's looking into cognitive aging and Alzheimer's.
Speaker 1 (13:07):
Oh yeah, I've heard of her.
Speaker 2 (13:08):
It's scary, but she found that two thirds of people
with Alzheimer's are postmenopausal women.
Speaker 1 (13:14):
Wow, that's a huge number, it is.
Speaker 2 (13:16):
And what's even worse is that this difference, it's been
ignored for so long, just brushed off as part of
getting old.
Speaker 1 (13:23):
Oh that's frustrating it.
Speaker 2 (13:25):
Is, and doctor have talks about these wild goose chases.
So many women go on trying to get a diagnosis,
you know, being referred to different specialists, getting tons of tests,
and ending up with prescriptions that don't even work.
Speaker 1 (13:38):
That sounds exhausting, it is.
Speaker 2 (13:39):
But she's hopeful about the future. With better education for
doctors and more access to good quality care, more women
will get the right diagnosis and treatment, including MHT when
it's appropriate.
Speaker 1 (13:50):
That's good days.
Speaker 2 (13:50):
Plus this will help lower health care costs in the
long run because those unnecessary tests and specialist visits will
go down.
Speaker 1 (13:57):
Makes sense, and doctor Haver shares this satistic that shows
just how long this journey can be. The average woman
experiences symptoms for about seven and a half yearsh and
if those hot flashes start early, it can be even longer,
up to twelve years. That's a long time, it is,
and we have to remember this is all based on
what we know now, which isn't everything right. As we
(14:20):
do more research, those timelines might change. Doctor Heber's hope
is that as more people learn about menopause, women will
be able to spot their own symptoms and get help sooner.
Speaker 2 (14:30):
Absolutely so let's talk diagnosis. A lot of women want
to know, is there a test that can tell you
for sure if you're in perimenopause. Doctor Habers says, unfortunately,
there is no single blood test, urine test, or saliva
tests that can definitively diagnose it.
Speaker 1 (14:44):
Oh bummer.
Speaker 2 (14:44):
Yeah, it's because hormone levels are all over the place
during that transition. But she does mention this clarity ox
mind test.
Speaker 1 (14:51):
What's that.
Speaker 2 (14:51):
It involves taking several blood samples over a few days,
and they have this app where you track your symptoms
and periods. Okay, in the end you get a report
you can share with your doctor.
Speaker 1 (15:01):
Makes sense. Yeah, so it's more information for your doctor
to work with.
Speaker 2 (15:04):
Right, especially since not all doctors are experts on menopause yet.
Speaker 1 (15:07):
Yeah, that's a good point.
Speaker 2 (15:09):
But even without a special test, doctor Haer says, a
doctor who knows their stuff about menopause should be able
to diagnose perimenopause just by talking to you. They need
to listen to your symptoms and actually believe you, not
just say it's normal aging or something psychological. It's so
important totally, and they might order blood work not to
diagnose perimenopause, but to rule out other things that could
(15:30):
be causing those symptoms, you know, like thyrite issues or
autoimmune diseases.
Speaker 1 (15:35):
Takes sense.
Speaker 2 (15:36):
The goal is to create a treatment plan together you
and your doctor based on what's best for you.
Speaker 1 (15:41):
That's the ideal scenario, absolutely.
Speaker 2 (15:43):
So let's break down those menopause stages. Perimenopause is the
first phase, the beginning of the end of your ovaries working.
And it's funny most women only really realized they were
in it when they look back.
Speaker 1 (15:56):
Really.
Speaker 2 (15:56):
Yeah, the big clue is your periods get all messed up,
cycle gets longer or shorter, or the flow changes. That's perimenopause.
Speaker 1 (16:05):
Okay, so it's not just about the hot flashes and.
Speaker 2 (16:07):
Night sweats, Nope, not just that. It's mainly because your
estrogen and progesterone, those key hormones are going up and
down like a roller coaster.
Speaker 1 (16:16):
So it's that hormonal fluctuation exactly.
Speaker 2 (16:19):
Doctor Haver says. Perimenopause usually lasts about four years, but
it can be shorter or way longer, like over ten
years for some women. And the symptoms, oh my gosh.
Speaker 1 (16:27):
It's a long list, like how long are we talking.
Speaker 2 (16:29):
We're talking anxiety, brain fog, low libido, feeling tired all
the time, hair changes, headaches, hot flashes, irregular periods, insomnia,
joint pain, mood swings, heart palpitations, skin changes, problems peeing,
vaginal dryness, and even weight changes. It's no wonder some
doctors miss it.
Speaker 1 (16:48):
Wow, that's allowed to keep track of.
Speaker 2 (16:50):
It is And as doctor have said, doctors aren't always
trained well enough on menopause. There's not enough research funding
and historically women's health hasn't been taken as seriously.
Speaker 1 (16:59):
That's true.
Speaker 2 (16:59):
In fact, one survey found that a third of women
wait at least three years to get the right diagnosis.
Speaker 1 (17:05):
That's crazy, it is.
Speaker 2 (17:06):
So. Moving on to menopause itself, doctor Haver says, it's
simply when your periods stop for good. Officially, it's after
twelve months without a period, makes sense. The average age
is fifty one in the US. Okay, Biologically, it's because
your ovaries have stopped releasing eggs and making enough.
Speaker 1 (17:22):
Hormones, so it's like they're retiring.
Speaker 2 (17:24):
Yeah, exactly. And then comes postmenopause, which is all the
years after menopause.
Speaker 1 (17:30):
Post menopause yep.
Speaker 2 (17:32):
Doctor Haver stresses that menopause isn't just about your period's ending.
It also kicks off faster aging and a general decline
in health.
Speaker 1 (17:39):
Oh that's not great, no.
Speaker 2 (17:40):
But there's a silver lining, she says, the later you
naturally go through menopause, the better. It's linked to living longer,
stronger bones, fewer fractures, and less heart disease, probably because
you have estrogen's protection for longer.
Speaker 1 (17:53):
So it's not all bad news.
