I Choose...Destigmatizing Menopause with Dr. Mary Claire Haver
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You're listening to I Choose Me with Jenny Garth. Hi, everyone. Welcome to I Choose Me. This podcast is all about the choices we make and where they lead us. So yeah, I've talked a little bit about it before, but menopause is finally getting its day in the sun. Today, I choose to get into it. Let's talk about it.

There is so much to discuss about menopause and all its phases and symptoms and side effects. Whether you are going through it or about to go through it, or you know someone who's going through it, there's just too much to discuss.

too much stigma about this chapter of life that all of us women will eventually go through. My guest today is the author of the number one New York Times bestselling book, The New Menopause. She's a board-certified OBGYN, a certified menopause practitioner from the Menopause Society, and a certified culinary medicine specialist. She's all about demystifying menopause, which I love. She's

She is a leading voice on the topic. Please welcome Dr. Mary Claire Haver to the I Choose Me podcast. I'm so, so happy to have you with us today. I'm so happy to be here. This is so fun. It's so good. It's so good. Let me just tell you something that happened last night. My husband, he thinks he's funny. He said, what is going on with this menopause stuff? It's more like manopause. I feel like you're in your manopause phase.

I was like, that's a good one, babe. Have you heard that yet? Absolutely. All the time. All the time. Or me, no pause. Man, no more. There's a million things we can do with it. Talk to me about what happened with you. Why did you decide...

that amplifying this conversation around menopause and women's health in this category was so important to you? Kind of my journey was I was a traditional OBGYN in a big academic institution. I taught residents, medical students.

And I had a very robust private practice and I was happy. And I really thought I'd do that job till I retired, you know, in like 20 more years. And then my patients were aging with me because you kind of get out and you get all the newly pregnant people. And I was newly pregnant. And so we have babies together and then we grow old together. And,

You know, I was seeing these trends in my patients who were aging of, you know, these random complaints that we couldn't seem to get to the bottom of, like joint pain, not sleeping, libido, weight gain. You know, and I was just kind of taught this is what happens when women age and get over it. We call them whining women in clinic when I was in training, you know, meaning, you

She's just whining. This is the time of her life. She needs to suck it out. There's nothing we can do. Never in all of my training was I ever taught that this constellation of symptoms might be related to what the hell is going on in her ovaries right now. Wow. So...

I'm like, something's not right with me. Something's not right with all my patients because I go to church with these women. We go out to dinner. It's a small town with a big university, right? I know them outside of their little complaint list in the office. And I know they run marathon, you know, like,

And you're like, these are women who this should not be happening to in this percentage. Right. And they're eating right. They're working out. They're doing all the things. And they're like, look, I'm falling apart. And so, you know, we're testing for thyroid. We're doing all the workups and everything's coming back normal. And they're not fully menopausal. So their hormone levels really aren't diagnostic at this point.

And I'm like, we're doing this wrong. Something's wrong. So the main complaint was weight gain. So that's where I started, you know, and that's what was happening to me. Suddenly I was, you know, I'd had thin privilege most of my life and then all of a sudden I

I had a belly and I couldn't get rid of it despite doubling down at the gym. So I called the PhD, you know, nutrition scientists at the university. I delivered all their kids and said, what the hell is going on with us? Like, what about women in menopause? Why is this happening? This is nearly universal. And they're like, yeah. So there's something to do with inflammation. And they just sent me down the like,

PubMed, which is the repository for medical data studies. And I start reading all this stuff about inflammation and how, you know, inflammation and menopause are definitely tied. And then this weight gain and this new belly fat deposition and inflammation is tied. And I start like, well, wait a minute.

this is happening and this is happening. Menopause and inflammation seems to be a thing. I just realized there was such little data there and no one was teaching it to me. I was busy delivering babies and pap smears and all the stuff we do. So I just went down rabbit hole after rabbit hole, put together a nutrition program for my patients and me and my girlfriends and, you know, started talking about it on social media. I didn't have a Machiavellian plan to become one of the leading voices in

In the menopause movement. I was a busy mom of two kids. My husband worked overseas. You know, I was just trying to stay alive. But as I talked more about it, more people started listening and asking me more questions, which would fuel my curiosity. And I go look up more stuff. So really, it wasn't planned. I just started talking about it, started validating people's symptoms, telling them that they weren't crazy. This is actually a thing.

And it just grew and grew and grew. And the more I would teach and share, the more people would join. And now we have got almost over four and a half million followers across the different channels. In your menopause. I'm happy to be in your menopause, by the way. It's really...

You know, my miniverse, as I like to call it. Oh, miniverse. Because it is just a bunch of people who are there to help each other out and share experiences and make a- I love that. Crazy. Yeah. That sounds like an amazing way, a platform, a way to develop a platform and such an incredible way for you to reach so many women. It's because you're so passionate about it because it's happening to you. Mm-hmm.

I love that. I went through it. I'm still going through it. I'm still aging and I accept that. But I just read a quote today from one of my friends who has this program called Menopause Bootcamp, and she's an incredible personal trainer. But she's really focusing on us now because forever, I was a cardio queen. I worked out to be thin. That was the goal. I had no thoughts of muscles or any of that.

And, you know, our mothers and grandmothers just kind of got to our age and we're like, this is it. And they end up in nursing homes with cognitive deficits and dementia and frailty and all this stuff, by and large, you know, not all.

Thank God. But I don't want to accept that and that there's stuff that we can do now to prevent that in 30 years. I mean, there has to be. That's a driving force for me, too. Like, I don't want to go down the road that my parents went down as far as their health, you know? Yeah.

So that pushes me every day to just stay healthy and take better care of myself then because I have the knowledge and they didn't. Right. Right. When I think of the things that came out of my mom's mouth about trying to stay healthy, like eating oleo instead of butter, you know, that's her conception of health and, you

you know, fighting forever to stay thin and not giving herself proper nutrition just so that she could be thin. Now she's paying the price. Yeah. You know, so same, same. So when, you know, when our patients come into clinic and we, we take care of the acute problems, the joint pain, the brain fog, the whatever, you know, we fix all of that. Then I'm like, okay, now let's plan the next 30 years. I love that. I need you.

I'm like, what can we do? What path can we put you on to avoid ending up like, if they come in and they're like, my mom's amazing. She's 85. She's driving her own car. She's taking care of herself. I'm like, let's do whatever she's doing because that's working. But if they're like, she's can't take care of herself. We're looking at home. So we're having to disrupt our lives. Like I want to, don't want to disrupt my kids' lives, you know, as little as possible. You know, I don't expect to live forever.

ever, but I don't want one of those long protracted times of infirmity if it can be avoided. It is a big, I wouldn't say disruptants because I have my mom now who's in her 80s and is getting less and less mobile and doesn't want to leave her house. And she spends a lot of time reading and I'm always calling her and saying, mom, how about a walk today? Just let's go out. Let's get a walk in.

