June 7, 2025 • 49 mins
Hold onto your muffins! Dr. Aoife O’Sullivan (MD, MSCP), Dr. Christine Hart Kress (DNP, MSCP), and Dr. Rebbecca Hertel (DO, MSCP) sit down with renowned menopause and sexual medicine specialist Dr. Kate White to shatter the myth that menopause means the end of your sex life.
In this no-holds-barred conversation, you’ll learn:
🔥 Why half your life happens after menopause – and how to make it your best half
💞 The real sexual issues nobody talks about (hint: it’s way more than just dryness)
🚨 Why UTIs become a sneaky threat – and how to fight back
🧠 The truth about libido: It’s not just “being in the mood”
About Our Guest:
Board-certified OB/GYN Dr. Kate White (@drkatewhiteobgyn) brings 26 years of expertise in menopause and sexual medicine. From her Charleston practice to her new podcast Heads And Tails, she’s on a mission to:
✔️ Validate women’s experiences
✔️ Demystify sexual health in midlife
✔️ Help you advocate for your needs
Featured Resources:
🎙️ Dr. White’s Podcast Heads And Tails: Coming Soon!
Connect With Us on Instagram:
✨ Dusty Muffins Podcast: @thedustymuffins
✨ Dr. Aoife: @portlandmenopausedoc
✨ Dr. Rebbecca: @drrebbeccaherteldo
✨ Dr. Christine: @christinehartkress_dnp
✨ Dr. White: @drkatewhiteobgyn
Equal parts science-backed and laugh-out-loud relatable, this episode will leave you empowered to embrace this chapter with confidence – and maybe even excitement.Subscribe for more real talk about thriving through menopause!
Remember: They’re doctors sharing knowledge, not your personal physicians. Always consult your own healthcare provider for medical advice.
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-dusty-muffins--6539849/support.
In this no-holds-barred conversation, you’ll learn:
🔥 Why half your life happens after menopause – and how to make it your best half
💞 The real sexual issues nobody talks about (hint: it’s way more than just dryness)
🚨 Why UTIs become a sneaky threat – and how to fight back
🧠 The truth about libido: It’s not just “being in the mood”
About Our Guest:
Board-certified OB/GYN Dr. Kate White (@drkatewhiteobgyn) brings 26 years of expertise in menopause and sexual medicine. From her Charleston practice to her new podcast Heads And Tails, she’s on a mission to:
✔️ Validate women’s experiences
✔️ Demystify sexual health in midlife
✔️ Help you advocate for your needs
Featured Resources:
🎙️ Dr. White’s Podcast Heads And Tails: Coming Soon!
Connect With Us on Instagram:
✨ Dusty Muffins Podcast: @thedustymuffins
✨ Dr. Aoife: @portlandmenopausedoc
✨ Dr. Rebbecca: @drrebbeccaherteldo
✨ Dr. Christine: @christinehartkress_dnp
✨ Dr. White: @drkatewhiteobgyn
Equal parts science-backed and laugh-out-loud relatable, this episode will leave you empowered to embrace this chapter with confidence – and maybe even excitement.Subscribe for more real talk about thriving through menopause!
Remember: They’re doctors sharing knowledge, not your personal physicians. Always consult your own healthcare provider for medical advice.
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-dusty-muffins--6539849/support.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome to the Dusty Muffins, where menopause meets sisterhood and strength.
We're three menopause specialists coming together to laugh, share, and
empower you through the wild ride of menopause and perimenopause.
Whether you're curious, confused, or just looking for real talk,
you're in the right place. We're here to answer your
burning questions, educate, and advocate all with a dash of
(00:26):
humor and a lot of heart. So pull up your
chair and join the conversation. Before we dive in, Please remember,
while we're doctors, we're not your doctors. This podcast is
for educational purposes only, and it's not a substitute for
medical advice. We encourage you to partner with your own
medical clinician to address your unique health needs. This is
(00:47):
the Dusty Muffins.
Speaker 2 (00:50):
All right. Today, we're thrilled to welcome one of the
most passionate and powerhouse voices in menopause and sexual medicine,
Doctor k.
Speaker 3 (00:56):
White.
Speaker 2 (00:57):
Doctor White is a board certified menopause and sexual medicine
and specialists with twenty six years of experience caring for
women in all stages in midlife.
Speaker 1 (01:05):
She treats patients at Low Country OBGYN in Charleston, South Carolina,
and shares her wisdom across the breadth of social media.
She's made it her mission to spread evidence based menopause
care far and wide, including lecturing nationally and internationally in
the checkout line at Target or anywhere there is a
midlife woman.
Speaker 4 (01:25):
And now she's teaming up with her husband, a marriage
and family counselor, to launch a brand new podcast called
Heads and Tails, focused on what really goes on in
midlife relationships, hormones, and healing. We're so excited to talk
about everything from hot flashes to healthy aging, hormone education,
and what it's like to create a podcast with your
(01:46):
life partner. I am doctor Ifa O'Sullivan, a Board certified
family physician and Menopause Society Certified practitioner, and I see
patients through my telemedicine practice here in Oregon and Washington.
Speaker 2 (01:59):
Actor Rebmcca Hurdle, I'm a Board certified ostopathic family medicine
physician and a Menopause Society Certified practitioner. I have your
private tele medicine practice and I see patients in several
different states.
Speaker 1 (02:12):
I'm doctor Christine Harkrass, a board certified women's health nurse
practitioner and menopause certified practitioner, and I see patients via
telemedicine in several states as well.
Speaker 4 (02:21):
Welcome to the podcast, doctor White.
Speaker 3 (02:24):
Thank you so much. You know you're my favorite muffins ever,
even more than I think you're probably right by far
my favorite muffins, and so glad to be with you
brilliant women and be able to share this passion that
we all have.
Speaker 2 (02:40):
That's awesome. So is carrit cake your favorite?
Speaker 3 (02:42):
Otherwise I'd have to say otherwise it's one percent.
Speaker 2 (02:49):
Absolutely. All right, Well, let's get into it. So, Kate,
you've spent over two decades in the exam room with
midlife women. What are the most common or maybe most
surprising concerns your patient bring up about menopause and sexual health?
Speaker 3 (03:04):
Gosh, you know, I think that it's the main thing
that I see is it's so surprising to them, you know,
it just that it's it comes to them out of nowhere.
We've got lots of lots of education about hey, your
period's coming, and oh you know this is you know,
here's what to expect when you're expecting, But what was
(03:26):
like what to expect when those hot flashes start and
you feel like you're losing your mind.
Speaker 4 (03:32):
Yeah, I mean even ourselves, right, I think we would
all say we were shocked when it happened to us.
Speaker 2 (03:41):
Absolutely, we finally figured it out, right, Yeah.
Speaker 4 (03:44):
Do you think that's why we're all so passionate about
it because we don't want any other woman to have
to go through what we went through.
Speaker 3 (03:51):
Absolutely, And not only that, would they do We not
want them to go through what we went through as individuals,
But I think that we don't want them to be
in this situation that we were in as healthcare providers,
completely uneducated to how to help these people. I don't
know how it was for you, but I, as a
(04:15):
going through all that residency training, I got almost no
education on menimo. If I saw someone coming in with
their review of systems that had sixteen things with that
and their main complaint was I just don't feel like myself. Well,
I know how to make your users stop bleeding. I
know how to uh, you know, take care of evol
(04:37):
of our abscess. I don't know how to make you
feel like you. And now now I actually do know
how to make you feel a little bit more like
you and and try to help you navigate what is
normal what is not normal. But I think that was
that was the hardest part for me and for people
who are out there and have no resources to say,
(04:59):
try to figure out how to navigate the changes that
they're going through with their relationships and how it affects
them in every part of their life, every relationship they have.
That's that's my goal and the goal of the podcast
that I'm starting with my husband, because we both see
it and have lived it.
Speaker 1 (05:19):
Yeah, we were probably like me when they would come
in with those sixteen different weirdo things and I felt
hopeless and you know, helpless to help them. I always said,
go see your family practice, and.
Speaker 3 (05:35):
We're like going to make me feel.
Speaker 4 (05:36):
Like now we felt the same. My heart sink. Patients
like I would see their name on my schedule time
after time, and my heart would sink because I felt
so useless to them. I really feel, And this is
what I teach as well. When I'm teaching residents, a
job so much easier knowing.
Speaker 3 (05:57):
A little bit at a time, trying to say got
to be. I think that people feel like they come
in and they are they are literally in a crisis mode.
And when when people say midlife crisis, it is a
crisis because they don't feel like they can act effectively
in any portion of your life anymore. And I think
that that's not not everyone's life is completely falling apart,
(06:19):
but it's probably falling apart in one area or the other.
And and we try to kind of guide them that
it's not a crisis. This is just a recalibration. We're
going to everyone, relationship you're in, you're romantic, your parental, professional,
even your relationship to yourself. It all feels it. And
(06:40):
so how do we help them navigate that recalibration? Right?
Speaker 2 (06:45):
So you kind of had to shift a little bit,
right if you're like just traditional OBGYN practice to then
encompass the section. So how did yeah, how did that?
How did you do that or what was the easiest
way or how did you navit?
Speaker 3 (07:00):
Get that shift? So it started off just with education
a little bit at a time, trying to say, I've
got to be able to help these people, and I'm
not equipped. So it started off with is WITCH, which
I think everybody's here is an International Society for Study
of Women's Sexual Health. Because I really felt like I
(07:20):
was not getting adequate education in this area from ACAG,
which is American College Obstucsion and Gynecology, so IF which
focuses on women's sexual health, which of course we had
no education in either really, but part of a lot
of big part of that is hormone care and that
(07:40):
menopausal hormone transition is so much affected by that. So
started to get off going into those educational meetings and
getting education for myself that way, which is a great
way for people who are practitioners to find that education
that they're lacking. They do a great job there, and
(08:02):
then I kind of got swept up into it. I
don't know, some of you know that my best friend
from residency is a doctor that some of you have
heard of, is doctor Mary clair Haveer, And so she
came to me when she was doing her menopause res
treat for the first time, and she said, hey, I
really need someone to do the sexual medicine lecture for me.