Speaker 2 (17:55):
Definitely not. And when you hit menopause it depends on
a bunch of things. Your genes, your ethnicity, your overall health,
life style choices like smoking that makes it come earlier,
and bm I higher bmi I might delay it, and
your reproductive history claeser role too, like when you got
your first period and how many pregnancies you've had.
Speaker 1 (18:14):
So if you had your period earlier, had lots of periods,
does that mean menopause come sooner.
Speaker 2 (18:19):
It's not a hard rule, but there's connection. You have
a set number of eggs, right, so starting periods early
or having them more often could mean you run out sooner.
But pregnancy actually pauses ovulation, so that might delay menopause. Oh,
I see, but it's not that simple. Other things are involved,
and then they're surgery. If you have a hysterectomy but
(18:40):
keep your ovaries, you usually don't hit menopause right away.
Speaker 1 (18:43):
Okay, So that's different from removing the ovaries.
Speaker 2 (18:45):
Huge difference. If you have both ovaries removed, it's called
surgical menopause. Your hormones drop suddenly and that can be
dangerous if you don't get treatment, like higher risk of
heart disease and even dying earlier.
Speaker 1 (18:57):
Wow, that's serious, it is.
Speaker 2 (19:00):
Moving just one ovary can lead to earlier menopause. And
then there's this condition called premature ovarian insufficiency or POI.
That's when your ovary stop working before you turn forty.
Speaker 1 (19:11):
Before forty, that's young, it is.
Speaker 2 (19:13):
And women with POI might still have some estrogen production
and even opulate sometimes, but it's risky because losing estrogen
early raises the risk of heart disease, osteoporosis, and cognitive decline.
Speaker 1 (19:26):
So they need extra care.
Speaker 2 (19:27):
Absolutely. They often need hormone therapy, regular exercise, and enough
calcium and vitamin D.
Speaker 1 (19:33):
So important.
Speaker 2 (19:34):
Yeah. The bottom line is every woman will experience menopause.
So the more we understand about these stages and what
affects them, the better we can handle this natural part
of life.
Speaker 1 (19:44):
That's a great takeaway. So what happens in our bodies
during this whole menopausal transition?
Speaker 2 (19:48):
Right, So doctor Haber gets real personal in her book,
sharing her own story about those tough menopause symptoms. She
had to see multiple specialists and hormone therapy was a
game changer for her. She also acknowledged is that women
react to menopause in different ways emotionally, and it's understandable
to resist this idea of a reproductive year's ending the
big change huge, But she says, listen, fighting the truth
(20:11):
is pointless. What's important is to understand what's happening in
our bodies and do what we can to protect our health.
Speaker 1 (20:17):
So knowledge is power, right.
Speaker 2 (20:19):
Exactly, And she says understanding those changes in your endocrine system,
how your hormones are shifting, it helps you get the
support you need. And she warns us don't fall for
those expensive hormone balancing products.
Speaker 1 (20:32):
Yeah, those are everywhere they.
Speaker 2 (20:33):
Are, and she calls it self gaslighting. You know, you
try them, they don't work, and then you start doubting yourself.
That's a good point, so stick with evidence based approaches.
Talk to your doctor.
Speaker 1 (20:43):
Good advice. So let's break this down. How does the
menstrual cycle normally work?
Speaker 2 (20:47):
Right, So doctor Hieber gives us a quick rundown. There's
the follicular phase, ovulation, and the luteal phase. It's all
this intricate dance of hormones.
Speaker 1 (20:56):
Okay, and what changes during periodmenopause.
Speaker 2 (20:58):
Your ovaries start preducing less estrogen and progesterone.
Speaker 1 (21:02):
Right.
Speaker 2 (21:03):
That sends a signal to your brain, specifically the hypothalamus,
which is like the control center.
Speaker 1 (21:08):
Okay.
Speaker 2 (21:08):
The hypothalamus then releases more of this hormone. It's called
gonadotropin releasing hormone. That's a mouthful, I know, right, And
that triggers your pituitary gland, another part of your brain,
to make more follical stimulating hormone or FSH and lutinizing
hormone or LH. FSH and LH yeah, and those are
supposed to tell your ovaries to keep making follicles and
(21:31):
releasing eggs. But as your ovaries slow down, those f
SH and LH levels stay high because your brain's like, hey,
ovaries get to work, but they're not listening as well,
So it's like a miscommunication kind of. Doctor Haer makes
it clear that saying there's a hormonal imbalance is way
too simple. Oh, it's about figuring out the root cause
(21:51):
of your symptoms, not just chasing this vague idea of imbalance.
And she's really against those unregulated products claiming to fix
Oh yeah, those supplements and stuff Exactly, they usually don't work,
they cost a fortune, and some might even be dangerous.
Talk to a doctor instead, one who knows about menopause.
Speaker 1 (22:08):
Good advice. Now, what about the health risks that come.
Speaker 2 (22:12):
With menopause, right, Doctor Haber says, it's not just about
feeling uncomfortable. Menopause can have real long term effects on
your health.
Speaker 1 (22:18):
So it's more than just hot flashes and mood swings.
Speaker 2 (22:21):
Oh definitely.
Speaker 1 (22:22):
What kind of things are we talking about.
Speaker 2 (22:23):
Let's start with osteoporosis. Okay, estrogen is super important for
strong bones because it helps build new bone tissue. But
when your estrogen levels plummet during menopause, you're at a
much higher risk for osteoporosis and fractures, so.
Speaker 1 (22:37):
Your bones become weaker.
Speaker 2 (22:39):
Exactly. It affects a huge number of postmenopausal women. And
get this, there's even a link between those hot flashes
and lower bone density.
Speaker 1 (22:48):
Wow. So even the symptoms can have.
Speaker 2 (22:51):
Consequences, right, And there are other risk factors too early menopause,
family history, low BMI, smoking, drinking too much alcohol, and
some medications can also increase your risk.
Speaker 1 (23:03):
What about screening, Like, how do you know if you're
at risk?
Speaker 2 (23:06):
The standard test is a dexa scan. It measures your
bone density. They usually recommend it around sixty five. But
if you have those rix factors we talked about, you
might need it earlier.
Speaker 1 (23:16):
Good to know. Now, what about heart health?