And I don't want my kids to have to worry about me. Same as you. In your book, you say that every organ system in a woman's body is affected by menopause, their brain health, their heart, their lungs, and their kidneys. Yeah.

Explain that. I think that, you know, forever we define menopause as cessation of periods. So the end of your cycles and hot flashes, the vasomotor symptoms. But what we're now realizing is, my goodness, the cognitive changes, the mental health changes. So starting at the brain, you know, palpitations are now recognized as a common vasomotor symptom. They're lumped in there with hot flashes and night sweats. No, no, very few cardiologists know this because they weren't taught this, you know. Right.

Like in the lungs, new onset asthma, very common in menopause. And it tends to be atypical. This doesn't happen to men, you know, in their midlife. It just happens to women. Autoimmune disease, joint pain, muscle pain. Of course, the genital urinary system, recurrent UTIs, vaginal pain, loss of lubrication, on and on and on. And so what you go through is very different than what I go through. Our menopause footprint, you know, our symptom profile is as unique as we are.

And doctors love a checklist. You know, that's how we're trained. Like if it looks like a duck and walks like a duck, it's a duck. And the duck for menopause, it's just outside of your period stopping and hot flashes can be really hard or can overlap with several of the disease states. You know, it's hard to tell hypothyroidism away from perimenopause sometimes. It is. It is because you go in and you're wondering what's going on with you and you have all these other different weird symptoms and they're not really linked. Right.

So everybody's just confused. That was my experience. So my goal, you know, besides educating my followers so that they can have an informed conversation is really, you know, part of our like the doctor menopause, the clinician menopause, because we have nurse practitioners and lots of, you know, psychologists and stuff is we're now pushing the medical societies to be

recognize these things and start training our clinicians coming up in the world so that, you know, at least the next generation, we're going to have to fight. I mean, we're the fighters, but they're going to benefit so much from all of your messaging and all this data that you're gathering and this information. Right. Incredible. So, yeah, we're not men with breasts, you know, we're a gender. Imagine that. So, yeah.

Our skin too, though. That's another organ that is incredibly affected by menopause. So wound healing, besides the obvious cosmetic things, which, you know, which are shocking in five years, Jenny, we lose 30 to 50% of our collagen. Oh my God, where'd it go? Like, I feel like overnight, you know, now definitely, you know, hormone therapy helps. You can do very safe topical hormone therapy that works beautifully. Of course, all the cosmetic treatments and stuff, but,

I don't know a woman who goes through it, who like wakes up every day and is like, what happened to do? It's not saying what happened to my skin. It's a cosmetic stuff, you know, wound healing and, and,

you know, just the health of your skin, the trends to epidermal water loss, you know, we're much more likely to become dehydrated, you know, because our skin becomes so thin and we're just blowing off, you know, plus the hot flashes, you know, and sweating. So it's just crazy how it affects us all. It's like a massive cyclone that comes into your life and just does all kinds of destruction. And then it's like, bye, bye. And I'll take all that with me.

Explain the difference for those that don't know, because I definitely did not know when I didn't know when I was in perimenopause. I didn't know what perimenopause was. I didn't know the definition of menopause being 12 months after your last period, which I learned once I was 12 months after my last period. So can you explain the difference for people like perimenopause and then postal? Okay. So we'll do a little baby lesson in endocrinology. Okay, perfect. Thank you.

to educate your listeners, this is, this is so critical. So different, big difference between females and males. We have lots of differences, but as far as our gonads go, so ovaries and testicles, men make their genetic material, their sperm fresh every day. Okay. Women are born with a limited egg supply. They form when we're still in our mother's uteruses, right? And

And then we're born with one to two million eggs. By the time we're 30, we're down to 10%. By the time we're 40, we're down to 3%. Menopause really represents you've run out of eggs. Okay. So now let's go to your normal, your 25 year old self for 90% of us have normal regular cycles, very predictable if you're healthy. Okay. What happens, why we ovulate is that the hypothalamus, which is a gland in our brain, is constantly sampling our blood supply for estrogen, estradiol.

And when the levels get low, as they do towards the end of the cycle, it sends a signal to the pituitary gland and other gland to make stimulating hormones that will say ovary, let's get an egg out and ovulate. So that'll begin the production of estradiol through the ovulation process. What happened, and that goes like a very EKG, like very predictable rise and fall of our hormones month after month after month in a healthy woman. Okay. Okay.

It happens in perimenopause. So perimenopause, by definition, is the transition between what I just talked about, normal reproducible cycles to no more cycles. The chaos zone in the middle is perimenopause. Now what happens here is we reach a critical egg threshold level where the same signals that we're sending down each month stop working because we don't have enough eggs. We don't have enough follicles left to respond. Right.

So the hypothalamus is like, hey, where's my estradiol? Pituitary is like, I sent the signal and it's like, send more. So we end up getting much higher levels of the stimulating hormones from the pituitary. But you don't have the same temporal. So what used to look like this now is delayed because it took a while for the signals to go back and forth. Then you get a much higher surge of that FSH and then you get much lower drops.

And so what used to look like an EKG now becomes chaotic month after month, and it's not predictable at all. And so in that chaos zone, 90% of us will have abnormal uterine bleeding, heavy periods, light periods, no periods, too many, too frequent, too few, too craziness. Only about 10% will just wake up and not have a period again.

There's usually a calling card, hot flashes and the night sweats, the joint pain that, you know, the symptoms. But most importantly, the brain hates chaos. It loves predictability.

And when our estrogen and progesterone and testosterone levels start going haywire in perimenopause is when we see the biggest changes in the brain, both mental health. We have a 40% increase of depression, anxiety across the perimenopause transition. So you were living your best life. Nothing has changed. No stressors have changed. And all of a sudden you've lost your resilience. You're cranky or depressed or

or snappy or the things that used to bother you are now bothering you, you know, a lot more. And so also our cognitive ability. So our ability to think you're forgetting names. You can't remember your job is suddenly becoming harder. You're, you've got something on the tip of your tongue and you can't, you know, and like that all happens to us every once in a while, but this is like a consistent pattern. This is a hallmark of the cognitive changes in perimenopause. And then you have this person,

Crazy fluctuation. Crazy time turns into full menopause. Now, bottomed out, there are no eggs left and now you have no estrogen. Oh, then the fun. You know, when I was in Perry, I was like, all right, let's get this over with. Enough already. Just stop already, period, so that I can be done with this. And I was kind of like hoping for it. Now that I'm in it, I'm like, wait, I kind of miss it. Yeah. Yeah.

