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00:23Hi babies! Hi!
00:36it came on so sudden
00:39I woke up I had had a disagreement with my husband and he was right it wasn't that I was
00:45right he
00:46was right and I just felt like I don't have my edge anymore I don't have I don't even have
00:52like
00:53clear thinking and all of a sudden like I say voices but it kind of was like that like this
01:00feeling of you don't matter you don't really matter because everything will be okay without
01:08you and maybe you create more problems than you do good so I got in my car and I drove
01:14and I didn't
01:15tell my husband I took my phone totally off so nobody could find me before I did that I downloaded
01:20podcasts about suicide do I call a suicide hotline do I call my husband what do I do do I
01:28go to a
01:28hospital I sat and I cried and I cried for probably five hours straight and I called John
01:36and I told him where I was and I told him I was scared and he said just just come
01:40home just come
01:40home and I'll take care of you and so I did I came home I called my doctors I called
01:46my psychiatrist I
01:47called my therapist I got in the next day to see them it's a place I don't ever want to
01:52go back to
01:53I don't and I realize now what what I think some people go through and it's hard because you don't
01:59see the other side when you're in it it's almost like this vacuum it's so empty and it's so lonely
02:05and you feel like there's nothing out there menopause has the worst PR campaign in the history of the
02:11universe the longer your body is without hormones the less healthy you are the research has shown that
02:17these things increase the risk of cancer adverse effects were increases in breast cancer and
02:22cardiovascular disease they're dangerous that is just not true the men at the top have no idea
02:28what happens to a menopausal body we are harming women if you don't advocate for yourself nobody else
02:34is gonna do it I wasn't being listened to I had to start fighting for my life right away
02:39you should begin noticing perimenopausal symptom between the ages of 35 and 45 this is like the perfect
02:46time to get people all of the tools so the transition is easier and more pleasant I don't
02:52think hormone therapies for everyone but I think that's not even putting it into the equation is
02:56such a disservice they think that if they take hormone therapy that that's gonna solve everything
03:00it's not you're really defying mother nature's plan for you we have to look at exercise we have to look
03:07at
03:07diet menopause still is taboo there's just not a lot of education we have to teach about the journey
03:14before it's impacting us it's gonna take a generation of women that stands up and says not me
03:34it felt like it happened immediately it felt like all of a sudden I'm sure it was you know we
03:40were taking baby steps into it but when it first struck me is like wow this she's not the same
03:46person
03:47you're walking on eggshells I mean we still love each other and we still talk and we chat but at
03:52any moment that could go awry very quickly and how do I deal with that and why is it happening
03:58so I'm confused annoyed I'm frustrated I mean she didn't even know she's going through it
04:05hey hey how was your trip it was wonderful
04:09missed you missed you now it's much better and she's she's she's happier
04:18hey little by little I started kind of digging out of that and I'm out of it you know I
04:24I I feel I
04:25still get scared you know I I don't ever want to go back there but at least I'm aware I'm
04:31aware of
04:31what that is I'm aware of what that feels like and I'm also aware that it's temporary
04:40I think the most dramatic stories are around mental health and that they were suicidal despondent
04:48really feeling like they had nothing left to contribute to the world marriages ending
04:53relationships disintegrating and that getting on hormone therapy took so much of that away it's
05:01harder to eat right and to work out and to foster relationships when inside that noise in your
05:07head is like you're you're bad you're terrible you don't want to do anything you know you can't
05:10figure out what's going on and so those to me are women who felt like they didn't say anything but
05:16that they were nearly suicidal it would be better the world would be better off without them they
05:20didn't see a reason to live suddenly having a reason to live again do you think HRT played a role
05:25and yeah I do I do think that me realizing that I need to be serious about my health
05:32committing to it and saying okay Heather give it a shot but do it a hundred percent just don't
05:38willy-nilly it I have been on it very religiously and it's made a difference it really has and I've
05:44come to accept that I am going to be on this and it's okay and it's okay for me to
05:49depend on this and
05:50it's really okay for me to depend on other people I'm not quite sure but the bitter melon that I'm
05:59growing I'm gonna build these trellises that doesn't sound good bitter melon why would I want