(08:24):
And I had been going to switch, and I said,
I can do that. So I little did I know
that would start a fire storm of women's demand for
more education and swept up into really seeing the need
and being very passionate about being part of that answer
(08:46):
for people.
Speaker 4 (08:47):
I think it was doctor Hafer who did a post
a while ago on the American College of Obstetrics and Gynecology.
There Green Journal, the journal that they produce, and she
went through a few of them and pointed out how
there were almost no articles on women in midlife. It
was all gynecology and by pregnancy, and almost nothing about menopause.
Speaker 3 (09:13):
Yeah, I mean ten if you look at if you
just try to find any research on midlife women, there's
about ten percent of all them. And there's not that
much research out there for women in general. This is specific,
but ten percent of it is on midlife women, and
it's half of our lives. Half of our lives. We're
(09:33):
spending this in whether you're looking at how it affects
our hearts, in cardiology, whether it affects our bones, whether
it affects certainly, I mean in sexual health, we have
like we have two three if you include test asterone
medications for female sexual health. How many do we have
for men? Like at least? Yeah, So if there's not
(09:57):
the backing there of uh, the research dollars, yeah, it's
just not going to happen. So and the and the
drives as we are in a tremendous position to demand
that we get the attention medically and research wise that
that we really deserve. And uh, I think that's fine
(10:19):
that forward motion is becoming from a grassroots position, but
we still have a lot of Okay, what do I
do right now? And how do I manage the situations
that I'm in right now? How do I I've got
all these hormone shifts and I feel like that you're
affecting my brain. And you look at people like doctor
Lise Musconi who is doing doing that research on how
(10:40):
the how the hormones affect our brain. I'm sure that
you guys have felt heard people come in and people
say really worried that they are going crazy or they're
just completely losing their capacity to dementia, and it's very frightening.
(11:04):
And and they'll people will say come in and they say, well,
people tell me that this that this uh, menopause changes
are all in my head. I'm like, well, they're not wrong.
It is in your head, right, I mean, it's not
a wrong thing to say. Interceptors or progesture interceptors and
and estrogen and they're all neurotransmitters, which means a neurotransmitter.
(11:28):
It literally is what helps transmit the information to your brain,
and your brain transmit that information to the rest of
your body. And so to say that it's all in
your head, well yeah, and there's nothing wrong with that,
so let's think what's going on and carry oh yeah whatever. Research.
Speaker 4 (11:51):
We don't even have proper billing codes when it comes
to women. I mean, try and find a billing code
for perimenopause, but you can find a billing code for
being soaked up into a jet engine. That's there, you know, yeah.
Speaker 3 (12:06):
Being packed by this is weird. Yes, I actually it's
funny that you say that. I actually was looking because
they our Electronic Macroasurance system changed some of the billing
codes this past week and I looked for a code
for some In sexual medicine, one thing that can happen
is actually you can have something as the hormones change
and you can get something called clitteral pimosis, which is
(12:29):
you all know, is where that litteral hood becomes adherent
around the clitterists and it can really impact people with
them with sexual pain and clteral pain, but also decreased
uh sensitivity of the clitters. So they people are like,
oh my god, my orgasm just went away. I don't
understand what's going on. And you can see. And so
there's a procedure that we can do to release that
(12:51):
that adhesion around the clitterists and it's called clteral fimosis.
It's been known for many years, that's what you call it.
And I to get find the code which had previously
been in there, and it was gone, Wow, they want
they taken it out. I was like, and I said, hey,
I'm doing this procedure for this patient and that code
is gone, and they're they're like, well, let me see,
(13:13):
let me see if I can find something close. I like, what, yeah,
if you can. If I'm trying to guarantee you if
the code for phimosis of the penis disappeared, you wouldn't
see that back there.
Speaker 2 (13:29):
It would have never disappeared.
Speaker 3 (13:32):
Exactly. So it is a it's a it's a definitely
a two tiered system that we're trying to make try
to correct. But it's a little bit at a time,
and people would have to even recognize that this problem
is a problem and something that can and should be corrected.
So Hey, did you you know before go.
Speaker 1 (13:52):
Into ishuish did you do that procedure or were you
even aware of that procedure? Because I think you and
I trained about the same time and as women's health
I I started my career in obgyn residency, so I
called myself the twenty first resident because I was lucky
enough to go to all of their lectures, and I
(14:14):
until I joined ish WISH, I had never heard of that.
I'm like, do what right?
Speaker 3 (14:20):
Honestly, we weren't even trained to really look at the
clittericists or the clinical hood for sure. I mean that
was it was barely a's like, oh yeah, when I
talk about vaginal dryness, I think this is a very
thing that I think is shifted so tremendously in for
me is when we were taught about using vaginal estrogen,
(14:43):
and I had wonderful professors, and I don't mean to
say that, but it was a very misogynistic way of
looking at vaginal estrogen because if they you would, we
were asked, are you having any dryness with intercourse? Are
you having any pain with intercourse? Which good, it's good
we're asking it at all. If they said that they
were not having any vaginal dryness or pain with intercourse.
Speaker 5 (15:06):
Then that was it.
Speaker 3 (15:07):
You didn't talk about it vaginal estrogen anymore. And we
weren't even asked to say, hey, are you are you
having some giants in your bulba? Is it uncomfortable when
you're sitting just or walking with your friends. It was
all about sexual activities and if you if you were
not a sexually active person, we didn't care. I mean,
it wasn't We were not taught to care. I think
(15:30):
that that that now we know, Oh my gosh, all
these women who are leaking urine have urinary urgency getting
up in the middle of the night. That is your
that is estrogen in your vagina, but your vagina also
has the urethra and the bladder and all these areas
around it. And we've got to care about it because
(15:51):
if you look at the admissions to hospital for women
over sixty, twenty twenty five percent of those are for
UTI related events and then can leave to mental status
changes and euroscepsis and it's going to be killing them.
But we were just never trained, and you know, we
know what we know now what we know, and we
just want to make sure that women are out there
(16:12):
advocating for themselves and saying, hey, I need my urethra
to not be thin and open and let have a Baeterian.
I need it to be bulky and nice and fluffy
and keeping everything fresh. Even if I'm not having a
penis go in there, I need to protect myself. So
(16:33):
you know, if you are having pens going there, then
it's even better to have a little bad vestment into
or anything going there or anything. Yeah, you can be
good hands with your own that's right.
Speaker 2 (16:44):
I like that you in good hands with your own hand.
Sometimes you're probably in better hands with your.
Speaker 3 (16:50):
Own hand, honestly, right, right, So it is. It's about
a shift of thinking, a recalibration of all of our brains,
whether we're the practitioner or or the patient, and looking
at advocating for yourself and the different and your changing needs.
What else are we talking about? What about your work?
(17:10):
How about how you your identity and your your your
your brain changes and everything change with your relationship to work.
I mean, I think all of us are at that
point where we've made a changing Oh yeah.
Speaker 4 (17:23):
I mean so many women leave the workforce during this
menopausal transition because well, they first of all, don't realize
what's wrong, and they're completely overwhelmed. Like that's the words
you hear all the time.
Speaker 3 (17:36):
Isn't it?
Speaker 4 (17:36):
Like you was saying earlier, like I don't feel like
myself the other really the really common thing is I'm overwhelmed.
Speaker 3 (17:44):
Yeah, yeah, I think that we would look at the
all different things you've got to you're shifting your priorities
from ambition to meaningful and meaningful change and what you're
what you're looking for out of your career. You're navigating
that job dissatisfaction, and that it comes to burn out
(18:09):
from those things. And I know for me, I maybe
b it's not new to my brain, but how I'm
managing it has changed tremendously. I I honestly, I've always
I have I have a standing task. I've always been
able to manage things. And I got to the point
in one of the things that really impacted me that
I thought, where I saw, my brain is not functioning
(18:32):
the same as when we send in controlled substances if
you have or if you have to send in me
or hoestosterone, which that's a whole other why it should
be controlled but whatever, that's a whole other episode. But
you have to you send it to the pharmacy and
then you have to have a six digit confirmation code
that for that. And I could not remember six digits
(18:54):
from the time I had my phone in my hand
till I went to important And I was like, what
is wrong? I am losing I cannot even remember six
six digits to get from here to here. And so
when I when I started increasing my hormone patch, which
is what I use personally for my estra out patch,
I got to a point and I and one day
(19:17):
I was like, oh my gosh, I can remember the
numbers again. It's like it was like I said, my
brain is actually working again. I mean and my focus.
I was able to focus a little bit better other
things again. Yeah, I still need a standing desk. Yeah
(19:37):
but I uh but I that ad D that increases
in in in that menopause transition is devastating to women,
especially if you have if they have higher executive fund
function jobs that they feel like they are not capable.
(19:58):
That's why they leave the work. They're like, why I
can't even be trying to do this. I can't trust
my own brain to be able to safely make this
do the things that I've been doing for your ears.
Speaker 4 (20:11):
Yeah, absolutely, and you're stopping in the middle of a
sentence and can't remember what you were going to say,
or you have to make a presentation and you're so
worried you will forget the words or have a hot
flash in the middle of it all. I mean, there's
so many reasons for women to leave the workforce. Around
this time.