I mean, a lot of women are grateful, thankful that especially if they had horrible periods or just EMS or menstrual migraines, that that is over and they can get on with their lives. But there are benefits to estrogen in our body, especially in the brain and the joints, you know, and our gut microbiome. All of it's affected. Yeah. And that no one has ever taught us this is...

bonkers to me. Right. I just saw a study where 90% of girls were never taught about menopause in school, like nothing, like in their health class, like that there would ever be, even if it's just like the end of your fertility, you

It's just like this vague kind of... Something your grandma deals with. Right. Yeah. And I really had a negative connotation about menopause myself. And I just thought, oh, that's for people. I remember thinking, I hate menopause. I don't want to take care of people at menopause. And now that's all I do. And...

God, I am living my best life. I am happier, healthier, better relationships, better boundaries. I'm guiltless. I have no shame. I feel like I'm helping people. I'm teaching. But if I had not,

everything I think about health and how I'm going to age, learned how to prioritize myself and stop putting everybody's needs in front of mine, I would not be here today. And all I want is for what I feel for everyone to have that chance. Oh, I love that. And you, I feel it from you. When I look at you, when I read your book, by the way, your book, I have it right here, The New Men of Oz. It's really great. Thank you for writing that because it

It's conversations that we haven't had before and we need to have. I agree. You are inspiring women our age to go for their best life. And I love that about you. Our kids have said to us since we moved to Minnesota, we are far more active than we've ever been anywhere else we've ever lived. Moving to Minnesota opened up a lot of doors for us. Just this overall sense of community, the values that Minnesotans have. It's a real accepting, loving community, especially with two young kids.

See what makes Minnesota the star of the North. New residents share why they love calling it home at exploreminnesota.com slash live.

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I'm Carissa Thompson from Calm Down with Erin and Carissa. Erin, you know I love me an Airbnb. One time, in fact, I rented a house right on the beach because I had looked at hotel rates for the hotel right on the beach and it was astronomical.

I got the whole house for the weekend to celebrate my birthday. It was amazing. The Stoll Andrews household, we're traveling deep right now. We've got the baby. We've got the dogs. We've got the nanny. I mean, that is why Airbnb is so much better for us than a hotel. We get more space. You know, we get more bathrooms. We now don't have to share a bedroom with Mac when it's time for him to go down. We don't have to feel weird about not going down or waking him up.

We get a kitchen area to help make his food. You get it. Well, you mentioned the dog thing. I don't have the kiddos, but I have 97 animals. And let me just tell you, hotels aren't willing to have these large dogs come into the room. My cows, my chickens, my pig.

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What about birth control? I've been on and off birth control my whole life. Does that affect the onset of Perry? Yeah. So we need more studies, but we have lots of women who are on birth control. And I was on one of them. I was on it, God, 30 years to, well, contraception, but also for treatment of my PC or, you know, covering the symptoms of my PCOS. And I was happy on them. I did great on them. No problem. We know that because we,

We suppress ovulation with birth control pills. Women who are, the longer you're on them, you tend to get an extra year or so, you know, if you're on like long-term 10 plus years, you might get an extra year or so out of the shelf life of your ovaries because we suppressed ovulation. We lose about 11,000 eggs each month with the ovulatory process. So, so a little bit, not hugely clinically significant, but there is a little bit, you

You know, I worry about it. And probably what happened to me was, you know, when we're on long term birth control, and for me, it was medically treating something that I was happy with, you know, what did that do to my bone and muscle strength, you know, not having those normal levels of testosterone and estrogen. Yeah.

It's just always something scary when you're like, well, I hope this goes well. Yeah. And I was happy to be treated because I did a lot of PCOS and what it did to me. There's trade-offs. There's risks and benefits for everything. But nobody sat me down and was like, okay, listen, this is...

bigger conversation than we thought. And we do need to have more studies, but this, you know, you probably should be doing more weightlifting in the gym to hang on to your muscle mass because we're going to be suppressing your testosterone, your natural testosterone as well with this. Our symptoms change according to what phase we're in, right? In a menstrual cycle. Yeah. So if you're, you know, premenstrual,

your estrogen levels are rising. So the first half of your cycle, so progesterone is zero, very, very low. Testosterone does ebb and flow, but not nearly as much as estrogen, but it's fairly steady state compared to the others. And then we have a rise in estrogen mid-cycle, and then it kind of goes down right after, and then we have a little bit more of a rise, and then it plummets in a healthy menstrual cycle. And perimenopause, who even knows? There's no way to predict. It's like, what?

We need more studies. We need more data. We do. Let me give you this, okay?

PubMed is like where I go. It's like Google for doctors or Google for clinicians to look up vetted medical journal articles. Like, you know, everything in there is pretty, pretty upfront. And I just type in the word pregnancy. I get 1.1 million articles. Amazing. Right. That's great. We need healthy pregnancies. I've had two of them. Then I type in the word menopause. There's 97,000 articles. So 10 to one difference. Uh-huh. Roughly a little less than 10. Why? I'm like,

Am I 90% less important in this phase of my life than I was when I was pregnant? I mean, that's what they want us to believe. That's what we've been led to believe. Wait, so I type in the word perimenopause. I just did this and there's 6,700 articles. Whoa. Yeah. We got work to do. People don't know that there are stages, that there are different symptoms, that everybody's different. It's a real mystery to so many people and definitely to men.

Right. Now, here you are, a partner trying to support a loved one through this. So the best appointments I have are when the partners come because they're usually coming for a place of support and understanding. And I just love talking about all these things for them. Yeah, well, they need it. It really helps. It really does because they're so in the dark. They're so in the dark. But why is that?

Historically speaking, why are we as women so underserved? From a medical standpoint, when you look at how women have been treated, so much of women's health has been... How a woman expresses certain diseases has been...

compared to how a man does it. So like atypical chest pain is female chest pain. You know, a woman is much more likely to die if she comes into the ER with a heart attack than a man because everything's based off of how the average white male, sorry, that's just how the US medical system developed.

acts and how drugs affect him. They didn't even study female rats in all the animal models. It was always males because women are harder. Females are harder because we have cycle fluctuations. And so being excluded from all these studies. So that's one thing. It's all in her head is another thing. It is real. It's taught. I was taught that a woman tends to

psychological issues. Right. And then you're gaslit. Yeah. So, yeah. And so instead of believing a woman and what she's saying is true, we were taught, you know, is she having a bad day? Does she need some rest? Do you need a vacation? Does she need some wine? You know, give her an antidepressant. She'll be fine. Yeah.

