May 28, 2025 • 24 mins
In this episode, Amy Alkon discusses her new book 'Going Menopostal' and sheds light on the often overlooked topics of menopause and perimenopause. She highlights the gaps in medical training regarding women's health, the myths surrounding menopause, and the importance of understanding hormonal changes. Alkon emphasizes the need for evidence-based medical care and encourages women to take charge of their health by educating themselves about their bodies. The Karol Markowicz Show is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Wednesday & Friday.
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Episode Transcript
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Speaker 1 (00:03):
Hi, and welcome back to the Karl Marco Show on iHeartRadio.
I'm going to take a break from monologues for a bit.
I know people like them and I like doing them,
but I feel like they're a little disorganized and they're
just about whatever I'm thinking that day. And I know
that that is maybe part of their appeal. They're kind
(00:26):
of spontaneous. It's like I saw this, or I was
thinking this, or I read this. But I want to
make them a little more cohesive. I want to jump
around from topic to topic less and I want to
have a wider point. I'm almost at the two year
mark of this podcast, and I've learned a lot since
(00:49):
I started. I love my listeners and I respect your time,
so I want to spend this summer figuring out how
to make the monologues less jumpy and more coherent so
that my listeners get more out of them. I'd love
to hear from you all about what you'd like the
(01:09):
monologues to be going forward, or anything else you'd like
to tell me at Carol Markowitz Show at gmail dot com.
I'd love to hear from you. Please let me know
how your summer's going. Thanks for listening coming up my
interview with Amy Alkin. But first, folks, we're seeing something
(01:30):
truly disturbing. Anti Semitism is on the rise around the world,
and sadly right here in America. Jewish schools being targeted,
synagogues threatened, families living in fear. It's something we'd hoped
we'd never see again in our lifetime. And let me
say this, silence is not an option. This is the
(01:53):
moment to take a stand. That's why I want to
tell you about the International Fellowship of Christian and Jews
or IFCJ. They are on the front lines providing real
help where it's needed most. They're giving food and shelter
to Jewish families under threat, building bomb shelters for children,
(02:14):
helping survivors of hate rebuild their lives. And they don't
just respond to crisis, they work every day to prevent it.
Your gift of only forty five dollars will help support
their life saving work by helping provide food, shelter, and
much more. The Bible says I will bless those who
(02:35):
bless you. Supporting IFCJ is a spiritual stand. It's showing
up for God's people when it counts. So please call
eight eight eight four eight eight IFCJ. That's eight eight
eight four eight eight four three two five, or go
to IFCJ dot org. Every dollar helps, don't wait, be
(03:00):
the difference. Visit IFCJ dot org or call eight eight
eight for eight eight IFCJ.
Speaker 2 (03:09):
Now, welcome back to the Carol Markowitz Show on iHeartRadio.
My guest today is Amy Alcon, an award winning investigative
science writer who specializes in science help, using scientific evidence
to solve real world problems. Amy's new book is called
Going Menopostal What you and your doctor need to Know
(03:32):
about the real science of menopause and Perimenopause.
Speaker 3 (03:35):
Hi.
Speaker 2 (03:36):
Amy's so nice to be have you on.
Speaker 3 (03:38):
This is great, Come on, thank you.
Speaker 2 (03:40):
I'm a longtime fan. As you know, I have read
your previous books. I'm extremely excited to read this one.
Speaker 1 (03:46):
Your new book is a serious look at menopause and
perimenopause and the way that it's often ignored by doctors
and researchers.
Speaker 2 (03:56):
So why is that? Is it just sexism?
Speaker 3 (03:59):
No, No, it's not sexism at all. Many of the
researchers are women. The problem is that, first of all,
it's there's a whole medicine wide problem that our medicine
is not really evidence based, and people find this really
hard to believe. But there are three big myths about
our medical care. One is that doctors are able to
read science and make decisions based in science. They're actually
(04:21):
not taught to read science in med school. Med schools
and medical institutions are so at fault here. You know,
people think, oh, you're going to bash doctors. I don't. Actually,
this is the responsibility of med schools and providers to provide.
If the doctors aren't trained in science, someone needs to
be there, you know, nerds to you know, say okay,
(04:43):
here's what the science says, and to generate practice standards,
which are the guidelines doctors go by to treat you.
And then the other the other two myths of that
doctors are trained in diagnostic reasoning. I'll a doctor house.
If anyone's seen that show.
Speaker 1 (04:57):
I love it.
Speaker 2 (04:57):
I have never watched it, but I watch them. The
clips of it now are going viral again for some reason.
Speaker 3 (05:03):
Well, they do this differential diagnosis where they look to
see what is the underlying condition causing your symptoms and
what doctors do. This is a big medical error. They
will treat your symptoms without looking for the underlying disorder.
So if you have a headache, you know, maybe you
just are stressed out and you need some whatever tile
(05:23):
it all, or maybe you have a brain tumor. Now
if we cure your headache, we've lost an important signal.
So it's vital that we look for underlying conditions. And
then the third one is that doctors, this is so horrible.