Speaker 2 (20:28):
Mine was reading. I couldn't read, and I mean I
could read, I couldn't remember. I couldn't I couldn't I
could not comprehend the things that I'd have to three
four or five six times, like my patient charts, and
we talked about that before, and you're just like, this
is my life, this is my job.
Speaker 4 (20:47):
Yeah, And to go to that from being so amazing
at multitasking and like just juggling all these balls always
for your whole life. So being in a position where
you can't remember, I mean every time I put that
code in, now, Okate, I have the same story as you.
Every time I put it in and I'm able to
remember it, I think back, I remember what it was
(21:09):
like not to be able to remember the code, and
I also think, like how far back that went for me,
Like that's probably you know, I started hormones a few
years ago, but I probably looking back because that responded
to hormone treatment, I could have probably started that ten
fifteen years ago, which would have put me in early menopause.
You know, my periods are still going, but I was
(21:31):
starting that menopause transition really early.
Speaker 3 (21:34):
Yeah, it is. It is a when you realize how
poorly you were functioning, and it really really impacts you
and how those different parts that lack of estrogen affects
different parts of your brain at the prefrontal cortex, which
is responsible for that executive functioning and the efficient use
(21:59):
of ADA and all those other things, like you're positioning
in space on your balance.
Speaker 4 (22:08):
I mean, I've told the girls before, but there was
one year where I broke toes four times, like my
brain just didn't know where I was in space, you know, Like,
and I knew there was something wrong, but I just
presumed it was a brain tumor. I genuinely thought I
must have a brain.
Speaker 3 (22:25):
This weekend, I was lucky. I was with my girlfriends
and my my friend said she really wanted to get
she just wants to get an MRI of her brain
because she feels like she has got to there, that
there's got to be a brain tumor or something in there,
And I said, no, I think it is. We it is.
This is just you need to get that balance back
(22:46):
to get your get your formone levels active in your
brain again. It's a it's a mess. I think.
Speaker 1 (22:55):
One thing that's been driving me a little bit crazy
on social media, right, because there there's definitely this divide
on social media, you know, between providers, right, the providers
who will only state things if it is in the research,
which we all know we haven't been doing much research.
And then there is a group of providers, which I
(23:19):
think we're all part of, that you know, uses the
research that there is available, combined with the experiences of
what we see in our clinical you know, in our
clinical settings to help to help patients, right, because I
know just recently someone was someone was like, no, ADHD
(23:40):
doesn't present itself during perimenopause or menopause. You either always
have it, you can't just develop it. Or people who
say testosterone isn't good for brain fog, even though we
know it's a mood hormone.
Speaker 3 (23:53):
And you know, I think I.
Speaker 1 (23:55):
Think all of us have seen how testosterone helps pull
every thing back together. But how women once you get
their estrogen at a good physiological level, then they start
to be able to function again, especially in those higher
executive roles. And you know, it really drives me crazy
because if you know, I think that's like the modern
(24:17):
thought of menopause therapy now, right, is you know, taking
into account what we know and trying to fill in
those gaps. And I think if we're waiting for all
of the research before we treat patients, then you know
we're all going to be dead by that, right, Yeah.
Speaker 3 (24:36):
Or definitely not being able to get half the stuff
we need to do done because we can't find it.
We're like, get you, get out the door. So I
think it is looking for nuanced care is really what
you have to do is make sure that you're being
(24:57):
mindful of the risk of that fits and talking to
your patients about they're making the for them, uh, and
and trying to make sure that the relationship that you
have with your your patient is open enough that you
can say, hey, this is this is what we know,
this is what we don't know, this is what we're using.
(25:19):
We're giving you back a meda hormone that you have
been making and sometimes still are making imperimenopause in huge amounts.
We're just trying to regulate it. We try this, and
if it doesn't work for you, we try something different.
But overall, we are giving patients an opportunity to try
(25:39):
to regain some control and recalibrate where where they are
at this point where where there's so much pay.
Speaker 1 (25:50):
So tell us, Kate, what is Heads and Tails about?
And why did you decide to co host with your
husband Jay?
Speaker 3 (25:57):
Is how that impacts your job, your your partner's relationship,
your work relationship, relationship with your uh partially launched or
fully launched kids, all those things. I think that uh
uh it and Heads and Tails is going to address
(26:18):
just midlife relationship changes and and how how we can
navigate those and the things you can change and the
things you can't change and try to keep it together,
I say, with marriages, and we definitely see that. Yeah,
there's there are divorce rates for all relationships throughout their day.
But yeah, and there and there. But once we get
(26:39):
to that midlife, as Jay will say, he has seen, uh,
there's a lot more. All of a sudden, it spikes
in through it's almost it's pretty even men and women
coming to a file for a divorce until you get
to this age, the forties to fifties, and a tremendous
spike in women seeking divorce. And so why is that?
(27:04):
What is that change? And I s A and we've
as we've talked about it. He I said, I can
tell you what the change is is you've got brain
changes that make you less tolerant and and you start
re evaluating what your priorities are for yourself. And uh
and so that we he he won. He's always been
(27:25):
extremely supportive. He's been through over g y N residency
and good friends with all of my friends who are
doing this, and so he and he's a little bit
of a show pony anyway. So he was he was
a magician in Las Vegas and so and so he
doesn't mind being on the stage. And so he says
(27:46):
he's got a thousand hobbies, none of which makes any money.
Speaker 6 (27:48):
So he's a musician and a musician and uh so
he's he's actually highly entertaining me, thank goodness.
Speaker 3 (28:01):
So he is. He's a but he also brings the
perspective of he's not educated in menopause. He's only educated
by being in the vortex of all this conversation for
so many years and really seeing these changes that I've
been I come home and like, of course, you don't
believe I talked to this person's day. So that's the
(28:22):
kind of And so I think it brings in a
unique perspective because we've been through these changes. He's seen
me navigating these changes, but he's also helped Yeah, thousands
of couples through the same type of transitions.
Speaker 4 (28:36):
Is that how you met him, Kate? Did he get
you up on the stage in one of his magic tricks?
Speaker 7 (28:40):
Yeah?
Speaker 3 (28:40):
Well, well he put me in that box, cut me
in half, and then he's like, if you want to
be putting your back together, you better say yeah. So
we actually met. We met. I was eighteen. It was
the summer between high school and college. But we didn't
date that whole time. Oh my goodness.
Speaker 1 (29:02):
Is there are there any topics that you're excited or
either or maybe even topests that you're nervous to dig
into together?
Speaker 3 (29:10):
Yeah? So I think that one of the ones that
we really want to look at is the changing needs
that you have in terms of communicating your there's the
changing uh sexual function and how you how part of
that is communication and not just communication of how your
(29:32):
changing needs are and the changes that we have physically,
but also that that uh, sexuality is a form of
communication and so and that is that is a big
thing that that could changes in the if you if
you were not, if you weren't communicating well before this
all these changes happened, then there certainly are things that
(29:54):
you're going to have to work on extra rd to
try to get that communication established, uh and try to
reevaluate because you're it's it's such a they've got so
many changes going on at once, and you're if you're
you're also navigating the changes in your job, and you're
and dealing with children and and certainly many of us
(30:16):
also with our parents and the physical and emotional needs
that they have at this stage. Uh. It's a lot
to try to bring balance and harmony into this evolution. UH.
And so we've got lots I feel like we've got
lots of different points to to to meet uh on
(30:38):
of these different relationships. And I feel like women are
excited to hear about it because they're like, yes, me too,
I'm doing dealing with through those same things, and they're like,
I don't even like my dogs that much anymore. And
sometimes it just seems like a lot of dealing.
Speaker 1 (30:56):
They breathe love, they snore at night, You're not that
cute anymore.
Speaker 4 (31:02):
When you bring it up, women are willing to talk
about it, like they want to talk about it, you know,
even when you go to a party or you're out
for drinks or some of them with friends. Women are
totally ready to talk about it, Like if we ask
them in the office, if we ask our patients, they'll
tell us. We just have to make sure we ask
them because they won't volunteer that information, right.
Speaker 3 (31:23):
No, And honestly, for the most part, we aren't given
in our current platform of most medical care, we're not
given the time to talk to people about it. And
it's like the last thing, like, right, let's hope she
doesn't bring any at us, right, because it is. And
(31:43):
it's trying to find the right format and the right
outlet to try to get the information to women because
in the fifteen minute allotment, which is frequently double booked,
so you actually have, you know, seven and a half
half minutes to talk about and do their exam and
all that. It just is it's really hard and it's
(32:04):
not fair. And and hopefully by educating, not having good
therapists like marriage and family counselors and that are helpful
and they can they can say, hey, this sounds like
maybe you it's something I have the time to talk to,
but maybe I can be able to help you guide
(32:25):
guide you to uh the right person to talk of.
Maybe you need to talk about hormones to your to
your without blaming everything in their relationship on her and
say this is your problem and it's your it's your hormones,
because that certainly is not it's a recalibration of everyone's
(32:46):
midlife and and men have that recalibration to and their
relationship to their jobs. And don't mean a good way
go have a whole A whole episode is going to
be about retirement and how the change of your relationship
in when one or both partners retires and and now
(33:07):
they have to re evaluate who they are in the
in relationship to their personal identity. But as one of
my friends and I love that we were talking. I
have a game group of girls that they were called
game gals, and we get together and just and play
(33:27):
games and talk about our lives and and she said
her husband recently retired and she had to remind him
that she was not his employee.
Speaker 7 (33:38):
Because he's used to having one. Yeah, well he gets
to boss around all day and she's like, yeah, and
I'm not one of them.
Speaker 3 (33:47):
And so I have my own set of things going on.