Yeah, this is why. I don't even understand what a hot flash is, like why that happens. So there is a thermoregulatory center in our brain that controls our body temperature. So everybody has had a fever, right? And you know what that feels like. You are hot. You can't figure out why. You start sweating, especially if you have the flu and you have a really bad...

That's kind of a hot flash. So mine and the way most are, it feels like, so the thermoregulatory center becomes unstable from the loss of estrogen, we think. And you just start profusely sweating for no reason without a trigger. So I could just be sitting here and all of a sudden I'd feel something in my chest and then I would just feel this heat wave come up my neck and head. And like for me, the back of my head starts sweating and it would just drip down my back and my chest would be sweating. And at night it would wake me up

You know, when that would happen because I'm hot and then I throw the covers off and I'm soaking wet and then I'm freezing. Exactly. It's the hot cold for me. You get so hot that you sweat and then you're freezing because you're basically naked. Yeah, you're wet. So and that, you know, and then when you disrupt sleep, I mean, there is one of the top menopause researchers. She's much older.

in the U S and I just read a quote from her and I wanted to roll my eyes so hard. I mean, there's the old school menopause, the old guard, I'm probably gonna get in trouble for saying this, but yeah,

The people who kind of, you know, and God bless them. They did great research back in the day, but they kind of are really reluctant to accept that other organ systems can be affected by menopause. And she's like, no, no, no, no, no. The reason why you're having brain fog is because your hot flashes are waking you up at night and you're losing sleep. Despite multiple medical journal articles coming out, showing PET scans of the brain going through menopause. Oh, wow.

I mean, it's just that kind of misknowledge, I think, and people talking about that as much as they have. I think it's a narrative that they have that like, listen, women are just, and then she, this similar researcher out of Australia is like, it's just tough to be a midlife woman. It has nothing to do with menopause. This is just what women go through at this age. I'm like, no, that's not good enough. I,

I was living my, I was perfectly fine until I hit a certain age. I changed nothing. No stressors, no diet, no exercise. My body completely changed. My brain function completely changed. I'm not a doctor. I didn't go to med school. It makes sense to me. And so I don't understand how it couldn't make sense to much more intelligent people. And I started hormone therapy and I got 90% better. Yep. I just gave my body back what I used to have.

turns out all those things kind of went away. Let's talk about it then, hormone replacement therapy. So I look at it as if I had hypothyroidism. So if every woman's thyroid tanked at 50 and you

You were born with, you know, all of your thyroid globulin cells and they started deteriorating, you know, and then all of a sudden at 50, they were gone. No one would question you going on thyroid hormones for the rest of your life, you know, and why do we do this to women? And so menopause hormone therapy is basically just giving your body back.

estrogen, progesterone, and sometimes testosterone in levels that were similar to what you would have gotten in your pre menopause years. And for me, it's like basically telling my body functions to just operate at their usual level because the loss of estrogen and testosterone leads to dysfunction. Well, it makes sense. But why did it get such a bad rap?

Well, okay. Why did it scare people off? In the 80s and 90s, probably, you know, depending on the numbers, 40 to 44% of women, it was recommended. All women should be on HRT. Okay. Okay.

So about 44% of women chose to be on it. Now, some had hot flashes, some didn't. And what they knew from observational data was that women tended to have less heart attacks and less death from cardiovascular disease or at later ages than women who weren't taking HRT that were age matched. But that was an observational study. That's not proof. That's just like, hmm, why is this happening? Now, the...

The theory was that, well, women on HRT tend to be healthier and wealthier because they have access to, you know, medical doctors more often. And maybe it's just an artifact of the healthier, wealthy patient population. So let's do this large randomized controlled study to see if hormone therapy will decrease, truly decrease the risk of cardiovascular disease.

So that was the Women's Health Initiative. Billion-dollar study, 37,000 patients enrolled. They have two arms. So it was placebo-controlled. This is like the gold standard study. So at the time, the top two prescriptions given were Premarin and PremPro. Not really what we give now. So that's one caveat. They only tested one formulation. If you had a uterus, you have to have a progestogen. So they gave Premarin, which is conjugated equine estrogen, and medroxyprogesterone acetate. Lots of big words, just say PremPro. And then

And then the women who had had hysterectomies got Fremont because you don't need the extra progesterone. So off they go. They see after a couple of years in the estrogen plus progesterone arm that the women had a very slight increased risk of breast cancer over the placebo group. Okay. So it went from...

four out of 10,000 per year to like seven out of 10,000 per year, which, so there's relative risk and absolute risk. Relative risk, that was like a 25% increase in relative risk, different than the absolute risk, which was less than 1% per year, okay? Just depends on how you skew the statistics. So they halt the study for that arm. They call a press conference. Don't release the data. Don't let any of the doctors review it, you know, and say at this press conference, estrogen causes breast cancer. We've stopped the study. This is horrible, okay?

Every newspaper, every news show was before social media. Front page cover was the number one news medical news story of 2002. It was my last year of training, by the way. I'll never forget this. And 80% of women threw their stuff in the trash. Stop taking it. I don't want to die. Blah, blah, blah, blah, blah. Antidepressants went up four times. Sleeping medications went up three times. Blood pressure medication, cholesterol, all that statins.

You know, the loss of hormone therapy, women had to go on polypharmacy to get everything controlled that hormones used to control. The estrogen only arm continued for a couple more years, and they did see an increased risk, slightly, of stroke, which we knew. We knew, okay, that after the age of 60, if you're on hormone therapy, your risk of stroke goes up a little bit. Like, oh my God, it causes stroke. They did not see an improvement in cardiovascular disease risk, no improvement. So now the average age was 63. Okay.

because they're looking for cardiovascular disease as an outcome. Okay. Which is reasonable. If you're looking for heart disease, you, you got, it takes time to develop it. So much older population than would have really started HRT, usually at 50, 51, 49, you know, somewhere in that age. And they excluded everyone with hot flashes because you would know if you had placebo because your hot flashes get better.

So women with hot flashes tend to have the really, really bad disease. And so women with severe hot flashes are higher risk for other conditions later on. So it was a really kind of skewed study.

And when they've gone back and looked at it, the women, they had younger women in the study. So when they looked at the patients who started HRT within 10 years of their menopause, they did have decreased risk of cardiovascular disease. It was just the older patients. So estrogens, it turns out, is better at prevention than cure.