They are not trained to correctly assess risk. So they
can't tell you what's my risk of this or that
they either will not get it right or they rely
(05:47):
on these overblown pharmaceutical company rep percentages that are actually
not meaningful to individuals at all. Their comparisons of one
group to another. So when they say like fifty percent
less risk, well that might be you know, it's a
very small number. You know, it's not your risk, it's
(06:10):
just this group to the other one. And so these
are huge problems. And then there's a scandal in gynecology
that people don't know about. So in gynecology, almost no
doctors have any training, not even an hour of training
in menopause or perimenopause science, right because they it's medical education,
(06:32):
medical education is so terrible. These schools are lazy. There's
no reason to change them because they're just dodgy bureaucrats
who run them, you know, taking in the donation dollars,
and why start these programs in diagnostic reasoning and proper
risk assessment? These cost money, These require change. New hires
(06:53):
will just do what we're doing. And this is horrible.
This is horrible because the father of evidence based medical
David Sackett, said, fifty percent of what you learn in
med school will be wrong. The problem is we don't
know which fifty percent, and it changes. The medicine changes
so quickly. Now, so doctors. They when you go to
(07:13):
the doctor, they treat you. They will send you guide
ecology departments will send you to a baby doctor. Doctors
who are maternity specialists, and those doctors are made to
treat you in something they have zero training and expertise.
And this is medically unethical. This is unethical. They should.
I write about this in the book by a cardiologist
(07:34):
I think her name is Sarah Holland she said, you know,
she's doing these massive cardiovascular operations. And she said, if
my patient wants me to prescribe allergy medicine. I apologize
and say, I know it would be more convenient, but
I don't know that area. She might prescribe the wrong thing.
And so because of this, doctors, you go to your
doctor with perimenopausal symptoms, you know, and the doctor doesn't
(07:57):
know what they are, dismisses you, norse the symptoms, doesn't
treat you or mistreats you. Doctors will give patience antidepressants.
This is terrible. I think people have been reading in
the news. You know, there are great tapering problems for people,
and what they don't do. They might antidepressants can bring
down hot flashes, but they don't. They don't solve all
(08:21):
these problems that you have and unhealth underlying unhealth in perimenopause,
for example, your bones. They don't protect your bones the
way our natural hormones do. And what doctors don't know
the cause of great suffering during perimenopause. And I should
name some of the symptoms so women get hot flashes.
(08:43):
This is how I started the book. I was sitting here.
I live in Venice, California. This is like the most
temperate place in the world. You know, It's breezy summer day,
and all of a sudden. I'm sitting here at my
desk and I'm sure. I'm like, why do I feel
like I'm locked in a trunk in the everplace? He's crazy?
I thought, oh my god, I hot flash. And you know,
you want to go to your doctor and say, I'm uncomfortable.
(09:05):
What should I do? But I know better. I've been
coached since around two thousand and seven by this very
generous epidemiologist and biostatistician, Sander Greenland. He's a co author
of the seminal book in the field, and he has
helped me learn how to critically evaluate research and look
and see if the methodology is adequate. All studies are flawed,
(09:28):
but are they so flawed that you cannot you know
that they're not conclusive about anything, and you look for
a body of work. You don't just go buy one study.
This is a problem where people say, oh, do your
own research. Well, you have to know what to look at,
and you have to look at a great deal of
research to know you know where, you need to know
the whole landscape. So all of this is so terrible,
(09:50):
So you go to your doctor. I oh, so sorry,
I cut off my story. Basically, I started doing this
deep dive into the research to figure out what the sciences,
and I saw this just massive gap between the practice standards.
These are the standards for treating you, the guidelines for
treating you that these doctors, I mean, they just read
(10:11):
them off a list because they don't know themselves, no training,
and they're victims in this. It is horrible to expect
a doctor to do this. And this is you know,
status quo in these departments. So people don't say no,
they want to keep their jobs. They just get there.
They're young and new, so they just okay, do the
best I can. That's horrible. That's horrible, you know, And
(10:31):
so they don't have any ability to really know what's
going on with you. And so women are left with
these symptoms and some of them. One of the things
I went through a horrible perimenopause. Now perimenopause, I should say,
is that transition period to menopause, three to ten years
leading up to menopause, when your hormones start to go
(10:52):
whack out basically, and what people don't know, what doctors
don't know, they think that perimenopause is this menopause light
that your estrogen.
Speaker 1 (11:02):
That's what I really thought it was.
Speaker 3 (11:04):
Yeah, I did too. Believe me, all these things I
was disabused on when I read the science. What actually
happens is that your estrogen spikes and dives and this
causes a release of stress hormones. This is the most
horrible thing. And then if you don't have the second
hormone of the menstrual cycle, estrogen's partner, progesterone, being made,
(11:25):
you can get really sick, which is what happened to me.
And the reason progesterone is not made in perimenopause is
that not all of our cycles are ovulatory. This is
one third throader throughout our lives. And this is all
the stuff on progesterone and perimenopause comes from the research
of Geraln. Pryor, who is this fierce woman who grew
up in Alaska with no running water electricity, daughter of missionaries,
(11:48):
and brings that fierceness to science. She's an enochronologist and
has tried to put perimenopause on the map for its
unique hormonal state, and also have progesterone research, which is
very important. So progesterone is made when you ovulate, when
the little eggsaft ruptures and the egg is released. So
but in perimenopause and then sometimes before you don't have ovulation.
(12:12):
You know, normal, you have a normal period. It doesn't
seem any different, but there's no eggsact rupture. And what
happens that is that you don't have progesterone made because
it's makes the litter that's left behind called the corpus lute,
this yellow waxy stuff. And then you have a you
have days of progesterone, you know where you if you
have an adequate number where you progest your own you know,
(12:33):
from the ovulation, then you are protected, your bones are protected,
You're able to sleep, which I lost. This insomni is
a huge thing. Yeah, and you're not.