So if you want somebody to come help you move
this lawn mower into your car, and it's right where
when I'm supposed to be going leaving the house, I
am not going to stop and help you lose your
lawd mowner. Even though my stopping to help you stop
(34:08):
what I'm doing and help you move this lawnmower is
a way that you feel loved. I mean I have to.
Speaker 7 (34:17):
You're gonna have to figure out another way for me
to show my love for you, because that is because
it is it's one of those changes where, well, if
you're not paying attention to me, that that mean in
the way that I.
Speaker 3 (34:30):
Feel like I need that attention. It feels like I'm
not you don't love me, and it says like I
don't love you, But I do have an appointment and
I cannot get back in to get my haircut and
if this I don't get this appointment, it's gonna be
six weeks. You know, I was like rebook that, So
it's it is a whole different way of feeling relationship
and fulfilling each other's needs in there, in your love
(34:54):
and your heart, but also and sexually, but like every
aspect of your relationship.
Speaker 4 (35:00):
Yeah, something you brought up there is really important. I'd
love for our listeners to know anyone who's not in medicine.
When you see your doctor, you know, the chances are
they have somewhere between seven and a half and fifteen
minutes to spend with you. But they also there's a
note that has to be done, which takes somewhere between
(35:20):
five and ten minutes. There are prescriptions that have to
be done, and sometimes referrals or you know, orders for
X rays or blood work, and somehow you are supposed
to do that thirty minutes or more of work in
that seven and a half minutes. I mean, it's like
going to your hairdresser and saying, you know, i'd like
my roots done. You've got seven and a half minutes.
(35:43):
I mean, it's just insane how we've allowed this to happen.
But that is the current scenario. So when you go in,
it's good to know that you know.
Speaker 3 (35:52):
And it's not fair to patience me that they are
not responsible for how much or how little time that
we've been allotted, but it is and I don't have
the perfect answer, but knowing that you want to come
in and have a specific problem focused exam or time
(36:17):
and realizing that even if you have that problem focused time,
it's probably going to be fifteen minutes or really ten
minutes that unfortunately, that's kind of how we're set up
and it's not ideal. And I will tell you it
is amazing. I know you guys have all done it.
We can get a shitload ton Yeah, ten minutes, I
(36:40):
mean it's amazing. But really how much we can get done,
I don't know. And yes, they're different ways of their
different platforms, and there are different there are people that
have great more flexible schedules, but it's not accessible to everyone.
(37:00):
I mean, if you there are the places that where
you can do have visits that are not restricted by insurance,
and unfortunately that is that's the case, and it and
you may need to certainly you should seek out somebody
who is menopause. A modern metopause provider, I would say, right,
(37:22):
temporarily educated in menopause, and there are ways to find
that more of the people that are affiliated with the
Menopause society, but also with a switch as we said
International Stife or Studio and Sexual Health, which is the longest,
but uh those are going to be providers or practitioners
(37:42):
that you that are have sought out on their own
outside of any uh any right, there's the word see
if it's gone any any demands of their nor there's
demands a demanded certification by American College of the Sex
(38:05):
Niccology or American Family of College or family practitioners. They
have said this is important enough to me that I
want to go out and get the current and up
to date information.
Speaker 5 (38:16):
So those are good places to start. But also if
you may need to say go outside of the traditional
medical care and.
Speaker 3 (38:28):
You may be finding someone who will be able to
provide longer appointments and more in depth, especially if you
have complicated medical problems that would make providing that care
a little bit more difficult.
Speaker 4 (38:43):
With all the training that you've done through issuish case,
you know, when you see your patients, is there one
particular myth that you find yourself busting over and over
again with regards to women's sexual health, say or one
that you prefer to bust.
Speaker 3 (38:59):
Oh, sure, I think that one of the myths that
is that you that it just is normal and you
should be able it should just happen, like sexual relationship
should continue to be exactly what it was, and that
there's there's no need to change and evolve in your
(39:21):
communication or so that there's a lot of that we
should have spontaneous desire at the same level that we
did when we first met and where everything else in
our life has changed. Everything is changing, there's a lot
of hormone changes, and we should that that that your
(39:41):
sexual life and your sexual function in your and your
relationship to your partner should be exactly the same. And
that if you don't have spontaneous desire, it means that
you're broken and and and you are I say, Helly
Casperson of course is one of our dear friends and
also and colleagues and uh and looking at sexual medicine.
(40:03):
If you haven't heard her podcast, you are not broken.
It is an amazing resource. But it's your libido isn't
a fixed thing. It's responsive and they've got lots. It's
impacted by all kinds of things. That sex is communication
you have to and the and your hormones that are
(40:24):
communicating with your brain, but also your communication with your
partner and all the outside stresses that you have to
have an ongoing dialogue to make that to try to
maintain that. But also you've got the intimacy is a
big part of your relationship and a big part of sex,
and so sex doesn't exist in a bubble in your bedroom.
(40:48):
You know, intimacy has to be have attention throughout the
day and and that sort of emotional intimacy as well
as it has to be part of physical intimacy. You
can't you can't really dissociate them. So that that that apple,
that's that's one of the things. Sorry, that was a
very long way.
Speaker 7 (41:09):
That's a great answer things for changing and you have
to be willing to uh to change with them and
realize that that you it does, it's not automatic and
uh and it's going to require a little maintenance, just
like everything at this point.
Speaker 3 (41:27):
Mm hmm.
Speaker 2 (41:29):
I think that's a good point for both, you know,
women and partners in general. Right, so as women are
navigating this, but then their partners. They are always asking,
you know, what can I.
Speaker 3 (41:39):
Do to help?
Speaker 2 (41:40):
And I think sometimes just understanding that you know your
partner is also changing. You know, if you have a
male partner, they're changing in midlife as well, and so
it's you know, it's part of the change together. And
you know, maybe it should be a pre wreck like
this midlife therapy, like you know, how to navigate your
relationship in mid life.
Speaker 3 (42:00):
Yes, I think we should be a requirement for sure.
Speaker 4 (42:03):
Or we sent you turn you know, thirty five and
you get sent a copy of Kelly Casperson's book and
the tube of vaginal estrogen, yes, and some uber loop.
You know, there's countries where when you're pregnant, you receive
(42:24):
in the mail from the government this beautiful box and
it's quite large, and it's packed with diapers and baby
clothes and safe shampoo and all these things. And then
you can use the box itself as a little bassinette.
And that's all provided by people paying taxes, and that
(42:44):
is couples out of government funds. And I genuinely think
we should be sent our vaginal estrogen and you are
not broken into thirty five to every woman vibrator.
Speaker 1 (42:59):
Oh yeah, an idea, we should just sign that box.
All the things that would be in that box, that being.
Speaker 2 (43:05):
Good insta life care package, your blow up, you want
to see this, Yeah.
Speaker 3 (43:12):
Yeah, a little jazz. Yeah yeah, yeah, that's just sparkles.
That's right exactly. So I think that that is I
think that that those are the changes that I think
would be that The myth is that it's just not
(43:33):
it's just does it's not automatic and uh, and all
the things that you have to do to maintain your
bones and you know, like I know, you'll put one
more thing on the list, but it is not automatic
and it does require a little bit maintenance and and uh,
I think that that's one of the good things that
will be in the part of that podcast is I mean,
Jay is a dude. I mean he's he said, I'm
(43:55):
going to ask all the dude questions that to help
you want something that both partners will listen to as
they're riding down the road and be happy to be
listening to it together and be like that they have
guys be like, oh, I have that question too, and
I need to know. I want to know how to
make this because I think in for the most part.
(44:16):
People want to make their relationships better. That's why they're
in a relationship. Is they want they want they want
to get make it stronger and make it better. And uh,
and so he's going to be there to ask those
questions that all those guys are thinking, but they're a
little afraid to ask.
Speaker 2 (44:34):
That's awesome. So you're a doctor, speaker, a mom of two,
and now a podcaster. Do you embrace the beautiful chaos
or do you feel like you're losing your marbles like
like we do?
Speaker 3 (44:47):
Ask me? Yeah, say with my friends and we're all
this weekend and we're all at different phases. One of
them just sold her company, another one is you know,
full on or you know just had uh has has
two that are one one's working, ones just got out
(45:08):
of college and trying to figure out that transition. Like
she's like owns her own business and is she going
to expand is she going to sell? Is she going
to bring our partner? All these things while trying to
make sure that their kids are good and all that.
And then you've got I've got we And then we
have friends who who have they been on their own
path and they are they did not they're in their
(45:31):
their single and they have always been single, and they
they're good with that, but they're also trying to navigate
those changes for themselves and what their direction is. And
and so it's not just people that are in coupled relationships.
There's all there's the relationship to yourself that's changing and
how you feel about yourself and where you're going, and
(45:52):
I mean it's not just that. And they have all
the same relationships with their parents and and with their
friend ends, and it just so it's all these changes
that we're all navigating day to day. And am I
do I feel like I'm managing the chaos? Yeah? I
would say I some days better than others. But but
(46:12):
again it's it's uh, it's this having the support and
knowing that there are people out there that are I mean,
the the supportive group that I have is amazing and
I couldn't do it without them, and I I feel
like there are a lot of people that are doing
it without any support, and so we can be that
(46:32):
for them, then I would be really happy. Mm hmm.
Speaker 1 (46:36):
So, Kate, if you are listeners with one message about
navigating menopause, intimacy or relationships in midlife What would it
be I would.
Speaker 3 (46:47):
I would say that you really need to think of
it as the recalibration. You know, it's it's it's uh,
maybe a little bit off that you just got to
recalibrate and uh and and re examine how to get
back on track. But it's not it's actually not broken.
(47:08):
It's just a little off track and we can get
there and help them to go navigate how to recalibrate
those relationships to be able to enjoy that. The fruits
of all are everything that's come from from all the
hard work and everything we put into it so far.