It's very stabilizing to the blood vessels that line our carotid arteries and our hearts is where strokes come from and where the atherosclerotic disease happens. And, you know, not to say you'll never develop those diseases, but it can delay the progression, but you must start early.

It turns out in the brain, estrogen is a huge, huge, huge benefit in the brain. But you got to start kind of early in order to see those benefits at least 10 years as well. Okay, so what's a number early? So right now the quote is to have the cardiovascular preventative and cognitive preventative benefits. So within 10 years of your menopause or before the age of 60.

Okay. That being said, I do start patients new. Now, if you turn 60 and you're on HRT and you're doing great and you have no risk factors, you can keep going. There's no age at which you have to stop. You don't have to stop it if you're 60. No.

Okay. You can continue those preventative benefits, but if you already have severe atherosclerotic disease, estrogen is not going to make it better. Okay. And some people think it may make it worse. So in my patients, like above 60 with risk factors, I'm getting a calcium cardiac score and like extensive testing to see if they have disease. I don't want to add estrogen on top for, you know, potentially making that disease worse. Right. Okay. Okay.

Our kids have said to us since we've moved to Minnesota, we are far more active than we've ever been anywhere else we've ever lived. Moving to Minnesota opened up a lot of doors for us. Just this overall sense of community, the values that, you know, Minnesotans have. It's a real accepting, loving community, especially with two young kids. See what makes Minnesota the star of the North. New residents share why they love calling it home at exploreminnesota.com/live.

My brother-in-law died suddenly, and now my sister and her kids have to sell their home. That's why I told my husband we could not put off getting life insurance any longer. An agent offered us a 10-year, $500,000 policy for nearly $50 a month. Then we called SelectQuote. SelectQuote found us identical coverage for only $19 a month.

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I'm Carissa Thompson from Calm Down with Erin and Carissa. Erin, you know I love me an Airbnb. One time, in fact, I rented a house right on the beach because I had looked at hotel rates for the hotel right on the beach and it was astronomical. Eesh.

I got the whole house for the weekend to celebrate my birthday. It was amazing. The Stoll Andrews household, we're traveling deep right now. We've got the baby. We've got the dogs. We've got the nanny. I mean, that is why Airbnb is so much better for us than a hotel. We get more space. You know, we get more bathrooms. We now don't have to share a bedroom with Mac when it's time for him to go down. We don't have to feel weird about not going down or waking him up. We get

We get a kitchen area to help make his food. You get it. Well, you mentioned the dog thing. I don't have the kiddos, but I have 97 animals. And let me just tell you, hotels aren't willing to have these large dogs come into the room. My cows, my chickens, my pigs.

all of the above. But Airbnb, not only do they allow pets to come in, but they also have better locations, honestly, than some of these places that you look at with hotels. And you get the overall experience. Another thing that I love, Erin, is the guest favorites feature. So it's a collection of some of Airbnb's most loved homes based on reviews and reliability. And nobody loves a review more than Steve Condari. This guy wins.

will read all of them. So this feature makes it super easy for us to decide which one we want to go to. So we're not wasting hours deciding if the review is actually reliable. It helps make the search for the perfect Airbnb easier. And you can check out places that other people have loved as well.

I heard today, I've known this before, a friend of mine has a company, but I heard today in the news about estrogen in the form of a vaginal topical ointment being used on the face. I think you might have posted about it too. Yeah, she's my friend. So I've been using topical estrogen. What's it called? Estradiol? How do you say it? Estradiol.

Estradiol. There's two forms that have been tested. There's estriol. So estrogen vaginal cream is typically estradiol 0.01% or yeah, 0.01% vaginal cream.

And that's something someone's supposed to just rub on their vagina and it's supposed to absorb. So that's for the treatment of vaginal atrophy and it works beautifully well. Okay. Some people have been putting it on their face as well. And they've actually done studies with the topical estrogen. This is a very, very low dose. This is not the estrogen that you would get the cream and the sprays and everything for systemic therapy. This is a much lower percentage. Okay.

They tested the blood levels of women putting it on their vaginas and on their faces, and there's no systemic absorption. So there's no worries about blood clots or any of that or endometrial cancer, none of that, okay? As long as you use that

preparation meant for the vagina, the low, low dose, the low, low dose and estriol cream, which is another form of estrogen. It's actually the estrogen that's created in our placentas when we're pregnant. And so they've been able to synthesize that and the estriol cream can be used on the face as well with similar, similar efficacy. And those are usually compounded

So that's the one that I've been using because my friend's company made it. And I was like, yeah, yeah, I'll try it. She sent me one for free. I fell in love with it. And of course, now I just buy it. So I can talk about it without having to say sponsored. No, this is good. I mean, it's a conversation that's been going on, but now it seems like it's becoming public. And I think everybody's going to be talking about it. Don't skip the vagina. If you're, you know, people are like,

Well, I'm just going to put it down there. I'm like, no, please. You know, you're down there. That's the health part. This is cosmetic. Yes. We talked a lot about symptoms. Hot flashes, obviously. That's like the no brainer symptom. But brain fog, you know, it's just like when you have postpartum, when you just had your baby and your hormones are gone, whack a doodle. It's a silent like misery.

And nobody knows what's going on in you, but you. I feel like the brain fog is another just silent struggle that people don't understand. Because I mean, it happens to me at least three times a day where I walk into a room and I have no idea why I'm in there. That's brain fog. Yeah. Or you can't find a word or you can't...

remember a name or, you know, and these, these things, they will happen to us from time to time. But when it becomes a pattern and all of a sudden you're questioning your judgment, one in five women are quitting their jobs at our age because of this. It's so bad, especially as they feel inadequate positions. Oh,

who require lots of cognitive ability, you know, our patients are, they are really struggling and like not and hitting a wall, hitting a wall at work. It's scary. It's so scary. And, you know, we're losing the McKinsey company just did this incredible report looking at lost economic and the economic impact of these women who were supposed to be leading companies who can't do it.

you know, 20% of women walk away. Not because of an aging parent or stuff. They can't, they don't want to be, you know, they can't do their job confidently. Is there a correlation between brain fog and early onset dementia? Okay. So we all tend to have cognitive decline in early perimenopause and early menopause. And then for those of us not on the path to dementia, it recovers. Okay. Later.