Speaker 2 (12:43):
Insomnia is actually I would say, I'm I'm in my
late forties. The sleeplessness is the only like symptom that
I recognize right now. But even going to the doctor
for that, it's very like, well, you know, maybe wear
yourself out more, go on more water.
Speaker 1 (13:00):
I'm like, no, no, I have My sleep is not.
Speaker 2 (13:04):
I was an amazing sleeper. I was a champion sleeper,
and now I've gotten to where, you know, I definitely
have an issue, and it's it's clearly because I'm heading
in the minopousal menopausal direction. Like you say, doctors just
don't know what to do about it.
Speaker 3 (13:22):
So this is what's so important. This is what I
did with this book, going menapostal. What I do. Medicine
is not going to change doctors institutions. They are not
going to be evans based overnight. But we need care
now that is evidence based. So what I do is
I bring the evidence to all of us in ordinary language.
I have right over there on my router. Write every
(13:43):
page of this book for Pamela d. That is a
note to myself to not be a jerk or you know,
write things to show like how smart I am. Right,
we don't care. Write it in the most accessible, understandable
language because it's hard stuffed. And I also put in
all this humor because you cannot read a book like this.
It's terrifying stuff without having these vacations. Right, and so
(14:07):
with the sleep thing, what's really important is to do
this quantitative basil temperature testing. Now people test their more
first morning temperature to see if they're ovulating. Now, the
book contains this horrible fact that we do not have
a twenty day menstrual cycle. This is wrong. Some women
have much longer ones or shorter ones. And these all
(14:29):
of these ovulation apps, I mean, they're leading women who
are expecting to know when they're fertile with the wrong information.
It's really horrible. But what is effective is measuring your
first morning temperature through this quantitative basil temperature taking. And
then what happens is and this is a bit detailed,
so you can look this up in the book, but
(14:50):
you want to see if you have enough days where
you're having progesterone and it's indicated by temperature rise that
you are protected, that you have this really important protective hormone.
And because I didn't, and you know, I didn't have
enough progesterone, I wasn't I wasn't ovulating. My sleep was
so horrible. I had terrible brain fog. I was waking
(15:13):
up like you. I mean I never champion. Yes, like
someone hit me with a large frying pan. And then
and this was like this, I mean, now I lay
me down to thrash five or six times a night.
The torture. I tried every hot, showers, cold, I mean,
do my feet need to be colder? It was like
all this voodoo, you know, and so yeah, science in
(15:37):
this I realized I needed progesterone, and I had to
fight three battles with TiSER Permanente, my medical provider, to
get the progesterone, to get the amount I need, which
they do not give you in America. They don't give
you an amount protective of the endometrium, which is three
hundred milligrams of oral micronized progesterone per night, and then
(15:57):
to get it covered, you know, and I should say
my ecologist, he was wonderful. I have a male you know,
not like one of those patients like if you're my cancer,
if you're my oncologist and you haven't had my lung cancer,
well I'm not going to go here. He's fantastic, and
so he treated me with great respect and listen, I
am an annoying human being. And I threw just a
(16:19):
mountain of studies at him and then at his boss,
who was then the head of Kaiser grond Ecology, and
they actually met with me and listened and were persuaded
by the evidence I provided, and so they covered the drug,
gave me the amount I needed, which they'd taken France
since nineteen eighty safely, you know. And as they said
to me, well, that's not American you know research. I'm sorry,
(16:42):
like our French woman in Martians or to think he's
dressed better and eat better food, you know, I mean,
it's crazy. So that gave me my sleep. What it
also does to protect my bones, my cardiovascular system. And
this is a huge thing I want to mention about menopause.
We have this fraudulent research that came out around two
(17:02):
thousand and two, the Women's Health Initiative study that basically said,
you know, you're gonna get breast cancer your head.
Speaker 2 (17:09):
That's been I mean, I feel like I've read so
many articles about how that's been disproven and that's just
no longer considered the case in the medical world.
Speaker 3 (17:20):
It was methodological crap, and it was it was fraud
basically because these researchers in two thousand and two, I mean,
if you tell the true story, you know, or if
you actually first of all do appropriate testing, you don't
have women scared and you know, throwing their estrogen prescriptions
in the toilet. What they said is that healthy menopausal
women will get you know, breast cancer, Alzheimer's, et cetera. Well, wait,
(17:44):
a second. The women in the study were like seventy
nine years old, seventy five? You don't give does grandma
going to the doctorate account of hormones? No? And the
thing is what we know now, there's something called the timing.
It's a critical window, the time hypothesis, and it's there's
good evidence behind this that if you are a healthy
(18:04):
woman you don't have plaque building up your arteries. You're not.
You're healthy right at menopause and you start ester. Can
you initiate it then then it will be health when protective?
And what doctors said the head of Kaiser, the current
head of Kaiser Gnecology, this is so appalling. My doctor,
my excellent gynecologist who listens and considers the science is out,
(18:25):
you know, and so till August. So I had to
meet with her. She tells me you need to tape
her off estrogen at sixty. I said like, oh, this
is so so outdated and so disproven that even the
menopause society they're always behind the times. In twenty twenty two,
my point was like last three weeks ago in twenty
to twenty two, they came out and there said there
(18:46):
is no stopping rule. You know, it's to be decided
on individual health. And the thing is people think, well
I should get off estrogen. No, if you are, if
you're healthy, it needs to be you need to be monitored.