(47:31):
It's just it's it's worth it and try to get there.
Speaker 4 (47:36):
Yeah, that's a nice way to wrap up, and thank
you so much for being here with us today.
Speaker 3 (47:43):
Are doing what we're doing.
Speaker 4 (47:44):
Yeah, it's been such a pleasure, and that I was
just about to say thank you for all the hard
work that you're doing with all the women that you
take care of, and I was I was going to
let people know how to find you. So you're on
Instagram and TikTok as doctor Kate White ob g i N.
Your practice is Low Country obg y N in Charleston,
(48:04):
South Carolina, and your new podcast, which is coming out soon,
is going to be called Heads and Tails.
Speaker 3 (48:11):
Heads and Tails correct, All right.
Speaker 4 (48:14):
When is that coming out?
Speaker 3 (48:17):
Believe? Yeah, so it will drop and I'll have it
out there. Yeah.
Speaker 4 (48:22):
Well you've already got three listeners.
Speaker 3 (48:24):
Don't worry, you.
Speaker 2 (48:27):
Got it. Oh my husband, I'm sure our husbands I
would assume too, at least mine, he'd like.
Speaker 3 (48:32):
That kind of stuff.
Speaker 4 (48:33):
Oh, definitely, at least six. And then we'll get here
on our producer here.
Speaker 3 (48:41):
Like plus seven already just today that. Yeah, you find
us up and to all.
Speaker 4 (48:47):
Our dusty muffins out there, share this with your midlife besties,
subscribe and leave us a review. We're here for the laughs,
the learning, and the liberation that midlife brings
Welcome to the Dusty Muffins, where menopause meets sisterhood and strength.
We're three menopause specialists coming together to laugh, share, and
empower you through the wild ride of menopause and perimenopause.
Whether you're curious, confused, or just looking for real talk,
you're in the right place. We're here to answer your
burning questions, educate, and advocate all with a dash of
(00:26):
humor and a lot of heart. So pull up your
chair and join the conversation. Before we dive in, Please remember,
while we're doctors, we're not your doctors. This podcast is
for educational purposes only, and it's not a substitute for
medical advice. We encourage you to partner with your own
medical clinician to address your unique health needs. This is
(00:47):
the Dusty Muffins.
Speaker 2 (00:50):
All right. Today, we're thrilled to welcome one of the
most passionate and powerhouse voices in menopause and sexual medicine,
Doctor k.
Speaker 3 (00:56):
White.
Speaker 2 (00:57):
Doctor White is a board certified menopause and sexual medicine
and specialists with twenty six years of experience caring for
women in all stages in midlife.
Speaker 1 (01:05):
She treats patients at Low Country OBGYN in Charleston, South Carolina,
and shares her wisdom across the breadth of social media.
She's made it her mission to spread evidence based menopause
care far and wide, including lecturing nationally and internationally in
the checkout line at Target or anywhere there is a
midlife woman.
Speaker 4 (01:25):
And now she's teaming up with her husband, a marriage
and family counselor, to launch a brand new podcast called
Heads and Tails, focused on what really goes on in
midlife relationships, hormones, and healing. We're so excited to talk
about everything from hot flashes to healthy aging, hormone education,
and what it's like to create a podcast with your
(01:46):
life partner. I am doctor Ifa O'Sullivan, a Board certified
family physician and Menopause Society Certified practitioner, and I see
patients through my telemedicine practice here in Oregon and Washington.
Speaker 2 (01:59):
Actor Rebmcca Hurdle, I'm a Board certified ostopathic family medicine
physician and a Menopause Society Certified practitioner. I have your
private tele medicine practice and I see patients in several
different states.
Speaker 1 (02:12):
I'm doctor Christine Harkrass, a board certified women's health nurse
practitioner and menopause certified practitioner, and I see patients via
telemedicine in several states as well.
Speaker 4 (02:21):
Welcome to the podcast, doctor White.
Speaker 3 (02:24):
Thank you so much. You know you're my favorite muffins ever,
even more than I think you're probably right by far
my favorite muffins, and so glad to be with you
brilliant women and be able to share this passion that
we all have.
Speaker 2 (02:40):
That's awesome. So is carrit cake your favorite?
Speaker 3 (02:42):
Otherwise I'd have to say otherwise it's one percent.
Speaker 2 (02:49):
Absolutely. All right, Well, let's get into it. So, Kate,
you've spent over two decades in the exam room with
midlife women. What are the most common or maybe most
surprising concerns your patient bring up about menopause and sexual health?
Speaker 3 (03:04):
Gosh, you know, I think that it's the main thing
that I see is it's so surprising to them, you know,
it just that it's it comes to them out of nowhere.
We've got lots of lots of education about hey, your
period's coming, and oh you know this is you know,
here's what to expect when you're expecting, But what was
(03:26):
like what to expect when those hot flashes start and
you feel like you're losing your mind.
Speaker 4 (03:32):
Yeah, I mean even ourselves, right, I think we would
all say we were shocked when it happened to us.
Speaker 2 (03:41):
Absolutely, we finally figured it out, right, Yeah.
Speaker 4 (03:44):
Do you think that's why we're all so passionate about
it because we don't want any other woman to have
to go through what we went through.
Speaker 3 (03:51):
Absolutely, And not only that, would they do We not
want them to go through what we went through as individuals,
But I think that we don't want them to be
in this situation that we were in as healthcare providers,
completely uneducated to how to help these people. I don't
know how it was for you, but I, as a
(04:15):
going through all that residency training, I got almost no
education on menimo. If I saw someone coming in with
their review of systems that had sixteen things with that
and their main complaint was I just don't feel like myself. Well,
I know how to make your users stop bleeding. I
know how to uh, you know, take care of evol
(04:37):
of our abscess. I don't know how to make you
feel like you. And now now I actually do know
how to make you feel a little bit more like
you and and try to help you navigate what is
normal what is not normal. But I think that was
that was the hardest part for me and for people
who are out there and have no resources to say,
(04:59):
try to figure out how to navigate the changes that
they're going through with their relationships and how it affects
them in every part of their life, every relationship they have.
That's that's my goal and the goal of the podcast
that I'm starting with my husband, because we both see
it and have lived it.
Speaker 1 (05:19):
Yeah, we were probably like me when they would come
in with those sixteen different weirdo things and I felt
hopeless and you know, helpless to help them. I always said,
go see your family practice, and.
Speaker 3 (05:35):
We're like going to make me feel.
Speaker 4 (05:36):
Like now we felt the same. My heart sink. Patients
like I would see their name on my schedule time
after time, and my heart would sink because I felt
so useless to them. I really feel, And this is
what I teach as well. When I'm teaching residents, a
job so much easier knowing.
Speaker 3 (05:57):
A little bit at a time, trying to say got
to be. I think that people feel like they come
in and they are they are literally in a crisis mode.
And when when people say midlife crisis, it is a
crisis because they don't feel like they can act effectively
in any portion of your life anymore. And I think
that that's not not everyone's life is completely falling apart,
(06:19):
but it's probably falling apart in one area or the other.
And and we try to kind of guide them that
it's not a crisis. This is just a recalibration. We're
going to everyone, relationship you're in, you're romantic, your parental, professional,
even your relationship to yourself. It all feels it. And
(06:40):
so how do we help them navigate that recalibration? Right?
Speaker 2 (06:45):
So you kind of had to shift a little bit,
right if you're like just traditional OBGYN practice to then
encompass the section. So how did yeah, how did that?
How did you do that or what was the easiest
way or how did you navit?
Speaker 3 (07:00):
Get that shift? So it started off just with education
a little bit at a time, trying to say, I've
got to be able to help these people, and I'm
not equipped. So it started off with is WITCH, which
I think everybody's here is an International Society for Study
of Women's Sexual Health. Because I really felt like I
(07:20):
was not getting adequate education in this area from ACAG,
which is American College Obstucsion and Gynecology, so IF which
focuses on women's sexual health, which of course we had
no education in either really, but part of a lot
of big part of that is hormone care and that
(07:40):
menopausal hormone transition is so much affected by that. So
started to get off going into those educational meetings and
getting education for myself that way, which is a great
way for people who are practitioners to find that education
that they're lacking. They do a great job there, and
(08:02):
then I kind of got swept up into it. I
don't know, some of you know that my best friend
from residency is a doctor that some of you have
heard of, is doctor Mary clair Haveer, And so she
came to me when she was doing her menopause res
treat for the first time, and she said, hey, I
really need someone to do the sexual medicine lecture for me.
(08:24):
And I had been going to switch, and I said,
I can do that. So I little did I know
that would start a fire storm of women's demand for
more education and swept up into really seeing the need
and being very passionate about being part of that answer
(08:46):
for people.
Speaker 4 (08:47):
I think it was doctor Hafer who did a post
a while ago on the American College of Obstetrics and Gynecology.
There Green Journal, the journal that they produce, and she
went through a few of them and pointed out how
there were almost no articles on women in midlife. It
was all gynecology and by pregnancy, and almost nothing about menopause.
Speaker 3 (09:13):
Yeah, I mean ten if you look at if you
just try to find any research on midlife women, there's
about ten percent of all them. And there's not that
much research out there for women in general. This is specific,
but ten percent of it is on midlife women, and
it's half of our lives. Half of our lives. We're
(09:33):
spending this in whether you're looking at how it affects
our hearts, in cardiology, whether it affects our bones, whether
it affects certainly, I mean in sexual health, we have
like we have two three if you include test asterone
medications for female sexual health. How many do we have
for men? Like at least? Yeah, So if there's not
(09:57):
the backing there of uh, the research dollars, yeah, it's
just not going to happen. So and the and the
drives as we are in a tremendous position to demand
that we get the attention medically and research wise that
that we really deserve. And uh, I think that's fine
(10:19):
that forward motion is becoming from a grassroots position, but
we still have a lot of Okay, what do I
do right now? And how do I manage the situations
that I'm in right now? How do I I've got
all these hormone shifts and I feel like that you're
affecting my brain. And you look at people like doctor
Lise Musconi who is doing doing that research on how
(10:40):
the how the hormones affect our brain. I'm sure that
you guys have felt heard people come in and people
say really worried that they are going crazy or they're
just completely losing their capacity to dementia, and it's very frightening.