Oh, thank goodness. Okay. It does tend to recover. You'll never quite be where you were, but it does. The brain rewires, you know, from the lack of estrogen and then you learn how to kind of compensate for it. Okay. The brain keeps going.

unless you're on the Alzheimer dementia spectrum and you keep going down. So, you know, the greatest book written on this and a brand new article just came out. Lisa Moscone wrote The Menopause Brain. And she's a neuroscientist out of Will Cornell. And she does PET scan after PET scan of women's brains in different levels of menopause. And it's absolutely fascinating. And

And it's just so validating. You know, it's almost like I don't care if it's fixed at this point. Like, at least I know I'm not nuts. And, you know, but she says Alzheimer's is a disease with symptoms of old in old age, but it begins in midlife and menopause accelerates the deposition of the plex. Yeah, it's a shame. But even with the ApoE4 gene.

But HRT, like women on HRT have higher brain volume and better scores than women not. What do you call it? The APO? So there's a APOE4, I think, gene, which is the genetic marker for Alzheimer's. Alzheimer's. And even people, so they studied that group and there was a few of the women who actually got put on HRT for hot flashes. And they had bigger brain volumes and better cognition scores than their age matched women.

Women, you know, when they started young than the women who never got HRT with the genetic predisposition. It's so fascinating. Bodies are so crazy. Fascinating. Wow. I totally get it why you became a doctor. Loss of sleep. That's another huge. I had a lot of loss of sleep. Mm hmm.

And that is what was the final driving factor combined with the hot flashes and the brain fog. I guess they all go together. But I said, I can't lose my sleep and I'm not sleeping. I just wake up like five times a night, whether it's from a hot flash or just because. And that's why I decided to go on estrogen. Why are we losing our sleep? Is it because of the hot flashes? Yeah.

Two reasons. The hot flashes are just sleep disruptive. They'll wake you up. Right. So, but even though we can get those under control, women are still struggling to sleep. Not as much as before. So with the anxiety, if someone is on the spectrum of their anxieties getting higher and the racing thoughts at night, that's one of the things. Progesterone works incredibly well for that. Or that 3 a.m. wake up and then you can't shut your brain off to go back to sleep. Mm-hmm.

Progesterone works for that. The other thing is our bladders can wake us up. So if you're having irritable bladder or you're having incontinence or bladder spasms, then vaginal estrogen can do a beautiful job here of calming all that tissue down so that you can sleep through that disruption. But for my patients who we've gotten the half flashes under control,

and she's still struggling with the wake-ups or the racing thoughts, progesterone, you can go up to three and even 400 milligrams a night.

for that the other thing is if I choose to drink and this is most of my patients if I choose alcohol I am choosing not to sleep there is no way around it for me I know man and then there's just that's not a decision you have to make because I'd rather sleep than have a glass of wine yeah I'd rather wake up refreshed yeah yeah and I'm sad because I'd love to just you know have wine or drink like my friends but I know how it affects me yeah

So I have really serious conversations with my patients. Like, I can't fix this. We don't know what, you know, no one studied this yet. We know what's happening. You know, and it could be that our body composition is changing and yada, yada, yada. It's a good thing to cut out of your life. Yeah, and there's really no medical benefit to it. I mean, it's poison. We can work on other ways to stress release. So, yeah.

Yes, please. Let's talk about this hypoactive sexual desire disorder. Yeah. A.K.A. low libido. A.K.A. I'm not in the mood. There's many ways we can sum that one up. 50% of my patients have HSTD and it's very, very common. So hypoactive sexual desire disorder. So when a woman comes in and I screen all my patients for this when they hit the door, I have low libido. There's kind of a medical checklist we have to go through. Are you having pain? Okay.

Okay. So when we look at the buckets of why a woman's sexual function is not where she wants it to be, one is relationship disorder. I'm not going to fix that. You know, do you have a supportive partner? You know, if when you're by yourself, you're happy. And when you're with this person, there's zero interest. That's, you know, that's a counseling issue or whatever. That's, you know, here. No, no, no. I love him. I wish, you know, did you ever have

A great desire. Yes, I used to and it's just gone. I can't seem to make it come back. I'm like, okay, are you having pain? Yes or no, we have to fix that get to the bottom of that. Then there's arousal disorders, which are not that common in women, but they can happen and orgasmic disorders.

So arousal disorder is you're struggling to get blood flow to the area. Your brain's saying yes, but nothing's happening in the pelvis. Okay. That's where female Viagra can come into play because that will increase just like in a man, it will increase blood flow to the genitalia and kind of get things moving in that direction, but it's not going to do anything for your brain. Wait, what's female Viagra? Is it called Viagra? Viagra. Yeah. Okay. Giving a woman Viagra can help with that. And sometimes they just put the pill in the vagina and let it dissolve and work there. Okay.

The other is orgasmic disorder. And like 10% of women never, ever, ever have orgasms in their lives. And if that was men, wouldn't this be a national emergency? We would have heard about it. And so there's primary and secondary. So we get to the bottom of that. Then what's left is HSTD, hypoactive sexual desire disorder, basically like

Love this person. Everything's great in my life. I can't figure out why I can't get the signal up here. There's some medications that work really well for that. So there's two FDA approved medications. One is Addi, which is the pill you take every day. It works at the level of neuroreceptors.

Great story on how long it took for them to get past the FDA compared to Viagra, which took like 37 minutes. Okay. Oh my God. Cindy Eckerd, you have to listen to her. She's amazing. Then there's Vilisi, which is an injection that you give yourself 30 minutes before. But some patients who does well, they love it. It works on melanocortin and, you know, kind of opens up things in the brain there.

Where do you inject it? Anywhere. Okay. Usually in the abdomen. Most people just grab the skin and pop it in. And you just wait. And then you wait 30 minutes. And then there's testosterone, which works. That works the best. But unfortunately, we don't have an FDA approved medication. It works in postmenopausal women beautifully. And so probably half of my patients end up on testosterone. As long as you give it in physiologic doses, it's

then they usually don't have a lot of side effects and we're just restoring their levels. And they're so happy. It also, you know, has very promising research on brain function on, but there's just testosterone receptors everywhere. And when my patients come in and they are sarcopenic, because I have a body scanner in my office or they have low bone density, you know, peni osteoporosis, I'm using it in their toolkit of how are we going to get your bones stronger, you know, or keep your bones strong.

of, you know, resistance training, protein, the weighted vest, all that plus testosterone. So most of my patients, when we go through the options, choose testosterone because it seems to have multiple benefits. And can you be on estrogen, progesterone and testosterone? Yeah, we call it the mega pack. That's like a dream come true. I'm on all three. Yeah. Wow. I got to get on that train. Our kids have said to us since we moved to Minnesota, we are far more active than we've ever been anywhere else we've ever lived.