But if you're a healthy person, when you initiate it
and you remain healthy and your monitor for that, what
you want is to be taking estrogen when you're old,
because when do we break bones at seventy nine? And
(19:08):
we break them because we fall.
Speaker 1 (19:10):
There's stigma around talking about menopause.
Speaker 2 (19:14):
There's nausea, there's bleeding. None of it is very attractive, right,
But there's also the sense that menopause means you're ancient
and it's the end of the road. And you kind
of turn that on its head in the book and
say that it could be the start of your new
life or your new path. What do you mean by that?
Speaker 3 (19:33):
Exactly? See, if you have your health, then you can
just be you all your life and just be a
little wrinkled, you know, and there are things that go wrong,
but this is so important. I do not accept the
stigma that we are less, you know when we age,
And so I go around telling people, I mean I
was shove it at them I'm sixty one, I'm sixty one.
I'm sixty one because.
Speaker 2 (19:55):
I'm very I'm forty eight and I'm open about it
and I don't care, and I'm never gonna lie about
my age.
Speaker 3 (20:01):
And the thing is, I'm a better human being in
every way, you know, except for my eyesight. Now it's
sixty one than I ever was. I'm kinder, you know,
my work is better. It's just wonderful to be this
age and be the person I am now. And I
see those so many women. Something happens at fifty women
(20:23):
we have we tend to be, many of us timid
in some ways, you know, And at fifty, so many
women developed this confidence almost out of nowhere, where they
will speak up, you know, pitch themselves, put themselves out there,
stand up for things. And this is exciting, and you
can even if that's not naturally occurring for you. The
thing is, you know, our emotions and our way of being.
(20:45):
This is not a mandate. You can choose to be
that way, and you can choose to be this about
age also to be this way. And the reason that
it's it's important to do this is that we can
have a whole like third or fourth act. And so
my friend I'll give my friend w Levin as an example.
She I met at the Alternative Weekly newspaper conferences. I
(21:07):
was selling my syndicated column. She was selling John Callahan,
the cartoonist, and she was She's an agent. She's really
great at that. Well. She is now a pretty legendary ceramicist.
She sells her work all over galleries, you know, the
like designers. It's really sought after. And this just happened
in a few years and she developed this and this
(21:29):
is the way. And like a neighbor of mine, missus
Abbot Kinney, she used to be on Twitter. She does
literacy volunteering for adults, teaching adults to read at our
library here in Venice. So you can volunteer, you can
move to Portugal. You know, there's some of it you
can do and you just have to decide. You know
that that really I call it old is the new black.
(21:49):
I'm old. I'm old. I say it. I'm old, and
I'm fabulous. You know the thing you're old? Yes I am,
I am.
Speaker 2 (21:57):
It gets me into my my one of my three
questions that I ask all my guests, what do you
worry about?
Speaker 3 (22:03):
Oh? My god? I worry that I've missed something, that
I'm not getting the science right. I have such a
responsibility to people, and so luckily this worry and the
lack of you know, the sort of arrogance that comes
with being formally educated, you know, has me looking at
things and relooking at things and sending my workout to
(22:24):
be fact checked. I tell people actually to like kick
my ass, wipe the floor with me, because they don't
believe you when you say you want criticism. But that's
really important to me, and that is my terror.
Speaker 2 (22:34):
I love that we're going to take a quick break
and be right back on the Carol Marcowitch Show. What
advice would you give your sixteen year old self? Like,
what did sixteen year old Amy not know that you
wish she did.
Speaker 3 (22:49):
Respect is not conditional on other people's behavior. I had
no friends until I was fifteen, and you become sort
of suck up. And the thing is you are not going,
first of all, not going to get them to be
your friends or like you if you behave without self respect,
if you're you know, sucking up and trying to you know,
trying to get people like you. And so the best
(23:10):
thing is to just be you, proud you, not suck up,
you know, not let it ever be relative.
Speaker 1 (23:16):
I love it.
Speaker 2 (23:17):
I can't imagine you ever being a suck up. Honestly,
you're so independent and outspoken. I just feel like you're
I've never thought, oh, Amy doesn't say what she thinks.
Speaker 3 (23:28):
No, but this is the thing we can all change,
you know. I talked in the book about choosing resilience.
You know, we have a lot of stuff go wrong
with us, you know, and you can choose to have
that attitude. I have this beautiful quote, I'm not going
to remember it, but my friend Leslie Gray Streeter talks
about I'm the child of Jim Crow, her husband who's widowed.
They had just adopted a baby, all of this, but
(23:50):
she said, I choose joy, you know, and it makes
me cheer up each time. And that's the way you can.
You can choose to have that attitude. And I think
that it's really important to do that to understand that.
Speaker 1 (24:01):
I love it. Well. I've loved this conversation.
Speaker 2 (24:04):
I can't wait to read. Going menipostal end us here
with your best tip for my listeners on how they
can improve their lives.
Speaker 3 (24:14):
If you if you live to be healthy if you
do this, if you do weight bearing exercise, slow speed
strength training, and you'll eat a very low carb or
cardboard diet. These are the two things you need to
be healthy throughout your lifespan. And this is the most
These are the two most important tips I can give you.
Speaker 2 (24:33):
I love that so much. Thank you so much for
coming on Amy. Check out her new book Going Menipostal,
What you and your doctor need to know about the
real science of menopause and perimenopause. Thank you so much, Amy.