Speaker 2 (23:18):
Oh, that's a big one. Your cholesterol levels can really
go haywire during menopause. Oh no, yeah, and it's those
declining estrogen and progesterone levels. Again, they affect how your
blood vessels work. They can make your vessels constrict more,
your liver might make more clotting proteins, and the cells
lining your blood vessels they become less effective at protecting you.
Speaker 1 (23:39):
That's scary, it is.
Speaker 2 (23:40):
And on top of those regular heart disease risks, there
are menopause specific ones like hitting menopause early, having your
ovaries removed, or even having really bad menopause symptoms.
Speaker 1 (23:52):
Wow.
Speaker 2 (23:52):
And the worst part is heart disease. It often doesn't
have symptoms until it's pretty bad.
Speaker 1 (23:57):
So how do you catch it early?
Speaker 2 (23:58):
Well, regular checkups aren't always enough. Doctor Haver suggests this
test called a coronary calcium score test. Okay, it's a
better way to check for early heart problems, but it's
not always covered by insurance. That's not great, no, but
it might be worth it. And this brings us back
to that timing hypothesis. Starting hormone therapy within ten years
of metopause can significantly lower your risk of heart disease.
Speaker 1 (24:20):
So again, timing is key.
Speaker 2 (24:22):
Absolutely.
Speaker 1 (24:22):
Okay, So we talked about bones and heart health. What
else is there?
Speaker 2 (24:26):
Well, insulin resistance and metabolic syndrome are big concerns too.
Insulin resistance, yeah, it's all about how your body processes sugar. Normally,
your body uses insulin to get sugar from your blood
into your cells for energy. Makes sense, But with infulin resistance,
your cells don't respond to insulin as well, so sugar
builds up in your blood.
Speaker 1 (24:45):
That doesn't sound good.
Speaker 2 (24:46):
It's not. It leads to high blood sugar and constant inflammation,
and it's a big step towards pre diabetes and type
two diabetes.
Speaker 1 (24:55):
So it's something to watch out for for sure.
Speaker 2 (24:58):
The tricky part is regular bloe tests might not catch
it early on.
Speaker 1 (25:02):
Which would we look for?
Speaker 2 (25:03):
Then, keep an eye on your triglycerid levels, your blood pressure,
and your HDL cholesterol. Okay, if those triglycerides and blood
pressure are high and HDL is low, it could be
a sign of insulin resistance in metabolic syndrome.
Speaker 1 (25:16):
Got it, So we need to be proactive about checking
those numbers absolutely. Now, what about this weight gain that
so many women experience during menopause.
Speaker 2 (25:25):
Oh, yeah, that's a common complaint. And it's not just
about gaining weight overall. It's about where you gain it.
Speaker 1 (25:32):
What do you mean.
Speaker 2 (25:33):
It's about that visceral fat, the deep belly fat that
surrounds your organ.
Speaker 1 (25:37):
Oh. That's a bad kind of.
Speaker 2 (25:38):
Fat, right, it is. It's linked to a lot of
health problems. And guess what. Estrogen plays a role here too.
Speaker 1 (25:44):
Really.
Speaker 2 (25:45):
Yeah, as your estrogen levels drop, your body starts storing
more fat in that visceral area.
Speaker 1 (25:50):
So even if the number on the scale doesn't change much,
your body composition can.
Speaker 2 (25:54):
Shift exactly, Doctor Haer says, before menopause women typically have
five eight percent visceral fat, but after it jumps up
to fifteen twenty percent. That's a big difference. That's huge,
it is, and several things can contribute, eating too much,
not moving enough, stress genes, and not sleeping.
Speaker 1 (26:15):
Well, it's like a perfect storm, right.
Speaker 2 (26:16):
And there's this thing called your waist to hip ratio.
It's a quick way to see if you're carrying too
much belly fat. You can also get special scans like
TODEXO or inbody to measure your body composition more accurately.
But the research on whether hormone therapy helps with visceral
fat is still kind of.
Speaker 1 (26:33):
Mixed, so that's not a guaranteed solution.
Speaker 2 (26:35):
Not yet. But lifestyle changes those are key.
Speaker 1 (26:38):
Makes sense. Now, what about muscle loss, I've heard that's
a concern too.
Speaker 2 (26:43):
It is. It's called sarcopenia, and you guessed it. Estrogen
is involved here too.
Speaker 1 (26:47):
It seems like estrogen affects everything it does.
Speaker 2 (26:50):
Estrogen helps your muscles regenerate and repair themselves. So when
it declines, you start losing muscle.
Speaker 1 (26:55):
Mass, so you become weaker.
Speaker 2 (26:57):
Yeah, and that affects your mobility, your strength, how much
fat you carry and even your metabolism
All right, so welcome to Bookcast. We bring you best
selling books in minutes. And guess what today we're diving
deep into a book that's been like everywhere, the New Menopause,
Navigating your Path through Hormonal Change with Purpose, Power and Facts.
It's by doctor Mary clare haveor that's right, it's me
Sarah and I'm Paul.
Speaker 2 (00:20):
And for everyone listening, whether you're like personally curious about menopause,
maybe you know someone going through it, or you just
like to stay in the know about you know, those
big health topics, this deep dive is for you. We're
going to pull out all the important stuff from doctor
Haer's book, and we're going to do it fast, but
we're going to make sure you get it all.
Speaker 1 (00:37):
Yeah, exactly. Uh. Our mission is to really break down
all the most important things doctor Haver's saying. So we
want you to understand all the ins and outs of menopause.
I feel like you've got the power of knowledge, you know,
so you can advocate for the best care possible. Oh yes,
so let's jump right in. You know, doctor Have really
hits on this whole thing about substandard care, like so
(00:59):
many women just feel dismissed when they go see a
doctor about menopause.
Speaker 2 (01:03):
Oh for sure.
Speaker 1 (01:04):
And it's like, you really feel it when you read
some of these stories, right, I mean both from like
her social media and also a study from the Journal of.
Speaker 2 (01:12):
Women's Health, Yes, from twenty twenty three.