06:04to eat something like that because it's got like special medicinal qualities like it helps
06:08I know a bunch of old guys you think they would have said something what's interesting is a lot of
06:15them are divorced and they're all got divorced in the late 40s in the 50s they play a lot of
06:21golf
06:21and they escaped the house and their comment was she was crazy well was she really
06:33I know when we talked for the very first time I heard a shocking statement from you women between
06:40the ages of 45 and 55 are the ones who commit the most suicides so what is the impact of
06:46perimenopause and menopause on women who are this age so we really really really need to do more
06:55research on this right because that is fact you can cdc that immediately and you can see that that age
07:02group 45 to 55 is the highest rate of suicide and women will say I've worked my whole life to
07:10get to
07:1047 52 have this beautiful house these children that have now grown this career that I love and I just
07:19feel no joy nothing where does that come from if there's one thing in common that all those women have
07:28it's the hormone decline through perimenopause to menopause that's the one common thing a lot of
07:36people going through perimenopause do not know that what they're struggling with is actually related to
07:43hormonal fluctuations so a lot of people will go to the doctor and say I feel like I'm going crazy
07:49or
07:50something's wrong with me I can't focus I can't do these things anymore or I'm driving everyone crazy
07:56because of my mood swings they think there's something wrong with them okay maybe you're just
08:01stressed maybe something's happening in your personal life so let's see if this is a depression
08:07or let's see if you have major depressive disorder or something else mental health related and no one
08:14thinks about hormones when you look at a 30 and a four year someone in their 30s in their 40s
08:18they
08:19don't necessarily look like someone who's unhealthy so automatically it has to be something mental health
08:26related it's not something related to a biological hormonal fluctuations that's not what people are
08:31thinking about when I first experienced perimenopause before I even knew what it was I entered a dark
08:43mental space that shook me to my core perimenopause is more than just a checklist of symptoms it can take
08:52a serious toll in ways we're still only beginning to understand in 2021 I had a period of time where
09:06I
09:06missed three consecutive periods and that was the first time ever in my life and they're like you're
09:11pregnant yeah they were all like you're pregnant you're pregnant I was like no I'm not so my primary
09:16had already taken all of my blood work and my my estradiol was 17 she was like all right I'm
09:22gonna
09:22send you to this gynecologist so I go to this gynecologist and he treated me like I was crazy he
09:29kind of was like the attitude was kind of like why are you why are you here why are you
09:33bringing this to
09:33me like like a regular periods are normal and also at this time I was having hot flashes that were
09:40oh my
09:41god unbearable but they but they they were soon to get worse so this was the just the beginning
09:47so this is in 21 so at this time I'm having these hot flashes I'm so glad that I'm here
09:52with you
09:52because you understand I gave him all this paperwork and he's like well well you know it's probably
09:58just stress he barely even looked at he's I'm like okay well here like look at these blood
10:02these blood work this blood work he just skimmed through them he's like no no no and then he goes
10:07he goes
10:07well how's your mental health and I was like why why why does that matter and he was like well
10:13I'm
10:13wondering if this is just stress and anxiety related and then he's going off about that he's like and
10:18he's like recommending therapists and this is the kicker of that whole thing I leave and I get a call
10:23from my pharmacy for prescriptions that he put in he prescribed me antibiotics and a painkiller
10:31I think the norm for so long has been to treat women like men and so so much of the
10:39science the
10:40research and the way we've been taught to treat chronic disease has been this is how we would treat
10:46men so let's copy and paste that onto women but women are entirely different physiologic creatures
10:53men have steady sex hormones every day of their lives in fact the hardest thing they have to do is
11:00go through puberty and then like that's it right women have monthly cycles and women get pregnant and
11:07have miscarriages and traumatic births and then perimenopause and then menopause and then postmenopause
11:14so our physiology is so uniquely different and that's just never been honored
11:22our lifestyle as monks is different than that of most women
11:28Gretchen an ashram student gave us insight into a challenge many perimenopausal women face in the
11:35workplace I was working full-time I have a degree in environmental science so I've been working in that