Speaker 1 (24:44):
Thanks so much for joining us on the Carol Marco
which show. Subscribe wherever you get your podcasts.
Hi, and welcome back to the Karl Marco Show on iHeartRadio.
I'm going to take a break from monologues for a bit.
I know people like them and I like doing them,
but I feel like they're a little disorganized and they're
just about whatever I'm thinking that day. And I know
that that is maybe part of their appeal. They're kind
(00:26):
of spontaneous. It's like I saw this, or I was
thinking this, or I read this. But I want to
make them a little more cohesive. I want to jump
around from topic to topic less and I want to
have a wider point. I'm almost at the two year
mark of this podcast, and I've learned a lot since
(00:49):
I started. I love my listeners and I respect your time,
so I want to spend this summer figuring out how
to make the monologues less jumpy and more coherent so
that my listeners get more out of them. I'd love
to hear from you all about what you'd like the
(01:09):
monologues to be going forward, or anything else you'd like
to tell me at Carol Markowitz Show at gmail dot com.
I'd love to hear from you. Please let me know
how your summer's going. Thanks for listening coming up my
interview with Amy Alkin. But first, folks, we're seeing something
(01:30):
truly disturbing. Anti Semitism is on the rise around the world,
and sadly right here in America. Jewish schools being targeted,
synagogues threatened, families living in fear. It's something we'd hoped
we'd never see again in our lifetime. And let me
say this, silence is not an option. This is the
(01:53):
moment to take a stand. That's why I want to
tell you about the International Fellowship of Christian and Jews
or IFCJ. They are on the front lines providing real
help where it's needed most. They're giving food and shelter
to Jewish families under threat, building bomb shelters for children,
(02:14):
helping survivors of hate rebuild their lives. And they don't
just respond to crisis, they work every day to prevent it.
Your gift of only forty five dollars will help support
their life saving work by helping provide food, shelter, and
much more. The Bible says I will bless those who
(02:35):
bless you. Supporting IFCJ is a spiritual stand. It's showing
up for God's people when it counts. So please call
eight eight eight four eight eight IFCJ. That's eight eight
eight four eight eight four three two five, or go
to IFCJ dot org. Every dollar helps, don't wait, be
(03:00):
the difference. Visit IFCJ dot org or call eight eight
eight for eight eight IFCJ.
Speaker 2 (03:09):
Now, welcome back to the Carol Markowitz Show on iHeartRadio.
My guest today is Amy Alcon, an award winning investigative
science writer who specializes in science help, using scientific evidence
to solve real world problems. Amy's new book is called
Going Menopostal What you and your doctor need to Know
(03:32):
about the real science of menopause and Perimenopause.
Speaker 3 (03:35):
Hi.
Speaker 2 (03:36):
Amy's so nice to be have you on.
Speaker 3 (03:38):
This is great, Come on, thank you.
Speaker 2 (03:40):
I'm a longtime fan. As you know, I have read
your previous books. I'm extremely excited to read this one.
Speaker 1 (03:46):
Your new book is a serious look at menopause and
perimenopause and the way that it's often ignored by doctors
and researchers.
Speaker 2 (03:56):
So why is that? Is it just sexism?
Speaker 3 (03:59):
No, No, it's not sexism at all. Many of the
researchers are women. The problem is that, first of all,
it's there's a whole medicine wide problem that our medicine
is not really evidence based, and people find this really
hard to believe. But there are three big myths about
our medical care. One is that doctors are able to
read science and make decisions based in science. They're actually
(04:21):
not taught to read science in med school. Med schools
and medical institutions are so at fault here. You know,
people think, oh, you're going to bash doctors. I don't. Actually,
this is the responsibility of med schools and providers to provide.
If the doctors aren't trained in science, someone needs to
be there, you know, nerds to you know, say okay,
(04:43):
here's what the science says, and to generate practice standards,
which are the guidelines doctors go by to treat you.
And then the other the other two myths of that
doctors are trained in diagnostic reasoning. I'll a doctor house.
If anyone's seen that show.
Speaker 1 (04:57):
I love it.
Speaker 2 (04:57):
I have never watched it, but I watch them. The
clips of it now are going viral again for some reason.
Speaker 3 (05:03):
Well, they do this differential diagnosis where they look to
see what is the underlying condition causing your symptoms and
what doctors do. This is a big medical error. They
will treat your symptoms without looking for the underlying disorder.
So if you have a headache, you know, maybe you
just are stressed out and you need some whatever tile
(05:23):
it all, or maybe you have a brain tumor. Now
if we cure your headache, we've lost an important signal.
So it's vital that we look for underlying conditions. And
then the third one is that doctors, this is so horrible.
They are not trained to correctly assess risk. So they
can't tell you what's my risk of this or that
they either will not get it right or they rely
(05:47):
on these overblown pharmaceutical company rep percentages that are actually
not meaningful to individuals at all. Their comparisons of one
group to another. So when they say like fifty percent
less risk, well that might be you know, it's a
very small number. You know, it's not your risk, it's
(06:10):
just this group to the other one. And so these
are huge problems. And then there's a scandal in gynecology
that people don't know about. So in gynecology, almost no
doctors have any training, not even an hour of training
in menopause or perimenopause science, right because they it's medical education,
(06:32):
medical education is so terrible. These schools are lazy. There's
no reason to change them because they're just dodgy bureaucrats
who run them, you know, taking in the donation dollars,
and why start these programs in diagnostic reasoning and proper
risk assessment? These cost money, These require change. New hires
(06:53):
will just do what we're doing. And this is horrible.