(11:04):
And and they'll people will say come in and they say, well,
people tell me that this that this uh, menopause changes
are all in my head. I'm like, well, they're not wrong.
It is in your head, right, I mean, it's not
a wrong thing to say. Interceptors or progesture interceptors and
and estrogen and they're all neurotransmitters, which means a neurotransmitter.
(11:28):
It literally is what helps transmit the information to your brain,
and your brain transmit that information to the rest of
your body. And so to say that it's all in
your head, well yeah, and there's nothing wrong with that,
so let's think what's going on and carry oh yeah whatever. Research.
Speaker 4 (11:51):
We don't even have proper billing codes when it comes
to women. I mean, try and find a billing code
for perimenopause, but you can find a billing code for
being soaked up into a jet engine. That's there, you know, yeah.
Speaker 3 (12:06):
Being packed by this is weird. Yes, I actually it's
funny that you say that. I actually was looking because
they our Electronic Macroasurance system changed some of the billing
codes this past week and I looked for a code
for some In sexual medicine, one thing that can happen
is actually you can have something as the hormones change
and you can get something called clitteral pimosis, which is
(12:29):
you all know, is where that litteral hood becomes adherent
around the clitterists and it can really impact people with
them with sexual pain and clteral pain, but also decreased
uh sensitivity of the clitters. So they people are like,
oh my god, my orgasm just went away. I don't
understand what's going on. And you can see. And so
there's a procedure that we can do to release that
(12:51):
that adhesion around the clitterists and it's called clteral fimosis.
It's been known for many years, that's what you call it.
And I to get find the code which had previously
been in there, and it was gone, Wow, they want
they taken it out. I was like, and I said, hey,
I'm doing this procedure for this patient and that code
is gone, and they're they're like, well, let me see,
(13:13):
let me see if I can find something close. I like, what, yeah,
if you can. If I'm trying to guarantee you if
the code for phimosis of the penis disappeared, you wouldn't
see that back there.
Speaker 2 (13:29):
It would have never disappeared.
Speaker 3 (13:32):
Exactly. So it is a it's a it's a definitely
a two tiered system that we're trying to make try
to correct. But it's a little bit at a time,
and people would have to even recognize that this problem
is a problem and something that can and should be corrected.
So Hey, did you you know before go.
Speaker 1 (13:52):
Into ishuish did you do that procedure or were you
even aware of that procedure? Because I think you and
I trained about the same time and as women's health
I I started my career in obgyn residency, so I
called myself the twenty first resident because I was lucky
enough to go to all of their lectures, and I
(14:14):
until I joined ish WISH, I had never heard of that.
I'm like, do what right?
Speaker 3 (14:20):
Honestly, we weren't even trained to really look at the
clittericists or the clinical hood for sure. I mean that
was it was barely a's like, oh yeah, when I
talk about vaginal dryness, I think this is a very
thing that I think is shifted so tremendously in for
me is when we were taught about using vaginal estrogen,
(14:43):
and I had wonderful professors, and I don't mean to
say that, but it was a very misogynistic way of
looking at vaginal estrogen because if they you would, we
were asked, are you having any dryness with intercourse? Are
you having any pain with intercourse? Which good, it's good
we're asking it at all. If they said that they
were not having any vaginal dryness or pain with intercourse.
Speaker 5 (15:06):
Then that was it.
Speaker 3 (15:07):
You didn't talk about it vaginal estrogen anymore. And we
weren't even asked to say, hey, are you are you
having some giants in your bulba? Is it uncomfortable when
you're sitting just or walking with your friends. It was
all about sexual activities and if you if you were
not a sexually active person, we didn't care. I mean,
it wasn't We were not taught to care. I think
(15:30):
that that that now we know, Oh my gosh, all
these women who are leaking urine have urinary urgency getting
up in the middle of the night. That is your
that is estrogen in your vagina, but your vagina also
has the urethra and the bladder and all these areas
around it. And we've got to care about it because
(15:51):
if you look at the admissions to hospital for women
over sixty, twenty twenty five percent of those are for
UTI related events and then can leave to mental status
changes and euroscepsis and it's going to be killing them.
But we were just never trained, and you know, we
know what we know now what we know, and we
just want to make sure that women are out there
(16:12):
advocating for themselves and saying, hey, I need my urethra
to not be thin and open and let have a Baeterian.
I need it to be bulky and nice and fluffy
and keeping everything fresh. Even if I'm not having a
penis go in there, I need to protect myself. So
(16:33):
you know, if you are having pens going there, then
it's even better to have a little bad vestment into
or anything going there or anything. Yeah, you can be
good hands with your own that's right.
Speaker 2 (16:44):
I like that you in good hands with your own hand.
Sometimes you're probably in better hands with your.
Speaker 3 (16:50):
Own hand, honestly, right, right, So it is. It's about
a shift of thinking, a recalibration of all of our brains,
whether we're the practitioner or or the patient, and looking
at advocating for yourself and the different and your changing needs.
What else are we talking about? What about your work?
(17:10):
How about how you your identity and your your your
your brain changes and everything change with your relationship to work.
I mean, I think all of us are at that
point where we've made a changing Oh yeah.
Speaker 4 (17:23):
I mean so many women leave the workforce during this
menopausal transition because well, they first of all, don't realize
what's wrong, and they're completely overwhelmed. Like that's the words
you hear all the time.
Speaker 3 (17:36):
Isn't it?
Speaker 4 (17:36):
Like you was saying earlier, like I don't feel like
myself the other really the really common thing is I'm overwhelmed.
Speaker 3 (17:44):
Yeah, yeah, I think that we would look at the
all different things you've got to you're shifting your priorities
from ambition to meaningful and meaningful change and what you're
what you're looking for out of your career. You're navigating
that job dissatisfaction, and that it comes to burn out
(18:09):
from those things. And I know for me, I maybe
b it's not new to my brain, but how I'm
managing it has changed tremendously. I I honestly, I've always
I have I have a standing task. I've always been
able to manage things. And I got to the point
in one of the things that really impacted me that
I thought, where I saw, my brain is not functioning
(18:32):
the same as when we send in controlled substances if
you have or if you have to send in me
or hoestosterone, which that's a whole other why it should
be controlled but whatever, that's a whole other episode. But
you have to you send it to the pharmacy and
then you have to have a six digit confirmation code
that for that. And I could not remember six digits
(18:54):
from the time I had my phone in my hand
till I went to important And I was like, what
is wrong? I am losing I cannot even remember six
six digits to get from here to here. And so
when I when I started increasing my hormone patch, which
is what I use personally for my estra out patch,
I got to a point and I and one day
(19:17):
I was like, oh my gosh, I can remember the
numbers again. It's like it was like I said, my
brain is actually working again. I mean and my focus.
I was able to focus a little bit better other
things again. Yeah, I still need a standing desk. Yeah
(19:37):
but I uh but I that ad D that increases
in in in that menopause transition is devastating to women,
especially if you have if they have higher executive fund
function jobs that they feel like they are not capable.
(19:58):
That's why they leave the work. They're like, why I
can't even be trying to do this. I can't trust
my own brain to be able to safely make this
do the things that I've been doing for your ears.
Speaker 4 (20:11):
Yeah, absolutely, and you're stopping in the middle of a
sentence and can't remember what you were going to say,
or you have to make a presentation and you're so
worried you will forget the words or have a hot
flash in the middle of it all. I mean, there's
so many reasons for women to leave the workforce. Around
this time.
Speaker 2 (20:28):
Mine was reading. I couldn't read, and I mean I
could read, I couldn't remember. I couldn't I couldn't I
could not comprehend the things that I'd have to three
four or five six times, like my patient charts, and
we talked about that before, and you're just like, this
is my life, this is my job.
Speaker 4 (20:47):
Yeah, And to go to that from being so amazing
at multitasking and like just juggling all these balls always
for your whole life. So being in a position where
you can't remember, I mean every time I put that
code in, now, Okate, I have the same story as you.
Every time I put it in and I'm able to
remember it, I think back, I remember what it was
(21:09):
like not to be able to remember the code, and
I also think, like how far back that went for me,
Like that's probably you know, I started hormones a few
years ago, but I probably looking back because that responded
to hormone treatment, I could have probably started that ten
fifteen years ago, which would have put me in early menopause.
You know, my periods are still going, but I was
(21:31):
starting that menopause transition really early.
Speaker 3 (21:34):
Yeah, it is. It is a when you realize how
poorly you were functioning, and it really really impacts you
and how those different parts that lack of estrogen affects
different parts of your brain at the prefrontal cortex, which
is responsible for that executive functioning and the efficient use
(21:59):
of ADA and all those other things, like you're positioning
in space on your balance.
Speaker 4 (22:08):
I mean, I've told the girls before, but there was
one year where I broke toes four times, like my
brain just didn't know where I was in space, you know, Like,
and I knew there was something wrong, but I just
presumed it was a brain tumor. I genuinely thought I
must have a brain.
Speaker 3 (22:25):
This weekend, I was lucky. I was with my girlfriends
and my my friend said she really wanted to get
she just wants to get an MRI of her brain
because she feels like she has got to there, that
there's got to be a brain tumor or something in there,
And I said, no, I think it is. We it is.