Moving to Minnesota opened up a lot of doors for us. Just this overall sense of community, the values that Minnesotans have. It's a real accepting, loving community, especially with two young kids. See what makes Minnesota the star of the North. New residents share why they love calling it home at exploreminnesota.com slash live.

My brother-in-law died suddenly, and now my sister and her kids have to sell their home. That's why I told my husband we could not put off getting life insurance any longer. An agent offered us a 10-year, $500,000 policy for nearly $50 a month. Then we called SelectQuote. SelectQuote found us identical coverage for only $19 a month.

A savings of $369 a year. Whether you need a $500,000 policy or a $5 million policy, SelectQuote could save you more than 50% on term life insurance. For your free quote, go to SelectQuote.com. SelectQuote.com. That's SelectQuote.com. SelectQuote. We shop, you save. Full details on example policies at SelectQuote.com slash commercials.

Introducing the TikTok 5 smartwatch for kids 3 and up with safe in-app messaging, video calling, GPS location tracking, no social media, and no games. It's tech-powered peace of mind. Now that I'm all done with school shopping, I feel like I can relax. I don't think I'll ever be able to relax since Jackson is starting 5th grade and walking to school now. Have you looked into TikTok? TikTok, the TikTok 5 smartwatch. Here, look.

Look, I can track Allison and we can message back and forth. She gets her independence and I get my peace of mind. That's exactly what I need. I've been resisting giving Jackson technology. I guess I just needed a TikTok 5. It's the safest way to introduce it. Save big with the back to school sale. Get $35 off right now. Rock back to school with TikTok 5.

Discover more at mytiktok.com. That's T-I-C-K-T-A-L-K. That's T-I-C-K-T-A-L-K.

Time is a luxury for us, especially if you're a mom. That's why we need a skincare routine that's easy, fast, and gives us results. Plus, one of your products had thousands of five-star reviews. Were natural and affordable? Well, say hello to Dime Beauty. Dime Beauty is clean, high-end skincare that is affordable. And it really works. Not sure where to start? I highly recommend the Work System.

It's everything you need in one powerful package. Take out the guesswork with a proven routine that includes a gentle yet effective cleanser, a super skin toner, two incredible serums, and two luxurious moisturizers. See what everyone is raving about. Dime has over

2 million happy customers and their product reviews are literally 5 stars. And right now through Monday, it's the Dime Anniversary Sale. Get 25% off site-wide. Go to DimeBeautyCO.com for 25% off every product on the site. That's DimeBeautyCO.com for 25% off. But hurry, the Dime Anniversary Sale ends Monday. Go to DimeBeautyCO.com.

I'm Carissa Thompson from Calm Down with Erin and Carissa. Erin, you know I love me an Airbnb. One time, in fact, I rented a house right on the beach because I had looked at hotel rates for the hotel right on the beach and it was astronomical.

I got the whole house for the weekend to celebrate my birthday. It was amazing. The Stoll Andrews household, we're traveling deep right now. We've got the baby. We've got the dogs. We've got the nanny. I mean, that is why Airbnb is so much better for us than a hotel. We get more space. You know, we get more bathrooms. We now don't have to share a bedroom with Mac when it's time for him to go down. We don't have to feel weird about not going down or waking him up.

We get a kitchen area to help make his food. You get it. Well, you mentioned the dog thing. I don't have the kiddos, but I have 97 animals. And let me just tell you, hotels aren't willing to have these large dogs come into the room. My cows, my chickens, my pigs.

All of the above. But Airbnb, not only do they allow pets to come in, but they also have better locations, honestly, than some of these places that you look at with hotels. And you get the overall experience. Another thing that I love, Erin, is the guest favorites feature. So it's a collection of some of Airbnb's most loved homes based on reviews and reliability. And nobody loves a review more than Steve Condari. This guy wins.

will read all of them. So this feature makes it super easy for us to decide which one we want to go to. So we're not wasting hours deciding if the review is actually reliable. It helps make the search for the perfect Airbnb easier and you can check out places that other people have loved as well.

I've seen you before with your weighted vest. What the heck is happening with that? So there's great studies. You know, women our age and older are rarely studied. It's really sad. But there are actually some really nice studies looking on women and men in long-term care facilities measuring muscle and bone strength and all the tools that they use. So I call it my osteoporosis prevention pack. And because, you know, you fall and break a hip.

You're dead. 30% of us will die even with surgery in a year after the age of 65.

That's nine years for me. That's not good. That's coming up. So, you know, I'm, I'm doing everything I can. So the weighted vest is just a hack. I'm actually going to develop one with QVC. I love this. I'm in line because I have one and I love it, but it doesn't fit over the women's chest very well. They were made for men as per use. And so I want to make one where we can kind of slide the stuff around, fit around our girl parts. So my God, you, uh,

I'm so excited for you to come to the queue with all your hacks, all your things.

It's going to be really great. So that's just like a weighted thing that you do wear that like hiking, working out. Yeah. So I tell my patients start wearing it around the house, doing housework, walk the dog, you know, until you start with about 10% of your body weight. So, you know, 12 pounds, 15 pounds, nothing crazy. And then as you get stronger, you wear it more and more. I now wear it when I'm working out. Like, and I also, I turn my treadmill into a walking desk.

And so I'll put the desk on an incline, throw on my weighted vest and I'm doing research or doing Zoom calls for work. Not a podcast, but yeah. You're not doing it right now. No. How high is your weight up to now? Of course, my husband got into it. So now we have eight, which no one wears anymore. We have 12, 15, 20, 25, 30 and 35. So he wears the heavier ones. Every once in a while, I'll put the heavier one just to feel, but I'll take it off in like 30 minutes. So...

That is great, though. What a way to strengthen yourself. I mean, just overall. So the study showed improved bone density and improved muscle strength and improved balance. So that's so important for us to decrease risk. You know what I'm obsessed with right now? Stretching.

Yeah. I cannot get enough of it. Every night I lay in front of the TV on the floor. I put my little yoga mat down and my dogs come around and we stretch. And like I get into every joint because I...

I feel like when you get sedentary and your joints lock up, they get rusty. I mean, there's data showing stretching decreases the risk of falls because you're decreasing your motion if you don't stretch. Can we go back for one second about the libido thing? How can we get our partners to be understanding or compassionate or I don't even know what the right word is, but it's a challenge.

Because they don't understand what's happening. Right. And we ourselves don't understand exactly what's happening. Some of the most impassioned letters I get or DMs are from partners. Help me help her. How, you know, and I'm like, educate yourself.

So that you can understand what she's going through. And this is not her fault. She is in there and she still loves you more than likely, you know, but she's likely she is going through a cataclysmic change right now. And none of this is your fault. And so here are the ways to support her. Go with her.