11:42field for over 20 years so that was a big part of my life was work when I was in
11:48my late 30s or
11:49so I started having like just really severe periods I'm busy right I've got a little kid I've got a
11:59ton
11:59of things to do all the time so I don't have time for that so I ignored it for a
12:04few years at some point
12:06it got to where I couldn't ignore it I was leading a tour of our facility with my manager and
12:14it was for
12:15some important clients that we had and I had been nervous about it all day because I knew this was
12:20going to be an issue I'm my period so I was like doing all the prep that I could you
12:24know and still
12:25partway through that tour it had to be interrupted and I had to leave it never crossed my mind that
12:31it it
12:32could be perimenopause which now in hindsight I'm totally sure that's what it was I worked really hard
12:38to hide all my symptoms not just you know when I was having issues with my period but some of
12:46the
12:46other symptoms I had too I mean it was I felt like those things couldn't be shared because it looks
12:51like weakness it looks like something's wrong with me maybe I'm not going to be able to do my job
12:56and I never wanted it to look like that the topic of hormones menopause paramenopause it's sort of
13:04taboo to talk about it makes people uncomfortable they don't want to know so that is definitely
13:11present in the workplace I got two words for this meal shut up everybody's so excited the gabber gets
13:21to answer these I have a very front-facing job I love the stage I love camera I'm really comfortable
13:26with it but then I started noticing questioning myself the anxiety the low confidence like all of a
13:32sudden I'm questioning the weirdest things that I've worked through my 30s about my attention span
13:36my memory is out the window it takes me three times as long to do everything because I have to
13:42like catch myself write it down ask a couple people to remind me I'll tell myself I have a call
13:47in five
13:48minutes and I will be out the door taking a walk like it's it's crazy do you want to see
13:53this is this is
13:54no joke this is this is how my alarm looks now it's just daily this is like I'm reminding myself
14:01that four or five four ten four fifteen four twenty because I have to tell myself every second if I
14:06need
14:06to get out the door or I need to go prepare my notes to go get the drink of water
14:11to go take the go
14:12to the bathroom and then get on the zoom that's how bad it is now around my period time I
14:20would say I
14:20feel like I got hit by a truck just like emotionally just it's a lot my cycle got really heavy
14:28they went
14:29to look inside also to see if I have fibroids or anything causing it and it was nothing so as
14:36another thing that I said okay maybe this is hormonal so do they recommend any hormones no so I think
14:45I
14:45probably need to go to a hormone specialist a lot of times women will present to their gynecologist
14:58with an initial change in the way their periods present and for you it was very heavy and disturbing
15:06and likely draining you precious resources a lot of women find themselves anemic and tired I am anemic
15:13too yes yeah it's it's unbelievable how many women I find they're anemic I'm like no wow
15:21that's a big one is the periods really start to shift and they can become happier they can I mean
15:28I
15:28I kind of joke and I'm like it's no woman's tear it's anything goes in perimenopause as far as I
15:34feel
15:34like emotional it's frustrating that we have to sit on a call with you and why
15:45I know would I not be able to have this for my gynecologist but because it's really like you
15:51really suffer you do you really suffer and you don't know how to communicate to your spouse or
15:58your family what's happening because you don't know what's happening and when I would get my
16:04period I would really feel like I got hit by a truck like I didn't want to talk to anyone
16:11and go into a doctor I'm sorry it's okay it's okay and not getting any help it's just frustrating
16:23men we like to fix stuff like if it's a problem we want to come in with a solution and
16:28there was
16:28something I couldn't fix it made me feel like I wasn't uh doing my job as a husband it made
16:37me feel
16:37like I was uh just like helpless it felt like I was alone but I know for her it's probably
16:44felt
16:44she was alone as far as your intimate life with your husband has that been impacted because I mean
16:53sometimes you don't want to be bothered sometimes you want to be bothered but then even when you want
16:58to squeeze it in then your hormones aren't cooperating you don't feel like it or you're tired
17:02or whatever yeah absolutely female sexual dysfunction or just lower sexual desire are very very
17:09common in this stage of life because we rely very much as females on our hormones to help drive
17:16some of that desire there are some medical interventions for libido we actually have
17:22two medications right now that are currently FDA approved for fit for female sexual health and then