This is just you need to get that balance back
(22:46):
to get your get your formone levels active in your
brain again. It's a it's a mess. I think.
Speaker 1 (22:55):
One thing that's been driving me a little bit crazy
on social media, right, because there there's definitely this divide
on social media, you know, between providers, right, the providers
who will only state things if it is in the research,
which we all know we haven't been doing much research.
And then there is a group of providers, which I
(23:19):
think we're all part of, that you know, uses the
research that there is available, combined with the experiences of
what we see in our clinical you know, in our
clinical settings to help to help patients, right, because I
know just recently someone was someone was like, no, ADHD
(23:40):
doesn't present itself during perimenopause or menopause. You either always
have it, you can't just develop it. Or people who
say testosterone isn't good for brain fog, even though we
know it's a mood hormone.
Speaker 3 (23:53):
And you know, I think I.
Speaker 1 (23:55):
Think all of us have seen how testosterone helps pull
every thing back together. But how women once you get
their estrogen at a good physiological level, then they start
to be able to function again, especially in those higher
executive roles. And you know, it really drives me crazy
because if you know, I think that's like the modern
(24:17):
thought of menopause therapy now, right, is you know, taking
into account what we know and trying to fill in
those gaps. And I think if we're waiting for all
of the research before we treat patients, then you know
we're all going to be dead by that, right, Yeah.
Speaker 3 (24:36):
Or definitely not being able to get half the stuff
we need to do done because we can't find it.
We're like, get you, get out the door. So I
think it is looking for nuanced care is really what
you have to do is make sure that you're being
(24:57):
mindful of the risk of that fits and talking to
your patients about they're making the for them, uh, and
and trying to make sure that the relationship that you
have with your your patient is open enough that you
can say, hey, this is this is what we know,
this is what we don't know, this is what we're using.
(25:19):
We're giving you back a meda hormone that you have
been making and sometimes still are making imperimenopause in huge amounts.
We're just trying to regulate it. We try this, and
if it doesn't work for you, we try something different.
But overall, we are giving patients an opportunity to try
(25:39):
to regain some control and recalibrate where where they are
at this point where where there's so much pay.
Speaker 1 (25:50):
So tell us, Kate, what is Heads and Tails about?
And why did you decide to co host with your
husband Jay?
Speaker 3 (25:57):
Is how that impacts your job, your your partner's relationship,
your work relationship, relationship with your uh partially launched or
fully launched kids, all those things. I think that uh
uh it and Heads and Tails is going to address
(26:18):
just midlife relationship changes and and how how we can
navigate those and the things you can change and the
things you can't change and try to keep it together,
I say, with marriages, and we definitely see that. Yeah,
there's there are divorce rates for all relationships throughout their day.
But yeah, and there and there. But once we get
(26:39):
to that midlife, as Jay will say, he has seen, uh,
there's a lot more. All of a sudden, it spikes
in through it's almost it's pretty even men and women
coming to a file for a divorce until you get
to this age, the forties to fifties, and a tremendous
spike in women seeking divorce. And so why is that?
(27:04):
What is that change? And I s A and we've
as we've talked about it. He I said, I can
tell you what the change is is you've got brain
changes that make you less tolerant and and you start
re evaluating what your priorities are for yourself. And uh
and so that we he he won. He's always been
(27:25):
extremely supportive. He's been through over g y N residency
and good friends with all of my friends who are
doing this, and so he and he's a little bit
of a show pony anyway. So he was he was
a magician in Las Vegas and so and so he
doesn't mind being on the stage. And so he says
(27:46):
he's got a thousand hobbies, none of which makes any money.
Speaker 6 (27:48):
So he's a musician and a musician and uh so
he's he's actually highly entertaining me, thank goodness.
Speaker 3 (28:01):
So he is. He's a but he also brings the
perspective of he's not educated in menopause. He's only educated
by being in the vortex of all this conversation for
so many years and really seeing these changes that I've
been I come home and like, of course, you don't
believe I talked to this person's day. So that's the
(28:22):
kind of And so I think it brings in a
unique perspective because we've been through these changes. He's seen
me navigating these changes, but he's also helped Yeah, thousands
of couples through the same type of transitions.
Speaker 4 (28:36):
Is that how you met him, Kate? Did he get
you up on the stage in one of his magic tricks?
Speaker 7 (28:40):
Yeah?
Speaker 3 (28:40):
Well, well he put me in that box, cut me
in half, and then he's like, if you want to
be putting your back together, you better say yeah. So
we actually met. We met. I was eighteen. It was
the summer between high school and college. But we didn't
date that whole time. Oh my goodness.
Speaker 1 (29:02):
Is there are there any topics that you're excited or
either or maybe even topests that you're nervous to dig
into together?
Speaker 3 (29:10):
Yeah? So I think that one of the ones that
we really want to look at is the changing needs
that you have in terms of communicating your there's the
changing uh sexual function and how you how part of
that is communication and not just communication of how your
(29:32):
changing needs are and the changes that we have physically,
but also that that uh, sexuality is a form of
communication and so and that is that is a big
thing that that could changes in the if you if
you were not, if you weren't communicating well before this
all these changes happened, then there certainly are things that
(29:54):
you're going to have to work on extra rd to
try to get that communication established, uh and try to
reevaluate because you're it's it's such a they've got so
many changes going on at once, and you're if you're
you're also navigating the changes in your job, and you're
and dealing with children and and certainly many of us
(30:16):
also with our parents and the physical and emotional needs
that they have at this stage. Uh. It's a lot
to try to bring balance and harmony into this evolution. UH.
And so we've got lots I feel like we've got
lots of different points to to to meet uh on
(30:38):
of these different relationships. And I feel like women are
excited to hear about it because they're like, yes, me too,
I'm doing dealing with through those same things, and they're like,
I don't even like my dogs that much anymore. And
sometimes it just seems like a lot of dealing.
Speaker 1 (30:56):
They breathe love, they snore at night, You're not that
cute anymore.
Speaker 4 (31:02):
When you bring it up, women are willing to talk
about it, like they want to talk about it, you know,
even when you go to a party or you're out
for drinks or some of them with friends. Women are
totally ready to talk about it, Like if we ask
them in the office, if we ask our patients, they'll
tell us. We just have to make sure we ask
them because they won't volunteer that information, right.
Speaker 3 (31:23):
No, And honestly, for the most part, we aren't given
in our current platform of most medical care, we're not
given the time to talk to people about it. And
it's like the last thing, like, right, let's hope she
doesn't bring any at us, right, because it is. And
(31:43):
it's trying to find the right format and the right
outlet to try to get the information to women because
in the fifteen minute allotment, which is frequently double booked,
so you actually have, you know, seven and a half
half minutes to talk about and do their exam and
all that. It just is it's really hard and it's
(32:04):
not fair. And and hopefully by educating, not having good
therapists like marriage and family counselors and that are helpful
and they can they can say, hey, this sounds like
maybe you it's something I have the time to talk to,
but maybe I can be able to help you guide
(32:25):
guide you to uh the right person to talk of.
Maybe you need to talk about hormones to your to
your without blaming everything in their relationship on her and
say this is your problem and it's your it's your hormones,
because that certainly is not it's a recalibration of everyone's
(32:46):
midlife and and men have that recalibration to and their
relationship to their jobs. And don't mean a good way
go have a whole A whole episode is going to
be about retirement and how the change of your relationship
in when one or both partners retires and and now
(33:07):
they have to re evaluate who they are in the
in relationship to their personal identity. But as one of
my friends and I love that we were talking. I
have a game group of girls that they were called
game gals, and we get together and just and play
(33:27):
games and talk about our lives and and she said
her husband recently retired and she had to remind him
that she was not his employee.
Speaker 7 (33:38):
Because he's used to having one. Yeah, well he gets
to boss around all day and she's like, yeah, and
I'm not one of them.
Speaker 3 (33:47):
And so I have my own set of things going on.
So if you want somebody to come help you move
this lawn mower into your car, and it's right where
when I'm supposed to be going leaving the house, I
am not going to stop and help you lose your
lawd mowner. Even though my stopping to help you stop
(34:08):
what I'm doing and help you move this lawnmower is
a way that you feel loved. I mean I have to.
Speaker 7 (34:17):
You're gonna have to figure out another way for me
to show my love for you, because that is because
it is it's one of those changes where, well, if
you're not paying attention to me, that that mean in
the way that I.
Speaker 3 (34:30):
Feel like I need that attention. It feels like I'm
not you don't love me, and it says like I
don't love you, But I do have an appointment and
I cannot get back in to get my haircut and
if this I don't get this appointment, it's gonna be
six weeks. You know, I was like rebook that, So
it's it is a whole different way of feeling relationship
and fulfilling each other's needs in there, in your love
(34:54):
and your heart, but also and sexually, but like every
aspect of your relationship.
Speaker 4 (35:00):
Yeah, something you brought up there is really important. I'd
love for our listeners to know anyone who's not in medicine.
When you see your doctor, you know, the chances are
they have somewhere between seven and a half and fifteen
minutes to spend with you. But they also there's a
note that has to be done, which takes somewhere between
(35:20):
five and ten minutes. There are prescriptions that have to
be done, and sometimes referrals or you know, orders for
X rays or blood work, and somehow you are supposed
to do that thirty minutes or more of work in
that seven and a half minutes. I mean, it's like
going to your hairdresser and saying, you know, i'd like
my roots done. You've got seven and a half minutes.
(35:43):
I mean, it's just insane how we've allowed this to happen.
But that is the current scenario. So when you go in,
it's good to know that you know.