Speaker 1 (01:15):
Women are hearing things like, oh, just pop some time
and I'll get some rest. Or you can't be a perimenopause,
you're not having hot flashes.
Speaker 2 (01:21):
Yeah. The common thread, though, really is that women just
don't feel validated, right, right. They have to see so
many different doctors before someone actually takes them seriously. Ohay,
or worse, they're told it's just natural, get over it,
or welcome to your new normal, as if their struggles
are you know, nothing.
Speaker 1 (01:39):
And doctor Haber's really saying this isn't just a few
isolated incidents. This is more common than we want to believe.
Speaker 2 (01:46):
Oh absolutely, And she even talks about how this can
lead to unhealthy coping mechanisms, you know, yeah, like maybe
why we see increased alcohol use among women going through this.
Speaker 1 (01:55):
It makes you wonder like why why are so many
women at this, you know, really important time in their
life just feeling dismissed and unheard?
Speaker 2 (02:04):
Right, And like without any real hope for getting better.
Speaker 1 (02:07):
Right.
Speaker 2 (02:07):
You know, in the medical field we talk about access
to care, but what are the barriers for women actually
having a good experience, you know, a positive, helpful experience
with their healthcare during menopause.
Speaker 1 (02:20):
Well, and one of the biggest things seems to be
just how different menopause can be for everyone.
Speaker 2 (02:26):
Oh absolutely, I.
Speaker 1 (02:27):
Mean, doctor Haer makes it clear. It's not just those
things we always hear about, you know, right, the hot flashes,
the night sweats, bone density, or problems with your you know,
lady parts.
Speaker 2 (02:38):
Right, It's so much more than that, so much more.
The list of potential symptoms, it's huge. We're talking about
stuff like acid reflux, acne breakouts, women are even noticing
their bodies are processing alcohol differently.
Speaker 1 (02:50):
Wow.
Speaker 2 (02:50):
So when you have such a wide range of symptoms,
it can be hard for doctors to even recognize it,
let alone diagnose it accurately or treat it effectively.
Speaker 1 (02:58):
Right, And for you listening, it's important to remember that
the menopause will transition. It's not a one size fits.
Speaker 2 (03:03):
All, definitely not.
Speaker 1 (03:05):
Some women have a ton of symptoms during perimenopause, and
then you know, everything's kind of smooth sailing after that, right,
But other women it's the total opposite, totally.
Speaker 2 (03:13):
It's unique for everyone and how menopause affects you. It
depends on so many things, your genes, your lifestyle, like
your diet, how much you exercise, whether you smoke, you know,
even your reproductive history. It all comes into play.
Speaker 1 (03:28):
Doctor Haver makes this really interesting point, you know, where
she talks about how doctors usually diagnose things right, Like
they use what they remember learning and then try to
match your symptoms to what they think the problem might be. Yeah,
but a lot of doctors they just haven't been trained
enough to recognize all these wider symptoms of menopause.
Speaker 2 (03:45):
That's right. It's like traditional medical training. It focuses on
just a handful of symptoms hot flashes, night sweats, problems peeing,
and not being able to sleep. Yeah, it's just such
a narrow view of what's actually a really complicated shift
in your body.
Speaker 1 (04:00):
For doctor Have it took her own personal experience going
through menopause, you know, to really get it, and she
had to do a lot of research on her own. Yeah,
she had to go way beyond what she learned in
med school.
Speaker 2 (04:11):
Absolutely, and I think that's why she calls it endocrinological aging,
because it's just so much more than just you know,
a few simple symptoms.
Speaker 1 (04:18):
And all that personal experience, plus being a doctor, it
makes her really believe that understanding the research, that's what
gives women the power to talk to their doctors about
hormone therapy or MHT and all those other ways to
deal with menopause.
Speaker 2 (04:32):
Absolutely, that knowledge is power, and ultimately it's about breaking
down those barriers to getting good quality care during menopause.
That's what she wants. More awareness, better education for women
and doctors, and just being proactive taking those steps to
get what you need.
Speaker 1 (04:48):
That's so important.
Speaker 2 (04:49):
Yeah.
Speaker 1 (04:50):
So, speaking of perspective, doctor have actually officially hit menopause
in October twenty twenty two.
Speaker 2 (04:55):
Oh wow, so she's right there with us.
Speaker 1 (04:57):
Yeah, at age fifty six. So this is all very
fresh for her, very recent. Yeah, and she really highlights
that historically, people going through menopause and beyond, they just
haven't been a priority, not in society and definitely not
in the medical world. It's true, research and funding for
women's health has lagged behind big time.
Speaker 2 (05:18):
And it's fascinating right when you look back at how
the treatment for menopause has changed so much over time.
It's almost like we've gone back and forth, back and
forth trying to figure out the best way to manage
symptoms and avoid those health risks totally.
Speaker 1 (05:32):
And you know, despite the fact that hormones were the
lack of them, that's what menopause is all about, there
hasn't always been a clear, trusted approach to it.
Speaker 2 (05:42):
And it's almost scary when you read about those historical perspectives, right,
Like doctor Haber talks about the whole idea of menopausal madness.
Speaker 1 (05:48):
Oh yeah, it's crazy.
Speaker 2 (05:49):
And those treatments back then leaches asylums, Like wow, it
definitely makes you appreciate how far we've come.
Speaker 1 (05:55):
Yeah, thankfully. And you know, she brings in this evolutionary
biology perspective, which is really interesting.
Speaker 2 (06:00):
Yeah, like women living so long after their reproductive years,
it's not really common in nature. I mean, we're living
into our seventies eighties. Menopause usually hits around fifty one,
so that's a lot of extra years, that's true. So
you know, she suggests maybe this longer life, this post
reproductive life, it's more like a modern thing, you know,
not something that evolution really had time to like perfect
(06:23):
that's mind blowing.
Speaker 1 (06:24):
It's like we're outliving our egg supply because of how
we live now.
Speaker 2 (06:26):
Right exactly, and that's a real challenge. But as doctor
Haber points out, even though menopause can be tough, at
least we're living in a time where we can try
to understand it and actually manage it.
Speaker 1 (06:36):
That's a good point.