This is horrible because the father of evidence based medical
David Sackett, said, fifty percent of what you learn in
med school will be wrong. The problem is we don't
know which fifty percent, and it changes. The medicine changes
so quickly. Now, so doctors. They when you go to
(07:13):
the doctor, they treat you. They will send you guide
ecology departments will send you to a baby doctor. Doctors
who are maternity specialists, and those doctors are made to
treat you in something they have zero training and expertise.
And this is medically unethical. This is unethical. They should.
I write about this in the book by a cardiologist
(07:34):
I think her name is Sarah Holland she said, you know,
she's doing these massive cardiovascular operations. And she said, if
my patient wants me to prescribe allergy medicine. I apologize
and say, I know it would be more convenient, but
I don't know that area. She might prescribe the wrong thing.
And so because of this, doctors, you go to your
doctor with perimenopausal symptoms, you know, and the doctor doesn't
(07:57):
know what they are, dismisses you, norse the symptoms, doesn't
treat you or mistreats you. Doctors will give patience antidepressants.
This is terrible. I think people have been reading in
the news. You know, there are great tapering problems for people,
and what they don't do. They might antidepressants can bring
down hot flashes, but they don't. They don't solve all
(08:21):
these problems that you have and unhealth underlying unhealth in perimenopause,
for example, your bones. They don't protect your bones the
way our natural hormones do. And what doctors don't know
the cause of great suffering during perimenopause. And I should
name some of the symptoms so women get hot flashes.
(08:43):
This is how I started the book. I was sitting here.
I live in Venice, California. This is like the most
temperate place in the world. You know, It's breezy summer day,
and all of a sudden. I'm sitting here at my
desk and I'm sure. I'm like, why do I feel
like I'm locked in a trunk in the everplace? He's crazy?
I thought, oh my god, I hot flash. And you know,
you want to go to your doctor and say, I'm uncomfortable.
(09:05):
What should I do? But I know better. I've been
coached since around two thousand and seven by this very
generous epidemiologist and biostatistician, Sander Greenland. He's a co author
of the seminal book in the field, and he has
helped me learn how to critically evaluate research and look
and see if the methodology is adequate. All studies are flawed,
(09:28):
but are they so flawed that you cannot you know
that they're not conclusive about anything, and you look for
a body of work. You don't just go buy one study.
This is a problem where people say, oh, do your
own research. Well, you have to know what to look at,
and you have to look at a great deal of
research to know you know where, you need to know
the whole landscape. So all of this is so terrible,
(09:50):
So you go to your doctor. I oh, so sorry,
I cut off my story. Basically, I started doing this
deep dive into the research to figure out what the sciences,
and I saw this just massive gap between the practice standards.
These are the standards for treating you, the guidelines for
treating you that these doctors, I mean, they just read
(10:11):
them off a list because they don't know themselves, no training,
and they're victims in this. It is horrible to expect
a doctor to do this. And this is you know,
status quo in these departments. So people don't say no,
they want to keep their jobs. They just get there.
They're young and new, so they just okay, do the
best I can. That's horrible. That's horrible, you know, And
(10:31):
so they don't have any ability to really know what's
going on with you. And so women are left with
these symptoms and some of them. One of the things
I went through a horrible perimenopause. Now perimenopause, I should say,
is that transition period to menopause, three to ten years
leading up to menopause, when your hormones start to go
(10:52):
whack out basically, and what people don't know, what doctors
don't know, they think that perimenopause is this menopause light
that your estrogen.
Speaker 1 (11:02):
That's what I really thought it was.
Speaker 3 (11:04):
Yeah, I did too. Believe me, all these things I
was disabused on when I read the science. What actually
happens is that your estrogen spikes and dives and this
causes a release of stress hormones. This is the most
horrible thing. And then if you don't have the second
hormone of the menstrual cycle, estrogen's partner, progesterone, being made,
(11:25):
you can get really sick, which is what happened to me.
And the reason progesterone is not made in perimenopause is
that not all of our cycles are ovulatory. This is
one third throader throughout our lives. And this is all
the stuff on progesterone and perimenopause comes from the research
of Geraln. Pryor, who is this fierce woman who grew
up in Alaska with no running water electricity, daughter of missionaries,
(11:48):
and brings that fierceness to science. She's an enochronologist and
has tried to put perimenopause on the map for its
unique hormonal state, and also have progesterone research, which is
very important. So progesterone is made when you ovulate, when
the little eggsaft ruptures and the egg is released. So
but in perimenopause and then sometimes before you don't have ovulation.
(12:12):
You know, normal, you have a normal period. It doesn't
seem any different, but there's no eggsact rupture. And what
happens that is that you don't have progesterone made because
it's makes the litter that's left behind called the corpus lute,
this yellow waxy stuff. And then you have a you
have days of progesterone, you know where you if you
have an adequate number where you progest your own you know,
(12:33):
from the ovulation, then you are protected, your bones are protected,
You're able to sleep, which I lost. This insomni is
a huge thing. Yeah, and you're not.
Speaker 2 (12:43):
Insomnia is actually I would say, I'm I'm in my
late forties. The sleeplessness is the only like symptom that
I recognize right now. But even going to the doctor
for that, it's very like, well, you know, maybe wear
yourself out more, go on more water.