Speaker 3 (35:52):
And it's not fair to patience me that they are
not responsible for how much or how little time that
we've been allotted, but it is and I don't have
the perfect answer, but knowing that you want to come
in and have a specific problem focused exam or time
(36:17):
and realizing that even if you have that problem focused time,
it's probably going to be fifteen minutes or really ten
minutes that unfortunately, that's kind of how we're set up
and it's not ideal. And I will tell you it
is amazing. I know you guys have all done it.
We can get a shitload ton Yeah, ten minutes, I
(36:40):
mean it's amazing. But really how much we can get done,
I don't know. And yes, they're different ways of their
different platforms, and there are different there are people that
have great more flexible schedules, but it's not accessible to everyone.
(37:00):
I mean, if you there are the places that where
you can do have visits that are not restricted by insurance,
and unfortunately that is that's the case, and it and
you may need to certainly you should seek out somebody
who is menopause. A modern metopause provider, I would say, right,
(37:22):
temporarily educated in menopause, and there are ways to find
that more of the people that are affiliated with the
Menopause society, but also with a switch as we said
International Stife or Studio and Sexual Health, which is the longest,
but uh those are going to be providers or practitioners
(37:42):
that you that are have sought out on their own
outside of any uh any right, there's the word see
if it's gone any any demands of their nor there's
demands a demanded certification by American College of the Sex
(38:05):
Niccology or American Family of College or family practitioners. They
have said this is important enough to me that I
want to go out and get the current and up
to date information.
Speaker 5 (38:16):
So those are good places to start. But also if
you may need to say go outside of the traditional
medical care and.
Speaker 3 (38:28):
You may be finding someone who will be able to
provide longer appointments and more in depth, especially if you
have complicated medical problems that would make providing that care
a little bit more difficult.
Speaker 4 (38:43):
With all the training that you've done through issuish case,
you know, when you see your patients, is there one
particular myth that you find yourself busting over and over
again with regards to women's sexual health, say or one
that you prefer to bust.
Speaker 3 (38:59):
Oh, sure, I think that one of the myths that
is that you that it just is normal and you
should be able it should just happen, like sexual relationship
should continue to be exactly what it was, and that
there's there's no need to change and evolve in your
(39:21):
communication or so that there's a lot of that we
should have spontaneous desire at the same level that we
did when we first met and where everything else in
our life has changed. Everything is changing, there's a lot
of hormone changes, and we should that that that your
(39:41):
sexual life and your sexual function in your and your
relationship to your partner should be exactly the same. And
that if you don't have spontaneous desire, it means that
you're broken and and and you are I say, Helly
Casperson of course is one of our dear friends and
also and colleagues and uh and looking at sexual medicine.
(40:03):
If you haven't heard her podcast, you are not broken.
It is an amazing resource. But it's your libido isn't
a fixed thing. It's responsive and they've got lots. It's
impacted by all kinds of things. That sex is communication
you have to and the and your hormones that are
(40:24):
communicating with your brain, but also your communication with your
partner and all the outside stresses that you have to
have an ongoing dialogue to make that to try to
maintain that. But also you've got the intimacy is a
big part of your relationship and a big part of sex,
and so sex doesn't exist in a bubble in your bedroom.
(40:48):
You know, intimacy has to be have attention throughout the
day and and that sort of emotional intimacy as well
as it has to be part of physical intimacy. You
can't you can't really dissociate them. So that that that apple,
that's that's one of the things. Sorry, that was a
very long way.
Speaker 7 (41:09):
That's a great answer things for changing and you have
to be willing to uh to change with them and
realize that that you it does, it's not automatic and
uh and it's going to require a little maintenance, just
like everything at this point.
Speaker 3 (41:27):
Mm hmm.
Speaker 2 (41:29):
I think that's a good point for both, you know,
women and partners in general. Right, so as women are
navigating this, but then their partners. They are always asking,
you know, what can I.
Speaker 3 (41:39):
Do to help?
Speaker 2 (41:40):
And I think sometimes just understanding that you know your
partner is also changing. You know, if you have a
male partner, they're changing in midlife as well, and so
it's you know, it's part of the change together. And
you know, maybe it should be a pre wreck like
this midlife therapy, like you know, how to navigate your
relationship in mid life.
Speaker 3 (42:00):
Yes, I think we should be a requirement for sure.
Speaker 4 (42:03):
Or we sent you turn you know, thirty five and
you get sent a copy of Kelly Casperson's book and
the tube of vaginal estrogen, yes, and some uber loop.
You know, there's countries where when you're pregnant, you receive
(42:24):
in the mail from the government this beautiful box and
it's quite large, and it's packed with diapers and baby
clothes and safe shampoo and all these things. And then
you can use the box itself as a little bassinette.
And that's all provided by people paying taxes, and that
(42:44):
is couples out of government funds. And I genuinely think
we should be sent our vaginal estrogen and you are
not broken into thirty five to every woman vibrator.
Speaker 1 (42:59):
Oh yeah, an idea, we should just sign that box.
All the things that would be in that box, that being.
Speaker 2 (43:05):
Good insta life care package, your blow up, you want
to see this, Yeah.
Speaker 3 (43:12):
Yeah, a little jazz. Yeah yeah, yeah, that's just sparkles.
That's right exactly. So I think that that is I
think that that those are the changes that I think
would be that The myth is that it's just not
(43:33):
it's just does it's not automatic and uh, and all
the things that you have to do to maintain your
bones and you know, like I know, you'll put one
more thing on the list, but it is not automatic
and it does require a little bit maintenance and and uh,
I think that that's one of the good things that
will be in the part of that podcast is I mean,
Jay is a dude. I mean he's he said, I'm
(43:55):
going to ask all the dude questions that to help
you want something that both partners will listen to as
they're riding down the road and be happy to be
listening to it together and be like that they have
guys be like, oh, I have that question too, and
I need to know. I want to know how to
make this because I think in for the most part.
(44:16):
People want to make their relationships better. That's why they're
in a relationship. Is they want they want they want
to get make it stronger and make it better. And uh,
and so he's going to be there to ask those
questions that all those guys are thinking, but they're a
little afraid to ask.
Speaker 2 (44:34):
That's awesome. So you're a doctor, speaker, a mom of two,
and now a podcaster. Do you embrace the beautiful chaos
or do you feel like you're losing your marbles like
like we do?
Speaker 3 (44:47):
Ask me? Yeah, say with my friends and we're all
this weekend and we're all at different phases. One of
them just sold her company, another one is you know,
full on or you know just had uh has has
two that are one one's working, ones just got out
(45:08):
of college and trying to figure out that transition. Like
she's like owns her own business and is she going
to expand is she going to sell? Is she going
to bring our partner? All these things while trying to
make sure that their kids are good and all that.
And then you've got I've got we And then we
have friends who who have they been on their own
path and they are they did not they're in their
(45:31):
their single and they have always been single, and they
they're good with that, but they're also trying to navigate
those changes for themselves and what their direction is. And
and so it's not just people that are in coupled relationships.
There's all there's the relationship to yourself that's changing and
how you feel about yourself and where you're going, and
(45:52):
I mean it's not just that. And they have all
the same relationships with their parents and and with their
friend ends, and it just so it's all these changes
that we're all navigating day to day. And am I
do I feel like I'm managing the chaos? Yeah? I
would say I some days better than others. But but
(46:12):
again it's it's uh, it's this having the support and
knowing that there are people out there that are I mean,
the the supportive group that I have is amazing and
I couldn't do it without them, and I I feel
like there are a lot of people that are doing
it without any support, and so we can be that
(46:32):
for them, then I would be really happy. Mm hmm.
Speaker 1 (46:36):
So, Kate, if you are listeners with one message about
navigating menopause, intimacy or relationships in midlife What would it
be I would.
Speaker 3 (46:47):
I would say that you really need to think of
it as the recalibration. You know, it's it's it's uh,
maybe a little bit off that you just got to
recalibrate and uh and and re examine how to get
back on track. But it's not it's actually not broken.
(47:08):
It's just a little off track and we can get
there and help them to go navigate how to recalibrate
those relationships to be able to enjoy that. The fruits
of all are everything that's come from from all the
hard work and everything we put into it so far.
(47:31):
It's just it's it's worth it and try to get there.
Speaker 4 (47:36):
Yeah, that's a nice way to wrap up, and thank
you so much for being here with us today.
Speaker 3 (47:43):
Are doing what we're doing.
Speaker 4 (47:44):
Yeah, it's been such a pleasure, and that I was
just about to say thank you for all the hard
work that you're doing with all the women that you
take care of, and I was I was going to
let people know how to find you. So you're on
Instagram and TikTok as doctor Kate White ob g i N.
Your practice is Low Country obg y N in Charleston,
(48:04):
South Carolina, and your new podcast, which is coming out soon,
is going to be called Heads and Tails.
Speaker 3 (48:11):
Heads and Tails correct, All right.
Speaker 4 (48:14):
When is that coming out?
Speaker 3 (48:17):
Believe? Yeah, so it will drop and I'll have it
out there. Yeah.
Speaker 4 (48:22):
Well you've already got three listeners.
Speaker 3 (48:24):
Don't worry, you.
Speaker 2 (48:27):
Got it. Oh my husband, I'm sure our husbands I
would assume too, at least mine, he'd like.
Speaker 3 (48:32):
That kind of stuff.
Speaker 4 (48:33):
Oh, definitely, at least six. And then we'll get here
on our producer here.
Speaker 3 (48:41):
Like plus seven already just today that. Yeah, you find
us up and to all.
Speaker 4 (48:47):
Our dusty muffins out there, share this with your midlife besties,
subscribe and leave us a review. We're here for the laughs,
the learning, and the liberation that midlife brings
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