Speaker 2 (06:37):
So, you know, to understand estrogen's role, we got to
go back a bit, back to the early research that
set the stage. As early as in nineteen thirty three,
they were already making and prescribing estrogen. It was called
eminine back then.
Speaker 1 (06:51):
Eminine.
Speaker 2 (06:52):
Yeah. First they got it from placentas, then from pregnant
women's urine. It was supposed to help with menstrual cramps
and menopause.
Speaker 1 (07:00):
So that's before Premarin exactly.
Speaker 2 (07:02):
Premarin came along later and it was made from a
pregnant mayor's urine. The FDA approved it in nineteen forty two.
But thankfully, like doctor Haer points out, we have more
options now that don't involve animals.
Speaker 1 (07:13):
That's good.
Speaker 2 (07:13):
But the interesting thing is how Premarin kind of kicked
off this back and forth about hormone treatments for menopause.
Once companies realized there was money to be made, they
jumped in. By nineteen forty seven, there were already over
fifty different types of estrogen products on the market.
Speaker 1 (07:28):
Wow.
Speaker 2 (07:29):
And then pop culture got involved. Doctor Haer talks about
this bestseller from nineteen sixty eight called Feminine Forever. It
basically said estrogen therapy would keep women feminine and prevent diseases.
But she does point out this kind of icky, get
your wife back message in the marketing nicks. Yeah, it's like,
while the book did talk about women having a good
(07:49):
sex life at any age, the underlying message was more
about what men wanted.
Speaker 1 (07:53):
You know. It was a different time for sure.
Speaker 2 (07:55):
Yeah, b cringe worthy looking back, but either way, the
book boosted sales. By nineteen s seventy five, estrogen was
one of the most prescribed drugs in the US.
Speaker 1 (08:03):
Where everyone was taking it pretty much.
Speaker 2 (08:05):
But then same year nineteen seventy five, boom, a big
study comes out in the New England Journal of Medicine.
It linked taking estrogen alone without progesterone to a higher
risk of endometrial cancer in women who still had a uterus.
Oh wow, Yeah, it was a game changer. Lots of
women stopped taking estrogen. It made everyone rethink hormone products,
(08:26):
not just menopause treatments, but birth control pills too. It
really shifted the whole approach to menopause.
Speaker 1 (08:31):
That's a huge deal. It makes you realize, you know,
when we talk about big shifts in menopause treatment, we
got to talk about the Women's Health Initiative, the WHI. Oh.
Speaker 2 (08:39):
Absolutely, the WHI was a game changer. It completely reshaped
the landscape of hormone therapy and it impacted so many
women going through menopause. For sure.
Speaker 1 (08:49):
Leading up to the WHI, there was a lot of
hope around MHT, right, Yeah, definitely. We knew it helped
with hot flashes, night sweats, and we thought it could
also protect against things like osteoporosis and vaginal atrophy.
Speaker 2 (09:00):
And the WHI it was designed to look at those
potential benefits and also you know, figure out if there
were any risks, like you know, for heart disease or cancer.
But the initial findings they were pretty negative about those risks,
especially for heart disease and breast cancer, which wasn't what
anyone expected, right, It was a shock and the fallout
was huge. Many doctors just wouldn't prescribe HRT anymore. Some
(09:21):
even took women off of it even if they were
doing well on it, you know, wow, which was tough
for a lot of women who really felt those hormones
were helping them. Doctor Haber points out that because of this,
millions of women lost access to something that was easing
their symptoms.
Speaker 1 (09:35):
Right, they couldn't get relief.
Speaker 2 (09:36):
Exactly, and countless others missed out on the potential benefits,
especially if they had started MHT at the right.
Speaker 1 (09:42):
Time, right right.
Speaker 2 (09:43):
And the big question then and now is about the
cancer risks. Doctor Haver doesn't shy away from it. She
knows it's a big concern and that people connect hormone
therapy with cancer and.
Speaker 1 (09:55):
It's understandable, right, Like it's scary to think.
Speaker 2 (09:57):
About, absolutely.
Speaker 1 (09:59):
Yeah.
Speaker 2 (09:59):
But what's in interesting is this idea of the timing hypothesis.
It suggests that starting MHT closer to menopause, when your
hormones are still closer to their premenopause levels, might actually
help prevent some diseases.
Speaker 1 (10:12):
Oh that makes sense, yeah.
Speaker 2 (10:13):
Think about it. The drop in estrogen during menopause can
increase the risk of breast cancer in some women. And
it can also mess with your heart health. Your cholesterol
levels go up, you get more plaque and your arteries.
Speaker 1 (10:25):
Yeah.
Speaker 2 (10:25):
Yeah, basically without enough estrogen, your body is less protected.
The American Heart Association even said in twenty twenty that
going through menopause is a big factor in those rise
in cholesterol levels, metabolic syndrome risk, and even changes in
your blood vessels.
Speaker 1 (10:41):
Wow, so it's not just about getting older, it's about
the hormonal changes exactly.
Speaker 2 (10:45):
And here's a key takeaway. Doctor Haver says women who
started MHT within ten years of menopause they had about
half the risk of heart disease compared to those who
started later or didn't use it at all.
Speaker 1 (10:55):
So timing really does matter big time.
Speaker 2 (10:58):
That's why it's so important to know when you hit
menopause and talk to your doctor about MHT for sure.
Speaker 1 (11:03):
And you know, doctor Haber also talks about this problem
within the medical field, how women's health specialties have been
kind of siloed. Yeah, like it wasn't always common for
a doctor to be an expert in everything delivering babies, gynecology, cancer,
and menopause. That's true, and that lack of like being
able to see the whole picture has sometimes made it
(11:23):
harder for women to get good care. Yeah, she's saying
that any doctor who takes care of women should be
able to talk about menopause and MHT. Yeah, explain the
good and the bad, the risks and the benefits. Yeah.
Speaker 2 (11:35):
No more brushing women off. They deserve better than that, exactly.
The good news is new doctors are now learning that
MHT is generally safe and should be part of the conversation.
That's great, but it takes time for those changes in
training to actually reach all the doctors out there. So
doctor Haber says, women need to be proactive and really
advocate for themselves, right, don't be afraid to speak up.