Speaker 1 (13:00):
I'm like, no, no, I have My sleep is not.
Speaker 2 (13:04):
I was an amazing sleeper. I was a champion sleeper,
and now I've gotten to where, you know, I definitely
have an issue, and it's it's clearly because I'm heading
in the minopousal menopausal direction. Like you say, doctors just
don't know what to do about it.
Speaker 3 (13:22):
So this is what's so important. This is what I
did with this book, going menapostal. What I do. Medicine
is not going to change doctors institutions. They are not
going to be evans based overnight. But we need care
now that is evidence based. So what I do is
I bring the evidence to all of us in ordinary language.
I have right over there on my router. Write every
(13:43):
page of this book for Pamela d. That is a
note to myself to not be a jerk or you know,
write things to show like how smart I am. Right,
we don't care. Write it in the most accessible, understandable
language because it's hard stuffed. And I also put in
all this humor because you cannot read a book like this.
It's terrifying stuff without having these vacations. Right, and so
(14:07):
with the sleep thing, what's really important is to do
this quantitative basil temperature testing. Now people test their more
first morning temperature to see if they're ovulating. Now, the
book contains this horrible fact that we do not have
a twenty day menstrual cycle. This is wrong. Some women
have much longer ones or shorter ones. And these all
(14:29):
of these ovulation apps, I mean, they're leading women who
are expecting to know when they're fertile with the wrong information.
It's really horrible. But what is effective is measuring your
first morning temperature through this quantitative basil temperature taking. And
then what happens is and this is a bit detailed,
so you can look this up in the book, but
(14:50):
you want to see if you have enough days where
you're having progesterone and it's indicated by temperature rise that
you are protected, that you have this really important protective hormone.
And because I didn't, and you know, I didn't have
enough progesterone, I wasn't I wasn't ovulating. My sleep was
so horrible. I had terrible brain fog. I was waking
(15:13):
up like you. I mean I never champion. Yes, like
someone hit me with a large frying pan. And then
and this was like this, I mean, now I lay
me down to thrash five or six times a night.
The torture. I tried every hot, showers, cold, I mean,
do my feet need to be colder? It was like
all this voodoo, you know, and so yeah, science in
(15:37):
this I realized I needed progesterone, and I had to
fight three battles with TiSER Permanente, my medical provider, to
get the progesterone, to get the amount I need, which
they do not give you in America. They don't give
you an amount protective of the endometrium, which is three
hundred milligrams of oral micronized progesterone per night, and then
(15:57):
to get it covered, you know, and I should say
my ecologist, he was wonderful. I have a male you know,
not like one of those patients like if you're my cancer,
if you're my oncologist and you haven't had my lung cancer,
well I'm not going to go here. He's fantastic, and
so he treated me with great respect and listen, I
am an annoying human being. And I threw just a
(16:19):
mountain of studies at him and then at his boss,
who was then the head of Kaiser grond Ecology, and
they actually met with me and listened and were persuaded
by the evidence I provided, and so they covered the drug,
gave me the amount I needed, which they'd taken France
since nineteen eighty safely, you know. And as they said
to me, well, that's not American you know research. I'm sorry,
(16:42):
like our French woman in Martians or to think he's
dressed better and eat better food, you know, I mean,
it's crazy. So that gave me my sleep. What it
also does to protect my bones, my cardiovascular system. And
this is a huge thing I want to mention about menopause.
We have this fraudulent research that came out around two
(17:02):
thousand and two, the Women's Health Initiative study that basically said,
you know, you're gonna get breast cancer your head.
Speaker 2 (17:09):
That's been I mean, I feel like I've read so
many articles about how that's been disproven and that's just
no longer considered the case in the medical world.
Speaker 3 (17:20):
It was methodological crap, and it was it was fraud
basically because these researchers in two thousand and two, I mean,
if you tell the true story, you know, or if
you actually first of all do appropriate testing, you don't
have women scared and you know, throwing their estrogen prescriptions
in the toilet. What they said is that healthy menopausal
women will get you know, breast cancer, Alzheimer's, et cetera. Well, wait,
(17:44):
a second. The women in the study were like seventy
nine years old, seventy five? You don't give does grandma
going to the doctorate account of hormones? No? And the
thing is what we know now, there's something called the timing.
It's a critical window, the time hypothesis, and it's there's
good evidence behind this that if you are a healthy
(18:04):
woman you don't have plaque building up your arteries. You're not.
You're healthy right at menopause and you start ester. Can
you initiate it then then it will be health when protective?
And what doctors said the head of Kaiser, the current
head of Kaiser Gnecology, this is so appalling. My doctor,
my excellent gynecologist who listens and considers the science is out,
(18:25):
you know, and so till August. So I had to
meet with her. She tells me you need to tape
her off estrogen at sixty. I said like, oh, this
is so so outdated and so disproven that even the
menopause society they're always behind the times. In twenty twenty two,
my point was like last three weeks ago in twenty
to twenty two, they came out and there said there
(18:46):
is no stopping rule. You know, it's to be decided
on individual health. And the thing is people think, well
I should get off estrogen. No, if you are, if
you're healthy, it needs to be you need to be monitored.
But if you're a healthy person, when you initiate it
and you remain healthy and your monitor for that, what
you want is to be taking estrogen when you're old,
because when do we break bones at seventy nine? And
(19:08):
we break them because we fall.