17:29off off off label you can use very small amounts of testosterone therapy that is something that some
17:36individuals in perimenopause do explore as well how are women treated different from men when it comes
17:44to sexual medicine oof this is a good one the truth of the matter is is that if every single
17:49guy woke up on
17:50his 50th birthday and found that he couldn't think he couldn't sleep he couldn't function and his penis
17:57was the size of a breakfast sausage so that he could never have sex again no doctor would say to
18:03him
18:03this is just part of aging deal with it I mean they would declare a national emergency and the surgeon
18:10general would be on CNN every week giving updates while everyone scrambled to have some kind of a solution
18:16for these poor guys who couldn't think sleep or have sex again yet this is exactly what women are going
18:23through and there's no attention being paid why because they're women I grew up as a urologist where
18:31we have predominantly training in male sexual health and so we all the time will talk to men about their
18:37erections about their orgasm about their ejaculate we'll ask them questions we have treatment options we have
18:42very comfortable conversations with men about quality of life and sexual health we don't really
18:47talk to women about those issues we expect them to come to us with the questions just going through
18:52menopause can drastically affect your sexual health doing absolutely nothing but nobody warns you or tells
18:57you that it's going to happen we actually did a study in 2020 we did a survey of muslim women
19:07and sexual
19:08concerns and 40 percent had sexual pain during their lifetime and more than 60 percent of them never sought care
19:15for
19:15it because of the stigmas around sex because they didn't think that their doctor would you know look at them
19:20the same
19:21way they didn't think there were resources they thought sex sexual pain was normal you can actually ask these
19:25questions and you should actually seek treatment for it your orgasms are just as important as his and just having
19:32them
19:32understand that and having that discussion around that has been eye opening for a lot of people a lot of
19:36my patients we have
19:38older couples or older men and women they come in and the man has problems with erection and we give
19:45him some testosterone and we might give him some Viagra or Cialis or these these medications and then what
19:52do we do for the woman at the same time so his female partner that he's trying to put this
19:56erect penis into her
19:58vagina that vagina is dealing with genital urinary syndrome of menopause vaginal atrophy pain with sex dryness
20:06decreased lubrication decreased sensation of her clitoris and then when sex hurts and it's painful
20:13that's a really negative loop feedback loop on your brain and your brain's your biggest sexual organ we're
20:18treating the man's sexual dysfunction and we're leaving the woman untreated and also sometimes in pain
20:25and for her menopausal symptoms we give her an antidepressant and what does that do to her libido well
20:34it's a well-known side effect of an ssri is to lower libido and how do we treat perimenopausal women
20:40oh
20:40you can't have hormones yet we're going to put you on a birth control pill and we're going to also
20:44give
20:44you some prozac ssri so we've just given you now two medications that lower libido we know oral
20:51contraceptive pills can cause that your your testosterone be lowered and can cause vaginal dryness
20:57and decrease lubrication and that same woman isn't told here on the birth control pill you might have
21:03some vaginal dryness you can have your birth control and you can have vaginal estrogen and we
21:08can keep you happy but no one no one does that for her and then we wonder why when do
21:14divorce rates peak
21:1645 to 50 do we wonder why there's relationship difficulties it's not just about sex but
21:23i mean let's be honest it's an important part of relationships
21:28john they're growing i planted these on wednesday or thursday oh look at them all
21:35during that time the sex life barely exists and which is an important part of marriage i mean it's
21:45not the only part but it's an important part and uh you don't want something to take that away
21:50yeah it did that took a hit and that causes frustration for a man of course and you're
21:58trying not to be a jerk about it but you know it's selfish but uh you know we we're a
22:05little
22:05not as empathetic or sympathetic as we should have been
22:09and i certainly haven't been so vaginal dryness what did that look like in your life with your
22:16husband and your relationship with the vaginal dryness i thought it was a uti i was getting
22:22ready to go on a trip and i was going overseas and i can feel it coming on fast so
22:26i had to go to the er
22:28i was leaving the next day i had to get medication so i went the doctor came in and he
22:34said basically you