Speaker 1 (11:56):
And that brings us to these, you know, bigger problems
that are affecting menopause care. Doctor Haver points to the
lack of research funding as a huge reason why a
lot of women can't find good help.
Speaker 2 (12:08):
It's a shame. But thankfully people are getting frustrated and
that's actually creating change.
Speaker 1 (12:12):
Oh, that's good.
Speaker 2 (12:13):
Yeah, Like she describes it as this ground swal of change.
We're seeing companies investing more than ever before in menopause research.
Speaker 1 (12:21):
Really, that's great news.
Speaker 2 (12:22):
It is. They're also developing new technologies and products specifically
for menopausal health. There's a real momentum building. I love
to hear that, and the scope of the research is expanding.
It's not just about those obvious symptoms anymore. Doctor Haver
highlights how they're looking into new treatments, how menopause effects
our mood, brain fog and other cognitive issues, the risks
(12:44):
for heart disease and diabetes, problems with muscles and bones,
even skin solutions.
Speaker 1 (12:49):
Wow, it's amazing how much more we're learning.
Speaker 2 (12:51):
And here's something really exciting. There's this new focus on perimenopause,
which you know, for a lot of women can be
even harder than postmenopause.
Speaker 1 (13:00):
Yeah, for sure.
Speaker 2 (13:01):
Doctor have also talks about the work of doctor Lisa
Mosconi who's looking into cognitive aging and Alzheimer's.
Speaker 1 (13:07):
Oh yeah, I've heard of her.
Speaker 2 (13:08):
It's scary, but she found that two thirds of people
with Alzheimer's are postmenopausal women.
Speaker 1 (13:14):
Wow, that's a huge number, it is.
Speaker 2 (13:16):
And what's even worse is that this difference, it's been
ignored for so long, just brushed off as part of
getting old.
Speaker 1 (13:23):
Oh that's frustrating it.
Speaker 2 (13:25):
Is, and doctor have talks about these wild goose chases.
So many women go on trying to get a diagnosis,
you know, being referred to different specialists, getting tons of tests,
and ending up with prescriptions that don't even work.
Speaker 1 (13:38):
That sounds exhausting, it is.
Speaker 2 (13:39):
But she's hopeful about the future. With better education for
doctors and more access to good quality care, more women
will get the right diagnosis and treatment, including MHT when
it's appropriate.
Speaker 1 (13:50):
That's good days.
Speaker 2 (13:50):
Plus this will help lower health care costs in the
long run because those unnecessary tests and specialist visits will
go down.
Speaker 1 (13:57):
Makes sense, and doctor Haver shares this satistic that shows
just how long this journey can be. The average woman
experiences symptoms for about seven and a half yearsh and
if those hot flashes start early, it can be even longer,
up to twelve years. That's a long time, it is,
and we have to remember this is all based on
what we know now, which isn't everything right. As we
(14:20):
do more research, those timelines might change. Doctor Heber's hope
is that as more people learn about menopause, women will
be able to spot their own symptoms and get help sooner.
Speaker 2 (14:30):
Absolutely so let's talk diagnosis. A lot of women want
to know, is there a test that can tell you
for sure if you're in perimenopause. Doctor Habers says, unfortunately,
there is no single blood test, urine test, or saliva
tests that can definitively diagnose it.
Speaker 1 (14:44):
Oh bummer.
Speaker 2 (14:44):
Yeah, it's because hormone levels are all over the place
during that transition. But she does mention this clarity ox
mind test.
Speaker 1 (14:51):
What's that.
Speaker 2 (14:51):
It involves taking several blood samples over a few days,
and they have this app where you track your symptoms
and periods. Okay, in the end you get a report
you can share with your doctor.
Speaker 1 (15:01):
Makes sense. Yeah, so it's more information for your doctor
to work with.
Speaker 2 (15:04):
Right, especially since not all doctors are experts on menopause yet.
Speaker 1 (15:07):
Yeah, that's a good point.
Speaker 2 (15:09):
But even without a special test, doctor Haer says, a
doctor who knows their stuff about menopause should be able
to diagnose perimenopause just by talking to you. They need
to listen to your symptoms and actually believe you, not
just say it's normal aging or something psychological. It's so
important totally, and they might order blood work not to
diagnose perimenopause, but to rule out other things that could
(15:30):
be causing those symptoms, you know, like thyrite issues or
autoimmune diseases.
Speaker 1 (15:35):
Takes sense.
Speaker 2 (15:36):
The goal is to create a treatment plan together you
and your doctor based on what's best for you.
Speaker 1 (15:41):
That's the ideal scenario, absolutely.
Speaker 2 (15:43):
So let's break down those menopause stages. Perimenopause is the
first phase, the beginning of the end of your ovaries working.
And it's funny most women only really realized they were
in it when they look back.
Speaker 1 (15:56):
Really.
Speaker 2 (15:56):
Yeah, the big clue is your periods get all messed up,
cycle gets longer or shorter, or the flow changes. That's perimenopause.
Speaker 1 (16:05):
Okay, so it's not just about the hot flashes and.
Speaker 2 (16:07):
Night sweats, Nope, not just that. It's mainly because your
estrogen and progesterone, those key hormones are going up and
down like a roller coaster.
Speaker 1 (16:16):
So it's that hormonal fluctuation exactly.
Speaker 2 (16:19):
Doctor Haver says. Perimenopause usually lasts about four years, but
it can be shorter or way longer, like over ten
years for some women. And the symptoms, oh my gosh.
Speaker 1 (16:27):
It's a long list, like how long are we talking.
Speaker 2 (16:29):
We're talking anxiety, brain fog, low libido, feeling tired all
the time, hair changes, headaches, hot flashes, irregular periods, insomnia,
joint pain, mood swings, heart palpitations, skin changes, problems peeing,
vaginal dryness, and even weight changes. It's no wonder some
doctors miss it.
Speaker 1 (16:48):
Wow, that's allowed to keep track of.
Speaker 2 (16:50):
It is And as doctor have said, doctors aren't always
trained well enough on menopause. There's not enough research funding
and historically women's health hasn't been taken as seriously.