Speaker 1 (19:10):
There's stigma around talking about menopause.
Speaker 2 (19:14):
There's nausea, there's bleeding. None of it is very attractive, right,
But there's also the sense that menopause means you're ancient
and it's the end of the road. And you kind
of turn that on its head in the book and
say that it could be the start of your new
life or your new path. What do you mean by that?
Speaker 3 (19:33):
Exactly? See, if you have your health, then you can
just be you all your life and just be a
little wrinkled, you know, and there are things that go wrong,
but this is so important. I do not accept the
stigma that we are less, you know when we age,
And so I go around telling people, I mean I
was shove it at them I'm sixty one, I'm sixty one.
I'm sixty one because.
Speaker 2 (19:55):
I'm very I'm forty eight and I'm open about it
and I don't care, and I'm never gonna lie about
my age.
Speaker 3 (20:01):
And the thing is, I'm a better human being in
every way, you know, except for my eyesight. Now it's
sixty one than I ever was. I'm kinder, you know,
my work is better. It's just wonderful to be this
age and be the person I am now. And I
see those so many women. Something happens at fifty women
(20:23):
we have we tend to be, many of us timid
in some ways, you know, And at fifty, so many
women developed this confidence almost out of nowhere, where they
will speak up, you know, pitch themselves, put themselves out there,
stand up for things. And this is exciting, and you
can even if that's not naturally occurring for you. The
thing is, you know, our emotions and our way of being.
(20:45):
This is not a mandate. You can choose to be
that way, and you can choose to be this about
age also to be this way. And the reason that
it's it's important to do this is that we can
have a whole like third or fourth act. And so
my friend I'll give my friend w Levin as an example.
She I met at the Alternative Weekly newspaper conferences. I
(21:07):
was selling my syndicated column. She was selling John Callahan,
the cartoonist, and she was She's an agent. She's really
great at that. Well. She is now a pretty legendary ceramicist.
She sells her work all over galleries, you know, the
like designers. It's really sought after. And this just happened
in a few years and she developed this and this
(21:29):
is the way. And like a neighbor of mine, missus
Abbot Kinney, she used to be on Twitter. She does
literacy volunteering for adults, teaching adults to read at our
library here in Venice. So you can volunteer, you can
move to Portugal. You know, there's some of it you
can do and you just have to decide. You know
that that really I call it old is the new black.
(21:49):
I'm old. I'm old. I say it. I'm old, and
I'm fabulous. You know the thing you're old? Yes I am,
I am.
Speaker 2 (21:57):
It gets me into my my one of my three
questions that I ask all my guests, what do you
worry about?
Speaker 3 (22:03):
Oh? My god? I worry that I've missed something, that
I'm not getting the science right. I have such a
responsibility to people, and so luckily this worry and the
lack of you know, the sort of arrogance that comes
with being formally educated, you know, has me looking at
things and relooking at things and sending my workout to
(22:24):
be fact checked. I tell people actually to like kick
my ass, wipe the floor with me, because they don't
believe you when you say you want criticism. But that's
really important to me, and that is my terror.
Speaker 2 (22:34):
I love that we're going to take a quick break
and be right back on the Carol Marcowitch Show. What
advice would you give your sixteen year old self? Like,
what did sixteen year old Amy not know that you
wish she did.
Speaker 3 (22:49):
Respect is not conditional on other people's behavior. I had
no friends until I was fifteen, and you become sort
of suck up. And the thing is you are not going,
first of all, not going to get them to be
your friends or like you if you behave without self respect,
if you're you know, sucking up and trying to you know,
trying to get people like you. And so the best
(23:10):
thing is to just be you, proud you, not suck up,
you know, not let it ever be relative.
Speaker 1 (23:16):
I love it.
Speaker 2 (23:17):
I can't imagine you ever being a suck up. Honestly,
you're so independent and outspoken. I just feel like you're
I've never thought, oh, Amy doesn't say what she thinks.
Speaker 3 (23:28):
No, but this is the thing we can all change,
you know. I talked in the book about choosing resilience.
You know, we have a lot of stuff go wrong
with us, you know, and you can choose to have
that attitude. I have this beautiful quote, I'm not going
to remember it, but my friend Leslie Gray Streeter talks
about I'm the child of Jim Crow, her husband who's widowed.
They had just adopted a baby, all of this, but
(23:50):
she said, I choose joy, you know, and it makes
me cheer up each time. And that's the way you can.
You can choose to have that attitude. And I think
that it's really important to do that to understand that.
Speaker 1 (24:01):
I love it. Well. I've loved this conversation.
Speaker 2 (24:04):
I can't wait to read. Going menipostal end us here
with your best tip for my listeners on how they
can improve their lives.
Speaker 3 (24:14):
If you if you live to be healthy if you
do this, if you do weight bearing exercise, slow speed
strength training, and you'll eat a very low carb or
cardboard diet. These are the two things you need to
be healthy throughout your lifespan. And this is the most
These are the two most important tips I can give you.
Speaker 2 (24:33):
I love that so much. Thank you so much for
coming on Amy. Check out her new book Going Menipostal,
What you and your doctor need to know about the
real science of menopause and perimenopause. Thank you so much, Amy.
Speaker 1 (24:44):
Thanks so much for joining us on the Carol Marco
which show. Subscribe wherever you get your podcasts.
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Clay Travis
Buck Sexton
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