22:37have atrophy of your vagina which i was just like what i wasn't expecting atrophy of my vagina he
22:45prescribed me some some cream and think of it like watering a flower that's pretty much what you're
22:50doing and as we age it just dries up that tissue becomes brittle and so with sexual intercourse you
22:59can have micro tears and then think about if you're dry inside and you have a micro tear what can
23:05happen bacteria gets in there so bacteria gets in there how long does it take to heal we know that
23:11when we have a cut we want it to be out in the air we want it to have oxygen
23:15to heal inside your body
23:18it's a lot harder women feel like it's their fault that they don't want to have sex the sex hurts
23:26well
23:27why are you dry you're dry because you don't like me you're not interested in me i don't turn you
23:31on
23:31anymore no it's not that it's my body is different now nobody explained it to me
23:43i think about all the time the fact of my struggles in my entire life but especially through
23:52childbirth and perimenopause and menopause that i had resources i had the best doctors and i was
24:01still being ignored so what does that mean for women who don't have access to the best of the best
24:10what
24:10does it mean for them and that's across the board that's everything mental health issues all of it and
24:16until we take care of those who are the most vulnerable then none of us can be free
24:31how can women be more informed and well equipped as they experience hormone changes
24:42we've heard that the uk is the global leader in menopause care what are they doing differently
24:49that we can learn from on the right side
24:59this is going to be really weird
25:00wow i can't even process it's going to be the opening scene confusion
25:13you know dr louise we're coming from the united states to meet with you and learn from you we want
25:20answers you know and you've been leading the way out here and we're really curious what does it look
25:25like in general in the uk and around the world i feel like you're you're one of the global leaders
25:30in the menopause movement what's the situation do you want me to be honest of course it's awful it's
25:36absolutely awful and i think it's got worse actually the biggest reason is that it is a hormone
25:42deficiency that has health risks that's fact that's not me making it up because i'm coming at it from
25:49that angle as a physician with an interest in chronic diseases it's disrupting and making people
25:56feel on edge whereas usually it's gynecologists saying it's some hot flushes and sweats you'll get
26:02through it don't worry it's a transition period it's a natural process there's lots of things that are
26:09natural that are still damaging to our body so it's the it's this sort of willful blindness that's
26:15happening which really frustrates me but it's huge because it affects every single woman and that's
26:22different to anything else in medicine
26:28so i have endometriosis adenomyosis and fibroids um took me 22 years to get a diagnosis because of
26:36medical dismissal i just felt i wasn't firing on all cylinders i do a lot of work with lots of
26:43different
26:44things so i'm constantly spinning plate and the first response i got uh was well do you think you
26:52need antidepressants just listen to your body like you know it better than anyone else does and there's
26:58a lot of information and it's unfair that we need to look for it ourselves and maybe our doctors aren't
27:03able to give it to us
27:07people look at me and say it's amazing what you're doing uk is leading is it really you know we've
27:14gone
27:14from 10 to 14 percent of menopausal women taking hormone treatment before the whi it was about 30 percent
27:22and increasing in the us as you know it's about 40 percent and now it's about four percent you know
27:28we've
27:28got such a big way to go to really make a difference
27:44who's behind all of this like is there a conspiracy is there a bigger agenda is somebody benefiting from
27:52the fear that's going on i find that question really hard to answer because i think there's
27:57complex layers to it i think the medical establishment doesn't like a million women running in and
28:04shouting at it and that is what we are doing and we are very good at doing our own research
28:09online
28:10there's a great deal of anger i think that that's that's erupted but i also think there's quite an
28:16old-fashioned feminism here there's that sort of natural feminist movement that we will go through
28:22this menopause transition we will survive and we will maybe you know give up using fancy face creams
28:29and we will be ourselves and of course we will and you know there's a witch crone power movement out
28:35there and that is great and i go you are welcome to you your full croneness or witchness i love
28:43it
28:43but i would also like my joints to work at the same time i do not want to have heart
28:48palpitations
28:49i do not want to have alzheimer's and i think that feminist movement a little bit of it says we
28:55don't