Speaker 1 (16:59):
That's true.
Speaker 2 (16:59):
In fact, one survey found that a third of women
wait at least three years to get the right diagnosis.
Speaker 1 (17:05):
That's crazy, it is.
Speaker 2 (17:06):
So. Moving on to menopause itself, doctor Haver says, it's
simply when your periods stop for good. Officially, it's after
twelve months without a period, makes sense. The average age
is fifty one in the US. Okay, Biologically, it's because
your ovaries have stopped releasing eggs and making enough.
Speaker 1 (17:22):
Hormones, so it's like they're retiring.
Speaker 2 (17:24):
Yeah, exactly. And then comes postmenopause, which is all the
years after menopause.
Speaker 1 (17:30):
Post menopause yep.
Speaker 2 (17:32):
Doctor Haver stresses that menopause isn't just about your period's ending.
It also kicks off faster aging and a general decline
in health.
Speaker 1 (17:39):
Oh that's not great, no.
Speaker 2 (17:40):
But there's a silver lining, she says, the later you
naturally go through menopause, the better. It's linked to living longer,
stronger bones, fewer fractures, and less heart disease, probably because
you have estrogen's protection for longer.
Speaker 1 (17:53):
So it's not all bad news.
Speaker 2 (17:55):
Definitely not. And when you hit menopause it depends on
a bunch of things. Your genes, your ethnicity, your overall health,
life style choices like smoking that makes it come earlier,
and bm I higher bmi I might delay it, and
your reproductive history claeser role too, like when you got
your first period and how many pregnancies you've had.
Speaker 1 (18:14):
So if you had your period earlier, had lots of periods,
does that mean menopause come sooner.
Speaker 2 (18:19):
It's not a hard rule, but there's connection. You have
a set number of eggs, right, so starting periods early
or having them more often could mean you run out sooner.
But pregnancy actually pauses ovulation, so that might delay menopause. Oh,
I see, but it's not that simple. Other things are involved,
and then they're surgery. If you have a hysterectomy but
(18:40):
keep your ovaries, you usually don't hit menopause right away.
Speaker 1 (18:43):
Okay, So that's different from removing the ovaries.
Speaker 2 (18:45):
Huge difference. If you have both ovaries removed, it's called
surgical menopause. Your hormones drop suddenly and that can be
dangerous if you don't get treatment, like higher risk of
heart disease and even dying earlier.
Speaker 1 (18:57):
Wow, that's serious, it is.
Speaker 2 (19:00):
Moving just one ovary can lead to earlier menopause. And
then there's this condition called premature ovarian insufficiency or POI.
That's when your ovary stop working before you turn forty.
Speaker 1 (19:11):
Before forty, that's young, it is.
Speaker 2 (19:13):
And women with POI might still have some estrogen production
and even opulate sometimes, but it's risky because losing estrogen
early raises the risk of heart disease, osteoporosis, and cognitive decline.
Speaker 1 (19:26):
So they need extra care.
Speaker 2 (19:27):
Absolutely. They often need hormone therapy, regular exercise, and enough
calcium and vitamin D.
Speaker 1 (19:33):
So important.
Speaker 2 (19:34):
Yeah. The bottom line is every woman will experience menopause.
So the more we understand about these stages and what
affects them, the better we can handle this natural part
of life.
Speaker 1 (19:44):
That's a great takeaway. So what happens in our bodies
during this whole menopausal transition?
Speaker 2 (19:48):
Right, So doctor Haber gets real personal in her book,
sharing her own story about those tough menopause symptoms. She
had to see multiple specialists and hormone therapy was a
game changer for her. She also acknowledged is that women
react to menopause in different ways emotionally, and it's understandable
to resist this idea of a reproductive year's ending the
big change huge, But she says, listen, fighting the truth
(20:11):
is pointless. What's important is to understand what's happening in
our bodies and do what we can to protect our health.
Speaker 1 (20:17):
So knowledge is power, right.
Speaker 2 (20:19):
Exactly, And she says understanding those changes in your endocrine system,
how your hormones are shifting, it helps you get the
support you need. And she warns us don't fall for
those expensive hormone balancing products.
Speaker 1 (20:32):
Yeah, those are everywhere they.
Speaker 2 (20:33):
Are, and she calls it self gaslighting. You know, you
try them, they don't work, and then you start doubting yourself.
That's a good point, so stick with evidence based approaches.
Talk to your doctor.
Speaker 1 (20:43):
Good advice. So let's break this down. How does the
menstrual cycle normally work?
Speaker 2 (20:47):
Right, So doctor Hieber gives us a quick rundown. There's
the follicular phase, ovulation, and the luteal phase. It's all
this intricate dance of hormones.
Speaker 1 (20:56):
Okay, and what changes during periodmenopause.
Speaker 2 (20:58):
Your ovaries start preducing less estrogen and progesterone.
Speaker 1 (21:02):
Right.
Speaker 2 (21:03):
That sends a signal to your brain, specifically the hypothalamus,
which is like the control center.
Speaker 1 (21:08):
Okay.
Speaker 2 (21:08):
The hypothalamus then releases more of this hormone. It's called
gonadotropin releasing hormone. That's a mouthful, I know, right, And
that triggers your pituitary gland, another part of your brain,
to make more follical stimulating hormone or FSH and lutinizing
hormone or LH. FSH and LH yeah, and those are
supposed to tell your ovaries to keep making follicles and
(21:31):
releasing eggs. But as your ovaries slow down, those f
SH and LH levels stay high because your brain's like, hey,
ovaries get to work, but they're not listening as well,
So it's like a miscommunication kind of. Doctor Haer makes
it clear that saying there's a hormonal imbalance is way
too simple. Oh, it's about figuring out the root cause
(21:51):
of your symptoms, not just chasing this vague idea of imbalance.
And she's really against those unregulated products claiming to fix
Oh yeah, those supplements and stuff Exactly, they usually don't work,
they cost a fortune, and some might even be dangerous.
Talk to a doctor instead, one who knows about menopause.
Speaker 1 (22:08):
Good advice. Now, what about the health risks that come.