I mean, the study's showing that when the men go with the women to the doctor, they're much more likely to be believed and get therapy. Absolutely. And then help her find a menopause-educated provider so that you guys can have an informed conversation about her health care. I love that. It's just about supporting her. I mean, if something were to happen to your spouse physically, you would support them automatically. So this is just something that...

needs to be on the partner's radars for sure. For sure. I did want to talk about you are a mother of two. I am a mother of three daughters as well. And I just want to

No. Okay, so our moms and grandmas weren't talking about it. Now our daughters are starting to hear us talk about it. It's becoming less taboo to talk about. What can we do to help them not be afraid of it, to not be so fearful of it?

So I have this, what I would tell myself at 35. So these are like the tenants I try to teach them. But again, they're prone to social media and societal expectations.

My oldest is in medical school now. So she's, you know, a little radicalized for menopause care because of me. And my youngest is 20 in college and she's actually interning for a menopause telemedicine company this summer. So again, my kids are not the normal. No, they're going to carry on though. They're going to help my daughter. What I would tell, you know, what things I would, the tenants I would try to teach my children, you know, or teach the next generation strong over skinny. Okay.

OK, yes. You know, moving your body to be strong and not thin is is key here because we're going to, you know, trying to get that in their head that they're going to reach a maximum muscle and bone strength around age 30. And then age is going to start trying to take it away from us and aging process. And then that accelerates in menopause. So so these habits of getting this stuff down now.

of moving your body for strength and a strong brain and a strong heart and strong muscles and strong bones. You can do that now. And, and not just focus on cardio to be skinny is, is going to serve you so much better nutrition over calories, this obsessive, you know, calorie counting. It's not helping us. It's not helping, you know, still living with, you know, incredible levels of morbid obesity and, you know,

really looking at their nutrition, you know, how much magnesium are you getting? How much fiber, how much protein? These are the things I talked to my kid about. How much sugar is in that? Or, you know, like, like trying to fill your plate, like trying to eat more instead of being so restrictive. Yeah.

And then educate, learning about this is a natural phase of life. You shouldn't be scared of it, but it is going to happen and it can affect you in kind of where here's what happened to mom. You know, you watched me go through it. My older daughter now says, I guess it was kind of not fair that I was a teenager. I was the teenager I was, and you were going through perimenopause at the same time. Right. If they only knew. She knows now. And I look back at that Mary Claire, I'm like, oh my gosh. Yeah. Yeah.

buying off the handle. Uh-huh. Dark times, but look how much better we are now. Yeah. Yeah. Tell me though about that. You are a certified culinary medicine specialist. So that goes hand in hand with that, giving the right nutritional messages.

So when I decided to like, I was like, I'm going to fix this menopause fat problem, weight gain, whatever. I didn't even know about visceral fat. I just thought fat was fat. So I enrolled in this. I wanted to get a master's in nutrition. And again, I was at a university and one of the professors was like, well, there's this culinary medicine program that's popped up and there's a professor at Tulane who's running it.

you know, you probably could enroll in that. And it looks like it's going to give you all the basics you need without having to like enroll in a university while you're a teaching professor. Like that, it was too hard. Yeah. Like, okay. So I learned so much. We didn't learn much nutrition in medical school, hardly like scratch the surface. This was like the best thing I ever did about, you know, the blue zone and Mediterranean and dietary patterns and how, you know,

It was just incredible. And so I wrapped up all of that to like create the Galveston diet, my first book for my patients and followers. And then it turned into a book and a thing. But quickly, as soon as I wrote that I was, you know, sharing on social media about it and people were asking me more and more menopause questions in general. So then I, you know, I'm curious. So I just keep researching and that's how menopause came about. Yeah. I mean the connection with food and the

the sugar and the, like what you were saying right now, I'm just, it's all about for me, protein intake and fiber intake. Same. I look at my plate and it's like protein plants, you know, and how much of that is fiber. Right. I just made a huge vat of like beans with ground Turkey. And that's like our meal prep for the week. You know, we can munch on it whenever, and I know I'm going to get on hand and my fiber. Exactly. Yeah.

Well, I feel like we've talked about so many great things. You have been doing the circuit talking so much about menopause and your new book, and you've just been doing such a great job. Is there anything that you ever would think like, oh, I wish we could just talk a little bit about that? You know, just menopause is inevitable, but suffering is not. And

the more we normalize this and talk about it in our own unique experiences and the more the world's going to pay attention, because I think they're paying attention now. They are. Now it's like getting our legislators and our, you know, government agencies and our medical schools and stuff to like get on board. We're probably 20 years away from like,

Our daughters being able to confidently walk into a clinician's office and discuss their menopause and have adequate care. So it's just, you know, we have to fill in the gaps for now. Oh, my God. It just makes me so excited, though. I have to throw my cards up because the work you're doing is so important to our generation, our daughters, our granddaughters. I just I'm so motivated by you and inspired. And I'm glad that we met at the Q50. Yeah, that was awesome. Before we go, I want to ask you what...

was your last I choose me moment. You know, I've had to put up boundaries in relationships and it's okay. I have to put my own mental health first.

And, you know, it doesn't mean I don't love someone or whatever, but in order to live my best life and be the person I want to be, sometimes I have to say no and put up a boundary where I'm not going to let this affect me or I'm not going to get involved in that drama. And that is one of the most powerful things of my menopause is just having no guilt or shame about that. I love that. Well, thank you, Dr. Haber. You're welcome. Thank you.

Oh, how I love her. That conversation with Dr. Mary Claire Haver was so interesting. And honestly, it just gives me so much hope. I feel inspired and I feel heard. I'm just, I'm so grateful that she came on the podcast and gave us all this information. Menopause is something that half the population is going to go through. And I'm just really happy to be a part of the conversation and to use my platform to destigmatize this because it's

It's something as women, we shouldn't be ashamed to talk about. So as we continue to choose ourselves each week, this week, I want to encourage you to have a conversation with another woman in your life, your mother, your best friend, your sister, your partner about menopause. What do they know about it? Are they in it? How was it? What was their experience? Did they feel alone?

How did they handle it? As women, we talk about a lot of things we go through. So why don't we talk about the menopause chapter? Let's just all do our part to amplify this topic. And it starts right here by talking about it with each other. I love you. Thanks for listening to I Choose Me. You can check out all our social links and Dr. Mary Claire Haver's info in our show notes.

Make sure to follow, rate, and review the podcast and use the hashtag I choose me. I'll be right here next week and I hope you choose to be here too.

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