28:56like big pharma and many of us do not like big pharma but we have to work with them a
29:01bit on this or
29:02it's not going to happen
29:07while i search for answers in the uk sadhvianabuthi travels to florida to meet with a world-renowned
29:14orthopedic surgeon
29:35my name is dr vonda wright i'm an orthopedic sports surgeon and longevity doc and my work sits at the
29:42intersection of longevity the health of a woman and performance across a lifespan get 40 i was in
29:49the best shape of my life and then at 47 i thought i was going to die because that is
29:56when
29:57my estrogen became so low that i started having night sweats brain fog hot flashes in inconvenient
30:06times i started having chest palpitations that i thought were related to the fact that my family
30:12dies of heart disease i started doing deep research to figure out what is going on and
30:17oh lo and behold of course this is perimenopause and started searching out what to do for it
30:26here's the deal we talk most about hot flashes night sweats brain fog all the things that happen
30:32during perimenopause and they are troublesome but for the most part once you get past menopause and
30:39are in postmenopausal the severity of those will lessen but if we do not get in front of the musculoskeletal
30:47syndrome of menopause where you lose muscle you lose bone you get rapid arthritis you're painful
30:53all over so you stop exercising and you become metabolically disabled you will become frail why
30:59do i care about frailty so much why is that such a disastrous way to live here's why i am
31:06a practicing
31:07orthopedic surgeon i still have to take call and this is what i see a woman has fallen down and
31:13broken
31:14her hip oftentimes she's incontinent because she is the gynecourinary syndrome of menopause
31:20she often has so much heart disease that the medical doctor cannot even clear her for me to fix her
31:27bone in surgery and she often has mental decline sometimes frank dementia
31:32that is frailty that i see every day today so that when i get really animated which i sometimes do
31:39about getting in front of menopause not only educating women enabling them through lifestyle
31:46and hormone therapy to get in front of this it's because i see the future of frailty today
31:51with every woman that i take care of with a hip fracture who's not only broken she's incontinent
31:57with a uti she has heart disease and her brain function has declined and do you know what that
32:03woman wants me to know about her she's not always been this way that she has not always been frail
32:09she wants me to know what she did for a living she wants me to know about her children that
32:13she
32:14raised she wants me to know about all the things she did she wants me to know that she was
32:19once vital
32:20like i am standing in front of her as her surgeon and i say to people all the time unless
32:25we get in
32:26front of this frailty is our destiny but it is preventable i feel the most important thing is
32:36having information that is right and evidence-based that is really crucial because without information
32:43you're not going to be able to make a choice that's right for you have information involve others as
32:49well it shouldn't be something that you have to endure alone and don't rush into a decision you
32:56don't have to decide anything today or tomorrow or next week or next year feel very comfortable and
33:01empowered but make sure also that you receive the right advice support help treatment from the right
33:08person in the beginning i was like i'm never doing hrt i want to go the natural way with the
33:17natural
33:18approach and then i started asking what does the natural approach look like and the doctors are
33:23like i mean there is a lifestyle that can help you but there is nothing natural that you can do
33:29to
33:29replace the hormones that you will lose as you age right so but the one thing that really got me
33:36was when i heard that hrt could prevent osteoporosis yes i have this fear about osteoporosis just
33:43because you're little i'm little yeah i have a small frame i've always had it what can you tell
33:48me about you know like is it something that i based on what i know it's hard to tell without
33:53looking at my your dexa scan yes but is it something that i really should consider based on kind of
33:59like
33:59what you see i think there is never an age when you have a risk factor for osteoporosis not to
34:05have
34:05a dexa scan now there's a difference between what insurance will pay for and having a risk but i think
34:12it
34:12would be very insightful to get a dexa scan so we see where are we today because you might not
34:19be
34:19presenting with perimenopause sleep deficit or all the things that are common but we don't know what's
34:25going on with your bones unless we look and if they're perfect well then perfect and if they're
34:32osteopenic then we gotta go on this i call it health optimization we're optimizing your current
34:37health you're not diseased you're not sick but we're going to optimize all the things