Speaker 2 (22:12):
With menopause, right, Doctor Haber says, it's not just about
feeling uncomfortable. Menopause can have real long term effects on
your health.
Speaker 1 (22:18):
So it's more than just hot flashes and mood swings.
Speaker 2 (22:21):
Oh definitely.
Speaker 1 (22:22):
What kind of things are we talking about.
Speaker 2 (22:23):
Let's start with osteoporosis. Okay, estrogen is super important for
strong bones because it helps build new bone tissue. But
when your estrogen levels plummet during menopause, you're at a
much higher risk for osteoporosis and fractures, so.
Speaker 1 (22:37):
Your bones become weaker.
Speaker 2 (22:39):
Exactly. It affects a huge number of postmenopausal women. And
get this, there's even a link between those hot flashes
and lower bone density.
Speaker 1 (22:48):
Wow. So even the symptoms can have.
Speaker 2 (22:51):
Consequences, right, And there are other risk factors too early menopause,
family history, low BMI, smoking, drinking too much alcohol, and
some medications can also increase your risk.
Speaker 1 (23:03):
What about screening, Like, how do you know if you're
at risk?
Speaker 2 (23:06):
The standard test is a dexa scan. It measures your
bone density. They usually recommend it around sixty five. But
if you have those rix factors we talked about, you
might need it earlier.
Speaker 1 (23:16):
Good to know. Now, what about heart health?
Speaker 2 (23:18):
Oh, that's a big one. Your cholesterol levels can really
go haywire during menopause. Oh no, yeah, and it's those
declining estrogen and progesterone levels. Again, they affect how your
blood vessels work. They can make your vessels constrict more,
your liver might make more clotting proteins, and the cells
lining your blood vessels they become less effective at protecting you.
Speaker 1 (23:39):
That's scary, it is.
Speaker 2 (23:40):
And on top of those regular heart disease risks, there
are menopause specific ones like hitting menopause early, having your
ovaries removed, or even having really bad menopause symptoms.
Speaker 1 (23:52):
Wow.
Speaker 2 (23:52):
And the worst part is heart disease. It often doesn't
have symptoms until it's pretty bad.
Speaker 1 (23:57):
So how do you catch it early?
Speaker 2 (23:58):
Well, regular checkups aren't always enough. Doctor Haver suggests this
test called a coronary calcium score test. Okay, it's a
better way to check for early heart problems, but it's
not always covered by insurance. That's not great, no, but
it might be worth it. And this brings us back
to that timing hypothesis. Starting hormone therapy within ten years
of metopause can significantly lower your risk of heart disease.
Speaker 1 (24:20):
So again, timing is key.
Speaker 2 (24:22):
Absolutely.
Speaker 1 (24:22):
Okay, So we talked about bones and heart health. What
else is there?
Speaker 2 (24:26):
Well, insulin resistance and metabolic syndrome are big concerns too.
Insulin resistance, yeah, it's all about how your body processes sugar. Normally,
your body uses insulin to get sugar from your blood
into your cells for energy. Makes sense, But with infulin resistance,
your cells don't respond to insulin as well, so sugar
builds up in your blood.
Speaker 1 (24:45):
That doesn't sound good.
Speaker 2 (24:46):
It's not. It leads to high blood sugar and constant inflammation,
and it's a big step towards pre diabetes and type
two diabetes.
Speaker 1 (24:55):
So it's something to watch out for for sure.
Speaker 2 (24:58):
The tricky part is regular bloe tests might not catch
it early on.
Speaker 1 (25:02):
Which would we look for?
Speaker 2 (25:03):
Then, keep an eye on your triglycerid levels, your blood pressure,
and your HDL cholesterol. Okay, if those triglycerides and blood
pressure are high and HDL is low, it could be
a sign of insulin resistance in metabolic syndrome.
Speaker 1 (25:16):
Got it, So we need to be proactive about checking
those numbers absolutely. Now, what about this weight gain that
so many women experience during menopause.
Speaker 2 (25:25):
Oh, yeah, that's a common complaint. And it's not just
about gaining weight overall. It's about where you gain it.
Speaker 1 (25:32):
What do you mean.
Speaker 2 (25:33):
It's about that visceral fat, the deep belly fat that
surrounds your organ.
Speaker 1 (25:37):
Oh. That's a bad kind of.
Speaker 2 (25:38):
Fat, right, it is. It's linked to a lot of
health problems. And guess what. Estrogen plays a role here too.
Speaker 1 (25:44):
Really.
Speaker 2 (25:45):
Yeah, as your estrogen levels drop, your body starts storing
more fat in that visceral area.
Speaker 1 (25:50):
So even if the number on the scale doesn't change much,
your body composition can.
Speaker 2 (25:54):
Shift exactly, Doctor Haer says, before menopause women typically have
five eight percent visceral fat, but after it jumps up
to fifteen twenty percent. That's a big difference. That's huge,
it is, and several things can contribute, eating too much,
not moving enough, stress genes, and not sleeping.
Speaker 1 (26:15):
Well, it's like a perfect storm, right.
Speaker 2 (26:16):
And there's this thing called your waist to hip ratio.
It's a quick way to see if you're carrying too
much belly fat. You can also get special scans like
TODEXO or inbody to measure your body composition more accurately.
But the research on whether hormone therapy helps with visceral
fat is still kind of.
Speaker 1 (26:33):
Mixed, so that's not a guaranteed solution.
Speaker 2 (26:35):
Not yet. But lifestyle changes those are key.
Speaker 1 (26:38):
Makes sense. Now, what about muscle loss, I've heard that's
a concern too.
Speaker 2 (26:43):
It is. It's called sarcopenia, and you guessed it. Estrogen
is involved here too.
Speaker 1 (26:47):
It seems like estrogen affects everything it does.
Speaker 2 (26:50):
Estrogen helps your muscles regenerate and repair themselves. So when
it declines, you start losing muscle.
Speaker 1 (26:55):
Mass, so you become weaker.
Speaker 2 (26:57):
Yeah, and that affects your mobility, your strength, how much
fat you carry and even your metabolism
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