34:42and then we're going to measure your dexa scan we'll know what your bones do and then we can make
34:46a plan based on data i traveled to the uk hoping for answers but what i found was disturbing they're
35:01not
35:01as ahead as we thought there's confusion dismissal and a lot of suffering everywhere it made me realize
35:11no one is coming to save us we have to keep asking questions keep pushing for our own health and
35:18others
35:28in regards to endometriosis yeah so i've had this major pain going to the bathroom number two
35:36and it feels like i'm going into labor like i'm literally like holding onto the walls sometimes
35:41and it's just like so much pain i started getting on the um hrt and i feel like it dropped
35:48like the
35:48pain is less but then i asked the np and she's like let's just keep watching if your pain gets
35:54worse
35:54and i'm like is there an answer is hrt the answer so i don't know do we know it's endometriosis
36:00for
36:00sure number one no could be a fissure oh this is only happening during periods ah okay that is sorry
36:07ah so yeah that can be endometriosis that's like oh ding ding ding was that the beginning of
36:12perimenopause and didn't even know it you i don't who knows so we did things get dysfunctional in peri
36:19but you can develop endometriosis anytime okay that was my question so
36:24you know you can the first period or your last period you could develop it
36:50i feel like my entire life
36:55changed after seeing dr shepherd truly i felt like for the first time since
37:02i started perimenopause you know six years ago i hadn't felt like myself
37:09like that's a long time it is and and to still to be navigating and obviously we know that hormones
37:17change and they're constantly changing and and maybe what's working for me right now isn't going to be
37:22the the the protocol forever but i changed my workouts i changed my eating uh she got me on the
37:31right doses i got on the right dose of estrogen almost instantly like within that first week of me
37:39changing the doses i started to feel different i i understand that what i did is not going to be
37:45for
37:45everybody but i feel like the first thing that i did was make a choice to change
37:58as a guy you want to help you want to be like i want to take care of you i
38:01want to make it better
38:02sometimes that's not possible it's not the right answer having the knowledge and becoming empowered
38:10makes her uh definitely i never felt like what i was going through was too much for him like i
38:18never
38:18felt like judged or like i was broke from him right it's like i felt broken and i felt all
38:26those
38:26things on my own i didn't need anybody else to help me feel that way but like he he never
38:31made me feel
38:33bad about being chunky or any other thing i never thought of being chunky but all right
38:47anubuti are you taking a short tea or what's going what's the situation here i'm curious no not yet
38:55i've been i've been kind of fighting it i i don't know why i have this resistance to um not
39:04doing it
39:05like i it's like a feeling of trying to fix everything that's wrong right now like in my body before
39:12i get
39:12on hrt again it's not that i oppose the treatment um i know like i know i will do it
39:21it's it's more of a
39:22matter of when do i really need it yet am i is that am i there is it like early
39:29enough to prevent
39:30like disease osteoporosis like is this the right time to do it i think as that my tests come through
39:37i think that's what's gonna really help me to make a decision
39:42with sadhvianabuti having a smaller frame osteoporosis is her concern
39:48on the other hand in recent months i've gained 12 pounds despite my healthy lifestyle
40:07the main concern that i see when patients show up into my office during their perimenopausal or
40:12menopausal years is because weight gain despite being healthy first of all i want you to know
40:20that you're not crazy that those changes that you're experiencing in your bodies are real that
40:25it's not because you're slacking because i know that it feels like you're doing your best you're
40:30eating healthy you're exercising but we know that during menopause estrogen progesterone goes down fat
40:36accumulation goes up muscle mass goes down this happens just by breathing we're losing muscle mass
40:44at accelerated rates and we're gaining fat in new places so all of a sudden a woman never in her
40:50life
40:51has new belly fat what she's calling belly fat she's wider here when she's never had that issue in
40:58her life and she's done nothing different other than go through menopause no changes in her nutrition no
41:02changes in her movement her calories in calories out has been stable yet she's gaining fat in a new
41:07place and when we lose muscle mass we lose our basal metabolic rate the amount of muscle that you
41:14have determines how many calories you burn at rest muscle is the organ of longevity and when we lose
41:20estrogen we also lose testosterone our muscle mass accelerate loss accelerates outside of just the aging
41:28process so we've got this kind of double whammy happening with menopause where we're losing muscle
41:32and now we're driving new fat to new areas and that visceral fat acts very differently than
41:39subcutaneous fat does hrt help at all or hrt helps we know that women who are on hrt have less
41:45visceral fat
41:46deposition than they don't now putting a woman on hrt does not guarantee weight loss i get to show
41:52patients in my office because i have a body scanner and sometimes they'll come in and they've maybe only
41:56lost five pounds or something after three six months and they're like and i'm like you've gained four
42:02pounds of muscle you were dehydrated on the last scan so you've got water you know you've got more
42:07water inside of your body and you've lost 10 pounds of fat and they're like oh i'm like and look
42:13how
42:13much your visceral fat has dropped you're so much healthier and for them that's everything because
42:18everything before was measured their health their well-being their social currency on that number on
42:23scale and it is a terrible indicator of chronic risk of chronic disease
42:36if you only have time for one thing you are going to lift weights because muscle can build bone muscle
42:44is a metabolically active organ muscle is critical for preventing insulin and sensitivity so if you only
42:51have one thing you are going to build muscle then okay what's next anti-inflammatory nutrition we have
42:58got to quit poisoning ourselves in this country by eating the 16 pounds of added sugar that processed
43:04food manufacturers put into packaged food sugar is cooking you from the inside out it's inflaming your
43:10body now i am not anti-carb but if you want carbs then you must eat complex carbs so instead
43:17of white
43:18potatoes from a box you're going to eat a sweet potato with all the stringy fiber and the skin on
43:24it the
43:25way that you eat makes a huge difference you need to prioritize protein antioxidants good carbs good fats
43:34but you need to eat balance and you need to eat a lot of protein in your diet to prevent
43:40muscle loss
43:41perimenopausal patient comes in to me and she's got you know x y and z symptoms we immediately talk
43:47about nutrition so making sure she's getting enough fiber in her diet okay at least 25 grams per day most
43:54women are getting about 12. there was a study that was done a few years ago where they looked at
43:59fiber
44:00intake and cognition scores in 60 and 70 and 80 year olds and the higher the fiber up to about
44:0634 grams per
44:07day the higher your cognition scores were on tests so high fiber diets are definitely related to
44:15health and longevity and staying out of the nursing home we talk about vitamin d i check a vitamin d
44:20level
44:20on every single patient who comes in my office and 80 of them are not just low i mean low
44:25like really
44:27deficient so we have a talk around vitamin d rich foods hard to do for a lot of people especially
44:32if
44:33you're vegetarian and we talk about supplementation we talk about omega-3 fatty acids another great
44:38antioxidant anti-inflammatory turmeric has been shown to be helpful for hot flashes it also helps
44:45with visceral fat we talk about collagen supporting skin and now there's some good data showing collagen
44:52a certain type of collagen supplement does seem to be helpful for osteoporosis so everything we do is
44:57focused on keeping the heart strong keeping the bones strong keeping the mind strong so that you can
45:02function as you get older
45:11i'm determined to feel like myself again and being on progesterone alone isn't enough without
45:17consulting my hormone therapy provider i started using my leftover estrogen and the results were not
45:24what i hoped for so i wanted to make this video for myself to document how i'm feeling lately i
45:36have been
45:37super struggling i am a dull knife and it's it's affecting my work i'm forgetting my words i can't
45:47say sentences it's difficult to piece things together it's it's hard to even have an opinion it's hard to
45:54just absorb just other people just talking to you and understand what they're saying and process it and
46:01i feel like this is the worst the brain fog has been if it's brain fog brain fog i feel
46:09like a frog
46:12brain frog anyways i just want to document this because i just want to tell my future self that
46:18well i guess it's hormones um but just wanted to list kind of what i'm feeling right now
46:28our stories do not reflect personal failures they only reveal a systemic one
46:36no one prepares us for these changes and the risks associated with hormone decline
46:43what would a future look like where women's health is prioritized
46:48all right we have a bone scan bone density scan for you so it shows that you do have some
46:55osteopenia
46:56right which means that it's not osteoporosis so not significant bone loss yet but it does mean
47:04it does mean that there is evidence of loss that is weakening your bones
47:10so
47:15so
47:24so
47:25so
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